ASCP Board of Certification MLS Computer Adaptive Testing

A gram-positive bacillus that has a rod-coccus cycle (short, thin rods in young cultures and cocci in older cultures) and an odor resembling cheese is:

Brevibacterium spp.

From the IgG molcule illustration which region is the heavy chain

A

Which of the following substances may mask parasites in a stool sample?

Barium

Which of the following is a genetic platelet disorder characterized by giant platelets, abnormal screening tests for platelet function and moderate to severe thrombocytopenia?

Bernard-Soulier syndrome

To assess drug concentrations during the trough phase:

Blood should be drawn immedtiately before the next dose is given

An aerobic Gram-negative coccobacillus was isolated from a nasopharyngeal swab 48 hours after culture from a 6-month-old with the following culture characteristics on Bordet-Gengou agar: Small zones of beta-hemolysis Urease: positive (24 hours) Oxidase: negative Motility: negative The MOST probable identification of this isolate is:

Bordetalla parapertussis

Which of the following phenotypes is most indicative of a natural killer (NK) cell?

CD2+,CD3-,CD11b,CD16+

Which of the following genotypes is found with the hightest frequency in the caucasion population?

CDe/ce

A Rh negative individual has produced an anti-D antibody. Which situation has the ability to stimulate this production of anti-D?

Delivering a Rh positive baby

Which of the following serological tests would be used for the diagnosis of Q-fever?

EIA or indirect immunoflourescence

Corneal tissue transplantation has an extremely high success rate for a variety of reasons, including all of the following with the exception of:

Eccentrically place grafts

The number of patients correctly diagnosed for the disease or not having the disease is defined as:

Efficency Efficency equation (TP+TN)/(TP+FP+FN+TN) x 100

What is the identificaiton of the cyst measruing 6um in section D?

Endolimax nana

The reactions observed in the photograph to the right reveals a motile, gas producing, lactose fermenter that produces acetyl methyl carbinol in VP broth and has the ability to utilize sodium citrate as its sole source of carbon. The most likely identification is:

Enterobacter aerogenes

The egg is in the infective stage of this parasite for humans. What is the identification of this organism?

Enterobius vermicularis (pinworm) infects humans after ingestion of eggs. The eggs migrate to the digestive tract, to the small intestine, where they hatch and release larvae. Although Schistosoma mansoni and Taenia solium have eggs in their corresponding life cycles, this form is not the infective stage for human infections.

Select the answer that lists the correct size of protozoan cysts in order from smallest to largest

Hartmanni, histolytica, coli HHE (smallest to largest)

In which disorder do neonates demonstrate the presence of Bart's hemoglobin that changes to beta chain tetramers in adults?

Hemoglobin H disease

Which potent inhibitor of platelet aggregation is released by endothelial cells?

Prostacyclin

All of the following conditions would be associated with an increased level of alpha-fetoprotein, EXCEPT?

Prostate cancer

The 12 µm in diameter cyst illustrated in this lactophenol-stained mount can be identified as Entamoeba histolytica. Based on the characteristics seen in the image, what feature of the chromatoidal bar prompts this differential identification?

Rounded ends

Serological detection of the Vi antigen aids in the identificaiton of:

Salmonella Typhi

What is the characteristic RBC that is uniquely associated with HbSS?

Sickle cell (drepancocyte)

All of the following carbohydrates are considered reducing sugars EXCEPT:

Sucrose GLR are (glucose, lactose, and ribose)

T lymphocytes are characterized by all of the following functions EXCEPT which?

