AMT MT Study Guide Exam 551 Questions with Verified Answers,100% CORRECT

AMT MT Study Guide Exam 551 Questions with Verified Answers The three major phases of laboratory testing that a QA program should evaluate include a. mean, standard deviation, and coefficient of variation. b. pre-op, operative, and post-op. c. pre-analytical, analytical, and post-analytical. d. outpatient, inpatient, and non-patient. - CORRECT ANSWER c. pre-analytical, analytical, and post-analytical. The process by which test results achieve the same high levels of accuracy and precision that can be reproduced across measurement systems, laboratories and time is referred to as a. laboratory process control. b. laboratory calibration. c. laboratory standardization. d. laboratory verification. - CORRECT ANSWER c. laboratory standardization. What characteristics/functions do calibrators have? a. They contain a known amount of analyte being tested. b. They monitor the quality of reagents. c. They monitor the quality of the sample. d. They prevent equipment failure. - CORRECT ANSWER a. They contain a known amount of analyte being tested. An abrupt demonstrated change in the mean is a a. shift. b. trend. c. variance. d. deviation. - CORRECT ANSWER a. shift. Qualitative examinations are those that a. qualify for waived testing. b. produce non-numerical results. c. do not require quality control. d. do not require proficiency testing. - CORRECT ANSWER b. produce non-numerical results. A property of a test that is used to describe its quality (such as accuracy, precision, sensitivity, etc.) is a a. performance characteristic. b. performance enhancement. c. performance verification. d. performance specification. - CORRECT ANSWER a. performance characteristic Under CLIA law, the process of testing and adjusting an instrument or test system to establish a correlation between the measured response and the concentration or amount of the substance that is being measuredby the test procedure is a. calibration. b. calibration verification. c. a challenge. d. quality control. - CORRECT ANSWER a. calibration. What agency determines the complexity of a lab test system? a. CMS b. FDA c. CDC d. OSHA - CORRECT ANSWER b. FDA Certain moderate complexity microscopy tests (such as urine sediment evaluation and skin scrapings) commonly performed by healthcare providers in the office setting are classified as a. provider moderate complexity tests. b. provider exempt status. c. provider personnel testing. d. provider performed microscopy. - CORRECT ANSWER d. provider performed microscopy. Policies and procedures that are intended to promote the quality and validity of test data and ensure the reliability and integrity of data generated by analytical laboratories is known as a. CLIA Law. b. Quality Assurance Plan (QAP). c. Good Clinical Laboratory Practice (GCLP). d. Total Quality Management (TQM). - CORRECT ANSWER c. Good Clinical Laboratory Practice (GCLP). Devices based on electrophoretic principles are used in the clinical laboratory to perform all of the following except to a. measure quantities of various proteins in plasma, urine, and CSF. b. separate enzymes into their component isoenzymes. c. identify antibodies. d. measure molecules in a characteristic spectrum called the emission spectrum. - CORRECT ANSWER d. measure molecules in a characteristic spectrum called the emission spectrum. The chemistry methodology that is based on the fact that substances of clinical interest selectively absorb or emit electromagnetic energy at different wavelengths is a. flourometry. b. atomic absorption. c. spectrophotometry. d. photometry. - CORRECT ANSWER c. spectrophotometry. Given %T, how is absorbance calculated? a. log %T - 2. b. log %T + 2. c. 2 + log %T. d. 2 - log %T. - CORRECT ANSWER d. 2 - log %T. Prohibiting recapping of needles is an example of a. a workplace control. b. an engineering control. c. a best practice in the workplace. d. a human resources requirement. - CORRECT ANSWER a. a workplace control. The majority of all centrifuge accidents result from a. electrical malfunctions. b. faulty mechanisms. c. user error. d. crowded work conditions. - CORRECT ANSWER c. user error. Material Safety Data Sheets (M.S.D.S.) are now called a. Chemical Safety Sheets. b. Safety Data System. c. Material Data System. d. Safety Data Sheets. - CORRECT ANSWER d. Safety Data Sheets. In order for a laboratory to handle TB sputum and TB materials, the laboratory must operate at a a. biosafety level of 2+ or 3. b. biosafety level 4. c. location where air exchange is continuous. d. location where fume hood exhausts are monitored daily. - CORRECT ANSWER a. biosafety level of 2+ or 3. What is the molarity of an unknown HCL solution with a specific gravity of 1.10 and an assay percentage of 18.5%? (Atomic weights: H = 1.00794, Cl = 35.4527) a. 203.5 M b. 36.5 M c. 5.6 M d. 5.2 M - CORRECT ANSWER c. 5.6 M 1.10 * 0.185 = 0.2035 g/mL 0.2035 g/mL * 1000 = 203.5 g/L Molarity = (g/L) / molecular weight (MW) 203.5 / 36.5 = 5.6 M MCV = HCT * 10/(?) a. MCHC b. MCV c. RBC d. MCH - CORRECT ANSWER c. RBC A substage lens of the microscope that focuses light on the slide specimen is the a. condenser. b. aperture. c. C-mount. d. diaphragm. - CORRECT ANSWER a. condenser. The magnification of a microscope is determined by the a. high power objective multiplied by the low power objective. b. thickness of the condenser. c. powers of the eyepiece and objective. d. fine focus adjustment. - CORRECT ANSWER c. powers of the eyepiece and objective. You have just completed morning rounds when you realize that you have an unlabeled tube in your tray. You are certain you know what patient the tube belongs to. How should you proceed? a. After sorting the tubes you see what specimen is missing, discard the unlabeled tube and go recollect the specimen. b. After sorting the tubes, you see what specimen is missing so label your unlabeled tube with that patient's information. c. Discard the tube and hope know one realizes there is a missing specimen. d. Discard all your tubes and redraw everyone to make sure all the specimens are correct. - CORRECT ANSWER a. After sorting the tubes you see what specimen is missing, discard the unlabeled tube and go recollect the specimen. You are working in receiving and receive urine specimens with the following labels. Select the label that contains the required labeling elements for a primary specimen. a. Name: Jane Deer<br>DOB: 3-6-3<br>Room #: 123<br>Collect time/date: 0550 7/6/13 b. Name: Deer, JR<br>DOB: 3/6/2003<br>Location: clinic<br>Collect time/date: 0550 7/6/13 c. Name: Deer, Jane Ray<br>DOB: 3/6/2003<br>Hospital number: 234345<br>Collect time/date: 0550 7/6/2013 d. Name: Deer, Jane<br>DOB: 3/6/2003<br>Hospital number:<br>Collect time/date: 0500 7/6/2013 - CORRECT ANSWER c. Name: Deer, Jane Ray<br>DOB: 3/6/2003<br>Hospital number: 234345<br>Collect time/date: 0550 7/6/2013 A gel separator tube is received with orders for a direct antiglobulin test (DAT) and serum Glucose test. How should this request be handled? a. Centrifuge the specimen and aliquot some serum into another tube for chemistry. Then send the tube to blood bank for the DAT. b. Centrifuge the specimen once it has clotted and deliver it to chemistry for the serum glucose test. The DAT will need to be recollected because this is not the appropriate specimen. c. Have both tests recollected since this is not an appropriate specimen for either test. d. Send the specimen to blood bank first for the DAT and ask them to send it on to chemistry when they are through. - CORRECT ANSWER b. Centrifuge the specimen once it has clotted and deliver it to chemistry for the serum glucose test. The DAT will need to be recollected because this is not the appropriate specimen. Within what time