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1222 Cards in this Set
- Front
- Back
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The minimum Hg concentration in a fingerstick from a male blood donor is:
a. 12.0 g/dL(120g/L) b. 12.5 g/dL(125g/L) c. 13.5 g/dL(135g/L) d. 15.0g/dL(150g/L) |
B. 12.5 g/dL (125 g/L)
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Which of the following constitutes permanent rejection status of a donor?
a. a tattoo 5 months ago b. recent close contact with a patient with viral hepatitus c. 2 units of blood transfused 4 months previously d. confirmed positive test for HBsAg 10 yrs. earlier |
D. confirmed positive HBsAg 10 years previously
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Physical examination requirments for blood donation:
a. hemoglobin b. hematocrit c. blood pressure d. temperature e. pulse f. weight |
a. >12.5 g/dL(125g/L)
b. >38% c. <180 systolic <100 diastolic d. <37.4 C (99.5F) e. 50-100 f. >110 lb. (50kg) |
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Venipuncture site must be cleaned with a scrub solution of:
a. hypochlorite b. isopropyl alcohol c. 10% acetone d. PVP iodine comples |
D. PVP iodine complex
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All donors blood testing must include:
a. complete Rh phenotype b. anti-CMV testing c. DAT d. serological test for syphilis |
D. serological test for syphilis
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During the preparation of Platlet Concentrates from whole blood, the blood should be:
a. cooled towards 6 C b. cooled towards 20-24 C c. warmed to 37 C d. heated to 57 C |
B. cooled towards 20-24 C
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The western blot is a confirmatory test for:
a.CMV antibody b. anti-HIV-1 c. HBsAg d. serum protein abnormality |
B. anti-HIV-1
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The test that is currently used to detect donors who are infected with the AIDS virus is:
a. anti-HBc b. anti-HIV-1,2 c. HBsAg d. ALT |
B. anti-HIV-1,2
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A commonly used screening method for anti-HIV detection is;
a. latex agglutination b. RIA c. TLC d. ELISA |
D. ELISA
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A unit of packed cells is split into 2 aliquots under closed sterile conditions at 8am. The expiration time for each aliquot is:
a. 4pm the same day b. 8pm the same say c. 8am the next morning d. the original date of the unsplit unit |
D. the original date of the unsplit unit
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When platlets are stored on a rotator set on an open bench top, the ambient air temps. must be recorded:
a. once a day b. twice a day c. every 4 hours d. every hour |
C. every 4 hours
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Which of the following is the correct storage temp for the component listed:
a. Cryo AHF - 4*C b. FFP - -20*C c. Frozen RBC - -40*C d. Platlets - 37* C |
B. FFP - -20*C
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A unit of RBC's is issued at 9am and at 9:10am it is returned to the blood bank. the container has NOT been entered but the unit has NOT been refrigerated during this time span. the best course of action for the tech is to:
a. culture the unit for bacteria b. discard the unit if not used within 24 hrs c. store the unit at room temp d. record the return and place the unit back into inventory |
D. record the return and placed the unit back into inventory
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Optimun storage temperature for RBC's
a. -80*C b. -20*C c. -12*C d. 4*C |
D. 4*C
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If the seal is entered on a unit of RBC's stored at 1*C to 6*C, what is the maximum allowable storage period in hours?
a. 6 b. 24 c. 48 d. 72 |
B. 24 hours
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Optimum storage for cryo AHF is:
a. -20*C b. -12*C c. 4*C d. 22*C |
A. -20*C
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Cryo AHF must be transfused within what period of time following thawing and pooling?
a. 4 hrs b. 8 hrs c. 12 hrs d. 24 hrs. |
A. 4 hours
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Platlets prepared in a polyolefin type container, stored at 22*-24*C in 50mL of plasma and gentlly agitated can be used for up to:
a. 24 hrs b. 48 hrs c. 3 days d. 5 days |
D. 5 days
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Optimum storage temperature for platelets:
a. -20*C b. -12*C c. 4*C d. 22*C |
D. 22*C
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According to AABB standards FFP must be infused within what period of time following thawing:
a. 24 hrs b. 36 hrs c. 48 hrs d. 72 hrs |
A. 24 hours
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Cryo AHF, if maintained in the frozen state at -18*C or below, has a shelf life of:
a. 42 days b. 6 months c. 12 months d. 36 months |
C. 12 months
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Once thawed, FFP must be transfused within:
a. 4 hrs b. 8 hrs c. 12 hrs d. 24 hrs |
D. 24 hours
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In the liquid state, plasma must be stored at:
a. 1 - 6*C b. 22*C c. 37*C d. 56*C |
A. 1 - 6*C
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Which apherisis platelets product should be irradiated:
a. autologous unit collected prior to surgery b. random stock unit going to a patient with DIC c. a directed donation given by a mother for her son d. a directed donation given by an unrelated family friend |
C. a directed donation given by a mother for her son
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Irradiation of a unit of RBC's is done to prevent the replication of donor:
a. granulocytes b. lymphocytes c. red cells d. platelets |
B. Lymphocytes
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Plastic bag overwraps are recommended when thawing FFP in 37*C waterbath. because they prevent:
a. FFP bag from cracking b. water from slowly dialyzing across the bag membrane c. the entry ports from being contaminated with water d. the label from peeling |
C. the entry portals from being contaminated with water
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Which of the following blood components must be prepared within 8 hrs after phlebotomy:
a. RBC's b. FFP c. Frozen rbc's d. Cryp AHF |
B. Fresh Frozen Plasma
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A blood component prepared by thawing FFP at refrigerator temp and removing the fluid portion is:
a. Plasma Protein Fraction b. Cryo AHF c. Factor IX Complex d. FP24 |
B. Cryoprecipitated AHF
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Upon inspection, a unit of Plts is noted to have visible clots. but otherwise appears normal. the tech should:
a. issue without concern b. filter to remove clots c. centrifuge to express off the clots d. quarantine for gram stain and culture |
D. Quarantine for Gram stain and culture
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Which of the following is proper procedure for preparation of platelets from Whole Blood:
a. light spin followed by hard spin b. light spin followed by 2 hard spins c. 2 light spins d. hard spin followed by a light spin |
A. light spin followed by a hard spin
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The linked HLA genes on each chomosome constitutes a:
a. allele b. trait c. phenotype d. haplotype |
D. Haplotype
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A blood donor has the genotype: hh, AB. what is his RBC phenotype?
a. A b. B c. O d. AB |
C. O
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An individual has been sensitzed to the k antigen and has produced and anti-k. What is her most probable Kell system genotype:
a. KK b. Kk c. kk d. K0K0 |
A. KK
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Given the following typing results, what is the donors racial ethnicitly:
a. African Amer. b. Asian Amer. c. Native Amer. d. Cuacasian |
A. African American
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The linked HLA genes on each chomosome constitutes a:
a. allele b. trait c. phenotype d. haplotype |
D. Haplotype
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In an emergency situtation, Rh-neg. red cells are transfused into a Rh-pos person of the genotype CDe/CDe. the first antibody most likely to develop is:
a. anti-c b. anti-d c. anti-e d. anti- E |
A. Anti-c
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A blood donor has the genotype: hh, AB. what is his RBC phentype?
a. A b. B c. O d. AB |
C. O
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Most blood group systems are inherited as:
a. sex-linked dominant b. sex-linked recessive c. autosomal recessive d. autosomal codominant |
D. autosomal codominant
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The linked HLA genes on each chomosome constitutes a:
a. allele b. trait c. phenotype d. haplotype |
D. Haplotype
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The mating of an Xg(a+) man and a Xg(a-) women will only produce:
a. Xg(a-)sons + Xg(a-) daughters b. Xg(a+)sons + Xg(a+)daughters c. Xg(a-) sons + Xg(a+) daughters d. Xg(a+) sons + Xg(a-) daughters |
C. Xg(a-) sons and Xg(a+) daughters
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An individual has been sensitzed to the k antigen and has produced and anti-k. What is her most probable Kell system genotype:
a. KK b. Kk c. kk d. K0K0 |
A. KK
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Given the following typing results, what is the donors racial ethnicitly:
Le(a-b-) Fy(a-b-) Js(a+b+) a. African Amer. b. Asian Amer. c. Native Amer. d. Cuacasian |
A. African American
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The red cells of a nonsecretor will most likely type as:
a. Le(a-b-) b. Le(a+b+) c. Le(a+b-) d. Le(a-b+) |
C. Le(a+b-)
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A blood donor has the genotype: hh, AB. what is his RBC phentype:
a. A b. B c. O d. AB |
C. O
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In an emergency situtation, Rh-neg. red cells are transfused into a Rh-pos person of the genotype CDe/CDe. the first antibody most likely to develop is:
a. anti-c b. anti-d c. anti-e d. anti- E |
A. Anti-c
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Which of the following phenotype will react with anti-F:
a. rr b. R1R1 c. R2R2 d. R1R2 |
A. rr
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An individual has been sensitzed to the k antigen and has produced and anti-k. What is her most probable Kell system genotype:
a. KK b. Kk c. kk d. K0K0 |
A. KK
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Most blood group systems are inferited as:
a. sex-linked dominant b. sex-linked recessive c. autosomal recessive d. autosomal codominant |
D. autosomal codominant
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A women types as Rh-pos. She has an anti-c titer of 32 at AHG. Her baby has a neg DAT and is not affected by HDFN. What is the fathers most likely Rh phenotype.
a. rr b.r"r c. R1r d. R2r |
C. R1r
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Given the following typing results, what is the donors racial ethnicitly:
Le(a-b-) Fy(a-b-) Js(a+b+) a. African Amer. b. Asian Amer. c. Native Amer. d. Cuacasian |
A. African American
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The mating of an Xg(a+) man and a Xg(a-) women will only produce:
a. Xg(a-)sons + Xg(a-) daughters b. Xg(a+)sons + Xg(a+)daughters c. Xg(a-) sons + Xg(a+) daughters d. Xg(a+) sons + Xg(a-) daughters |
C. Xg(a-) sons and Xg(a+) daughters
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In an emergency situtation, Rh-neg. red cells are transfused into a Rh-pos person of the genotype CDe/CDe. the first antibody most likely to develop is:
a. anti-c b. anti-d c. anti-e d. anti- E |
A. Anti-c
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The red cells of a nonsecretor will most likely type as:
a. Le(a-b-) b. Le(a+b+) c. Le(a+b-) d. Le(a-b+) |
C. Le(a+b-)
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Which of the following phenotype will react with anti-F:
a. rr b. R1R1 c. R2R2 d. R1R2 |
A. rr
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Most blood group systems are inherited as:
a. sex-linked dominant b. sex-linked recessive c. autosomal recessive d. autosomal codominant |
D. autosomal codominant
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A women types as Rh-pos. She has an anti-c titer of 32 at AHG. Her baby has a neg DAT and is not affected by HDFN. What is the fathers most likely Rh phenotype.
a. rr b.r"r c. R1r d. R2r |
C. R1r
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The mating of an Xg(a+) man and a Xg(a-) women will only produce:
a. Xg(a-)sons + Xg(a-) daughters b. Xg(a+)sons + Xg(a+)daughters c. Xg(a-) sons + Xg(a+) daughters d. Xg(a+) sons + Xg(a-) daughters |
C. Xg(a-) sons and Xg(a+) daughters
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The red cells of a nonsecretor will most likely type as:
a. Le(a-b-) b. Le(a+b+) c. Le(a+b-) d. Le(a-b+) |
C. Le(a+b-)
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which of the following phenotype will react with anti-F:
a. rr b. R1R1 c. R2R2 d. R1R2 |
A. rr
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A women types as Rh-pos. She has an anti-c titer of 32 at AHG. Her baby has a neg DAT and is not affected by HDFN. What is the fathers most likely Rh phenotype.
a. rr b.r"r c. R1r d. R2r |
C. R1r
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The linked HLA genes on each chomosome constitutes a:
a. allele b. trait c. phenotype d. haplotype |
D. Haplotype
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A blood donor has the genotype: hh, AB. what is his RBC phentype:
a. A b. B c. O d. AB |
C. O
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An individual has been sensitzed to the k antigen and has produced and anti-k. What is her most probable Kell system genotype:
a. KK b. Kk c. kk d. K0K0 |
A. KK
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Given the following typing results, what is the donors racial ethnicitly:
a. African Amer. b. Asian Amer. c. Native Amer. d. Cuacasian |
A. African American
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In an emergency situtation, Rh-neg. red cells are transfused into a Rh-pos person of the genotype CDe/CDe. the first antibody most likely to develop is:
a. anti-c b. anti-d c. anti-e d. anti- E |
A. Anti-c
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Most blood group systems are inherited as:
a. sex-linked dominant b. sex-linked recessive c. autosomal recessive d. autosomal codominant |
D. autosomal codominant
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The mating of an Xg(a+) man and a Xg(a-) women will only produce:
a. Xg(a-)sons + Xg(a-) daughters b. Xg(a+)sons + Xg(a+)daughters c. Xg(a-) sons + Xg(a+) daughters d. Xg(a+) sons + Xg(a-) daughters |
C. Xg(a-) sons and Xg(a+) daughters
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The red cells of a nonsecretor will most likely type as:
a. Le(a-b-) b. Le(a+b+) c. Le(a+b-) d. Le(a-b+) |
C. Le(a+b-)
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Which of the following phenotype will react with anti-F:
a. rr b. R1R1 c. R2R2 d. R1R2 |
A. rr
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A women types as Rh-pos. She has an anti-c titer of 32 at AHG. Her baby has a neg DAT and is not affected by HDFN. What is the fathers most likely Rh phenotype.
a. rr b.r"r c. R1r d. R2r |
C. R1r
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The linked HLA genes on each chomosome constitutes a:
a. allele b. trait c. phenotype d. haplotype |
D. Haplotype
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A blood donor has the genotype: hh, AB. what is his RBC phentype:
a. A b. B c. O d. AB |
C. O
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An individual has been sensitzed to the k antigen and has produced and anti-k. What is her most probable Kell system genotype:
a. KK b. Kk c. kk d. K0K0 |
A. KK
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Given the following typing results, what is the donors racial ethnicitly:
a. African Amer. b. Asian Amer. c. Native Amer. d. Cuacasian |
A. African American
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In an emergency situtation, Rh-neg. red cells are transfused into a Rh-pos person of the genotype CDe/CDe. the first antibody most likely to develop is:
a. anti-c b. anti-d c. anti-e d. anti- E |
A. Anti-c
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Most blood group systems are inherited as:
a. sex-linked dominant b. sex-linked recessive c. autosomal recessive d. autosomal codominant |
D. autosomal codominant
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The mating of an Xg(a+) man and a Xg(a-) women will only produce:
a. Xg(a-)sons + Xg(a-) daughters b. Xg(a+)sons + Xg(a+)daughters c. Xg(a-) sons + Xg(a+) daughters d. Xg(a+) sons + Xg(a-) daughters |
C. Xg(a-) sons and Xg(a+) daughters
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The red cells of a nonsecretor will most likely type as:
a. Le(a-b-) b. Le(a+b+) c. Le(a+b-) d. Le(a-b+) |
C. Le(a+b-)
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which of the following phenotype will react with anti-F:
a. rr b. R1R1 c. R2R2 d. R1R2 |
A. rr
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A women types as Rh-pos. She has an anti-c titer of 32 at AHG. Her baby has a neg DAT and is not affected by HDFN. What is the fathers most likely Rh phenotype.
a. rr b.r"r c. R1r d. R2r |
C. R1r
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Which of the following red cell typings are most commonly found in the African Americans:
a. Lu(a-b-) b. Jk(a-b-) c. Fy(a-b-) d. K-k- |
C. Fy(a-b-)
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4 units of blood are needed for elective surgery. the patient serum contains anti-C, anti-e, anti-Fya and anti-Jkb. Which of the following would be the best source of donor blood:
a. test all units in current stock b. test 100 group O Rh-neg c. test 100 group compatible donors d. rare donor file |
D. Rare Donor File
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In relationship testing a "Direct exclusion" is established when a genetic marker is:
a. absent in child, present in mother and alleged father b. absent in child, present in mother and absent in alleged father c. present in child, absent in mother and present in father alleged father d. present in child, absent in the mother and alleged father |
D. Present in child, absent in the mother and the alleged father
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In a relationship testing case the child has a genetic marker that is absent in the mother and cannot be demonstrated in the alleged father. What type of paternity exclusion is this:
a. indirect b. direct c. prior probablilty d. Hardy-Weinbery |
B. Direct
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Human blood groups were dicovered around 1900 by:
a. Jules Bordet b. Louis Pasteur c. Karl Landsteiner d. PL Mollison |
C. Karl Landsteiner
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Cells of the A3 subgroup will:
a. react with Dolichos biflorus b. bE-with anti-A c. five a mixed field reaction with anti-A,B d. bE- with anti-H |
C. give a mixed field reaction with anti-A,B
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The enzyme responsible for conferring H activity on the red cell membrane is alpha_:
a. galactosyl transferase b. n-acetylgalactosaminyl tranferase c. L-fucosyl transferase d. N-acetylglucosaminyl transferase |
C. L-fucosyl transferase
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Even in the absence of prior transfusion or pregnancy, individuals with the bombay phenotype will always have naturally occuring:
a. anti-Rh b. anti-K0 c. anti-U d. anti-H |
D. Anti-H
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The antibody in the Luthern system that is best detected at lower temps:
a. anti-Lua b. anti-Lub c. anti-Lu3 d. anti-Luab |
A. Anti-Lua
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Anti-Sda is strongly suspected if:
a. the patient has been previously transfused b. the agglutinates are mixed field and refractile c. the patient is group A or B d. only a small number of panel cells are reactive |
B. the agglutinates are mixed field and refractile
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HLA antibodies are:
a. naturally occuring b. induced by multiple transfusions c. directed against granulocyte antigen only d. frequently cause hemolytic transfusion reactions. |
B. induced by multiple transfusions
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Genes of the major histocompatibility complex:
a. code for HLA-A,HLA-B, and HLA-C antigens only b. are linked to genes in the ABO system c. are the primary genetic sex-determinants d. contribute to the coordiation of cellular and humoral immunity |
D. contribute to the coordination of cellular and humoral immunity
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Saliva from which of the following individuals would neutralize an auto anti-H in the serum of a group A, Le(a-b+) patient:
a. group A, Le(a-b-) b. group A, Le(a+b-) c. group O, Le(a+b-) d. group O, Le(a-b+) |
D. Group O, Le(a-b+)
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Which of the following Rh antigens has the highest frequency in Caucasians:
a. D b. E c. c d. e |
D. e
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Which of the following red cell antigens are found on glycophorin-A:
a. M,N b. Lea, Leb c. S, s d. P, P1,pk |
A. M,N
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Which of the following is a characteristic of anti-f?
a. associated with warm autoimmune hemolytic anemia b. found in the serum of patients with infectious mononucleosis c. detected at lower temps in the serum of normal individuals d. found only in the serum of group O individuals |
B. found in the serum of patients with infectious mononucleosis
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Paroxysmal cold hemoglobinuria is associated with antibody specificity toward which of the following:
a. Kell system antigens b. Duffy system antigens c. P antigen d. I antigen |
C. P antigen
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In a case of cold autoimmune hemolytic anemia, the patient's serum would most likely react 4+ at immediate spin with:
a. group A cells, B cells and O cells, but not his own cells b.cord cells but not his own or other adult cells c. all cells of a group O cell panel and his own cells d. only penicillin treated panel cells, not his own |
C. all cells of a group O cell panel and his own cells
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Cold agglutinin syndrome is associated with an antibody specificity toward which of the following:
a. Fy:3 b. P c. I d. Rh:1 |
C. I
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Which of the following is a characterisitc of anti-I?
a. often associated with HDFN b. reacts best at room temp or 4*C c. reacts best at 37*C d. is usually IgG |
B. reacts best at room temperature or 4*C
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The Kell antigen is:
a. absent from the red cells of neonates b. strongly immunogenic c. destroyed by enzymes d. has a frequency of 50% in the random population |
B. strongly immunogenic
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The antibodies of the Kidd blood group system:
a. react best by the IAT b. are predominately IgM c. often cause allergic transfusion reactions d. do not generally react with antigen-positive, enzyme-treated RBC's |
A. react best by the IAT
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Protolytic enzyme treatment of red cells usually destroys which antigen?
a. Jka b. E c. Fya d. k |
C. Fya
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Anti-Fya is:
a. usually a cold reactive agglutinin b. more reactive when tested with enzyme treated RBC's c. capable of causing hemolytic transfusion reactions d. often an autoagglutinin |
C. capable of causing hemolytic transfusion reactions
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Resistance to malaria is best associated with which of the following blood groups.
a. Rh b. I/i c. P d. Duffy |
D. Duffy
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A blood component used in the treatment of hemophilia A is:
a. Factor VIII concentrate b. FFP c. Platelets d. Whole Blood |
A. Factor VIII Concentrate
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An obstetrical patient has had 3 previous pregnancies. her 1st baby was healthy, the 2nd was jaundiced at birth and required and exchange transfusion, while the 3rd was stillborn. Which of the following is the most likely cause:
a. ABO incompatability b. immune deficiency disease c. congenital spherocytic anemia d. Rh incompatability |
D. Rh incompatability
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ABO hemolytic disease of the newborn:
a. usually requires an exchange transfusion b. most often occurs in 1st born children c. frequently results in stillbirth d. is usually seen only in the newborn of group O mothers |
D. is usually seen only in the newborn of group O mothers
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Which of the following antigens in most likely to be involve in HDFN.
a. Lea b. P1 c. M d. Kell |
D. Kell
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ABO HDFN differs from Rh HDFN is that:
a. Rh HDFN is clinically more severe that ABO HDFN b. the DAT test is weaker in Rh HDFN than ABO c. Rh HDFN occurs in the 1st pregnancy d. the mother's antibody screen is positive in ABO HDFN |
A. Rh HDFN is clinically more severe than ABO HDFN
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A group A, Rh positive infant of a group O, Rh positive mother has a weakly positive DAT and moderately elevated bilirubin 12 hours after birth. the most likely cause is:
a. ABO incompatability b. Rh incompatability c. blood group incompatibility due to and antibody to a low frequency antigen d. neonatal jaundice not associated with blood group |
A. ABO incompatability
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The Liley method of predicting the severity of HDFN is based on the amniotic fluid:
a. bilirubin concentration by standard methods b. change in optical density measured at 450nm c. Rh determination d. ratio of lecithin to sphingomyelin |
B. change in optical density measured at 450 nm
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These lab results were obtained on maternal and cord blood samples:
Mother: A- baby: AB+ DAT 3+ cord hemoglobin 10g/dL Does the baby have HDFN? a. no, as indicated by the cord hemoglobin b. yes, although the cord hemoglobin is normal, the DAT indicates HDFN c. yes, the DAT and cord hemoglobin level both support HDFN d. no, a diagnosis of HDN cannot be established without cord bilirubin levels |
C. Yes, the DAT and cord hemoglobin level both support HDN
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Which unit should be selected for exchange transfusion if the newborn is group A, Rh pos. and the mother is Group A, Rh pos with anti-c?
a. A, CDe/CDe b. A, cDE/cDE c. O, cde/cde d. A, cde/cde |
A. A,CDe/CDe
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A blood specimen from a pregnant woman is found to be group B, Rh neg. and the serum contains anti-D with a titer of 512. What would be the most appropriate type of blood to have available for a possible exchange transfusion for her infant?
a. O, Rh-neg b. O, Rh-pos c. B, Rh-neg d. B, Rh-pos |
A. O, Rh-neg
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Blood selected for exchange transfusion must:
a. lack RBC antigens corresponding to maternal antibodies b. be <3 days old c. be the same Rh as the baby d. be ABO compatible with the father |
A. lack RBC antigens corresponding to maternal antibodies
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When the main objective of an exchange transfusion is to remove the infant's antibody-sensitized RBC's and to control hyperbilirubinemia the blood product of choice is ABO compatabile:
a. FFP b. RBC's washed c. RBC suspended in FFP d. heparinized RBC's |
C. RBC suspended in FFP
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To prevent graft vs host disease RBC's prepared for infants who have received intrauterine transfusions should be:
a. saline washed b. irradiated c. frozen and deglycerolized d. group-and Rh-compatabile with the mother |
B. irradiated
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What is the most appropriate interpretation for the laboratory data given below when an Rh-neg woman has an Rh-pos child?
mother: 1 rosette/3 fields Pos. Cntl.: 5 rosetts/3 fields Neg Cntl: no rosettes a. mother is not a candidate for RhIg b. mother need 1 vial RhIg c. mother need 2 vials RhIg d. the fetal maternal hemorrhage needs to be quantified |
B. mother needs 1 vial of RhIg
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The results of a Kleihauer-Butke stain indicate a fetomaternal hemorrhage of 35 mL of WHOLE BLOOD. How many vials of Rh immune globulin would be required.
a. 1 b. 2 c. 3 d. 4 |
B. 2 vials
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A fetal maternal hemorrhage of 35 mL of fetal Rh-pos PACKED RBC's has been detected in an Rh-neg woman. How many vials of Rh immune globulin should be given
a. 0 b. 1 c. 2 d. 3 |
D. 3 vials
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Criteria determining Rh immune globulin eligibility include:
a. mother is Rh-pos b. mother is Rh-neg c. mother has not been previously immunized to the D antigen d. infant has a positive DAT |
C. mother has not been previously immumized to the D antigen
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Rh immume globulin administration would not be indicated in an Rh-neg woman who has a:
a. first trimester abortion b. husband who is Rh-pos c. anti-D titer of 1:4,096 d. mother having a positive DAT |
C. anti-D titer of 1:4, 096
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A Kleihauer-Betke stain of a postpartum blood film revealed 0.3 fetal cells. What is the estimated volume of the fetomaternal hemorrhage expressed as whole blood:
a. 5 b. 15 c. 25 d. 35 |
B. 15
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Based upon Kleinhauer-Betke test results, which of the following formulas is used to determine the volume of fetomaternal hemorrhage expressed in mL of whole blood.
a % of fetal cell present x 30 b % of fetal cell present x 50 c % of maternal cells x 30 d % of maternal cells x 50 |
B. % of fetal cells present x 50
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The rosette test will detect a fetomaternal hemorrhage as small as:
a. 10 mL b. 15 mL c. 20 mL d. 30 mL |
A. 10 mL
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A 40 year old man with autoimmune hemolytic anemia due to anti-E has a hemoglobin level of 10.8 g/dL. This patient will most likely be treated with:
a. whole blood b. RBC's c. FFP d. no transfusion |
D. No Transfusion
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A patient in the immediate post bone marrow transplant period has a hematocrit of 21%. The red cell product of choice for this patient would be:
a. packed b. saline washed c. microaggregate filtered d. irradiated |
D. Irradiated
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HLA antigen typing is important in screening for:
a. ABO incompatability b. a kidney donor c. Rh incompatability d. a blood donor |
B. a kidney donor
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Anti-E is identified in a panel at the antiglobulin phase. When check cells are added to the tubes no agglutination is seen. The most appropriate course of action would be to:
a. quality control the AHG reagent and check cells and repeat the panel b. open a new vial of check cells for subsequent testing that day c. open a new vial of AHG for subsequent testing that day d. record the check cell reactions and report the antibody panel result |
A. quality control the AHG reagent and check cells and repeat the panel
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Which of the following represents an acceptably identified patient for sample collection and transfusion
a. a handwritten band with patients name and hospital identification number is affixed to the patients leg b. the addressographed hospital band is taped to the patients bed c. an unbanded patient responds positively when his name is called d. the chart transported witht he patient contains his armband not yet attached |
A. a handwritten band with patients name and hospital identification number is affixed to the patients leg
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The following test results are noted for a unit of blood labeled group A, Rh-neg,
anti-A 4+ anti-B 0 anti-D 3+ What should be done next? a. transfuse as a group A, Rh-neg b. transfuse as a group A, Rh-pos c. notify the collecting facility d. discard the unit |
C. notify the collecting facilty
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What information is essential on patient blood sample labels drawn for compatability testing?
a. biohazard sticker for AIDS patients b. patients room number c. unique patient medical # d. phlebotomist initials |
C. unique patient medical number
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Granulocytes for transfusion should:
a. be administered through a microaggregate filter b. be ABO compatible with the recipients serum c. be infused within 72 hrs of collection d. never be transfused to patients with a history of febrile transfusion reaction. |
B. be ABO compatabile with the recipients serum
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A neonate will be transfused for the first time with group O Red Blood Cells. Which of the following is appropriate compatibility testing?
a. crossmatch with mothers serum b. crossmatch with babys serum c. no crossmatch is necessary if initial plasma screening is negative d. no screening or crossmatching is necessary for neonates |
C. no crossmatch is necessary if intial plasma screening is negative
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A group B, Rh-neg patient has a positive DAT. Which of the following situations would occur?
a. all major crossmatches would be incompatible b. the weak D test and control would be positive c. the antibody screen test would be positive d. the forward and reverse ABO groupings would not agree |
B. the weak D test and control would be positive
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The following reaction were obtained:
cells tested anti-A 4+ anti-B 3+ anti-A,B 4+ serum test: A1 cells 2+ B cells 4+ The technologist washed the patients cells with saline and repeated the forward typing. A saline replacement technique was used with the reverse typing. the following results were obtained: anti-A 4+ anti-B 0 anti-A,B 4+ serum A1 cells 0 B cells 4+ the results are consistent with: a. acquired immunodeficiency disease b. Bruton agammaglobulinemia c. multiple myeloma d. acquired "B" antigen |
C. multiple myeloma
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What is the most likely cause of the following ABO discrepancy?
Cells anti-A 0 anti-B 0 serum A1 cells 0 B cells 0 a. recent transfusion with group O blood b. antigen depression due to leukemia c. false-neg cell typing due to rouleaux d. obtrained from the heel stick of a 2 month old baby |
D. obtained from a heel stick of a 2 month old baby
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Which of the following is characteristic of Tn polyagglutinable red cells?
a. if group O, they may appear to have acquired a group A antigen b. they show strong reactions when the cells are enzyme treated c. they react with Arachis hypogaea lectin d. the polyagglutination is a transient condition |
A. if group O, they may appear to have acquired a group A antigen
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Mixed field agglutination encountered in ABO grouping with no history of transfusion would most likely be due to:
a. Bombay phenotyoe (oh) b. T activation c. A3 red cells d. positive IAT |
C. A3 red cells
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Which of the following is a characteristic of polyagglutinable red cells?
a. can be classified by reactivitly with Ulex europaeus b. are agglutinated by most adult sera c. are always an acquired condition d. autocontrol is always positive |
B. Are agglutinated by most adult sera
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The test for weak D is performed by incubating patients red cells with:
a. several different dilutions of anti-D derum b. anti-D serum followed by washing and antiglobulin serum c. anti-Du serum d. antiglobulin serum |
B. anti-D serum followed by washing and antiglobulin serum
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The following results were obtained when testing a sample from a 20 year old first time blood donor
Forward anti-A 0 anti-B 0 Reverse A1 cells 0 B cells 3+ What is the most likely cause of tis ABO discrepancy? a. loss of antigen due to disease b. acquired B C. phenotype O"h" (bombay) d. weak subgroup of A |
D. phenotype O "h" (Bombay)
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A mother is Rh neg and the father is Rh pos. their baby is Rh neg. It may be concluded that
a. the father is homozygous for D b. the mother is heterozygous for D c. the father is heterozygous for S d. at least 1 of the 3 Rh typings must be incorrect |
C. the father is heterozygous for D
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Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of:
a. complement b. anticoagulants c. preservatives d. penicillin |
A. complement
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Review the following schematic diagram:
patient serum+reagent group O cells --- incubate---read for agglutination---wash---add AHG---agglutination observed The next step would be: a. add check cells as a confirmatory measure b. identify the cause of the agglutination c. perform an elution technique d. perform a DAT |
B. identify the cause of the agglutination
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The following results were obtained in pretransfusion testing:
sceen cell 1 @37*C 0 @IAT 3+ sceen cell 2 @37*C 0 @IAT 3+ autocontrol @37*C 0 @IAT 3+ The most probable cause of these results are: a. rouleaux b. a warm autoantibody c. a cold autoantibody d. multiple alloantobodies |
B. a warm autoantibody
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A patient is typed as group O,Rh pos and crossmatched with 6 units of blood. At the IAT phase of testing, both antibody screening cells and 2 crossmatched units are incompatable. What is the most likely cause of the incompatibility?
a. recipient alloantibody b. recipient autoantibody c. donors have pos. DAT's d. rouleaux |
A. recipient alloantibody
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a patient received 2 units of RBC's and had a delayed transfusion reaction. Pretranfusion 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 for the original results?
a. red cell were overwashed b. centrifuge time was prolonged c. patient's serum was omitted from the original test d. antiglobulin reagent was neutralized |
C. patient's serum was omitted from the original testing
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At the indirect antiglobulin phase of testing there is no agglutination between patient serum and screening cells. One of 3 donor units was incompatable. The most probable explanation for these findings is that the:
a. patient has an antibody directed against a high incidence antigen b, patient has an antibody directed against a low incidence antigen c. donor has an antibody directed against donor cells d. donor has a positive antibody screen |
B. patient has an antibody against a low incidence antigen
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The major crossmatch will detect an:
a. group A patient mistyped as a group O b. unexpected red cell antibody in the donor unit c. Rh-neg donor unit mislabeled as Rh-pos d. recipient antibody directed against antigens on the donor red cells |
D. recipient antibody directed against antigens on the donor red cells
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Which of the following would most likely be responsible for an incompatible antiglobulin crossmatch?
a recipients red cells possess a low frequency antigen b. anti-K antibody in donor serum c. recipients red cells are polyagglutinable d. donor red cells have a positive DAT |
D. donor red cells have a positive DAT
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A reason why a patient's crossmatch may be incompatible while the antibody screen is negative is:
a. the patient has an antibody against a high incidence antigen b. the incompatible donor unit has a positive DAT c. cold agglutinins are interfering in the crossmatch d. the patient's serum contains warm autoantibody |
B. the incompatible donor unit has a positive DAT
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A blood specimen types as A, Rh-pos with a negative antibody screen. 6 units of group A, Rh-pos RBC's were crossmatched and 1 unit was incompatable in the antiglobulin phase. The same result was obtained when the test was repeated. Which should be done first?
a. repeat the ABO grouping on the incompatible unit using a more sensitive technique b. test a panel of red cells that possesses low incidence antigens c. perform a DAT on the donor unit d. obtain a new specimen and repeat the crossmatch |
C. preform a direct antiglobulin test on the donor unit
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During emergency situations when there is no time to determine ABO group and Rh type on a current sample for transfustion, the patient is known to be A, Rh-neg. the technologist should:
a. refuse to release any blood until the patient's sample has been typed b. release A Rh-neg RBC's c. release O Rh-neg RBC's d. release O Rh-pos RBC's |
C. release O, Rh-neg RBC's
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A 29 year old male is hemorrhaging severely. He is AB, Rh-neg. 6 units of blood are required STAT. Of the following types available in the blood bank, which would be most preferable for crossmatch?
