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PRACTICE QUESTIONS M Flashcards

1
Q

Isoimmunization to platelet antigen HPA-1a and the placental transfer of maternal antibodies would be expected to cause newborn:

a. thrombocytopenia
b. leukocytosis
c. leukopenia
d. erythrolastosis

A

a. thrombocytopenia

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2
Q

When immersion oil has been used for microscopic review of microorganisms in a tissue section, it is important to remove the oil from the objective lens immediately:

a. by wiping with a paper towel
b. with xylene-soaked gauze
c. by removing the objective and washing it in water
d. with lens paper

A

d. with lens paper

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3
Q

You are reviewing the following result. You should *insert pic

a. report the result as <13 ng/dL
b. rerun the sample prior to reporting because <13 ng/dL is a highly unusual result
c. wait for the sample to go back and run neat

A

c. wait for the sample to go back and run neat

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4
Q

You are reviewing the following results on a 73-year old female patient. The patient has been in the ICU for the past 3 days. The previous results below are from three hours ago. What are your next steps? *insert pic

a. pull the sample first. inspect for bubbles
b. rerun the tests. investigate how the sample was collected

A

a. pull the sample first. inspect for bubbles
b. rerun the tests. investigate how the sample was collected

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5
Q

A patient’s sample for a CK results when the sample is run neat, 1:2 and 1:10. The result comes across in Epic as >42, 670 U/L after the 1:10 dilution. What should you do next?

a. report the result as >42, 670 U/L
b. make an offline 1:10 dilution with saline and run the diluted sample with a 1:10 onboard dilution. Multiply the result prior to reporting
c. put the sample for a redraw

A

a. report the result as >42, 670 U/L

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6
Q

In the Cardinal Urinalysis System, after decanting the spun sample using a petter, how much sediment should be left in the conical tube?

a. 0.5 mL
b. 1 mL
c. 1.5 mL
d. 2.0 mL

A

b. 1 mL

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7
Q

Refer to the UA Dipstick results below:
*Color: Amber
Clarity: Slightly cloudy
Glucose: Negative
*Bilirubin: Large (3+)
Ketones: Negative
Specific Gravity: 1:010
Blood: Negative
*pH: 5.5
Protein: Negative
Urobilinogen: <2 mg/dL
Nitrite: Negative
Leukocyte Esterase: Negative
*Bilirubin Ictotest Confirmed: Positive

a. bilirubin crystal
b. tyrosine crystal
c. ammonium biurate
d. sulfur crystal

A

a. bilirubin crystal

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8
Q

Identify ALL the elements present from a Wet Prep Vaginal swab below: *insert pic

A

a. clue cells
b. yeast

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9
Q

Which of the following is a potential complication of massive transfusions?

a. citrate toxicity with hypercalcemia
b. heparin-induced thrombocytopenia
c. hypothermia due to 1-6 degrees Celsius storage temp of red cells
d. iron overload from donor red cells leaking intracellular iron

A

c. hypothermia due to 1-6 degrees Celsius storage temp of red cells

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10
Q

What is the most important consideration for a patient requiring red cell transfusion due to severe anemia when their serum contains a warm autoantibody?

a. determine specificity of autoantibody
b. determine the presence of underlying alloantibody/ies.
c. determine the immunoglobulin class of the autoantibody
d. avoid transfusion therapy

A

b. determine the presence of underlying alloantibody/ies.

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11
Q

MHA-TP is another serological test for syphilis. MHA represents the methodology, which is:

a. microbiological human antibodies
b. micro hemagglutination assay
c. micro hemostatic array
d. multi-hemagglutinins assay

A

b. micro hemagglutination assay

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12
Q

When performing the Directogen Meningitis Combo Test on Cerebrospinal Fluid, the test card or slide should be rotated on a mechanical rotator for 10 mins at 100 rpm ± 2 rpm. The procedure requires use of a moistened humidifying cover during this rotation period. Which of the following is most likely to occur if you forget to use the moistened humidifying cover?

a. false-positive due to evaporation bringing the latex bead closer together
b. false-negative due to evaporation of the CSF
c. false-positive due to the loss of temperature control
d. loss of sample and reagent due to liquids not being contained by the cover

A

a. false-positive due to evaporation bringing the latex bead closer together

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13
Q

A pediatrician contacted the laboratory to ask which test or tests would be most useful in the case of a child suspected of having complications following Strep throat. The technologist asked this physician some questions about what she was trying to determine and found that the pediatrician wanted the test or tests most likely not to miss potential antibodies produced against streptococcal antigens. Which of the following should the technologist recommend?

a. Streptozyme test followed, if positive by ASO
b. ASO test followed, if positive, by Streptozyme
c. Culture followed, if positive, by Rapid Strep cassette testing.
d. Rapid Strep cassette testing following, if positive by culture