frame should a urine specimen that does not contain preservative be processed for a routine urinalysis if it is stored at room temperature? a. Within one hour of collection b. Within two hours of collection c. Within four hours of collection d. Within five hours of collection - CORRECT ANSWER b. Within two hours of collection Which of the following actions is appropriate when a cerebrospinal fluid (CSF) specimen is delivered to the laboratory's specimen processing area? a. Refrigerate the specimens immediately. b. Deliver the specimens to the testing area along with routine specimens when it is convenient. c. Deliver the specimens immediately to the appropriate testing areas. d. Incubate the specimen until routine testing can take place. - CORRECT ANSWER c. Deliver the specimens immediately to the appropriate testing areas. Which of the following characterizes reversed-phase liquid-liquid chromatography? a. Mobile phase is nonpolar relative to the polar stationary phase b. Mobile and stationary phases are nonpolar c. Mobile and stationary phases are polar d. Mobile phase is polar relative to the nonpolar stationary phase - CORRECT ANSWER d. Mobile phase is polar relative to the nonpolar stationary phase The measurement of the decrease in intensity of an incident light beam as it passes through a solution of particles defines which of the following methods? a. Turbidimetry b. Nephelometry c. Chemiluminescence d. Bioluminescence - CORRECT ANSWER a. Turbidimetry Which of the following labels is used in the detection of electrochemiluminescence? a. Acridinium esters b. Dioxetane c. Tritium d. Ruthenium III - CORRECT ANSWER d. Ruthenium III POCT devices use a variety of analytical principles such as reflectance, spectrophotometry, fluorescence, and ________. a. ESI b. IFE c. RIA d. PCR - CORRECT ANSWER d. PCR The amount of wavelength isolation is a function of the monochromator type and of which of the following? a. Width of entrance and exit slits b. Height of entrance and exit slits c. Width of entrance and height of exit slits d. Height of entrance and width of exit slits - CORRECT ANSWER a. Width of entrance and exit slits Which of the following is one of the most common clinical applications of GC-MS analysis? a. Drug testing b. Screening for genetic disorders c. Confirmation of inborn errors of metabolism d. Antiretroviral testing - CORRECT ANSWER a. Drug testing An immunoassay methodology using either europium or phycobiliproteins would use which detection method? a. Gamma counter b. Luminometer c. Fluorometer d. Photometer - CORRECT ANSWER c. Fluorometer What is the relationship between plasma creatinine and muscle mass? a. Inversely proportional b. Approximately equal c. Directly proportional d. Exactly equal - CORRECT ANSWER c. Directly proportional A high-protein diet may cause a a. prerenal plasma urea increase. b. postrenal plasma urea increase. c. prerenal plasma urea decrease. d. postrenal plasma urea decrease. - CORRECT ANSWER a. prerenal plasma urea increase. Catabolism of which of the following results in the formation of uric acid? a. Proteins b. Pyrimidines c. Porphyries d. Purines - CORRECT ANSWER d. Purines Jendrassik-Grof or Evelyn-Malloy are the most commonly used methods to measure a. Fructose b. Bilirubin c. Urea d. Cholesterol - CORRECT ANSWER b. Bilirubin The reference range of urobilinogen is a. 0.1-1.0 mg/dL every 2 hours. b. 0.1-1.0 µmol/L every 2 hours. c. 0.1-1.0 Ehrlich units every 2 hours. d. 0.1-1.0 Babson units every 2 hours. - CORRECT ANSWER c. 0.1-1.0 Ehrlich units every 2 hours. Which is used as the indicator enzyme in the measurement of ALT? a. LD b. AST c. ALP d. CK - CORRECT ANSWER a. LD Which of the following is the formation of glucose-6-phosphate from sources other than carbohydrates? a. Gluconeogenesis b. Glycolysis c. Glycogenolysis d. Glycogenesis - CORRECT ANSWER a. Gluconeogenesis With which enzyme does carbohydrate metabolism begin? a. Pancreatic amylase b. Lactate dehydrogenase c. Salivary amylase d. Phosphofructokinase - CORRECT ANSWER c. Salivary amylase A serum electrophoretic pattern showing a β-γ bridge would likely be from a patient with a. liver cirrhosis. b. nephritic syndrome. c. inflammation. d. myelomatosis. - CORRECT ANSWER a. liver cirrhosis. Which of the following associations of creatine kinase and disease condition is correct? a. CK-MM and Reye's syndrome b. CK-BB and muscular dystrophy c. CK-MB and inflammatory heart disease d. CK-MB and acute renal failure - CORRECT ANSWER c. CK-MB and inflammatory heart disease What is the protein portion of an enzyme? a. Holoenzyme b. Zymogen c. Apoenzyme d. Isoenzyme - CORRECT ANSWER c. Apoenzyme AST is classified as a(an) a. oxidoreductase. b. transferase. c. hydrolase. d. isomerase. - CORRECT ANSWER b. transferase. Elevations in ALP levels are seen in hepatobiliary and which other disorders? a. Kidney b. Lung c. Pancreas d. Bone - CORRECT ANSWER d. Bone Which enzyme catalyzes the interconversion of lactate and pyruvate? a. PK b. LD c. GP d. CK - CORRECT ANSWER b. LD Anterior pituitary hormones include LH, FSH, TSH, GH, and a. ACTH and cortisol. b. Inhibin and IGF-1. c. ACTH and prolactin. d. E2 and T3. - CORRECT ANSWER c. ACTH and prolactin Parathyroid glands increase or decrease PTH secretion in response to changes in levels of which of the following? a. Sodium b. Potassium c. Chloride d. Calcium - CORRECT ANSWER d. Calcium Growth hormone is an amphibolic hormone because it directly influences which processes? a. Both anabolic and catabolic b. Only anabolic c. Only catabolic d. Neither anabolic nor catabolic - CORRECT ANSWER a. Both anabolic and catabolic Which of the following lipoproteins transfers triglycerides from the intestine to the liver? a. CM b. LVDL c. LDL d. HDL - CORRECT ANSWER a. CM n most enzymatic methods for cholesterol measurement, cholesterol oxidase reacts with free cholesterol to produce which of the following? a. Cholesteryl esters b. NADH c. H2O2 d. Cholestenone - CORRECT ANSWER c. H2O2 Ionized calcium is measured on automated systems by which of the following methods? a. CPC b. AAS c. TLC d. ISE - CORRECT ANSWER d. ISE Which of the following is the immediate precursor to angiotensin II? a. Renin b. Angiotensinogen c. Angiotensin III d. Angiotensin I - CORRECT ANSWER d. Angiotensin I Which of the following is the method of choice for confirmation testing following a positive opiate drug screening result? a. AAS b. HPLC c. Immunoassay d. GC-MS - CORRECT ANSWER d. GC-MS Chronic exposure to organic mercury is cumulative because most of it is bound to which of the following? a. Adipose tissue b. Neuronal proteins c. Renal tubules d. Splenic tissue - CORRECT ANSWER b. Neuronal proteins Formic acid formed by the metabolism of methanol is responsible for which of the following? a. Liver cirrhosis b. Optic neuropathy c. Renal tubular damage d. Severe CNS symptoms - CORRECT ANSWER b. Optic neuropathy Serum copper levels less than the reference interval and increased urinary levels describe which condition? a. Wilson's disease b. Addison's disease c. Cushing's syndrome d. Reye's syndrome - CORRECT ANSWER a. Wilson's disease Which of the following is a functional test used to assess fetal lung maturity? a. L/S ratio b. PG c. FSI d. Lamellar body counts - CORRECT ANSWER c. FSI Which of the following determinations is used to assess the total body lead poisoning burden? a. Zinc protoporphyrin b. 1,25-dihydroxyvitamin D c. GFR d. Whole blood lead - CORRECT ANSWER d. Whole blood lead Which of the following is a semi-synthetic opiate with 2-3 times the analgesic potency of its parent compound, morphine? a. Codeine b. Fentanyl c. Heroin d. Tramadol - CORRECT ANSWER c. Heroin The dose that would be predicted to produce a toxic effect in 50% of a population is