Practice Exam Flashcards
Identify the organism:
A. Penicillium
B. Blastoconidia
C. Sporothrix
D. Candida
A. Penicillium
Eosinophils in LAP (Leukocyte Alkaline Phosphatase) score:
A. Not counted
B. Double the value
C. Constant value
D. None of the above
A. Not counted
Eosinophils do not show alkaline phosphatase activity and must not be counted.
Prolonged apnea, anesthesized by succinylcholine, the enzyme responsible for the reaction is?
A. Cholinesterase
B. Aldolase
C. Pseudocholinesterase
D. AFP
C. Pseudocholinesterase
Pseudocholinesterase is a drug metabolizing enzyme responsible for hydrolysis of the muscle relaxant drugs succinylcholine and mivacurium. Deficiency from any cause can lead to prolonged apnea and paralysis following administration of succinylcholine and mivacurium.
These crystals are indicative of:
A. Liver disease
B. Nephrotic syndrome
C. Albuminuria
D. Normal
A. Liver disease
Tyrosine crystals appear as fine silky needles arranged in sheaves or bundles in acid urine. They are rarely present and may appear together with leucine and bilirubin crystals in liver disease.
The following results were obtained from a pure culture of gram negative rods recovered from the pulmonary secretions of a 10 year old cystic fibrosis patient with pneumonia:
Oxidase (+), Motility (+), Growth at 42C (+), Pigment = red (Nonfluorescent)
A. Pseudomonas aeruginosa
B. Burkholderia cepacia
C. Burkholderia pseudomallei
D. Pseudomonas stutzeri
A. Pseudomonas aeruginosa
P. aeruginosa is growing as a biofilm within the lungs of cystic fibrosis patients. In certain conditions, P. aeruginosa can secrete a variety of pigments, including pyocyanin (blue-green), pyoverdine (yellow-green and fluorescent), and pyorubin (red-brown). These can be used to identify the organism.
What to do?
Mother: Type “O”, Rh negative, no antibody to D Ag
Child: Type “O”, Rh positive
A. Transplacental transfusion
B. RhIg administration
C. Do nothing, report the results
D. DAT
B. RhIg administration
Rh immunoglobulin is a blood product that can stop your immune system from attacking Rh-positive cells. When an Rh incompatibility is identified, Rhogan will be given as a shot during week 28 of pregnancy.
(It will be given after chorionic villus sampling, amniocentesis, miscarriage, ectopic pregnancy, abortion, uterine bleeding, or any trauma during pregnancy that could leak some of the fetal cells over to you.)
Test for Paroxysmal Cold Hemoglobinuria (PCH):
A. Autohemolysis test
B. Donath-Landsteiner Test
C. Sucrose hemolysis test
D. NOTA
B. Donath-Landsteiner test
Normal = (-) hemolysis on test and control
PCH = (-) hemolysis on control but (+) hemolysis on test sample
In emphysema, the absence of alpha-1 globulin peak is due to the deficiency of:
A. A1-Antitrypsin (AAT)
B. Macroglobulin
C. Hemopexin
D. Transferrin
A. A1-Antitripsin (AAT)
Alpha-1 antitrysin deficiency is an inherited disorder that may cause lung disease and liver disease. Affected individuals often develop emphysema, which is a lung disease caused by damage to the small air sacs in the lungs (alveoli). Characteristic features of emphysema inlcude difficulty breathing, a hacking cough, and a barrel-shaped chest.
Which of the following pigments will deposit on urate and uric acid crystals to form a precipitate described as “brick dust”?
A. Urobilin
B. Bilirubin
C. Uroerythrin
D. Urochrome
C. Uroerythrin
Uroerythrin is a red pigment in the urine, where it is part of a group of yellow, brown, and red pigments generally designated as urochrome.
Mostly seen in urines that have been refrigerated, resulting in precipitation of amorphous urates.
Protein electrophoresis in pH 8.6. What proteins are closest to the cathode?
A. Albumin and Alpha 2
B. Albumin and Alpha 1
C. Beta and Gamma
D. NOTA
C. Beta and Gamma
Order of migration from Anode (+) to Cathode (-): Albumin, Alpha-1, Alpha-2, Beta, and Gamma
An ASO test can only be valid if the controls have yielded acceptable results. Which of the following indicates a valid ASO test?
A. Hemolysis in both SLO and red cell control
B. Positive control, hemolysis in all tubes
C. No hemolysis on SLO control
D. No hemolysis on red cell control
D. No hemolysis on red cell control
For an ASO tube test to be valid, the SLO control should show hemolysis and the RBC control tube should show no hemolysis.
SLO = Streptolysin O (toxin)
57% Hematocrit is normal in:
A. Male
B. 1 year old child
C. Newborn
D. Female
C. Newborn
Normal hematocrit value for a newborn is 45% to 61%.
Absorbs light and emits at longer wavelength:
A. Fluorometer
B. Nephelometer
C. AAS
D. TLC
A. Fluorometer
A fluorometer or fluorimeter is a device used to measure parameters of fluorescence: its intensity and wavelength distribution of emission spectrum after excitation by a certain spectrum of light. These parameters are used to identify the presence and amount of specific molecules in a medium. Modern fluorometers are capable of detecting fluorescent molecule concentrations as low as 1 part per trillion.
The reverse Camp test, lecithinase production, double zone hemolysis and gram stain morphology are all useful in the identification of:
A. Campylobacter jejuni
B. Staphylococcus aureus
C. Listeria monocytogenes
D. Clostridium perfringens
D. Clostridium perfringens
C. perfringens is a Gram-positive, rod-shaped, anaerobic, spore-forming pathogenic bacterium of the genus Clostridium. C. perfringens shows double-zone hemolysis on blood agar. Small area of beta hemolysis are noted (complete lysis of RBCs) surrounded by a larger zone of alpha hemolysis (partial hemolysis).
Causative agent of infectious Mononucleosis:
A. Cytomegalovirus
B. Epstein-Barr virus
C. Poxvirus
D. HPV
B. Epstein-Barr virus
EBV, also known as humna herpesvirus 4, is a member of the herpes virus family. It is one of the most common human viruses. EBV spreads most commonly through body fluids, primarily saliva. EBV can cause infectious mononucleosis (glandular fever), and other illnesses.
Anti-A = 4+
Anti-B = 4+
Weak D = 2+
Rh control = 0
A cells = 0
B cells = 0
A. ABO grouping is wrong
B. Rh grouping is wrong
C. Rh control is wrong
D. Do nothing, interpret the results
D. Do nothing, interpret the results
Patient is AB positive (Rh). Rh control should be negative.
Anti-A = 0
Anti-B = +mf
A cells = 4+
B cells = 0
A. Polyagglutination
B. Bx
C. Both
D. None of the above.
B. Bx
Smudge cells are seen in what type of leukemia?
A. Acute myelogenous leukemia (AML)
B. Chronic myelogenous leukemia (CML)
C. Acute lymphocytic leukemia (ALL)
D. Chronic lymphocytic leukemia (CLL)
D. Chronic lymphocytic leukemia (CLL)
Smudge cells are remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure. Smudge cells, also called basket cells, are most often associated with abnormally fragile lymphocytes in disorders such as CLL.
Widal and Well-Felix tests are classified under what type of serologic test?
A. Passive agglutination
B. Reverse passive agglutination
C. Direct agglutination
D. Coagglutination
C. Direct agglutination
Febrile agglutination tests, such as Widal and Well-Felix, are examples of direct agglutination.
Widal test is an agglutination test in which specific typhoid fever antibodies are detected by mixing the patient’s serum with killed bacterial suspension of Salmonella carrying specific O, H, AH and BH antigens and observed for clumping ie. Antigen-antibody reaction. The main principle of Widal test is that if homologous antibody is present in patient’s serum, it will react with respective antigen in the suspension and gives visible clumping on the test slide or card.
Weil-Felix reaction is a serological test for detecting Rickettsial antibody in the serum of a patient using heterophile antigen. This is a non specific agglutination reaction. Antibodies produced against Rickettsial antigen cross reacts with OX19 and OX2 strain of Proteus vulgaris and OXK strains of Proteus mirabilis. Patients infected with R. rickettsiae develops antibody which is reactive to Proteus vulgairis OX19 and OX2 while patients infected to R. prowazekii develops antibody which is reactive to Proteus vulgaris OX19.
In HIV:
A. increased total lymphocyte
B. increased CD8
C. decreased CD4
D. normal CD8/CD4
C. decreased CD4
Increased levels of TdT (Terminal deoxynucleotidyl transferase) activity are indicative of:
A. Acute lymphocytic leukemia
B. Acute myelocytic leukemia
C. Burkitt lymphoma
D. Eosinophilia
A. Acute lymphocytic leukemia
TdT, also known as DNA nucleotidylexotransferase (DNTT) or terminal transferase, is a specialized DNA polymerase expressed in immature, pre-B and pre-T lymphoid cells, and acute lymphoblastic leukemia/lymphoma cells.
Causative agent of pseudomembranous colitis?
A. C. perfringens
B. C. difficile
C. C. jejuni
D. All of the above
B. C. difficile
Pseudomembranous colitis refers to swelling or inflammation of the large intestine (colon) due to an overgrowth of C. difficile bacteria. This infection is a common cause of diarrhea after antibiotic use.
Excessively blue stain causes:
A. prolonged staining time
B. inadequate washing
C. too high alkalinity of stain
D. AOTA
D. AOTA
Select the best/acceptable donor for blood donation:
A. patient that received a transfusion 8 months ago
B. woman that gave birth 4 weeks ago
C. man that donated blood 10 weeks ago
D. patient with Hgb: 11 g/dL
C. man that donated blood 10 weeks ago
Only choice C is qualified to donate. The interval between whole blood donations is 8 weeks (56 days).
Sputum sample has 25 PMN cells, 10 epithelial cells on HPO, in oil immersion bacteria and fungi were seen, what to do?
A. culture bacteria only
B. culture fungi only
C. culture both bacteria and fungi
D. reject specimen
C. culture both bacteria and fungi
The specimen meets the criteria for a good specimen, culturing both bacteria and fungi would be the best answer.
Which of the following disorders is associated with Dohle bodies and giant platelets?
A. Alder-Reilly anomaly
B. Chediak Higashi syndrome
C. May-Hegglin anomaly
D. Pelger-Huet anomaly
C. May-Hegglin anomaly
May-Hegglin anomaly (MHA) is an autosomal dominant disorder characterized by various degrees of thrombocytopenia that may be associated with purpura and bleeding; giant platelets containing few granules; and large, well-defined, basophilic, cytoplasmic inclusion bodies in granulocytes that resemble Dohle bodies.
