POPCORN 2 Flashcards
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
D. K/A
Which organisms are plump coccobacilli that may resist decolorization and may be mistaken for Neisseria spp?
A. Acinetobacter spp.
B. Bordetella spp.
C. Stenotrophomonas sp.
D. Burkholderia sp.
A. Acinetobacter spp.
Which organism has large, smooth, glistening colonies with a lavender pigment and smells like ammonia?
A. Acinetobacter spp.
B. Bordetella spp.
C. Stenotrophomonas sp.
D. Burkholderia sp.
C. Stenotrophomonas sp.
All of the following agars may be used to isolate Helicobacter except:
A. Campy-CVA
B. Skirrow’s
C. Thiosulfate-citrate-bile salts-sucrose agar (TCBS)
D. modified Thayer-Martin
C. Thiosulfate-citrate-bile salts-sucrose agar (TCBS)
NOTE:
Stool specimens submitted for culture of H. cinaedi and H. fennelliae are inoculated onto selective media used for Campylobacter isolation but without cephalothin such as Campy-CVA.
For the recovery of H. pylori from tissue biopsy specimens including gastric antral biopsies, non-selective agar media, including chocolate agar and Brucella agar with 5% sheep blood, have resulted in successful recovery of the organisms.
Selective agar such as Skirrow’s and modified Thayer-Martin agar also support growth.
Which of the following tests is most helpful in differentiating C.jejuni from the other Campylobacter spp.?
A. Nitrate reduction
B. Urease activity
C. Hippurate hydrolysis
D. Susceptibility to nalidixic acid
C. Hippurate hydrolysis
A positive hippurate hydrolysis is a characteristic of:
A. Campylobacter coli
B. Campylobacter jejuni
C. Campylobacter lari
D. Campylobacter fetus
B. Campylobacter jejuni
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
A. Guillain-Barré syndrome
A 60-year-old man suffered from fever, watery diarrhea, abdominal pain, and nausea. Three weeks later, he was admitted to the hospital unable to speak but coherent and oriented. Neurological examination revealed bilateral muscle weakness in his legs. Within hours, the muscle weakness extended to his arms and chest. He was diagnosed with Guillain–Barré syndrome. With which organism was he most likely infected?
A. Campylobacter jejuni
B. Clostridium tetani
C. Cytolmegalovirus
D. Salmonella enterica
E. Shigella sonnei
A. Campylobacter jejuni
Which of the following organisms is coagulase positive?
A. S. saprophyticus
B. S. haemolyticus
C. S. hominis
D. S. pseudointermedius
D. S. pseudointermedius
Which test is used for the determination of inducible clindamycin resistance in staphylococci and streptococci?
A. E-test
B. D-zone test
C. A-test
D. CAMP test
B. D-zone test
The D-zone susceptibility test is used to test inducible resistance on S. aureus strains demonstrating an initial antibiotic susceptibility profile of:
A. Erythromycin sensitive, clindamycin sensitive
B. Erythromycin resistant, clindamycin sensitive
C. Erythromycin resistant, clindamycin resistant
D. Erythromycin sensitive, clindamycin resistant
B. Erythromycin resistant, clindamycin sensitive
Resistance to clindamycin can be induced in vitro by
A. Ampicillin
B. Erythromycin
C. Gentamicin
D. Penicillin
B. Erythromycin
Infection caused by non–acid-fast aerobic actinomycetes is usually chronic, granulomatous lesions of the skin referred to as:
A. Mycelium
B. Necrosis
C. Impetigo
D. Mycetoma
D. Mycetoma
Which Nocardia sp. causes more than 80% of human infections?
A. N. asteroides
B. N. brasiliensis
C. N. otitidiscaviarum
D. N. farcina
A. N. asteroides
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
D. P. aeruginosa
The colonial appearance of this bacteria on BAP agar is gray, translucent, smooth, glistening colonies, which may also have a dry, claylike consistency:
A. Neisseria gonorrhoeae
B. Neisseria elongata
C. Moraxella catarrhalis
D. Moraxella osloensis
B. Neisseria elongata
Large, nonpigmented or gray, opaque, smooth; friable “HOCKEY PUCK” consistency; colony may be moved intact over surface of CAP:
A. Neisseria gonorrhoeae
B. Neisseria meningitidis
C. Neisseria elongata
D. Moraxella catarrhalis
D. Moraxella catarrhalis
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
C. Pasteurella multocida
Distinct odor that is often referred to as a “chocolate cake” or “burnt chocolate” smell:
A. Burkholderia cepacia
B. Eikenella corrodens
C. Proteus sp.
D. Staphylococcus aureus
C. Proteus sp.
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
A. Liver cirrhosis
Which of the following Haemophilus species is an agent of a sexually transmitted disease?
A. H. parainfluenzae
B. H. influenzae
C. H. ducreyi
D. H. segnis
C. H. ducreyi
Which encapsulated type of H. influenzae is most common?
A. Type a
B. Type b
C. Type c
D. Type d
B. Type b
All of the following organisms require X and V factors, except:
A. H. influenzae
B. H. haemolyticus
C. H. influenzae biotype aegyptius
D. Aggregatibacter aphrophilus
D. Aggregatibacter aphrophilus
Which of the following is an effective drug for treating chancroid?
A. Ampicillin
B. Erythromycin
C. Amoxicillin
D. Tetracycline
B. Erythromycin
Bartonella quintana has been known to cause:
A. Carrion’s disease
B. Trench fever
C. Cat-scratch disease
D. Lyme disease
B. Trench fever
Campylobacter are:
A. Small, curved, motile, gram-positive bacilli
B. Small, curved, motile gram-negative bacilli
C. Small, curved, nonmotile, gram-negative bacilli
D. Small, curved, nonmotile, gram-negative bacilli
B. Small, curved, motile gram-negative bacilli
Campylobacter species should be grown at what optimum temperature?
A. 25° C
B. 37° C
C. 42° C
D. None of the above
C. 42° C
Which of the following agars should be used for culturing Legionella?
A. CIN
B. BCYE
C. SMAC
D. XLD
B. BCYE
What is the specimen of choice for culturing B. pertussis?
A. Throat
B. NP swab
C. Sputum
D. Anterior nose
B. NP swab
The most reliable serologic test for diagnosis of B. pertussis in adults and adolescents is:
A. Complement fixation
B. Agglutination
C. Anti-PT ELISA (antibody to pertussis toxin)
D. EIA
C. Anti-PT ELISA (antibody to pertussis toxin)
Optimal recovery of F. tularensis is acquired by:
A. Increased CO2
B. Enriched media containing cysteine
C. 24-hour growth at room temperature
D. Anaerobic conditions
B. Enriched media containing cysteine
When S. moniliformis is acquired by ingestion, the disease is called:
A. Trench fever
B. Haverhill fever
C. Cat scratch disease
D. Lyme disease
B. Haverhill fever
Spirillum minus also causes rat-bite fever in humans and is referred to as:
A. Haverhill fever
B. Legionnaire’s disease
C. Hantavirus
D. Sodoku
D. Sodoku
The natural habitat of Streptobacillus moniliformis is the upper respiratory tract of:
A. African dwarf frogs
B. Wild and laboratory rats
C. Prairie rattlesnakes
D. Black-footed ferrets
B. Wild and laboratory rats
Specimen characteristics of an anaerobic infection include:
A. Foul odor, presence of sulfur granules, and green fluorescence
B. Foul odor, presence of metachromatic granules, and green fluorescence
C. Foul odor, sulfur smell, and red fluorescence
D. Foul odor, presence of sulfur granules, and red fluorescence
D. Foul odor, presence of sulfur granules, and red fluorescence
NOTE:
Upon receipt in the laboratory, specimens should be inspected for characteristics that strongly indicate the presence of anaerobes:
1. Foul odor
2. Sulfur granules (associated with Actinomyces spp., Propionibacterium spp., or Eubacterium nodatum)
3. Brick red fluorescence under long wavelength ultraviolet (UV) light (associated with pigmented Prevotella or Porphyromonas spp).
Sulfur granules in a clinical specimen indicate the presence of:
A. Clostridium spp.
B. Fusobacterium spp.
C. Actinomyces spp.
D. Peptostreptococcus spp.
C. Actinomyces spp.
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.
C. Clostridium and Bacteroides spp.
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
C. N-glycolylmuramic acid and an increase in lipid content
Which organism causes Rocky Mountain spotted fever?
A. Chlamydia trachomatis
B. Ehrlichia chaffeensis
C. Rickettsia rickettsii
D. Coxiella burnetii
C. Rickettsia rickettsii
Which serovar of Chlamydia trachomatis causes lymphogranuloma venereum?
A. A
B. C
C. H
D. L1
D. L1
Which of the following organisms is acquired via exposure to infected birds?
A. Coxiella burnetii
B. Chlamydia psittaci
C. Anaplasma phagocytophilum
D. Tropheryma whipplei
B. Chlamydia psittaci
Transmission of Orientia tsutsugamushi is associated with what vector?
A. Ticks
B. Fleas
C. Lice
D. Chiggers
D. Chiggers
Which fungus is most often acquired by traumatic implantation into the skin?
A. Histoplasma capsulatum
B. Sporothrix schenckii
C. Coccidioides immitis
D. Penicillium marneffei
B. Sporothrix schenckii
What are the optimal temperature and incubation time before a FUNGAL blood culture is reported as negative?
A. 37°C; 21 days
B. 37°C; 7 days
C. 30°C; 21 days
D. 30°C; 7 days
C. 30°C; 21 days
Which test can be used to differentiate T. mentagrophytes from T. rubrum?
A. Fluorescence using a Wood’s lamp
B. In vitro hair perforation
C. Red color on reverse side of colony
D. Pyriform microconidia
B. In vitro hair perforation
Which dimorphic fungus may be contracted by people who clean chicken coops?
A. Blastomyces dermatitidis
B. Histoplasma capsulatum
C. Coccidioides immitis
D. Paracoccidioides brasiliensis
B. Histoplasma capsulatum
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
A. Chromoblastomycosis
Which of the following is a fungus known to cause chromoblastomycosis?
A. Curvularia spp.
B. Acremonium spp.
C. Bipolaris spp.
D. Cladosporium spp.
D. Cladosporium spp.
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
D. C. albicans, C. dubliniensis
In the virus laboratory, most manipulation of viruses occurs at what safety level?
A. Biosafety Level 1
B. Biosafety Level 2
C. Biosafety Level 3
D. No biosafety is needed
B. Biosafety Level 2
Which family of viruses produces one of the most lethal hemorrhagic fevers?
A. Bunyaviridae
B. Filoviridae
C. Flaviviridae
D. Arenaviridae
B. Filoviridae
A pulmonary syndrome, referred to as hanta pulmonary syndrome, that often results in death is carried in the excreta of:
A. Bats
B. Cats
C. Mice
D. Birds
C. Mice
The three respiratory agents most often responsible for causing croup in pediatric patients are:
A. Parainfluenza, RSV, and rhinovirus
B. Influenza A, RSV, and parainfluenza 3
C. Coronavirus, RSV, and rhinovirus
D. Parainfluenza, RSV, and metapneumovirus
D. Parainfluenza, RSV, and metapneumovirus
TAPEWORM SCOLEX:
Spatulate, 3 × 1 mm; no rostellum or hooklets; has 2 shallow grooves (bothria)
Diphyllobothrium latum
TAPEWORM SCOLEX:
Quadrate, 1-2 mm in diameter; no rostellum or hooklets; 4 suckers
Taenia saginata
TAPEWORM SCOLEX:
Quadrate, 1-mm diameter; has rostellum and hooklets; 4 suckers
Taenia solium
TAPEWORM SCOLEX:
0.2-0.5 mm in diameter; has conical/retractile rostellum armed with 4-7 rows of small hooklets; 4 suckers
Dipylidium caninum
TAPEWORM SCOLEX:
Knoblike but not usually seen; has rostellum and hooklets; 4 suckers
Hymenolepis nana
TAPEWORM SCOLEX:
Knoblike but not usually seen; has rostellum but no hooklets; 4 suckers
Hymenolepis diminuta
The BAERMANN TECHNIQUE yields a good concentration of the living larvae of:
A. Angiostrongylus cantonensis
B. Brugia malayi
C. Enterobius vermicularis
D. Strongyloides stercoralis
D. Strongyloides stercoralis
In which of the following sets of nematodes can each organism cause a pneumonia-like syndrome in a person exposed to heavy infection with any of the three parasites?
A. Ascaris lumbricoides, Trichuris trichiura, or Onchocerca volvulus
B. Enterobius vermicularis, Dracunculus medinensis, or Trichuris trichiura
C. Strongyloides stercoralis, Wuchereria bancrofti, or Angiostrongylus costaricensis
D. Necator americanus, Ascaris lumbricoides, or Strongyloides stercoralis
D. Necator americanus, Ascaris lumbricoides, or Strongyloides stercoralis
Inhabits the small intestine and is usually demonstrated as rhabditiform larva (no eggs usually seen) in stool sample:
A. Hookworm
B. Trichuris trichiura
C. Ascaris lumbricoides
D. Strongyloides stercoralis
D. Strongyloides stercoralis
Which parasite causes eosinophilic meningoencephalitis, a form of larva migrans causing fever, headache, stiff neck, and increased cells in the spinal fluid?
A. Necator americanus
B. Angiostrongylus cantonensis
C. Ancylostoma braziliense
D. Strongyloides stercoralis
B. Angiostrongylus cantonensis
Symptoms and signs mimic those of TUBERCULOSIS, and should always be suspected in patients with tuberculosis who are non-responsive to treatment:
A. Ascaris lumbricoides
B. Necator americanus
C. Strongyloides stercoralis
D. Paragonimus westermani
D. Paragonimus westermani
Finely granular, “ground glass” appearance; clear differentiation of ectoplasm and endoplasm; if present, vacuoles are usually small; RBCs not present in cytoplasm
A. Endolimax nana
B. Entamoeba coli
C. Entamoeba dispar
D. Entamoeba histolytica
C. Entamoeba dispar
Finely granular, “ground glass” appearance; clear differentiation of ectoplasm and endoplasm; if present, vacuoles are usually small; presence of red blood cells (RBCs) is diagnostic
A. Endolimax nana
B. Entamoeba coli
C. Entamoeba dispar
D. Entamoeba histolytica
D. Entamoeba histolytica
Entamoeba dispar is most easily confused morphologically with:
A. Entamoeba coli
B. Entamoeba hartmanni
C. Dientamoeba fragilis
D. Entamoeba histolytica
E. Blastocystis hominis
D. Entamoeba histolytica
Early ring stages of the fifth human malaria, Plasmodium knowlesi, resemble those of:
A. Plasmodium malariae
B. Plasmodium ovale
C. Plasmodium falciparum
D. Plasmodium vivax
C. Plasmodium falciparum
Older developing stages (trophs, schizonts) of the fifth human malaria, P. knowlesi, resemble those of:
A. Plasmodium malariae
B. Plasmodium ovale
C. Plasmodium falciparum
D. Plasmodium vivax
A. Plasmodium malariae
Synchronized rupture of RBCs every 72 hours:
A. P. falciparum
B. P. vivax
C. P. ovale
D. P. malariae
D. P. malariae
Which species of Plasmodium may readily be identified when crescent-shaped gametocytes are found in stained blood films?
A. P. falciparum
B. P.malariae
C. P.ovale
D. P.vivax
A. P. falciparum
Which species of malaria parasite usually has ameboid trophozoites and produces small reddish dots in the red blood cell cytoplasm?
A. Plasmodium knowlesi
B. Plasmodium falciparum
C. Plasmodium malariae
D. Plasmodium vivax
D. Plasmodium vivax
Trophozoite tends to form “BANDS” across the cell:
A. P. vivax
B. P. malariae
C. P. falciparum
D. P. ovale
B. P. malariae
Quadrate scolex with 4 suckers; no rostellum or hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta
B. T. saginata
Quadrate scolex with 4 suckers; has rostellum and hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta
C. T. solium
Proglottids with 15 to 20 lateral branches in dichotomous or tree-like arrangement:
A. D. latum
B. T. saginata
C. T. solium
D. D. caninum
B. T. saginata
Proglottids with 7 to 13 lateral branches in a dendritic or finger-like arrangement:
A. D. latum
B. T. saginata
C. T. solium
D. D. caninum
C. T. solium
A primary differential feature between Hymenolepis nana egg and H. diminuta egg is which of the following?
