MLT ASCP Review 8
In the blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with: - Sodium - Potassium - Chloride - Phosphorus
Chloride
What is the purpose of using alcohol-acetone or acetone in the Gram stain procedure? - Fixes all Gram positive organisms - Decolorizes all Gram positive organisms - Decolorizes all Gram negative organisms - Fixes all Gram negative organisms
Decolorizes all Gram negative organisms
Cytomegalovirus (CMV) appears to suppress cell-mediated immune functions. Which of the following is a characteristic finding in persons infected with CMV? - Increased CD4+ cells; decreased CD8+ cells - Increased CD4+ cells, increased CD8+ cells - Decreased CD4+ cells, increased CD8+ cells - Decreased CD4+ cells, decreased CD8+ cells
Decreased CD4+ cells, increased CD8+ cells
Which of the following dimorphic molds produces spherical or oval conidia, each supported by an individual conidiophore (lollipop)? - Blastomyces dermatitidis - Coccidioides immitis - Histoplasma capsulatum - Sporothrix schenckii
Blastomyces dermatitidis
During data analysis in flow cytometry, how are cells gated? - By placing a gate around cells with the same light-scattering - By placing a gate around cells with different light-scattering - By placing a gate around cells with different fluorescent properties - By placing a gate around cells that have no fluorescence
By placing a gate around cells with the same light-scattering
The "recognition unit" of the classical complement pathway refers to which of the following? - C5b, C6, C7, C8, C9 - C1q - C3a - C4
C1q
Which two of the following biomarkers are not specific to cardiac muscle and my be elevated in patients with injury to muscle other than cardiac muscle? - cTnl and cTnT - CK-MB and Myoglobin - cTnT and CK-MB - Myoglobin and cTnl
CK-MB and Myoglobin
A lipid panel consists of which of the following tests? - Potassium, sodium, chloride, CO2 - AST, ALT, alkaline phosphatase, total protein, albumin, total bilirubin, direct bilirubin - Cholesterol, lipoprotein, HDL, triglycerides - Glucose, BUN, creatinine, sodium, potassium, chloride, CO2, calcium, albumin, phosphorus
Cholesterol, lipoprotein, HDL, triglycerides
A recto-sogmoidoscopy revealed pseudomembranes in a patient with severe diarrhea following prolonged treatment with ampicillin. Which of the following organisms is MOST likely to be isolated? - Bacteriodes fragilis - Clostridium botulinum - Clostridium difficile - Fusobacterium nucleatum
Clostridium difficile
Cocci may arrange as diplococci, tetrads, chains, and clusters. The morphologic arrangement of the genus Staphylococcus is: - Singly - Diplococci - Chains - Clusters
Clusters
Within three days, at 25*C, a sputum specimen placed on Sabouraud's dextrose agar with chloramphenicol and cycloheximide produced moist, greyish growth, with a white aerial mycelium. The patient had a history of travel to national parks in California. The questionable organism is MOST likely: - Histoplasma capsulatum - Blastomyces immitis - Coccidioides immitis - Paracoccidiodes brasiliensis
Coccidioides immitis
What is the role of albuminuria testing? - Monitor diabetic patient carbohydrate management - Detect serum albumin levels in early renal disease - Detect small urinary concentrations of albumin before there is irreparable renal damage - Diagnose renal failure in a type 1 diabetic patient
Detect small urinary concentrations of albumin before there is irreparable renal damage
What is the purpose of the BUN test? - Rules out acute heart failure in the emergency setting - Determines the amount of urea in blood - Evaluates abnormalities in the extrinsic coagulation pathway and monitors coumadin therapy - Evaluates abnormalities in the intrinsic coagulation pathway and monitors heparin therapy
Determines the amount of urea in the blood
A patient experiences a mild allergic reaction to a transfusion, including urticaria, erythema, and itching. What is the most likely source of the allergen? - IgA on mast cells - Drugs or food consumed by the blood donor - Insoluble allergens - Donor red blood cells
Drugs or food consumed by the blood donor
Lewis Blood Group System is a human blood group unlike most others. The antigen is produced and secreted by exocrine glands, eventually adsorbing to the surface of red cells. It's expression is based on the genetic expression of the Lewis and Secretor genes. Based on the following genotype (Le) (Se), what would you predict the Lewis antigen phenotypic expression to be? - Le(a-b-) - Le(a+b+) - Le(a-b+) - Le(a+b-)
Le(a-b+)
