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1222 Cards in this Set

  • Front
  • Back
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)
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
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)
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
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
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
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
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
A commonly used screening method for anti-HIV detection is;
a. latex agglutination
b. RIA
c. TLC
d. ELISA
D. ELISA
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
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
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
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
Optimun storage temperature for RBC's
a. -80*C
b. -20*C
c. -12*C
d. 4*C
D. 4*C
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
Optimum storage for cryo AHF is:
a. -20*C
b. -12*C
c. 4*C
d. 22*C
A. -20*C
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
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
Optimum storage temperature for platelets:
a. -20*C
b. -12*C
c. 4*C
d. 22*C
D. 22*C
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
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
Once thawed, FFP must be transfused within:
a. 4 hrs
b. 8 hrs
c. 12 hrs
d. 24 hrs
D. 24 hours
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
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
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
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
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
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
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
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
The linked HLA genes on each chomosome constitutes a:
a. allele
b. trait
c. phenotype
d. haplotype
D. Haplotype
A blood donor has the genotype: hh, AB. what is his RBC phenotype?
a. A
b. B
c. O
d. AB
C. O
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
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
The linked HLA genes on each chomosome constitutes a:
a. allele
b. trait
c. phenotype
d. haplotype
D. Haplotype
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
A blood donor has the genotype: hh, AB. what is his RBC phentype?
a. A
b. B
c. O
d. AB
C. O
Most blood group systems are inherited as:
a. sex-linked dominant
b. sex-linked recessive
c. autosomal recessive
d. autosomal codominant
D. autosomal codominant
The linked HLA genes on each chomosome constitutes a:
a. allele
b. trait
c. phenotype
d. haplotype
D. Haplotype
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
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
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
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-)
A blood donor has the genotype: hh, AB. what is his RBC phentype:
a. A
b. B
c. O
d. AB
C. O
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
Which of the following phenotype will react with anti-F:
a. rr
b. R1R1
c. R2R2
d. R1R2
A. rr
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
Most blood group systems are inferited as:
a. sex-linked dominant
b. sex-linked recessive
c. autosomal recessive
d. autosomal codominant
D. autosomal codominant
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
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
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
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
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-)
Which of the following phenotype will react with anti-F:
a. rr
b. R1R1
c. R2R2
d. R1R2
A. rr
Most blood group systems are inherited as:
a. sex-linked dominant
b. sex-linked recessive
c. autosomal recessive
d. autosomal codominant
D. autosomal codominant
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
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
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-)
which of the following phenotype will react with anti-F:
a. rr
b. R1R1
c. R2R2
d. R1R2
A. rr
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
The linked HLA genes on each chomosome constitutes a:
a. allele
b. trait
c. phenotype
d. haplotype
D. Haplotype
A blood donor has the genotype: hh, AB. what is his RBC phentype:
a. A
b. B
c. O
d. AB
C. O
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
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
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
Most blood group systems are inherited as:
a. sex-linked dominant
b. sex-linked recessive
c. autosomal recessive
d. autosomal codominant
D. autosomal codominant
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
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-)
Which of the following phenotype will react with anti-F:
a. rr
b. R1R1
c. R2R2
d. R1R2
A. rr
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
The linked HLA genes on each chomosome constitutes a:
a. allele
b. trait
c. phenotype
d. haplotype
D. Haplotype
A blood donor has the genotype: hh, AB. what is his RBC phentype:
a. A
b. B
c. O
d. AB
C. O
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
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
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
Most blood group systems are inherited as:
a. sex-linked dominant
b. sex-linked recessive
c. autosomal recessive
d. autosomal codominant
D. autosomal codominant
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
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-)
which of the following phenotype will react with anti-F:
a. rr
b. R1R1
c. R2R2
d. R1R2
A. rr
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
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-)
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
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
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
Human blood groups were dicovered around 1900 by:
a. Jules Bordet
b. Louis Pasteur
c. Karl Landsteiner
d. PL Mollison
C. Karl Landsteiner
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
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
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
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
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
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
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
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+)
Which of the following Rh antigens has the highest frequency in Caucasians:
a. D
b. E
c. c
d. e
D. e
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
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
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
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
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
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
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
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
Protolytic enzyme treatment of red cells usually destroys which antigen?
a. Jka
b. E
c. Fya
d. k
C. Fya
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
Resistance to malaria is best associated with which of the following blood groups.
a. Rh
b. I/i
c. P
d. Duffy
D. Duffy
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
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
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
Which of the following antigens in most likely to be involve in HDFN.
