Board of Certification questions

Which test is the primary screening test for HIV? a serum enzyme linked immunosorbent assay (ELISA) b western blot c quantitative HIV RNA d CD4 count

a serum enzyme linked immunosorbent assay (ELISA)

Anti-extractable nuclear antigens are most likely associated with which of the following anti-nuclear antibody immunofluorescent patterns? a speckled b rim c diffuse d nuclear

a speckled

When the exact concentration of the solute of a solution is known and is used to evaluate the concentration of an unknown solution, the known solution is: a standard b normal c control d baseline

a standard

Ureaplasma urealyticum is difficult to grow in the laboratory on routine media because of its requirements for: a sterols b horse blood c ferric pyrophosphate d surfactant such as Tween^R 80

a sterols

The MOST commonly used serological indicator of recent streptococcal infection is the antibody to: a streptolysin O b hyaluronidase c NADase d DNA

a streptolysin O

The reliability of a test to be positive in the presence of the disease it was designed to detect is known as: a accuracy b sensitivity c precision d specificity

b sensitivity

The immunoglobulin classes MOST commonly found on the surface of circulating B lymphocytes in the peripheral blood of normal persons are: a IgM, IgA b IgM, IgG c IgM, IgD d IgM, IgE

c IgM, IgD

Which of the following is the MOST common humoral immune deficiency disease? a Bruton agammaglobulinemia b IgG deficiency c selective IgA deficiency d Wiskott-Aldrich syndrome

c selective IgA deficiency

What cell shape is MOST commonly associated with an increased MCHC? a tear drop cells b target cells c spherocytes d sickle cells

c spherocytes

To assure an accurate ammonia level result, the specimen should be: a incubated at 37C prior to testing b spun and separated immediately, tested as routine c spun, separated, iced, and tested immediately d stored at room temperature until tested

c spun, separated, iced, and tested immediately

What cell is MOST commonly associated with vaginal contamination? a white b transitional c squamous d glitter

c squamous

Aldosterone is released by the adrenal cortex upon stimulation by: a renin b angiotensinogen c angiotensin I d angiotensin II

d angiotensin II

A haptenic determinant will react with: a both T cells and antibody b T cells but not antibody c neither T cells nor antibody d antibody but not T cells

d antibody but not T cells

The immunoglobulin class associated with *immediate hypersensitivity* or atopic reactions is: a IgA b IgM c IgD d IgE

dIgE

The enzyme present in almost all tissues that may be separated by electrophoresis into 5 components is: a lipase b transaminase c creatinine kinase d lactate dehydrogenase

d lactate dehydrogenase

The visible serological reaction between soluble antigen and its specific antibody is: a sensitization b precipitation c agglutination d opsonization

b precipitation

The light-colored zone adjacent to the nucleus in a plasma cell is the: a ribosome b chromatin c mitochondria d Golgi area

Golgi area

Hemoglobin A1c represents:

*glycosylation of valine in the polypeptide N-terminus of normal adult hemoglobin*

The life span of a platelet is:

10 days

Which of the following immunoglobulins is present in the highest concentration in *normal human serum*? a IgM b IgG c IgA d IgE

*b IgG*

The MOST *heat labile* fraction of alkaline phosphatase is obtained from: a liver b bone c intestine d placenta

*b bone*

Many fungal infections are transmitted to man via inhalation of infectious structures. Which of the following is usually contracted in this manner? a Sporothrix schenckii b Trichophyton rubrum c Malassezia furfur d Histoplasma capsulatum

*d Histoplasma capsulatum*

The enzyme, which exists chiefly in skeletal muscle, heart, and brain, is grossly elevated in *active muscular dystrophy*, and rises early in *myocardial infarction* is: a lipase b transaminase c lactate dehydrogenase d creatinine kinase

*d creatinine kinase*

*Serum "anion gap" is increased in patients with:* a renal tubular acidosis b diabetic alkalosis c metabolic acidosis due to diarrhea d lactic acidosis

*d lactic acidosis*

*Regan isoenzyme has the same properties as alkaline phosphatase that originates in the:* a skeleton b kidney c intestine d placenta

*d placenta*

The cyanmethemoglobin method of measuring hemoglobin cannot detect this form of hemoglobin: a methemoglobin b carboxyhemoglobin c deoxyhemoglobin d sulfhemoglobin

*d sulfhemoglobin*

Colds and other acute respiratory diseases are most often associated with:

Adenovirus

What is the best method to diagnose lactase deficiency?

H2 breath test

A PCR-based assay is performed to determine the clonality of B cells in a patient using a forward primer specific for the innermost framework region and a reverse primer complimentary to the joining region (of the immunoglobulin heavy chain). The resulting electropherogram (middle is extremely large) was obtained. Assuming all controls worked properly for the assay, what is your interpretation of the results for this patient? a patient is normal b patient has mononucleosis c patient has a polyclonal population of B cells d patient has monoclonal population of B cells

D patient has a monoclonal population of B cells

What is the MCV if the Hct is 20%, the RBC is 1.5 x 10^6/µL (1.5 x 10^12/L) and the Hgb is 6 g/dL (60 g/L)? A. 68 pg B. 75 pg C. 115 pg D. 133 pg

D. 133 pg

The assembly of the complement "membrane attack unit" is initiated with the binding of: A. C1 B. C3 C. C4 D. C5

D. C5

The most common genetic defect associated with cystic fibrosis is called: a CFTR delta-F508 b trisomy 21 c Philadelphia chromosome d fragile X

a CFTR delta-F508

When myocardial infarction occurs, the first enzyme to become elevated is: a CK b LD c AST d ALT

a CK

A liquid fecal specimen from a 3-month-old infant is submitted for culture. The stool culture should detect Salmonella, Shigella and: a Campylobacter spp b Clostridium botulinum c Entamoeba hartmanni d enterotoxigenic Escherichia coli

a Campylobacter spp

An organism recovered from a sputum has the following characteristics: Culture: growth at 6 days on *buffered charcoal yeast extract (BCYE) agar*, incubated under aerobic conditions with C02 at 35°C Gram stain: *delicate branching gram-positive bacilli* acid-fast stain: branching, filamentous, *"partially" acid-fast bacterium* These results are consistent with which of the following genera? a Nocardia b Mycobacterium c Actinomyces d Streptomyces

a Nocardia

Gram-positive cocci in chains are seen on a gram stain from a blood culture. The organism grows as a beta-hemolytic colony. Further tests that could be performed include: a PYR, bacitracin, and hippurate b catalase and agglutination test for Protein A c oxidase and mass spectrometry d Voges-Proskauer and methyl red

a PYR, bacitracin, and hippurate

Which structure is MOST resistant to denaturation? a RNA:RNA duplexes b RNA:DNA duplexes c DNA:DNA duplexes d all are equally resistant to denaturation

a RNA:RNA duplexes

A 56-year-old male has 2 sets of blood cultures that grow Gram-positive cocci after being admitted to the hospital with an *oozing leg wound post operation*. The infected area is *red, swollen, and warm to the touch*. A red line has appeared at the site of the wound and is beginning to travel up the patient's leg. Biochemicals performed from the *beta hemolytic colonies on the sheep blood agar plate* revealed the following: - CAMP test: negative - hippurate hydrolysis: negative - PYR: positive - bacitracin: sensitive - 65% NaCl: no growth - bile esculin: negative The most likely identification is: a Streptococcus pyogenes b Streptococcus agalactiae c Staphylococcus aureus d Enterococcus faecalis

a Streptococcus pyogenes

In the direct fluorescent antibody test for primary syphilis, spirochetes are detected by addition of labeled antibody to? a Treponema pallidum b cardiolipin c human immunoglobulin d nonpathogenic treponemes

a Treponema pallidum

Appropriate culture requirements for a specimen from a patient suspected of having tularemia include: a a media with cysteine such as buffered charcoal yeast extract agar b colistin nalidixic acid agar c Mueller-Hinton agar with 5% sheep blood agar d Regan-Lowe media

a a media with cysteine such as buffered charcoal yeast extract agar

Communication is enhanced by: a a planned strategy that includes listening skills and ensuring an understanding with questions b relying on email, memos and voice mail to communicate new information c formal, hierarchical patterns instead of informal networking patterns d assumptions if there are questions about the intent of the message

a a planned strategy that includes listening skills and ensuring an understanding with questions

Hemoglobin H disease results from: a absence of 3 of 4 alpha genes b absence of 2 of 4 alpha genes c absence of 1 of 1 alpha genes d absence of all 4 alpha genes

a absence of 3 of 4 alpha genes

A DPT vaccination is an example of: a active humoral-mediated immunity b passive humoral-mediated immunity c cell-mediated immunity d immediate hypersensitivity

a active humoral-mediated immunity

Which of the following nucleotides is a purine? a adenine b cytosine c thymine d uracil

a adenine

Bromcresol purple at a pH of 5.2 is used in a colorimetric method to measure: a albumin b golbulin c Bence Jones protein d immunoprotein

a albumin

Detection of which of the following substances is most useful to monitor the course of a patient with testicular cancer? a alpha-fetoprotein b carcinoembryonic antigen c prolactin d testosterone

a alpha-fetoprotein

Which locus is used to identify the gender of the individual from whom a DNA sample is obtained? a amelogenin b CSF1PO c TPOX d vWA

a amelogenin

The result of an anti-nuclear antibody test was a titer of 1:320 with peripheral pattern. Which of the following sets of results best correlate with these results? a anti-dsDNA titer 1:80, a high titer of antibodies to Sm b anti-mitochondrial antibody titer of 1:160, and antibodies to RNP c anti-Scl-70, and antibodies to single-stranded DNA d high titers of anti-SS-A and anti-SS-B

a anti-dsDNA titer 1:80, a high titer of antibodies to Sm

In primary biliary cirrhosis, which of the following antibodies is seen in high titers? a anti-mitochondrial b anti-smooth muscle c anti-DNA d anti-parietal cell

a anti-mitochondrial

Specific (secondary) granules of the neutrophilic granulocyte: a appear first at the myelocyte stage b contain esterases c are formed on the mitochondria d are derived from azurophil (primary) granules

a appear first at the myelocyte stage

Increased CSF lactate is found in: a bacterial meningitis b Reye encephalopathy c spina bifida d multiple sclerosis

a bacterial meningitis

An oncology patient has the following results: - WBC -- Day 1: 8.0 x 10^3/uL Day 3: 2.0 x 10^3/uL - RBC -- Day 1: 3.50 x 10^3/uL Day 3: 3.45 x 10^3/uL - Hgb -- Day 1: 10.0 g/dL Day 3: 9.9 g/dL - Hct -- Day 1: 29.8% Day 3: 29.5% - Plt -- Day 1: 180 x 10^3/uL Day 3: 150 x 10^3/uL The most probable explanation is: A. chemotherapy B. cold antibody C. clotted specimen D. inadequate mixing

a chemotherapy

An automated method for measuring chloride which generates silver ions in the reaction is: a coulometry b mass spectrometry c chromatography d polaography

a coulomtery

A serum sample drawn in the emergency room from a 42-year-old man yielded the following laboratory results: Patient's CK: 185 U/L; AST: 123 U/L; CKMB: 6 U/L Reference range CK:15-160 U/L; AST: 0-48 U/L; CKMB: 2-12 U/L Which of the following conditions might account for these values? a crush injury to the thigh b cerebrovascular accident c pulmonary infarction d early acute hepatitis

a crush injury to the thigh

The abnormal erythrocyte (spherocyte) in the center [of this image] may result from which of the following processes? a deficiencies of cellular membrane proteins b absence of plasma lipoprotiens c defects in the cellular lipid bilayer d deficiencies of cellular enzymes

a deficiencies of cellular membrane proteins

Chromatography is based on the principle of: a differential solubility b gravity c vapor pressure d temperature

a differential solubility

Factors that contribute to a pCO2 electrode requiring 60-120 seconds to reach equilibrium include the: a diffusion characteristics of the membrane b actual blood pO2 c type of calibrating standard (ie, liquid or humidified gas) d potential of the polarizing mercury cell

a diffusion characteristics of the membrane

In the Malloy and Evelyn method for the determination of bilirubin, the reagent that is reacted with bilirubin to form a purple azobilirubin is: a dilute sulfuric acid b diazonium sulfate c sulfobromophthalein d diazotized sulfanilic acid

a dilute sulfuric acid

Osmolality is a measure of: a dissolved particles, including ions b undissolved molecules only c total salt concentration d molecule size

a dissolved particles, including ions

In polycythemia vera, the platelet count is: a elevated b normal c decreased d variable

a elevated

What type of enzyme can be used to cut a chromosome into smaller fragments of DNA without removing any nucleotides or functional groups? a endonuclease b exonuclease c ligase d phosphatase

a endonuclease

Which stain is used to measure sperm viability? a eosin nigrosin b Wright c toludine blue d Papanicolaou

a eosin nigrosin

Cells for the transport of O2 and CO2 are: a erythrocytes b granulocytes c lymphocytes d thrombocytes

a erythrocytes

On a smear made directly from a finger stick, no platelets were found in the counting area. The first thing to do is: a examine the slide for clumping b obtain another smear c perform a total platelet count d request another finger stick

a examine the slide for clumping

A falsely low result for urobilinogen may occur if the urine specimen is: a exposed to light b adjusted to a neutral pH c cooled to room temperature d collected in a nonsterile container

a exposed to light

A hemophiliac male and a normal female can produce a: a female carrier b male carrier c male hemophiliac d normal female

a female carrier

Which of the [above] figures demonstrates a reaction pattern of identity? a figure which has dome in between top and bottom areas [figure 1] b figure which has one line under each one species crossing near the top [figure 2] c figure which has two lines under one species [figure 3] d figure which has center of media circled [figure 4]

a figure which has dome in between top and bottom areas [figure 1]

Refer to the following illustration: This symbol indicates which of the following hazards? a flammable b electrical c radiation d biohazard

a flammable

The osmolality of a urine or serum specimen is measured by a change in the: a freezing point b sedimentation point c midpoint d osmotic pressure

a freezing point

An organism has been identified as a member of the *fluorescent group of Pseudomonas*. Which of the following sets of tests should be used to determine the species of the organism? a growth at 42 degrees Celsius, pyocyanin production, gelatinase production b pyocyanin production, gelatinase production, OF glucose c growth at 37 degrees Celsius, pyocyanin production OF glucose d gelatinase production, growth at 52 degrees Celsius, H2S

a growth at 42 degrees Celsius pyocyanin production gelatinase production

A classical ELISA test was performed on a sample from a 67-year-old male patient who was suspected of having ingested large amounts of drug X. The ELISA procedure was performed as follows: 1. incubation of patient sample in antibody-coated microtiter plate wells 2. plate washing 3. addition of peroxidase-linked drug X conjugate 4. incubation followed by plate washing 5. addition of hydrogen peroxide 6. evaluation of color change a hydrogen peroxide is the substrate b conjugate contains the antibody c the test is homogenous d the test is noncompetitive

a hydrogen peroxide is the substrate

A patient has the following results: *increased serum calcium levels* *decreased serum phosphate levels* *increased levels of parathyroid hormone* This patient most likely has: a hyperparathyroidism b hypoparathyroidism c nephrosis d steatorrhea

a hyperparathyroidism

Media used to culture Mycobacterium tuberculosis include:

Lowenstein-Jensen agar and Middlebrook 7H11 agar

Which of the following red cell antigens are found on glycophorin-A?

M, N

Organisms that are part of the Mycobacterium tuberculosis complex (MTBC) include Mycobacterium tuberculosis:

M. avium and M. bovis

In skin tests, a wheal and flare development is indicative of: a immediate hypersensitivity b delayed hypersensitivity c anergy d Arthus reaction

a immediate hypersensitivity (edema and erythema)

Blood collected in EDTA undergoes which of the following changes if kept at room temperature for 6-24 hours? a increased hematocrit and MCV b increased ESR and MCV c increased MCHC and MCV d increased reticulocyte count and hematocrit

a increased hematocrit and MCV

Respiratory acidosis is described as a(n): a increase in CO2 content and pCO2 with a decreased pH b decreased in CO2 content with an increased pH c increase in CO2 content with an increased pH d decrease in CO2 content and pCO2 with a decreased pH

a increased in CO2 content and pCO2 with a decreased pH

Biochemical abnormalities characteristic of polycythemia vera incldue: a increased serum B12 binding capacity b hypouricemia c hypohistaminemia d increased erythropoietin

a increased serum B12 binding capacity

Which of the following methods is susceptible to the solvent displacing effect that results in *falsely decreased electrolyte values*? a indirect ion-selective electrodes b direct ion-selective electrodes c alkaline electrophoretic separation of ions d fluorescence

a indirect ion-selective electrodes [dilution]

Which of the following stains is closely associated with the lysosomal enzyme in primary (azurophilic) granules? a myeloperoxidae b nonspecific esterase c methylene blue d Prussian blue

a myeloperoxidase

A 45-year-old woman has a fasting serum glucose concentration of 95 mg/dL (5.2 mmol/L) and a 2-hour postprandial glucose concentration of 105 mg/dL (5.8 mmol/L). The statement which best describes this patient's fasting serum glucose concentration is: a normal; reflecting glycogen breakdown by the liver b normal; reflecting glycogen breakdown by skeletal muscle c abnormal; indicating diabetes mellitus d abnormal; indicating hypoglycemia

a normal; reflecting glycogen breakdown by the liver

Peripheral blood smears from patients with untreated pernicious anemia are characterized by: a pancytopenia and macrocytosis b leukocytosis and elliptocytosis c leukocytosis and ovalocytosis d pancytopenia and microcytosis

a pancytopenia and macrocytosis

A low concentration of serum phosphorus is commonly found in: a patients who are receiving carbohydrate hyperalimentation b chronic renal disease c hypoparathyroidism d patients with pituitary tumors

a patients who are receiving carbohydrate hyperalimentation

While performing an analysis of a baby's urine, the laboratorian notices the specimen has a "mousy" odor. Of the following substances that may be excreted in urine, the one that MOST characteristically produces this odor is: a phenylpyruvic acid b acetone d coliform bacili d porphyrin

a phenylpyruvic acid

An emphysema patient suffering from *fluid accumulation in the alveolar spaces* is likely to be in what metabolic state? a respiratory acidosis b respiratory alkalosis c metabolic acidosis d metabolic alkalosis

a respiratory acidosis (oxygen capacity)

Which test is used to evaluate the cellular immune system in a patient? a skin test for commonly encountered antigens b determination of isohemagglutinin titer c immunoelectrophoresis of serum d measurement of anti-HBsAg after immunization

a skin test for commonly encountered antigens

A physician attempts to aspirate a knee joint and obtains 0.1 mL of slightly bloody fluid. Addition of acetic acid results in turbidity and a clot. This indicates that: a the fluid is synovial fluid b plasma was obtained c red blood cells caused a false-positive reaction d the specimen is not adequate

a the fluid is synovial fluid

A 16-year-old boy with *infectious mononucleosis* has a cold agglutinin titer of 1:2000. An important consideration of this antibody's clinical relevance is the: a thermal range b titer at 4C c specificity d light chain type

a thermal range

Polarized light can often be used to differentiate between: a uric acid crystals and cystine crystals b hyaline and waxy crystals c squamous and transitional epithelial cells d red blood cells and white blood cells

a uric acid crystals and cystine crystals

The yellow color of urine is primarily due to: a urochrome pigment b methemoglobin c bilirubin d homogenistic acid

a urochrome pigment

The process of testing and documenting changes made to a laboratory information system is known as: a validation b quality engineering c customization d hazard analysis

a validation

In the hexokinase method for glucose determination, the actual end product measured is the:

NADH produced from the reduction of NAD

What is the MOST common anaerobic bacteria isolated from infectious processes of soft tissue and anaerobic bacteremia? a Bacteriodes fragilis b Fusobacterium nucleatum c Porphyromonas asaccharolytica d Clostridium perfringens

a Bacteriodes fragilis

Which organism is the MOST common *anaerobic bacteria* isolated from infectious processes of soft tissue and anaerobic bacteremia? a Bacteroides fragilis b Fusobacterium nucleatum c Porphyromonas asaccharolytica d Clostridium perfringens

a Bacteroides fragilis

A 25-year-old woman is seen by a physician because of Raynaud phenomenon, myalgias, athralgias and difficult swallowing. There is no evidence of renal disease. An ANA titer is 1:5120 with a *speckled pattern with mitotic cells*. Which of the following are also likely to be found in this patient? a high-level nDNA antibody and a low CH50 level b high-level Sm antibody c high-titer rheumatoid factor d high-level ribonucleoprotein (RNP) antibody

d high-level ribonucleoprotein (RNP) antibody

The hormone that triggers ovulation is: a follicle-stimulating hormone (FSH) b luteinizing hormone (LH) c thyroid-stimulating hormone (TSH) d human chorionic gonadotropin (HCG)

d human chorionic gonadotropin (HCG)

A common cause of respiratory alkalosis is: a vomiting b starvation c asthma d hyperventilation

d hyperventilation

Urobilinogen is formed in the: a kidney b spleen c liver d intestine

d intestine

After receiving a 24-hour urine for quantitative total protein analysis, the laboratorian must first: a subculture the urine for bacteria b add the appropriate preservative c screen for albumin using a dipstick d measure the total volume

d measure the total volume

The first step in analyzing a 24-hour urine specimen for quantitative urine protein is: a subculture the urine for bacteria b add the appropriate preservative c screen for albumin using a dipstick d measure the total volume

d measure the total volume

Which method of tissue preservation is inappropriate for molecular testing? a snap freeze b ethanol c formaldehyde d mercuric chloride

d mercuric chloride

The aPTT is a coagulation screening test that is also used to: a evaluate the extrinsic coagulation pathway b monitor Coumadin therapy c require tissue thromboplastin d monitor unfractionated heparin therapy

d monitor unfractionated heparin therapy

Cell description: -Size: 12 to 16 µm -nucleus: oval, notched, folded over to horseshoe shape -Chromatin: fine lacy, stains light purple-pink -Nucleoli: none present -Cytoplasm: abundant, slate gray, with many fine lilac-colored granules The cell is a: A. promyelocyte B. lymphocyte C. neutrophil D. monocyte

d monocyte

Legal pre-employment questions on an application are: a medical history of an employee b place of birth c felonies unrelated to job requirements d name and address of person to notify in case of emergency

d name and address of person to notify in case of emergency

Pellagra is associated with deficiency of which of the following vitamins? a A b B1 c thiamine d niacin

d niacin

The most sensitive substrate for the detection of beta-lactamases is: a penicillin b ampicillin c cefotoxin d nitrocefin

d nitrocefin

Which of the following tests is diagnostic in DIC? a thrombin time b D-dimer c fibrinogen d none of the above

d none of the above

A patient presents to the coumadin clinic with an INR of 3.1. He has a mechanical heart valve. The level of anticoagulant should be: a decreased b increased c stopped d not adjusted

d not adjusted (account for the mechanical heart valve)

Evaluation of sperm morphology is performed by staining an air-dried smear with Wright, Giemsa, or Papanicolaou stain and evaluating 200 sperm using: a a 4x objective (40x magnification) b a 10x objective (100x magnification) c a 40x objective (400x magnification) d oil immersion and a 100x objective (1000x magnification)

d oil immersion and a 100x objection (1000x magnification)

Which test is used to differentiate viridans streptococci from Streptococcus pneumoniae? a CAMP test b bacitracin disk test c hippurate hydrolysis test d optochin test

d optochin test

All of the findings listed below may be seen in autoimmune hemolytic anemias. The one considered to be the *most* characteristic is: a increased reticulocyte count b leukopenia and thrombocytopenia c peripheral spherocytosis d positive direct antiglobulin test

d positive direct antiglobulin test

The term used to describe reproducibility is: a sensitivity b specificity c accuracy d precision

d precision

A formed stool is received in the laboratory at 10:30 pm for ova and parasite exam. The night shift technologist is certain that the workload will prevent examination of the specimen until 7 am when the next shift arrives. The technologist should: a request that a new specimen be collected after 7 am b hold the specimen at room temperature c examine a direct prep for trophozoites and freeze the remaining specimen d preserve the specimen in *formalin* until it can be examined

d preserve the specimen in *formalin* until it can be examined

A 45-year-old woman complains of fatigue, heat intolerance and hair loss. Total and free T4 are abnormally low. If the TSH showed marked elevation, this would be consistent with: a Graves disease b an adenoma of the thyroid c thyrotoxicosis d primary hypothyroidism

d primary hypothyroidism

What precaution should be taken to prevent infection of laboratory personnel when processing specimens for mycobacterial culture? a add NALC in the ratio of 1 part NALC to 1 part specimen b process all specimens under ultraviolet light c centrifuge specimens only after the addition of preservative d process all specimens in a biological safety hood

d process all specimens in a biological safety hood

BSL-3 organisms are those that: a cause human disease but are not readily transmitted among hosts b do not ordinarily cause human disease; they require minimal safety procedures c have very high risk of serious disease and no available treatment or vaccine d produce serious disease and are transmitted by respiratory route

d produce serious disease and are transmitted by respiratory route

A newborn baby boy is known to have a homozygous protein C deficiency. This puts him at a risk for: a DVT b warfarin induced skin necrosis c increased risk of thrombosis d purpura fulminans

d purpura fluminans *[bruises easily]*

The following urine results were obtained on a 25-year-old female: pH: 70 color: yellow appearance: cloudy protein: + glucose: negative blood small: small specific gravity: 1.015 bacteria: many WBC casts: 0-3/lpf WBC/hpf: 30-40 These results are most compatible with: a glomerularnephritis b renal calculus c cystitis d pyelonephritis

d pyelonephritis

The most common cause of bleeding in patients is: a qualitative platelet defect b qualitative abnormality of fibrinogen c quantitative abnormality of fibrinogen d quantitative abnormality of platelets

d quantitative abnormality of platelets (quantitative over qualitative)

A single, reliable screening test for detecting neonatal infection in the absence of clinical signs is: a serum immunoelectrophoresis b different leukocyte count c CD4 cells counts d quantitative serum IgM determination

d quantitative serum IgM determination

Monitoring the load of HIV circulating in a patient's plasma would best be accomplished using which method? a ELISA b DNA sequencing c northern blot d real-time nucleic acid amplification

d real-time nucleic acid amplification

Members of the Enterobacteriaceae share which of the following characteristics? a produce cytochrome oxidase b ferment lactose c produce beta-hemolysis d reduce nitrate to nitrite

d reduce nitrate to nitrite

Members of the family Enterobacteriaceae share which one of the following characteristics? a produce cytochrome oxidase b ferment lactose c produce beta-hemolysis d reduce nitrate to nitrite

d reduce nitrate to nitrite

The mycobacteria that produce a deep yellow or orange pigment both in the dark and light are: a nonchromogens b photochromogens c rapid growers nonchromogens d scotochromogens

d scotochromogens

Blood is drawn from a patient for serological tests for a viral disease shortly after the time of onset and again 4 weeks later. The results of the tests are considered diagnostic if the: a first antibody titer is 2x the second b first and second antibody titers are equal c first antibody titer is 4x the second d second antibody titer is at least 4x the first

d second antibody titer is at least 4x the first

The first step in the quantitation of serum iron is: a direct reaction with appropriate chromogen b iron saturation of transferrin c free iron precipitation d separation of iron from transferrin

d separation of iron from transferrin

When a patient presents with an elevated factor VIII level what test will impacted? a prolong PT b shorten PT c prolong PTT d shorten PTT

d shorten PTT

When a patient presents with an elevated factor VIII level what test will be impacted? a prolonged PT b shortened PT c prolonged PTT d shortened PTT

d shortened (factor VIII --> intrinsic pathway --> PTT)