A

a. Streptozyme test followed, if positive by ASO

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14
Q

Individuals who type as blood group O

a. have anti-A and anti-B in their plasma or serum
b. have no antibodies in their plasma or serum
c. have anti-O in their plasma or serum
d. have anti-A only in their plasma or serum

A

a. have anti-A and anti-B in their plasma or serum

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15
Q

You have just received a urine sample for culture from the hospital floor. The specimen was collected 4 hours ago and has been refrigerated at 4℃ in the interim time period. How should you proceed with processing the specimen?

a. plant the urine to the appropriate media and incubate according to your hospital procedures

b. plant the urine to the appropriate media and incubate according to your hospital procedures. Add a comment to the specimen results that indicates the urine was refrigerated for 4 hours

c. call the physician to ask if the culture is still needed

d. call the floor immediately and have the nursing personnel recollect the specimen and bring to the laboratory in a timely manner.

A

a. plant the urine to the appropriate media and incubate according to your hospital procedures

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16
Q

Enzyme-linked immunoassays (ELISA) employ the use of ______________________ to produce visible endpoint

a. precipitin band
b. antibodies bound to enzymes
c. fluorescent stain
d. none of the above

A

b. antibodies bound to enzymes

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17
Q

Polymerase Chain Reaction (PCR) is the best developed and most widely used nucleic acid amplification method for the detection of viruses. PCR involves enzymatic duplication of short DNA sequences to produce millions to billions of copies. An advancement, is reverse transcriptase PCR (RT-PCR) which uses reverse transcriptase to convert viral RNA to cDNA. Which viruses are commonly detected using reverse transcriptase?

a. rubellavirus, rotavirus, and norovirus in feces, HCV
b. influenza virus, HPV, and CMV
c. HCV, HIV, CMV
d. rotavirus and norovirus in feces, HPV and HSV

A

a. rubellavirus, rotavirus, and norovirus in feces, HCV

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18
Q

Females may have false-negative results in early PKU tests because:

a. girls do not produce phenylalanine until a week after birth
b. the level of phenylalanine blood levels rise slower in girls
c. girls produce a substance which lyses the phenylalanine in the blood in the first days after birth
d. phenylalanine can only be detected in urine in girls

A

b. the level of phenylalanine blood levels rise slower in girls

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19
Q

A pseudogerm tube occurs when

a. the inoculum used to perform the test is too heavy
b. alternative substrates are used
c. there is a constriction present at the base of the germ tube where it attaches to the mother cell
d. all of the above

A

c. there is a constriction present at the base of the germ tube where it attaches to the mother cell

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20
Q

A CSF specimen appears clear. The technologist should:

a. needs to perform an electronic cell count on the CSF fluid
b. needs to perform a manual cell count on the CSF fluid
c. does not have to do a manual cell count on the CSF fluid
d. should perform an electronic cell count unless the order specifies as a manual count

A

b. needs to perform a manual cell count on the CSF fluid

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21
Q

Under CLIA law, the assaying of materials of known concentration in the same manner as patient samples to substantiate the instrument or test system’s calibration throughout the reportable range for the patient results is?:

a. calibration
b. calibration verification
c. challenge
d. quality control

A

b. calibration verification

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22
Q

Which of the following may be said to be true of fluorescent spectroscopy?

a. low sensitivity and low specificity
b. low sensitivity and high specificity
c. high sensitivity and low specificity
d. high sensitivity and high specificity

A

d. high sensitivity and high specificity

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23
Q

Which of the following methods are used to characterize monoclonal proteins?

a. IEP and IFE
b. DIF and RID
c. IEP and RID
d. DIF and IFE

A

a. IEP and IFE

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24
Q

POCT devices use a variety of analytical principles such as reflectance spectrophotometry, fluorescence, and ____________?

a. ESI
b. IFE
c. RIA
d. PCR

A

d. PCR

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25
Q

Rapid tests for D-dimer

a. can report qualitative and quantitative results for the D fragment
b. can report only qualitative results
c. can report only quantitative results
d. can not be used in clinical laboratories

A

a. can report qualitative and quantitative results for the D fragment

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26
Q

You are running prothrombin time (PT) and activated partial thromboplastin time (aPTT) for pre-op testing that came from an outpatient clinic. You get an alarm from your analyzer indicating that there is no endpoint clotting time. The patient has no history of bleeding problems and is on no medication that would cause excessive long coagulation times. The specimen was in a 3.2% sodium citrate tube that was received in the lab 20 mins after it was collected and spun immediately upon arrival. What may be the cause for the failure to clot?

a. the specimen needed to sit for at least 30 mins before it is centrifuged
b. the specimen had a clot in it that was not detected upon arrival in the lab
c. the specimen should have been drawn in an EDTA tube for this testing
d. the specimen should have been kept at body temp

A

b. the specimen had a clot in it that was not detected upon arrival in the lab

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27
Q

A patient with rheumatoid arthritis has been undergoing treatment for the disease for several months. The rheumatologist has ordered two CRP levels (by latex agglutination) and the results are seen in the table below. Which of the following answers is the best interpretation of the CRP results provided?