a. Lea
b. P1
c. M
d. Kell
D. Kell
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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)
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
Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of:
a. complement
b. anticoagulants
c. preservatives
d. penicillin
A. complement
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
The process of separation of antibody from its antigen is known as:
a. diffusion
b. adsorption
c. neutralization
d. elution
D. elution
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
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
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
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)
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Servere intravascular hemolysis is most likely caused by antibodies of which blood group system?
a. ABO
b. Rh
c. Kell
d. Duffy
A. ABO
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
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
A trauma patient who has just received 10 units of blood may develop:
a. anemia
b. polycythemia
c. leukocytosis
d. thrombocytopenia
D. thrombocytopenia
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
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
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
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
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
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
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
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
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
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
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
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
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
Fever and chills are symptoms of which of the following transfusion reactions?
a. citrate toxicity
b. circulatory overload
c. allergic
d. febrile
D. febrile
Hives and itching are symptoms of which of the following transfusion reactions?
a. febrile
b. allergic
c. circulatory overload
d. bacterial
B. allergic
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
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
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
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
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
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
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
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
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
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
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)
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
The most frequent transfusion-associated disease complication of blood transfusion is:
a. cytomegalovirus(CMV)
b. syphilis
c. hepatitis
d. AIDS
C. hepatitis
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
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
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
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
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
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
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
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
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
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
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
The creatinine clearance is reported in:
a. mg/dL
b. mg/24hrs
c. mL/min
d. mL/24hrs
C. mL/min
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
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
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
Urine that develops a port wine color after standing may contain:
a. melanin
b. porphyrins
c. bilirubin
d. urobilogen
B. porphyrins
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
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
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
A brown/black urine would most likely contain:
a. bile pigment
b. porphyrins
c. melanin
d. blood cells
c. melanin
The yellow color of urine is primarily due to:
a. urochrome pigment
b. methemoglobin
c. bilirubin
d. homgenistic acid
A. urochrome pigment
Red urine may be due to:
a. bilirubin
b. excess urobilin
c. myoglobin
d. homogenistic acid
C. myoglobin
Urine osmolality is related to:
a. pH
b. filtration
c. specific gravity
d. volume
C. specific gravity
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
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
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
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
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
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
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
The protein section of the urine reagent strip is most sensitive to:
a. albumin
b. mucoprotein
c. Bence Jones protein
d. globulin
A. allbumin
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
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
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
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
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
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
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
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
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
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
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
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
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
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
In most compound light microscopes, the ocular lens has a magnification of:
a. 10x
b. 40x
c. 50x
d. 100x
A. 10x
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
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
The presence of leukocytes in the urine is known as:
a. chyluria
b. hematuria
c. leukocytosis
d. pyuria
D. pyuria
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
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
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
What cell is most commonly associated with vaginal contamination?
a. white
b. transitional
c. squamous
d. glitter
C. squamous
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
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
The possibility of detecting glitter cells is associated with urine that is:
a. acidic
b. dilute
c. alkaline
d. concentrated
B. dilute
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
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
All casts typically contain:
a. albumin
b. globulin
c. immunoglobulins G and M
d. Tamm-Horsfall glycoprotein
D. Tamm-Horsfall glycoprotein
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
Which of the following casts is most likely to be found in healthy people?
a. hyaline
b. RBC
c. waxy
d. WBC
A. hyaline
Which of the following casts is most indicative of end stage renal disease?
a. hemoglobin
b. granular
c. cellular
d. waxy
D. waxy
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
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
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
Which of the following casts most frequently appears to have a brittle consistency?
a. hyaline
b. granular
c. waxy
d. fatty
C. waxy
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
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
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
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
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
Which of the following is an abnormal crystal described as a hexagonal plate?
a. cystine
b. tyrosine
c. leucine
d. cholesterol
A. cystine
After warming, a cloudy urine clears. This is due to the presence of:
a. urates
b. phosphates
c. WBC's
d. bacteria
A. urates
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
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
Which of the following crystals appear as fine, silky needles?
a. chloresterol
b. leucine
c. hemosiderin
d. tyrosine
D. tyrosine
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
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
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
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
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
When identifying urinary crystals, which reagent strip result is most important?
a. protein
b. pH
c. specific gravity
d. nitrite
B. pH
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
Which of the following exhibits rapid motility in urine sediment?