What term best describes the relatedness of sequences, the percent identity or conservation? a domain b homology c motif d similarity

d similarity

What is the conformation of DNA at 95C? a double-stranded b fragmented c hairpin loop d single-stranded

d single-stranded

Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure? a chloride b calcium c potassium d sodium

d sodium

Biochemical reactions of an organism are consistent with Shigella. A suspension is tested in antiserum without resulting agglutination. However, after 15 minutes of boiling, agglutination occurs in group-D antisera. The Shigella species is: a dysentariae b flexneri c boydii d sonnei

d sonnei

Isoenzyme assays are performed to improve: a precision b accuracy c sensitivity d specificity

d specificity

Acquired immunity can be characterized as having what qualities? a nonadaptive and nonspecific b internal and external mechanisms c sensitivity and short acting d specificity and memory

d specificity and memory

Pre-analytical variables in laboratory testing include: a result accuracy b report delivery to the ordering physician c test turnaround time d specimen acceptability

d specimen acceptability

Patients with G6PD deficiency are LEAST likely to have hemolytic episodes in which of the following situations? a following the administration of oxidizing drugs b following the ingestion of fava beans c during infections d spontaneously

d spontaneously

Erroneous ammonia levels can be eliminated by all of the following except: a assuring water and reagents are ammonia-free b separating plasma from cells and performing test analysis as soon as possible c drawing the specimen in a prechilled tube and immersing the tube in ice d storing the specimen protected from light until the analysis is done

d storing the specimen protected from light until the analysis is done

When evaluating a peripheral blood smear for a reticulocytes count, the red blood cells are observed to overlap throughout the slide. The most likely explanation is: a grease on the slide prevented even spreading b improper proportions of blood and stain were used c the slide was dried too quickly d the drop used for the slide preparation was too large

d the drop used for the slide preparation was too large

A drug that relaxes the smooth muscles of the bronchial passages is: a acetaminophen b lithium c phenytoin d theophylline

d theophylline

Beriberi is associated with deficiency of vitamin: a A b C c niacin d thiamine

d thiamine

Virbio parahaemolyticus [VPH] is best isolated from feces on: a eosin methylene blue (EMB) agar b Hektoen enteric (HE) agar c Salmonella Shigella (SS) agar d thiosulfate citrate bile salts (TCBS) agar

d thiosulfate citrate bile salts (TCBS) agar

The screening test for congenital hypothyroidism is based upon: a free T4 level in the newborn b thyroid-binding globulin level in the newborn c thyroid-releasing globulin level in the newborn d total thyroxine (T4) level in the newborn

d total thyroxine (T4) lvel in the newborn

Hageman factor (XII) is involved in each of the following reactions EXCEPT: a activation of C1 to C1 esterase b activation of plasminogen c activation of factor XI d transformation of fibrinogen to fibrin

d transformation of fibrinogen to fibrin

Which of the following morphologic characteristics is consistently associated with *hairy cell leukemia*? a small cells b clumped nuclear chromatin c flocculent dark blue cytoplasm d uneven cytoplasmic margins

d uneven cytoplasmic margins

The degree to which the kidney concentrates the glomerular filtrate can be determined by: a urine creatine b serum creatinine c creatinine clearance d urine to serum osmolality ratio

d urine to serum osmolality ratio

All casts are typically composed of: a albumin b globulin c immunoglobulins G and M d uromodulin

d uromodulin

Which of the following sample preparations is appropriate to use for evaluation of sperm agglutination? a dried smear stained with Papanicolaou stain b fixed smear stained with eosin-nigrosin stain c smear stained with Wright stain d wet preparation

d wet preparation

Amino transferase enzymes catalyze the:

exchange of amino and keto groups between alpha-amino and alpha-keto acids

A heterophile antigen is best described as?

existing in an unrelated animal

Morphologic variants of plasma cells include:

flame cells

Which of the following serum constituents is unstable if a blood specimen is left standing at room temperature for 8 hours before processing?

glucose

The different water content of electrolytes and plasma makes true glucose concentration in whole blood a function of the:

hematocrit

The most specific method for the assay of glucose in all body fluids utilizes:

hexokinase

In a specimen collected for plasma glucose analysis, sodium fluoride:

inhibits glucose

The best method for ionized calcium involves the use of:

ion-selective electrode that detects changes in potential when Ca+ binds reversibly to the membrane

Increased levels of TdT activity are indicative of:

acute lymphocytic lymphoma

Which of the following is a glyolytic enzyme that catalyzes the cleavage of fructose-1, 6-diphosphate to glyceraldehyde-3-phosphate and dihydroxyacetone phosphate?

aldolase

Soluble immune complexes are formed under the condition of:

antigen excess

Given the following values: 100, 120, 150, 140, 130 What is the mean? a 100 b 128 c 130 d 640

b 128 (add numbers and divide by number of intervals)

The molecular-based diagnostic test for Mycobacterium tuberculosis uses ribosomal RNA as the target. Primers are made to be specific for which RNA subunit? a 5.8S b 16S c 18S d 28S

b 16S

During a normal pregnancy, quantitative human chorionic gonadotropin (HCG) levels peak how many weeks after the last menstrual period? a 2-4 b 8-10 c 14-16 d 18-20

b 8-10

The results of STR typing of a child

b AF2 is most likely the father of the child

Which of the following organisms can *grow in the small bowel* and cause diarrhea in children, *traveler's diarrhea*, or a severe *cholera-like syndrome* through the production of enterotoxins? a Yersinia enterolitica b Escherichia coli c Salmonella typhi d Shigella dysenteriae

b Escherichia coli

What type of short read files with quality scores are used for storing next generation sequencing read data? a FASTA b FASTQ c RRBS d WGBS

b FASTQ

Examples of Category A agents of bioterrorism include: a Bacillus anthracis, MDR tuberculosis b Francisella tularensis, Yersinia pestis c Hanta virus, variola major virus d VRE, Bacillus cereus

b Francisella tularensis, Yersinia pestis

An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs and characterized by red cell inclusions formed by denatured hemoglobin is: a lactate dehydrogenase deficiency b G6PD deficiency c pyruvate kinase deficiency d hexokinase deficiency

b G6PD deficiency

A vaginal/rectal swab is collected from a pregnant patient to screen for group B Streptococcus colonization. The best medium to inoculate the specimen to is: a CNA agar b LIM broth c sheep blood agar d thioglycollate agar

b LIM broth

Refer to the following data: pt1 -- HBsAg - anti-HBc IgM - anti-HAV IgM + pt2 -- HBsAg + anti-HBc IgM + anti-HAV IgM - pt3 -- HBsAg - anti-HBc IgM + anti-HAV IgM - From the test results above, it can be concluded that patient #3 has: a recent acute hepaitits A b acute hepatitis B c acute hepatitis C (non-A/non-B hepatitis) d chronic hepaitis B

b acute hepaitis B

Normal serum constituents that can rapidly increase during infection, injury or trauma are referred as? a haptens b acute phase reactants c opsonins d chemotaxins

b acute phase reactants

Which of the following will cause erroneous results when using a phase optical system for enumerating platelets? a lysed RBCs b aggregated platelets c diluted sample d intact leukocytes

b aggregated platelets

Ghost red blood cells are seen in urine that is: a acidic and dilute b alkaline and dilute c acidic and concentrated d alkaline and concentrated

b alkaline and dilute

In which of the following metabolic diseases will urine turn dark brown to black upon standing? a phenylketonuria b alkaptonuria c maple syrup disease d aminoaciduria

b alkaptonuria

Which of the following enzymes catalyzes the conversion of *starch to glucose and maltose*? a malate dehydrogenase (MD) b amylase (AMS) c creatinine kinase (CK) d isocitric dehydrogenase (ICD)

b amylase (AMS)

Which of the following causes of thrombophilia most often presents as thrombotic episodes with *resistance to heparin*? a protein C deficiency b antithrombin deficiency c prothrombin G20210A deficiency d factor V Leiden

b antithrombin deficiency

Package inserts may be used: a instead of a typed procedure b as a reference in a procedure c at the bench but not in the procedure manual d if initiated and dated by the laboratory director

b as a reference in a procedure

Penicillin resistance in Neisseria gonorrhoeae can be due to the organism producing: a beta-D-galactosidase b beta-lactamase c butyrate esterase d DNase

b beta-lactase

Psittacosis is transmittable to man via contact with: a insects b birds c cattle d dogs

b birds

Kernicterus is an abnormal accumulation of bilirubin in: a heart tissue b brain tissue c liver tissue d kidney tissue

b brain tissue

An organism previously thought to be nonpathogenic, Moraxella catarrhalis, is now known to be associated with opportunistic respiratory infection and nosocomial transmission. Characteristic identification criteria include: a beta-lactamase negative b butyrate esterase positive c gram-negative bacilli d oxidase negative

b butyrate esterase positive

A reciprocal relationship exists between: a sodium and potassium b calcium and phosphate c chloride and CO2 d calcium and magnesium

b calcium and phosphate

Which of the following crystals can be found in acidic urine? a calcium carbonate b calcium oxalate c calcium phosphate d triple phosphate

b calcium oxalate (phosphate/carbonate belong in basic urine)

While performing a routine urinalysis, the laboratorian notes a 2+ protein result. They should: a request another specimen b confirm with the acid preparation test c test for Bence Jones protein d report the result obtained without further testing

b confirm with the acid preparation test

Chronic carriers of HBV: a have chronic symptoms of hepatitis b continue to carry HBV c do not transmit infection d carry HBV but are not infectious

b continue to carry HBV

In a double-beam photometer, the additional beam is used to: a compensate for variation in wavelength b correct for variations in light source intensity c correct for changes in light path d compensate for variations in slit-widths

b correct for variations in light source intensity

The finding of a large amount of uric acid crystals in a urine specimen from a 6-month-old boy: a may actually be diaper fibers b could indicate Lesch-Nyhan syndrome c should not be reported d may indicate improper feeding

b could indicate Lesch-Nyhan syndrome

Laboratory findings in hereditary spherocytosis include: a decreased WBCs b decreased RBC band 3 protein c reticulocytopenia d positive direct antiglobulin test

b decreased RBC band 3 protein

An increased amount of cytoplasmic basophilia in a blood cell indicates: a increased cytoplasmic maturation b decreased cytoplasmic maturation c reduction in size of the cell d decreased nuclear maturation

b decreased cytoplasmic maturation

Patients with factor XIII deficiency have: a an abnormal aPTT b delayed bleeding c tissue damage d joint bleeds

b delayed bleeding

What is the most common presentation of factor XIII deficiency? a clinically inapparent b delayed bleeding tendency c severe bleeding responsive to DDAVP d severe bleeding not responsive to DDAVP

b delayed bleeding tendency

A patient had glucosuria, hyperglycemia, and polyuria. These findings are MOST consistent with: a renal glucosuria b diabetes mellitus c emotional stress d eating a heavy meal

b diabetes mellitus

An agglutination test wherein the *antigen is a natural component of the infectious entity* is a(n): a indirect agglutination procedure b direct agglutination procedure c passive agglutination procedure d reverse passive agglutination procedure

b direct agglutination procedure

A urine's specific gravity is directly proportional to: a turbidity b dissolved solids c salt content d sugar content

b dissolved solids

Sodium determination by indirect selective electrode is falsely decreased by: a elevated chloride levels b elevated lipid levels c decreased protein levels d decreased albumin levels

b elevated lipid levels

In the Jendrassik-Grof reaction for total bilirubin, alkaline tartrate is added to: a form diazo bilirubin, a reddish chromogen b eliminate many spectrophotometric interferences c act as an accelerator d react with delta-bilirubin

b eliminate many spectrophotometric interferences

During sweat collection, a consideration that can result in a falsely high result is: a high ambient temperature b evaporation c preparation of area with type 1 water d high sweat rate

b evaporation

Which one of the following values obtained during a glucose tolerance test are diagnostic of diabetes mellitus? a 2-hour specimen = 150 mg/dL (8.3 mmol/L) b fasting plasma glucose = 126 mg/dL (6.9 mmol/L) c fasting plasma glucose = 110 mg/dL (6.1 mmol/L) d 2-hour specimen = 180 mg/dL (9.9 mmol/L)

b fasting plasma glucose = 126 mg/dL (6.9 mmol/L)

A pediatric inpatient presents with an aPTT of 54.8 seconds. With an abnormal thrombin time of 26 seconds (12-19 seconds), a reptilase time is performed and is normal at 15 seconds (12-19 seconds). Based on these results, what disorder has been ruled out? a lupus anticoagulant b fibrinogen deficiency c heparin contamination d presence of a DTI

b fibrinogen deficiency

Which chemical is a potential carcinogen? a potassium chloride b formaldehyde c mercury d picric acid

b formaldehyde

In which of the following conditions would a NORMAL level of creatinine kinase be found? a acute myocardial infarction b hepatitis c progressive muscular dystrophy d intramuscular injection

b hepatitis

Which infectious agent is considered to be the primary occupational health hazard regarding transmission of bloodborne pathogens? a human immunodeficiency virus b hepaititis B c tuberculosis d methicillin-resistant Staphylococcus aureus

b hepatitis B

A patient with renal tubular acidosis would most likely excrete a urine with a: a low pH b high pH c neutral pH d variable pH

b high pH

False-positive results can occur for fecal occult blood due to the ingestion of: a ascorbic acid b horseradish a acetaminophen d blueberries

b horseradish

The advantage of thick blood smears for malarial parasites is to: a improve staining of the organisms b improve detection of the organisms c remove RBC artifacts d remove platelets

b improve detection of the organisms

Refractive index is a comparison of: a light velocity in solutions to light velocity in solids b light velocity in air to light velocity in solutions c light scattering by air to light scattering by solutions d light scattering by particles in solution

b light velocity in air to light velocity in solutions

Serum levels that define hypoglycemia in pre-term or low birth weight infants are: a the same as adults b lower than adults c the same as a normal full-term infant d higher than a normal full-term infant

b lower than adults

Antinuclear antibody tests are performed to help diagnose: a acute leukemia b lupus erythematosus c hemolytic anemia d Crohn disease

b lupus erythematosus (*ANA* tests for systemic rheumatic diseases)

The cytoplasmic abnormality of the white blood cell of Alder-Reilly anomaly is found in the: a endoplasmic reticulum b lysosomes c mitochondria d ribosomes

b lysosomes

Milky urine from a 24-year-old woman would most likely contain: a spermatozoa b many white blood cells c red blood cells d bilirubin

b many white blood cells

Which of the following is an important cellular mediator of immune complex tissue injury? a mast cell b neutrophil c basophil d eosinophil

b neutrophil

Shigella species characteristically are: a urease positive b nonmotile c oxidase positive d lactose fermenters

b nonmotile

Following ingestion of ethylene glycol (antifreeze) numerous crystals are found in the urine. The shape of these crystals is: a flat with notched corners b oval/dumbbell c coffin-lid d rosettes/rhomboid

b oval/dumbbell

Most automated blood gas analyzers directly measure: a pH, HCO3 and % O2 saturation b pH, pCO2 and pO2 c HCO3, pCO2 and pO2 d pH, pO2 and % O2 saturation

b pH, pCO2 and pO2

The regulation of calcium and phosphorus metabolism is accomplished by which of the following glands? a thyroid b parathyroid c adrenal glands d pituitary

b parathyroid

Erythropoietin acts to: a shorten the replication time of the granulocytes b stimulate RNA synthesis of erythroid cells c increase colony-stimulating factors produced by the B lymphocytes d decease the release of marrow reticulocytes

b stimulate RNA synthesis of *erythroid cells*

In the Clauss fibrinogen method, the time to clot formation in plasma is measured after the addition of: a calcium b thrombin c phospholipids d kaolin

b thrombin

Which of the following cells is most likely to be seen in the urine sediment following a catheterization procedure? a squamous epithelial b transitional epithelial c white blood d renal tubular epithelial

b transitional epithelial

In dideoxy chain termination sequencing (Sanger method), what does a heterozygous nucleotide position look like on an electropherogram? a 1 peak twice the height of those around it b 2 peaks in the same position, one twice the height of the other c 2 peaks of equal height at the same position d 3 peaks of equal height at the same position

c 2 peaks of equal height at the same position

A drug has a half-life of 6 hours. If a dose is given every 6 hours, a steady-state drug level would usually be achieved in: a 3-5 hours b 10-12 hours c 24-42 hours d 48-50 hours

c 24-42 hours

A patient has the following serum results: - Na+: 140. mmol/L - K+: 4.0 mmol/L - glucose: 95. mmol/L - BUN: 10. mg/dL (3.57 mmol/L) Which osmolality is consistent with these results? a 188 b 204 c 270 d 390

c 270

Which percentage of total serum calcium is nondiffusible protein bound? a 80-90% b 51-60% c 40-50% d 10-130%

c 40-50%

The following data were calculated on a series of 30 determinations of serum uric acid control: mean = 5.8 mg/dL, 1 standard deviation = 0.15 mg/dL. If confidence limits are set at + 2 standard deviations, which of the following represents the allowable limits for the control? a 5.65-5.95 mg/dL b 5.35-6.25 mg/dL c 5.50-6/10 mg/dL d 5.70-5.90 mg/dL

c 5.50-6.10 mg/dL

When quantifying the amount of genomic DNA in a sample by spectrophotometry, an OD 260 of 1.0 corresponds to what concentration of DNA? a 10 ug/mL b 20 ug/mL c 50 ug/mL d 100 ug/mL

c 50 ug/mL

A clean catch urine (obtained with a 0.01 mL calibrated loop) grows 60 colonies of Escherichia coli. Which of the following represents the final colony count in CFU/mL? a 60 CFU/mL b 600 CFU/mL c 6,000 CFU/mL d 60,000 CFU/mL

c 6,000 CFU/mL

The reference range for the pH of arterial blood measured at 37C is: a 7.28-7.34 b 7.33-7.37 c 7.35-7.45 d 7.45-7.50

c 7.35-7.45

Normally the bicarbonate concentration is about 24 mEq/L and the carbonic acid concentration is about 1.2; p = 6.1, log 20 = 1.3. Using the equation pH = pK + log [salt]/[acid], calculate the pH. a 7.28 b 7.38 c 7.40 d 7.42

c 7.40

What is the proper pH for the buffered solution used to perform serum protein electrophoresis? a 5.6 b 7.6 c 8.6 d 9.6

c 8.6

A translocation in which chromosome pair creates a BCR/ABL 1 fusion gene product associated with *chronic myeloid leukemia*? a 11;18 b 14;18 c 9;22 d 9;14

c 9;22

While swimming in a lake near his home, a young boy cut his foot, and an infection developed. The culture grew a *nonfastidious Gram-negative, oxidase positive, beta-hemolytic, MOTILE BACILLI that produced deoxyribonuclease (DNAse)*. The MOST likely identifcation is: a Enterobacter cloacae b Serratia marcescens c Aeromonas hydrophilia d Escherchia coli

c Aeromonas hydrophilia

C3b and Fc receptors are present on: a B lymphocytes b monocytes c B lymphocytes and monocytes d neither B lymphocytes nor monocytes

c B lymphocytes and monocytes

Humoral antibodies are produced by which cells? a macrophages b T lymphocytes c B lymphocytes d neutrophils

c B lypmhocytes

Which organism commonly causes food poisoning by consumption of foods containing excessive populations of organisms or preformed enterotoxin? a Salmonella enteritidis b Shigella sonnei c Bcaillus cereus d Escherichia coli

c Bacillus cereus

Which of the following is cleaved as a result of activation of the classical complement pathway? a properdin factor B b C1q c C4 d C3b

c C4

Which of the following complement components is a strong chemotactic factor as well as a strong anaplyatoxin? a C3a b C3b c C5a d C4a

c C5a

If a stool sample is sent to the laboratory to rule out Clostridium difficle, what medium should the microbiologist use and what is the appearance of this organism on this medium? a BBE: colonies turn black b Brucella agar: red pigmented colonies c CCFA: yellow, ground glass colonies d CNA: double zone hemolytic colonies

c CCFA: yellow, ground glass colonies

A *positive ANA* with the pattern of *anti-centromere antibodies* is MOST frequently seen in patients with: a rheumatoid arthritis b systemic lupus erythematosus c CREST syndrome d Sjogren syndrome

c CREST syndrome

A positive ANA with the pattern of anti-centromere antibodies is MOST frequently seen in patients with: a rheumatoid arthritis b systemic lupus erythematosus c CREST syndrome d Sjogren syndrome

c CREST syndrome

The sediment of a urine specimen with a reagent strip glucose of 250 mg/dL and a pH of 5.5 is ideal for the presence of: a cystine crystals b Trichomonas vaginalis c Candida albicans d ammonium biurate crystals

c Candida albicans

Which of the following best depicts the general route of production in a human cell? a mRNA --> DNA --> protein b protein --> mRNA --> DNA c DNA --> mRNA --> protein d DNA --> protein --> mRNA

c DNA --> mRNA --> protein

Which test has the greatest sensitivity for antigen detection? a precipitin b agglutinaiton c ELISA d complement fixation

c ELISA

Which test has the greatest sensitivity for antigen detection? a precipitin b agglutination c ELISA d complement fixation

c ELISA

A young girl cuts her foot on a rock while swimming at the ocean. Her foot begins to show signs of infection and her parents take her to the ER. A culture grows a *non-lactose* fermenting Gram-negative rod that produces copious amounts of *hydrogen sulfide* and gas, is *indole positive and motile*. The organism most likely isolated is: a Shigella spp b Escherchia spp c Edwardsiella spp d Klebsiella spp

c Edwardsiella spp

The stock cultures needed for quality control testing of oxidase production are: a Escherichia coli--Klebsiella pneumoniae b Salmonella typhimurium--Escherichia coli c Escherichia coli--Pseudomonas aeruginosa d Proteus mirabilis--Escherichia coli

c Escherichia coli--Pseudomonas aeruginosa

For diagnosis of late latent or tertiary syphilis, the most appropriate assay is: a RPR b VDRL c FTA-ABS d FTA-ABS IgM

c FTA-ABS

An example of an organ specific disease with autoimmune antibodies is: a Wegner granulomatosus b rheumatoid arthritis c Hashimoto thyroiditis d systemic lupus erythematosus

c Hashimoto thyroiditis

In the hemoglobin solubility (dithionate) test, which type of hemoglobin causes turbidity (positive reaction)? a HgbD b HgbE c HgbS d HgbA

c HgbS

Which description bests fits the Donath-Landsteiner antibody? a IgM cold agglutinin b biphasic IgM hemolysin c IgG biphasic hemolysin d IgG warm agglutinin

c IgG biphasic hemolysin

It is important to note that when an infant is born, levels of specific antibody of the following class are used to indicate neonatal infection: a IgA b IgG c IgM d IgD

c IgM

The initial immune response following fetal infection with rubella is the production of which class(es) of antibodies? a IgG b IgA c IgM d both IgG and IgA

c IgM

Which of the following immunoglobulins is the MOST efficient at agglutination? a IgG b IgA c IgM d IgE

c IgM

Which of the following immunoglobulins is the most efficient at agglutination? a IgG b IgA c IgM d IgE

c IgM

Rheumatoid factor is most often which of the following classes: a IgE b IgA c IgM d IgG

c IgM (has to be AUTOantibody)

In a patient with an increased red cell mass into the 99th percentile and serum erythropoietin level below reference range for normal, which of the following critical confirms a diagnosis of polycythemia vera? a bone marrow panymyelosis b inv(16) mutation c JAK2 V617F mutation d BCR-ABL1 translocation

c JAK V617F mutation

A screening procedure for detecting hemoglobin F is the: a fluorescent spot test b dithionite solubility test c Kleihauer-Betke test d heat instability test

c Kleihauer-Betke test

Which reagent generates a signal during the annealing stage of a quantitative real time PCR reaction? a SYBR Green b Hydrolysis (Taqman) probes c Molecular Beacon d Scorpions primers

c Molecular Beacon

The drug procainamide is prescribed to treat cardiac arrhythmia. What biologically active liver metabolite of procainamide is often measured simultaneously? a phenobarbitol b quinidine c N-acetyl procainamide (NAPA) d lidocaine

c N-acetyl procainamide (NAPA)

A physician requested that electrolytes on a multiple myeloma patient specimen be run by direct ISE and not indirect ISE because: a excess protein binds Na in indirect ISE b Na is falsely increased by indirect ISE c Na is falsely decreased by indirect ISE d excess protein reacts with diluent in indirect ISE

c Na is falsely *decreased* by indirect ISE

Which of the following require laboratories to establish a chemical hygiene plan? a CAP (College of American Pathologists) b ACS (American Chemical Society) c OSHA (Occupational Safety and Health Act) d CLIA (Clinical Laboratory Improvements Act)

c OSHA (Occupational Safety and Health Act

A 1-2 mm translucent, nonpigmented colony, isolated from an anaerobic culture of a lung abscess after 72 hours, was found to fluoresce *brick-red under ultraviolet light*. A Gram stain of the organism revealed a *coccobacillus* that had the following characteristics: - inhibited growth in bile - susceptibility to colistin - resistance to vancomycin and kanamycin - negative for catalase, esculin hydrolysis and indole The identification of this isolate is: a Bacteriodes ovatus b Propionibacterium acnes c Prevotella melaninogenica d Prophyromonas asaccharolytica

c Prevotella melaninogenica

Reverse transcriptase would be best described as a: a DNA-dependent DNA polymerase b DNA-dependent RNA polymerase c RNA-dependent DNA polymerase d RNA-dependent RNA polymerase

c RNA-dependent DNA polymerase

Which statement is true concerning the analysis of short tandem repeats (STR)? a STR are amplified by reverse transcriptase PCR b STR code for small cytokines c STR are analyzed by capillary electrophoresis d STR analysis requires high molecular weight DNA

c STR are analyzed by capillary electrophoresis

An organism was inoculated to a TSI tube and gave the following reactions: alkaline slant/acid butt, H2S, gas produced This organism most likely is: a Klebsiella pneumoniae b Shigella dysenteriae c Salmonella typhimurium d Escherichia coli

c Salmonella typhimurium

Which of the following organisms is, to date, considered universally susceptible to penicillin: a Haemophilus influenzae b Neisseria gonorrhoeae c Streptococcus pyogenes d Corynebacterium diphtheriae

c Streptococcus pyogenes

The principle of the reagent strip test for microalbuminuria is: a a diazo reaction b the protein error of indicators c an immunochemical reaction d the release of hydrogen ions to an indicator

c an immunochemical reaction

A wet preparation is made from a fresh focal specimen and stained with Wright stain. The laboratorian reports the presence of 3-5 WBC per high power field noting that the cells are neutrophils. These results indicate the patient most likely has: a poethepatic biliary obstruction b a noninflammatory condition such as malabsorption c an inflammatory condition such as ulcerative colitis d malabsorption syndrome

c an inflammatory condition such as ulcerative colitis

The specificity of an immunoassay is determined by the: a label used on the antigen b method used to separate the bound from free antigen c antibody used in the assay d concentration of unlabeled antigen

c antibody used in the assay

Which of the following are true statements about selective IgA deficiency? a associated with a decreased incidence of allergic manifestations b high concentration of secretory component in the saliva c associated with an increased incidence of autoimmune diseases d found in approximately 1 out of every 50 persons

c associated with an increased incidence of autoimmune diseases

The synovial fluid easily forms small drops from the aspirating syringe. This viscosity is: a normal b increased c associated with inflammation d associated with hypothyroidism

c associated with inflammaiton

Which of the following would be evidence of a successful vasectomy? a seminal pH >7.8 b less than 10% of sperm with forward progression c azoospermia d head-to-head agglutination

c azoospermia

Urine samples should be examined within 1 hour of voiding because: a RBCs, leukocytes and casts agglutinate on standing for several hours at room temperature b urobilinogen increases and bilirubin decreases after prolonged exposure to light c bacterial contamination will cause alkalinzation of the urine d ketones will increase due to bacterial and cellular metabolism

c bacterial contamination will cause alkalinzation of the urine

Most of the carbon dioxide in blood is in the form of: a dissolved CO2 b carbonate c bicarbonate ion d carbonic acid

c bicarbonate ion

The most important buffer pair in plasma is the: a phosphate/biphosphate pair b hemoglobin/imidazole pair c bicarbonate/carbonic acid pair d sulfate/bisulfate pair

c bicarbonate/carbonic acid pair

Which of the following is DECREASED in serum during the active stages of systemic lupus erythematosus? a anti-nuclear antibody b immune complexes c complement (C3) d anti-DNA

c complement (C3)

T lymphocytes that possess the CD8 surface marker mediate which of the following T cell functions? a delayed type hypersensitivity b regulatory c cytotoxic d helper

c cytotoxic

Which pair does NOT match with respect to amniotic fluid? a colorless -- normal b dark red brown -- fetal death c dark green -- hemolytic disease of the newborn d blood-streaked -- traumatic collection

c dark green -- hemolytic disease of the newborn

On an automated hematology analyzer, if the RBC is erroneously increased, how will other parameters be affected? a increased MCHC b increased hemoglobin c decreased MCH d increased MCV

c decreased MCH

Chylomicrons are present in which of the following dyslipidemias? a familial hypercholesterolemia b hypertriglyceridemia c deficiency in liporotein lipase activity d familial hypoalphalipoproteinemia

c deficiency in lipoprotein lipase activity

The ability to make good decisions often depends on the use of a logical sequence of steps that include: a defining problem, considering options, implementing decisions b obtaining facts, considering alternatives, reviewing results c defining problem, obtaining facts, considering options d obtaining facts, defining problem, implementing decision

c defining problem, obtaining facts, considering options

A yellow colony from a wound culture tested catalase-positive and coagulase-negative. The organism stained as Gram-positive cocci in clusters. Which of the following tests would differentiate between a coagulase-negative Staphylococcus and Micrococcus? a novobiocin susceptibility b leucine aminopeptidase (LAP) production c furazolidone (100 ug/disk) susceptibility d hydrolysis of bile esculin

c furazolidone (100 ug/disk) susceptibility

The MOST sensitive enzymatic indicator for liver damage from ethanol intake is: a alanine eminotransferase (ALT) b aspartate aminotransferase (AST) c gamma-glutamyl transferase (GGT) d alkaline phophatase

c gamma-glutamyl transferase (GGT)