Within the genus Campylobacter, the laboratory test most helpful in selectively identifying Campylobacter jejuni is: - Indoxyl acetate - Hippurate hydrolysis - Nitrate reduction - Susceptibility to nalidixic acid
Hippurate hydrolysis
Which of the following casts might be found in the urine of a healthy individual after strenuous exercise? - Epithelial casts and granular casts - Hyaline casts and granular casts - Granular casts and waxy casts - Waxy casts and hyaline casts
Hyaline casts and granular casts
The majority of Lewis antibodies are of which immunoglobulin class? - IgM - IgG - IgE - IgA
IgM
What term is defined as the presence of arthropods in or upon a human host? - Infection - Disease - Symbiosis - Infestation
Infestation
The vast MAJORITY of would-be invaders are killed or inactivated primarily by which part of the immune system? - Cell mediated immunity - Specific immunity - Humoral immunity - Innate immunity
Innate immunity
Which one of the following statements about serum ferritin is true? - It is a sensitive indicator of iron deficiency - Elevation of serum ferritin is specific for hemochromatosis - It is synonymous with transferrin - It is a better test for bone marrow iron stores than a Prussian blue stain of marrow particles
It is a sensitive indicator of iron deficiency
According to CLIA '88, which of the following personnel is responsible for ensuring the employment of qualified, competent testing personnel within a moderate to high complexity testing environment? - General supervisor - Laboratory director - Laboratory manager - Technical supervisor
Laboratory director
Which of the following cells would be increased in the CSF of a patient suspected of having multiple sclerosis? - Neutrophils - Lymphocytes - Macrophages - Monocytes
Lymphocytes
The process of freeze drying bacteria is called: - Agglutination - Inhibition - Lyophilization - Precipitation
Lyophilization
Semi-automated and automated urine chemical reagent strip readers: - Increase the sensitivity of the urine dipsticks - Increase the specificity of the urine dipsticks - Remove subjectivity allowing for better reproducibility - Guarantee the sensitivity and specificity of urine dipsticks
Remove subjectivity allowing for better reproducibility
Which of the following statements characterize a reticulocyte? - Reticulum visible with a supravital stain, such as new methylene blue - Reticulum visible with Wright stain - Contains some organelles used for hemoglobin production - Pyknotic nucleus still present in the cell
Reticulum visible with a supravital stain, such as new methylene blue
What molecular technique is appropriate for HIV-1 genotyping? - Reverse Transcriptase Polymerase Chain Reaction - Multiplex Polymerase Chain Reaction - Real-Time Polymerase Chain Reaction - Strand Displacement Amplification
Reverse Transcriptase Polymerase Chain Reaction
Anti-U antibodies can be produced by which of the following genotypes? - M-N- - S+s+ - S+s- - S-s-
S-s-
Consumption of undercooked poultry or the handling of reptiles could cause which of the following conditions? - Pasturellosis - Brucellosis - Tularemia - Salmonellosis
Salmonellosis
An electrolyte panel is composed of which of the following tests? - Sodium, potassium, glucose, chloride - Potassium, glucose, chloride, albumin - Sodium, potassium, chloride, CO2 - Chloride, cholesterol, chloride, glucose
Sodium, potassium, chloride, CO2
All of the following are associated with RBC macrocytosis EXCEPT? - Alcoholism - Hypothyroidism - B12 deficiency - Thalassemia
Thalassemia
B lymphocytes and T lymphocytes are derived from: - Hematopoietic stem cells - Macrophages or monocytes - Mucosa-associated lymphoid tissue (MALT) - Granulocytes
Hematopoietic stem cells
Whole blood is composed of approximately: - 75% formed elements and 25% plasma - 60% formed elements and 40% plasma - 45% formed elements and 55% plasma - 30% formed elements and 70% plasma
45% formed elements and 55% plasma
Of the following, what is the recommended routine testing to be performed on a newborn of a group B Rh positive female? - ABO and Rh testing would routinely be performed in this scenario - ABO, Rh, and DAT would routinely be performed in this scenario - ABO, Rh, and antibody screening would routinely be performed in this scenario - ABO/Rh, DAT and/or antibody screening are NOT routinely performed in this scenario
ABO/Rh, DAT and/or antibody screening are NOT routinely performed in this scenario
Which group of conditions increases the risk of HbS polymerization? - Acid pH, dehydration, decreased level of 2,3-DPG - Alkaline pH, dehydration, increased level of 2,3-DPG - Acid pH, dehydration, increased level of 2,3-DPG - Alkaline pH, dehydration, decreased level of 2,3-DPG
