CSMLS Practice Quiz

Question 1 of 56

1

Which naturally occurring antibody(ies) is(are) found in the serum of a group A Rh negative patient

Select one of the following:

anti-D
anti-B
anti-A,B
anti-D and anti-B

Explanation

Question 2 of 56

1

Holes are noted in a cryostat section of muscle. Which of the following is the most likely cause?

Select one of the following:

Improper adjustment of the antiroll plate.
Freezing the muscle in liquid nitrogen.
Too small a clearance angle.
Freezing the section in frozen isopentane in liquid nitrogen.

Explanation

Question 3 of 56

1

Which of the following is true regarding H&E staining using an automated stainer?

Select one of the following:

the staining should be checked daily only if you are preparing your own staining reagents
the staining should always be checked microscopically slide-by-slide
the staining should be microscopically checked daily using known control tissues
microscopic stain checks are not if you are purchasing your reagents

Explanation

Question 4 of 56

1

Which of the following is true of quality control materials for internal QC?

Select one of the following:

they must always have a known value directly traceable to a reference method
they should approximate the chemical and physical properties of the sample being tested
they should sit on the bench and continue to be used until the bottle is empty or values are > +2SD
they should be run daily for a week to collect values required to create Levey-Jennings plots

Explanation

Question 5 of 56

1

During a routine quality control check, a Kirby-Bauer disc susceptibility test is performed and the resulting zones of inhibition are too large. Which of the following is a possible cause of this result?

Select one of the following:

inoculum too dense
antibiotics stored at higher temperature than recommended
antibiotic discs applied immediately after inoculation of plate
agar depth too thick

Explanation

Question 6 of 56

1

Which antibody could be produced by an R1r individual transfused with R2R2 blood?

Select one of the following:

anti-e
anti-E
anti-C
anti-c

Explanation

Question 7 of 56

1

A good screening test for alcohol ingestion employs comparing the calculated osmolality with what other measurement?

Select one of the following:

the osmolar gap
freezing point depression osmometer measurement
vapor-pressure osmometer measurement
boiling point elevation osmometer measurement

Explanation

Question 8 of 56

1

When performing a D typing on a patient, a technologist observes that the Rh control is positive. As a result, which of the following would he perform next?

Select one of the following:

repeat D typing with high-protein antiserum
weak D test
full Rh phenotype
Direct Antiglobulin Test

Explanation

Question 9 of 56

1

When entering blood gas results manually into the LIS what should be done if a critical value warning appears when a pH value of 7.14 is entered?

Select one of the following:

follow the critical value protocol
immediately consult with the supervisor
check for decimal placement
look at previous results

Explanation

Question 10 of 56

1

Gram positive cocci in chains which grow as small translucent colonies surrounded by a clear zone of hemolysis were isolated from a throat swab. These colonies were found to be catalase negative and resistant to a 0.04 unit bacitracin disc. Which of the following tests would be most useful in identifying this organism?

Select one of the following:

susceptibility to optochin
tube coagulase test
antibody latex agglutination
Taxo A disc

Explanation

Question 11 of 56

1

What should be done with patient results that are outside reference intervals but are within the percent differences programmed into the delta check?

Select one of the following:

repeat the assay
phone the results to the doctor
release the results immediately after review
have the specimen recollected

Explanation

Question 12 of 56

1

What statement about the dry reagent strip blood test is true?

Select one of the following:

a non-hemolyzed trace is present when there are 1-2 RBC/high power field
test for blood is based on its reaction with oxidase
test for blood is positive for hemoglobin and myoglobin
salicylates cause a false positive reaction

Explanation

Question 13 of 56

1

Both hemoglobin and myoglobin will react with the H2O2 on the pad, which gives a positive result. The colour of the urine (brown vs red) and microscopic examination (red cells) can be used to differentiate haemoglobin from myoglobin. Oxidizing reagents such as bleach can also cause a false positive reaction for blood test, however, salicylate is reducing reagent. Oxidase is used to test for urine glucose.