represented by which of the following? a. ED<sub>50</sub> b. LD<sub>50</sub> c. TD<sub>50</sub> d. ID<sub>50</sub> - CORRECT ANSWER c. TD<sub>50</sub> Due to the variable cross-reactivity with immunoassays, positive results are considered to be presumptive positives with which class of drugs? a. MDMA b. THC c. Amphetamines d. Phencyclidine - CORRECT ANSWER c. Amphetamines The purposes of TDM are to ensure that the drug dosage provides the maximum therapeutic benefit and which of the following? a. Identify the standard dose b. Identify when the drug is outside the therapeutic range c. Determine the efficiency of absorption d. Determine the route of administration - CORRECT ANSWER b. Identify when the drug is outside the therapeutic range What is the final product of hepatic ethanol metabolism? a. Acetaldehyde b. Acetone c. Acetic acid d. Acetate - CORRECT ANSWER c. Acetic acid Which of the following is a good indicator of chronic malnutrition? a. Transferrin b. Transtryretin c. C-reactive protein d. Albumin - CORRECT ANSWER d. Albumin When conducting a manual leukocyte count, what area of the Neubauer hemacytometer is used to count cells? a. Center square only b. 4 corner squares c. 4 corner and center of center square d. All 9 squares - CORRECT ANSWER d. All 9 squares The average life span of an erythrocyte is 120 days; the aging cells are removed from the circulation by a. spleen. b. liver. c. pancreas. d. gallbladder. - CORRECT ANSWER a. spleen. You are reviewing a blood smear and come across the cells seen below. Based on this slide, what are the cells and what could the possible diagnoses be? a. Normal red blood cells, there is nothing wrong with this patient b. Elliptocyte that are seen in hereditary elliptocytosis c. Howell-Jolly bodies that are seen in has hemolytic anemia d. Stippled red blood cells that are seen in lead poisoning. - CORRECT ANSWER d. Stippled red blood cells that are seen in lead poisoning. What type of cell is a precursor of the non-nucleated mature red cells in the blood? a. Rouleaux b. Megaloblast c. Reactive cells d. Nucleated red cells - CORRECT ANSWER d. Nucleated red cells When held up to the light, a properly stained blood smear will have what color? a. Deep blue at the feathered edge b. Light pink-purple at the feathered edge c. Bright red at the feathered edge d. Light aqua at the feathered edge - CORRECT ANSWER b. Light pink-purple at the feathered edge In humans, a white blood cell is also known as a(n) a. carbinocyte. b. erythrocyte. c. thrombocyte. d. leukocyte. - CORRECT ANSWER d. leukocyte. Decreased leukocyte counts are seen in the CBC in cases of a. inflammation. b. metabolic intoxication. c. viral infections. d. anxiety. - CORRECT ANSWER c. viral infections. Microcytic/hypochromic anemia is most commonly caused by a. disseminated intravascular coagulation (DIC). b. lead poisoning. c. Vitamin B12 deficiency. d. iron deficiency. - CORRECT ANSWER d. iron deficiency. During the CBC differential, the tech has observed the erythrocytes are smaller than the nucleus of mature lymph and they have an increased central pallor. These erythrocytes will be described as a. normocytic, hyperchromic. b. normocytic, normochromic. c. microcytic, normochromic. d. microcytic, hypochromic. - CORRECT ANSWER d. microcytic, hypochromic. In simplified terms, iron deficiency anemia may result from the following a. Increased iron intake (either from inadequate diet or impaired absorption), decreased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or decreased iron requirements in infancy, pregnancy and lactation b. Increased iron intake (either from inadequate diet or impaired absorption), increased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or increased iron requirements in infancy, pregnancy and lactation c. Decreased iron intake (either from inadequate diet or impaired absorption), decreased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or decreased iron requirements in infancy, pregnancy and lactation d. Dec - CORRECT ANSWER d. Decreased iron intake (either from inadequate diet or impaired absorption), increased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or increased iron requirements in infancy, pregnancy and lactation Megaloblastic erythrocytes have an abnormal developmental sequence. As they develop, cells of the megablastic sequence have a more open or immature chromatin pattern in the nucleus, referred to as a. asynchronous maturation. b. iron deficiency anemia. c. thalassemias. d. sideroblastic anemias. - CORRECT ANSWER a. asynchronous maturation. Drabkin's hemoglobin reagent is no longer used because it contains a. cyanide. b. caustic. c. cobalt. d. carbon. - CORRECT ANSWER a. cyanide. Erythrocytes that are sickle shaped, drepanocytes, are also a. anisocytosis. b. poikilocytosis. c. echinocytic. d. stromatocytic. - CORRECT ANSWER b. poikilocytosis. What has been selected as the method of choice by the Clinical Laboratory Standards institute (CLSI) for measuring erythrocyte sedimentation rate (ESR)? a. Westergren method b. Erythrocyte sedimentation rate c. Reticulocyte count d. Rouleaux - CORRECT ANSWER a. Westergren method Which cytochemical stain is used to help distinguishing Acute Lymphocyte Leukemia from malignant lymphoma? a. Leukocyte alkaline phosphatase (LAP) b. Acid phosphatase c. Esterases d. Terminal Deoxynucleotidyl Transferase (TdT) - CORRECT ANSWER d. Terminal Deoxynucleotidyl Transferase (TdT) Which cytochemical stain is used in differentiating the cell lineage of malignant cells in the bone marrow that stains phospholipids, neutral fats, and sterols? a. Chloroacetate esterase b. Myeloperoxidase c. Specific esterase d. Sudan Black B - CORRECT ANSWER d. Sudan Black B A peripheral blood smear with a left shift has an increase in a. immature monocytes. b. reactive lymphocytes. c. immature neutrophils. d. mature lymphocytes. - CORRECT ANSWER c. immature neutrophils. Patient X was discovered to be a platelet clumper when using EDTA anticoagulant. A repeat platelet count was performed on a 3.2% buffered sodium citrate (blue top) evacuated tube with a 4.5 mL draw. The corrected platelet count should be multiplied by a factor of a. 1.1. b. 3.2. c. 4.5. d. 1.406. - CORRECT ANSWER a. 1.1. Critically low platelet counts are called to the doctor/nurse when the count is a. below 20 x 10<sup>9</sup>/L. b. above 120<sup>10</sup>/L. c. between 150-400 x 1,000/μL. d. between 150-400 x 10<sup>11</sup>/μL. - CORRECT ANSWER a. below 20 x 10<sup>9</sup>/L A slightly hazy body fluid is submitted for a manual cell count. It is diluted 1:100. All nine squares are counted on the hemocytometer, totaling 101 leukocytes. The reported leukocyte count should be a. 11.2 x 10<sup>9</sup>/L. b. 1.12 x 10<sup>9</sup>/L. c. 112 x 10<sup>6</sup>/L. d. 11.2 x 10<sup>6</sup>/L. - CORRECT ANSWER a. 11.2 x 10<sup>9</sup>/L. If one is doing an electrophoresis of hemoglobin and is using cellulose acetate at an alkaline pH of 8.6, permitting the flow of electrons from the cathode to the anode, which hemoglobin migrates the fastest to the anode? a. HbA b. HbS c. HbC d. HbD - CORRECT ANSWER a. HbA What is the difference between polymerase chain reaction (PCR) and reverse transcriptase PCR (rtPCR)? a. Following amplification, PCR generates a DNA product and rtPCR generates a RNA product. b. Substrate used for rtPCR is RNA instead of DNA. c. Deoxyribonucleotides is added to the reaction mixture of PCR versus ribonucleotides added to the rtPCR reaction mixture. d. None of the above. - CORRECT ANSWER b. Substrate used for rtPCR is RNA instead of DNA. On blood films prepared with Wright's stain, what is/are abnormally early released of the RBCs from the marrow into the peripheral blood and is indicated by the presence of nucleated RBCs or polychromatophilic