Quiz
CSMLS Practice Quiz
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Questions in this quiz (56)
1Which naturally occurring antibody(ies) is(are) found in the serum of a group A Rh negative patient
- Aanti-D
- Banti-B
- Canti-A,B
- Danti-D and anti-B
2Holes are noted in a cryostat section of muscle. Which of the following is the most likely cause?
- AImproper adjustment of the antiroll plate.
- BFreezing the muscle in liquid nitrogen.
- CToo small a clearance angle.
- DFreezing the section in frozen isopentane in liquid nitrogen.
3Which of the following is true regarding H&E staining using an automated stainer?
- Athe staining should be checked daily only if you are preparing your own staining reagents
- Bthe staining should always be checked microscopically slide-by-slide
- Cthe staining should be microscopically checked daily using known control tissues
- Dmicroscopic stain checks are not if you are purchasing your reagents
4Which of the following is true of quality control materials for internal QC?
- Athey must always have a known value directly traceable to a reference method
- Bthey should approximate the chemical and physical properties of the sample being tested
- Cthey should sit on the bench and continue to be used until the bottle is empty or values are > +2SD
- Dthey should be run daily for a week to collect values required to create Levey-Jennings plots
5During 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?
- Ainoculum too dense
- Bantibiotics stored at higher temperature than recommended
- Cantibiotic discs applied immediately after inoculation of plate
- Dagar depth too thick
6Which antibody could be produced by an R1r individual transfused with R2R2 blood?
- Aanti-e
- Banti-E
- Canti-C
- Danti-c
7A good screening test for alcohol ingestion employs comparing the calculated osmolality with what other measurement?
- Athe osmolar gap
- Bfreezing point depression osmometer measurement
- Cvapor-pressure osmometer measurement
- Dboiling point elevation osmometer measurement
8When 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?
- Arepeat D typing with high-protein antiserum
- Bweak D test
- Cfull Rh phenotype
- DDirect Antiglobulin Test
9When 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?
- Afollow the critical value protocol
- Bimmediately consult with the supervisor
- Ccheck for decimal placement
- Dlook at previous results
10Gram 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?
- Asusceptibility to optochin
- Btube coagulase test
- Cantibody latex agglutination
- DTaxo A disc
11What should be done with patient results that are outside reference intervals but are within the percent differences programmed into the delta check?
- Arepeat the assay
- Bphone the results to the doctor
- Crelease the results immediately after review
- Dhave the specimen recollected
12What statement about the dry reagent strip blood test is true?
- Aa non-hemolyzed trace is present when there are 1-2 RBC/high power field
- Btest for blood is based on its reaction with oxidase
- Ctest for blood is positive for hemoglobin and myoglobin
- Dsalicylates cause a false positive reaction
13Both 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.
- A7.3 x 10^9 /L
- B8.2 x 10^9 /L
- C8.6 x 10^9 /L
- D7.6 x 10^9 /L
14Which 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?
- Aanti-K
- Banti-E
- Canti-Fya
- Danti-Jkb
15What does staining leukemic cells for myeloperoxidase help to distinguish?
- ACLL from ALL
- BAML from ALL
- CAML from CML
- DCLL from CML
16A 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:- Athe organism is a non-fermentative bacillus
- Bthe organism is viable but does not decarboxylate the amino acid
- Cthe test is invalid and must be repeated
- Dthe organism is negative for lysine and ornithine
17Given 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- A16 ml/min
- B120 ml/min
- C16 ml/min/1.73m^2
- D120 ml/min/1.73m^2
18What happens to hemoglobin's affinity for oxygen when hemoglobin binds 2,3-DPG?
- Ait decreases
- Bit increases
- Cit remains constant
- Dit becomes saturated
19The Philadelphia chromosome is predominately associated with which leukemia?
- Achronic lymphocytic leukemia
- Bacute myeloblastic leukemia
- Cchronic myelogenous leukemia
- Dacute lymphoblastic leukemia
20A 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?