Select one of the following:

7.3 x 10^9 /L
8.2 x 10^9 /L
8.6 x 10^9 /L
7.6 x 10^9 /L

Explanation

Question 14 of 56

1

Which of the following antibodies would not show any reactivity when tested against a panel of reagent red blood cells which had been treated with ficin?

Select one of the following:

anti-K
anti-E
anti-Fya
anti-Jkb

Explanation

Question 15 of 56

1

What does staining leukemic cells for myeloperoxidase help to distinguish?

Select one of the following:

CLL from ALL
AML from ALL
AML from CML
CLL from CML

Explanation

Question 16 of 56

1

A suspect Enterobacteriaceae isoalte was inoculated to a TSI and decarboxylase test. The TSI showed K/A with gas. The decarboxylase showed:

base: purple, turbid
lysine: purple, turbid
ornithine: purple, turbid

These results indicate:

Select one of the following:

the organism is a non-fermentative bacillus
the organism is viable but does not decarboxylate the amino acid
the test is invalid and must be repeated
the organism is negative for lysine and ornithine

Explanation

Question 17 of 56

1

Given the following patient test results, what is the creatinine clearance?
serum creatinine 100 μmol/L
urine creatinine 8.64 mmol/L
24 hour urine volume 2000 mL
BSA 1.73m^2

Select one of the following:

16 ml/min
120 ml/min
16 ml/min/1.73m^2
120 ml/min/1.73m^2

Explanation

Question 18 of 56

1

What happens to hemoglobin's affinity for oxygen when hemoglobin binds 2,3-DPG?

Select one of the following:

it decreases
it increases
it remains constant
it becomes saturated

Explanation

Question 19 of 56

1

The Philadelphia chromosome is predominately associated with which leukemia?

Select one of the following:

chronic lymphocytic leukemia
acute myeloblastic leukemia
chronic myelogenous leukemia
acute lymphoblastic leukemia

Explanation

Question 20 of 56

1

A technologist is performing a nitrate reduction test. When dimethyl-α-naphthylamine and sulfanilic acid were added, the medium did not change colour. What should the technologist do?

Select one of the following:

record the test result as positive
record the test result as negative
reincubate the tube overnight
add zinc to the tube

Explanation

Question 21 of 56

1

The alcian blue staining reactions of colonic epithelial goblet cells on serial sections from the same tissue block show the following staining results:

Alcian Blue @ pH 1.0 1+ (stain intensity)
Alcian Blue @ pH 2.5 3+
Alcian Blue @ pH 4.5 3+

Select one of the following:

The colonic epithelial goblet cells contain only carboxylated glycoproteins.
The colonic epithelial goblet cells contain neutral glycoproteins.
The colonic epithelial goblet cells contain only sulphated glycoproteins.
The colonic epithelial goblet cells contain both sulphated and carboxylated glycoproteins.

Explanation

Question 22 of 56

1

If QC was performed on a batch of Hugh-Leifson O-F (oxidative-fermentative) media, which of the following results would correspond with acceptable QC?

Select one of the following:

(open) (closed)
Escherichia coli yellow yellow
Pseudomonas aeruginosa yellow yellow
Acinetobacter lwoffi yellow blue-green
(open) (closed)
Escherichia coli yellow yellow
Pseudomonas aeruginosa blue-green yellow
Acinetobacter lwoffi blue-green blue-green
(open) (closed)
Escherichia coli blue-green blue-green
Pseudomonas aeruginosa yellow blue-green
Acinetobacter lwoffi yellow yellow
(open) (closed)
Escherichia coli yellow yellow
Pseudomonas aeruginosa yellow blue-green
Acinetobacter lwoffi blue-green blue-green

Explanation

Question 23 of 56

1

A 26 year old female out-patient presents to her physician with symptoms of uncomplicated cystitis. A culture of her urine grows gram positive cocci. What organism would these cocci likely represent?

