MT ASCP/AMT Final Assessment Exam 300 Questions with Verified Answers,100% CORRECT

MT ASCP/AMT Final Assessment Exam 300 Questions with Verified Answers In absorption spectrophotometry: A) Absorbance is directly proportional to transmittance B) Percent transmittance is directly proportional to concentration C) Percent transmittance is directly proportional to the light path length D) Absorbance is directly proportional to concentration - CORRECT ANSWER Absorbance is directly proportional to concentration Which formula correctly described the relationship between absorbance and %T? A) A=2-log%T B) A=2+log%T C) A= -log%T - 2 D) A=1+log%T - CORRECT ANSWER A=2-log%T 3. Which element is reduced at the cathode of a Clark polarographic electrode? A) Silver B) Oxygen C) Chloride D) Potassium - CORRECT ANSWER Oxygen 4. Which of the following best represents the reference (normal) range for arterial pH? A) 7.35-7.45 B) 7.42-7.52 C) 7.28-7.68 D) 6.85-7.56 - CORRECT ANSWER 7.35-7.45 5. What is the normal ration of bicarbonate to dissolved carbon dioxide in arterial blood? A) 1:10 B) 10:1 C) 20:1 D) 30:1 - CORRECT ANSWER 20:1 6. A patient's blood gas results are as follows: pH = 7.26; dco2=2.0mmol/L; HCO3-=29mmol/L. These results would be classified as: A) Metabolic acidosis B) Metabolic alkalosis C) Respiratory acidosis D) Respiratory alkalosis - CORRECT ANSWER respiratory acidosis 7. Which of the following is the primary mechanism of compensation for metabolic acidosis? A) Hyperventilation B) Aldosterone release C) Release of epinephrine D) Bicarbonate excretion - CORRECT ANSWER Hyperventilation 8. Which of the following conditions will cause an increased anion gap? A) Diarrhea B) Hypoaldosteronism C) Hyperkalemia D) Renal failure - CORRECT ANSWER Renal failure 9. Which of the following conditions is associated with hypophosphatemia? A) Rickets B) Multiple myeloma C) Renal failure D) Hypervitaminosis D - CORRECT ANSWER Rickets 10. Which of the following conditions is associated with hypokalemia? A) Addison's disease B) Hemolytic anemia C) Digoxin intoxication D) Alkalosis - CORRECT ANSWER Alkalosis 11. Which of the following condition is associated with hypernatremia? A) Diabetes insipidus B) Hypoaldosteronism C) Burns D) Diarrhea - CORRECT ANSWER Diabetes insipidus 12. Which of the following values is the threshold critical value for low plasma potassium? A) 1.5mmol/L B) 2.0mmol/L C) 2.5mmol/L D) 3.5mmol/L - CORRECT ANSWER 2.5 mmol/L 13. Which electrolyte level best correlates with plasma osmolality? A) Sodium B) Chloride C) Bicarbonate D) Calcium : - CORRECT ANSWER Sodium 14. Which of the following is characteristic of type 1 diabetes mellitus? A) Requires an oral glucose tolerance test for diagnosis B) Is the most common form of diabetes mellitus C) Usually occurs after age 40 D) Requires insulin replacement to prevent ketosis - CORRECT ANSWER Requires insulin replacement to prevent ketosis 15. Which of the following is the reference method for measuring serum glucose? A) Somogyi-Nelson B) Hexokinase C) Glucose oxidase D) Glucose dehydrogenase - CORRECT ANSWER Hexokinase 16. Creatinine is formed from the: A) Oxidation of creatine B) Oxidation of protein C) Deamination of dibasic amino acids D) Metabolism of purines - CORRECT ANSWER oxidation of creatine 17. Urea is produced from: A) The catabolism of proteins and amino acids B) Oxidation of purines C) Oxidation of pyrimidines D) The breakdown of complex carbohydrates - CORRECT ANSWER The catabolism of proteins and amino acids 18. Blood ammonia levels are usually measured in order to evaluate A) Renal failure B) Acid-base status C) Hepatic coma D) Gastrointestinal malabsorption - CORRECT ANSWER Hepatic coma 19. Select the lipoprotein fraction that carries most of the endogenous triglycerides A) VDRL B) LDL C) HDL D) Chylomicrons - CORRECT ANSWER VDRL 20. Which apoprotein is inversely related to risk for coronary heart disease? A) Apoprotein A-I B) Apoprotein B C) Apoprotein C-II D) Apoprotein E-IV - CORRECT ANSWER Apoprotein A-I 21. Which condition produces the highest elevation of serum lactate dehydrogenase? A) Pernicious anemia B) Myocardial infarction C) Acute hepatitis D) Muscular dystrophy - CORRECT ANSWER Pernicious anemia 22. A patient has a plasma myoglobin level of 10µg/L at admission. Three hours later the myoglobin is 14µ/L and the Troponin I is 0.04µg/L (reference range 0-0.04µg/L). These results are consistent with which condition? A) Skeletal muscle injury B) Acute MI C) Unstable angina D) No evidence of myocardial or skeletal muscle injury - CORRECT ANSWER No evidence of myocardial or skeletal muscle 23. Select the most sensitive marker for alcoholic liver disease A) GLD B) ALT C) AST D) GGT - CORRECT ANSWER GGT 24. Hyperparathyroidism is most consistently associated with: A) Hypocalcemia B) Hypocalcuria C) Hypophosphatemia D) Metabolic alkalosis - CORRECT ANSWER Hypophosphatemia 25. Which of the following diseases is characterized by primary hyperaldosteronism caused by adrenal adenoma, carcinoma, or hyperplasia? A) Cushing's disease B) Addison's disease C) Conn's disease D) Pheochromocytoma - CORRECT ANSWER Conn's disease 26. The serum TSH level is decreased in: A) Primary hyperthyroidism B) Primary hypothyroidism C) Secondary hyperthyroidism D) Euthyroid sick syndrome - CORRECT ANSWER Primary hypothyroidism 27. Which of the following is the best analyte to monitor for recurrence of ovarian cancer? A) CA-15-3 B) CA-19-9 C) CA-125 D) CEA - CORRECT ANSWER CA-125 28. What is the primary clinical utility of measuring CEA? A) Diagnosis of liver cancer B) Diagnosis of colorectal cancer C) Screening for cancers of endodermal origin D) Monitoring for recurrence of cancer - CORRECT ANSWER Monitoring for recurrence of cancer 29. Which two liver enzymes are seen elevated in hepatobiliary disease? A) AST and ALT B) ALP and ALT C) ALP and GGT D) AST and GGT - CORRECT ANSWER ALP and GGT 30. Beriberi is associated with deficiency of: A) Vitamin A B) Vitamin C C) Niacin D) Thiamine - CORRECT ANSWER Thiamine 31. Zollinger-Ellison syndrome is characterized by a marked elevation of: A) Gastrin B) Cholecystokinin C) Pepsin D) Glucagon - CORRECT ANSWER Gastrin 32. Scurvy is associated with deficiency of: A) A B) C C) Niacin D) Thiamine - CORRECT ANSWER C 33. This trace element plays a key role in protein and nucleic acid synthesis: A) Manganese B) Selenium C) Zinc D) Copper - CORRECT ANSWER Zinc 34. In quality control, ±2 standard deviations from the mean include what percent of the sample population? A) 50 B) 68 C) 95 D) 99.7 - CORRECT ANSWER 95 35. During an evaluation of adrenal function, a patient had plasma cortisol determinations in the morning after awakening and in the evening. Laboratory results indicated that the morning value was higher than the evening concentration. This is indicative of A) Normal finding B) Cushing syndrome C) Addison's disease D) Hypopituitarism - CORRECT ANSWER Normal finding 36. Given the following results:ALP Slight increaseALT Marked increaseAST Marked increaseGGT Slight increaseThis is most consistent with: A) Acute hepatitis B) Chronic hepatitis C) Obstructive jaundice D) Liver hemangioma - CORRECT ANSWER Acute hepatitis 37. Major actions of angiotensin II include: A) Increased pituitary secretion of renin B) Increased vasoconstriction C) Increased parathyroid hormone secretion by the parathyroid D) Decreased adrenal secretion of aldosterone - CORRECT ANSWER Increased vasoconstriction 38. What is the metabolite of ethanol? A) Benzoylecgonine B) 6-acetylmorphine C) Acetaldehyde D) Carboxylic acid - CORRECT ANSWER Acetaldehyde 39. What is the gold standard methodology for Toxicology testing? A) Immunoassay B) Electrophoresis C) Liquid Chromatography D) Mass Spectrometry - CORRECT ANSWER Mass Spectrometry 40. Calculate the coefficient of variation for a set of data where the mean = 89 mg/dL