SAMPLE: 1-15-23 QUALITATIVE: POS
Semi-quanti:
1:2= +
1:4= +
1:8= +
1:16= +
1:32= +
1:64= +
1:128= +
1:256= 0

SAMPLE: 4-25-23 QUALITATIVE: POS
Semi-quanti:
1:2= +
1:4= +
1:8= +
1:16= +
1:32= +
1:64= 0
1:128= 0
1:256= 0

a. the inflammation from the RA is decreasing with treatment
b. the inflammation from the RA is increasing despite treatment
c. the treatment has been ineffective and the inflammation has not significantly changed
d. the concentration of rheumatoid factor has decreased due to treatment

A

a. the inflammation from the RA is decreasing with treatment

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28
Q

Transfusion-related complications

a. include infection, transmission, alloimmunization, and immunohematological reactions
b. are rare and non-significant
c. include weight loss, hypertension, and diarrhea
d. are always life-threatening

A

a. include infection, transmission, alloimmunization, and immunohematological reactions

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29
Q

An organism that can live and grow in reduced concentrations of oxygen, but prefers an anaerobic environment is known as

a. facultative anaerobe
b. capnophile
c. an aerotolerant anaerobe
d. obligate anaerobe

A

c. an aerotolerant anaerobe

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30
Q

You suspect that the yeast isolated from the oral cavity of a patient with HIV is Candida albicans. How could you determine that the isolate is not Candida dubliniensis?

a. germ tube
b. cornmeal agar
c. growth at 42℃
d. none of these methods

A

c. growth at 42℃

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31
Q

A patient has a blood glucose level of 200 mg/dL. Two hours later, the patient undergoes a spinal tap and a blood glucose is run immediately. Which of the following is the most likely glucose level in the spinal fluid of a normal patient?

a. 60 mg/dL
b. 100 mg/dL
c. 130 mg/dL
d. 200 mg/dL

A

c. 130 mg/dL

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32
Q

All of the following about a 24-hour collection beginning at 7 am are true, except:

a. empty the bladder at 7 am and discard
b. that it is used for hormone measurement
c. that it is used for creatinine clearance measurement
d. discard the last urine collected in the 24 hour urine collection period

A

d. discard the last urine collected in the 24 hour urine collection period

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33
Q

A current laboratory testing method for toxin A/N can be used for either primary or confirmatory testing is:

a. culture
b. NAAT
c. polymerase chain reaction
d. agarose gel electrophoresis

A

b. NAAT

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34
Q

The rubella antibody IgM response

a. usually peaks immediately after vaccination
b. usually occurs within 3 weeks after rash and post vaccination
c. is undetected
d. occurs before rash appears

A

b. usually occurs within 3 weeks after rash and post vaccination

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35
Q

What is the final product of hepatic ethanol metabolism?

a. acetaldehyde
b. acetone
c. acetic acid
d. acetate

A

c. acetic acid

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36
Q

The human hemoglobin molecule

a. contains twelve globin chains
b. contains protein and heme
c. made of two proteins
d. made of four chains

A

d. made of four chains

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37
Q

A physician suspects his patient may have rheumatic fever due to an untreated Streptococcus A infection. The physician requests an anti-streptolysin o titer. The results are shown below:

Reagent Red cells + Patient serum
120 Todd units- no hemolysis
240 Todd units- no hemolysis
360 Todd units- no hemolysis
420 Todd units- hemolysis
540 Todd units- hemolysis
620 Todd units- hemolysis

The results indicate:

a. the patient has anti-streptolysin O antibodies preventing hemolysis of the reagent red cells
b. the patient does NOT have anti-streptolysis O antibodies because there is no hemolysis in the initial tubes
c. the test should be repeated because there should be NO hemolysis in any tube
d. the sample us showing postzone and should be diluted futher

A

a. the patient has anti-streptolysin O antibodies preventing hemolysis of the reagent red cells

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38
Q

A specimen just collected in a spinal tap is taken immediately to the lab and examined. The specimen is centrifuged in a microhematocrit tube. The supernatant is xanthochromic most likely indicating:

a. the patient has a decreased level of protein
b. the patient has bacteria in the spinal fluid
c. the patient had a traumatic tap
d. the patient had a previous brain bleed

A

d. the patient had a previous brain bleed

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39
Q

A gastric biopsy sample from a patient complaining abdominal pain is urease positive. What organism is responsible?

a. Vibrio
b. Salmonella typhi
c. Helicobacter pylori
d. Yersinia enterocolitica

A

c. Helicobacter pylori

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40
Q

HEp-2 cells play which of the following roles when used in Fluorescent Antinuclear Antibody (FANA) testing?

a. the substrate on the slide containing the antinuclear antigens to which the antinuclear antibodies, if present will bind

b. the fluorochrome, which will illuminate if the antibody to which they are conjugated, binds

c. the HEp-2 is one of the antinuclear antibodies being tested for

d. these are a control and display only one type of positive fluorescent pattern to be sure the test is working correctly