Which of the following is used to compare two sets of mean?
A. Chi-square
B. CV
C. Standard Deviation
D. Paired T-test
D. Paired T-test
The Paired Samples T-Test is a statistical test used to determine if 2 paired groups are significantly different from each other on your variable of interest. Your variable of interest should be continuous, be normally distributed, and have a similar spread between your 2 groups. Your 2 groups should be paired (often two observations from the same group) and you should have enough data (more than 5 values in each group).
A patient was diagnosed with streptococcal pharyngitis 6 weeks ago. Now he is showing signs of glumerulonephritis. What will be seen in the renal biopsy?
A. S. agalactiae
B. S. pyogenes
C. H. influenzae
D. S. aureus
B. S. pyogenes
S. pyogenes is the most common causative agent of pharyngitis.
Which of the following is the product of purine metabolism?
A. Ammonia
B. Creatinine
C. Uric acid
D. Bilirubin
C. Uric acid
Which of the following lab tests can differentiate P. aeruginosa from P. putida?
A. Flagella
B. Oxidase production
C. Growth at 42 C
D. Pyoverdin production
C. Growth at 42 C
P. aeruginosa has the widest range of growth temperature (25-42C)
A gram stain performed on a sputum specimen revealed gram-negative diplococci within PMNs. Oxidase testing is positive and carbohydrate degradation test is inert. The organism is:
A. Moraxella catarrhalis
B. Neisseria meningitidis
C. Neisseria lactamica
D. NOTA
A. Moraxella catarrhalis
M. catarrhalis is biochemically inert and does not ferment carbohydrates (assacharolytic)
Which of the following is a quality test for an autoclave?
A. weekly spore test with B. stearothermophilus
B. weekly calibration with high quality calibrator device
C. monthly spore test with B. stearothermophilus
D. All of the above
A. weekly spore test with B. stearothermophilus
Reason for synovial fluid turbidity:
A. crystals
B. protein
C. immunoglobulin
D. All of the above
A. crystals
Birefringent crystals are found in the synovial fluid of >90% of patients with acutely inflamed joints. Crystal identification aids in the diagnosis of joint disease. Monosodium urate crystals are seen in gouty fluids. Urate crystals are mainly needle-shaped and strongly doubly refractile, and may be found within leukocytes. Calcium pyrophosphate crystals are present in chondrocalcinosis. Calcium pyrophosphate dehydrate crystals usually appear as rhomboids and tend to be small, measuring between 1 and 20 um.
Alpha-1 globulin flat curve in a protein electrophoresis indicates?
A. Multiple myeloma
B. Inflammation
C. Juvenile cirrhosis
D. Nephrotic syndrome
C. Juvenile cirrhosis
AAT flat curve = AAT deficiency
AAT is INCREASED in inflammation.
Fasting Blood Sugar: 120 mg/dl, OGTT: 140 mg/dl
A. Non-diabetic
B. Diabetes mellitus
C. Impaired plasma glucose
D. Normal
C. Impaired plasma glucose
FBS: 0-50 mg/dl = hypoglycemia
FBS: 50-100 mg/dl = Normal
FBS: 100-125 = Impaired
FBS: >126 = provisional diabetes
Which of the following diseases results from a familial absence of high density lipoprotein (HDL)?
A. Krabble disease
B. Gaucher disease
C. Tangier disease
D. Tay-Sachs disease
C. Tangier disease
Tangier disease is an inherited disorder characterized by significantly reduced levels of HDL in the blood. HDL transports cholesterol and certain fats (phospholipids) from the body’s tissues to the liver, where they are removed from the blood. HDL is often referred to as the “good cholesterol” because high levels of this substance reduces the chance of developing heart and blood vessel diseases.
Alkali denaturation test detects what type of hemoglobin?
A. Hemoglobin C
B. Hemoglobin F
C. Hemoglobin S
D. Hemoglobin H
B. Hemoglobin F
The test is based on differences between maternal and fetal hemoglobin. Maternal blood contains adult hemoglobin composed of two alpha and two beta subunits (aka hemoglobin A or HbA; i.e., normal adult hemoglobin). Fetal blood contains fetal hemoglobin composed of two alpha and two gamma subunits (aka hemoglobin F or HbF; i.e., normal fetal hemoglobin).
Fetal hemoglobin is resistant to alkali denaturation.
Urine color due to increased bilirubin?
A. Pink
B. Red
C. Dark yellow
D. Brown
C. Dark yellow
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. It makes urine appear dark yellow (yellow foam).
SSA (+); Protein reagent strip (-):
A. presence of protein other than albumin
B. false positive result
C. false negative result
D. specimen too old
A. presence of protein other than albumin
Nephelometry involves the measurement of:
A. light scatter
B. atomic absorption
C. light absorption
D. light transmission
A. light scatter
Carrier of endogenous triglycerides:
A. VLDL
B. LDL
C. HDL
D. Chylomicrons
A. VLDL
Which of the following least react with Anti-H?
A. O
B. A2
C. A1
D. A1B
D. A1B
O>A2>B>A2B>A1>A1B
Compute the UIBC (Unsaturated Iron Binding Capacity):
Serum iron = 120
TIBC = 215
A. 130
B. 95
C. 128
D. 85
B. 95
The UIBC is calculated by subtracting the serum iron from the TIBC: 215-120 = 95
Which of the following enzymes has the longest elevation after Myocardial Infarction (MI)?
A. CK-MB
B. Myoglobin
C. Troponin
D. All of the above
C. Troponin
Troponin stays elevated up to 10-14 days after MI.
Carbon dioxide in ISE measures:
A. CO2 pressure
B. CO2 content
C. pH
D. HCO3
A. CO2 pressure
The carbon dioxide ion selective electrode uses a gas-permeable membrane to separate the sample solution from the electrode internal solution. Dissolved carbon dioxide in the sample solution diffuses through the membrane until an equilibrium is reached between the partial pressure of CO2 in the sample solution and the CO2 in the internal filling solution. In any given sample the partial pressure of carbon dioxide will be proportional to the concentration of carbon dioxide.
Which of the following tests is used to screen Chronic Granulomatous Disease (CGD)?
A. Ham’s acidified serum test
B. NBT (Nitroblue Tetrazolium) Dye test
C. G6PD Fluorescent Screening test
D. All of the above
B. NBT (Nitroblue Tetrazolium) Dye test
Indirectly detects the production of superoxide by neutrophils represented by a blue-black precipitate
Useful in the diagnosis of chronic granulomatous disease
Increased enzyme activity that is present in neutrophils during a bacterial infection is capable of reducing this stain to formazan, which forms a black precipitate (positive), in fatal granulomatous disease the neutrophils do not have the normal ability to kill certain organisms and are unable to reduce the stain (negative)
In chronic active hepatitis, high titers of which of the following antibodies are seen?
A. Anti-smooth muscle
B. Antimitochondrial
C. Anti-DNA
D. Anti-parietal cell
A. Anti-smooth muscle
Chronic Active Hepatitis (CAH) has at least 2 subsets:
(1) Classic (Type 1) - associated with a positive ANA test and positive smooth muscle antibodies. The condition is associated with an attack on the hepatocytes.
(2) Type 2 - most often seen in children; positive for antibodies to liver-kidney microsome type 1 (ALKM-1) and/or liver-cytosol antigen 1 (ALC-1).
Duckert’s Test 5M Urea Solubility Test is used for the detection of:
A. Factor II deficiency
B. Factor XIII deficiency
C. Factor VIII deficiency
D. Factor XII deficiency
B. Factor XIII deficiency
Duckert’s Test is for factor XIII deficiency.
Reagent: 5M urea
Normal: Clot is insoluble to urea (24 hrs)
Abnormal: Clot is soluble to urea (24 hrs) = Factor XIII deficiency
What enzyme is increased in Mumps?
A. Amylase
B. Lipase
C. LDH
D. CK
A. Amylase
Salivary amylase levels are elevated in Mumps.
What is the specimen of choice for FK506 (Tacrolimus), Cyclosporine and Sirolimus?
A. Gray top
B. Heparin sodium
C. Lavender top (EDTA)
D. Red top
C. Lavender top (EDTA)
Tacrolimus, cyclosporine, and sirolimus are immunosupressive drugs and are tested using whole blood.
What is the biosafety level and biologic safety cabinet used for Poxvirus?
A. Biosafety Level III; Safety Cabinet II
B. Biosafety Level 1; Safety Cabinet III
C. Biosafety Level II; Safety Cabinet II
D. None of the above
C. Biosafety Level II; Safety Cabinet II
BSL I - BSC I
BSL II - BSC II
BSL III - BSC III
BSL IV - BSC III
A patient’s record shows a previous anti-Jk(b), but the current antibody screen is negative. What further testing should be done before transfusion?
A. Give Jk(b) negative crossmatch compatible blood.
B. Crossmatch type specific unit and release any compatible units for transfusion.
C. Phenotype the patient’s red cells for the Jk(b) antigen
D. All of the above.
A. Give Jk(b) negative crossmatch compatible blood
Delayed hemolytic transfusion reactions may occur in recipients who are previously immunized but who do not have detectable antibody, if they receive blood with the corresponding antigen. When there is a history of clinically significant antibodies, donor red cells should be phenotyped and antigen-negative blood selected. A complete AHG crossmatch must be performed.
“Cold antibody,” the blood in the patient’s toes, fingertips, and earlobes is cooler than 37C and the antibody coats cooled cells, binds complement, and causes hemolysis:
A. Anti-P
B. Anti-I
C. Anti-i
D. Anti-M
B. Anti-I
Anti-I antibodies are the most common antibodies found if antibody screens are done at immediate spin at room temperature. They are IgM immunoglobulins. Auto-anti-I is a common “cold agglutinin.” High-titer anti-I is also commonly associated with Mycoplasma pneumoniae infections. Treatment would be giving the patient appropriate antibiotics.
Concentration of a substance is directly proportional to the amount of light absorbed or inversely proportional to the logarithm of the transmitted light:
A. Nernst equation
B. Beer’s law
C. Boyle’s law
D. None of the above
B. Beer’s Law
A yellow colony from a wound culture tested catalase-positive and coagulase negative. The organism stained as gram-positive cocci in clusters. Which of the following tests would differentiate between coagulase-negative Staphylococcus and Micrococcus?
