BOC review
Which of the following is NOT considered a characteristic of paroxysmal cold hemoglobinuria (PCH)? - Patient population: children and young adults - Pathogenesis: following viral infection - Site of hemolysis: intravascular - Autoantibody class: IgM
Autoantibody class: IgM
Which of the following is a genetic platelet disorder characterized by giant platelets, abnormal screening tests for platelet function and moderate to severe thrombocytopenia? - Glanzmann's thombasthenia - Gray platelet syndrome - Delta storage pool disease - Bernard~Soulier syndrome
Bernard~Soulier syndrome
Bordet-Gengou plates are used to isolate: - Mycobacterium tuberculosis - Corynebacterium diphtheriae - Bordetella pertussis - Haemophilus influenzae
Bordetella pertussis
Following a myocardial infarction which of the following enzymes will be the first to become elevated: - CK - LDH - GGT - ALT
CK
What detection method releases of light energy as the product of a chemical reaction? - Chemiluminescence - Radioactivity - Fluorescence - Electrophoresis
Chemiluminescence
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 I BSC - Class II BSC - Class III BSC - Class IV BSC
Class II BSC
A tool used to show chain of command by defining responsibility and authority is a/an: -Hospital employee directory -Organizational strategic plan -Clinical laboratory lean design -Organization chart
Clinical laboratory lean design
Blood serum contains each of the following substances EXCEPT: -Water -Sugars -Coagulation proteins -Electrolytes
Coagulation proteins
Which one of the following statements is correct in regard to the Health Insurance Portability and Accountability Act (HIPAA)? - It is acceptable to talk about a patient's test results with a friend who works in a doctor's office because you know you can trust them. - Employees do not need to verify the identity of individuals requesting test result information - It is acceptable to discuss patient laboratory results with a laboratory coworker in a crowded hospital elevator - Confidential medical information should never be discussed outside of the laboratory
Confidential medical information should never be discussed outside of the laboratory
Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes? -Silver -Glass -Platinum -Gold
Glass
In serum electrophoresis all of the following proteins reside in the band closet to the anodal end EXCEPT: Retinol-binding protein (RBP) Transthyretin Albumin Haptoglobin
Haptoglobin
All of the following are examples of entities covered by the HIPAA Privacy Rule, EXCEPT? - Hospital - Physician's offices - Health care billing companies - Hospital and laboratory accrediting agencies
Hospital and laboratory accrediting agencies
Which blood group is most frequently associated with Cold Agglutinin Disease (CAD)? Kell Kidd Duffy I
I
The laboratory compliance plan states that an employee can be disciplined for violating laws and compliance policies up to and including: - Verbal warning - Written notice - Disciplinary probation - Immediate termination
Immediate termination
Which of the following methods may be employed to definitively identify Bence-Jones proteins? -Immunoelectrophoresis -Sulfosalicyclic acid precipitation -Heat precipitation at 40-60C -Urine dipstick
Immunoelectrophoresis
The classic TORCH panel of tests includes the following diseases with the exception of: - Rubella - Toxoplasma gondii - Infectious mononucleosis - Cytomegalovirus
Infectious mononucleosis
What is the effect of a compound on the accuracy of detection of a particular analyte? -Recovery -Interference -Interferents -Matrix
Interference
Which of the following analytes would be decreased due to delay in centrifugation? -Ionized Calcium -Potassium -ALT -AST
Ionized Calcium
In clinical genetics, the major consequence of chromosomal deletion: - Is the loss of specific genes that are localized to the deleted chromosomal segment. - No change in the copy numbers of genes found in these deleted chromosomal locations. - Is the exclusion of large-scale chromosomal deletion. - Is the inability to differentiate a chromosomal deletion from a nucleotide sequence abnormality.
Is the loss of specific genes that are localized to the deleted chromosomal segment.
Nephelometry involves the measurement of: -Light absorption. -Light transmission. -Light scatter. -Atomic absorption.
Light scatter.
What is the MOST important consideration before using a space heater in a health care facility? - The space heater does not have exposed elements - The heating elements in the space heater do not exceed 212F - The space heater is approved for use and inspected by the facilities management department - The space heater can be plugged directly into an outlet without the use of an extension cord.
