Term
Auer rods may be seen in blasts of all the following conditions EXCEPT:
A. Acute Myelomonocytic leukemia (M4)
B. Acute lymphocytic leukemia (El, L2, L3)
C. Acute myelocytic leukemia (M1, M2)
D. Acute promyelocytic leukemia (M3) |
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Definition
B.
Aurer rods are only found in myeloblasts. Therefore in lymphcytic leukemia with lymphoblasts, aurer rods would not be seen. |
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Term
Deviations from Beer’s Law are caused by:
A. very low concentration of absorbing material
B. polychromatic light
C. very high concentrations of substance being measured in a colorimetric reaction
D. stray light |
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Definition
D.
Beer's law is based on the fact that absorbance is directly proportional to the concentration of a solution. Therefore, stray light can alter the absorbance results in this type of assay. |
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Term
BNP is synthesized and secreted by which of the following parts of the body?
A. Kidney
B. Liver
C. Heart
D. Adrenal gland |
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Definition
C.
BNP, or brain natriuretic peptide is made by your heart and shows how well your heart is working. BNP is released by the left ventrical myocardium in response to the ventricular wall stress or tension that occurs in chronic heart failure. |
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Term
When a unit of packed RBC’s is split using the open system, each half-unit must be issued within:
A. 24 hours
B. 48 hours
C. 30 days
D. the original expiration date
E. 72 hours |
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Definition
A.
If a unit is entered without use of a sterile connection device (open system) it must be used within 24 hours of entry. Closed systems retain the same expiration date as the original whole blood unit. |
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Term
The lymphokine most important for increased natural killer cell activity and decreased viral replication in cells is:
A. Interferon gamma
B. Interleukin 3
C. Interleukin 4
D. Interleukin 5 |
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Definition
A.
Interferon gamma serves various purposes in immunologic response, including the promotion of natural killer cell activity as well as decreased viral replication by using enzymes to decreasin protein replication, both viral or host, inside of the cell. |
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Term
A mixing study should be performed within what time frame following collection of the specimen?
A. 4 hours
B. 8 hours
C. 24 hours
D. 48 hours |
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Definition
A.
A mixing study should be performed within 4 hours of specimen collection. |
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Term
The protozoa are classified and placed in groups based on which of the following criteria?
A. Organelles designed for motility
B. Size
C. Appearance of the cytoplasm
D. Morphologic forms |
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Definition
A.
Although size, nuclear characteristics, appearance of the cytoplasm, and specific morphologic forms present vary among the protozoa, these criteria are not utilized in the classification of the protozoa. Classification is typically based on the organelles present that aid the various groups of organisms in locomotion: amebae - pseudopodia; flagellates and hemoflagellates - flagella; Balantidium coli - cilia; and members of the sporozoa - no obvious motility structures. |
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Term
Which of these white blood cell populations would have the MOST side scatter when analyzed using flow cytometry?
A. Monocytes
B. Lymphocytes
C. Granulocytes |
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Definition
C.
Granulocytes are the most granular population; they have the most side scatter of the cell populations that are listed. |
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Term
Which one of the following antigen markers is BEST associated with stem cells?
A. CD3
B. CD10
C. CD18
D. CD34
E. CDC007 |
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Definition
D.
CD34, a cell surface marker, presents on undifferentiated pluripotential hemopoietic stem cells. CD34 is a cell surface glycoprotein and functions as a cell-cell adhesion factor. |
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Term
Hematocrit is:
A. Percentage of blood made up of serum
B. Concentration of serum X 100
C. Percentage of blood made up of red cells
D. Concentration of red cells X 100 |
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Definition
C.
Hematocrit is the percentage by volume of RBCs in a specimen of whole blood. |
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Term
Which of the following conditions can produce a normal APTT and a prolonged PT?
A. Factor IX deficiency
B. Factor VII deficiency
C. Factor VIII deficiency
D. Factor X deficiency |
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Definition
B.