A. Novobiocin susceptibility
B. Furazolidone (100 ug/disk) susceptibility
C. Bile esculin
D. Leucine aminopeptidase production
B. Furazolidone (100 ug/disk) susceptibility
Micrococcus and Staphylococcus can be differentiated by susceptibility to furazolidone (100 ug/disk).
Staphylococcus = susceptible
Micrococcus = resistant
A characteristic morphologic feature in hemoglobin C disease is:
A. Macrocytosis
B. Spherocytosis
C. Rouleaux formation
D. Target cells
D. Target cells
Codocytes, also known as target cells, are RBCs that have the appearance of a bullseye.
Type of light observed at 750 nm:
A. Ultraviolet
B. Infrared
C. Blue
D. Green
B. Infrared
Visible range: 400-700 nm
<400 nm: UV light
>700 nm: Infrared
What disease is associated with the possession of HLA-B27?
A. Ankylosing spondylitis
B. Hashimoto’s disease
C. Goodpasture’s syndrome
D. SLE
A. Ankylosing spondylitis
Ankylosing spondylitis belongs to a group of arthritis conditions that tend to cause chronic inflammation of the spind. The HLA-B27 gene can be detected in the blood of most patients with ankylosing spondylitis.
Which is an appropriate specimen to diagnose Dracunculus medinensis?
A. Stool
B. Skin snipping
C. Sputum
D. All of the above
B. Skin snipping
Dracunculiasis is typically asymptomatic for the first year. Symptoms typically develop when the worm erupts through the skin. Local symptoms include intense itching and a burning pain at the site of the skin lesion.
Falsely increased potassium:
A. sample is not covered with carbon paper
B. tourniquet left for more than 10 minutes
C. sample is not chilled
D. All of the above
B. tourniquet left for more than 10 minutes
Excessive tourniquet time or fist clenching during phlebotomy leads to efflux of potassium from the muscle cells into the bloodstream.
Moth balls (naphthalene) poisoning may show which of the following red cell characteristics?
A. Howell-Jolly bodies
B. Ovalocytes
C. Sickle cells
D. Heinz bodies
D. Heinz bodies
Ingestion of naphthalene-containing mothballs is a common occurrence in children. Heinz body formation, hemoglobinuria and mild methemoglobinaemia can occur due to poisoning with this substance.
Which of the following methods used for HIV identification is considered a signal amplification technique?
A. DNA PCR
B. Reverse Transcriptase PCR
C. Branched Chain DNA Analysis
D. Nucleic acid sequence-based assay (NASBA)
C. Branched Chain DNA Analysis
Branched DNA (bDNA) is a signal amplification technology used in clinical and research labs to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays.
The best diagnostic test for excessive alcoholic consumption:
A. AST
B. ALP
C. GGT
D. ALT
C. GGT
GGT can be used to screen for chronic alcohol abuse (it will be elevated in about 75% of chronic drinkers) and to monitor for alcohol use.
Which of the following factors are affected by Coumadin therapy?
A. III, VII, VIII
B. X, V, II, I
C. II, VII, IX, X
D. All of the above
C. VII, IX, X
The following factors are said to be vitamin K dependent factors. Coagulation factors affected by coumadin drugs are: II, VII, IX, and X.
The descending arrangement of lipoproteins according to protein/lipid ratio:
A. Chylomicron, IDL, VLDL, LDL, HDL
B. HDL, LDL, IDL, VLDL
C. Chylomicron, VLDL, IDL, LDL
D. None of the above
B. HDL, LDL, IDL, VLDL
Aman medium contains which of the following?
A. Nile blue
B. Cotton blue
C. Victoria blue
D. Toluidine blue
B. Cotton blue
Aman medium contains lactophenol blue. It contains lactic acid, phenol, and aniline blue (cotton blue). It is an excellent mounting medium for most fungi. It preserves and stains fungi with shades of blue.
Urine with a specific gravity consistently between 1.002 and 1.003 indicates:
A. Acute glomerulonephritis
B. Renal tubular failure
C. Addison’s disease
D. Diabetes insipidus
D. Diabetes insipidus
Low specific gravity (1.001-1.003) may indicate the presence of diabetes insipidus, a disease caused by impaired function of anitdiuretic hormone (ADH). Low SG may also occur in patients with glomerulonephritis and other renal abnormalities.
Elevated level of aminolevulinic acid in urine due to the presence of?
A. Magnesium
B. Copper
C. Lead
D. Zinc
C. Lead
Lead poisoning affects many organs in the body. Lead inhibits gamma-aminolevulinic acid dehydratase (ALAD), an enzyme with two co-dominantly expressed alleles, ALAD1 and ALAD2.
When performing a semen analysis, sperm count is done:
A. after collection
B. after liquefaction
C. no certain time
D. None of the above
B. after liquefaction
Liquefaction takes approximately 20-30 minutes.
An organism that exhibits the satellite phenomenon around colonies of staphylococci is:
A. Klebsiella pneumoniae
B. Neiserria gonorrhae
C. Haemophilus influenzae
D. Neisseria meningitidis
C. Haemophilus influenzae
H. influenzae requires X and V factors. Sheep blood agar supplies X factor and the staphylococci produce V factor, so colonies grow around staph colonies.
The drug procainamide is prescribed to treat cardiac arrhythmia. What biologically active liver metabolite of procainamide is often measured simultaneously?
A. N-acetylprocainamide (NAPA)
B. Primidone
C. Phenobarbital
D. Benzoylecgonine
A. N-acetylprocainamide (NAPA)
Viral specimen was received in the lab, what would the tech do when sending it to a reference laboratory within 96 hours?
A. Store in ambient temperature
B. Lyophilize the sample
C. Loffler’s serum slant and refrigerate
D. Pack in ice
D. Pack in ice
Dry ice (4 degrees): 1. Stuart’s viral transport medium, 2. Leibovitus-Emory, 3. Earles/Hanks balance salt solution.
Which of the following Plasmodium would least likely show the presence of trophozoites and schizonts in the peripheral blood?
A. P. malariae
B. P. vivax
C. P. falciparum
D. P. ovale
C. P. falciparum
Laboratory Results: Decreased T3, Decreased T4, Decreased TSH
A. Secondary hyperthyroidism
B. Secondary hypothyroidism
C. Primary hyperthyroidism
D. Primary Hypothyroidism
B. Secondary hypothyroidism
The cause of secondary hypothyroidism is failure of the pituitary gland to secrete TSH.
Causative agent of eye conjunctivitis:
A. C. trachomatis
B. H. ducreyi
C. L. monocytogenes
D. T. pallidum
A. C. trachomatis
Irreversible step in platelet aggregation?
A. release of PDF3
B. release of ADP
C. platelet shape
D. All of the above
B. release of ADP
Under normal conditions, small disk-shaped platelets circulate in the blood freely and without interaction with one another. ADP is stored in dense bodies inside blood platelets and is released upon platelet activation. ADP interacts with a family of ADP receptors found on platelets (P2Y1, P2Y12, and P2X1), which leads to platelet activation.
What is the treatment for warfarin toxicity?
A. Vitamin K
B. Cryoprecipitate
C. Factor IX concentrate
D. Factor VIII concentrate
A. Vitamin K
Why is albumin the first protein to be detected in tests for renal failure?
A. Its molecular size is the largest.
B. Its molecular size is the smallest.
C. It is very negatively charged.
D. None of the above.
B. Its molecular size is the smallest.
In a healthy individual, the kidneys prevent albumin and other proteins from entering the urine as waste. If the kidneys are damaged however, it will allow proteins to pass into the urine. The first type of protein to appear in urine is albumin as its molecular size is smaller than most other proteins.
What is the causative agent of “Cat scratch disease”?
A. Pasteurella multocodia
B. Bartonella henselae
C. Afipia felis
D. Pleisomonas
B. Bartonella henselae
CIN (Cefsulodin, Irgasan, Novobiocin) Agar is a recommended culture medium for the recovery of:
A. Rhodococcus equi
B. Cardiobacterium hominis
C. Brucella suis
D. Yersinia enterocolitica
D. Yersinia enterocolitica
CIN Agar is recommended for use in the selective and differential isolation of Yersinia and Aeromonas species from clinical specimens, environmental samples, and food sources. Yersinia enterocolitica will exhibit bull’s eye appearance on the said agar.
What stain is recommended for the identification of Cryptococcus neoformans?
A. Methyl red
B. Congo red
C. Wright stain
D. India Ink
D. India Ink
Cryptococcus neoformans can be visualized by the India Ink due to its large polysaccharide capsule. Organisms that possess a polysaccharide capsule exhibit a halo around the cell against the black background created by the India Ink.
Which of the following can result from an underfilled EDTA tube?
A. decreased platelets
B. decreased RBC count
C. decreased microhematocrit
D. decreased hemoglobin
C. decreased microhematocrit
What is the significance of eosinophils in urine?
A. kidney tumors
B. acute interstitial nephritis
C. parasitic infection
D. UTI
B. acute interstitial nephritis
Greater than 5% eosinophils in urine indicates acute interstitial nephritis.
Marker for pancreatic cancer:
A. CA 15-3
B. CA 19-9
C. CA125
D. CEA
B. CA 19-9
CA 15-3 - breast cancer
CA 125 - ovarian cancer
CEA - cancer of the large intestine (colon and rectal cancer)
Which of the following results can be expected during a menstrual cycle?
A. increased TIBC
B. increased ferritin
C. increased % saturation
D. normal transferrin
A. increased TIBC
A TIBC value above 450 mcg/dL usually means that there is a low level of iron in your blood. This may be caused by lack of iron in the diet, increased blood loss during menstruation, pregnancy, or chronic infection.
Indole - negative
MR - negative
LDC - negative
ODC - positive
ADH - positive
A. K. pneumoniae
B. K. oxytoca
C. E. cloacae
D. E. aerogenes
C. E. cloacae
Causes of excessively pink stain:
A. low pH of the buffer
B. insufficient staining
C. excessive washing/rinsing
D. All of the above
D. all of the above
Which of the following would show dosage?
A. Anti-e
B. Anti-M
C. Anti-K
D. Anti-Le(a)
B. Anti-M
MNS antibodies display dosage = they react stronger against cells which are homozygous vs. heterozygous for the antigen in question.
Postprandial turbidity of the serum is due to the presence of:
A. fatty acid
B. cholesterol
C. phospholipid
D. lipoproteins
D. lipoproteins
For approximately 2-8 hours following a meal, there is an additional lipoprotein class, called chylomicrons, representing the transport of dietary fat absorbed in the intestine.
Blood was collected on November 1. It was then frozen in glycerol on November 5. What should the expiration date read?