Synthesize antibody

Xenodiagnosis has historically been used to detect:

T. cruzi

The end product of fermentative metabolism of the Escherichia, Salmonella, and Shigella genera is which of the following

Various mixed acids

When performing an anti-human globulin (AHG) test, it is important to completely wash the red cells because:

Washing prevents neutralization of the anit-human globulin AHG serum

Which of the following tests require a 72 hour stool fecal collection?

quantitative fecal fat

The qualitative differences between A1 and A2 phenotypes includes all of the following EXCEPT:

the lack of agglutination of patient red cells with anti-A reagent

The normal myeloid-to-erythroid ratio (M:E ratio) ranges from:

2:1 to 4:1

Given the following information, calculate the results in mg/24 hrs for a 24-hour urine protein.Total volume for 24 hours = 2,400 mL Urine protein = 2.7 mg/dL

64.7mg/24 hours 2.7 x 2400/ 24x1/100 = 64.8

A technologist performed a STAT spinal fluid count by pipetting undiluted spinal fluid in a Neubauer Counting Chamber and counting both sides of the chamber (4 large WBC squares on each side). A total of 54 White Cells were counted. How many White Cells would there be per cubic millimeter?

67.5 54/8 squares x .1uL

The laboratory workplace includes many hours of computer use. The suggested time for a break after 30 minutes of computer use is:

1-2 minutes

A Cytochrome P450 2D6 (CYP2D6) ultrarapid metabolizer (UM) would require ___________ dose of an active drug (non-prodrug) that is metabolized by CYP2D6 than a CYP2D6 extensive metabolizer (EM).

A higher

Which of the following fresh frozen plasma ABO types would be suitable for transfusion to an AB negative patient?

AB negative and AB positive only

Which of the following analytes would be icreased due to delay in centrifugation?

AST

Which of the following enzymes is associated with conditions affecting skeletal muscles?

Aldolase

Which of the following blood test is used to determine acute pancreatitis?

Amylase

Hormonal variation throughout the menstrual cycle typically shows:

An abrupt rise in luteinzing hormone (LH) 3-36 hours prior to ovulation

Which of the following is a mechanism known to cause platelet satellitosis (satellitism)?

An antibody directed against the platelet membrane

The following statements are true regarding the Lewis blood group EXCEPT:

Antigens are a structual component of the red cell membrane

All of the following are lancefield carbohydrate antigens found on beta-hemolytic streptococcus species. All of the following antigens are found on organisms from the streptococcus anginosus group EXCEPT?

B group B strept is found on streptococcus agalactiae

This species of candida accoutns for around 20 % of urinary yeast isolates

Candida glabrata Candida glabrata is the second most common Candida species to cause disease (Candida albicans is the most common). In urinary yeast isolates, it is identified about 20 percent of the time. Infections tend to be aggressive and difficult to treat with traditional antifungal therapy. It has different sugar assimilation patterns than Candida albicans, notably rapid assimilation of trehalose, so it can easily be differentiated.

Which of the following consequences of severe hemolytic disease of the fetus and newborn (HDFN) is most associated with neonatal death before or shortly after birth?

Cardiac failure

Which of the following statement is INCORRECT regarding the bone marrow biopsy specimen?

Cellular morpholoigcal detail can be determined

This isolate, identified as Enterobacter cloacae, was recovered from the urine and blood cultures of a patient who had recently returned from India where he had received a total hip replacement. He presented to the ED with multiple decubiti, sinusitis, and a urinary tract infection. The Hodge Test that was performed on this organism was negative. What resistance mechanism may be identified from the KB plate and the susceptibility interpretations?

Chromsomal AmpC plus Porin Mutation

Which type of lipoprotein is the least dense?

Chylomicrons

At a minimum, the following class of biological safety cabinet (BSC) must be used when manipulating potential bioterrorism agents and if aerosols are likely:

Class II BSC

Which of the following clinical lab departments performs the most tests?

Clinical chemistry

Which one of these parasites is hermaphroditic in its adult phase?

Clonorchis sinesis

Which of the following Clostridium spp. produces a toxin that is a potential bioweapon?

Clostridum botulinum

The Gram stain shown in the image was prepared from a positive anaerobic blood culture bottle after 36 hours incubation. Based on the morphology of the bacterial cells (some with spores, noted by the blue arrows), what is the most likely identification?