Select one of the following:

Staphylococcus epidermidis
Staphylococcus saprophyticus
Streptococcus agalactiae
Staphylococcus aureus

Explanation

Question 24 of 56

1

What should a technologist do if she obtains low results for all analytes in a specimen?

Select one of the following:

check the patient's diagnosis for over-hydration
change the wash reagent for the probe
check and see if the reagents have expired
look for sampling error such as a clot in the probe or specimen

Explanation

Question 25 of 56

1

What may cause wrinkles in sections during flotation?

Select one of the following:

What may cause wrinkles in sections during flotation?
floating the ribbon too slowly
having the water bath too hot
floating the ribbon for too short a time

Explanation

Question 26 of 56

1

How many units of packed red cells would be required to raise the hemoglobin of an average sized patient from 80 g/L to 110 g/L?

Select one of the following:

7
3
1
5

Explanation

Question 27 of 56

1

What does the D-dimer lab test detect?

Select one of the following:

degradation products of both fibrinogen and fibrin
fibrin degradation products
fibrinogen monomer
fibrinogen

Explanation

Question 28 of 56

1

A control slide is stained with H&E using an automated tissue stainer. Upon microscopic assessment following staining in Harris hematoxylin, the nuclei appear blue-purple with an obvious chromatin pattern. What would be the appropriate action at this stage?

Select one of the following:

prepare a new hematoxylin solution
accept the results and continue with the procedure for the rest of the slides
decrease the pH of the hematoxylin staining solution
increase the pH of the hematoxylin staining solution

Explanation

Question 29 of 56

1

A midstream urine is received in the laboratory from a recently discharged inpatient. The requisition indicates the date of collection as yesterday making the specimen 24.5 hours old but the specimen feels warm to the touch. What should the technologist do?

Select one of the following:

process the specimen following the usual protocol
call the floor to double-check the collection date
discard the specimen, send out a rejected specimen report
process the specimen with a warning about the delay in transportation

Explanation

Question 30 of 56

1

What would processing tissues through alcohol stations that are contaminated with water initially result in?

Select one of the following:

incomplete infiltration of the tissue with paraffin
excessive hardening of tissue
incomplete clearing of the tissue
incomplete fixation of the tissue

Explanation

Question 31 of 56

1

Every piece of equipment in the laboratory has a log which is used to document QC values during start-up. How can this log be used?

Select one of the following:

to ensure that start-up procedures are performed properly
to assist in trouble-shooting for random and systemic error
to force every technologist to perform tasks in a uniform manner
to prevent errors in the start-up procedure

Explanation

Question 32 of 56

1

Which of the following is recommended for the detection of penicillin resistance in Streptococcus pneumoniae?

Select one of the following:

beta-lactamase testing
penicillin 10 units
oxacillin 1 μg
nafcillin 10 μg

Explanation

Question 33 of 56

1

A cloudy cerebrospinal fluid has an increased leukocyte count and a decreased glucose concentration. What is the most probable type of meningitis in a patient with these CSF results?

Select one of the following:

tubercular
fungal
bacterial
viral

Explanation

Question 34 of 56

1

Which of the following contains only ferric iron?

Select one of the following:

myoglobin
oxyhemoglobin
methemoglobin
sulfhemoglobin

Explanation

Question 35 of 56

1

An immunocompromised 58-year-old female chemotherapy patient received two units of packed RBC. The patient died 3 days later, and the report from the autopsy revealed that her death was due to septic shock. The blood bags were cultured and the following results were noted. Growth of gram-negative rods on both the BAP and MAC

Lactose neg
Sucrose pos
Citrate neg
Indole neg
VP neg
H2S neg
Urea pos
motility @ 22°C pos
motility @ 37°C neg

Select one of the following:

Enterobacter cloacae
Yersinia enterocolitica
Citrobacter freundii
Escherichi coli

Explanation

Question 36 of 56

1

A grossly lipemic specimen needs to be tested for potassium using a direct ISE method. How should the technologist proceed?

