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Question # 4

Serological diagnosis of active or recent infection generally requires the demonstration of IgM antibody, or the demonstration of a fourfold rise in the titer of specific IgG antibody.

Which of the following would be considered most significant as it relates to serological testing:

A.

Presence of an antibody titer is generally diagnostic

B.

Rise of antibody titers is diagnostic

C.

Concentration of antibody is diagnostic

D.

Cross reactivity is not significant

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Question # 5

A zone of inhibition is the area around an antibiotic-infused paper disk that does not show any bacterial growth. The antibiotic impregnated on the disk will diffuse into the agar in the area surrounding the disk. If the bacteria are sensitive to the antibiotic, they cannot grow near the disk. The size of the zone is proportional to how sensitive the organism is. If the organism is resistant to the antibiotic, it will grow very closely to the disk.

The size of the zone of suppressed growth on a sensitivity plate using sensitivity disks is referred to as the zone of:

A.

beta hemolysis

B.

alpha hemolysis

C.

gamma hemolysis

D.

inhibition

E.

susceptibility

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Question # 6

Glycoprotein IIb/IIIa is integral in the process of platelet aggregation as well as clot retraction.

A defective clot retraction might be caused by which one of these?

A.

Lack of or defect of platelet receptor glycoprotein Ib

B.

Lack of or defect of platelet receptor Ilb/IIIa

C.

Insufficient storage of ADP in platelet granules

D.

Absence or defect of von Willebrand's factor

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Question # 7

This scenario's answer can be calculated by first deciding what the total quality control labor costs are as well as what the total consumable costs are. In this case, if quality control is run 3 times per day, a total of 1095 quality control runs are performed each year. The direct labor cost of $2.63 multiplied by 1095 quality control runs equals $2879.85 per year in quality control direct labor. The hospital pays $354.00 per month on quality control consumables, which equals $4248.00 per year. The total quality control costs in a year are equal to $2879.85 + $4248.00 = $7127.85. If 76,000 new chemistry tests panels are peformed each year, the total quality control cost per new chemistry test panel will be $0.09.

General Hospital is considering the addition of a new chemistry panel containing 12 tests. The laboratory is asked to calculate the total cost of quality control per new chemistry test panel. Quality control must be performed 3 times per day (every 8 hours). The labor cost per quality control test for this panel is $2.63. A month's worth of quality control reagent costs $354.00. What is the total quality control cost per new chemistry test panel if 76,000 of these new panels are performed each year?

A.

$0.01

B.

$0.09

C.

$0.04

D.

$1.70

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Question # 8

A casual blood glucose >/= 200 mg/dL on a patient with symptoms and an A1C >/= 6.5% meet diagnostic criteria for diabetes.

Chemistry

A physician is evaluating a 45-year-old obese male for diabetes and orders a plasma glucose at time of evaluation and a HbA1C one week later. The patient has a family history of diabetes and currently exhibits symptoms of diabetes.

What would be the best course of action if these are the blood glucose results?

Casual Blood Glucose: 208 mg/dL

HbA1C one week later: 7.2%

A.

Order insulin levels; if decreased, diagnose diabetes

B.

Patient meets criteria for diagnosis of diabetes

C.

Order a C-peptide for diagnosis

D.

The patient is at risk for diabetes (pre-diabetic); monitor for diabetes with yearly FPG levels

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Question # 9

In combined fiscal years 2005 through 2009, transfusion-related acute lung injury (TRALI) caused the higest number of reported fatalities (48%), followed by hemolytic transfusion reactions (26%) due to non-ABO (16%) and ABO (10%) incompatibilities. Complications of microbial infection, transfusion-associated circulatory overload (TACO), and anaphylactic reactions each accounted for a smaller number of reported fatalities.

A.

Anaphylactic reactions

B.

Febrile non-hemolytic reactions

C.

Transfusion-related acute lung injury (TRALI)

D.

Transfusion-associated graft versus host disea

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Question # 10

The part of the microscope that holds the objective lenses is called the _______________.

A.

objective

B.

condenser

C.

revolving nosepiece

D.

fine adjustment

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Question # 11

The red blood cell distribution width (RDW) increases as the severity of alpha thalassemia increases because of changing MCV as the bone marrow produces smaller cells. In addition, if Hemoglobin H bodies are present, they result in the formation of schiztocytes (RBC fragments) that can have an effect on the MCV and RDW.