a. AB,Rh-pos b. A, Rh-neg c. A, Rh-pos d. O, Rh-neg |
B. A, Rh-neg
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A patient is group A2B, Rh-pos and has a antiglobulin reacting anti-A1in his serum. He is in the operating room bleeding profusely and group A2B RBC's are not available. Which of the following blood types is first choice for crossmatching?
a. B,Rh-pos b. B, Rh-neg c. A1B, Rh-pos d. O, Rh-neg |
A. B,Rh-pos
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A 10% red cell suspension in saline is used in a compatibility test. Which of the following would most likely occur?
a. a false-pos result due to antigen excess b. a false-pos result due to the prozone phenomenon c. a false-neg result due to the prozone phenomenon d. a false-neg result due to antigen excess |
D. a false-negative result due to antigen excess
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A patient received 4 units of blood 2 years previously and now has multiple antibodies. He has not been transfused since that time. It would be most helpful to:
a. phenotype his cells to determine which additional alloantibodies may be produced b. recommend the use of directed donors, which are more likely to be compatible c. use proteolytic enzymes to destroy the "in vitro" activity of some of the antbodies d. freeze the patient's serum to use for antigen typing of compatible units |
A. phenotype his cells to determine which additional alloantibodies may be produced
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Autoantibodies demonstrating blood group specificity in warm autoimmune hemolytic anemia are associated more often with which blood group system.
a. Rh b. I c. P d. Duffy |
A. Rh
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An antibody that causes in vitro hemolysis and reacts with the red cells of 3 out of 10 crossmatched donor units is most likely:
a. anti-Lea b. anti-s c. anti-k d. anti-E |
A. anti- Lea
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In the process of identifying an antibody, the technologist observed 2+ reactions with 3 out of the 10 cells in a panel after the immediate spin phase. There was no reactivity after incubation at 37*C and after the anti-human globulin test phase. The antibody most likely is:
a. anti-Pa b. anti-Lea c. anti-C d. anti-Fya |
B. anti-Lea
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Transfusion of Ch+(Chido-pos) red cells to a patient with anti-Ch has been reported to cause:
a. no clinically significant red cell destrustion b. clincally significant immune red cell destruction c. desreased 51Cr red cell survivals d. febrile transfusion reactions |
A. no clinically significant red cell destruction
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Which characteristics are true of all 3 of the following antibodies: anti-Fya, anti-Jka and anti-K?
a. detected at IAT phase and may cause HDFN and transfustion reactions b. not detected with enzyme treated cells; may cause delayed transfusion reactions c. requires the IAT technique for detection' usually not responsible for causing HDFN d. may show dosage effect; may cause sever hemolytic transfusion reactions |
A. detected at IAT phase and may cause HDFN and transfusion reactions
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Which of the following tests is most commonly used to detect antibodies attached to a patient's red blood cells in vivo?
a. DAT b. complement fixation c. IAT d. immunofluorescence |
A. direct antiglobulin test
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In a DAT and IAT tests, false-neg reactions may result in the:
a. patient's blood specimen was contaminated with bacteria b. patient's blood specimen was collected into tubes containing silicon gel c. saline used for washing the serum/cell mixture has been stored in glass or metal containers d. addition of AHG is delayed for 40 minutes or more after washing the serum/cell mixture. |
D. addition of AHG is delayed for 40 minutes or more after washing the serum/cell mixture
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Polyspecific reagents used in the DAT test should have specificity for:
a. IgG and IgA b. IgG and C3d c. IgM and IgA d. IgM and C3d |
D. IgM and C3d
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In the direct antiglobulin test, the antiglobulin reagent is used to:
a. mediate hemolysis of indicator red cells by providing complement b. precipitate anti-erythrocyte antibodies c. measure antibodies in a test serum by fixing complement d. detect preexisting antibodies on erythrocytes |
D. detect preexisting antibodies on erythrocytes
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AHG control cells:
a. can be used as a poitive control for anti-C3 reagents b. can be used only for the IAT c. are coated only with IgG antibody d. must be used to confirm all positive antiglobulin reactions |
C. are coated with IgG
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A 56 year old female with cold agglutinin disease has a positive DAT. When the DAT is repeated using monospecific antiglobulin sera, which of the following is most likely to be detected?
a. IgM b. IgG c. C3d d. C4a |
C. C3d
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Use of EDTA plasma prevents activation of the classical complement pathway by:
a. causing rapid decay of complement components b. chelating Mg++ ions, which prevents the assembly of C6 c. chelating Ca++ ions, which prevents assembly of C1 d. preventing chemotaxis |
C. chelating Ca++ ions, which prevents assembly of C1
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The drug cephalsporin can cause a positive DAT with hemolysis by which of the following mechanisms?
a. drug dependent antibodies reacting with drug treated cells. b. drug dependent antibodies reacting in the presence of a drug c. drug independent with autoantibody production d. nonimmunologic protein adsorption with positive dat |
b. drug dependent antibodies reacting in the pressence of a drug
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Crossmatch results at the antiglobulin phase were neg. When 1 drop of check cells was added, no agglutination was seen. The most likely explantion is that the:
a. red cells were overwashed b. centrifuge speed was to high c. residual patient serum inactivated the AHG reagent d. laboratorian did not add enough check cells |
c. residual patient serum inactivated the AHG reagent
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Which of the following might cause a false-neg IAT?
a. over-reading b. IgG coated screen cells c. addition of an extra drop of serum d. too heavy a cell suspension |
D. too heavy a cell suspension
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The purpose of testing with anti-A,B is to detect:
a. anti-A1 b. anti-A2 c. subgroups of A d. subgroups of B |
C. subgroups of A
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What is the most appropriate diluent for preparing a solution of 8% bovine albumine for red cell control reagent?
a. deionized water b. destilled c. normal saline d. Alserver solution |
C. normal saline
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Which of the following antigens gives exhanced reactions with its corresponding antibody following treatment of the red cells with proteolytic exzymes?
a. Fya b. E c. S d. M |
B. E
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Of the following the most useful technique in the identification and classification of high-titer, low-avidity antibodies is/are:
a. reagent red cell panels b. adsorption and elution c. titration and inhibition d. cold autoadsorption |
C. titration and inhibition
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To confirm a serum antibody specificity identified a anti-P1, a neutralization study was performed and the following results obtained:
serum + P1 substance serum + saline both negative with P1 + RBC's What conclusion can be made from these results. a. anti-P1 is confirmed b. anti-P1 is ruled out c. a second antibody is suspected due to the results of the neg ative control d. anti-P1 cannot be confirmed due to the results of the negative control |
D. anti-P1 cannot be confirmed due to the results of the negative control
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An antibody screen performed using solid phase technology revealed a diffuse layer of RBC's on the bottom of the well. these results indicate:
a. a positive reaction b. a negative reaction c. serum was not added d. red cells have a positive DAT |
A. a positive reaction
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On Monday a patient's K antigen typing result was positive. 2 days later the patient's K typing was negative. The patient was transfused with 2 units of FFP. The tech might conclude that the:
a. transusion of FFP affected the K typing b. wrong patient was drawn c. decreased serum bilirubin d. agglutination with normal adult ABO compatible sera |
D. agglutination with normal adult ABO compatible sera
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While performing an antibody screen, a test reaction is suspected to be rouleaux. A saline replacement test is performed and the reaction remains. What is the best interpretation:
a. original reaction of rouleaux is confirmed b. replacement test is invalid and should be repeated c. original reaction was due to true agglutination d. antibody screen is negative |
C. original reaction was due to true agglutination
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Which of the following is useful for removing IgG from RBC's with a positive DAT to perform a phenotype?
a. bromelin b. chloroquine c. LISS d. DTT |
B. chloroquine
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A patient's serum contains a mixture of antibodies. One of the antibodies is identified as anti-D. Anti-Jka and Fya and possibly another antibody are present. What technique may be helpful to identify the other antibody?
a. enzyme panel: select cell panel b. thiol reagents c. lowering the pH and increasing the incubation time d. using albumin as an enhancement media in combination with selective adsorption |
A. enzyme panel; select cell panel
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A sample gave the following results:
cells with anti-A 3+ cells with anti-B 4+ serum with A1 cells 2+ serum with b cells 0 Which lectin should be used first to resolve the discrepancy? a. Ulex europaeus b. Arachis hypogaea c. Dolichos biflorus d. Vicia graminea |
C. Dolichos biflorus
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The serum of a group O, Cde/Cde donor contains anti-D. In order to prepare a suitable anti-D reagent from this donor's serum, which of the following cells would be suitable for the adsorption?
a. group O. Cde/Cde b. group O, Cde/cde c. group A2B, CDe/cde d. groupA1B, cde/cde |
D. group A1B, cde/cde cells
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The process of separation of antibody from its antigen is known as:
a. diffusion b. adsorption c. neutralization d. elution |
D. elution
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One of the most effective methods for the elution of warm autoantibodies from RBC's utilizes:
a. 10% sucrose b. LISS c. change is pH d. distilled water |
C. change in pH
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How would the hematocrit of a patient with chronic anemia be affected by the transfusion of a unit of Whole Blood containing 475 mL of blood, vs 2 units of RBC's each with a total volume of 250 mL?
a. patient's hematocrit would be equally affected by the Whole Blood or the RBC's b. RBC's would provide twice the increment in hematocrit as the Whole Blood c. Whole Blood would provide twice the increment in hematocrit as the RBC's d. Whole Blood would provide a change in hematocrit slightly less than the RBC's |
B. RBC's would provide twice the increment in hematocrit as the Whole Blood
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After checking the inventory, it was noted that there were no units on the shelf marked "May Issue an Uncrossmatched: For Emergency Only"
Which of the following should be place on this shelf? a. 1 unit of each of the ABO blood groups b. units of group O, Rh-pos Whole Blood c. units of group O, Rh-neg RBC's d. any units that are expiring at midnight |
C. units of group O, Rh-neg RBC's
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A 42 year old male of average body mass has a history of chronic anemia requiring transfusion support. 2 units of RBC's are transfused. If the pretransfusion hemoglobin was 7.0g/dL, the expected posttransfusion hemoglobin concentration should be:
a. 8.0 g/dL(80g/L) b. 9.0 g/dL(90g/L) c. 10.0 g/dL(100g/L) d. 11.0 g/dL(110g/L) |
B. 9.0 g.dL (90g/L)
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How many units of RBC's are required to raise the hematocrit of a 70 kg nonbleeding man from 24% to 30%
a. 1 b. 2 c. 3 d. 4 |
B. 2
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Transfusion of plateletpheresis products fro HLA-compatible donors is the preferred treatment for:
a. recently diagnosed cases of TTP with severe thrombocytopenia b. acute leukemia in relapse with neuropenia, thrombocytopenia and sepsis c. immune thrombocytopenic purpura d. severely thrombocytopenic patients, known to be refractory to random donor platelets |
D. severely thrombocytopenic patients, known to be refractory to random donor platelets
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Which of the following is consistent with standard blood bank procedure governing the infusion of FFP?
a. only blood group specific plasma may be administered b. group O may be administered to recipients of all blood groups c. group AB may be administered to AB recipients only d. group A may be administered to both A and O recipients |
D. group A may be administered to both A and O recipients
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A patient who is group AB, Rh-neg needs 2 units of FFP. Which of the following units of plasma wouldbe nost acceptable for transfusion?
a. group O, Rh-neg b. group A, Rh-neg c. group B, Rh-pos d. group AB, Rh-pos |
D. group AB, Rh-pos
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What increment of platelets/uL in the typical 70-kg human, is expected to result from each single unit of platelets transfused to a non-HLA sensitized recipient?
a. 3,000 - 5,000 b. 5,000 - 10,000 c. 20,000 - 25,000 d. 25,000 - 30.000 |
B. 5,000 - 10,000
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A patient received about 15mL of compatible blood and developed severe shock, but no fever. If the patient needs another transfusion, what kind of RBC component should be given?
a. RBC's b. RBC's, washed c. RBC's, Irradiated d. RBC's, leukocyte reduced |
B. Red Blood Cells. Washed
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FFP from a group A, Rh-pos donor may be safely transfused to a patient who is group:
a. A, Rh-neg b. B, Rh-neg c. AB, Rh-pos d. AB, Rh-neg |
A. A, Rh-neg
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A patient admitted to the trauma unit requires emergency release of FFP. His blood donor card states that he is group AB,Rh-pos. Which of the following blood groups of FFP should be issued?
a. A b. B c. AB d. O |
C. AB
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FFP:
a. contains all labile coaglulative factors except cryo AHF b. has a higher risk of transmitting hepatitis than does Whole Blood c. should be transfused within 24 hours of thawing d. need not be ABO compatible |
C. should be transfused within 24 hours of thawing
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10 units of group A platelets were tranfused to a group AB patient. The pretransfusion platelet count was 12 x 10 to the 3rd/uL and the posttransfusion count was 18 x 10 to the 3rd/uL. From this information the laboratorian would most likely conclude that the patient:
a. needs group AB platelets to be effective b. clinical data does not suggest a need for platelets c. has developed antibodies to the transfused platelets d. should receive irradiated platelets |
C. has developed antibodies to the transfused platelets
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Hypotension, nausea, flushing, fever and chills are symptoms of which of the following transfusion reactions?
a. allergic b. circulatory overload c. hemolytic d. anaphylatic |
c. Hemolytic
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An unexplained fall in hemoglobin and mild jaundice in a patient transfused with RBC's 1 week previously would most likely indicate:
a. paroxysmal nocturnal hemoglobinuria b. posttransfusion hepatitis infection c. presence of HLA antibodies d. delayed hemolytic tranfusion reaction |
D. delayed hemolytic transfusion reaction
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In a delayed transfusion reaction the causative antibody is generally too weak to be detected in routine compatibility testing and antibody screening tests, but is typically detectable at what point after transfusion?
a. 3-6 hours b. 3-7 days c. 60-90 days d. after 120 days |
B. 3-7 days
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The most serious hemolytic transfusion reactions are due to incompatibility in which of the following blood group systems?
a. ABO b. Rh c. MN d. Duffy |
A. ABO
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Servere intravascular hemolysis is most likely caused by antibodies of which blood group system?
a. ABO b. Rh c. Kell d. Duffy |
A. ABO
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Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions?
a. Lewis b. Kidd c. MNS d. I |
b. Kidd
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After receiving a unit of RBC's, a patient immediately developed flushing, nervousness, fever spike of 102*F, shaking, chills and back pain. The plasma hemoglobin was elevated and there was hemoglobinuria. Laboratory investigation of this adverse reaction would most likely show:
a. an error in ABO grouping b. an error in Rh typing c. presence of anti-Fya in patient's serum d. presence of gram-neg bacteria in blood bag |
A. an error in ABO grouping
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A trauma patient who has just received 10 units of blood may develop:
a. anemia b. polycythemia c. leukocytosis d. thrombocytopenia |
D. thrombocytopenia
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The most appropriate laboratory test for early detection of acute posttransfusion hemolysis is:
a. a visual inspection for free plasma hemoglobin b. plasma haptoglobin concentration c. examination for hematuria d. serum bilirubin concentration |
A. a visual inspection for free plasma hemoglobin
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During initial investigation of a suspected hemolytic transfusion reaction, it was observed that the posttransfusion serum was yellow in color and the DAT was negative. Repeat ABO typing on the posttransfusion sample confirmed the pretransfusion results. What is the next step in this investigation?
a. repeat compatibility testing on suspected units b. perform plasma hemoglobin and haptoglobin determinations c. use enhancement media to repeat the antibody screen d. no further serological testing is necessary |
D. no further serological testing is necessary
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Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC, and renal failure?
a. bacterial contamination b. circulatory overload c. febrile d. anaphylactic |
A. bacterial contamination
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Hemoglobinuria, hypotension and generalized bleeding are symptoms of which of the following transfusion reactions?
a. allergic b. circulatory overload c. hemolytic d. anaphylatic |
C. hemolytic
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When evaluating a suspected tranfusion reaction, which of the following is the ideal sample collection time for a bilirubin determination?
a. 6 hrs posttransfusion b. 12 hrs posttransfusion c. 24 hrs posttransfusion d. 48 hrs posttransfusion |
A. 6 hrs posttransfusion
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A patients's records show a previous anti- Jkb, but the current antibody screen is neg. What further testing should be done before transfusion?
a. phenotype the patient's red cells for Jkb antigen b. perform a cell panel on the patient's serum c. crossmatch type specific units and release only compatible units for transfusion d. give Jkb neg crossmatch compatible blood |
D. give Jkb negative crossmatch blood
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A posttransfusion blood sample from a patient experiencing chills and fever show distinct hemolysis. TheDAT is positive(mixed field). What would be the most helpful to determine the cause of the reaction?
a. auto control b. elution and antibody ID c. repeat antibody screen on the donor unit d. bacteriologic smear and culture |
B. elution and antibody identification
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In a delayed hemolytic transfusion reaction, the DAT is typically:
a. negative b. mixed-field positive c. positive due to complement d. negative when the antibody screen is negative |
b. mixed-field positive
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For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment goal should be to:
a. prevent alloimmunization b. diminish chills and fever c. prevent hemoglobinemia d. reverse hyptension and minimize renal disease |
D. reverse hyptension and minimize renal damage
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A patient multiply transfused with RBC's developed a headache, nausea, fever and chills during his last transfusion. What component is most appropriate to prevent this reaction in the future?
a. RBC's b. RBC's, irradiated c. RBC's, leukocyte reduced d. RBC's selected as CMV-reduced-risk |
c. RBC's leulocyte reduced
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Leukocyte-poor RBC's would most likely be indicated for patients with a history of :
a. febrile transfusion reaction b. iron deficiency anemia c. hemphilia A d. von Willebrand disease |
A. febrile transfusion reactions
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Posttransfusion anaphylactic reactions occur most often in patients with:
a. leukocyte antibodies b. erythrocyte antibodies c. IgA deficiency d. Factor VIII deficiency |
C. IgA deficiency
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Which of the following transfusion reactions occurs after infusion of only a few milliliters of blood and gives no history of fever?
a. febrile b. circulatory overload c. anaphylactic d. hemolytic |
C. anaphylatic
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Fever and chills are symptoms of which of the following transfusion reactions?
a. citrate toxicity b. circulatory overload c. allergic d. febrile |
D. febrile
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Hives and itching are symptoms of which of the following transfusion reactions?
a. febrile b. allergic c. circulatory overload d. bacterial |
B. allergic
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A temp. rise of 1*C or more occuring is association with a transfusion, with no abnormal results in the transfusion reaction investigation. usually indicates which of the following reactions?
a. febrile b. circulatory overload c. hemolytic d. anaphylactic |
A. febrile
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A 65 yr old woman experienced shaking, chill, and a fever of 102*F(38.9*C) approximately 40 minutes following the transfusion of a second unit of RBC's. The most likely explanation for the patient's symptoms is:
a. transfusion of bacteriall contaminated blood b. congestive heart failure c. anaphylactic transfusion reaction d. febrile transfusion reaction |
D. Febrile transfusion reaction
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A sickle cell patient who has been multiply transfused experiences fever and chills after receiving a unit of RBC's. Transfusion investigation studies show:
DAT: neg Plasma hemolysis: none The patient is most likely reacting to: a. IgA b. plasma protein c. red cells d. white cells or cytokines |
D. white cells or cytokines
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Symtoms of dyspnea, cough, hypoxemia, and pulmonary edema within 6 hrs. of transfusion is most likely which type of reaction?
a. anaphylactic b. hemolytic c. febrile d. TRALI |
D. TRALI
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A patient with a coagulopathy was transfused with FP24(FFP within 24 hrs of collection). After infusion of 15 mL, the patient experienced hypotension, shock, chest pain and difficulty in breathing. The most likely cause of the reaction is:
a. anti-IgA b. bacterial contamination c. intravascular hemolysis d. leukoagglutinins |
A. anti-IgA
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To prevent febrile transfusion reactions, which RBC product should be transfused?
a. RBC's irradiated b. CMV-neg RBC's c. RBC's, leukocyte reduced d. IgA-deficient donor blood |
C. RBC's leuko-reduced
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During the issue of an autologous unit of Whole Blood, the supernatant plasma is observed to be dark red in color. What would be the best course of action?
a. the unit may be issued only for autologous use b. remove the plasma and issue the unit as RBC's c. issue the unit only as washed RBC's d. quanantine the unit for further testing |
D. quarantine the unit for further testing
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Coughing, cyanosis and difficult breathing ar symptoms of which of the following transfusion reactions?
a. febrile b. allergic c. circulatory overload d. hemolytic |
C. circulatory overload
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Which of the following is a nonimmunlogic adverse effect of a transfusion?
a. hemolytic reaction b. febrile nonhemolytic reaction c. congestive heart failure d. urticaria |
C. congestive heart failure
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Congestive heart failure, severe headache and/or peripheral edema occurring soon after transfusion is indicative of which type of transfusion reaction?
a. hemolytic b. febrile c. anaphylactic d. circulatory overload |
D. circulatory overload
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A patient with sever anemia became cyanotic and developed tachycardia, hypertension and difficulty breathing after receiving 3 units of blood. No fever or other symptoms were evident. this is most likely what typeof reaction?
a. febrile b. transfusion-associated circulatory overload(TACO) c. anaphylactic d. hemolytic |
B. transfusion associated circulatory overload (TACO)
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A patient became hypotensive and went into shock after receiving 50 mL of a unit of RBC's. She had a shaking chill and her temp. rose to 104.8*F(40.0*C). A transfusion reaction investigation was initiated but no abnormal results were seen. What additional testing should be performed?
a. gram stain and culture of the donor unit b. lymphocytotoxicity tests for leukoagglutinins c. plasma IgA levels d. elution and antibody screen |
A. gram stain and culture of the donor unit
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The most frequent transfusion-associated disease complication of blood transfusion is:
a. cytomegalovirus(CMV) b. syphilis c. hepatitis d. AIDS |
C. hepatitis
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The purpose of a low-dose irradiation of blood components is to:
a. prevent posttransfusion purpura b. prevent graft-vs-host disease c. steilize components d. prevent noncardiogenic pulmonare edema |
B. prevent graft-vs-host disease
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Irradiation of donor blood is done to prevent which of the following adverse effects of transfusion?
a. febrile transfusion reaction b. CMV c. transfusion associated graft-vs-host disease d. transfusion related acute lung injury (TRALI) |
C. transfusion associated graft-vs-host disease
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The most important step in the safe administration of blood is to:
a. perform compatibility testing accurately b. get an accurate patient history c. exclude disqualified donors d. accurately identify the donor unit and recipient |
D. accurately identify the donor unit and recipient
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After receiving a 24 hr urine for quantitative total protein analysis the technician must first:
a. subculture the urine for bacteria b. add the appropriate preservative c. screen for albumin using a dipstick d. measure the total volume |
D. measure the total volume
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False results in the urobilinogen testing may occur if the urine specimen is:
a. exposed to light b. adjusted to a neutral pH c. cooled to room temp d. collected in a nonsterile container |
A. exposed to light
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A clean catch urine is submitted to laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hrs. later, the specimen is sent to the mocrobiology department for culture. The specimen should:
a. be centrifuged, and the supernatant culture b. be rejected due to the time delay c. not be cultured if no bacteria are seen d. be processed for culture only if the nitratite is positive |
B. be rejected due to the time delay
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Which of the following urine results is most apt to be changed by prolonged exposure to light?
a. pH b. protein c. ketones d. bilirubin |
D. bilirubin
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Urine samples should be examined within 1 hr of voiding because:
a. RBC's, leukocytes and casts agglutinate on standing for several hrs at room temp b. urobilinogen increases and bilirubin decreases after prolonged exposure to light c. bacterial contamination will cause alkalinization of the urine d. ketones will increase due to bacterial and cellular metabolism |
C. bacterial contamination will cause alkalinization of the urine
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A urine specimen comes to the laboratory 7 hrs after it is obtained. It is acceptable for culture only if the specimen has been stored:
a. at room temp b. at 4-7*C c. frozen d. with a preservative additive |
b. at 4-7*C
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Which of the following would be affected by allowing a urine specimen to remain at room temp for 3 hrs before analysis:
a. occult blood b. specific gravity c. pH d. protein |
C. pH
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Failure to observe RBC casts in a urine specimen can be caused by;
a. staining the specimen b. centrifuging an unmixed specimen c. mixing the sediment after decantation d. examining the sediment first under low power |
B. centrifuging an unmixed specimen
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The creatinine clearance is reported in:
a. mg/dL b. mg/24hrs c. mL/min d. mL/24hrs |
C. mL/min
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Microalbumin can be measured by a random urine collection. An increased microalbumin is predictive of:
a. diabetes mellitus b. nephropathy c. hypertension d. nephrotic syndrome |
B. nephropathy
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A patient with uncontrolled Diabetes mellitus will most likely have:
a. pale urine with a high specific gravity b. concentrated urine with a high specific gravity c. pale urine with a low specific gravity d. dark urine with a high specific gravity |
A. pale urine with high specific gravity
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While performing an analysis of a baby's urine, the technologist notices the specimen to have a "mousy" odor. Of the following substances that may be excreted in urine, the one that most characteristically produces this odor is:
a. phenylpyruvic acid b. acetone c. coliform basilli d. porphyrin |
A. phenylpyruvic acid
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Urine that develops a port wine color after standing may contain:
a. melanin b. porphyrins c. bilirubin d. urobilogen |
B. porphyrins
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Urine from a 50 yr old man was noted to turn dark red on standing. This change is caused by:
a. glucose b. porphyrins c. urochrome d. creatinine |
B. porphyrins
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The clarity of a urine sample should be determined:
a. using glass tubes only; never plastic b. following thorough mixing of the specimen c. after addition of sulfosalicylic acid d. after the specimen cools to room temp |
B. after thorough mixing of the specimen
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Milky urine from a 24 yr old woman would most likely contain:
a. spermatozoa b. many white blood cells c. RBC's d. bilirubin |
B. many white blood cells
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A brown/black urine would most likely contain:
a. bile pigment b. porphyrins c. melanin d. blood cells |
c. melanin
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The yellow color of urine is primarily due to:
a. urochrome pigment b. methemoglobin c. bilirubin d. homgenistic acid |
A. urochrome pigment
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Red urine may be due to:
a. bilirubin b. excess urobilin c. myoglobin d. homogenistic acid |
C. myoglobin
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Urine osmolality is related to:
a. pH b. filtration c. specific gravity d. volume |
C. specific gravity
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Urine specific gravity is an index of the ability of the kidney to:
a. filter the plasma b. concentrate the urine c. alter the hydogen ion concentration d. reabsorb sodium ions |
B. concentrate the urine
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Osmolality is a measure of:
a. disolved particles, including ions b. undissociated molecules only c. total salt concentration d. molecule size |
A. dissolved particles, including ions
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To prepare a solution appropriate for quality control of the refractometer, a technician should use:
a. urea with a specific gravity of 1.040 b. water with a specific gravity of 1.005 c. sodium chloride with a specific gravity of 1.022 d. calcium chloride with a specific gravity of 40 |
C. sodium chloride with a specific gravity of 1.022
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Use of a refractometer over a urinometer is preferred due to the fact that the refractometer uses:
a. large volume of urine and compensates for temp b. small volume of urine and compensates for glucose c. small volume of urine and compensates for temp d. small volume of urine and compensates for protein |
C. small volume of urine and compensates for temperature
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The method of choice for performing a specific gravity measurement of urine following administration of x-ray contrast dyes is;
a. reagent strip b. refractometer c. urinometer d. densitometer |
A. reagent strip
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Upon standing at room temp, a urine pH typically:
a. decreases b. increases c. remains the same d. changes depending on bacterial concentration |
B. increases
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Urine reagent strips should be stored in a
a. refrigerator(4-7*C) b. incubator(37*C) c. cool dry area d. open jar exposed to air |
C. cool dry area
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The protein section of the urine reagent strip is most sensitive to:
a. albumin b. mucoprotein c. Bence Jones protein d. globulin |
A. allbumin
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Which of the following reagents is used to react with ketones in the urine?
a. sodium nitroprusside b. acetoacetic acid c. acetone d. beta-hydroxybutyric acid |
A. sodium nitroprusside
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A reagent strip area impregnated with stabilized, diazotized 2,4-sichloroaniline will yield a positive reactions with:
a. bilirubin b. hemoglobin c. ketones d. urobilinogen |
A. bilirubin
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When employing the urine reagent strip method, a false-positive protein result may occur in the presence of :
a. large amounts of glucose b. x-ray contrast media c. Bence Jones protein d. highly alkaline urine |
D. highly alkaline urine
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A 17 yr old girl decided to go on a starvation diet. After 1 week of starving herself, what substance sould most likely be found in her urine?
a. protein b. ketones c. glucose d. blood |
B. ketones
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A 2 yr old child had a positive urine ketone. This would most likely be caused by:
a. vomiting b. anemia c. hypoglycemia d. biliary tract obstruction |
A. vomiting
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Microscopic analysis of a urine specimen yields a moderate amount of RBC's in spite of a neg. result for occult blood using a reagent strip. The technologist should determine if this patient has taken:
a. vit C b. a diuretic c. high blood pressure med d. antibiotics |
A. vitiamin C
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To prepare the reagent used in confirmatory protein testing, a technician would:
a. dissolve 3 g sulfosalicylic acid in 100 mL of water b. dissolve 5 g trichloroacetic acid in 100 mL of water. c. combine 3 mL of hydrochloric and 97 mL of water d. combine 5 mL of glacial acetic acid and 95 mL of water |
A. dissolve 3 g sulfosalicylic acid in 100 mL of water
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A positive result for bilirubin on a reagent strip should be followed up by:
a. notifying the physician b. requesting a new specimen c. performing an Ictotest d. performing a urobilinogen |
C. performing an Ictotest
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Ammmonium sulfate was added to red urine. The urine had a positive reaction for blood, but no RBC's were seen on microscopic exam. After centrigugation the supernatant fluid is red. The abnormal color is caused by:
a. pyriduim b. hemoglobin c. porphyrins d. myoglobin |
D. myoglobin
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A urine tested with Clinitest exhibits a passthrough reaction and is diluted by adding 2 drops of urine to 10 drops of water. This dilution is:
a. 1:4 b. 1:5 c. 1:6 d. 1:8 |
C. 1:6
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When performing a routine urinallysis, the technologist notes a 2+ protein result. He should:
a. request another specimen b. confirm with the acid precipitation test c. test for Bence Jones protein d. report the result obtained without further testing |
B.confirm with the acid precipitation test
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The confirmatory test for a positive protein result by the reagent strip method uses:
a. Ehrlich reagent b. a diazo reaction c. sulfosalicylic acid d. a copper reduction tablet |
C. sulfosalicylic acid
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A urine specimen is analyzed for glucose by a glucose oxidase reagent strip and a copper reduction test. If both results are positive, which of the following interpretations is correct?
a. galactose is present b. glucose is present c. lactose is not present d. sucrose is not present |
B. glucose is present
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An urinalysis performed on a 2 week old infant with diarrhea shows a neg reaction with the glucose oxidase reagent strip. A copper reduction tablet test should be performed to check the urine sample for the presence of:
a. glucose b. galactose c. bilirubin d. ketones |
B. galactose
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In most compound light microscopes, the ocular lens has a magnification of:
a. 10x b. 40x c. 50x d. 100x |
A. 10x
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The best way to lower the light intensity of the microscope is to:
a. lower the condenser b. adjust the aperture diaphragm c. lower the rheostat d. raise the condenser |
C. lower the rheostat
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The advantage to using phase microscopy in urinalysis is to :
a. provide higher magnification b. enhance constituents with a low refractive index c. allow constituents to stain more clearly d. provide a larger field of view |
B. enhance constituents with a low refractive index
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The presence of leukocytes in the urine is known as:
a. chyluria b. hematuria c. leukocytosis d. pyuria |
D. pyuria
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Oval fat bodies are:
a. squamous epithelial cells that contain lipids b. renal tubular epithelial cells that contain lipids c. free-floating fat droplets d. whit blood cells with phagocytized lipids |
B. renal tubular epithelial cells that contain lipids
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A microscopic exam of urine sediment reveals ghost cells. These RBC's seen in urine with a:
a. >2% glucose concentrations b. specific gravity <1.007 c. large amounts of ketone bodies d. neutral pH |
B. specific gravity <1.007
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Glitter cells are a microscopic finding of:
a. RBC in hypertonic urine b. RBC in hypotonic urine c. white blood cells in hypertonic urine d. white blood cells in hypotonic urine |
D. white blood cells in hypotonic urine
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What cell is most commonly associated with vaginal contamination?
a. white b. transitional c. squamous d. glitter |
C. squamous
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A reagent strip test for blood has been reported positive. Microscopic exam fails to yield RBC's. This patient's condition can be called:
a. hematuria b. hemogloginuria c. oliguria d. hemosiderinuria |
B. hemoglobinuria
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Ghost RBC's are seen in urine that is:
a. acidic and dilute b. alkaline and dilute c. acidic and concentrated d. alkaline and concentrated |
B. alkaline and dilute
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The possibility of detecting glitter cells is associated with urine that is:
a. acidic b. dilute c. alkaline d. concentrated |
B. dilute
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Clue dells are a form of:
a. squamous epithelial cells b. urotherlial cell c. white blood cell d. renal tubular epithelial cell |
A. squamous epithelial cells
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Which of the following cells is most likely to be seen in the urine sediment following a catherterization procedure?
a. squamous epithelial cell b. urothelial cell c. white blood cell d. renal tubular epithelial cell |
B. urothelial cell
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All casts typically contain:
a. albumin b. globulin c. immunoglobulins G and M d. Tamm-Horsfall glycoprotein |
D. Tamm-Horsfall glycoprotein
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Hyaline casts are usually found:
a. in the center of the coverslip b. under subdued light c. under very bright light d. in the supernatant |
B. under subdues light
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Which of the following casts is most likely to be found in healthy people?
a. hyaline b. RBC c. waxy d. WBC |
A. hyaline
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Which of the following casts is most indicative of end stage renal disease?
a. hemoglobin b. granular c. cellular d. waxy |
D. waxy
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Which of the following aids in differentiating a spherical transitional cell from a round renal tubular cell?
a. spherical transitional cell is larger b. eccentrically-placed nucleus in the renal tubular cell c. eccentrically-placed nuclues in the spherical transitional cell d. round renal tubular cell is larger |
B. eccentrically-placed nucleus in the renal tubular cell
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The urine microscopic constituents that best differentiate between cystitis and pyelonephritis are:
a. WBC's b. bacteria c. RBC's d. WBC casts |
D. WBC casts
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Granular casts found in the urine of a football player admitted to the hospital with a broken leg occurring during the game can be the result of:
a. excessive bruising b. strenuous exercise c. excess power drink ingestion d. bone fracture |
B. strenuous excercise
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Which of the following casts most frequently appears to have a brittle consistency?
a. hyaline b. granular c. waxy d. fatty |
C. waxy
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To distinguish between a clump of WBC's and a WBC cast it is important to observe:
a. the presence of free floating WBC's b. a positive leukocyte reaction c. a positive nitrite reaction d. the presence of a cast matrix |
D. the presence of a cast matrix
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Spherical urothelial cells may be confused with:
a. oval fat bodies b. renal tubular epithelial cell c. glitter cells d. lymphocytes |
B. renal tubular epithelial cells
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Prior to reporting a RBC cast, it is important to observe:
a. free floating RBC's b. hyaline casts c. granular casts d. increased WBC's |
A. free floating RBC's
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In a specimen with a large amount of bilirubin, which of the following sediment constituents would be most noticeably bile-stained?
