PRACTICE Flashcards
- In the tolbutamide tolerance test, blood specimens are obtained for glucose and insulin before ________ of 1 g of a water-soluble form of tolbutamide and at 2, 15, 30, 60, 90, and 120 minutes afterwards.
a. Oral administration
b. Intramuscular injection
c. Intravenous injection
d. Sublingual administration
C
- Current NCEP guidelines recommend patients be seated for how many minutes before sampling for cholesterol to prevent hemoconcentration:
a. 5 minutes
b. 10 minutes
c. 15 minutes
d. 20 minutes
A
- A hormone which regulates water reabsorption in the collecting duct:
a. Aldosterone
b. Antidiuretic hormone
c. Growth hormone
d. Prolactin
B
- A system that stimulates water reabsorption by the collecting duct:
a. ADH
b. RAAS
c. Growth hormone
d. Thyroid hormone
B
- Most potent estrogen:
a. Estrone
b. Estradiol
c. Estriol
d. Testosterone
B
- Which of the following is the most potent androgen?
a. Androstenedione
b. Dehydroepiandrosterone
c. Androsterone
d. Testosterone
D
- 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
- Urine solute exhibiting diurnal variation:
a. Creatinine
b. Glucose
c. Nitrite
d. 17-hydroxysteroids
D
- Blood specimen for the creatinine clearance is collected:
a. At the start of the urine collection period
b. At the end of the urine collection period
c. At about 12 hours into urine collection period
d. Any time during the urine collection period
C
- Reflectance photometry uses the principle that light reflection from the test pads _________ in proportion to the intensity of color produced by the concentration of the test substance.
a. Increases
b. Decreases
c. Variable
d. Undetermined
B
- Black pleural fluid:
a. Hemothorax
b. Chylous material from thoracic duct leakage
c. Rupture of amoebic liver abscess
d. Aspergillus infection
D
- Possible cause of bulky or frothy stool:
a. Lower GI bleeding
b. Upper GI bleeding
c. Intestinal constriction
d. Pancreatic disorder
D
- Standard precautions state:
a. Handle only known HBV-positive or HIV-positive specimens as infectious
b. Personal protective equipment is required for only direct patient contact
c. Blood and body fluid precautions must be observed for all patients’ blood and body fluid specimens
d. Infectious specimens must be labeled with the biohazard symbol
C
- The Biosafety Level that includes most common laboratory microorganisms and involves organisms such as HBV, HIV and enteric pathogens is:
a. BSL 1
b. BSL 2
c. BSL 3
d. BSL 4
B
- A listless 12-month-old boy with a fever of 103°F was taken to the emergency department. He had been diagnosed with an ear infection 3 days earlier. A spinal tap was performed, but only one tube of CSF was obtained from the lumbar puncture. The single tube of CSF should be submitted first to which department?
a. Chemistry
b. Microbiology
c. Hematology
d. Cytology/Histology
B
- Brown or green color surrounding the colony:
a. Alpha hemolysis
b. Beta hemolysis
c. Gamma hemolysis
d. Alpha prime hemolysis
A
- Chocolate agar contains:
a. Chocolate
b. Clotted blood
c. Brown nutrient agar
d. Hemolyzed red blood cell
D
- All of the following are differential media except:
a. Blood agar
b. Chocolate agar
c. MacConkey’s agar
d. Eosin methylene blue agar
B
- Addition of egg yolk to nutritive media:
a. Basal medium
b. Enriched medium
c. Enrichment medium
d. Selective medium
B
- Inhibitor of Mannitol Salt Agar:
a. Mannitol
b. Phenol red
c. Neutral red
d. Sodium chloride
D
- Salmonella-Shigella (SS) Agar is a modification of:
a. BAP
b. CAP
c. DCA
d. EMB
C
- Which method is most useful for confirmation that a culture isolate is Group B streptococcus?
a. Southern blotting
b. Polymerase chain reaction
c. Direct hybridization
d. Probe capture assay
C
- 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
- A large, aerobic, beta-hemolytic, gram-positive rod is isolated from an eye culture. Subsequent testing reveals it is motile and produces a wide zone on egg yolk agar. The most likely identification of this organism is:
a. Bacillus anthracis
b. Escherichia coli
c. Bacillus cereus
d. Clostridium perfringens
C
- Definitive host of Taenia saginata:
a. Cattle
b. Pig
c. Dog
d. Man
D
- In infections with Taenia solium, humans can serve as the:
a. Definitive host
b. Intermediate host
c. Either the definitive or the intermediate host
d. None of these options
C
- It is more frequent in populations living in conditions of poverty or poor hygiene, in day care centers, and in persons living in institutional settings or prisons.