Select one of the following:

do the tests but note on the report that the lipemia will falsely decrease the results
airfuge the specimen before analysis
perform the testing as usual as lipemia will not affect the results
insist that the specimen be re-drawn after the patient has fasted

Explanation

Question 37 of 56

1

How should a potassium value of 15 mmol/L be interpreted?

Select one of the following:

it is implausible and requires investigation
it is probably due to hemolysis
it is probably due to lipemia
it is physiologically possible but should be phoned after repeating

Explanation

Question 38 of 56

1

What is an appropriate disposal method for ammoniacal silver solutions?

Select one of the following:

boil off the liquid, then dispose the solute into chemical waste
allow the solution to dry, then scrape into chemical waste
reduce all the silver salts with formaldehyde and then dry the solute before discarding in general waste and pouring the liquid down the drain
pour the solution into saturated aqueous sodium chloride and then dispose according to regulations

Explanation

Question 39 of 56

1

What should be done when a laboratory reporting error is corrected?

Select one of the following:

the correct result should be called and identified as a corrected report followed by documentation of the call
all records of the original report should be discarded
the person who made the error and their reason for committing it should be found out before the result is corrected
the new result should be called and the nurse asked to discard all records of the original report

Explanation

Question 40 of 56

1

Which of the following mothers is a candidate for Rh immune globulin?

Select one of the following:

O pos mother with negative antibody screen; A pos newborn
O neg mother with negative antibody screen; A neg newborn
A neg mother with positive antibody screen (anti-S); A pos newborn
O neg mother with positive antibody screen (anti-D); A pos newborn

Explanation

Question 41 of 56

1

A standard with a transmission value of 50% and a concentration of 100 g/L is used to estimate an unknown specimen with a transmission value of 75%. What is the concentration of the unknown specimen in g/L?

Select one of the following:

55
150
42
67

Explanation

Question 42 of 56

1

Which of the following methods is the safest and most appropriate for disinfecting a cryostat where adequate ventilation is not available?

Select one of the following:

formaldehyde vapour
hypochlorite solution followed by water
glutaraldehyde solution
phenolic compound followed by absolute ethanol

Explanation

Question 43 of 56

1

A single tube of cerebrospinal fluid is received in the laboratory and the following tests are requested: total protein, albumin, IgG quantitation, microbial culture, Gram stain, leukocyte count and differential cell count. Where should the sample tube be sent first?

Select one of the following:

chemistry for protein analysis and fractionation
hematology for leukocyte count and differential cell count
aliquot small sample and send a portion to each department
microbiology for microbial culture and Gram stain

Explanation

Question 44 of 56

1

A patient is positive for anti-Fya, anti-Jkb and anti-K. How many units of blood will have to be screened to find two compatible units, given the following antigen frequencies?

Fya positive = 60%
Jkb positive = 70%
K positive = 10%

Select one of the following:

24
48
8
18

Explanation

Question 45 of 56

1

Two levels of QC material and the Westgard 1 2S rule as a warning rule to check the other quality control rules are being used by a technologist. On the same run, one of your QC values is +2.1SD while the other QC value is -2.2SD. What action should be taken on the basis of these QC results?

Select one of the following:

troubleshoot for systemic error
troubleshoot for random error
these QC values should be regarded as warnings and the analysis continued
both QC values should be repeated and the rules reassessed

Explanation

Question 46 of 56

1

Which of the following would lead to an inpatient total serum calcium result of less than 1 mmol/L?

Select one of the following:

the specimen may be contaminated with heparin anticoagulant
the patient pumped their fist while the tourniquet was on
the tourniquet was likely left on for too long
the specimen may be contaminated with EDTA anticoagulant

Explanation

Question 47 of 56

1

What is the calculated serum osmolality in mOsm/kg given the following serum results?
Sodium 145 mmol/L
Potassium 4.2 mmol/L
Chloride 104 mmol/L
Bicarbonate 26 mmol/L
Urea 5 mmol/L
Glucose 10.3 mmol/L

Select one of the following:

160
15
294
305

Explanation

Question 48 of 56

1

100 values on a healthy population have Gaussian distribution and give the following values: mean 50 IU/L and SD 5 IU/L. Which of the following statement is true about this population?