macrocytes on blood films prepared with Wright's stain? a. Shift cells b. Absolute reticulocyte count c. Reticulocyte production index d. Westergren method - CORRECT ANSWER a. Shift cells Which genetic defect is found with chronic myelogenous leukemia and is detected through molecular tests? a. BCR/ABL1 b. RUNX1/RUNX1T1 c. BCR/MLL d. PML/RARA - CORRECT ANSWER a. BCR/ABL1 For cell counters using light scatter, the light is termed monochromatic. This means the light has only one a. wavelength. b. source. c. cell at a time. d. light receptor. - CORRECT ANSWER a. wavelength. The diluting solution used to carry electrical current in electrical impedance counters is a (an) a. elementalyte. b. hierogram. c. electrolyte. d. hirstite. - CORRECT ANSWER c. electrolyte. Flow cytometry cell counting is able to qualify and quantitate the subsets of lymphocytes. This ability is highly informative in the diagnosis of a. CLL only. b. leukemias. c. autoimmune diseases only. d. All of the Above. - CORRECT ANSWER b. leukemias. The active enzyme that is responsible for digesting fibrin or fibrinogen is a. Plasminogen. b. Plasmin. c. Fibrinolysis. d. Zymogen. - CORRECT ANSWER b. Plasmin. Which of the following factors belong in the intrinsic pathway? a. Factor I, factor II, factor V, factor X b. Factor I, factor II, factor V, factor VII c. Factor VIII, factor X, factor XI, factor XII d. Factor VIII, factor IX, factor XI, factor XII - CORRECT ANSWER D. Factor VIII, factor IX, factor XI, factor XII Warfarin/Coumadin Drug Therapy to prevent clots, aims for a controlled INR value of a. 10-13. b. 1-1.4. c. 2-3. d. 1.5-2.5. - CORRECT ANSWER c. 2-3. A platelet count above the normal reference range is termed a. thrombus. b. thrombocytosis. c. thrombolytic. d. This condition does not exist. - CORRECT ANSWER b. thrombocytosis. You are working in the coagulation department after service has just finished doing a 6 month preventive maintenance (PM) check on the coag analyzer that includes removing all current data in the analyzer. After the PM check, you run quality control (QC) for prothrombin time (PT) and activated partial thromboplastin time (aPTT). The QC for the aPTT is within 2 SD but the PT control is outside of 6 SD. In troubleshooting, what might the problem be? a. QC after maintenance is not really needed so if the pre maintenance QC is okay, then you can continue with patient testing. b. The ISI value that is currently in the instrument was set back to zero after maintenance and needs to be re-entered before patient testing is resumed. c. The controls must be contaminated so make up new controls and re-run just the PT test. d. It is normal for the PT to change after a preventive maintenance, so the range for the QA will need to - CORRECT ANSWER b. The ISI value that is currently in the instrument was set back to zero after maintenance and needs to be re-entered before patient testing is resumed. After an extended bleeding time for abnormal hemostasis, the next test(s) the surgeon would order would be a. platelet adhesion and platelet aggregation. b. activated partial thromboplastin time only. c. protime and activated partial thromboplastin time. d. protime only. - CORRECT ANSWER a. platelet adhesion and platelet aggregation. What has these characteristics: purpose is plasma factors; measures concentration and activity of fibrinogen in stage III; monitors coumarin therapy. a. Clot reaction b. Thrombin time c. Fibrinogen d. Platelet count - CORRECT ANSWER b. Thrombin time Which of the following results would be consistent with a factor XIII deficiency? Select one:a. Abnormal PT, Abnormal APTT, Normal Fibrinogen, Normal Thrombin b. Normal PT, Abnormal APTT, Abnormal Fibrinogen, Normal Thrombin c. Normal PT, Abnormal APTT, Normal Fibrinogen, Normal Thrombin d. Normal PT, Normal APTT, Normal Fibrinogen, Normal Thrombin - CORRECT ANSWER d. Normal PT, Normal APTT, Normal Fibrinogen, Normal Thrombin What measures factors II, VII, IX, and X? a. Prothrombin group b. Clot retraction group c. Thrombin group d. Fibrin group - CORRECT ANSWER a. Prothrombin group The activity of factor V in plasma deteriorates even when the plasma is frozen. It is the most unstable of the coagulation factors and is also known as a. stable factor. b. ionized calcium. c. labile coagulation factor. d. tissue factor. - CORRECT ANSWER c. labile coagulation factor. Thrombin is generated from a precursor of this substance and is involved in the common pathway of both the extrinsic and the intrinsic clotting pathways. What is synthesized by the liver through the action of Vitamin K? a. Tissue factor b. Thromboplastin c. Prothrombin d. Fibrinogen - CORRECT ANSWER c. Prothrombin You are running at prothrombin time (PT) and activated partial thromboplastin time (aPTT) for pre-op testing that came from an outpatient clinic. You get an alarm from your analyzer indicating that there is no endpoint clotting time. The patient has no history of bleeding problems and is on no medication that would cause excessive long coagulation times. The specimen was in a 3.2% sodium citrate tube that was received into the lab 20 minutes after it was collected and spun immediately upon arrival. What may be the cause for the failure to clot? a. The specimen needed to sit for at least 30 minutes before it is centrifuged. b. The specimen had a clot in it that was not detected upon arrival in the lab. c. The specimen should have been drawn in an EDTA tube for this testing. d. The specimen should have been kept at body temperature. - CORRECT ANSWER b. The specimen had a clot in it that was not detected upon arrival in the lab. The physician in the emergency department has a patient that might have a pulmonary embolism (PE) and calls you to ask what coagulation test would be the best to rule out this diagnosis. a. PT b. aPTT c. D-dimer d. Mixing studies - CORRECT ANSWER c. D-dimer A doctor's office calls needing help ordering tests for fibrinolysis but can not recall which test to order. You advise them of the tests for a. plasmin and plasminogen. b. fibrin. c. thrombus. d. procoagulant. - CORRECT ANSWER a. plasmin and plasminogen. A patient was admitted from the ED to the ICU with a preliminary diagnosis of severe sepsis. The phlebotomist was instructed to collect extra tubes while they had venous access to ensure that add-on testing could be ordered as needed in the next couple of hours. All of the needed tubes were labeled correctly, tested successfully, and the phlebotomist noted that the patient had a great vein. The clerical staff received two extra tubes and set those aside in a test tube rack at room temperature. One tube was a serum sample and the other was an EDTA whole blood tube that settled into plasma and red cells. After several hours the technologist went to process the two extra tubes and freeze the serum and plasma. She found that the serum tube showed hemolysis and the plasma tube did not. Which of the following explains these findings? a. The classical complement pathway was activated only in the serum tube resulting in for - CORRECT ANSWER a. The classical complement pathway was activated only in the serum tube resulting in formation of the MAC. An antigen is any _________________ that can bind specifically to an antibody. a. protein b. cell c. collagen d. molecule - CORRECT ANSWER d. molecule The stage of syphilis infection in which a patient does not exhibit any symptoms but is still potentially infectious is called a. secondary syphilis. b. latent syphilis. c. tertiary syphilis. d. congenital syphilis. - CORRECT ANSWER b. latent syphilis. A patient with rheumatoid arthritis has been undergoing treatment for the disease for several months. The rheumatologist has ordered two CRP levels (by latex agglutination) and the results are seen