a. Diphyllobothrium latum
b. Hymenolepis nana
c. Taenia saginata
d. Taenia solium
B
- Skin pH that keeps most microorganisms from growing:
a. 5.6
b. 6.5
c. 7.2
d. 8.0
A
- Which cell is the most potent phagocytic cell in tissue and the most effective at antigen presentation?
a. Neutrophil
b. Dendritic cell
c. Eosinophil
d. Basophil
B
- It is used to treat hepatitis C and Kaposi’s sarcoma, as well as certain leukemias and lymphomas:
a. TNF-alpha
b. TNF-beta
c. IFN-alpha
d. IFN-beta
C
- IgA in serum:
a. Monomer
b. Dimer
c. Pentamer
d. None of these
A
- IgA in secretions:
a. Monomer
b. Dimer
c. Pentamer
d. None of these
B
- A single ASO titer is considered to be moderately elevated if the titer is at least ___ Todd units in an adult:
a. 166
b. 200
c. 240
d. 320
C
- A single ASO titer is considered to be moderately elevated if the titer is at least ____ Todd units in a child:
a. 166
b. 200
c. 240
d. 320
D
- This disease was endemic in Haiti and was subsequently contracted and CARRIED TO EUROPE by COLUMBUS CREW:
a. Gonorrhea
b. Syphilis
c. HIV
d. Tuberculosis
B
- Which of the following serologic tests detects the polysaccharide capsule ANTIGEN in serum and CSF of patients with suspected infection with Cryptococcus neoformans?
a. Complement fixation
b. India ink test
c. Latex agglutination
d. Hemagglutination test
C
- LATEX AGGLUTINATION for cryptococcal _____ is now recommended test for Cryptococcus neoformans.
a. Polysaccharide capsule
b. Antigen
c. Antibody
d. Nucleic acids
B
- T in TORCH:
a. T cells
b. Terminal
c. Toxoplasmosis
d. Trichinosis
C
- Humans have _____ chromosomes.
a. 2
b. 22
c. 23
d. 46
D
- Humans have how many pairs of autosomes?
a. 22
b. 23
c. 44
d. 46
A
- 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
- Stem cells present several days after fertilization, may develop into any cell type except they cannot develop into fetus:
a. Multipotential stem cells
b. Pluripotential stem cells
c. Totipotential stem cells
d. Any of these
B
- Stem cells 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. Any of these
A
- A unit of packed cells is split into 2 aliquots under closed sterile conditions at 8 AM. The expiration time for each aliquot is now:
a. 4 PM on the same day
b. 8 PM on the same day
c. AM the next morning
d. The original date of the unsplit unit
D
- What would be the result of group A blood given to an O patient?
a. Nonimmune transfusion reaction
b. Immediate hemolytic transfusion reaction
c. Delayed hemolytic transfusion reaction
d. Febrile nonhemolytic transfusion reaction
B
- Conduct of practice is lacking in due care:
a. Negligence
b. Malpractice
c. Carelessness
d. Unprofessionalism
A
- Sentinel event:
a. Insufficient specimen
b. Positive blood culture
c. Wrong medication
d. Surgery on wrong patient or body part
D
- The polymerase chain reaction (PCR) involves three processes. Select the order in which these occur.
a. Extension → Annealing → Denaturation
b. Annealing → Denaturation → Extension
c. Denaturation → Annealing → Extension
d. Denaturation → Extension → Annealing
C
- In the PCR cycle, how is denaturation accomplished?
a. Heat
b. Alkali treatment
c. Addition of sulfonylurea
d. Formamide
A
- What is the unique characteristic of the DNA polymerase, Taq DNA polymerase, used in PCR?
a. It can be enzyme labeled
b. It is more efficient than eukaryotic polymerases
c. It is heat stable
d. It works with DNA of any species
C
- In PCR testing, the initial step involves adding the DNA in question to a mixture of taq polymerase, excess nucleotides, MgCl2, and primers. This mixture is placed in which of the following instruments to allow the amplification to take place?
a. Flow cytometer
b. Capillary array sequencer
c. Thermal cycler
d. Electrophoresis chamber
C
Factor to convert immunoglobulin value from mg/dL to g/L
0.01
Immunoglobulin conversion factors:
mg/dL to g/L: 0.01
mg/dL to mg/L: 10
A substance that yield hydrogen or hydronium ion when dissolved in water:
A substance that can yield hydroxyl ions:
Combination of a weak acid or weak base; system that resists changes in pH:
‒ An ACID is a substance that can yield a HYDROGEN ion (H+) or
HYDRONIUM ion when dissolved in water.