Acid pH, dehydration, increased level of 2,3-DPG
Which nitrogenous base would bind with thymine in forming a double-stranded DNA? - Adenine - Cytosine - Uracil - Guanine
Adenine
Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity? - Leptin - Resistin - TNF-a - Adiponectin
Adiponectin
All of the following statements are true regarding the significance of performing direct microscopic examinations for culture, EXCEPT: - Provide a quality control comparison to the culture for actual isolated recovered. - It can provide the physician with a rapid presumptive diagnosis - May serve as a guide for selecting appropriate culture media based on microorganisms observed - Allows the microbiologist to discard the sample and cancel testing if no organisms are observed
Allows the microbiologist to discard the sample and cancel testing if no organisms are observed
All of the following are applications of real-time PCR, EXCEPT? - Microbe identification - Genotyping HLA components - Identification of DNA sequences - Amplification of DNA for northern blot
Amplification of DNA for northern blot
A febrile nonhemolytic transfusion is characterized by which of the following? - An increase in temperature of >1*C above 37*C during transfusion - Appearance of hives - Fever above 37*C which develops 24 hours later - A decrease in temperature of <2*C below 37*C following transfusion
An increase in temperature of >1*C above 37*C during transfusion
In providing crossmatch-compatible blood units, all of the following antibodies are most often clinically insignificant EXCEPT: - Anti-Jkb' - Anti-P1 - Anti-M - Anti-Lea
Anti-M
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? - A - B - F - G
B
A traveler is being evaluated at a local hospital for gastrointestinal pain, fever, and diarrhea. The patient has recently returned from a month-long visit to Southeast Asia. The patient has no recent history of sexual activity or IV drug use but did describe conditions of poor sanitation where they were living. If liver function test results were elevated and bilirubinuria was noted, which of the following would be the next logical test to order? - ELISA test or the Hepatitis B Surface Antigen (HBsAg) - Recombinant Immunoblot Assay (RIBA) test for Hepatitis C - Western Blot test for HIV - ELISA testing for Hepatitis A antigens in the stool
ELISA testing for Hepatitis A antigens in the stool
Which of the following statements about lipoproteins is FALSE: - Elevated LDL causes a decreased risk of atherosclerosis - Reduced LDL causes a decreased risk of atherosclerosis - Elevated HDL causes a decreased risk of atherosclerosis - Elevated total cholesterol causes an increased risk of atherosclerosis
Elevated LDL causes a decreased risk of atherosclerosis
Increases in blood ammonia levels would be expected in which of the following conditions: - Diabetes - Obstructive jaundice - End stage cirrhosis - Myocardial infarction
End stage cirrhosis
The properties of enzymes are CORRECTLY described by which of the following statements? - Enzyme activity is not altered by heat denaturation - Enzymes are protein catalysts of biological origin - Enzymes are stable proteins and unaffected by pH changes - Enzymes affect the rate of a chemical reaction by raising the activation energy needed
Enzymes are protein catalysts of biological origin
All of the following factors are involved in the intrinsic pathway, EXCEPT? - Factor XII - Factor VII - Factor IX - Factor XI
Factor VII
An antibody screen utilizing polyethylene glycol (PEG) was performed. Reaction readings of this antibody screen are analyzed after immediate spin and again at 37*C incubation with subsequent centrifugation. How will the centrifugation of the tubes affect the patient's results? - Reactions will be enhanced - No effect will be seen - False positives may be seen - False negatives may be seen
False positives may be seen
What would be the best way to determine how much RhIg should be given to a postpartum female who received RhIg antenatally and demonstrates the anti-D antibody at delivery? - Antibody titration - Flow cytometry - Rosette test - Kleihauer-Betke acid elution
Flow cytometry
Conditions that produce elevated CSF protein levels include all of the following EXCEPT: - Meningitis - Multiple sclerosis - Hemmorhage - Fluid leak
Fluid leak
Regarding hemoglobin synthesis, which of the following constitutes the alpha globin chain coding? - Two gene loci; one each on chromosome 11 - Four gene loci; two each on chromosome 11 - Two gene loci; one each on chromosome 16 - Four gene loci; two each on chromosome 16