Only the factor VII would cause and increase only in the PT result as factors IX and VIII are tested only in the aPTT test and factor X is tested for in both tests. |
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Term
he BEST way to thaw Fresh Frozen Plasma is to thaw it by:
A. leaving it at room temperature away from agitation
B. refrigerating the FFP on a bottom rack
C. placing the FFP in a 37º C or lower in a water bath
D. placing the FFP in a 121º C or higher in a steam sterilizer |
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Definition
C.
Fresh frozen plasma must be thawed at a maximum of 37oC in a water bath or similar equipment that has been validated and is temperature monitored. When using a water bath, the FFP should be wrapped in a plastic liner. After thawing, it is recommended that the FFP be administered immediately, preferably within 2 hours post-thaw. |
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Term
What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hrs?
A. 9.5 mL/min
B. 13.6 mL/min
C. 95 mL/min
D. 136 mL/min
E. 1.36 mL/min |
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Definition
C.
One method of calculating a glomerular filtration rate is using creatinine and urine volume to determine creatinine clearance. The equation is as follows:
Creatinine Clearance = (urine creatinine X urine flow rate) / plasma creatinine; where urine flow rate = volume in mL /24 hours x h/60 min)
In this case = creatinine clearance = 124 X (2200/24 x hour/60) / 2 = 94.7 or 95 ml/min |
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Term
On an electronic cell counter, hemoglobin determination may be falsely elevated caused by the presence of:
A. Lipemic or icteric plasma
B. Leukocytopenia or Leukocytosis
C. Rouleaux or agglutinated RBCs
D. Anemia or Polycythemia |
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Definition
A.
Since hemoglobin is measured spectrophotometrically on hematology analzyers, interference from lipemia or icteric specimens can lead to decreased light detected and measured through the sample and therefore inaccurate hemoglobin results occur. |
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Term
Where does most cerebrospinal fluid originate?
A. cerebral arachnoid space
B. choroid plexus
C. ventricles
D. lumbar region |
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Definition
B.
Cerebrospinal fluid originates from the choroid plexus. |
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Term
Fetal lung maturity can be determined from amniotic fluid because the surfactant is PRIMARILY composed of:
A. protein
B. cholesterol
C. glycerol
D. triglycerides
E. phosphatidylcholine and other phospholipids |
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Definition
E.
Assessment of the status of amniotic fluid phospholipids has become important in determining fetal lung maturity. During pregnancy, it has been documented that the ratio of lecithin to sphingomyelin (L/S ratio), with respect to pediatric gestational age, is a reliable predictor of maturity. |
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Term
Group O blood cannot be transfused to a person with “Bombay blood" type because the Bombay individual has:
A. Anti-H
B. Anti-A
C. Anti-B
D. H substance on his cells
E. Anti-i |
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Definition
A.
Group O blood has the most H substance of all blood types; therfore, in a patient who has the Bombay phenotype (hh), the anti-H can react and cause incompatibility issues. |
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Term
pH alteration of normal blood in a closed vessel standing at 37oC for 1 hour is approximately
A. 0.01 to 0.02 pH unit
B. 0.02 to 0.04 pH unit
C. 0.04 to 0.08 pH unit
D. 0.08 to 0.12 pH unit |
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Definition
C.
The pH of freshly drawn blood decreases at a rate of 0.06 pH units/hour at 37oC, but only 0.006 pH units/hour at 4oC. |
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Term
Which ethnic group has the highest incidence of hereditary hemochromatosis in the United States?
A. Caucasians of Celtic descent
B. African Americans
C. Persons of Mediterranean descent
D. Hispanics |
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Definition
A.
In the US, Caucasians of Celtic descent have the highest incidence of hereditary hemochromatosis. |
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Term
The phenotypic property of Saccharomyces yeast species that is helpful in establishing its species identification is:
A. Polysaccharide capsule
B. Ascospore production
C. Trehalose assimilation |
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Definition
B.
The identification of Saccharomyces species can be confirmed by looking for the formation of ascospores after incubation of a subculture on ascospore agar.
Torulopsis (Candida) glabrata has the unique characteristic of assimilating only glucose and trehalose.