A. Nov. 1: 1 year from now
B. Nov. 5: 1 year from now
C. Nov 1: 10 years from now
D. Nov. 5: 10 years from now
C. Nov 1: 10 years from now
Blood is sometimes frozen in order to preserve rare types. Glycerol is used in the freezing process. Once frozen, the expiration date of the blood is extended to 10 years from the date of phlebotomy. If the blood is needed, it is defrosted and the new expiration date becomes only 24 hours from the time it is defrosted.
Hallmarks of this type of anemia:
Formation of a fusion protein, AML1-ETO or RUNX1-RUNX1T1, due to a translocation of chromosome 8 to chromosome 21 or t(8;21):
A. acute myeloid leukemia (AML)
B. chronic lymphocytic leukemia (CLL)
C. acute promyelocytic leukemia (APL)
D. All of the above.
A. acute myeloid leukemia (AML)
FAB M2 is a subtype of AML. It is also known as “acute myeloblastic leukemia with maturation.”
Why does a refrigerated alkaline urine become turbid?
A. amorphous phospates
B. amorphous urates
C. WBC
D. bacteria
A. amorphous phosphates
Amorphous phosphates are formed in alkaline urine and are colorless. The precipitate of amorphouse phosphates is white, while amorphous urates are yellow, yellow-brown, or pinkish in color. They tend to form in acidic urine and their precipitate is pink with a cloudy appearance in mixed urine. Amorphous urates are a normal presence in the urine.
In the NFPA safety diamond, the blue quadrant gives information about:
A. reactivity hazard
B. health hazard
C. additional notices
D. flammability hazard
B. health hazard
Blue quadrant = health hazard
Red quadrant = flammability hazard
Yellow quadrant = reactivity/stability hazard
White = special information
Blood was collected in a blue top (sodium citrate) tube for coagulation studies. After centrifugation, packed red cells (Hct) comprised 60% of the whole blood. What should the MLS do next?
A. add citrate anticoagulant
B. reduce citrate anticoagulant
C. dilute with NSS
D. report result
B. reduce citrate anticoagulant
In 1980, CLSI released H21-A4 guidelines for coagulation testing, which included the recommendation to adjust/correct the amount of citrate in blue-top evacuated blood collection tubes for patients presenting with hematocrits greater than 55%.
Why must RBCs be washed in saline at least 3 times before the addition of AHG?
A. To remove traces of free serum globulins.
B. To wash away any hemolyzed cells
C. To neutralize any excess AHG reagent
D. All of the above
A. To remove traces of free serum globulins
The term that denotes a situation in which the effect of two antimicrobial agents together is greater than the sum of the effects of either drug alone is:
A. antagonism
B. additivism
C. sensitivity
D. synergism
D. synergism
The peripheral blood smear below would be seen in which of the following conditions?
A. presence of cold-agglutinins
B. Rheumatoid arthritis
C. Paroxysmal Cold Hemoglobinuria
D. None of the above
A. presence of cold-agglutinins
Cold agglutinin disease (CAD) is a rare disorder affecting 15% of patients with autoimmune hemolytic anemia (AIHA). The disease is defined by the presence of cold agglutinins (autoantibodies which are active at temperatures below 30°C). Cold agglutinins cause red blood cells to clump together (agglutinate) at low temperatures.
Cold agglutinin disease can be primary (idiopathic) or secondary, caused by an underlying condition, such as infection (Mycoplasma pneumoniae, Infectious mononucleosis, CMV), lymphoproliferative disorder, autoimmune disease or neoplasm.
The majority of cold agglutinin disease is secondary and is due to the presence of monoclonal IgM (kappa subtype in the majority of the cases), which has the properties of a cold agglutinin and is associated with an underlying low-grade B-cell lymphoma (Waldenström’s macroglobulinemia or lymphocytic lymphoma).
Idiopathic and lymphoma-associated cold AIHA tend to be chronic while infections tend to cause an acute disease.
The extrinsic system of coagulation is monitored by which test?
A. Activated Partial Thromboplastic Time (APTT)
B. Prothrombin Time (PT)
C. Fibrinogen assay
D. Thrombin Time (TT)
B. Prothrombin Time (PT)
Identify the organism: gram positive bacilli; non-motile; non-hemolytic; catalase positive; spore forming.
A. B. anthracis
B. B. cereus
C. N. meningitidis
D. N. lactamica
A. B. anthracis
The important distinguishing characteristics between B. anthracis and B. cereus is motility.
B. anthracis = non-motile
B. cereus = motile
Which of the following conditions is the most common cause of increased anion gap?
A. metabolic alkalosis
B. metabolic acidosis
C. respiratory acidosis
D. respiratory alkalosis
B. metabolic acidosis
High anion gap metabolic acidosis is generally caused by the body producing too much acid or not producing enough bicarbonate. This is often due to an increase in lactic acid or ketoacids, or it may be a sign of kidney failure. More rarely, high anion gap metabolic acidosis may be caused by ingesting methanol or overdosing on aspirin.
The oxygen sensitive indicator that is used to ensure that anaerobic jars or chambers have met the anaerobic conditions required for anaerobes to grow is:
A. methylene blue
B. bromphenol blue
C. thymol blue
D. bromthymol blue
A. methylene blue
Methylene blue is used as an indicator of anaerobiosis. It remains blue when there is oxygen present in the environment but turns colorless if anaerobic conditions are met.
Primidone monitoring: suspected to have primidone overdose, but the serum concentration is within the normal range. What should the MLS do next?
A. measure procainamide concentration
B. measure phenobarbital concentration
C. measure phenytoin concentration
D. eliminate primidone overdose as possible diagnosis
B. measure phenobarbital concentration
Primidone is a structural analog of phenobarbital.
The absence of the Philadelphia chromosome in granulocytic leukemia suggests:
A. polyclonal origin of the disease
B. excellent response to therapy
C. rapid progression of the disease
D. conversion from another myeloproliferative disorder
C. rapid progession of the disease
Auer rods are most likely present in which of the following conditions:
A. Acute myelocytic leukemia
B. Erythroleukemia
C. Chronic myelocytic leukemia
D. Burn patient
A. Acute myelocytic leukemia
- *RBC:** Normocytic normochromic type of anemia
- *WBC:** Multiple myeloblasts ( more than 20%) will be seen. Myeloblasts may contain several fine rods-like structures called Auer rods. These are seen only in acute leukemias of myeloid differentiation.
- *PLATELETS:** Moderate to severe thrombocytopenia can be seen.
What is the coefficient of variation if the mean is 90 and the standard deviation is 5.48?
A. 2.75
B. 6.09
C. 5.68
D. 30
B. 6.09
The Schales and schales method is a mercurimetric titration used in the analysis of:
A. Chloride
B. Calcium
C. Phosphorus
D. Chromium
A. Chloride
The schales and schales method is a mercurimetric titration method for chloride analysis. It involves titrating chloride with a solution of mercury forming soluble but non-ionized mercuric chloride.
Reactive monocytosis is seen in:
A. Tuberculosis
B. allergic reactions
C. hypersensitivity reactions
D. Infectious mononucleosis
A. Tuberculosis
All patients with tuberculosis demonstrate a marked increase in proliferation activity of monocytes and premature monocyte marrow release. These changes indicate a high monocyte consumption, which is probably caused by a high macrophage death rate due to the high macrophage-toxicity of tubercle bacilli.
Which of the following people would be deferred for blood donation?
A. An employee who got the hepatitis vaccine 1 week ago.
B. An autologous donor with a hemoglobin of 11 g/dl.
C. A donor who was given hepatitis B immune globulin 6 months ago.
D. All of the above.
C. A donor who was given hepatitis B immune globulin 6 months ago.
Unconjugated bilirubinemia is seen in:
A. primary biliary cirrhosis
B. acute hepatitis
C. chronic hemolytic anemia
D. All of the above
C. Chronic hemolytic anemia
Synovial fluid arrived in the laboratory. It is viscous. What do you do next?
A. add acetic acid
B. dilute with NSS
C. add hyaluronidase
D. perform test immediately
C. add hyaluronidase
Induced tryptic digestion of hyaluronic acid will destroy the synovial fluid lubricating abilities without lowering its viscosity. It has also been shown that hyaluronic acid can be depolymerized without altering its lubricating capacity.
Which test differentiates E. coli 0157:H7?
A. mannitol
B. sorbitol
C. lactose
D. glucose
B. sorbitol
E. coli 0157:H7 is an enteric pathogen that typically causes hemorrhagic colitis and blood diarrheal illnesses. It may be followed by hemolytic uremic syndrome, especially in young children. MacConkey Agar with Sorbitol is recommended for isolation of this organism. E. coli 0157:H7 is a sorbitol nonfermenter, thus forms colorless colonies while any bacteria capable of fermenting sorbitol (including other E. coli species) form pink colonies on MacConkey agar with sorbitol.
Leptospira culture media:
A. Fletcher
B. TCBS
C. MAC
D. EMBC
A. Fletcher
In respiratory acidosis, a compensatory mechanism is the increase in:
A. respiration rate
B. plasma bicarbonate concentration
C. ammonia formation
D. blood pCO2
B. plasma bicarbonate concentration
Principle of the reagent strip pH:
A. double indicator system
B. change in dissociation constant (pKa)
C. sodium nitroprusside reaction
D. none of the above
A. double indicator system
It is common to use a double indicator system comprising methyl red and bromothymol blue. Methyl red produces a color change from red to yellow in the range of pH 4-6 and the bromothymol blue changes from yellow to blue between pH 6-9. In the range 5-9 the strips show colors that change from orange at pH 5, passing through yellow and green to dark blue at pH 9.
An isolate on chocolate agar from a patient with epiglottitis was suggestive of Haemophilus spp. Additional testing showed that the isolate required NAD for growth and was nonhemolytic. Which Haemophilus species is most likely the cause?
A. H. ducreyi
B. H. parainfluenzae
C. H. haemolyticus
D. H. influenzae
B. H. parainfluenzae
H. parainfluenzae requires NAD (V factor) for growth but not hemi (X factor). This distinguishes it from H. influenzae.
H. haemolyticus is hemolytic.
H. ducreyi does not cause epiglottitis.
Causative agent of “Cat bite fever”:
A. Pasteurella multicoda
B. Actinomyces israelli
C. Bartonella henselae
D. Leptospira interrogans
A. Pasteurella multicoda
What plasma level is decreased in hyperglycemia?
A. sodium
B. calcium
C. potassium
D. magnesium
A. sodium
Hyperglycemia causes osmotic shifts of water from the intracellular to the extracellular space, causing a relative dilutional hyponatremia.