The Red cell Distribution Width (RDW) in alpha thalassemia is

A.

within normal limits

B.

usually increased

C.

usually decreased

D.

dependent upon severity

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Question # 12

A blood culture to evaluate septicemia is performed in:

A.

microbiology.

B.

hematology.

C.

urinalysis.

D.

toxicology.

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Question # 13

The approximate volume of CSF in an adult is 90-150 mL.

What is the approximate volume of spinal fluid in an adult?

A.

10-40 mL

B.

50-70 mL

C.

90-150 mL

D.

200-500 mL

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Question # 14

Dce is found in 4% of whites and 44% of blacks.

DCe is found in 42% of whites and 17% of blacks.

DcE is found in 14% of whites and 11% of blacks.

dce is found in 37% of whites and 26% of blacks.

Blood bank

The most common Rh haplotype among whites is:

A.

Dce

B.

DCe

C.

DcE

D.

dce

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Question # 15

The electrolyte panel consists of potassium, sodium, chloride, carbon dioxide. These analytes are also typically ordered within other panels as well, including the basic metabolic and complete metabolic panels.

An electrolyte panel (lytes, chem-4) consists of:

A.

Potassium, Sodium, Chloride, Carbon dioxide

B.

Potassium, Sodium, Chloride, Glucose

C.

Potassium, Sodium, Chloride, Creatinine

D.

Potassium, Sodium, Chloride, BUN

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Question # 16

Either immunofixation or immunoelectrophoresis can be used to confirm Bence-Jones proteinuria.

Which of the following methods would be used to confirm the presence of Bence-Jones protein in the urine:

A.

Urine protein electrophoresis

B.

Sulfosalicylic acid

C.

Isoelectric focusing

D.

Immunofixation

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Question # 17

The correct answer for this question is 1300 mg/dL. The laboratorian performed a 1:4 dilution by adding 0.25 mL (or 250 microliters) of patient sample to 750 microliters of diluent. This creates a total volume of 1000 microliters. So, the patient sample is 250 microliters of the 1000 microliter mixed sample, or a ratio of 1:4. Therefore, the result given by the chemistry analyzer must be multiplied by a dilution factor of 4. 325 mg/dL x 4 = 1300 mg/dL.

After experiencing extreme fatigue and polyuria, a patient's basic metabolic panel is analyzed in the laboratory. The result of the glucose is too high for the instrument to read. The laboratorian performs a dilution using 0.25 mL of patient sample to 750 microliters of diluent. The result now reads 325 mg/dL. How should the techologist report this patient's glucose result?

A.

325 mg/dL

B.

1300 mg/dL

C.

975 mg/dL

D.

1625 mg/dL

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Question # 18

CD34, a cell surface marker, presents on undifferentiated pluripotential hemopoietic stem cells. CD34 is a cell surface glycoprotein and functions as a cell-cell adhesion factor.

Which one of the following antigen markers is BEST associated with stem cells?

A.

CD3

B.

CD10

C.

CD18

D.

CD34

E.

CDC007

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Question # 19

The anticoagulant present in a light-blue stopper tube is:

A.

Ethylenediaminetetraacetic acid (EDTA)

B.

sodium citrate

C.

heparin

D.

potassium oxalate

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Question # 20

1. B

2. C

3. A

Granular casts are composed of plasma protein aggregates and cellular remnants. Granular casts appear as cylinders of coarse, or fine, highly refractive particles.

Broad casts or "renal failure' casts are formed in the collecting ducts as the result of urinary stasis and are two to six times the size of other types of casts. Any type of cast can be a broad cast. Broad casts are typically seen in patients with advanced renal failure.

Hyaline casts, the type most commonly seen in urine sediment, have a refractive index similar to the urine in which they are suspended. For this reason, hyaline casts will appear almost invisible under brightfield microscopy, but are easily of seen by phase-contrast microscopy.

Match the following descriptions of casts with their appropriate name:

1. Casts with highly refractive particles

2. "Renal failure" cast

3. Low refractive index

A.

Hyaline casts

B.

Granular Casts

C.

Broad

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Question # 21

Hematology

What is Coombs sera comprised of:

A.

Complement

B.

Indicator red cells

C.

Anti-human globulins

D.

Anti-red cell globulins

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Question # 22

Though automated extraction machines have many benefits over manual methods the costs are high and generally require a high throughput of samples in order to justify the costs.

Automated extraction has many benefits over the traditional manual methods. The most important benefit is that the nucleic acid isolated is constantly consistent. There is a reduced amount of manipulation with dramatically decreases the chance of cross contamination. Also, automated extraction machines are considered moderate complexity and can be performed by a wider variety of laboratory professionals.