Select one of the following:

95% had values between 45 and 55 IU/L
97.5% had values > 60 IU/L
5% were not healthy
2.5% had values <40 IU/L

Explanation

Question 49 of 56

1

Which of the following assays has the poorest precision?

Analyte Mean (mmol/L) Standard Deviation
Calcium 2.5 0.3
Potassium 4.0 0.4
Sodium 140 4.0
Chloride 100 2.5

Select one of the following:

Calcium
Potassium
Sodium
Chloride

Explanation

Question 50 of 56

1

Blood from a newborn has low thyroxine (T4) and elevated TSH compared to reference ranges for that age. These results are most consistent with

Select one of the following:

congenital hypopituitarism
congential primary hypothyroidism
congential secondary hypothyroidism
a normal response to pregnancy induced changes in maternal thyroid function

Explanation

Question 51 of 56

1

A pediatric renal transplant patient had a suprapubic urine collection performed. In the lab, a technologist plated the specimen following protocol with a 0.1 mL calibrated loop. At 18 hours there are 8 colonies of a coliform growing on the plate. What colony count would be reported?

Select one of the following:

8 X 10^6 CFU/L
<10 X 10^4 CFU/L
800,000 CFU/L
80,000 CFU/L

Explanation

Question 52 of 56

1

Which of the following is/are true about a cryostat

Select one of the following:

The cryostat is a microtome in a refrigerated cabinet used to cut fixed tissue.
Is usually maintained at -35°C
Is a potential infection hazard
All of the above

Explanation

Question 53 of 56

1

A technologist did the following to a frozen section of liver. the section was taken through to 70% alcohol, treated with saturated Oil red O in 70% alcohol, rinsed with 70% alcohol, then the nuclei were stained with Harris hematoxylin. The technologist then dehydrated, cleared and mounted the sections in Permount. What results should she see under microscopic observation if unsaturated fats were present in the frozen section.

Select one of the following:

blue-purple nuclei
red lipids, blue-purple nuclei
red lipids and cytoplasm, blue-purple nuclei
the mounted sections would be unstained

Explanation

Question 54 of 56

1

You have been asked to freeze a muscle for Muscle Histochemistry. You place isopentane into liquid nitrogen until it has begun to freeze you then place the muscle into the isopentane. The result of your actions are which of the following?

Select one of the following:

large ice crystal artefacts
over frozen tissue
properly frozen tissue
the tissue is ruined

Explanation

Question 55 of 56

1

When testing your patient sample, you find all 3 screen cells positive at IAT phase. When an antibody panel is done, all cells except one are positive. The patient auto control is negative. Which of the following is the most likely explanation for this reaction pattern?

Select one of the following:

antibody to a high-frequency antigen
antibody to a low-frequency antigen
warm reacting autoantibody
cold reacting autoantibody

Explanation

Question 56 of 56

1

Chem 7, 9, 12, 17, 18, 24, 29, 34, 36, 37, 40, 43, 46, 47, 50
Micro 5, 10, 16, 20, 22, 23, 32, 33, 35, 43, 51
Hem 13, 15, 19, 27, 43
Transfusion 1, 6, 8, 14, 26, 40, 44, 55
AP 2, 3, 21, 25, 28, 30, 38, 42, 52, 53, 54
QC 3, 4, 5, 22, 28, 31, 45, 48, 49
Calculation 13, 17, 26, 40, 44, 47, 48, 49, 51
Situational/Troubleshoot 2, 8, 9, 11, 24, 25, 29, 37, 39, 43
Tricky 1, 16, 17, 28, 30, 36, 40, 49, 51, 52, 53

This is a categorization of all the questions in this quiz. Hopefully, this will give you an idea of which area you may need to focus on (if any).