Polycythemia vera mutation?
A. ADAMS
B. JAK2
C. Rpp
D. Bcl/BCR
B. JAK2
Approximately 95% of all PV patients have a mutation of the JAK2 gene in their blood-forming cells. This mutation leads to hyperactive JAK (Janus Kinase) signaling, causing the body to make the wrong number of blood cells.
Which of the following conditions is consistent with the following results:
2 month old baby with normal WBC, normal platelets, reticulocyte count = 0.1%
A. pure red cell aplasia
B. chronic myelogenous leukemia
C. myelofibrosis with myeloid metaplasia
D. polycythemia vera
A. pure red cell aplasia
In calibrating a centrifuge, one should use a:
A. tachometer
B. barometer
C. revulometer
D. nanometer
A. tachometer
Which of the following conditions have the following results:
presence of Philadelphia Chromosome (t9;22); LAP = 0
A. Acute Lymphocytic Leukemia
B. Chronic Myelogenous Leukemia
C. Acute Myelogenous Leukemia
D. All of the above
B. Chronic Myelogenous Leukemia
The Philadelphia chromosome is a specific abnormality in chromosome 22 of leukemia cancer cells (particularly CML cells). This chromosome is defective and unusually short because of reciprocal translocation of genetic material between chromosome 9 and chromosome 22, and contains a fusion gene called BCR-ABL1. A very good way to differentiate Leukomoid reaction from CML is by doing a Leukocyte Alkaline Phosphatase (LAP) staining. LAP score for Leukomoid reaction is high, while low for CML.
A CSF specimen was sent to the laboratory at 2am. A gram stain was done and subsequent culture is to be done by the next shift. What temperature should the specimen be kept?
A. incubated at 35 degrees celsius
B. stored at room temperature
C. stored at 70 degrees celsius
D. freeze the specimen
A. incubated at 35 degree celsius
Fastidious organisms such as Neisseria and Haemophilus frequently isolated from the CSF of patients with bacterial meningitis are preserved by placing the fluid in 3-7% CO2 at 35-37C (or at room temperature for no longer than 30 minutes), if the specimen cannot be cultured immediately.
A swab sample was taken from a wound and incubated on three different medias (including anaerobic media), no growth after. What happened?
A. wrong medias used
B. swab material inhibited the sample
C. incubation problem
D. All of the above
B. swab material inhibitied the sample
Which of the following is the best approach when introducing a new manual technique?
A. case presentation
B. workshop
C. lecture
D. all of the above
B. workshop
What is the normal value for Mean Corpuscular Volume (MCV)?
A. 50-80 fl
B. 100-200 fl
C. 80-100 fl
D. 60-90 fl
C. 80-100 fl
A and B blood group antigens are derived when glycosyltransferases add specific sugars to precursor H. What is the terminal sugar for B antigen?
A. Fucose
B. D-galactose
C. N-acteylglucosamine
D. N-acetylgalactosamine
B. D-galactose
L-fucose = terminal sugar for O antigen
N-acetylglucosamine = terminal sugar for A antigen
D-galactose = terminal sugar for B antigen
Uncompetitive inhibition:
A. the inhibitor binds the enzyme-substrate complex
B. the inhibitor binds to the allosteric site
C. the inhibitor competes with the substrate towards the active site in an enzyme
A. the inhibitor binds the enzyme-substrate complex
What type of anemia is caused by Hookworm infection?
A. normocytic, normochromic
B. microcytic, hypochromic
C. macrocytic, normochromic
D. normocytic, hypochromic
B. microcytic, hypochromic
Azotemia is an increase in which of the following?
A. BUN
B. Creatinine
C. Ammonia
D. Uric Acid
A. BUN
Azotemia is a medical condition characterized by abnormally high levels of nitrogen containing compounds.
What is measured in the urease method determination of BUN?
A. Uricase
B. Urea
C. NAD
D. Nitrogen
C. NAD
NAD is being measured in the final step of urease method determination of BUN. It is measured at 340 nm.
Specific gravity measured by refractometer: 1.035. Protein and glucose both trace in reagent strip:
A. presence of X-ray medium
B. Albuminuria
C. Glucosuria
D. Normal
A. presence of X-ray medium
X-ray medium/radiographic dye can cause erroneous results in urine specific gravity measurement.
High concentrations of protein and glucose (high MW substances) can intefere with specific gravity results and must be corrected for.
Which group of molds can be ruled out when septate hyphae are observed in a culture?
A. Dematiaceous
B. Zygomycetes
C. Dermatophytes
D. Dimoprhic molds
B. Zygomycetes
Zygomycetes commonly recovered from clinical specimens are Rhizopus spp. and Mucor spp. Both display aseptae hyphae, while the other groups above display septate hyphae.
Which of the following will be the first to increase after myocardial infarction (MI)?
A. LD
B. CK-MB
C. Myoglobin
D. Troponin I
C. Myoglobin
Myoglobin is a small, oxygen-binding protein found in the heart and skeletal muscle. When heart or skeletal muscle is injured, myoglobin is released into the blood. Blood levels of myoglobin can rise very quickly with severe muscle damage and can be measured within a few hours following an injury.
Which of the following viruses is responsible for hand, foot, and mouth disease?
A. Herpes
B. Coronavirus
C. Coxsackie A
B. Retrovirus
C. Coxsackie A
Hand, foot, and mouth disease (HFMD) is usually caused by Enterovirus 71 or Coxsackie virus A16.
A urine specimen was kept in the refrigerator overnight (10 degrees). The glucose level is 1000 mg/dl. The speicific gravity is 1.020. What should the tech do?
A. correct for temperature
B. correct for glucose
C. ask for a new specimen
D. do nothing, report the results
A. correct for temperature
High protein, glucose, and bilirubin levels can elevate specific gravity. Low temperature may decrease the sensitivity of the test.
What is the shelf life of CPDA-1?
A. 35 days
B. 12 days
C. 21 days
D. 1 year
A. 35 days
Citrate phosphate dextrose-adenine 1: A medium which supplies ATP and extends the shelf life of packed red cells destined for transfusion to 35 days with a higher ATP level than earlier-generation red cell preservation media.
In primary biliary cirrhosis, which of the following antibodies is seen in high titers?
A. Anti-parietal cell
B. Anti-DNA
C. Anti-smooth muscle
D. Anti-mitochondrial
D. Anti-mitochondrial
Non-treponemal assays for syphilis such as Rapid Plasma Reagin (RPR) and Veneral Disease Research Laboratory (VDRL) detects the presence of:
A. Anti-cardiolipin antibodies
B. Cardiolipin
C. Anti-treponemal antibodies
D. Treponema pallidum
A. Anti-cardiolipin antibodies
Sterilization of an autoclave:
A. 121C at 20 lbs/psi for 30 minutes
B. 121C at 15 lbs/psi for 15 minutes
C. 85C for 15 lbs/psi for 30 minutes
D. 100C for 20 lbs/psi for 50 minutes
B. 121C at 15 lbs/psi for 15 minutes
Many autoclaves are used to sterilize equipment and supplies by subjecting them to high-pressure saturated steam at 121C (249F) for around 15-20 minutes depending on the size of the load and the contents.
Reference range verification is performed in a new methodology to:
A. test instrument precision
B. test instrument accuracy
C. assess control ranges
D. all of the above
A. test instrument precision
A newborn infant has a WBC count of 37,000/ul with the differential count revealing the presence of 50 nRBCs per 100 WBCs. What is the corrected WBC count?
A. 15,000/ul
B. 24,700/ul
C. 27,300/ul
D. 12,500/ul
B. 24,700/ul
Interpret and determine what is the cause:
RBC reagent strip = positive
Microscopy = no RBC seen
A. dilute with acid solution
B. dilute with alkaline urine
C. dilute with NSS
D. all of the above
B. dilute with alkaline urine
Pink mucoid colonies on MAC
TSI = A/A
Spot indole test = POSITIVE
A. Klebsiella oxytoca
B. Enterobacter gergoviae
C. Klebsiella pneumoniae
D. Salmonella
A. Klebsiella oxytoca
Which of the following blood tests uses radioimmunoassay tests to detect direct and specific IgE?
A. Radioallergosorbent Test (RAST)
B. Radioimmunosorbent Test (RIST)
C. A and B
D. None of the above
A. Radioallergosorbent Test (RAST)
RAST = detects direct and specific IgE
RIST = detects serum IgE
Increased growth rate (cell division), susceptible to antimicrobial agents:
A. stationary/plateau phase
B. lag phase
C. log/exponential phase
D. decline phase
C. log/exponential phase
Latex agglutination for Staphylococcous aureus:
A. Protein A and nuclease
B. Phosphatase and protein A
C. Protein A and clumping factor
D. All of the above
C. Protein A and clumping factor
The single most important test used to distinguish S.aureus from other staphylococci demonstrates production of coagulase. S.aureus produces two forms of coagulase. Bound coagulase, otherwise known as “clumping factor”, can be detected by carrying out a slide coagulase test, and free coagulase can be detected using a tube coagulase test.
The slide coagulase test is traditionally carried out with a drop of plasma (rabbit plasma anticoagulated with EDTA is recommended) but often are used commercial latex slide agglutination tests (in the picture drySPOT™, Oxoid). Blue latex particles are coated with porcine fibrinogen, rabbit IgG and polyclonal antibodies raised against capsular polysaccharide of S.aureus. The test is able to detect the presence of bound coagulase, Protein A (a protein found on the cell surface of about 95% of human strains of S.aureus; it has the ability to bind the Fc portion of immunoglobulin G (IgG) and capsular polysaccharide (present in certain methicillin-resistant strains of S.aureus). The capsule can mask both Protein A and the clumping factor thereby preventing agglutination.
Approximately 97% of human strains of S.aureus possess both bound coagulase and extracellular staphylocoagulase.
S.hyicus, S.intermedius, S.lugdunensis, S.xylosus, S.schleiferi and S.haemolyticus may give positive results in coagulase tests (or rapid latex procedures). S.aureus and S.hyicus are PYRase negative. All the other strains named above will be positive. S.hyicus and S.intermedius are rarely encountered in the clinical laboratory.
Which of the following regulates myocyte contraction?
A. cardiac troponins
B. CK-MB
C. Myoglobin
D. all of the above
A. cardiac troponins
Troponins are contractile proteins that regulate muscle contraction along with tropomyosin and calcium.
What are glass membrane electrodes used to measure?