All of the following are considered benefits of automated isolation and extraction equipment EXCEPT:

A.

Automated isolation equipment is cheaper and more practical

B.

Automated isolation equipment requires less manipulation

C.

Automated isolation equipment is considered moderate complexity

D.

Automated isolation equipment provides consistent results

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Question # 23

Listeria monocytogenes is the correct answer. The motility agar is showing motility at the top of the tube, but not deeper; typical of this catalase-positive, gram positive bacillus. Streptococcus agalactiae would be catalase negative and a coccus. Erysipelothrix rhusiopathiae would be H2S-positive and catalase negative. Escherichia coli is a gram negative bacillus.

This Gram-positive bacillus grew as a diffusely beta-hemolytic colony from a newborn. It was catalase positive and had tumbling motility on a hanging drop preparation. This is how it appeared on triple sugar iron agar and motility medium. What is the most likely diagnosis?

A.

Listeria monocytogenes

B.

Streptococcus agalactiae

C.

Erysipelothrix rhusiopathiae

D.

Escherichia coli

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Question # 24

The combination of complement C4, C2 and C3 that binds to the antigen-antibody complex in the initial reaction step in the classical pathway of complement activation is called the activation unit.

Which of the following is the "activation unit" in the classical complement pathway?

A.

C1

B.

C2

C.

C4, C2, C3

D.

C5, C6, C7, C8, C9

E.

C1, C2, C9

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Question # 25

Gluconeogenesis is the formation of glucose from noncarbohydrates when carbohydrate intake is absent, a fasting state. The hormone cortisol along with glucagon and epinephrine all stimulate this metabolic pathway. Insulin; however, inhibits this pathway and is therefore the correct answer.

Which of the following hormones inhibits gluconeogenesis, the formation of glucose from noncarbohydrate sources such as amino acids, glycerol, and fatty acids?

A.

Insulin

B.

Epinephrine

C.

Cortisol

D.

Glucagon

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Question # 26

The DAT is most likely to be negative in ABO HDFN. It's possible that the washing done as part of the DAT may break the bonds between anti-A (or anti-B) and the newborn's poorly developed A (or B) antigens.

For which of the following antibodies is the DAT most likely to be negative when testing a newborn for possible HDFN?

A.

anti-A

B.

anti-c

C.

anti-D

D.

anti-K

E.

anti-Fya

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Question # 27

The structures involved in the production of semen include the prostate, the seminal vesicles, and the bulbourethral gland, along with the testes and epididymis.

Semen is produced as a combination of secretions from the different regions of the male reproductive tract. Each fraction differs in chemical composition and function.

Spermatozoa are produced in the testes. They mature in the epididymis. The testes also produce testosterone and inhibin.

Fluid from the seminal vesicles accounts for approximately 70% of semen volume. The seminal vesicles are the source of fructose in semen. Fructose is used by the spermatozoa as an energy source.

The prostate gland supplies about 20% of the volume of semen. Its fluids include acid phosphatase and proteolytic enzymes that lead to coagulation and subsequent liquefaction of semen. The prostate also contains most of the IgA found in semen.

The bulbourethral gland produces mucoproteins that make up about 5% of the volume of semen.

The pituitary gland is not directly involved in the production of semen; instead hormones are released which stimulate the production of sperm. The urethra is not involved in the production of semen.

Which of the following are directly involved in the production of semen?

A.

Prostate

B.

Pituitary gland

C.

Seminal vesicles

D.

Bulbourethral gland

E.

Urethra

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Question # 28

The ApoB/ApoA1 ratio has a positive risk marker (ApoB-100) and a negative risk marker (ApoA1). Risk diminishes as ApoA1 goes up (a negative marker) and risk increases in proportion to ApoB concentrations (a positive risk marker). This 'double-edged sword' provides good risk prediction. The other risk markers in question do not have this dual-advantage.

Which risk marker has both positive and negative cardiovascular risk integrated into its measurement?

A.

LpPLA2

B.

Oxidized LDL

C.

ApoB/ApoA1

D.

hs-CRP

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Question # 29

During primary hypothyroidism, where a defect in the thryoid gland is producing low levels of T3 and T4, the TSH level is increased. TSH is released in elevated quantities in an attempt to stimulate the thryoid to produce more T3 and T4 as part of a feedback mechanism.

Serum TSH levels five-times the upper limit of normal in the presence of a low T4 and low T3 uptake could mean which of the following:

A.