‒ A BASE is a substance that can yield HYDROXYL ions (OH-).
‒ A BUFFER, the combination of a weak acid or weak base and its salt, is
a system that resists changes in pH.
Heparin is added ____ per mL of blood in each test tube.
0.2 mg per Ml
Detection and quantification of the separated protein after electrophoresis is
accomplished by:
‒ Amperometry
‒ Chromatography
‒ Coulometry
‒ Densitometry
Densitometry
It transports protein for thyroxine and triiodothyronine (thyroid hormones); it
also binds with retinol-binding protein to form a complex that transports
retinol (vitamin A):
‒ Albumin
‒ Haptoglobin
‒ Orosomucoid
‒ Prealbumin
Prealbumin
A low ___ level is a sensitive marker of poor nutritional status.
‒ Ceruloplasmin
‒ Hemopexin
‒ Prealbumin
‒ Transferrin
Prealbumin
Major roles of ______ is to maintain the equilibrium of cholesterol in
peripheral cells by the REVERSE CHOLESTEROL TRANSPORT pathway:
‒ Chylomicrons
‒ LDL
‒ VLDL
‒ HDL
HDL
Abetalipoproteinemia is also known as:
‒ Anderson’s disease
‒ Bassen-Kornzweig syndrome
‒ Sitosterolemia
‒ Tangier disease
Bassen-Kornzweig syndrome
If left unprotected from light, bilirubin values may reduce by _____ per hour.
‒ 10 to 30%
‒ 30 to 50%
‒ 50 to 70%
‒ 70 to 90%
30 to 50%
Use of wetting agents or incorrect pH buffers ______ the amount of
unconjugated bilirubin:
‒ Decreases unconjugated bilirubin
‒ Increases unconjugated bilirubin
‒ Indeterminate
‒ No effect
Increases unconjugated bilirubin
ALP isoenzyme that will resist heat denaturation at 65°C for 30 minutes:
‒ Bone ALP
‒ Intestinal ALP
‒ Liver ALP
‒ Placental ALP
Placental ALP
Given the following results: ALP: marked increased; AST: slight increased;
ALT: slight increased; and GGT: marked increased. This is most consistent
with:
‒ Acute hepatitis
‒ Osteitis fibrosa
‒ Chronic hepatitis
‒ Obstructive jaundice
Obstructive jaundice
A physician orders several laboratory tests on a 55-year-old male patient who
is complaining of pain, stiffness, fatigue and headaches. Based on the
following serum test results, what is the most likely diagnosis? ALP:
significantly increased; GGT: normal
‒ Biliary obstruction
‒ Cirrhosis
‒ Hepatitis
‒ Osteitis deformans (Paget disease)
Osteitis deformans (Paget disease)
A 42-year-old male presents with anorexia, nausea, fever, and icterus of the
skin and mucous membranes. He noticed that his urine had appeared dark
for the past several days. The physician orders a series of biochemical tests.
Based on the following test results, what is the most likely diagnosis? ALP:
slightly elevated; ALT: markedly elevated; AST: markedly elevated; GGT:
slightly elevated; Serum total bilirubin: moderately elevated; Urine bilirubin:
positive; and Fecal urobilinogen: decreased
‒ Acute hepatitis
‒ Alcoholic cirrhosis
‒ Metastatic carcinoma of the pancreas
‒ Obstructive jaundice
Acute hepatitis
Assay methods for AST are generally based on the principle of the Karmen
method, which incorporates a coupled enzymatic reaction using:
‒ Glutamic oxaloacetic transaminase
‒ Glutamic pyruvic transaminase
‒ Lactate dehydrogenase
‒ Malate dehydrogenase
Malate dehydrogenase
The typical assay procedure for ALT consists of a coupled enzymatic reaction
using ____ as the indicator enzyme.
‒ Glutamic oxaloacetic transaminase
‒ Glutamic pyruvic transaminase
‒ Lactate dehydrogenase
‒ Malate dehydrogenase
Lactate dehydrogenase
LOW LEVELS of maternal AFP indicate an increased risk for:
‒ Anencephaly
‒ Down syndrome
‒ Presence of twins
‒ Spina bifida
Down syndrome
‒ Conditions associated with an elevated AFP level include spina bifida,
neural tube defects, abdominal wall defects, anencephaly (absence of
the major portion of the brain), and general fetal distress.
