AMT MLT Exam Study Guide/Practice Test #2

Chain of custody.

Beginning with the moment the specimen is collected and transported to the laboratory, to the analysis itself and the reporting of the results, must be documented by a process known as

Mercury arc and deuterium discharge

Which lamps are most common when working in the ultraviolet region?

tyrosine

Which of the following crystals should be accompanied by a positive test for urine bilirubin?

Degree to which a measurement represents the true value.

Which of the following is a definition of accuracy in blood banking?

Recording data on appropriate log

Which of the following is an example of good record keeping in Blood Banking?

Drug testing

Which of the following is one of the most common clinical applications of GC-MS analysis?

Glomerulus

Which of the following is part of the nephron and mainly functions to filter incoming blood?

Streptococcus pneumoniae

Which of the following organisms is commonly tested for β-lactamase production by the cefinase method?

A condition when a mother makes an antibody to red cell antigens from the fetus.

Which of the following statements is true regarding hemolytic disease of the newborn (HDN)?

L/S ratio

Which of the following tests performed on amniotic fluid is used to screen for Fetal Lung Maturity?

Anemia, Polycythemia, Multiple myeloma

Which physiologic conditions make it difficult to make a good blood smear due to the abnormal composition of the blood?

Asian

Which population in the U.S. has the highest frequency of the group B phenotype?

diazo reaction

Which reagent strip test is associated with a screening test for bilirubin?

Thin-layer chromatography

Which test is commonly used to test for fructose, sucrose, dextrose, lactose, xylose, galactose, and arabinose, because these are sugars most often found in urine?

EM Quant

Which test is used when interference is suspected from any reagent strip tests that depend on presence of hydrogen peroxide?

Weiner

Which theory with regards to Rh believes that each parent gives one Rh gene but that alleles at one gene locus are responsible for expression of their system antigens on the red cell?

Alpha-fetoprotein

Which tumor marker is an abundant serum protein and normally synthesized by the fetal liver?

Aminoglycosides

Which type of antibiotic would you see tested only on inpatients because they are not well absorbed from the gastrointestinal tract?

35 days

Whole blood units are stored at 1 - 6oC for how many days if collected in CPDA-1?

ketones

With a high glucose on a urine strip you may also expect to see

Bile solubility test

With the addition of a bile salt, sodium desoxycholate, the lytic process is accelerated with this test, what is this test?

india ink, latex agglutination

You have a budding yeast isolate from a spinal fluid sample. What tests could you perform to determine if the isolate is Cryptococcus?

Chylomicrons

__________ give serum its characteristic milky appearance (lipemia) when blood is drawn after a meal.

a hematoma.

Failure to apply sufficient pressure to the venipuncture site could result in

intravenous lines, edema, scarring or burn patients, dialysis patients, and mastectomy patients.

Five specific situations may result in a difficult venipuncture or may be the sources of preanalytical error. They are:

one end of the bacterial cell, both ends of the bacterial cell, the entire cell surface.

Flagella are located on

Type I

For qualitative chemistry procedures and for most procedures done in hematology, immunology, microbiology, and other clinical test areas, this type of water is suitable. This type of water is used for general lab tests that do not require Type I water.

deep blue to purple

Gram positive organisms after gram staining appear ___________________.

Celsius plus 273

How do you convert Celsius to Kelvin?

Sudan III.

Identification of oval fat bodies is confirmed by staining with

Calibration

If I wanted to standardize an instrument to help eliminate errors, that could harm a patient or donor, what is the process?

Patient identification error

If during an immediate spin crossmatch, if the results are incompatible what is likely the cause?

Triglyceride and HDL

If testing of a lipoprotein profile in a non-fasting state, then which of the following tests can be used?

Solid-phase immunosorbent assay (SPIA).

If the antibody directed toward the agent being assayed is fixed firmly to a solid matrix, either to the outside of a spherical plastic or metal bead or some other solid matrix, the system is called

A

If you mix an unknown antigen (patient red cell) with a known antibody (Anti-A) and get visible agglutination, which unknown antigen is detected?

Elution

IgG antibody complexes on red blood cells can be dissociated and placed in a solution to test specificity. What process is this?

