Practice Exam Ex 1
A 1:10 dilution is made on a CSF sample. Five squares on each side of the hemacytometer are counted for a total of 10 squares and a total of 150 cells are recorded. What is the count per microliter? 527 758 833 1500
1500
How many grams of sodium hydroxide are required to prepare a 200 ml solution of a 10% (weight per volume) solution? (Atomic weights: Na = 23; 0 = 16; H = 1) 4g 10g 20g 40g
20g
What is the expected life span of a normal red blood cell? 3-4 months 1-2 months 3-6 weeks 1-3 weeks
3-4 months
One standard 300 µg vial of RhIg contains enough anti-D to protect against what amount of whole blood exposure? 15 mL 30 mL 1 L 5 mL
30 mL
What is the optimal time to begin initial microscopic examination of a semen specimen, assuming liquefaction is complete? 30 minutes 2 hours 4 hours 8 hours
30 minutes
A hepatic function panel A consists of which of the following tests? AST, ALT, Alkaline Phosphatase, Total Protein, Albumin, Total Bilirubin, Direct Bilirubin Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, Calcium Cholesterol, Lipoprotein, HDL, Triglycerides Potassium, Sodium, Chloride, CO2
AST, ALT, Alkaline Phosphatase, Total Protein, Albumin, Total Bilirubin, Direct Bilirubin
Using an automated cell counter analyzer, an increased Red Cell Distribution Width (RDW) should correlate with which of the following? Leukocytosis Anisocytosis Spherocytosis Macrocytosis
Anisocytosis
What is the Indirect Antiglobulin Test (IAT) usually used to detect? Antibodies coating red cells Antibodies in the plasma Antigens coating red cells Antigens in the plasma
Antibodies in the plasma
Which of the following assays should be performed after a specimen is shown to contain HIV antibodies when tested with a 4th generation HIV-1/HIV-2 antibody immunoassay? HIV-1 Immunofluorescent assay Western blot HIV viral load by nucleic acid amplification Antibody immunoassay to differentiate HIV-1 and HIV-2
Antibody immunoassay to differentiate HIV-1 and HIV-2
Most infections caused by Streptococcus anginosus can be treated with any of the following antibiotics, EXCEPT: Penicillin Ampicillin Aztreonam Cefazolin
Aztreonam
The renal threshold is best described as: Concentration at which a substance in the blood spills into the urine Concentration at which reabsorption first occurs Concentration at which kidney can no longer filter the blood Concentration at which kidney failure begins
Concentration at which a substance in the blood spills into the urine
Which analyte may be falsely decreased due to a delay in transport time to the laboratory? Glucose Potassium Magnesium LD
Glucose
What is the function of LD in the body? Interconversion of lactate to glucose Non-reversible conversion of pyruvate to lactate Interconversion of lactate and pyruvate Conversion of glucose to lactate
Interconversion of lactate and pyruvate
Which of the following methods would be employed to collect sweat for chloride analysis: Electrophoresis Counter electrophoresis Iontophoresis Isoelectric focusing
Iontophoresis
A CSF sample was cytocentrifuged and the smear was stained. Which of the following statements is true about the type of cell shown in the image? Increased numbers of this cell is seen in patients with bacterial meningitis. It lines the arachnoid space (central nervous system). It is a monocyte. It is a malignant cell.
It lines the arachnoid space (central nervous system).