a. squamous epithelial cells b. WBC casts c. cystine crystals d. renal tubular epithelial cells |
D. renal tubular epithelial cells
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A white precipitate in a urine specimen with a pH of 7.5 would most probably be caused by:
a. amorphous urates b. WBC's c. amorphous phosphates d. bacteria |
C. amorphous phosphates
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Which of the following is an abnormal crystal described as a hexagonal plate?
a. cystine b. tyrosine c. leucine d. cholesterol |
A. cystine
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After warming, a cloudy urine clears. This is due to the presence of:
a. urates b. phosphates c. WBC's d. bacteria |
A. urates
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Tiny-colorless dumbbell shaped crystals were found in an alkaline urine sediment. They most likely are:
a calcium oxalate b. calcium carbonate c. calcuim phosphate d. amorphous phosphate |
B. calcium carbonate
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Which of the following crystals may be found in acidic urine:
a. calcium carbonate b. calcium oxalate c. calcium phosphate d. triple phosphate |
B. calcium oxalate
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Which of the following crystals appear as fine, silky needles?
a. chloresterol b. leucine c. hemosiderin d. tyrosine |
D. tyrosine
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Which of the following crystals is seen in an amber urine with a positive bilirubin?
a. ammonium biurate b. cystine c. tyrosine d. uric acid |
C. tyrosine
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Following ingestion of ethelene glycol numerous crystals are found in the urine. The shape of these crystals is:
a. flat with notched corners b. oval/dumbbell c. coffin-lid d. rosettes/rhomboid |
B. oval/dumbbell
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|
Polarized light can often be used to differentiate between:
a. fibers and mucus clumps b. hyaline and waxy casts c. squamous and transitional spithelial cells d. RBC's and WBC's |
A. fibers and mucus clumps
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Which of the following contaminants has a dimpled center and will polarize?
a. starch b. oil droplets c. air bubbles d. pollen grains |
A. starch
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A technologist is having trouble differentiating between RBC's, oil droplets and yeast cells on a urine microscopy. Acetic acid should be added to the sediment to:
a. lyse the yeast cells b. lyse the RBC's c. dissolve the oil droplets d. crenate the RBC's |
B. lyse the RBC's
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When identifying urinary crystals, which reagent strip result is most important?
a. protein b. pH c. specific gravity d. nitrite |
B. pH
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|
Bacteria are considered significant in the urine sediment when the:
a. nitrite is positive b. protein is positive c. specimen is cloudy d. leukocytes is positive |
D. leukocytes is positive
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|
Which of the following exhibits rapid motility in urine sediment?
a. spermatozoa b. Trichomonas vaginalis c. Gardnerella vaginalis d. Enterobius vermicularis |
B. Trichomonas vaginalis
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|
|
Which of the following positive chemical reactions is most closely associated with the presence of yeast in the urine sediment?
a. nitrite b. protein c. glucose d. blood |
c. glucose
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|
A 21 yr old woman had glucose in her urine with a normal blood sugar. These findings are most consistent with:
a. renal glycosuria b. diabetes insipidus c. diabetes mellitus d. alkaline tide |
A. renal glycosuria
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|
A 62 yr old patient with hyperlipoproteinemia has a large amount of protein in his urine. Microscopic analysis yields moderate to many fatty, waxy, granular and cellular casts. Many oval fat bodies are also noted. This is most consistent with:
a. nephrotic syndrome b. viral infection c. acute pyeloneohritis d. acute glomerulonephritis |
A. nephrotic syndrome
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|
A specimen with a negative nitrate reaction and a positive leukocytes reaction that has WBC's, WBC casts and no bacteria in the sediment will be seen in cases of:
a. cystitis b. pyelonephritis c. acute interstitial nephritis d. acute glomerulonephritis |
C. acute interstitial nephritis
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|
The sediment of a urine specimen with a reagent strip glucose of 250 mg/dL and a pH of 5.5 is ideal for the presence of:
a. cystine crystals b. Trichomonas vaginalis c. Canidida albicans d. thorny apple crystals |
C. Candida albicans
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|
The normal renal threshold for glucose in the adult is approximately:
a. 50 mg/dL b. 100 mg/dL c. 160mg/dL d. 300mg/dL |
C. 160mg/dL (8.8 mmol/L)
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|
The volume of urine excreted in a 24 hr period by an adult patient was 300mL. This condition would be termed:
a. anuria b. oliguria c. polyuria d. dysuria |
B. oliguria
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A patient has glucosuria, hyperglycemia and polyuria. These findings are most consistent with:
a. renal glucosuria b. diabetes mellitus c. emotional stress d. eating a heavy meal |
B. diabetes mellitus
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A normal glomerular filtration rate is:
a. 1 mL/min b. 120 mL/min c. 660 mL/min d. 1200 mL/min |
B. 120 mL/min
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Normal urine primarily consists of:
a. water, protein, and sodium b. water, urea, and protein c. water, urea, and sodium chloride d. water, urea and bilirubin |
C. water, urea, and sodium chloride
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An abdominal fluid is submitted from surgery. The physician wants to determine if this fluid could be urine. The technologist should:
a. perform a culture b. smell the fluid c. test for urea and creatinine d. test for protein, glucose and pH |
C. test for urea and creatinine
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Which of the following components are present in serum but not present in the glomerular filtrate?
a. glucose b. amino acids c. urea d. large molecular weight proteins |
D. large molecular weight proteins
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Polyuria is usually correlated with:
a. acute glomerulonephritis b. diabetes mellitus c. hepatitis d. tubular damage |
B. diabetis mellitus
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Cessation of urine flow is defined as:
a. azotemia b. dysuria c. diuresis d. anuria |
D. anuria
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The reason for performing a Clinitest on a newborn's urine is to check for:
a. fructose b. galactose c. glucose d. lactose |
B. galactose
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Ketones in urine are due to:
a. complete utilization of fatty acids b. incomplete fat metabolism c. high carbohydrate diets d. renal tubular dysfunction |
B. incomplete fat metabolism
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Reagent strip tests for ketones measure primarily:
a. acetone b. acetoacetic acid c. chloesterol d. beta-hydroxbutyric acid |
B. acetoacetic acid
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Bilirubinluria may be associated with:
a. strenuous excercise b. increased destruction of platelets c. viral hepatitis d. hemolytic anemia |
C. viral hepatitis
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Glycosuria may be due to:
a. hypoglucemia b. increased real threshold c. renal tubular dysfunction d. increased glomerular filtration rate |
C. renal tubular dysfunction
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The urinary tract structures responsible for renal concentration are the:
a. renal pelvis b. coritcal nephrons c. renal papillae d. juxtamedullary nephrons |
D. juxtamedullary nephrons
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The most accurate test to determine renal concentration is:
a. osmolarity b. glomerular filtration rate c. specific gravity d. tubular reabsorption rate |
A. osmolarity
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To avoid falsely elevated spinal fluid cell counts :
a. use an aliquot from the first tube collected b. use only those specimens showing no turbidity c. centrifuge all specimens before counting d. select an aliquot from the last tube collected |
D. select an aliquot from the last tube collected
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To prepare the reagent used for mucin clot determination of synovial fluid, water is mixed with:
a. hydrochloic acid b. sodium hydroxide c. trichloroacetic acid d. glacial acetic acid |
D. glacial acetic acid
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False-positive results can occur for fecal occult blood due to the ingestion of:
a. ascorbic acid b. horseradish c. acetaminophen d. blueberries |
B. horseradish
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The chromogen for the fecal occult blood test is:
a. gum guaiac b. NADH c. o-toluidine d. p-aminocinnamaldehyde |
A. gum guaiac
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A build up of fluid in a body cavity is called:
a. an effusion b. a transudate c. an exudate d. mitastasis |
A. an effusion
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Ascites us collected by:
a. thoracentesis b. lumbar puncture c. amniocentesis d. paracentesis |
D. paracentesis
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Amniotic fluid is tested for the concentration of lamellar bodies. This test determines:
a. fetal lung maturity(FLM) b. HDFN c. alpha-fetoprotein(AFP) d. trisomy 21 |
A. fetal lung maturity
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Amniocentesis should be performed to:
a. screen for Down syndrome b. to confirm a high maternal serum alpha-fetoprotein c. to test bilirubin levels for an Rh pos. mother d. test folic acid levels in fetal blood |
B. to confirm a high maternal serum alpha-fetoprotein (MSAFP)
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A sweat chloride >60mEq/L (60mmol/L) is indicative of:
a. multiple sclerosis b. muscular dystrophy c. respiratory distress syndrome d. cystic fibrosis |
D. cystic fibrosis
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The most common genetic defect associated with cystic fibrosis is called:
a. delta-F508 b. trisomy 21 c. Philidelphia chromosome d. fragile X |
A. delta-F508
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A CSF was collected from a 5 yr old with a fever and 3 tubes were transported to the lab. Tube 1 had 50,000 RBC/mL and 48 WBC/mL. Tube 3 had 10 RBC/mL and 0 WBC/mL. What is the most likely explanation for the discrepancy?
a. tube 3 was QNS b. bacterial meningitis c. subarachnoid hemorrhage d. tramatic tap |
D. traumatic tap
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The appearance of normal CSF is:
a. pale yellow and clear b. colorless and clear c. opalescent d. xanthochromic |
B. colorless
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A CSF was hazy and the WBC was too high to perform undiluted. The technologist took 50 mL of sample and added 500 mL of saline. The cell count on the diluted sample was 200 WBC/mL. This should be multiplied by:
a. 10 b. 11 c. 1/10 d. 1/11 |
B. 11
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The finding of hemosiderin laden macrophage in a CSF sample indicates:
a. bacterial infection b. viral infection c. previous hemorrhage d. traumatic tap |
C. previous hemorrhage
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Which of the following is the best indicator of Reye syndrome for CSF(hepatic encephalopathy)
a. glutamine b. ammonia c. ALT d. bilirubin |
A. glutamine
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A tau isoform of transferrin is a carbohydrate deficient protein found only in:
a. CSF b. sweat c. amniotic fluid d. semen |
A. CSF
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Which marker can be used to identify a body fluid as semen?
a. PSA b. alkaline phiosphatase c. fructose d. hyaluronic acid |
A. PSA
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Which stain is used to measure sperm viability?
a. eosin nigrosin b. Wright c. toluidine blue d. Papanicolaou |
A. eosin nigrosin
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The dimensions of a hemacytometer are:
a. 3 x 3 x 0.1mm b. 1 x 1 x 10mm c. 3 x 10 x 1mm d. 1 x 1 x 0.3mm |
A. 3 x 3 x 0.1mm
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Rapid forward progression of sperm is rated as:
a. 1.0 b. 2.0 c. 3.0 d. 4.0 |
D. 4.0
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Methods used as screening tests for cystic fibrosis include:
a. coulometric Cl measurement b. Cl selective electrodes c. sweat conductivity d. pilocarpine iontophorisis |
C. sweat conductivity
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Which pair does not match with respect to amniotic fluid?
a. colorless---normal b. dark red/brown---fetal death c. dark green---HDFN d. blood-streaked---traumatic tap |
C. dark green ----HDFN
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Amniotic fluid is evaluated using a liley graph and change in absorbance at 450nm. What is being evalusted and why?
a. bilirubin, which increases in HDN b. AFP, which increases in spina bifida c. SCG, which increases in Down syndrome d. lamellar bodies, which increase with fetal lung maturity |
A. bilirubin, which increases in HDN
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Peritoneal lavage is used to:
a. detect intra-abdominal bleeding in blunt injury b. dialyze patients with end stage renal disease c. replace ascites with saline d. perform therapeuric thoracentesis. |
A. to detect intra-abdominal bleeding in blunt injury
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Tumor markers that can be measured on body fluids include all except:
a. CEA b. CA 125 c. ANA d. CYFRA 21-1 |
C. ANA
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Which semen result is abnormal?
a. sample pours in droplets after 60 minutes b. >50% are motile within 1 hour of collection c. pH 7.5 d. motility of 1.0 |
D. motility of 1.0
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Increased CSF lactate is found in:
a. bacterial meningitis b. Reye encephalopathy c. spina bifida d. multiple sclerosis |
A. bacterial meningitis
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Decreased CSF protein can be found in:
a. meningitis b. hemorrhage c. multiple sclerosis d. CSF leakage |
D. CSF leakage
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What calculation is used to determine if there is a breach in the blood brain barrier?
a. IgG index b. CSF/serum albumin index c. fluid/serum LD ratio d. albumin gradient |
B. CSF/serum albumin index
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Preanalytical variables in laboratory department for a recollect:
a. result accuracy b. report delivery to the ordering physician c. test turnaround time d. specimen acceptablitiy |
D. specimen acceptability
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The first procedure to be followed if the blood gas instrument is out-of-control for all parameters is:
a. recalibrate, then repeat control b. repeat control on the next shift c. replace electrodes, then repeat control d. report patient results after duplicate testing |
A. recalibrate then repeat controls
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The mean value of a series of hemoglobin controls was found to be 15.2 g/dL, and the standard deviation was calculated at 0.20. Acceptable control range for the laboratory is +-2 standard deviations. Which of the following represents the allowable limits for the control?
a. 14.5-15.5g/dL b. 15.0-15.4g/dL c. 15.2-15.6g/dL d. 14.8-15.6g.dL |
D. 14.8-15.6g/dL
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Upon completion of a run of cholesterol tests, the technician recognizes that the controls are not within the 2 standard deviations confidence range. What is the appropriate course of action?
a. report the results without any other action b. run a new set of controls c. run a new set of controls and repeat specimens d. recalibrate instrument and run controls |
C. run new controls and repeat specimens
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The following data was calculated on a series of 30 determinations of serum uric acid control:
mean=5.8mg/sL, 1 standard deviation = 0.15mg/dL. If the confidence limits are set at =-2 standard deviations, which of the following represents the allowable limits for the control? a. 5.65-5.95mg/dL b. 5.35-6.25mg/dL c. 5.50-6.10mg/dL d. 5.70-5.90mg/dL |
C. 5.50-6.10mg/dL
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An index of precision is statistically known as the:
a. median b. mean c. standard deviation d. coefficient of variation |
D. coefficient of variation
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The term used to describe reproducibility is:
a. sensitivity b. specificilty c. accuracy d. precision |
D. precision
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The ability of a procedure to measure only the component it claims to measure is called:
a. specificity b. sensitivity c. precision d. reproducibility |
A. specificity
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The extent to which measurements agree with the true value of the quantity being measured is known as:
a. reliability b. accuracy c. reproducibility d. precision |
B. accuracy
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Diagnostic specificity is defined as the percentage of individuals:
a. with a given disease who have a positive result by a given test b. without a given disease who have a negative result by a give test. c. with a given disease who have a negative result by a given test d. witout a given disease who have a positive result by a given test |
B. without a given disease who have a negative result by a given test
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Employees are quaranteed the right to engage in self-organization and collection bargaining through representatives of their choice, or to refrain from these activities by which of the following?
a. Civil Rights Act b. Freedom of Information Act c. Clinical Laboratory Improvements Act d. National Labor Relations Act |
D. National Labor Relations Act
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Which of the following organizations was formed to encourage the voluntary attainment of uniformly high standards in institutional medical care?
a. Centers for Disease Control b. Health Care Finance Administration c. The Joint Commission d. Federal Drug Administration |
C. the Joint Commission
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The process by which agency or organization uses predetermined standards to evaluate and recognize a program of study in an institution is called:
a. regulation b. licensure c. accreditation d. credentialing |
C. accreditation
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CLIA was established to provide oversight to:
a. research labs b. point of care testing bly nonlaboratory personnel c. CAP-accredited labs d. any lab performing patient testing |
D. any lab performing patient testing
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CAP requires refrigerator temperature to be recorded:
a. daily b. weekly c. monthly d. periodically |
A. daily
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A paper or electronic report of lab results must include:
a. the name of the person who collected the specimen b. the test price c. a pathologist's signature d. the name and address of the testing laboratory |
D. the name and address of the testing laboratory
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CAP requires that glassware cleaning practices include periodic testing for:
a. chemical residues b. silicates c. detergents d. heavy metals |
C. detergents
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HIPAA is a federal law that requires:
a. confidentiality of patient's health care information between 2 organizations b. reporting of errors in laboratory results c. access to patient records when there is a lawsuit d. unannounced inspections by accreditation agencies |
A. confidentiality of patients' health care information between 2 organizations
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Your friend calls and asks you to access his test results. Which of the following does this violate?
a. CAP b. The Joint Commision c. HIPAA d. CLIA |
C. HIPAA
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A technician is asked to clean out the chemical reagent storeroom and discard any reagents not used in the past 5 years. How should the technician proceed?
a. discard chemicals into biohazard containers where they will later be autoclaved b. pour reagents down the drain, followed by flushing of water c. consult MSDS sheets for proper disposal d. pack all chemicals for incineration |
C. consult MSDS for proper disposal
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Using a common labeling system for hazardous material identification such as HMIS or NFPA 704, the top red quadrant represents which hazard?
a. reactivity b. special reactivity c. health d. flammability |
D. flammability
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If the HMIS or NFPA 704 hazardous material identification system has a number 4 in the left blue quadrant, it represents a:
a. high health hazard b. low health hazard c. high reactivity hazard d. low reactivity hazard |
A. high health hazard
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Which chemical is a potential carcinogen?
a. potassium chloride b. formaldehyde c. mercury d. picric acid |
B. formaldehyde
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Compressed gas cyinders should:
a. be stored with flammable materials b. be transported by rolling or dragging c. have safety covers removed when pressure regulators are unattached d. be secured upright to the wall or other stable source |
D. be secured upright to the wall or other stable source
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The HMIS or NFPA 704 hazardous material identification system rating for a slightly toxic chemical would be:
a. 1 in the yellow quadrant b. 4 in the blue quadrant c. 1 in the blue quadrent d. 4 in the yellow quadrent |
1 in the blue quadrent
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A chemical that causes immediate visible destruction or irreversible alterations of human tissue at the contact site is best classified as:
a. carcinagenic b. toxic c. ignitable d. corrosive |
D. corrosive
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When hazardous chemicals are tranferred from the original appropriately labeled containers to a secondary container for immediate use by the person performing the transfer, it:
a. must be labeled with an emergency response phone number b. must be labeled with the identity or contents of the hazardous chemical c. must be labeled with hazard warning related to the effect on involved target organs d. does not require labeling |
D. does not require labeling
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A technologist spilled 10 gallons of formaldehyde on the floor. After determining the chemical poses a significant health hazard. the first action step would be to:
a. notify emergency assistance b. control the spill with appropriate absorbent material c. evacuate the area d. don appropriate personal protective equipment |
C. evacuate the area
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One of the elements of a written laboratory chemical hygiene plan is to:
a. require employees who handle chemicals to have annual medical evaluations b. prohibit use of carcinogens c. designate a laboratory chemical hygiene officer d. perform chemical monitoring every 6 months of OSHA regulated substances |
C. designate an chemical hygiene officer
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The purpose of the OSHA hazard Communication , General Idustry Standard, 29 CFR, Subpart Z, 1910.1200, is to require employees to establish a program ensuring personnel are provide with information regarding the workplace dangers of:
a. bloodborne pathogens b. enviromental hazards c. general safety hazards d. hazardous chemical |
D. hazardous chemicals
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When working with sharp equipment and objects use:
a. double-glove technique with specimen handling gloves b. mechanical device c. paper towel or gauze as a barrier d. two-handed technique |
B. mechanical device
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For safe operation of a centrifuge:
a. clean with soap/detergent when maintenance is performed or spills occur b. open the centrifuge cove when it is in the precess of slowing down c. leave liquid specimen tubes uncovered during centrifugation d. ensure proper balance is maintained |
D. ensure proper balance is maintained
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Incident reports for occupational injury or illness should:
a. include information on the employee's past medical history b. be filed only for incidents involving serious injury of illness c. be filed for all incidents including near miss incidents d. not be retained after review by a safety committee or officer |
C. be filed for all incidents including near miss incidents
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According to OSHA, what type of sign should be posted in an area where an immediate hazard exists and where special precautions are necessary?
a. red, black and white "Danger" sign b. yellow, and black "Caution" sign c. green and white "Safety Instruction" sign d. orange and black "Biohazard " sign |
A. red, black and white "Danger" sign
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All laboratory instruments should:
a. have repairs conducted while connected to facility wiring b. be grounded or double insulated c. have safety checks performed initially and then every 6 months d. be connected to multiple outlet adapters |
B. be grounded or double insulated
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If areas of the laboratory are designated as "clean " or "contaminated" it is appropriate for a technologist to:
a. clean technical are bench tops after spills and on a weekly basis b. wear a lab coat in the break or lunch room c. apply lip balm in a contaminated area d. touch a contaminted are phone with ungloved hands if hands are washed afterwards |
D. touch a "contaminated" area phone with ungloved hands if hands are washed afterwards
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For fire safety and prevention:
a. fire drills should be announced and practiced in advance b. hallways and corridors shoudl be clear and free of obstruction at all times c. only one exit is necessary in laboratories that contain an explosive hazard d. hazard evealuations only need to be done prior to initiation of clinical operations |
B. hallways and corridors should be clear and free of obstructions at all times
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Flammable and combustible liquids in containers > 5 gallons should be stored in a(n)
a. flammable safety cabinet vented to room air b. nonexplosive proof refrigerator c. fume hood d. approved safety can |
D. approved safety can
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After receiving appropriate training, the first step in using a fire extinguisher is to:
a. sweep the flow of the hose from side to side b. pull the pin c. squeeze the top handle or lever d. aim the hose at the bottome of the fire |
B. pull the pin
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To help prevent electrical fires in healthcare facilities:
a. use multiple outlet or gang plug adapters b. change circuit breakers annually c. tage over worn witing with certified electrical tape d. use only UL or other safety-agency-rated electrical equipment |
D. use only UL or other safety-agency-rated electrical equipment
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In addition to keeping the load close to your body and tightening you abdominal muscles when lifting heavy boxes of supplies, it is important to bend at the:
a. waist; lift with legs and buttocks b. knees and hips; lift with legs and buttocks c. knees and hips; lift with arms and back d. waist; twist your body when lifting |
B. knees and hips; lift with legs and buttocks
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A fire occurs in the laboratory. the first course of action is to:
a. evacuate the area b. pull the fire alarm box c. remove persons from immediate danger d. containt the fire by closing doors |
C. remove persons from immediate danger
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An electrical equipment fire breaks out in the lab. Personnel have been removed from immediate danger, the alarm has been activated. What is the next action to be taken?
a. evacuated the facility b. contain the fire by closing doors c. extinguish fire with type A extinguisher d. lock all windows and doors in the immediate area |
B. contain the fire by closing the doors
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Class C fires involve:
a. grease and oil b. xylene and alcohol c. paper, wood, and platics d. electrical equipment |
D. electrical equipment
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A technologist spashed a corrosive chemical in his/her eyes. to prevent permanent injury, the first action should be to:
a. bandage the eyes and seek immediate emergency medical assistance b. flush eyes with a chemical of opposite pH to neutralize the injury c. use the eyewash station to flush eyes with water for 15 mins. d. seek immediate emergency medical assistance |
C. use the eyewash station to flush eyes with waterfor 15 mins.
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A technologist spilled concentrated hydrochloric acid on his/her clothing and skin, affecting a large portion of the body. After removing involved clothing the next first aid treatment step would be to:
a. seek immediate emergency medical assistance b. use emergency safety shower and flush body with water c. apply burn ointment to affected skin d. pour baking soda on the skin and bandage |
B. use emergency safety shower and flush body with water
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An example of personal protective equipment is:
a. biological safety cabinet b. emergency safety shower c. eyewash station d. lab coat |
D. lab coat
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Gloves worn in the lab for specimen processing must be removed and hands washed when:
a. answering the telephone in the technical work area b. carrying a specimen outside thetechnical work area through "clean" area c. answering the telephone in a designated "clean" area d. after handling specimens from know isolation precaution patients |
C. answering the phone is a designated "clean" area
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Safety glasses, face shields or other eye and face protectors must be worn when:
a. working with caustic or toxic materials b. present in technical work area c. viewing microbioloty culture plates d. processing specimens using a splash barrier |
A. working with caustic or toxic materials
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To prevent injury, a safe lab work practice is to:
a. secure long hair and jewelry b. store well-wrapped food in the supply fridge c. wear contact lenses for eye protection d. wear comfortable, rubber-bottomed ,open weaved shoes |
A. secure long hair and jewelry
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Safe handling and disposal of laboratory generated infectious waste require:
a. disinfection of all waste b. thorough mixing of infectious and noninfectious waste c. separation of infectious and noninfectious waste d. incineration of all waste |
C. separation of infectious and noninfectious waste
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Which of the following is the best choice for decontaminating bench tops contaminated by the AIDS virus?
a. sodium hypochlorite bleach b. formalin c. a quaternary ammonium compound d. 100% alcohol |
A. sodium hypochlorite bleach
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The safest method of disposing of hypodermic needles is:
a. recap the needle with its protective sheath prior to discarding b. cut the needle with a special device before disposal c. discard the needle in an impereable container without other handling immediately after use d. drop the needle in the waste basket immediately after use |
C. discard the needle in an impermeable container without other handling immediately after use
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Precautions for health care workers dealing with patients or patient specimens include:
a. mouth pipetting when specimens lack a "Precaution" label b. reinserting needles into their original sheaths after drawing blood from a patient c. wearing a mask and disposable gown to draw blood d. prompt cleaning of bloodspills with a disinfectant solution such as sodium hypochlorite |
D. prompt cleaning of blood spills with a disinfectant solution such as sodium hypochlorite
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Infection rate is highest for laboratory professionals exposed to blood and body fluids containing:
a. hepatitis A b. hepatitis B c. CMV d. HIV |
B. hepatitis B
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Which of the following forms of exposure places a technologist at the highest risk for infection with HIV?
a. aerosol inhalation(eg: AIDS patient sneezes) b. ingestion(eg. mouth pipetting) c. needlestick d. splash |
C. needlestick
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Which disinfectant inactivates HIV and HBV?
a. alcohol b. iodine c. phenol d. sodium hypochlorite |
D. sodium hypochlorite
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Filters gererally used in biological safety cabinets to protect the laboratory worker from particulates and aerosols generated by microbiology manipulations are:
a. fiberglass b. HEPA c. APTA d. charcoal |
B. HEPA
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What is the single most effective method to prevent nosocomial spread of infection?
a. wear mask, gown and gloves b. require infectious patients to mask c. wear a N95 respirator mask d. perform frequent and appropriate hand hygiene |
D. perform frequent and appropriate hand hlygiene
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Contaminated needles and syringes without safety self-sheathing devices should be:
a. shearedby a needle cutter or bent b. re-capped using a two-handed technique c. discarded directly into an appropriate sharps container d. removed from the syringe/needle holder |
C. discarded directly into an appropriate sharps container
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Use of "standard"(universal)
precautions minimizes exposure to: a. bloodborne pathogens b. chemical hazards c. radiation hazards d. environmental hazards |
A. bloodborne pathogens
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After and accidental needle stick with a contaminated needle, the first action should be to:
a. apply antiseptic ointment to the wound b. seek immediate medical assistance c. bandage the wound d. thoroughly wash the wound with soap and water |
D. thoroughly wash the wound with soap and water
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What is the most likely mode of transmission for bloodborne pathogens in laboratory acquired infections?
a. parenteral inoculation of blood b. contact with intact skin c. airborne transmission d. fecal-oral transmission |
A. parenteral inoculation of blood
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Which infectious agent is considered to be the primary occupational health hazard regarding transmission of bloodborne pathogens?
a. HIV b. HBV c. TB d. MRSA |
B. Hepititis B
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When processing specimens for mycobacterial testing, what specific engineering control must be used?
a. horizontal laminar flow hood b. barrier protection only c. biological safety cabinet d. fume hood |
C. biological safety cabinet
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Hepatitis B vaccine is:
a. administered as a single 1-time injection b. required for all healthcare employees c. must be provided by the employer free of charge d. recommended only when an exposure incident occurs |
C. must be provided by the employer free of charge
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The most effective disinfectant recommended for bloodborne pathogens is:
a. sodium hypochlorite b. isopropyl alcohol c. chlorhexidine gluconate d. povidone-iodine |
A. sodium hypochlorite
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When processing patient blood specimens and handling other potentiallly infectious material, the best choice of gloves is:
a. reusable utility gloves b. latex gloves only c. single use and disposable gloves d. cut-resistant gloves |
C. single use and disposable gloves
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While processing patient specimens, a technologist splashes a few small drops of a bronchial wash speciment in his/her gloves. The first action should be to:
a. wash the gloves with antiseptic/soap and water b. continue to wear the gloves until grossly contaminated or leaving the area c. wash the gloves with an appropriate disinfectant d. change gloves and wash hands with antiseptic/soap and water |
D. change gloves and wash hands with antiseptic/soap and water
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Which of the following questions can be legally asked on an employment application?
a. are you a US citizen b. what is you date of birth c. is your wife/husband employed full time d. do you have any dependents |
A. are you a US citizen
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Legal pre-employment questions on an application are:
a. medical history of an employee b. place of birth c. felonies unrelated to job requirements d. name and address of person to notify in case of emergency |
D. name and address of person to notify in case of emergency
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Which of the following activities is not under the direction or control of the lab manager?
a. number of employees b. direct test costs c. skill mix d. military leave |
D. military leave
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An automated CK assay gives a reading that is above the limits of linearity. A dilution of the serum sample is made by adding 1 mL of serum to 9 mL of water. The instrument now reads 350U/L. The correct report on theundiluted serum should be:
a. 2,850 U/L b. 3,150U/L c. 3,500U/L d. 3,850U/L |
C. 3,500 U/L
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The unit of measure for a standard solution is:
a. g/L b. % c. mg/% d. mg/mL |
D. mg/mL
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A glucose determination was read on a spectrophotometer. The absorbance reading of the standard was 0.30. The absorbance reading of the unknown was 0.20. The value of the unknown is:
a. 2/3 of the standard b. 3/5 of the standard c. the same as the standard d. 1.5 x the standard |
A. 2/3 of the standard
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A technician is asked by the supervisor to prepare a standard solution from the stock standard. What is the glassware of choice for this solution?
a. graduated cylinder b. volumetric flask c. acid-washed beaker d. graduated flask |
B. volumetric flask
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How many mL of red blood cells are to be used to make 25mL of a 4% red cell suspension?
a. 0.25mL b. 0.5mL c. 1mL d. 2mL |
C. 1 mL
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The volume of 25% stock sufosalicylic acid needed to prepare 100mL of 5% working solutions is:
a. 1.25mL b. 5mL c. 20mL d. 50mL |
C. 20mL
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How many grams of sodium chloride are needed to prepare 1 L of 0.9% normal saline?
a. 0.9 b. 1.8 c. 9.0 d. 18.0 |
C. 9.0
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Which of the following is the formula for standard deviation?
a. square root of the mean b. square root of (sum of squared differenced)/(N-1) c. square root of the varience d. square root of (mean)/(sum of squared differences) |
B. square root of (sum of squared differences)/(N-1)
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The acceptable limit of error in the chemistry laboratory is 2 standard deviations. If you run the normal control 100 times, how many of the values would be out of the control range due to random error?
a. 1 b. 5 c. 10 d. 20 |
B. 5
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A mean value of 100 and a standard deviation of 1.8mg/dL were obtained from a set of glucose measurements on a control solution. The 95% confidence interval in mg/dL would be:
a. 94.6-105.4 b. 96.4-103.6 c. 97.3-102.7 d. 98.2-101.8 |
B. 96.4-103.6
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When 0.25 mL is diluted to 20mL, the resulting dilutions is:
a. 1:20 b. 1:40 c. 1:60 d. 1:80 |
D. 1:80
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When the exact concentration of the solute of a solution is known and is used to evaluate the concentration of an unknown solution, the known solution is:
a. standard b. normal c. control d. baseline |
A. standard
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A serum glucose sample was too high to read, so a 1:5 dilution using saline was made(dilution A). Dilution A was tested and was again too high to read. A further 1:2 dilution was made using saline(dilution B). To calculate the result, the dilution B value must be multiplied by:
a. 5 b. 8 c. 10 d. 20 |
C. 10
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In performing a spinal fluid protein determination, the specimen is diluted 1 part spinal fluid to 3 parts saline to obtain a result low enough to measure. To calculate the protein concentration, the result must be:
a. multiplied by 3 b. multiplied by 4 c. divided by 3 d. divided by 4 |
B. multiplied by 4
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If 0.5 mL of a 1:300 dilution contains 1 antigenic unit, 2 antigenic units would be contained in 0.5 mL of a dilution of:
a. 1:150 b. 1:450 c. 1:500 d. 1:600 |
A. 1:150
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Which of the following is theformula for calculating the dilution of a solution.
a. V1+C1=V2+C2 b. V1+C2=V2+C1 c. V1xC1=V2xC2 d. V1xV2=V1xC2 |
C. V1xC1=V2xC2
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A colormetric method calls for the use of 0.1 mL of serum, 5mL of reagent and 4.9 mL of water. What is the dilution of the serum in the final solution?
a. 1:5 b. 1:10 c. 1:50 d. 1:100 |
D 1:100
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Four mL of water are added to 1 mL of serum. This represents which of the following serum dilutions?
a. 1:3 b. 1:4 c. 1:5 d. 1:6 |
C. 1:5
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Which of the following is the formula for calculating a percent (w/v) solution?
a. grams of solute/volume of solvent x 100 b. grams of solute x volume of solvent x 100 c. volume of solvent/grams of solute x 100 d. (grams of solute x volume of solvent)/ 100 |
A. grams of solute/volume of solvent x 100
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A solution contains 20 g of solute dissolved in 0.5 L of water. What is the percentage of this solution?
a. 2% b. 4% c. 6% d. 8% |
B. 4%
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How many grams of sulfosalicylic acid(MW=254) are required to prepare 1 L of a 3% (w/v) solution?
a. 3 b. 30 c. 254 d. 300 |
B. 30
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How many mL of a 3% solution can be made if 6 grams of solute are available?
a. 100mL b. 200mL c. 400mL d. 600mL |
B. 200mL
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The following 5 sodium control values in unit were obtained:
140, 135, 138, 140, 142 Calculate the coefficient of variation: a. 1.9% b. 2.7% c. 5.6% d. 6.1% |
A. 1.9%
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The statistical term for the average value is the:
a. mode b. median c. mean d. coefficient of variation |
C. mean
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The most frequent value in a collection of data is statistically known as:
a. mode b. median c. mean d. standard deviation |
A. mode
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Which of the following is the formula for arithmetic mean?
a. square root of the sum of values b. sum of values x number of values c. number of values/sum of values d. sum of values/number of values |
D. sum of values/number of values
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Given the following values:
100, 120, 150, 140, 130 What is the mean? a. 100 b. 128 c. 130 d. 640 |
B. 128
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Which of the following is the formula for coefficient of variation?