A

a. the substrate on the slide containing the antinuclear antigens to which the antinuclear antibodies, if present will bind

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41
Q

Your laboratory is about to begin offering a fourth generation ELISA test for HIV screening. Which of the following sets of antibodies/antigens can the fourth generation test detect?

a. anti-HIV-1, anti-HIV-2, and p24 antigen
b. anti-HIV-1 and anti-HIV-2 only
c. only antu-HIV-1
d. only anti-p24 and anti-HIV-2

A

a. anti-HIV-1, anti-HIV-2, and p24 antigen

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42
Q

The results of a cold agglutinin titer are shown:

Temp RT 4°C 37°C
1:1 2+ 4+ 0
1:2 2+ 4+ NT
1:4 2+ 3+ NT
1:8 1+ 3+ NT
1:16 1+ 2+ NT
1:32 0 1+ NT
1:64 0 0 NT

Which of the following statements explain these results?

a. the negative result at 37°C indicated that this is a true cold agglutinin
b. the negative result at 37°C indicates that the results of all testing are invalid
c. the results are not consistent at any phase with a cold agglutinin
d. the results indicate variations in technique of pipetting and the result should be repeated

A

a. the negative result at 37°C indicated that this is a true cold agglutinin

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43
Q

Using safe needle devices is an example of:

a. workplace control
b. an engineering control
c. best practice in the workplace
d. a human resources equipment

A

b. an engineering control

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44
Q

You are going to draw a timed cardiac specimen. When you arrive to collect the specimen, the patient’s physician and nurse are with the patient. Being an Allied Health Professional, how do you proceed?

a. go back to the laboratory and wait until later to collect the specimen
b. from outside the curtained area, inform the physician that you are here to collect a timed blood specimen and ask permission to enter the curtained area
c. cancel the test in the computer system because it cannot be collected at the specified time
d. enter the curtained area and tell the physician and patient you have to collect the specimen right now

A

b. from outside the curtained area, inform the physician that you are here to collect a timed blood specimen and ask permission to enter the curtained area

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45
Q

Which of the following instruments ionizes the target molecule then separates and measure the mass-to-charge ratio?

a. atomic absorption spectrometer
b. ion selective electrode
c. mass spectrometer
d. gas chromatography

A

c. mass spectrometer

46
Q

A high-protein diet may cause a:

a. prerenal plasma urea increase
b. postrenal plasma urea increase
c. prerenal plasma urea decrease
d. postrenal plasma urea decrease

A

a. prerenal plasma urea increase

47
Q

Ionized calcium is measured on automated systems by which of the following methods?

a. CPC
b. AAS
c. TLC
d. ISE

A

a. CPC

48
Q

Which of the following is a drug that requires metabolic processes to transform it into the physiologically active form?

a. pre-protodrug
b. protodrug
c. prodrug
d. predrug

A

c. prodrug

49
Q

A monocyte’s nuclei has the appearance of:

a. three lobes with strands
b. three lobes
c. multiple sausages
d. multiple nucleoli

A

b. three lobes

50
Q

The Hemoglobin S solubility test uses anticoagulated whole blood, mixed with the lysing agent, saponin and a reducing agent, sodium dithionate. hemoglobin is released and the reduced. Blood containing hemoglobin S gives a solubility test of:

a. a red turbid liquid
b. a red clear liquid
c. a colorless turbid liquid
d. a colorless clear liquid

A

a. a red turbid liquid

51
Q

Reverse transcription PCR

a. uses reverse transcriptase to produce cDNA from transcript
b. uses T7 RNA polymerase to produce transcript from cDNA
c. uses T7 RNA polymerase to produce cDNA from transcript
d. uses RNase H to degrade RNA in DNA; RNA hybrids

A

a. uses reverse transcriptase to produce cDNA from transcript

52
Q

When deciding which antimicrobial agents to test and report on an isolate, which of the following statements is NOT true?

a. the final identification of the organism should guide the drugs reported
b. the location(s) of the infection(s) or the dissemination of the infection should guide the antibiotics reported
c. the age of the patient is a factor in the selection of antibiotics chosen to report
d. the resistance patterns of the institution do not need to be regarded in the selection of antibiotics to report

A

d. the resistance patterns of the institution do not need to be regarded in the selection of antibiotics to report

53
Q

A 3-year old boy was playing in the dirt. His mother stopped him and immediately cleaned his hands with an alcohol-based hand sanitizer. Which of the following beneficial processes could the mother actually be hindering?

a. triggering of systematic inflammation in response to antibody production
b. exposure to foreign antigens using selection of thymocytes that are only capable of recognizing nonself antigens
c. development of thymocytes that only recognize self (non-foreign) antigens
d. exposure to soil parasites resulting in systemic hydatid cyst formation