A. A flattened side for H. diminuta egg
B. A thick shell for H. nana egg
C. Polar filaments in H. nana egg
D. Radial striations in H. diminuta egg
C. Polar filaments in H. nana egg
Fluke(s) associated with CHOLECYSTITIS (inflammation of the gallbladder), and CHOLANGIOCARCINOMA (cancerous growth in bile duct epithelium):
A. F. buski
B. P. westermani
C. C. sinensis, O. viverrini
D. S. japonicum
C. C. sinensis, O. viverrini
The organism is transmitted through a bite of the tabinid fly or deer fly of the genus Chrysops.
A. B. malayi
B. L. loa
C. O. volvulus
D. W. bancrofti
B. L. loa
The parasite is transmitted by the black fly, Simulium spp.
A. B. malayi
B. L. loa
C. O. volvulus
D. W. bancrofti
C. O. volvulus
It resembles egg of S. haematobium, but acid-fast positive:
A. Schistosoma japonicum
B. Schistosoma mansoni
C. Schistosoma intercalatum
D. Schistosoma mekongi
C. Schistosoma intercalatum
It causes alveolar hydatid disease which is the most lethal of all helminthic diseases:
A. Taenia saginata
B. Taenia solium
C. Echinococcus granulosus
D. Echinococcus multilocularis
D. Echinococcus multilocularis
Intermediate host of Echinococcus multilocularis:
A. Dogs
B. Foxes
C. Coyotes
D. Rodents
D. Rodents
Infection may resemble acute appendicitis:
A. Parastrongylus costaricensis
B. Gnathostoma sp.
C. Toxocara cati
D. Parastrongylus caninum
A. Parastrongylus costaricensis
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
D. Ancylostoma duodenale
The principle most commonly used to measure the concentration of a particular analyte in the CHEMICAL examination of urine is:
A. Reflectance photometry
B. Digital imaging
C. Flow cytometry
D. Auto particle recognition
A. Reflectance photometry
In automated urinalysis, the specific gravity is measured by:
A. Light transmittance
B. Light scattering
C. Refractometry
D. Turbidity
C. Refractometry
All of the following are true concerning fully automated urine chemistry analyzers, except:
A. They are designed for a high-volume urinalysis laboratory
B. The reagent strip is dipped into the well-mixed urine
C. The urine moves through the instrument
D. A sample probe aspirates the urine
B. The reagent strip is dipped into the well-mixed urine
The advantages of an automated urine microscopy analyzer over manual microscopy includes:
A. Cost-effective
B. Centrifugation not required
C. Standardized results
D. All of the above
D. All of the above
Which of the following is a complete urinalysis automated urinalysis system?
A. AUTION ELEVEN AE 4022
B. Clinitek Atlas
C. iQ200 Automated Urine Microscopy
D. Clinitek AUWi Pro System
D. Clinitek AUWi Pro System
What two technologies are used for urine sediment analysis?
A. Light scattering and refractometry
B. Light scattering and flow cytometry
C. Flow cytometry and digital imaging
D. Digital imaging and refractometry
C. Flow cytometry and digital imaging
Which automated urine particle counter combines urine flow cytometry with digital image analysis?
A. UN-2000
B. iRICELL
C. UF-100i
D. iQ 200
A. UN-2000
Which of the following urine sediment particles cannot be autovalidated but will be flagged and must be reviewed by laboratory personnel?
A. RBCs
B. WBCs
C. RTEs
D. Squamous epithelial cells
C. RTEs
Which of the automated body fluid analyzers does not need to dilute or pretreat body fluids before analysis?
A. ADVIA 2120i
B. XN Series
C. iQ200
D. None of the above
B. XN Series
What is a disadvantage of counting body fluid cells using an automated instrument versus a Neubauer hemocytometer?
A. Less labor-intensive and time-consuming
B. More precise
C. Unable to count low WBC numbers and malignant cells
D. Able to perform a WBC differential
C. Unable to count low WBC numbers and malignant cells
The ultimate goal of a quality assessment program is to
A. maximize the productivity of the laboratory.
B. ensure that patient test results are precise.
C. ensure appropriate diagnosis and treatment of patients.
D. ensure the validity of laboratory results obtained.
D. ensure the validity of laboratory results obtained.
Which of the following is a postanalytical component of a QA program?
A. Critical values
B. Procedures
C. Preventive maintenance
D. Test utilization
A. Critical values
Analytical components of a QA program are procedures and policies that affect the
A. technical testing of the specimen.
B. collection and processing of the specimen.
C. reporting and interpretation of results.
D. diagnosis and treatment of the patient.
A. technical testing of the specimen.
The purpose of quality control materials is to
A. monitor instrumentation to eliminate downtime.
B. ensure the quality of test results obtained.
C. assess the accuracy and precision of a method.
D. monitor the technical competence of laboratory staff.
C. assess the accuracy and precision of a method.
Why are written procedures necessary?
A. To assist in the ordering of reagents and supplies for a
B. To appropriately monitor the accuracy and precision of a procedure
C. To ensure that all individuals perform the same task consistently
D. To ensure that the appropriate test has been ordered
C. To ensure that all individuals perform the same task consistently
Which of the following is not considered to be an analytical component of QA?
A. Reagents (e.g., water)
B. Glassware (e.g., pipettes)
C. Instrumentation (e.g., microscope)
D. Specimen preservation (e.g., refrigeration)
D. Specimen preservation (e.g., refrigeration)
Which of the following sources should include a protocol for the way to proceed when quality control results exceed acceptable tolerance limits?
A. A reference book
B. A procedure
C. A preventive maintenance manual
D. A specimen-processing protocol
B. A procedure
Technical competence is displayed when a laboratory practitioner
A. documents reports in a legible manner.
B. recognizes discrepant test results.
C. independently reduces the time needed to perform a procedure (e.g., by decreasing incubation times).
D. is punctual and timely
B. recognizes discrepant test results.
Quality control materials should have
A. a short expiration date.
B. a matrix similar to patient samples.
C. their values assigned by an external and unbiased commercial manufacturer.
D. the ability to test preanalytical variables.
B. a matrix similar to patient samples.
Within one facility, what is the purpose of performing duplicate testing of a specimen by two different laboratories (i.e., in-house duplicates)?
A. It provides little information because the results are already known.
B. It saves money by avoiding the need for internal quality control materials.
C. It provides a means of evaluating the precision of a method.
D. It can detect procedural and technical differences among laboratories
D. It can detect procedural and technical differences among laboratories
Interlaboratory comparison testing as with proficiency surveys provides a means to
A. identify critical values for timely reporting to clinicians.
B. ensure that appropriate documentation is being performed.
C. evaluate the technical performance of individual laboratory practitioners.
D. evaluate the performance of a laboratory compared with that of other laboratories.
D. evaluate the performance of a laboratory compared with that of other laboratories.
The primary purpose of a Standard Precautions policy in the laboratory is to
A. ensure a safe and healthy working environment.
B. identify processes (e.g., autoclaving) to be used to neutralize infectious agents.
C. prevent the exposure and transmission of potentially infectious agents to others.
D. identify patients with hepatitis B virus, human immunodeficiency virus, and other infectious diseases.
C. prevent the exposure and transmission of potentially infectious agents to others.
Which agency is responsible for defining, establishing, and monitoring safety and health hazards in the workplace?
A. Occupational Safety and Health Administration
B. Centers for Disease Control and Prevention
C. Chemical Hygiene Agency
D. National Fire Protection Association
A. Occupational Safety and Health Administration
Which of the following is not considered personal protective equipment?
A. Gloves
B. Lab coat
C. Disinfectants
D. Goggles
C. Disinfectants
Which of the following actions represents a good laboratory practice?
A. Washing or sanitizing hands frequently
B. Wearing lab coats outside the laboratory
C. Removing lab coats from the laboratory for laundering at home in 2% bleach
D. Wearing the same gloves to perform venipuncture on two different patients because the patients are in the same room
A. Washing or sanitizing hands frequently
Which of the following is not an acceptable disposal practice?
A. Discarding urine into a sink
B. Disposing of used, empty urine containers with nonhazardous waste
C. Discarding a used, broken specimen transfer pipette with noninfectious glass waste
D. Discarding blood specimens into a biohazard container
C. Discarding a used, broken specimen transfer pipette with noninfectious glass waste
Which of the following is not part of a Chemical Hygiene Plan?
A. To identify and label hazardous chemicals
B. To educate employees about the chemicals they use (e.g., providing material safety data sheets)
C. To provide guidelines for the handling and use of each chemical type
D. To monitor the handling of biological hazards
D. To monitor the handling of biological hazards
Which of the following information is not found on a safety data sheet (SDS)?
A. Exposure limits
B. Catalog number
C. Hazardous ingredients
D. Flammability of the chemical
B. Catalog number
Which of the following is the urine specimen of choice for cytology studies?
A. First morning specimen
B. Random specimen
C. Midstream “clean catch” collection
D. Timed collection
B. Random specimen
Which of the following specimens usually eliminates contamination of the urine with entities from the external genitalia and the distal urethra?
A. First morning specimen
B. Midstream “clean catch” specimen
C. Random specimen
D. 4-hour timed collection
B. Midstream “clean catch” specimen
Substances that show diurnal variation in their urinary excretion pattern are best evaluated using a
A. first morning specimen.
B. midstream “clean catch” specimen.
C. random specimen.
D. timed collection.
D. timed collection.
Which of the following will not cause erroneous results in a 24-hour timed urine collection?
A. The collection starts and ends in the evening.
B. Two first morning specimens are included in the collection.
C. Multiple collection containers are not mixed together before specimen testing.
D. A portion of the collection is removed before total volume measurement.
A. The collection starts and ends in the evening.
A 25-year-old woman complains of painful urination and is suspected of having a urinary tract infection. Which of the following specimens should be collected for a routine urinalysis and urine culture?
A. First morning specimen
B. Timed collection
C. Midstream “clean catch” specimen
D. Random specimen
C. Midstream “clean catch” specimen
An unpreserved urine specimen collected at midnight is kept at room temperature until the morning hospital shift. Which of the following changes will most likely occur?
A. Decrease in urine color and clarity
B. Decrease in pH and specific gravity
C. Decrease in glucose and ketones
D. Decrease in bacteria and nitrite
C. Decrease in glucose and ketones
Which of the following is the most common method used to preserve urine specimens?
A. Acid addition
B. Thymol addition
C. Freezing
D. Refrigeration
D. Refrigeration
If refrigeration is used to preserve a urine specimen, which of the following may occur?
A. Cellular or bacterial glycolysis will be enhanced.
B. Formed elements will be destroyed.
C. Amorphous crystals may precipitate.
D. Bacteria will proliferate.
C. Amorphous crystals may precipitate.
Which of the following urine preservatives is acceptable for both urinalysis and urine culture?
A. Boric acid
B. Chlorhexidine
C. Dowicil 200
D. Formalin
A. Boric acid
How much urine is usually required for a manually performed routine urinalysis?
A. 5 to 10 mL
B. 10 to 15 mL
C. 20 to 30 mL
D. 50 to 100 mL
B. 10 to 15 mL
Which of the following substances is higher in urine than in any other body fluid?
A. Chloride
B. Creatinine
C. Glucose
D. Protein
B. Creatinine
How many nephrons are found in the average kidney?
A. 13,000
B. 130,000
C. 1.3 million
D. 13 million
C. 1.3 million
Ultrafiltration of plasma occurs in glomeruli located in the renal
A. cortex.
B. medulla.
C. pelvis.
D. ureter.
A. cortex.
Formation of the ultrafiltrate in the glomerulus is driven by the
A. hydrostatic blood pressure.
B. oncotic pressure of the plasma proteins.
C. osmotic pressure of the solutes in the ultrafiltrate.
D. pressures exerted by the glomerular filtration barrier.
A. hydrostatic blood pressure.
Which of the following is a characteristic of renin, an enzyme secreted by specialized cells of the juxtaglomerular apparatus?
A. Renin stimulates the diffusion of urea into the renal interstitium.
B. Renin inhibits the reabsorption of sodium and water in the nephron.
C. Renin regulates the osmotic reabsorption of water by the collecting tubules.
D. Renin causes the formation of angiotensin and the secretion of aldosterone.
D. Renin causes the formation of angiotensin and the secretion of aldosterone.
The kidneys play an important role in the
1. excretion of waste products.
2. regulation of water and electrolytes.
3. maintenance of acid-base equilibrium.
4. control of blood pressure and fluid balance.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.
D. All are correct.
What percent of the original ultrafiltrate formed in the urinary space actually is excreted as urine?
A. 1%
B. 10%
C. 25%
D. 33%
A. 1%
NOTE:
The fact that only 1% (approximately 1200 mL) of the original plasma ultrafiltrate presented to the renal tubules is excreted as urine is evidence of the large amount of reabsorption that takes place within the renal tubules.
Substances bound to plasma proteins in the blood can be eliminated in the urine by
A. glomerular secretion.
B. glomerular filtration.
C. tubular secretion.
D. tubular reabsorption.
C. tubular secretion.
The renal threshold level for glucose is 160 to 180 mg/dL. This corresponds to the
A. rate of glucose reabsorption by the renal tubules.
B. concentration of glucose in the tubular lumen fluid.
C. plasma concentration above which tubular reabsorption of glucose occurs
D. plasma concentration above which glucose is excreted in urine
D. plasma concentration above which glucose is excreted in urine
More than 66% of filtered water, sodium, and chloride and 100% of filtered glucose, amino acids, and proteins are reabsorbed in the
A. collecting tubules.
B. distal tubules.
C. loops of Henle.
D. proximal tubules
D. proximal tubules
Water reabsorption occurs throughout the nephron except in the
A. cortical collecting tubules.
B. proximal convoluted tubules.
C. ascending limb of the loops of Henle.
D. descending limb of the loops of Henle
C. ascending limb of the loops of Henle.
Antidiuretic hormone regulates the reabsorption of
A. water in the collecting tubules.
B. sodium in the collecting tubules.
C. sodium in the distal convoluted tubule.
D. water and sodium in the loop of Henle
A. water in the collecting tubules.
The final concentration of the urine is determined within the
A. collecting ducts.
B. distal convoluted tubules.
C. loops of Henle.
D. proximal convoluted tubules.
A. collecting ducts.
Which of the following solutes are present in the largest molar amounts in urine?
A. Urea, chloride, and sodium
B. Urea, creatinine, and sodium
C. Creatinine, uric acid, and ammonium
D. Urea, uric acid, and ammonium
A. Urea, chloride, and sodium
Renal excretion is NOT involved in the elimination of
A. electrolytes and water.
B. normal byproducts of fat metabolism.
C. soluble metabolic wastes (e.g., urea, creatinine).
D. exogenous substances (e.g., drugs, x-ray contrast media).
B. normal byproducts of fat metabolism.
The concentration of which substances provides the best means of distinguishing urine from other body fluids?
A. Creatinine and urea
B. Glucose and protein
C. Uric acid and ammonia
D. Water and electrolytes
A. Creatinine and urea
What is the definition of the osmolality of a solution?
A. The density of solute particles per liter of solvent
B. The mass of solute particles per kilogram of solvent
C. The number of solute particles per kilogram of solvent
D. The weight of solute particles per liter of solvent
C. The number of solute particles per kilogram of solvent
Serum osmolality remains relatively constant, whereas the urine osmolality ranges from
A. one-third to one-half that of serum.
B. one-third to equal that of serum.
C. one to three times that of serum.
D. three to five times that of serum.
C. one to three times that of serum.
Another name for excessive thirst is
A. polydipsia.
B. polyuria.
C. hydrophilia.
D. hydrostasis.
A. polydipsia.
Specific gravity measurements are not affected by
A. temperature.
B. solute charge.
C. solute mass.
D. solute number.
B. solute charge.
Osmolality is a measure of solute
A. density.
B. mass.
C. number.
D. weight.
C. number.
Which of the following solutes, if added to pure water, affects the specific gravity of the resultant solution more than it affects its osmolality?
A. Sodium
B. Chloride
C. Potassium
D. Glucose
D. Glucose
Occasionally the specific gravity of a urine specimen exceeds that physiologically possible (i.e., >1.040). Which of the following substances when found in urine could account for such a high value?
A. Creatinine
B. Glucose
C. Mannitol
D. Protein
C. Mannitol
The excretion of large volumes of urine (>3 L/day) is called
A. glucosuria.
B. hyperuria.
C. polydipsia.
D. polyuria.
D. polyuria.
The daily volume of urine excreted normally ranges from
A. 100 to 500 mL/day.
B. 100 to 1800 mL/day.
C. 500 to 1800 mL/day.
D. 1000 to 3000 mL/day.
C. 500 to 1800 mL/day.
NOTE:
Strasinger: Normal daily urine output is usually 1200 to 1500 mL, a range of 600 to 2000 mL is considered normal.