a. (standard deviation x 100)/standard error b. (mean x 100)/standard deviation c. (standard deviation x 100)/mean d. (varience x 100)/mean |
C. (standard deviation x 100)/mean
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The sodium content (in grams) in 100 grams of NaCl is approximately: (atomic weights: Na=23,Cl=35.5)
a. 10 b. 20 c. 40 d. 60 |
C. 40
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Which of the following is the formula for calculating the gram equivalent weight of a chemical?
a. MW x oxidation number b. MW/oxidation number c. MW + oxidation number d. MW - oxidation number |
B. MW/oxidation number
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80 grams of NaOH (MW=40) are how many moles?
a. 1 b. 2 c. 3 d. 4 |
B. 2
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A serum potassium (MW = 39) is 19.5 mg/100mL. This value is equal to how many mEq/L?
a. 3.9 b. 4.2 c. 5.0 d. 8.9 |
C. 5.0
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Which of the following is the formula for calculating the number of moles of a chemical?
a. g/GMW b. g x GMW c. GMW/g d/ (g x 100)/GMW |
A. g/GMW
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A 1 molal solution is equivalent to:
a. a solution containing 1 mole of solute per kg of solvent b. 1,000 mL of solultion containing 1 mole of solute c. a solution containing 1 g equivalent weight of solute in 1 L of solution d. a 1 L solution containing 2 moles of solute |
A. a solution containing 1 mole of solute per kg of solvent
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Which of the following is the formula for calculating the molaritly of a solution?
a. number of moles of solute/L of solution b. number of moles of solute x 100 c. 1 GEW of solute x 10 d. 1 GEW of solute/L of solution |
A. number of moles of solute/L of solution
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How many mL of 0.25 N NaOH are needed to make 100 mL of a 0.05% solution of NaOH?
a. 5mL b. 10mL c. 15mL d. 20mL |
D. 20 mL
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The reliability of a test to be positive in the presence of the disease it was designed to detect is known as:
a. accuracy b. sensitivity c. precision d. specificity |
B. sensitivity
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Which of the following parameters of a diagnostic test will vary with the prevalence of a given disease in a population?
a. precision b. sensitivity c. accuracy d. specificity |
C. accuracy
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Package inserts may be used:
a. instead of a typed procedure b. as a reference in a procedure c. at the bench but not in the procedure manual d. if initialed and dated by the lab director |
B. as a reference in a procedure
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The first step to be taken when attempting to repair a piece of electrical equipment is:
a. check all the electronic connections b. reset all the printed circuit boards c. turn the instrument off d. replace all the fuses |
C. turn the instrument off
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The methodology based on the amount of energy absorbed by a substance as a function of its concentration and using a specific source of the same material as the substance analyzed is:
a. flame emission photometry b. atomic absorption spectrophotometry c. emission spectrography d. x-ray fluorescence spectrometry |
B. atomic absorbtion spectrophotometry
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Which of the following wavelengths is within th ultrviolet range?
a. 340 nm b. 450 nm c. 540 nm d. 690 nm |
a. 340 nm
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One means of checking a spectrophotometer wavelength calibration is the visible range is by using a:
a. quartz filter b. diffraction grating c. quartz prism d. didymium filter |
D. didymuin filter
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In spectrophotometry, the device that allows for a narrow band of wavelengths is the:
a. hollow cathode lamp b. monchromater c. refractometer d. photodetector |
B. monochromator
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The nanometer is a measurement of:
a. wavelength of radient energy b. specific gravitly c. density d. intensity of light |
A. wavelength of radiant energy
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In a double-beam photometer, the additional beam is used to:
a. compensate for variation in wavelength b. correct for variations in light source intensitly c. correct for changes in light path d. compensate for variation in slit-widths |
B. correct for variations in light source intensity
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Nephelometers measure light:
a. scattered at a right angle to the light path b. absorbed by suspended particles c. transmitted by now-particulate mixtures d. reflected back to the source form opaque suspensions |
A. scattered at a right angle to the light path
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Which of the following is used to verify wavelength settings for narrow bandwidth spectrophometers?
a. didymium filters b. prisms c. holmium oxide glass d. diffraction gratings |
C. holmuin oxide glass
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Which of the following statements about fluorometry is true?
a. a compound fluoresces when it absorbs light at 1 wavelength and emits light at a second wavelength b. the detector in a fluorometer is positioned at 180* from the excitation source c. fluorometry is less sensitive that spectrophotometry d. an incandescent lamp is commonly used in a fluorometer |
A. a compound fluoresces when it absorbs light at 1 wavelength and emits light as a second wavelength
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The measurement of light scattered by particles in the sample is the principle of:
a. spectrophotometry b. fluorometry c. nephelometry d. atomic absorbtion |
C. nephelometry
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In a spectrophotometer, light of a specific wavelength is isolated from the light source by the:
a. double beam b. monochromater c. aperture d. slit |
B. monochromater
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A mass spectrometer detects which property of ionized molecules?
a. column retention time b. charge to mass ratio c. mass to charge ratio d. fluorescence |
C. mass to charge ratio
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Chromatography is based on the principle of:
a. differential solubility b. gravity c. vapor pressure d. temperature |
A. differential solubility
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To be analyzed by gas liquid chromatography a compound must:
a. be volatile or made volatile b. not be volatile c. be water-soluble d. contain a nitrogen atom |
A. be volatile or made volatile
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A true statement about column chromatography methods, including high-performance liquid and gas chromatography, is that it:
a. all utilizes a flame ionization detector b. requires derivation of nonvolatile compounds c. can be used to separate gases , liquids, or soluble solids d. can be used for adsorption, partition, ion-exchange and steric-exclusion chromatography |
D. can be used for adsorption, partition, ion-exchange and steric-exclusion chromatography
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An ion-exchange electrode measures the:
a. activity of one ion only b. concentration of one ion only c. activity of one ion much more than the other ions present d. activity of only H+ ions |
C. activity of one ion much more than other ions present
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The selectivity of an ion-selective electrode is determined by the:
a. properties of the membrane used b. solution used to fill the electrode c. magnitude of the potential across the membrane d. internal reference electrode |
A. properties of the membrane used
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A centrifuge head has a diameter of 60cm and spins at 3,000 RPMs. What is the maximum achievable G force. (g=0.00001 x radius in cm x RPM squared
a. 1.8 G b. 2,700 G c. 27,000 G d. 90,000 G |
B. 2,700 G
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In a centrifugal analyzer, centrifugal force is used for:
a. add reagents to the rotor b. transfer liquids from the inner disc to the outer cuvette c. measure changes in optical density in the centrifugal force field d. counteract thetendency of precipitates to settle in the cuvette |
B. transfers liquids from the inner disc to the outer cuvetts
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Which of the following is the best guide to consistent centrfugation?
a. potentiometer setting b. armature setting c. tachometer reading d. rheostate readings |
C. tachometer readings
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A benifit of microassays, such as point of care methods, include:
a. increased analytical reliability b. reduced sample volume c. increased diagnostic specificity d. reduced numbers of repeated tests |
B. reduced sample volume
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In the proper use of cobalt treated-anhydrous CaCl2, the desiccant should be:
a. changed when it turns pink b. changed when it turns blue c. kept in the dark d. dept in the cold |
A. changed when it turns pink
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Enzyme multiplied immunoassay technique differ from all other types of enzyme immunoassays in that:
a. lysozyme is the only enzyme used to label the hapten molecule b. no separation of bound and free antigen is required c. inlhibition of the enzyme label is accomplished with polyethylene glycol d. antibody absorption to polystyrene tubes precludes competition to laveled and unlaveled antigen |
B. no separation of bound and free antigen is required
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Which of the following statements about immunoassays using enzyme labeled antibodies or antigens is correct?
a. inactivation of the enzyme is required b. the enzyme label is less stable than an isotopic label c. quantitation of the label can be carried out with a spectrophotometer d. the enzyme label is not an enzyme found naturally in serum |
C. quantitation of the label can be carried out with a spectrophotometer
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Which of the following immunoassay labels offer the greatest detection limit?
a. fluorescence b. electrochemiluminescence c. radioactivity d. chemiluminescence |
B. electrochemiluminescence
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When employees are going to be responsible for implementing a change in procedure or policy, the manager should:
a. make the decision and direct the employees to implement it b. solicit the employee input but do what he/she thinks should be done c. involve the employees in the decision-making process from the very beginning d. involve only those employees in the decision-making process who would benefit from the change |
C. involve the employees in the decision-making process from the very beginning
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The ability to make good decisions often depends on the use of a logical sequence of steps that include:
a. defining problem, considering options, implementing decisions b. obtaining facts, considering alternatives, reviewing results c. defining problem, obtaining facts, considering options d. obtaining facts, defining problem, implementing decision |
C. defining the problem, obtaining the facts, considering the options
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In planning an instructional unit, the term goal has been defined as a:
a. plan for reaching certain objectives b. set of specific tasks c. set of short and long term plans d. major purpose or final desired result |
D. major purpose or final desired result
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Communication is enhanced by:
a. a planned strategy that includes listening skills and ensuring an understanding with questions b. relying on email, memos and voice mail to communicate new info c. formal, hierarchical patterns instead of informal networking patterns d. assumptions if ther are questions about the intent of the message |
A. a planned strategy that includes listening skills and ensuring an understanding with questions
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In its guidelines, CAP stresses that communication must be effective and efficient. An effective component to enhance a multifaceted communication plan in the clinical laboratory is:
a. posting department goals on communication bulletin boards b. daily meetings with a question to foster conversation and focus the discussion c. written email to communicate all new chages in processe and procedures d. posting errors on communication bulletin boards to prevent repeat errors |
B. daily meetings with a question to foster conversation and focus the discussion
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CODE 128, ISBT 128, CODE 39 and Interleaved 2 and 5 symbologies are used by laboratory information systems to create which of the following?
a. barcode labels b. worklists c. instrument download files d. patient reports |
A. barcode labels
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A standard electronic file format recommended for transmitting data from the laboratory information system to an electronic medical record is:
a. Health Level 7 b. ISBT 128 c. FTP d. SNOMED |
A. Health Level 7
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Auto-verification of test results requires all of the following to be established by the lab except:
a. patient results entered in the LIS via an instrument interface b. patient results evaluated based on validated rules defined in the LIS c. successful quality control testing obtained prior to releasing patient results d. review of results by a qualified technologist or technician |
D. review of results by a qualified technologist or technician
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Validation of calculated test results performed by a laboratory information system must be performed:
a. every 6 months b. annually c. biannually d. only upon intial LIS installation |
C. biannually
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The hematology lab is evaluating new instruments for purchase. The supervisor wants to ensure that the instrument they select has directional interface capabilities. The instrument specification necessary to meet this requirement is:
a. 9,600 baud rate b. on-board test selection menu c. HL-7 file format d. host query mode |
D. host query mode
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The Chem. Dept. has requested that a new test be defined in the LIS to run on the existing analyzer. The new test set up is completed by the LIS coordinator. A few days later, the accessioning department receives a request for the new test but an error is displayed when they try to place the order. All other tests can be successfully ordered. The most likely cause of the error is the:
a. instrument interface for the Chem. analyzer is down b. test was not defined on the Chem. worklist c. database did not properly update with the new test information d. ADT interface with the hospital system is down |
C. database did not properly update with the new test information
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The process of testing and documenting changes made to a laboratory informations system is known as:
a. validation b. quality engineering c. cutomization d. hazard analysis |
A. validation
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Performance of laboratory information system back-up procedures includes all of the following except:
a. creating an exact copy of LIS date b. off-site storage of the data media c. shutting down the LIS and bringing it back up d. completion at regularly defined intervals |
C. shutting down the LIS and bringing it back up
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During the G2 phase of the cell cycle, the DNA content of a cell is:
a. haploid b. diploid c. triploid d. tetraploid |
D. tetraploid
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Intervening sequences are found in:
a. heteronuclear RNA b. mature mRNA c. ribosomal RNA d. transfer RNA |
A. heteronuclear RNA
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A metaphase chromosome with primary constriction that gives the chromosome clearly defined short and long arms is considered:
a. acrocdentric b. submetacentric c. metacentric d. telocentric |
B. submetacentric
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The 2 allelles for a sex-linked disease are X and x. The mutant allele is x. What is the percentage of male offspring that would be expected to be affected by the disease from parents who have thefollowing genotypes.
mother - Xx father - xY a. 0 b. 25 c. 50 d. 100 |
C. 50
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The term that best describes males regarding X-linked genes is:
a. heterozygous b. homozygous c. haplozygous d. hemizygous |
D. hemizygous
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The mode of inheritance of mitochondrial DNA is:
a. dominant b. recessive c. codominant d. maternal |
D. maternal
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Chelex 100 resin is used to:
a. purify mRNA from total RNA b. extract total RNA from cells c. extract DNA from cells' d.remove unincorporated primers from PCR reactions prior to gel analysis of PCR products |
C. extract DNA from cells
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The fluorescent dye that exhibits the greatest sensitivity for quantization of DNA is:
a. ethiduim bromide b. Hoechst 33258 c. propidium iodide d. SYBR green |
D. SYBR green
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When quantifying the amount of genomic DNA is a sample by spectrophotometry, an OD 260 of 1.0 corresponds to what concentration of DNA?
a. 10ug/mL b. 20ug/mL c. 50ug/mL d. 100ug/mL |
C. 50ug/mL
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Denaturation of DNA during a PCR reaction refers to breaking:
a. hydrogen bonds between nitrogenous bases in base=paired nucleotides b. phosphodiester bonds between nitrogenous bases in base-paired nucleotides c. covalent bonds between nitrogenous bases in base-paired nucleotides d. peptide bonds between nitrogenous bases in base-paired nucleotides |
A. hydrogen bonds between nitrogenous bases in base-paied nucleotides
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What is the most critical step in determining the specificity of a PCR reaction?
a. denaturation temp b. annealing temp c. extension temp d. number of cycles in the PCR reaction |
B. annealing temperature
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A PCR reaction in which 4 different sets of primers are used to simultaneously amplify 4 distinct loci in the same reaction tube is known as a:
a. multiplex PCR reaction b. heteroplex PCR reaction c. polyplex PCR reaction d. quadraples PCR reaction |
A. multiplex PCR reaction
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A translocation in which chromosome pair creates a BCR/ABL1 fusion gene product associated with CML?
a. 11;18 b. 14;18 c. 9;22 d. 9;14 |
C. 9;22
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Following overnight fasting, hypoglucemia in adults is defined as a glucose of:
a. <70 mg/dL(<3.9 mmol/L) b. <60 mg/dL(<3.3mmol/L) c. <55 mg/dL(<3.0mmol/L) d. <45mg/dL(<2.5mmol/L) |
D. <45mg/dL
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The preparation of a patient for standard glucose tolerance testing should include:
a. a high carbohydrate diet for 3 days b. a low carbohydrate diet for 3 days c. fasting for 48 hrs prior to testing d. bed rest for 3 days |
A. high carbohydrate diet for 3 days
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In a fasting glucose was 90 mg/dL, which of the following 2 hr PP glucose result would most closely represent normal glucose metabolism?
a. 55mg/dL(3.0mmol/L) b. 100mg/dL(5.5mmol/L) c. 180mg/dL(9.9mmol/L) d. 260mg/dL(14.3mmol/L) |
B. 100mg/dL (5.5mmol/L)
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A healthy person with a blood glucose of 80 mg/dL(4.4 mmol/L) would have a simultaneously determined cerebrospinal fluid glucose value of:
a. 25mg/dL(1.4mmol/L) b. 50mg/dL(2.3mmol/L) c. 100mg/dL(5.5mmol/L) d. 150mg/dL(8.3mmol/L) |
B. 50 mg/dL (2.3mmol/L)
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A 25 yr old man became nauseated and vomited 90 mins after receiving a standard 75g carbohydrate dose for an oral glucose tolerance test. The best course of action is to:
a. give the patient a glass of orange juice and continiue the test b. start the test over immediately with a 50 g carbohydrate dose c. draw blood for glucose and discontinue the test d. place the patient in a recumbent position, reassure him and continue the test. |
c. draw blood for glucose and discontinue the test
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Cerebrospinal fluid for glucose assay should be:
a. refrigerated b. analyzed immediately c. heated to 56 *C d. stored at room temperature after centrifugation |
B. analyzed immediately
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Which of the following 2 hr PP glucose values demonstrates unequivocal hyperglycemia diagnostic for diabetes mellitus?
a. 160mg/dL(8.8mmol/L) b. 170mg/dL(9.4mmol/L) c. 180mg/dL(9.9mmol/L) d. 200mg/dL(11.0mmol/L) |
D. 200 mg/dL(11.0 mmol/L)
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A 45 yr old woman has a fasting serum glucose concentration of 95mg/dL(5.2mmol/L)and a 2 hr pp glucose concentration of 105mg/dL(5.8mmol/L). The statement which best describes this partient's fasting serum glucose concentration is:
a. normal;reflecting glycogen breakdown by the liver b. normal;reflecting glycogen breakdown by skeletal muscle c. abnormal;indication diabetes mellitus d. abnormal;indicating hypoglycemia |
A. normal;reflecting glycogen breakdown by the liver
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Serum levels that define hypoglycemia in pre-term or low birth weight infants are:
a. the same as adults b. lower than adults c. the same as a normal full-term infant d. higher than a normal full-term infant |
B lower than adults
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Pregnant women with symptoms of thirst, frequent urination or inexplained weight loos should have shich of the following tests performed?
a. tolbutamide test b. lactose tolerance test c. epinephrine tolerance test d. glucose tolerance test |
D. glucose tolerance test
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In the fasting state, the arterial and capillary blood glucose concentration varies from the venous glucose concentration by approximately how many mg/d:(mmol/L)
a. 1mg/dL(0.05mmol/L) b. 5mg/dL(0.27mmol/L) c. 10mg/dL(0.55mmol/L) d. 15mg/dL(0.82mmol/L) |
B. 5mg/dL(0.27mmol/L:)
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The conversion of glucose or other hexoses into lactate or pyruvate is called:
a. glycogenesis b. glycogenolysis c. gluconeogenesis d. glycolysis |
D. glycolysis
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Which of the following values obtained during a glucose tolerance test are diagnostic of diabetes mellitus?
a. 2 hr specimen = 150 mg/dL(8.3mmol/L) b. fasting plasma glucose = 126mg/dL(6.9mmol/L) c. fasting plasma glucose = 110mg/dL(6.1mmol/L) d. 2 hr specimen = 180 mg/dL(9.9mmol/L) |
B. fasting plasma glucose = 126mg/dL(6.9mmol/L)
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The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding:
a. 1-3 weeks b. 4-5 weeks c. 6-8 weeks d. 16-20 weeks |
C. 6-8 weeks
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Monitoring long term glucose control in patients with adult onset diabetes mellitus can best be accomplished by measuring:
a. weekly fasting 7am serum glucose b. glucose tolerance testing c. 2 hr pp serum glucose d. hemoglobin A1c |
D. hemoglobin A1
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Total glycosylated hemoglobin levels in a hemolysate reflect the:
a. average blood glucose levels of the past 2-3 months b. average blood glucose levels for the past week c. blood glucose level at the time the sample is drawn d. hemoglobin A1c level at the time the sample is drawn |
A. average blood glucose levels of the past 2-3 weeks
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Which of the following hemoglobins has glucose-6-phosphate on the amino-terminal valine of the beta chain?
a. S b. C c. A2 d. A1c |
D. A1c
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A patient with hemolytic anemia will:
a. show a decrease in glycated Hgb value b. show a increase in glycated Hgb value c. show little or no change in glycated Hgb value d. demonstrate an elevated Hgb A1 |
A. show a decrease in glycated Hgb value
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In using ion-exchange chromatographic methods, falsely increased levels of Hgb A1c might be demonstrated in the presence of:
a. iron deficiency anemia b. pernicious anemia c. thalassemias d. Hgb S |
D. Hgb S
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An increase in serum acetone is indicative of a defect in the metabolism of:
a. carbohydrates b. fats c. urea nitrogen d. uric acid |
A. carbohydrates
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An infant with diarrhea is being evaluated for a carbohydrate intolerance. His stool yields a positive copper reduction test and a pH of 5.0. It should be concluded that:
a. further tests are indicated b. results are inconsistent-repeat both tests c. the diarrhea is not due to carbohydrate intolerance d. the tests provided no useful informtion |
A. further tests are indicated
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Blood samples were collected at the beginning of an exercise class and after thirty mins. of aerobic activity. Which of the following would be most consistent with the post exercise sample?
a. normal lactic acid, low pyrubate b. low lactic acid, elevated pyruvate c. elevated lactic acid, low pyruvate d. elevate lactic acid, elevated pyruvate |
D. elevated lactic acid, elevated pyruvate
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What is the best method to diagnose lactase deficiency?
a. H2 breath trest b. plasma aldolase level c. LDH level d. d-xylose test |
A. H2 breath test
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The expected blood gas results for a patient in chronic renal failure would match the pattern of:
a. metabolic acidosis b. respiratory acidosis c. metabolic alkalosis d. respiratory alkalosis |
A. metabolic acidosis
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Severe diarrhea causes:
a. metabolic acidosis b. matabolic alkalosis c. respiratory acidosis d. respiratory alkalosis |
A. metabolic acidosis
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Factors that contribute to a PCO2 electrode requiring 60-120 seconds to reach equilibrium include the:
a. diffusion characteristics of the membrane b. actual blood PO2 c. type of calibrating standard d. potential of the polarizing mercury cell |
A. diffusion characteristics of the membrane
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An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state?
a. respiratory acidosis b. respiratory alkalosis c. metabolic acidosis d. metabolic alkalosis |
A. respiratory acidosis
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At blood pH 7.40, what is the ratio of bicarbonate to carbonic acid?
a. 15:1 b. 20:1 c. 25:1 d. 30:1 |
B. 20:1
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The reference range for the pH of arterial blood measured at 37*C is:
a. 7.28-7.34 b. 7.33-7.37 c. 7.35-7.45 d. 7.45-7.50 |
C. 7.35 - 7.45
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A 68 yr old man arrives in the emergency room with a glucose level of 722mg/dL (39.7mmol/L) and serum acetone of 4+ undiluted. An arterial blood gas from this patient is likely to be:
a. low pH b. high pH c. low PO2 d. high PO2 |
A. low pH
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A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would be consistent with this diagnosis?
a. high PCO2, increased HCO3 b. low PCO2, increased HCO3 c. high PCO2, decreased HCO3 d. low PCO2, decreased HCO3 |
A. high PCO2, increased HCO3
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A person suspected of having metabolic alkalosis would have which of the following laboratory findings?
a. CO2 content and PCO2 elevated, pH decreased b. CO2 content decreased and pH elevated c. CO2 content, PCO2 and pH decreased d. CO2 content and pH elevated |
D. CO2 content and pH elevated
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Metabolic acidosis is described as a:
a. increase in CO2 content and PCO2 with a decrease pH b. decrease in CO2 content with an increased pH c. increase in CO2 with an increased pH d. decrease in CO2 content and PCO2 with a decreased pH |
A. increase in CO2 content and PCO2 with a decreased pH
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A common cause of respiratory alkalosis is:
a. vomiting b. stavation c. asthma d. hyperventialtion |
D. hyperventilation
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Acidosis and alkalosis are best defined as fluctuations in blood pH and CO2 content due to changes in:
a. Bohr effect b. O2 content c. bicarbonate buffer d. carbonic anhydrase |
C. bicarbonate buffer
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A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood had been exposed to room air for at least 30 mins. The following change in blood gases will occur:
a. CO2 content increased/PCO2 decreased b. CO2 content and PO2 increased/pH increased c. CO2 content and PCO2 decreased/pH decreased d. PO2 increased/HCO3 decreased |
D. PO2 increased/ HCO3 decreased
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Select the test which evaluates renal tubular function:
a. IVP b. creatinine clearance c. osmolarity d. microscopic urinalysis |
C. osmolarity
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The degree to which the kidney concentrates the glomerular filtrate can be determined by:
a. urine creatine b. serum creatinine c. creatinine clearance d. urine to serum osmolality ratio |
D. urine to serum osmolality ratio
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Osmolal gap is the difference between:
a. the ideal and real osmolality values b. calculated and measured osmolality values c. plasma and water osmolality values d. molality and molarity at 4*C |
B. calculated and measured osmolality values
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The most important buffer pair in plasma is the:
a.phosphate/biphosphate b. hemoglobin/imidazole c. bicarbonate/carbonic acid d. sulfate/bisulfate |
C. bicarbonate/carbonic acid pair
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Quantitation of Na+ and K+ by ion selective electrode is the standard method because:
a. dilution is required for flame photometry b. there is no lipoprotein interference c. of advances in electrochemistry d. of the absence of an internal standard |
C. of advances in electrochemistry
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What battery of tests is most useful in evaluating an anion gap of 22mIq/L(22mmol/L)?
a. Ca++, Mg++, PO-4, and pH b. BUN, creatinine, salicylate and methanol c. AST, ALT, LD and amyase d. glucose, CK, myoglobin, and cryoglobulin |
B. BUN, creatinine, salicylate and methanol
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Most of the carbon dioxide present in blood is in the form of:
a. dissolved CO2 b. carbonate c. bicarbonate ion d. carbonic acid |
C. bicarbonate ion
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Serum anion gap is increased in patients with:
a. renal tubular acidosis b. diabetes alkalosis c. metabolic acidosis due to diarrhea d. lactic acidosis |
D. lactic acidosis
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The anion gap is useful for quality control of laboratory results for:
a. amino acids and proteins b. blood gas analyzers c. Na, K, Cl, and CO2 d. Ca, Ph, Mg |
C. sodium, potassium, chloride, and total CO2
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The buffering capacity of blood is maintained by a reversible exchange process between bicarbonate and:
a. sodium b. potassium c. calcium d. chloride |
d. chloride
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In respiratory acidosis, a compensatoroy mechanism is the increase in:
a. respiration rate b. ammonia formation c. blood PCO2 d. plasma bicarbonate concentration |
D. plasma bicarbonate concentration
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Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?
a. chloride b. calcium c. potassium d. sodium |
D. sodium
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A potassium level of 6.8mIq/L(6.8mmol/L) is obtained. Before reporting the results the first step the technologist should take is to:
a. check the serum for hemolysis b. rerun the test c. check the age of the patient d. do nothing, simply report out the result |
A. check the serum for hemolysis
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The solute that contributes the most to the total serum osmolality is :
a. glucose b. sodium c. chloride d. urea |
B. sodium
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A sweat chloride result of 55mEq/L955mmmol/L) and a sweat sodium of 52 mEq/L(52mmol/L) were obtained on a patient who has a history of respiratory problems. The best interpretation of these results is:
a. normal b. normal sodium and an abnormal chloride test should be repeated c. abnormal results d. borderline results, the test should be repeated |
D. borderline results, the test should be repeated
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Which of the following is true about direct ion selective electrodes for electrolytes?
a. whole blood specimens are acceptable b. elevated lipids cause falsely decreased results c. elevated proteins cause falsely decreased results d. elevated platelets cause falsely increased results |
A. whole blood is acceptable
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Sodium determination by indirect ion selective electrode is falsely decreased by:
a. elevated chloride levels b. elevated lipid levels c. decreased protein levels d. decreased albumin levels |
B. elevated lipid levels
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A physician requested that electrolytes on a multiple myeloma patient specimen be run by direct ISE and not indirect ISE because:
a. excess protein binds Na in indirect ISE b. Na falsely increased by indirect ISE c. Na is falsely decresed by indirect ISE d. excess protein reacts with diluent in indirect ISE |
C. Na is falsely decreased by indirect ISE
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Which percentage of total serum calcium is nondiffusible protein bound?
a. 80% - 90% b. 51% - 60% c. 40% - 50% d. 10% - 30 % |
C. 40% - 50%
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Calcium concentration in the serum is regulated by:
a. insulin b. parathyroid hormone c. thyroxine d. vitamin C |
B. parathyroid hormone
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The regulation of calcium and phosphorous metabolism is accomplished by which of the following glands?
a. thyroid b. parathyroid c. adrenal gland d. pitutary |
B. parathyroid
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A patient has the following results:
increased serum calcium decreased serum phosphate increased levels of parathyroid hormone: This patient most likely has: a. hyperparathyroidism b. hypoparathyroidism c. nephrosis d. steatorrhea |
A. hyperparathyroidism
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A hospitalized patient is experiencing increased neuromuscular irritability (tetany). Which of the following tests should be ordered immediatly?
a. calcium b. phosphate c. BUN d. glucose |
A. calcium
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Which of the following is most likely to be ordered in addition to serum calcium to determine cause of tetany?
a. magnesium b. phosphate c. sodium d. vitamin D |
A. magnesium
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A reciprocal relationship exists between:
a. sodium and potassium b. calcium and phosphate c. chloride and CO2 d. calcium and magnesium |
B. calcium and phosphate
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Fasting serum phosphate concentration is controlled primarily by the:
a. pancreas b. skeleton c. parathyroid glands d. small intestine |
C. parathyroid gland
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A low concentration of serum phosphorus is commonly found in:
a. patients who are receiving carbohydrate hyperalimentation b. chronic renal disease c. hypoparathyroidism d. patients with pituitary tumors |
A. patients who are receiving carbohydrate hyperalimentation
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The primary function of serum albumin in the peripheral blood is to:
a. maintain colloidal osmotic pressure b. increase antibody production c. increase fibrinogen formation d. maintain blood viscosity |
A. maintain colloidial osmotic pressure
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The first step in analyzing a 24 hr urine specimen for quantitative urine protein is:
a. subculture the urine for bacteria b. add the appropriate preservative c. screen for albumin using a dipstick d. measure the total volume |
D. measure the total volume
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The following data was obtained from a cellulose acetate protein electrophoresis scan:
albumin area 75 units gamma globulin area - 30 units total area - 180 units total protein 6.4g.dL(65g/L) The gamma globulin content in g/dL is: a. 1.1g/dL(11g/L) b. 2.7g/dL(27g/L) c. 3.8g/dL(38g/L) d. 4.9g/dL(49g/L) |
A. 1.1 g.dL ( 11 g.L)
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Total iron binding capacity measures the serum iron transporting capacity of:
a. hemglobin b. ceruloplasmin c. transferrin d. ferritin |
C. transferrin
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The first step in the quantitation of serum iron is:
a. direct reaction with appropriate chromogen b. iron saturation of transferrin c. free iron precipitation d. separation of iron from transferrin |
D. separation of iron from transferrin
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To assure an accurate ammoinia level result, the specimen should be:
a. incubated at 37*C prior to testing b. spun and separated immediately, tested as routine c. spun, separated, iced, and tested immediately d. stored at room temp. until tested |
C. spun, separated, iced, and tested immediately
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A serum sample demonstrates and elevated result when tested with the Jaffe reaction. This indicates:
a. prolonged hypothermia b. renal functional impairment c. pregnance d. arrhythmia |
B. renal functional impairment
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Creatinine clearance is used to estimate the:
a. tubular secretion of creatinine b. glomerual secretion of creatinine c. renal glomerular and tubular mass d. glomerular filtration rate |
D. glomerular filtration rate
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A blood-creatinine value of 5.0 mg/dL (442.0umol/L) is most likely to be found with which of the following blood values?
a.osmolality: 292mOsm/kg b. uric acid: 8mg/dL c. urea nitrogen: 80 mg/dL d. ammonia: 80ug/dL |
C. urea nitrogen: 80 mg/dL (28.56mmol/L)
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90% of the copper present in the blood is bound to:
a. transferrin b. ceruloplasmin c. albumin d. cryoglogulin |
B. ceruloplasmin
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The principle of the occult blood test depends upon the:
a. coagulase ability of blood b. oxidative power of atmospheric oxygen c. hydrogen peroxide in hemoglobin d. peroxidase-like activity of hemoglobin |
D. peroxidase-like activity of hemoglobin
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Hemoglobin S can be separated from hemoglobin D by:
a. electrophoresis on a different medium and acidic pH b. hemoglobin A2 quantitation c. electrophoresis at higher voltage d. Kleihauer-Betke acid elution |
A. electrophoresis on a different medium and acidic pH
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On electrophoresis at alkaline pH, which of the following is the slowest migrating hemoglobin?
a. Hgb A b. Hgb S c. Hgb C d. Hgb F |
C. HgbC
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Kernicterus is an abnormal accumulation of bilirubin in:
a. heart tissue b. brain tissue c. liver tissue d. kidney tissue |
B. brain tissue
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A stool specimen that appears black and tarry should be tested for the presence of :
a. occult blood b. fecal fat c. trypsin d. excess mucus |
A. occult blood
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The most specific enzyme test for acute pancreatitis is:
a. acid phosphatase b. trypsin c. amylase d. lipase |
D. lipase
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Which of the following enzymes catalyzes the conversion of starch to glucose and maltose?
a. malate dehydrogenase b. amylase c. creatine kinase d. isocitric dehydrogenase |
B. amylase
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A physician suspects his patient has pancratitis. Which test would be most indicative of this disease?
a. creatinine b. LD isoenzymes c. beta-hydroxybutyrate d. amylase |
D.amylase
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Asparate amino transferase (AST) is characteristically eleveted in diseases of the:
a. liver b. kidney c. intestine d. pancreas |
A. liver
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Amino tranferase enzymes catalyze the:
a. exchange of amino groups and sulfhydydryl groups between alpha-amino and sufur-containing acids b. exchange of amino and keto groups between alpha-amino and alph-keto acids c. hydrolysis of amino acids and keto acids d. reversible transfer of hlydrogen from amino acids to coenzyme |
B. exchange of amino and keto groups between alpha-amino and alpha-keto acids
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Aspartate aminotranferase and alanine aminotrasferase are both elevated in which of the following diseases?
a. muscular dystrophy b. viral hepatitis c. pulmonary emboli d. infectious mononucleosis |
B. viral hepatitis
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The greatest activities of serum AST and ALT are seen in which of the following?
a. acute viral hepatitis b. primary biliary cirrhosis c. metastatic hepatic cirrhosis d. alcoholic cirrhosis |
A. acute viral hepatitis
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Which of the following clinical disorders is associated with the greatest elevation of lactate dehydrogenase isoenzyme?
a. pneumonia b. glomerulonephritis c. pancreatitis d. pernicious anemia |
D. perncious anemia
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The enzyme which exists chiefly in skeletal muscle, heart, and brain, is grossly elevated in active muscular dystrophy, and rises early in myocardial infarction is:
a. lipase b. transaminase c. lactate dehydrogenase d. creatine kinase |
D. creatine kinase (CK)
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The enzyme present in almost all tissues that may be separated by electrophoresis into 5 components is:
a. lipase b. transaminase c. creatine kinase d. lactate dehydrogenase |
D. lactate dehydrogenase
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A common cause of a falsely increased LD1 fraction of lactic dehydrogenase is:
a. specimen hemolysis b. liver disease c. congestive heart failure d. drug toxicity |
A. specimen hemolysis
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The pressence of which of the following isoenzymes indicates acute myocardial damage?
a. CKMM b. CKMB c. CKBB d. none |
B. CKMB
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In which of the following conditions would a normal level of creatine kinase be found?
a. acute myocardial infarct b. hepatitis c. progressive muscular dystrophy d. intramuscular injection |
B. hepatitis
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Of the following diseases, the one most often associated with elevations of LD isoenzymes 4 and 5 on elctrophoresis is:
a. liver disease b. hemolytic anemia c. myocaridal infarction d. pulmonary edema |
a. liver disease
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When myocardial infarction occurs, the first enzyme to become elevated is:
a. CK b. LD c. AST d. ALT |
A. CK
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A scanning of a CK isoenzyme fractionation revealed 2 peaks: A slow cathodic peak (CKMM) and an intermediate peak(CKMB).