In the indirect immunofluorescence method of antibody detection in patient serum, the labeled antibody is: a human anti-goat immunoglobulin b rheumatoid factor c goat anti-human immunoglobulin d complement

c goat anti-human immunoglobulin

The white cell feature most characteristic of pernicious anemia is: a eosinophilia b toxic granulation c hypersegmentation d reactive lymphocytes

c hypersegmentation

What is the immunologic method utilized in the flow cytometer? a latex agglutination b enzyme linked immunoassay c immunofluorescence d radioimmunoassay

c immunofluorescence

A diagnosis of primary adrenal insufficiency requires demonstration of: a decreased urinary 17-keto- and 17-hydroxysteroids b decreased cortisol production c impaired response to ACTH stimulation d increased urinary cortisol excretion after metyrapone

c impaired response to ACTH stimulation

The presence of leukocytes in urine is known as: a chyluria b hematuria c leukocytosis d pyuria

c leukocytosis

Which of the following may be measured in CSF to evaluate the effectiveness of treatment for multiple sclerosis? a bilirubin b lactate c myelin basic protein d glutamine

c myelin basic protein

Which of the following is associated with pseudo-Pelger-Huet anomaly? a aplastic anemia b iron deficiency anemia c myelogenous leukemia d Chediak-Higashi syndrome

c myelogenous leukemia

A scanning of a CK isoenzyme fractionation revealed 2 peaks: a slow cathodic peak (CKMM) and an intermediate peak (CKMB). A possible interpretation for this pattern is: a brain tumor b muscular dystrophy c myocardial infarction d viral hepatitis

c myocardial infarction

Fasting serum phosphate concentration is controlled primarily by the: a pancreas b skeleton c parathyroid glands d small intestine

c parathyroid glands

Automated analyzers generally incorporate mechanical versions of manual techniques. Modern instruments are packed in a wide array of configurations. The most common configuration is: a continuous flow analyzers b multiple specimen and multiple channel analyzers c random access analyzers d total automation analyzers

c random access analyzers

A patient has the following laboratory results: - RBC: 2.35 x 10^6/uL - WBC: 3.0 x 10^3/uL - Plt: 95.0 x 10^3/uL - Hgb: 9.5 g/dL - Hct: 27% - MCV: 115 fL - MCH: 35% - MCHC: 40 pg Which of the following tests would contribute toward the diagnosis? a reticulocyte count b platelet factor 3 c serum B12 and folate d leukocyte alkaline phosphatase

c serum B12 and folate

Tests for Haemophilus influenzae beta-lactamase production: a are not commercially available b include tests that measure a change to an alkaline pH c should be performed on all blood and CSF isolates d are NOT valid for any other bacterial species

c should be performed on all blood and CSF isolates

Calibration of refractometers is performed by measuring the specific gravity of distilled water and: a protein b glucose c sodium chloride d urea

c sodium chloride

Urine osmolality is related to: a pH b filtration c specific gravity d volume

c specific gravity

Qualitative methods used as screening tests for cystic fibrosis include: a coulometric CI measurement b CI selective electrodes c sweat conductivity d pilocarpine iontophoresis

c sweat conductivity

A patient has the following blood values: - RBC: 6.5 x 10^6/uL - Hgb: 13.0 g/dL - Hct: 39% - MCV: 65 fL - MCH: 21.5 pg - MCHC: 33% These results are compatible with: a iron deficiency b pregnancy c thalassemia major d beta thalassemia major

c thalassemia major

In immunofixation electrophoresis: a the antibody reacts with the antigen and then the complex is electrophoresed b the antigen is electrophoresed into an antibody containing gel c the antigen is electrophoresed and then monospecific antisera is reacted with it d the antigen is electrophoresed, transferred to nitrocellulose and then antibody reacts with it and an EIA is performed

c the antigen is electrophoresed and then monospecific antisera is reacted with it

The key structural difference that distinguishes immunoglobulin subclasses is the: a number of domains b stereometry of the hypervariable region c the sequence of the constant regions d covalent linkage of the light chains

c the sequence of the constant regions

Total iron-binding capacity measures the serum iron transporting capacity of: a hemoglobin b ceruloplasmin c transferrin d ferritin

c transferrin

Antibody idiotype is dictated by the: a constant region of heavy chain b constant region of light chain c variable regions of heavy and light chains d constant regions of heavy and light chains

c variable regions of heavy and light chains

Normal urine primarily consists of: a water, protein and sodium b water, urea and protein c water, urea and sodium chloride d water, urea and bilirubin

c water, urea and sodium chloride

Which of the following is true of *acute lymphoblastic lymphoma* (ALL)? a. occurs most commonly in children 1-2 years of age b. patient is asymptomatic c. primitive lymphoid-appearing cells accumulate in bone marrow d. children under 1 year of age have a good prognosis

c. primitive lymphoid-appearing cells accumulate in bone marrow

An increase in serum acetone is indicative of a defect in the metabolism of:

carbohydrate

Media used to support growth of Legionella pneumophila should contain the additives:

charcoal and yeast extract

A male urethral discharge specimen submitted for culture should be inoculated to:

chocolate and modified Thayer-Martin agars

Turbidity in serum suggests elevation of:

chylomicrons

Which sequence represents the replicate DNA strand of 5'-GGG ATC GAT GCC CCT TAA AGA GTT TAC-3' a 5'-GGG ATC GAT GCC CCT TAA AGA GTT TAC-3' b 5' CCC TAG CTA CGG GGA ATT TCT CAA ATG-3' c 3' GGGATC GAT GCC CCT TAA AGA GTT TAC-3' d 3' CCC TAG CTA CGG GGA ATT TCT CAA ATG-3'

d 3' CCC TAG CTA CGG GGA ATT TCT CAA ATG-3' (reciprocal)

The optimal incubator temperature for isolation of the Campylobacter jejuni coli group is: a 4C b 20C c 25C d 42C

d 42C

Given the following data: Hgb: 8 g/dL (80 g/L) Hct: 28% RBC: 3.6x10^6/uL (3.6x10^12/L) The MCV is: a 28 um^3 (28 fL) b 35 um^3 (35 fL) c 40 um^3 (40 fL) d 77 um^3 (77 fL)

d 77 um^3 (77 fL) -- [MCV=(Hct x 10)/RBC]

Incompatibility by which of the following procedures in an absolute contraindication to allotransplantation? a MLC (mixed lymphocyte culture) b HLA typing c Rh typing d ABO grouping

d ABO grouping

Antibodies are produced by: a killer cells b marrow stem cells c mast cells d B cells

d B cells

False-positive rheumatoid factor in agglutination and nephelometric methods can be due to elevated levels of: a cryoglobulin b histidine-rich-glycoprotein c aspartame d C1q

d C1q

Which medium could the technologist use to verify that a yeast isolate from a blood culture is pure? a Sabouraud dextrose agar b potato dextrose agar c cornmeal agar d CHROMagar^TM

d CHROMagar^TM

A person suspected of having metabolic alkalosis would have which of the following laboratory findings? a CO2 content and pCO2 elevated, pH decreased b CO2 content decreased and pH elevated c CO2 content, pCO2 and pH decreased d CO2 content and pH elevated

d CO2 content and pH elevated

The formation of germ tubes presumptively identifies: a Candida tropicalis b Candida parasilosis c Candida glabrata d Candida albicans

d Candida albicans

Laboratory workers should always work under a biological safety hood when working with cultures of: a Streptococcus pyogenes b Staphylococcus aureus c Candida albicans d Coccidioides immitis

d Coccidioides immitis

In the indirect fluorescent anti-nuclear antibody test, a homogenous pattern may indicate the presence of antibody to: a RNP b Sm c RNA d DNA

d DNA

The following procedure has been routinely used for detection of hepatitis B surface antigen (HBsAg) because of its high level of sensitivity: a hemagglutination b counterimmunoelectrophoresis c radial immunodiffusion d ELISA

d ELISA

Which of the following glycosylated hemoglobins is recommended by the ADA guidelines for testing *diabetic patients*? a HgbA1a b HgbA2 c HgbA1b d HgbA1c

d HgbA1c

Which of the following cytokines is most responsible for eosinophil differentiation and release from the bone marrow? a IL-1 b IL-2 c IL-4 d IL-5

d IL-5

Which 2 immunoglobulin classes have a "J" chain associated with the structure? a IgG, IgA b IgA, IgE c IgG, IgM d IgM, IgA

d IgM, IgA

The most widely used methods for bilirubin measurement are those based on the: a Jaffe reaction b Schales and Schales method c 8-hydroxyquinoline reaction d Jendrassik-Grof method

d Jendrassik-Grof method

Which of the RBC indices is a measure of the amount of hemoglobin in individual red blood cells? a MCHC b MCV c Hct d MCH

d MCH

Which parameter is most consistently abnormal in cases of hereditary spherocytosis? a RBC count b MCV c Hemoglobin d MCHC

d MCHC

Which of the following anomalies is an *autosomal dominant* disorder characterized by irregularly-shaped inclusions in *polymorphonuclear neutrophils, abnormal giant platelets and often thrombocytopenia*? a Pelger-Huet b Chadiak-Higashi c Alder-Reilly d May-Hegglin

d May-Hegglin

When grown in the dark, yellow to orange pigmentation of the colonies is usually demonstrated by: a Mycobacterium tuberculosis b Mycobacterium kansasii c Mycobacterium fortuitum d Mycobacterium scrofulaceum

d Mycobacterium scrofulaceum

Primary amoebic encephalitis is caused by: a Entamoeba coli b Dientamoeba fragilis c Endomilax nana d Naegleria fowleri

d Naegleria fowleri

An 18-year-old boy is admitted to the hospital with suspected meningitis. He is lethargic and presents with a rigid neck. He has not had most of the recommended vaccines from childhood to now. Gram stain of his spinal fluid shows many PMNs with intra and extra cellular Gram-negative diplococci. The suspected pathogen is: a Listeria monocytogenes b Haemophilus influenzae c Streptococcus agalactiae d Neisseria meningitidis

d Neisseria meningitidis

Which of the following RBC inclusions are seen in sideroblastic anemia and contain high amounts of iron? a Cabot rings b Howell-Jolly bodies c Heinz bodies d Pappenheimer bodies

d Pappenheimer bodies

A nonfermenting Gram-negative bacillus is isolated from a wound. The nitrate and oxidase are strongly positive. The growth on Mueller-Hinton agar produces pyoverdin. The organism is: a Burkholderia cepacia b Moraxella lacunata c Chryseobacterium (Flavobacterium) meningosepticum d Pseudomonas aeruginosa

d Pseudomonas aeruginosa

On a follow-up visit to her health care provider, a young woman was given the results of her FTA-ABS test. She had been symptomatic for a couple of months before this visit, with fever, swollen cervical lymph nodes, fatigue, and rash affecting the palms of her hands and the soles of her feet, but she was now feeling better. Earlier test strategies that would expect the health care provider to have requested include all of the following EXCEPT: a RPR b TPHA c VDRL d RAST

d RAST

Arterial thrombosis is caused by: a RBC & platelets b fibrin & WBC c thrombin & FXIII d WBC & platelets

d WBC & platelets

Which one of the following Gram-negative bacilli ferments glucose? a Alcaligenes faecalis b Burkholderia ccepacia c Acinetobacter lwoffi d Yersinia enterocolitica

d Yersinia enterocolitica

Hereditary deficiency of late complement components (C5, C6, C7 or C8) can be associated with which of the following conditions? a pneumococcal septicemia b small bowel obstruction c systemic lupus erythematosus d a systemic gonococcal infection if exposed

d a systemic gonococcal infection if exposed

Chronic lymphocytic leukemia is defined as a(n): a malignancy of the thymus b accumulation of prolymphocytes c accumulation of hairy cells d accumulation of monoclonal B cells

d accumulation of monoclonal B cells

An eosinophil count may be requested on urine from a patient with suspected: a acute glomerularnephritis b cystitis c renal lithiasis d acute interstitial nephritis

d acute interstitial nephritis

An eosinophil may be requested on urine from a patient with suspected: a acute glomerularnephritis b cystitis c renal lithiasis d acute interstitial nephritis

d acute interstitial nephritis

A block in the differentiation or maturation of, and an accumulation of immature hematopoietic progenitors is a hallmark of: a chronic lymphocytic leukemia b myelodysplastic syndromes c polycythemia vera d acute myelocytic leukemia

d acute myelocytic leukemia (AML)

Which of the following can affect the PFA-100 closure time? a aspirin b thrombocytopenia c anemia d all of the above

d all of the above [aspirin/thrombocytopenia/anemia]

Gram stain of a thigh wound showed many gram-positive spore-forming bacilli. The specimen was placed on brain heart infusion blood agar and incubated aerobically at 35°C for 3 days. At the end of that time, the plates showed no growth. The most likely explanation is that some of the specimen should have been incubated: a on chocolate agar b for 5 days c under 5% CO2 d anaerobically

d anaerobically

Initiation of the activation mechanism of the alternative pathway complement pathway differs from that of the classical pathway in that: a antigen-antibody complexes containing IgM or IgG are required b endotoxin alone cannot initiate activation c C1 component of complement is involved d antigen-antibody complexes containing IgA or IgE may initiate activation

d antigen-antibody complexes containing IgA or IgE may initiate activation

Which of the following calcium procedures utilizes lanthanum chloride to eliminate interfering substances? a o-cresolphthalein complexone b precipitation with chloranilic acid c chelation with EDTA d atomic absorption spectrophotometry

d atomic absorption spectrophotometry

Compressed gas cylinders should: a be stored with flammable materials b be transported by rolling or dragging c have safety covers removed when pressure regulators are unattached d be secured upright to the wall or other stable source

d be stored upright to the wall or other stable source

Cocaine is metabolized to: a carbamazepine b codeine c hydrocodone d benzoylecgonine

d benzoylecgonine

What is the animal reservoir of the West Nile virus? a mice b rats c domestic cats d birds

d birds

Most chemical methods for determining total protein utilize which of the following reactions? a molybdenum blue b ferri-ferrocyanide c resorcinol-HCL d biuret

d biuret

A Gram-negative bacillus has been isolated from feces, and the confirmed biochemical reactions fit those of Shigella. The organism does not agglutinate in Shigella antisera. What should be done next? a test the organism with a new lot of antisera b test with Vi antigen c repeat the biochemical tests d boil the organism and retest with the antisera

d boil the organism and retest with the antisera

Alpha-fetoprotein, an oncofetal antigen, is LEAST likely to be found in: a pregnancy b hepatocellular carcinoma c cirrhosis d breast carcinoma

d breast carcinoma

The presence of hemoglobin H may be demonstrated by: a Prussian blue stain b Wright stain c Giemsa stain d brilliant cresyl blue

d brilliant cresyl blue

Before unconjugated bilirubin can react with Ehrlich diazo reagent, which of the following must be added? a acetone b ether c distilled water d caffeine

d caffeine

A true statement about column chromatography methods, including high-performance liquid and gas chromatography, is that it: a all utilizes a flame ionization detector b requires derivation of nonvolatile compounds c can be used to separate gases, liquids or soluble solids d can be used for adsorption, partition, ion-exchange and steric-exclusion chromatography

d can be used for adsorption, partition, ion-exchange and steric-exclusion chromatography

Polyclonal B activation: a inhibits antibody production b requires the participation of T helper cells c results from the activation of suppressor T cells d can induce autoantibody production

d can induce autoantibody production

The buffering capacity of blood is maintained by a reversible exchange process between bicarbonate and: a sodium b potassium c calcium d chloride

d chloride

What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens? a cortisol b catecholamines c progesterone d cholesterol

d cholesterol

Which of the following is *most* closely associated with iron deficiency anemia? a iron overload in tissue b macrocytes c basophilic stippling d chronic blood loss

d chronic blood loss

An index of precision is statistically known as the: a median b mean c standard deviation d coefficient of variation

d coefficient of variation

Carcinoembryonic antigen (CEA) is most likely to be produced in a malignancy involving the: a brain b testes c bone d colon

d colon

MHC class III genes code for? a antigens b antibodies c lymphocytes d complement

d complement

Antibody allotype is determined by the: a constant region of heavy chain b constant region of light chain c variable regions of heavy and light chains d constant regions of heavy and light chains

d constant regions of heavy and light chains

A chemical that causes immediate visible destruction or irreversible alterations of human tissue at the contact site is best classified as: a carcinogenic b toxic c ignitible d corrosive

d corrosive

Serum samples collected from a patient with pneumonia demonstrate a rising antibody titer to Legionella. A bronchoalveolar lavage (BAL) specimen from this patient had a positive antigen test for Legionella but no organisms were recovered on buffered charcoal yeast extract medium after 2 days of incubation. The best explanation is that the: a antibody titer represents an earlier infection b positive antigen test is a false positive c specimen was cultured on the wrong media d culture was not incubated long enough

d culture was not incubated long enough

Which of the following is characteristic of polycythemia vera? a elevated urine erythropoietin levels b increased oxygen affinity of hemoglobin c decreased hematocrit d decreased or absent bone marrow iron stores

d decreased or absent bone marrow iron stores

Thalassemias are characterized by: a structural abnormalities in the hemoglobin molecule b absence of iron in hemoglobin c decreased rate of heme synthesis d decreased rate of globin synthesis

d decreased rate of *globin* synthesis

DNA sequencing of hypervariable regions 1 and 2 (HV1 and HV2) is used to: a detect polymorphisms in human TP53 b genotype strains of Mycoplasma c monitor chemotherapy for B cell lymphoma d detect polymorphisms in human mitochondrial DNA

d detect polymorphisms in human mitochondrial DNA

Unregulated and excessive formation of thrombin and plasmin is seen in: a liver disease b vitamin K deficiency c hemolytic disease of the newborn d disseminated intravascular coagulation (DIC)

d disseminated intravascular coagulation (DIC)

Excess antigen in precipitation gel reactions will: a have no effect on the precipitate reaction b not dissolve precipitate after formation c enhance the precipitate reaction d dissolve the precipitate after formation

d dissolve the precipitation after formation

For safe operation of a centrifuge: a clean with soap/detergent when maintenance is performed or spills occur b open the centrifuge cover when it is in the process of slowing down c leave liquid specimen tubes uncovered during centrifugation d ensure proper balance is maintained

d ensure proper balance is maintained

Listeria can be confused with some Streptococcaceae because it is beta-hemolytic and: a nonmotile b catalase negative c oxidase positive d esculin positive

d esculin positive

The analytical measurement range (AMR): a confirms that the calibrations settings are valid b establishes the range of values that can be measured with dilution c can be measured using linearity materials of any matrix d establishes the range of values that can be measured without dilution

d establishes the range of values that can be measured without dilution

Many microspherocytes, schistocytes and *spherocytes with budding cytoplasm* can be seen on peripheral blood smears of patients with: a hereditary spherocytosis b disseminated intravascular coagulation (DIC) c acquired autoimmune hemolytic anemia d extensive burns

d extensive burns

A patient is diagnosed with amyloidosis, they will be deficient in which of the following factors? a factor II b factor V c factor VII d factor X

d factor X

Unless blood gas measurements are made immediately after sampling, in vitro glycolysis of the blood causes a: a rise in pH and pCO2 b fall in pH and a rise in pO2 c rise in pH and a fall in pO2 d fall in pH and a rise in pCO2

d fall in pH and a rise in pCO2

In the FTA-ABS test, the presence of a beaded pattern of fluorescence along the treponeme indicates: a positive identification of Treponema pallidum b presumptive diagnosis of active syphilis c presence of non-treponemal antibody (NTA) d false-positive reaction

d false-positive reaction

Using a common labeling system for hazardous material identification such as HMIS or NFPA 704, the top red quadrant represents which hazard? a reactivity b special reactivity c health d flammability

d flammability

Excess D-dimers indicate that clots have been: a converted to fibrin monomers b released into the circulation c stimulated to activate platelets d formed and are being excessively lysed

d formed and are being excessively lysed

To prepare the reagent used for mucin clot determination of synovial fluid, water is mixed with: a hydrochloric acid b sodium hydroxide c sodium chloride d glacial acetic acid

d glacial acetic acid

Creatinine clearance is used to estimate the: a tubular secretion of creatinine b glomerular secretion of creatinine c renal glomerular and tubular mass d golmerular filtration rate

d glomerular filtration rate

The conversion of glucose or other hexoses into lactate or pyruvate is called? a glycogenesis b glycogenolysis c gluconeogenesis d glycolysis

d glycolysis

A characteristic that is helpful in separating Pseudomonas aeruginosa from other members of the Pseudomonas family is: a a positive test for cytochrome oxidase b oxidative metabolism in the OF test c production of fluorescein pigment d growth at 42C

d growth at 42C

The purpose of OSHA Hazard Communication, General Industry Standard, 29 CFR, Subpart Z, 1910.1200, is to require employers to establish a program ensuring personnel are provided with information regarding the workplace dangers of: a bloodborne pathogens b environmental hazards c general safety hazards d hazardous chemicals

d hazardous chemicals

Which of the following RBC inclusions are seen in sideroblastic anemia and contain high amounts of iron?

Pappenheimer bodies

Which of the following is the formula for calculating the MCHC? a (Hgb x 100)/Hct b Hgb/RBC c RBC/Hct d (Hct x 1000)/RBC

a (Hgb x 100)/Hct

Polyuria is usually correlated with: A. acute glomerulonephritis B. diabetes mellitus C. hepatitis D. tubular damage

B. diabetes mellitus

Cells known to be actively phagocytic include: A. neutrophils, monocytes, basophils B. neutrophils, eosinophils, monocytes C. monocytes, lymphocytes, neutrophils D. lymphocytes, eosinophils, monocytes

B. neutrophils, eosinophils, monocytes

The genus of virus associated with *anogenital warts*, cervical dysplasia, and *neoplasia* is:

Human Papillomavirus

Mycobacteria that produce pigment only after exposure to light are classified as: a nonchromogens b photochromogens c scotochromogens d rapid growers

b photochromogens

Which of the following is the formula to calculate a manual white cell count?

(number of white cells counted x dilution x 10)/# of squares counted

*Multifocal brain lesions* in AIDS patients are commonly caused by: a Toxoplasma gondii b Pneumocystis jiroveci c Cryptosporidium parvum d Taenia solium

*a Toxoplasma gondii*

The preparation of a patient for standard glucose tolerance testing should include: a a high carbohydrate diet for 3 days b a low carbohydrate diet for 3 days c fasting for 48 hours prior to testing d bed rest for 3 days

*a a high carbohydrate diet for 3 days*

Mycobacterium tuberculosis is initially isolated from the sputum of a 35-year-old male. Antimicrobial susceptibility testing on this isolate is:

*a routinely performed*

What stain is most often used as a screening stain when mycobacteria is suspected in a *respiratory* specimen?

*auramine O*

The ratio of *kappa to lambda* light chain-producing cells in normal individuals is: a 1:1 b 2:1 c 3:1 d 4:1

*b 2:1*

The presence of which of the following isoenzymes indicates *acute myocardial damage*? a CKMM b CKMB c CKBB d none

*b CKMB*

The characteristic peripheral blood morphologic feature in *multiple myeloma* is: a cytotoxic T cells b rouleaux formation c spherocytosis d macrocytosis

*b rouleaux formation*

*Specimens for mycobacterial culture that routinely undergo the digestion and decontamination process include:*

*bronchial washings and sputum*

*A medium that can be used to recover Francisella tularensis is:*

*buffered charcoal yeast extract agar*

Fluid from a *cutaneous black lesion* was submitted for routine bacterial culture. After 18 hours of incubation at 35C there was *no growth on MacConkey agar*, but *3+ growth on sheep blood agar.* The colonies were nonhemolytic, nonmotile, 4-5 mm in diameter and off-white with a *ground glass appearance*. Each colony had an irregular edge with *comma-shaped outgrowths* that stood up like "beaten egg whites" when gently lifted with an inoculating needle. A Gram stain of a typical colony showed *large, Gram-positive rectangular bacilli*. The organism is MOST likely: a Clostridium perfringens b Aeromonas hydrophila c Bacillus anthracis d Mycobacterium marinum

*c Bacillus anthracis*

Ten heparinized plasma samples were assayed for bilirubin by Jendrassik-Grof method on analyzer 1, and by the Evelyn-Malloy method on analyzer 2, in a method comparison study. The results were all 10-20% higher from analyzer 2 most likely because: a the caffeine-benzoate stabilizer in the 2nd analyzer prevented falsely decreased results as found in analyzer 1 b fibrinogen in the plasma samples caused falsely decreased results in the Jendrassik-Grof method c alcohol reagents in the second method cause precipitation of proteins and increased background turbidity d hemolysis caused greater interference in method 1 than in method 2

*c alcohol reagents in the second method cause precipitation of proteins and increased background turbidity*

*Combined immunodeficiency* disease with *loss of muscle coordination* is referred to as: a DiGeorge syndrome b Bruton aggamglobulinemia c ataxia telangiectasia d Wiskott-Aldrich syndrome

*c ataxia telangiectasia*

The specimen of choice for detection of RSV is: a nasopharyngeal aspirate b cough plate c expectorated sputum d throat swab

*c expectorated sputum*

Which one of the following is a characteristic of hepatits B virus? a hepatitis B infects CD4+ T lymphocytes b it can be reactivated, causing "shingles" c it is an enveloped DNA virus that is primarily a blood-borne pathogen d this RNA virus is almost always transmitted by the fecal-oral route

*c it is an enveloped DNA virus that is primarily a blood-borne pathogen*

A 28-year-old man is seen by a physician because of several months of *intermittent low back pain*. The patinet's symptoms are suggestive of *ankylosing spondylitis*. Which of the following laboratory studies would support this diagnosis? a a decreased synovial fluid CH50 level b low serum CH50 level c positive HLA-B27 antigen test d rheumatoid factor in the synovial fluid

*c positive HLA-B27 antigen test*

A urethral swab obtained from a man with a *urethral exudate* was plated directly on *chocolate agar and modified Thayer-Martin agar*, and a Gram stain was made. The Gram stain showed Gram-negative diplococci. The culture plates were incubated at 35C in ambient air, but had no growth at 48 hours. The MOST likely failure for organism growth is that: a wrong media were used b anaerobic chocolate agar plate not set up c organism only grows at room temperature d organism requires CO2 for growth

*d organism requires CO2 for growth*

Blood samples were collected at the beginning of an exercise class and after thirty minutes of aerobic activity. Which of the following would be most consistent with the post-exercise sample?

*elevated lactic acid* elevated pyruvate

*Which of the following methods for quantitation of high-density lipoprotein is MOST suited for clinical laboratory use?*

*homogeneous*

*Differentiation of Mycobacterium avium and Mycobacterium intracellulare can be accomplished by:*

*nitrate reduction test*

Differentiating tests that will separate Burkholderia from Stenotrophomonas include:

*oxidase*

Increased total serum LD activity is:

*sensitive but not specific to neoplastic disease*

A nonfermenting organism that grows on MacConkey, is *nonmotile, oxidase negative, and has the chracteristic negative Gram stain with coccobacilli* is: a b c d

Acinetobacter baumannii

Which of the following is the larger residual split portion of C3? A. C3a B. C3b C. C4 D. CIq

B. C3b

An organism that must be included in a microaerophilic environment for optimal recovery is:

Campylobacter jejuni

Which of the following is the "membrane attack complex" of complement activation? A. C1 B. C3 C. C4, C2, C3 D. C5b, C6, C7, C8, C9

D. C5b, C6, C7, C8, C9

Which feature distinguishes Erysipelothrix rhusiopathiae from other clinically significant *non-spore-forming, Gram-positive, facultatively anaerobic bacilli*? a "tumbling" motility b beta-hemolysis c more pronounced motility at 25 C than 37 C d H2S production

H2S production

Encephalitis is *most commonly* associated with which of the following viruses?

