ASCP Review Exam Questions and Complete Solutions Graded A+

  1. What is the predominant cell type in CLL? Answer: B cell 2. What enzyme can help with the diagnosis of muscular dystrophy? Answer: Creatine phosphokinase (CPK) 3. What are howell-jolly bodies? Answer: dna fragments 4. True or false: Lupus anticoagulant causes micro emboli formation in blood vessels of SLE patients Answer: true 5. What solution is used for the measurement of HDL? Answer: Heparin-manganese 6. In blood bank DAT testing, 3 AHG tubes are negative. When check cells were added, it was still negative. What was the error? Answer: serum was omitted from the reaction 7. How does oral contraceptive change iron store levels? Answer: iron stores are higher 8. What are blastoconidia? Answer: one large mother cell that produces mu cells 9. A catalase positive, gram positive bacilli with diptheroid morphology is highly resistant to many antibiotics and is associated with immu mised patients. Answer: C. deptheriae 10. In chronic active hepatitis, hight titers of which of antibodies are seen? Answer: - anti-smooth muscle 11. A chronically ill patient, becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is Answer: Answer: Ammonia 12. On an automated coagulation analyzer, PT controls are in range but PTT controls are out of range. New controls produce the same results. What do you do? Answer: CaCl2 may have been added to the APTT reagent. Change reagents and repeat 13. True or false regarding weak D phenotype Answer: A change in expression of D antigen epitopes Answer: False, All epitopes are present but under-expressed 14. A patients plasma was screened for alloantibodies and was positive for anti-K. What percentage of ABO compatible blood units would be K antigen negative and chosen for transfusion? Answer: 91 15. What nutrient is in an anaerobic agar to help the growth of anaerobes? Answer: - cysteine 16. Test results low TSH and elevated free T4. How would you interpret these results? Answer: hyperthyroidism 17. How do you differentiate between Yersinia pestis and Y.entercolitica? Answer: moti- ity 18. Individuals who are negative for THIS blood type are resistant to P. vivax infecion. Answer: Duffy 19. If TIBC is 240 mcg/dl and serum iron is 144 mcg/dl and ferritin is 250 mcg/L, what is the UIBC%? Answer: TIBC = iron + UIBC 240 = 144 + x 96 = x 96/240 = 0.4 = 40% 20. What is the terminal sugar of the B antigen? Answer: d-galactose 21. What blood group antigens are not a part of the RBC membrane and are synthesized by tissues cells, carried by plasma and adsorbed onto the RBC surface? Answer: Lewis 22. What does a PCO2 electrode measure? Answer: pH 23. What is another name for Cooley's anemia? Answer: Thalassemia major 24. What urine test can help diagnose Pheochromocytoma? Answer: Methanephrines 25. What are these red cells and in what condition are they seen cytes in liver disease 26. What plasma level is decreased in hyperglycemia? Answer: sodium 27. In biliary obstruction, how does the urine bilirubin and urobilinogen change? Answer: urine bilirubin Answer: positive urobilinogen Answer: decreased/negative 28. On a urinalysis test, blood is positive in the strip test, but no red cells are seen under the microscope. What can be an explanation? Answer: hypotonic and alkaline urine 29. If the life span of RBCs are shortened, how does urine bilirubin levels change? Answer: urine bilirubin Answer: negative urine urobilinogen Answer: increased 30. Which are used to compare two sets of mean? Answer: Paired T-test 31. A blood collection was stopped after collecting 369ml of donor blood. What can it be used for now? Answer: Whole blood 32. AST/ALT ratio in a patient is significantly high (more than 2). this suggest? Answer: alcoholic liver disease 33. VMA test is done for diagnosis of what disease? Answer: Supporting diagnosis of neuroblastoma 34. In testing a blood bank specimen, Anti IgG (+) and Anti C3d (+) Answer: What should the MLS do? Answer: Elution 35. Beta-hCG is a marker for what disease? Answer: Testicular cancer 36. Tyrosine crystals indicate Answer: liver disease 37. A 4 year old's peripheral blood shows cells with increased N cells with 2 nucleoli. The nuclei of cells are indented and irregul most likely diagnosis? Answer: ALL 38. a blue top specimen was drawn from a catheter and tested for PT and PTT. The result are significantly higher than yesterday's results. What is the most likely explanation? Answer: heparin contamination 39. If total cholesterol is 220 mg/dL, HDL is 45 mg/dL, and triglyceride is250 mg/dL, what is the concentration of LDL? Answer: LDL= Total - HDL - (trig/5) x = 220 - 45 - (250/5) x = 125 40. Which bacteria is of concern regarding water contamination? Answer: above 41. Patient with bloody sputum does to a hosptal's emergency room. The culture shows green mold. Which infection is most likely? Answer: Aspergillosis 42. What marker is first to increase after MI? Answer: myoglobin 43. In hydrops fetalis what hemoglobin is found? Answer: barts 44. What types of cells in sezary syndrome become cancerous? Answer: t cells 45. What is the significance of eosinophils in urine? Answer: acute interstitial nephritis 46. Identify cyst Answer: Answer: E. histolytica 47. gram negative bacteria, normall found in the oropharyngeal tract of mam- mals, they are involved in pathogenesis of some animal bite wounds as well as periodontal disease. This bacteria exhibits gliding motility. Answer: Capnocytophagia 48. HPV test is more often done for what condition? Answer: genital warts 49. A gram stain from an abdominal abcess shows gram negative rods. It grows anaerobically in the presence of bile esculin. What choice is the most likely identification? Answer: Bacteroides fragilis 50. What test is used to measure unfractionated heparin therapy? Answer: APTT 51. In obstructuve live disease, RBCs tend to have the following morphology Answer:- Answer: Macrocytic 52. How do RBCs look like in concentrated urine samples? Answer: crenated 53. Sputum sample has 25 PMN cells, 10 epithelial cells on HPO, in oil immer- sion bacteria and fungi were seen, what to do? Answer: culture both bacteria and fungi 54. In unconjugated bilirubinemia Answer: unconjugated bilirubin = (+/-) urine bilirubin = (+/-) urine urobilinogen = (+/-) Answer: unconjugated bilirubin = (+) urine bilirubin = (-) urine urobilinogen = (-) 55. Detection of antigen in urine specimens can be used for which of the following pneumonia infections? Answer: Legionella 56. What is the role of a supervisor in the laboratory? Answer: democratic 57. What disease is presented with monocytosis? Answer: tuberculosis 58. This electrophoresis is suggestive of what condition? Answer: nephr 59. PEA and Columbia CNA agar are used to culture Answer: Answer: gram positive bacteria 60. Specimen of choice for FK506 (tacrolimus), cyclosporine, and sirolimus?- Answer: Lavender top EDTA 61. Which acute phase protein is high in nephrotic syndrome? Answer: alpha 2 macroglobulin 62. Why are early morning sputum specimens recommended for TB testing?- Answer: more concentrated specimen 63. Which carbohydrate is used in media plates to differentiate S. aureus from other Staph spp? Answer: mannitol 64. What does a delta check mean when oing automated clinical measure- ments? Answer: significant change in patient's results compared to previous result 65. When primidone is administered, what other compound must be quantified in serum to monitor drug levels? Answer: Phenobarbital 66. In Cushing's disease, how does ACTH and Cortisol levels ch ACTH and cortisol are up 67. What test is done when exposure to pesticides is suspected? Answer: - Cholinesterase 68. The extrinsic system of coagulation is monitored by which t 69. What is the best diagnostic test for excessive alcohol consumption? Answer: GGT 70. If RBC lifespan is shortened, what will happen to HbA1c? Answer: Lower results 71. Total cholesterol is 190, HDL is 35, triglycerides is 180. What is LDL? Answer: LDL = total - HDL - (tri/5) x = 190 - 35 - (180/5) x = 119 72. A gram stain