When the body is dehydrated, the kidneys
A. excrete excess solutes in a constant volume of urine.
B. excrete solutes in as small a volume of urine as possible.
C. decrease the quantity of solutes excreted and decrease the urine volume.
D. increase the quantity of solutes excreted while holding the urine volume constant.
B. excrete solutes in as small a volume of urine as possible.
The excretion of less than 400 mL of urine per day is called
A. anuria.
B. hypouria.
C. nocturia.
D. oliguria.
D. oliguria.
The ultrafiltrate in the urinary space of the glomerulus has a specific gravity of
A. 1.005 and a lower osmolality than the blood plasma.
B. 1.010 and the same osmolality as the blood plasma.
C. 1.015 and a higher osmolality than the blood plasma.
D. 1.035 and a higher osmolality than the blood plasma.
B. 1.010 and the same osmolality as the blood plasma.
All of the following conditions may produce nocturia except
A. anuria.
B. pregnancy.
C. chronic renal disease.
D. fluid intake at night.
A. anuria.
Which renal function is assessed using specific gravity and osmolality measurements?
A. Concentrating ability
B. Glomerular filtration ability
C. Tubular excretion ability
D. Tubular secretion ability
A. Concentrating ability
A fluid deprivation test is used to
A. determine renal plasma flow.
B. investigate the cause of oliguria.
C. assess renal concentrating ability.
D. measure the glomerular filtration rate.
C. assess renal concentrating ability.
The volume of plasma cleared per minute in excess of that required for solute elimination is called the
A. creatinine clearance.
B. free-water clearance.
C. osmolar clearance.
D. renal clearance.
B. free-water clearance.
Which of the following is an endogenous substance used to measure glomerular filtration rate?
A. Urea
B. Inulin
C. Creatinine
D. p-aminohippurate
C. Creatinine
Creatinine is a good substance to use for a renal clearance test because it
A. is exogenous.
B. is reabsorbed.
C. is affected by fluid intake.
D. has a constant plasma concentration
D. has a constant plasma concentration
Which of the following groups would be expected to have the greatest 24-hour excretion of creatinine?
A. Infants
B. Children
C. Women
D. Men
D. Men
Creatinine clearance results are “normalized” using an individual’s body surface area to account for variations in the individual’s
A. age.
B. sex.
C. dietary intake.
D. muscle mass.
D. muscle mass.
A 24-hour urine collection is preferred for determination of creatinine clearance because of diurnal variation in the
A. glomerular filtration rate.
B. plasma creatinine.
C. creatinine excretion.
D. urine excretion.
A. glomerular filtration rate.
What percentage of the total cardiac output is received by the kidneys?
A. 8%
B. 15%
C. 25%
D. 33%
C. 25%
The color of normal urine is due to the pigment
A. bilirubin.
B. urobilin.
C. uroerythrin.
D. urochrome
D. urochrome
Which of the following urine characteristics provides the best rough indicator of urine concentration and body hydration?
A. Color
B. Clarity
C. Foam
D. Volume
A. Color
NOTE:
Because urochrome is excreted at a constant rate, the intensity of the yellow color in a fresh urine specimen can give a rough estimate of urine concentration. A dilute urine will be pale yellow and a concentrated specimen will be dark yellow.
Which of the following pigments deposits on urate and uric acid crystals to form a precipitate described as “brick dust”?
A. Bilirubin
B. Urobilin
C. Uroerythrin
D. Urochrome
C. Uroerythrin
Which of the following criteria should one use to consistently evaluate urine color and clarity?
1. Mix all specimens well.
2. Use the same depth or volume of a specimen.
3. Evaluate the specimens at the same temperature.
4. View the specimens against a dark background with good lighting.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.
A. 1, 2, and 3 are correct.
Select the urine specimen that does NOT indicate the possible presence of blood or hemoglobin.
A. Clear, red urine
B. Cloudy, brown urine
C. Clear, brown urine
D. Cloudy, amber urine
D. Cloudy, amber urine
A urine that produces a large amount of white foam when mixed should be suspected to contain increased amounts of
A. bilirubin.
B. protein.
C. urobilin.
D. urobilinogen.
B. protein.
Which of the following substances can change the color of a urine and its foam?
A. Bilirubin
B. Hemoglobin
C. Myoglobin
D. Urobilin
A. Bilirubin
The clarity of a well-mixed urine specimen that has visible particulate matter and through which newsprint can be seen but not read should be described as
A. cloudy.
B. flocculated.
C. slightly cloudy.
D. turbid.
A. cloudy.
Which of the following urine specimens is considered normal?
A. A freshly voided urine that is brown and clear
B. A freshly voided urine that is yellow and cloudy
C. A clear yellow urine specimen that changes color upon standing
D. A clear yellow urine specimen that becomes cloudy upon refrigeration
D. A clear yellow urine specimen that becomes cloudy upon refrigeration
A white or beige precipitate in a “normal” alkaline urine most likely is caused by
A. amorphous phosphates.
B. amorphous urates.
C. uric acid crystals.
D. radiographic contrast media.
A. amorphous phosphates.
Which of the following methods used to determine the specific gravity of urine does NOT detect the presence of urine protein or glucose?
A. Harmonic oscillation densitometry
B. Reagent strip
C. Refractometry
D. Urinometry
B. Reagent strip
Which of the following specific gravity values is physiologically impossible?
A. 1.000
B. 1.010
C. 1.020
D. 1.030
A. 1.000
Which of the following methods is an indirect measure of specific gravity?
1. Reagent strip
2. Urinometry
3. Refractometry
4. Harmonic oscillation densitometry
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.
B. 1 and 3 are correct.
The principle of the reagent strip method for measuring specific gravity is based on
A. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen.
B. the pH of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen.
C. the pKa of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen.
D. the pH of a polyelectrolyte increasing in proportion to the ionic concentration of the specimen.
A. the pKa of a polyelectrolyte decreasing in proportion to the ionic concentration of the specimen.
Which of the following as described is NOT a colligative property?
A. Boiling point elevation
B. Freezing point depression
C. Osmotic pressure depression
D. Vapor pressure depression
C. Osmotic pressure depression
Which of the following will not influence the volume of urine produced?
A. Diarrhea
B. Exercise
C. Caffeine ingestion
D. Carbohydrate ingestion
D. Carbohydrate ingestion
To preserve the integrity of reagent strips, it is necessary that they are
A. humidified adequately.
B. stored in a refrigerator.
C. stored in a tightly capped container.
D. protected from the dark.
C. stored in a tightly capped container.
Using quality control materials, one should check reagent strip performance
1. at least once daily.
2. when a new bottle of strips or tablets is opened.
3. when a new lot number of strips or tablets is placed into use.
4. once each shift by each laboratorian performing urinalysis testing.
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.
A. 1, 2, and 3 are correct.
Which of the following is not checked by quality control materials?
A. The technical skills of the personnel performing the test
B. The integrity of the specimen, that is, that the specimen was collected and stored properly
C. The test protocol, that is, that the procedure was performed according to written guidelines
D. The functioning of the equipment used—for example, the refractometer and the reagent strip readers
B. The integrity of the specimen, that is, that the specimen was collected and stored properly
Quality control materials used to assess the performance of reagent strips and tablet tests must
A. be purchased from a commercial manufacturer.
B. yield the same results regardless of the commercial brand used.
C. contain chemical constituents at realistic and critical detection levels.
D. include constituents to assess the chemical and microscopic examinations.
C. contain chemical constituents at realistic and critical detection levels.
Which of the following is NOT a source of erroneous results when reagent strips are used?
A. Testing a refrigerated urine specimen
B. Timing using a clock without a second hand
C. Allowing excess urine to remain on the reagent strip
D. Dipping the reagent strip briefly into the urine specimen
D. Dipping the reagent strip briefly into the urine specimen
Select the primary reason why tablet (e.g., Ictotest) and chemical tests (e.g., sulfosalicylic acid precipitation test) generally are performed.
A. They confirm results suspected about the specimen.
B. They are alternative testing methods for highly concentrated urines.
C. Their specificity differs from that of the reagent strip test.
D. They are more sensitive to the chemical constituents in urine.
C. Their specificity differs from that of the reagent strip test.
In a patient with chronic renal disease, in whom the kidneys can no longer adjust urine concentration, the urine specific gravity would be
A. 1.000.
B. 1.010.
C. 1.020.
D. 1.030.
B. 1.010.
Urine pH normally ranges from
A. 4.0 to 9.0.
B. 4.5 to 7.0.
C. 4.5 to 8.0.
D. 5.0 to 6.0.
C. 4.5 to 8.0.
Urine pH can be modified by all of the following EXCEPT
A. diet.
B. increased ingestion of water.
C. ingestion of medications.
D. urinary tract infections.
B. increased ingestion of water.
The double-indicator system used by commercial reagent strips to determine urine pH uses which two indicator dyes?
A. Methyl orange and bromphenol blue
B. Methyl red and bromthymol blue
C. Phenol red and thymol blue
D. Phenolphthalein and litmus
B. Methyl red and bromthymol blue
Normally, daily urine protein excretion does not exceed
A. 150 mg/day.
B. 500 mg/day.
C. 1.5 g/day.
D. 2.5 g/day.
A. 150 mg/day.
Which of the following proteins originates in the urinary tract?
A. Albumin
B. Bence Jones protein
C. β2-Microglobulin
D. Uromodulin
D. Uromodulin
Which of the following statements best describes the chemical principle of the protein reagent strip test?
A. The protein reacts with an immunocomplex on the pad, which results in a color change.
B. The protein causes a pH change on the reagent strip pad, which results in a color change.
C. The protein accepts hydrogen ions from the indicator dye, which results in a color change.
D. The protein causes protons to be released from a polyelectrolyte, which results in a color change.
C. The protein accepts hydrogen ions from the indicator dye, which results in a color change.
Which of the following aids in the differentiation of hemoglobinuria and hematuria?
A. Urine pH
B. Urine color
C. Leukocyte esterase test
D. Microscopic examination
D. Microscopic examination
Which of the following blood cells will not be detected by the leukocyte esterase pad because it lacks esterases?
A. Eosinophils
B. Lymphocytes
C. Monocytes
D. Neutrophils
B. Lymphocytes
Microscopic examination of a urine sediment revealed an average of 2 to 5 white blood cells per high-power field, whereas the leukocyte esterase test by reagent strip was negative. Which of the following statements best accounts for this discrepancy?
A. The urine is contaminated with vaginal fluid.
B. Many white blood cells are lysed, and their esterase has been inactivated.
C. Ascorbic acid is interfering with the reaction on the reagent strip.
D. The amount of esterase present is below the sensitivity of the reagent strip test.
D. The amount of esterase present is below the sensitivity of the reagent strip test.
NOTE:
Sensitivity of the pad:
Multistix: 5 to 15 WBCs/hpf
Chemstrip: 10 to 25 WBCs/hpf
Which of the following substances or actions can produce FALSE POSITIVE nitrite results?
A. Ascorbic acid
B. Vaginal contamination
C. Strong reducing agents
D. Improper specimen storage
D. Improper specimen storage
Which of the following substances if present in the urine results in a negative Clinitest?
A. Fructose
B. Lactose
C. Galactose
D. Sucrose
D. Sucrose
The glucose reagent strip test is more sensitive and spe- cific for glucose than the Clinitest method because it detects
A. other reducing substances and higher concentrations of glucose.
B. no other substances and higher concentrations of glucose.
C. other reducing substances and lower concentrations of glucose.
D. no other substances and lower concentrations of glucose
D. no other substances and lower concentrations of glucose
The glucose specificity of the double sequential enzyme reaction used on reagent strip tests is due to the use of
A. gluconic acid.
B. glucose oxidase.
C. hydrogen peroxide.
D. peroxidase.
B. glucose oxidase.
Which of the following ketones is not detected by the reagent strip or tablet test?
A. Acetone
B. Acetoacetate
C. Acetone and acetoacetate
D. β-Hydroxybutyrate
D. β-Hydroxybutyrate
The ketone reagent strip and tablet tests are based on the reactivity of ketones with
A. ferric chloride.
B. ferric nitrate.
C. nitroglycerin.
D. nitroprusside
D. nitroprusside
The bilirubin reagent strip and tablet tests are based on
A. Ehrlich’s aldehyde reaction.
B. the oxidation of bilirubin to biliverdin.
C. the reduction of bilirubin to azobilirubin.
D. the coupling of bilirubin with a diazonium salt.
D. the coupling of bilirubin with a diazonium salt.
Which of the following are characteristic urine findings from a patient with hemolytic jaundice?
A. A positive test for bilirubin and an increased amount of urobilinogen
B. A positive test for bilirubin and a decreased amount of urobilinogen
C. A negative test for bilirubin and an increased amount of urobilinogen
D. A negative test for bilirubin and a decreased amount of urobilinogen
C. A negative test for bilirubin and an increased amount of urobilinogen
Which of the following results shows characteristic urine findings from a patient with an obstruction of the bile duct?
A. A positive test for bilirubin and an increased amount of urobilinogen
B. A positive test for bilirubin and a decreased amount of urobilinogen
C. A negative test for bilirubin and an increased amount of urobilinogen
D. A negative test for bilirubin and a decreased amount of urobilinogen
B. A positive test for bilirubin and a decreased amount of urobilinogen
Which of the following conditions can result in FALSE POSITIVE bilirubin results?
A. Elevated concentrations of nitrite
B. Improper storage of the specimen
C. Ingestion of ascorbic acid
D. Ingestion of certain medications
D. Ingestion of certain medications
Urobilinogen is formed from the
A. conjugation of bilirubin in the liver.
B. reduction of conjugated bilirubin in bile.
C. reduction of bilirubin by intestinal bacteria.
D. oxidation of urobilin by anaerobic intestinal bacteria.
C. reduction of bilirubin by intestinal bacteria.
The classic Ehrlich’s reaction is based on the reaction of urobilinogen with
A. diazotized dichloroaniline.
B. p-aminobenzoic acid.
C. p-dichlorobenzene diazonium salt.
D. p-dimethylaminobenzaldehyde.
D. p-dimethylaminobenzaldehyde.
Which of the available chemical principles is MOST SPECIFIC for the detection of urobilinogen?
A. Ictotest
B. Ehrlich’s reaction
C. Azo coupling reaction
D. Double sequential enzyme reaction
C. Azo coupling reaction
NOTE:
Chemstrip incorporates an azo-coupling (diazo) reaction using 4-methoxybenzene-diazonium-tetrafluoroborate to react with urobilinogen. This reaction is more specific for urobilinogen than the Ehrlich reaction.
Which of the following reagent strip tests can be affected by ascorbic acid, resulting in falsely low or false-negative results?
1. Blood
2. Bilirubin
3. Glucose
4. Nitrite
A. 1, 2, and 3 are correct.
B. 1 and 3 are correct.
C. 4 is correct.
D. All are correct.
D. All are correct.
Which of the following best describes the mechanism of ascorbic acid interference?
A. Ascorbic acid inhibits oxidation of the chromogen.
B. Ascorbic acid inactivates a reactant, promoting color development.
C. Ascorbic acid removes a reactant from the intended reaction sequence.
D. Ascorbic acid interacts with the reactants, producin a color that masks the results.
C. Ascorbic acid removes a reactant from the intended reaction sequence.
NOTE:
Reagent strip tests that use hydrogen peroxide or a diazonium salt are subject to ascorbic acid interference. Whether these compounds are impregnated in the reaction pad or are produced by a first reaction, they are removed by ascorbic acid, which prevents the intended reaction.
Smallest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
D. Wiskott-Aldrich syndrome
Largest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
B. Bernard-Soulier syndrome
Sodium citrate in the concentration of a _____ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies.
A. 1.5%
B. 15%
C. 3.2%
D. 3.8%
C. 3.2%
EDTA is used in concentrations of __ of blood.
A. 0.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
C. 2.5 mg/1 mL of whole blood
D. 3.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
An HLA specimen is collected in a tube containing:
A. ACD
B. EDTA
C. Silica
D. Thrombin
A. ACD
Most common complication encountered in obtaining a blood specimen:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
A. Ecchymosis (bruise)
It is caused by leakage of a SMALL AMOUNT OF BLOOD in the tissue around the puncture site:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
A. Ecchymosis (bruise)
Leakage of a LARGE AMOUNT OF BLOOD around the puncture site causes the area to rapidly swell:
A. Ecchymosis (bruise)
B. Hematoma
C. Hemoconcentration
D. None of these
B. Hematoma
Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage:
A. Cardiovascular complications
B. Vascular complications
C. Neurological complications
D. Infections
C. Neurological complications
Cardiovascular complications of phlebotomy:
1. Cardiac arrest
2. Hypotension
3. Syncope
4. Shock
A. 1 and 2
B. 1 and 3
C. 1, 2 and 3
D. 1, 2, 3 and 4
D. 1, 2, 3 and 4
Which of the following is the medical term for fainting?