Herpes Simplex Virus

Monitoring long-term glucose control in patients with adult onset diabetes mellitus can best be accomplished by measuring:

HgbA1c

On electrophoresis at alkaline pH, which of the following is the slowest migrating hemoglobin?

HgbC

What Mycobacterium does not usually fluoresce when stained with a fluorescent stain?

Mycobacterium fortuitum

In the assay of lactate dehydrogenase (LD), the reaction is dependent upon which of the following coenzyme systems? a NAD/NADH b ATP/ADP c Fe^2+/Fe^3+ d Cu/Cu^2+

NAD/NADH

Wright-stained peripheral smear: - Schuffner dots - parasites with irregular "spread-out" trophozoites - 12-24 merozoites - wide range of stages

Plasmodium vivax

The causative agent of cysticercosis is: a Taenia solium b Taenia saginata c Ascaris lumbricoides d Trichuris trichiura

a Taenia solium

Which of the following is the formula for calculating a percent (w/v) solution? a grams of solute/volume of solvent x 100 b grams of solute x volume of solvent x 100 c volume of solvent/grams of solute x 100 d (grams of solute x volume of solvent)/100

a (grams of solute/volume of solvent) x 100

Which of the following is the formula to calculate a manual white cell count? a (number of cells counted x dilution x 10)/number of squares counted b (number of cells counted x dilution)/10 x number of squares counted c number of cells counted x dilution d number of cells counted x number of squares counted

a (number of cells counted x dilution x 10)/number of squares counted

The profile that matches the typical test profile for chronic active hepatitis due to hepatitis B virus is: a -- positive for HBsAg and anti-HBc; negative for IgM anti-HBc and anti-HBs b -- positive for HBsAg and IgM anti-HBc; negative for anti-HBc and anti-HBs c -- negative for HBsAg, IgM anti-HBc and anti-HBs; positive for anti-HBc d -- negative for HBsAg, IgM anti-HBc and anti-HBc; positive for anti-HBs

a -- positive for HBsAg and anti-HBc; negative for IgM anti-HBc and anti-HBs

The HMIS or NFPA 704 hazardous material identification system rating for a slightly toxic chemical would be: a 1 in the yellow quadrant b 4 in the blue quadrant c 1 in the blue quadrant d 4 in the yellow quadrant

a 1 in the yellow quadrant

Refer to the following flow cytometric data. - absolute WBC: 8,930 - total lymphocytes: 30% - B lymphocytes: 40% - T lymphocytes: 58% Calculate the absolute count for B lymphocytes. a 1,072 b 2,679 c 3,572 d 6,251

a 1,072

The following data was obtained from a cellulose acetate protein elecrophoresis scan: - albumin area (aa): 75 units - gamma globulin area (gga): 30 units - total area (ta): 180 units - total protein (tp): 6.3 g/dL (65 g/L) The gamma globulin content in g/dL is: a 1.1 g/dL (11 g/L) b 2.7 g/dL 27 g/L) c 3.8 g/dL (38 g/L) d 4.9 g/dL (49 g/L)

a 1.1 g/dL (11 g/l) -- [(gga/ta) x tp]

A 45-year-old male of average height and weight was administered to the hospital for renal function studies. He had the following lab results: - urine createnine: 120 mg/dL - serum/plasma creatinine: 1.5 mg/dL - total urine volume in *24 hours*: 1800 mL Calculate the creatinine clearance for this patient in mL/min. a 100 b 144 c 156 d 225

a 100

The following test results were obtained: - urine creatinine: 90 mg/dL - serum/plasma creatinine: 0.90 mg/dL - patient's total body surface: 1.73 m^2 - total urine volume in *24 hours*: 1500 mL Given the following data, the patient's creatinine clearance, in mL/min, is: a 104 b 124 c 144 d 150

a 104

In most compound light microscopes, the ocular lense has a magnification of: a 10x b 40x c 50x d 100x

a 10x

A patient sample contains 500 particles/mL. 200 uL of sample is extracted, and DNA is eluted into 200 uL. 5 uL of DNA is added per PCR reaction. Calculate the average number of viral particles added per PCR reaction, assuming 100% extraction efficiency. a 2.5 b 25 c 250 d 2500

a 2.5

What is the MCH if the Hct is 20%, the RBC is 2.4 x 10^6/µL (2.4 x 10^12/L) and the Hgb is 5 g/dL (50 g/L)? a 21 pg b 23 pg c 25 pg d 84 pg

a 21 pg [(Hgb x 10)/RBC]

The normal controls for a quantitative B lymphocyte assay should have a value of what percentage of total lymphocytes counted? a 21% b 48% c 76% d 89%

a 21%

The screen for adrenal cortical hyperfunction with the greatest sensitivity and specificity is: a 24-hour urine free cortisol b plasma cortisol c urinary 17-hydroxycorticosteroids d plasma corticosterone

a 24-hour urine free cortisol

The buffer pH most effective at allowing amphoteric proteins to migrate toward the cathode in an electrophoretic system would be: a 4.5 b 7.5 c 8.6 d 9.5

a 4.5

A 24-hour urine specimen (total volume = 1,136 mL [11.36 dL]) is submitted to the laboratory for quantitative urine protein. Calculate the amount of protein excreted per day, if the total protein is 52 mg/dL. a 591 mg b 487 mg c 220 mg d 282 mg

a 591 mg

What is usually the factor VIII level in a hemophiliac patient with spontaneous bleeding? a <1% b 5-10% c 20-30% d 50-60%

a <1%

Night blindness is associated with deficiency of which of the following vitamins? a A b C c niacin d thiamine

a A

Interpretation of and sources of interference in serum enzyme analysis should consider that a significant source of ___________ is found in RBCs. a AST b ALT c GGT d CK

a AST

Which of the following zygomycetes has *sporangiophores that arise between rhizoids*? a Absidia (Lichthemia) b Cunninghamella c Fusarium d Rhizopus

a Absidia (Lichthemia)

The Gram stain of drainage from a pulmonary sinus tract shows many WBCs and 3+ branching Gram-positive bacilli. Colonies grown only on anaerobic media after 3 days incubation. They are yellow-tan and have a molar tooth appearance. The MOST likely genus is: a Actinomyces b Bacterioides c Fusobacterium d Nocardia

a Actinomyces

A dematiaceous mold grew in 4 days on Sabouraud agar, isolated from a foot wound. The [image] shows chaining macroconidia with longitudinal and horizontal septations. The most likely identification is: a Alternaria b Curvularia c Paecilomyces d Scopulariopsis

a Alternaria

A dematiaceous mold grew in 4 days on Sabouraud agar, isolated from a foot wound. The image shows chaining mitochondria with longitudinal and horizontal septations. The most likely identification is: a Alernaria b Curvularia c Paecilomyces d Scopulariopsis

a Alternaria

Which one of the following questions can be legally asked on an employment application? a Are you eligible to work in the United States? b What is your date of birth? c Is your wife/husband employed full time? d Do you have any dependents?

a Are you eligible to work in the United States?

Which of the following is a dimorphic fungus? a Blastomyces dermatitidis b Candida albWhich of the following is a dimorphic fungus? a Blastomyces dermatitidis b Candida albicans c Cryptococcus neoformans d Aspergillus fumigatusicans c Cryptococcus neoformans d Aspergillus fumigatus

a Blastomyces dermatitidis

Molecular-based testing was performed on a nasopharyngeal swab sample taken from a patient. Results are reported as positive for IS481 and negative for IS1000. These results indicate the patient's nasopharynx is colonized with: a Bordetella pertussis b Bordetella holmesii c Bordetella parapertussis d Bordetella spp.

a Bordetella pertussis

Which of the following is the "recognition unit" in the CLASSICAL complement pathway? a C1q b C3a c C5 d C4

a C1q

Which of the following releases histamine and other mediators from basophils? a C3a b properdin factor B c C1q d C4

a C3a

Protein S forms a *reversible complex* with: a C4b binding protein b protein C c total protein S d Fc receptors

a C4b binding protein

Rheumatoid factors are immunoglobulins with specificity for allotypic determinants located on the: a Fc fragment of IgG b Fab fragment of IgG c J chain of IgM d secretory component of IgA

a Fc fragment of IgG

Rheumatoid factor consists of antibodies that bind the: a Fc portion of the IgG molecule b Fab portion of the IgG molecule c Fc portion of the IgM moleucle d Fab portion of the IgM molecule

a Fc portion of the IgG molecule

A patient has a congenital nonspherocytic hemolytic anemia. After exposure to *anti-malarial drugs* the patient experiences a severe hemolytic episode. This episode is characterized by red cell inclusions caused by *hemoglobin denaturation*. Which of the following conditions is *most* consistent with these findings? a G6PD deficiency b thalassemia major c pyruvate kinase deficiency d paroxysmal nocturnal hemoglobinuria

a G6PD deficiency

Hepatitis B, a disease arising from a *DNA virus*, is diagnosed in its acute phase via serology for HBsAg, HBeAg, IgM alpha-HBC and total alpha-HB c. Once a patient reaches chronic HBV infection, effectiveness of therapy may be evaluated using: a HBV DNA testing with real-time PCR b alpha-HBe testing c alpha-HBs testing d IgM alpha-HBc

a HBV DNA testing with *real-time PCR*

Hepatitis Bl a disease arising from a DNA virus, is diagnosed in its acute phase via serology for HBsAg, IgM alpha-HBc and total alpha-HBc. Once a patient reaches chronic HBV infection, effectiveness of therapy may be evaluated using: a HBV DNA testing with realtime PCR b alpha-HBe testing c alpha-HBs testing d IgM alpha-HBc

a HBV DNA testing with realtime PCR

An organism that exhibits the satellite phenomenon around colonies of Staphylococcus aureus is: a Haemophilus influenzae b Neisseria meningitidis c Neisseria gonorrhoeae d Klebsiella penumoniae

a Haemophilus influenzae

Antibodies to which of the following immunoglobulins is known to have produced anaphylactic reactions following blood transfusion? a IgA b IgD c IgE d IgG

a IgA

The J-chain is associated with which of the following immunoglobulins? a IgA b IgG c IgE d IgD

a IgA

Which of the following immunoglobulin classes is associated with a secretory component (transport piece)? a IgA b IgD c IgE d IgG

a IgA

Which class of immunoglobulin is thought to function as an antigenic receptor site on the surface of immature B lymphocytes? a IgD b IgE c IgA d IgG

a IgD

Which IgG subclass is most efficient at crossing the placenta? a IgG1 b IgG2 c IgG3 d IgG4

a IgG1

A technologist on the respiratory bench notices an increased number of patients on the ICU growing the same, drug resistant gram-negative rod from sputum specimens. Which department in the hospital will the microbiology laboratory work with to collect data on positive patients? a Infection control b Hospital administration c The Joint Commission d Food and Drug Administration

a Infection control

In the immunoinhibition phase of the CKMB procedure: a M subunit is inactivated b B subunit is inactivated c MB is inactivated d BB is inactivated

a M subunit is inactivated

Which testing platform meets this description? An isolated colony is irradiated by a laser, which ionizes the *biomolecules* and causes them to become accelerated in an *electric field.* The ionized biomolecules then enter a *flight tube* where they are separated by their *mass-to-charge ratio*. a MALDI-TOF b multiplex PCR c pulsed-field gel electrophoresis

a MALDI-TOF

Automated hematology analyzers calculate the hematocrit using which of the following parameters? a MCV and RBC b MCH and RBC c Hgb and RBC d MCV and MCHC

a MCV and RBC

An antimicrobial susceptibility method recommended to detect vancomycin-intermediate Staphylococcus aureus is: a MIC broth dilution b agar dilution c kinetic diffusion d disk diffusion

a MIC broth dilution

Which DNA+ organism's colony is not easily broken up and therefore displays the "hockey puck" characteristic where it can be pushed across the plate of medium? a Moraxella catarrhalis b Neisseria gonorrhoeae c Neisseria meningitidis d VIbrio cholera

a Moraxella catarrhalis

In the assay of lactate dehydrogenase (LD), the reaction is dependent upon which of the following coenzyme systems? a NAD/NADH b ATP/ADP c Fe++/Fe+++ d Cu/Cu++

a NAD/NADH

In the assay of lactate dehydrogenase, which of the following products is actually measured? a NADH b ATP c lactic acid d pyruvic acid

a NADH

A patient's abnormal lymphocytes are positive for CD2 antigen, lack C3 receptors, and are negative for surface immunoglobulin. This can be classified as a disorder of: a T cells b B cells c monocytes d natural killer cells

a T cells

An isolate from a stool culture gives the following growth characteristics and biochemical reactions: - MacConkey agar: colorless colonies - Hektoen agar: yellow-orange colonies - TSI: acid slant/acid butt, no gas, no H2S - urea: positive These screening reactions are consistent with which of the following enteric pathogens? a Yersinia enterocolitica b Shigella sonnei c Vibrio parahaemolyticus d Campylobacter jejuni

a Yersinia enterocolitica

Kohler Illumination is: a a method to ensure optimal contrast and resolution b a method to magnify objects c an indication of the type of light source in use d one method of phase contrast magnification

a a method to ensure optimal contrast and resolution

A molal solution is equivalent to: a a solution containing 1 mole of solute per kg of solvent b 1,000 mL of solution containing 1 mole of solute c a solution containing 1 GEW of solute in 1 L of solution d a 1 L solution containing 2 moles of solute

a a solution containing 1 mole of solute per kg of solvent

Acceptable specimen sources for culture of anaerobic bacteria includes: a abscess b stool c clean catch urine d vaginal

a abscess

An immunofluorescence test using reagent antibody directed against the CD3 surface marker would identify which of the following cell types in a sample of human peripheral blood? a all mature T lymphocytes b T helper lymphocytes only c cytotoxic T lymphocytes only d T regulatory cells only

a all mature T lymphocytes

A patient underwent renal transplant, receiving a kidney from an *unrelated* donor. This type of transplant is: a allograft b syngraft c autograft d xenograft

a allograft (same species but not same person)

Which of the following enzymes are used in the diagnosis of *acute pancreatitis*? a amylase (AMS) b aspartate aminotransferase (AST) c gamma-glutamyl transferase (GGT) d lactate dehydrogenase (LD)

a amylase (AMS)

The RDW-CV and RDW-SD performed by automated hematology analyzers are calculations that provide: a an index of the distribution of RBC volumes b a calculated mean RBC hemoglobin concentration c a calculated mean cell hemoglobin d the mean RBC volume

a an index of the distribution of RBC volumes

What is the most common presentation of precursor T-ALL? a anterior mediastinal mass b bone marrow involvement/cytopenias c cervical lymphadenopathy d dermal lymphatic infiltrates

a anterior mediastinal mass

An orthopedic patient is placed on low molecular weight heparin after back surgery, in order to determine if the level of LMWH is therapeutic, the test to monitor levels would be: a anti-Xa assay b aPTT c PT d anti-IIa assay

a anti-Xa assay

In an indirect ELISA method designed to *detect antibody to the rubella virus in patient serum*, the conjugate used should be: a anti-human IgG conjugated to an enzyme b anti-rubella antibody conjugated to an enzyme c rubella antigen conjugated to an enzyme d anti-rubella antibody conjugated to a substrate

a anti-human IgG conjugated to an enzyme

Which of the following is not a mechanism involved in the complement cascade? a apoptosis b opsonization c inflammation d cytolysis

a apoptosis

Total glycosylated hemoglobin levels in a hemolysate reflects the: a average blood glucose levels of the past 2-3 months b average blood glucose levels of the past week c blood glucose levels at the time the sample is drawn d HgbA1c level at the time the sample is drawn

a average blood glucose levels of the past 2-3 months

In the Jendrassik-Grof method for the determination of serum bilirubin concentration, quantitation is obtained by measuring the green color of: a azobilirubin b bilirubin glucoronide c urobilin d urobilinogen

a azobilirubin

A vaginal swab is received in the laboratory for testing and immediately placed in sterile psychological saline to prepare a suspension. A wet mount is prepared and the laboratorian reports the presence of *numerous clue cells*. This most likely indicates the patient has: a bacterial vaginosis b candidiasis c trichomoniasis d atrophic vaginitis

a bacterial vaginosis

Evidence of active red cell regeneration may be indicated on a blood smear by: a basophilic stippling, nucleated red blood cells and polychromasia b hypochromia, macrocytes and nucleated red blood cells c hypochromia, basophilic stippling and nucleated red blood cells d Howell-Jolly bodies, Cabot rings and basophilic stippling

a basophilic stippling, nucleated red blood cells and polychromasia

To be analyzed by gas liquid chromatography a compound must: a be volatile or made volatile b bad sample detector c effluent line obstructed d strip chart motor hanging up

a be volatile or made volatile

Microbiology related urgent or critical results include positive: a blood cultures, cerebrospinal fluid cultures and acid-fast smears b blood cultures, urine cultures and ova & parasite examinations c cerebrospinal fluid cultures, fungal cultures and ova & parasite examinations d streptococcus pyogenes throat screens, bronchial washing cultures and fungal cultures

a blood cultures, cerebrospinal fluid cultures and acid-fast smears

Biochemical reactions of an organism are consistent with Salmonella. A suspension is tested in polyvalent antiserum A through G and Vi antiserum. There is agglutination in the Vi antiserum only. What should be done next? a boil suspension of the organism for 10 minutes to inactivate the Vi antigen b test organism with individual antisera for agglutination c report "no Salmonella isolated" d repeat biochemical identification of the organism

a boil suspension of the organism for 10 minutes to inactivate the Vi antigen

A hospitalized patient is experiencing increased neuromuscular irritability (tetany). Which of the following tests should be ordered immediately? a calcium b phosphate c BUN d glucose

a calcium

In synovial fluid, the most characteristic finding in pseudogrout is: a calcium pyrophosphate dihydrate crystals b cartilage debris c monosodium urate crystals d hemosiderin-laden macrophages

a calcium pyrophosphate dihydrate crystals

Coulometry is often used to measure: a chloride in sweat b the pH in saliva c bicarbonate in urine d ammonia in plasma

a chloride in sweat

Using polarized light microscopy, which of the following urinary elements are birefringent: a cholesterol b triglycerides c fatty acids d neutral fats

a cholesterol

All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with: a chronic myelocytic leukemia b myelofibrosis with myeloid metaplasia c erythroleukemia d acute myelocytic leukemia

a chronic myelocytic leukemia (gradual changes means no drastic variation in immature and mature cells)

A patient presents with an aPTT of 49 seconds (25-35 seconds). A mixing study is performed with results as follows: - 1:1 mix = 39.8 seconds - pooled normal plasma = 32.0 seconds The results indicate: a circulating anticoagulant b factor deficiency c decreased platelets d fibrinolysis

a circulating anticoagulant

Hemoglobin S can be separated from hemoglobin D by which of the following methods? a citrate agar gel electrophoresis at pH 5.9 b thin-layer chromatography c alkali denaturation d agarose gel electrophoresis at pH 8.4

a citrate agar gel electrophoresis at pH 5.9

What accounts for the majority of cases of sideroblastic anemia? a clonal stem cell defect b medications c alcohol d irradiation

a clonal stem cell defect

The electrical resistance method of cell counting requires:

a conductive liquid

HIPAA is a federal law that requires: a confidentiality of patients' health care information between 2 organizations b reporting of errors in laboratory results c access to patient records when there is a lawsuit d unannounced inspections by accreditation agencies

a confidentiality of patients' health care information between 2 organizations

*Antibody class and antibody subclass* are determined by major physiochemical differences and antigenic variation found primarily in the: a constant region of heavy chain b constant region of light chain c variable regions of heavy and light chains d constant regions of heavy and light chains

a constant region of heavy chain

Delayed hypersensitivity may be induced by: a contact sensitivity to inorganic chemicals b transfustion reaction c anaphylactic reaction d bacterial septicemia

a contact sensitivity to inorganic chemicals

D-dimers are produced from: a crosslinked and stabilized fibrin clots b decreased fibrinogen and platelets c plasminogen being converted to plasmin d generation of thrombin from endothelial cells

a crosslinked and stabilized fibrin clots

CAP requires refrigerator temperatures to be recorded: a daily b weekly c monthly d periodically

a daily

Incorrect results on a urine culture were recorded in the patient record in ICU. Therefore, a Problem Action Form is required and should contain: a date, problem, investigation, corrective action, outcome b employee certification number, problem, corrective action c employee years of experience, date, investigation of issue d signatures of attending physician and pathologist

a date, problem, investigation, corrective action, outcome

A cardiac glycoside that is used in the treatment of congenital heart failure and arrythmias by increasing the force and velocity of myocardial contraction is: a digoxin b acetaminophen c lithium d phenytoin

a digoxin

When there is a disparity between the results of the fibrinogen antigen and the activity, the most likely diagnosis is: a dysfibrinogenemia b hypofibrinogenemia c hyperfibrinogenemia d afibrinogenemia

a dysfibrinogenemia (opposites)

Immunoediting describes the theory that our immune system prevents many cancers. Its three phases (called the 3 'e's) include all of the following EXCEPT: a efficiency b equilibrium c escape d elimination

a efficiency

Arterial blood that is collected in a *heparinized syringe but exposed to room air* would be most consistent with the changes in which of the following specimens? a elevated pO2, decreased pCO2, elevated pH b decreased pO2, elevated pCO2, decreased pH c unchanged pO2, elevated pCO2, unchanged pH d decreased pO2, decreased pCO2, decreased pH

a elevated pO2, decreased pCO2, elevated pH

Which of the following is the best indicator of Reye syndrome for CSF (hepatic encephalopathy)? a glutamine b ammonia c ALT d bilirubin

a gluatmine

A patient is diagnosed as having bacterial septicemia. Which of the following would best describe the expected change in his peripheral blood? a granulocytic leukemoid reaction b lymphocytic leukemoid reaction c neutropenia d eosinophilia

a granulocytic leukemoid reaction

The majority of the iron in an adult is found as a constituent of: a hemoglobin b hemosiderin c myoglobin d transferrin

a hemoglobin

Increased concentrations of alpha-fetoprotein (AFP) in adults are most characteristically associated with: a hepatocellular carcinoma b alcoholic cirrhosis c chronic active hepatitis d multiple myeloma

a hepatocellular carcinoma

A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would be consistent with this diagnosis? a high TCO2, increased HCO3 b low TCO2, increased HCO3 c high TCO2, decreased H2CO3 low TCO2, decreased H2CO3

a high TCO2, increased HCO3

If the HMIS or NFPA 704 hazardous material identification system has a number 4 in the left blue quadrant, it represents a: a high health hazard b low health hazard c high reactivity hazard d low reactivity hazard

a high health hazard

Which of the following casts is most likely to be found in healthy people? a hyaline b red blood cell c waxy d white blood cell

a hyaline

Denaturation of DNA during a PCR reaction refers to breaking: a hydrogen bonds between nitrogenous bases in base-paired nucleotides b phosphodiester bonds between nitrogenous bases in base-paired nucleotides c covalent bonds between nitrogenous bases in base-paired nucleotides d peptide bonds between nitrogenous bases in base-paired nucleotides

a hydrogen bonds between nitrogenous bases in base-paired nucleotides

Acute disseminated intravascular coagulation (DIC) is characterized by: a hypofibrinogenemia b thrombocytosis c negative D-dime d shortened thrombin time

a hypofibrinogenemia

A hematology analyzer counts red blood cells by which method? a impedance b chromogenic c photometric d turbidimetric

a impedance

A patient is on 100 mg of aspirin/day to prevent the formation of clots caused by platelets. The mechanism in which aspirin impairs platelet function is by: a inactivating cyclooxygenase which blocks thromboxane A2 b impairs vWF by via Gp Ib/IX/V receptor c decreased amounts of arachidonic acid d deactivation of ADP and phsopholipase A2

a inactivating cyclooxygenase which blocks thromboxane A2

The classic antibody response pattern following infection with hepatitis A is: a increase in IgM antibody; decrease in IgM antibody; increase in IgG antibody b detectable presence of IgG antibody only c detectable presence of IgM antibody only d decrease in IgM antibody; increase in IgG antiboyd of the IgG3 subtype

a increase in IgM antibody; decrease in IgM antibody; increase in IgG antibody

A patient with polycythemia vera who is treated by phlebotomy is MOST likely to develop a deficiency of: a iron b vitamin B12 c folic acid d erythropoietin

a iron

A 56-year-old man was admitted to the hospital for treatment of a bleeding ulcer. The following laboratory data were obtained: - RBC: 4.2 x 10^6/uL - WBC: 5.0 x 10^3/uL - Hct: 30% - Hgb: 8.5 g/dL (85 g/L) - serum iron: 40 ug/dL (7.2 umol/L) - TIBC: 460 ug/dL (82.3 umol/L) - serum ferritin: 12 ng/mL (12 ug/L) Examination of the bone marrow revealed the absence of iron stores. This data is most consistent with which of the following conditions? a iron deficiency anemia b anemia of chronic disease c hemachromatosis d acute blood loss

a iron deficiency anemia

The serum hemolytic complement level (CH50): a is a measure of total complement activity b provides the same information as a serum factor B level c is detectable when any component of the classical system is congenitally absent d can be calculated from the serum concentrations

a is a measure of total complement activity

The most potent plasminogen activator in the contact phase of coagulation is: a kallikrein b streptokinase c HMWK d fibrinogen

a kallikrein

Group B, beta-hemolytic streptococci may be distinguished from other hemolytic streptococci by which of the following methods? a latex antigen grouping b growth in 6.5% NaCl broth c growth on bile esculin medium d bacitracin susceptibility

a latex antigen grouping

Aspartate amino transferase (AST) is characteristically elevated in the disease of the: a liver b kidney c intestine d pancreas

a liver

Of the following diseases, the one most often associated with *elevations of lactate dehydrogenase isoenzymes 4 and 5 on electrophoresis* is: a liver disease b hemolytic anemia c myocardial infarcation d pulmonary edema

a liver disease

A 68-year-old man arrives in the emergency room with a glucose level of 722 mg/dL and serum acetone of 4+ undiluted. An arterial blood gas from this patient is: a low pH b high pH c low pO2 d high pO2

a low pH

Biological false-positive VDRL reactions are frequently encountered in patients with: a lupus erythematosus b acquired immune deficiency syndrome (AIDS) c gonorrhea d tertiary syphilis

a lupus erythematosus

The characteristic morphologic feature in folic acid deficiency is: a macrocytosis b target cells c basophilic stippling d rouleaux formation

a macrocytosis

Which of the following is most likely to be ordered in addition to iodized calcium to determine the cause of tetany? a magnesium b phosphate c sodium d vitamin D

a magnesium

The function of serum albumin in the peripheral blood is to: a maintain colloidal osmotic pressure b increase antibody production c increase fibrinogen formation d maintain blood viscosity

a maintain colloidal osmotic pressure

In amniotic fluid, the procedure to detect hemolytic disease of the newborn is: a measurement of absorbance at 450 nm b creatinine c lecithin/sphingomyelin ratio d estriol

a measurement of absorbance at 450 nm

Which of the following cells is the largest cell in the bone marrow? a megakaryocyte b histiocyte c osteoblast d mast cell

a megakaryocyte

Which of the following is associated with Chediak-Highashi syndrome? a membrane defect of lysosomes b Dohle bodies and giant platelets c 2-lobed neutrophils d mucopolysaccharidosis

a membrane defect of lysosomes

Severe diarrhea causes: a metabolic acidosis b metabolic alkalosis c respiratory acidosis d respiratory alkalosis

a metabolic acidosis

The expected blood gas results for a patient in chronic renal failure would match the pattern of: a metabolic acidosis b respiratory acidosis c metabolic alkalosis d respiratory alkalosis

a metabolic acidosis

Which red cell morphology may be expected in a *treated* polycythemia vera patient? a microcytic cells b teardrop cells c helmet cells d oval macrocytes

a microcytic cells

The laboratory findings on a patient are as follows: MCV: 55 um^3 (55fL) MCHC: 25% MCH: 17 pg A stained blood film of this patient would most likely reveal a red cell picture that is: a microcytic, hypochromic b macrocytic, hypochromic c normocytic, normochromic d microcytic, normochromic

a microcytic, hypochromic (everything is low)