The thyroid has been established as the cause of hypothyroidism

B.

The thyroid is ruled-out as the cause of hypothyroidism

C.

The pituitary has been established as the cause of hypothyroidism

D.

The diagnosis is consistent with secondary hyperthyroidism

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Question # 30

Which of the following tests detect LTBI:

A.

BAMT

B.

culture

C.

PCR

D.

Two-step TST

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Question # 31

Alpha-fetoprotein is a substance typically used in the triple test during pregnancy and for screening chronic liver disease patients for hepatocellular carcinoma.

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

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Question # 32

A key laboratory characteristic by which Mycobacterium bovis can be separated from Mycobacterium tuberculosis is:

A.

Niacin accumulation when grown on egg based medium

B.

Ability to take up iron salts from the culture medium

C.

Growth inhibition by thiopine-2-carboxylic acid hydrazide (T2H)

D.

Semiquantitative catalase

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Question # 33

All the following characteristics are accurate for the influence of Health Insurance Portability and Accountability Act (HIPAA) except

A.

Establishes a minimum standard for security of electronic health information and the electronic interchange of information

B.

Replaced federal, state, or other laws that grant individuals even greater privacy protections than HIPAA

C.

Directly effects the laboratory information system (LIS)

D.

Covers entities that are free to retain or adopt more protective policies or practices

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Question # 34

Thrombocytes, or platelets, are of course involved with hemostasis, not immunity.

Immunology

Which of the following would not be considered a part of the body's cellular immune system:

A.

Macrophages

B.

Mast cells

C.

Neutrophils

D.

Thrombocytes

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Question # 35

Alkaline over acid, or K/A, in TSI reactions is associated with the fermatation of glucose alone and the utilization of peptone.

Which of the following sugars has been fermented by a gram-negative rod that has produced an alkaline slant and an acid butt on triple sugar iron agar (TSI).?

A.

lactose

B.

sucrose

C.

glucose

D.

glucose and sucrose

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Question # 36

The presence of hyaline, septate hyphae, and a young conidiophore with a foot cell and a swollen vesicle in a fungus culture are excellent clues indicative of Aspergillus. Aspergillus has the ability to infect primarily immunocompromised hosts, and causes pneumonia and/or disseminates to other organs. Clinical specimens should be inoculated onto primary isolation media, such as Sabouraud's dextrose agar. Aspergillus spp. are fast growing and can be white, yellow, yellow-brown, brown to black or green in color.

The presence of hyaline, septate hyphae, and a young conidiophore with a foot cell and a swollen vesicle in a fungus culture are excellent clues indicative of:

A.

Acremonium

B.

Aspergillus

C.

Paecilomyces

D.

Penicillium

E.

Scopulariopsis

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Question # 37

Medical ethics

A.

Includes situational ethics

B.

has strict guidelines

C.

Applies to laboratory professionals and includes situational ethics

D.

Applies to laboratory professionals

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Question # 38

Identify the following cell types by matching them with their respective image.

A.

Stromal Cells

B.

Osteoblast

C.

Macrophage with hemophagocytosis

D.

Megakaryocyte

E.

Osteoclast

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Question # 39

Which of the following CD markers is NOT present on a normal mature T cell?

A.

CD20

B.

CD7

C.

CD3

D.

CD5

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Question # 40

Though automated extraction machines have many benefits over manual methods the costs are high and generally require a high throughput of samples in order to justify the costs.

Automated extraction has many benefits over the traditional manual methods. The most important benefit is that the nucleic acid isolated is constantly consistent. There is a reduced amount of manipulation with dramatically decreases the chance of cross contamination. Also, automated extraction machines are considered moderate complexity and can be performed by a wider variety of laboratory professionals.

All of the following are considered benefits of automated isolation and extraction equipment EXCEPT:

A.

Automated isolation equipment is cheaper and more practical

B.

Automated isolation equipment requires less manipulation

C.

Automated isolation equipment is considered moderate complexity

D.

Automated isolation equipment provides consistent results

Full Access
Question # 41

The characteristic that distinguishes vancomycin-resistant Enterococcus faecium and Enterococcus faecalis from other Enterococcus species is their lack of motility.

Enterococci are all catalase-negative. Growth on bile esculin agar and in 6.5% salt broth are two characteristics that have commonly been used to identify Enterococcus to the genus level. A positive esculin in combination with a positive PYR reaction is another approach to presumptive identification.

Which one of these characteristics distinguishes vancomycin-resistant Enterococcus faecium and Enterococcus faecalis from other Enterococcus species?