and 2 standard deviations is A) 7.7% B) 7.9% C) 15.7% D) 15.8% - CORRECT ANSWER 7.9% 41. In the condition Kernicterus, the abnormal accumulation of bilirubin occurs in what tissue? A) Brain B) Liver C) Kidney D) Blood - CORRECT ANSWER Brain 42. Which of the following is the major mineralocorticoid? A) Aldosterone B) Cortisol C) Corticosterone D) Testosterone - CORRECT ANSWER Aldosterone 43. Select the main estrogen produced by the ovaries and used to evaluate ovarian function. A) Estriol B) Estradiol C) Epiestriol D) Hydroxyestrone - CORRECT ANSWER Estradiol 44. Regan isoenzyme has the same properties as alkaline phosphatase that originates in the: A) Skeleton B) Kidney C) Intestine D) Placenta - CORRECT ANSWER Placenta 45. What is the percentage of serum calcium that is ionized? A) 30% B) 45% C) 60% D) 80% - CORRECT ANSWER 45% 46. Creatinine clearance is used to estimate the: A) Tubular secretion of creatinine B) Glomerular secretion of creatinine C) Renal glomerular and tubular mass D) Glomerular filtration rate - CORRECT ANSWER Glomerular filtration rate 47. Which of the following readies the uterus for implantation of an embryo? A) FSH B) LH C) hCG D) Progesterone - CORRECT ANSWER Progesterone 48. Which of the formulas is correct for creatinine clearance? A) U/P x V x 1.73/A B) P/V x U x A/1.73 C) P/V x U x 1.73/A D) U/V x P x 1.73/A - CORRECT ANSWER U/P x V x 1.73/A 49. Which hormone controls sodium reabsorption? A) Aldosterone B) Anti-Diuretic Hormone C) Renin D) Angiotensin II - CORRECT ANSWER Aldosterone 50. The thyrotropin releasing hormone (TRH) stimulation test rules out the diagnosis of mild or subclinical hyperthyroidism if TRH infusion causes: A) Rise in plasma TSH B) No rise in plasma TSH C) Rise in plasma growth hormone D) No rise in plasma growth hormone - CORRECT ANSWER Rise in plasma TSH 1. What test is used along with the mean cell volume (MCV) to morphologically classify anemias? A) red blood count B) hemoglobin C) hematocrit D) red cell distribution width (RDW) - CORRECT ANSWER red cell distribution width (RDW) 2. Transferrin receptors can be measured and are elevated when: A) erythropoietin increases B) transferrin increases C) iron stores are decreased D) chronic disease is present - CORRECT ANSWER iron stores are decreased 3. Mature T cells with cerebriform, clefted nuclei found in the skin and peripheral blood describe: A) hairy cells B) prolymphocytes C) lymphoblasts D) Sézary cells - CORRECT ANSWER Sezary cells 4. What condition is most associated with autosplenectomy? A) abdominal trauma B) thrombocytopenia C) sickle cell anemia D) iron deficiency - CORRECT ANSWER sickle cell anemia 5. Which of the following has a pyknotic nucleus? A) Pronormoblast B) basophilic normoblast C) polychromatophilic normoblast D) orthochromic normoblast - CORRECT ANSWER orthochromic normoblast 6. Depletion of serum haptoglobin indicates: A) decreased erythropoiesis B) extravascular hemolysis C) intravascular hemolysis D) increased phagocytosis of macrophages - CORRECT ANSWER intravascular hemolysis 7. The principle energy source for mature red blood cells is: A) Krebs cycle B) hexose monophosphate pathway C) adenosine triphosphate (ATP) generated from anaerobic glycolysis D) adenosine diphosphate (ADP) generated from aerobic glycolysis - CORRECT ANSWER adenosine triphosphate (ATP) generated from anaerobic glycolysis 8. What important function does 2,3-biphosphoglycerate (2,3-BPG) perform? A) maintains iron in the hemoglobin molecule in the ferrous state B) prevents oxidative injury to the red cell C) facilitates the delivery of oxygen to tissue D) aids in the exchange of membrane lipids with lipids in plasma - CORRECT ANSWER facilitates the delivery of oxygen to tissue 9. Which of the following is true of megakaryocytes as they mature? A) nucleus becomes polyploidy B) cytoplasmic basophilia becomes more pronounced C) size decreases D) nucleoli become more prominent - CORRECT ANSWER nucleus becomes polyploidy 10. Lymphocytes become transformed when they are: A) being stimulated by an antigen B) undergoing mitosis C) dying D) moving to secondary lymphoid tissues - CORRECT ANSWER being stimulated by an antigen 11. What is the basic hemoglobin defect in the thalassemias? A) One of the globin chains has an amino acid substitution B) A structurally normal globin chain is absent or produced at lower levels C) Heme is produced at a lower concentration D) Iron is not incorporated into the protoporphyrin ring to form heme - CORRECT ANSWER A structurally normal globin chain is absent or produced at lower levels 12. Why are infants with beta-thalassemia major not ill until approximately 6 months of age? A) Infants are protected by their high concentration of fetal hemoglobin. B) Infants have less need for hemoglobin because of their small body size. C) Infants have less need for hemoglobin because of their smaller lung capacity. D) Infants have a high red count and thus higher hemoglobin from a higher than normal concentration of erythropoietin. - CORRECT ANSWER Infants are protected by their high concentration of fetal hemoglobin 13. A patient has 30% hemoglobin F. Which of the following can be eliminated? A) four missing genes for alpha chain production B) heterozygous hereditary persistence of fetal hemoglobin C) thalassemia intermedia D) the patient is a normal 1-month-old infant - CORRECT ANSWER four missing genes for alpha chain production 14. Megaloblastic anemias are caused by a defect in the synthesis of: A) DNA B) RNA C) Erythropoietin D) Heme - CORRECT ANSWER DNA 15. Pernicious anemia (PA) can be distinguished from folate deficiency by the: A) presence of hypersegmented neutrophils B) mean cell volume (MCV) C) bone marrow findings D) presence of autoantibodies to intrinsic factor (IF) - CORRECT ANSWER presence of autoantibodies to intrinsic factor (IF) 16. Why is glucose-6-phosphate dehydrogenase (G6PD) important for normal red cell survival? A) Hemoglobin oxygen affinity is increased in its absence. B) It is required to regenerate reduced glutathione. C) It is required for insertion of iron into the protoporphyrin ring to form heme. D) Alpha chains are produced in excess in its absence. - CORRECT ANSWER It is required to regenerate reduced glutathione 17. What is the pathogenesis of microangiopathic hemolytic anemia (MAHA)? A) Microthrombi and fibrin formed on damaged endothelial cells trap and break red cells. B) Chemicals or heat destroy red blood cells. C) The spleen sequesters red cells in an attempt to remove abnormal inclusions. D) Antibodies that activate complement are formed and destroy the red cell membrane. - CORRECT ANSWER Microthrombi and fibrin formed on damaged endothelial cells trap and break red cells 18. Renal failure is a prominent feature of: A) hemolytic uremic syndrome (HUS) B) thrombotic thrombocytopenic purpura (TTP) C) Plasmodium malariae infection D) march hemoglobinuria - CORRECT ANSWER hemolytic uremic syndrome (HUS) 19. Moderate to marked target cells are found on a blood smear. Which of the following can most likely be eliminated? A) hemoglobin C disease B) hereditary Spherocytosis C) hemoglobin E disease D) liver disease - CORRECT ANSWER hereditary spherocytosis 20. Toxic granulation, Döhle bodies, and vacuolization in neutrophils are often found together in A) May-Hegglin anomaly B) bacterial infection C) Chédiak-Higashi syndrome D) Alder-Reilly anomaly - CORRECT ANSWER bacterial infection 21. What do all chronic myeloproliferative disorders (MPDs) share? A) Philadelphia chromosome B) increased red cell mass C) increased blood cells; overlapping clinical and laboratory features D) serious thromboembolic complications - CORRECT ANSWER increased blood cells; overlapping clinical and laboratory features 22. A patient has an increased red count, hemoglobin, and hematocrit. Which of the following features points to secondary