shows gram positive cocci in chains, non-hemolytic. The bacteria will grow on 6.5% NaCl and is bile esculin positive. What is the most likely ID? Answer: enterococcus 73. In Auramine-Rhodamine stain for acid fast bacteria, what is the function of potassium permanganate? Answer: quenching factor 74. Stray light can be detected in the spectrophotometer by utilizing a Answer: sharp cut off filter 75. A blood smear is made that covered 60% of the slide, WBCs are clustered at the end, what do you do? Answer: reject the slide 76. What rule was broken? Answer: No violation 77. Which conditions can be observed in cushing's syndrome? Answer: Hyper- glycemia/hypercalcemia 78. What does SIADH present with? Answer: hyponatremia due to dilution 79. Anti-P titers are often increased in Answer: hydatid cyst disease 80. What are heinz bodies made of Answer: denatured hemoglobin 81. True or false regarding antibodies to CMV IgG = any infection over lifetime IgM - recent or reinfection Answer: true 82. In which type of malaria schizonts are rarely, if ever, seen? Answer: P. fa 83. In Hashimoto's thyroiditis, how do the levels of T4 and TSH change? Answer: TSH high T4 low 84. Hair perforation test is for the identification of which two fungi? Answer: Trichophy- ton mentagrophyte T. rubrum 85. Which of the following serves as the specimen of choice for the demon- stration of tertiary syphilis? Answer: CSF 86. Serum ferritin levels in pregnant women are Answer: lower than normal values 87. Inside of a reference electrode is filled with what solution? Answer: 88. A patient with presentation of a pancreatic mass will be tested for? Answer: CA 19-9 89. Enzymes enhance which blood groups? Answer: ABO, Rh, Kidd, Lew 90. Identify Answer: Alternatia 91. What test is used to confirm the presence of bence-jones proteins? Answer: im- munofixation electrophoresis 92. A patient has hypercalcemia, what to order next? Answer: PTH Excess PTH ’ hypercalcemia 93. What factor mediates formation of prothrombin to thrombin? Answer: Xa 94. A patient diagnosed with acute MI is treated with streptokinase. What test is abnormal immediately after treatment? Answer: D-dimer 95. Acidic urine specimens are frequently seen in? Answer: high protein diets 96. If RPR test is positive and the ABS-FTA test is negative, wh interpretation of the results? Answer: False RPR, repeat in 2 weeks 97. True or false regarding the clinitest? Used to detect glucose, galactose, and other reducing sugars Answer: true 98. Poisoning with moth balls may show which of the following red cell char- acteristics? Answer: heinz bodies 99. Which of the following anemia exhibits pancytopenia? pernicious megaloblastic iron deficiency aplastic Answer: aplastic anemia 100. How do you calculate coefficient of variation? Answer: (standard deviation/ mean) X 100 101. Which mycobacterium is found in tap water? Answer: M. gordonae 102. How does free to total PSA ratio show risk of prostate cancer? Answer: The higher the ratio, the LESSER the risk 103. What is a carrier of endogenous triglycerides? Answer: VLDL 104. The bacteria pictured what isolated from a clinical specimen in absence of oxygen. The gram stain from choc agar shows lon tapered ends. What i the most likely ID? Answer: Fusobacterium 105. How do you differentiate between primary and secondary hypothy- roidism? Answer: TSH 106. the anemias of the qualitative hemoglobinopathies, such as sickle cell anemia, are morphologically classified as Answer: Answer: Normocytic, normochromic 107. In hemolytic anemia, how does bilirubin levels change? Answer: Unconjugated bilirubin Answer: increase Urine urobilinogen Answer: increase 108. What method is used for quantifying fecal fat? Answer: gas chromatography 109. In primary biliary cirrhosis, which of the following antibodies is seen in high titers? Answer: Anti-mitochondrial 110. What enzyme is increased in mumps? Answer: Serum amylase 111. A 3 year old's urine specimen shows 25 renal tubular epithelial cells under high objective, granular casts, 3-5 WBC, nitrite is negative. Answer: acute tubular necrosis 112. Pernicious anemia is specifically associated with a deficiency in which of the following? Answer: intrinsic factor 113. Presence of which substance in urine is an early sign of renal disease?