A. Sclerosis
B. Stasis
C. Supine
D. Syncope
D. Syncope
An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do?
A. Convince the patient to cooperate and collect the sample anyway.
B. Have the nurse physically restrain the patient and draw the specimen.
C. Notify the patient’s nurse and document the patient’s refusal.
D. Return to the lab, cancel the test request, and inform the physician.
C. Notify the patient’s nurse and document the patient’s refusal.
Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?
A. Ask the patient to state her name; if it matches the requisition, continue.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed.
D. Tell the nurse that you will not collect the specimen and return to the lab.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
A phlebotomist who encounters a comatose patient with no ID band should:
A. Notify the phlebotomy supervisor
B. Check the patient’s identify with the patient’s roommate
C. Leave the requisition at the nurse’s station
D. Ask the nurse to band the patient
D. Ask the nurse to band the patient
A solution used to clean the site before routine venipuncture is:
A. 5.25% sodium hypochlorite.
B. 70% isopropyl alcohol.
C. 70% methanol.
D. Povidone–iodine.
B. 70% isopropyl alcohol.
This antiseptic has been traditionally used to obtain the high degree of skin antisepsis required when BLOOD CULTURES are being collected:
A. 70% Ethyl alcohol
B. 70% Isopropanol
C. Hydrogen peroxide
D. Povidone–iodine
D. Povidone–iodine
When drawing a blood alcohol specimen, it is acceptable to clean the arm with:
A. Benzalkonium chloride
B. Isopropyl alcohol
C. Methanol prep.
D. Tincture of iodine
A. Benzalkonium chloride
Stem cells are present in the first few hours after an ovum is fertilized; most versatile type of stem cell:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. Any of these
C. Totipotential stem cells
Disseminated intravascular coagulation (DIC) is most often associated with which of the following types of acute leukemia?
A. Acute myeloid leukemia without maturation
B. Acute promyelocytic leukemia
C. Acute myelomonocytic leukemia
D. Acute monocytic leukemia
B. Acute promyelocytic leukemia
Fibrinogen in Hemophilia A:
A. Normal
B. Decreased
C. Increased
D. Variable
A. Normal
Fibrinogen in vWD:
A. Normal
B. Decreased
C. Increased
D. Variable
A. Normal
Fibrinogen in Hemophilia B:
A. Normal
B. Decreased
C. Increased
D. Variable
A. Normal
Fibrinogen in Hemophilia C:
A. Normal
B. Decreased
C. Increased
D. Variable
A. Normal
Fibrinogen in Primary Fibrinolysis:
A. Normal
B. Decreased
C. Increased
D. Variable
B. Decreased
Fibrinogen in Secondary Fibrinolysis:
A. Normal
B. Decreased
C. Increased
D. Variable
B. Decreased
Factor VII deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
B. Prolonged PT, Normal APTT, Normal TCT
Hemophilia A:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
A. Normal PT, Prolonged APTT, Normal TCT
Factor X deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
C. Prolonged PT and APTT, Normal TCT
Fibrinogen deficiency:
A. Normal PT, Prolonged APTT, Normal TCT
B. Prolonged PT, Normal APTT, Normal TCT
C. Prolonged PT and APTT, Normal TCT
D. Prolonged PT, APTT and TCT
D. Prolonged PT, APTT and TCT
Acute, uncompensated DIC
1. Prolonged PT, PTT and TT
2. Normal fibrinogen
3. Increased FDPs
A. 1 only
B. 1 and 2
C. 1 and 3
D. 1, 2 and 3
C. 1 and 3
The only abnormal test result in CHRONIC DIC:
A. PT
B. APTT
C. Thrombin time
D. D-dimer
D. D-dimer
Neutrophil in the maturation-storage phase:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
B. 7 to 10 days
Basophil in the maturation-storage phase:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
D. 12 hours
Eosinophil in the maturation-storage phase:
A. 2.5 days
B. 3.5 days
C. 8.5 hours
D. 12 hours
A. 2.5 days
Average life span of neutrophils in circulating blood:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
A. 7 to 10 hours
Average life span of basophils in circulating blood:
A. 7 to 10 hours
B. 7 to 10 days
C. 8.5 hours
D. 12 hours
C. 8.5 hours
Eosinophils remain in the maturation-storage phase for about:
A. 2 days
B. 2.5 days
C. 3 days
D. 3.5 days
B. 2.5 days
The time from the last myelocyte mitotic division to the emergence of mature eosinophils from the marrow is about:
A. 2 days
B. 2.5 days
C. 3 days
D. 3.5 days
D. 3.5 days
Which of the following is contained in the primary granules of the neutrophil?
A. Lactoferrin
B. Myeloperoxidase
C. Histamine
D. Alkaline phosphatase
B. Myeloperoxidase
NEW TYPES OF THROMBOPLASTINS for measuring the PT are mixtures of phospholipids and recombinantly derived from:
A. Rabbit tissue factor
B. Human tissue factor
C. Horse tissue factor
D. Sheep tissue factor
B. Human tissue factor
Plasma thromboplastin antecedent:
A. Factor V
B. Factor IX
C. Factor XI
D. Factor XII
C. Factor XI
Plasma thromboplastin component:
A. Factor V
B. Factor IX
C. Factor XI
D. Factor XII
B. Factor IX
The prothrombin assay requires that the patient’s citrated plasma be combined with which one of the following?
A. Thromboplastin
B. Calcium chloride and thromboplastin
C. Calcium chloride
D. Kaolin
B. Calcium chloride and thromboplastin
Assess deficiencies of all factors except VII and XIII:
A. Platelet count
B. Prothrombin time (PT)
C. Partial thromboplastin time (PTT)
D. Thrombin time
C. Partial thromboplastin time (PTT)
Hemoglobin appears for the first time:
A. Pronormoblast
B. Basophilic normoblast
C. Polychromatophilic normoblast
D. Orthochromic normoblast
C. Polychromatophilic normoblast
The heme portion of the hemoglobin molecule consists of ____ iron (Fe2+) atom(s) and ____ pyrrole rings that are joined to each other.
A. One iron and two pyrrole rings
B. One iron and four pyrrole rings
C. Two iron and four pyrrole rings
D. Four iron and four pyrrole rings
B. One iron and four pyrrole rings
Which globin chains compose hemoglobin A1?
A. Two alpha chains and two beta chains
B. Two alpha chains and two delta chains
C. Two alpha chains and two gamma chains
D. Two beta chains and two delta chains
A. Two alpha chains and two beta chains
Decreased production of erythropoietin by the damaged kidney:
A. Anemia of chronic disease
B. Anemia of renal insufficiency
C. Anemia in liver disease
D. Anemia in endocrine disease
B. Anemia of renal insufficiency
Which of the following is likely to occur FIRST in iron deficiency anemia?
A. Decreased serum iron
B. Increased TIBC
C. Decreased serum ferritin
D. Increased transferrin
C. Decreased serum ferritin
All of the following are embryonic hemoglobin, except:
A. Gower 1 hb
B. Gower 2 hb
C. Portland 1 hb
D. Portland 2 hb
D. Portland 2 hb
Hb A1:
A. 2 alpha + 2 beta globin chains
B. 2 alpha + 2 delta globin chains
C. 2 alpha + 2 delta globin chains
D. 2 zeta + 2 epsilon globin chains
A. 2 alpha + 2 beta globin chains
Hb F:
A. 2 alpha + 2 beta globin chains
B. 2 alpha + 2 delta globin chains
C. 2 alpha + 2 gamma globin chains
D. 2 zeta + 2 epsilon globin chains
C. 2 alpha + 2 gamma globin chains
Which mutation is shared by a large percentage of patients with polycythemia vera, essential thrombocythemia, and primary myelofibrosis?
A. BCR/ABL
B. JAK2 V617F
C. PDGFR
D. RUNX1
B. JAK2 V617F
The level of erythropoietin in the urine is _____ in patients with PV compared with other kinds of polycythemia.
A. Increased
B. The same
C. Variable
D. Decreased
D. Decreased
Aspirin ingestion has the following hemostatic effect in a normal person.
A. Prolongs the bleeding time
B. Prolongs the clotting time
C. Inhibits factor VIII
D. Has no effect
A. Prolongs the bleeding time
A donor taking Feldene will not be able to donate platelets for:
A. 2 days
B. 7 days
C. 2 weeks
D. 4 weeks
A. 2 days
A whole-blood donor currently on clopidogrel (Plavix) is precluded from donating which product?
A. Platelets
B. Red blood cells
C. FFP
D. Cryoprecipitate
A. Platelets
A prolonged thrombin time is indicative of which of the following antithrombotic therapies?
A. Prasugrel
B. Clopidogrel
C. Aspirin
D. Heparin
D. Heparin
What test is commonly used to monitor warfarin therapy
A. INR
B. APTT
C. TT
D. Ecarin time
A. INR
What test is used to monitor heparin therapy?
A. INR
B. APTT
C. TT
D. PT
B. APTT
POCT/BED-SIDE
Which of the following is the preferred method to monitor heparin therapy at the point of care during cardiac surgery?
A. APTT
B. Activated clotting time test (ACT)
C. PT
D. TT
B. Activated clotting time test (ACT)
What clotting factors (cofactors) are inhibited by protein S?
A. V and X
B. Va and VIIIa
C. VIII and IX
D. VIII and X
B. Va and VIIIa
Phlebotomy is used as a therapeutic treatment for:
A. Diabetes
B. Hypothyroidism
C. Phlebitis
D. Polycythemia
D. Polycythemia
A modification of which procedure can be used to measure fibrinogen?
A. PT
B. APTT
C. Thrombin time
D. Fibrin degradation products
C. Thrombin time
More than half of the cases have been described in Ashkenazi Jews, but individuals of any ethnic group may be affected:
A. Hemophilia A
B. Hemophilia B
C. Hemophilia C
D. vWD
C. Hemophilia C
What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
A. Factor VIII
B. Fibrinogen
C. Thrombin
D. Factor X
B. Fibrinogen
A patient on therapeutic warfarin will most likely have a(n)
A. Normal PT/INR, increased APTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
C. Normal PT/INR, normal APTT, normal bleeding time, normal platelet count
D. Increased PT/INR, normal APTT, prolonged bleeding time, low platelet count
B. Increased PT/INR, increased APTT, normal bleeding time, normal platelet count
This organ is usually suspended whole in 10% buffered formalin for 2 to 3 weeks to ensure fixation and some hardening prior to sectioning.
A. Lungs
B. Liver
C. Brain
D. Amputated foot
C. Brain
Which of the following organs should not be dissected before they are fixed?
A. Eyes
B. Lungs
C. Heart
D. Liver
A. Eyes
A blood service facility duly authorized by the DOH – Center for Health Development (CHD), whose main function is to collect blood from volunteer non-renumerated blood donors:
A. Blood Bank (BB)
B. Blood center (BC)
C. Blood collection unit (BCU)
D. Blood station (BS)
C. Blood collection unit (BCU)
A blood service facility duly authorized by the DOH – CHD, whose main function is the storage, issuance, transport and distribution of whole blood and packed red cells:
A. Blood Bank (BB)
B. Blood center (BC)
C. Blood collection unit (BCU)
D. Blood station (BS)
D. Blood station (BS)
A non-hospital-based blood service facility, licensed by DOH Bureau of Health Facilities and Services (BHFS), whose main function is to process blood units into blood components and testing these units for five (5) infectious disease markers:
A. Blood Bank (BB)
B. Blood center (BC)
C. Blood collection unit (BCU)
D. Blood station (BS)
B. Blood center (BC)
All of the following bacterial cell walls contains mycolic acid, EXCEPT:
A. Nocardia
B. Rhodococcus
C. Streptomyces
D. Corynebacterium
C. Streptomyces
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
C. N-glycolylmuramic acid and an increase in lipid content
For manual WBC count, allow the dilution to sit for ________ to ensure that the red blood cells have lysed.
A. 3 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes
C. 10 minutes
For manual WBC count, after charging the hemacytometer, place it in a moist chamber for _______ before counting the cells to give them time to settle.
A. 3 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes
C. 10 minutes
For manual platelet count, place the charged hemacytometer in a moist chamber for _________ to allow the platelets to settle.
A. 3 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes
D. 15 minutes
Full conversion of hemoglobin to cyanmethemoglobin:
A. 1 minute
B. 3 minutes
C. 10 minutes
D. 30 minutes
C. 10 minutes
High WBC count that can cause turbidity and a falsely high hemoglobin result:
A. WBCs > 10 x 10 9th/L
B. WBCs > 20 x 10 9th/L
C. WBCs > 50 x 10 9th/L
D. WBCs > 70 x 10 9th/L
B. WBCs > 20 x 10 9th/L
High platelet count that can cause turbidity and a falsely high hemoglobin result:
A. Platelets > 150 x 10 9th/L
B. Platelets > 200 x 10 9th/L
C. Platelets > 500 x 10 9th/L
D. Platelets > 700 x 10 9th/L
D. Platelets > 700 x 10 9th/L
When the correct area of a specimen from a patient with a normal RBC count is viewed, there are generally about ____ RBCs per 100x oil immersion field.
A. 10 to 15 RBCs per OIF
B. 20 to 25 RBCs per OIF
C. 100 to 150 RBCs per OIF
D. 200 to 250 RBCs per OIF
D. 200 to 250 RBCs per OIF
To evaluate normal platelet numbers in an appropriate area of a blood smear, approximately how many platelets should be observed per oil immersion field?
A. 1-4
B. 4-10
C. 8-20
D. 20-50
C. 8-20
A widely used hemagglutination test for detecting antibody to Treponema pallidum is:
A. MHA-TP test
B. FTA-ABS test
C. VDRL test
D. Hemagglutination inhibition assay
A. MHA-TP test
All of the following are primary manifestations of Legionnaires’ disease except?
A. Trench fever
B. Pontiac fever
C. Endocarditis
D. Pneumonia
A. Trench fever
Which of the following agars should be used for culturing Legionella?
A. CIN
B. BCYE
C. SMAC
D. XLD
B. BCYE
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
D. Marburg virus
What is the safe volume of blood to be drawn for pediatric blood cultures?
A. <1 mL
B. 1 to 5 mL
C. 5 to 10mL
D. 10 to 20 mL
B. 1 to 5 mL
NOTE:
For infants and small children, only 1 to 5 mL of blood should be drawn for bacterial culture.
Psittacosis is a lower respiratory infection in humans caused by contact with what animal?
A. Swine
B. Seals
C. Cats
D. Birds
D. Birds
What is the primary etiologic agent in children with epiglottitis?
A. Haemophilus influenzae type b
B. Corynebacterium diphtheriae
C. Streptococcus pyogenes
D. Staphylococcus aureus
A. Haemophilus influenzae type b
What virus traditionally causes viral parotitis?
A. Influenza virus
B. Parainfluenza virus
C. Rhinovirus
D. Mumps virus
D. Mumps virus
When setting up a urine culture, a calibrated loop is used that delivers a specific amount of urine to the media plate. What is that amount?
A. 0.01 or 0.001 mL of urine
B. 0.10 or 0.01 mL of urine
C. 0.001 or 0.0001 mL of urine
D. None of the above is correct
A. 0.01 or 0.001 mL of urine
NOTE:
Most often, microbiologists use a calibrated loop designed to deliver a known volume, either 0.01 or 0.001 mL of urine.
These loops, made of platinum, plastic, or other material, can be obtained from laboratory supply companies.
The calibrated loop that delivers the larger volume of urine (0.01 mL) is recommended to detect lower numbers of organisms in certain specimens.
Which organism is associated with thrombotic thrombocytopenia purpura?
A. Shigella dysenteriae
B. Clostridium difficile
C. EHEC (VTEC)
D. Vibrio cholerae
C. EHEC (VTEC)
Poor dental hygiene can lead to osteomyelitis of the jaw; what organism is most often responsible for this type of infection?