This organism, identified as a Klebsiella oxytoca, was recovered from the blood of an elderly patient with an infected anal fissure . The Vitek identified this organism as an ESBL. After reviewing the Kirby-Bauer plate and susceptibility interpretations, what is the resistance mechanism demonstrated by this organism? Klebsiella pneumoniae carbapenemase (KPC) Extended-spectrum beta-lactamase (ESBL) AmpC beta-lactamase K-1 beta-lactamase
K-1 beta-lactamase
ABO blood groups were discovered by: Drew Lindemann Hicks Landsteiner
Landsteiner
In the microbiology laboratory, four specimens are received at the same time. The specimen that should be processed immediately is: Unpreserved sputum Feces in preservative Tissue for quantitation Pericardial fluid
Pericardial fluid
The phase of testing where most errors occur is: Pre-analytical phase Analytical phase Post-Analytical phase Reporting phase
Pre-analytical phase
All of the following characteristics describe T lymphocytes EXCEPT? CD4 & CD 8 positive Production of surface immunoglobulins Production of cytokines and chemokines Recruitment of inflammatory cells to site of inflammation or infection
Production of surface immunoglobulins
Which of the following best defines specific gravity: Weight Volume Density The density of a solution compared to the density of water
The density of a solution compared to the density of water
Which of the following conditions/findings is most likely associated with the peripheral blood picture in the photomicrograph? Hereditary spherocytosis Lead poisoning Transfusion dimorphism Folic acid deficiency
Transfusion dimorphism
What is considered the cause of urticarial transfusion reactions? IgA deficient individuals receiving plasma products containing IgA IgG or IgM antibody along with complement Tissue damage from the formation of immune complexes Transfusion of certain food allergens or drugs in plasma products
Transfusion of certain food allergens or drugs in plasma products
Glucuronic acid is used in the liver for conjugating what compound from hemoglobin degradation? Unconjugated bilirubin Conjugated bilirubin Urobilinogen Urobilin
Unconjugated bilirubin
The principle of most commercially available d-dimer assays is: Measuring the time it takes a patient's clot to lyse and form d-dimers Measuring plasminogen levels Using specific antisera to detect d-dimers' neo-epitopes Adding thrombin to patient plasma and measuring the time it takes to clot
Using specific antisera to detect d-dimers' neo-epitopes
All of the following decrease medical errors in the clinical laboratory, EXCEPT: Accuracy Precision Variance Reduced coefficient of variation
Variance
When considering therapeutic drug monitoring, which two organ systems are associated with drug elimination? Cardiac and pulmonary Hepatic and renal Renal and cardiac Hepatic and respiratory
Hepatic and renal
Respiratory acidosis is associated with: Normal pH High pH Decreased pCO2 Increased pCO2
Increased pCO2
The peroxidase stain is useful in differentiating between which cells? Lymphocytic and granulocytic cells Monoblastic and myeloblastic cells Leukemoid reaction and myelocytic leukemia Eosinophils and neutrophils
Lymphocytic and granulocytic cells
A patient with multiple myeloma has the following reactions in the ABO typing: Anti-A= w+ Anti-B = w+ Anti-A,B = w+ Auto control = w+ A1 Cells = 4+ B cells = 4+ What is probably causing these results? Rouleaux Subgroup of A Patient has hypogammaglobulinemia Patient has selective IgA deficiency
Rouleaux
If a TSI agar slant shows a neutral or slightly alkaline slant, acid butt, no/gas production, and no H2S production, the organism might be: Salmonella typhi Proteus vulgaris Shigella dysenteriae Proteus mirabilis
Shigella dysenteriae
From the IgG molecule illustration, which region is the heavy chain? A B C D
A
If the unit is going to be transfused within the collection facility, autologous blood must always be tested for which of the following before transfusion? ABO, Rh ABO, Rh, HBsAg ABO, Rh, HIV ABO, Rh, HBsAg, HIV
ABO, Rh
The ketone component that is measured by the nitroprusside reaction is: Acetoacetic acid Beta-hydroxybutyric acid Acetone C-Reactive Protein
Acetoacetic acid
Which of the following blood tests is used in the evaluation of hepatic disease? Amylase Alanine aminotransferase (ALT or SGPT) Creatinine Alkaline phosphatase (ALP)
Alanine aminotransferase (ALT or SGPT)
Which one of the following usually shows a decrease during an acute phase response? Albumin Alpha-1 Antitrypsin Fibrinogen Ceruloplasmin
Albumin
When preparing platelet concentrates from whole blood, after the second spin and excess plasma has been expressed from the platelets, what is the next step in platelet preparation? Allow the platelets to rest for 1-2 hours at 20-24°C. Agitate the platelets vigorously for 1-2 hours at 20-24°C. Pool several platelet concentrates together immediately and irradiate. Freeze the platelet concentrate immediately at < 18°C.
Allow the platelets to rest for 1-2 hours at 20-24°C.