Autoantibodies in the absence of Sm are found in patients with: a mixed connective tissue disease b systemic lupus erythematosus c Crohn disease d multiple myeloma

a mixed connective tissue disease

A new PT reagent is being set up in the coagulation laboratory. The ISI of the new reagent is 1.0 vs the previous reagent with an ISI of 2.1. The new reagent is said to be: a more sensitive b less sensitive c insensitive d no change

a more sensitive

In patients who present with bleeding disorder caused by platelets, the most common type of bleeding is: a mucosal bleeding b hemarthrosis c delayed bleeding d deep hematomas

a mucosal bleeding

The following serum laboratory results were obtained: - decreased albumin and calcium - increased creatinine, phosphorus and magnesium These results are most compatible with: a multiple myeloma b primary hyperparathyroidism c chronic renal failure d secondary hyperparathyroidism

a multiple myeloma

A PCR reaction in which 4 different sets of primers are used to simultaneously amplify 4 distinct loci in the same reaction tube is known as: a multiplex PCR reaction b heteroplex PCR reaction c polyplex PCR reaction d quadraplex PCR reaction

a multiplex PCR reaction

When hazardous chemicals are transferred from the original appropriately labeled container(s) to a secondary container for immediate use by the person performing the transfer, it: a must be labeled with an emergency response phone number(s) b must be labeled with the identity or contents of the hazardous chemical(s) c must be labeled with hazard warnings related to the effect on involved target organs d does not required labeling

a must be labeled with an emergency response phone number(s)

Skin, lactic acid secretions, stomach acidity, and the motion of cilia represent which type of immunity? a natural b acquired c adaptive d auto

a natural

A patient with an aPTT of 62.5 seconds (23-35 seconds) and the only factor that is decreased is factor XII. What is the clinical picture for this patient? a negative bleeding history b prolonged PFA c decreased risk of thrombosis d epistaxis

a negative bleeding history

Which of the following are found in association with megaloblastic anemia? a neutropenia and thrombocytopenia b decreased LD activity c increased erythrocyte folate levels d decreased plasma bilirubin levels

a neutropenia and thrombocytopenia

Which cell type shows the most intense staining with myeloperoxidase? a neutrophil b Basophil c lymphocyte d monocyte

a neutrophil

The M:E ratio in polycythemia vera is usually: a normal b high c low d variable

a normal

Plasma for cortisol determinations were collected at 7 AM, after waking the patient, and at 10 PM that evening. The cortisol level of the morning sample was higher than the evening sample. This is consistent with: a normal finding b Cushing syndrome c Addison disease d hypopituitarism

a normal finding

Macrophage phagocytosis of bacteria is enhanced by which of the following: a opsonin b antigen c hapten d secretory piece

a opsonin

Which of the following activities is associated with C3b? a opsonization b anaphylaxis c vasoconstriction d chemotaxis

a opsonization

Which one of the following results is typical of Campylobacter jejuni? a optimal growth at 42C b oxidase negative c catalase negative d nonmotile

a optimal growth at 42C

A patient urine sample has an increased protein and a high specific gravity. Which of the following would be a more accurate measure of urine concentration? a osmolality b ketones c refractive index d pH

a osmolality

A patient with uncontrolled diabetes mellitus will most likely have: a pale urine with a high specific gravity b concentrated urine with a high specific gravity c pale urine with a low specific gravity d dark urine with a high specific gravity

a pale urine with a high specific gravity

Plesiomonas shigelloides is a member of the family Enterobacteriaceae. The characteristic that differentiates Pleisiomonas from other Enterobacteriaeae is: a positive oxidase b glucose fermentation c reduction of nitrates to nitrites d growth on MacConkey agar

a positive oxidase

In assessing the usefulness of a new laboratory test, *sensitivity* is defined as the percentage of a positive specimens correctly identified b false-positive specimens c negative specimens correctly identified d false-negative specimens

a positive specimens correctly identified

Rheumatoid factor in a patient's serum may cause a false: a positive test for the detection of IgM class antibodies b negative test for the detection of IgM class antibodies c positive test for the detection of IgG class antibodies d negative test for the detection of IgG class antibodies

a positive test for the detection of IgM class antibodies

What kind of antige-antibody reaction would be expected if soluble antigen is added to homologous antibody? a precipitation b agglutination c complement fixation d hemagglutination

a precipitation

Which of the following describes an antigen-antibody precipitation reaction of non-identity? a precipitin lines cross, forming double spurs b precipitin lines fuse, forming a single spur c no precipitin lines are formed d precipitin lines fuse, forming a single arc

a precipitin lines cross, forming double spurs

Intervening sequences are found in: a precursor mRNA b mature mRNA c ribosomal RNA d transfer RNA

a precursor mRNA

A 68-year-old female patient tells her physician of being "cold all the time" and recent weight gain, with no change in diet. The doctor orders a TSH level, and the laboratory reports a value of 8.7 uU/mL (reference range = 0.5-5.0 uU/mL). The patient most likely has: a primary hypothyroidism b Graves disease c a TSH-secreting tumor d primary hyperthyroidism

a primary hypothyroidism

The selectivity of an ion-selective electrode is determined by the: a properties of the membrane used b solution used to fill the electrode c magnitude of the potential across the membrane d internal reference electrode

a properties of the membrane used

A patient is taking 10 mg per day of Coumadin (warfarin). The results of which the following laboratory tests will be most impacted? a protein C b antithrombin c factor V Leiden d factor VIII

a protein C

There is a bulge in the DNA double helix at position 292 of a gene. This bulge is most likely due to which type of base mispairing? a purine:purine b purine:pyrimidine c pyrimidine:pyrimidine d adenine:thymine

a purine:purine

Flocculation tests for syphilis detect the presence of: a reagin antibody b antigen c hemolysin d Forssman antigen

a reagin antibody

The first procedure to be followed if the blood gas instrument is out of control for all parameters is: a recalibrate, then repeat control b repeat control on the next shift c replace electrodes, then repeat control d report patient results after duplicate

a recalibrate, then repeat control

According to OSHA, what type of warning sign should be posted in an area where an immediate hazard exists and where special precautions are necessary? a red, black and white "Danger" sign b yellow and black "Caution" sign c green and white "Safety Instruction" sign d orange and black "Biohazard" sign

a red, black and white "Danger" sign

A leukocyte count and differential on a 40-year-old Caucasian man revealed: WBC: 5.4 x 10^9/L segmented neutrophils: 20% lymphocytes: 58% monocytes: 20% eosinophils: 2% This represents: a relative lymphocytosis b absolute lymphocytosis c relative neutrophilia d leukopenia

a relative lymphocytosis

When performing a stool culture, a colony type typical of an *enteric pathogen* is subcultured on a blood agar plate. The resulting pure culture is screened with several tests to obtain the following results: - TSI: acid butt, alkaline slant, no gas, no H2S - phenylalanine deaminase: negative - motility: positive - serological typing: Shigella flexneri (Shigella subgroup B) The serological typing is verified with new kit and controls. The best course of action would be to: a report the organism as Shigella flexneri without further testing b verify reactivity of motility medium with positive and negative controls c verify reactivity of the TSI slants with positive and negative controls for H2S production d verify reactivity of phenlyalanine deaminase with positive and negative controls

a report the organism as Shigella flexneri without further testing

A phase-platelet count was performed and the total patient count was 356,000/uL. Ten high power (100x) fields on the stained blood smear were examined for platelets and the results per field were: 16, 18, 15, 20, 19, 17, 19, 18, 20, 16 The next step would be to: a report the phase-platelet count since it correlated well with the slide b repeat the phase-platelet count on a recollected specimen and check for clumping c check 10 additional fields on the blood smear d repeat the platelet count using a different method

a report the phase-platelet count since it correlated well with the slide

A liquid stool specimen is collected at 10:00 pm and brought to the laboratory for culture and ova and parasite examination. It is refrigerated until 10:10 am the next day, when the physician requests that the technologist look for amoebic trophozoites. The best course of action would be to: a request a fresh specimen b perform a concentration on the original specimen c perform a trichrome stain on the original specimen d perform a saline wet mount on the original specimen

a request a fresh specimen

Antibodies directed at native DNA are most frequently associated with which pattern of fluorescence in the IFA-ANA test? a rim b diffuse c speckled d centromere

a rim

Nephelometers measure light: a scattered at a right angle to the light path b absorbed by suspended particles c transmitted by now-particulate mixtures d reflected back to the source from opaque suspensions

a scattered at a right angle to the light path

An Enterococcus isolated from multiple blood cultures in a patient endocarditis should be: a screened for high level aminoglycoside resistance b checked for tolerance c assayed for serum antimicrobial activity d tested for beta-lactamase production

a screened for high level aminoglycoside resistance

How does GPIb become activated in vivo and in vitro, respectively? a shear force, ristocetin b ristocetin, compression c activation of ADP receptor, ristocetin d binding vWF, epinephrine

a shear force, ristocetin

In a pH meter reference electrodes may include: a silver-silver chloride b quinhydrone c hydroxide d hydrogen

a silver-silver chloride

The most effective disinfectant recommended to bloodborne pathogens is: a sodium hypochloridte b isopropyl alcohol c chlorhexidine gluconate d povidone-iodine

a sodium hypochlorite

A common cause of a falsely increased LD1 fraction of lactic dehydrogenase is: a specimen hemolysis b liver disease c congestive heart failure d drug toxicity

a specimen hemolysis

Macrophages are characterized by: a surface receptors for C3b complement b surface CD3 expression c in vitro synthesis of immunoglobulin d large amounts of rough endoplasmic reticulum

a surface receptors for C3b complement

Which of the following applies to cryoscopic osmometry? a temperature at equilibrium is a function of the number of particles in solution b temperature plateau for a solution is horizontal c freezing point of a sample is absolute d initial freezing of a sample produces an immediate solid state

a temperature at equilibrium is a function of the number of particles in solution

Which of the following is an important marker for the presence of immature B cells in patients with acute lymphocytic leukemia (ALL)? a terminal deoxynucleotidyl transferase (TdT) b adenosine deaminase c G6PD d purine nucleoside phosphorylase

a terminal deoxynucleotidyl transferase (TdT)

Which of the following is useful in the detection and management of carcinoma of the prostate? a total prostate-specific antigen b prostatic acid phosphate c human chorionic gonadotropin d alpha-fetoprotein

a total prostate-specific antigen

Blood was collected in a serum separator tube on a patient who has been fasting since midnight. The time of collection was 7 AM. The laboratory test which should be recollected is: a triglycerides b iron c LD d sodium

a triglycerides

What is the best method to rule out the possibility of genomic DNA giving a false-positive result in a reverse transcriptase (RT)PCR reaction? a use of upstream and downstream primers that span an exon-intron-exon region of the target b treatment of RNA that will be used in the RT reaction with RNase c addition of uracil-N-glycolase to the RT reaction d omission of Taq DNA-polymerase from the PCR reaction

a use of upstream and downstream primers that span an exon-intron-exon region of the target

A 2-year-old had a positive urine ketone. This would most likely be caused by: a vomiting b anemia c hypoglycemia d biliary tract obstruction

a vomiting

A patient returns from a camping trip, where he vacationed for several days in a *tick-endemic environment*. One month after his return home, he visited his health care provider with complaints of fatigue, numbness and *history of rash* surrounding an insect bit that occurred immediately on his return home from vacation. Suspecting *Lyme disease*, his clinician ordered an ELISA to test for Lyme antibody, results of which were equivocal on two different tests. His health care provider then ordered follow-up testing with: a western blot b southern blot c northern blot d eastern blot

a western blot

A turbid cerebrospinal fluid is most commonly caused by increased: a white blood cells b protein c glucose d bacterial organisms

a white blood cells

AST and ALT are both elevated in which of the following diseases?

viral hepatitis

When the red cells of an individual fail to react with anti-U, they usually fail to react with:

anti-S

The protein portion of an enzyme complex is called the: a apoenzyme b coenzyme c holoenzyme d proenzyme

apoenzyme

Refer to the following data from a peripheral blood sample: - WBC: 10.0 x 10^3/uL - neutrophils: 68% - lymphocytes: 25% (40% T cells) - monocytes: 4% - eosinophils: 2% - basophils: 1% The expected total number of T cells is: a 200 b 1,000 c 2,000 d 2,500

b 1,000

The fluid leaving the glomerulus normally has a specific gravity of: a 1.001 b 1.010 c 1.020 d 1.030

b 1.010

If a fasting glucose was 90 mg/dL, which of the following 2-hour postprandial glucose results would most closely represent normal glucose metabolism? a 55 mg/dL b 100 mg/dL c 180 mg/dL d 260 mg/dL

b 100 mg/dL

The normal glomerular filtration rate is: a 1 mL/min b 120 mL/min c 660 mL/min d 1,200 mL/min

b 120 mL/min

A peripheral blood total leukocyte count is 10.0 x 10^3/uL. The differential reveals 55% neutrophils, 2% eosinophils, 40% lymphocytes and 3% monocytes. Assuming a leukocyte recovery of 85-95%, what is the expected number of T cells in a normal individual? a 750/uL b 2,500/uL c 4,000/uL d 8,000/uL

b 2,5000/uL

A cholesterol QC chart has the following data for the normal control: - X (mean): 137 mg/dL - #x: 1,918 mg/dL - 2 SD: 6 mg/dL - N: 14 The coefficient of variation for this control is: a 1.14% b 2.19% c 4.38% d 9.49%

b 2.19% [CV = (SD/mean) x 100%]

How many mL of a 3% solution can be made if 6 grams (0.006 kg) of solute are available? a 100 mL b 200 mL c 400 mL d 600 mL

b 200 mL (3/100 = 6/x, solve for x)

At blood pH 7.40, what is the ratio of bicarbonate to carbonic acid? a 15:1 b 20:1 c 25:1 d 30:1

b 20:1

An RNA sample is isolated from peripheral blood cells of a patient. When performing spectrophotometric analysis to determine the yield of RNA in the sample you find the 1:40 dilution of the 0.5 mL sample gives an OD 260 reading of 0.03125 and an OD 280 reading of 0.01760. What is the total number of RNA contained in the 0.5 mL sample? a 50 ug b 25 ug c 12.5 ug d 5 ug

b 25 ug

What is the MCHC if the Hct is 20%, the RBC is 2.4 x 10^6/µL (2.4 x 10^12/L), and the Hgb is 5 g/dL (50 g/L)? a 21% b 25% c 30% d 34%

b 25% [(Hgb/Hct) x 100]

Treatment of IgG with papain results in how many fragments from each immunoglobulin molecule? a 2 b 3 c 4 d 5

b 3

Cholesterol crystals will most likely be observed in urine that contains: a 3+ glucose b 4+ protein c WBC casts d triple phosphate crystals

b 4+ protein

In the fasting state, the arterial and capillary blood glucose concentration varies from the venous glucose concentration by approximately how many mg/dL (mmol/L)? a 1 mg/dL (0.05 mmol/L) higher b 5 mg/dL (0.27 mmol/L) higher c 10 mg/dL (0.55 mmol/L) higher d 15 mg/dL (0.82 mmol/L) higher

b 5 mg/dL (0.27 mmol/L) higher

A healthy person with a blood glucose of 80 mg/dL (4.4 mmol/L) would have a simultaneously determined cerebrospinal fluid glucose value of: a 25 mg/dL b 50 mg/dL c 100 mg/dL d 150 mg/dL

b 50 mg/dL (2.3 mmol/L) -- slightly low

Urine specific gravity is an index of the ability of the kidney to: a filter the plasma b concentrate the urine c alter the hydrogen ion concentration d reabsorb sodium ions

b concentrate the urine

HLA typing of a family yields the following results: Locus A; Locus B father: (8, 12); (17, 22) mother: (7, 12); (13, 27) On the basis of these genotypes, predict the possibility of ankylosing spondylitis in this percentage of their children. A. 25% of their children B. 50% of their children C. 75% of their children D. 100% of their children

b 50% of their children

Sera to be tested for IFA-ANA 6 days after drawing is best stored at: a room temperature b 5C +/2C c -70C in a constant temperature freezer d -20C in a frost-free self-defrosting freezer

b 5C +/2C

Given the following data: WBC: 5.0 x 10^3/uL lymphocytes: 15% CD4: 8% the foll Calculate the absolute CD4: a 40 b 60 c 400 d 750

b 60

Cells that are precursors of plasma cells and also produce immunoglobulins are: a macrophages b B lymphocytes c T lymphocytes d monocytes

b B lymphocytes

An organism from aperitoneal absecess is isolated on kanamycin-vancomycin laked blood agar and grows black colonies on BBE agar. It is nonpigemented, catalase positive, and indole negative. The genus of this organism is: a Acidominococcus b Bacteriodes c Porphyromonas d Prevotells

b Bacteriodes

The presence of 20% bile in agar will allow growth of: a Fusobacterium necrophorum b Bacteroides fragilis c Prevotella melaninogenica d Porphyromonas asaccarolytica

b Bacteroides fragilis

Scurvy is associated with deficiency of the following vitamins? a A b C c niacin d thiamine

b C

Components of the complement system most likely to coat a cell are: a C1 and C2 b C3 and C4 c C6 and C7 d C8 and C9

b C3 and C4

Potent chemotactic activity is associated with which of the following components of the complement system: a C1q b C5a c C3b d IgG

b C5a

Which one of the following viruses is responsible for the most common congenital infection in the United States? a VZV b CMV c EBV d adeonvirus

b CMV

The serological test for syphilis recommended for detecting antibody in cerebrospinal fluid [CSF] is: a non-treponemal antibody b CSF-VDRL c FTA-ABS d MHA-TP

b CSF-VDRL

Anaerobic gram-positive bacilli with subterminal spores were isolated from a peritoneal abscess. The colony has a swarming appearance. The most likely identification of this organism is: a Bacillus cerues b Clostridium septicum c Eubacterium lentum d Bifidobacterium dentium

b Clostridium septicum

Auer rods are characterized as: a fused primary granules b DNA precipitates c denatured hemoglobin d large cytoplasmic granules

b DNA precipitates

A native of Thailand has a normal hemoglobin level. Hemoglobin electrophoresis on cellulose acetate shows 70% hemoglobin A and approximately 30% of a hemoglobin with the mobility of hemoglobin A2. This is most consistent with: a C trait b E trait c O trait d D trait

b E trait

A patient is suspected of having amebic dysentery. Upon microscopic examination of a fresh fecal specimen for ova and parasites, the following data were obtained: - a trophozoite of 25 um - progressive, undirectional crawl - evenly distributed peripheral chromatin - finely granular cytoplasm This information indicates: a Entamoeba coli b Entamoeba histolytica c Endolimax nana d Iodamoeba butschlii

b Entamoeba histolytica

Infection of the urinary tract is MOST frequently associated with: a Staphylococcus aureus b Escherichia coli c Enterococcus faecalis d Serratia marcescens

b Escherichia coli

Which of the following ions is bound to hemoglobin in methemoglobin? a Ca^2+ b Fe^3+ c Fe^2+ d Mg^2+

b Fe^3+

Von Willebrand factor mediates platelet adhesion by binding to platelet receptor: a GP Ib/IIa b GP Ib/GPIX/GPV c GP IIb/IIa d GP Ib/GPIIIa/GP X

b GP Ib/GPIX/GPV

Which platelet surface antigen acts as the receptor for fibrinogen? a GPIb/V/IX b GPIIb/IIIa c GPIa/IIa d GPIc/IIa

b GPIIb/IIIa

An aspirate of a deep wound was plated on blood agar plates aerobically and anaerobically. At 48 hours there was growth on the anaerobic plate only. The next step in the evaluation of this culture is to: a reincubate both plates for another 24 hours b Gram stain and begin organism identification c call physician and request blood culture d set up a Bauer-Kirby susceptibility test

b Gram stain and begin organism identification

The antigen marker most closely associated with transmissibility of HBV infection is: a HBsAg b HBeAg c HBcAg d HBV

b HBeAg

The persistence of which marker is the best evidence of chronic HBV infection? a HBeAg b HBsAg c anti-HBe d anti-HBs

b HBsAg

Bone marrow transplant donors and their recipients must be matched for which antigen system(s)? a ABO-Rh b HLA c CD4/CD8 d PI^a1

b HLA

MHC Class I includes which peptides/proteins? a complement b HLA A, B, C c cytokines d HLA DP, DQ, DR

b HLA A, B, C

The immunoglobulin class typically found to be present in saliva, tears and other secretions is: a IgG b IgA c IgM d IgD

b IgA

Measurement of serum levels of which of the following immunoglobulins can serve as a screening test for allergies? a IgA b IgE c IgG d IgM

b IgE

*Anti-phospholipid antibodies* associated with *autoimmune disorders* tend to have immunoglobulin (IgG) that belongs to which of the following subclasses? a IgG1 and IgG3 b IgG2 and IgG4 c IgG1 and IgG4 d IgG2 and IgG3

b IgG2 and IgG4

Clinical resistance to penicillin correlates most frequently with beta-lactamase production in: a Chlamydia trachomatis b Neisseria gonorrhoeae c Neisseria meningitidis d Treponema pallidum

b Neisseria gonorrhoeae

A patient has been taking aspirin regularly for arthritic pain. Which one of the following tests is most likely to be abnormal in this patient? a platelet count b PFA-100 c prothrombin time (PT) d activated partial thromboplastin time

b PFA-100

>100,000 CFU/mL of a Gram-negative bacilli were isolated on MacConkey from a urine specimen. Biochemical results are as follows: glucose: acid, gas produced indole: negative urea: positive TDA: positive H2S: positive The organism is most likely: a Morganella morganii b Proteus mirabilis c Proteus vulgaris d Providencia stuartii

b Proteus mirabilis

Which genera are positive for phenylalanine deaminase (PAD) production? a Klebsiella, Serratia, Enterobacter b Proteus, Providencia, Morganella c Enterobacter, Escherichia, and Salmonella d Citrobacter, Klebsiella, Pantoea

b Proteus, Providencia, Morganella

Which of the following stains can be used to differentiate siderotic granules (Pappenheimer bodies) from basophilic stippling? a Wright b Prussian blue c crystal violet d myeloperoxidase

b Prussian blue

A serological test for syphilis that depends upon the detection of cardiolipin-lecithin-cholesterol antigen is: a FTA-ABS b RPR c MHA-TP d TPI

b RPR

In the indirect fluorescent anti-nuclear antibody test, a speckled pattern may indicate the presence of antibody to: a histone b Sm c RNA d DNA

b Sm

Which of the following exhibits rapid motility in urine sediment? a spermatozoa b Trichomonas vaginalis c Gardnerella vaginalis d Enterobius vermicularis

b Trichomonas vaginalis

Which of the following dermatophytes can be identified with its clavate or peg-shaped microconidia that resemble "birds on a wire"? a Microsporidium canis b Trichophyton rubrum c Epidermophytonfloccosum d Trichophyton tonsurans

b Trichophyton rubrum

Which of the following is a known limitation of the uracil-N-glycosylase (UNG) chemistry commonly used for PCR contamination containment? a Taqman probes are not compatible b UNG will regain activity if temperatures drop below 55C c dUTP substitution increases affinity of probes d UNG inactivates GC residues of naturally occurring DNA

b UNG will regain activity if temperatures drop below 55C

The creatinine clearance (mL/min) is equal to: a urinary creatinine (mg/dL)/[volume of urine (mL/min) x plasma creatinine (mg/L)] b [urinary creatinine (mg/dL) x volume of urine (mL/min)]/[plasma creatinine (mg/L)] c urinary creatinine (mg/dL)/[volume of urine (mL/hour) x plasma creatinine (mg/L)] d [urinary creatinine (mg/dL) x volume of urine (mL/hour)]/[plasma creatinine (mg/L)]

b [urinary creatinine (mg/dL) x volume of urine (mL/min)]/[plasma creatinine (mg/L)]

Evidence indicates that the genetic defect in thalassemia usually results in: a the production of abnormal globin chains b a quantitative deficiency in RNA resulting in decreased globin chain production c a structural change in the heme portion of the hemoglobin d an abnormality in the alpha- or beta-chain binding or affinity

b a quantitative deficiency in RNA resulting in decreased globin chain production

Blood CO2 may be measured by: a direct colorimetric measurement of dissolved CO2 b a self-contained potentiometric electrode c measurement of CO2-saturated hemoglobin d measurement of CO2 consumed at the cathode

b a self-contained potentiometric electrode

When cleaning up a small (5 mL) blood spill on the countertop, the first step after donning appropriate personal protective equipment is to: a flood the area with an appropriate intermediate to high-level disinfectant b absorb the spill with disposable absorbent material c evacuate the area for 30 minutes d clean the area with an aqueous detergent solution

b absorb the spill with disposable absorbent material

The extent to which measurements agree with the true value of the quantity being measured is known as: a reliability b accuracy c reproducibility d precision

b accuracy

Reagent test strip pads for ketones primarily measure: a acetone b acetoacetic acid c cholesterol d beta-hydroxybutyric acid

b acetoacetic acid

Children who have infections with beta-hemolytic streptococci can develop: a acute pyelonephritis b acute glomerulonephritis c chronic glomerulonephritis d nephrosis

b acute glomerulonephritis

Cerebrospinal fluid for glucose assay should be: a refrigerated b analyzed immediately c heated to 56C d stored at room temperature after centrifugation

b analyzed immediately

The MOST rapid immediate hypersensitivity reaction is associated with: a transfusion b anaphylaxis c contact dermatitis d serum sickness

b anaphylaxis (about 30 minutes wait)

An 89-year-old Caucasian female was transferred to the hospital from a nursing facility for treatment of chronic urinary tract infection with proteinuria. The patient presented with the following laboratory data: - WBC: 10.0 x 10^3/uL - RBC: 3.1 x 10^6/uL - Hgb: 7.2 g/dL - Hct: 24% - MCV: 78 um^3 - MCH: 23 pg - MCHC: 31% - serum iron: 29 ug/dL - TIBC: 160 ug/dL - serum ferritin: 100 ng/mL These data are most consistent with which of the following conditions: a iron deficiency anemia b anemia of chronic inflammation c hemochromatosis d acute blood loss

b anemia of chronic inflammation

The RDW is elevated on a CBC report. The smear would show: a hypochromia b anisocytosis c poikilocytosis d macrocytosis

b anisocytosis

What is the most critical step in determining the specificity of a PCR reaction? a denaturation temperature b annealing temperature c extension temperature d number of cycles in the PCR reaction

b annealing temperature

What assay would confirm the immune status to hepatitis B virus? a HBsAg b anti-HBs c IgM anti-HBcAg d hepatitis C Ag

b anti-HBs

In chronic active hepatitis, high titers of which of the following antibodies are seen? a anti-mitochondrial b anti-smooth muscle c anti-DNA d anti-parietal cells

b anti-smooth msucle

Immunoassays are based on the principle of: a separation of bound and free analyte b antibody recognition of homologous antigen c protein binding to isotopes d production of antibodies against drugs

b antibody recognition of homologous antigen

Hereditary angioedema is characterized by: a decreased activity of C3 b decreased activity of C1 esterase inhibitor c increased activity of C1 esterase inhibitor d increased activity of C2

b decreased activity of C1 esterase inhibitor

A 20-year-old woman with sickle cell anemia whose usual hemoglobin concentration is 8 g/dL (80 g/L) develops fever, increased weakness and malaise. The hemoglobin concentration is 4 g/dL (40 g/L) and the reticulocyte count is 0.1%. The MOST likely explanation for her clinical picture is: a increased hemolysis due to hypersplenism b aplastic crisis c thrombotic crisis d occult blood loss

b aplastic crisis

A salicylate level is performed to detect toxicity caused by ingestion of excess: a acetaminophen b aspirin c ibuprophen d pseudoephedrine

b aspirin

A urine specimen comes to the laboratory 7 hours after it is obtained. It is acceptable for culture only if the specimen has been stored: a at room temperature b at 4-7C c frozen d with a preservative additive

b at 4-7C

Microbiology culture results are made available within the hospital information system: a at regular intervals when information on bacterial growth is available, no direct specimen nor 'no growth' status information should be released b at regular intervals when information becomes available such as direct specimen testing results and all interim reports to include "no growth" updates c when all direct specimen and culture results are finalized, no interim results should be released d when the primary care practitioner requests updates on culture results, otherwise only final direct specimen and culture results are released

b at regular intervals when information becomes available such as direct specimen testing results and all interim reports to include "no growth" updates