polycythemia over polycythemia vera (PV)? A) increased white count B) increased red cell mass C) bone marrow erythroid hyperplasia D) decreased arterial O2 saturation - CORRECT ANSWER decreased arterial O2 saturation 23. A child has monotonous blasts in the peripheral blood that have scant blue cytoplasm. They are CALLa (CD10) positive. Which form of acute lymphoid leukemia (ALL) is most likely? A) immature B cell B) immature T cell C) mature B cell D) mature T cell - CORRECT ANSWER immature B cell 24. An adult patient has a white blood count of 80 x 109/L. The differential has 92% Sudan Black B-positive blasts and 8% lymphocytes. Which of the following is most likely? A) acute myeloid leukemia, minimally differentiated B) acute myeloid leukemia without maturation C) immature B cell acute lymphoid leukemia D) acute megakaryocytic leukemia - CORRECT ANSWER acute myeloid leukemia without maturation 25. A middle-aged man has a white blood cell (WBC) count of 80 x 109/L with 90% lymphocytes and many smudge cells. Which of the following is most likely? A) chronic lymphocytic leukemia (CLL) B) hairy cell leukemia C) T cell lymphoma D) Sézary syndrome - CORRECT ANSWER chronic lymphocytic leukemia (CLL) 26. What are the major hematopoietic sites in the fetus and in the adult? Fetus Adult a. lymph nodes spleen b. liver bone marrow c. liver spleen d. bone marrow liver A) a B) b C) c D) d - CORRECT ANSWER Fetus-liver/ Adult-bone marrow 27. Malignant proliferation of plasma cells with osteolytic bone lesions and the presence of monoclonal immunoglobulin in the serum describe: A) Waldenström Macroglobulinemia B) marginal zone B cell lymphoma C) follicle center lymphoma D) multiple myeloma - CORRECT ANSWER multiple myeloma 28. Which of the following would be an unexpected finding in chronic myeloid leukemia (CML)? A) increased eosinophils and basophils in the peripheral blood B) 20% blasts in the peripheral blood C) hypercellular bone marrow with granulopoiesis D) white blood count of 100 x 109/L - CORRECT ANSWER 20% blasts in the peripheral blood 29. Which of the following anomalies is an autosomal dominant disorder characterized by irregularly sized inclusions in polymorphonuclear neutrophils, abnormal giant platelets, and often thrombocytopenia? A) Pelger-Huet B) Chediak-Higashi C) Alder-Reilly D) May-Hegglin - CORRECT ANSWER May-Hegglin 30. Which of the following is associated with Chediak-Higashi syndrome? A) Membrane defect of lysosomes B) Dohle-like bodies and giant platelets C) Two-lobed neutrophils D) Mucopolysaccharidosis - CORRECT ANSWER Membrane defect of lysosomes 31. A bone marrow slide shows foam cells ranging from 20 to 100 µm in size with vacuolated cytoplasm containing sphingomyelin and is faintly PAS positive. This cell type is most characteristic of: A) Gaucher's disease B) Myeloma with Russell bodies C) Di Guglielmo disease D) Niemann-Pick disease - CORRECT ANSWER Niemann-Pick disease 32. The most appropriate screening test for detecting hemoglobin S is: A) Osmotic fragility B) Dithionite solubility C) Kleihauer-Betke D) Heat instability test - CORRECT ANSWER Dithionite solubility 33. Hemoglobin H disease results from: A) Absence of 3 of 4 alpha genes B) Absence of 2 of 4 alpha genes C) Absence of 1 of 4 alpha genes D) Absence of all 4 alpha genes - CORRECT ANSWER Absence of 3 of 4 alpha genes 34. The presence of excessive rouleaux formation on a blood smear is often accompanied by an increased: A) Reticulocyte count B) Sedimentation rate C) Hematocrit D) Erythrocyte count - CORRECT ANSWER Sedimentation rate 35. The leukocyte alkaline phosphatase activity is increased in: A) Erythroleukemia B) Leukemoid reaction C) Chronic granulocytic leukemia D) Acute granulocytic leukemia - CORRECT ANSWER Leukemoid reaction 36. The most appropriate screening test for hereditary spherocytosis is: A) Osmotic fragility B) Sucrose hemolysis C) Heat instability test D) Kleihauer-Betke - CORRECT ANSWER Osmotic fragility 37. The most appropriate screening test for paroxysmal nocturnal hemoglobinuria is: A) Heat instability test B) Sucrose hemolysis C) Osmotic fragility D) Dithionite solubility - CORRECT ANSWER Sucrose hemolysis 38. Factors commonly involved in producing anemia in patients with chronic renal disease include: A) Marrow hypoplasia B) Ineffective erythropoiesis C) Vitamin B12 deficiency D) Increased erythropoietin production - CORRECT ANSWER Ineffective erythropoiesis 39. If polychromasia is increased in the peripheral smear, the ____________ should be elevated. A) White cell count B) Red cell count C) Reticulocyte count D) Basophil count - CORRECT ANSWER Reticulocyte count 40. Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is: A) Temperature dependent B) Complement independent C) Antibody mediated D) Caused by a red cell membrane defect - CORRECT ANSWER Caused by a red cell membrane defect 41. Which of the following represents characteristic features of iron metabolism in patients with anemia of a chronic disorder? A) Serum iron is normal, transferrin saturation is normal, TIBC is normal B) Serum iron is increased, transferrin saturation is increased, TIBC is normal or slightly increased C) Serum iron is normal, transferrin saturation is markedly increased, TIBC is normal D) Serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased - CORRECT ANSWER Serum iron is decreased, transferrin saturation is decreased, TIBC is normal or decreased 42. In which of the following disease states are teardrop cells and abnormal platelets most characteristically seen? A) Chronic myelocytic leukemia B) Multiple myeloma C) Uremia D) Myeloid metaplasia - CORRECT ANSWER Myeloid metaplasia 43. Lab findings in hereditary spherocytosis do NOT include: A) Reticulocytosis B) Shortened erythrocyte survival C) Decreased osmotic fragility D) Increased MCHC - CORRECT ANSWER Decreased osmotic fragility 44. What is the MCH if the hematocrit is 20%, the RBC is 2.4 x 106/µL, and the hemoglobin is 5 g/dL? A) 21 pg B) 23 pg C) 25 pg D) 84 pg - CORRECT ANSWER 21 pg 45. In an uncomplicated case of severe iron deficiency anemia, which of the following sets represents the typical pattern of results? Serum Serum % Marrow % Marrow Serum Iron TIBC Saturation Sideroblasts Iron Stores Ferritin a. Decreased increased decreased decreased increased increased b. Decreased decreased decreased decreased decreased decreased c. Decreased increased decreased decreased decreased decreased d. Decreased decreased increased increased increased increased - CORRECT ANSWER Decreased increased decreased decreased decreased decreased 46. The presence of schistocytes in the peripheral blood indicates which of the following processes? A) iron deficiency anemia B) intravascular hemolysis C) megaloblastic anemia D) extravascular hemolysis - CORRECT ANSWER intravascular hemolysis 47. Why does Plasmodium falciparum infection result in the most serious hemolysis of the various forms of malaria? A) Only reticulocytes are invaded B) Reticulocytes and red blood cells <10 days old are invaded C) Only mature red blood cells are invaded D) Red blood cells of all ages are invaded - CORRECT ANSWER Red blood cells of all ages are invaded 48. In which malaria species do you see a characteristic band in the trophozoite stage? A) Plasmodium vivax B) Plasmodium ovale C) Plasmodium falciparum D) Plasmodium malariae - CORRECT ANSWER Plasmodium malariae 49. What is the last erythrocyte precursor capable of cell division? A) Orthochromic Normoblast B) Reticulocyte C) Basophilic Normoblast D) Polychromatic Normoblast - CORRECT ANSWER Polychromatic Normoblast 50. Given the following data:WBC 8.5 x 103/µL Differential Segs 56% Bands 2% Lymphs 30% Monos 6% Eos 6%What is the absolute lymphocyte count? A) 170 B) 510 C) 2550 D) 4760 - CORRECT ANSWER 2550 1. Which of the following is part of primary hemostasis? A) Fibrinolysis B) blood vessels