Acetoacetic acid

In fat catabolism (the phase of metabolism in which fats are broken down for energy), what is produced first?

Decreased iron intake (either from inadequate diet or impaired absorption), increased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or increased iron requirements in infancy, pregnancy and lactation

In simplified terms, iron-deficiency anemia may result from the following:

RBC

In the calculation of MCV = HCT x 10/___?

Chorea and undulant fever

In the vast majority of infections, there is at least some increase in the ESR. What are two exceptions?

Digoxin

Many cardiac conditions are treated with drugs, but only a few require TDM. The two classes of drugs that need monitoring are the cardiac glycosides and the antiarrhythmics. Which drug belongs to the glycosides?

c. Calcofluor White

KOH used in conjunction with what fluorescent dye will enable the microbiologist to visualize fungal structures?

Evaluate the overall quality of the blood film, estimate the leukocyte count, and scan the blood film for abnormal cells and clumps of platelets.

Low power examination (10x objective) includes the following:

Safety Data Sheets

Material Safety Data Sheets (MSDSs) are now called:

Gram positive bacilli, gram negative bacilli, gram positive cocci, gram negative cocci

Most bacteria can be divided into what four distinct groups based on gram stain results?

Enterobius vermicularis

Most laboratories use the clear cellophane tape method to collect and prepare this specimen for examination

Type 2

Non-insulin dependent diabetes, is characterized by insulin resistance and progressive hyperglycemia and is called "adult-onset diabetes" is

low power.

Cellular casts should first be examined under

Electric equipment.

Class C fire extinguishers are used for

detection of the toxins A and B by PCR test on a diarrheal specimen.

Clostridium difficile disease can be diagnosed by

Platelet count, platelet aggregation assays, platelet adhesion, and clot retraction

Current tests for platelets include:

Accuracy

Describes how close a test result is to the true value.

Hemoglobinopathies.

Disorders in which the presence of structurally abnormal hemoglobin is considered to play an important role pathologically are called

. LDH-5

Due to LDH nonspecificity, it is best to separate into isoenzyme fractions. LDH can be separated into five major fractions. Disorders of skeletal muscle will show elevated levels of which LDH isoenzyme?

Patient serum with donor cells

During a major side crossmatch compatibility for packed red blood cells, what is used for testing?

that exist inside the body of animals and can cause endogenous infections.

Endogenous anaerobes are organisms

antibodies bound to enzymes

Enzyme-linked immunoassays (ELISA) employ the use of _______________ to produce a visible end point.

Liver

Every function in the living cell depends on proteins. Most of the plasma proteins are synthesized in what organ?

(Leukocyte count x100)/(100 + # of NRBC)

Nucleated erythrocytes may falsely elevate leukocyte count which a correct leukocyte count must be performed as a corrective procedure. Which of the below is the correct formula?

perform a pre-warm technique.

One method to avoid reactivity with a cold antibody is

Blood gases, slides/smear, EDTA tubes, other additive minicontainers, and serum containers

Order of draw for capillary specimens:

Disseminated intravascular coagulation (DIC).

Particle agglutination is used for detecting D-dimers associated with

Pseudomonas aeruginosa

Phenylethyl alcohol agar (PEA) inhibits the growth of gram negative organisms except

4 hours

Pooled platelets that have been stored at 20-24oC expire within how many hours?

Extrinsic pathway

Prothrombin time measures which pathway?

Material safety data sheet (MSDS).

Reference materials about the individual chemical are provided by all chemical manufacturers and suppliers by means of

. specimen was left standing too long before it was sent

Specimen was received in the lab and it had a very strong ammoniacal odor, what could be a cause of this?

Fibrinogen.

The APTT measures factors XII, XI, IX, VIII, V, II and

Pictograms

The GHS brings with it a new chemical labeling standard using ____________.

Plasmin.

The active enzyme that is responsible for digesting fibrin or fibrinogen is

Labile coagulation factor.