A. Actinomyces spp.
B. Staphylococcus aureus
C. Prevotella spp.
D. Fusobacterium spp.
A. Actinomyces spp.
OFTEN RECOVERED FROM PATIENTS WITH MALIGNANCIES OF COLON
Anaerobic gram-positive bacilli with subterminal spores were recovered from several blood cultures obtained from a patient diagnosed with a malignancy of the colon. The following results were recorded:
* Indole = Neg
* Urease = Neg
* Lipase = Neg
* Catalase = Neg
* Lecithinase = Neg
* Growth on blood agar = Swarming colonies
What is the correct identification?
A. Clostridium septicum
B. Clostridium perfringens
C. Clostridium sordellii
D. Propionibacterium acnes
A. Clostridium septicum
Slowly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite
C. Bradyzoite
Rapidly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite
D. Tachyzoite
The two species of flies responsible for the transmission are Glossina palpalis and Glossina tachinoides:
A. Leishmania donovani
B. Leishmania tropica
C. Trypanosoma brucei gambiense
D. Trypanosoma brucei rhodesiense
C. Trypanosoma brucei gambiense
The two primary species of fly vectors responsible for transmitting are Glossina morsitans and Glossina pallidipes:
A. Leishmania donovani
B. Leishmania tropica
C. Trypanosoma brucei gambiense
D. Trypanosoma brucei rhodesiense
D. Trypanosoma brucei rhodesiense
When undercooked meat is digested in the stomach, the larvae are resistant to the gastric pH and pass to the intestine, where they invade the mucosa:
A. Ancylostoma duodenale
B. Ascaris lumbricoides
C. Dracunculus medinesis
D. Trichinella spiralis
D. Trichinella spiralis
Most common identified species of filarial worms that infect humans:
A. Brugia malayi
B. Loa loa
C. Mansonella ozzardi
D. Wuchereria bancrofti
D. Wuchereria bancrofti
Sheathed microfilaria, nuclei continuous up to the tip of the tail:
A. B. malayi
B. L.loa
C. O. volvulus
D. W. bancrofti
B. L.loa
Definitive host and the reservoir for W. bancrofti:
A. Anopheles
B. Aedes
C. Culex fatigans
D. Human
D. Human
Tail is often referred to as “SHEPHERD’S CROOK”:
A. Onchocerca volvulus
B. Mansonella perstans
C. Mansonella ozzardi
D. Mansonella streptocerca
D. Mansonella streptocerca
Infective stage is the SHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis
B. Ancylostoma duodenale, Necator americanus
Infective stage is the UNSHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis
A. Strongyloides stercoralis
Eggs can be confused with POLLEN GRAINS:
A. Diphyllobothrium latum
B. Dipylidium caninum
C. Hymenolepis nana
D. Taenia spp.
D. Taenia spp.
Gravid proglottids resemble RICE GRAINS (dry) or CUCUMBER SEEDS (moist):
A. Diphyllobothrium latum
B. Dipylidium caninum
C. Hymenolepis nana
D. Taenia spp.
B. Dipylidium caninum
Oxidase positive, urease negative:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these
A. B. pertussis
Oxidase and urease positive:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these
C. B. bronchiseptica
Oxidase negative, urease positive:
A. B. pertussis
B. B. parapertussis
C. B. bronchiseptica
D. None of these
B. B. parapertussis
Catalase positive, lactose negative, xylose positive:
A. Haemophilus aegypticus
B. Haemophilus ducreyi
C. Haemophilus parainfluenzae
D. Haemophilus influenzae
D. Haemophilus influenzae
More likely to contain trophozoites:
A. Liquid/diarrheic stool
B. Formed stool
C. Soft stool
D. None of these
A. Liquid/diarrheic stool
May contain trophozoites and cysts:
A. Liquid stool
B. Diarrheic stool
C. Formed stool
D. Soft stool
D. Soft stool
More likely to contain cysts (less likely to contain trophozoites)
A. Liquid stool
B. Diarrheic stool
C. Formed stool
D. Soft stool
C. Formed stool
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
D. Alcaligenes faecalis
Distinct odor that is often referred to as a “chocolate cake” or “burnt chocolate” smell:
A. Burkholderia cepacia
B. Eikenella corrodens
C. Proteus sp.
D. Staphylococcus aureus
C. Proteus sp.
RTE cell from the proximal convoluted tubules:
A. Columnar or convoluted
B. Cuboidal
C. Round or oval
D. None of these
A. Columnar or convoluted
RTE cell from the distal convoluted tubules:
A. Columnar or convoluted
B. Cuboidal
C. Round or oval
D. None of these
C. Round or oval
RTE cells from the collecting duct:
A. Columnar or convoluted
B. Cuboidal
C. Round or oval
D. None of these
B. Cuboidal
As little as 0.1 mL of CSF combined with one drop of _______ produces an adequate cell yield when processed with the cytocentrifuge.
A. 10% formalin
B. 40% formalin
C. 10% albumin
D. 30% albumin
D. 30% albumin
A DAILY CONTROL SLIDE FOR BACTERIA IN CSF:
A. 95% ethanol
B. 30% albumin
C. 0.2 mL saline and 2 drops 95% ethanol
D. 0.2 mL saline and 2 drops 30% albumin
D. 0.2 mL saline and 2 drops 30% albumin
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
A. Serum AST and ALT levels
Which of the following analytes is the best indicator of hepatobiliary damage?
A. AST
B. ALT
C. ALP
D. Bilirubin
C. ALP
Fluorophore-labeled thyroxine competes with patient thyroxine for antibody in homogeneous system. Antibody-bound labeled thyroxine rotates slowly, emitting lower energy light.
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)
A. Fluorescent polarization immunoassay (FPIA)
Fluorogenic substrate–labeled TSH is competing with patient TSH for antibody in this homogeneous assay. Only unbound (leftover) labeled TSH reacts with the enzyme to form fluorescent product. There is a direct relationship between fluorescence and the amount of TSH present in the test sample.
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)
B. Fluorescent substrate-labeled inhibition immunoassay
Peroxidase-labeled antibody binds with patient hormone (antigen) to form complex (similar to ELISA). Addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time.
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)
C. Chemiluminescence
Similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone:
A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)
D. Microparticle enzyme immunoassay (MEIA)
Primary hyperthyroidism:
A. Normal T3 T4, increased TSH
B. Normal T3 T4, decreased TSH
C. Increased T3 T4, increased TSH
D. Increased T3 T4, decreased TSH
D. Increased T3 T4, decreased TSH
Secondary hyperthyroidism:
A. Normal T3 T4, increased TSH
B. Normal T3 T4, decreased TSH
C. Increased T3 T4, increased TSH
D. Increased T3 T4, decreased TSH
C. Increased T3 T4, increased TSH
Subclinical hyperthyroidism:
A. Normal T3 T4, increased TSH
B. Normal T3 T4, decreased TSH
C. Increased T3 T4, increased TSH
D. Increased T3 T4, decreased TSH
B. Normal T3 T4, decreased TSH
Wastes of Lean:
1. Defects
2. Waiting
3. Motion
4. Emotion
A. 1 and 3
B. 2 and 4
C. 1, 2 and 3
D. 1, 2, 3 and 4
C. 1, 2 and 3
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
C. 180 rpm for 4 minutes
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
D. 180 rpm for 8 minutes
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
B. 100 rpm for 8 minutes
Black belts dedicate _______ of their time to quality improvement projects, proactively addressing process and quality problems.
A. 10%
B. 20%
C. 70%
D. 100%
D. 100%
Green belts contribute ______ of their time to improvement projects while delivering their normal job functions.
A. 10%
B. 20%
C. 70%
D. 100%
B. 20%
Black belts
A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used
B. Project coaches or leaders
Green belts
A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used
C. Project team members
Blue belts
A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used
A. Project sponsors or champions
A nurse calls the laboratory technologist on duty asking about blood collection for the analysis of enzymes (AST, ALP, ALT, GGT, CK). Which of the following tubes would you suggest the technologist collect?
A. Red top
B. EDTA
C. Oxalate
D. Fluoride
A. Red top
Primum non nocere comes from the Hippocratic Oath and means:
A. To first things first.
B. First do no harm.
C. Quality is foremost.
D. Ready to serve.
B. First do no harm.
Phlebos = vein; tome = incision
The term phlebotomy is derived from Greek words that, literally translated, mean to:
A. Cut a vein.
B. Draw blood.
C. Stick a vein.
D. Withdraw blood.
A. Cut a vein.
CONTACT PRECAUTION
Which of the following patients would require contact precautions pending a diagnosis?
A. A child with a maculopapular rash highly suggestive of rubeola (measles)
B. A diapered patient with symptoms of infection with an enteric pathogen
C. An HIV-positive patient who has a cough, fever, and pulmonary infiltrate
D. A man with a severe persistent cough indicative of Bordetella pertussis
B. A diapered patient with symptoms of infection with an enteric pathogen
When the chain of infection is broken, an:
A. Individual is immune to that microbe.
B. Individual is susceptible to infection.
C. Infection is prevented from happening.
D. Infection will most likely be the result.
C. Infection is prevented from happening.
Which type of precautions would be used for a patient who has pulmonary tuberculosis?
A. Airborne
B. Droplet
C. Contact
D. Reverse
A. Airborne
DROPLET PRECAUTION
An example of a disease requiring droplet isolation is:
A. Pertussis.
B. Rubeola.
C. Scabies.
D. Varicella
A. Pertussis.
Class C fires involve:
A. Combustible metals.
B. Electrical equipment.
C. Flammable liquids.
D. Ordinary materials.
B. Electrical equipment.
This equipment is required when one is collecting a specimen from a patient in airborne isolation.
A. Eye protection
B. Full face shield
C. Mask and goggles
D. N95 respirator
D. N95 respirator
You accidentally splash a bleach solution into your eyes while preparing it for cleaning purposes. What is the first thing to do
A. Dry your eyes quickly with a clean paper towel or tissue.
B. Flush your eyes with water for a minimum of 15 minutes.
C. Proceed to the emergency room as quickly as possible.
D. Put 10 to 20 drops of saline into your eyes immediately.
B. Flush your eyes with water for a minimum of 15 minutes.
The first thing to do in the event of electrical shock to a coworker or patient is to:
A. Call for medical assistance.
B. Keep the patient warm.
C. Shut off the electricity source.
D. Start CPR if indicated.
C. Shut off the electricity source.
Alcohol-based antiseptic hand cleaners can be used in place of hand washing if:
A. Gloves were worn during the prior activity.
B. Hands are first cleaned with detergent wipes.
C. Hands were washed after the prior activity.
D. No dirt or organic matter is seen on the hands.
D. No dirt or organic matter is seen on the hands.
Most reference ranges are based on normal laboratory test values for:
A. Fasting patients.
B. Healthy people.
C. ill individuals.
D. Treated patients.
B. Healthy people.
PLUMBISM - deleterious effect of gradual accumulation of ______ in body tissues, as a result of repeated exposure.
A. Arsenic
B. Cyanide
C. Lead
D. Mercury
C. Lead
Two standard deviations (2 SD) from the mean in a normal distribution curve would include:
A. 99% of all values
B. 95% of all values
C. 75% of all values
D. 68% of all values
B. 95% of all values
Acceptable limits of a control value must fall:
A. Within ±1 standard deviation of the mean
B. Between 1 and 2 standard deviations of the mean
C. Within ±2 standard deviations of the mean
D. Within ±3 standard deviations of the mean
C. Within ±2 standard deviations of the mean
Typically, a patient test result that EXCEEDS 3 SD of the mean value for analyte is found with a frequency of:
A. 1 in 5
B. 1 in 20
C. 1 in 100
D. Never
C. 1 in 100
Potentiometric methods are most useful for which of the following types of analytes?
A. Proteins
B. Electrolytes
C. Drugs of abuse
D. Lipids
B. Electrolytes
Which of the following tests is a good marker of nutritional status?
A. Immunoglobulin M
B. Prealbumin
C. Ceruloplasmin
D. Lp(a)
B. Prealbumin
Which test is used as an indicator of congestive heart failure?
A. CRP
B. BNP
C. Cholesterol
D. Troponin
E. Haptoglobin
B. BNP
Which test is the most specific for myocardial infarction?
A. LDH
B. CK
C. Troponin
D. Myoglobin
C. Troponin
In which condition would TIBC be high?
A. Hemochromatosis
B. Chronic illness
C. Malnutrition
D. Iron deficiency
D. Iron deficiency
When performing a stool culture, a colony type typical of an enteric pathogen is subcultured on a blood agar plate. The resulting pure culture is screened with several tests to obtain the following results:
* TSI: acid butt, alkaline slant, no gas, no H2S
* Phenylalanine deaminase: negative
* Motility: positive
* Serological typing: Shigella flexneri (Shigella subgroup B)
The serological typing is verified with new kit and controls. The best course of action would be to:
A. Report the organism as Shigella flexneri without further testing
B. Verity reactivity of motility medium with positive and negative controls
C. Verify reactivity of the TSI slants with positive and negative controls for H2S production
D. Verify reactivity of phenylalanine deaminase with positive and negative controls
B. Verity reactivity of motility medium with positive and negative controls
In order to isolate Campylobacter coli/jejuni, the fecal specimen should be:
A. Inoculated onto selective plating media and incubated in reduced oxygen with added CO2 at 42°C
B. Stored in tryptic soy broth before plating to ensure growth of the organism
C. Inoculated onto selective plating media and incubated at both 35°C and at room temperature
D. Incubated at 35°C for 2 hours in Cary-Blair media before inoculating onto selective plating media
A. Inoculated onto selective plating media and incubated in reduced oxygen with added CO2 at 42°C
A liquid fecal specimen from a three-month-old infant is submitted for microbiological examination. In addition to culture on routine media for Salmonella and Shigella, this specimen should be routinely:
A. Examined for the presence of Entamoeba hartmanni
B. Examined for the presence of Camylobacter sp.
C. Screened for the detection of enterotoxigenic Escherichia coli
D. Placed in thioglycollate broth to detect Clostridium botulinum
B. Examined for the presence of Camylobacter sp.
Of the following bacteria, the most frequent cause of prosthetic heart valve infections occurring within 2 to 3 months after surgery is:
A. Streptococcus pneumoniae
B. Streptococcus pyogenes
C. Staphylococcus aureus
D. Staphylococcus epidermidis
D. Staphylococcus epidermidis
The following results were obtained from a culture of unknown origin:
* Gram stain: gram-negative diplococci
* Indophenol oxidase: positive
* Glucose: positive
* Maltose: negative
* Sucrose: negative
The most likely source of the specimen would be the:
A. Respiratory tract
B. Blood
C. Genitourinary tract
D. Cerebrospinal fluid
C. Genitourinary tract
Propionobacterium acnes is most often associated with:
A. Food poisoning
B. Post-antibiotic diarrhea
C. Tooth decay
D. Blood culture contamination
D. Blood culture contamination
A patient has a suspected diagnosis of subacute bacterial endocarditis. His blood cultures grow non-spore-forming pleomorphic gram-positive bacilli only in the anaerobic bottle. What test(s) will give a presumptive identification of this microorganism?
A. Beta-hemolysis and oxidase
B. Catalase and spot indole
C. Esculin hydrolysis
D. Hydrolysis of gelatin
B. Catalase and spot indole
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
D. H2S production
A Campylobacter species isolated from a stool culture gives the following biochemical reactions:
* Nalidixic acid: susceptible
* Cephalothin: resistant
* Oxidase: positive
* Catalase: positive
* Hippurate hydrolysis: positive
This biochemical profile is consistent with:
A. Campylobacter fetus
B. Campylobacter jejuni
C. Campylobacter coli
D. Campylobacter laridis
B. Campylobacter jejuni
A specimen was collected for therapeutic drug monitoring (TDM) in a red top evacuated tube. The appropriate course of action is to:
A. Accept the specimen
B. Reject the specimen
C. Warm the specimen
D. Send the specimen to a reference lab
A. Accept the specimen
Which of the following immunoglobulins is most efficient at activating complement via the classical pathway?
A. IgG2
B. IgG4
C. IgM
D. IgA
C. IgM
A positive ANA with the pattern of anticentromere antibodies is most frequently seen in patients with:
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. CREST syndrome
D. Sjogren syndrome
C. CREST syndrome
In the indirect fluorescent anti-nuclear antibody test, a speckled pattern may indicate the presence of antibody to:
A. Histone
B. Sm
C. RNA
D. DNA
B. Sm
Autoantibodies in the absence of Sm are found in patients with:
A. Mixed connective tissue disease
B. Systemic lupus erythematosus
C. Crohn disease
D. Multiple myeloma
A. Mixed connective tissue disease
Positive rheumatoid factor is generally associated with:
A. Hyperglobulinemia
B. Anemia
C. Decreased erythrocyte sedimentation rate
D. Azotemia
A. Hyperglobulinemia
High titers of antimicrosomal antibodies are most often found in:
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Chronic hepatitis
D. Thyroid disease
D. Thyroid disease
In chronic active hepatitis, high titers of which of the following antibodies are seen?
