MLT ASCP Review 5
A spectrophotometric scan of amniotic fluid may be valuable in the determination of which of the following conditions: - Neural tube defects - Maternal hypertension - Hemolytic disease of the newborn - Maternal diabetes
Hemolytic disease of the newborn
A known sickle cell trait patient has a hemoglobin electrophoresis test performed. Which of the following hemoglobin percentage sets would most closely match this patient's diagnostic state? - Hbg A= 90% Hgb S= 8% Hgb A2= 2% Hgb F= 0% - Hgb A= 60% Hgb S= 38% Hgb A2= 2% Hgb F= 0% - Hbg A= 40% Hgb S= 58% Hgb A2= 2% Hgb F= 0% - Hgb A= 25% Hgb S= 70% Hbg A2= 2% Hgb F= 3%
Hgb A= 60% Hgb S= 38% Hgb A2= 2% Hgb F= 0%
A complete blood count is performed on a post-surgical, post transfusion patient. The red cell distribution width (RDW) reported with the automated cell count is 16.5%. The reference interval at this laboratory is 11.0-14.5%. What would be demonstrated on the peripheral smear that relates directly to the RDW value? - Ansiocytosis - Macrocytosis - Microcytosis - Nucleated red blood cells
Anisocytosis
Which of the following characteristics of cerebrospinal fluid is present if blood is due to subarachnoid hemorrhage (SAH)? - Sample clots on standing - Blood is evenly distributed in all tubes - Supernatant is clear when centrifuged within one hour - Blood is more visible in the first tube collected and less and less visible in each subsequent tube thereafter
Blood is evenly distributed in all tubes
Which is in the correct order from the lowest concentration of H antigen to the highest concentration of H antigen? - Bombay, A1B, A1, A2B, B, A2, O - A1, O, B, A2, Bombay, A1B, A2B - Bombay, O, A1B, A2, A1, B, A2B - A1B, A2B, A2, O, B, A1, Bombay
Bombay, A1B, A1, A2B, B, A2, O
Homogentisic acid in urine will cause urine to be which of the following colors? - Green - Pink - Port-wine - Brown/black
Brown/black
Which type of kinetic reactions are reactions in which the enzyme is in excess and the substrate concentration is the limiting factor? - Zero order - First order - Second order - Third order
First order
The presence of two sporocysts each containing four banana-shaped sporozoites is characteristic of this organism; however, only oocysts with one sporocyst are typically seen in patient specimens. Which of the following organisms does this represent? - Cystoisospora belli - Sarcocystis spp - Cryptosporidium parvum - Blastocystis hominis
Sarcocystis spp
While serum elevations are NOT generally seen in early stages, which of the following tumor markers are elevated in more advanced stages of breast cancer? - CEA and AFP - AFP and CA 125 - PSA and CA 15-3 - CA 15-3 and CA 549
CA 15-3 and CA 549
Which of the following organisms causes thrush? - Cryptococcus neoformans - Aspergillus spp. - Candida albicans - Nocardia neoformans
Candida albicans
Which of the following enzymes is associated with conditions affecting skeletal muscles? - Aldolase - Alkaline phosphatase (ALP) - Gamma-glatamyltransferase - 5'-nucleotidase
Aldolase
All of the following are factors that will affect migration in gel electrophoresis, EXCEPT? - Gel concentration - Size of particle - Voltage used - Amount of light present
Amount of light present
In therapeutic drug monitoring, a person who is classified as an ultrarapid metabolizer (UM) would need _________ of a drug metabolized by that enzyme. - A lower dose - A higher dose - The standard dose - There is no such thing as an ultrarapid metabolizer
A higher dose
Colonies growing on a blood agar plate are grey, white, and swarming. The same organism growing on XLD agar have black centers with pigmentation that does not extend into the agar. A presumptive identification of Proteus spp. can be made. Select the biochemical reaction that serves to separate Proteus vulgaris from Proteus mirabilis. - Positive indole - Positive urease - Negative Methyl Red - Positive Phenylalanine deaminase
Positive indole (P. vulgaris = + indole)
Of the following anticonvulsant medications, which one does not rely solely on the liver to metabolize it for excretion? - Valproic acid - Phenobarbital - Phenytoin - Carbamazepine