The activity of factor V in plasma deteriorates even when the plasma is frozen; it is the most unstable of the coagulation factors and is also known as

IgG

The antiglobulin test is important because it detects what antibodies that have attached to red cells either in vivo or in vitro but do not demonstrate visible agglutination in testing?

sensitization

The binding of an antibody or complement component to a red cell is the definition of

a. Final volume b. Unique number assigned to pool c. Name of preparing facility

The blood bank industry adopted a standard of labeling units. What are the specific labeling requirements in addition to the standard for pooled components?

Creatinine clearance

The calculation of which of the following renal function tests are becoming the standard laboratory method for determining glomerular filtration rate (GFR).

Calibration

The comparison of an instrument measurement or reading to a known physical constant.

Antiepileptic

The drug phenobarbital is a slow-acting barbiturate that effectively controls several type of seizures and is considered which class of drug?

perform the testing as soon as possible on a room temperature specimen

The first rule for providing a meaningful urinalysis test is to

Analyze serial dilutions of linearity check material multiple times to minimize effects of imprecision

The following procedure describes linearity determination for each direct measured parameter on a hematology analyzer.

Anti-D

The immune serum globulin that is given to D negative pregnant mothers is to prevent production of which antibody following delivery?

D-galactose.

The immunodominant sugar for the B antigen is

CA 15-3

The main purpose of this assay is to monitor breast cancer patients after mastectomy. It is positive in patients with other conditions, including liver disease, some inflammatory conditions, and other carcinomas.

pharmacokinetics.

The mathematics modeling of drug concentration in circulation which helps assist in establishing a dosage regimen is

Turbidimetry

The measurement of the decrease in intensity of an incident light beam as it passes through a solution of particles defines which of the following methods?

Flourescent.

The microscope commonly used in cellular biology that has the ability to distinguish between living and dead cells and monitor activity within living cells is the

Haemophilus influenzae, Streptococcus pneumoniae and occasionally Staphylococcus aureus.

The most common causes of bacterial conjunctivitis in children are

Kohler illumination.

The most common method of illuminating specimens on a microscope is

16

The new Safety Data Sheets (SDSs) will require ______ specific sections, ensuring consistency in the presentation of the information.

40X objective

The objective that should never have oil used on it is the

Insulin and glycogen.

The pancreas contains islets of Langerhans, which produce

TnI

The patient presented at the clinic after returning from a fishing trip. Chief complaint is left-sided anterior chest pain that started 3 days ago. Patient states no injury. Which cardiac test would give the physician the best picture of diagnosis?

flatworms.

The phylum Platyhelminthes are

phenoytpe.

The physical expression of inherited traits is determined by reacting red cells with known antisera and observing for the presence or absence of hemagglutination is

Age, Genetic make-up, Route of inoculation

The primary immune response is elicited as the first exposure to a foreign antigen and is influenced by the characteristics of the antigen and immune response. What are some host properties contributing to the immune response?

Tubules

The process of formation of urine by selective reabsorption takes place in which part of the kidneys?

bromthymol blue and methyl red

The reagent strip tests for pH uses a double indicator system which uses what two chemicals?

AST

The reduction of oxaloacetate to malate by malate dehydrogenase is used in the measurement of which enzyme?

Landsteiner's rule.

The rule of stating that normal, healthy individuals possess ABO antibodies to the ABO blood group antigens that are absent from their red cells is termed

cephalic, basilic and median cubital.

The three veins that are typically used for venipuncture are the

Plasma.

The total volume of blood in an average adult is about 6 L, or 7% to 8% of the body weight. About 45% of this amount is composed of red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes); the remaining 55% is the liquid fraction

a first and second morning specimen.

The urine collection used to evaluate orthostatic proteinuria is

Kidney failure

There are five stages of chronic kidney disease. In looking at the results of a glomerular filtrate rate of 13 ml/min per 1.73 m2, which stage would you say this patient was in?

Maltese Cross

This characteristic is formed in the oval fat droplets that contain cholesterol it is?

Direct antiglobulin test (DAT)

This is one of the most useful procedures for distinguishing immune from nonimmune mechanisms that can underlie hemolytic anemias. What test is used to detect RBCs that have been coated with antibodies?

Human chorionic gonadotropin

This marker is strongly suggestive of pregnancy or a malignant tumor such as endodermal sinus tumor, teratocarcinoma, choriocarcinoma, molar pregnancy, testicular embryonal carcinoma, or oat cell carcinoma of the lung.