A

b. exposure to foreign antigens using selection of thymocytes that are only capable of recognizing nonself antigens

54
Q

The purpose of adsorption of patient serum with the Reiter strain of T. pallidum in the FTA-ABS test for syphilis is to:

a. remove cross-reactivity with other treponemes that do not cause syphilis
b. remove cross-reactivity with the Nichols strain of syphilis which us non pathogenic
c. ensure reactivity with only the Reiter strain of syphilis, the most common form of syphilis in humans
d. ensure reactivity with only the reiter strain of syphilis, the most common form of syphilis in humans

A

a. remove cross-reactivity with other treponemes that do not cause syphilis

55
Q

The use of a control latex in latex agglutination testing helps to determine if the positive test result is due to:

a. nonspecific agglutination reactions
b. the presence of the antibody in the specimen exceeds the concentration of antigen
c. co-agglutination
d. cold agglutinating antibodies

A

a. nonspecific agglutination reactions

56
Q

An ampicillin-sensitive Enterococcus faecalis isolated from a blood culture has high-level resistance to the aminoglycoside gentamicin. Which of the following combinations of antibiotics could possibly used for the treatment?

a. ampicillin and gentamicin
b. ampicillin and streptomycin
c. ampicillin and tobramycin
d. ampicillin and amikacin

A

b. ampicillin and streptomycin

57
Q

Blood was collected in a serum separator tube on patient who has been fasting since midnight. The time of collection was 7am. The laboratory test which should be recollected is:

a. triglycerides
b. iron
c. LD
d. sodium

A

a. triglycerides

58
Q

Refer to the following graph: *insert pic

A new methodology for amylase has been developed and compared with the existing method as illustrated in the graph shown above. The new method can be described as:

a. poor correlation with constant bias
b. good correlation with constant bias
c. poor correlation with no bias
d. good correlation with no bias

A

b. good correlation with constant bias

59
Q

What method may be used to resolve the patient’s ABO serum typing?

Anti-A: 4+
Anti-B: 0
Anti-D: 4+
A1 cells: 2+
B cells: 4+
Antibody screening: SC I, SC II, Autocontrol
Immediate spin: 2+, 2+, 2+
Room Temp: 3+, 3+, 3+

LISS= low ionic strength solution

a. DTT-treat patient’s red cells
b. warm saline wash patient’s red cells
c. enzyme treat patient’s red cells
d. cold autoadsorption

A

d. cold autoadsorption

60
Q

Which of the following markers is expressed in most cases of AML?

a. CD2
b. CD10
c. CD11b
d. CD117

A

d. CD117

61
Q

A heel stick procedure for blood collection must be employed until the child is at least how old?

a. 6 months
b. 12 months
c. 18 months
d. 24 months

A

b. 12 months

62
Q

The material stained blue in the image below is: *insert pic

a. cartilage
b. muscle
c. collagen
d. reticulin

A

c. collagen

63
Q

Blood is diluted 1:200, and a platelet count is performed. 180 platelets were counted in the center square millimeter on one side of the hemacytometer and 186 on the other side. The total platelet count is:

a. 146,000/µL
b. 183,000/µL
c. 366,000/µL
d. 732,000/µL

A

c. 366,000/µL

64
Q

A clean-catch urine is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hours later, the specimen is sent to the microbiology department for culture. The specimen should:

a. be centrifuged and the supernatant cultured
b. be rejected due to time delay
c. not be cultured if no bacteria are seen
d. be processed for culture only if the nitrate is positive

A

b. be rejected due to time delay

65
Q

no #65

A

skip muna

66
Q

A clean catch urine culture (obtained with a 0.01 mL calibrated loop) grows 60 colonies of Escherichia coli. Which of the following represents the final colony count in CFU/mL?

a. 60 CFU/mL
b. 600 CFU/mL
c. 6000 CFU/mL
d. 60,000 CFU/mL

A

c. 6000 CFU/mL

67
Q

A 2-year old child with a decreased serum T4 is described as being somewhat dwarfed, stocky, overnight, and having coarse features,. Of the following, the most informative additional laboratory test would be the serum:

a. thyroxine-bonding globulin (TBG)
b. thyroid-stimulating hormone (TSH)
c. triiodothyronine (T3)
d. cholesterol

A

b. thyroid-stimulating hormone (TSH)

68
Q

A 40-year old man with autoimmune hemolytic anemia due to anti-E has a hemoglobin of 10.8 g/dL (108 g/L). This patient will most likely be treated with:

a. whole blood
b. red blood cells
c. fresh frozen plasma
d. no transfusion

A

d. no transfusion

69
Q

What is the conformation of DNA at 95°C?

a. double-stranded
b. fragmented
c. hairpin loop
d. single-stranded

A

d. single-stranded

70
Q

Which of the following patients will have a falsely depressed glycated albumin concentration?

a. a 30-year old man who is morbidly obese
b. a 25-year old woman who is pregnant
c. a 40-year old woman with iron deficiency anemia
d. a 60-year old man with cirrhosis