Phenobarbital
What is an appropriate use for molecular (DNA) tests for mutations of the HFE gene, the gene found in the majority of patients diagnosed with hereditary hemochromatosis (HH)? - Testing family members of persons with HH - Screening of all newborns - Predicting the severity of iron overload - Identifying persons with iron overload
Testing family members of persons with HH
What type of chemical is lithium? - An anionic metal - A synthetic salt - A cationic metal - A naturally occurring salt
A cationic metal
A standard is used to check the _________ of a method or instrument - Precision - Accuracy - Variance - Stability
Accuracy
Most of the carbon dioxide present in the blood is in the form of: - Bicarbonate - Carbonate - Carbonic acid - Dissolved CO2
Bicarbonate
Which of the following organisms is considered to be pathogenic - Entamoeba histolytica - Entamoeba coli - Chilomastix mesnili - Trichomonas hominis
Entamoeba histolytica
Which of these describes the mode of action of the beta-lactam class of antibiotics? - Inhibits protein synthesis - Inhibits DNA synthesis - Inhibits cell wall synthesis - Inhibits RNA synthesis
Inhibits cell wall synthesis
All of the following are characteristics of type 2 diabetes mellitus EXCEPT: - Insulin levels may or may not be abnormal - More common than type one diabetes - Requires insulin therapy to control hyperglycemia - It commonly occurs in adults
Requires insulin therapy to control hyperglycemia
What part of an immunoglobulin molecule exists as kappa or lambda chains? - Fc - Fab - Heavy chains - Light chains
Light chains
What is the half-life of IgG? Why is the duration of the half-life significant? - 1-3 days; it is the first antibody produced in an immune response - 5-6 days; 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
After an acute myocardial infarction (AMI), myoglobin levels will rise within 3 hours and peak at 8-12 hours. When will they return to normal? - 10-20 hours - 5-10 hours - 3-4 days - 18-30 hours
18-30 hours
What is the increase in the risk percentage for developing antibodies against red cell antigens (RBC alloimmunization) for patients who are characterized as chronically transfused patients? - 1%-4% - 2%-8% - 5%-10% - 20%-50%
2%-8%
Which of the following laboratory results is characteristic for a patient with Von Willebrand disease? - Decreased bleeding time - Normal FVIII levels - Normal platelet function tests - Abnormal platelet aggregation response to ristocetin
Abnormal platelet aggregation response to ristocetin
What is the cause of iron overload in hereditary hemochromatosis? - Absorption of excessive amounts of iron in the small intestine - Ingestion of excessive amounts of iron from diet or supplements - Inability of the body to excrete normal amounts of dietary iron - Failure of developing red blood cells to incorporate iron into protoporphyrin IX
Absorption of excessive amounts of iron in the small intestine
After birth, which of the following is the biggest concern for a newborn infant suffering from hemolytic disease of the fetus and newborn? - Accumulation of bilirubin - Anemia due to red blood cell destruction - Decrease in bilirubin level - Low hematocrit levels
Accumulation of bilirubin
Which of the following blood tests is used in the determination of prostate cancer? - Acid phosphatase - Alkaline phosphatase - Alanine aminotransferase (ALT or SGPT) - Creatinine
Acid phosphatase
Oliguria is usually correlated with: - Acute glomerulonephritis - Diabetes mellitus - Hepatitis - Tubular damage
Acute glomerulonephritis
Which of the following characteristics of HDFN is NOT different for ABO and Rh HDFN? - Disease predicted in titers - Anemia at birth - Antibody is IgG - Bilirubin at birth
Antibody is IgG
Which of the following blood group antigens are most susceptible to destruction by the action of enzymes? - D - Jka - Lea - Fya
Fya
Diseases associated with a dysfunction of polymorphonuclear neutrophils (PMNs) include all of the following with the exception of: - Chediak-Higashi syndrome (CH) - Chronic granulomatous diseases (CGDs) - Gaucher's Disease - Meyloperoxidase deficiency (MPO)