Four gene loci; two each on chromosome 16
Bioavaliability of an oral drug refers to the: - Availability for therapeutic administration - Ratio of protein-bound to free drug - Amount of drug transformation - Fraction of the drug that is absorbed into systemic circulation
Fraction of the drug that is absorbed into systemic circulation
All of the following are standard methods for measuring the specific gravity of urine, EXCEPT: - Urine reagent strips - Freezing point depression - Refractometry - Harmonic oscillation densitometry
Freezing point depression
Blood cultures are collected from a septic patient with a history of chronic urinary tract infections. The sheep blood agar and the chocolate agar grow a creamy colony that has feet like or star like projections from the colony. The Gram stain of the colony demonstrates a budding yeast with pseudohyphae. What would be the next step in identifying the organism? - Catalase - Oxidase - Germ tube - Spot indole
Germ tube
A kidney graft would have the BEST chance of survival post-transplantation if it were: - HLA non-identical, mixed lymphocyte culture (+), ABO identical - HLA identical, mixed lymphocyte culture (+), ABO identical - HLA identical, mixed lymphocyte culture (-), ABO identical - HLA identical, mixed lymphocyte culture (+), ABO non-identical
HLA identical, mixed lymphocyte culture (-), ABO identical
On a Cytospin preparation from a pleural fluid, 50% of the cells have the following characteristics: - Uniform, regular arrangement - Some cells resemble a "fried egg" - Multiple nuclei - Smooth nuclear outline and homogenous chromatin - When present in clumps, there are clear spaces between the cells ("windows") How should these cells be classified? - Atypical cancer cells - Mesothelial cells - Tumor cells - Ependymal cells
Mesothelial cells
Which of the following conditions would NOT allow HDFN to occur as a result of Rh incompatibility? - Mother Rh-negative, father Rh-positive - Mother Rh-negative, baby Rh-positive - Mother Rh-negative, father Rh-negative - Mother Rh-negative, father Rh-unknown
Mother Rh-negative, father Rh-negative
An accumulation of this results in a heavily granulated appearance in Alder-Reilly Anomoly? - Sphingomyelinase - Mucopolysaccharide - Beta-glucocerebrosidase - Myeloperoxidase
Mucopolysaccharide
Which molecular methodology is used to detect multiple targets in a single sample of CSF when meningitis/encephalitis is suspected? - Nested PCR - Multiplex PCR - Northern blot - Broad range PCR
Multiplex PCR
Can an autologous donor donate blood at 4pm on Monday if she is having surgery at 10am on Wednesday? - No, the minimal allowable time between the last donation and surgery is 72 hours - No, the minimal allowable time between the last donation and surgery is eight weeks - Yes, the patient can donate, but only half a unit - Yes, an autologous donor can donate up to 24 hours prior to surgery
No, the minimal allowable time between the last donation and surgery is 72 hours
Which blood group antibodies would you find in a group AB individual? - Anti-A - Anti-B - Anti-A, Anti-B - None
None
Which of the following statements regarding peak level in therapeutic drug monitoring is true? - Peak level is the point at which the drug is lowest in the patient's body - Peak level is assessed by collecting a blood sample right before the next dose of the drug is given - Peak level is the point at which the drug is highest in the patient's body - Peak level is assessed by collecting a urine sample right after the next dose of the drug is given
Peak level is the point at which the drug is highest in the patient's body
What is the most common treatment for HDFN due to ABO incompatibility? - Intravenous immune globulin (IVIG) - Intrauterine transfusion - Phototherapy - Exchange transfusion
Phototherapy
Donation of which apheresis blood product more than once every four weeks requires monitoring of total plasma protein antibody levels? - Red cell apheresis - Plateletpheresis - Plasmapheresis - Leukapheresis
Plasmapheresis
Based on the following specificity and sensitivity informaiton, which of the answer choices is true? Procedure #1 detected 70/100 true positives and 100/100 true negatives Procedure #2 detected 90/100 true positives and 80/100 true negatives - Procedure 1 is more sensitive and less specific - Procedure 2 is more sensitive and less specific - Procedure 1 is more sensitive and more specific - Procedure 2 is more sensitive and more specific