1% ammonium oxalate solution

To perform the manual platelet count, whole blood is diluted with what solution using the unopette system?

contact, airborne, and droplet.

Transmission-based precautions are divided into three basic categories:

New methylene blue

Using this stain helps precipitate residual ribosomal RNA within reticulocytes.

indicate renal disease.

Waxy Casts are almost always pathologic because they

Heterophil antibodies

What are defined as antibodies that are stimulated by one antigen and react with an entirely unrelated surface antigen present on cells from different mammalian species?

Category C

What category of bioterrorism agents has the following characteristics? These agents have the third-highest priority and include emerging pathogens that could be engineered for mass dissemination in the future because of availability, ease of production and dissemination?

Prokaryotes

What cells do not have a nucleus or any membrane bound organelles such as mitochondria, and their ribosomes are a smaller size than eukaryotic ribosomes?

Porphyrins

What compound shows a strong absorbance near 400 nm and often displays a characteristic orange-red fluorescence?

Klebsiella pneumoniae

What gram negative rod is associated with lobar pneumonia in hospitalized patients?

Westergren method

What has been selected as the method of choice by the Clinical Laboratory Standards Institute (CLSI) for measuring erythrocyte sedimentation rate (ESR)?

<i>Ehrlichia chaffeensis</i>

What is a gram negative, obligate intracellular parasite that multiplies in monocytic white cells (human monocytic ehrlichiosis)?

Apheresis

What is a method of blood collection where whole blood is removed from a donor and separated into components and that one or more components are retained and the other is returned to the patient?

Acetest

What is a tablet test for acetone and acetoacetic acid based on a color reaction with sodium nitroprusside?

Closure time (CT)

What is a test system to assess platelet-related primary hemostasis with greater accuracy and reliability than bleeding time?

Lipase

What is an enzyme that hydrolyzes the ester linkage of fats to produce alcohols and fatty acids? It is found primarily in the pancreas.

Rheumatoid arthritis (RA) agglutination test

What is based on the reaction between patient antibodies in the serum, known as the rheumatoid factor (RF), and an antigen derived from human gamma globulin (IgG)?

Bilirubin

What is derived from the iron-containing heme portion of hemoglobin, which is released from the breakdown of RBCs?

Phenylethyl alcohol agar

What is essentially sheep blood agar with phenylethyl alcohol added?

<i>Plasmodium spp</i>

What is identified by using thick and thin blood smears are made to allow for better detection of parasites forum in blood, such as

Antigenicity

What is influenced by molecular size, foreignness, shape of the molecule, and chemical composition?

Lipemic specimens

What is milky-white in color and may interfere with chemical determinations such as triglyceride assay?

Glucagon

What is secreted by the alpha cells of the pancreas, is the major hormone that opposes the action of insulin, increasing blood glucose by stimulating the breakdown of glycogen (glycogenolysis) by the liver?

Magnesium

What is the fourth most abundant cation in the body and second most abundant intracellular ion? In addition, this electrolyte has high concentrations found in bone and muscle.

30 mL

What is the maximum amount of fetomaternal hemorrhage (FMH) D positive fetal red cells a women is allowed to lose for one dose of RhIG?

Enzymatic Law

What is the most accurate answer for enzyme activity on a diluted 1:4 specimen with a 500 u value?

Hematuria

What is the presence of RBCs in the urine referred to as?

Antisepsis

What is the process used to decrease the number of microorganisms that are present on the skin?

IU

What is the recommendation of the Enzyme Commission of the International Union of Biochemistry for reporting enzyme results?

Three stool samples, 1 or 2 days apart, within a 10 day period

What is the recommended protocol for collecting a stool sample?

Patient cells

What is the source of antigen for performing the forward group ABO/D typing?

Taxonomy

What is the study of the classification process?

. Direct immunofluorescent assay

What is the technique that uses a conjugated antibody to detect antigen-antibody reactions that can be seen with a fluorescent microscope?

Agglutination

What is the term applied to aggregation of particulate test antigens?

Gram positive

What is the term for bacteria that stain purple/blue as a result of retention of crystal violet-iodine complex?