The traditional Polymerase Chain Reaction (PCR) procedure has three important functions and include all of the following EXCEPT: Synthesis of a labeled antisense probe Identification of a target nucleotide sequence Amplifies DNA Amplifies RNA
Amplifies RNA
Most disorders associated with a primary immunodeficiency are _________ disorders. T-cell disorders B-cell disorders Complement disorders Platelet disorders
B-cell disorders
The tech working on an aerobic wound culture is identifying a colony that is large, gray, and non-hemolytic on blood agar. The tech prepares a Gram stain of the colony and notices a consistency similar to whisked egg whites. Gram stain reveals a large Gram-positive bacillus. What is the most likely identification of this colony? Bacillus anthracis Bacillus cereus Burkholderia mallei Francisella tularensis
Bacillus anthracis
A mother brings in her 6-year-old son to the clinic with concerns of learning difficulties from his school and also states he seems very tired all the time. The family has been staying in an old, run down motel recently as they try to find housing with no other significant family history. Testing was ordered to include a CBC. The CBC shows a microcytic anemia but otherwise normal results. Which of the following would be present upon manual differential review? Sickle cells Pappenheimer bodies Howell-Jolly bodies Basophilic stippling
Basophilic stippling
A urine specimen produced yellow foam when shaken. What is the cause of the yellow foam? Phosphates Bilirubin Normal Red blood cells
Bilirubin
Estrogen (ERs) and progesterone (PRs) receptors used as tumor markers are most commonly employed to provide prognostic information about: Breast cancer Uterine cancer Menopause Cervical cancer
Breast cancer
Which of the following tumor markers is associated with the colon? PSA CEA Beta hCG AFP
CEA
Which of the following is true of C-reactive protein (CRP) when being used to assess the risk of cardiovascular disease? CRP levels are high in cardiovascular disease. CRP levels are not affected by cardiovascular disease. CRP levels are low in cardiovascular disease. CRP has little clinical utility for assessing cardiovascular disease.
CRP levels are high in cardiovascular disease.
Which one of the following drugs/drug classes is the MOST COMMON cause of drug-induced immune hemolytic anemia? Levodopa Quinidine Cephalosporins Levofloxacin
Cephalosporins
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
Which of the following would be a possible cause of a positive direct antiglobulin test (DAT)? Transfusion reaction and warm autoimmune disease only Warm autoimmune disease and clot tube stored at 4°C only Clot tube stored at 4oC and transfusion reaction only Clot tube stored at 4oC, transfusion reaction, and warm autoimmune disease.
Clot tube stored at 4oC, transfusion reaction, and warm autoimmune disease.
Which laboratory assay is a highly specific indicator and the most sensitive assay for a diagnosis of rheumatoid arthritis? Cyclic citrullinated peptide Sensitized sheep cells Latex particle agglutination C-Reactive Protein agglutination
Cyclic citrullinated peptide
Which of the following may result in a platelet count of 230.0 X 109/L with a bleeding time of 15 minutes. Defective platelet function Decreased platelet production Increased platelet production Increased platelet destruction
Defective platelet function
Which of the statements below regarding the diagnosis of pancreatitis is CORRECT? Amylase and lipase are as predictive in chronic as in acute pancreatitis. Diagnostic sensitivity for acute pancreatitis is increased by assaying both amylase and lipase. Chronic pancreatitis occurs more often in women. Increased amylase levels stay increased after the cause of the pancreatitis is removed.
Diagnostic sensitivity for acute pancreatitis is increased by assaying both amylase and lipase.
A two-year old male patient has the following hemogram results: Hgb = 6.7g/dLHct = 20%Platelets = 355 x 109/LRBC = 3.0 x1012/LWBC = 8.75 x 109/L Differential = 6% eos, 20% segs, 68% lymphs, 6% monos Which of the following is the MOST likely diagnosis? Dietary iron deficiency Idiopathic thrombocytopenia Lymphocytic leukemia Lead poisoning
Dietary iron deficiency
For the diagnosis of Systemic Lupus Erythematosus (SLE) which of the following test principles provides the highest specificity? FANA ELISA Latex ANA CRP
ELISA
Which of the following terms is used to describe the appearance of rod-shaped bacteria? Budding Septate Filamentous Lancet
Filamentous
Which of the following statements is false about von Willebrand's disease (vWD)? vWD can be inherited or acquired. vWD can involve qualitative or quantitative changes in von Willebrand's Factor (vWF). Functional vWF molecules usually occur as monomers or dimers. Functional ELISA tests and ristocetin co-factor assays have been used to test vWF function.