C) Coagulation factors D) Inhibitors - CORRECT ANSWER blood vessels 2. Which of the following aids in preventing excess clotting? A) Thrombin B) factor VII C) calcium D) protein C - CORRECT ANSWER protein C 3. What substance digests the fibrin clot after healing? A) Plasmin B) activated protein C C) tissue plasminogen activator (TPA) D) alpha-2-antiplasmin - CORRECT ANSWER Plasmin 4. Which of the following is decreased in disseminated intravascular coagulation (DIC)? A) Fibrinogen B) PT C) PTT D) FDP - CORRECT ANSWER Fibrinogen 5. Patients who have a deficiency of protein C or protein S have which type of disorder? A) Bleeding B) Thrombotic C) Bruising D) Hypercalcemia - CORRECT ANSWER Thrombotic 6. What platelet membrane receptor binds fibrinogen and supports platelet aggregation? A) GP Ib/IX/V B) GP IIb/IIIa C) GP Ia/IIa D) P2Y1 - CORRECT ANSWER GP IIb/IIIa 7. Which of the following is associated with Glanzmann's thrombasthenia? A) Normal bleeding time B) Normal ADP aggregation C) Abnormal ristocetin aggregation D) Absence of clot retraction - CORRECT ANSWER Absence of clot retraction 8. Which of the following is characteristic of Bernard-Soulier Syndrome? A) Giant platelets B) Normal bleeding time C) Abnormal aggregation with ADP D) Increased platelet count - CORRECT ANSWER Giant platelets 9. Which of the following platelet responses is most likely associated with Glanzmann's thrombasthenia? A) Decreased platelet aggregation to ristocetin B) Defective ADP release, normal response to ADP C) Decreased amount of ADP in platelets D) Markedly decreased aggregation to epinephrine, ADP, and collagen - CORRECT ANSWER Markedly decreased aggregation to epinephrine, ADP, and collagen 10. Which of the following platelet responses is most likely associated with Bernard Soulier Syndrome? A) Decreased platelet aggregation to ristocetin B) Defective ADP release, normal response to ADP C) Decreased amount of ADP in platelets D) Markedly decreased aggregation to epinephrine, ADP, and collagen - CORRECT ANSWER Decreased platelet aggregation to ristocetin 11. Coagulation factors affected by Coumadin (warfarin) drugs are: A) VIII, IX, and X B) I, II, V, and VII C) II, VII, IX, and X D) II, V, and VII - CORRECT ANSWER II, VII, IX and X 12. A bleeding time is used to evaluate the activity of: A) Platelets B) Prothrombin C) Labile factor D) Factor XIII - CORRECT ANSWER Platelets 13. What would be the expected screening test results for a patient with a fibrin stabilizing factor deficiency? A) PT prolonged B) APTT prolonged C) PT and APTT prolonged D) PT and APTT normal - CORRECT ANSWER PT and APTT normal 14. The thrombin time will be prolonged in the presence of all the following except A) Elevated fibrinogen degradation products B) Heparin C) Factor I deficiency D) Factor II deficiency - CORRECT ANSWER Factor II deficiency 15. The prothrombin time test requires that the patient's plasma be combined with: A) Platelet lipids B) Thromboplastin C) Calcium and activator D) Calcium and thromboplastin - CORRECT ANSWER Calcium and thromboplastin 16. All the following test results are characteristic of DIC except A) Decreased fibrinogen concentration B) Negative test for degradation products C) Decreased platelet count D) Prolonged PT - CORRECT ANSWER Negative test for degradation products 17. Which factors are consumed in clotting and therefore absent in serum? A) I, V, VIII, XIII B) I, II, V, VIII, XIII C) II, VII, IX, X D) VIII, IX, XI, XII - CORRECT ANSWER I, II, V, VIII, XIII 18. What is the diagnosis of a child who has onset of bleeding signs and symptoms, while having a normal CBC, a normal physical examination, and no family history of hemorrhagic abnormalities or thrombocytopenia? A) TTP B) ITP C) HUS D) May-Hegglin Anomaly - CORRECT ANSWER ITP 19. Which of the following is characteristic of platelet disorders? A) Deep muscle hemorrhages B) Retroperitoneal hemorrhages C) Mucous membrane hemorrhages D) Severely prolonged clotting times - CORRECT ANSWER Mucous membrane hemorrhages 20. Identify the platelet receptor and plasma protein required for normal platelet adhesion. A) Platelet receptor GP IV Plasma protein factor VIII B) Platelet receptor PF-4 Plasma protein factor V C) Platelet receptor GP IIb/IIIa Plasma protein fibrinogen D) Platelet receptor GP Ib/IX/V Plasma protein von Willebrand factor - CORRECT ANSWER Platelet receptor GP Ib/IX/V Plasma protein von Willebrand factor 21. The following data were obtained on a patient:PT 20 secTT 13 sec (Ref range 9-13 sec)APTT 55 secAPTT plus aged serum CorrectedAPTT plus adsorbed plasma Not correctedWhich of the following coagulation factors is deficient? A) Factor V B) Factor VIII C) Factor X D) Factor XI - CORRECT ANSWER Factor X 22. The following lab results were obtained for a patient with an inherited autosomal dominant trait: Bleeding time Prolonged Platelet adhesiveness Abnormal PT Normal APTT Normal These findings are most consistent with: A) Hemophilia A B) Factor X deficiency C) Factor XI deficiency D) Von Willebrand's disease - CORRECT ANSWER Von Willebrand's disease 23. A patient develops unexpected bleeding and the following test results were obtained:Prolonged PT and APTT, Decreased fibrinogen, Increased fibrin split products, Decreased platelets What is the most probable cause of these results? A) Familial afibrinogenemia B) Primary fibrinolysis C) DIC D) Liver disease - CORRECT ANSWER DIC 24. The following results are obtained on a 3-year-old boy with sudden severe hemorrhagic problems:Bleeding time NormalPT NormalAPTT ProlongedAPTT 1:1 Mixing Study CorrectedPlatelet aggregation Normal with ristocetin, ADP, collagen, and epinephrineThese clinical manifestations and lab results are consistent with A) Aspirin B) Von Willebrand's disease C) Hemophilia A D) Factor VII deficiency - CORRECT ANSWER Hemophilia A 25. Results on a patient presenting with sudden severe hemorrhagic problems are as follows:Bleeding time NormalPT NormalAPTT ProlongedAPTT 1:1 Mixing Study No correctionThese clinical manifestations and lab results are consistent with A) Coumadin therapy B) Von Willebrand disease C) Hemophilia A D) Presence of a circulating inhibitor - CORRECT ANSWER Presence of a circulating inhibitor 1. What reagent contains antibodies to multiple antigenic epitopes? A) Heterophile antibody-based B) Monoclonal-based C) Alloantibody-based D) Polyclonal-based - CORRECT ANSWER Polyclonal-based 2. The frequency of the D-negative phenotype in the population is: A) 85% B) 50% C) 35% D) 15% - CORRECT ANSWER 15% 3. The phase of the agglutination reaction is important in the interpretation of the antibody screen or antibody identification panel because it: A) determines whether an autoantibody is present. B) determines whether there is a delayed transfusion reaction. C) provides clues on antibody dosage. D) indicates the class of the antibody. - CORRECT ANSWER indicates the class of the antibody 4. An antibody screen on a patient with a prior history of transfusion was negative. The crossmatch, performed at immediate spin and antihuman globulin, was incompatible with 1 unit selected. The next step in the investigation would be to: A) perform a panel on the patient's serum. B) redraw the patient and begin a new crossmatch. C) perform a direct antiglobulin test on the incompatible unit. D) crossmatch a new unit and discard the incompatible unit. - CORRECT ANSWER perform a direct antiglobulin test on the incompatible unit 5. How long following transfusion must the recipient sample be stored? A) 14 days B) 7 days C) 5 days D) 10 days - CORRECT ANSWER 7 days 6. To be considered a candidate for Rh immune globulin, the mother is __________ and the infant is __________. A) D-positive, D-positive B) D-negative, D-negative C) D-positive, D-negative D) D-negative, D-positive - CORRECT ANSWER D-negative, D-positive 7. Why is incubation omitted in the direct antihuman