‒ Low levels of maternal AFP indicate an increased risk for Down
syndrome and trisomy 18, while it is increased in the presence of twins
and neural tube defects.
Which set of results is consistent with uncompensated metabolic acidosis?
‒ pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg
‒ pH 7.30 HCO3- 16 mmol/L pCO2 28 mm Hg
‒ pH 7.45 HCO3- 22 mmol/L pCO2 40 mm Hg
‒ pH 7.40 HCO3- 25 mmol/L pCO2 40 mm Hg
pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg
Hirsutism, which can be quantified using a measurement technique known as
the:
‒ Ferriman-Gallwey scale
‒ Liley graph
‒ T-score
‒ Z-score
Ferriman-Gallwey scale
Decreased T3 and T4, increased TSH:
‒ Primary hypothyroidism
‒ Secondary hypothyroidism
‒ Primary hyperthyroidism
‒ Secondary hyperthyroidism
Primary hypothyroidism
Fluorophore-labeled thyroxine competes with patient thyroxine for antibody
in homogeneous system. Antibody-bound labeled thyroxine rotates slowly,
emitting lower energy light.
‒ Fluorescent polarization immunoassay (FPIA)
‒ Fluorescent substrate-labeled inhibition immunoassay
‒ Chemiluminescence
‒ Microparticle enzyme immunoassay (MEIA)
Fluorescent polarization immunoassay (FPIA)
Fluorogenic substrate–labeled thyroxine competing with patient T4 for
antibody in a homogeneous assay. Only unbound, leftover labeled T4 reacts
with enzyme to form fluorescent product.
‒ Fluorescent polarization immunoassay (FPIA)
‒ Fluorescent substrate-labeled inhibition immunoassay
‒ Chemiluminescence
‒ Microparticle enzyme immunoassay (MEIA)
Fluorescent substrate-labeled inhibition immunoassay
The half-life of the circulating cocaine is: (Bishop)
‒ 0.5 to 1 hour
‒ 1 to 2 hours
‒ 2 to 3 hours
‒ 3 to 4 hours
0.5 to 1 hour
Water that is suitable for human consumption (i.e., water that can be used
for drinking or cooking):
‒ Boiled water
‒ Distilled water
‒ Filtered water
‒ Potable water
Potable water
In the laboratory, a program that monitors the TOTAL TESTING PROCESS with
the aim of providing the highest quality patient care:
‒ Quality assessment/assurance (QA)
‒ Quality control (QC)
‒ Quality systems (QS)
‒ None of these
Quality assessment/assurance (QA)
In an institution, a COMPREHENSIVE PROGRAM in which all areas of
operation are monitored to ensure quality with the aim of providing the
highest quality patient care:
‒ Quality assessment
‒ Quality assurance
‒ Quality control
‒ Quality systems
Quality systems
The methodology for a Lean Six Sigma quality improvement team will include
consideration of all of the following factors EXCEPT:
‒ Define
‒ Measure
‒ Analyze
‒ Improve
‒ Communicate
Communicate
Project team members:
‒ Black belts
‒ Green belts
‒ Blue belts
‒ White belts
Green belts
‒ The three most common team roles are the project coaches/leaders
(black belts), project team members (green belts), and project sponsors
(blue belts).
Green belts contribute ____ of their time to improvement projects while
delivering their normal job functions.
‒ 20%
‒ 40%
‒ 60%
‒ 100%
20%
‒ Black belts dedicate 100% of their time to quality improvement
projects, proactively addressing process and quality problems.
‒ Green belts contribute 20% of their time to improvement projects while
delivering their normal job functions.
Most effective at reducing hazards:
‒ PPE
‒ Administrative controls
‒ Engineering controls
‒ Substitution
‒ Elimination
Elimination
In the hierarchy of controls, arrange the following from the least effective to the most effective:
PPE, administrative controls, engineering controls, substitution, elimination
Duplication of DNA:
Synthesis of RNA from a DNA template:
Synthesis of protein:
‒ Replication
‒ Transcription
‒ Translation
Which one of the following specimen requests is acceptable?