A possible interpretation for this pattern is: a. brain tumor b. muscular dystrophy c. myocardial infarction d. viral hepatitis |
C. myocardial infarction
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A 10 yr old child was admitted to pediatrics with an intial diagnosis of skeletal muscle disease. The best confirmatory tests would be:
a. creatine kinase and iscitrate dehydrogenase b. gamma-glutamyl transferase and alkaline phosphatase c. aldolase and creatine kinase d. lactate dehydrogenase and malate dehydrogense |
C. aldolase and creatine kinase
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In the immunoinhibition phase of the CKMB procedure:
a. M subunit is inactivated b. B subunit is inactivated c. MB is inactivated d. BB is inactivated |
A. M subunit is inactivated
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The presence of increased CKMB activity on a CK electrophoresis pattern is most likely found in a patient suffering from:
a. acute muscular stress following strenuous exercise b. malignant liver disease c. myocardial infarction d. severe head injury |
C. myocardial infarction
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Increased serum lactic dehydrogenase activity due to elevation of fast fraction (1 and 2) on electrophoretic separation is caused by:
a. nephrotic syndrome b. hemolytic anemia c. pancratitis d. hepatic damage |
B. hemolytic anemia
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What specimen preparation is commonly used to perform the alkaline phosphatase isoenzyme determinations?
a. serum is divided into 2 aliquots, one is frozen and the other is refrigerated b. serum is divided into 2 aliquots, one is heated at 56*C and the other is unheated c. no preparation is necessary since the assay used EDTA plasma d. protein-free filtrate is prepared first |
B. serum is divided into 2 aliquots, one is heated to 56*C and the other in unheated
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Regan isoenzyme has the same properties as alkaline phosphatase that originates in the:
a. skeleton b. kidney c. intestine d. placenta |
D. placenta
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The most heat labile fraction of alkalline phosphatase is obtained from:
a. liver b. bone c. intestine d. placenta |
B. bone
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The most senstive enzyme indicator for liver damage from ethanol intake is:
a. ALT b. AST c. GGT d. alkaline phosphatase |
C. GGT gamma glutamyl transferse
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Isoenzyme assays are performed to improve:
a. percision b. accuracy c. sensitivity d. specificity |
D. specificity
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The protein portion of an enzyme complex is called the:
a. apoenzyme b. coenzyme c. holoenzyme d. proenzyme |
A. apoenzyme
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Which of the following chemical determinations may be of help in establishing the presence of seminal fluid?
a. LD b. ICD (isocitrate dehydrogenase) c. acid phosphatase d. alkaline phosphatase |
c. acid phosphatase
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A 1 yr old girl with a hyperlipoproteinemia and lipase deficiency has the following lipid profile:
cholesterol - 300 mg/dL LDL increased HDL decreased triglycerides 200 mg/dL chylomicrons present A serum specimen from this patient that was refridgerated overnighr would most likely be: a. clear b. cloudy c. creamy layer over cloudy serum d. creamy layer over clear serum |
D. creamy layer over clear serum
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Chylomicrons are present in which of the following dyslipidemias?
a. familial hypercholesterolemia b. hypertriglyceridemia c. deficiency in lipoprotein lipase activity d. familial hypoalphalipoproteinemia |
C. deficiency in lipoprotein lipase activity
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Turbidity is serum suggests elevation of:
a. cholesterol b. total protein c. chylomicrons d. albumin |
C. chylomicrons
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TSH is produced by the:
a. hypothalamus b. pituitary gland c. adrenal cortex d. thyroid |
b. pituitary gland
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A patient has the following thyroid profile:
total T4 decreased free T4 decreased thyroid peroxisase antibody - positive TSH - decreased This patient most probably has: a. hyperthyroidism b. hypothyroidism c. a normal thyroid d. Graves disease |
B. hypothyroidism
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A 45 yr old woman complains of fatigue, heat intolerance and hair loss. Total and free T4 are abnormally low. If the TSH showed marked elevation, this would be consistent with:
a. Graves disease b. an adenoma of the thyroid c. thyrotoxicosis d. primary hypothyroidism |
D. primary hypothyroidism
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The majority of thyroxine(T4) is converted into the more biologically active hormone:
a. thyroglobulin b. thyroid-stimulating hormone c. triiodothyronine d. thyrotropin-releasing hormone |
C. T3- triiodothyronine
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A 2 yr old child with a decreased serum T4 is described as being somewhat dwarfed, stocky, overweight, and having coarse features. Of the following, the most informative additional lab test would be the serum:
a. thyroxine binding globulin b. thyroid-stimulating hormone c. triiodothyronine d. cholesterol |
B. thyroid stimulating hormone (TSH)
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The recommended initial thyroid function test for either a healthy, asymptomatic patient, or a patient with symptoms which may be realted to a thyroid disorder is:
a. free thyroxine (free T4) b. thyroid stimulating hormone (TSH) c. total thyroxine (T4) d. triiodothyronine (T3) |
B TSH thyroid stimulating hormone
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A 68 yr old female patient tells her physician of being cold all the time and recent weight gain, with no change in diet. The doctor orders a TSH level, and the lab reports a value of 8.7uU/mL(reference range-0.5-5.0uU/mL) this patient most likely has:
a. primary hypothyroidism b. Graves disease c. a TSH secreting tumor d. primary hyperthyroidism |
A. primary hypothyroidism
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Which of the following is secreted by the placenta and used for the early determination of pregnancy?
a. folliclestimulating hormone (FSH) b. Human chorionic gonadotropin (HCG) c. luteinizing hormone (LH) d. progesterone |
B. HCG human chorionic gonadotropin
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In amniotic fluid, the procedure used to detect hemolytic disease of the newborn is:
a. measurement of absorbance at 450 nm b. creatinine c. lecithin/sphingomyelin ratio d. estriol |
A. measurement of absorbance at 450 nm
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During a normal pregnancy, quantitative human chorionic gonadotropin levels peak how many weeks after the last menstrual period?
a. 2 - 4 b. 8 - 10 c. 14 - 16 d. 18 - 20 |
B. 8 - 10
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Which of the following steroids is an adrenal cortical hormone?
a. angiotensinogen b. aldosterone c. epinephrine d. growth hormone |
B. aldosterone
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What common substrate is used in the biosysthesis of adrenal steroids, including androgens and estrogens?
a. cortisol b. catecholamines c. progesterone d. cholesterol |
D. cholesterol
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Plasma for corisol determinations were collected at 7am, after waking the patient, and at 10 pm that evening. The corisol level of the morning sample was higher that the evening sample. This is consistant with:
a. a normal finding b. Cushing syndrome c. Addison disease d. hypopituitarism |
A. a normal finding
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Night blindness is associated with deficiency of which of the following vitamins?
a. A b. C c. niacin d. thiamine |
A. vitamin A
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Beriberi is associated with deficiency of vitamin:
a. A b. C c. niacin d. thiamine |
D. thiamine
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Scurvy is associated with deficiency of which of the following vitamins?
a. A b. C c. niacin d. thiamine |
B vitamin C
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Rickets is associated with deficiency of which of the following vitamins?
a. B1 b. C c. niacin d. D |
D. vitamin D
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Pellagra is associated with deficiency of which of the following vitamins?
a. A b. B1 c. thiamine d. niacin |
D. niacin
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The major action of angiotensin II is:
a. increased pituitary secretion of vasopressin b. increased vasoconstriction c. increased parathormone secretion by the parathyroid d. decreased adrenal secretion of aldosterone |
B. increased vasoconstriction
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The urinary excretion product measured as an indicator of epinephrine production is:
a. dopamine b. dihydroxyphenylalanine c. homovanillic acid d. vanillylmandelic acid |
D. vanillylmandelic acid (VMA)
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Which of the following hormones regulates normal blood calcuim levels?
a. thyroxine b. estriol c. parathyroid hormone d. growth hormone |
C. parathyroid hormone
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A diagnosis of primary adrenal insufficiency requires demonstration of:
a. decreased urinary 17-keto and 17-hydroxysteroids b. decreased cortisol production c. impaired response to ACTH stimulation d. increased urinary cortisol excretion after metyrapone |
C. impaired response to ACTH stimulation
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The screen for adrenal cortical hyperfunction with the greatest sensitivity and specificity is:
a. 24 hr urine free cortisol b. plasma cortisol c. urinary 17-hydroxycoricosteroids d. plasma corticosterone |
A. 24 hr urine free corisol
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Whch of the following sample collections would give an accurate assessment of potential excess cortisol production?
a. collect a plasma sample as a baseline, and another one-hr after administration of metyrapone b. collect a plasma sample at 8am only c. collect a 24 hr urine free cortisol d. collect a plasma sample at 8am and at 8am the next day |
C. collect a 24 hr urine free cortisol
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Clinical assays for tumor markers are most important for:
a. screening for the presence of cancer b. monitoring the course of a known cancer c. confirming the absence of disease d. identifying patients at risk for cancer |
B. monitoring the course of a known cancer
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Detection of which of the following substances is most useful to monitor the course of a patient with testicular cancer?
a. alpha-fetoprotein b. carcinoembryoic antigen c. prolactin d. testosterone |
A. alpha-fetoprotein
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Increased concentrations of alpha-fetoprotein in adults are most characteristically associated with:
a. hepatocellular carcinoma b. alcoholic cirrhosis c. chronic active hepatitis d. multiple myeloma |
A. hepatocellular carcinoma
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Carcinoembryonic antigen is most likely to be produced in a malignancy involving the:
a. brain b. testes c. bone d. colon |
D. colon
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Which of the following is useful in the detection and management of carcinoma of the prostate?
a. total prostate-specific antigen b. prostatic acid phosphatase c. human chorionic gonadotropin d. alpha-fetoprotein |
A. total prostate-specific antigen
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Which of the following statements most correctly describes the utility of clinical laboratory assays for tumor markers?
a. tumor markers are useful to screen asymptomatic patients for tumors b. tumor markers are highly specific c. tumor markers indicate the likelyhood of an idividual developing a tumor d. tumor markers are useful in tracking the efficacy of treatment |
D. tumor markers are useful in tracking the efficacy of treatment
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Cancer antigen 125 is a tumor marker associated with:
a. breast cancer b. colon cancer c. lung cancer d. ovarian and endometrial carcinoma |
D. ovarian and endometrial carcinoma
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In addition to carcinoma of the prostate, elevated prostate- specific antigen can occur due to:
a. aspirin therapy b. exogenous steroid use c. benign prostatic hyperplasia d. stain therapy (cholesterol lowering drug) |
C. benign prostatic hyperplasia
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A drug has a half life of 6 hrs. If a dose is given every 6 hrs, a steady state drug level would usually be achieved in:
a. 3 - 5 hrs b. 10 - 12 hrs c. 24 - 42 hrs d. 48 - 50 hrs |
C. 24 - 42 hrs
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The drug procainamide is prescribed to treat cardiac arrhythmia. What biologically active liver metabolite of procainamide is often measured simultaneously?
a. phenobarbitol b. quinidine c. n-acetyl procainamide d. lidocaine |
C. NAPA - N-acetyl procainamide
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Cocaine is metabolized to:
a. carbamazepine b. codeine c. bydrocodone d. benzolylecgonine |
D. benzoylecgonine
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The metabolite 11-nor-tetrahydrocannabinol-9-COOH can be detected by innumoassay 3 -5 days afte a single use of:
a. methamphetamine b. cocaine c. benzodiazepine d. marijuana |
D. marijuana
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A 3 yr old child was evaluated for abdominal pain and anorexia by a physician. A CBC revealed a hemoglobin of 9.8g/dL and basophilic stippling of RBC's. The doctor should order further tests to check for poisoning from:
a. arsenic b. iron c. mercury d. lead |
D. lead
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A carbonate salt used to control manic depressive disorders is:
a. digoxin b. acetminophen c. lithium d. phenytoin |
C. lithium
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An antiepileptic used to control seizure disorders is:
a. digoxin b. acetaminophen c. lithium d. phenytoin |
D. phenytoin
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A drug that relaxed the smooth muscles of the bronchial passages is:
a. acetaminophen b. lithium c. phenytoin d. theophylline |
D. theophylline
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A cardiac glycoside that is used in the treatment of congenital heart failure and arrhythmias by increasing the force and velocity of myocardial contraction is:
a. digoxin b. acetaminophen c. lithium d. phenytoin |
A. digoxin
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A salicylate level is performed to detect toxicity caused by ingestion of excess;
a. acetaminophen b. aspirin c. ibuprofen d. pseudoephedrine |
B. aspirin
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Lithium therapy is widely used in the treatment of:
a. hypertension b. hyperactivity c. aggression d. manic-depressive disorder |
D. manic depressive disorder
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Testing for the diagnosis of lead poisoning should include:
a. erythrocyte protoporphyrin b. urine delta-aminolevulinic acid c. whole blood lead d. zinc protoporphyrin |
C. whole blood lead
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Blood received in the lab for blood gas analysis must meet which of the following requirements?
a. on ice, thin fibrin strands only, no air bubbles b. on ice, no clots, fewer than 4 air bubbles c. on ice, no clots, no air bubbles d. room temp, no clots, no air bubbles |
C. on ice, no clots, no air bubbles
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ln a specimen collected for plasma glucose analysis, sodium fluoride:
a. serves as a coenzyme of hexokinase b. prevents reactivity of non-glucose reducing substances c. precipitates proteins d. inhibits glycolysis |
D. inhibits glycolysis
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As part of a hyperlipidemia screening program, the following results were obtained on a 25 yr old woman 6 hrs after eating:
triglycerides 260mg/dL cholesterol 120 mg/dL Which of the following is the best interpretation of these results? a. both results are normal and not affected by the recent meal b. cholesterol is normal, but triglycerides are elevated, which may be attributed to the recent meal c. both results are elevated, indicating a metabolic problem in addition to the nonfasting state d. both results are below normal despite the recent meal, indicating a metabolic problem |
B. cholesterol is normal, but triglycerides are elevated, which may be attributed to the recent meal
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Blood was collected in a serum separator tube on a patient who has been fasting since midnight. The time of collection was 7am. The lab test which should be recollected is:
a. triglycerides b. iron c. LD d. sodium |
A. triglycerides
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Unless blood gas measurments are made immediately after sampling, in vitro glycolysis of the blood causes a:
a. rise in pH and PCO2 b. fall in pH and a rise in PO2 c. rise is pH and a fall in PO2 d. fall in pH and a rise in PCO2 |
D. fall in pH and a rise in PCO2
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Which of the following serum constituents is unstable if a blood specimen is left standing at room temp for 8 hrs before processing:
a. cholesterol b. triglycerides c. creatinine d. glucose |
D. glucose
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An arterial blood specimen submitted for blood gas analysis was obtained at 8:30am but was not received in the lab until 11am. The technologist should:
a. perform test immediately upon receipt b. perform the test only if the specimen was submitted in ice water c. request a venous blood specimen d. request a new arterial specimen be obtained |
D. request a new arterial specimen be obtained
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A 24 hr urine specimen (total volume=1,136 mL) is submitted to the lab for quantitative urine protein. Calculate the amount of protein excreted per day, if the total protein is 52mg/dL
a. 591 mg b. 487 mg c. 220 mg d. 282 mg |
A. 591mg
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The following results were obtained:
urine creatinine 90mg/dL serum creatinine 0.90mg/dL total body surface 1.73m total urine in 24 hrs 1500mL Given the above data, the patient's creatinine clearance in mL/min is: a. 104 b. 124 c. 144 d. 150 |
A. 104
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A 45 yr old male of average height and weight was admitted to the hospital for renal function studies. He had the following lab results:
urine creatinine 120mg/dL serum creatinine 1.5mg/dL total volume 1800/mL Calculate the creatinine clearance for this patient in mL/min a. 100 b. 144 c. 156 d. 225 |
A. 100
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Which of the following is the formula for calculating absorbance given the percent transmittance of a solution?
a. 1 - log(%T) b. log(%T)/2 c. 2 x log(%T) d. 2 - log(%T) |
D. 2 - log(%T)
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Which of the following is the Henderson Hasselbalch equation?
a. pKa=pH+log([acid]/[salt]) b. pKa=pH+log([salt]/[acid]) c. pH=pKa+log([acod]/[salt]) d. pH=pKa+log([salt]/[acid]) |
D. pH = pKa + log ([salt]/[acid])
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The creatinine clearance is equal to:
a. urinary creatinine(mg/L)/[volume of urine(mL/min) x plasma creatinine(mg/L)] b. [urinary creatinine(mg/L) x volume(mL/min) /plasma creatinine(mg/L)] c. urinary creatinine(mg/L) / [volume of urine(mL/hour) x plasma creatinine(mg/L)] d. [urinary creatinine(mg/L) x volume(mL/hour)] / plasma creatinine(mg/L) |
B. [urinary creatinine(mg/L) x volume of urine(mL/min) x plasma creatinine(mg/L)]
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Normally the bicarbonate concentration is about 24mEq/L and the carbonic acid concentration is about 1.2; pK=6.1, log 20 = 1.3. Using the equation pH=pK + log[salt]/[acid]. calculate the pH
a. 7.28 b. 7.38 c. 7.40 d. 7.42 |
C. 7.40
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Which of the following methods is susceptible to the solvent displacing effect the results in falsely decreased electrolyte values?
a. indirect ion selective electrodes b. direct ion selective electrodes c. spectrophotometric d. fluorescence |
A. indirect ion selective electrodes
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To detect barbiturate abuse when analyzing urine specimens, immunoassay is the method of choice for screening. The method of choice for confirmation is:
a. nephelometry b. thin layer chromatography c. gas chromatography/mass spectrometry d. ultaviolet absorption spectroscopy |
C. gas chromatography / mass spectrometry
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When separating serum proteins by cellulose acetate electrophoresis, using Veronal buffer at pH 8.6. beta globulin migrates:
a. faster than albumin b. slower than gamma globulins c. faster than gamma globulin d. faster than alpha-2 globulin |
C. faster than gamma globulins
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Hemoglobin S can be separated from hemoglobin D by which of the following methods?
a. agar gel electrophoresis at pH 5.9 b. thin layerchromatography c. alkali denaturation d. ammonium precipitation |
A. agar gel electrophoresis at pH 5.9
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What is the proper pH for the buffered solution used to perform serum protein electrophoresis?
a. 5.6 b. 7.6 c. 8.6 d. 9.6 |
C. 8.6
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The buffer pH most effective at allowing amphoteric proteins to migrate toward the cathode in an electrophoretic system would be:
a. 4.6 b. 7.5 c. 8.6 d. 9.5 |
A. 4.6
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An electrode has a silver/silverchloride anode and a platinum wire cathode. It is suspended in KCl solution and separated from the blood to be analyzed by a selectively permeable membrane. Such an electrode is used to measure which of the following?
a. pH b. PCO2 c. PO2 d. HCO3 |
C. PO2
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Hydrogen ion concentation in blood is usually determined by means of which of the following electrodes?
a. silver b. glass c. platinum d. platinum-lactate |
B. glass
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An automated method for measuring chloride which generates silver ions in the reaction is:
a. coulometry b. mass spectroscopy c. chromatography d. polarography |
A. coulometry
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Coulometry is often used to measure:
a. chloride in sweat b. the pH in saliva c. bicarbonate in urine d. ammonia in plasma |
A. chloride in sweat
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In a pH meter reference electrodes may include:
a. silver-silver chloride b. quinhydrone c. hydroxide d. hydrogen |
A. silver-silver chloride
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Most automated blood gas analyzers directly measure:
a. pH, HCO3 and %O2 saturation b. pH, PCO2 and PO2 c. HCO3, PCO2, and PO2 d. pH, PO2 and % O2 saturation |
B. pH, PCO2, and PO2
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Blood PCO2 may be measured by:
a. direct colorimetric measurement of dissolved CO2 b. a self-contained potentiometric electrode c. measurement of CO2-saturated hemoglobin d. measurement of CO2 consumed at the cathode |
B a self contained potentiometric electrode
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Valinomycin enhances the selectivity of the electrode used to quantitate:
a. sodium b. chloride c. potassium d. calcium |
C. potassium
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Which blood gas electrode is composed of silver/silver chloride reference electrode and glass?
a. PO2 b. pH c. PCO2 d. HCO3 |
C. PCO2
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Most chemical methods for determining total protein utilize which of the following reactions?
a. molybdenum blue b. ferri-ferrocyanide c. resorcinol-HCL d. biuret |
D. biuret
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Bromcresol purple at a pH of 5.2 is used in a colorimetric method to measure:
a. albumin b. globulin c. Bence Jones protein d. immunoprotein |
A. albumin
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Magnesium carbonate is added in an iron binding capacity determinations in order to:
a. allow color to develop b. precipitate protein c. bind with hemoglobin iron d. remove excess unbound iron |
D. remove excess unbound iron
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The most specific method for the assay of glucose utilizes:
a. hexokinase b. glucose oxidase c. glucose-6-phosphatase d. glucose dehdrogenase |
A. hexokinase
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Which of the following calcium procedures utilizes lanthanum chloride to eliminate interfering substances?
a. o-crsolphthalein complexone b. precipitation with chloranilic acid c. atomic absorption spectrophotometry |
D. atomic absorption spectrophotometry
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Before unconjugated bulirubin can react with Ehrlich diazo reagent, which of the following must be added?
a. acetone b. ether c. distilled water d. caffeine |
D. caffeine
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The most widely used methods for bilirubin measurement are those based on the:
a. Jaffe reaction b. Schales and Schales method c. 8-hydroxyquinoline reaction d. Jendrassik-Grof method |
D. Jendrassik-Grof method
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In the Malloy and Evelyn method for the determination of bilirubin: the reagent that is reacted with bilirubin to form a purple azobilirubin is:
a. dilutre sulfuric acid b. diazonium sulfate c. sulfobromophthalein d. diazotizedsulfanilic acid |
D. diazotizedsulfanilic acid
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In the Jendrassik-Grof reaction method for the determination of serum bilirubin concentration quantitation is obtained by measureing the green color of:
a. azobilirubin b. bilirubin glucuronide c. urobilin d. urobilinogen |
A. azobilirubin
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In the Hendrassid-Grof reaction for total bilirubin, bilirubin reacts with diazotized sulfantilic acid to form:
a. diazo bilirubin b. biliverdin c. azobilirubin d. bilirubin glucuronide |
C. azobilirubin
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In the assay of lactate dehydrogenase , the reaction is dependent upon which of the following coenzyme systems?
a. NAD/NADH b. ATP/ADP c. Fe++/Fe+++ d. Cu/Cu++ |
A. NAD/NADH
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Which of the following is a glycolytric enzyme that catalyzes the cleavage of fructose-1, 6-diphosphate to glyceraldehyde-3-phosphate anddihydroxyacetone phosphate?
a. aldolase b. phosphofructokinase c. pyruvate kinase d. glucose-6-phosphate dehydrogenase |
A. aldolase
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The substance that is measured to estimate the serum concentration of triglycerides by most methods is:
a. phosphlipids b. glycerol c. fatty acids d. pre-beta lipoprotein |
B. glycerol
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A chemiluminescent EIA:
a. measures absorption of light b. is less sensitive than radioisotopic reactions c. is monitored by the use of a gamma counter d. is quantitated by the amount of light produced by the reactions |
D. is quantitated by the amount of light produced by the reaction
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The osmolality of a urine or serum specimen is measured by a change in the:
a. freezing point b. sedimentation point c. midpoint d. osmotic pressure |
A. freezing point
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Which of the following applies to cryoscopic osmometry?
a. temperature at equilibrium is a function of the number of particles in solution b. temperature plateau for a solution is horizontal c. freezing pont of a sample is absolute d. initial freezing of a sample produces an immediate solid state |
A. temperature at equilibrium is a function of the number of particles in solution
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The light-colored zone adjacent to the nucleus in a plasmacyte is the:
a. ribosime b. chromatin c. mitochondria d. Golgi area |
D. Golgi area
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Which of the following responses lists these compounds in the order in which they are found?
a. 4,3,1,2 b. 2,3,1,4 c. 4,2,3,1 d. 2,1,3,4 |
B. 2,3,1,2
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The majority of the iron in an adult is found as a constituent of:
a. hemoglobin b. hemosiderin c. myoglobin d. transferrin |
A. hemoglobin
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The main function of the hexose monophosphate shunt in the erythrocyte is to:
a. regulate the level of 2,3-DPG b. provide reduced glutathione to prevent oxidation of hemoglobin c. prevent the reduction of heme iron d. provide energy for membrane maintainance |
B. provide reduced glutathione to prevent oxdation of hemoglobun
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In order for hemoglobin to combine reversibly with oxygen, the iron must be:
a. complexed with haptoglobin b. freely circulating in the cytoplasm c. attached to transferrin d. in the ferrous state |
D. in the ferrous state
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In which of the following disease states are teardrop cells and abnormal platelets most characteristicallly seen?
a. hemolytic anemia b. multiple myeloma c. G-6-PD deficiency d. mlyeloid metaplasia |
D. myeloid metaplasia
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In the normal adult, the spleen acts as a site for:
a. storage of RBC's b. production of RBC's c. sythesis of erlythropoietin d. removal of imperfect and aging cells |
D. removal of imperfect and aging cells
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After the removal of RBC's from the circulation hemoglobin is broken down into:
a. iron,prophyrin,amino acids b. iron,protoporohyrin,globin c. heme,protoporphytin, amino acids d. heme,hemosiderin,globin |
B. iron, protoporphyrin, and globin
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Heinz bodies are:
a. readily identified with polychrome stains b. rarely found in glucose-6-phosphate dehydrogenase deficient erythrocytes c. closely associated with spherocytes d. denatured hemoglobin inclusion that are readily removed by the spleen |
D. denatured hemoglobin inclusion that are readily removed by the spleen
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Cells for the transport of O2 and CO2 are:
a. erythrocytes b. granulocytes c. lymphocytes d. thromboclytes |
A. erythrocytes
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Erythropoietin acts as:
a. shorten the replication time of the granulocytes b. stimulate RNA synthesis of erythroid cells c. increase colony-stimulating factors produced by the B-lymphs d. decrease the release of marrow reticulocytes |
B. stimulate RNA synthesis of erythroid cell
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What cell shape is most commonly associated with an increased MCHC?
a. teardrop cells b. target cells c. spherocytes d. sickel cells |
C. spherocytes
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Which of the following characteristics are common the hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria?
a. autosomal dominant inheritance b. red cell membrane defect c. positive DAT d. measured platelet count |
B. red cell membrane defects
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Which of the following is most closely associated with iron deficiency anemia?
a. iron overload in tissue b. target cells c. basophilic stippling d. chronic blood loss |
D. chronic blood loss
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Evidence indicates that the genetic defect in thalassemia usually results in:
a. the production of abnormal globin chains b. a quantitative deficiency in RNA resulting in decreased globin chain production c. a structural change in the heme portion of the hemoglobin d. an abnormality in the alpha- or beta- chain binding or affinity |
B. a quantitative deficiency in RNA resulting in decreased globin chain production
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An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs and characterized by red cell inclusions formed by denatured hemoglobin is:
a. LD defieciency b. G-6-PD deficiency c. pyruvate kinase deficiency d. hexokinase deficiency |
B. G-6-PD deficiency
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Pateints with A(-) type G-6-PD deficiency are least likely to have hemolytic episodes in which of the following situations?
a. following the administration of oxidizing drugs b. following the ingestion of fava beans c. during infections d. spontaneously |
D. spontaneously
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A patient has a congenital nonspherocytic hemolytic anemia. After exposure to anti-malarial drugs the patient experiences a severe hemolytic episode. This episode is characterized by red cell inclusions caused by hemoglobin denaturation. Which of the following conditions is consistent with these findings?
a. G-6-PD deficiency b. thalassemia major c. pyruvate kinase deficiency d. paroxysmal nocturnal hemoglobinuria |
A. G-6-PD deficiency
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Peripheral blood smears from patients with untreated anemia are characterized by:
a. pancytopenia and macrocytosis b. leukocytosis and elliptocytosis c. leukocytosis and ovalocytes d. pancytopenia and microcytosis |
A. pancytopenia and macrocytosis
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Lab tests performed on a patient indicate macrocytosis, anemia, leukopenia and thrombocytopenia. Which of the following disorders is the patient most likely to have?
a. anemia of chronic disorder b. vitamin B12 deficiency c. iron deficiency d. acute hemorrhage |
B. vitamin B12 deficiency
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The characteristic morphologic feature in folic acid deficiencly is:
a. macrocytosis b. target cells c. basophilic stippling d. rouleaux formation |
A. macrocytosis
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The most likely cause of the macrocytosis that often accompanies anemia of myelofibrosis is:
a. folic acid deficiency b. increased reticulocyte count c. inadequate B12 absorbtion d. pyridoxine deficience |
A. folic acid deficiency
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A characteristic morphologic feature in hemglobin C disease is:
a. macrocytosis b. spherocytosis c. rouleaux formation d. target cells |
D. target cells
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Thalassemias are characterized by:
a. structural abnormalities in the hemoglobin molecule b. absence of iron in hemoglobin c. decreased rate of heme synthesis d. decreased rate of globin synthesis |
D. decreased rate of globin synthesis
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Lab findings in hereditary spherocytosis do not include:
a. decreased osmotic fragility b. increased autohemolysis corrected by glucose c. reticulocytosis d. shortened erythrocyte survival |
A. decreased osmotic fragilitly
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Which of the following types of polycythemia is a severely burned patient most likely to have?
a. polycythemia vera b. polycythemia, secondary to hypoxia c. relative polycythemia associated with dehydration d. polycythemia associated with renal disease |
C. relative polycythemia associated with dehydration
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Which of the following is most likely to be seen in lead poisoning?
a. iron overload in tissue b. codocytes c. basophilic stippling d. ringed sideroblasts |
C. basophilic stippling
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The characteristic morphologic feature in lead poisoning is:
a. macrocytosis b. target cells c. basophilic stippling d. rouleaux formation |
C. basophilic stippling
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Which of the following technical factors will cause a decreased erythrocyte sedimentation rate?
a. gross hemolysis b. small fibrin clots in the sample c. increased room temp d. tilting of the tube |
B. small fibrin clots in the sample
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Which of the RBC indices is a measure of the amount of hemoglobin in individual RBC's?
a. MCHC b. MCV c. Hct d. MCH |
D. MCH
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The RDW-CV and RDW-SD performed by automated cells counters are calculations that provide:
a. an index of the distribution of RBC volume b. a calculated mean RBC hemoglobin concentration c. a calculated MCH d. the mean RBC volume |
A. an index of the distribution of RBC volume
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The erythocyte sedimentation rate can be falsely elevated by:
a. tilting the tube b. refrigerated blood c. air bubbles in the column d. specimen being to old |
A. tilting the tube
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Which of the following is the formula for absolute cell count?
a. number of cells counted /total count b. total count/number of cells counted c. 10 x total count d. % of cells counted x total count |
D. % of cells counted x total count
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The lab tests performed on a patient indicate macrocytosis, anemia, leukopenia and thrombocytopenia. Which of the following disorders is the patient most likely to have?
a. iron deficiency b. hereditary spherocytosis c. vitamin B12 dificiency d. acute hemorrhage |
C. vitamin B12 dificiency
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The mean value of a reticulocyte count on a specimen of cord blood from a healthy, full term newborns is approximately:
a. 0.5% b. 2.0% c. 5.0% d. 8.0% |
C. 5.0%
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A RBC about 5um in diameter that stains bright red and shows no central pallor is a:
a. spherocyte b. leptocyte c. microcyte d. macrocyte |
A. spherocyte
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Evidence of active red cell regeneration may be indicated on a blood smear by:
a. basophilic stippling, NRBC, and polychromasia b. hypochromia, macrocytes and NRBC's c. hypochromia, basophilic stippling and NRBC's d. Howell-Jolly bodies, Cabot rings and basophilic stippling |
A. basophilic stippling, NRBC's and polchromasia
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The pressence of excessive rouloux formation on a blood smear is often accompanied by:
a. reticulocyte count b. sedimentation rate c. hematocrit d. erythrocyte count |
B. sedimentation rate
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The characteristic peripheral blood morphologic feature in multiple myeloma is:
a. cytotoxic T cells b. rouleaux formation c. spherocytosis d. macrocytosis |
B. rouleaux formation
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In polycythemia vera, the hemoglobin, hematocrit, RBC count and red cell mass are:
a. elevated b. normal c. decreased |
A. elevated
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The M:E ration in polycythemia vera is usually:
a. normal b. high c. low d. variable |
A. normal
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Many microspherocytes, schistocytes and budding off of spherocytes can be seen on peripheral blood smears of patients with:
a. hereditary spherocytosis b. DIC c. acquired autoimmune hemolytic anemia d. extensive burns |
D. extensive burns
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Which of the following is most closely associated with erythroleukemia?
a. ringed sideroblasts, nuclear budding and Howel-Jolly bodies b. DIC c. micromegakaryocytes d. lysozlymuria |
A. ringed sideroblasts, nuclear budding and Howell-Jolly bodies
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The most characteristic peripheral blood smear finding in multiple myeloma is:
a. plasmacytic satellitosis in the bone marrow b. many plasma cells in the peripheral blood c. many Mott cells in the peripheral blood d. rouleaux formation of the red cells |
D. rouleaux formation of the red cells
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A common source of interference in the cyanmethemoglobin method is:
a, hemolysis b. very high WBC count c. cold agglutinins d. clumped platelets |
B. very high WBC count
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The most appropriate screening test for detecting hemoglobin F is:
a. osmotic fragility b. dithionite solubility c. kleihauer-Betke d. heat instability test |
C. Kleihauer-Betke
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The most appropriate screening test for hemoglobin S is:
a. Kleihauer-Betke b. dithionite solubility c. osmotic fragililty d. sucrose hemolysis |
B. dithionite solubility
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Hematology standards include:
a. stabilized RBC suspension b. latex particles c. stabilized avian RBC's d. certified cyanmethemoglobin solution |
D. certified cyanmethemoglobin solution
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When using the turbidity method for detecting the pressence of hemoglobin S, an incorrect interpretation may be made when there is a:
a. concentratuion of <7g/dL hemoglobin b. glucose concentration >150mg/dL c. blood sugar > 2 hrs old d. increased hemoglobin |
D. increased hemoglobin
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The lab findings on a patient are as follows:
MCV 55um MCHC 25% MCH 17pg A stained blood film of this patient would most likely reveal a red cell picture that is: a. microcytic, hypochromic b. macrocytic, hypochromic c. normocytic, normochromic d. microcytic, normochromic |
A. microcytic, hypochromic
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A patient has a high cold agglutinin titer. Automated cell counter results reveal an elevated MCV, MCH and MCHC. Individual erythrocytes appear normal on a stained smear, but agglutinates are noted.The appropriate course of action would be to:
a. perform the RBC,Hgb and Hct determinations using manual methods b. perform the RBC determination by a manual method; use the automated results for the Hgb and Hct c. repeat the determination using a microsample of diluted blood d. repeat the determinations using a prewarmed microsample of diluted blood |
D. repeat the determinations using a prewarmed microsample of dilulted blood
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A blood sample from a patient wiht a high titer cold agglutinin, analyzed at room temp, with an electronic particle counter would cause an error in the:
a. Hgb and MCV b. MCHC and WBC c. WBC and RBC d. MCV and MCHC |
D. MCV and MCHC
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When using an electronic cell counter, which of the following results can occur in the presence of a cold Agglutinin:
a. increased MCV and decreased RBC b. increased MCV and normal RBC c. decreased MCV and incresed MCHC d. decreased MCV and RBC |
A. increased MCV and decreased RBC
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In polycythemia vera, the leukocyte alkaline phosphatase activity is:
a. elevated b. normal c. decreased |
A. elevated
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Which of the following is the formula for MCH?