A.

PYR positive reaction

B.

Non-motility

C.

Catalase negative

D.

Growth on bile esculin agar

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Question # 42

Post-hepatic obstruction is characterized by a marked increase in alkaline phosphatase, GGT, conjugated bilirubin, as well as other hepatic enzymes. The slight rise of ALT suggests that the issue is not hepatitis. Renal and cardiovascular failure do not match the symptom of jaundice or the abnormal laboratory values.

Chem

Which of the following conditions would be suggested by a jaundiced patient experiencing a marked rise in alkaline phosphatase, conjugated bilirubin, and a slight rise in ALT:

A.

Cardiovascular disease

B.

Hepatitis

C.

Post-hepatic obstruction

D.

Renal failure

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Question # 43

The type of isolation category that always requires a HEPA mask or respirator to be worn is:

A.

contact

B.

droplet

C.

airborne

D.

blood and body fluid

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Question # 44

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

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Question # 45

Gram-positive bacteria retain the primary crystal violet stain that is applied in the Gram stain because of the cross-linking of the thick peptidoglycan layer in their cell walls. Their cell walls contain less lipids than that of a gram-negative bacteria, and this reduces the permeability of their cell wall to the organic solvents that are used as a decolorizer. When the counterstain is added, it may enter the gram-positive cell, but does not change the color of the cells.

A thick peptidoglycan is MOST often associated with which of the following types of bacteria?

A.

Gram-negative bacteria

B.

Gram-positive bacteria

C.

Both gram-negative and gram-positive bacteria

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Question # 46

In DIC, or disseminated intravascular coagulation, the prothrombin time is increased due to the consumption of the coagulation factors due to the tiny clots forming throughout the vasculature. This is also the reason that the fibrinogen levels and platelet levels are decreased. Finally FDP, or fibrin degredation products, are increased due to the formation and subsequent dissolving of many tiny clots in the vasculature. The FDPs are the pieces of fibrin that are left after the fibrinolytic processes take place.

Which of the following laboratory results would be seen in a patient with acute Disseminated Intravascular Coagulation (DIC)?

A.

prolonged PT, elevated platelet count, decreased FDP

B.

normal PT, decreased fibrinogen, decreased platelet count, decreased FDP

C.

prolonged PT, decreased fibrinogen, decreased platelet count, increased FDP

D.

normal PT, decreased platelet count, decreased FDP

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Question # 47

Which specimen should be collected last?

Question options:

A.

Specimen requiring special handling

B.

Clotted specimen

C.

Fasting specimen

D.

STAT specimen

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Question # 48

FAB M5 is acute monoblastic leukemia

FAB M1 is acute myeloblastic leukemia without maturation

FAB M3 is acute promyelocytic leukemia

FAB M4 is acute myelomonocytic leukemia

Which FAB designation is called the "true" monocytic leukemia and is characterized by monoblasts, promonocytes, and monocytes?

A.

FAB Ml

B.

FAB M3

C.

FAB M4

D.

FAB M5

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Question # 49

Clostridium difficile is a gram-positive, spore-forming bacilli. The remaining organisms will all stain gram-negative on direct smear or smears made from culture.

Which of the following organisms are gram-positive?

A.

Neisseria gonorrhoeae

B.

Brucella species

C.

Clostridium difficile

D.

Pseudomonas aeruginosa

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Question # 50

Allergen-specific IgE, synthesized in response to allergens, becomes fixed to receptors on cellular membranes, especially those of basophils. If these receptor-bound IgE molecules are aggregated on re-exposure to specific allergen, both mast cells and basophils produce mediators that result in the allergic response. IgE-antigen interaction at the cell surface causes degranulation of cells and release of substances including: histamine, SRS-A, platelet activator, a kallikrein, and an eosinophil chemotactic factor. Basophils are the principal cells that bind IgE antibody while their number of receptor sites is proportional to serum IgE levels. Eosinophils are drawn to the site by the basophil chemotaxis mechanism, but are not the main cell which binds the IgE antibody.

Immunology

The mediator cells that bind MOST to IgE antibodies are:

A.

Basophils

B.

Eosinophils

C.

Polymorphonuclear neutrophils

D.

Macrophages

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Question # 51

Hemolytic anemia, myelodysplasia, and liver disease may each fit this peripheral blood picture. Each of these conditions can display peripheral blood macrocytosis. It is easy to observe the overall larger size of the red blood cells in this image compared to the normal lymphocyte also present.