a. spermatozoa
b. Trichomonas vaginalis
c. Gardnerella vaginalis
d. Enterobius vermicularis
B. Trichomonas vaginalis
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
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
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
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
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
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)
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
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
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
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
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
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
Polyuria is usually correlated with:
a. acute glomerulonephritis
b. diabetes mellitus
c. hepatitis
d. tubular damage
B. diabetis mellitus
Cessation of urine flow is defined as:
a. azotemia
b. dysuria
c. diuresis
d. anuria
D. anuria
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
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
Reagent strip tests for ketones measure primarily:
a. acetone
b. acetoacetic acid
c. chloesterol
d. beta-hydroxbutyric acid
B. acetoacetic acid
Bilirubinluria may be associated with:
a. strenuous excercise
b. increased destruction of platelets
c. viral hepatitis
d. hemolytic anemia
C. viral hepatitis
Glycosuria may be due to:
a. hypoglucemia
b. increased real threshold
c. renal tubular dysfunction
d. increased glomerular filtration rate
C. renal tubular dysfunction
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
The most accurate test to determine renal concentration is:
a. osmolarity
b. glomerular filtration rate
c. specific gravity
d. tubular reabsorption rate
A. osmolarity
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
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
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
The chromogen for the fecal occult blood test is:
a. gum guaiac
b. NADH
c. o-toluidine
d. p-aminocinnamaldehyde
A. gum guaiac
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
Ascites us collected by:
a. thoracentesis
b. lumbar puncture
c. amniocentesis
d. paracentesis
D. paracentesis
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
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)
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
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
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
The appearance of normal CSF is:
a. pale yellow and clear
b. colorless and clear
c. opalescent
d. xanthochromic
B. colorless
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
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
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
A tau isoform of transferrin is a carbohydrate deficient protein found only in:
a. CSF
b. sweat
c. amniotic fluid
d. semen
A. CSF
Which marker can be used to identify a body fluid as semen?
a. PSA
b. alkaline phiosphatase
c. fructose
d. hyaluronic acid
A. PSA
Which stain is used to measure sperm viability?
a. eosin nigrosin
b. Wright
c. toluidine blue
d. Papanicolaou
A. eosin nigrosin
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
Rapid forward progression of sperm is rated as:
a. 1.0
b. 2.0
c. 3.0
d. 4.0
D. 4.0
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
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
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
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
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
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
Increased CSF lactate is found in:
a. bacterial meningitis
b. Reye encephalopathy
c. spina bifida
d. multiple sclerosis
A. bacterial meningitis
Decreased CSF protein can be found in:
a. meningitis
b. hemorrhage
c. multiple sclerosis
d. CSF leakage
D. CSF leakage
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
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
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
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
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
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
An index of precision is statistically known as the:
a. median
b. mean
c. standard deviation
d. coefficient of variation
D. coefficient of variation
The term used to describe reproducibility is:
a. sensitivity
b. specificilty
c. accuracy
d. precision
D. precision
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
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
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
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
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
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
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
CAP requires refrigerator temperature to be recorded:
a. daily
b. weekly
c. monthly
d. periodically
A. daily
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
CAP requires that glassware cleaning practices include periodic testing for:
a. chemical residues
b. silicates
c. detergents
d. heavy metals
C. detergents
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
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
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
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
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
Which chemical is a potential carcinogen?
a. potassium chloride
b. formaldehyde
c. mercury
d. picric acid
B. formaldehyde
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Class C fires involve:
a. grease and oil
b. xylene and alcohol
c. paper, wood, and platics
d. electrical equipment
D. electrical equipment
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.
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
An example of personal protective equipment is:
a. biological safety cabinet
b. emergency safety shower
c. eyewash station
d. lab coat
D. lab coat
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
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
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
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
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
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
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
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
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
Which disinfectant inactivates HIV and HBV?
a. alcohol
b. iodine
c. phenol
d. sodium hypochlorite
D. sodium hypochlorite
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
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
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
Use of "standard"(universal)
precautions minimizes exposure to:
a. bloodborne pathogens
b. chemical hazards
c. radiation hazards
d. environmental hazards
A. bloodborne pathogens
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
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
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
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
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
The most effective disinfectant recommended for bloodborne pathogens is:
a. sodium hypochlorite
b. isopropyl alcohol
c. chlorhexidine gluconate
d. povidone-iodine
A. sodium hypochlorite
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
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
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
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
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
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
The unit of measure for a standard solution is:
a. g/L
b. %
c. mg/%
d. mg/mL
D. mg/mL
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
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
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
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
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
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)
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
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
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
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
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
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
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
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
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
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
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
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%
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
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
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%
The statistical term for the average value is the:
a. mode
b. median
c. mean
d. coefficient of variation
C. mean
The most frequent value in a collection of data is statistically known as:
a. mode
b. median
c. mean
d. standard deviation
A. mode
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
Given the following values:
100, 120, 150, 140, 130
What is the mean?