Precipitation

What is the term used to describe the aggregation of soluble test antigens?

Brightfield microscopy

What is the traditional method for the observation of the urine sediment?

Rapid plasma regain (RPR)

What is the widely used nontreponemal serological test?

Jaundice

What is the yellow discoloration of the plasma, skin, and mucous membranes that is caused by the abnormal metabolism, accumulation, or retention of bilirubin called?

Thrombin time

What laboratory test has the following characteristics? Its purpose is plasma factors. It measures concentration and activity of fibrinogen in stage III and monitors coumarin therapy.

Megaloblastic anemias

What macrocytic anemias are the results of vitamin B12 or folic acid deficiency, or a combination of both?

rothrombin group

What measures factors II, VII, IX, and X?

Erythrocyte sedimentation rate

What measures the rate of setting of erythrocytes in diluted human plasma?

Lowenstein-Jensen medium

What medium is best for the Mycobacterium tuberculosis?

Streak plate method

What method is used for quantitating the growth of microorganisms in the urine and is the classic culture method typically used in many clinical laboratories?

Southern blot

What molecular technique can determine single-base mutations that include sickle cell anemia and hemophilia A?

Sedimentation

What procedure uses gravity or centrifugation and allows recovery of all protozoa, egg, and larvae present in the specimen?

Enzyme immunoassay (EIA)

What provides an alternative to immunofluorescent assays and uses nonisotopic label, which offers the advantage of safety and demonstrates specificity, sensitivity, and rapidity? This method is popular for waived, over the counter testing.

Occupational Exposure to Bloodborne Pathogens

What regulation that became law in 1992, requires that laboratories develop, implement, and comply with a plan that ensures the protective safety of laboratory staff to potential infectious blood-borne pathogens and manage and handle medical waste in a safe and effective manner?

Secondary hemostasis

What results in the formation of a blood clot because coagulation factors present in the blood interact, forming a fibrin network and a thrombus, to stop the bleeding completely? Slow lysis of the thrombus begins, and final repair to site of the injury takes place.

Ion-selective electrode (ISE) potentiometry

What uses a glass ion-exchange membrane for sodium assay and a valinomycin neutral-carrier membrane for potassium assay and has been incorporated into many automated chemistry analyzers?

Renal threshold

What varies from person to person and is the lowest blood glucose concentration that will result in glycosuria?

Levey-Jennings chart

When a new lot number of controls are used with a hematology analyzer, the new control material must be tested and plotted to establish the mean and the control limits. How is this plotted?

Plasma (top layer), buffy coat (grayish white cellular layer composed of white blood cells and platelets), red blood cells (bottom layer).

When a preserved blood specimen is allowed to stand for a time, the components will settle into the following three distinct layers:

Large center square

When counting platelets using the unopette system (a manual method), which area is used to count on the Neubauer hemacytometer?

The resistance patterns of the institution do not need to be regarded in the selection of antibiotics to report.

When deciding which antimicrobial agents to test and report on, an isolate which of the following statements is NOT true?

Microcytic erythrocytes

When evaluating erythrocyte histogram, a shift to the left of the erythrocyte series should correspond to the following type of erythrocytes?

Megakaryocytes

When performing a bone marrow differential count, which cell is not included?

Weak D positive

When performing an antihuman globulin test that is positive for Anti-D and negative for Rh control, how would you interpret the results?

crenated.

When the patient's urine is hypertonic, the RBC's appear

Impedance

Which automated blood cell counting principle is based on increased resistance that occurs when a blood cell with poor conductivity passes through an electrical field?

Irradiated red blood cells

Which blood product would be best for a patient that the physician is concerned about that has graft versus host disease (GVHD)?

Immunosuppressive

Which class of drugs plays a role in determining the success of any transplant program?

Myeloperoxidase

Which cytochemical stain is the most sensitive and specific stain for granulocytes?

Sudan black B (BBB)

Which cytochemical stain is used in differentiating the cell lineage of malignant cells in the bone marrow that stains phospholipids, neutral fats, and sterols?

Lipase

Which enzyme is used almost exclusively for the diagnosis of acute pancreatitis?