A

a. a 30-year old man who is morbidly obese

*
- a 25-year old woman who is pregnant (GA = NC)
- a 40-year old woman with iron deficiency anemia (GA = NC)
- a 60-year old man with cirrhosis (↑GA)

71
Q

A patient has a suspected diagnosis of subacute bacterial endocarditis. His blood cultures form non-sporeforming pleomorphic gram-positive bacilli only in the anaerobic bottle. What tests will give a presumptive ID?
* insert pic

A
  • propionibacterium acnes; perform catalase and indole test
  • catalase (+), indole V
72
Q

During initial investigation of a suspected hemolytic transfusion reaction, it was observed that the posttransfusion serum was yellow in color and the direct antiglobulin test was negative. What is the next step in this investigation?

a. repeat compatibility testing on suspected unit(s)
b. perform plasma hemoglobin and haptoglobin determinations
c. use enhancement media to repeat the antibody screen
d. no further serologic testing is necessary

A

d. no further serologic testing is necessary

73
Q

Fructosamine approximates which of the following?

a. unweighted average of blood glucose over the preceding 100 days
b. unweighted average of blood glucose over the preceding 30 days
c. weighted average of blood glucose over the preceding 100 days
d. weighted average of blood glucose over the preceding 30 days

A

d. weighted average of blood glucose over the preceding 30 days

*
- HbA1c reflects a weighted average of blood glucose concentration over the preceding 100 days
- GA reflects glucose concentration over the previous 40 days
- Fructosamine reflects glucose concentration over the previous 30 days

74
Q

Test performed to monitor diabetes in patients with hemolytic anemia:

a. HbA1c
b. fructosamine
c. FBS
d. OGTT

A

b. fructosamine

75
Q

Which of the following is consistent with Adrenal Cushing Syndrome?

a. ACTH increased, cortisol increased
b. ACTH decreased, cortisol increased
c. ACTH increased, cortisol decreased

A

b. ACTH decreased, cortisol increased

*
ADRENAL CUSHING’S SYNDROME- ↓ ACTH; ↑CORTISOL

PITUITARY CUSHING’S SYNDROME (CUSHING’S DISEASE)- ↑ACTH; ↑ CORTISOL

CONGENITAL ADRENAL HYPERPLASIA- ↑ ACTH; ↓ CORTISOL

76
Q

A 46-year old patient who has a lipid profile test has the following results:
- Triglyceride: 200
- HDL: 50
- LDL (Direct measurement): 100

a. repeat the cholesterol only
b. compute the chylomicrons
c. report the calculated LDL-c
d. repeat the triglyceride only

A

c. report the calculated LDL-c

77
Q

In order for a laboratory to handle TB sputum and TB materials, the laboratory must operate at a:

a. biosafety level of 2+ or 3
b. biosafety level 4
c. location where air exchange occurs
d. location where fume hood exhausts are monitored daily

A

a. biosafety level of 2+ or 3

78
Q

Calculate the % saturation, given the following:
UIBC: 185
Serum iron: 125
Transferrin: 230

a. 25%
b. 35%
c. 40%
d. 45%

A

c. 40%

*
TIBC= UIBC + Serum Fe

% Saturation of Fe= Serum Fe/TIBC x 100

NV= 20-55%

79
Q

An acid-fast bacillus recovered from an induced sputum had the following characteristics:
*Pigmentation: yellow in the dark, turning a deeper yellow-orange after 2 weeks of light exposure
*Nitrate reduction: negative
*Tween hydrolysis: positive at 5-10 days
*Urease: negative

a. M. scrofulaceum
b. M. gordonae
c. M. szulgai
d. M. flavescens

A

b. M. gordonae

80
Q

A CSF sample for culture arrived late and the MLS only manages to perform Gram stain in his shift, what should the technologist do next?

a. incubate at 35°C
b. room temperature
c. refrigerator temperature
d. freeze

A

a. incubate at 35°C

*
4°C: urine, stool, viral samples, sputum
37°C: CSF
-20°C: serum
-70°C: tissue samples, long-term storage

VIRAL SAMPLES:
- storage at 4°C
- transport at -70°C

80
Q

A 75 kg female has a fibrinogen level of 45 mg/dL. Her hematocrit is 31%. How many bags of cryoprecipitate are needed to raise her fibrinogen to an acceptable level for hemostasis?

a. 5
b. 8
c. 10
d. 12

A

b. 8

81
Q

The Hair Baiting test is used to differentiate which two species of Trichophyton that produce red colonies on Saboraud agar plates?

a. T. mentagrophytes and T. rubrum
b. T. tonsurans and T. schoenleinii
c. T. tonsurans and T. violaceum
d. T. verrucosum and T. rubrum

A

a. T. mentagrophytes and T. rubrum

82
Q

Which of the following is a marker for bone formation?