Clostridum septicum

All of the following aerobic agars can be set up along with the anaerobic media, EXCEPT?

Columbia colistin-nalidixic acid agar

Which of the folowing analytes would be incerased due to delay in centriguation?

Creatinine

The measurement of sodium and chloride in the sweat is the most useful test for the diagnosis of what condition/disease?

Cystic fibrosis

This ubiquitous parasite is found primarily in areas where sheep and cattle are raised. The natural hosts for the completion of its life cycle are sheep. Humans often serve as accidental hosts. Which of the following conditions may be associated with the presence of this stool parasite 130-150 µm long by 60-90 µm wide?

Fascioliasis

Which of these methods measures fetal hemoglobin or D positive red cells or both to evaluate fetomaternal hemorrhage?

Flow cytometry

Which genetic description will NOT contain Bart's hemoglobin at birth ?

Heterzygous alpha thalassemia-2

Which antinuclear antibody (ANA) pattern is seen in the image on the right, which represents the result of an ANA test viewed using fluorescent microscopy? Note: (a) points to the nuclei of interphase cells, the primary consideration for discerning the ANA pattern and (b) indicates a metaphase mitotic cell.

Homogenous

Which of the following tests confirms the presence of Bence-Jones proteinuria:

Immunelectrophersis

Which of the following errors occurs in the analytical phase?

Incorrectly performed instrument calibration

A tech is wokring on a blood culture and after 24 hours of growth there are small gray non hemolytic colonies, resembling Enterococcus species. Gram stain of the colonies indicate gram-poisitve cocci in pairs and chains. The tech must set up a panel for full identification and sensitivity, which will not be ready until tomorrow. How should the tech report the culture today?

Issue a preliminary report of gram posiitve cocci Preliminary reports should always be used to give the physician any available information on the culture for treatment purposes. Since the tech knows there are Gram-positive cocci, but does not have a full identification yet, the preliminary report should indicate that Gram-positive cocci are present. Preliminary reports should be issues if there is culture growth. Even though a full identification is not available, Gram-positive cocci should be indicated since it is present in culture. By not issuing any report, the physician is not given any information to assist with patient treatment. Final reports are issued once the culture is complete. Since the tech is setting up a panel for identification and sensitivity, the culture is still in progress and should not yet have a final report. The information given indicates the tech set up a full identification and sensitivity panel. Thus, the only proven information today are the Gram-positive cocci. Reporting ofEnterococcus speciesbased on morphology alone could lead to a misidentification with other similarViridians StreptococcusorStreptococcus gallolyticus.

Which of the following tests on amniotic fluid would be included when assessing fetal lung maturity:

L/S Ratio The correct answer choice here is L/S ratio. The lecithin/sphingomyelin ratio is determined by examining the amniotic fluid of a pregnant mother. Because amniotic fluid is continuously swallowed or inhaled and then replaced or exhaled in uterus the ratio can be measured to determine how much surfactant is in the fetal lungs. This ratio will help determine how well the infant's lungs will perform breathing at birth. Alpha-fetoprotein is used in assessing the potential for genetic disorders. Bilirubin is used in diagnosing the cause of jaundice and other liver problems.Fetal hemoglobin is not used to assess fetal lung maturity.

Which one of these Lewis blood group system phenotypes usually produces anti-Lea?

Le (a-b-)

The Knott technique is used to identify:

Loa loa

All of the following are causes of hypernatremia EXCEPT:

Low aldosterone production

In patients with sickle cell disease, upon sickling what lab test will see an increase?