Gaucher's Disease
A deficiency of platelet receptor IIb/IIIa can be found on which of the following? - Glanzmann Thrombasthenia - Von Willebrand disease - Asprin therapy - Bernard-Soulier syndrome
Glanzmann Thrombasthenia
Which type of antibodies are known to cause transfusion-related acute lung injury (TRALI) reactions? - Red cell antibodies - Platelet antibodies - HLA antibodies - Both red cell antibodies and platelet antibodies
HLA antibodies
If a disease or disorder causes serum binding proteins (such as albumin) to decrease, what may occur if the dose of a highly protein-bound drug with a narrow therapeutic window is not adjusted? - The patient may not realize a therapeutic benefit (low free drug fraction) - The patient may experience toxic effects (high free drug fraction) - The serum level of the drug will most likely remain in the therapeutic range - Not enough information is provided to determine the effect of the drug on the patient
The patient may experience toxic effects (high free drug fraction)
Which of the following is the most common cause of hyperkalemia in hospitalized patients? - Cellular injury - Therapeutic potassium replacement - Chemotherapy - Leukemia
Therapeutic potassium replacement
In which organ or tissue do T-lymphocytes mature? - Bone marrow - Thymus - Lymph nodes - Spleen
Thymus
Acute intravascular hemolysis as the result of a blood transfusion is most often associated with which of the following causes? - Transfusion of ABO incompatible red blood cells - Allergic reaction - Passively transfused antibodies to HLA antigens - Transfusion-associated graft-versus-host disease
Transfusion of ABO incompatible red blood cells
Which of the following crystals would most likely be found in normal ALKALINE urine? - Amorphous urates - Triple phosphate - Uric acid - Calcium oxalate
Triple phosphate
A clinical laboratory scientist is reviewing the results of comparison studies between laboratory plasma glucose results and patients self-monitoring (whole blood) blood glucose (SMBG) results. Which SMBG results are to be expected? - Whole blood result is 11% higher - Whole blood result is 11% lower - Plasma result is 11% lower - The difference between results should be negligible
Whole blood result is 11% lower
What is the most frequent genotype among Rh0 (D) negative persons? - r'r - r'r" - rr - r"r
rr
The McLeod phenotype is associated with which of the following antigen systems? - Rh - P - Kell - MNS
Kell
Which of the following tests confirms the presence of Bence-Jones proteinuria: - Protein electrophoresis - Sulfosalicylic acid precipitation - Cryoprecipitation - Immunoelectrophoresis
Immunoelectrophoresis
The function of very low density lipoproteins (VLDL) is to transport: - Cholesterol from peripheral cells to the liver - Cholesterol and phospholipids to the peripheral cells - Exogenous triglycerides - Endogenous triglycerides
Endogenous triglycerides
Which of the following is matched correctly? - Enterobius vermicularis ova-ovoid in shape with one side flattened. The embryo is separated from the shell by a clear space - Trichomonas vaginalis-is considered an important factor in the etiology of carcinoma of the bladder. The ova are elongated and are 60x160 microns. They are a yellowish color, slightly transparent, and possess a delicate terminal spine - Schistosoma haematobium ova-have a characteristic oval body with a long thin tail and are 50 microns in length - Sperm-is highly motile, measuring 8-15 microns with a characteristic pear shape. It has multiple anterior flagella and the nucleus is often apparent
Enterobius vermicularis ova-ovoid in shape with one side flattened. The embryo is separated from the shell by a clear space
What condition would be suspected in an asymptomatic patient with greater than 20% atypical (reactive) lymphocytes on their peripheral blood smear? - Herpes simplex virus infection - Epstein-Barr virus infection - Bacterial meningitis - Acute leukemia
Epstein-Barr virus infection