a. osteocalcin
b. tartrate-resistant acid phosphatase
c. urinary pyridinoline and deoxypridinoline
d. urinary C-telopeptide and N-telopeptide crosslinks (CTx and NTx)

A

a. osteocalcin

83
Q

A patient diagnosed with streptococcal pharyngitis months ago is now having a sequelae resulting to acute glomerulonephritis and rheumatic fever. What will be the result of the renal biopsy culture

a. no growth
b. beta-hemolytic streptococci

A

a. no growth

84
Q

Consistent finding:
EBV IgG titer 1:128
EBV IgM <1:10
CMV IgG titer 1:128
CMV IgM ≥ 1:10
Toxoplasma IgG titer 1:128
Toxoplasma IgM <1:10

a. primary infection to CMV
b. primary infection to EBV
c. primary infection to Toxoplasma
d. coinfection with CMV and EBV

A

a. primary infection to CMV

85
Q

Respiratory fungal cultures from a patient with pulmonary infiltrates reveal a colony of pale cream-colored mold after 8 days at standard incubation conditions. Tape mounts demonstrate hyphae bearing round conidia borne slightly on short stalks, which resemble lollipops. Which of the following is the next course of action?

a. set up broth microdilution susceptibility test
b. set up slide culture for definitive morphologic identification
c. subculture isolate to 25°C for yeast-conversion assessment
d. refer isolate for molecular probe-based identification

A

d. refer isolate for molecular probe-based identification

86
Q

What is the most probably racial origin of this donor with the following typing results?
Le (a-b-), Fy (a-b-), Js (a+b+)

a. black
b. oriental
c. american indian
d. caucasian

A

a. black

87
Q

A sputum culture from 13-year old cystic fibrosis patient grew a predominance of short, gram-negative rods that tested oxidase negative. On MacConkey, chocolate, and blood agar plates, the organism appeared to have a lavender green pigment. Further testing showed:

DNAse: +
Lysine decarboxylase: (+)
Motility: +
Maltose: +
Glucose: + (oxidative)
Esculin hydrolysis: +

a. Stenotophomonas maltophilia
b. Acinetobacter baumanii
c. Pseudomonas aeruginosa
d. Burkholderia (Pseudomonas) cepacia

A

a. Stenotophomonas maltophilia

88
Q

Which of the following HbA1c tests is capable of detecting common hemoglobin mutations?

a. high-performance liquid chromatography
b. immunoassay
c. enzymatic assay
d. boronate affinity chromatography

A

a. high-performance liquid chromatography

89
Q

What is used to aid in the detection of rupture of fetal membranes (ROM) in pregnant women?

a. Amnisure
b. Fetal fibronectin
c. QuickVue β-HcG screen
d. AFP

A

a. Amnisure

*
Amnisure uses the principle of immunochormatography to detect PAMG-1 protein present in amniotic fluid of pregnant women

90
Q

Interpret the following results from an OSOM Monospot test: *insert pic

a. positive
b. negative
c. invalid

A

b. negative

91
Q

It is used to compare the magnitude of the bias (the difference between the means of the test and that of the comparative method) with that of the random error. This indicates only whether a statistically significant difference exists between the two SDs or means respectively.

a. paired t-test
b. F test
c. chi square test

A

a. paired t-test

92
Q

The confirmation of a heterophile antibody of infectious mononucleosis would be:

a. agglutination with horse cells
b. agglutination with guinea pig cells
c. agglutination of sheep cells after incubation with guinea pig cells, no agglutination of sheep cells after incubation with beef cells
d. agglutination of sheep cells after incubation with beef cells, no agglutination of sheep cells after incubation with guinea pig cells

A

c. agglutination of sheep cells after incubation with guinea pig cells, no agglutination of sheep cells after incubation with beef cells

93
Q

In the direct antiglobulin test, the antiglobulin reagent is used to:

a. mediate hemolysis of indicator red blood cells by providing complement
b. precipitate antierythrocyte antibodies
c. measure antibodies in a test serum by fixing complement
d. detect preeexisting antibodies on erythrocytes

A

d. detect preeexisting antibodies on erythrocytes

94
Q

A neonatal blood culture collected through a catheter grows a small yeast. Microscopically, the yeast appear round at one end, with a budlike structure on a broad base at the other end. Growth is enhanced around the olive oil-saturated disc. The organism isolated is:

a. Candida tropicalis
b. Malassezia furfur
c. Candida lipolytica
d. Malassezia pachydermatis

A

b. Malassezia furfur

95
Q

A 26-year old female is admitted with anemia of undetermined origin. Blood samples are received with a crossmatch request for six units of red blood cells. The patient is group A, Rh-negative and has no history of transfusion or pregnancy. The following results were obtained in pretransfusion testing:

                                  IS            37°C         IAT Screening cell I            0               0             3+ Screening cell II           0               0             3+ Autocontrol                  0               0             3+ All 6 donors                  0               0             3+