- Arecord the test result as positive
- Brecord the test result as negative
- Creincubate the tube overnight
- Dadd zinc to the tube
21The 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+- AThe colonic epithelial goblet cells contain only carboxylated glycoproteins.
- BThe colonic epithelial goblet cells contain neutral glycoproteins.
- CThe colonic epithelial goblet cells contain only sulphated glycoproteins.
- DThe colonic epithelial goblet cells contain both sulphated and carboxylated glycoproteins.
22If QC was performed on a batch of Hugh-Leifson O-F (oxidative-fermentative) media, which of the following results would correspond with acceptable QC?
- A(open) (closed)
Escherichia coli yellow yellow
Pseudomonas aeruginosa yellow yellow
Acinetobacter lwoffi yellow blue-green - B(open) (closed)
Escherichia coli yellow yellow
Pseudomonas aeruginosa blue-green yellow
Acinetobacter lwoffi blue-green blue-green - C(open) (closed)
Escherichia coli blue-green blue-green
Pseudomonas aeruginosa yellow blue-green
Acinetobacter lwoffi yellow yellow - D(open) (closed)
Escherichia coli yellow yellow
Pseudomonas aeruginosa yellow blue-green
Acinetobacter lwoffi blue-green blue-green
- A(open) (closed)
23A 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?
- AStaphylococcus epidermidis
- BStaphylococcus saprophyticus
- CStreptococcus agalactiae
- DStaphylococcus aureus
24What should a technologist do if she obtains low results for all analytes in a specimen?
- Acheck the patient's diagnosis for over-hydration
- Bchange the wash reagent for the probe
- Ccheck and see if the reagents have expired
- Dlook for sampling error such as a clot in the probe or specimen
25What may cause wrinkles in sections during flotation?
- AWhat may cause wrinkles in sections during flotation?
- Bfloating the ribbon too slowly
- Chaving the water bath too hot
- Dfloating the ribbon for too short a time
26How 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?
- A7
- B3
- C1
- D5
27What does the D-dimer lab test detect?
- Adegradation products of both fibrinogen and fibrin
- Bfibrin degradation products
- Cfibrinogen monomer
- Dfibrinogen
28A 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?
- Aprepare a new hematoxylin solution
- Baccept the results and continue with the procedure for the rest of the slides
- Cdecrease the pH of the hematoxylin staining solution
- Dincrease the pH of the hematoxylin staining solution
29A 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?
- Aprocess the specimen following the usual protocol
- Bcall the floor to double-check the collection date
- Cdiscard the specimen, send out a rejected specimen report
- Dprocess the specimen with a warning about the delay in transportation
30What would processing tissues through alcohol stations that are contaminated with water initially result in?
- Aincomplete infiltration of the tissue with paraffin
- Bexcessive hardening of tissue
- Cincomplete clearing of the tissue
- Dincomplete fixation of the tissue
31Every 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?
- Ato ensure that start-up procedures are performed properly
- Bto assist in trouble-shooting for random and systemic error
- Cto force every technologist to perform tasks in a uniform manner
- Dto prevent errors in the start-up procedure
32Which of the following is recommended for the detection of penicillin resistance in Streptococcus pneumoniae?
- Abeta-lactamase testing
- Bpenicillin 10 units
- Coxacillin 1 μg
- Dnafcillin 10 μg
33A 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?
- Atubercular
- Bfungal
- Cbacterial
- Dviral
34Which of the following contains only ferric iron?
- Amyoglobin
- Boxyhemoglobin
- Cmethemoglobin
- Dsulfhemoglobin
35An 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- AEnterobacter cloacae
- BYersinia enterocolitica
- CCitrobacter freundii
- DEscherichi coli
36A grossly lipemic specimen needs to be tested for potassium using a direct ISE method. How should the technologist proceed?
- Ado the tests but note on the report that the lipemia will falsely decrease the results
- Bairfuge the specimen before analysis
- Cperform the testing as usual as lipemia will not affect the results
- Dinsist that the specimen be re-drawn after the patient has fasted
37How should a potassium value of 15 mmol/L be interpreted?