in the table below. Which of the following answers is the best interpretation of the CRP results provided? Sample 1-15-14 Qualitative POS Semi-quantitative 1:2 + 1:4 + 1:8 + 1:16 + 1:32 + 1:64 + 1:128 + 1:256 0 Sample 4-15-14 Qualitative POS Semi-quantitative 1:2 + 1:4 + 1:8 + 1:16 + 1:32 + 1:64 0 1:128 0 1:256 0 Select one: a. The inflammation from the RA is decreasing with treatment. b. The inflammation from the RA is increasing despite treatment. c. The treatment has been ineffective and the inflammation has not significantly changed. d. The concentration of rheumatoid factor has decreased due to treatment. - CORRECT ANSWER a. The inflammation from the RA is decreasing with treatment. Many tests for pregnancy are immunochromatographic cassette tests. Which of the following best describes the principle behind this type of test? a. β-hCG in the patient's sample binds to monoclonal anti-β-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. b. α-hCG in the patient's sample binds to monoclonal anti-α-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. c. β-hCG in the patient's sample binds to monoclonal anti-α-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. d. α-hCG in the patient's sample binds to monoclonal anti-β-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. - CORRECT ANSWER a. β-hCG in the patient's sample binds to monoclonal anti-β-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. Toxin A/B produced by Clostridium difficile is a. detected in stool for a positive test. b. detected in serum only. c. detected only during the colonoscopy procedure. d. cannot be tested. - CORRECT ANSWER a. detected in stool for a positive test. A pediatrician contacted the laboratory to ask which test or tests would be most useful in the case of a child suspected of having complications following Strep throat. The technologist asked this physician some questions about what she was trying to determine and found that the pediatrician wanted the test or tests most likely not to miss potential antibodies produced against streptococcal antigens. Which of the following should the technologist recommend? a. Streptozyme test followed, if positive, by ASO b. ASO test followed, if positive, by Streptozyme c. Culture followed, if positive, by Rapid Strep cassette testing d. Rapid Strep cassette testing followed, if positive, by culture - CORRECT ANSWER a. Streptozyme test followed, if positive, by ASO A patient tests negative for rheumatoid factor. The patient does have symptoms consistent with rheumatoid arthritis. The physician should a. Do further testing because the RF test is negative in approximately 25% of patients who have the disease. b. Change the diagnosis to something other than RA because the RF test is positive in 100% of patients with the disease. c. Ask the laboratory to repeat the test on a second sample immediately because the only way to diagnose RA is through the use of the RF. d. Ask the laboratory to repeat the test on a plasma sample because the test should NOT be done on serum. - CORRECT ANSWER a. Do further testing because the RF test is negative in approximately 25% of patients who have the disease. Clostridium difficile is the leading cause of a. the common cold. b. adult respiratory syndrome. c. food poisoning. d. nosocomial diarrhea. - CORRECT ANSWER d. nosocomial diarrhea. Which of the following best describes what is occurring in the slide latex agglutination test for rheumatoid factor when the test is positive? a. Patient produced rheumatoid factor binds to the IgG bound to the carrier particles producing agglutination. b. Reagent IgG binds to the patient's red cells if they have produced rheumatoid factor inhibiting agglutination. c. Patient produced rheumatoid factor binds to reagent antigens bound to the slide and then latex particles adhere and show color if RF is present. d. Murine IgM binds to the patient IgG that has bound to the latex particles in the test, producing agglutination. - CORRECT ANSWER a. Patient produced rheumatoid factor binds to the IgG bound to the carrier particles producing agglutination. The type of fluorescent immunoassay that is based on the change in polarization of fluorescent light emitted from a labeled molecule when it is bound by antibody and is a competitive assay in which unlabeled antigen in the patient sample competes with labeled antigen for a limited number of antibody binding sites is a. FPIA. b. RIBA. c. chemiluminescence. d. FANA. - CORRECT ANSWER a. FPIA. Which technique is used to detect antigen-antibody reactions that can be seen with a fluorescent microscope? a. Enzyme Immunoassay (EIA) b. Fluorescent Antibody (FA) c. Direct Immunofluorescent Assay (DFA) d. Enzyme-linked immunosorbent assay (ELISA) - CORRECT ANSWER c. Direct Immunofluorescent Assay (DFA) The diseases known as mono or kissing disease, actually infectious mononucleosis, is caused by a. Hepatitis D virus. b. Pseudomonas aeruginosis c. the Epstein-Barr virus. d. the parainfluenza virus. - CORRECT ANSWER c. the Epstein-Barr virus. One of the most commonly used tests for antinuclear antibodies is a. indirect immunofluorescence. b. equine serum agglutination. c. a skin test. d. reverse polarization. - CORRECT ANSWER a. indirect immunofluorescence. A 42-year-old white female presents with a long history of on-again, off-again fevers, painful joints, loss of appetite, confusion, proteinuria and a facial rash resembling a butterfly across her nose and cheeks. The physician has performed testing previously but now orders an indirect immunofluorescence ANA test. The results are seen below: Pattern of Staining Seen: Speckled; Peripheral Antibody Suspected in Patient'sSerum: Sm;ds DNA Which of the following conclusions should the physician reach? Select one: a. This patient has ANA results consistent with systemic lupus erythematosus. b. This patient has ANA results consistent with scleroderma. c. This patient has ANA results consistent with Sjögren's syndrome. d. This patient's ANA results are inconclusive. - CORRECT ANSWER a. This patient has ANA results consistent with systemic lupus erythematosus. A Weil-Felix Reaction assay was once used commonly to test for febrile agglutinins that indicated evidence of infection with several Rickettsial diseases. The antigens used in this assay are derived from a. Proteus vulgaris b. Brucella spp. c.Escherichia coli d. Salmonella typhi - CORRECT ANSWER a.Proteus vulgaris. If a screening test for HIV, such as an ELISA test, is positive, which of the following would be the recommended confirmatory test? a. Western blot b. Viral culture c. Ouchterlony d. Antinuclear antibody - CORRECT ANSWER a. Western blot A mother who had received no prenatal care delivered a slightly underweight, 2 week premature, otherwise healthy looking baby boy. The physician ordered a rubella titer for both IgM and IgG specific antibodies on the neonate. The results of the titers are shown below: Antibody Tested For:IgG 1:1 POS 1:2 POS 1:4 POS 1:8 POS 1:16 POS 1:32 POS IgM 1:1 NEG 1:2 NEG 1: 8 NEG 1:16 NEG 1:32 NEG Which of the following is the best interpretation of these results? Select one: a. The neonate has received passive immunity from maternal antibody that crossed the placenta and is healthy. b. The neonate has received passive antibody from the mother by antibody crossing the placenta and now the baby is infected with rubella. c. The neonate has NOT received passive immunity from maternal antibody that crossed the placenta and is therefore at risk for possible rubella infection. d. The neonate has NOT received passive immunity from ma - CORRECT ANSWER a. The neonate has received passive immunity from maternal antibody that crossed the placenta and is healthy. The International Society of Blood Transfusion (ISBT) recognizes