a. Hct/(RBC x 1000) b. Hgb/Hct c. RBC/Hct d. (Hgb x 10)/RBC |
D. (Hgb x 10)/RBC
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Which of the following is the formula for MCHC?
a. (Hgb x 100)/Hct b. Hgb/RBC c. RBC/Hct d. (Hct x 1000)/RBC |
A. ( Hgb x 100 )/Hct
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Which of the following is the formula for MCV?
a. (Hgb x 10)/RBC b. Hgb/Hct c. (Hct x 10)/RBC d. RBC/Hct |
C. (Hct x 10)/RBC
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The primary confirmatory test for hereditary spherocytosis is:
a. osmotic fragility b. sucrose hemolysis c. heat instability test d. Kleihauer-Betke |
A. osmotic fragility
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A screening test for paroxysmal nocturnal hemoglobinuria is:
a. heat instabilitly test b. sucrose hemolysis c. osmotic fragility d. dithionite solubility |
B. sucrose hemolysis
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The Prussian blue staining of peripheral blood identifies:
a. Howell-Jolly bodies b. siderotic granuals c. reticulocytes d. basophilic stippling |
B siderotic granuals
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Supravital staining is important for reticulocytes since the cells must be living in order to stain the:
a. remaining RNA in the cell b. iron before it precipitates c. cell membrane before it dries out d. denatured hemoglobin in the cell |
A. remaining RNA in the cell
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Which of the following is used for staining reticulocytes?
a. Giemsa stain b. Wright stain c. new methylene blue d. Prussian blue |
C. new methylene blue
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Which of the following stains is used to demonstrate iron, ferritin and hemosiderin?
a. peroxidase b. Sudan black B c. periodic acid-Schiff d. Prussian Blue |
D. Prussian Blue
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Which of the following stains can be used to differentiate siderotic granuals from basophilic stippling?
a. Wright b. Prussian Blue c. crystal violet d. periodic acid-Schiff |
B. Prussian Blue
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A patient has pancytopenia, decreased total serum iron, decreased serum iron binding capacity, and show a homogeneous fluorescence pattern with a high titer on a fluorescent anti-nuclear antibody test. This is suggestive of :
a. polycythemia vera b. SLE c. iron deficiencly anemia d. hemoglobin SC disease |
B. systemic lupus erythematosus
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An increased amount of cytoplasmic basophilia in a blood cell indicates:
a. increased cytoplasmic maturation b. dercreased cytoplasmic maturation c. reduction in size of the cell d. decreased nuclear maturation |
B. decreased cytoplasmic maturation
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The term "shift to the left" refers to:
a. a microscope adjustment b. immature cell forms in the peripheral blood c. a trend on a levy-jennings chart d. a calibration adjustment on an instrument |
B. immature cell forms in the peripheral blood
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A term that means varying degrees of leukocytosis with a shift to the left and occasional nucleated red cells in the peripheral blood is:
a. polycythemia vera b. erythroleukemia c. leukoerythroblastosis d. megaloblastoid |
C. leukoerythroblastosis
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Cells that produce antibodies and lymphokines are:
a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes |
C. lymphocytes
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Specific granules of the neutrophilic granulocyte:
a. appear first at the myelocyte stage b. contain lysosomal exzymes c. are formed on the mitochondria d. are derived from azurophilic granules |
A. appear first at the myelocyte stage
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In normal adult bone marrow, the most common granulocyte is the:
a. basophil b. myeloblast c. eosinophil d. metamyelocyte |
D. metamyelocyte
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Elevation of the total granulocyte count above 7.7 x 10to the third is termed;
a. relative lymphocytosis b. leukocytosis c. relative neutrophilic leukocytosis d. absolute neutrophilic leukocytosis |
C. relative neutrophilic leukocytes
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Elevation of the granulocyte percentage above 75% is termed:
a. absolute lymphocytosis b. leukocytosis c. relative neutrophilic leukocytosis d. absolute neutrophilic leukocytosis |
C. relative neutrophilic leukocytosis
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Elevation of the lymphocyte percentage above 47% is termed:
a. relative lymphocytosis b. absolute lymphocytosis c. leukocytosis d. absolute neutrophilic leukocytosis |
A. relative lymphocytosis
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Elevation of the total white cell count above 12 x 10 to the third is termed:
a. relative lymphocytosis b. absolute lymphocytosis c. leukocytosis d. relative neutrophilic leukocytosis |
C. leukocytosis
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Termional deoxynucleotidyl tranferase is a marker found on:
a. hairy cell b. myeloblasts c. monoblasts d. lymphoblasts |
D. lymphoblasts
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Multipotent stem cells are capable of producing:
a. daughter cells of only one cell line b. only T-lymphs and B-lymphs c. erythopoeitin, thrombopoietin and leukopoietin d. lymphoid and myeloid stem cells |
D. lymphoid and myeloid stem cells
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The Philidelphia chromosone is formed by a translocation between the:
a. long arm of chromosome 22 and long are of chromosome 9 b. long arm of chromosome 21 and long are of chromosome 9 c. long arm of chromosome 21 and short arm of chromosone 6 d. long arm of chromosome 22 and short arm of chromsome 6 |
A. long arm of chromosome 22 and long arm of chromosome 9
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Phagocytosis is a function of:
a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes |
B. granulocytes
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The white cell feature most characteristic of pernicious anemia is:
a. eosinophilia b. toxic granulation c. hypersegmentation d. atypical lymphocytes |
C. hypersegmentation
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Which of the following conditions is not associated with a high incidence of leukemia?
a. paroxysmal nocturnal hemoglobinuria b. Fanconi anemia c. aplastic anemia d. megaloblastic anemia |
D. megaloblastic anemia
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The M:E ratio in chronic myelocytic leukemia is usually:
a. normal b. high c. low d. variable |
B. high
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Abnormalities found in erythroleukemia include:
a. rapid DNA synthesis b. marrow fibrosis c. megaloblastoid development d. increased erythrocyte survival |
C. megaloblastic development
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Neutropenia is not usually associated with:
a. viral infections b. Hodgkin disease c. select antibodies d. chemotherapy |
B. Hodgkin disease
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Auer rods are most likely present in which of the following?
a. chronic myelocytic leukemia b. myelofibrosis with myeloid metaplasia c. erythroleukemia d. acute myelocytic leukemia |
D. acute myelocytic leukemia
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In an uncomplicated case of infectious mononucleus, which of the following cells are affected?
a. erythrocytes b. lymphocytes c. monocytes d. thrombocytes |
B. lymphocytes
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The atypical lymphocyte seen in the peripheral smear of patients with infectious mono is probably derived from which of the following:
a. T lymphs b. B lymphs c. monocytes d. mast cells |
A. T lymphocytes
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The disease most frequently present in patients with atypical lymphocytosis and persistently negative tests is:
a. toxoplasmosis b. cytomegalovirus infection c. herpes virus infection d. viral hepatitis |
B. CMV- cytomegalovirus infection
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Which of the following is associated with pseudo-Pelger-Huet anomaly?
a. aplastic anemia b. iron deficiency anemia c. myelogenous leukemia d. Chediak-Higashi syndrome |
C. myelogenous leukemia
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In chronic myelocytic leukemia, blood histamine concentrations tend to reflect the :
a. number of platelets present b. serum uric acid concentrations c. number of basophils present d. the total number of granulocytes |
C. number of basophils present
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Biochemical abnormalities characteristic of polycythemia vera include:
a. increased serum B12 binding capacity b. hypouricemia c. hypohistaminemia d. decreased leukocyte alkaline phosphatase activitly |
A. increased B12 binding capacity
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50% - 90% myeloblasts in a peripheral blood smear is typical of which of the following?
a. chronic myelocytic leukemia b. myelofibrosis with myeloid metaplasia c. erythroleukemia d. acute myelocytic leukemia |
D. acute myelocytic leukemia
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The M:E ratio in acute myelocytic leukemia is usually:
a. normal b. high c. low d. variable |
B. high
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Which of the following is most closely associated with chronic myelononocytic leukemia?
a. Philadelphia chromosome b. DIC c. micromegakaryocytes d. lysozymuria |
D. lysozymuria
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The absence of intermediate maturing cells between the blast and mature neutrophil commonly seen in acute myelocytic leukemia and myelodysplastic syndrome is called:
a. subleukemia b. aleukemic leukemia c. leukemic hiatus d. leukemoid reaction |
C. leukemic hiatus
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Which of the following is most closely associated with chronic myelogenous leukemia?
a. ringed sideroblasts b. DIC c. micromegakaryocytes d. Philadelphia chromosome |
D. Philadelphia chromosome
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A block in the differentiation or maturation of, and an accretion of immature hematopoietic progenitors is a hallmark of:
a. chronic lymphocytic leukemia b. myeloproliferative diseases c. polycythemia vera d. acute myelogenous leukemia |
D. acute myelogenous leukemia
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All stages of neutrophils are most likely to be seen in the peripheral blood of patient with:
a. chronic myelocytic leukemia b. myelofibrosis with myeloid metaplasia c. erythroleukemia d. acute myelocytic leukemia |
A. chronic myelocytic leukemia
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All of the following conditions are myeloproliferative disorders except:
a. myelocytic leukemia b. lymphocytic leukemia c. polycythemia vera d. idiopathic thrombocythemia |
B. lymphocytic leukemia
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A patient has a tumor that concentrates erythropoietin. He is most likely to have which of the following types of polycythemia?
a. polycythemia vera b. polycythemia, secondary to hypoxia c. benign familial polycythemia d. polycythemia associated with renal disease |
D. polycythemia associated with renal disease
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Which of the following types of polycythemia is most often associated with emphysema?
a. polycythemia vera b. polycythemia, secondary to hypoxia c. relative polycythemia associated with dehydration d. polylcythemia associated with renal disease |
B. polycythemia, secondary to hypoxia
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Hemorrhage in polycythemia vera is the result of:
a. increased plasma viscosity b. persistent thrombocytosis c. splenic sequestration of platelets d. abnormal platelet function |
D. abnormal platelet function
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A patient diagnosed with polycythemia vera 5 yrs ago has a normal hematocrit, decreased hemoglobin, and microcytic, hypochromic red cells. What is the most probable cause for the current blood situation?
a. phlebotomy b. myelofibrosis c. proleukemia d. aplastic anemia |
A. phlebotomy
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A patient has been treated for polycythemia vera for several yrs. His blood smear now shows:
Oval macrocytes Howell-Jolly bodies Hypersegmented neutrophil Large, agranular platelets the most probable cause of this bloodpicture is: a. iron deficiency b. alcoholism c. dietary B12 deficiency d. chemotherapy |
D. chemotherapy
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In infectious mono, lymphocytes tend to be:
a. small with little cytoplasm b. normal c. decreased in number d. enlarged and indented by surrounding structures |
D. enlarged and idented by surrounding structures
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In comparison to malignant lymphoma cells, reactive lymphs:
a. have a denser nuclear chromatin b. are known to be T cells c. have more cytoplasm and more mitochondria d. are morphologically more variable throughout the smear |
D. are morphologically more variable throughout the smear
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Which of the following is true of acute lymphoblastic leukemia?
a. occurs most commonly in children 1 -2 yrs old b. patient is asymptomatic c. massive accumulation of primitive lymphoid-appearing cells in bone marrow occurs d. children under 1 yr of age have a good prognosis |
C. massive accumulation of primitive lymphoid-appearing cells in bone marrow occur
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The most common form of childhood leukemia:
a. acute lymphocytic b. acute granulocytic c. acute moncytic d. chronic granulocytic |
A. acute lymphocytic
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Chronic lymphocytic leukemia is defined as:
a. malignancy of the thymus b. accumulation of prolymphocytes c. accumulation of hairy cells in the spleen d. accumulation of monoclonal B cells with a block in cell maturation |
D. accumulation of monoclonal B cells with a block in cell maturation
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Which of the following is not a characteristic usually associated with hairy cell leukemia?
a. pancytopenia b. mononuclear cells with ruffled edges c. spenomegaly d. increased resistance to infection |
D. increased resistance to infection
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Morphologic variants pf plasma cells do not include:
a. flame cells b. morula cells c. grape cells d. Gaucher Cells |
D. Gaucher cells
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Of the following, the disease most closely associated with cytoplasmic granule fusion is:
a. Chediak-Higashi syndrome b. Pelger-Huet anomaly c. May-Hegglin anomaly d. Alder-Reilly anomaly |
A. Chediak-Higashi syndrome
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Which of the following anomalies is an autosomal dominant disorder characterized by irregularly-sized inclusions in polymorphonuclear neutrophis, abnormal giant platelets and ofter thrombocytopenia?
a. Pelgar-Huet b. Chedial-Higashi c. Alder-Reilly d. May-Hegglin |
D. May-Hegglin
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Of the following, the disease most closely associated with granulocyte hyposegmentation is:
a. May-Hegglin b. Pelger-Huet c. Chediak-Higashi d. Gaucher disease |
B. Pelgar-Huet anomaly
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Which of the following cell types is characteristic of Pelgar-Huet anomaly:
a. band form b. pince-nez form c. normal neutrophil d. myelocyte |
B. pince-nez form
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Which of the following is associated with Chediak-Higashi syndrome?
a. membrane defect of lysosomes b. Dohle bodies and giant platelets c. two-lobed neutrophils d.mucopolysaccharidosis |
A. membrane defect of lysosomes
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Which of the following is associated with Alder-Reilly inclusions?
a. membrane defect of lysosomes b. Dohle bodies and giant platelets c. chronic myelogenous leukemia d. mucopolysaccharidosis |
D. mucopolysaccharides
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Which of the following is associated with May-Hegglin anomaly?
a. membrane defect of lysosomes b. Dohle bodies and giant platelets c. chronic myelogenous leukemia d. mucopolysaccharides |
B. Dohle bodies and giant platelets
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A differential was performed on an asymptomatic patient. The differential included 60% neutrophils, 55 of which had 2 lobes and 5 had 3 lobes. There were no other abnormalities. This is consistent with which of the following anomalies?
a. Pelgar-Huet b. May-Hegglin c. Alder-Reilly d. Chediak-Higashi |
a. Pelgar-Huet
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The cytoplasmic abnormality of the white blood cell of Alder-Reilly anomaly is found in the:
a. endoplasmic reticulum b. lysosomes c. mitochondria d. ribosomes |
B. lysosomes
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|
Of the following, the disease
most closely associated with mucopolysaccharidosis is; a. Pelgar-Huet b. Chediak-Higashi c. Gauchers disease d. Alder-Reilly |
D. Alder- Reilly anomaly
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|
Of the following, the disease
most closely associated with glucocerbrosidase dificieny is: a. Gauchers disease b. Chediak-Higashi c. Pergar- Huet d. May-Hegglin |
A. Gaucher disease
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Of the following, the disease most closely associated with pale blue inclusions in granulocytes and giant platelets:
a. Gauchers disease b. Alder-Reilly c. May-Hegglin d. Pelgar-Huet |
C. May-Hegglin
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|
In synovial fluid , the most characteristic microscopic finding in gout is:
a. calcium pyrophosphate crystals b. cartilage debris c. monosodium urate crystals d. hemosiderin laden macrophages |
C. monosodium urate crystals
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|
Which of the following is the formula for manual white cell count?
a.(number of cells counted x dilution x 10)/number of squares counted b. (number of cells counted x dilution)/10 x number of squares counted c. number of cells counted x dilution d. number of cell counted x number of squares counted |
A. (number of cell counted x dilution x 10)/number of squares counted
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A mean cell hemoglobin concentration over 36 g/dL is frequently found in :
a. hereditary spherocytosis b. lipemia c. active cold agglutinin disease d. all of the above |
D. all of the above
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|
An unexplained elevation of the prothrombin time in a 72 yr old smoker who has been diagnosed with chronic pulmonary obstructive disease is most likely due to:
a. an elevated hematocrit b. a decreased hematocrit c. vitamin K deficiency d. decreased thrombin activity |
A. an elevated hematocrit
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|
A patient diagnosed as having bacterial septicemia. Which of the following would best describe the expected change in his peripheral blood?
a. granulocytic leukemoid reaction b. lymphocytic leukomoid reaction c. neutropenia d. eosinophila |
A. granulocytic leukomoid reaction
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|
The most characteristic morphologic features of atypical lymphs include:
a. course nuclear chromatin and basophilic cytoplasm b. blue-grey cytoplasm, fine nuclear chromatin c. nucleoli and deep blue RNA-rich cytoplasm d. a stretched nucleus and cytoplasmic indentations |
A. coarse nuclear chromatin and basophilic cytoplasm
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|
In synovial fluid, the most characteristic finding in pseudogout is:
a. calcuim pyrophosphate dihydrate crystals b. cartilage devris c. monosodium urate crystals d. hemosiderin-laden macrophages |
A. calcium pyrophosphate dihydrate crystals
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|
In synovial fluid, the most characteristic finding in traumatic arthritis is:
a. monosodium urate crystals b. cartilage debris c. calcium pyrophosphate dihydrate crystals d. hemosiderin laden macrophages |
D. Hemosiderin-laden macrophages
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|
|
Which of the following stains in closely associated with the lysosomal enzyme in primary granules?
a. peroxidase b. Sudan black B c. periodic acid-Schiff d. Prussian blue |
A. peroxidase
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|
In flow cytometric analysis, low angle or forward scatter of a laser light beam provides information that pertains to a cell's:
a. volume b. viability c. granularity d. lineage |
A. volume
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|
In flow cytometric analysis, right angle of side scatter of a laser light beam provides information that pertains to the cell's:
a. volume b. viability c. granularity d. lineage |
C. granularity
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|
vWF antigen can be found in which of the following?
a. myeloblast b. monoblast c. lymphoblast d. megakaryoblast |
D. megakaryoblast
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|
Which of the following is characteristic of cellular changes as megakaryoblasts mature into megakaryocytes within the bone marrow?
a. progressive decrease in overall cell size b. increasing basophilia of cytoplasm c. nuclear division without cytoplasmic division d. fusion of the nuclear lobes |
c. nuclear division without cytoplasmic division
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|
Which of the following cells contain hemosiderin?
a. magakaryocyte b. osteoclast c. histiocyte d. mast cell |
C. histiocyte
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|
Which of the following cells is the largest cell in the bone marrow?
a. megakaryocyte b. histiocyte c. osteoblast d. mast cell |
A. megakaryocyte
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|
Normal platelets have a circulating life-span of approximately:
a. 5 days b. 10 days c. 20 days d. 30 days |
B. 10 days
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|
Platelet activity is affected by:
a. calcium b. aspirin c. hyperglycemia d. hypoglycemia |
B. aspirin
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|
Cells involved in hemostasis are:
a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes |
D. thrombocytes
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|
In polycythemia vera, the patelet count is:
a. elevated b. normal c. decreased d. variable |
A. elevated
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|
|
Which of the following is characteristic of platelet disorders?
a. deep muscle hemorrhage b. retroperitoneal hemorrhage c. mucous membrane hemorrhages d. severely prolonged clotting times |
C. mucous membrane hemorrhages
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|
|
Which of the following is characteristic of Bernard - Soulier syndrome?
a. giant platelets b. normal bleeding time c. abnormal aggregation with ADP d. increased platelet count |
A. giant platelets
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|
A phase-platelet count is performed using a platelet Unopette. 155 platelets are counted on one side of the hemacytometer in the center square millimeter, and 145 are counted on the other side in the same area. After making the appropriate calculations, the next step would be to:
a. repeat the procedure, using a 1:20 dilution with acetic acid b. report the calculated value c. collect a new specimen d. repeat the procedure, using a 1:200 dilution with saline |
B. report the calculated value
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|
The chamber counting method of platelet enumeration:
a. allows direct visualization of the particles being counted b. has a high degree of precision c. has a high degree of reproducibility d. is the method of choice for the performance of 50 - 60 counts per day |
A. allows direct visualization of the particles being counted
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|
An automated platelet count indicates platelet clumping, which is confirmed by examining the smear. The technician should:
a. repeat the count on the same sample b. report the automated count c. perform a manual count d. recollect in sodium citrate |
D. recollect in sodium citrate
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|
A bleeding time is used to evaluate the activity of:
a. platelets b. prothrombin c. labile factor d. Factor VIII |
A. platelets
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A patient has been taking aspirin regularly for arthritic pain. Which of the following tests is most likely to be abnormal in this patient?
a. platelet count b. template bleeding time c. prothrombin time d. activated partial thromboplastin time |
B. template bleeding time
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|
Which of the following detects or measures platelet function?
a. bleeding time b. prothrombin time c. thrombin time d. partial thromboplastin time |
A. bleeding time
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|
Platelet aggregation is dependent in vitro on the presence of:
a. calcium ions b. sodium citrate c. thrombin d. potassium |
A. calcium ions
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|
Coagulation factors affected by warfarin drugs are:
a. VIII, IX, and X b. I, II, V, and VII c. II, VII, IX and X d. II, V, and VII |
C. II, VII, IX and X
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|
Which of the following statements concerning Vitamin K is NOT true?
a. there are 2 sources of Vit. K: vegetables and bacterial b. Vit. K converts precursor molecules into functional coagulation factors c. heparin inhibits the action of Vit. K d. Vit. K is fat soluble |
C. heparin inhibits the action of Vitamin K
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|
|
Which of the following is Vitamin-K dependent?
a. Factor XII b. fibrinogen c. antithrombin III d. Factor VII |
D. Factor VII
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|
Which of the following factors is used only in the extrinsic coagulation pathway?
a. II b. V c. VII d. VIII |
C. VII
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|
Hageman Factor (XII) is involved in each of the following reactions except:
a. activation of C1 to C1 esterase b. activation of plasminogen c. activation of Factor XI d. transformation of fibrinogen to fibrin |
D. transformation of fibrinogen to fibrin
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|
Prothrombin is:
a. a protein fromed by the liver in the presence of Vitamin K b. an enzyme that converts fibrinogen into fibrin threads c. the end product of the reaction between fibrinogen and thrombin d. a protein released by platelets during coagulation |
A. a protein formed by the liver in the presence of Vitamin K
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|
|
Which of the following coagulation factors is considered to be liabile?
a. II b. V c. VII d. X |
B. V
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|
The most potent plasminogen activator in the contact phase of coagulation is:
a. kallikrein b. streptokinase c. HMWK d. fibrinogen |
A. kallikrein
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|
|
Which of the following is characteristic of Factor XII deficiency.
a. negative bleeding history b. normal clotting times c. decreased risk of thrombosis d. epistaxis |
A. negative bleeding history
|
|
|
Which of the following factor defiencies is associated with either no bleeding or only a minor bleeding tendency, even after trauma or surgery?
a. Factor X b. Factor XII c. Factor XIII d. Factor V |
B. Factor XII
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|
|
The 2 factors that differentiate liver disease from Vit. K deficiency are:
a. II and VII b. IX and VII c. VIII and IX d. V and VII |
D. V and VIi
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|
|
Which of the following factors typically shows an increase in liver disease?
a. Factor VII b. Factor VIII c. Factor IX d. Factor X |
B. Factor VIII
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|
A patient has a normal prothrombin time and a prolonged activated partial thromboplastim time using a kaolin activator. The APTT corrects to normal when the incubation time is increased. These suggest that the patient has:
a. hemophilia A b. Hageman Factor (XII) deficiency c. Fletcher Factor deficiency d. Factor V deficiency |
C. Fletcher Factor deficiency
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|
|
A hemophiliac male and a normal female can produce: a. a female carrier
b. a male carrier c. a male hemophiliac d. a normal female |
A. a female carrier
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|
|
Plasma from a patient with lupus coagulation inhibitor can show:
a. prolonged APTT and normal PT b. prolonged thrombin timer c. no change with platelet neutralization d. complete correction when incubated with normal plasma |
A. prolonged APTT and normal PT
|
|
|
Acute DIC is characterized by:
a. hypofibrinogenemia b. thrombocytosis c. negative D-dimer d. shortened thrombin time |
A. hypofibrinogenemia
|
|
|
The prothrombin time test requires that the patient's citrated plasma be combined with:
a. platelet lipids b. thromboplastin c. Ca++ and platelets and lipids d. Ca++ and thromboplastin |
D. Ca++ and thromboplastin
|
|
|
In the APTT test, the patient's plasma is mixed with:
a. ADP and calcium b. tissue thromboplastin and collagen c. phospholipid and calcium d. tissue thromboplastin and calcium |
C. phospholipid and calcium
|
|
|
The APTT:
a. tests the extrinsic coagulation pathway b. monitors Coumadin therapy c. requires tissue thromboplastin d. monitors heparin therapy |
D. monitors heparin therapy
|
|
|
Aliquots of plasma with a prolonged PT and prolonged APTT are mixed using various ratios of patient plasma and normal plasma. All samples are incubated at 37*C and are tested at 10-,30-, and 60-min. intervals. The PT and APTT results on all of the mixtures are corrected .These results would indicate the presence of:
a. circulating anticoagulant b. factor deficiency c. contaminated reagent d. antibodies |
B. factor deficiency
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|
|
A patient is taking 10 mg per day of coumadin. The results of which of the following lab tests will be most impacted?
a. protein C level b. antithrombin III level c. Factor V Leiden mutation d. Factor VIII level |
A. protein C level
|
|
|
A prolonged thrombin time and a normal reptilase-R time are characteristic of :
a. dysfibrinogenemia b. increased D-Dimer c. fibrin monomer-split product complexed d. therapeutic heparinization |
D. therapeutic heparinization
|
|
|
The best test to determine if a sample is contaminated with heparin is:
a. fibrinogen b. thrombin time c. prothrombin time d. stypven time |
B. thrombin time
|
|
|
In the Clauss fibrinogen method, the time to clot formation in plasma is measured after the addition of:
a. calcium b. thrombin c. phospholipids d. kaolin |
B. thrombin
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|
|
If a patient presents with a prolonged APTT that does not correct upon mixing, the next test performed should be:
a. Factor II b. DRVVT c. Factor VIII d. platelet count |
B. DRVVT
|
|
|
Excess D-Dimer indicate that clots have been:
a. converted to fibrin monomers b. released into circulation c. formed and are being excessively lysed d. stimulated to activate platelets |
C. formed and are being excessively lysed
|
|
|
D-Dimers are produced from:
a. cross-linked and stabilized fibrin clot b. decreased fibrinogen and platelets c. plasminogen converting to plasmin d. gereration of thrombin from endothelial cells |
A. cross-linked and stabilized fibrin clot
|
|
|
A bedside test that can be used to monitor heparin activity is the:
a. activated clotting time b. stypven time c. reptilase time d. partial thrombplastin time |
A. activated clotting time
|
|
|
Which of the following lab findings is associated with Factor VIII deficiency?
a. prolonged activated partial tromboplastin time b. clot solubility in a 5 molar urea solution c. prolonged thrombin time d. prolonged prothrombin time |
B. clot solubility in a 5 molar urea solution
|
|
|
Heparin acts by:
a. precipitating fibrinogen b. binding calcium c. activating plasma d. inhibiting thrombin |
D. inhibiting thrombin
|
|
|
Low molecular weight heparin is monitored by a:
a. anti-Xa assay b. APTT c. PT d. anti-IIa assay |
A. anti-Xa assay
|
|
|
In an automated cell counter the WBC printed result is "+++" The next step is to:
a. repeat after warming the sample to 37*C b. make an appropriate dilution of the sample c. recalibrate the machine from pooled samples d. request a new sample immediately |
B. make an appropriate dilution of the sample
|
|
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A specimen run on an automatic cell counter has a platelet count of 19 x 10 to the third. The first thing the tech should do is:
a. report the count after the batch run is completed b. request a new specimen c. review the stained blood smear d. notify the lab manager |
C. review the stained blood smear
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The electrical resistance method of cell counting requires:
a. equal-sized particles b. a conductive liquid c. 2 internal electrodes for current d. 3 apertures for counting |
B. a conductive liquid
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On an electronic particle counter, if the RBC is erroneously increased, how will other parameters be affected?
a. increased MCHC b. increased Hgb c. decreased MCH d. increased MCV |
C. decreased MCH
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On setting up the electronic particle counter in the morning, one of the controls is slightly below the range for the MCV. Which of the following is indicated?
a. call for service b. adjust the MCV up slightly c. shut down the instrument d. repeat the control |
D. repeat the control
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Which of the following will not cause erroneous results when using a phase optical system for enumerating platelets?
a. incipient clotting b. decreased hematocrit c. Howell-Jolly bodies d. leukocyte cytoplasmic fragments |
B. decreased hematocrit
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The most common cause of error when using automated cell counters is:
a. contamination of the element b. inadequate mixing of the sample prior to testing c. variation in voltage of the current supply d. a calibrating error |
B. inadequate mixing of the sample prior to testing
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The ideal capillary blood collection site on a newborn is:
a. tip of the thumb b. ear lobe c. plantar surface of the heel d. the great toe |
C. plantar surface of the heel
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When evaluating a smear for a retic count, the tech observes that the RBC's are overlapping throughout the entire slide. The most likely explanation is:
a. grease on the slide prevented even spreading b. improper proportions of blood and stain were used c. the slide was dried to quickly d. the drop used for the slide preparation was too large |
D. the drop used for the slide preparation was too large
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If a blood smear is dried too slowly, the RBC's are oftern:
a. clumped b. crenated c. lysed d. destroyed |
B. crenated
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A citrated blood specimen for coagulation studies is to be collected from a polycythemic patient. the anticoagulant should be:
a. the standard volume b. reduced in volume c. changed to EDTA d. changed to oxalate |
B. reduced in volume
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Blood collected in EDTA undergoes which of the following changes if kept at room temp for 6 - 24 hrs.
a. increased Hct and MCV b. increased ESR and MCV c. increased MCHC and MCV d. decreased reticulocyte count and Hct |
A. increased Hct and MCV
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The specimen of choice for preparation of blood films for manual differential leukocyte counts is whole blood collected in:
a. EDTA b. oxalate c. citrate d. heparin |
A. EDTA
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A platelet determination was preformed on an automated instrument and a very low value was obtained. The platelets appeared adequate when estimated from the stained blood film. The best explanation for this discrepancy is:
a. many platelets are abnormally large b. blood sample is hemolyzed c. white cell fragments are present in the blood' d. red cell fragments are present in the blood |
A. many platelets are abnormally large
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When platelets concentrate at the edges and feathered end of a blood smear, it is usually due to:
a. abnormal proteins b. inadequate mixing of blood and anticoagulant c. hemorrhage d. poorly made wedge smear |
D, poorly made wedge smear
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On a smear made directly from a finger stick, no platelets were found in the counting area. The first thing to do is:
a. examine the slide for clumping b. obtain another smear c. perform a total platelet count d. request another finger stick |
A. examine the slide for clumping
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The anticoagulant of choice for routine coagulation procedures is:
a. sodium oxalate b. sodium citrate c. heparin d. sodium fluoride |
B. sodium citrate
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A blue top tube is drawn for coagulation studies, the sample is a short draw results may be:
a. falsely shortened b. correct c. unable to be obtained d. falsely prolonged |
D. falsely prolonged
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The ISI in the INR represents the reagents:
a. activator b. specificity c. phospholipids d. sensitivity |
D. sensitivity
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On Monday a patient's Hgb determination was 11.3 g/dL and on Tuesday it measured 11.8 g/dL. The standard deviation of the method used is +-0.2 g/dL. Which of the following can be concluded about the Hgb values given?
a. one value probably resulted from lab error b. there is poor precision, daily quality control chars should be checked c. the second value is out of range and should be repeated d. there is no significant change in the patient's Hgb concentration |
D. there is no significant change in the patient's Hgb concentration
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Antinuclear antibody tests are performed to help diagnose:
a. acute leukemia b. lupus erythematosus c. hemolytic anemia d. Crohn disease |
B. lupus erythematosus
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Sera to be tested for IFA-ANA 6 days after drawing is best stored at:
a. room temp b. 5*C+-2*C c. -70*C in a constant temp freezer d. -20*C in a frost free self defrosting freezer |
B. 5*C +- 2*C
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Antibodies directed at native DNA are most frequently associated with which pattern of fluorescence in the IFA-ANA test?
a. rim b. diffuse c. speckled d. centromere |
A. rim
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The tech observes apparent homogenous staining of the nucleus of interphase cells while performing an IFA-ANA, as well as staining of the chromosomes in mitotic cells . This result is:
a. indicative of 2 antibodies, which should be separately reported after titration b. expected for anti-DNA antibodies c. inconsistent; the test should be reported with new reagent d. expected for anti-centromere antibodies |
B. expected for anti-DNA antibodies
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The result of an anti-nuclear antibody test was a titer of 1:320 with a peripheral pattern. Which of the following sets of results best correlate with these results?
a. anti-dsDNA titer 1:80 and a high titer of antibodies to Sm b. antimitochondrial antibody titer 1:160 and antibodies to RNP c. anti-Scl-70 and antibodies to single stranded DNA d. high titers of anti-SS-A and anti-SS-B |
A. anti-dsDNA titer 1:80 and a high titer of antibodies to Sm
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Which of the following is the most sensitive and appropriate method for the detection of rheumatoid factor?
a. nephelometry b. immunofixation electrophoresis c. immunofluorescence d. manual latex agglutination |
A. nephelometry
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Rheumatoid factor reacts with:
a. inert substances such as latex b. Rh-pos erythrocytes c. kinetoplasts of Crithidia luciliae d. gamma globulin-coated particles |
D. gamma globulin-coated particles
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A consistently and repeatedly negative IFA-ANA is:
a. strong evidence against untreated SLE b. associated with active SLE c. characteristic of SLE with renal involvement d. associated with lupus inhibitor |
A. strong evidence against untreated SLE
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Positive rheumatoid factor is generally associated with:
a. hyperglobulinemia b. anemia c. dereasedESR d. azotemia |
A. hyperglobulinemia
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SLE patients often have which of the following test results?