A. Antimitochondrial
B. Anti-smooth muscle
C. Anti-DNA
D. Anti-parietal cell
B. Anti-smooth muscle
In primary biliary cirrhosis, which of the following antibodies is seen in high titers?
A. Anti-mitochondrial
B. Anti-smooth muscle
C. Anti-DNA
D. Anti-parietal cell
A. Anti-mitochondrial
In an anti-nuclear antibody indirect immunofluorescence test, a sample of patient serum shows a positive, speckled pattern. Which would be the most appropriate additional test to perform?
A. Anti-mitochondrial antibody
B. Immunoglobulin quantitation
C. Screen for Sm and RNP antibodies
D. Anti-DNA antibody using Crithidia luciliae
C. Screen for Sm and RNP antibodies
Blood is drawn from a patient for serological tests for a viral disease at the time of onset and again 4 weeks later. The results of the tests are considered diagnostic if the:
A. First antibody titer is 2x the second
B. First and second antibody titers are equal
C. First antibody is 4x the second
D. Second antibody titer is at least 4x the first
D. Second antibody titer is at least 4x the first
The disappearance of HBsAg and HBeAg, the persistence of anti-HBc, the appearance of anti-HBs, and often of anti-HBe indicate:
A. Early acute HBV hepatitis
B. Early convalescent phase HBV hepatitis
C. Recovery phase of acute HBV hepatitis
D. Carrier state of acute HBV hepatitis
C. Recovery phase of acute HBV hepatitis
A bacterial protein used to bind human immunoglobulins is:
A. HAV antibody, IgA type
B. Escherichia coli protein C
C. Staphylococcal protein A
D. HAV antibody, IgG type
C. Staphylococcal protein A
Which of the following is the best indicator of an acute infection with the hepatitis A virus?
A. The presence of IgG antibodies to hepatitis A virus
B. The presence of IgM antibodies to hepatitis A virus
C. A sharp decline in the level of IgG antibodies to hepatitis A virus
D. A rise in both IgM and IgG levels of antibody to hepatitis A virus
B. The presence of IgM antibodies to hepatitis A virus
The antigen marker most closely associated with transmissibility of HBV infection is:
A. HBs Ag
B. HBe Ag
C. HBc Ag
D. HBV
B. HBe Ag
IgM antibodies are frequently hemolytic because of:
A. Their dimeric structure
B. The molecule’s 5 antigen binding sites
C. Their sedimentation coefficient of 7 to 15s
D. Their efficient ability to fix complement
D. Their efficient ability to fix complement
Treatment of IgG with papain results in how many fragments from each immunoglobulin molecule?
A. 2
B. 3
C. 4
D. 5
B. 3
Which IgG subclass is most efficient at crossing the placenta?
A. IgG1
B. IgG2
C. IgG3
D. IgG4
A. IgG1
Patients suffering from Waldenstrom macroglobulinemia demonstrate excessively increased concentrations of which of the following?
A. IgG
B. IgA
C. IgM
D. IgD
C. IgM
T cells are incapable of:
A. Collaborating with B cells in antibody responses
B. Secretion of immunoglobulins
C. Secretion of cytokines
D. Producing positive skin tests
B. Secretion of immunoglobulins
Tumor markers found in the circulation are most frequently measured by:
A. Immunoassays
B. Thin-layer chromatography
C. High-pressure liquid chromatography
D. Colorimetry
A. Immunoassays
A 28-year-old man is seen by a physician because of several months of intermittent low back pain. The patient’s symptoms are suggestive of ankylosing spondylitis. Which of the following laboratory studies would support this diagnosis?
A. A decreased synovial fluid CH50 level
B. Low serum CH50 level
C. Positive HLA-B27 antigen test
D. Rheumatoid factor in the synovial fluid
C. Positive HLA-B27 antigen test
HLA-B8 antigen has been associated with which of the following pairs of diseases?
A. Ankylosing spondylitis and myasthenia gravis
B. Celiac disease and akylosing spondylitis
C. Myasthenia gravis and celiac disease
D. Reiter disease and multiple sclerosis
C. Myasthenia gravis and celiac disease
Individuals with a _________ are prone to developing severe, recurrent life-threatening infections with encapsulated bacteria such as Streptococcus pneumoniae and may also be subject to immune complex diseases; such complexes can lodge in the kidney and result in glomerulonephritis:
A. C1 deficiency
B. C2 deficiency
C. C3 deficiency
D. C5 deficiency
C. C3 deficiency
Discovery of genetic principles underlying the generation of antibodies with different specificities:
A. Gerald Edelman
B. Cesar Milstein
C. Susumu Tonegawa
D. Louis Pasteur
C. Susumu Tonegawa
The biochemical tests performed on a gram-positive bacillus were consistent with those of Corynebacterium diphtheriae. The MLS should now:
A. Perform a spore stain of the colonies
B. Determine if the isolate is toxigenic by performingan Elek test
C. Perform an agglutination test to confirm theorganism’s identity
D. Subculture the organism to Hektoen enteric medium and examine for black colonies
B. Determine if the isolate is toxigenic by performingan Elek test
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
A. Pseudomonas aeruginosa
Father of Immunology: (Stevens, Turgeon)
A. Edward Jenner
B. Louis Pasteur
C. Ellie Metchnikoff
D. Susumu Tonegawa
B. Louis Pasteur
The appearance of Koplik spots in the oral mucosa of patients is characteristic of infection with what viral agent?
A. Hepatitis
B. Measles
C. Rabies
D. Smallpox
B. Measles
Kaposi sarcoma is associated with infection by:
A. Adenovirus
B. Cytomegalovirus
C. Hepatitis E virus
D. Human herpes virus 8
D. Human herpes virus 8
The type of cell culture that best supports the growth of cytomegalovirus is:
A. HeLa cells
B. HEp-2 cells
C. Human fibroblast cells
D. Primary monkey kidney (PMK) cells
C. Human fibroblast cells
An example of a virus associated with latent infections is:
A. Influenza
B. Rotavirus
C. Rubella
D. Varicella-zoster
D. Varicella-zoster
Which of the following opportunistic diseases is NOT closely associated with acquired immune deficiency syndrome?
A. Cryptococcosis
B. Cryptosporidiosis
C. Malaria
D. Mycobacteriosis
C. Malaria
An 8-week-old infant was admitted to the hospital with symptoms of low birth weight, jaundice, and neurologic defects. Intranuclear inclusions were found in epithelial cells from the urine. The most likely diagnosis in this case would be infection by:
A. Cytomegalovirus
B. Epstein-Barrvirus
C. Herpes simplex virus
D. Rubella virus
A. Cytomegalovirus
Which organism fails to grow on artificial media or in cell cultures?
A. Chlamydia trachomatis
B. Neisseria gonorrhoeae
C. Treponema pallidum
D. Herpes simplex virus
C. Treponema pallidum
A cell culture line used for the recovery of Chlamydia trachomatis from clinical specimens is:
A. HeLa cells
B. Hep-2
C. BHK-21
D. McCoy
D. McCoy
Rickettsiae infecting man multiply preferentially within which of the following cells?
A. Reticuloendothelial
B. Hepatic
C. Renal tubule
D. Endothelial
D. Endothelial
Which hepatitis B marker is the best indicator of early acute infection?
A. HBs Ag
B. HBe Ag
C. Anti-HBc
D. Anti-HBs
A. HBs Ag
Which is the FIRST ANTIBODY detected in serum after infection with hepatitis B virus (HBV)?
A. Anti-HBs
B. Anti-HBc IgM
C. Anti-HBe
D. All are detectable at the same time
B. Anti-HBc IgM
Which hepatitis antibody confers immunity against reinfection with hepatitis B virus?
A. Anti-HBc IgM
B. Anti-HBc IgG
C. Anti-HBe
D. Anti-HBs
D. Anti-HBs
John comes in to donate a unit of whole blood at the collection center of the community blood supplier. The EIA screen is reactive for anti-HIV-1/2. The test is repeated in duplicate and is nonreactive. John is:
A. Cleared for donation
B. Deferred for 6 months
C. Status is dependent on confirmatory test
D. Deferred for 12 months
A. Cleared for donation
Interpret the following results for HIV infection.
* ELISA: positive
* Repeat ELISA: negative
* Western blot: no bands
A. Positive for HIV
B. Negative for HIV
C. Indeterminate
D. Further testing needed
B. Negative for HIV
What is the main difficulty associated with the development of an HIV vaccine?
A. The virus has been difficult to culture; antigen extraction and concentration are extremely laborious
B. Human trials cannot be performed
C. Different strains of the virus are genetically diverse
D. Anti-idiotype antibodies cannot be developed
C. Different strains of the virus are genetically diverse
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
A. Consideration of Entamoeba histolytica versus Entamoeba dispar
A patient is being seen in the emergency department for a low-grade fever, headache, and general malaise after returning from Africa on a photographic safari. The physician has requested blood for malaria; the laboratory would like to have patient information regarding:
A. Specific travel history and body temperature every 4 hours
B. Liver function tests and prophylactic medication history
C. Transfusion history and body temperature every 4 hours
D. Prophylactic medication history and specific travel history
D. Prophylactic medication history and specific travel history
A nursing student working in the emergency department accidentally stuck herself with a needle after removing it from an intravenous set taken from a suspected drug user. The best course of action, after reporting the incident to her supervisor, is to:
A. Test the student for HIV virus if flu-like symptoms develop in 2–4 weeks
B. Immediately test the patient and the student for HIV using an EIA or ELISA test
C. Perform a Western blot assay on the student’s serum
D. Draw blood from the student only and freeze it for further testing
B. Immediately test the patient and the student for HIV using an EIA or ELISA test
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
C. Optochin, bile solubility, PYR
An isolate recovered from a vaginal culture obtained from a 25-year-old female patient who is 8 months pregnant is shown to be a gram-positive cocci, catalase negative, and β-hemolytic on blood agar. Which tests are needed for further identification?
A. Optochin, bile solubility, PYR
B. Bacitracin, CAMP, PYR
C. Methicillin, PYR, trehalose
D. Coagulase, glucose, PYR
B. Bacitracin, CAMP, PYR
A 1-month-old infant underwent a spinal tap to rule out bacterial meningitis. The CSF was cloudy, and the smear showed many pus cells and short gram-positive rods. After 18 hours, many colonies appeared on blood agar that resembledStreptococcus spp. or L. monocytogenes. Which of the following preliminary tests should be performed on the colonies to best differentiate L. monocytogenes from Streptococcus spp.?
A. Hanging-drop motility (25°C) and catalase
B. PYR and bacitracin
C. Oxidase and glucose
D. Coagulase and catalase
A. Hanging-drop motility (25°C) and catalase
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
B. M. microti
Which mycobacterium is associated with Crohn’s disease?
A. M. marinum
B. M. paratuberculosis
C. M. avium
D. M. gordonae
B. M. paratuberculosis
Growth inhibition by thiophene-2-carboxylic hydrazide (T2H) is used to differentiate M. tuberculosis from which other Mycobacterium specie?
A. M. bovis
B. M. avium–intracellulare complex
C. M. kansasii
D. M. marinum
A. M. bovis
Which mechanism is responsible for botulism in infants caused by Clostridium botulinum?
A. Ingestion of spores in food or liquid
B. Ingestion of preformed toxin in food
C. Virulence of the organism
D. Lipase activity of the organism
A. Ingestion of spores in food or liquid
The classic form of foodborne botulism is characterized by the ingestion of:
A. Spores in food
B. Preformed toxin in food
C. Toxin H
D. All of these options
B. Preformed toxin in food
A gram-positive spore-forming bacillus growing on sheep-blood agar anaerobically produces a double zone of β-hemolysis and is positive for lecithinase. What is the presumptive identification?
A. Bacteroides ureolyticus
B. Bacteroides fragilis
C. Clostridium perfringens
D. Clostridium difficile
C. Clostridium perfringens
Which of the following is the most sensitive test to detect congenital syphilis?
A. VDRL
B. RPR
C. Microhemagglutinin test for T. pallidum (MHA-TP)
D. Polymerase chain reaction (PCR)
D. Polymerase chain reaction (PCR)
A newborn is to be tested for a vertically transmitted HIV infection. Which of the following tests is most useful?
A. HIV PCR
B. CD4 count
C. Rapid HIV antibody test
D. HIV IgM antibody test
A. HIV PCR
Inoculum size for DISK DIFFUSION susceptibility testing:
A. 1 x 10^4 CFU/mL
B. 1.5 x 10^5 CFU/mL
C. 1.5 x 10^8 CFU/mL
D. 5 x 10^5 CFU/mL
C. 1.5 x 10^8 CFU/mL
Inoculum size for AGAR DILUTION susceptibility testing:
A. 1 x 10^4 CFU/spot
B. 1.5 x 10^5 CFU/spot
C. 1.5 x 10^8 CFU/spot
D. 5 x 10^5 CFU/spot
A. 1 x 10^4 CFU/spot
Inoculum size for BROTH DILUTION susceptibility testing:
A. 1 x 10^4 CFU/mL
B. 1.5 x 10^5 CFU/mL
C. 1.5 x 10^8 CFU/mL
D. 5 x 10^5 CFU/mL
D. 5 x 10^5 CFU/mL
Most common cause of ASEPTIC MENINGITIS, an inflammation of the brain parenchyma:
A. Arenavirus
B. Cytomegalovirus
C. Enterovirus
D. Herpes simplex virus 2
C. Enterovirus
Subacute sclerosing panencephalitis (SSPE) is a progressive, disabling, and deadly brain disorder related to ______ infection.
A. Chickenpox (varicella)
B. Smallpox (variola major)
C. German measles (rubella)
D. Measles (rubeola)
D. Measles (rubeola)
An immunocompromised patient was admitted to the hospital with a diagnosis of HEMORRHAGIC CYSTITIS. Which combination of virus and specimen would be most appropriate to diagnose a viral cause of this disorder?
A. BK virus—urine
B. Human papilloma virus—skin
C. Hepatitis B virus—serum
D. Epstein–Barr virus—serum
A. BK virus—urine
JC Virus:
A. Hemorrhagic cystitis
B. Progressive multifocal leukoencaphalopathy
C. Keratoconjunctivitis
D. Lymphocytic choriomeningitis
B. Progressive multifocal leukoencaphalopathy
BK Virus:
A. Hemorrhagic cystitis
B. Progressive multifocal leukoencaphalopathy
C. Keratoconjunctivitis
D. Lymphocytic choriomeningitis
A. Hemorrhagic cystitis
It causes alveolar hydatid disease which is the most lethal of all helminthic diseases:
A. Taenia saginata
B. Taenia solium
C. Echinococcus granulosus
D. Echinococcus multilocularis
D. Echinococcus multilocularis
Intermediate host of Echinococcus multilocularis:
A. Dogs
B. Foxes
C. Coyotes
D. Rodents
D. Rodents
The drug of choice for treatment of Paragonimus infections is:
A. Metrifonate
B. Praziquantel
C. Bilarcil
D. Niclosamide
B. Praziquantel
The drug of choice for treatment of schistosome infections is:
A. Metrifonate
B. Praziquantel
C. Bilarcil
D. Niclosamide
B. Praziquantel
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
B. Iodamoeba butschlii
The only cestode to have an aquatic life cycle:
A. T. saginata
B. T. solium
C. H. nana
D. D. latum
D. D. latum
Methods other than packaged microsystems used to identify anaerobes include:
A. Antimicrobial susceptibility testing
B. Gas–liquid chromatography (GLC)
C. Special staining
D. Enzyme immunoassay
B. Gas–liquid chromatography (GLC)
Specimen characteristics of an anaerobic infection include:
A. Foul odor, presence of sulfur granules, and green fluorescence
B. Foul odor, presence of metachromatic granules, and green fluorescence
C. Foul odor, sulfur smell, and red fluorescence
D. Foul odor, presence of sulfur granules, and red fluorescence
D. Foul odor, presence of sulfur granules, and red fluorescence
Which of the following viruses is predominantly associated with respiratory disease and epidemics of keratoconjunctivitis?
A. Adenovirus
B. Molluscum contagiosum virus
C. Norwalkvirus
D. Rotavirus
A. Adenovirus
Microscopically, numerous smooth, thin-walled, club-shaped, multiseptate (2 to 4 μm) macroconidia are seen. They are rounded at the tip and are borne singly on a conidiophore or in groups of two or three. MICROCONIDIA ARE ABSENT, spiral hyphae are rare, and chlamydoconidia are usually numerous.