Which porphyria has a defect in the ferrochetalase enzyme within the RBC, causing redness, edema, and burning when exposed to light? - Erythropoietic protoporphyria - Congenital erythropoietic porphyria - X-linked protoporphyria - Variegate porphyria
Erythropoietic protoporphyria
The properties of an antibody class are defined by the: - Size of the immune complex - Nature of the stimulating antigen - Fab end of the molecule - Fc end of the molecule
Fc end of the molecule
Which additional fraction would be seen if plasma rather than serum was subjected to electrophoresis: - Alpha-1 antitrypsin - Alpha-2 macroglobulin - Fibrinogen - Gamma globulins
Fibrinogen
Which of the following is a direct nucleic acid test? - Fluorescence Polarization Immunization (FPI) - Polymerase Chain Reaction (PCR) - Fluorescence In Situ Hybridization (FISH) - Nucleic Acid Sequence-Based Amplification (NASBA)
Fluorescence In Situ Hybridization (FISH)
In the heterozygous state of HbS, referred to as sickle cell trait, which of the following hemoglobins appear in combination with HbS? - HbE - HbA - HbC - HbD
HbA
Which of the following is the predominant immunoglobulin class for anti-A and anti-B antibodies in group B and group A individuals? - IgM - IgG - IgA - IgE
IgM
A new clinic in the area is sending a very large number of additional chemistry tests to the laboratory. The existing chemistry instrument is only 2 years old and works well, however, there is a need to acquire a high throughput instrument. Which of the following is the appropriate "Justification Category?" - Decreased turnabout time - Decreased cash flow potential - Increased testing volume - Increased reagent cost
Increased testing volume
Which abnormal gene is inherited within Chediak Higashi resulting in dysfunctional cells and susceptible to infections consequently? - LYST - JAK2 - TET2 - ADAMTS13
LYST
Which of the following is characteristic of Alder-Reilly anomaly? - Giant, dysfunctional lysosomal cytoplasmic granules - Dohle body-like inclusions composed of precipitated myosin heavy chains - Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides - Decreased nuclear segmentation and coarse chromatin in leukocytes
Large, darkly staining cytoplasmic granules composed of partially digested mucopolysaccharides
Which one of these Lewis blood group system phenotypes usually produces anti-Lea? - Le(a+b+) - Le(a+b-) - Le(a-b+) - Le(a-b-)
Le(a-b-)
Identify a characteristic of an organ non-specific disorder that distinguishes it from an organ specific disorder: - Lesions caused by deposition of antigen-antibody immune complexes - Antigens only available to lymphoid system in low concentrations - Lymphoid invasion, parenchymal destruction by questionable cell-mediated hypersensitivity or antibodies - Tendency to develop cancer in a specific location of the body
Lesions caused by deposition of antigen-antibody immune complexes
In a normal CSF the protein concentration as compared to that in the plasma is generally: - Less than 50% - Less than 30% - Less than 10% - Less than 1%
Less than 1%
The Knott technique serves as a means of identifying: - Plasmodium vivax - Babesia microti - Loa loa - Strongyloides stercoralis
Loa loa
This medium is used for the cultivation and identification of Corynebacterium diphtheria. It contains serum and egg which stimulates growth and the production of metachromatic granules in the cells. Select this media from the following: - CIN medium - TCBS medium - Modified Tinsdale medium - Loeffler medium
Loeffler medium
Which of the following is the main function of the ASCP Board of Certification? - Set standards for CLIA competency testing - Assure laboratory compliance with CLSI Standards - Maintain a registry of certified personnel - Certify CLIA competency of laboratory personnel
Maintain a registry of certified personnel
Critical results from the microbiology department must be communicated to the clinician immediately. All of the following results are considered critical EXCEPT: - Positive spinal fluid Gram stain or culture - Blood smear for malaria - Negative acid-fast stain - Streptococcus pyogenes from a surgical wound
Negative acid-fast stain