MCHC The correct answer here is MCHC. The mean corpuscular hemoglobin concentration is, by definition, the concentration of hemoglobin in a given volume of blood. Upon sickling, there is a subsequent increase in the MCHC in proportion to the number of molecules in the deoxygenated state. MCV is the mean corpuscular volume which shows the average volume of red blood cells. Being an average value, there is not as drastic of a change in this value with sickle cell patients. The red blood cell count will not be increased but decreased. Sickle cells undergo much more stress from oxygenating and deoxygenating leading to sickling. This repeated sickling and oxygenating leads to RBCs with shorter lifespans and an eventual decrease in RBC value. Hematocrit is the ratio of red blood cells to the total volume of blood. The hematocrit will also not increase but rather decrease in patients with sickle cell anemia.

Which of the following scenarios represents appropriate detection of MRSA by the Kirby Bauer method?

MHA: direct colony suspension; 35'C; cefoxitin disk; 18 hours incubation

A patient has a WBC count of 4.0 x 109/L. Giant platelets, as seen in the image, are observed on the Wright stained peripheral smear. Blue-staining inclusions are also observed in several of the neutrophils. Considering the morphology noted by the white arrow, what is the identity of this patient's blue-staining WBC inclusions?

May-Hegglin anomaly inclusion

Which of the following will cause an acidic urine pH?

Meat-filled diet

What is the first stage of the Wuchereria bancrofti life cycle in human infections?

Microfilariae in blood or skin of humans

You are collecting a blood specimen for forensic legal alcohol testing. Could you tell me which of the following need to be done before starting the specimen collection process?

Must inform the patinet that the blood about to be collected is for alcohol testing

Which of the following Mycobacterium species is positive for nitrate reduction?

Mycobaterium tuberculosis

A 30-year-old woman developed progressive, painful swelling of the right foot after incurring traumatic penetration of the soft tissue by a splinter. The wound initially healed. The upper photograph is a direct Gram stain of purulent material expressed from a sinus tract. The lower photograph illustrates the colony that grew out in 72 hours, which had a "musty" odor. The most likely identification is:

Nocardia brasilliensis

All of the following are methods employed for measuring the specific gravity of urine, EXCEPT?

Osmolality

What procedure utilized leukapheresis to collect the buffy coat from whole blood?

Photopheresis Photopheresis utilizes leukapheresis to collect the buffy coat layer from whole blood. These cells are treated with 8-methoxypsoralen, exposed to ultraviolet A light and then reinfused into the patient. Photopheresis has been shown to be efficacious and has been approved by the Food and Drug Administration for the treatment of cutaneous T-cell lymphoma.

A patient has a history of repeated spontaneous abortion. Coagulation studies reveal an elevated APTT, normal PT, normal platelet function, and normal thrombin time. Schistocytes were seen on the peripheral blood smear. Which test should be performed to determine if the patient has lupus anticoagulant?

Platelet neutralization test Platelet neutralization tests are one of the confirmatory tests that can be used to determine if a patient has a circulating lupus antibody, or lupus anticoagulant. The principle in this test involves the use of a freeze-thawed platelet suspension that, when mixed with the patient plasma, will neutralize the anti-phospholipid antibodies (lupus anticoagulant) present and allow for a corrected APTT result upon re-testing.

Which finding best distinguishes immune hemolytic anemia from other hemolytic anemias?

Positive DAT

This antinuclear antibody (ANA) pattern is characterized by granular staining in the nuclei of the interphase cells (a). There is also an absence of staining in the chromosomal area of the metaphase mitotic cells (b). The slide is viewed using fluorescent microscopy. Which pattern is this?

Speckled In order for the ANA to be positive there must be a clearly discernible pattern in the nuclei of the interphase cells. Metaphase mitotic cells are used to assist in identification of the ANA pattern. The image shown displays the features of a speckled ANA pattern: granular/speckled staining in the nuclei of the interphase cells (a) and absence of staining in the chromosomal area of the metaphase mitotic cells (b). The nucleoli do not stain; thus, the pattern is not nucleolar. A homogeneous pattern would show uniform staining of the nuclei in the interphase cells and presence of staining in the chromatin of the dividing cells. The centromere pattern is characterized by many discrete speckles in both the nuclei of interphase cells and the chromatin of dividing cells.