A. CaCl2
B. Bicarbonate
C. pH
D. Na+
C. pH
After checking the inventory, it was noted that there were no units on the shelf marked “May Issue as Uncrossmatched: For Emergency Use Only.” Which of the following should be placed on the shelf?
A. 2 units of each of the ABO blood groups
B. 1 unit of group O, Rh positive whole blood
C. any units that are expiring within the day
D. units of group O, Rh negative red blood cells
D. units of group O, Rh negative red blood cells
What is the correct PCR sequence?
A. annealing, extension, denaturation
B. extension, denaturation, annealing
C. denaturation, extension, annealing
D. denaturation, annealing, extension
D. denaturation, annealing, extension
Denaturation - this step is the first regular cycling event and consists of heating the reaction chamber to 94-98*C for 20-30 seconds. This causes DNA melting, or denaturation, of the double-stranded DNA template by breaking the hydrogen bonds between complementary bases, yeilding 2 single-stranded DNA molecules.
Annealing - the reaction temperature is lowered to 50-60*C for 20-40 seconds, allowing annealing of the primers to each of the single-stranded DNA templates. Two different primers are typically included in the reaction mixture: one for each of the 2 single-stranded complements containing the target region. The primers are single-stranded sequences themselves, but are much shorter than the length of the target region, complementing only very short sequences at the 3’ end of each strand.
Extension - the temperature depends on the DNA polymerase used; the optimum activity temperature for Taq polymerase is approximately 75-80*C, though a temperature of 72*C is commonly used with this enzyme. In this step, the DNA polymerase synthesizes a new DNA strand complementary to the DNA template strand by adding free dNTPs from the reaction mixture.
What test is used to monitor unfractionated heparin therapy?
A. APTT
B. PT
C. drvvt
D. TT
A. APTT
A urine specimen was submitted for isolation of cytomegalovirus (CMV). The urine was inoculated into human fibroblast tissue culture tubes. After 72 hours, no cytopathic effect was observed in the culture tubes. The most appropriate course of action is to:
A. repeat the test using monkey kidney cell culture tubes
B. repeat CMV serology as CMV cannot be isolated
C. incubate the culture tubes for at least 2-3 weeks longer
D. request a fecal specimen as urine is inappropriate
C. incubate the culture tubes for 2-3 weeks longer
CMV is a slow growing herpesvirus, and may require 3 weeks to grow in conventional viral culture.
The urine sample is the best sample for the recovery of CMV. There are inclusion bodies in leukocytes of urine sediments.
CMV produces an increase in the absolute number of suppressor cell (CD8+) lymphocytes and a decrease in helper cell (CD4+) lymphocytes.
The binding strength of an antibody for an antigen is referred to as:
A. avidity
B. specificity
C. affinity
D. titer
A. avidity
Accumulation of glucocerebroside with wrinkled/crumpled cytoplasm (chicken scratch):
A. Tay Sach’s disease
B. Gaucher’s disease
C. Sandhoff’s disease
D. Sea blue histocytes
B. Gaucher’s disease
5HIAA in urine indicates:
A. carcinoid tumors
B. renal disease
C. nephrotic syndrome
D. all of the above
A. carcinoid tumors
The 5-hydroxyindoleacetic acid (5-HIAA) urine test is used to help diagnose and monitor carcinoid tumors. It may be ordered by itself or along with a blood serotonin and/or chromogranin A level. 5-HIAA is the primary metabolite of serotonin that is excreted in urine. Concentrations of 5-HIAA may be significantly increased when a person has a carcinoid tumor that produces serotonin.
Adrenal Cushing Syndrome mechanism:
A. ACTH decreased, cortisol decreased
B. ACTH increased, cortisol increased
C. ACTH decreased, cortisol increased
D. ACTH increased, cortisol decreased
C. ACTH decreased, cortisol increased
When the adrenal glands develop a tumor, like any other endocrine gland, they usually produce excess amounts of the hormone normally produced by these cells. if the adrenal tumor is composed of cortisol-producing cells, excess cortisol will be produced. Under these conditions, the normal pituitary will sense the excess cortisol and will stop making ACTH in an attempt to slow the adrenal down. In this manner, physicians can really distinguish whether excess cortisol is the result of a pituitary tumor or an adrenal tumor.
Analysis of CSF for oligoclonal bands is used to screen for which of the following disease states?
A. Goodpasture’s Syndrome
B. SLE
C. Myasthenia gravis
D. Multiple sclerosis
D. Multiple sclerosis
Oligoclonal bands are an important indicator in the diagnosis of MS. More than 95% of all patients with MS have permanently observable oligoclonal bands.
Identify the organism in the picture below:
It is sometimes referred to as the “pork worm” due to it typically being encountered in undercooked pork products.
A. Trichinella spiralis
B. Trichuris trichura
C. Enterobius vermicularis
D. Taenia saginata
A. Trichinella spiralis
Burr cells are seen in the peripheral blood smear. What is this indicative of?
A. Anemia
B. Uremia (Kidney disease)
C. Leukemia
D. Liver disease
B. Uremia (kidney disease)
In addition to carcinoma of the prostate, elevated prostate-specific antigen (PSA) can occur due to:
A. benign prostatic hyperplasia
B. statin therapy (cholesterol lowering drug)
C. exogenous steroid use
D. aspirin therapy
A. benign prostatic hyperplasia
Which of the following tests should be done first in order to differentiate Aeromonas spp. from the Enterobacteriaceae?
A. Urease
B. Oxidase
C. OF glucose
D. catalase
B. oxidase
Aeromonas: TSI reaction: A/A, oxidase positive
Enterobacteriaceae: oxidase negative
Vibrio culture media:
A. Fletcher’s agar
B. Bismuth Sulfite agar
C. TCBS
D. BAP
C. TCBS
Thiosulfate-citrate-bile salts-sucrose agar, or TCBS agar, is a type of selective agar culture plate that is used in microbiology laboratories to isolate Vibrio spp.
Order of migration of hemoglobins during alkaline electrophoresis, starting from the origin towards the anode:
A. C, S, F, A
B. C, S, A, F
C. S, C, A, F
D. A, F, S, C
A. C, S, F, A
Role of the supervisor in the laboratory:
A. Laissez-faire
B. Autocratic
C. Democratic
D. All of the above
C. Democratic
Democratic - supervisor acts according to the mutual consent and discussion, or in other words he consults subordinates in the process of decision making. This is also known as participative or consultative supervision.
Autocratic - the supervisor wields absolute power and wants complete obedience from his subordinates. He wants everything done strictly according to his instructions and never likes any intervention from his subordinates.
Laissez-faire - also known as independent supervision; under this type of supervision, maximum freedom is allowed to the subordinates; this supervisor never interferes in the work of the subordinates.
A patient with anti-K and an anti-JKa in her plasma needs 2 units of RBCs for surgery. How many group specific units would need to be screened to find 2 units of compatible RBCs? The frequency of JKa+ is 80% and the K+ frequency is 15%.
A. 6
B. 12
C. 3
D. 10
B. 12
Formula:
Number of units to crossmatch is equivalent to: # of units needed by the patient/(frequency of negativity of antigen #1 x frequency of negativity of antigen #2).
Negativity of Jka+ is .20%, Negativity of K+ is .85%.
Using the formula: 2 units/(.20 x .85) = 11.76 rounded to 12.
What analyte is monitored in preeclampsia?
A. potassium
B. ammonia
C. magnesium
D. ionized calcium
C. magnesium
Preeclampsia is a pregnancy-specific disorder characterized by hypertension and excess protein excretion in the urine. It is an important cause of maternal and fetal morbidity and mortality worldwide. Magnesium sulfate (MgSO4) is the agent most commonly used for the treatment of eclampsia and prophylaxis of eclampsia in patients with severe pre-eclampsia.
Which of the following is a primary immunodeficiency characterized by cellular (T-cell lymphocytes) deficiency, defective thymus gland, congenital heart disease, and hypocalcemia?
A. Down Syndrome
B. DiGeorge Syndrome
C. Edward’s Syndrome
D. Severe Combined Immunodeficiency
B. DiGeorge Syndrome
DiGeorge Syndrome is a primary immunodeficiency disease characterized by abnormal formation of certain tissues during fetal development. The defect may affect the thymus gland and impair production of T lymphocytes. Most people with DiGeorge syndrome have a genetic defect on chromosome 22.
The image below shows immunofluorescence staining pattern of anti-DsDNA antibodies on Crithidia lucillae substrate. What autoimmune disease is indicative of this pattern?
A. Rheumatoid arthritis
B. SLE
C. Gout
D. Myasthenia gravis
B. SLE
The kinetoplast located near the flagellum is stained, indicating the presence of anti-dsDNA antibodies in a person with SLE.
What blood type should be transfused to the baby?
Mother: Type O, Rh negative, with anti-D, anti-C, anti-I, and anti-Lea
Child: Type A, Rh positive, DAT (+)
A. Type O, Rh negative, without C, I, and Lea antigen
B. Type O, Rh negative, with C, I, and Lea antigen
C. Type A, Rh positive, with C, I, and Lea antigen
D. None of the above
A. Type O, Rh negative, without C, I, and Lea antigen
In what blood group type expression of antigens is weakened, or in some cases negative, during pregnancy?
A. P
B. Lewis
C. i/I
D. Kell
B. Lewis
Pregnant women transiently exhibit Le(a-b-) phenotype and Lewis antibodies are sometimes formed during pregnancy.
A urine pH of 4.5 or less can be seen in:
A. high protein intake
B. vomiting
C. hyperventilation
D. hyponatremia
A. high protein intake
In a regression analysis protein intake proved to be an independent factor modulating the ratio between urin-pH and renal ammonium excretion. The concomitant increase of renal net acid excretion and maximum renal acid excretion capacity in periods of high protein intake appears to be a highly effective response of the kidney to a specific food intake, leaving a large renal surplus capacity for an additional renal acid load.
Which of the following is the preferred culture media for Legionella pneumophila?
A. Regan Lowe Agar
B. Buffered Charcoal Yeast Extract (BCYE) Agar
C. Celsulodin Irgassan Novobiocin (CIN) Agar
D. Chocolate Agar
B. Buffered Charcoal Yeast Extract (BCYE) agar
BCYE agar is a selective growth medium used to culture or grown certain bacteria, particularly the gram-negative species Legionella pneumophila. It has also been used for the recovery of Acanthamoeba keratitis.
The Legionellaceae are aerobic and nutritionally fastidious organisms. They require L-cysteine and iron salts for growth. Growth on BCYE agar after 3 or more days of incubation with no growth on blood agar and/or chocolate agar is one of the most useful presumptive clues that an isolate could be a species of Legionella.