The property MOST responsible for the migration of proteins in an electrical field is: - Molecular weight - Net surface charge - Endosmotic flow - Voltage
Net surface charge
Malassezia furfur is the cause of tinea versicolor. To cultivate this organism, the agar should be overlaid with: - Water - Olive oil - India ink - Ethanol
Olive oil
Which type of Plasmodium infection has a 72-hour cycle, tends to infect old cells, and will have normal sized red blood cells? - Plasmodium vivax - Plasmodium ovale - Plasmodium malariae - Plasmodium falciparum
Plasmodium malariae
All of the following are reasons for conduction compatibility testing EXCEPT: - Prevent recipient alloimmunization - Verify ABO and Rh - Select proper blood products - Detect antibodies against donor cells
Prevent recipient alloimmunization
In addition to a Romanowsky stain, which one of the following would be useful in the routine evaluation of a bone marrow? - Chloroacetate esterase - Periodic Acid-Schiff (PAS) - Prussian blue - Sudan Black B
Prussian blue
The kidneys perform all of the following functions EXCEPT: - Acid-base balance - Hormone production - Reabsorption of waste products - Water and electrolyte balance
Reabsorption of waste products
What physiological factor causes sedimentation in the Erythrocyte Sedimentation Rate (ESR)? - Elevated levels of immunoglobulins - Increased concentrations of fibrinogen - Rouleaux formation - Tilted tube, varying from the vertical
Rouleaux formation
To ensure quality within the preanalytical phase of laboratory testing, quality assurance activities includes monitoring all of the following preanalytical variables EXCEPT: - Selection of reference materials used for validation purposes - Laboratory test utilization - Positive patient identification - The stability of patient specimens during transport
Selection of reference materials used for validation purposes
A patient has been diagnosed with an upper gastrointestinal bleed. Which of the following would be characteristic for this condition? - Red stool - Pale yellow, white or grey stool - Stool much darker brown or black in color - Mucous or blood streaked mucus stool
Stool much darker brown or black in color
Which one of the following is not an acute phase protein? - Alpha-1 Antitrypsin - C-Reactive protein - Protein S - Fibrinogen
Protein S
Which of the following inclusions may be observed on a Wright-stained peripheral blood smear if a patient has a splenectomy? - Reticulocytes - Basophilic stippling - Howell-Jolly bodies - Schistocytes
Howell-Jolly bodies
A newborn presents with neonatal alloimmune thrombocytopenia. What is the most likely cause of this condition? - Maternal antibodies to neonatal platelet antigens - Maternal antibodies to neonatal ABO antigens - Maternal antibodies to neonatal white cell antigens - Maternal antibodies to neonatal D antigen
Maternal antibodies to neonatal platelet antigens
You are running quality control for Hemoglobin A1c by high pressure liquid chromatography (HPLC). The high control was 2.5 standard deviations above the mean. The low control was 2.2 standard deviations below the mean. Should you continue to run patient samples? - Yes. Neither QC value exceeded 3 standard deviations and therefore did not violate a Westgard QC rule. - Yes. Although a Westgard 1-3s rule was violated, it only indicates caution and not rejection of the QC run. - No. These QC values indicate a violation of the Westgard 4-1s rule and are therefore cause for rejection. - No. These QC values indicate a violation of the Westgard R-4s rule and are therefore cause for rejection.
No. These QC values indicate a violation of the Westgard R-4s rule and are therefore cause for rejection.
Plasma exchange is the current treatment for all of these conditions, EXCEPT: - Warm autoimmune hemolytic anemia (WAIHA) - Diarrhea-associated hemolytic uremic syndrome (HUS) - Thrombotic thrombocytopenic purpura (TTP) - Pernicious anemia
Pernicious anemia
All of the following conditions would be associated with an increased level of alpha-fetoprotein, EXCEPT? - Prostate cancer - Hepatocellular carcinoma - Viral hepatitis - Testicular tumors
Prostate cancer