Thyroxine

Which hormone is classified as an example of an amino acid-related hormone?

acetone and acetoacetic acid.

Acetest tablet test is used to confirm

Pseudomonas aeruginosa

A 10 year old child presents to his primary care physician with a complaint of severe ear pain. The child had been swimming in the lake several days earlier. The culture from the ear grew a gram negative rod with a grapelike odor. The colonies were flat and spreading with rough edge and a metallic sheen. It was indole negative and oxidase positive. What is the likely organism?

Neisseria gonorrhoeae

A 20 year old male presents to the Emergency room with heavy urethral discharge that had been present for 3 days. He has been sexually active with several partners and has used no contraceptives. A culture of the discharge grows gram negative diplococci with adjacent sides that are flattened and is oxidase positive. What is the likely organism?

3% CO2

A candle jar will provide what atmospheric condition?

test for the presence of beta-lactamase enzyme in a bacterial isolate.

A cefinase disk may be used to

physical, chemical and microscopic qualities of urine.

A complete urinalysis usually includes the examination of

Troponin.

A complex of three proteins that bind to the thin filaments of striated cardiac or skeletal muscle and regulate muscle contraction is

amorphous phosphates precipitated

A freshly voided urine was yellow and clear. It was placed in the refrigerator until it could be brought to the lab. When it arrived in the lab, it had a white precipitate. Which of the following is the most likely explanation for this urine's appearance upon arrival in the lab?

Trichomonas

A pear shaped flagellate with an undulating membrane commonly found in urine sediment is

H

A person who is said to be a secretor is an individual that has the Se allele and expresses the soluble form of which antigen in their secretions?

Granulocytic leukocytes

A positive indicator with a rating of 2+ on the leukocyte esterase of a urine reagent strip is indicative of what type of cells?

Quality control

A process that monitors the accuracy and reproducibility of results through the use of control specimens.

Azotemia.

A significant increase in the plasma concentrations of urea and creatinine, in kidney insufficiency, is known as

the patient had a previous brain bleed.

A specimen just collected in a spinal tap is taken immediately to the lab and examined. The specimen is centrifuged in a microhematocrit tube. The supernatant is xanthochromic most likely indicating

. antigen.

A substance that is foreign and binds specifically to an antibody or a T-cell receptor is a definition of

Polycythemia, Hemochromatosis, Porphyrias

A therapeutic phlebotomy is performed on a patient to withdraw blood from a patient for medical reasons. Which of the following is a common indication of therapeutic phlebotomy?

Category A.

Agents anthrax, botulism, plague, smallpox, tularemia, filoviruses, and arenaviruses are classified as

Category B.

Agents brucellosis, epsilon toxin, food contaminants, glanders, melioidosis, psittacosis, Q fever, and ricin toxin are classified as

amorphous urates.

All but the following crystals are found in alkaline urine except

2015

All chemical manufacturers and distributors must comply with all of the new provisions in the revised standards by June 1 ______________.

discard the last urine collected in the 24 hour urine collection period.

All of the following about a 24-hour collection beginning at 7 a.m. are true except

Vitamin C.

All of the following are causes of blue/green urine except

Poikilocytosis.

Alteration in shape which include: spherocytes, schistocytes, sickle cells, drepanocytes, ovalocytes, and target cells is called

C-reactive protein (CRP)

An inflammation sensitive protein that can be measured by immunoassays is

Fusobacterium nucleatum

An isolate from a properly collected abscess yields an anaerobic, gram-negative bacillus with tapered ends. The colonies were breadcrumb-like, indole positive, nitrate negative, vancomycin resistant, kanomycin susceptible and colistin susceptible. The most likely identification is

Promyelocyte

As the neutrophil matures, the characteristics that help distinquish the cell also change. Which neutrophil has reddish purple primary granules, also called nonspecific or azurphilic granules?

. dark or pigmented hyphae.

Dematiaceous fungi produce

Colorimetric assay

Specific Gravity may be measured with all the following except

the weight of all proteins

Specific Gravity, measures all except

they share several characteristics such as mode of transmission, dipmorphism and dissemination.

Systemic mycoses are historically grouped together because they