A. Epidermophyton floccosum
B. Microsporum canis
C. Trichophyton mentagrophytes
D. Trichophyton rubrum
A. Epidermophyton floccosum
Fluorescence on Wood’s lamp, growth in rice medium:
A. Microsporum canis
B. Microsporum gypseum
C. Microsporum audouinii
D. Epidermophyton floccosum
A. Microsporum canis
Fluorescence on Wood’s lamp, no growth in rice medium:
A. Microsporum canis
B. Microsporum gypseum
C. Microsporum audouinii
D. Epidermophyton floccosum
C. Microsporum audouinii
A flexible calcium alginate nasopharyngeal swab is the collection device of choice for recovery of which organism from the nasopharynx?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Corynebacterium diphtheriae
D. Bacteroides fragilis
C. Corynebacterium diphtheriae
Deoxycholate agar (DCA) is useful for the isolation of:
A. Enterobacteriaceae
B. Enterococcus spp.
C. Staphylococcus spp.
D. Neisseria spp.
A. Enterobacteriaceae
The most sensitive method for the detection of β-lactamase in bacteria is by the use of:
A. Chromogenic cephalosporin
B. Penicillin
C. Oxidase
D. Chloramphenicol acetyltransferase
A. Chromogenic cephalosporin
A gram-negative rod is recovered from a catheterized urine sample from a nursing home patient. The lactose-negative isolate tested positive for indole, urease, ornithine decarboxylase, and phenylalanine deaminase and negative for H2S. The most probable identification is:
A. Edwardsiella spp.
B. Morganella spp.
C. Ewingella spp.
D. Shigella spp.
B. Morganella spp.
The most noted differences between P. aeruginosa and Stenotrophomonas maltophilia are:
A. Oxidase, catalase, and TSI
B. Oxidase, catalase, and ONPG
C. Oxidase, 42°C growth, and polar tuft of flagella
D. Catalase, TSI, and pigment
C. Oxidase, 42°C growth, and polar tuft of flagella
Which biochemical tests are needed to differentiate Burkholderia cepacia from S. maltophilia?
A. Pigment on blood agar, oxidase, DNase
B. Pigment on MacConkey agar, flagellar stain,motility
C. Glucose, maltose, lysine decarboxylase
D. TSI, motility, oxidase
A. Pigment on blood agar, oxidase, DNase
Alcaligenes faecalis (formerly A. odorans) is distinguished from Bordetella bronchiseptica with which test?
A. Urease (rapid)
B. Oxidase
C. Growth on MacConkey agar
D. Motility
A. Urease (rapid)
Cetrimide agar is used as a selective isolation agar for which organism?
A. Acinetobacter spp.
B. Pseudomonas aeruginosa
C. Moraxella spp.
D. Stenotrophomonas maltophilia
B. Pseudomonas aeruginosa
A 15-year-old female complained of a severe eye irritation after removing her soft-contact lenses. A swab of the infected right eye was obtained by an ophthalmologist, who ordered a culture and sensitivity test. The culture was plated on blood agar and MacConkey agar. At 24 hours, growth of a gram-negative rod that tested positive for cytochrome oxidase was noted. The Mueller–Hinton sensitivity plate showed a bluish-green “lawn” of growth that proved highly resistant to most of the antibiotics tested except amikacin, tobramycin, and ciprofloxacin. What is the most likely identification?
A. Burkholderia cepacia
B. Pseudomonas aeruginosa
C. Stenotrophomonas maltophilia
D. Acinetobacter baumannii
B. Pseudomonas aeruginosa
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.
B. Pasteurella spp.
A gram-positive coccus recovered from a wound ulcer from a 31-year-old diabetic patient showed pale yellow, creamy, β-hemolytic colonies on blood agar. Given the following test results, what is the most likely identification?
* Catalase = +
* Glucose OF: positive open tube, negative sealed tube
* Mannitol salt = Neg
* Slide coagulase = Neg
A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Micrococcus spp.
D. Streptococcus spp.
C. Micrococcus spp.
Not considered normal flora, presence in specimens is almost always considered clinically significant:
A. Streptococcus agalactiae
B. Streptococcus pyogenes
C. Enterococcus spp.
D. Viridans streptococci
B. Streptococcus pyogenes
Unopened, sliced BACON, packaged in material somewhat highly resistant to oxygen permeability, is spoiled mostly by
A. Lactobacilli
B. Micrococci
C. Fecal Streptococci
D. Molds
A. Lactobacilli
Identification of Clostridium tetani is based upon:
A. Gram stain of the wound site
B. Anaerobic culture of the wound site
C. Blood culture results
D. Clinical findings
D. Clinical findings
Which gram-negative bacilli produce black pigment and brick red fluorescence when exposed to an ultraviolet light source?
A. Porphyromonas spp. and Prevotella spp.
B. Fusobacterium spp. and Actinomyces spp.
C. Bacteroides spp. and Fusobacterium spp.
D. All of these options
A. Porphyromonas spp. and Prevotella spp.
Which of the following is the best technique to identify Dientamoeba fragilis in stool?
A. Formalin concentrate
B. Trichrome-stained smear
C. Modified acid-fast–stained smear
D. Giemsa’s stain
B. Trichrome-stained smear
Small protozoa that have been missed on wet mounts or concentration methods are often detected with:
A. India ink
B. Iodine
C. Giemsa stain
D. Trichrome stain
D. Trichrome stain
Which of the following genera contain the organisms responsible for the disease scabies caused by the itch mite?
A. Sarcoptes spp.
B. Pediculus spp.
C. Ornithodorus spp.
D. Dermatophagoides spp.
A. Sarcoptes spp.
AUTOFLUORESCENCE requires no stain and is recommended for the identification of:
A. Entamoeba histolytica cysts
B. Toxoplasma gondii tachyzoites
C. Dientamoeba fragilis trophozoites
D. Cyclospora cayetanensis oocysts
D. Cyclospora cayetanensis oocysts
Top to bottom Layers obtained in FECT:
A. Debris/fats, ether, formalin, sediment
B. Ether, debris/fats, formalin, sediment
C. Ether, formalin, debris/fats, sediment
D. Formalin, ether, debris/fats, sediment
B. Ether, debris/fats, formalin, sediment
Large, usually multiseptate and club-shaped or spindle-shaped spores are called which of the following?
A. Microconidia
B. Macroconidia
C. Conidiophores
D. Phialides
B. Macroconidia
A patient with a Wood’s lamp–positive, dermatophytic infection has a skin scraping taken for culture. The organism grows on SDA agar with a light-tan front and salmon-colored reverse. Microscopically the organism produces rare distorted macroconidia and rare microconidia. Additionally, there was no growth on sterile rice media. What is the most likely organism?
A. Microsporum canis
B. Microsporum gypseum
C. Microsporum audouinii
D. Epidermophyton floccosum
C. Microsporum audouinii
Which of the following is a key characteristic of Coccidioides immitis?
A. Has a higher dissemination rate in white females
B. Is endemic in the northeastern United States
C. Produces endosporulating spherules in tissue
D. Forms foot cells
C. Produces endosporulating spherules in tissue
A landscaper noticed a hard, unmovable lump under the skin of his index finger but decided to ignore it. A month later, the lump ulcerated to present a necrotic appearance, and two more lesions developed further up the wrist and forearm.
* A histologic stain of material from deep in the lesions showed elongated yeast cells resembling cigars.
What disease is suspected?
A. Mycetoma
B. Sporotrichosis
C. Chromoblastomycosis
D. Blastomycosis
B. Sporotrichosis
Trophozoite forms of amoebae are found in what type of stool specimen?
A. Formed
B. Loose
C. Soft
D. Watery
D. Watery
Ova recovered from the stool are routinely used to diagnose infections caused by all of the following except?
A. Necator americanus
B. Ascaris lubricoides
C. Trichuris trichiura
D. Strongyloides stercoralis
D. Strongyloides stercoralis
The test of choice and most sensitive assay for use with CSF to diagnose aseptic meningitis caused by enterovirus is which of the following?
A. Cell culture
B. PCR
C. Antigenemia immunoassay
D. Shell vial assay
B. PCR
Which of the following is the specimen of choice for detecting rotavirus?
A. Throat swab
B. Urine sample
C. Bronchoalveolar wash
D. Feces sample
D. Feces sample
Necator americanus rhabditiform larvae can be differentiated from Strongyloides stercoralis rhabditiform larvae by:
A. Length of the notched tail
B. Length of the head region
C. Segmentation
D. Size of the genital primordium
D. Size of the genital primordium
The only known human tapeworm with an operculum is:
A. Diphyllobothrium latum
B. Hymenolepis nana
C. Giardia lamblia
D. Schistosoma haematobium
A. Diphyllobothrium latum
Container for stool culture:
A. Stuart’s medium
B. Amies medium
C. Sterile, screw capped container
D. Clean, leakproof container
D. Clean, leakproof container
A gram-negative diplococcus isolated from a patient’s CSF specimen gives the following results:
Additional characteristics of this organism include:
Chocolate agar: Growth
SBA: Growth
Oxidase: Positive
CTA test:
* Glucose, yellow
* Maltose, yellow
* Lactose, red
* Sucrose, red
This organism is most likely which of the following?
A. N. meningitidis
B. N. gonorrhoeae
C. N. lactamica
D. M. catarrhalis
A. N. meningitidis
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
D. Acetone/ethanol
______ protect from viral infection by recognizing and destroying infected cells and ______ protect us indirectly by producing cytokines to stimulate B cells.
A. CD4+ cytotoxic T lymphocytes; CD8+ T helper lymphocytes
B. CD8+ cytotoxic T lymphocytes; CD4+ T helper lymphocytes
C. NK cells; CD8 + T helper lymphocytes
D. NK cells; CD4 + cytotoxic T lymphocytes
B. CD8+ cytotoxic T lymphocytes; CD4+ T helper lymphocytes
Features used in identifying Cryptococcus neoformans should include which of the following?
A. Capsule formation, mucoid, creamy-white to yellow colonies, urea positive
B. No capsule formation, produces mycelial forms, urea positive
C. Capsule formation, mucoid, creamy-white to yellow colonies, urea negative
D. No capsule formation, budding yeast cells, mucoid, creamy-white colonies, partially acid-fast
A. Capsule formation, mucoid, creamy-white to yellow colonies, urea positive
Most commonly encountered autoimmune hemolytic anemia:
A. Drug-induced AIHA
B. Cold AIHA
C. Warm AIHA
D. Mixed-type AIHA
C. Warm AIHA
The L-pyrolidonyl-b-naphthylamide (PYR) hydrolysis test is a presumptive test for which of the following streptococci?
A. Groups A and B
B. Streptococcus pneumoniae and group C
C. Group A and Enterococcus
D. Group A and Streptococcus bovis
C. Group A and Enterococcus
Adult location of S. japonicum:
A. Veins surrounding the bladder
B. Venules of the small intestines
C. Venules of large intestines
D. None of these
B. Venules of the small intestines
Adult location of S. mansoni:
A. Veins surrounding the bladder
B. Venules of the small intestines
C. Venules of large intestines
D. None of these
C. Venules of large intestines
Adult location of S. haematobium:
A. Veins surrounding the bladder
B. Venules of the small intestines
C. Venules of large intestines
D. None of these
A. Veins surrounding the bladder
It resembles egg of S. haematobium, but acid-fast positive:
A. Schistosoma japonicum
B. Schistosoma mansoni
C. Schistosoma intercalatum
D. Schistosoma mekongi
C. Schistosoma intercalatum
Babesia is an organism that has been implicated in disease from both splenectomized and nonsplenectomized patients. Morphologically, the parasites resemble:
A. Plasmodium falciparum rings
B. Leishmania donovani amastigotes
C. Trypanosoma cruzi trypomastigotes
D. Plasmodium vivax developing rings
E. Trypanosoma brucei gambiense trypomastigotes
A. Plasmodium falciparum rings
Plasmodium vivax and Plasmodium ovale are similar because they:
A. Exhibit Schüffner’s dots and have a true relapse in the life cycle
B. Have no malarial pigment and multiple rings
C. Commonly have appliqué forms in the red cells
D. Have true stippling, do not have a relapse stage, and infect old red cells
E. Have a 72-hour periodicity cycle in the RBCs
A. Exhibit Schüffner’s dots and have a true relapse in the life cycle
Eye infections with Acanthamoeba spp. have most commonly been traced to:
A. Use of soft contact lenses
B. Use of hard contact lenses
C. Use of contaminated lens care solutions
D. Failure to remove lenses while swimming
E. Dust in the eyes
C. Use of contaminated lens care solutions
Which of the following roundworms is capable of autoinfection, hyperinfection, and a heavy worm burden with characteristic larval migration required in the life cycle?
A. Ancylostoma duodenale
B. Enterobius vermicularis
C. Strongyloides stercoralis
D. Ascaris lumbricoides
C. Strongyloides stercoralis
Which tapeworm cannot be identified to the species level based on its egg morphology; instead, proglottids must be examined?
A. Diphyllobothrium
B. Dipylidium
C. Hymenolepis
D. Taenia
D. Taenia
Infection with Clonorchis or Opisthorchis may result from eating raw or undercooked:
A. Aquatic vegetation
B. Crabs
C. Crayfish
D. Freshwater fish
D. Freshwater fish
Most of the pathology associated with parasitic infections results from which of the following?
A.Symbiotic relationships with the host
B.Elaborate parasitic life cycles
C.Immune response to the offending organism
D.Innate defense mechanisms of the host
C.Immune response to the offending organism
The chronic nature of parasitic infections is caused by the host’s
A.Inability to eliminate the infective agent
B.Type I hypersensitivity response to the infection
C.Ability to form a granuloma around the parasite
D.Tendency to form circulating immune complexes
A.Inability to eliminate the infective agent
Infective stage is the SHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis
B. Ancylostoma duodenale, Necator americanus
Infective stage is the UNSHEATHED FILARIFORM LARVA:
A. Strongyloides stercoralis
B. Ancylostoma duodenale, Necator americanus
C. Ascaris lumbricoides
D. Enterobius vermicularis
A. Strongyloides stercoralis
When undercooked meat is digested in the stomach, the larvae are resistant to the gastric pH and pass to the intestine, where they invade the mucosa:
A. Ancylostoma duodenale
B. Ascaris lumbricoides
C. Dracunculus medinesis
D. Trichinella spiralis
D. Trichinella spiralis
Symptoms and signs mimic those of TUBERCULOSIS, and should always be suspected in patients with tuberculosis who are non-responsive to treatment:
A. Ascaris lumbricoides
B. Necator americanus
C. Strongyloides stercoralis
D. Paragonimus westermani
D. Paragonimus westermani
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
D. Dracunculus medinensis
Which of the following are appropriate Ascaris lumbricoides prevention and control strategies?
A. Proper water treatment
B. Appropriate food handling
C. Use of insect repellent
D. Proper sanitation practices
D. Proper sanitation practices
This organism is associated with PRIMARY AMOEBIC MENINGOENCEPHALITIS (PAM):
A. Naegleria fowleri
B. Acanthamoeba sp.
C. Entamoeba histolytica
D. Giardia lamblia
A. Naegleria fowleri
This organism is associated with GRANULOMATOUS AMEBIC ENCEPHALITIS (GAE):
A. Entamoeba histolytica
B. Dientamoeba fragilis
C. Naegleria fowleri
D. Acanthamoeba sp.
D. Acanthamoeba sp.
Individuals become infected with G. intestinalis (G. lamblia) by which of the following?