a. high titers of DNA antibody b. decreased serum immunoglobulin levels c. high titers of anti-smooth muscle antibodies d. high titers of antimitochondrial antibody |
A. high titers of DNA antibody
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Rheumatoid factors are immunoglobulins with specificity for allotypic determinations located on the:
a. Fc fragment of IgG b. Fab fragment of IgG c. J chain of IgM d. secretory component of IgM |
A. Fc fragent of IgG
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Rheumatoid factor in a patient's serum may cause a false:
a. positive test for the detection of IgM class antibodies b. negative test for the detection of IgM class antibodies c. positive test for the detection of IgG class antibodies d. negative test for the detection of IgG class antibodies |
A. positive test for the detection of IgM class antibodies
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Rheumatoid factors are defined as:
a. antigens found in the sera of patients with rheumatoid arthritis b. identical to the rheumatoid arthritis precipitin c. autoantibodies with specificitly for the Fc portion of the immunoglobulin mmolecule d. capable of forming circulating immune complexes only when IgM-type autoantibody is present |
C. autoantibodies with specificity for the Fc portion of the immunoglobulin molecule
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High titers of antimicrosomal antibodies are most often found in:
a. rheumatoid arthritis b. SLE c. chronic hepatitis d. thyroid disease |
D. thyroid disease
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In chronic active hepatitis, high titers of which of the following antibodies are seen?
a. antimitochondrial b. anti-smooth muscle c. anti-DNA d. anti-parietal cell |
B. anti-smooth muscle
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Anti-RNA antibodies are often present in idividuals having an anti-nuclear antibody immunofluorescent pattern that is:
a.speckled b. rim c. diffuse d. nucleolar |
D. nucleolar
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Anti-extractable nuclear antigens are most likely associated with which of the following anti-nuclear antibody immunofluorescent pattern:
a. speckled b. rim c. diffuse d. nucleolar |
A. speckled
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In an anti-nuclear antibody indirect immunofluorescence test, a sample of patient serum show a positive, speckled pattern. Which would be the most appropriate additional test to perform?
a. antimitochondrial antibody b; immunoglobulin quantitation c. screen for Sm and RNP antibodies d. anti=DNA antibody using C luciliae |
C. screen for Sm and RNP antibodies
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In the indirect immunofluorescence method of antibody detection in patient serum, the labeled antibody is:
a. human anti-goat immunoglobulin b. rheumatoid factor c. goat anti-human immunoglobulin d. complement |
C. goat anti-human immunoglobulin
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Which of the following describes an antigen-antibody reaction?
a. the reaction is reversible b. the reaction is the same as a chemical reaction c. a lattice is formed at prozone d. a lattice is formed at postzone |
A. the reaction is reversible
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The most common label in direct fluorescent antibody technique is:
a. alkaline phosphatase b. horseradish peroxidase c. fluorescein isothiocyanate d. calcofluor white |
C. fluorescein isothiocyanate
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A substrate is first exposed to a patient's serum, then after washing, anti-human immunoglobulin labeled with a fluorochrome is added. The procedure described is:
a. fluorescent quenching b. direct fluorescence c. indirect fluorescence d. fluorescence inhibition |
C. indirect fluorescence
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Avidity may be defined as the:
a. degree of hemolysis b. titer of an antigen c. dilution of an antibody d. strength of a reacting antibody |
D. strength of a reacting antibody
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In the interpretation of agglutination tests for febrile diseases, which of the following is of the greatest diagnostic importance?
a. anamnestic reactions caused by heterologous antigens b. rise in titer of the patient's serum c. history of previous vaccination d. naturally occuring antibodies prevalent wher the disease is endemic |
B. rise in titer of the patients serum
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Cholesterol is added to the antigen used in flocculation tests for syphilis to:
a. destroy tissue impurities present in the alcoholic beef heart extract b. sensitize the sheep RBC's c. decreased specificity of the antigen d. increase sensitivity of the antigen |
D. increase sensitivity of the antigen
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The strength of a visable reaction is known as:
a. prozone reaction b. absorption c. avidity d. elution |
C. Avidity
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Which of the following describes an antigen antibody precipitation reaction of non-identity?
a. precipitin lines cross, forming double spurs b. precipitin lines fuse, forming a single spur c. no precipitin line are formed d. precipitin lines fuse, forming a single arc |
A. precipitin lines cross, forming double spurs
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Which test has the greatest sensitivity for antigen detection?
a. precipitation b. agglutination c. ELISA d. complement fixation |
C. ELISA
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Excess antigen in precipitation gel reactions will:
a. have no effect on the precipitate reaction b. not dissolve precipitate after formation c. enhance the precipitate reaction d. dissolve the precipitate after formation |
D. dissolve the precipitate after formation
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Soluble immune complexes are formed under the condition of:
a. antigen deficiency b. antigen excess c. antibody excess d. complement |
B. precipitate
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The visible serological reaction between soluble antigen and its specific antibody is:
a. sensitization b. precipitation c. agglutination d. opsonization |
B. precipitation
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The enzyme control tube is an ASO hemolytic assay exhibits no cell lysis. What is the most likely explanation for this?
a. inncorrect pH of buffer b. low ionic strength buffer c. oxidation of the enzyme d. reduction of the enzyme |
C. oxidation of the enzyme
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In a positive anti-streptolysin "O" enzyme inhibition test, the patient's:
a. steptolysin "O" enzyme in the patient serum neutralizes the anti-streptolysin "O" reagent, resulting in no hemolysis b. RBC are hemolyzed by the streptolysin "O" enzyme in the reagent. c. anti-streptolysin "O" neutralizes the streptolysin "O" reagent, resulting in hemolysis d. anti-streptolysis "O" inhibits the reagent streptolysin "O" resulting in no hemolysis |
D. anti-streptolysin "O" neutralizes the streptolysin "O" reagent, resulting in hemolysis
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Blood is drawn from a patient for serological tests for viral disease at the time of onset and again 4 wks later. The results of the tests are considered diagnostic if the:
a. first antibody titer is 2x the second b. first and second antibody titers are equal c. first antibody is 4x the second d. second antibody titer is a least 4x the first |
D. second antibody titer is at least 4x the first
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Which of the following is most useful in establishing a diagnosis in the convalescence phase of a viral infection?
a. slide culture b. serological techniques c. shell vial d. culture on McCoy media |
B. serological techniques
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The best method to detect infections due to rubella, Epstein-Barr and HIV is:
a. antigen detection by EIA b. cell culture c, antigen detection by western blot d. antibody detection by ELISA |
D. antibody detection by ELISA
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immunoassays are based on the principle of:
a. separation of bound and free analyte b. antibody recognition of homologous antigen c. protein binding to isotopes d. production of antibodies against drugs |
B. antibody recognition of homologous antigen
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A DPT vaccination is an example of:
a. active humoral mediated immunity b. passive humoral mediated immunity c. cell mediated immunity d. immediate hypersensitivity |
A. active humoral mediated immunity
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Cells know to be actively phagocytic include:
a. neutrophils, monocytes, basophils b. neutrophils, eosinophils, monocytes c. monocytes, lymphocytes, neutrophils d. lymphocytes, eosinophils, monocytes |
B. neutrophils, eosinophils, monocytes
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When testing a patient for HIV antibody, which of the following is used to confirm a positive screening test?
a. radioimmunoassay b. Western blot c. immunofluorescence d. ELISA |
B. Western blot
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What kind of antigen-antibody reaction would be expected if soluble antigen is added to homologous antibody?
a. precipitation b. agglutination c. complement fixation d. hemaggllutination |
A. precipitation
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The Rapid Plasma Reagin test:
a. is useful in screening for syphilis b. is useful in diagnosing syphilis c. does not give false positives d. used heated plasma |
A. is useful in screening for syphilis
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Flocculation tests for syphilis detect the pressence of:
a. reagin antibody b. antigen c. hemolysin d. Forssman antigen |
A. reagin antibody
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In the cold agglutinin test, the tubes containing the serum and erythrocytes are allowed to stand overnight in the refrigerator, and the results are read the next morning. If a disk of the erythrocytes floats up from the bottom of the tube with only the flick of a finger, this is read as a:
a. 4+ reaction b. 2+ reaction c. 1+ reaction d. negative |
A. 4+ reaction
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Flocculation tests for syphilis use antigen composed of:
a Treponema pallidum b. reagin c. cardiolipin and lecithin d. charcoal |
C. cardiolipin and lecithin
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A VDRl serum sample is heat inactivated, then placed in the refridgerator for overnight storage. Before being tested, the serum must be:
a. kept colder than 10*C b. allowed to equilibrate to room temp c. warmed to 37*C d. reheated to 56*C for 10 minutes |
D. reheated to 56*C for 10 minutes
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Substances that are antigenic only when coupled to a protein carrier are:
a. opsonins b. haptens c. adjuvants d. allergens |
B. haptens
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A serological test for syphilis that depends upon the detection of cardiolipin-lecithin-cholesterol antigen is:
a. FTA-ABS b. RPR c. MHA-TP d. TPI |
B. RPR
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The serological test for syphilis recommended for detecting antibody in cerebrospinal fluid is:
a. nontreponemal antibody b. CSF-VDRL c. FTA-ABS d. MHA-TP |
B. CSF-VDRL
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What assay would confirm the immune status to hepatitis B virus:
a. HBsAg b. anti-HBs c. IgM anti-HBcAg d. hepatitis V Ag |
B. anti-HBs
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The following procedure has been routinely used for detection of hepatitis B surface antigen because of its level of sensitivitly:
a. hemagglutination b. counter-immunoelectrophoresis c. radial ummunodiffusion d. ELISA |
D. ELISA
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In an indirect ELISA method designed to detect antibody to the rubella virus in patients serum, the conjugate used should be:
a. anti-human IgG conjugated to an enzyme b. anti-rubella antibody conjugated to an enzyme c. rubella antigen conjugated to an enzyme d. anti-rubella antibody conjugated to a substrate |
A. anti-human IgG conjugated to an enzyme
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Which of the following is the best indicator of an acute infection with the hepatitis A virus?
a. the presence of IgG antibodies to hepatitis A virus b. the presence of IgM antibodies to the hepatitis A virus c. a sharp decline in the level of IgG antibodies to hepatitis A virus d. a rise in both IgM and IgG levels of antibody to hepatitis A virus |
B. the presence of IgM antibodies to hepatitis A virus
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Biological false-positive VDRL reactions are frequently encountered in patients with:
a. lupus erythromatosus b. AIDS c. gonorrhea d. teriart syphilis |
A. lupus erythromatosus
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Which serological marker of HBV infection indicates recovery and immunity?
a. viral DNA polymerase b. HBe antigen c. anti-HBs d. HBsAg |
C. anti-HBs
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For diagnosis of late latent or tertiary syphilis the most appropriate assay is:
a. RPR b. VDRL c. FTA-ABS d. FTA-ABS IgM |
C. FTA-ABS
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A 26 yr old nurse developed fatique, a low grade fever, polyarthritis and uricaria. 2 months earlier she had cared for a patient with hepatitis. Which of the following findings are likely to be observed in this nurse?
a. a negative hepatitis B surface antigen b. elevated AST and ALT levels c. a positive rheumatoid factor d. a positive Monospot test |
B. elevated AST and ALT levels
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The classic antibody response pattern following infection with hepatitis A is:
a. increase in IgM antibody; decrease in IgM antibody, increase in IgG antibody b. detectable presence of IgG antibody only c. detectable presence of IgM antibody only d. decrease in IgM antibody, increased in IgG antibody of the IgG3 subtype |
A. increase in IgM antibody, decrease in IgM antibody, increase in IgG antibody
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The ELISA technique for the detection of HBsAg:
a. requires radiolabeled Clq b. is quantitated by degree of fluorescence c. uses anti-HBs linked to horseradish peroxidase d. uses beads coated with HBsAg |
C. uses anti-HBs linked to horseradish peroxidase
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The antigen marker most closely associated with tranmissibility of HBV infection is:
a. HBsAg b. HBeAg c. HBcAg d. HBV |
B. HBeAg
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Chronic carriers of HBV:
a, have chronic symptoms of hepatitis b. continue to carry HBV c. do not transmit infection d. carry HBV but are not infectious |
B. continue to carry HBV
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The initial immune response following fetal infection with rubella is the production of which class of antibodies?
a. IgG b. IgA c. IgM d. both IgG and IgA |
C. IgM
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A maternal serum rubella titer that is equal to or greater than 1:8 indicates:
a. probable immunity to rubella b. evidence of acute rubella infection c. susceptibility to rubella infection d. absence of acute rubella |
A. probable immunity to rubella
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Which of the following is a treponemal test?
a. RST b. RPR c. FTA-ABS d. VDRL |
C. FTA-ABS
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The air temp troughout the serology lab is 20*C. How will this affect VDRL and RPR test results?
a. no effect-the acceptable test range is 20 - 24*C b. weaken reactions so that false negatives occur c. strengthen reactions so that positive titers appear elevated d. increase the number of false positives from spontaneous clumping |
B. weaken reactions so that false negatives occur
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Which lab technique is most frequently used to diagnose and follow the course of therapy of a patient with secondary syphilis?
a. flocculation b. precipitation c. complement fixation d. indirect immunofluorescene |
A. flocculation
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The most commonly used serlogical indicator of recent strepotcoccal infection is the antibody to:
a. streptolysin "O" b. hyaluronidase c. NADase d. DNA |
A. streptolysin O
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Antibodies composed of IgG immunoglobulin:
a. occur during the primary response to antigen b. are larger molecules that IgM antibodies c. can cross the placenta from mother to fetus d. can be detected in saline crossmatches |
C. can cross the placenta from mother to fetus
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Measurement of serum levels of which of the following immunoglobulin can serve as a screening test for multiple allergies?
a. IgA b. IgE c. IgG d. IgM |
B. IgE
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Cells that are precursors of plasma cells and also produce immunoglobulins are:
a. macrophages b. B lymphs c. T lymphs d. monocytes |
B. B lymphocytes
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IgM antibodies are frequently hemolytic because of:
a. their dimeric structure b. the molecules 5 antigen binding sites c. their sedimentation coefficient of 7-15 S d. their efficient ability to fix complement |
D. their efficient ability to fix
complement |
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To which of the following classes do the antibodies that cause hemolytic disease of the newborn belong?
a. IgA b. IgE c. IgG d. IgD |
C. IgG
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It is important to note when an infant is born, levels of specific antibody of the following class are used to indicate neonate infection:
a. IgA b. IgG c. IgM d. IgD |
B. IgG
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Antibodies are produced by:
a. killer cells b. marrow stem cells c. mast cells d. B cells |
D. B cells
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Antibody class and antibody subclass are determined by major physiochemical differences and antigenic variations found primarily in the:
a. constant region of heavy chain b. constant region of light chain c. variable regions of heavy and light chains d. constant regions of heavy and light chains |
A. constant regions of the heavy chain
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Which of the following immunoglobulin classes is associated with a secretory component:
a. IgA b. IgD c. IgE d. IgG |
A. IgA
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The immunoglobulin class typically found to be present in saliva, tears, and other secretions is:
a. IgG b. IgA c. IgM d. IgD |
B. IgA
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Treatment of IgG with papain results in how many fragments from each immunoglobulin molecule?
a. 2 b. 3 c. 4 d. 5 |
B. 3
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The immunglobulin class associated with immediate hypersensitivity or atopic reactions is:
a. IgA b. IgM c. IgD d. IgE |
D. IgE
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Which of the following immunoglobulins is the most efficient at agglutination?
a. IgG b. IgA c. IgM d. IgE |
C. IgM
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The key structural difference that distinguishes immunoglobulin subclasses is the:
a. number of domains b. stereometry of the hypervariable reagion c. the sequence of the constant regions d. covalent linkage of the light chains |
C. the sequence of the constant regions
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The IgM molecule is a:
a. dimer b. trimer c. tetramer d. pentamer |
D. pentamer
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Which of the following immunoglobulins is present in the highest concentration in normal human serum?
a. IgM b. IgG c. IgA d. IgE |
B. IgG
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Which of the following statements about immunoglobulins is true?
a. immunoglobulins are produced by T lymphs b. IgA class is determined by the gamma heavy chain c. IgA class exists as serum and secretory molecules d. there are only 2 subclasses of IgG |
C. IgA class exists as serum and secretory molecules
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Antibody idiotype is dictated by the:
a. constant region of the heavy chain b. constant region of the light chain c. variable regions of heavy and light chains d. constant regions of heavy and light chains |
C. variable regions of heavy and light chains
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Antibody allotype is determined by the:
a. constant region of heavy chain b. constant region of light chain c. varible regions of heavy and light chains d. constant regions of heavy and light chains |
D. constant regions of heavy and light chains
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Which IgG subclass is most efficient at crossing the placenta?
a. IgG1 b. IgG2 c. IgG3 d. IgG4 |
A. IgG1
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The J chain is associated with which of the following immunoglobulins?
a. IgA b. IgG c. IgE d. IgD |
A. IgA
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Macrophage phagocytosis of bacteria is enhanced by which of the following:
a. opsonin b. antigen c. hapen d. secretory piece |
A. opsonin
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Which of the following is most likely to activate the alternative pathway of complement activation?
a. lipopolysaccharides b. glycoproteins c. haptens d. IgG complexed with antigen |
C. haptens
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Which of the following is the larger residual split portion of C3?
a. C3a b. C3b c. C4 d. C1q |
B. C3b
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Which of the following activities is associated with C3b?
a. opsonization b. anaphylaxis c. vasoconstriction d. chemotaxis |
A. opsonization
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After a penicillin injection a patient rapidly developes resiratory distress, vomiting and hives. This reaction is primarily mediated by:
a. IgG b. IgA c. IgM d. IgE |
D. IgE
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Which of the following is the "recognition unit" in the classical complement pathway?
a. C1q b. C3a c. C4 d. C5 |
A. C1q
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In immuofixation electrophoresis:
a. the antibody reacts with the antigen and them to complex is electrophoresed b. the antigen is electrophoresed into an antibody containing gel c. the antigen is electrophoresed and then monospecific antisera is reacted with it d. the antigen is eletrophoresed. transferred to nitrocellulose and then antibody reacts with it and an EIA is performed |
C. the antigen is electrophoresed and then monospecific antisera is reacted with it
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Which of the following is the "membrane attack complex" of complement activation?
a. C1 b. C3 c. C4, C2, C3 d. C5b, C6, C7, C8, C9 |
D. C5b, C6, C7, C8, C9
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Which of the following releases histamine and other mediators from basophils?
a. C3 b. properdin factor B c. C1q d. C4 |
A. C3a
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A single reliable screening test for detecting neonatal infection in the absence of clinical signs is:
a. serum immunoelectrophoresis b. differential leukocyte count c. CD4 cell counts d. quantitative serum IgM determination |
D. quantitative serum IgM determination
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Bence Jones proteins are:
a. immunoglobulin carabolic fragments in the urine b. monoclonal light chains c. whole immunoglobulins in the urine d. Fab fragments of a monoclonal protein |
B. monoclonal light chains
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Humoral antibodies are produced by which cells?
a. macrophages b. T lymphs c. B lymphs d. neutrophils |
C. B lymphocytes
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Initiation of the activation mechanism of the alternative complement pathway differs from that of the classical pathway in that:
a. antigen-antibody complexed containing IgM or IgG are required b. endotoxin alone cannot initiate activation c. C1 component of complement is involved d. antigen-antibody complexed containing IgA or IgE may initiate activation |
D. Antigin-antibody complexes containing IgA and IgE may initiate activation
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The component associated only with the alternative pathway of complement activation is:
a. C4 b. C1q c. properdin factor B d. C3a |
C. porperdin factor B
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Potent chemotactic activity is associated with which of the following components of the complement system:
a. C1q b. C5a c. C3b d. IgG |
B. C5a
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Hereditary angioedema is characterized by:
a. decreased activity of C3 b. decreased activity of C1 esterase inhibitor c. increased activity of C1 esterase inhibitor d. increased activity of C2 |
B. decreased activity of C1 esterase inhibitor
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Which of the following has been associated with patients who have holzygous C3 defieciency?
a. undetectable hemolytic complement activity in the serum b. SLE c. no detectable disease d. a lifelong history of life-threatening infections |
D. a lifelong history of life-threatening infections
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Hereditary deficiency of early complement components is associated with:
a. pneumococcal septicemia b. small bowel obstruction c. lupus erythematosus like syndrome d. gonococcemia |
C. lupus erythematosus like syndrome
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Hereditary deficiency of late complement components can be associated with which of the following conditions?
a. pneumococcal septicemia b. small bowel obstruction c. SLE d. a systemic gonococcal infection if exposed |
D. a systemic gonococcal infection if exposed
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Which immunologic mechanism is usually involved in bronchial asthma?
a. immediate hypersensitivity b. antibody mediated cytotoxicity c. immune complex d. delayed hypersensitivity |
A. immediate hypersensitivity
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Antihistimines like Benadryl:
a. depress IgE production b. block antigen binding to surface IgE c. bind histamine d. block H1 histamine receptors |
D. block H1 histamine receptors
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A child has severe hay fever. A total IgE measurement was performed by the ouchterlony immunodiffusion method. No lines of precipitation appeared on the immunodiffusion plate. The most likely explanation is:
a. IgE antibodies are not produced in children who have hay fever b. hay fever is mediated by the cellular system c. IgE is to low a concentration to be detected by this method d. IgA is the antibody commonly produced in people with hay fever |
C. IgE is in too low a concentration to be detected by this method
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Which test is used to evaluate the cellular immune system in a patient?
a. skin test for commonly encountered antigens b. determination of isohemoagglutinin titer c.immunoeletrophoresis of serum d. measurement of anti-HbsAg after immunization |
A. skin test for commonly encountered antigens
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T cells are capable of:
a. collaborating with B cells in antibody responses b. secretion of immunoglobulins c. secretion of cytokines d. producing positive skin tests |
B. secretions of immunoglobulins
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T lymphs are incapable of functioning as:
a. cytotoxic cells b. helper cells c. phagocytic cells d. regulatory cells |
C. phagocytic cells
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Tumor markers found in the circulation are most frequently measured by:
a, immunoassays b. thin-layer chromatography c. high-pressure liquid chromatography d. colorimetry |
A. immunoassays
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A patient with a B-cell deficiency will most likely exhibit;
a. decreased phagocytosis b. increased bacterial infections c. decreased complement levels d. increased complement levels |
B. increased bacterial infections
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A patient with aT-cell deficiency will most likely exhibit:
a. increased immune complex formation b. increased parasitic infections c. decreased IgE-mediated responses d. decresed complement levels |
B. increased parasitic infections
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Which of the following is an important cellular mediator of immune complex tissue injury?
a. mast cell b. neutrophil c. basophil d. eosinophil |
B. neutrophil
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Which of the following mediators is released during T cell activation?
a. immunoglobulins b. thymosin c. serotonin d. cytokines |
D. cytokines
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Which of the following terms describes a graft between genetic unidentical individuals belonging to the same species?
a. autograft b. isograft c. allograft d. xenograft |
C. allograft
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T lymphs that possess the CD8 surface marker mediate which of the following T cell functions?
a. delayed type hypersensitivity b. regulatory c. cytotoxic d. helper |
C. cytotoxic
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Delayed hypersensitivity may be induced by:
a. contact sensitivity to inorganic chemicals b. transfusion reaction c. anaphylactic reaction d. bacterialsepticemia |
A. contact sensitivity to inorganic chemicals
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The most rapid immediate hypersensitivity reaction is associated with:
a. transfusion b. anaphylaxis c. contact dermatitis d. serum sickness |
B. anaphylaxis
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An immunofluorescence test using reagent antibody directed against the CD3 surface marker would identify which of the following cell typed in a sample of human peripheral blood?
a. all mature T lymphs b. T helper lymphs only c. cytotoxic T lymphs only d. T regulatory cell only |
A. all mature T lymphocytes
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In flow cytometry, labeled cells:
a. scatter the light and absorb fluorescence b. absorb fluorescence and emit electronic impulses c. scatter the light and emit fluorescence d. absorb both fluorescence and light |
C. scatter the light and emit fluorescence
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A marked decrease in the CD4 lymphocytes and decrease in the CD4/CD8 ratio:
a. is diagnostic for bacterial septicemia b. may be seen in most hereditary immunodeficiency disorders c. is associated with a viral induced immunodeficiency d. is only seen in patients with advanced disseminated cancer |
C. is associated with a viral induced immunodeficiency
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What is the immunologic method utilized in the flow cytometer?
a. latex aggultination b. enzyme linked immunoassay c. immunofluorescence d. radioimmunoassay |
C. immunofluorescence
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A patients abnormal lymphocytes are positive for CD2 antigen, lack C3 receptors and are negative for surface immumoglobulins. This can be classified as a disorder of:
a. T cells b. B cells c. monocytes d. natural killer cells |
A. T cells
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Proper media for culture of a urethral discharge from a man include:
a. sheep blood and phenylethyl alcolhol agars b. eosin methylene blue and sheep blood agars c. thioglycollate broth and chocolate agar d. chocolate agar and modified a Thayer Martin agar |
D. chocolate and modified Thayer Martin agars
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A sheep blood agar plate inoculated with 0.001 mL of urine grows 70 colonies of Staphylcoccus aureus. How many colony forming units per mL of urine should be reported:
a. 70 b. 700 c. 7000 d. 70000 |
D. 70000
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The lowest concentration of antibiotic that inhibits growth of a test organism is the :
a. minimum inhibitory concentration b. serum inhibitory concentration c. minimum bactericidal titer d. miximum inhibitory titer |
A. minimum inhibitory concentration
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The steam autoclave method of sterilization:
a. uses 15 lbs of pressure for 15 minutes b. utilizes dry heat for 20 minutes c. produces a miximum temp of 100*C d. requires a source of ethylene oxide |
A. uses 15 lbs of pressure for 15 minutes
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The expected colony count in a suprapubic urine from a healthy individual is:
a. 0 CFU/m: b. 100 CFU/mL c. 1,000 CFU/mL d. 100,000 CFU/mL |
A. 0 CFU/mL
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An aspirate of a deep wound was plated on blood agar plates and incubated aerobically and anaerobically. At 24 hrs there was growth on both plates. This indicates that the orgainism is a:
a. nonfermenter b. obligate anaerobe c. aerobe d. facultative anaerobe |
D. facultative anaerobe
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A penicillin resitant Neisseria gonorrhoeae produces:
a. alpha-hemolysin b, beta-lactamase c. enterotoxin d. coagulase |
B. beta-lactamase
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Which selective medium is used for the isolation of gram-positive microorganisms?
a. columbia CNA with 5% sheep blood b. trypticase soy agar with 5% sheep blood c. eosin methylene blue d. modified Thayer-Martin |
A. columbia CNA with 5% sheep blood
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The most sensitive substrate for the detection of beta-lactamases is:
a. penicillin b. ampicillin c. cefoxitin d. nitrocefin |
D. nitrocefin
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An Enterococcus isolated from multiple blood cultures in a patient endocarditis should be:
a. screened for high level aminoglycoside resistance b. checked for tolerence c.assayed for serum antimicrobial activity d. tested for beta-lactamase production |
A. screened for high level aminoglycoside resistance
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In the Kirby-Bauer disk diffusion susceptibility test, which variable is critical when testing Pseuomonas species for antibiotic susceptibililty to aminoglycosides?
a. incubation temp b. duration of incubation c. cation content of media d. depth of agar |
C. cation content of media
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The procedure that assures the most accurate detection of mecA-mediated oxacillin resistance in routine broth microdilution susceptibility testing against S aureus is:
a. addition of 4% NaCl b. incubation at 30*C c. incubation for 48 hrs d. use of cefoxitin for testing |
D. use of cefoxitin for testing
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Susceptibility testing performed on quality control organisms using a new media lot number yielded zone sizes that were too large for all antibiotics tested. The testing was repeated using media from a previously used lot number, and all zone sizes were acceptable. Which of the following best explains the unacceptable zone sizes?
a. the antibiotic disks were not stored with the proper desiccant b. the depth of the media was too thick c. the depth of the media was too thin d. the antibiotic disks were not properly applied to the media |
C. the depth of the media was too thin
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3 sets of blood cultures were obtained from an adult patient with fever and suspected endocaritis. The aerobic bottle of one set had growth of Staphylococcus epidermidis at 5 days of incubation. This indicates that;
a. there was a low grade bacteria b. the organism is most likely a contaminant c. the patient has a line infection d. the blood culture bottles are defective |
B. the organism is most likely a contaminant
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In order to isolate Campylobacter coli/jejuni the fecal specimen should be:
a. inoculated onto selective plating media and incubated in reduced oxygen with added CO2 at 42*C b. stored in tryptic soy broth before plating to ensure growth of the organism c. inoculated onto selective plating media and incubated at both 35*C and at room temp d. incubated at 35*C for 2 hrs in Cary-Blair media before inoculating onto selective plating media |
A. inoculated onto selective plating media and incubated in reduced oxygen with added CO2 at 42*C
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Which type of microscope would be most useful in examining viruses and the structure of microbial cells?
a. electron b. phase-contrast c. dark-field d. bright-field |
A. electron
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After satisfactory performance of daily disk diffusion susceptibility quality control is documented the frequency of quality control can be reduced to:
a. twice a week b. every week c. every other week d.every month |
B. every week
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In disk diffusion susceptibility testing, as an antimicrobial agent diffuses away from the disk, the concentration antibiotic is:
a. increased b. decreased c. unchanged d. inoculum dependent |
B. decreased
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The most common cause for failure of a GasPak anaerobic jar to establish an adequate environment for anaerobic incubation is:
a. the failure of the oxidation reduction potential indicator system due to deterioration of methylene blue b. the failure of the packet to generate adequate H2 and/or CO2 c. condensation of water on the inner surface of the jar d. catalysts that have become inactivated after repeated use |
D. catalysts that have become inactivated after repeated use
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Which of the following specimen requests is acceptable?
a. feces submitted for anaerobic culture b. Foley catheter tip submitted for aerobic culture c. rectal swab submitted for direct smear for gonococci d. urine for culture of acid-fast bacilli |
D. urine for culture of acid fast bacilli
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Which of the following groups of specimens would be acceptable for anaerobic culture?
a. vaginal, eye b. ear, leg tissue c. pleural fluid, brain abscess d. urine, sputum |
C. pleural fluid, brain abscess
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A liquid fecal specimen from a 3 month old infant is submitted for microbiological exam. In addition to culture on routine media for Salmonella and Shigella, this specimen should be routinely:
a. examined for the presence of Entamoeba hartmanni b. examined for the presence of Campylobacter sp. c. screened for the detection of enterotoxigenic Escherichia coli d. placed in thioglycollate broth to detect Clostridium botulinum |
B. examined for the presence of Campylobacter sp
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Cerebrospinal fluid from a febrile 25 yr old man with possible meningitis is rushed to the lab for a stat gram stain and culture. While performing the gram stain, the tech accidently spills most of the specimen. The smear shows many neutrophils and no microorganisms. Since there is only enough CSH to innoculate one plate, the tech should use a;
a. blood agar plate b. chopped meat glucose c. chocolate agar plate d. Thayer-Martin plate |
C. chocolate agar plate
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Which of the following is the most appropriate specimen source and primary media battery?
a. endocervical- chocolate, Martin Lewis b. sputum-sheep blood, Thayer-Martin, KV-laked blood c. CSF,- Columbia CNA, MacConkey d. urine- sheep blood, chocolate, Columbia CNA |
A. endocervical-chocolate, Martin Lewis
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Which of the following in the most appropriate specimen source and primary media battery/
a. Legionella species-Regan Lowe b. Clostridium Difficile-phenylethyl alcohol c. Campylobacter species- charcoal yeast extract d. Yersina enterocolitica- cefsulodin-irgasan-novoviocin |
D. Yersinia entercolitica - cesulodin-irgasan-novobiocin (CIN)
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Upon review of a sputum Gram stain, the technician notes that the nuclei of all of the neutrophils present in the smear are staining dark blue. The best explanation for this finding is:
a. the slide was inadequately decolorized with acetone/alcohol b. the sputum smear was prepared to thin c. the cellular components have stained as expected d. the iodine was omitted from the staining procedure |
A. the slide was inadequately decolorized with acetone/alcohol
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When performing a Kovac indole test, the substrate must contain:
a. indole b. tryptophan c. ornithine d. paradimethylaninobenzalde-hyde |
B. trytophan
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The ONPG test allows organisms to be classified as a lactose fermenter by testing for which of the following?
a. permease b. beta-galactosidase c. beta-lactamase d. phosphatase |
B. beta-galacosidease
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A medium that aids in the persumptive identification of organisms based on their appearance on the medium is called:
a. enriched b. selective c. differential d. specialized |
C. differential
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Which of the following methods is inadequate for the detection of vancomycin-intermediate S aureus?
a. broth macrodilution b. agar dilution c. gradient diffusion d. disk diffusion |
D. Disk Diffusion
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In a disk diffusion susceptibility test, which of the following can result if disks are placed on the inoculated media and left at room temp for an hour before incubation?
a. the antibiotic would not diffuse into the medium, resulting in no zone b.Too many organisms in the inoculum c. the presence of 0.5% NaCl in the medium d. a medium with a pH of 7.4 |
B. too many organisms in the inoculum
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First generation cephalosporins can be adequately represented by:
a. cefotetan b. ceftriaxone c. cephalothin d. cefoxitin |
C. cephalothin
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An antibiotic that inhibits cell wall synthesis is:
a. chloramphenicol b. penicillin c. sulfamethoxazole d. colistin |
B. penicillin
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Which of the following organisms does not require susceptibility testing to the antimicrobial indicated when isolated from a clinically significant source?
a.Staphylococcus Aureus-clindamycin b. Proteus mirabilis- gentamicin c. Streptococcus pyogenes-penicillin d. Escherichia coli - levofloxacin |
C. Streptococcus pyogenes - penicillin
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Which of the following must be incubated in a microaerophilic environment for optimal recovery of the organism?
a. Campylobactor jujuni b. Escheria Coli c. Pseudomonas aeruginosa d. Proteus mirabilis |
A. Campylobacter jujuni
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Vibrio parahaemolyticus can be isolated best from feces on:
a. eosin mehtylene blue agar b. Hektoen Shigella agar c. Salmonella Shigella agar d. thiosulfate citrate bile salts agar |
D. thiosulfate citrate bile salts agar
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Which of the following media can be used to culture Campylobacter jujuni?
a. Skirrow medium b. CIN agar c. anaerobic CNA agar d. bismuth sulfite |
a. Skirrow medium
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Tests for beta-lactemase production in Haemophilus infuenzae;
a. are not commercially available b. include tests that measure a change to an alkaline pH c. should be performed on all blood and CSF isolates d. are not valid for any other bacterial species |
C. should be performed on all blood and CSF isolates
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Media used to support growth of Legionella pneumophila should contain which of the following?