globulin test? A) Incubation will cause hemolysis. B) The antigen-antibody complex has already formed in vivo. C) IgM antibodies are detected in the direct antiglobulin test. D) The direct antiglobulin test can be used in an emergency to replace the indirect test. - CORRECT ANSWER The antigen-antibody complex has already formed in vivo. 8. Antibodies detected in the immediate spin crossmatch are usually of which of the following immunoglobulin classes? A) IgD B) IgA C) IgG D) IgM - CORRECT ANSWER IgM 9. A person who inherits the Le, Se, and H genes will have red cells that phenotype: A) Le(a+b-) B) Le(a-b-) C) Le(a-b+) D) Le(a+b+) - CORRECT ANSWER Le(a-b+) 10. A patient demonstrated the following symptoms: hypotension, tachycardia, cold or clammy skin, and cyanosis. What is the most likely cause? A) Anaphylactic shock B) Congestive heart failure C) Hypovolemic shock D) Graft-versus-host disease - CORRECT ANSWER Hypovolemic shock 11. Proteolytic enzymes should not be used to screen for antibodies because: A) some antigens are destroyed by enzymes, which would cause the antibodies to be missed. B) red cells must be treated with enzymes first, which makes this technique impractical. C) the reagent is too expensive for routine use. D) clinically insignificant antibodies are enhanced. - CORRECT ANSWER some antigens are destroyed by enzymes, which would cause the antibodies to be missed 12. A facility does not validate a refrigerator before use. What is a potential outcome? A) The facility is in compliance if the equipment functions properly. B) The facility is in compliance if the blood products stored in it are not transfused. C) The facility is in violation of AABB and may no longer be members. D) The facility is in violation of current good manufacturing practices and could be cited by the Food and Drug Administration. - CORRECT ANSWER The facility is in violation of current good manufacturing practices and could be cited by the Food and Drug Administration 13. In which type of hemolytic disease of the fetus and newborn is the first-born affected? A) M B) D C) ABO D) E - CORRECT ANSWER ABO 14. Which of the following blood group systems has been implicated in transfusion reactions on the first exposure to incompatible red blood cells? A) Rh B) Kidd C) ABO D) Kell - CORRECT ANSWER ABO 15. Antibody screening of the recipient is performed as a component of compatibility testing to detect: A) red cell alloantibodies. B) irregular antigens on the recipient's red cells. C) human leukocyte antigen antibodies. D) incompatibilities with the donor's red cells. - CORRECT ANSWER red cell alloantibodies 16. Antibodies to which of the following blood group system show dosage (i.e., are stronger with homozygous expression of the antigen)? A) Lutheran B) P C) Kell D) Duffy - CORRECT ANSWER Duffy 17. What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used? A) No effect B) Hemolysis C) False positives D) False negatives - CORRECT ANSWER False negatives 18. Most "naturally occurring" ABO system antibodies fall into which class? A) IgG B) IgA C) IgM D) IgE - CORRECT ANSWER IgM 19. A 300-µg dose of Rh immune globulin contains sufficient anti-D to protect against how much whole blood? A) 100 mL B) 25 mL C) 30 mL D) 50 mL - CORRECT ANSWER 30 mL 20. A 44-year-old woman has a hemoglobin level of 6.1 g/dL. White blood cell and platelet counts are within normal levels. The patient is group O D-negative with a negative antibody screen. Crossmatches are compatible. However, 15 minutes after the first transfusion is started, she experiences erythema and hives. What type of transfusion reaction is occurring? A) Urticarial B) Acute hemolytic C) Delayed hemolytic D) Febrile nonhemolytic - CORRECT ANSWER Urticarial 21. To prevent graft-versus-host disease, red blood cells prepared for intrauterine transfusions should be: A) saline washed. B) ABO and D-compatible with the mother. C) frozen and deglycerolized. D) irradiated. - CORRECT ANSWER irradiated 22. Which ABO phenotype selection contains the most H antigen and the least H antigen, respectively, on the red cell's surface? A) A2, A1B B) A1B, O C) O, A1B D) B, A - CORRECT ANSWER O, A1B 23. Nucleic acid tests are used to screen for: A) hepatitis C virus, West Nile virus, and HIV. B) human T-cell lymphotropic virus-I/human T-cell lymphotropic virus-II, HIV-1/HIV-2, and hepatitis C virus. C) Chagas disease, malaria, and syphilis. D) hepatitis B virus, hepatitis C virus, and HIV. - CORRECT ANSWER hepatitis C virus, West Nile virus, and HIV 24. Infants do not require crossmatching if they are less than: A) 5 months old B) 4 months old C) 6 months old D) Crossmatching is always required - CORRECT ANSWER 4 months old 25. A technologist was being trained in a different area of the blood bank and noticed that the person training her had not recorded the results of a test. To be helpful, she carefully recorded the results she saw at a later time, using the technologist's initials. Is this acceptable procedure? A) Yes; because she used the other technologist's initials. B) No; she should have brought the error to the technologist's attention. C) Yes; as long as she records the result in pencil. D) Yes; all results must be recorded regardless of who did the test. - CORRECT ANSWER No; she should have brought the error to the technologist's attention 26. Given the following ABO phenotyping data: REVERSE Anti-A: 2+mf A1 cells: 0 Anti-B: 0 B cells: 3+ What could be a plausible explanation for this discrepancy? A) Rouleaux formation B) Positive direct antiglobulin test C) T-activation of red cells D) Group O blood products given to group A - CORRECT ANSWER Group O blood products given to group A 27. The indirect antihuman globulin test is incubated at what temperature? A) 37° C B) 56° C C) 22° C D) 4° C - CORRECT ANSWER 37° C 28. A recipient with group A phenotype requires a transfusion of 2 units of frozen plasma. Which of the following types are appropriate to select for transfusion? A) AB and A B) AB and B C) B and A D) O and A - CORRECT ANSWER AB and A 29. Compatibility procedures will address all of the following except to: A) maximize in vivo survival rate of red cells. B) check ABO compatibility. C) prevent life-threatening transfusion reactions. D) prevent antibody formation. - CORRECT ANSWER prevent antibody formation. 30. Which of the following phenotypes is heterozygous? A) Jk(a+b-) B) Fy(a-b+) C) Le(a+b-) D) Fy(a+b+) - CORRECT ANSWER Fy(a+b+) 31. The antiglobulin test was performed using gel technology. A button of cells was observed at the bottom of the microtube following centrifugation. This result indicates a: A) problem with the card B) failure to wash correctly C) negative reaction D) strong positive reaction - CORRECT ANSWER negative reaction 32. Patient M.M. was admitted to the hospital with acute bleeding. Anti-E was detected in the patient's serum. Four E-negative units of blood were crossmatched for the patient. The units were compatible at immediate spin and following the antiglobulin test. After the antiglobulin test was performed, IgG sensitized red cells gave a 2+ agglutination reaction. The proper interpretation of this 2+ agglutination reaction is the: A) antihuman globulin washing procedure was adequate. B) patient's anti-E reacted with the IgG-sensitized red cells. C) crossmatch was incompatible. D) IgG-sensitized red cells spontaneously agglutinated. - CORRECT ANSWER antihuman globulin washing procedure was adequate 33. A transfusion reaction investigation should include all of the following except: A) posttransfusion patient temperature. B) collection of a blood sample. C) human leukocyte antigen type. D) reidentification of the patient and transfused component. - CORRECT ANSWER human leukocyte antigen type 34. The temperature of a shipment of red blood cell units that were received from the local blood center was recorded