After 3-4 days of incubation, small white colonies of Legionella appear in BCYE agar which becomes grey in a few days. The colonies are round and convex with entire edges. The isolate may show typical ground glass (or iridescent) colony appearance.
In the hypothalamic-pituitary-adrenal axis, the hypothalamus stimulates the release of cortisol from the adrenal gland through:
A. ACTH
B. Corticotropin Releasing Hormone (CRH)
C. Gonadotropin Releasing Hormone (GRH)
D. Thyrotropin Releasing Hormone (TRH)
B. Corticotropin Releasing Hormone (CRH)
A positive culture of sputum was stained. Carbolfucshin was added, washed, decolorized and malachite blue was used as counter stain. Two entire fields were scanned and no acid fast bacilli were found. The most probable cause is:
A. wrong primary stain was used
B. wrong counter stain was used
C. inadequate scanning of the slide
D. inadequate decolorization
C. inadequate scanning of the slide
Good practice in reading AFB slides should be 100 fields.
Which of the following antigen(s) is enhanced by enzymes?
A. Kidd, Rh
B. Lewis, P
C. ABO
D. All of the above
D. All of the above
(KLARP) Kidd, Lewis, ABO, Rh, and P antigens are enhanced by enzymes.
MNS and Duffy antigens are destroyed by enzymes.
Biosafety Level (BSL) for Mycobacterium tuberculosis:
A. BSL I
B. BSL II
C. BSL III
D. BSL IV
C. BSL III
Biosafety level 3 is commonly used for research and diagnostic work involving various microbes that can be transmitted by aerosols and/or cause severe disease. These include Francisella tularensis, Mycobacterium tuberculosis, Chlamydia psittaci, Venezuelan equine encephalitis virus, Eastern equine encephalitis virus, SARS coronavirus, Coxiella burnetti, Rift Valley fever virus, Rickettsia rickettsii, several species of Brucella, chikungunya, yellow fever virus, and West Nile virus.
The protein electrophoresis shown below indicates:
A. A1-Antitrypsin deficiency
B. Multiple Myeloma
C. Nephrotic syndrome
D. All of the above
B. Multiple myeloma
Which of the following would cause a peripheral blood smear like this?
A. PCH
B. Mycoplasma pneumoniae
C. PNH
D. All of the above
B. Mycoplasma pneumoniae
Precipitation of ribosomes and RNA:
A. Heinz bodies
B. Howell-Jolly bodies
C. Basophilic stippling
D. Auer rods
C. Basophilic stippling
Fine stippling = polychromatophilia
Coarse stippling = lead poisoning
Production of abnormally small amounts of urine:
A. Anuria
B. Oliguria
C. Polyuria
D. Aminoaciduria
B. Oliguria
Oliguria is clinically classified as an output more than 80 ml/day but less than 400 ml/day.
Anuria is clinically defined as less than 50 ml of urine output per day.
Polyuria is a condition usually defined as excessive or abnormally large production or passage of urine.
Blood agglutination was noted in the below picture. What would the lab tech do to differentiate it from Rouleaux?
A. Prewarm
B. dilute with 22% albumin
C. dilute with normal saline
D. all of the above
C. dilute with normal saline
The saline test confirms the presence of agglutination by mixing a drop of uncoagulated blood with a (larger) drop of saline solution. The mixture is then placed on a slide with a coverslip and observed under the microscope. In the presence of agglutination, the RBCs will remain clumped: this indicates a positive test. In the presence of rouleaux formation (a physiological phenomenon associated with plasma proteins), the RBCs will spread out individually: this indicates a negative test.
Which ionophore is used in a potassium electrode?
A. copper
B. valinomycin
C. glass
D. fluoride
B. valinomycin
Which of the following patients is most at risk for hyperosmolar non-ketotic coma?
A. 70 year old, Type 2 diabetic patient
B. 30 year old, Type 2 diabetic patient
C. 40 year old hypertensive patient
D. all of the above
A. 70 year old, Type 2 diabetic patient
Hyperosmolar hyperglycemia state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. The main risk factor is a history of diabetes mellitus type 2. Older people are most commonly affected.
The presence of teardrop cells in a peripheral bloodsmear is indicative of what deficiency?
A. DNA
B. RNA
C. G6PD
D. Myeloperoxidase
A. DNA
Anti IgG (+); C3d (+): What should the lab tech do?
A. elution
B. IAT
C. DAT
D. Pre-warm
A. elution
The term elution refers to removing an antibody that is attached to the surface of an RBC. This procedure is most commonly used in the identification of complicated antibodies, sometimes in the workup of transfusion reactions or hemolytic disease of the newborn, as well as in the workup of warm autoantibodies.
What is the sugar fermented by Staphylococcus aureus?
A. mannitol
B. sucrose
C. glucose
D. maltose
A. mannitol
Mannitol salt agar is a commonly used growth medium in microbiology. It encourages the growth of a group of certain bacteria while inhibiting the growth of others. It contains high concentration (7.5-10%) of salt (NaCl), making it selective for gram positive bacteria Staphylococci (and Micrococcaceae) since this level of NaCl is inhibitory to most other bacteria. It is also a differential medium for mannitol fermenters, containing mannitol and the indicator phenol red. S. aureus produce yellow colonies with yellow zones, whereas other Staphylococci produce small pink or red colonies with no color change to the medium. If an organism can ferment mannitol, an acidic byproduct is formed that will cause the phenol red in the agar to turn yellow.
Specimen for the diagnosis of rotavirus:
A. urine
B. throat swab
C. blood
D. stool
D. stool
The rotavirus test is a stool test used to diagnose a rotavirus infection. Rotavirus affects the intestines and causes vomiting and diarrhea. This infection is especially common in young children, but it can affect adults too. A rotavirus infection causes a condition call viral gastroenteritis.
Calculate for the % saturation:
UIBC = 185
Fe = 125
A. 80%
B. 50%
C. 40%
D. 30%
C. 40%
First, we need to find the TIBC.
TIBC = UIBC + Fe
TIBC = 185 + 125 = 310
Now compute for % saturation: serum iron/TIBC x 100
% saturation = (125/310) x 100 = 40%
Who discovered the ABO blood group system?
A. Susumu Tonegawa
B. Karl Landsteiner
C. Kyle Metchnikoff
D. none of the above
B. Karl Landsteiner
From which source are you most likely to see the following parasite?
A. stool
B. urine
C. sputum
D. blood
B. urine
Schistosoma haematobium is an important digenetic trematode, and is found in Africa and the Middle East. It is a major agent of schistosomiasis; more specifically, it is associated with urinary schistosomiasis.
Tropical sprue has the peripheral blood picture of:
A. malaria
B. thalassemia
C. megaloblastic anemia
D. IDA
C. megaloblastic anemia
Tropical sprue is a malabsorption disease commonly found in tropical regions, marked with abnormal flattening of the villi and inflammation of the lining of the small intestine. Megaloblastic anemia is a macrocytic, normochromic anemia.
Identify the organism below:
A. Taenia saginata
B. Enterobius vermicularis
C. Trich trichiura
D. Taenia solium
C. Trichuris trichiura
The human whipworm is a round worm that causes trichuriasis when it infects a human large intestine. It is commonly known as the whipworm, which refers to the shape of the worm; it looks like a whip with sider “handles” at the posterior end. “Football shaped egg with hyaline plugs at each end.”
Which of the following is associated with Alder-Reilly inclusions?
A. Two-lobed neutrophils
B. Mucopolysaccharidosis
C. Membrane defect of lysosomes
D. Dohle bodies and giant platelets
B. Mucopolysaccharidosis
The Alder-Reilly anomaly is seen in the mucopolysaccharidoses. The most characteristic finding is the metachromatic granules surrounded by a clear zone seen in lymphocytes. Dense granules, resembling toxic granulation in neutrophils, are seen in all leukocytes.
Hair perforation test/hair baiting test is for identification of which two fungi?
A. Aspergillus niger and A. japonicus
B. Tinea pedis and T. corporis
C. Trichophyton mentagrophyte and T. rubrum
D. Candida albicans and C. tropicalis
C. Trichophyton mentagrophyte and T. rubrum
T. mentagrophyte = positive
T. rubrum = negative
The principle of the reagent strip test for urine protein depends on:
A. copper reduction
B. protein error of indicators
C. an enzyme reaction
D. toluidine reaction
B. protein error of indicators
Anti IgG (-); C3d (+); What should the lab tech do?
A. Elution
B. IAT
C. DAT
D. Pre-warm
D. Pre-warm
Prewarm technique can be used to prevent cold-reactive alloantibodies or autoantibodies from reacting in the IAT phase. Specifically, prewarm technique prevents cold antibodies from binding complement at RT (as opposed to 37C) and subsequently being detected by anti-C3 in the IAT by polyspecific AHG serum.
Identify the red cell inclusions:
A. Heinz bodies
B. Basophilic stippling
C. Howell-Jolly bodies
D. Auer rods
A. Heinz bodies
Stray light can be detected in a spectrophotometer by utilizing a:
A. sharp cut off filter
B. mercury vapor lamp
C. potassium dichromate solution
D. holmium oxide glass
A. sharp cut off filter
A 2 year old child with decreased serum T4 is described as being somewhat dwarfed, stocky, overweight, and having coarse features. Of the following, the most informative additional laboratory test would be the serum:
A. cholesterol
B. triiodothyronine (T3)
C. thyroid-stimulating hormone (TSH)
D. thyroxine-binding hormone (TBG)
C. thyroid-stimulating hormone (TSH)
A fetomaternal hemorrhage of 45 ml of fetal Rh-positive packed RBCs has been detected in an Rh-negative woman. How many vials of Rh immune globulin (Rhogam) should be given?
A. 1
B. 2
C. 3
D. 4
D. 4
One vial of Rh immune globulin protects against a fetomaternal hemorrhage of 15 ml of red cells or 30 ml of whole blood. Divide the volume of fetomaternal hemorrhage (45 ml) by 15 = 3, then always add 1 extra vial = 4 vials.