The space heater is approved for use and inspected by the facilities management department
In what portion of the amplification curve (logarithmic plot) should the threshold be set for a real-time PCR? -At the baseline - Within the log-linear phase - At the plateau - At the last cycle
Within the log-linear phase
At a minimum, how frequently should an ocular micrometer be calibrated? -Once per year. -Once every six months. -Once every month. -After major cleaning of the microscope or replacing objectives.
After major cleaning of the microscope or replacing objectives.
How are the bacterial organisms that cause tuberculosis (Mycobacterium tuberculosis) primarily transmitted? - Airborne droplets/aerosols - blood specimens - Contaminated food - Water
Airborne droplets/aerosols
All of the following are common ways that bloodborne pathogens are transmitted, EXCEPT? -Sexual contact -Drug users sharing needles -Airborne particles in schools and offices -An infant's exposure to its mother's body fluids
Airborne particles in schools and offices
When can a doctor order a panel made up of tests he/she specifically wants? -any time they want -only if the laboratory ensures the ordering physician knows what tests are included in the panel or profile and has the appropriate procedure and diagnostic codes for each test -if approved by a department head -if the panel is used by the doctor at another laboratory and they have approved it
only if the laboratory ensures the ordering physician knows what tests are included in the panel or profile and has the appropriate procedure and diagnostic codes for each test
The laboratory workplace includes many hours of computer use. The suggested time for a break after 30 minutes of computer use is: - 1-2 minute break - 3-5 minute break - 5-10 minute break - 20 minute break
- 1-2 minute break
Which of the following statements regarding a biomarker with high sensitivity is TRUE? -Accurately identifies the presence of disease and has few false-negatives -Accurately identifies the presence of disease and has few false-positives -Accurately detects the absence of disease and has few false-negatives -Accurately detects the absence of disease and has few false-positives
-Accurately identifies the presence of disease and has few false-negatives
If a person comes in direct contact with an electrical source and sustains an electrical shock, which of the following actions should be taken once the current has been shut off and/or the person has been freed from contact with the current? -Call 911 immediately and have the victim stay in motion -Place an icepack on the affected area -Call 911 immediately and lower the victim's head below the trunk of the body and elevate the legs -No additional actions are required
-Call 911 immediately and lower the victim's head below the trunk of the body and elevate the legs
What is the normality (N) of a 700 mL solution that contains 5g of H2SO4 (gmw=98g/mol, valence=2)? 0.146 N 0.00014 N 0.023 N 0.841 N
0.146 N
The wavelength of the light measured by a spectrophotometer is generally designated in nanometers. A nanometer is equal in meters to: - 10^-11 meters - 10^-9 meters - 10^-4 meters - 10^-2 meters
10^-9 meters
What is the half-life of IgG? Why is the duration of the half-life significant? - 1-3days; it is the first antibody produced in an immune response. - 5-6days; it participates in an immediate hypersensitivity reaction. - 18-23 days; it is important for B-cell activation and/or regulation. - 18-23 days; it binds with neonatal Fc receptor.
18-23 days; it binds with neonatal Fc receptor
A computer monitor should be set approximately how many inches away from the eyes? 1-3 inches 5-10 inches 10-15 inches 20-40 inches
20-40 inches
A 200 mg/dL solution was diluted 1:10. The diluted solution was then additionally diluted 1:5. What is the concentration of the final solution? - 2mg/dL - 4mg/dL - 20mg/dL - 40mg/dL
4mg/dL
The weight of NaCl present in 650 mL of a 0.85% NaCl solution is: -0.55 grams -2.76 grams - 5.53 grams -27.62 grams
5.53 grams
According to the lower normal reference limit stated by WHO, which of the following sperm concentrations would be considered abnormally low? - 25x 10^6 spermatozoa/mL - 5x 10^6 spermatozoa/mL - 15x 10^6 spermatozoa/mL - 35x 10^6 spermatozoa/mL
5x 10^6 spermatozoa/mL
For a certain method, a control has a mean result of 12 with a standard deviation (SD) of 2. What is the acceptable 95% range for this control? 10-14 8-16 6-16 4-18
8-16
Which of the following represents the approximate percentage of the Caucasian population that is Rh positive? - 35% - 65% - 85% - 95%
85%
When are data collected in a real-time PCR procedure? - Prior to addition of fluorescent dyes or probes - At a single end point - During nucleic acid amplification - During the cooling stage