Functional vWF molecules usually occur as a monomers or dimers.
Each of the following hypothalamic hormones is correctly matched with the anterior pituitary hormone that it releases EXCEPT: TRH --> TSH GnRH --> LH and FSH CRH --> ACTH GHRH --> Oxytocin
GHRH --> Oxytocin
Which represents peak 1 (closest to the cathode) in this serum protein electrophoresis (SPE) scan? Alpha-1 Alpha-2 Beta Gamma
Gamma
A representative congenital monocyte-macrophage functional disorder is: Chédiak-Higashi syndrome Gaucher's disease Leukocyte adhesion deficiency Systemic inflammatory response syndrome (SIRS)
Gaucher's disease
A Renal Function Panel consists of which of the following tests? AST, ALT, Alkaline Phosphatase, Total Protein, Albumin, Total Bilirubin, Direct Bilirubin Cholesterol, Lipoprotein, HDL, Triglycerides Potassium, Sodium, Chloride, CO2 Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, Calcium, Albumin, Phosphorus
Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, Calcium, Albumin, Phosphorus
The presence of Gram negative intracellular diplococci in a genital specimen from a male is diagnostic of which disease? Gonorrhea Chlamydia Syphilis Chancroid
Gonorrhea
The parents' blood types are AB and O. What could be the only possible blood type(s) of their children? Group A only Group B only Group O only Group A or B only
Group A or B only
When serotyping Salmonella typhi, false negative reactions can occur when testing. For example, a Salmonella typhi isolate tested Vi antiserum positive and O antiserum negative. What should be done next? Report out results as they are correct Heat specimen and repeat O antiserum test Heat specimen and repeat Vi antiserum test Check antiserum expiration date
Heat specimen and repeat O antiserum test
A reagent strip test for hemoglobin has been reported positive. Microscopic examination fails to yield red blood cells. This patient's urine condition can be called: Hematuria Hemoglobinuria Oliguria Hemosiderinuria
Hemoglobinuria
The Major Histocompatibility Complex (MHC) codes for which antigens? ABO Kell Rhesus Human Leukocyte Antigens
Human Leukocyte Antigens
Illustrated in the photograph is a close in view of a 70 µm oval ovum with a thin, smooth outer shell and an inner membrane containing three pairs of hooklets (hexacanth embryo). This ovum is indigenous primarily in rats and mice and only rarely found in human feces. When found, the infected person usually has minimal symptoms; however, in heavy infections, particularly in those who are immune-suppressed, abdominal pain, diarrhea and anal pruritis may be experienced. What is the best presumptive identification of this tapeworm ovum? Hymenolepis nana Hymenolepis diminuta Taenia saginata Taenia solium
Hymenolepis diminuta
Laboratory tests which distinguish Polycythemia Vera (PV) from Chronic Myelogenous Leukemia (CML) include all of the following EXCEPT: The JAK 2 mutation Nucleated red blood cells Elevated LAP score Hypercellular bone marrow
Hypercellular bone marrow
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 patient presents with fatigue. The CBC results are as seen below: Considering all of the above information and the cells indicated by the arrows that were observed on the peripheral smear, what is the probable mechanism for the anemia that the patient is experiencing? Increased destruction of red blood cells (RBCs) caused by an intracorpuscular abnormality Decreased production of RBCs Sudden blood loss Increased destruction of red blood cells (RBCs) caused by an extracorpuscular abnormality
Increased destruction of red blood cells (RBCs) caused by an intracorpuscular abnormality
Which one of the following combinations of organisms would be appropriate positive and negative controls to verify the specific test functions listed? Beta hemolysis - Escherichia coli and Streptococcus pyogenes Catalase - Staphylococcus aureus and Staphylococcus epidermidis Hydrogen sulfide production - Proteus mirabilis and Salmonella typhi Indole - Escherichia coli and Klebsiella pneumonia