The best way to find compatible blood is to:

a. do an antibody identification panel
b. use the saline replacement technique
c. use the prewarm technique
d. perform the warm autoadsorption

A

d. perform the warm autoadsorption

96
Q

What chemical is used to treat patient red blood cells to perform a phenotype when DAT is positive due to IgG?

a. ZZAP (a mixture of papain or ficin, DTT, and phosphate-buffered saline)
b. EDTA glycine acid (EGA)
c. 2-Mercaptoethanol 2-ME
d. Dithiotheitol (DTT)

A

b. EDTA glycine acid (EGA)

97
Q

The following results were obtained:

                     Infant                 Mother Anti-A                  0                          4+ Anti-B                  0                           0 Anti-D                  0                           0 Rh control           NT                        0

DAT 4+ NT
Ab screen NT Anti-D

*NT= not tested

Which of the following is the most probably explanation for these results?

a. ABO hemolytic disease of the newborn
b. Rh hemolytic disease of the newborn, infant has received intrauterine transfusions
c. Rh hemolytic disease of the newborn, infant has a false-negative Rh-typing
d. large fetomaternal hemorrhage

A

c. Rh hemolytic disease of the newborn, infant has a false-negative Rh-typing

98
Q

To rule out an antibody while performing the alloabsorption procedure, which condition should be met?

a. the absorbing cell should possess the antigen and the panel cell should lack it
b. the absorbing cell should possess the antigen and the panel cell should also possess it
c. the absorbing cell should lack the antigen and the panel cell should also lack it
d. the absorbing cell should lack the antigen and the panel cell should possess it

A

a. the absorbing cell should possess the antigen and the panel cell should lack it

99
Q

A donor has anti-K and Anti-Fya. How many units should a transfusion service expect to screen in order to find two compatible units?

*K-negative donors 91%, Fya negative 32%

a. 5
b. 7
c. 10
d. 29

A

b. 7

100
Q

Sperm motility evaluations are performed:

a. immediately after the specimen is collected
b. within 1-2 hours of collection
c. after 3 hours of incubation
d. after 6-hour intervals for one day

A

b. within 1-2 hours of collection

101
Q

After performing 4 alloabsorptions on a patient sample using ZZAP, the autoantibody was not removed and the strength has not changed. What is the most probable reason?

a. sometimes autoantibodies cannot be removed
b. the autoantibody could have specificity for the Kidd system
c. more absorptions are required to remove the autoantibody
d. the autoantibody could have specificity for the Kell system

A

d. the autoantibody could have specificity for the Kell system

102
Q

Leukocyte-reduced red blood cells are ordered for a newly diagnosed bone marrow candidate. What is the best way to prepare this product?

a. crossmatch only CMV seronegative units
b. irradiate the unit with 1500 rads
c. wash the unit with saline prior to transfusion
d. transfuse through a 3 Log leukocyte removing filter

A

d. transfuse through a 3 Log leukocyte removing filter

103
Q

What chemical is used when confronted with ABO/Rh typing problems and the DAT negative control is reactive?

a. ZZAP
b. EGA
c. chloroquine diphosphate
d. DTT

A

d. DTT

104
Q

A 15-year old, 45 kg boy with hemophilia A presents to the physician with a knee joint that is swollen and discolored. He is diagnosed with hemarthrosis. Subsequent values indicate:
Hct: 33%
FVIII level: 3%

Calculate the dose of FVIII concentrate this boy should receive:

a. 6
b. 8
c. 10
d. 12

A

d. 12

105
Q

Indicative of the given peripheral blood finding: *insert pic

a. PCH
b. rheumatoid arthritis
c. presence of cold autoantibodies
d. SLE

A

c. presence of cold autoantibodies

106
Q

What virus belonging to the Reoviridae group causes gastroenteritis in infants and young children but asymptomatic infection in adults?

a. Coxsackie B virus
b. Rotavirus
c. Respiratory syncytial virus
d. Norwalk virus

A

c. Respiratory syncytial virus

107
Q

Blastoconidia:

a. arise from the side of the hypha
b. mother budding a daughter cell with constriction
c. spores formed during unfavorable condition
d. derived from fragmentation of the mycelium

A

b. mother budding a daughter cell with constriction

108
Q

Which results would be expected for the prothrombin time (PT) and activated partial thromboplastin time (APTT) in a patient with polycythemia?

a. both prolonged
b. both shortened
c. normal PT, prolonged APTT
d. both normal

A

a. both prolonged

109
Q

A patient received 2 units of red blood cells and had a delayed transfusion reaction. Pretransfusion antibody screening records indicate no agglutination except after the addition of IgG sensitized cells. Repeat testing of the pretransfusion specimen detected an antibody at the antiglobulin phase. What is the most likely explanation of the original results?

a. red cells were overwashed
b. centrifugation time was prolonged
c. patient’s serum was omitted from the original testing
d. antiglobulin reagent was neutralized

A

c. patient’s serum was omitted from the original testing

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