Procedure 2 is more sensitive and less specific
Which is the main limitation of standard PCR that is not a limitation of real-time PCR? - Requirement of a large initial sample - Procedure requires endpoint measurement that may not be in direct proportion to initial sample - Ability to detect PCR product during the plateau stage - Slow turnaround time compared to culture methods
Procedure requires endpoint measurement that may not be in direct proportion to initial sample
Which of the following stages of neutrophilic granulocyte cellular development is at the second stage from the least mature stage? - Band neutrophil - Promyelocyte - Metamyelocyte - Myeloblast
Promyelocyte
The following is true of the disk diffusion method of measuring antimicrobial sensitivity: - Provides a semi-quantitative MIC value - Provides only an interpretation value of sensitive intermediate, or resistant correlated to MIC values - Requires minimal standardization - Commonly automated method of antimicrobial susceptibility testing
Provides only an interpretation value of sensitive intermediate, or resistant correlated to MIC values
A tech is working on a urine culture and finds the following isolates: Escherichia coli:>100,000 cfu/mL Enterococcus faecalis: 50,000 cfu/mL Klebsiella pneumoniae: 30,000 cfu/mL How should the tech continue with the work up? - Quantitate culture and report as mixed urethral flora/contaminants - Perform sensitivity on the E.coli and list other as contaminants - Perform sensitivity on the E.coli and K.pneumoniae and list E.faecalis as a contaminant - Reject culture due to contamination
Quantitate culture and report as mixed urethral flora/contaminants
Which of the following statements is TRUE for specific gravity measured by the reagent strip method? - The reagent strip method is based on the relationship between ionic concentration and specific gravity - The reagent strip method is based on the fact that light is refracted in proportion to the amount of total solids dissolved in the urine - The reagent strip method is affected by the presence of x-ray contrast media in the urine specimen - An alkaline pH would not affect the specific gravity result using a reagent strip method
The reagent strip method is based on the relationship between ionic concentration and specific gravity
A patient suffering from Celiac disease and Chron's disease is given a new oral medication that has a narrow therapeutic window. Which of the following would be true? - An oral medication is never effective for a patient that these diseases. The drug must be given through an IV - Toxicity in this patient is not likely since most of the drug won't be absorbed - Therapeutic drug monitoring (TDM) would be helpful to see how much drug has been absorbed - Serum drug levels obtained 15 minutes after the oral dose should confirm the drug was absorbed
Therapeutic drug monitoring (TDM) would be helpful to see how much drug has been absorbed
A tube has broken during centrifuging, what is the most likely reason? - The tube was not filled all the way to the top - Tube was not properly balanced in the centrifuge - The tube was stored in the refrigerator before centrifugation - The tube did not have a stopper
Tube was not properly balanced in the centrifuge
A blood sample is left on a phlebotomy tray for four hours before it is delivered to the laboratory. Which group of tests could still be performed? - Glucose, Na, K, Cl, PCO2 - Uric acid, BUN, creatinine - Total and direct bilirubin - CK, ALT, ALP, ACP
Uric acid, BUN, creatinine
All of the following variables related to the collection of blood may falsely increase the potassium level, EXCEPT? - Drawing a purple-top tube prior to a red-top tube - Mixing the blood collection tube aggressively - Pouring some sample from a purple-top EDTA tube into a red-top tube to make up for low collection volume - Using a 21 G needle with a 10 mL collection tube
Using a 21 G needle with a 10 mL collection tube
Infections with this organism typically either present as primary septicemia or wound infections. Septicemia likely occurs after the organism is ingested while consuming shellfish. Wound infections are associated with some type of aquatic exposure. What organism does this describe? - Vibrio vulnificus - Staphylococcus aureus - Erysipelothrix rhusiopathae - Salmonella typhi
Vibrio vulnificus
The term pharmacokinetics BEST describes: - What the drug does to the body - Concentration of drug at it's sites of action - What the body does to the drug - Concentration of the drug at the time of administering
What the body does to the drug