a. 100
b. 128
c. 130
d. 640
B. 128
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
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
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
80 grams of NaOH (MW=40) are how many moles?
a. 1
b. 2
c. 3
d. 4
B. 2
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Chromatography is based on the principle of:
a. differential solubility
b. gravity
c. vapor pressure
d. temperature
A. differential solubility
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
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
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
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
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
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
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
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
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
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
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
Which of the following immunoassay labels offer the greatest detection limit?
a. fluorescence
b. electrochemiluminescence
c. radioactivity
d. chemiluminescence
B. electrochemiluminescence
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Intervening sequences are found in:
a. heteronuclear RNA
b. mature mRNA
c. ribosomal RNA
d. transfer RNA
A. heteronuclear RNA
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
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
The term that best describes males regarding X-linked genes is:
a. heterozygous
b. homozygous
c. haplozygous
d. hemizygous
D. hemizygous
The mode of inheritance of mitochondrial DNA is:
a. dominant
b. recessive
c. codominant
d. maternal
D. maternal
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
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
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
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
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
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
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
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
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
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)
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)
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
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
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)
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
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
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
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:)
The conversion of glucose or other hexoses into lactate or pyruvate is called:
a. glycogenesis
b. glycogenolysis
c. gluconeogenesis
d. glycolysis
D. glycolysis
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)
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
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
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
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
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
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
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
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
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
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
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
Severe diarrhea causes:
a. metabolic acidosis
b. matabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis
A. metabolic acidosis
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
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
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
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
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
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
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
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
A common cause of respiratory alkalosis is:
a. vomiting
b. stavation
c. asthma
d. hyperventialtion
D. hyperventilation
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
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
Select the test which evaluates renal tubular function:
a. IVP
b. creatinine clearance
c. osmolarity
d. microscopic urinalysis
C. osmolarity
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
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
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
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
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
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
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
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
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
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
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
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
The solute that contributes the most to the total serum osmolality is :
a. glucose
b. sodium
c. chloride
d. urea
B. sodium
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
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
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
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
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%
Calcium concentration in the serum is regulated by:
a. insulin
b. parathyroid hormone
c. thyroxine
d. vitamin C
B. parathyroid hormone
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
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
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
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
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
Fasting serum phosphate concentration is controlled primarily by the:
a. pancreas
b. skeleton
c. parathyroid glands
d. small intestine
C. parathyroid gland
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
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
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
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)
Total iron binding capacity measures the serum iron transporting capacity of:
a. hemglobin
b. ceruloplasmin
c. transferrin
d. ferritin
C. transferrin
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
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
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
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
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)
90% of the copper present in the blood is bound to:
a. transferrin
b. ceruloplasmin
c. albumin
d. cryoglogulin
B. ceruloplasmin
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
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
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
Kernicterus is an abnormal accumulation of bilirubin in:
a. heart tissue
b. brain tissue
c. liver tissue
d. kidney tissue
B. brain tissue
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
The most specific enzyme test for acute pancreatitis is:
a. acid phosphatase
b. trypsin
c. amylase
d. lipase
D. lipase
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
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
Asparate amino transferase (AST) is characteristically eleveted in diseases of the:
a. liver
b. kidney
c. intestine
d. pancreas
A. liver
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
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
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
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
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)
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
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
The pressence of which of the following isoenzymes indicates acute myocardial damage?
a. CKMM
b. CKMB
c. CKBB
d. none
B. CKMB
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
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
When myocardial infarction occurs, the first enzyme to become elevated is:
a. CK
b. LD
c. AST
d. ALT
A. CK
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
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
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
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
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
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
Regan isoenzyme has the same properties as alkaline phosphatase that originates in the:
a. skeleton
b. kidney
c. intestine
d. placenta
D. placenta
The most heat labile fraction of alkalline phosphatase is obtained from:
a. liver
b. bone
c. intestine
d. placenta
B. bone
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
Isoenzyme assays are performed to improve:
a. percision
b. accuracy
c. sensitivity
d. specificity
D. specificity
The protein portion of an enzyme complex is called the:
a. apoenzyme
b. coenzyme
c. holoenzyme
d. proenzyme
A. apoenzyme
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
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
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
Turbidity is serum suggests elevation of:
a. cholesterol
b. total protein
c. chylomicrons
d. albumin
C. chylomicrons
TSH is produced by the:
a. hypothalamus
b. pituitary gland
c. adrenal cortex
d. thyroid
b. pituitary gland
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
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
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
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)
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
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
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
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
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
Which of the following steroids is an adrenal cortical hormone?
