This is a timed quiz.
You have 1 hour to complete the 56 questions in this quiz.
Which naturally occurring antibody(ies) is(are) found in the serum of a group A Rh negative patient
anti-D and anti-B
Holes are noted in a cryostat section of muscle. Which of the following is the most likely cause?
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.
Which of the following is true regarding H&E staining using an automated stainer?
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
Which of the following is true of quality control materials for internal QC?
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
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?
inoculum too dense
antibiotics stored at higher temperature than recommended
antibiotic discs applied immediately after inoculation of plate
agar depth too thick
Which antibody could be produced by an R1r individual transfused with R2R2 blood?
A good screening test for alcohol ingestion employs comparing the calculated osmolality with what other measurement?
the osmolar gap
freezing point depression osmometer measurement
vapor-pressure osmometer measurement
boiling point elevation osmometer measurement
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?
repeat D typing with high-protein antiserum
weak D test
full Rh phenotype
Direct Antiglobulin Test
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?
follow the critical value protocol
immediately consult with the supervisor
check for decimal placement
look at previous results
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?
susceptibility to optochin
tube coagulase test
antibody latex agglutination
Taxo A disc
What should be done with patient results that are outside reference intervals but are within the percent differences programmed into the delta check?
repeat the assay
phone the results to the doctor
release the results immediately after review
have the specimen recollected
What statement about the dry reagent strip blood test is true?
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
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.
7.3 x 10^9 /L
8.2 x 10^9 /L
8.6 x 10^9 /L
7.6 x 10^9 /L
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?
What does staining leukemic cells for myeloperoxidase help to distinguish?
CLL from ALL
AML from ALL
AML from CML
CLL from CML
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:
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
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
What happens to hemoglobin's affinity for oxygen when hemoglobin binds 2,3-DPG?
it remains constant
it becomes saturated
The Philadelphia chromosome is predominately associated with which leukemia?
chronic lymphocytic leukemia
acute myeloblastic leukemia
chronic myelogenous leukemia
acute lymphoblastic leukemia
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?
record the test result as positive
record the test result as negative
reincubate the tube overnight
add zinc to the tube
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+
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.
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?
Escherichia coli yellow yellow
Pseudomonas aeruginosa yellow yellow
Acinetobacter lwoffi yellow blue-green
Escherichia coli yellow yellow
Pseudomonas aeruginosa blue-green yellow
Acinetobacter lwoffi blue-green blue-green
Escherichia coli blue-green blue-green
Pseudomonas aeruginosa yellow blue-green
Acinetobacter lwoffi yellow yellow
Escherichia coli yellow yellow
Pseudomonas aeruginosa yellow blue-green
Acinetobacter lwoffi blue-green blue-green
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?
What should a technologist do if she obtains low results for all analytes in a specimen?
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
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
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?
What does the D-dimer lab test detect?
degradation products of both fibrinogen and fibrin
fibrin degradation products
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?
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
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?
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
What would processing tissues through alcohol stations that are contaminated with water initially result in?
incomplete infiltration of the tissue with paraffin
excessive hardening of tissue
incomplete clearing of the tissue
incomplete fixation of the tissue
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?
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
Which of the following is recommended for the detection of penicillin resistance in Streptococcus pneumoniae?
penicillin 10 units
oxacillin 1 μg
nafcillin 10 μg
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?
Which of the following contains only ferric iron?
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
motility @ 22°C pos
motility @ 37°C neg
A grossly lipemic specimen needs to be tested for potassium using a direct ISE method. How should the technologist proceed?
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
How should a potassium value of 15 mmol/L be interpreted?
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
What is an appropriate disposal method for ammoniacal silver solutions?
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
What should be done when a laboratory reporting error is corrected?
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
Which of the following mothers is a candidate for Rh immune globulin?
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
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?
Which of the following methods is the safest and most appropriate for disinfecting a cryostat where adequate ventilation is not available?
hypochlorite solution followed by water
phenolic compound followed by absolute ethanol
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?
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
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%
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?
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
Which of the following would lead to an inpatient total serum calcium result of less than 1 mmol/L?
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
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
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?
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
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
Blood from a newborn has low thyroxine (T4) and elevated TSH compared to reference ranges for that age. These results are most consistent with
congential primary hypothyroidism
congential secondary hypothyroidism
a normal response to pregnancy induced changes in maternal thyroid function
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?
8 X 10^6 CFU/L
<10 X 10^4 CFU/L
Which of the following is/are true about a cryostat
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
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.
red lipids, blue-purple nuclei
red lipids and cytoplasm, blue-purple nuclei
the mounted sections would be unstained
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?
large ice crystal artefacts
over frozen tissue
properly frozen tissue
the tissue is ruined
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?
antibody to a high-frequency antigen
antibody to a low-frequency antigen
warm reacting autoantibody
cold reacting autoantibody
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).