When macrocytes are present, they should be examined for their shape (round vs. oval), the hemoglobin content (central pallor), and whether or not there are any inclusions present in the cell.

Iron deficiency would not be the correct answer in this case, since this condition is associated with microcytosis instead.

The complete blood count was obtained from a patient recently admitted to the emergency room. The red blood cell indices obtained revealed an MCV of 115 femtoliters (fL) (normal range 80 - 90 fL). The patient met the criteria for a peripheral blood smear examination. A representative field is shown on the right.

Which of the following conditions may be indicated by the results seen on this peripheral blood smear?

A.

Hemolytic anemia

B.

Myelodysplasia

C.

Iron deficiency

D.

Liver disease

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Question # 52

Valine substitutes for glutamic acid in the Beta 6 position to produce HbS.

To produce hemoglobin S, glutamic acid that is normally present in the sixth position on the beta globin chain is substituted with which of the following?

A.

Cystine

B.

Guanine

C.

Thyamine

D.

Valine

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Question # 53

Yellow stopper tubes are used for all of the following except:

Question options:

A.

human leukocyte antigen (HLA) typing

B.

paternity testing

C.

blood cultures

D.

lead testing

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Question # 54

The presence of a clot is acceptable in:

A.

red stopper tubes

B.

lavender stopper tubes

C.

green stopper tubes

D.

light blue stopper tubes

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Question # 55

HLA-DR is a class II MHC.

HLA-A, HLA-B, and HLA-C are all class I MHC.

Which of the following antigens is classified as a Major Histocompatibility Complex

Class II antigen (MHCII)?

A.

HLA-A

B.

HLA-B

C.

HLA-C

D.

HLA-DR

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Question # 56

If your reactions are strong at immediate spin (3+) and then get weaker at AHG (w+), it could mean the presence of a strong cold antibody.

Cold antibodies tend to be IgM and their optimum phase for reactivity is immediate spin. Incubation and washing of the sample may cause the agglutination that occurred at room temperature to break down. This would appear as a weaker reaction at AHG.

If the reaction strengths varied in each panel cell then that could be an indication that there are multiple antibodies present.

Your screen cells are 3+ at immediate spin and weak (W)+ at AHG. Your auto control is negative for both phases. Some of your antibody panel cells are 3+ at immediate spin and negative at AHG. What should you suspect?

A.

A warm autoantibody is present

B.

A cold antibody may be present

C.

Bad specimen draw

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Question # 57

A laboratory scientist is preparing a chemical reagent for testing and accidentally spills the chemical on the counter. How is this contamination taken care of?

A.

The laboratory scientist must consult with their supervisor on the proper way to clean the spill.

B.

The laboratory scientist can ask a co-worker to assist in the cleanup of the spill.

C.

The laboratory scientist can just wipe the spill with saline and throw the towel in the garbage.

D.

The laboratory scientist needs to consult with the safety data sheets (SDSs).

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Question # 58

This is the total magnification of the high dry objective lens.

A.

100X

B.

40X

C.

400X

D.

1000X

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Question # 59

Insulin is the hormone that is mainly responsible for the entry of glucose into the cell for energy production

Glucagon and epinephrine promote glycogenolysis, conversion of glycogen to glucose, which increases plasma glucose. Cortisol, along with glucagon, increases gluconeogenesis, formation of glucose from noncarbohydrates, which also raises plasma glucose concentration.

Chemistry

Which of the following hormones is mainly responsible for the entry of glucose into the cell for energy production?

A.

Epinephrine

B.

Glucagon

C.

Cortisol

D.

Insulin

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Question # 60

Convert the following temperature from Fahrenheit to Celsius

102 degrees F

A.

38.9 degrees C

B.

14 degrees C

C.

77 degrees C

D.

39.2 degrees C

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Question # 61

Ferritin and hemosiderin are considered storage forms of iron.

Which substance(s) is/are considered iron storage compounds?

A.

hemosiderin

B.

ferritin

C.

hemoglobin

D.

myoglobin

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Question # 62

The body of a tapeworm is composed of successive segments known as proglottids. Each mature proglottid has both male and female reproductive structures.

What is the anatomical feature of a tapeworm that possesses both male and female reproductive structures?

A.

Brood capsule

B.

Proglottid

C.

Rostellum

D.

Scolex

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Question # 63

Fibers can be mistaken for casts on occasion, especially hyaline casts. Fibers, however, are usually thinner and appear less uniform in structure than casts do.