During nucleic acid amplification
All of the following forms of microscopy are commonly used in the clinical laboratory, EXCEPT Bright-field microscopy Light microscopy Electron microscopy Fluorescence microscopy
Electron microscopy
Ninety-nine percent of lead absorbed in the body is taken up by what after absorption? - Lungs - Gastrointestinal tract - Heart - Erythrocytes
Erythrocytes
All of the following are indicators of sepsis, EXCEPT? - Erythrocytosis - Increased heart rate - Leukocytosis - Increased body temperature
Erythrocytosis
Which of the following is used to analyze risk and highlight aspects of a process that should be targeted for improvement? - Voice of customers (VOC) - Quality control plan (QCP) - Supplier, inputs, process, outputs, and customer (SIPOC) diagram - Failure mode and effects analysis (FMEA)
Failure mode and effects analysis (FMEA)
Which of the following are terms used to describe storage pool iron? Hemosiderin and myoglobin Ferritin and hemosiderin Hemopectin and hemoglobin Apoferritin and transferrin
Ferritin and hemosiderin
Isopropyl alcohol is considered (a): -Sensitizer -Flammable. -Corrosive. -Non-Flammable
Flammable
A technologist decides to make a 1:20 dilution of cerebrospinal fluid (CSF) after briefly evaluating a portion of the sample microscopically. After making the dilution and charging chambers, the number of cells that observed in each of the large squares of the hemocytomenter is >100. What should the technologist do to obtain the most accurate count? -Count all four corner squares -Make a smaller dilution -Make a larger dilution -No dilution necessary
Make a larger dilution
The education coordinator for the hospital is required to develop competency assessment activities for the POCT providers in the emergency department. What document may serve as a guideline for specific steps to be included in the assessments? Blank log sheets Completed QC records Manufacturer's instructions Safety data sheets (SDS)
Manufacturer's instructions
What information can you find on the label affixed to the primary container of a hazardous chemical? - Date of discovery - Physical description of contents. - Emergency personnel contact information. - Manufacturer's name and contact information
Manufacturer's name and contact information
Creatinine excretion correlates best with which of the following parameters: Age Sex Muscle mass Body weight
Muscle mass
All of the following are characteristic of Burkholderia pseudomallei EXCEPT? -Has been reported as the cause of laboratory-acquired infection. -Oxidase positive - Non-motile -Catalase positive
Non-motile
All of the following would result in a rejection of an analytical run under the Westgard rules, EXCEPT: -One control observation exceeding the mean by 2.5 SD -One control observation exceeding the mean by 3.5 SD -Two consecutive control observations, one exceeding the mean by +2.5SD, and the other by -2.5SD -Ten consecutive control observations all less than the mean
One control observation exceeding the mean by 2.5 SD
The antiphagocytic capsule of Streptococcus pneumoniae is composed of: Proteins Polysaccharides Lipids Lipoproteins
Polysaccharides
To ensure precision and accuracy of the reagent strip tests used for chemical analysis of urine, it is necessary that: - Only a positive control be run on a daily basis - Positive controls be run on a daily basis and negative controls be run when opening a new bottle of test strips - Positive and negative controls be run on a daily basis and when a new bottle of test strips is opened - Positive and negative controls are not required for urine strips
Positive and negative controls be run on a daily basis and when a new bottle of test strips is opened
Which of the following would best be determined by running the same control specimen multiple times: - Regression - Reliability - Accuracy - Precision
Precision
Based on the following specificity and sensitivity information, which of the answer choices in 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
What is the identifying characteristic of Aureobasidium pullulans? - The production of a black yeast-like colony - The production of polar germ tubes - The production of urn-shaped phialides - Dictyospores
The production of a black yeast-like colony
It is essential to recognize the distinction between quality control (QC) limits and QC goals. Which is the true statement regarding these terms? -QC specifications (goals) are the criteria used to decide that a given method meets the clinical requirements -QC limits may be derived from the total allowable error, biological variation, or other medical decision criteria. -QC specifications (goals) are defined by the process itself based on its natural variation. -QC limits are what you want and QC specification are what you have.