- Ait is implausible and requires investigation
- Bit is probably due to hemolysis
- Cit is probably due to lipemia
- Dit is physiologically possible but should be phoned after repeating
38What is an appropriate disposal method for ammoniacal silver solutions?
- Aboil off the liquid, then dispose the solute into chemical waste
- Ballow the solution to dry, then scrape into chemical waste
- Creduce all the silver salts with formaldehyde and then dry the solute before discarding in general waste and pouring the liquid down the drain
- Dpour the solution into saturated aqueous sodium chloride and then dispose according to regulations
39What should be done when a laboratory reporting error is corrected?
- Athe correct result should be called and identified as a corrected report followed by documentation of the call
- Ball records of the original report should be discarded
- Cthe person who made the error and their reason for committing it should be found out before the result is corrected
- Dthe new result should be called and the nurse asked to discard all records of the original report
40Which of the following mothers is a candidate for Rh immune globulin?
- AO pos mother with negative antibody screen; A pos newborn
- BO neg mother with negative antibody screen; A neg newborn
- CA neg mother with positive antibody screen (anti-S); A pos newborn
- DO neg mother with positive antibody screen (anti-D); A pos newborn
41A 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?
- A55
- B150
- C42
- D67
42Which of the following methods is the safest and most appropriate for disinfecting a cryostat where adequate ventilation is not available?
- Aformaldehyde vapour
- Bhypochlorite solution followed by water
- Cglutaraldehyde solution
- Dphenolic compound followed by absolute ethanol
43A 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?
- Achemistry for protein analysis and fractionation
- Bhematology for leukocyte count and differential cell count
- Caliquot small sample and send a portion to each department
- Dmicrobiology for microbial culture and Gram stain
44A 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%- A24
- B48
- C8
- D18
45Two 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?
- Atroubleshoot for systemic error
- Btroubleshoot for random error
- Cthese QC values should be regarded as warnings and the analysis continued
- Dboth QC values should be repeated and the rules reassessed
46Which of the following would lead to an inpatient total serum calcium result of less than 1 mmol/L?
- Athe specimen may be contaminated with heparin anticoagulant
- Bthe patient pumped their fist while the tourniquet was on
- Cthe tourniquet was likely left on for too long
- Dthe specimen may be contaminated with EDTA anticoagulant
47What 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- A160
- B15
- C294
- D305
48100 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?
- A95% had values between 45 and 55 IU/L
- B97.5% had values > 60 IU/L
- C5% were not healthy
- D2.5% had values <40 IU/L
49Which 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- ACalcium
- BPotassium
- CSodium
- DChloride
50Blood from a newborn has low thyroxine (T4) and elevated TSH compared to reference ranges for that age. These results are most consistent with
- Acongenital hypopituitarism
- Bcongential primary hypothyroidism
- Ccongential secondary hypothyroidism
- Da normal response to pregnancy induced changes in maternal thyroid function
51A 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?
- A8 X 10^6 CFU/L
- B<10 X 10^4 CFU/L
- C800,000 CFU/L
- D80,000 CFU/L
52Which of the following is/are true about a cryostat
- AThe cryostat is a microtome in a refrigerated cabinet used to cut fixed tissue.
- BIs usually maintained at -35°C
- CIs a potential infection hazard
- DAll of the above
53A 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.
- Ablue-purple nuclei
- Bred lipids, blue-purple nuclei
- Cred lipids and cytoplasm, blue-purple nuclei
- Dthe mounted sections would be unstained
54You 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?
- Alarge ice crystal artefacts
- Bover frozen tissue
- Cproperly frozen tissue
- Dthe tissue is ruined
55When 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?
- Aantibody to a high-frequency antigen
- Bantibody to a low-frequency antigen
- Cwarm reacting autoantibody
- Dcold reacting autoantibody
56Chem 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).- ABlank 1
- BBlank 2
- CBlank 3
- DBlank 4
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- Questions taken from Medical Laboratory Science courses of BCIT.
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- tiramisu_sarang
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