as 8° C. The correct course of action is to: A) place the units in inventory because the temperature is acceptable. B) have the units tested for bacterial contamination before release. C) send the units back to the blood center. D) quarantine the units until approved by the supervisor. - CORRECT ANSWER place the units in inventory because the temperature is acceptable 35. How often can a person donate a unit of whole blood for a directed donation? A) 2 weeks B) 8 weeks C) 48 hours D) 24 hours - CORRECT ANSWER 8 weeks 36. Which of the following transfusion reactions has the highest incidence? A) Transfusion-related acute lung injury B) Graft-versus-host disease C) Hemolytic reactions due to ABO incompatibility D) Urticarial - CORRECT ANSWER Urticarial 37. Cold autoantibodies are typically of which specificity? A) Leb B) M C) I D) N - CORRECT ANSWER I 38. The weak D test detects: A) missing D mosaic B) Du antigen C) weak D antigen D) weak D antibody - CORRECT ANSWER weak D antigen 39. Select the test that uses IgG-sensitized red cells (check cells). A) Rh-antigen typing B) B-antigen detection C) Antiglobulin test D) D-antigen typing - CORRECT ANSWER Antiglobulin test 40. In an antibody identification panel, only one red cell was negative at the antihuman globulin phase. On ruling out and matching the pattern, an anti-k was identified. What further testing is necessary to confirm the antibody? A) Perform an adsorption using "k"-positive cells. B) Two more K-negative cells should be tested. C) Treat the panel cells with enzymes and perform the panel again. D) Two more k-negative cells should be tested. - CORRECT ANSWER Two more k-negative cells should be tested 41. A thorough donor history is the only way to prevent: A) Syphilis B) Cytomegalovirus C) human T-cell Lymphotropic virus-I D) malaria - CORRECT ANSWER malaria 42. How would you interpret the results if both the anti-D reagent and the Rh control were 2+ agglutination reactions? A) Unable to determine without further testing B) Depends on whether the sample was from a patient or a blood donor C) D-positive D) D-negative - CORRECT ANSWER Unable to determine without further testing 43. Unacceptable quality control results for the antiglobulin test performed in test tubes may be noticed if: A) the reagents used were improperly stored. B) the technologist performing the test was never trained. C) preventive maintenance has not been performed on the cell washer. D) all are correct - CORRECT ANSWER all are correct 44. Which of the following products is tested for bacterial contamination following storage? A) Red blood cells, frozen B) Platelets C) Cryoprecipitated AHF D) Fresh frozen plasma - CORRECT ANSWER Platelets 45. Leukocyte-poor red blood cells are indicated for patients with: A) febrile transfusion reactions. B) iron deficiency anemia. C) hemophilia A. D) cancer undergoing chemotherapy treatments. - CORRECT ANSWER febrile transfusion reactions 46. Rh system antibodies characteristically give: A) reactions that are enhanced with enzymes. B) weak reactions with panel cells. C) mixed-field reactions on panels. D) strong reactions with panel cells when read at immediate spin phase. - CORRECT ANSWER reactions that are enhanced with enzymes 47. When group O blood is not available for transfusion, what is the next alternative? A) Washed group B red blood cells B) Group AB red blood cells C) None D) Group A red blood cells - CORRECT ANSWER None 48. Which of the following phenotypes will react with anti-f? A) rr B) R2R2 C) R1R2 D) R1R1 - CORRECT ANSWER rr 49. Which of the following is used in the treatment of hemophilia A? A) Factor VIII concentrate B) Fresh frozen plasma C) Platelets D) Factor XIII concentrate - CORRECT ANSWER Factor VIII concentrate 50. A group O patient was crossmatched with group B red blood cells. What phase of the crossmatch will first detect this incompatibility? A) Indirect antiglobulin B) Immediate spin C) None of them; unit is compatible D) 37˚ C low-ionic strength solution - CORRECT ANSWER Immediate spin 1. Cell-mediated immune responses such as attacking and killing microorganisms or host cells damaged or infected are carried out by A) lymphocytes of the T (thymus-derived) class B) lymphocytes of the B (bone marrow-derived) class C) neutrophils D) basophils - CORRECT ANSWER lymphocytes of the T (thymus-derived) class 2. Which immune system cells destroy infected or malignant host cells? A) B lymphocytes B) T lymphocytes C) Natural killer cells D) Neutrophils - CORRECT ANSWER Natural killer cells 3. The presence of this antibody usually indicates recent or active infection. A) IgG B) IgA C) IgM D) IgE - CORRECT ANSWER IgM 4. The antibody that primarily protects body surfaces lined with mucous membranes such as the eyes and intestines is A) IgG B) IgA C) IgM D) IgE - CORRECT ANSWER IgA 5. All of the following are true statements about IgM except: A) it is produced during a primary antibody response B) it has the largest molecular weight of all of the immunoglobulin classes C) it fixes complement D) it is capable of crossing the maternal-fetal placental barrier - CORRECT ANSWER it is capable of crossing the maternal-fetal placental barrier 6. The name of the process that promotes attraction of phagocytic cells toward a foreign particle is: A) Diapedesis B) Chemotaxis C) Opsonization D) Cytolysis - CORRECT ANSWER Chemotaxis 7. When an antibody-coated antigen is phagocytized, what component of the antibody molecule must fit into a receptor on the phagocytic cell? A) Variable H B) Variable L C) Fab region D) Fc region - CORRECT ANSWER Fc region 8. Which characteristic is not associated with B lymphocytes? A) Demonstrate surface immunoglobulin (sIg) B) Differentiate into plasma cells with antigenic stimulation C) Participate in an anamnestic response as memory cells D) Can directly lyse a foreign antigen - CORRECT ANSWER Can directly lyse a foreign antigen 9. The force of attraction between an antibody and a single antigenic determinant is: A) Avidity B) Affinity C) ionic bonding D) Van der Waals forces - CORRECT ANSWER Affinity 10. In indirect hemagglutination testing, the: A) antigens of the red blood cells are bound by antibodies B) antigen passively attached to red blood cells are bound by antibodies C) antibody reacts with antibodies D) soluble antigens react with antibodies - CORRECT ANSWER antigen passively attached to red blood cells are bound by antibodies 11. The radioallergosorbent test (RAST): A) uses antigen specific IgE antibody B) uses non-covalently-bound antibody on a cellulose disc C) uses non-covalently-bound antibody on a cellulose RIA plate D) has an excess of antibody present in the test system - CORRECT ANSWER uses antigen specific IgE antibody 12. The TORCH IgM and IgG assay includes detection of all of the following except: A) Cytomegalovirus B) Epstein-Barr virus C) Rubella D) infectious mononucleosis - CORRECT ANSWER infectious mononucleosis 13. The substance detected by the RPR assay is: A) T. pallidum B) Cardiolipin C) Reagin D) B. burgdorferi - CORRECT ANSWER Reagin 14. Which hepatitis B serologic marker is the classic first indication of a hepatitis B infection? A) Anti-Hbc B) Anti-Hbe C) HbsAg D) HbcAg - CORRECT ANSWER HbsAg 15. Anaphylaxis is characterized by all of the following statements except: A) it can cause death due to asphyxiation B) massive release of histamine from mast cells and basophils C) prior sensitization to an allergen D) associated with a significant increase in eosinophils in the circulating blood - CORRECT ANSWER associated with a significant increase in eosinophils in the circulating blood 16. Histamine can: A) cause obstructed airflow to the bronchioles B) exert an anticoagulant effect C) cause decreased capillary permeability D) enhance opsonization in phagocytosis - CORRECT ANSWER cause obstructed airflow to the bronchioles 17. A speckled