Used to differentiate Salmonella from Citrobacter:
A. Lysine decarboxylase
B. ONPG
C. Indole
D. Vogues Proskauer
A. Lysine decarboxylase
Salmonella = positive
Citrobacter = negative
Identify the organism:
A. Clostridium difficile
B. Mycobacterium tuberculosis
C. Listeria monocytogenes
D. Corynebacterium diphtheriae
B. Mycobacterium tuberculosis
Mycobacterium tuberculosis is an obligate pathogenic bacterial species in the family Mycobacteriaceae and the causative agent of tuberculosis. M. tuberculosis has an unusual waxy coating on its cell surface primarily due to the presence of mycolic acid. Cells are curved, rod-shaped and are often seen wrapped together, due to the presence of fatty acids in the cell wall that stick together. This appearance is referred to as cording, like strands of cord that make up a rope. M. tuberculosis is characterized in tissue by caseating granulomas containing Langhans giant cells, which have a “horseshoe” pattern of nuclei.
Antidiuretic hormone (ADH) regulates the reabsorption of:
A. water
B. potassium
C. calcium
D. glucose
A. water
ADH binds to receptors on cells in the collecting ducts of the kidney and promotes reabsorption of water back into the circulation. In the absence of ADH, the collecting ducts are virtually impermeable to water, and it flows out as urine.
With what leukemia is Disseminated Intravascular Coagulation (DIC) associated?
A. M1
B. M6
C. CML
D. M3
D. M3
M3 - Acute Promyelocytic Leukemia (T15;17)
What is the purpose of Protein S and Protein C?
A. act as a natural anticoagulant
B. activates protein coagulants
C. activates fibrinolytic system
D. all of the above
A. act as a natural anticoagulant
Protein S and C are two vitamin K denpendent plasma proteins that work in concert as a natural anticoagulant system. Activated protein C is the proteolytic component of the complex and protein S serves as an activated protein C binding protein that is essential for assembly of the anticoagulant complex on cell surfaces.
The formation of germ tubes presumptively identifies:
A. Candida tropicalis
B. Candida albicans
C. Candida glabarata
D. Candida parapsilosis
B. Candida albicans
Identify the crystal shown below:
A. Calcium oxalate
B. Tyrosine
C. Triple phosphate
D. Fiber
C. Triple phosphate
Triple phosphate crystals form in alkaline urine and are composed of magnesium, ammonium, and phosphate. These are rectangular in shape or similar to a “coffin lid.” They are sometimes associated with a bacterial urinary tract infection caused by urea splitting bacteria.
Lifetime marker of HBV infection:
A. Anti-HBc
B. Anti-HBs
C. HbsAg
D. HbcAg
A. Anti-HBc
HBcAb
Gram negative bacterial, normally found in the oropharyngeal tract of mammals, they are involved in the pathogenesis of some animal bite wounds as well as periodontal diseases. This bacteria exhibits gliding motility.
A. Leptospira
B. Actinobacillus
C. Capnocytophaga
D. Chlamydia
C. Capnocytophaga
Cessation of urine flow is defined as:
A. azotemia
B. anuria
C. dysuria
D. diuresis
B. anuria
Presence of lupus anticoagulant leads to:
A. activation of the fibrinolytic system
B. thrombosis (micro emboli clots)
C. bleeding
D. continuous activation of the clotting cascade
B. thrombosis (micro emboli clots)
Lupus anticoagulant is a misnomer, as it is actually a prothrombotic agent. Lupus anticoagulant antibodies in living systems cause an increase in inappropriate blood clotting.
According to AABB standards, fresh frozen plasma (FFP) must be infused within what period of time following thawing?
A. 24 hours
B. 36 hours
C. 48 hours
D. 72 hours
A. 24 hours
Final degenerative form of a cast:
A. waxy cast
B. hyaline cast
C. WBC cast
D. RBC cast
A. waxy cast
Intraoperative autologous blood stored in 1-5C.
How many hours can it be stored before transfusion?
A. 4
B. 5
C. 12
D. 24
D. 24 hours
Identify the organism:
A. Blastomyces dermatitidis
B. Malasezia furfur
C. Alternaria
D. Candida albicans
A. Blastomyces dermatitidis
What amino acid substitution is responsible for Hemoglobin S?
A. Lysine for glutamic acid at sixth position of the beta chain
B. Valine for glutamic acid at sixth position of the beta chain
C. Arginine for glutamic acid at sixth position of the beta chain
D. Alanine for glutamic acid at sixth position of the beta chain
B. Valine for glutamic acid at sixth position of the beta chain
Which assay, using a 24-hour urine, is considered the BEST single screening test for pheochromocytoma?
A. Homovallic acid
B. Metanephrines
C. Vanillylmandelic acid (VMA)
D. Catecholamines
B. Metanephrines
Thrombocytosis: 1,000 x 10^9/L, functionally abnormal platelets:
A. Essential thrombocythemia
B. Polycythemia vera
C. Absolute thrombocythemia
D. None of the above
A. Essential thrombocythemia
Essential thrombocythemia is an uncommon disorder in which your body produces too many blood platelets but functionally abnormal. This condition may cause you to feel fatigued, lightheaded and to experience headaches and vision changes. It also increases your risk of blood clots.
Cystic fibrosis associated bacteria(s):
A. Burkholderia cepacia
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. All of the above
D. All of the above
Portwine urine color:
A. Antibiotics intake
B. Cola intake
C. Bilirubinemia
D. Porphyria
D. Porphyria
In acute intermittent porphyria, the substrate porphobilinogen will accumulate in the urine. It spontaneously polymerizes to coporphobilinogen in urine giving urine a port-wine color.
Which of the following Plasmodium species will you see Schuffner dots?
A. P. vivax
B. P. ovale
C. P. malariae
D. A and B
D. A and B
Schuffner’s dots refers to a hematological finding that is associated with malaria, exclusively found in P. ovale and P. vivax. Plasmodium vivax induces morphologic alterations in the infected host RBCs that are visible by light microscopy in Romanowsky-stained blood smears as multiple brick-red dots. These morphologic changes, referred to as Schuffner’s dots, are important in the ID of this species of malarial parasite and have been associated by electron microscopy with caveolavesicle complexes along the RBC plasmalemma.
Prolonged PT and aPTT with depleted fibrinogen levels and platelets can be associated with:
A. Acute DIC
B. Von Willebrand Disease
C. Hemophilia A
D. Glanzmann’s Thrombasthenia
A. Acute DIC
What is the formula for sensitivity?
A. TP/(TP+FN)x100
B. TP/(TP+FP)x100
C. (TP+FN)/TPx100
D. (TP+FP)/TNx100
A. TP/(TP+FN)x100
Bilirubin is tested for a newborn baby. For 3 consecutive days, the bilirubin results are high. On the 4th day, the bilirubin results are normal. Determine the cause:
A. Baby underwent phototherapy
B. Hemolysis on the 1st to 3rd day
C. Hemolysis on the 4th day
D. Normal results
A. Baby underwent phototherapy
Phototherapy (light treatment) is the process of using light to eliminate bilirubin in the blood. The baby’s skin and blood absorb these light waves and the bilirubin is changed into products. These products then pass through their system.
An initial screening for anti-HIV 1/2 using ELISA tested reactive. What should be done next?
A. Perform immunofixation test
B. Perform confirmatory test using PCR
C. Perform Western Blot
D. Repeat testing using ELISA
C. Perform Western Blot
Western blot is being used as a confirmatory test for HIV.
An initial screening for anti-HIV 1/2 using ELISA tested reactive. What should be done next?
A. Perform immunofixation test
B. Perform confirmatory test using PCR
C. Perform Western Blot
D. Repeat testing using ELISA
C. Perform Western Blot
Western blot is being used as a confirmatory test for HIV.
Which of the following is known as the metabolite of cocaine?
A. Metanephrines
B. Benzoylecgonine
C. Morphine
D. Benzenamine
B. Benzoylecgonine
Anaerobic gram negative cocci after jaw surgery:
A. Veillonella
B. Peptostreptococcus
C. Neisseria
D. Legionella
A. Veillonella
Veillonella spp. are nonmotile, gram-negative diplococci that are the anaerobic counterpart of Neisseria. Veillonella is part of the normal flora of the mouth and gastrointestinal tract and may be found in the vagina as well. Although of limited pathogenicity, Veillonella is often mistaken for the more serious gonococcal infection. Veillonella spp. are often regarded as contaminants; they are often associated with oral infections; bite wounds; head, neck, and various soft tissue infections; and they have also been implicated as pathogens in infections of the sinuses, lungs, heart, bone, and CNS. Recent reports have also indicated their isolation in pure culture in septic arthritis and meningitis.
Blood smear below denotes Hairy Cell Leukemia (HCL), which of the following tests is sued to identify this type of leukemia?
A. Myeloperoxidase
B. Tartrate-resistant acid phosphatase
C. Tartrate-resistant alkaline phosphatase
D. Sudan Black B
B. Tartrate-resistant acid phosphatase
On an automated instrument:
Hgb = 45 g/dL
Hct = 33%
The technologist does a manual Hct and the results is 33.5%. What should the MLS do next?
A. Repeat all
B. Ask for new specimen
C. Report the manual results and original Hgb result
D. Check for lipemia
D. Check for lipemia
-Lipemia (and it’s turbidity) will cause a falsely elevated hemoglobin result on many analyzers.
Macrocytes typically seen in megaloblastic anemia are:
A. tear drop shaped
B. ovalocytes
C. target cells
D. all of the above
B. ovalocytes
Megaloblastic anemia is an anemia (of macrocytic classification) that results from inhibition of DNA synthesis during RBC production. When DNA synthesis is impaired, the cell cycle cannot progress from the G2 growth stage to the mitosis (M) stage.
Autologous Donation:
A. no age requirement
B. Hgb at least 11 g/dL, Hct at least 33%
C. Single unit is removed at a time, with at least 3 day intervals
D. all of the above
D. all of the above
HBA1c results can be influenced by:
A. RBC life span
B. WBC life span
C. Amount of albumin
D. Concentration of glucose
A. RBC life span
Lower than expected values of HBA1c can be seen in people in with shortened RBC lifespan, such as with G-6-PD deficiency, sickle-cell disease, or any other condition causing premature RBC death.
Cast with high refractive index:
A. waxy cast
B. WBC cast
C. RBC cast
D. all of the above
A. waxy cast
Phenomenon in which large quantities of toxins are released as the bacteria dies during treatment:
A. swarming phenomenon
B. Tonegawa phenomenon
C. Jarisch-Herxheimer phenomenon
D. Ellie-Metchnikoff phenomenon
C. Jarisch-Herxheimer phenomenon
A Jarisch-Herxheimer reaction is a reaction to endotoxin-like products by the death of harmful microorganisms within the body during antiboitic treatment.
Identify the organism:
A. Enterobius vermicularis
B. Ascaris lumbricoides
C. Trichinella spiralis
D. Taenia solium
B. Ascaris lumbricoides