QC specifications (goals) are the criteria used to decide that a given method meets the clinical requirements
All of the following are decreased in beta thalassemia major EXCEPT -Mean corpuscular hemoglobin concentration (MCHC) - Mean corpuscular volume (MCV) - Red cell distribution width (RDW) - Red blood cell (RBC) count
RDW (RDW would be increased)
Which of the following best describes random error? -Results may be either above or below the mean. -Results are consistently below the mean. -Results are consistently above the mean. -Results must be either above or below the mean, but must be the same percentage away from the mean.
Results may be either above or below the mean.
All of the following Enterobacteriaceae below are appropriately matched with the characteristic listed, EXCEPT: - Escherichia coli~ indole positive - Citrobacter freundii~ H2S positive - Serratia marscens~ Vogues-Proskauer negative - Klebsiella pneumoniae~ indole negative
Serratia marscens~ Vogues-Proskauer negative
A small spill of blood had occurred that involves broken glass. Into which type of container should this be disposed? - Regular trash bag - Biohazard bag - Sharps container - Heavy duty trash bag
Sharps container
A chemical reaction that is utilized by many different analytical methods involves: - Fluorometry - Glucose oxidase - The reduction of NAD to NADH. - UV spectrophotometry.
The reduction of NAD to NADH
A chemical reaction that is utilized by many different analytical methods involves: -Fluorometry -Glucose oxidase -The reduction of NAD to NADH -UV spectrophotometry
The reduction of NAD to NADH
All of the following statements about blood cultures are correct, EXCEPT: -The volume of blood collected is important. Short draws will reduce the likelihood of successfully growing out bacteria. - If two separate sets of blood cultures are requested, do not draw them both from the same site at the same time. - Be sure to allow the iodine prep to dry on the patient's skin prior to performing the blood culture. - Since latex gloves are sterile, you may use your gloved finger without further preparation to feel the vein on a prepped arm before making the stick.
Since latex gloves are sterile, you may use your gloved finger without further preparation to feel the vein on a prepped arm before making the stick.
All of the following pose a significant risk of transmitting bloodborne pathogens, EXCEPT? - Blood urine - Semen - Pleural fluids - Sweat
Sweat
T lymphocytes are characterized by all the following functions EXCEPT which? -Secrete cytokines - Synthesize antibody - Comprise majority of cells in blood lymphocyte pool - Help regulate immune response
Synthesize antibody
All of the following are important in a laboratory infection control plan EXCEPT: - Clear goals for surveillance - System for placing blame - System for identifying infected patients - Trained personnel
System for placing blame
The lymphocyte subtype that controls autoimmunity in the peripheral blood is: - T reg - T H1 - T H2 - B
T reg
What is internal quality control? -Using only data from one shift in quality control calculations. -Comparing one laboratory's results to those of other similar laboratories. -Testing commercial materials in-house to quickly verify test validity. -Conducting in-house strategy meetings
Testing commercial materials in-house to quickly verify test validity.
Which of the following describes the basis for the freezing point Osmometer? -The freezing point depression is inversely proportional to the amount of solute in the solution - The freezing point depression varies as the logarithm of the concentration of solute - The freezing point depression is raised by an amount that is inversely proportional to the concentration of dissolved particles in the solution - The freezing point depression is lowered by an amount that is directly proportional to the concentration of dissolved particles in the solution.
The freezing point depression is lowered by an amount that is directly proportional to the concentration of dissolved particles in the solution.
Which of the following use target amplification methodologies? -Transcription mediated amplification (TMA) -Fluorescence in situ hybridization (FISH) -Northern Blot -Branched chain DNA (bDNA)
Transcription mediated amplification (TMA)
The following organism causes White Piedra which infects hairs on the face, scalp, and body areas: Microsporum canis Trichosporon beigelii Piedraia hartae Microsporum audouinii
Trichosporon beigelii
Following the treatment of an IgG molecule with papain, which of the following will remain? - Two Fab fragments each with a light chain and a partial heavy chain attached with a disulfide bond. - Four separate light chains and two separate heavy chains. - One unit that consists of two partial heavy chains, two light chains all attached with a disulfide bond. - Eight units, two complete light chains, and two heavy chains split in half.
Two Fab fragments each with a light chain and a partial heavy chain attached with a disulfide bond.