- Answer: microalbumin 114. Two consecutive values +/- 2SD of the mean break what rule Answer: 2,2S 115. Rh negative phenotype is most likely a results of Answer: RHD deletion 116. What condition causes ESR to decrease? Answer: Vibration of desk 117. Which bacteria produces a musty basement odor? Answer: Norca 118. calculate anion gap Answer: Na - (Cl + HCO3) 9 119. A bacteria is A/A and grows on Heokteon agar. What color would you expect the agar to turn? Answer: Yellow-Orange 120. A mycobacterium is grown in the dark and only after it is exposed to light, it produces a yellow pigment. This is characteristic of Answer: Answer: M. kansasii 121. Identify the disease with the ANA Answer: Scleroderma with CRE 122. 5HIAA test is used for what Answer: main metabolite of serotonin performed for dx of carcinoid tumor 123. If the DAT in cord blood is positive, what do you do next? Answer: Antibody screen on maternal blood 124. Which protein is the closest to the cathode in serum electro gamma 125. What is another name for echinocytes and when are they observed? Answer: burr cell, slowly drying smear 126. TIBC is 200 Iron is 125 What is UIBC? Answer: TIBC - iron = UIBC 75 127. Macrocytes typically seen in megaloblastic anemia are Answer: ovalocytes 128. What compounds has the same physiological effect as procainamide? Answer: - NAPA 129. Target cells can cause what in automated tested? Answer: High WB 130. Why would the color change from blue to orange then back to blue in clinitest Answer: Pass through phenomenon 131. An alkaline urine refrigerated become turbid because of? Answer: amorphous phosphates 132. rapid detection test for legionella in urine specimen Answer: antigen detection test 133. What can cause a false positive urobilinogen on urine strips? Answer: porpho- bilinogen 134. In rhabdomylosis, what causes kidney damage? Answer: myoglob 135. urine strip is positive for blood but under the microscope no what can cause this? Answer: dilute alkaline urine 136. what blood group reagent deteriorate faster while in use? Answer: MNS 137. What is fletcher's media used for? Answer: Leptospira 138. What is the drug of choice for MRSA? Answer: vancomycin 139. HGB = 12g/dl HCT = 36% MCHC = ? Answer: Hgb/Hct x 100 12/36 = x 33.3 = x 140. What can make CSF cloudy? Answer: Crystals 141. How are protein C results affected by coumadin? Answer: Decreased levels of protein C 142. Formula for sensitivity? Answer: TP/(TP+FN)*100 143. A gram stain is done in a CSF in the evening shift. How should it be stored for culture on the next day? Answer: Keep at around 35C or room temp 144. reactive monocytosis is seen in Answer: Tuberculosis 145. PT, APTT, and TT are all abnormal. What is the most likely cause? Answer: Afibrino- genemia 146. what reagent is used in sickle cell solubility test? Answer: sodium dithionite 147. True or false regarding megaloblastic anemia? Reticulocyte count is high Answer: FALSE 148. What are Pappenheimer bodies? Answer: iron particles 149. If an individual is a nonsecretor (sese) with lewish phenotype Le(a+b-) what antigen will be in their fluids? Answer: Le(a) 150. True or false regarding VWF It is deficienct in hemophilia A and it is required for platelet adhesion to collagen Answer: true 151. Best indicator of excessive alcohol consumption Answer: GGT 152. What factor is deficient in hemophilia b? Answer: Factor 9 153. on an automated instrument Answer: Hgb=45 g/dl Hct=33% the technologist does a manual Hct and the result is 33.5%. What should the MLS do next? Answer: Check for lipemia 154. which ionophore is used in potassium electrode? Answer: vanilomycin 155. 17-ketosteroid is produced in Answer: adrenal glands 156. What analyte is measured in preeclapmsia Answer: magnesium 157. What is flocculation? Answer: When fine particles are caused to clump together. 