A. Swimming in contaminated water
B. Ingesting contaminated food or drink
C. Inhalation of infective cysts
D. Walking barefoot on contaminated soil
B. Ingesting contaminated food or drink
One of the following protozoan organisms has been implicated in waterborne and foodborne outbreaks. The suspect organism is:
A. Pentatrichomonas hominis
B. Dientamoeba fragilis
C. Giardia lamblia
D. Balantidium coli
C. Giardia lamblia
Infection may mimic acute viral enteritis, bacillary dysentery, bacterial or other food poisoning, acute intestinal amebiasis, or “TRAVELER’S DIARRHEA” (ETEC). However, the type of diarrhea plus the lack of blood, mucus, and cellular exudate is consistent with:
A. Amebiasis
B. Ascariasis
C. Balantidiasis
D. Giardiasis
D. Giardiasis
Slowly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite
C. Bradyzoite
Rapidly multiplying trophozoite stage of Toxoplasma gondii:
A. Gametocyte
B. Sporozoite
C. Bradyzoite
D. Tachyzoite
D. Tachyzoite
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
D. In vitro hair penetration by T. mentagrophytes
Type of microscope that forms HALO of light around an object:
A. Bright-field
B. Dark-field microscope
C. Polarizing microscope
D. Phase-contrast
D. Phase-contrast
Three-dimensional images of high contrast and resolution are obtained, without haloing:
A. Bright-field microscopy
B. Polarizing microscopy
C. Phase-contrast microscopy
D. Interference contrast microscopy
D. Interference contrast microscopy
Most common type of microscopy performed in the urinalysis laboratory:
A. Bright-field microscopy
B. Phase-contrast microscopy
C. Polarizing microscopy
D. Interference-contrast microscope
A. Bright-field microscopy
Enhances visualization of elements with low refractive indices, such as hyaline casts, mixed cellular casts, mucous threads, and Trichomonas:
A. Bright-field microscopy
B. Phase-contrast microscopy
C. Polarizing microscopy
D. Interference-contrast microscope
B. Phase-contrast microscopy
Concentration of SSA in the cold precipitation method:
A. 1% sulfosalicylic acid
B. 3% sulfosalicylic acid
C. 5% sulfosalicylic acid
D. 10% sulfosalicylic acid
B. 3% sulfosalicylic acid
Albumin reagent strips utilizing the dye ________ has a higher sensitivity and specificity for albumin:
A. DIDNTB
B. TMB
C. DBDH
D. Tetrabromphenol blue
A. DIDNTB
Black color of Argyrol, an antiseptic, disappears with addition of:
A. Copper sulfate
B. Ferric chloride
C. Sodium nitroprusside
D. Trichloroacetic acid
B. Ferric chloride
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
B. Viscous and orange
Specimens containing _________ produce a yellow foam when shaken, which could be mistaken for bilirubin.
A. Phenazopyridine (Pyridium)
B. Phenindione
C. Methyldopa
D. Metronidazole (Flagyl)
A. Phenazopyridine (Pyridium)
Anticoagulant, orange in alkaline urine, colorless in acid urine.
A. Phenazopyridine (Pyridium)
B. Phenindione
C. Methyldopa
D. Metronidazole (Flagyl)
B. Phenindione
Phenol derivatives found in certain intravenous medications produce ______urine on oxidation.
A. Yellow
B. Orange
C. Green
D. Purple
C. Green
As a result of the brittle consistency of the cast matrix, they often appear fragmented with jagged ends and have notches in their sides. With supravital stains, these casts stain a homogenous, dark pink.
A. Hyaline
B. Cellular
C. Granular
D. Waxy
D. Waxy
Esterases also are present in which parasite?
A. Enterobius
B. Giardia
C. Schistosoma
D. Trichomonas
D. Trichomonas
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
B. 800 mL to 1,200 mL
Given the following laboratory results, what is the most likely cause for the patient’s condition:
Serum results
* BUN 35 mg/dL
* Creatinine 2 mg/dL
* Uric acid 9.5 mg/dL
Urine macroscopic results
* Glucose negative
* Blood positive
* WBCs negative
* pH 6
* Protein positive
* SSA 2+
Urine microscopic results
* 25 - 50 RBCs/hpf
* 0 - 2 WBCs/hpf
* 2 - 5 RBC casts
* 3 - 5 Hyaline casts
* 0 - 2 granular casts
* Few uric acid crystals
A. Gout
B. Glomerulonephritis
C. Pyelonephritis
D. Urinary tract infection
B. Glomerulonephritis
Calibration of centrifuges is customarily performed every ______.
A. Daily
B. Weekly
C. Every 3 months (quarterly)
D. Annually
C. Every 3 months (quarterly)
Centrifuges are routinely disinfected on a ___ basis.
A. Daily
B. Weekly
C. Monthly
D. Yearly
B. Weekly
The physician is concerned that a pregnant patient may be at risk for delivering prematurely. What would be the best biochemical marker to measure to assess the situation?
A. Inhibin A
B. Alpha1-Fetoprotein
C. Fetal fibronectin
D. Human chorionic gonadotropin
C. Fetal fibronectin
Reporting for squamous epithelial cells:
A. Rare, few, moderate or many per hpf
B. Rare, few, moderate or many per lpf
C. Average number per 10 hpf
D. Present, based on laboratory protocol
B. Rare, few, moderate or many per lpf
Reporting for transitional cells:
A. Rare, few, moderate or many per hpf
B. Rare, few, moderate or many per lpf
C. Average number per 10 hpf
D. Present, based on laboratory protocol
A. Rare, few, moderate or many per hpf
Reporting for RTE cells:
A. Rare, few, moderate or many per hpf
B. Rare, few, moderate or many per lpf
C. Average number per 10 hpf
D. Present, based on laboratory protocol
C. Average number per 10 hpf
The presence of _____ increases the OD of the amniotic fluid. Specimens are centrifuged at 2,000 g for 10 minutes and examined using a wavelength of 650 nm.
A. Bilirubin
B. Oxyhemoglobin
C. Lamellar bodies
D. None of these
C. Lamellar bodies
Close wound:
A. Abrasion
B. Hematoma
C. Laceration
D. Puncture
B. Hematoma
Peak levels of this analyte typically occur around 0800 hours.
A. Bilirubin
B. Cortisol
C. Eosinophil
D. Glucose
B. Cortisol
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
D. Cyanide
Oocysts of Cryptosporidium spp. can be detected in stool specimens using:
A. Modified Ziehl–Neelsen acid-fast stain
B. Gram stain
C. Methenamine silver stain
D. Trichrome stain
A. Modified Ziehl–Neelsen acid-fast stain
Which combination best describes a Gaussian (normal) distribution?
A. Median > mode
B. Mean = median = mode
C. Median > mean
D. Mode > mean
B. Mean = median = mode
A tumor marker for the diagnosis of urinary bladder cancer:
A. CA 19-9
B. HER-2/neu
C. Calcitonin
D. NMP
D. NMP
Nonmotile, non-spore-forming, obligate aerobe, acid-fast bacillus that often appears beaded or unstained using Gram stain; it is distinguished by its ability to form stable mycolate complexes with arylmethane dyes (carbolfuchsin, auramine, and rhodamine):
A. Streptococcus pneumoniae
B. Neisseria meningitidis
C. Hemophilus influenzae
D. Mycobacterium tuberculosis
D. Mycobacterium tuberculosis
Elevated in bronchoalveolar lavage of cigarette smokers, and in cases of bronchopneumonia, toxin exposure, and diffuse alveolar damage:
A. Neutrophils
B. Eosinophils
C. Marcophages
D. Mast cells
A. Neutrophils
An elevated urine urobilinogen and a negative test for urine bilirubin may indicated which of the following conditions?
A. Acute hepatic toxicity
B. Biliary obstruction
C. Hemolytic disease
D. Urinary tract infection
C. Hemolytic disease
An L/S ratio of 2.7 indicates:
A. Fetal distress
B. Fetal lung maturity
C. Fetal red cell destruction
D. Inadequate fetal pulmonary surfactants
B. Fetal lung maturity
Calcium pyrophosphate (pseudogout) in synovial fluid:
1. Needles
2. Rhomboid square, rods
3. Negative birefringence under compensated polarized light
4. Positive birefringence under compensated polarized light
A. 1 and 3
B. 1 and 4
C. 2 and 3
D. 2 and 4
D. 2 and 4
Bence Jones protein precipitates at temperatures between ___ , and redissolves at near ___ ° C.
A. Precipitates at 100 to 120C, and redissolves at 60C
B. Precipitates at 10 to 20C, and redissolves at 100C
C. Precipitates at 80 to 100C, and redissolves at 60C
D. Precipitates at 40 to 60C, and redissolves at 100C
D. Precipitates at 40 to 60C, and redissolves at 100C
Hoesch reagent consists of:
A. Ehrlich’s reagent in 3M HCl
B. Ehrlich’s reagent in 6M HCl
C. Ehrlich’s reagent in 3M NaOH
D. Ehrlich’s reagent in 6M NaOH
B. Ehrlich’s reagent in 6M HCl
Quadrate scolex with 4 suckers; no rostellum or hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta
B. T. saginata
Quadrate scolex with 4 suckers; has rostellum and hooklets:
A. D. latum
B. T. saginata
C. T. solium
D. H. diminuta
C. T. solium
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
B. Use the other arm
EDTA is used in concentrations of __ of blood.
A. 0.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
C. 2.5 mg/1 mL of whole blood
D. 3.5 mg/1 mL of whole blood
B. 1.5 mg/1 mL of whole blood
Sodium citrate in the concentration of a _____ solution has been adopted as the appropriate concentration by the ICSH and the International Society for Thrombosis and Hemostasis for coagulation studies.
A. 1.5%
B. 15%
C. 3.2%
D. 3.8%
C. 3.2%
Heparin is added ____ per mL of blood in each test tube.
A. 0.2 mcg per mL
B. 2.0 mcg per mL
C. 0.2 mg per mL
D. 2 mg per mL
C. 0.2 mg per mL
When measuring trace metals in blood other than lead, what type of tube should be used?
A. Navy blue top
B. Green top
C. Purple top
D. Red top
A. Navy blue top
Which of the ff. makes Mannitol Salt Agar (MSA) selective?
A.Mannitol
B.Phenol red
C.Neutral red
D. Sodium chloride
D. Sodium chloride
Stem cells are present in the first few hours after an ovum is fertilized; most versatile type of stem cell:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. Any of these
C. Totipotential stem cells
Stem cells can develop into any cell type, except they cannot develop into a fetus:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. None of these
B. Pluripotential stem cells
Stem cells that can be found in adults, but they are limited to specific types of cells to form tissues:
A. Multipotential stem cells
B. Pluripotential stem cells
C. Totipotential stem cells
D. None of these
A. Multipotential stem cells
Smallest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
D. Wiskott-Aldrich syndrome
Largest platelets seen:
A. Alport syndrome
B. Bernard-Soulier syndrome
C. May-Hegglin anomaly
D. Wiskott-Aldrich syndrome
B. Bernard-Soulier syndrome
Platelet adhesion defect:
A. Bernard-Soulier syndrome
B. Essential athrombia
C. Afibrinogenemia
D. Glanzmann thrombasthenia
A. Bernard-Soulier syndrome
Primary platelet aggregation defect(s):
1. Bernard-Soulier syndrome
2. Essential athrombia
3. Afibrinogenemia
4. Glanzmann thrombasthenia
A. 1 and 3
B. 2 and 4
C. 1, 2 and 3
D. Only 4
B. 2 and 4
Upon stimulation, platelets change in shape from discoid to _____, extend pseudopods, undergo internal contraction resulting in centralization of their alpha granules and dense granules, and release the granule contents.
A. Cylindrical
B. Irregular
C. Oval
D. Spherical
D. Spherical
RBC with membrane folded over:
A. Aplastic anemia
B. Iron deficiency anemia
C. Hemoglobin C, hemoglobin SC disease
D. Sickle cell anemia, thalassemia
C. Hemoglobin C, hemoglobin SC disease
Which hemoglobin contains four gamma chains and has an extremely high affinity for oxygen?
A. Hb H
B. Hb Bart’s
C. Hb Portland
D. Hb Gower 1
B. Hb Bart’s
The phosphotungstic acid hematoxylin (PTAH) is useful for demonstrating:
A. Edema fluid
B. Muscle striations
C. Ground substance
D. Reticulin network
B. Muscle striations
Warthin-Starry method:
A. Mycobacterium
B. Nocardia
C. Spirochetes
D. None of these
C. Spirochetes
What is the most sensitive lipid stain?
A. Oil red O
B. Sudan III
C. Sudan IV
D. Sudan Black B
D. Sudan Black B
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
C. Faster for one or a few individual sections
First step in automated tissue processor:
A. Cold formalin
B. Hot formalin
C. Cold ethanol
D. Hot ethanol
B. Hot formalin
The cell selected for chromosome analysis is usually in the ____ stage of cellular division.
A. Prophase
B. Metaphase
C. Telophase
D. Anaphase
B. Metaphase
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
A. 2.0 mm
Phlebotomy complications including diaphoresis, seizure, pain, and nerve damage:
A. Cardiovascular complications
B. Vascular complications
C. Neurological complications
D. Infections
C. Neurological complications
Target INR for pulmonary embolism (PE) treatment:
A. 1.0
B. 2.0
C. 3.0
D. 4.0
C. 3.0
Solid tumor counterpart of plasma cell leukemia:
A. Lymphoma well-differentiated
B. Lymphoma, undifferentiated
C. Lymphoma, poorly differentiated
D. Reticulum cell sarcoma
E. Myeloma
E. Myeloma
INR range recommended for most indications (e.g., treatment or prophylaxis of deep venous thrombosis [DVT], or prevention of further clotting in patients who have had a myocardial infarction):
A. 1.0 to 1.5
B. 1.5 to 2.0
C. 2.0 to 3.0
D. 2.5 to 3.5
C. 2.0 to 3.0
INR recommended for patients with prosthetic heart valves:
A. 1.0 to 1.5
B. 1.5 to 2.0
C. 2.0 to 3.0
D. 2.5 to 3.5
D. 2.5 to 3.5
The target INR for pulmonary embolism (PE) treatment is ____ for the duration of anticoagulation.
A. 1.0
B. 2.0
C. 2.5
D. 3.0
D. 3.0
Typically the size of a small lymphocyte and has a dark-staining, clumped, nuclear chromatin pattern; the distinctive folded, groove-like chromatin pattern is described as cerebriform.
A. Hairy cell
B. Sezary cell
C. Mott cell
D. Reed-Sternberg cell
B. Sezary cell
Maintains cellular energy by generating ATP:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway
D. Embden-Meyerhof pathway
Regulates oxygen affinity of hemoglobin:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway
C. Luebering-Rapaport pathway
Prevents oxidation of heme iron:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway
A. Methemoglobin reductase pathway
Prevents denaturation of globin of the hemoglobin molecule:
A. Methemoglobin reductase pathway
B. Hexose monophosphate shunt
C. Luebering-Rapaport pathway
D. Embden-Meyerhof pathway
B. Hexose monophosphate shunt
Most frequently implicated infected body fluid in HIV and HBV exposure in the workplace:
A. Saliva
B. Blood
C. Urine
D. Seminal fluid
B. Blood
Solid tumor counterpart of monocytic leukemia:
A. Lymphoma well-differentiated
B. Lymphoma, undifferentiated
C. Lymphoma, poorly differentiated
D. Reticulum cell sarcoma
E. Myeloma
D. Reticulum cell sarcoma
The heme portion of the hemoglobin molecule consists of ____ iron (Fe2+) atom and ____ pyrrole rings that are joined to each other.
A. 4 iron atoms, 4 pyrrole rings
B. 1 iron atom, 2 pyrrole rings
C. 1 iron atom, 4 pyrrole rings
D. 4 iron atoms, 4 pyrrole rings
C. 1 iron atom, 4 pyrrole rings
Preanalytical (pre-examination) errors, except:
A. Blood specimens collected in the wrong order
B. Incorrect labeling of specimen
C. Improper processing of specimen
D. Wrong assay performed
D. Wrong assay performed
Once the metamyelocyte stage has been reached, cells have undergone ______ cell divisions and the proliferative phase comes to an end.
A. 1 or 2 cell divisions
B. 2 or 3 cell divisions
C. 3 or 4 cell divisions
D. 4 or 5 cell divisions
D. 4 or 5 cell divisions
Clinical signs and symptoms commonly include low birth weight (<2,500 g), skin hyperpigmentation (café au lait spots), and short stature. Other manifestations can include skeletal disorders (aplasia or hypoplasia of the thumb), renal malformations, microcephaly, hypogonadism, mental retardation, and strabismus.
A. Diamond Blackfan anemia
B. Iron deficiency anemia
C. Fanconi anemia
D. Sideroblastic anemia
C. Fanconi anemia
Cardiovascular complications of phlebotomy:
1. Cardiac arrest
2. Hypotension
3. Syncope
4. Shock
A. 1 and 2
B. 1 and 3
C. 1, 2 and 3
D. 1, 2, 3 and 4
D. 1, 2, 3 and 4
In general, cytoplasmic color in younger cells:
A. Pink
B. Red
C. Dark blue
D. Light blue
C. Dark blue
Aldosterone is involved in the reabsorption of:
A. Potassium
B. Sodium
C. Bicarbonate
D. Hydrogen ion
B. Sodium
Refractive index compares the velocity of light in urine to the velocity of light in:
A. Air
B. Oil
C. Saline
D. Water
A. Air