pattern relates to: A) dsDNA, histones, DNA-histone complexes B) Sm, RNP, SS-A, SS-B, hnRNP, others C) centromere proteins A, B, and C D) nuclear lamins A, B, and C; nuclear pore proteins - CORRECT ANSWER Sm, RNP, SS-A, SS-B, hnRNP, others 18. Which of the following is cleaved as a result of activation of the classical complement pathway? A) Properdin factor B B) C1q C) C4 D) C3b - CORRECT ANSWER C4 19. The antigen marker most closely associated with transmissibility of HBV infections is: A) HBs B) HBe C) HBc D) HBV - CORRECT ANSWER HBe 20. Antibody class and antibody subclass are determined by: A) Constant region of heavy chain B) Constant region of light chain C) Disulphide bonds D) Fab region - CORRECT ANSWER Constant region of heavy chain 21. A transfusion reaction to erythrocyte antigens will activate which of the following immunopathologic mechanisms? A) Immediate hypersensitivity B) Arthus reaction C) Delayed hypersensitivity D) Immune cytolysis - CORRECT ANSWER Immune cytolysis 22. Systemic lupus erythematosus patients often have which of the following test results? A) High titers of DNA antibody B) Decreased serum immunoglobulin levels C) High titers of anti-smooth muscle antibodies D) High titers of antimitochondrial antibody - CORRECT ANSWER High titers of DNA antibody 23. Which IgG subclass is most efficient at crossing the placenta? A) IgG1 B) IgG2 C) IgG3 D) IgG4 - CORRECT ANSWER IgG1 24. Which of the following is the "C3 activation unit" in the classical complement pathway? A) C1q B) C3 C) C4b, C2a D) C5, C6, C7, C8, C9 - CORRECT ANSWER C4b, C2a 25. This product of Group A Strep is responsible for the beta hemolysis on the blood agar plate: A) Streptolysin O B) Streptolysin S C) Hyaluronidase D) Erythrogenic toxin - CORRECT ANSWER Streptolysin S 1. Nosocomial infections are those that A) develop and progress slowly B) develop quickly C) are contracted in the hospital environment D) develop quickly but last longer - CORRECT ANSWER are contracted in the hospital enviroment 2. Latent infections are those that A) develop and progress slowly B) develop quickly and end sooner C) exist as a silent phase in which the agent is causing no notable effect D) develop quickly but last longer - CORRECT ANSWER exist as a silent phase in which the agent is causing no notable effect 3. Organisms that have nutritional needs that are relatively complex and require extra media components to be used for growth are called A) Fastidious B) Capnophiles C) Neutrophils D) Halophiles - CORRECT ANSWER Fastidious 4. Which category of media would MacConkey agar best fit? A) Selective B) Differential C) Selective and differential D) Supportive - CORRECT ANSWER Selective and differential 5. What name is given to the type of hemolysis that produces incomplete hemolysis and a greening discoloration of the medium? A) Beta hemolysis B) Gamma hemolysis C) Alpha hemolysis D) Kappa hemolysis - CORRECT ANSWER Alpha hemolysis 6. Anaerobes grow best in A) ambient air, which contains 21% oxygen (O2) and a small amount (0.03%) of carbon dioxide B) increased concentrations of CO2 (5% to 10%) and approximately 15% O2 C) 5% to 10% hydrogen (H2), 5% to 10% CO2, 80% to 90% nitrogen (N2), and 0% O2 D) reduced O2 (5% to 10%) and increased CO2 (8% to 10%) - CORRECT ANSWER 5% to 10% hydrogen (H2), 5% to 10% CO2, 80% to 90% nitrogen (N2), and 0% O2 7. Choose the group of bacteria that is described as catalase-positive, gram-positive cocci that grow facultatively anaerobic and that form grapelike clusters. A) Neisseria B) Staphylococcus C) Micrococcus D) Streptococcus - CORRECT ANSWER Staphylococcus 8. The bacterial species that can be described as able to hydrolyze hippurate, beta hemolytic, a major cause of neonatal meningitis and sepsis, and producer of the CAMP factor is A) Enterococcus faecalis B) Streptococcus pneumoniae C) Streptococcus pyogenes D) Streptococcus agalactiae E) Viridans streptococci - CORRECT ANSWER Streptococcus agalactiae 9. Enterococci can be described as A) able to grow in 6.5% NaCl B) usually alpha hemolytic C) a major cause of pharyngitis D) often carrying an antiphagocytic capsule E) All of the above are true - CORRECT ANSWER able to grow in 6.5% NaCl 10. The drug of choice for most streptococcal infections is A) Vancomycin B) Streptomycin C) Penicillin D) Septra - CORRECT ANSWER Penicillin 11. Suspect spore-forming gram-positive bacilli that are hemolytic, motile, and penicillin-resistant and that produce a wide zone of lecithinase on egg yolk agar can be identified as A) Corynebacterium diphtheriae B) Bacillus anthracis C) Bacillus cereus D) Corynebacterium jeikeium - CORRECT ANSWER Bacillus cereus 12. The isolation of a small gram-positive, catalase-positive rod with a narrow zone of beta hemolysis isolated from blood or CSF should be used as strong presumptive evidence for A) Listeriosis B) Diphtheria C) Pertussis D) Tetanus - CORRECT ANSWER Listeriosis 13. The wet mount and Gram stain of vaginal secretions from a patient who has bacterial vaginosis caused by Gardnerella vaginalis will reveal A) large, squamous epithelial cells with numerous attached pleomorphic gram-variable or gram-negative coccobacilli and rods B) large numbers of large gram-positive rods C) large numbers of polymorphonuclear leukocytes D) All of the above are correct - CORRECT ANSWER large, squamous epithelial cells with numerous attached pleomorphic gram-variable or gram-negative coccobacilli and rods 14. Not only is this group of gram-negative bacteria considered normal flora of the gastrointestinal tract of humans and animals, but also it contains agents of important diseases such as gastroenteritis and enteric fevers, urinary tract infections, and bacterial pneumonia. A) Neisseriaceae B) Micrococcaceae C) Enterococcus D) Enterobacteriaceae - CORRECT ANSWER Enterobacteriaceae 15. The gram-negative bacillus that can be described as oxidase-negative, nitrate-positive, indole-negative, citrate-positive, methyl red-positive, urease-negative, H2S-positive is A) Klebsiella pneumoniae B) Proteus vulgaris C) Salmonella enteritidis D) Escherichia coli - CORRECT ANSWER Salmonella enteritidis 16. The swarming gram-negative bacillus that can be described as oxidase-negative, nitrate-positive, indole-negative, and H2S- positive is A) Proteus aerogenes B) Proteus vulgaris C) Proteus mirabilis D) Escherichia coli - CORRECT ANSWER Proteus mirabilis 17. Pertussis (whooping cough), an epidemic disease, is a highly contagious, acute infection of the upper respiratory tract caused by A) Brucella species B) Bordetella species C) Pasteurella species D) Francisella species - CORRECT ANSWER Bordetella species 18. Of the following media, which provides the factors necessary for the growth of Haemophilus spp.? A) 5% sheep blood agar B) Brain heart infusion agar C) Chocolate agar D) Nutrient agar - CORRECT ANSWER Chocolate agar 19. Campylobacter spp. can sometimes be detected by direct Gram stain examination of fecal sample, which would reveal many A) large, faintly staining gram-negative bacilli B) small, curved or seagull-winged gram-negative bacilli C) small gram-negative coccobacilli D) plump, faintly staining gram negative bacilli - CORRECT ANSWER small, curved or seagull-winged gram-negative bacilli 20. The selective medium thiosulfate citrate bile salts sucrose (TCBS) agar is especially formulated for isolating what pathogen from stool cultures? A) Vibrio B) Salmonella C) Shigella D) Plesiomonas - CORRECT ANSWER Vibrio 21. Organisms belonging to the genus Neisseria are A) gram-positive diplococci B) gram-negative diplococci C) gram-negative coccobacilli D) gram-negative bacilli - CORRECT ANSWER gram-negative diplococci 22. Which of the following bacterial species is part of animal flora and is transmitted to humans during close animal contact, including bites? A) Sphingomonas paucimobilis B) Eikenella corrodens