a. a total of 32 human blood group systems. b. a total of 8 human blood groups. c. only 4 major blood types. d. a total of 40 blood group systems as of 2008. - CORRECT ANSWER a. a total of 32 human blood group systems. The two most important human blood group systems are a. A and B. b. AB and O. c. O and RhD. d. ABO and RhD. - CORRECT ANSWER d. ABO and RhD. An individual's blood group or blood type is based on a. the presence or absence of inherited antigenic substances on RBCs. b. the presence or absence of antigens on WBCs. c. cellular proteins inherited from mother only. d. plasma glycoproteins. - CORRECT ANSWER a. the presence or absence of inherited antigenic substances on RBCs. If you have Type AB blood, you can receive a. only Type A blood. b. only blood you have donated for yourself. c. only type O blood. d. Types A, B, AB and O blood. - CORRECT ANSWER d. Types A, B, AB and O blood. Group A blood type individuals a. have anti-B in their plasma or serum. b. have anti-A in their plasma or serum. c. have anti-AB in their plasma or serum. d. have no antibodies in their plasma or serum. - CORRECT ANSWER a. have anti-B in their plasma or serum. The Rh, or Rhesus, group was discovered in 1937 with the assistance of a. Alexander S. Wiener. b. New England Region Blood Services. c. Red Cross workers in Africa. d. Zoologists. - CORRECT ANSWER a. Alexander S. Wiener. Blood grouping depends on observable antigen/antibody reactions such as a. hemolysis. b. agglutination. c. color change. d. a and b. - CORRECT ANSWER d. a and b. Type O blood can be given to anyone, regardless of their blood type. Type O individuals are called a. type-specific donors. b. universal blood donors. c. selected recipients. d. international blood donors. - CORRECT ANSWER b. universal blood donors. Individuals with blood type group B a. have anti-B in their plasma or serum. b. have no antibodies in their plasma or serum. c. have anti-AB in their plasma or serum. d. have anti-A in their plasma or serum. - CORRECT ANSWER d. have anti-A in their plasma or serum. Group AB individuals a. have anti-A and anti-B in their plasma or serum. b. have no antibodies in their plasma or serum. c. have anti-A only in their plasma or serum. d. have anti-B only in their plasma or serum - CORRECT ANSWER b. have no antibodies in their plasma or serum. The ABO group was discovered in early transfusion experiments by a. the American Red Cross. b. Karl Landsteiner in 1901. c. Karl Landsteiner in the early 1800s. d. Philip Levine in 1900. - CORRECT ANSWER b. Karl Landsteiner in 1901. _______________ are substances that can induce a specific immunologic response. a. Antibodies b. Antigens c. Carbohydrates d. T-cells - CORRECT ANSWER b. Antigens Immunity is a. protection afforded by exposure to infectious illness. b. only attained after having a specific disease. c. not naturally acquired. d. a response to allergens. - CORRECT ANSWER a. protection afforded by exposure to infectious illness. The basics of immunology are a. non-specificity and reactivity. b. antigenic stimuli and visible reactions. c. exposure, response and genetic variations. d. memory, specificity, recognition of "nonself". - CORRECT ANSWER d. memory, specificity, recognition of "nonself". Passive immunity a. is not protective. b. may stimulate disease. c. only protects from viruses. d. is produced in a body other than your own. - CORRECT ANSWER d. is produced in a body other than your own. A red cell transfusion not tested for compatibility has a risk of causing a. no reaction. b. only a minor reaction. c. an acute hemolytic reaction. d. decreased immunity. - CORRECT ANSWER c. an acute hemolytic reaction. When performing a screen cell and antibody panel as part of a crossmatch, if all screening cells, panel cells and the compatibility test are reactive at the antihuman globulin phase, what is this characteristic of? a. Cold antibodies b. Cold autoantibodies c. Anti-e d. Warm autoantibody - CORRECT ANSWER d. Warm autoantibody When the Rh negative mother produces antibodies to the fetal cells, a. they cannot cross back to the fetus. b. they cross back into the fetus, but cause no harm. c. the infant's immune system is compromised. d. they cross back into the developing infant and destroy the baby's circulating red cells. - CORRECT ANSWER d. they cross back into the developing infant and destroy the baby's circulating red cells. The destruction of fetal red cells causing jaundice is known as a. hepatic syndrome. b. intrauterine anemic syndrome. c. feto-maternal disease. d. hemolytic disease of the newborn. - CORRECT ANSWER d. hemolytic disease of the newborn. Certain additives may be added to antibody detection procedures to a. remove antibody properties. b. enhance the reaction. c. strip antigens from the red cells. d. produce a negative, or compatible result. - CORRECT ANSWER b. enhance the reaction. PEG is another antibody enhancement medium and stands for Select one: a. Polyethylene glycol. b. Polyethylene glycogens. c. Para-ethanol glycine. d. pH-enhanced glucose. - CORRECT ANSWER a. Polyethylene glycol. IgG antibody complexes on red blood cells can be dissociated and placed in a solution to test specificity. What process is this? Select one: a. Elution b. Adsorption c. Absorption d. Differential adsorption - CORRECT ANSWER a. Elution Red cells from donors are Select one: a. stable only 24 hours. b. stable up to 42 days in proper refrigeration. c. used in traumas, surgery, anemia treatments and other blood loss. d. answers b and c are correct. - CORRECT ANSWER d. answers b and c are correct. Platelets are administered to patients Select one: a. having cancer treatments. b. who have had an organ transplant. c. with bleeding during a surgical procedure. d. all of the above. - CORRECT ANSWER d. all of the above. GVHD may occur Select one: a. after an allogeneic transplant of bone marrow or stem cells. b. when newly transplanted cells are accepted by the recipient. c. after an autologous transplant. d. only if the donor is an identical twin. - CORRECT ANSWER a. after an allogeneic transplant of bone marrow or stem cells. One unit of donor blood can help multiple people. Some components from whole blood are a. serum, genetic substances, antibodies. b. red cells, amino acids, proteins. c. red cells, platelets, plasma, cryoprecipitates. d. lipids, antigens, plasma fractions. - CORRECT ANSWER c. red cells, platelets, plasma, cryoprecipitates. Transfusion-related complications Select one: a. include infection transmission, alloimmunization and immunohematologic reactions. b. are rare and non-significant. c. include weight loss, hypertension and diarrhea. d. are always life-threatening. - CORRECT ANSWER a. include infection transmission, alloimmunization and immunohematologic reactions. Platelets from whole blood are Select one: a. not often useful. b. stable 5 days at room temperature with constant agitation. c. stable only 24 hours. d. stable for 6 weeks in a darkened cold space. - CORRECT ANSWER b. stable 5 days at room temperature with constant agitation. Granulocytes may be harvested from whole blood by apheresis. They are Select one: a. used only in leukemia patients. b. not usually beneficial. c. often used to treat blood loss anemia. d. a type of white blood cells used to treat infections unresponsive to antibiotic therapy. - CORRECT ANSWER d. a type of white blood cells used to treat infections unresponsive to antibiotic therapy. Cryoprecipitated AHF is stable for one year frozen and can be used a. to treat patients with hemophilia, Von Willebrand disease and other coagulation abnormalities. b. instead of whole blood. c. for a volume expander. d. only in post operative patients. - CORRECT ANSWER a. to treat patients with hemophilia, Von Willebrand disease and