The methodology based on the amount of energy absorbed by a substance as a function of its concentration and using a specific source of the same material as the substance analyzed is: a flame emission photometry b atomic absorption spectrophotometry c emission spectrography d x-ray fluorescence spectometry

b atomic absorption spectrophotometry

Which cells are involved in immediate hypersensitivity reactions? a eosinophils b basophils c plasma cells d reactive lymphocytes

b basophils

All laboratory instruments should: a have repairs conducted while connected to faulty wiring b be grounded or double insulated c have safety checks performed initially and then every 6 months d be connected to multiple outlet adapters

b be grounded or double insulated

A clean-catch urine is submitted to the laboratory for routine analysis and culture. The routine analysis is done first, and 3 hours later, the specimen is sent to the microbiology department for culture. The specimen should: a be centrifuged, and the supernatant cultured b be rejected due to the time delay c not be cultured if no bacteria are seen d be processed for cultured only if the nitrate is positive

b be rejected due to the time delay

The ONPG test allows organisms to be classified as a lactose fermenter by testing for which of the following? a permease b beta-galactosidase c beta-lactamase d phosphatase

b beta-glactosidase

Tiny, colorless, dumbbell-shaped crystals were found in an alkaline urine sediment. They most likely are: a calcium oxalate b calcium carbonate c calcium phosphate d amorphous phosphate

b calcium carbonate

Identify this crystal (looks like pencil tips): a uric acid b calcium phosphate c calcium carbonate d triple phosphate acid

b calcium phosphate

Using a fluorescent microscope, a wet preparation of skin tissue reveals fluorescent septate hyphae. The smear was prepared using: a acridine orange b calcofluor white c Gomori methanamine silver d periodic acid-Schiff

b calcofluor white

Osmolal gap is the difference between: a the ideal and real osmolality values b calculated and measured osmolality values c plasma and water osmolality values d molality and molarity at 4C

b calculated and measured osmolality values

When staining *Mycobacteria*, the primary stain used in the acid-fast staining process is: a 1% acid fuschin b carbol fuschin c crystal violet d methylene blue

b carbol fuschin

A patient has a suspected diagnosis of subacute bacterial endocartitis. His blood cultures grow *non-spore-forming pleomorphic Gram-positive bacilli* only in the *anaerobic bottle*. What test(s) will give a presumptive identification of this microorganism? a beta-hemolysis and oxidase b catalase and spot indole c esculin hydrolysis d hydrolysis of gelatin

b catalase and spot indole

Failure to observe RBC casts in a urine specimen can be caused by: a staining the specimen b centrifuging an unmixed specimen c mixing the sediment after decantation d examining the sediment first under low power

b centrifuging an unmixed specimen

90% of the copper present in the blood is bound to: a transferrin b ceruloplasmin c albumin d cryoglobulin

b ceruloplasmin

What is the most common presentation of paroxysmal cold hemoglobinuria? a older people with Raynaud syndrome b children following a viral illness c neonates with congenital syphilis d alcoholics with advanced cirrhosis

b children following a viral illness (more vulnerable)

Which substrate is used for the detection of specific esterase? a acetate b chloroacetate c pararosanilin acetate d phenylene diacetate

b chloroacetate

The measurement principle that uses factor Xa which is to a patient plasma and added to a substrate is a: a factor assay b chromogenic assay c ELISA assay d immunogenic assay

b chromogenic assay

Given the following results: - alkaline phosphatase: slight increase - aspartate amino transferase: slight increase - alanine amino transferase: slight increased - gamma-glutamyl transferase: slight increase This is most consistent with: a acute hepatitis b chronic hepatitis c obstructive jaundice d liver hemangioma

b chronic hepatitis

A patient is suspected of having a factor XIII deficiency, which test is most likely abnormal: a prolonged activated partial thromboplastin time b clot solubility in a 5 molar urea solution c euglobulin clot lysis d prolonged thrombin time

b clot solubility in a 5 molar urea solution

The appearance of normal CSF is: a pale yellow and clear b colorless and clear c opalescent d xanthochromic

b colorless and clear

Which of the following sets of laboratory findings is consistent with hemolytic anemia? a normal or slightly increased erythrocyte survival; normal reticulocyte count b decreased erythrocyte survival; increased catabolism of heme c decreased serum lactate dehydrogenase activity; normal catabolism of heme d normal concentration of haptoglobin; marked hemoglobinuria

b decreased erythrocyte survival; increased catabolism of heme

The anemia of chronic infection is characterized by: a decreased iron stores in the reticoloendothelial system b decreased serum iron levels c macrocytic erythrocytes d increased serum iron binding capacity

b decreased serum iron levels

A 26-year-old nurse developed fatigue, a low-grade fever, polyarthritis and urticaria. Two months earlier she had cared for a patient with hepatitis. Which of the following findings are likely to be observed in this nurse? a a negative hepatitis B surface antigen test b elevated AST and ALT levels c a positive rheumatoid factor d a positive Monospot test

b elevated AST and ALT levels

The advantage to using phase microscopy in urinalysis is to: a provide higher magnification b enhance constituents with a low refractive index c allow constituents to stain more clearly d provide a larger field of view

b enhance constituents with a low refractive index

The serological test that can be modified to selectively detect only specific IgM antibody in untreated serum is: a Ouchterlony b enzyme immunoassay c hemagglutination inhibition d passive hemagglutination

b enzyme immunoassay

A heterophile antigen is best described as? a an auto-antigen b existing in an unrelated animal c resulting from an amnestic response d an adjuvant to increase immune response

b existing in an unrelated animal

The technologist observes apparent homogenous staining of the nucleus of interphase cells while performing an IFA-ANA, as well as staining of the chromosomes in mitotic cells. This result is: a indicative of 2 antibodies, which should be separately reported after titration b expected from anti-DNA antibodies c inconsistent; the test should be reported with new reagent d expected for anti-centromere antibodies

b expected from anti-DNA antibodies

Activated protein C (APC) resistance is associated with a mutation in: a thrombin b factor V c factor VIII d protein C

b factor V

In a patient diagnosed with liver disease, which one of the following factors typically shows an increase? a factor VII b factor VIII c factor IX d factor X

b factor VIII (*the rest are vitamin K dependent factors along with factor II*)

Which of the [above] figures demonstrates a reaction pattern of non-identity? a figure which has dome in between top and bottom areas [figure 1] b figure which has one line under each one species crossing near the top [figure 2] c figure which has two lines under one species [figure 3] d figure which has center of media circled [figure 4]

b figure which has one line under each one species crossing near the top [figure 2]

The clarity of a urine sample should be determined: a using glass tubes only; never plastic b following thorough mixing of the specimen c after addition of sulfosalicylic acid d after the specimen cools to room temperature

b following thorough mixing of the specimen

An urinalysis performed on a *2-week-old infant with diarrhea* shows a negative reaction with the glucose oxidase reagent strip. A copper reduction tablet test should be performed to check the urine sample for the presence of: a glucose b galactose c bilirubin d ketones

b galactose

Immunoglobulin idiotypic diversity is best explained by the theory of: a somatic mutation b germ line recombination c antigen induction d clonal selection

b germ line recombination

Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes? a silver b glass c platinum d platinum lactate

b glass

Which 2 diseases are usually preceded by infection with beta-hemolytic streptococci? a rheumatic fever, undulant fever b glomerulonephritis, rheumatic fever c rheumatic fever, tularemia d glomerulonephritis, undulant fever

b glomerulonephritis, rheumatic fever

A urine specimen is analyzed for glucose by a glucose oxidase reagent test strip and a copper reduction test. If both results are positive, which of the following interpretations is correct? a galactose is present b glucose is present c lactose is NOT present d sucrose is NOT present

b glucose is present

Clostridium difficile can be detected by: a fluorescent staining b glutamate dehydrogenase c growth on LKV media d high pressure liquid chromatography

b glutamate dehydrogenase

The substance that is measured to estimate the serum concentration of triglycerides by MOST methods is: a phospholipids b glycerol c fatty acids d pre-beta lipoprotein

b glycerol

Phagocytosis is a function of: a erythrocytes b granulocytes c lymphocytes d thrombocytes

b granulocytes

Substances that are antigenic only when coupled to a *protein carrier* are: a opsonins b haptens c adjuvants d allergens

b haptens

The smear represented [below] displays: a congenital ovalocytosis b hemoglobin C disease c poor RBC fixation d delay in smear preparation

b hemoglobin C disease

A reagent test strip pad for blood has been reported positive. Microscopic examination fails to yield red blood cells. This patient's condition can be called: a hematuria b hemoglobinuria c oliguria d hemosiderinuria

b hemoglobinuria

Increased serum lactic dehydrogenase activity due to elevation of fast fraction (1 and 2) on electrophoretic separation is caused by: a nephrotic syndrome b hemolytic anemia c pancreatitis d hepatic damage

b hemolytic anemia

Which condition has the highest stringency for DNA probe hybridization? a low temperature, low salt concentration b high temperature, low salt concentration c high temperature, high salt concentration d low temperature, high salt concentration

b high temperature, low salt concentration

Which of the following is secreted by the placenta and used for early detection of pregnancy? a follicle-stimulating hormone (FSH) b human chorionic gonadotropin (HCG) c luteinizing hormone (LH) d progesterone

b human chorionic gonadotropin (HCG)

The term "shift to the left" refers to: a a microscopic adjustment b immature cell forms in the peripheral blood c a trend on a Levy-Jennings chart d a calibration adjustment on an instrument

b immature cells form in the peripheral blood

Megaloblastic asynchronous development in the bone marrow indicates which one of the following? a proliferation of erythrocyte precursors b impaired synthesis of DNA c inadequate production of erythropoietin d deficiency of G6PD

b impaired synthesis of DNA

Upon standing at room temperature, a urine pH typically: a decreases b increases c remains the same d changes depending on bacterial concentration

b increases

Which method for quantifying DNA would be most appropriate when testing small FFPE tissue sections by next generation sequencing? a agarose gel b intercalating dyes c real-time PCR d UV adsorption

b intercalating dyes

After the removal of red blood cells from the circulation, hemoglobin is broken down into: a iron, porphyrin, and amino acids b iron, protoporphyrin, and globin c heme, protoporphyrin, and amino acids d heme, hemosiderin, and globin

b iron, protoporphyrin, and globin

In addition to keeping the load close to your body and tightening your abdominal muscles when lifting heavy boxes of supplies, it is important to bend at the: a waist; lift with legs and buttocks b knees and hips; lift with legs and buttocks c knees and hips; lift with arms and back d waist twist your body when lifting

b knees and legs; lift with legs and buttocks

A medical technologist is working on a stool culture from a patient with severe, bloody diarrhea. She wants to set up biochemicals to differentiate Shigella and E. coli. Which of the following tests would be the most appropriate? a hydrogen sulfide, ONPG, motility, urease b lactose, indole, ONPG, motility c urease, citrate, VP, hydrogen sulfide d gas, MR, urease, citrate

b lactose, indole, ONPG, motility

A 10 mL suspension, in water, is made from a *bloody stool* sample collected from a neonate. The specimen is centrifuged and the resulting *pink supernatant* transferred in equal volumes to 2 tubes. The first tube serves as a reference while the second tube is alkalinized with 1 mL of 0.25 M sodium hydroxide. The second tube *changes to yellow within 2 minutes*. This reaction indicates the presence of: a fetal hemoglobin (HgbF) b maternal hemoglobin (HgbA) c fetal white blood cells d maternal white blood cells

b maternal hemoglobin (HgbA)

The middle value of a data set is statistically known as the: a mean b median c mode d standard deviation

b median

A 4-year-old girl develops edema following a *recent immunization*. Laboratory studies reveal: serum albumin: 1.8 g/dL (18g/L) serum cholesterol: 450 mg/dL (11.66 mmol/L) serum urea nitrogen: 20 mg/dL (7.14 mmol/L) urinalysis: protein 4+; hyaline, granular and fatty casts These findings are most compatible with: a acute poststreptococcal glomerulonephritis b minimal change disease c acute pyelonephritis d diabetes mellitus

b minimal change disease (*seen in children after recent immunization*)

The lowest concentration of antibiotic that inhibits growth of a test organism is the: a minimum bactericidal concentration b minimum inhibitory concentration c serum bactericidal concentration d serum inhibitory concentration

b minimum inhibitory concentration

Clinical assays for tumor markers are most important for: a screening for the presence of cancer b monitoring the course of a known cancer c confirming the absence of disease d identifying patients at risk for cancer

b monitoring the course of a known cancer

Bence Jones proteins are: a immunoglobulin catabolic fragments in the urine b monoclonal light chains c whole immunoglobulins in the urine d Fab fragments of a monoclonal protein

b monoclonal light chains

In performing a spinal fluid protein determination, the specimen is diluted 1 part spinal fluid to 3 parts saline to obtain a result low enough to measure. To calculate the protein concentration, the result must be: a multiplied by 3 b multiplied by 4 c divided by 3 d divided by 4

b multiplied by 4

In hybridoma technology, the desirable fused cell is the: a myeloma-myeloma hybrid b myeloma-lymphocyte hybrid c lymphocyte-lymphocyte hybrid d lymphocyte-granulocyte hybrid

b myeloma-lymphocyte hybrid

An increased microalbumin concentration from a random urine collection is predictive of: a diabetes mellitus b nephropathy c hypertension d nephrotic syndrome

b nephropathy

A urine isolate Gram stain shows Gram-positive cocci in clusters. The organism tested catalase positive. To identify this organism from culture, the technician should perform a coagulase test and a/an: a polymyxin B susceptibility b novobiocin susceptibility c oxidase d beta-lactamase

b novobiocin susceptibility

Data on positive blood cultures due to contaminants are collected and distributed to outreach clinicians so they can review the: a laboratory's ability to identify contaminants growing from a blood culture b office phlebotomist's procedure for proper collection of a blood culture c rate at which the blood culture instrument identifies contaminated blood culture bottles d organism most commonly identified as a contaminant

b office phlebotomist's procedure for proper collection of a blood culture

The volume of urine excreted in a 24-hour period by an adult patient was 300 mL. This condition would be termed: a anuria b oliguria c polyuria d dysuria

b oliguria (exceeds the threshold)

What specimen preparation is commonly used to perform the alkaline phosphatase isoenzyme determination? a serum is divided into 2 aliquots, one is frozen and the other is refrigerated b serum is divided into 2 aliquots, one is heated at 56C and the other is unheated c no preparation is necessary since the assay uses EDTA plasma d protein-free filtrate is prepared first

b serum is divided into 2 aliquots, one is heated at 56C and the other is unheated

A characteristic morphologic feature in hemoglobin C disease is: a macrocytosis b spherocytosis c rouleaux formation d target cells

d target cells

(Refer to the figure.) An amplicon for gene X is 176 base pairs in size. A variant allele x, gives the same size amplicon but has an Alwl restriction enzyme recognition site that is not present in the amplicon arising from allele X. A PCR reaction is run on a DNA sample isolated from 3 patients. The sample is digested with Alwl after the PCR is complete and products of the digestion are resolved ona 4.0% agarose gel (- = no Alwl digestion, + = Alwl digestion) Assuming all appropriate controls have worked correctly, what is the interpretation for the genotype of patient #3 with regards to alleles X and x? a patient is homoxygous for X b patient is heterozygous for X and x c patient is homozygous for x d patient's genotype cannot be determined

b patient is heterozygous for X and x

TSH is produced by the: a hypothalamus b pituitary gland c adrenal cortex d thyroid

b pituitary gland

A 42-year-old male presented with fatigue, difficulty breathing, tingling in the hands and feet. The following laboratory results are obtained: - PT 25.6 seconds (ref range: 11.5-13.9 seconds) - aPTT: 77.5 seconds (ref range: 25.0-35.7 seconds) - Hgb: 23.5 g/dL - Hct: 76.2% The clinician questioned the results, as the patient had no bleeding symptoms. This result could be caused by: a aplastic anemia b polycythemia vera c chronic lymphocytic leukemia d sickle cell disorder

b polycythemia vera

Urine from a 50-year-old man was noted to turn dark red on standing. This change is caused by the presence of: a glucose b porphyrins c urochrome d creatinine

b porphyrins

Urine that develops a *port wine color* after standing may contain: a melanin b porphyrins c bilirubin d urobilinogen

b porphyrins

In the direct immunofluorescence assay for Legionella pneumophila, patient sample affixed to the slide is most likely detected with: a primary antigen with fluorescent conjugate b primary antibody with fluorescent conjugate c secondary antigen with fluorescent conjugate d secondary antibody with fluorescent conjugate

b primary *antibody* with fluorescent conjugate

The main function of the hexose monophosphate shunt in the erythrocyte is to: a regulate the level of 2,3-DPG b provide reduced glutathione to prevent hemoglobin oxidation c prevent the reduction of heme iron d provide energy for membrane maintenance

b provide reduced glutathione to prevent hemoglobin oxidation

After receiving appropriate training, the first step in using a fire extinguisher is to: a sweep the floor of the hose from side to side b pull the pin c squeeze the top handle or lever d aim the hose at the base of the fire

b pull the pin

Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria? a autosomal dominant inheritance b red cell membrane defects c positive direct antiglobulin test d measured platelet count

b red cell membrane defects

Which of the following is a WHO classification of myelodysplastic syndrome? a chronic myelomonocytic leukemia (CMML) b refractory thrombocytopenia c refractory cytopenia with excessive blasts (RAEB) d refractory neutrophilia

b refractory thrombocytopenia

A 21-year-old patient presents with pharyngitis. A throat swab is collected and submitted for anaerobic culture. This specimen should be: a set up immediately b rejected as unacceptable c inoculated into thioglycollate broth d sent to a reference laboratory

b rejected as unacceptable [does not use throat swab]

Characteristically, enterococci are: a unable to grow in 6.5% NaCl b relatively resistant to penicillin c sodium hippurate positive d bile esculin negative

b relatively resistant to penicillin

The purpose for routinely screening diabetes mellitus patients for microalbuminuria is to monitor the development of: a urinary tract infection b renal disease c yeast infections d diabetes insipidus

b renal disease

A serum sample demonstrates an elevated result when tested with the Jaffe reaction. This indicates: a prolonged hypothermia b renal functional impairment c pregnancy d arrhythmia

b renal functional impairment (renal)

Oval fat bodies are: a squamous epithelial cells that contain lipids b renal tubular epithelial cells that contain lipids c free-floating fat droplets d white blood cells with phagocytized lipids

b renal tubular epithelial cells that contain lipids

The following laboratory results were obtained: Serum electrolytes sodium: 136 mEq/L (136 mmol/L) potassium: 4.4 mEq/L (4.4 mmol/L) chloride: 92 mEq/L (92 mmol/L) bicarbonate: 40 mEq/L (40 mmol/L) Arterial blood pH: 7.32 PCO2: 79 mm Hg These results are most compatible with: a respiratory alkalosis b respiratory acidosis c metabolic alkalosis d metabolic acidosis

b respiratory acidosis

Using a supra vital stain, the polychromatic red blood cells below would probably be: a rubricytes (polychromatophilic normoblast) b reticulocytes c sickle cells d target cells

b reticulocytes

An individualized quality control plan (IQCP) does not require: a risk assessment b revalidation of test performance c quality control plan d quality assessment

b revalidation of test performance

The presence of rice bodies in a synovial fluid is strongly associated with: a gouty arthritis b rheumatoid arthritis c infection with Staphylococcus aureus d traumatic collection

b rheumatoid arthritis

T cells are incapable of: a collaborating with B cells in antibody responses b secretion of immunoglobulins c secretion of cytokines d producing positive skin tests

b secretion of immunoglobulins (*B lymphocytes only*)

The presence of excessive rouleaux formation on a blood smear is often accompanied by an increased: a reticulocyte count b sedimentation rate c hematocrit d erythrocyte count

b sedimentation rate

Which of the following is MOST useful in establishing a diagnosis in the convalescence phase of a viral infection? a slide culture b serological techniques c shell vial d culture on McCoy media

b serological techniques

The Prussian blue staining of peripheral blood identifies: a Howell-Jolly bodies b siderotic granules c reticulocytes d basophilic stippling

b siderotic granules

Upon review of a sputum Gram stain, the technician notes that all the neutrophil nuclei in the smear stained dark blue. The best explanation for this finding is the: a iodine was omitted from the staining procedure b slide was inadequately decolorized with acetone/alcohol c sputum smear was prepared too thin d cellular components have stained as expected

b slide was inadequately decolorized with acetone/alcohol

A microscopic examination of urine sediment reveals ghost cells. These red blood cells may be seen in urine with a: a >2% glucose concentrations b specific gravity <1.007 c large amounts of ketone bodies d neutral pH

b specific gravity <1.007

What protein is commonly defective in hereditary elliptocytosis? a ankyrin b spectrin c band 4.1 d elliptocin

b spectrin

Which of the following lab findings is associated with extravascular hemolysis? a decreased bilirubin b spherocytes c microcytes d hemoglobinuria

b spherocytes

Which of the following laboratory findings is associated with extravascular hemolysis? a decreased bilirubin b spherocytes c microcytes d hemoglobinuria

b spherocytes

The curve [below] was obtained by adding increasing amounts of a soluble antigen to fixed volumes of monospecific antiserum. The area in which the addition of more antibody would result in the formation of additional precipitate is: a the far left region [a] b the far right region [b] c the "middle" region [c] d the region left of the middle [d]

b the far right region [b]

Three sets of blood cultures were obtained from an adult patient with fever and suspected endocarditis. The aerobic bottle of one set had growth of Staphylococcus epidermidis at 5 days of incubation. This indicates that: a there was low-grade bacteremia b the organism is most likely a contaminant c the patient has a line infection d the blood culture bottles are defective

b the organism was most likely a contaminant

Which of the following is the best indicator of an *acute infection* with the hepatitis A virus? a the presence of IgG antibodies to hepatitis A virus b the presence of IgM antibodies to hepatitis A virus c a sharp decline in the level of IgG antibodies to hepatitis A virus d a rise in both IgM and IgG levels of antibodies to hepatitis A virus

b the presence of IgM antibodies to hepatitis A virus

A patient's serum is being analyzed in a sandwich assay. This patient has received mouse monoclonal antibody therapy, and shows a false-positive reaction in the sandwich assay, which is due to: a the mouse antibody in the patient's serum reacting to the antigen b the presence of human anti-mouse antibody activity c antibody to a mouse virus d production of a monoclonal gammopathy of unknown significance after the antibody treatment

b the presence of human anti-mouse antibody activity

A sample is sent to the laboratory for an anti-Xa assay. The result of the PTT is 65.7 seconds. The result of the anti-Xa assay is 0.9 U/mL of heparin. The patient is on Lovenox. Their anti-Xa level is: a subtherapeutic b therapeutic c supratherapeutic d prophylactic

b therapeutic

In the Clauss fibrinogen assay the time for clot formation in plasma is measured after the addition of: a calcium b thrombin c phospholipids d fibrin

b thrombin

The best test to determine if a sample contains residual heparin: a fibrinogen b thrombin time c prothrombin time d D-dimer

b thrombin time

A 2-year-old child with a decreased serum T4 is described as being somewhat dwarfed, stocky, overweight, and having coarse features. Of the following, the most informative additional laboratory test would be the serum: a thyroxine-binding globulin (TBG) b thyroid-stimulating hormone (TSH) c triiodothyronine (T3) d cholesterol

b thyroid-stimulating hormone (TS)

The recommended initial thyroid function test for either a healthy, asymptomatic patient or a patient with symptoms which may be related to a thyroid disorder is: a free thyroxine (free T4) b thyroid-stimulating hormone (TSH) c total thyroxine (T4) d triiodothyronine (T3)

b thyroid-stimulating hormone (TSH)

The Klenkow fragment of Escherichia coli DNA polymerase I is used: a to make cDNA from an RNA template b to label DNA probes by random primer labeling c in quantitative real time PCR d to label a DNA probe by nick translation

b to label DNA probes by random primer labeling

What is the purpose of the enzyme uracil-N-glycolase in a molecular diagnostics laboratory? a to lower the melting temperature of RNA:DNA hybrids in reverse transcriptase PCR reactions b to remove any previously generated amplicons containing dUTP from PCR reactions c to remove contaminating genomic DNA from a reverse transcriptase PCR reaction d to melt double-stranded DNA to single-stranded DNA in PCR reactions

b to remove any previously generated amplicons containing dUTP from PCR reactions

In a centrifugal analyzer, centrifugal force is used to: a add reagents to the rotor b transfer liquids from the inner disc to the outer cuvette c measure in optical density in the centrifugal force field d counteract the tendency of precipitates to settle in the cuvette

b transfer liquids from the inner disc to the outer cuvette

When performing a Kovac indole test, the substrate must contain: a indole b tryptophan c ornithine d paradimethylaminobenzaldehyde

b tryptophan

Hyaline casts are usually found: a in the center of the coverslip b under subdued light c under very bright light d in the supernatant

b under subdued light

A 59-year-old man is evaluated for back pain. Urine studies (urinalysis by multiple reagent strip) include: - SG: 1.017 - pH: 6.5 - protein: negative - glucose; negative - blood: negative - rare eputhelial cells - monoclonal spike in gamma globulin region Which of the following statements best explains these results? a urine protein is falsely negative due to the specific graviity b urine protein is falsely negative because the method is not sensitive for Bence Jones protein c micrscopic examination is falsely negative due to the specific gravity d electrophoresis is incorrect and should be repeated

b urine protein is falsely negative because the method is not sensitive for Bence Jones protein

The air temperature throughout the serology laboratory is 20C. How will this affect VDRL and RPR test results? a no effect--the acceptable test range is 20-24C b weaken reactions so that false-negatives occur c strengthen reactions so that positive titers appear elevated d increase the number of false-positives from spontaneous clumping

b weaken reactions so that false-negatives occur

Diagnostic specificity is defined as the percentage of individuals: a with a given disease who have a positive result by a given test b without a given disease who have a negative result by a given test c with a given disease who have a negative result by a given test d without a given disease who have a positive result by a given test

b without a given disease who have a negative result by a given test

Which of the following is the formula for calculating the mean corpuscular volume (MCV)? a (Hgb x 10)/RBC b Hgb/Hct c (Hct x 10)/RBC d RBC/Hct

c (Hct x 10)/RBC

Which of the following is the formula for the coefficient of variation? a (standard deviation x 100)/standard error b (mean x 100)/standard deviation c (standard deviation x 100)/mean d (variance x 100)/mean

c (standard deviation x 100)/mean

The colony count from a *suprapubic urine culture* growing 10 colonies of Staphylococcus saprophyticus is: a 0 CFU/mL b 100 CFU/mL c 1,000 CFU/mL d 100,000 CFU/mL

c 1,000 CFU/mL

The colony count from a suprapubic urine culture (0.01mL catheter) growing 10 colonies of Staphylococcus saprophyticus is: a 0 CFU/mL b 100 CFU/mL c 1,000 CFU/mL d 100,000 CFU/mL

c 1,000 CFU/mL

The real-time PCR curves represent dilutions of a single sample. Assuming PCR efficiency of 100%, what dilution is represented between aliquot A and aliquot B? a 2-fold b 5-fold c 10-fold d 20-fold

c 10-fold

A patient has the following laboratory results: RBC: 2.00 x 10^6/uL (2.00 x 10^12/L) Hct: 24% Hgb: 6.8 g/dL (68 g/L) reticulocytes: 0.8% The mean corpuscular volume (MCV) of the patient is: a 35 um^3 (35 fL) b 83 um^3 (83 fL) c 120 um^3 (120 fL) d 150 um^3 (150 fL)

c 120 um^3 (120 fL)

A urine tested with Clinitest exhibits a pass-through reaction and is diluted by adding 2 drops of urine to 10 drops water. This is a dilution of: a 1:4 b 1:5 c 1:6 d 1:8

c 1:6 (must be part to whole ratio)