Urinalysis & Other Body Fluids

Which of the following artifacts may be mistaken for casts?

A.

Air bubbles

B.

Fibers

C.

Coverslip scratches

D.

Talc particles

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Question # 64

Synovial fluid is actually quite viscous and does not have the same consistency as plasma. The reason for its thicker consistency is to provide cushion and reduce friction between the articular cartilage of synovial joints during movement.

Urinalysis & Other Body Fluids

All of the statements below about synovial fluid are true EXCEPT:

A.

arthrocentesis is performed as a means to evaluate arthritis and other joint disorders

B.

synovial fluid is present only in movable joints

C.

joint fluid resembles plasma in viscosity

D.

joint fluid has approximately the same glucose as plasma

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Question # 65

Failure to deliver glucose drawn in a serum separator tube (SST) to the laboratory within the recommended time will cause:

Question options:

A.

a falsely decreased glucose value

B.

a falsely increased glucose value

C.

glycolysis

D.

both A and C

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Question # 66

Patients who develop severe sepsis or septic shock commonly have increased plasma lactic acid values.

Patients who develop severe sepsis or septic shock commonly have __________ plasma lactic acid values.

A.

Decreased

B.

Normal

C.

Increased

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Question # 67

The recommended order of draw for a complete blood count (CBC), prothrombin time, and cholesterol is:

A.

light blue, red, and lavender

B.

light blue, lavender, and red

C.

red, lavender, and light blue

D.

lavender, light blue, and red

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Question # 68

True Statements:

Urine should be well mixed prior to dipping the reagent strip. Prolonged immersion may wash out test reagents.

False Statements:

Urine should be centrifuged prior to dipping the reagent strip. When visually reading the reagent strip, all results can be read immediately after dipping the strip in the urine specimen.

Which of the following statements are TRUE regarding the reagent strip test procedure? (Choose ALL of the correct answers)

A.

Urine should be centrifuged prior to dipping the reagent strip.

B.

Urine should be well mixed prior to dipping the reagent strip.

C.

When visually reading the reagent strip, all results can be read immediately after dipping the strip in the urine specimen.

D.

Prolonged immersion may wash out test reagents.

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Question # 69

Name the comprehensive written safety plan detailing the proper use and storage of hazardous chemicals in the workplace.

A.

chemical hygiene plan

B.

OSHA

C.

SOP

D.

MSDS

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Question # 70

Angiotensin is an oligopeptide in the blood that causes vasoconstriction, increased blood pressure, and release of aldosterone from the adrenals.

A major action of angiotensin II is:

A.

Increased pituitary secretion of petressin

B.

Increased vasoconstriction

C.

Increased parathormone secretion by the parathyroid

D.

Decreased adrenal secretion of aldosterone

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Question # 71

Flow cytometry employs a combination of fluorescent antibody tagging of cells and analysis with laser light scatter.

What principle(s) of flow cytometry are employed when performing immunophenotyping:

A.

Defraction gradients

B.

Impedance

C.

Defraction gradients and impedance

D.

Fluorescent antibody tagging and light scatter

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Question # 72

The best course of action when entering an isolation room is:

A.

following the directions from the sign on the door

B.

wearing a gown, a mask, and gloves

C.

wearing only a gown

D.

wearing only a mask

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Question # 73

Alkaline phosphatase, or ALP, is present in kidneys, liver, intestines, bone, and the placenta. The liver makes the largest amount of ALP. Some of the conditions associated with increased levels of ALP include: damaged liver cells, rapid bone growth (during puberty), bone diseases, or a disease that affects how much calcium is in the blood (hyperparathyroidism), and vitamin D deficiency.

Chemistry

Isoenzymes of alkaline phosphatase occur in:

A.

Kidney, bone, intestines, liver

B.

Bone, brain, liver, pancreas

C.

Liver, brain, spleen, intestines

D.

Brain, kidney, intestines, bone

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Question # 74

As maturation continues in the granulocytic series the nucleus of the metamyelocyte becomes kidney or bean shaped.

Identify the cell in this illustration indicated by the arrow:

A.

Monocyte

B.

Myeloblast

C.

Promonocyte

D.

Metamyelocyte

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Question # 75

One of the following may cause a laboratory acquired infection (LAI):

A.

Needlestick exposure

B.

Cut on the employee's hand that is not covered

C.

Applying chapstick in the laboratory

D.

All of the above

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Question # 76

G6PD deficiency causes an increased suseptibility to the oxidation of hemoglobin, which in turn, causes the precipitation of hemoglobin inside of the red blood cell.