Indole - Escherichia coli and Klebsiella pneumonia
A 10-year-old male presented to the local Appalachian Mountain clinic complaining of vomiting, fever, and severe abdominal pain. Patient history revealed that the child lives in the area in substandard conditions and receives only one balanced meal per day. A stool was collected and submitted for parasite study. This suspicious form, measuring 50 µm by 35 µm was found. This patient is most likely infected with: Hookworm Large intestinal roundworm Threadworm Whipworm
Large intestinal roundworm
In which of the following disorders would you probably observe coarse basophilic stippling on a Wright-stained peripheral blood smear? Hemolytic anemia Sideroblastic anemia Multiple myeloma Lead poisoning
Lead Poisoning
The analysis of a differential blood smear and laboratory results produced the following results: WBC: 47,000/µLHgb: 10.9 g/dLHct: 34%Differential:4% Monocytes20% Lymphocytes4% Myelocytes2% Promyelocytes15% Metamyelocytes25% Segmented Neutrophils30% BandsLeukocyte Alkaline Phosphatase (LAP) - increased What is the MOST likely disease/condition associated with these results? Myelofibrosis Leukemoid reaction Chronic myelogenous leukemia Acute myelogenous leukemia
Leukemoid reaction
Which of the following is most likely to interfere with the measurement of hemoglobin? Leukocytopenia EDTA Heparin Lipemia
Lipemia
All of the following activities are associated with platelets EXCEPT: Aggregation Adhesion Lysis Release of granules
Lysis
Which of the following cells are lining cells that could be seen in a peritoneal fluid? Choroidal cells Mesothelial cells Ependymal cells Squamous epithelial cells
Mesothelial cells
The following results were obtained on arterial blood: pH = 7.51pCO2= 49 mm HgHCO3- = 38.7 mmol/LpO2= 85 mm Hg These results are compatible with: Metabolic acidosis Respiratory acidosis Metabolic alkalosis Respiratory alkalosis
Metabolic alkalosis
What is the primary oxygen-carrying protein found in muscle? Hemoglobin Troponin Myoglobin BNP
Myoglobin
Identify the nucleated blood cell: Lymphocyte Neutrophil Basophil Monocyte
Neutrophil
Which of the following might cause a false positive indirect antiglobulin test (IAT)? Failure to adequately wash cells. Delay in the addition of antiglobulin reagent. Over-centrifugation High concentration of IgG paraprotein in a patient's serum
Over-Centrifugation
All of the following are characteristics of Brucella are EXCEPT: Oxidase negative Stain faintly as gram negative coccobacilli or short rods Urea positive Nonmotile
Oxidase negative
Oxacillin resistance of MRSA is due to production of which of the following penicillin binding proteins (PBPs)? PBP2 PBP2a PBP3 PBP4
PBP2a
Which of the following is considered a cause of hypomagnesemia (decreased levels of magnesium in the blood)? Hypothyroidism Hypoaldosteronism Pancreatitis Bone carcinoma
Pancreatitis
Which type of error is associated with the precision of the method? Instrument error Reagent error Random error Systematic error
Random error
The oxidation of hemoglobin to methemoglobin in acidic urine after several hours may cause which of the following color to produce? White Yellow Blue to green Red to brown
Red to brown
For which determination is the brilliant cresyl blue stain used MOST often? Malaria - ring forms Plasma Cells Reticulocytes Basophilic stippling
Reticulocytes
Which of the following accurately represents reverse typing? Reverse typing is performed using known reagent antisera to detect ABO antigens on the patient's red blood cells. Reverse typing is performed using known reagent red blood cells to detect ABO antibodies in the patient's serum or plasma. Reverse typing is performed using known reagent screening cells to detect clinically significant antibodies in the patient's serum or plasma. Reverse typing is performed using known reagent antisera to phenotype donor red blood cells for clinically significant antigens.
Reverse typing is performed using known reagent red blood cells to detect ABO antibodies in the patient's serum or plasma.