other coagulation abnormalities. Anti-A or Anti-B recipient antibodies Select one: a. are almost always capable of causing rapid destruction of incompatible transfused red cells. b. are least likely to cause hemolytic reactions. c. may cause only a delayed mild reaction. d. only attack type O donor red cells. - CORRECT ANSWER a. are almost always capable of causing rapid destruction of incompatible transfused red cells. Plasma must be stored a. at -18C or colder. b. at 0 C to 32 C. c. at room temperature. d. at 40F. - CORRECT ANSWER a. at -18C or colder. The leading cause of transfusion-related death reported to the FDA is Select one: a. TAD (Transfusion-associated dyspnea). b. FNHTR (Febrile non-hemolytic transfusion reaction). c. TRALI (Transfusion-related acute lung injury). d. TACO (Transfusion-associated circulatory overload). - CORRECT ANSWER c. TRALI (Transfusion-related acute lung injury). Per the FDA, approved anticoagulants for donor blood collection are Select one: a. ACD, CPD, CPDA-1. b. heparin and saline. c. EDTA, citrate, lithium heparin. d. solutions of sodium heparin. - CORRECT ANSWER a. ACD, CPD, CPDA-1. Platelets must be stored at Select one: a. -18C or below. b. 1C to 6C. c. 98.7F. d. 20 C to 24 C (room temperature). - CORRECT ANSWER d. 20 C to 24 C (room temperature). What is the process of destroying pathogenic organisms, but not necessarily all microorganisms or bacterial spores (endospores)? Select one: a. Sterilization b. Disinfection c. Antisepsis d. Filtration - CORRECT ANSWER b. Disinfection The use of control slides containing a gram positive and a gram negative organism should be used in the following circumstances. Select one: a. New lot of stain or decolorizing reagents b. Weekly c. Daily or even with each set of patient specimens stained for technologists that infrequently d. All of the above - CORRECT ANSWER d. All of the above What cells do not have a nucleus or any membrane bound organelles such as mitochondria, and their ribosomes are a smaller size than eukaryotic ribosomes? Select one: a. Prokaryotes b. Eukaryotes c. Nucleoid d. Taxonomy - CORRECT ANSWER a. Prokaryotes What is an organism that does not usually cause disease in a person with an intact immune system, but that can cause disease when the host's immune system has been compromised by disease or other condition that has damaged or changed the immune status of the host? Select one: a. Opportunistic pathogen b. Nosocomial infection c. Spore d. Community acquired infection - CORRECT ANSWER a. Opportunistic pathogen Anaerobic organism incubation consists of Select one: a. 0.03% CO<sub>2</sub>, 21% oxygen. b. 5-10% hydrogen, 5-10% CO<sub>2</sub>, 80-90% nitrogen, 0% oxygen. c. 5-10% CO<sub>2</sub> and 15% oxygen. d. 8-10% CO<sub>2</sub> and 5-10% oxygen. - CORRECT ANSWER b. 5-10% hydrogen, 5-10% CO<sub>2</sub>, 80-90% nitrogen, 0% oxygen. Which of the following is/are fluorescent stain(s) used in the detection of the mycobacteria? Select one: a. Auramine/Rhodamine b. Kinyoun's c. Ziehl-Neelson d. Both b and c - CORRECT ANSWER a. Auramine/Rhodamine The most common causes of bacterial conjunctivitis in children are Select one: philus influenzae Streptococcus pneumonia, and occasionally Staphylococcus aureus. b. Staphylococcus epidermidis and Lactobacillus spp. c. Propionibacterium acne> and Alpha-hemolytic streptococci. d. Herpes simplex and Varicella zoster. - CORRECT ANSWER philus influenzae Streptococcus pneumonia, and occasionally Staphylococcus aureus. What gram negative rod is associated with lobar pneumonia in hospitalized patients? Select one: a. Proteus vulgaris b. Enterbacter cloacae c. Klebsiella pneumoniae d. Escherichia coli - CORRECT ANSWER c. Klebsiella pneumoniae What gram positive cocci are most frequently associated with UTI's in young, sexually active females? a. Staphylococcus saprophyticus b. Enterococcus faecalis c. Staphylococcus intermedius d. Staphylococcus simulans - CORRECT ANSWER a. Staphylococcus saprophyticus MacConkey agar is classified as a. a differential media. b. a selective media. c. a supportive media. d. Both a and b. - CORRECT ANSWER d. Both a and b. If a stool specimen for culture will be delayed in transit, what preservative and storage temperature is best for preservation of the specimen? a. Refrigerate the specimen at 4C - no transport media is necessary at this temperature b. Culture swab with Amie's medium at room temperature c. Cary-Blair media at 4 C d. Polyvinyl alcohol (PVA) at room temperature - CORRECT ANSWER c. Cary-Blair media at 4 C Which of the following tests may be useful for differentiating Campylobacter jejuni from similar organisms? Select one: a. Catalase reaction b. Urease reaction c. Hippurate hydrolysis d. Growth at 42 C - CORRECT ANSWER c. Hippurate hydrolysis Which organism needs the X and V factors required for fastidious organisms? Select one: a. Haemophilus spp b. Salmonella c. Pseudomonas aeruginosa d. Streptococcus - CORRECT ANSWER a. Haemophilus spp A cefinase disk may be used to Select one: a. determine the isolate's sensitivity to cefinase. b. determine if a staphylococcal isolate is methicillin resistant. c. test for the presence of cefinase in a bacterial isolate. d. test for the presence of beta-lactamase enzyme in a bacterial isolate. - CORRECT ANSWER d. test for the presence of beta-lactamase enzyme in a bacterial isolate. An isolate from a properly collected abscess yields an anaerobic, gram-negative bacillus with tapered ends. The colonies were breadcrumb-like, indole positive, nitrate negative, vancomycin resistant, kanomycin susceptible and colistin susceptible. The most likely identification is a. Fusobacterium nucleatum b. Fusobacterium necrophorum c. Fusobacterium varium d. Fusobacterium mortiferum. - CORRECT ANSWER a. Fusobacterium nucleatum A gastric biopsy sample from a patient complaining of abdominal pain is urease positive. What organism is responsible? a. Vibrio spp b. Salmonella typhi c. Helicobacter pylori d. Yersina enterocolitica - CORRECT ANSWER c. Helicobacter pylori Which of the following is not a component of standard polymerase chain reaction? Select one: a. Deoxynucleotides b. Primers c. Restriction enzymes d. Magnesium - CORRECT ANSWER c. Restriction enzymes The use of a control latex in latex agglutination testing helps to determine if the positive test result is due to Select one: a. nonspecific agglutination reactions. b. the presence of the antibody in the specimen exceeds the concentration of antigen. c. co-agglutination. d. cold-agglutinating antibodies. - CORRECT ANSWER b. the presence of the antibody in the specimen exceeds the concentration of antigen. An ampicillin sensitive Enterococcus faecalis isolated from a blood culture has high-level resistance to the aminoglycoside gentamicin. Which of the following combinations of antibiotics could possibly be used for treatment? Select one: a. Ampicillin and gentamicin b. Ampicillin and streptomycin c. Ampicillin and tobramycin d. Ampicillin and amikacin - CORRECT ANSWER b. Ampicillin and streptomycin Methicillin resistant Staphylococcus aureus can be detected in clinical specimens by the use of probes and polymerase chain reactions by detection of a. the <i>mecA</i> gene encoding for PBP2a in the cell wall. b. the <i>erm</i> gene code for the methylation of the 23S rRNA. c. the <i>msrA</i> gene code for efflux mechanism. d. None of the above. - CORRECT ANSWER a. the <i>mecA</i> gene encoding for PBP2a in the cell wall. Streptococcal grouping tests are an example of Select one: a. enzyme immunoassays. b. immunofluorescent assays. c. particle agglutination. d. precipitin tests. - CORRECT ANSWER c. particle agglutination. Disk diffusion or the Kirby-Bauer method of susceptibility testing is performed by Select one: a. the use of