Which one of the following conditions is associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency?

A.

Microcytic red cells

B.

Precipitation of hemoglobin

C.

Faulty heme synthesis

D.

Hemoglobins with low oxygen affinities

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Question # 77

What has happened in a titer, if tubes #5-7 show a stronger reaction than tubes #1-4?

A.

poor technique

B.

postzone reaction

C.

prozone reaction

D.

equivalence reaction technical error

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Question # 78

The primary mechanism responsible for glomerular filtration is:

A.

Osmotic gradient

B.

Concentration of blood components

C.

Rate of blood flow through the kidneys

D.

Hydrostatic differential in glomerular tufts

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Question # 79

What is the first thing a phlebotomist should do in the event of an accidental needle stick?

A.

go to the employee health service and get a tetanus booster

B.

leave the area so that the patient does not notice the injury

C.

decontaminate the site and fill out an incident report

D.

check the patient's medical records

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Question # 80

Match each of the following:

1. Ratio of cellular area to total area in the bone marrow section.

2. Number of myeloid cells compared to nucleated erythroid cells.

3. Use low power to estimate their quantity and appearance.

4. Use Perls' Prussian blue stain.

A.

Myeloid-erythroid ratio

B.

Stored iron

C.

Overall cellularity

D.

Megakaryocytes

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Question # 81

The correct answer which best fits the characteristics in this question is Mycobacterium kansasii.

The remaining Mycobacterium strains can be elimated as:

Mycobacterium marinum is considered a fast-grower.

Mycobacterium scrofulaceum produce deep-yellow to orange pigmented colonies when grown in the either the light or dark.

Mycobacterium avium grows colonies which are nonpigmented in the light and dark which do not intensify after light exposure.

What is the MOST likely identification of an acid-fast bacillus that demonstrates the following characteristics?

slow growth

cream to tan colored colonies when grown in the dark

development of yellow pigment upon exposure to light

A.

Mycobacterium kansasii

B.

Mycobacterium marinum

C.

Mycobacterium avium

D.

Mycobacterium scrofulaceum

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Question # 82

The most important purpose of a requisition form is:

Question options:

A.

authorization to perform the procedure

B.

location of the patient

C.

providing a system to report results

D.

monitoring test result turnaround time

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Question # 83

Bacterial contamination can manifest itself in several ways including: the presence of clots, darker purple-black color of blood unit, unit can appear cloudy, hemolysis may be present.

During routine inspection, a unit of unexpired blood was noticed to have a black color with numerous small clots. What is the likely cause for this observation?

A.

the unit was frozen

B.

donor had DIC

C.

viral contamination

D.

bacterial contamination

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Question # 84

Microbiology

Matching: The detection of a distinct odor is often helpful in the presumptive identification of bacterial culture isolates. Match each of the odors listed with its corresponding bacterial species name.

1. Streptococcus anginosus (milleri)

2. Pseudomonas aeruginosa

3. Eikenella corrodens

4. Alcaligenes faecalis

A.

Pared apples

B.

Grapes

C.

Butterscotch

D.

Bleach

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Question # 85

L/S ratio <2.0 indicates an increased risk of respiratory distress syndrome (RDS) at delivery. L/S ratio <1.5 indicates a very high risk of developing RDS.

Which of the following statements regarding the L/S ratio is TRUE?

The correct answer is highlighted below

A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent respiratory distress syndrome (RDS)

A ratio of 1.5:1 indicates fetal lung maturity in pregnancies associated with diabetes mellitus.

Sphingomyelin levels increase during the 3rd trimester causing the L/S ratio to fall slightly during the last two weeks of gestation.

A phosphatidylglycerol (PG) spot indicates the presence of meconium in the amniotic fluid

Lecithin is in direct ratio with sphingomyelin

Heparin contamination is characterized by an elevation in the aPTT test and can also cause an increased PT test as well. Reptilase time tests are used to elimate the effects of heparin contamination as the reagents and method are resistant to the effects of antithrombin III, unlike the PT and aPTT tests. Therefore, it would be expected that a patient sample containing pre-analytical heparin contamination will show an increased aPTT (and sometimes PT as well) while showing a normal reptilase time.

A specimen drawn from an indwelling catheter that was contaminated by heparin would be indicated by:

A.

normal PT and aPTT results

B.

abnormal PT and normal PTT results

C.

prolonged aPTT and prolonged reptilase time test

D.

prolonged aPTT and normal reptilase time test

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