a. angiotensinogen
b. aldosterone
c. epinephrine
d. growth hormone
B. aldosterone
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
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
Night blindness is associated with deficiency of which of the following vitamins?
a. A
b. C
c. niacin
d. thiamine
A. vitamin A
Beriberi is associated with deficiency of vitamin:
a. A
b. C
c. niacin
d. thiamine
D. thiamine
Scurvy is associated with deficiency of which of the following vitamins?
a. A
b. C
c. niacin
d. thiamine
B vitamin C
Rickets is associated with deficiency of which of the following vitamins?
a. B1
b. C
c. niacin
d. D
D. vitamin D
Pellagra is associated with deficiency of which of the following vitamins?
a. A
b. B1
c. thiamine
d. niacin
D. niacin
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
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)
Which of the following hormones regulates normal blood calcuim levels?
a. thyroxine
b. estriol
c. parathyroid hormone
d. growth hormone
C. parathyroid hormone
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
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
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
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
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
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
Carcinoembryonic antigen is most likely to be produced in a malignancy involving the:
a. brain
b. testes
c. bone
d. colon
D. colon
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
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
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
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
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
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
Cocaine is metabolized to:
a. carbamazepine
b. codeine
c. bydrocodone
d. benzolylecgonine
D. benzoylecgonine
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
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
A carbonate salt used to control manic depressive disorders is:
a. digoxin
b. acetminophen
c. lithium
d. phenytoin
C. lithium
An antiepileptic used to control seizure disorders is:
a. digoxin
b. acetaminophen
c. lithium
d. phenytoin
D. phenytoin
A drug that relaxed the smooth muscles of the bronchial passages is:
a. acetaminophen
b. lithium
c. phenytoin
d. theophylline
D. theophylline
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
A salicylate level is performed to detect toxicity caused by ingestion of excess;
a. acetaminophen
b. aspirin
c. ibuprofen
d. pseudoephedrine
B. aspirin
Lithium therapy is widely used in the treatment of:
a. hypertension
b. hyperactivity
c. aggression
d. manic-depressive disorder
D. manic depressive disorder
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
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
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
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
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
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
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
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
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
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
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
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)
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])
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)]
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
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
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
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
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
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
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
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
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
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
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
In a pH meter reference electrodes may include:
a. silver-silver chloride
b. quinhydrone
c. hydroxide
d. hydrogen
A. silver-silver chloride
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
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
Valinomycin enhances the selectivity of the electrode used to quantitate:
a. sodium
b. chloride
c. potassium
d. calcium
C. potassium
Which blood gas electrode is composed of silver/silver chloride reference electrode and glass?
a. PO2
b. pH
c. PCO2
d. HCO3
C. PCO2
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
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
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
The most specific method for the assay of glucose utilizes:
a. hexokinase
b. glucose oxidase
c. glucose-6-phosphatase
d. glucose dehdrogenase
A. hexokinase
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
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
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
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
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
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
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
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
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
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
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
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
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
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
The majority of the iron in an adult is found as a constituent of:
a. hemoglobin
b. hemosiderin
c. myoglobin
d. transferrin
A. hemoglobin
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
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
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
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
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
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
Cells for the transport of O2 and CO2 are:
a. erythrocytes
b. granulocytes
c. lymphocytes
d. thromboclytes
A. erythrocytes
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
What cell shape is most commonly associated with an increased MCHC?
a. teardrop cells
b. target cells
c. spherocytes
d. sickel cells
C. spherocytes
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
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
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
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
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
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
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
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
The characteristic morphologic feature in folic acid deficiencly is:
a. macrocytosis
b. target cells
c. basophilic stippling
d. rouleaux formation
A. macrocytosis
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
A characteristic morphologic feature in hemglobin C disease is:
a. macrocytosis
b. spherocytosis
c. rouleaux formation
d. target cells
D. target cells
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
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
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
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
The characteristic morphologic feature in lead poisoning is:
a. macrocytosis
b. target cells
c. basophilic stippling
d. rouleaux formation
C. basophilic stippling
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
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
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
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
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
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
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%
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
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
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
The characteristic peripheral blood morphologic feature in multiple myeloma is:
a. cytotoxic T cells
b. rouleaux formation
c. spherocytosis
d. macrocytosis
B. rouleaux formation
In polycythemia vera, the hemoglobin, hematocrit, RBC count and red cell mass are:
a. elevated
b. normal
c. decreased
A. elevated
The M:E ration in polycythemia vera is usually:
a. normal
b. high
c. low
d. variable
A. normal
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
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
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
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