How many volumes of ethanol are added to 1 volume of a DNA:salt solution to cause the DNA to precipitate? a 1 b 1.5 c 2 d 2.5

c 2

Following overnight fasting, hypoglycemia in adults is defined as a glucose of: a </ 70 mg/dL b </ 60 mg/dL c </ 55 mg/dL d </ 45 mg/dL

c </ 55 mg/dL

In the anti-double-stranded DNA procedure, the antigen MOST commonly utilized is: a rat stomach tissue b mouse kidney tissue c Crithidia lucilae d Toxoplasma gondii

c Crithidia lucilae

Probes are often used during real time PCR to quantitate the formation of specific amplicons during the reaction. Which system involves the use of 2 distinct probes to generate a *fluorescent signal*? a hydrolysis (TaqMan) probes b molecular beacon c FRET d Scorpions primers

c FRET

Which of the following platelet antigens is the receptor for collagen? a GPIb/V/IX complex b GPIIb/IIIa complex c GPIa/IIa complex d GPIV/X complex

c GPIa/IIa complex

A friend calls and asks you to access his test results. Which of the following does this violate? a CAP b The Joint Commission c HIPAA d CLIA

c HIPAA

An example of an *organ specific* disease with autoimmune antibodies is: a Wegener granulomatous b rheumatoid arthritis c Hashimoto thyroiditis d systemic lupus erythematosus

c Hashimoto thyroiditis

Which of the following statements about immunoglobulins is true? a immunoglobulines are produced by T lymphocytes b IgA class is determined by the gamma heavy chain c IgA class exists as serum and secretory molecules d there are only 2 subclasses of IgG

c IgA class exists as serum and secretory molecules

To which of the following classes do the antibodies that cause hemolytic disease of the newborn belong? a IgA b IgE c IgG d IgD

c IgG

The IIF staining pattern on ethanol-fixed leukocytes slides shows a perinuclear or nuclear staining pattern. this pattern is typically due to: a C-ANCA b LKM c P-ANCA d GBM

c P-ANCA

Which T cell malignancy may retain "helper" activity with regard to immunoglobulin synthesis by B cells? a Hodgkin lymphoma b acute lymphocytic leukemia (ALL) c Sezary syndrome d chronic lymphocytic leukemia (CLL)

c Sezary syndrome (CD3+ and CD4+)

A young boy who routinely bites his finger nails develops a wound on his right pointer finger. A culture reveals alpha hemolytic, dry colonies on the blood and CNA plates that are *catalase negative, resistant to optochin, and 6.5% NaCl negative*. Gram stain of the colony is Gram-positive cocci in chains. The organism most likely isolated is: a Enterococcus faecium b Enterococcus faecalis c Streptococcus viridans d Streptococcus agalactiae

c Streptococcus viridans

Which organism *fails to grow* on artificial media or in cell cultures? a Chlamydia trachomatis b Neisseria gonorrhoeae c Treponema pallidum d herpes simplex virus

c Treponema pallidum

A patient sample has been tested in the routine laboratory with a PT and an aPTT. Six hours later factor assays are ordered on the same sample. Which factor is the most labile? a II b VII c VIII d X

c VIII (works with both PT and aPTT)

In an uncomplicated case of severe iron deficiency anemia, which of the following [sets] represents the typical pattern of results?

c [set c]: decreased serum iron, % saturation, marrow % sideroblasts, marrow iron stores, serum ferritin, HgbA2; increased serum TIBC

The recommended medium/media to innoculate for the primary isolation of Mycobacteria include: a a broth-based medium only b a solid-based medium only c a broth-based and a solid-based medium d solid-based media

c a broth-based and a solid-based medium

Proper collection of a sample for recovery of Enterobius vermicularis includes collecting: a a 24-hour urine specimen b a first morning stool collection with proper preservative c a scotch tape preparation from the perianal region d peripheral blood from a finger

c a scotch tape preparation from the perianal region

Which of the following parameters of a diagnostic test will vary in the presence of a given disease in a population? a precision b sensitivity c accuracy d specificity

c accuracy

Which of the following chemical determinations may be of help in establishing the presence of seminal fluid? a lactic dehydrogrenase (LD) b isocitrate dehydrogenase (ICD) c acid phosphatase d alkaline phosphatase

c acid phosphatase

A specimen with a negative nitrite reaction and a positive leukocyte esterase reaction that has WBCs, WBC casts, but no bacteria in the sediment will be seen in cases of: a cystitis b pyelonephritis c acute interstitial nephritis d acute glomerularnephritis

c acute interstitial nephritis (caused by allergic reaction-inflammation)

A patient presents with an aPTT of 24 seconds (25-35 seconds) which is below the normal range. A possible explanation for this result is the presence of a(n): a DVT b lupus anticoagulant c acute phase reactant d inhibitor

c acute phase reactant

What process does the fluorography represent? a amplification plot b fragment analysis c melt curve analysis d pyrosequencing

c melt curve analysis

A 10-year-old child was admitted to pediatrics with an initial diagnosis of skeletal muscle disease. The best confirmatory tests would be: a creatinine kinase and isocitrate dehydrogenase b gamma-glutamyl transferase and alkaline phosphatase c aldolase and creatinine kinase d lactate dehydrogenase and malate dehydrogenase

c aldolase and creatinine kinase

An *inhibitor of plasmin* activity is: a tPa b PAI-1 c alpha-2 antiplasmin d plasminogen

c alpha-2 *antiplasmin*

An inhibitor of plasmin activity is: a tPA b PAI-1 c alpha-2 antiplasmin d plasminogen

c alpha-2 antiplasmin

Which of the following about analytical errors is true? a analytical laboratory errors are easy for ordering providers to detect b analytical errors almost never happen in a CLIA accredited laboratory c analytical errors are not obvious to providers d analytical errors can be caused by poor patient preparation

c analytical errors are not obvious to providers

Which of the following statements about analytical errors is true? a analytical laboratory errors are easy for order providers to detect b analytical errors almost never happen in a CLIA accredited laboratory c analytical errors are not obvious to providers d analytical errors can be caused by poor patient preparation

c analytical errors are not obvious to providers

Which serological marker of HBV (hepaitis B virus) infection indicates recovery and immunity? a viral DNA polymerase b HBe antigen c anti-HBs d HBsAg

c anti-HBs

In a *positive* anti-streptolysin "O" enzyme inhibition test, the patient's: a streptolysin "O" enzyme in the patient serum neutralizes the anti-streptolysin "O" reagent, resulting in no hemolysis b red blood cells are hemolyzed by the streptolysin "O" enzyme in the reagent c anti-streptolysin "O" neutralizes the streptolysin "O" reagent, resulting in hemolysis d anti-streptolysin "O" inhibits the reagent streptolysin "O"'s, resulting in no hemolysis

c anti-streptolysin "O" neutralizes the streptolysin "O" reagent, resulting in hemolysis

Membrane-bound immunoglobulin molecules: a have an additional amino-terminal sequence of about 40 residues b are not anchored in a transmembrane configuration c are anchored by a hydrophobic sequence of about 26 residues d are anchored by a hydrophilic region

c are anchored by a hydrophobic sequence of about 26 regions

Immunodeficiency with thrombocytopenia and eczema is often referred to as: a DiGeorge syndrome b Bruton agammaglobulinemia c ataxia telangiectasia d Wiskott-Aldrich syndrome

c ataxia telangiectasia

Rheumatoid factors are defined as: a antigens found in the sera of patients with rheumatoid arthritis b identical to the rheumatoid arthritis precipitin c autoantibodies with specificity for the Fc portion of the immunoglobulin (IgG) molecule d capable of forming circulating complexes only when IgM-type autoantibody is present

c autoantibodies with specificity for the Fc portion of the immunoglobulin (IgG) molecule

The strength of a visible reaction is known as: a prozone reaction b absorption c avidity d elution

c avidity

Tumor-associated transplantation antigens (TAAs) are not found in: a fetal cells b tumor cells c bacterial cells d viral cells

c bacterial cells

A quality control procedure on a new batch of Mueller-Hinton agar plates using a Staphylococcus aureus ATCC strain and incubation in ambient air resulted in all the disk zone sizes measuring too small. The most likely reason for this is that the: a Mueller-Hinton plates were poured too thin b potency of the antibiotic disks is too high c bacterial suspension was not diluted to the proper concentration d incubation should have been in a 5-10% CO2 atmosphere

c bacterial suspension was not diluted to the proper concentration

The characteristic morphologic feature in lead poisoning is: a macrocytosis b target cells (codocytes) c basophilic stippling d rouleaux formation

c basophilic stippling

Incident reports for occupational injury or illness should: a include information on the employee's past medical history b be filed only for incidents involving serious injury or illness c be filed for all incidents including near miss incidents d not be retained after review by a safety committee or officer

c be filed for all incidents including near miss incidents

In addition to carcinoma of the prostate, elevated prostate-specific antigen (PSA) can occur due to: a aspirin therapy b exogenous steroid use c benign prostatic hyperplasia d statin therapy (cholesterol lowering drug)

c benign prostatic hyperplasia

Acidosis and alkalosis are best defined as fluctuations in blood pH and Co2 content due to changes in: a Bohr effect b O2 content c bicarbonate buffer d carbonic anhydrase

c bicarbonate buffer

Validation of calculated test results performed by a laboratory information system must be performed: a every 6 months b annually c biennially d only upon initial LIS instillation

c biennially

Methylation of cytosine residues is involved in the *alteration of gene expression* in a number of cancers. Which sequencing is best suited to determine if methylation of cytosine residues has taken place in the *promoter region* of a given gene? a Maxam/Gilbert chemical cleavage b Sanger dideoxyterminator c bisulfate sequencing d pyrosequencing

c bisulfate sequencing

The acute phase reactant that has the fastest response time and can rise 100x is? a alpha-1 antitrypsin b haptoglobin c c-reactive protein d ceruloplasmin

c c-reactive protein

Synovial fluid from a 68-year-old male reveals rhombic crystals with *weak positive birefringence* when viewed using polarized microscopy. These crystals can be identified as: a cholesterol b monosodium urate c calcium pyrophosphate dihydrate d hydroxyapatite

c calcium pyrophosphate dihydrate

Antibodies composed of IgG immunoglobulin: a occur during the primary response to antigen b are larger than IgM antibodies c can cross the placenta from mother to fetus d can be detected in saline crossmatches

c can cross the placenta from mother to fetus

Flocculation tests for syphilis use antigen composed of: a Treponema pallidum b reagin c cardiolipin and lecithin d charcoal

c cardiolipin and lecithin

The enterotoxin produced by certain strains of hemolytic, *coagulase positive Staphylococcus aureus*: a is the primary cause of subacute endocarditis b creates a biofilm on indwelling catheters c causes a rapidly occurring (2-6 hours after ingestion) food poisoning d is of extremely low virulence

c causes a rapidly occurring (2-6 hours after ingestion) food poisoning

Media used to support to support growth of *Legionella pneumophilia* should contain which of the following additives? a X and V factors b hemin and Vitamin K c charcoal and yeast extract d dextrose and laked blood

c charcoal and yeast extract

What type of identification system does this symbol represent? a transmission-based precautions b physical environmental hazards c chemical hazardous materials d radiation hazards

c chemical hazardous materials

Hairy cell leukemia is a(an): a acute myelocytic leukemia b chronic leukemia of myelocytic origin c chronic leukemia of lymphocytic origin d acute leukemia of monocytic origin

c chronic leukemia of lymphocytic origin (hairy cells are hairy lymphocytes)

The 20 nm spheres and filamentous structures of HBV are: a infectious b circulating aggregates of HBcAg c circulating aggregates of HBsAg d highly infectious when present in great abundance

c circulating aggregates of HBsAg

Which of the following sample collections would give an accurate assessment of potential exces cortisol production (hypercortisolism)? a collect a plasma sample as a baselin, and another 1-hour after administration of metyrapone b collect a plasma sample at 8 am only c collect a 24-hour urine free cortisol d collect a plasma sample at 8 am and at 8 am the next day

c collect a 24-hour urine free cortisol

Given this hematologic data: WBC: 5.0 X 10^3/ul lymphs: 15% Cd4: 8% Which of the following is the correct interpretation? a CD4% and absolute CD4 count are normal b consistent with an intact immune system c consistent with a viral infection such as HIV d technical error

c consistent with a viral infection such as HIV

A technician is asked to clean out the chemical reagent storeroom and discard any reagents not used in the past 5 years. How should the technician proceed? a discard chemicals into biohazard containers where they will b autoclaved b pour reagents down the drain, followed by flushing of water c consult SDS sheets for proper disposal d pack all chemicals for incineration

c consult SDS sheets for proper disposal

eGFR calculated by the MDRD-IDMS traceable study equation takes into account the patient's age, race, gender and serum concentration of which of the following: a urea b ammonia c creatinine d cystatin C

c creatinine

An antibiotic used to suppress or kill contaminating fungi in media is: a amphotericin B penicillin b chloramphenicol c cycloheximide d streptomycin

c cycloheximide

Which nucleotide has a high frequency of mutation in human chromosomal DNA? a adenine b thymine c cytosine d guanine

c cytosine

Tissue injury in systemic rheumatoid disorders such as systemic lupus erythematosus is thought to be caused by: a cytotoxic T cells b IgE activity c deposition of immune complexes d cytolytic antibodies

c deposition of immune complexes

One of the elements of a written laboratory chemical hygiene plan is to: a require employees who handle chemicals to have annual medical evaluations b prohibit use of carcinogens c designate a laboratory chemical hygiene officer d perform chemical monitoring every 6 months for OSHA regulated substances

c designate a laboratory chemical hygiene officer

A suspected anthrax lesion was submitted to the lab for preparation and testing. The test of choice to interrogate this sample is: a capture immunoassay b indirect immunoassay c direct immunoassay d sandwich immunoassay

c direct immunoassay

A 25-year-old man became nauseated and vomited 90 minutes after receiving a standard 75 mg carbohydrate dose for an oral glucose tolerance test. The best course of action is to: a give the patient a glass of orange juice and continue the test b start the test over immediately with a 50 g carbohydrate dose c draw blood for glucose and discontinue test d place the patient in a recumbent position, reassure him and continue the test

c draw blood for glucose and discontinue test

The following blood gas results were obtained: - pH: 7.18 - pO2: 86 mm Hg - pCO2: 60 mm Hg - O2 saturation: 92% - HCO3: 21 mmol/L - TCO2: 23 mmol/L - base excess: -8.0 mmol/L The patient's results are compatible with which of the following? a fever b uremia c emphysema d dehydration

c emphysema

A common use for pulsed-field gel electrophoresis is: a DNA fingerprinting b mitochondrial DNA typing c epidemiological typing of bacterial strains d tumor cell phenotyping

c epidemiological typing of bacterial strains

What is the most common cause of inherited thrombophilia? a antiphospholipid syndrome b prothrombin G20210A mutation c factor V Leiden d hyperhomocysteinemia

c factor V Leiden

When a patient is placed on warfarin therapy, the first factor that will be decreased is: a factor II b factor V c factor VII d factor VIII

c factor VII

When separating serum proteins by cellulose acetate electrophoresis, using Veronal buffer at pH 8.6, beta globulin migrates: a faster than albumin b slower than gamma globulin c faster than gamma globulin d faster than alpha-2 globulin

c faster than gamma globulin

Which of the [above] figures demonstrates a reaction pattern showing 2 different antigenic molecular species? a figure which has dome in between top and bottom areas [figure 1] b figure which has one line under each one species crossing near the top [figure 2] c figure which has two lines under one species [figure 3] d figure which has center of media circled [figure 4]

c figure which has two lines under one species [figure 3]

Isosthenuria is associated with a specific gravity which is usually: a variable between 1.001 and 1.008 b variable between 1.015 and 1.022 c fixed around 1.010 d fixed around 1.020

c fixed around 1.010

A confirmatory test for paroxysmal nocturnal hemoglobinuria is: a heat instability test b sucrose hemolysis c flow cytometric immunophenotyping d dithionite solubility

c flow cytometric immunophenotyping

To detect barbituate abuse when analyzing urine specimens, immunoassay is the method of choice for screening. The method of choice for confirmation is: a nephelometry b thin-layer chromatography c gas chromatography/mass spectometry d ultraviolet absorption spectroscopy

c gas chromatography/mass spectometry

The following urinalysis results were obtained from an 18-year-old woman in labor. - pH; 6.5 - protein: 30 mg/dL - glucose: 250 mg/dL - ketones: negative - bilirubin: small (color slightly abnormal) - blood: negative - nitrite: negative - urobilinogen: 0.1 EU/dL - specific gravity: 1.025 - copper reduction test: 1.0 g/dL Which of the following is the MOST likely explanation for the patient's copper reduction test? a only glucose is present b only lactose is present c glucose and possibly other reducing substances/sugars are present d results are false-positive due to the presence of protein

c glucose and possibly other reducing substances/sugars are present

A beta-hemolytic Streptococcus that is bacitracin-resistant and CAMP-positive is: a group A or B b group A c group B d group D

c group B

Which of the following is MOST likely to activate the alternative pathway of complement activation? a lipopolysaccharides b glycoproteins c haptens d IgG complexed with antigen

c haptens

An ammonia-like odor is characteristically associated with urine from patients who: a are diabetic b have hepatitis c have an infection with Proteus spp d have a yeast infection

c have an infection with *Proteus spp*

A 40-year-old Caucasian male was admitted to the hospital for treatment of anemia, lassitude, weight loss, and loss of libido. The patient presented with which of the following laboratory data: - WBC: 5.8 x 10^3/uL - RBC: 3.7 x 10^6/uL - Hgb: 10.0 g/dL - Hct: 32% - MCV: 86 um^3 - MCH: 26 pg - MCHC: 32% - serum iron: 220 ug/dL - TIBC: 300 ug/dL - serum ferritin: 2,800 ng/mL Examination of the bone marrow revealed erythroid hyperplasia with a shift to the left of erythroid precursors. Prussian blue staining revealed markedly elevated iron stores noted with occassional sideroblasts seen. This data is most consistent with which of the following conditions? a iron deficiency anemia b anemia of chronic disease c hemachromatosis d acute blood loss

c hemachromatosis

The porphyrin test was devised to detect strains of Haemophilus capable of: a amphicillin degradation b capsule production c hemin synthesis d chloramphenicol resistance

c heme synthesis

A 37-year-old male presented to his health care provider with recent onset of fatigue, fever, myalgias, nausea, vomiting and diarrhea, complaining that he felt like he was suffering from unremitting flu. Visible on his right forearm was a tattoo that he stated he had since age 17. In the last two days, he had noted onset of right upper quadrant abdominal pain and dark-colored urine. His diagnosis is most likely: a hepatitis B b hepatits D c hepatitis C d hepatitis A

c hepatitis C

Failure of the nephron to produce ammonia will result in urine with a: a low specific gravity b positive nitrite c high pH d positive protein

c high pH

A substrate is first exposed to a patient's serum, then after *washing*, anti-human immunoglobulin labeled with a flurochrome is added. The procedure described is: a fluorescent quenching b direct fluorescence c indirect fluorescence d fluorescence inhibition

c indirect fluorescence

When a natural killer cell comes in contact with a cell expressing MHC class I proteins what action will result? a perforins released b granzymes released c inhibition of killing d cytotoxic mechanisms

c inhibition of killing

Test methodology for monitoring parathyroid glandular function in diagnosis of hypo- or hyperparathyroidism should be focused on assessing: a intact PTHrP molecule b the C-terminal PTH c intact PTH amino acids 1-84 d N-terminal PTH amino acids 1-7

c intact PTH amino acids 1084

A marked decreased in the CD4 lymphocytes and decrease in the CD4/CD8 ratio: a is diagnostic for bacterial septicemia b may be seen in MOST hereditary immmunodeficiency disorders c is associated with a viral induced immunodeficiency d is only seen in patients with advanced disseminated cancer

c is associated with a *viral* induced immunofediciency

Hepatitis C differs from hepatitis A because it: a has a highly stable incubation period b is associated with a high incidence of icteric hepatitis c is associated with a high incidence of the chronic carrier state d is seldom implicated in cases of posttransfusion hepatitis

c is associated with a high incidence of the *chronic carrier state*

The C3b ccomponent of complement: a is undetectable in pathological sera b is a component of the C3 cleaving enzyme of the classical pathway c is cleaved by C3 inactivator into C3c and C3d d is not part of the alternative pathway

c is cleaved by C3 inactivator into C3c and C3d

The absence of intermediate maturing cells between the blast and mature neutrophil commonly seen in acute myelocytic leukemia and myelodysplastic syndromes is called: a subleukemia b aleukemic leukemia c leukemia hiatus d leukemoid reaction

c leukemia hiatus

A term that means varying degrees of leukocytosis with a *shift to the left* and occasional nucleated red cells in the peripheral blood is: a polycythemia vera b erythroleukemia c leukoerythroblastosis d megaloblastoid

c leukoerythroblastosis

A carbonate salt used to control manic-depressive disorders is: a digoxin b acetaminophen c lithium d phenytoin

c lithium

The best way to lower the light intensity of the microscope is to: a lower the condenser b adjust the aperture diaphragm c lower the rheostat d raise the condenser

c lower the rheostat

Cells that produce antibodies and lymphokines are: a erythrocytes b granulocytes c lymphocytes d thrombocytes

c lymphocytes

The creatinine clearance is reported in: a mg/dL b mg/24 hours c mL/min d mL/24 hours

c mL/min

DNA-based testing for the presence of MRSA uses PCR with primers specific for which gene? a vanA b inhA c mecA d rpoB

c mecA

A brown-black urine would most likely contain: a bile pigment b porphyrins c melanin d blood cells

c melanin

Acid urine that contains hemoglobin will darken on standing due to the formation of: a myoglobin b sulfhemoglobin c methemoglobin d red blood cells

c methemoglobin

Which is considered an epigenetic modification of DNA? a transversion of an A nucleotide to a T in an exon of a gene b transition of an A to a G in an intron of a gene c methylation of CpG islands in the promoter region of a gene d insertion of a nucleotide into the coding region of a gene

c methylation of CpG islands in the promoter region of a gene

Occasional spontaneous bleeding may occur in a hemophiliac who is classified as: a severe b mild c moderate d all of the above

c moderate

Hepatitis B vaccine is: a administered as a single 1-time injection b required for all healthcare employees c must be provided by the employer free of charge d recommended only when an exposure incident occurs

c must be provided by the employer free of charge

HLA-B8 antigen has been associated with which of the following pairs of diseases? a ankylosing spondylitis and myasthenia gravis b celiac disease and ankylosing spondylitis c myasthenia gravis and celiac disease d Reiter disease and multiple sclerosis

c myasthenia gravis and celiac disease

The presence of increased CKMB activity on a CK electrophoresis pattern is most likely found in a patient suffering from: a acute muscular stress following strenuous exercise b malignant liver disease c myocardial infarcation d severe head injury

c myocardial infarction

Red urine may be due to: a bilirubin b excess urobilin c myoglobin d homogenistic acid

c myoglobin

Nonspecific killing of tumor cells is carried out by: a cytotoxic T cells b helper T cells c natural killer cells d antibody and complement

c natural killer cells

Which of the following is used for staining reticulocytes? a Giemsa stain b Wright stain c new methylene blue d Prussian blue

c new methylene blue

[Refer to the following illustration]: This illustration represents the change in absorbance at 340 nm over a period of 8 minutes in an assay for lactate dehydrogenase. True statements about this figure include: a the reaction follows zero order kinetics b the reaction is proceeding from lactate to pyruvate c nonlinearity after 6 minutes is due to substrate exhaustion d the change in absorbance is due to reduction of NAD to NADH

c nonlinearity after 6 minutes is due to substrate exhaustion

Which of the following is characteristic of cellular changes as megakaryoblasts mature into megakaryocytes within the bone marrow? a progressive decrease in overall cell size b increasing basophilia of cytoplasm c nuclear division without cytoplasmic division d fusion of the nuclear lobes

c nuclear division without cytoplasmic division

Quantitation of Na+ and K+ by ion-selective electrode is the standard method because: a dilution is required for flame photometry b there is no lipoprotein interference c of advances in electrochemistry d of the absence of an internal standard

c of advances in electrochemistry

Blood received in the laboratory for blood gas analysis must meet which of the following requirements? a on ice, thin fibrin strands only, no air bubbles b on ice, no clots, fewer than 4 air bubbles c on ice, no clots, no air bubbles d room temperature, no clots, no air bubbles

c on ice, no clots, no air bubbles

Alpha granules are found on the platelet in the: a peripheral zone b sol gel zone c organelle zone d membranes

c organelle zone

The nucleated cell in this image may be seen in the peripheral blood of a normal newborn and is classified as a(an): a basophilic normoblast b polychromatophilic normoblast c orthochromatic normoblast d megaloblastic normoblast

c orthochromatic normoblast

Select the test which evaluates renal tubular function. a IVP b creatinine clearance c osmolarity d microscopic urinalysis

c osmolarity

What are the most appropriate screening tests to presumptively differentiate and identify the *nonfermentative* Gram-negative bacilli from the Enterobacteriaceae? a catalase, decarboxylation of arginine, growth on blood agar b motility, urease, morphology on blood agar c oxidase, nitrate reduction, growth on MacConkey agar d oxidase, indole, and growth on blood agar

c oxidase, nitrate reduction, growth on MacConkey agar

Which blood gas electrode is composed of a semi-permeable membrane, a silver/silver chloride reference electrode and glass electrode? a pO2 b % O2 Sat c pCO2 d HOC3

c pCO2

Which of the following would be affected by allowing a urine specimen to remain at room temperature for 3 hours before analysis? a occult blood b specific gravity c pH d protein

c pH

An electrode has a silver/silver chloride anode and a platinum wire cathode. It is suspended in KCl solution and separated from the blood to be analyzed by a selectively permeable membrane. Such an electrode is used to measure which of the following? a pH b pCO2 c pO2 d HCO3

c pO2

T lymphocytes are INcapable of functioning as: a cytotoxic cells b helper cells c phagocytic cells d regulatory cells

c phagocytic cells

Valinomycin enhances the selectivity of the electrode used to quantitate: a sodium b chloride c potassium d calcium

c potassium

The component associated only with the alternative pathway of complement activation is: a C4 b C1q c properdin factor B d C3a

c properdin factor B

What are patients with homozygous protein C deficiency particularly at an increased risk of developing? a posttransfusion purpura b warfarin skin necrosis c purpura fulminans d thrombocytophilia

c purpura fulminans

The disappearance of HBsAg and HBeAg, the persistence of anti-HBc, the appearance of anti-HBs, and often of anti-HBe indicate: a early acute HBV hepatitis b early convalescent phase HBV hepatitis c recovery phase of acute HBV hepatitis d carrier state of acute HBV hepatitis

c recovery phase of acute HBV hepatitis

Decreased CSF protein can be found in: a meningitis b hemorrahge c multiple sclerosis d CSF leakage

d CSF leakage

Unequivocal positive identification of each specimen can be achieved with analyzers that utilize bar code readers. One advantage of using bar code labels is: a elimination of manual specimen labeling b reduction of the number of lost specimens c reduction in specimen identification errors d reduction of specimen aliquoting errors

c reduction in specimen identification errors

Upon completion of a run of cholesterol tests, the technician recognizes that the controls are not within the 2 standard deviation confidence range. What is the appropriate course of action? a report the results without any other action b run a new set of controls c run a new set of controls and repeat specimens d recalibrate the instrument and run controls

c rune a new set of controls and repeat specimens

In flow cytometry, labeled cells: a scatter the light and absorb fluorescence b absorb fluorescence and emit electronic impulses c scatter the light and emit fluorescence d absorb both fluorescence and light

c scatter the light and emit fluorescence

A 65-year-old male with metastatic pancreatic carcinoma shows elevated PT and aPTT, platelet count 15 x 10^3/uL (15 x 10^9/L) and elevated D-dimer. On a blood smear you would see: a Howell-Jolly bodies b macro-ovalocytes c schistocytes d target cells

c schistocytes

In an anti-nuclear antibody indirect immunofluorescent test, a sample of patient serum shows a positive, speckled pattern. Which would be the most appropriate additional test to perform? a anti-mitochondrial antibody b immunoglobulin quantitation c screen for Sm and RNP antibodies d anti-DNA antibody using Crithidia luciliae

c screen for Sm and RNP antibodies

The primary advantage of the labeled immunoassays compared to unlabeled immunoassays is: a rapidity b quality c sensitivity d cost

c sensitivity

Safe handling and disposal of laboratory generated infectious waste require: a disinfection of all waste b thorough mixing of infectious and noninfectious waste c separation of infectious and noninfectious waste d incineration of all waste

c separation of infectious and noninfectious waste

A paired fasting plasma specimen was collected at the same time an arthrocentesis was performed. The difference in glucose concentrations between the 2 fluids was reported as 55 mg/dL. This result indicates a(an): a noninflammatory condition b inflammatory condition c septic condition d hemorrhagic condition

c septic condition

A Gram stain of a peritoneal fluid showed a large Gram-positive bacilli. There was a 3+ growth on anaerobic media only, with colonies producing a double zone of hemolysis. To assist with the classical identification of the organism, the microbiologist could: a determine if the organism ferments glucose b perform the oxidase test c set up egg yolk agar plate d test for bile tolerance

c set up egg yolk agar plate

To prepare a solution appropriate for quality control of the refractometer, the laboratorian should use: a urea with a specific gravity of 1.040 b water with a specific gravity of 1.005 c sodium chloride with a specific gravity of 1.022 d calcium chloride with an osmolarity of 460

c sodium chloride with a specific gravity of 1.022

The confirmatory test for a positive protein result by the reagent strip method uses: a Ehrlich reagent b a diazo reaction c sulfosalicylic acid d a copper reduction tablet

c solufosalicylic acid

MacConkey media for screening suspected cases of hemorrhagic E. coli O157:H7 must contain: a indole b citrate c sorbitol d lactose

c sorbitol

The following bilirubin results are obtained on a patient: day 1: 4.3 mg/dL (73.5 pmol/L) day 2: 4.6 mg/dL (78.7 pmol/L) day 3: 4.5 mg/dL (77.0 pmol/L) day 4: 2.2 mg/dL (37.6 pmol/L) day 5: 4.4 mg/dL (75.2 pmol/L) day 6: 4.5 mg/dL (77.0 pmol/L) Given that the controls were within range each day, what is a probable explanation for the result on day 4? a no explanation necessary b serum, not plasma, was used for testing c specimen had prolonged exposure to light d specimen was hemolyzed

c specimen had prolonged exposure to light

Which of the following is the best guide to consistent centrifugation? a potentiometer setting b armature settings c tachometer readings d rheostat readings

c tachometer readings

Which of the following is a true true statement about Bruton agammaglobulinemia? a it is only found in females b there are normal numbers of circulating B cells c there are decreased to absent concentrations of immunoglobulins d the disease presents with pyogenic infections 1 week after birth

c there are decreased to absent concentrations of immunoglobulins

In general, anaerobic infections differ from aerobic infection in which one of the following? a they usually respond favorably to aminoglycoside therapy b they usually arise from exogenous sources c they are usually polymicrobic d Gram stains of specimens are less helpful in diagnosis

c they are usually polymicrobic

A false elevation in a manual hematocrit (microhematocrit) determination may result from: a prolonged centrifugation b in vitro hemolysis c trapped plasma d incomplete sealing of the hematocrit tube

c trapped plasma

The majority of thyroxine (T4) is converted into the more biologically active hormone: a thyroglobulin b thyroid-stimulating hormone (TSH) c triiodothyronine (T3) d thyrotropin-releasing hormone

c triiodothyronine (T3)