Which of the following conditions would argue in favor of therapeutic drug monitoring (TDM) for a given drug?

The drug is given chronically

A prothrombin time (PT) specimen was collected at an outpatient clinic and will not be picked up by the testing laboratory's courier until several hours later. How should the specimen be stored until it is picked up by the courier?

The tube should remain unopened and be kept at room temperature 20-25'C

Which of the following statements is TRUE for specific gravity measured by the urine chemical reagent strip method?

The urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen.

This assay would be used to help rule-out heparin contamination in a coagulation sample:

Thrombin Time The thrombin time (TT) involves the addition of thrombin to platelet-poor plasma to stimulate the clotting process. It reflects the ability of the patient to convert fibrinogen to fibrin but is also sensitive to the presence of inhibitors that may be present in the plasma, like heparin. Therefore, it can be used to measure the effects of heparin on a coagulation sample.

Aspirin ingestion prevents the synthesis of this signaling molecule in the platelet?

Thromboxane A2

Many organisms as seen in the image labeled 'B', were found in a urine specimen of a 28-year-old male that was tested as part of a routine physical examination. What is the identification of these organisms?

Trichomonas vaginalis

The process of pipetting 1.0 mL of plasma or serum into a tube containing 1.0 mL of saline, mixing the contents, and then repeating the same procedure into several additional tubes also containing 1.0 mL of saline is referred to as:

Two-fold dilution Two-fold serial dilutions result in "halving" the amount of serum with each successive dilution. Basically, reducing the concentration of the serum in half with each dilution.

Which organism is MOST likely responsible for septic reactions associated with red blood cell transfusions?

Yersinia enterocolitica

The accuracy of an immunoassay is its ability to discriminate between results that are true positive and results that are true negative. Two parameters of test accuracy are specificity and sensitivity. Which of these statements apply to an immunoassay with high specificity?

Accurately identifies the absensce of disease

Which of the following phrases best descibres a segmented neutrophil?

Cytoplasm appears pink-purple due to small specific granules

Illustrated in the top photograph is a 4-day-old white to cream-colored colony with a yeast-like background, and the surface having a delicate silk-like consistency. Such colonies may be recovered as a contaminant in laboratory cultures. The identification is illustrated in a cornmeal agar mount shown in the bottom photograph. From these observations, the MOST likely identification of this yeast-like isolate is: Please select the single best answer

Geotrichum candidum

All of the following represent a 2 week temporary deferral from donating blood or blood products EXCEPT:

German measles rubella vaccine Measles (rubella), mumps, and polio vaccines all have a 2 week deferral period following the vaccination

Of the Enterobacteriaceae listed below, which of the following species fails to decarboxylate lysine, ornithine, and arginine?

Pantoea agglomerans

Which of the following D variants has the best likelihood to receive D-positive RBCs without any adverse effects?

Partial D

The type of hypersensiticity reaction assoicated with macrophage activation, cytokine-mediated inflammation is:

Type IV cell mediated hypersensitivity (T-cell dependent)

If detected in anitbody screen testing, which of the following antibodies is NOT considered clinically significant in prenatal patients?

anit-Leb Anti-Leb may be detected in antibody screen testing of prenatal patients; however, this antibody is considered clinically insignificant. It is not indicated in causing hemolytic disease of the fetus and newborn (HDFN).

What is the cause of iron overload in hereditary hemochromatosis?

absorption of excessive amounts of iron in the small intestine

Which marker is most useful for the detection of gestational trophoblastic disease?

hCG (human chorionic gonadotropin)

The results which would be MOST consistent with macroamylasemia are?

increased serum amylase and normal to low urine amylase values

What is the minimum number of reactive antigen-positive and non-reactive antigen-negative panel cells that must be present in order to identify a red cell antibody with statistical confidence?

three

Good Manufacturing Practices applies to all of the following EXCEPT:

waste