Which of the following techniques is likely to an adverse effect of a capillary speicmen? -Mixing the specimen containing an anticoagulant by gently inverting the sealed specimen container several times after collection of the specimen - puncture of the cleansed site after alcohol is completely dry -beginning collection immediately following puncture -holding the hand from which blood is being collected in a downward position during collection of the specimen.
beginning collection immediately following puncture
When using a flow cytometer, forward scatter measures which of the following parameters? cell size Clonality Cytoplasmic complexity (granularity) Fluorescence
cell size
An analytical method with a low detection limit would: -measure only what is being assayed -measure zero concentrations of analyte -perform accurately in the presence of interfering substances -measure low concentrations of analyte
measure low concentrations of analyte
A phlebotomist arrives in the blood draw area where a mother and her 3-year-old toddler have been seated. Prior to performing the capillary blood collection on the child, the phlebotomist asks the mother "Is this Amanda?" The mother says yes. The phlebotomist then proceeds to cleanse the child's middle finger with alcohol and allows the site to air dry before performing the finger puncture. The phlebotomist punctures the side of the fleshy pad of the child's finger, wipes away the first drop, fills a lavender top microcollection container, caps it, inverts it several times and lays it on the table. She makes sure that the child's finger has stopped bleeding and then tells the mother that they can go. She then labels the specimen. Using the scenario above, answer the following question: Which of the following steps in the venipuncture process did the phlebotomist perform correctly?
puncture site preparation
Which of the following analytes would be increased due to delay in centrifugation? Bicarbonate Folate Ionized Calcium ALT
ALT
Which of the following terms is the external peer-review process that recognizes educational programs that have met established educational standards? - Accreditation - Articulation - Certification - Licensure
Accreditation
Given the following hepatitis B serology results, what is the immune status of the patient? HBsAg: positive HBeAg: positive Anti-Hbc IgM: positive Anti- HBs: negative -Acute infection -Chronic infection - Immune to infection - Past infection
Acute infection
For laboratories with a PPMPs (provider-performed microscopy procedures) CLIA certificate, which of the following would be approved? WBC Differential Basic Chemistry panel Semen analysis Gram stain
semen analysis
What is the correct procedure when using a winged collection device (butterfly) to draw a light-blue top tube intended for a coagulation test if this is the first tube that will be collected in the draw? - Draw and discard a red-top tube that only contains an additive for clot activation before collecting the light-blue top tube that will be used for coagulation - Draw and discard a waste light-blue top tube before the tube that will be used for coagulation studies - Draw only the light-blue top tube that will be used for coagulation studies and then perform a second venipuncture for additional tubes - There is no correct procedure because a winged collection device cannot be used for collecting specimens for coagulation studies
Draw and discard a waste light-blue top tube before the tube that will be used for coagulation studies
There are several ways in which electrical hazards can be prevented, including all of the following, EXCEPT: - Use only explosion-rated equipment in hazardous atmospheres - Only operate electrical equipment with wet hands - Use only properly grounded equipment - Never work/repair "live" electrical equipment
Only operate electrical equipment with wet hands
All of the following are reasons why the 2009 H1N1 influenza pandemic propelled the development of molecular assays EXCEPT? -The pandemic created a shortage of cell culture materials. - Non-molecular rapid assays could not detect the novel virus in low concentrations. -Previously developed, commercially available molecular methods were labor intensive with lengthy turnaround times. - The availability of accurate and rapid diagnostics was supported by both the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA).
The pandemic created a shortage of cell culture materials.
You are performing a manual antibody titer in a clinical laboratory. You have made serial dilutions of a patient's plasma sample and you are looking for anti-streptolysin O antibodies. The first tube contains pure patient plasma. The second tube contains a 1:2 dilution of the first tube. the third tube contains a 1:2 dilution of the second tube and so on. the patient's antibodies no longer give visible reaction in tube 5, indicating their titer is tube 4 (or the last tube where there is a positive result). What is the concentration of antibodies in tube 4 compared to the concentration in tube 1? -the concentration of antibodies in tube 4 is the same as the concentration of antibodies in tube 1. -the concentration of antibodies in tube 4 is about 1/4 the concentration of antibodies in tube 1. -the concentration of antibodies in tube 4 is 1/8 the concentration of antibodies in tube 1. -the concentration of antibodies in tube 4 is 4 times the concentration of antibodies in tube 1.
the concentration of antibodies in tube 4 is 1/8 the concentration of antibodies in tube 1.