antimicrobial agents incorporated into an agar plate with a standardized inoculum of the organism placed on a filter paper disk. b. the use of antibiotic-impregnated filter paper disks placed on an agar plate that has been seeded with a lawn of bacteria. c. the introduction of antibiotic-impregnated filter paper disks into a broth dilution of a standardized inoculum of bacteria. d. a series of diluted broth inoculum incubated overnight in a microdilution well with a specific antibiotic. - CORRECT ANSWER b. the use of antibiotic-impregnated filter paper disks placed on an agar plate that has been seeded with a lawn of bacteria. Clostridium difficile disease can be diagnosed by Select one: a. the occurrence of diarrhea in a previously hospitalized patient on antibiotics. b. recovery of the organism from a patient's stool culture. c. a positive test for glutamate dehydrogenase by EIA. d. detection of the toxins A and B by PCR test on a diarrheal specimen. - CORRECT ANSWER d. detection of the toxins A and B by PCR test on a diarrheal specimen. Which of the following antibiotics can be used as a surrogate marker of resistance to oxacillin with Staphylococcus aureus? Select one: a. Erythromycin b. Vancomycin c. Cefoxitin d. Ceftazidime - CORRECT ANSWER c. Cefoxitin What is the preferred transport media for transporting viral specimens? Select one: a. Chlamydial transport medium (CTM) b. Sucrose glutamate phosphate (SPG) c. 2-sucrose phosphate (2-SP) d. Viral cell medium (VCM) - CORRECT ANSWER c. 2-sucrose phosphate (2-SP) The white blood cells that engulf and destroy viruses that have been blocked by antibodies are called Select one: a. dendritic cells. b. phagocytes. c. T cells. d. B cells. - CORRECT ANSWER b. phagocytes. You are examining a routine urinalysis specimen from a 25-year old woman presenting to the emergency room with dysuria and a frothy, mucopurulent vaginal discharge. You find a pear-shaped organism with anterior flagella and jerky motility. What is the likely identification of the organism? Select one: a. <i>Giardia lamblia</i> b. <i>Trichomonas vaginalis</i> c. <i>Dientamoeba fragilis</i> d. <i>Chilomastix mesnili</i> - CORRECT ANSWER b. <i>Trichomonas vaginalis</i> The class trematodes are Select one: a. roundworms. b. big worms. c. flukes. d. tapeworms. - CORRECT ANSWER c. flukes. What parasite is identified by using thick and thin blood smears which allows for better detection of the parasite in blood? Select one: a. <i>Plasmodium spp</i> b. <i>Trichomonas vaginalis</i> c. <i>Candida albicans</i> d. <i>Nocardia spp</i> - CORRECT ANSWER a. <i>Plasmodium spp</i> Fungi can generally be divided into what two broad groups, based on the appearance of the colonies formed in the clinical laboratory? Select one: a. Yeast and mold b. Septate hyphae and aseptate hyphae c. Systemic and superficial d. Cutaneous and subcutaneous - CORRECT ANSWER a. Yeast and mold A pseudogerm tube occurs when Select one: a. the inoculum used to perform the test is too heavy. b. alternative substrates are used. c. there is a constriction present at the base of the germ tube where it attaches to the mother cell. d. All of the Above - CORRECT ANSWER c. there is a constriction present at the base of the germ tube where it attaches to the mother cell Candida dubliensis and Candida albicans may be presumptively identified by the presence of Select one: a. growth at 22ºC. b. germ tubes. c. growth on Cornmeal agar. d. use of a Wood's lamp. - CORRECT ANSWER b. germ tubes. All but ________ can be found in increased levels with urines having a maple syrup odor. Select one: a. Leucine b. Isoleucine c. Tyrosine d. Valine - CORRECT ANSWER c. Tyrosine In the process of forming urine, simple filtration takes place in which part of the kidneys? Select one: a. Glomerulus b. Efferent capillaries c. Tubules d. Urethra - CORRECT ANSWER c. Tubules All of the following about a 24-hour collection beginning at 7 a.m. are true except Select one: a. empty the bladder at 7 a.m. and discard. b. that it is used for hormone measurement. c. that it is used for creatinine clearance measurement. d. discard the last urine collected in the 24 hour urine collection period. - CORRECT ANSWER d. discard the last urine collected in the 24 hour urine collection period. Finely granular casts indicate Select one: a. the amount of degradation that the cell inclusions have undergone. b. the amount of light through the condenser. c. an elevation in patient blood pressure. d. the amount of hydration at the Distal tubule. - CORRECT ANSWER a. the amount of degradation that the cell inclusions have undergone. You receive a fluid that you are asked to confirm as urine. Which of the following 2 tests should you do with the fluid? Select one: a. glucose and protein b. urea and glucose c. creatinine and protein d. urea and creatinine - CORRECT ANSWER d. urea and creatinine The urine collection used to evaluate orthostatic proteinuria is Select one: a. first morning specimen. b. second morning specimen. c. a first and second morning specimen. d. 24-hr collection. - CORRECT ANSWER c. a first and second morning specimen. The chemistry specimen tube from a spinal tap is not sent to the lab for 4 hrs. A spinal fluid glucose test is requested. Which of the following statements is true? Select one: a. The CSF will be decreased. b. The CSF glucose will be increased. c. The CSF glucose is not affected. d. The CSF will be twice the protein level of the CSF fluid. - CORRECT ANSWER a. The CSF will be decreased. A specimen just collected in a spinal tap is taken immediately to the lab and examined. The specimen is centrifuged in a microhematocrit tube. The supernatant is xanthochromic most likely indicating Select one: a. the specimen has a decreased level of protein. b. the patient has bacteria in the spinal fluid. c. the patient had a traumatic tap. d. the patient had a previous brain bleed. - CORRECT ANSWER d. the patient had a previous brain bleed. Qualitative examinations are those that Select one: a. qualify for waived testing. b. produce non-numerical results. c. do not require quality control. d. do not require proficiency testing. - CORRECT ANSWER b. produce non-numerical results The closeness of a measurement to its true value is referred to as Select one: a. accuracy. b. precision. c. bias. d. error. - CORRECT ANSWER a. accuracy. The three major phases of laboratory testing that a QA program should evaluate include Select one: a. mean, standard deviation, and coefficient of variation. b. pre-op, operative, and post-op. c. pre-analytical, analytical, and post-analytical. d. outpatient, inpatient, and non-patient. - CORRECT ANSWER c. pre-analytical, analytical, and post-analytical. Policies and procedures that encompass a range of activities that enable laboratories to achieve and maintain high levels of accuracy and proficiency despite changes in test methods and the volume of specimens tested is referred to as Select one: a. quality assurance. b. quality control. c. laboratory standardization. d. laboratory verification. - CORRECT ANSWER a. quality assurance. The process by which test results achieve the same high levels of accuracy and precision that can be reproduced across measurement systems, laboratories and time is referred to as Select one: a. laboratory process control. b. laboratory calibration. c. laboratory standardization. d. laboratory verification. - CORRECT ANSWER c. laboratory standardization. A substance or constituent for which the laboratory conducts testing is Select one: a. a challenge. b. an analyte. c. a proficiency test. d. quality control. - CORRECT ANSWER b. an analyte. Certain moderate complexity microscopy tests (such as urine sediment evaluation and skin scrapings) commonly performed by healthcare providers in the