158. Which donor candidate wont be accepted for a blood donation? Answer: D Hepatitis B vaccines deferred for 12 months 159. Lactic acid specimen should be Answer: on ice, separate from cells 160. Mac Answer: pink TSI Answer: A/A Indole Answer: Positive Answer: Klebsiella oxytoca 161. What does caffeine benzoate do in Jendrassik-Grof method for measur- ing bilirubin? Answer: accelerator 162. Anti-smith is associated with Answer: SLE 163. in photometric method of measuring bilirubin, analyzers measure the color change of what wavelength? Answer: 454 nm 164. What hepatitis B marker shows previous infection? Answer: Anti-HBc 165. In which condition is insufficient amounts of cortisol produced? Answer: Addi- son's disease 166. Cat scratch wound gram negative pleomorphic rods Answer: Bartonella 167. Formula for specificity Answer: TN/(TN+FP) 168. If a volume of fetal bleed is 62ml, how many vials of RhIG should be given to the mother? Answer: 3 169. Why is walking pneumonia not treated with penicillin? Answer: mycoplasma, the agent of walking pneumonia, does not have a cell wall 170. What should be the next step? Answer: incubate reagents and speci temperature for 15-30 minutes and repeat *maybe col agglutinin 171. A 3 year old child has severe anemia with a very low RBC of 1.7 x 106 cmm count but his WBC and platelet counts are normal. What is th diagnosis? Answer: Pure red cell aplasia 172. BAP Answer: Large, circular, gray, smooth colonies with swarming What test should be used to identify it? Answer: Indole 173. A 7 year old boy with dark urine. Stick shows large blood and moderate protein. 14 days ago he had a sore throat and fever. Athorat swab returns group A strep. A urine culture will most likely be Answer: Answer: Negative 174. What is used to diagnose hairy cell leukemia Answer: TRAP 175. 10 nucleated NRBC WBC Answer: 15,500/mm3 Correct WBC count Answer: 14,091 176. Strep pneumoniae exhibits what kind of hemolysis? Answer: alpha 177. What does latex agglutination test for? Answer: protein A and clumping factor 178. What differentiates steno. maltophilia from other non-fermenter gram negative rods? Answer: Oxidase negative DNAse positive 179. The binding strength of an antibody for an antigen is referred to as Answer: Answer: Avid- ity 180. A blue-top was drawn on a walk-in patient. PT >14s APTT >36s 1 Answer:1 mixing study shows no evidence of heparin contamination. Answer: dRVVT 181. In megaloblastic anemias, RBCs are Answer: Macrocytic, normochromic 182. Which drug is used to treat bipolar disorders (manic depression)? Answer: lithium 183. Burr cells are seen in Answer: uremia 184. What blood group expression of antigens is weakens or in some cases negative during pregnancy? Answer: lewis 185. The growth of which fungi can be enhanced by olive oil? Answer: Malassezia furfur 186. What parasite is known for uts autoinfection capability? Answer: Strongyloides stercoalis 187. D-dimer is normal, but FDP is abnormal. What does this mean? Answer: primary fibrinogenolysis 188. In respiratory acidosis, a compensatory mechanism is the increase in Answer: - plasma bicarbonate concentration 189. What is azotomia Answer: accumulation of waste products like urea, uric acid, creatine 190. What is the best blood type for blood transfusion of newborn babies? Answer: O negative crossmatched with maternal blood 191. Which method is used to differentiate between pseudomonas aeruginosa and P. putida? Answer: growth at 42C 192. What bacteria is H2S negative? Answer: Salmonella paratyphi A 193. True or false regarding Conn's syndrome Answer: Primary aldosteronism Answer: true 194. identify Answer: Histoplasma capsulatum 195. glass membrane electrode measures what? Answer: pH 196. gram negative diplococci within PMN Oxidase + Carbohydrate inert Answer: Moraxella catarrhalis 197. Specimen of choice for rotavirus? Answer: stool 198. What happens during the second phase of irreversible platelet aggrega- tion? Answer: release of ADP from dense granules