a. X and V factors b. hemin and Vitamin K c. charcoal and yeast extract d. dextrose and laked blood |
C. charcoal and yeast extract
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The best medium for culture of Bordetella pertussis is:
a. Regan-Lowe agar b. cystine blood agar c. Martin Lewis agar d. Ashdown agar |
A. Regan-Lowe agar
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The best medium for culture of Francisella tularenis is:
a. Bordet-Gengou meduim b. cystine glucose blood agar c. loeffler medium d. charcoal secective medium |
B. cystine glucose blood agar
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When processing throat swabs for a group A streptococcus culture, the medium of choice is:
a. sheep blood agar b. rabbit blood agar c. human blood agar d. horse blood agar |
A. sheep blood agar
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The ability to detect oxacillin resistant staphylococcus aureus may be enhanced by:
a. shortening incubation of standard susceptibility plates b. incubation susceptibility plates at 39* - 41*C c. using Mueller-Hinton broth with 2% NaCl d. adjusting inoculum ot 0.1 McFarland before inoculating suscepptibility plates |
C. using Meuller-Hinton broth with 2% NaCl
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The optimal wound specimen for cultures of anaerobic organisms should be:
a. a swab of lesion obtained before administration of antibiotics b. a swab of lesion obtained after administration of antibiotics. c. a syringe filled with pus, obtained before administration of antibiotics d. a syringe filled with pus, after administrtion of antibiotics |
C. a syringe filled with pus, obtained before administration of antibiotics
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A 21 yr old patient presents with pharyngitis. A throat swab is collected and submitted for anaerobic culture. This specimen should be:
a. set up immediately b. rejected as unacceptable c. inoculated into thioglycollate broth d. sent to a reference lab |
B. rejected as unacceptable
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An antibiotic used to suppress or kill contaminating fungi in media is:
a. penicillin b. cycloheximide c. streptomycin d. anphotericin B |
B. cycloheximide
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Production of beta-lactamase is inducible in which of the following:
a. Haemophilus influenzae b. Staphlylococcus aureus c. Corynebacterium diphtheriae d. Streptococcus pyogenes |
B. Staphylococcus aureus
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When using a control stain of Staphylococcus aureus, the tech notice that the zone around the oxacillin disk is too small. Which of the following is the most likely explanation?
a. innoculation of the plates 10 minutes after preparing the inoculum b. incubation of the Mueller-Hinton plates at 35*C c. use of a 0.25 McFarland standard to prepare inoculum d. use of outdated oxacillin disks |
D. use of outdated oxacillin disks
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Which of the following organisms may be mistaken for Neisseria gonorrhoeae in Gram stained smears of uterine cervix exudates?
a. Lactobacillus species b. Streptococcus agalactiae c. Pseudomonas aeruginosa d. Moraxella osloensis |
D. Moraxella osloenis
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Which of the following antimicrobials would be inappropriate to report on an E coli isolated from a wound culture?
a. gentamicin b. ampicillin c. cefazolin d. nitrofurantoin |
D. nitrofurantoin
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Which of the following combinations is useful for confirming the presence of extended spectrum beta-lactamases of E coli?
a. ampicillin + cefepime b. cefoxitin + penicillin c. ceftrazidime + clavulanic acid d. cefpodoxime + cefotaxime |
C. ceftazidime + clavulanic acid
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Which of the following is most important variable in the recovery of organisms in patients with bacteremia?
a. subculture of all bottles at day 5 of incubation b. the volume of blood cultured c. use of chlorhexadinefor skin antisepis d. collection of multiple blood culture sets from a single venipuncture |
B. the volume of blood cultured
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A vaginal/rectal swab is collected from a pregnant patient to screen for group B steptococcus colonization. What is the best medium to use for specimen inoculation?
a. blood agar b. LIM broth c. CNA agar d. thioglycollate broth |
B LIM broth
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To quality control the autoclave, a vial of Bacillus stearothermophilus is autoclaved and should the be:
a. inoculated to blood agar b. incubated at 37*C c. inoculated to chocolate agar d. incubated at 56*C |
D. icubated at 56*C
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In a quality control procedure on a new batch of Mueller-Hinton plates using a stock culture of staphylococcus aureus, all the disk zone sizes are too small. The most likely reason for this is that the:
a. Mueller-Hinton plates were poured to thin b. potency of the antibiotic disks is too high c. bacterial suspension ws not diluted to the proper concentration d. disks should have been set up on mannitol salt |
C. bacterial suspension was not diluted to the proper concentration
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Which of the following combinations of organisms would be appropriate as controls to test the functions listed?
a. beta-hemolysis-negative Escherichia coli and Streptococcus pyogenes b. catalase-negative Staphylococcus aureus and Staphylococcus epidermdis c. H2S production-negative Preteus mirabilis and Staphylococcus epidermidis d. indole-negative Escherichia coli and Preteus mirabilis |
D. indole-negative Escherichia coli and Proteus mirabilis
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A urine Gram stain shows gram-positive cocci in clusters. The organism tested catalase positive. To speciate this organism from culture, the technician should perform a coagulase test and a/an:
a. polymyxin B susceptibility b. novobiocin susceptibility c. oxidase d. beta-lactamase |
B. novobiocin susceptibility
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The Gram stain from a blood culture shows gram-positive cocci in chains. No growth occurs on blood agar plates incubated both aerobically and anaerobically. Additional testing should be done to detect the presence of:
a. Staphylacoccus saprophyticus b. Aerococcus urinae c. Abiotrophia defectiva d. Streptococcus pneumoniae |
C. Abiotrophia defectiva
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Viridans streptococci can be differentiated from Streptococcus pneumoniae by:
a. alpha hemolysis b. morphology c. catalase reaction d. bile solubility |
D. bile solubility
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A reliable test for distinguishing Staphylococcus aureus from other staphylococci is:
a. oxidase b. coagulase c. catalase d. optochin susceptibility |
B. coagulase
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The optochin(ethylhydrocupreine hydrochloride) disk is used for the identification of:
a. Haemophilus influenzae b. group A beta-hemolytic streptococci c. Streptococcus pneumoniae d. alpha-hemolytic streptococci |
C. Streptococcus pneumoniae
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In the optochin(ethylhydrocupreine hydrochloride) susceptibility test, if there is a zone of inhibition of 19-30mm surrounding the disk following overnight incubation at 37*C, the colony most likely consists of:
a. staphylococci b. streptococci c. pneumococci d. intestinal bacilli |
C. pneumococci
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Which 2 diseases are usually preceded by infection with beta-hemolytic streptocicci?
a. rheumatic fever, undulant fever b. glomerulonephritis, rheumatic fever c. rheumatic fever, tularemia d. glomerulonephritis, undulant fever |
B. glomerulonephritis, rheumatic fever
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The enterotoxin produced by certain strains of hemolytic, coagulase positive Staphylococcus aureus:
a. is destroyed by boiling for 15-30 minutes b. is identical to the dermonecrotic toxin c.causes one type of bacterial food poisoning d. is highly antigenic |
C. causes on type of bacterial food poisoning
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A gamma-hemolytic Streptococcus that blackens bile esculin agar but does not grow in 6.5% NaCl broth is most likely:
a. group B Streptococcus b. Enterococcus c. group D Streptococcus d. Streptococcus pneumoniae |
C. group D Streptococcus
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Gram stain examination from a blood culture bottle show dark blue, spherical organisms in clusters. Growth on sheep blood agar shows small, round, pale yellow colonies. Furthur tests should include:
a. catalase production and coagulase test b. bacitracin susceptibility and serological typing c. oxidase and deoxyribonuclease reactions d. Voges-Proskauer and methyl red reactions |
A. catalase production and coagulase test
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Gram-positive cocci in chains are seen on a Gram stain from a blood culture. The organism grows as a beta-hemolytic colony. Further tests that could be performed include:
a. bile esculin, PYR, bactracin, and hippurate b. catalase and coagulase c. oxidase and deoxyribonuclease d. Voges-Proskauer and methyl red |
A. bile esculin, PYR, bacitracin, and hippurate
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"Nutritionally deficient" streptococci are:
a. enterococci b. group D nonenterococci c. cell wall-deficient streptococci d. in the genera Granulicatella and Abiotrophia |
D. in the genera Granulicatella and Abiotrophia
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After 24 hrs a blood culture from a newborn grows catalase-negative, gram-positive cocci. The bacterial colonies are small, translucent and beta-hemolytic on a blood agar plate. Biochemical test results of a pure culture are:
bacitracin: resistant CAMP reaction: positive bile esculin: not hydrolyzed 6.5% NaCl broth: no growth Assuming that all controls react properly and reactions are verified, the next step would be to: a. perform a Streptococcus group typing b. report the organism as Streptococcus pneumoniae c. report the organism as Staphylcoccus aureus d. report the organism as Staphylococcus epedermidis |
A. perform a Streptococcus group typing
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A beta-hemolytic streptococcus that has been isolated from an ear culture grows up to the edge of a 0.04 unit bacitracin disk. Which of the following tests would help to determine if the organism is Enterococcus?
a. growth in 6.5% NaCl broth b. growth in the presence of penicillin c. optochin susceptibility d. fermentation of 10% lactose |
A. growth in 6.5% NaCl broth
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The organism most commonly associated with neonatal purulent meningitis is:
a. Neisseria meningitidus b. Streptococcus pneumoniae c. group B streptococci d. Haemophilus influenzae |
C. group B streptococcus
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An important cause of acute exudative pharyngitis is:
a. Staphylococcus aureus (beta-hemolytic) b. Streptococcus pneumoniae c. Streptococcus agalactiae d. Streptociccus pyogenes |
D. Streptococcus pyogenes
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Of the following bacteria, the most frequent cause of prosthetic heart valve infections occuring within 2-3 months after surgery is:
a. Streptococcus pneumoniae b. Streptococcus pyogenes c. Staphlococcus aureus d. Staphylococcus epidermidis |
D. Staphylococcus epidermidis
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A catheterized urine is inoculated onto blood and MacConkey agar using a 0.01mL loop. After 48 hrs, 68 colonies of a small translucent nonhemolytic organism grew on blood agar but not MacConkey. Testing reveals small gram-positive, catalase-negative cocci. The preliminary report and follow-up testing would be:
a. growth of 680 colonies/mL of gram-positive cocci, optochin and bacitracin susceptibility tests to follow b.Growth of 6,600 colonies/mL of a Streptococcus species, coagulase test to follow c. growth of 6,800 colonies/mL of a Streptococcus species, esculin hydrolysis and NaCl growth test to follow d. growth of 6,800 colonies/mL of a Streptococcus species, no tests to follow |
C. growth of 6,800 colonies/mL of a Streptococcus species, esculin hydrolysis and NaCl growth test to follow.
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Children who have infections with beta-hemolytic streptococci can develop:
a. acute pyelonephritis b. acute glomerulonephritis c. chronic glomerulonephritis d. nephrosis |
B. acute glomulonephritis
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A gram-positive coccus isolated from a blood culture has the following characteristics:
optochin susceptibility: neg bacitracin suscepticility: neg bile esculing hydrolysis: neg hippurate hydrolysis: Pos catalase: neg This organism is most likely: a. Staphylococcus aureus b. Strptococcus pneumoniae c. Streptococcus pyogenes d. Streptoccus agalactiae |
D. Streptococcus agalactiae
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A beta-hemolytic steptococci that is bacitracin-sensitive and CAMP-negative is:
a. group B b. group A c. beta-hemolytic, not group A, B or D d. beta-hemolytic, group D |
B. group A
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A beta-hemolytic Streptococcus that is bacitracin-resistant and CAMP-positive is:
a. group A or B b. group A c. group B d. beta-hemolytic, group D |
C. group B
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Group B, beta-hemolytic streptococci may be distinguished from other hemolytic streptococci by which of the following procedures?
a. latex antigen typing b. growth in 6.5% NaCl broth c. growth on esculin medium d. bacitracin susceptibility |
A. latex antigen typing
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It is important to differentiate between Enterococcus and group D streptococci because:
a. viridans streptococci are often confused with enterococci b. several enterococci cause severe puerperal sepsis c. group D streptococci are avirulent d. enterococci often show more antibiotic resistance than group D streptococci |
D. enterococci often show more antibiotic resistance than group D streptococci
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Streptococcus pneumoniae can be differentiated best from the viridans group of streptococci by:
a. Gram stain b. the type of hemolysis c. colonial morphology d. bile solubility |
D. bile solubility
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Characteristically, enterococci are:
a. unable to grow in 6.5% NaCl b. relatively resistant to penicillin c. sodium hippurate positive d. bile esculin negative |
B. relatively resistant to penicillin
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A beta-hemolytic, catlase-positive, gram-positive coccus is coagulase negative by the slide coagulase test. Which of the following is the most appropriate action in identification of this organism?
a. report a coagulase-negative Staphylococcus b. report a coagulase-negative Staphylococcus aureus c. reconfirm the hemolytic reaction on a fresh 24-hr culture d. do a tube coagulase test to confirm the slide test |
D. do a tube coagulase test to confirm the slide test
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Which of the following would best differentiate Streptococcus agalactiae from Streptococcus pyogenes?
a. ability to grow in sodium azide broth b. a positive bile-esculin reaction c. hydrolysis of sodium hippurate d. beta-hemolysis on sheep blood agar |
C. hydrolysis of sodium hippurate
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The most critical distinction between Staphylococcus aureus and other Staphylococcus is:
a. phosphatase reaction b. DNA production c. coagulase production d. hemolysis |
C. coagulase production
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Which of the following organisms is, to date, considered universally susceptible to penicillin;
a. Haemophilus influenzae b. Neisseria gonorrhea c. Streptococcus pyogenes d. Corynebacterium diphtheriae |
C. Streptococcus pyogenes
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A beta-hemolytic gram-positive coccus was isolated from the cerebrospinal fluid of a 2-day-old infant with signs of meningitis. The isolate grew on sheep blood agar under aerobic conditions and was resistant to a bactracin disc. Which of the following should be performed for the identification of the organism?
a. oxidase production b. catalase formation c. latex antigen typing d. esculin hydrolysis |
C. latex antigen typing
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How many hrs after eating contaminated food do initial symptoms of staphylococcal food poisoning typically occur?
a. 2-6 hrs b. 12-18 hrs c. 24-48 hrs d. 72 hrs |
A. 2 - 6 hours
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During the past month, Staphylococcus epidermidis has been isolated from blood cultures at 2-3 times the rate from the previous year. The most logical explanation for the increase in these isolates is that:
a. the blood culture media are contaminated with the organism b. the hospital ventilation system is contaminated with Stapyhlococcus epidermidis c. there has been a break in proper skin preparation before drawing blood for culture d. a relatively virulent isolate is being spread from patient to patient |
C. there has been a break in proper skin preparation before drawing blood for culture
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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 should differentiate between a coagulase-negative Staphylococcus and Micrococcus?
a. novobiocin susceptability b. leucine aminopeptidase production c. furazolidone(100ug/disk) susceptibility d. bile esculin |
C. furazolidone (100ug/disk)
susceptability |
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An isolate of an unknown beta-hemolytic Streptococcus is streaked perpendicular toa streak of beta-lysin-producing Staphylococcus aureus. After incubation a zone of arrowhead hemolysis is noted at the interface of the 2 streaks. What is the name of the test and the presumptive identification of the unknown Streptococcus?
a. hippurate hydrolysis and S agalactiae b. CAMP test and S pyrogenes c. hippurate hydrolysis and S pyrogenes d. CAMP test and S agalactiae |
D. CAMP test and S agalactiae
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Which of the following may be used as a positive quality control organism for the bile esculin test?
a. Staphylococcus epidermidis b. Staphylococcus aureus c. Streptococcus pyogenes d. Enterococcus faecalis |
D. Enterococcus faecalis
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Infection of the urinary tract is most frequently associated with:
a. Staphylococcus aureus b. Escherichia coli c. Enterococcus faecalis d. Serritia marescens |
B. Escherichia coli
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MacConkey media for screening suspected cases of hemorrhagic E coli O157:H7 must contain:
a. indole b. citrate c. sorbitol d. lactose |
C. sorbitol
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Members of the family Enterobacteriaceae share which one of the following characteristics?
a. produce cytochrome oxidase b. ferment lactose c. produce beta-hemolysis d. reduce nitrate to nitrite |
D. reduce nitrate to nitrite
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Which one of the following genera is among the least biochemically reactive members of the Enterobacteriaceae?
a. Proteus b. Pseudomonas c. Citrobacter d. Shigella |
D. Shigella
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Which one of the following gram-negative bacilli ferments glucose?
a. Alcaligenes faecalis b. Pseudomonas cepacia c. Acinetobacter lwoffii d. Yersinia enterocolitica |
D. Yersinia enterocolitica
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A sputum culture from an alcoholic seen in the ER grows gray, mucoid, stringy colonies on SBA. The isolate grows readily on MacConkey agar and forms mucoid, dark pink colonies. The colonies yield the following test results:
ONPG - positive indole - negative glucose - positive oxidase - negative citrate - positive VP - positive The organism is most likely: a. Edwardsiella tarda b. Klebsiella pneumoniae c. Escherichia coli d. Proteus vulgaris |
B. Klebsiella pneumoniae
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An organism was inoculated to a TSI tube and gave the following reactions:
alkaline slant/acid butt, H2S, gas produced This organism most likely is: a. Klebsiella pneumoniae b. Shigella dysenteriae c. Salmonella typhimurium d. Escherichia coli |
C. Salmonella typhimurium
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A TSI tube inoculated with an organism gave the following reactions:
alkaline slant, acid butt, no H2S, no gas produced This organism is most likely: a. Yersinia enterocolitica b. Salmonella typhi c. Salmonella enteritidis d. Shigella dysenteriae |
D. Shigella dysenteriae
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Which of the following organisms can grow in the small bowel and cause diarrhea in children, travelers diarrhea, or a severe cholera-like syndrome through the production of enterortoxins?
a. Yersinia enterocolitica b. Escherichia coli c. Salmonella typhi d. Shigella dylsenteriae |
B. Escherichia coli
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Shigella species characteristically are:
a. urease positive b. nonmotile c. oxidase positive d. lactose fermenters |
B. nonmotile
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A gram-negative bacillus has been isolated from feces, and the confirmed biochemical reactions fit those of Shigella. The organism does not agglutinate in Shigella antisera. What should be done next?
a. test the organism with a new lot of antisera b. test with Vi antigen c. repeat the biochemical test d. boil the organism and retest with the antisera |
D. boil the organism and retest with the antisera
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Biochemical reactions of an organism are consistant with Shigella. A suspension is tested in antiserum without resulting agglutination. However, after 15 mins. of boiling, agglutination occurs in group D antisera. The Shigella species is:
a. dysenteriae b. flexneri c. boydii d. sonnei |
D. sonnei
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A 25 yr old man who had recently worked as a steward on a transoceanic grain ship presented to the ER with high fever, diarrhea and prostration. Axillary lymph nodes were hemorrhagic and enlarged. A Wayson stain of the aspirate showed bacilli that were bipolar, resembling safety pins. The most likely ID of this organism is:
a. Brucella melitensis b. Streptobacillus moniliformis c. Spirillum minus d. Yersinia pestis |
D. Yersinia pestis
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A clean catch urine sample from a nursing home patient is cultured using a .001mL loop. It grows 67 colonies of a lactose fermenter that has the following biochemical reactions:
TSI: Acid/Acid oxidase: negative motility: positive indole: negative citrate: positive VP: positive lysine decarboxylase: neg. ornithine decarboxylase:pos urea: negative What should the mocrobiologist report? a. 670 CFU/mL Serratia marsecens species b. 6,700 CFU/mL Providencia stuartii c. 67,000 CFU/mL Enterobacter cloacae d. 67,000 CFU/mL Klebsiella oxytoca |
C. 67,000 CFU/mL Enteribacter cloacae
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Plesiomonas shigelloides is a relatively new member of the family Enterobacteriaceae. What characteristic separates it from other members of the Enterbacteriaceae?
a. it is oxidase positive b. it ferments glucose c. it produces pyocyanin d. it requires 10% CO2 for growth |
A. it is oxidase positive
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The stock cultures needed for quality control testing of motility are:
a. Salmonella typhimurium / Escherichia coli b. Escherichia coli / Pseudomonas aeruginosa c. Serratia marescens / Escherichia coli d. Klebsiella pneumoniae / Escherichia coli |
D. Klebsiella pneumoniae / Escherichia coli
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The stock cultures needed for quality control testing of oxidase production are:
a. Escherichia coli / Klebsiella pneumoniae b. Salmonella typhimurium / Escherichia coli c. Escherchia coli / Pseudomonas aeruginosa d. Proteus mirabilis / Escherchia coli |
C. Escherichia coli / Pseudomonas aeruginosa
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The stock cultures needed for quality control testing of deamination activity are:
a. Escherichia coli / Klebsiella pneumoniae b. Salmonella typhimurium / Escherichia coli c. Escherichia coli / Pseudomonas aeruginosa d. Proteus mirabilis / Escherichia coli |
D. Proteus mirabilis / Escherichia
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The stock cultures needed for quality control testing of deoxyribonuclease(DNase) production are:
a. Salmonella typhimurium / Escherichia coli b. Escherichia coli / Pseudonmonas aeruginosa c. Proteus mirabilis / Escherichia coli d. Serritia marescens / Escherichia |
D. Serratia marcescens / Escherichia coli
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Quality control of the spot indole test requires the use of ATCC cultures of:
a. Pseudomonas aeruginosa / Proteus mirabilis b. Salmonella typhi / Shigell sonnei c. Escherichia coli / Proteus vulgaris d. Escherichia coli / Enterobacter cloacae |
D. Escherichia coli / Enterobacter cloacae
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An organism that exhibits the satellite phenomenon around colonies of staphylococci is:
a. Haemophilus influenzae b. Neisseria meningitidis c. Neisseria gonorrhoeae d. Klebsiella pneumoniae |
A. Haemophilus influenzae
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An organism isolate from the surface of a skin burn is found to produce a diffusible green pigment on a blood agar plate. Furthur studies of the organism would most likely show the organism to be:
a. Staphylococcus aureus b. Serratia marcescens c. Flavobacterium meningosepticum d. Pseudomonas aeruginosa |
D. Pseudomonas aeruginosa
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A nonfermenting gram-negative bacillus is isolated from a wound. The nitrate and oxidase are strongly positive. The growth on SBA has a grape-like odor. The organism is:
a. Burkholderia cepacia b. Morexella lacunata c. Chryseobactrerium ( Flavobacterium) meningosepticum d. Pseudomonas aeruginosa |
D. Pseudomonas aeruginosa
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A small, gram-negative bacillus is isolated from an eye culture. It grows only of chocolate agar and is oxidase-variable. The most likely organism is:
a. Acinetobacter lwoffii b. Haemophilus influenzae c. Stenotrophomonas maltophilia d. Pseudomonas aeruginosa |
B. Haemophilus infuenzae
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The optimal incubator temp. for isolation of Campylobacter jejuni/coli group is:
a. 4*C b. 20*C c. 25*C d. 42*C |
D. 42*C
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A gastroenterologist submits a gastric biopsy from a patient with a peptic ulcer. To obtain presumptive evidence of Helicobacter pylori, a portion of the specimen should be added to which media?
a. urea broth b. tetrathionate c. selenite d. tryptophan |
A. urea broth
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A 4 yr old boy is admitted to the hospital with suspected menigitis. He has not had most of the childhood vaccines. The suspected pathogen is:
a. Listeria monocytogenes b. Haemophilus influenzae c. Streptococcus agalactiae d. Neisseria meningitidis |
B. Haemophilus influenzae
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A gram stain of a touch prep from a gastric biopsy shows gram-negative bacilli that are slender and curved. The most likely pathogen is:
a. Burkholderia capacia b. Corynebacterium urealyticum c. Helicobacter pylori d. Pasteurella multocida |
C. Helicobacter pylori
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A CSF has been inoculated onto SBA and choc agar plates and into a tube of trypticase soy broth. All media were incubated in an atmosphere of 5% CO2. Which of the following organisms would usually be isolated by this procedure?
a. Francisell tularensis b. Haemophilus influenzae c. Bordetella pertussis d. Bacteroides fragilis |
B. Haemophilus influenzae
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If present, a characteristic that is helpful in separating Pseudomonas aeruginosa from other members of the Pseudomonas family is:
a. positive test for cytochrome oxidase b. oxidative metabolism in the OF test c. production of fluorescein pigment d. growth at 42*C |
D, growth at 42*C
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Which of the following results is typical of Campylobacter jejuni?
a. optimal growth at 42*C b. oxidase negative c. catalase negative d. nonmotile |
A. optimal growth at 42*C
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Optimum growth of Campylobacter jejuni is obtained on suitable media incubated at 42*C in an atmosphere containing:
a. 6% O2, 10%-15% CO2, 85%-90% nitrogen b. 10% H2, 5% CO2, 85% nitrogen c. 10% H2, 10% CO2, 80% nitrogen d. 25% O2, 5% CO2, 70% nitrogen |
A. 6% O2, 10%-15% CO2, 85%-90% nitrogen
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Haemophilus influenzae is most likely considered normal indigenous flora in the:
a. oropharynx b. female genital tract c. large intestine d. small intestine |
A. oropharynx
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Haemophilus influenzae becomes resistant to ampicillin when the organism produces a:
a. capsule of polysaccharide material b. affinity for the beta-lactam ring of the ampicillin c. porphobilinogen d. beta-lactamase enzyme |
D. beta-lactamase enzyme
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An isolate on chocolate agar from a patient with epiglittitis was suggestive of Haemophilus species. Additional testing showed that the isolate required NAD for growth and was nonhemolytic. The organism is most likely Haemophilus:
a. haemolyticus b. ducreyi c. influenzae d. parainfluenzae |
D. parainfluenzae
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Which of the following specimens is considered to be the most sensitive for the recovery of Brucella in cases of chronic infection?
a. blood b. urine c. bone marrow d. lymph node |
C. bone marrow
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A gram negative bacillus with bipolar staining was isolated from a wound infection caused by a bite from a pet cat. The following characteristic reactions were seen:
oxidase - positive glucose OF - fermentative catalase - positive motility - negative MacConkey agar-no growth Which of the following is the most likely organism? a. Pseudomonas aeruginosa b. Pasteurella multocida c. Aeromonas hydrophila d. Vibrio cholerae |
B. Pasteurella multocida
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While swimming in a lake near his home, a young boy cut his foot, and an infection developed. The culture grew a nonfastidious gram-negative, oxidase positive, beta-hemolytic, motile bacilli that produced deoxyribonuclease. The most likely identification is:
a. Enterobacter cloacae b. Serritia marcescens c. Aeromonas hydrophila d. Escherichia coli |
C. Aeromonas hyudrophila
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Serum samples collected from a patient with pneumonia demonstrate a rising antibody titer to Legionella. A bronchoalveolar lavage(BAL)
specimen from this patient had a positive antigen test for legionella but no organisms were recovered on buffered charcoal yeast extract medium after 2 days of incubation. The best explanation is that the: a. antibody titer represents an earlier infection b. positive antigen test is a false positive c. specimen was cultured on the wrong media d. culture was not incubated long enough |
D. culture was not incubated long enough
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Which characterisitic best differentiates Acinitobacter species from Morazella species?
a. production of indophenol oxidase b. growth on MacConkey agar c. motility d. susceptibility to penicillin |
A. production of indophenol oxidase
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An organism has been identified as a member of the fluorescent group of Pseudomonas. Which of the following sets of tests should be used to determine the species of the organism?
a. growth at 42*C, pyocyanin production, gelatinase production b. pyocyanin production, gelatinase production, OF glucose c. growth at 37*C, pyocyanin production, OF glucose d. gelatinase production, growth at 52*C, H2S |
A. growth at 42*C, pyocyanin production, gelatinase production
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Appropriate culture requirements for a specimen from a patient suspected of having tularemia include:
a. a media with cysteine such as BYCA b. colistin nalidixic acid agar c. Mueller-Hinton agar with 5% sheep blood agar d. Regan-Lowe media |
A. a media with cysteine such as buffered charcoal yeast extract agar
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A laboratory aid receives a bronchoscopy sample with the request for culture Legionella. The assistant asks a microbiologist for direction of plating protocol. The correct response from the microbiologist is:
a. culture on thiosulfate citrate bile salt media b. incubate the culture media anaerobically c. reject the specimen and request a sputum sample d. culture on buffered charcoal yeast extract agar with antibiotics |
D. culture on buffered charcoal yeast extract agar with antibiotics
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A community hospital microbiology lab is processing significant numbers of stool cultures because of an outbreak of diarrhea following heavy rains and flooding in the country. A media that should be incorporated in the plating protocol is:
a. colistin nalidixin acid for Listeria b. MacConkey agar with sorbitol for Campylobacter c. mannitol salt agar for Enterococcus species d. thiosulfate citrate bile salts sucrose for Vibrio species |
D. thiosulfate citrate bile salts sucrose for Vibrio species
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Differentiating tests that will separate Burkholderia from Stenotrophomonas include:
a. Gram stain reaction b. growth on MacConkey c. glucose fermentation d. oxidase |
D. oxidase
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The lab receives a blood culture from a veterinarian who has been ill for many weeks with fevers in the afternoon and evenings, arthritis, and fatigue. The blood culture is positive after 5 days, and the organism has the following characteristics:
Gram stain: small, gram-negative,coccobacilli SBA: growth after 48 hrs with small, smooth, raised colonies. What should the mocrobiologist do next? a. consider the growth contamination and perform another gram stain b. perform biochemical identification for HACEK organisms c. perform identification and susceptability testing using an automated system d. take extra safety precautions for possible Brucella |
D. take extra safety precautions for possible Brucella
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The primary isolation of Neisseria gonorrhoeae requires:
a. anaerobic conditions b. starch media c. carbon dioxide d. blood agar |
C. carbon dioxide
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Assuming the agent isolated from a patient's spinal fluid produces a positive oxidase test, the most likely diagnosis is:
a. tuberculous meningitis b. meningococcal meningitis c. viral meningitis d. pneumococcal meningitis |
B. meningococcal meningitis
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The following results were obtained from a culture of unknown origin:
Gram Stain: gran-neg diplococci indophenol oxidase - pos. glucose - pos maltose - neg sucrose - neg The most likely source of the specimen would be the: a. respiratory tract b. blood c. genitourinary tract d. cerebrospinal fluid |
C. genitourinary tract
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An urethral swab obtained from a man with an urethral exudate was plated directly on choc. agar and modified Thayer-Martin agar, and a Gram stain was made. The gram stain showed gram-negative diplococci. The culture plates were incubated at 35*C, but had no growth at 48 hrs. The most likely failure for organism growth is that the:
a. wrong media were used b. gram stain was misread c. organism only grows at room temp d. organism requires CO2 for growth |
D. organism requires CO2 for growth
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A gram stain performed on a sputum specimen revealed gram-neg diplococci within PMN's. Oxidase testing is positive and carbohydrate degradation tests are inert. The organism is:
a. Neisseria lactamica b. Moraxell catarrhalis c. Neisseria meningitidis d. Neisseria sicca |
B. Moraxell catarrhalis
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Coagglutination is associated with:
a. Chlamydia trachomatis b. Neisseria gonorrheae c. Streptococcus pneumoniae d. Klebsiella pneumonia |
B. Neisseria gonorrhoeae
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Clinical resistance to penicillin correlates most frequently with beta-lactamase production in:
a. Neisseria gonorrhoeae b. Neisseria meningitidis c. Streptococcus agalactiae d. Streptococcus pyogenes |
A. Neisseria gonorrhoeae
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All species of the genus Neisseria have the enzyme to oxidase:
a. naphthylamine b. dimethylaminobenzaldehyde c. glucopyranoside d. tetramethyl - phenylenediamine |
D. tetremethyl - phenylenediamine
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The diagnosis of Neisseria gonorrhoeae in females is best made from:
a. clinical history b. an endocervical culture c. a gram stain of cervical secretions d. examination for clue cells |
B. an endocervical culture
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Which of the following is the most reliable test to differentiate Neisseria lactamica from Neisseria meningitidis?
a. acid from maltose b. growth on modified Thayer-Martin agar c. lactose degradation d. nitrite reduction to nitrogen gas |
C. lactose degradation
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Definative identification of Neisseria gonorrhoeae is made with the:
a. gram stain b. oxidase test c. degradation of amino acid d. hydrolysis of carbohydrates |
D. hydrolysis of carbohydrates
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A gram-neg diplococcus that grows on modified Thayer-Martin medium can be further confirmed as Neisseria gonorrhoeae if it is:
a. oxidase positive, glucose positive, and maltose positive b. oxidase positive and glucose positive, maltose negative c. oxidase positive and maltose positive, glucose negative d. glucose positve, oxidase negative and maltose negative |
B. oxidase positive and glucose positive, maltose negative
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An organism previously thought to be nonpathogenic, Moraxell catarrhalis, is now known to be associated with opportunistic respiratory infection and nosocomial transmission. Characteristic identification criteria include:
a. oxidase negative b. carbohydrate negative (asaccharolytic) c. beta-lactamase negative d. gram-negative bacilli |
B. carbohydrates negative (asaccharolytic)
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An autopsy performed on an 8 yr old child revealed Waterhouse-Friderichsen syndrome. Blood and throat cultures taken just prior to death were positive for which organism?
a. Neisseria gonorrhoeae b. Neisseria meningitidis c. Haemophilus influenzae d. Klebsiella pneumoniae |
B. Neisseria meningitidis
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A gram stain of organisms on Loeffler agar showed pleomorphic gram-positive bacilli. The organism should be subcultured to:
a. blood b. chocolate c. MacConkey d. potassium tellurite |
D. potassium tellurite
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Which organism commonly causes food poisoning by comsumption of foods containing excessive populations of organisms or preformed enterotoxin?
a. Salmonella enteritidis b. Shigella sonnei c. Bacillus cereus d. Escherichia coli |
C. Bacillus cereus
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The best procedure to differentiate Listeria monochytogenes from Corynebacterium species is:
a. catalase b. motility at 25*C c. motility at 35*C d. Gram stain |
B. motility at 25*C
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Establishing the pathogenicity of a microorganism isolated from a child's throat and identified as Corynebacterium diphtheria would depend upon:
a. the morphological appearance as revealed by Gram stain b. the type of hemolysis on blood agar c. a positive toxigenicity test d. the appearance of growth of Tinsdale tellurite agar |
C. a positive toxigenicity test
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Whic feature distinguishes Erysipelothrix rhusiopathiae from other clinically significant non-spore-forming, gram-positive, facultatively anaerobic bacilli?
a. "tumbling" motility b. beta-hemolysis c. more pronounced motility at 25*C than 35*C d. H2S production |
D. H2S production
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Listeria can be confused with some streptococci because of its hemolysis and because it is:
a. nonmotile b. catalase negative c. oxidase positive d. esculin positive |
D. esculin positive
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A branching gram-positive, partially acid-fact organism is isolated from a bronchial washing on a 63 yr old woman receiving chemotherapy. The organism does not hydrolyze casein, tyrosine or xanthine. The most likely identification is:
a. Actinomadura madurae b. Nocardia caviae c. Streptomyces somaliensis d. Nocardia asteroides |
D. Nocardia asteroides
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The characteristic that is most commonly associated with the presence of strict anaerobic bacteria and can be taken as presumptive evidence of their presence in a clinical specimen is the:
a. presence of a single bacterial species b. production of gas in a thioglycollate broth culture c. growth on a blood agar plate incubated in an anaerobic jar d. presence of a foul, putrid odor from tissue specimens and cultures |
D. presence of a foul, putrid odor from tissue specimens and cultures
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An aspirate of a deep wound was plated on blood agar plates aerobically and anaerobically. At 24 hrs ther was growth on the anaerobic plate only. The next step in the evaluation of this culture is to:
a. reincubate for another 24 hrs b. begin organism identification c. issue the final report d. set up a Bauer-Kirby sensitivity |
B. begin organism identification
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Anaerobic infections differ from aerobic infections in which of the following?
a. they usually respond favorably with aminoglycoside therapy b. they usually arise from exogenous sources c. they are usually polymicrobic d. Gram stains of specimens are less helpful in diagnosis |
C. they are usually polymicrobic
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