Rocky Mountain spotted fever (RMSF) is transmitted by the bite of a tick infected with: Coxiella burnetti Borrelia burgdorferi Borrelia recurrentis Rickettsia rickettsii
Rickettsia rickettsii
Which Enterobacteriaceae are non-lactose fermenters on MacConkey (MAC) agar, have green colonies with black centers on Hektoen enteric (HE) agar, and on xylose-lysine-deoxycholate (XLD) agar will have red colonies with black centers? Proteus spp. Edwardsiella spp. Salmonella spp. Shigella spp.
Salmonella spp.
The appearance of the bacterial colonies growing on the surface of the Hektoen Enteric (HE) agar plate shown in the photograph to the right are consistent with all of the following bacterial species EXCEPT: Serratia marcesens Shigella sonnei Klebsiella oxytoca Enterobacter sakasakii
Shigella sonnei
The cell diameter of a normal RBC is similar in size to the nucleus of a __________________. Small lymphocyte Normal platelet Segmented neutrophil Monocyte
Small lymphocyte
A 49-year-old male with pneumonia was treated with high-dose intravenous penicillin. He became jaundiced with yellow sclera. The image on the right is typical of other fields that were observed on his peripheral blood smear. Since penicillin may, in some individuals, cause autoimmune hemolytic anemia, the clinician requested a direct antiglobulin test (DAT) be performed. The DAT was positive, indicating that antibodies to the drug were produced, which then attached to the drug on the surface of the red cells. Hemolysis occured due to the drug-induced antibody attachment, leaving the patient with various abnormal red blood cell morphologies. Which of the following cell types would you report for this patient? Acanthocytes, nucleated red blood cells, polychromatophylic red blood cells Burr cells, spherocytes, polychromatophylic red blood cells Target cells, acanthocytes, polychromatophylic red blood cells Spherocytes, nucleated red blood cells, polychromatophylic red blood cells
Spherocytes, nucleated red blood cells, polychromatophylic red blood cells
The specimen of choice for the recovery of Entamoeba hartmanni is: CSF Genital discharge Stool Urine
Stool
What test can be used as a confirmatory test for proteinuria? Acetest Benedict's test Fehling's test Sulfosalicylic acid test
Sulfosalicylic acid test
Given the following laboratory results, what is the most likely diagnosis? HBsAg: Negative Anti-HBc: Negative Anti-HBs: Negative Acute Hepatitis B infection Susceptible to Hepatitis B infection Immune to Hep B due to past infection Immune to Hep B due to vaccination
Susceptible to Hepatitis B infection
A patient came into the emergency department with a swollen knee and the physician drained 20 mL of fluid from the patient's knee. What is the name of the fluid collected? Pleural fluid Ascitic fluid Synovial fluid Pericardial fluid
Synovial fluid
Contact dermatitis is mediated by: B lymphocytes Mast cells Polymorphonuclear cells T lymphocytes
T Lymphocytes
The purified protein derivative (PPD) test is also known as: Targeted tuberculin testing RPR QuantiFERON® assay SPOT TB® assay
Targeted tuberculin testing
What step must be performed before a rejuvenated blood unit may be transfused to the patient? The unit must be thawed. The unit must be warmed to room temperature. The unit must be washed. The unit must be agitated.
The unit must be washed.
A voided urine specimen is delivered from the women's clinic to the laboratory six hours after collection. The following results are reported: What might these results indicate? The patient has a urinary tract infection. The urine may have remained too long at room temperature and bacterial contaminants have affected the nitrite and pH results. The specimen had a preservative added. The leukocyte esterase result is wrong.
The urine may have remained too long at room temperature and bacterial contaminants have affected the nitrite and pH results.
A mother and young child arrive at the outpatient laboratory with a physician's order for a lead test on the child. The phlebotomist decides to perform a dermal puncture (fingerstick). What procedure is important to implement when a test for lead is collected by finger puncture that would NOT be necessary prior to an antecubital venipuncture? Asking the patient or child's parent to state his/her name and date of birth. Thoroughly washing patient's hands with soap and water. Cleansing the puncture site with alcohol and letting the alcohol air dry. Labeling the specimen with at least two patient identifiers.
Thoroughly washing patient's hands with soap and water.