‒ Feces submitted for anaerobic culture
‒ Foley catheter tip submitted for aerobic culture
‒ Rectal swab submitted for direct smear for gonococci
‒ Urine for culture of acid-fast bacilli
Urine for culture of acid-fast bacilli
Which of the following is the most appropriate method for collecting a urine
specimen from a patient with an indwelling catheter?
‒ Remove the catheter, cut the tip, and submit it for culture
‒ Disconnect the catheter from the bag, and collect urine from the
terminal end of the catheter
‒ Collect urine directly from the bag
‒ Aspirate urine aseptically from the catheter tubing
Aspirate urine aseptically from the catheter tubing
In thioglycolate broth, strictly aerobic organisms:
‒ Grow throughout the broth
‒ Grow toward the top of the broth
‒ Grow in the bottom of the broth
‒ Demonstrate flocculation
Grow toward the top of the broth
In thioglycollate broth, these organisms will grow slightly below the surface
where oxygen concentrations are lower than atmospheric concentrations:
‒ Obligate aerobes
‒ Obligate anaerobes
‒ Facultative anaerobes
‒ Microareophilic organisms
Microareophilic organisms
Susceptibility testing performed on quality control organisms using a new
media lot number yielded zone sizes that were too large for all antibiotics
tested. The testing was repeated using media from a previously used lot
number, and all zone sizes were acceptable. Which of the following best
explains the unacceptable zone sizes?
‒ The antibiotic disks were not stored with the proper desiccant
‒ The depth of the media was too thick
‒ The depth of the media was too thin
‒ The antibiotic disks were not properly applied to the media
The depth of the media was too thin
After satisfactory performance of daily disk diffusion susceptibility quality
control is documented, the frequency of quality control can be reduced to:
‒ Twice a week
‒ Every week
‒ Every other week
‒ Every month
Every week
An isolate of Staphylococcus aureus was cultured from an ulcer obtained
from the leg of a diabetic 79-year-old female patient. The organism showed
resistance to methicillin. Additionally, this isolate should be tested for
resistance or susceptibility to:
‒ Erythromycin
‒ Gentamicin
‒ Vancomycin
‒ Kanamycin
Vancomycin
Which test is used for the determination of inducible clindamycin resistance
in staphylococci and streptococci?
‒ E-test
‒ D-zone test
‒ A-test
‒ CAMP test
D-zone test
Even though clindamycin and erythromycin are in different classes, the mechanisms of resistance are similar. The presence of erythromycin can induce clindamycin resistance. The D-zone test is used to detect the presence of this inducible resistance
The D-zone susceptibility test is used to test inducible resistance on S. aureus
strains demonstrating an initial antibiotic susceptibility profile of:
‒ Erythromycin sensitive, clindamycin sensitive
‒ Erythromycin resistant, clindamycin sensitive
‒ Erythromycin resistant, clindamycin resistant
‒ Erythromycin sensitive, clindamycin resistant
Erythromycin sensitive, clindamycin resistant
Resistance to clindamycin can be induced in vitro by:
‒ Ampicillin
‒ Erythromycin
‒ Gentamicin
‒ Penicillin
Erythromycin
Greater than 100,000 CFU/mL of a gram-negative bacilli were isolated on MacConkey from a urine specimen. Biochemical results are as follows:
Glucose: acid, gas produced; Indole: negative; urea: positive; H2S: positive. The organism is most likely:
‒ Morganella morganii
‒ Proteus vulgaris
‒ Proteus mirabilis
‒ Providencia stuartii
Proteus mirabilis
A 64-year-old male with lymphoma has a positive blood culture at 18 hours incubation. The organism is a non-lactose fermenting gram-negative bacillus on MacConkey agar. Further testing gives the following reactions: oxidase: negative; motility: positive; TSI: alkaline/acid, no hydrogen sulfide; indole: positive; VP: positive; citrate: positive; urea: positive; phenylalanine deaminase: positive; ornithine decarboxylase: negative. The genus is:
‒ Morganella
‒ Proteus
‒ Providencia
‒ Serratia
Providencia
A community hospital microbiology laboratory is processing significant
numbers of stool cultures because of an outbreak of diarrhea following heavy
rains and flooding in the country. A media that should be incorporated in the
plating protocol is:
‒ Colistin nalidixic acid for Listeria
‒ MacConkey agar with sorbitol for Campylobacter
‒ Mannitol salt agar for Enterococcus species
‒ Thiosulfate citrate bile salts sucrose for Vibrio species
Thiosulfate citrate bile salts sucrose for Vibrio species