Select one of the following:

Blank 1
Blank 2
Blank 3
Blank 4

	Created by tiramisu_sarang over 10 years ago

	Copied by Queen Natasha about 9 years ago

Questions taken from Medical Laboratory Science courses of BCIT.

CSMLS Practice Quiz

Question 1 of 56

Which naturally occurring antibody(ies) is(are) found in the serum of a group A Rh negative patient

Select one of the following:

Explanation

Question 2 of 56

Holes are noted in a cryostat section of muscle. Which of the following is the most likely cause?

Select one of the following:

Explanation

Question 3 of 56

Which of the following is true regarding H&E staining using an automated stainer?

Select one of the following:

Explanation

Question 4 of 56

Which of the following is true of quality control materials for internal QC?

Select one of the following:

Explanation

Question 5 of 56

During a routine quality control check, a Kirby-Bauer disc susceptibility test is performed and the resulting zones of inhibition are too large. Which of the following is a possible cause of this result?

Select one of the following:

Explanation

Question 6 of 56

Which antibody could be produced by an R1r individual transfused with R2R2 blood?

Select one of the following:

Explanation

Question 7 of 56

A good screening test for alcohol ingestion employs comparing the calculated osmolality with what other measurement?

Select one of the following:

Explanation

Question 8 of 56

When performing a D typing on a patient, a technologist observes that the Rh control is positive. As a result, which of the following would he perform next?

Select one of the following:

Explanation

Question 9 of 56

When entering blood gas results manually into the LIS what should be done if a critical value warning appears when a pH value of 7.14 is entered?

Select one of the following:

Explanation

Question 10 of 56

Select one of the following:

Explanation

Question 11 of 56

What should be done with patient results that are outside reference intervals but are within the percent differences programmed into the delta check?

Select one of the following:

Explanation

Question 12 of 56

What statement about the dry reagent strip blood test is true?

Select one of the following:

Explanation

Question 13 of 56

Select one of the following:

Explanation

Question 14 of 56

Which of the following antibodies would not show any reactivity when tested against a panel of reagent red blood cells which had been treated with ficin?

Select one of the following:

Explanation

Question 15 of 56

What does staining leukemic cells for myeloperoxidase help to distinguish?

Select one of the following:

Explanation

Question 16 of 56

A suspect Enterobacteriaceae isoalte was inoculated to a TSI and decarboxylase test. The TSI showed K/A with gas. The decarboxylase showed: base: purple, turbid lysine: purple, turbid ornithine: purple, turbid These results indicate:

Select one of the following:

Explanation

Question 17 of 56

Given the following patient test results, what is the creatinine clearance? serum creatinine 100 μmol/L urine creatinine 8.64 mmol/L 24 hour urine volume 2000 mL BSA 1.73m^2

Select one of the following:

Explanation

Question 18 of 56

What happens to hemoglobin's affinity for oxygen when hemoglobin binds 2,3-DPG?

Select one of the following:

Explanation

Question 19 of 56

The Philadelphia chromosome is predominately associated with which leukemia?

Select one of the following:

Explanation

Question 20 of 56

A technologist is performing a nitrate reduction test. When dimethyl-α-naphthylamine and sulfanilic acid were added, the medium did not change colour. What should the technologist do?

Select one of the following:

Explanation

A suspect Enterobacteriaceae isoalte was inoculated to a TSI and decarboxylase test. The TSI showed K/A with gas. The decarboxylase showed:

base: purple, turbid
lysine: purple, turbid
ornithine: purple, turbid

These results indicate:

Given the following patient test results, what is the creatinine clearance?
serum creatinine 100 μmol/L
urine creatinine 8.64 mmol/L
24 hour urine volume 2000 mL
BSA 1.73m^2

The alcian blue staining reactions of colonic epithelial goblet cells on serial sections from the same tissue block show the following staining results:

Alcian Blue @ pH 1.0 1+ (stain intensity)
Alcian Blue @ pH 2.5 3+
Alcian Blue @ pH 4.5 3+