C) Pasteurella multocida D) Weeksella virosa - CORRECT ANSWER Pasteurella multocida 23. The tuberculin skin test, or PPD test, is based on A) delayed hypersensitivity cell-mediated immunity to certain antigenic components of the organism B) injection of M. tuberculosis under the skin and subsequent mild cutaneous infection C) antigen-antibody reactions occurring at the injection site D) All of the above are correct - CORRECT ANSWER delayed hypersensitivity cell-mediated immunity to certain antigenic components of the organism 24. Which of the following agents lacks a cell wall and is the smallest known free-living form? A) Chlamydia B) Mycoplasma C) Rickettsia D) Coxiella - CORRECT ANSWER Mycoplasma 25. The most common larvae found in stool specimens is A) Ascaris lumbricoides B) Strongyloides stercoralis C) Paragonimus westermanni D) Naegleria fowleri - CORRECT ANSWER Strongyloides stercoralis 26. A flagellate trophozoite that can be described as 9 to 12 μm, with one to two nuclei with no nuclear peripheral chromatin, a karyosome composed of four to eight large granules, and finely granular cytoplasm would most likely be A) Giardia lamblia B) Dientamoeba fragilis C) Iodamoeba bütschlii D) Chilomastix mesnili - CORRECT ANSWER Dientamoeba fragilis 27. Varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus are included in this widely disseminated group of viruses. A) Coronaviruses B) Herpes viruses C) Caliciviruses D) Filoviruses - CORRECT ANSWER Herpes viruses 28. Which of the following bacteria is positive for oxidase? A) Proteus mirabilis B) Klebsiella pneumonia C) Acinetobacter D) Neisseria - CORRECT ANSWER Neisseria 29. All of the following are capable of causing tuberculosis except: A) Mycobacterium tuberculosis B) Mycobacterium avium C) Mycobacterium bovis D) Mycobacterium africanum - CORRECT ANSWER Mycobacterium avium 30. One specific agar for Mycobacterium spp. is: A) Regan-Lowe B) Cystine tellurite C) Lowenstein-Jennings D) BCYE - CORRECT ANSWER Lowenstein-Jennings 31. Which of the following is known to cause Q fever? A) Bartonella henselae B) Bartonella quintana C) Coxiella D) Rickettsia rickettsii - CORRECT ANSWER Coxiella 32. Chlamydial infections have been implicated in: A) Urethritis and conjunctivitis B) Gastroenteritis and urethritis C) Neonatal pneumonia and gastroenteritis D) Neonatal meningitis and conjunctivitis. - CORRECT ANSWER Urethritis and conjunctivitis 33. The scolex of Taenia saginata has: A) 4 suckers B) No suckers and 14 hooklets C) 24 hooklets D) 26 to 28 sucking disks - CORRECT ANSWER 4 suckers 34. In a suspected case of Hansen's disease, a presumptive diagnosis is established by: A) Isolation of organisms on Lowenstein-Jensen medium B) Detection of weakly acid-fast rods in infected tissue C) Isolation of organisms on Loeffler's medium D) Detection of gram positive rods in infected tissue - CORRECT ANSWER Detection of weakly acid-fast rods in infected tissue 35. A patient is suspected of having amebic dysentery. Upon microscopic examination of a fresh fecal specimen for ova and parasite, the following data were obtained:Trophozoite of 25 µmProgressive crawlEvenly distributed peripheral chromatinFinely granular cytoplasmThis information probably indicates: A) Entamoeba coli B) Entamoeba histolytica C) Endolimax nana D) Iodamoeba bütschlii - CORRECT ANSWER Entamoeba histolytica 36. Three sets of blood cultures were obtained. The aerobic bottle of one set had growth of Staphylococcus epidermidis on the 7-day subculture. This indicates that: A) There was a low-grade bacteremia B) The organism is most likely a contaminant C) The subculture plates were defective D) The subculture should have been done at 5 days - CORRECT ANSWER The organism is most likely a contaminant 37. A gastroenterologist submits a gastric biopsy from a patient with a peptic ulcer. To obtain presumptive evidence of Helicobacter pylori, a portion of the specimen should be added to which media? A) Urea broth B) Tryptophane C) Hippurate hydrolysis D) PYR - CORRECT ANSWER Urea broth 38. An HIV-positive patient began to show signs of meningitis. Spinal fluid was collected and cultured for bacteria and fungus. A budding, encapsulated yeast was recovered. Which organism is consistent with this information? A) Cryptococcus neoformans B) Paracoccidioides brasiliensis C) Malassezia furfur D) Candida albicans - CORRECT ANSWER Cryptococcus neoformans 39. An anaerobic, spore-forming, gram positive bacillus isolated from a deep wound of the leg is most probably: A) Francisella tularensis B) Clostridium perfringens C) Bacillus subtilis D) Bacteroides - CORRECT ANSWER Clostridium perfringens 40. The formation of germ tubes presumptively identifies: A) Candida tropicalis B) Candida parapsilosis C) Candida glabrata D) Candida albicans - CORRECT ANSWER Candida albicans 41. Examine the minimum inhibitory concentration (MIC) tray shown below and determine the MIC for gentamicin.64 Clear 32 Clear 16 Clear 8 Clear 4 Clear 2 Clear Control Cloudy A) ≥64 g/mL B) 32 g/mL C) 16 g/mL D) ≤2 g/mL - CORRECT ANSWER ≤2 g/mL 42. Rose Gardener's disease is caused by A) Histoplasma capsulatum B) Sporothrix schenckii C) Blastomyces dermatitidis D) Coccidioides immitis - CORRECT ANSWER Sporothrix schenckii 43. Respiratory Syncytial virus (RSV) is best isolated using a: A) Nasopharyngeal aspirate B) Cough plate C) Expectorated sputum D) Throat swab - CORRECT ANSWER Nasopharyngeal aspirate 44. A gram stain from a swab of a hand wound reveals:Moderate gram positive cocci in chainsModerate large gram negative bacilliSelect the appropriate media that will selectively isolate each organism. A) KV-laked agar, Thayer-Martin B) Sheep blood, MacConkey C) CNA, Chocolate D) PEA, MacConkey - CORRECT ANSWER PEA, MacConkey 45. Which of the following has rhizoids between the sporangiophores? A) Mucor B) Absidia C) Rhizopus D) Trichophyton - CORRECT ANSWER Absidia 46. Erysipelothrix infections in humans characteristically produce A) Raised lesions on skin B) Central nervous system disease C) Formation of abscesses in visceral organs D) Disease in the lower respiratory tract - CORRECT ANSWER Raised lesions on skin 47. Which of the following antimicrobial agents acts by inhibiting protein synthesis? A) Rifampin B) Methicillin C) Gentamicin D) Vancomycin - CORRECT ANSWER Gentamicin 48. Which of the following antimicrobial agents acts by inhibiting cell wall synthesis? A) Vancomycin B) Clindamycin C) Naladixic acid D) Gentamicin - CORRECT ANSWER Vancomycin 49. A very small, single-stranded DNA virus that causes a febrile illness with a rash and is called the fifth childhood disease after rubeola, rubella, varicella, and roseola is: A) Rotavirus B) Adenovirus C) Coxsackie A virus D) Parvovirus - CORRECT ANSWER Parvovirus 50. Mycobacteria spp. can be detected by all of the following methods except: A) Ziehl-Neelson B) Auramine-rhodamine C) Acridine orange D) Kinyoun - CORRECT ANSWER Acridine orange 1. Which is the proper vein selection for venipuncture? A) Basilic, cephalic, median cubital B) Cephalic, median cubital, basilic C) Median cubital, basilica, cephalic D) Median cubital, cephalic, basilic - CORRECT ANSWER Median cubital, cephalic, basilic 2. The difference between serum and plasma is: A) Plasma contains fibrinogen B) Plasma is clear, serum is cloudy C) Serum is collected with an anticoagulant D) Serum is darker yellow in color than plasma - CORRECT ANSWER Plasma contains fibrinogen 3. Which of the following tubes are in the proper order of draw for the evacuated tube method? A) Lavender, light blue, red B) Light blue, red, green C) Red, green, light blue D) SST, light blue, green - CORRECT ANSWER Light blue, red, green 4. What special handling does a bilirubin specimen require? A) Keep at body temperature B) Protect from light C) Transport on ice D) None of the above - CORRECT ANSWER Protect from light 5. The tourniq