Which of the following crystals is seen in an *amber urine* with a *positive bilirubin*? a ammonium biurate b cystine c tyrosine d uric acid

c tyrosine (liver)

A blood creatinine value of 5.0 mg/dL is most likely to be found with which of the following blood values? a osmolality: 292 mOsm/kg b uric acid: 8 mg/dL c urea nitrogen: 80 mg/dL d ammonia: 80 ug/dL

c urea nitrogen: 80 mg/dL

Which of the following best represents the 3 steps of normal hemostasis (in order)? a decreased heart rate, adhesion of platelets, plug formation b platelet aggregation, formation of FXIII, fibrin plug c vasoconstriction, platelet aggregation, fibrin formation d vascular damage, stasis, endothelial injury

c vasoconstriction, platelet aggregation, fibrin formation

Testing for the diagnosis of lead poisoning should include: a erythrocyte protoporphyrin (EPP) b urine delta-aminolevulininc acid c whole blood lead d zinc protoporphyrin

c whole blood lead

Which nonculture method is best for the diagnosis of Neisseria gonorrhoeae in an adult female? a clinical history b Gram stain of cervical secretions c MALDI-TOF MS d NAAT

d NAAT

The laboratory is considering adoption of a rapid and sensitive "stand alone" method that detects Clostridium difficle toxins A and B. Which one of the following methodologies will provide this? a cell culture cytotoxin assay b latex agglutination c lecithinase production d NAAT

d NAAT

Which of the following is the primary reagent in the copper reduction tablet? a sodium carbonate b copper sulfate c glucose oxidase d polymerized diazonium salt

copper sulfate

The reason that an albumin:creatinine ratio can be performed on a random specimen is:

creatinine corrects for over or under body hydration

Which of the following is the formula for calculating the mean corpuscular hemoglobin (MCH)? a Hct/(RBC x 100) b Hgb/Hct c RBC/Hct d (Hgb x 10)/RBC

d (Hgb x 10)/RBC

Which one of the following sets of results is consistent with primary hypothyroidism, (eg, Hadhimoto thyroiditis): a -- decreased TSH and T4; positive antimicrosomal antibody b -- increased TSH and T4; positive antimicrosomal antibody c -- normal TSH; increased T4; negative antimicrosomal antibody d -- increased TSH; decreased T4; positive antimicrosomal antibody

d -- increased TSH; decreased T4; positive antimicrosomal antibody

Which of the following 2-hour postprandial glucose values demonstrates unequivocal hyperglycemia diagnostic for diabetes mellitus? a 160 mg/dL (8.8 mmol/L) b 170 mg/dL (9.4 mmol/L) c 180 mg/dL (9.9 mmol/L) d 200 mg/dL (11.0 mmol/L)

d 200 mg/dL (11.0 mmol/L)

Organisms that can be easily identified to the species level from the ova in fecal specimens include: a Metagonimus yokogawai, Heterophyes heterophyes b Taenia solium, Taenia saginata c Necator americanus, Ancylostoma duodenale d Paragonimus westermani, Hymenolepis nana

d Paragonimus westermani, Hymenolepis nana

A specimen from a foot ulcer of a 52-year-old male diabetic patient was sent to the Microscopy laboratory for culture. The following results were obtained from a clear colony growing on the MacConkey. - oxidase: positive - catalase: positive - OF tubes: oxidation positive - pigment production: blue/green - growth at 42C: positive The results indicate which of the following organisms has been isolated from the culture? a Acinetobacter baumannii b Serratia marcescens c Stenotrophomonas maltophilia d Pseudomonas aeruginosa

d Pseudomonas aeruginosa

An organism isolated from the surface of a skin burn is found to produce a diffusible green pigment on a blood agar plate. Further studies of the organism would most likely show the organism to be: a Staphylococcus aureus b Serratia marcescens c Flavobacterium meningosepticum d Pseudomonas aeruginosa

d Pseudomonas aeruginosa

Which one of the following genera is among the least biochemically reactive members of the Enterobacteriaceae? a Proteus b Pseudomonas c Citrobacter d Shigella

d Shigella

A TSI tube inoculated with an organism gave the following reactions: - alkaline slant, acid butt; no H2S, no gas produced This organism is MOST likely: a Yersinia enterocolitica b Salmonella typhi c Salmonella enteritidis d Shigella dysenteriae

d Shigella dysenteriae

A common cause of acute exudative pharyngitis is: a Staphylococcus aureus (beta-hemolytic] b Streptococcus pneumoniae c Streptococcus agalactiae d Streptococcus pyogenes

d Streptococcus pyogenes

The term "internal autoinfection" is generally used in referring to infections with: a Ascaris lumbricoides b Necator americanus c Trichuris thrichiura d Strongyloides stercoralis

d Strongyloides stercoralis

The 2 factors that differentiate liver disease from vitamin K deficiency are: a II and VII b IX and VII c VIII and IX d V and VII

d V and VII

A college student attended a beach party where *raw oysters and other shellfish* were consumed. The next day, he had symptoms of septicemia. The blood cultures grew Gram-negative bacilli with the following characteristics: - oxidase positive - MacConkey agar: pink colonies - O/129 (150 ug): susceptible The MOST likely organism is: a Aeromonas hydrophilia b Pseudomonas putida c Serratia marcescens d Vibrio vulnificus

d Vibrio vulnificus

A 50-year-old patient was found to have the following lab results: - Hgb: 7.0 g/dL (70 g/L) - Hct: 20% - RBC: 2.0 x 10^6/uL It was determined that the patient was suffering from pernicious anemia. Which of the following sets of results most likely was obtained from the same patient? a WBC: 17,500 platelet: 350,000 reticulocyte: 5.2% b WBC: 7,500 platelet: 80,000 reticulocyte: 4.1% c WBC: 5,000 platelet: 425,000 reticulocyte: 2.9% d WBC: 3,500 platelet: 80,000 reticulocyte: 0.8%

d WBC: 3,500 platelet: 80,000 reticulocyte: 0.8%

An example of personal protective equipment (PPE) is: a a biological safety cabinet b an emergency safety shower c an eyewash station d a lab coat

d a lab coat

Which of the following is the most common cause of anemia in hospitalized patients? a inadequate iron intake b inadequate folate intake c hemolytic anemia d anemia of chronic disease

d anemia of chronic disease

What is the specificity of cold autoagglutinin disease? a anti-i b anti-H c anti-Pr d anti-I

d anti-I

In pernicious anemia, which of the following antibodies is characteristically detected? a anti-mitochondrial b anti-smooth muscle c anti-DNA d anti-parietal cell

d anti-parietal cell

The best method to detect infections due to rubella, Epstein-Barr and human immunodeficiency viruses is: a antigen detection by EIA b cell culture c antigen detection by Western blot d antibody detection by EIA

d antibody detection by EIA

Cessation of urine flow is defined as: a azotemia b dysuria c diuresis d anuria

d anuria (no flow)

While processing patient specimens, a technologist splashes a few small drops of a bronchial wash on his/her gloves. The first action should be to: a wash the gloves with antiseptic/soap and water b continue to wear the gloves until grossly contaminated or leaving the area c wash the gloves with an appropriate disinfectant d change the gloves and wash hands with antiseptic/soap and water

d change the gloves and wash hands with antiseptic/soap and water

A *differential medium* that can be used as a primary isolation agar producing *predictable colored colonies* that can be distinguished from other organism colony types describes: a buffered charcoal yeast extract agar b blood phenylethyl alcohol agar c campylobacter blood agar d chromagar

d chromagar

Symptoms associated with the effects of rheumatoid factor include all of the following EXCEPT: a joint inflammation b immune complex deposition c capillary endothelial space widening d complement inhibition

d complement inhibition

Which of the following mediators is released during T cell activation? a immunoglobulins b thymosin c serotonin d cytokines

d cytokines

A first morning sputum specimen is received for acid-fast culture. The specimen is centrifuged, and the sediment is inoculated on 2 Lowenstein-Jensen slants, which are incubated at 35C in 5-10% CO2. After 1 week, the slants show abundant growth over the entire surface. Stains reveal Gram-negative bacilli. To avoid this problem: a utilize a medium that inhibits bacterial growth b add sodium hypochlorite to the sediment before inoculation c incubate the tubes at room temperature to retard bacterial growth d decontaminate the specimen with sodium hydroxide

d decontaminate the specimen with sodium hydroxide

Metabolic acidosis is described as a(an): a increase in CO2 content and pCO2 with a decreased pH b decrease in CO2 content with an increased pH c increase in CO2 with an increased pH d decrease in CO2 content and pCO2 with a decreased pH

d decrease in CO2 content and pCO2 with a decreased pH

Middlebrook 7H10 and 7H11 media must be refrigerated in the dark, and incubated in the dark as well. If these conditions are not met, the media may prove toxic for mycobacteria because: a carbon dioxide will be released b growth factors will be broken down c light destroys the ammonium sulfate d formaldehyde may be produced

d formaldehyde may be produced

Pregnant women with symptoms of *thirst, frequent urination or unexplained weight loss* should have which of the following tests performed? a tolbutamid test b lactose tolerance test c epinephrine tolerance test d glucose tolerance test

d glucose tolerance test

The term that best describes males regarding X-linked genes is: a heterzygous b homozygous c haplozygous d hemizygous

d hemizygous

When employing the urine reagent test strip method, a false-positive protein result may occur in the presence of: a large amounts of glucose b x-ray contrast media c Bence Jones protein d highly alkaline urine

d highly alkaline urine

Removing the immersion oil from a microscope lense is: a best accomplished with alcohol pads b never done c only required when you are dismantling the objective d important to prevent oil seeping behind the lens over time

d important to prevent oil seeping behind the lens over time

In order for hemoglobin to combine reversibly with oxygen, the iron must be: a complexed with haptoglobin b freely circulating c attached to transferrin d in the ferrous state

d in the ferrous state

"Nutritionally variant" streptococci are: a enterococci b group D enterococci c beta hemolytic streptococci d in the genera Granulicatella and Abiotrophia

d in the genera Granulicatella and Abiotrophia

Cholesterol is added to the antigen used in flocculation tests for syphilis to: a destroy tissue impurities present in the alcoholic beef heart extract b sensitize the sheep RBCs c decrease specificity of the antigen d increase specificity of the antigen

d increase the specificity of the antigen

Cerebrospinal fluid test results that are most consistent with *viral meningitis* include: a increased protein level b increased glucose level c increased lactate level d increased mononuclear leukocyte count

d increased mononuclear leukocyte count (lymphocytes)

Graft-versus-host disease is: a initiated by the recipient b a minor concern in bone marrow transplant c asymptomatic in most cases d initiated by the donor

d initiated by the donor

A chemiluminscent EIA: a measures absorption of light b is less sensitive than radioisotopic reactions c is monitored by the use of a gamma counter d is quantitated by the amount of light produced by the reaction

d is quantitated by the amount of light produced by the reaction

The urinary tract structures responsible for renal concentration are the: a renal pelvis b cortical nephrons c renal paillae d juxtamedullary nephrons

d juxtamedullary nephrons

Which of the following is NOT a potential source of post-analytical errors? a excessive delay in reporting or retrieving a test result b interpretation of result c verbal notification of test result d labeling the specimen at the nurses' station

d labeling the specimen at the nurses' station

Which of the following would be present in the filtrate as a result of glomerular damage? a glucose b amino acids c nonprotein nitrogen compounds d large molecular weight proteins

d large molecular weight proteins

A 3-year-old child was evaluated for abdominal pain and anorexia by a physician. A CBC revealed a hemoglobin of 9.8 g/dL (98 g/L) and basophilic stippling of the RBCs. The doctor should order further tests to check for poisoning from: a arsenic b iron c mercury d lead

d lead

The most specific *enzyme test* for *acute pancreatitis* is: a acid phosphatase b trypsin c amylase d lipase

d lipase

The most specific enzyme test for acute pancreatitis is: a acid phosphatase b trypsin c amylase d lipase

d lipase

The function of N-acetyl-L-cysteine in the reagent for acid-fast digestion-decontamination procedure is to: a inhibit growth of normal respiratory flora b inhibit growth of fungi c neutralize the sodium hydroxide d liquefy the mucus

d liquefy the mucus

Pluripotent hematopoietic stem cells are capable of producing: a daughter cells of only one cell line b only T lymphocytes and B lymphocytes c erythropoietin, thrombopoietin, and leukopoietin d lymphoid and myeloid stem cells

d lymphoid and myeloid stem cells

Lithium therapy is widely used in the treatment of: a hypertension b hyperactivity c aggression d manic-depressive (bipolar) disorder

d manic-depressive (bipolar) disorder

The mode of inheritance of mitochondrial DNA is: a dominant b recessive c codominant d maternal

d maternal

An example of a live attenuated vaccine is: a rabies b tetanus c hepatitis B d measles

d measles

In normal adult bone marrow, the most common granulocyte is the: a basophil b myeloblast c eosinophil d metamyelocyte

d metamyelocyte

Which of the following procedures is recommended to confirm that an unknown mold is one of the pathogenic dimorphic fungi? a animal inoculation b conversion from yeast to mold form c demonstration of sexual and asexual reproduction d molecular testing

d molecular testing

When processing a patient specimen for Gram stain and culture, the proper use of a biological safety cabinet includes: a bringing into the cabinet all required media and equipment just prior to setting up each individual specimen b keeping the ultraviolet light on for the first 30 minutes of working in the cabinet c not using any heat generating equipment such as open flames or microburner/incinerators d not disrupting the air curtain barrier by keeping air flow and exhaust grills unobstructed

d not disrupting the air curtain barrier by keeping air flow and exhaust grills unobstructed

Anti-RNA antibodies are often present in individuals having an anti-nuclear antibody immunofluorescent pattern that is: a speckled b rim c diffuse d nucleolar

d nucleolar

Given the following results: - alkaline phosphatase: marked increase - aspartate amino transferase: slight increase - alanine amino transferase: slight increased - gamma-glutamyl transferase: marked increase This is most consistent with: a acute hepatitis b osteitis fibrosa c chronic hepatitis d obstructive jaundice

d obstructive jaundice

Cancer antigen 125 (CA 125) is a tumor marker associated with: a breast carcinoma b colon cancer c lung cancer d ovarian and endometrial carcinoma

d ovarian and endometrial carcinoma

The best method to process specimens for mycobacterial culture contaminated with *Pseudomonas* is: a N-acetyl-L-cystine and NaOH b NaOH c zephiran-trisodium phosphate d oxalic acid

d oxalic acid

Which of the following is the Henderson-Hasselbalch equation? a pKa = pH + log([acid]/[salt]) b pKa = pH + log ([salt]/[acid]) c pH = pKa + log ([acid]/[salt]) d pH = pKa + log ([salt]/[acid])

d pH = pKa + log([salt]/[acid])

The results of a urinalysis on a first morning specimen are: - SG: 1.024 - pH: 8.5 - protein: negative - glucose: negative - uric acid crystals The next step is to repeat the: a micrscopic examination b protein and glucose c specific gravity d pH and microscopic examination

d pH and microscopic examination

A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood has been exposed to room air for at least 30 minutes. The following change in blood gases will occur: a CO2 content increased/pCO2 decreased b CO2 content and pO2 increased/pH increased c CO2 content and pCO2 decreased/pH decreased d pO2 increased/HCO3 decreased

d pO2 increased/HCO3 decreased

The International Federation for Clinical Chemistry (IFCC) recommends the use of methods such as the Bessey-Lowry-Brock method for determining alkaline phosphotase activity. The substrate used in this type of method is: a monophosphotase b phenylphosphotase c disodium phenylphosphotase d para-nitrophenylphosphotase

d para-nitrophenylphosphotase

The IgM molecule is a: a dimer b trimer c tetramer d pentamer

d pentamer

Which of the following clinical disorders is associated with the greatest elevation of lactate dehydrogenase isoenzyme 1? a pneumonia b glomerularnephritis c pancreatitis d pernicious anemia

d pernicious anemia

An antiepileptic (or anticonvulsant) used to control seizure disorders is: a digoxin b acetaminophen c lithium d phenytoin

d phenytoin

A urine specimen collected on an apparently healthy 25-year-old man shortly after he finished eating lunch was cloudy but showed normal results on a multiple reagent test strip analysis. The most likely cause of the turbidity is: a fat b white blood cells c urates d phosphates

d phosphates

What chemistry joins successive nucleotides of DNA? a glycosidic bonds b ionic bond c hydrogen bond d phosphodiester bond

d phosphodiester bond

In respiratory acidosis, a compensatory mechanism is the increase in: a respiration rate b ammonia formation c blood pCO2 d plasma bicarbonate concentration

d plasma bicarbonate concentration

In which of the following disease states are teardrop cells and abnormal platelets most characteristically seen? a hemolytic anemia b multiple myeloma c G6PD deficiency d primary myelofibrosis

d primary myelofibrosis

Considerations in ELISA testing DO NOT include: a competitive versus noncompetitive b heterogeneous versus homogeneous c luminscent vs fluorescent d radioactive versus colorimetric

d radioactive versus colorimetric

When using the sulfosalicylic acid test, false-positive protein results may occur in the presence of: a ketones b alkali c glucose d radiographic contrast material

d radiographic contrast material

The enzyme control tube in an ASO hemolytic assay exhibits no cell lysis. What is the MOST likely explanation for this? a incorrect pH of buffer b low ionic strength buffer c oxidation of the enzyme d reduction of the enzyme

d reduction of the enzyme

In the normal adult, the spleen acts as a site for: a storage of red blood cells b production of red blood cells c synthesis of erythropoietin d removal of imperfect and aging cells

d removal of imperfect and aging cells

Magnesium carbonate is added in a iron binding capacity determination in order to: a allow color to develop b precipitate protein c bind with hemoglobin iron d remove excess unbound iron

d remove excess unbound iron

On initial start-up of the automated hematology analyzer, one of the controls is slightly below the range for the MCV. Which of the following is indicated? a call for service b adjust the MCV up slightly c shut down the instrument d repeat the control

d repeat the control

An arterial blood specimen submitted for blood gas analysis was obtained at 8:30 AM but was not received in the laboratory until 11AM. The technologist should: a perform the test immediately upon receipt b perform the test only if the specimen was submitted in ice water c request a venous blood specimen d request a new arterial specimen be obtained

d request a new arterial specimen be obtained

Auto-verification of test results requires all of the following to be established by the laboratory except: a patient results entered into the LIS via an instrument interface b patient results evaluated based on validated rules defined in the LIS c successful quality control testing obtained prior to releasing patient results d review of results by a qualified technologist or technician

d review of results by a qualified technologist or technician

A 17-year-old female presents to her health care provider with symptoms of sore throat, cervical lymphadenopathy, fever, fatigue, and myalgias. Which of the following should be EXCLUDED from her differential diagnosis? a group-A strep pharyngitis b infectious mononucleosis c human immunodeficiency virus d rotavirus

d rotavirus

Which of the following is the formula for arithmetic mean? a square root of the sum of values b sum of values x number of values c number of values/sum of values d sum of values/number of values

d sum of values/number of values

All species of the genus Neisseria have the enzyme to oxidize: a naphthylamine b dimethylaminobenzaldehyde c glucopyranoside d tetramethyl-phenylenediamine

d tetramethyl-phenylenediamine

(248 on page 404) Susceptibility testing is performed on a Staphylococcus aureus isolate from a blood culture with the following results: susceptible results: cefazolin, clindamycin, erythromycin, trimethoprim/sulfamethoxazole, vancomycin resistant result(s): oxacilin What should the technologist do next? a ceftriaxone should be reported instead of cefazolin b clindamycin should be tested for inducible resistance prior to reporting c the trimethoprim/sulfamethoxazole result should be removed since all S. aureus are resistant d the cefazolin results should be changed to resistant since the oxacillin result is resistant

d the cefazolin results should be changed to resistant since the oxacillin result is resistant

A paper or electronic report of lab results must include: a the name of the person who collected the specimen b the test price c a pathologist's signature d the name and address of the testing laboratory

d the name and address of the testing laboratory

What does the black ring on the lower end of a microscope objective lens indicate? a the kind of microscope to use b the magnification of the objective c nothing; it is simply decorative d the objective is used with immersion oil

d the objective is used with immersion oil

The curve [below] was obtained by adding increasing amounts of a soluble antigen to fixed volumes of monospecific antiserum. The area [on the curve] where soluble antigen-antibody complexes have begun to form is: a the far left region [a] b the far right region [b] c the "middle" region [c] d the region left of the middle [d]

d the region slightly right of the very beginning of the curve [d]

In laser flow cytometry, applying a voltage potential to sample droplets as they stream past the light beam and using charged deflector plates results in: a an emission of red fluorescence from cells labeled with fluorescein isothiocyanate b an emission of green fluorescence from cells labeled with rhodamine c a 90 degree light scatter related to cell size d the separation of cells into subpopulations based on their charge

d the separation of cells into subpopulations based on their charge

IgM antibodies are frequently hemolytic because of: a their dimeric structure b the molecule's 5 antigen-binding sites c their sedimentation coefficient of 7-15 S d their efficient ability to fix complement

d their efficient ability to fix complement

Which of the following statements most correctly describes the utility of clinical laboratory assays for tumor markers? a tumor markers are useful to screen asymptomatic patients for tumors b tumor markers are highly specific c tumor markers indicate the likelihood of an individual developing a tumor d tumor markers are useful in tracking the efficacy of treatment

d tumor markers are useful in tracking the efficacy of treatment

When using a control strain of Staphylococcus aureus, the technologist notices that the zone around the cefotoxin disk is too small. Which of the following is the msot likely explanation? a inoculation of the plates 10 minutes after preparing the inoculum b incubation of the Mueller-Hinton plates at 35C c use of a 0.25 McFarland standard to prepare inoculum d use of outdated cefotoxin disks

d use of outdated cefotoxin disks

The urinary excretion product measured as an indicator of epinephrine production is: a dopamine b dihydroxyphenylalanine (DOPA) c homovanillic acid d vanillylmandelic acid (VMA)

d vanillylmandelic acid (VMA)

A pre-analytical error can be introduced by: a drawing a coagluation tube before an EDTA tube b mixing an EDTA tube 8-10 times c transporting the specimen in a biohazard bag d vigorously shaking of blood tube to prevent clotting

d vigorously shaking of blood tube to prevent clotting

[Refer to the following illustration]: Which of the following is the most likely interpretation of the LD isoenzyme scan illustrated above? a myocardial infarction b megaloblastic anemia c acute pancreatitis d viral hepatitis

d viral hepatitis

A 25-year-old male with celiac disease presents with occult positive stools. What vitamin deficiency should you consider? a vitamin A deficiency b vitamin D deficiency c vitamin E deficiency d vitamin K deficiency

d vitamin K deficiency

A 4-year-old boy presents with chronic ear infections and is on *prophylactic antibiotics*. he also presents with a *bleeding diathesis*. Factor assays reveal: - 100% factor VIII (ref range: 50-150%) - 75% factor V (ref range: 50-150%) - 38% factor IX (ref range 50-150%) - 22% factor II (ref range 50-150%) Possible causes are: a factor II deficiency b lupus anticoagulant c hemophilia d vitamin K deficiency

d vitamin K deficiency

In liver disease patients present with decreased synthesis of: a common pathway factors b intrinsic pathway factors c fibrinogen pathway factors d vitamin K dependent factors

d vitamin K dependent factors

A Wright-stained peripheral smear reveals the following: - erythrocyte enlarged 1 1/2x to 2x normal size - Schuffner dots - parasites with *irregular "spread-out" trophozoites, golden-brown pigment* - 12-24 merozoites - *wide range of stages* This is consistent with Plasmodium: a falciparum b malariae c ovalae d vivax

d vivax

The results on a patient are as follows: - PT: 18.5 seconds (11.0-13.5 seconds) - aPTT: 47.5 seconds (24-35 seconds) - thrombin time: 14.0 seconds (12-19 seconds) - ATIII: 82% (70-130% - protein C: 54% (77-167%) - proteinn S: 48% (65-140%) - activated protein C resistance: 2.6 (>2.1) These results reflect: a thrombophilia b factor IX deficiency c heparin d warfarin

d warfarin

Glitter cells are a microscopic finding: a red blood cells in hypertonic urine b red blood cells in hypotonic urine c white blood cells in hypertonic urine d white blood cells in hypotonic urine

d white blood cells in hypotonic urine

Which of the following is most closely associated with chronic myelogenous leukemia? a. ringed sideroblasts b. disseminated intravascular coagulation c. micromegakaryocytes d. BCR/ABL fusion gene

d. BCR/ABL fusion gene

Which of the following is a myeloproliferative neoplasm? a. refractory anemia b. secondary erythrocytosis c. myelomonocytic leukemia d. essential thrombocythemia

d. essential thrombocythemia

Chylomicrons are present in which of the following dyslipidemias?

deficiency in lipoprotein lipase activity

The following pattern of agglutination was observed in an antibody titration. 1: 1+ 2: 2+ 3: 4+ 4: 4+ 5: 3+ 6: 3+ 7: 2+ 8: 21 9: 1+ 10: 0 11: 0

prozoning

In an automated hematology analyzer, the WBC printed result is +++. The next step is to:

make an appropriate dilution of the sample

A flag of immature granulocytes (IG) is reported from a hematology analyzer. The next step is to perform a(an): a autoverification b smear review c manual differential d pathology review

manual differential

The phenomenon of an Rh-positive person whose serum contains anti-D is best explained by:

missing antigen epitopes

When processing a patient specimen for Gram stain and culture, the proper use of a biological safety cabinet includes:

not disrupting the air curtain barrier by keeping air flow and exhaust grills unobstructed

A stool specimen that appears black and tarlike should be tested for the presence of:

occult blood

A low concentration of serum phosphorus is commonly found in:

patients who are receiving carbohydrate hyperalimentation

WBC: 19.0 x 10^3/uL RBC: 7.2 x 10^6/uL Plt: 1,056 x 10^3/uL uric acid: 13.0 mg/dL O2 saturation: 93% red cell volume: 3,911 mL (normal = 1,600) segmented neutrophils: 84% (significantly high) bands: 10% lymphocytes: 3% (extremely/significantly low) monocytes: 2% eosinophils: 1%

polycythemia vera

A patient with hemolytic anemia will:

show a decrease in glycated Hgb value

Avidity may be defined as the:

strength of a reacting antibody

The following cold agglutinin titer results are observed: he dilutions at 4 degrees Celsius are positive until the 1:256 dilution

the best interpretation is: positive, 1:128