Cryptococcus species is characterized by the production of a thick, polysaccharide capsule. |
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Term
What is a prominent morphologic feature of lead poisoning:
A. Basophilic stippling
B. Hypersegmentation
C. Macrocytosis
D. Target cell |
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Definition
A.
Basophilic stippling is strongly associated with lead poisoning the lead toxicity can affect the bone marrow; causing this phenomenon. |
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Term
Which adipokine is synthesized and released by adipocytes and many other body cell types, is an inflammatory cytokine that stimulates the liver to produce C-reactive protein (CRP), and is increased in obesity and insulin resistance?
A. Leptin
B. IL-6
C. Adiponectin
D. Angiotensinogen |
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Definition
B.
IL-6 is synthesized and released by adipocytes and many other body cell types, is an inflammatory cytokine that stimulates the liver to produce C-reactive protein (CRP), and is increased in obesity and insulin resistance. |
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Term
The ADA recommends performing an oral glucose tolerance test (OGTT) on all individuals who are at increased risk for diabetes.
True
False |
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Definition
False
The ADA recommends regular screening for individuals who are at increased risk for diabetes. OGTT use is discouraged for these individuals unless blood glucose and HbA1C concentrations remain below diagnostic ranges for diabetes but patient displays symptoms of diabetes. |
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Term
The majority of anti-Lea antibodies are of which immunoglobulin class?
A. IgM
B. IgG
C. IgA |
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Definition
A.
The majority of Lea antibodies are IgM. |
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Term
Define:
Infarction
Angina
Congestive heart failure
Ischemia |
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Definition
Infarction- An area of tissue death that occurs due to lack of oxygen.
Angina- Chest pain caused by inadequate supply of oxygen to heart myocardium.
Congestive heart failure- A left ventricular dysfunction resulting from aging, hypertension, atherosclerosis or muscle damage from an AMI or repeated AMIs.
Ischemia- An inadequate blood supply that decreases availability of oxygen. |
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Term
Which of the following antigen groups is closely related to the ABO system:
A. Rh
B. Kell
C. I, i
D. Duffy |
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Definition
C.
I and i antigens are related biochemically and spatially to the ABH and Lewis antigens on the red cell membrane. Anti-I is usually an autoantibody. It is common as a benign cold autoagglutinin. Strong anti-I is associated with Mycoplasma pneumonia infection, where it may be associated with cold autoimmune hemolytic anemia. Anti-I is characterized by its failure to react with cord red cells. Anti-i generally occurs as a cold reactive IgM antibody in the setting of infectious mononucleosis. |
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Term
Which of the following cardiac biomarkers rises within 30 minutes - 4 hours after chest pain, peaks in 2 - 12 hours, and is usually normal within 24 - 36 hours.
A. Cardiac troponins
B. CK-MB
C. Myoglobin |
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Definition
C.
Myoglobin rises within 30minutes - 4 hours after chest pain, peaks in 2 - 12 hours, and is usually normal within 24 - 36 hours. |
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Term
It has already been established that the gated cell population is lymphocytic in nature. CD19 and CD20 cell surface antigens both appear on what type of lymphocytes?
A. B cells
B. T-helper cells
C. Cytotoxic T cells |
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Definition
A.
Normal mature B cells are positive for CD19 and CD20.
T-helper cells and cytotoxic T cells should not express these two antigens. |
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Term
The wavelength of the light measured by a spectrophotometer is generally designated in nanometers. A nanometer is equal in meters to:
A. 10e-11
B. 10e-9
C. 10e-4
D. 10e-2 |
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Definition
B.
There are 10e9 nanometers in every meter, so a nanometer is equal to 10e-9 meters. |
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Term
Platelet adhesion involves the absorption of this factor between receptors on the exposed subendothelial tissue, and by receptors on the platelets themselves?
A. Christmas Factor
B. Stuart-Prower Factor
C. Hageman Factor
D. Von Willebrands Factor |
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Definition
D.
In hemostasis, the adhesion of platelets to the collagen exposed on subendothelial cell surfaces is mediated by von Willebrand factor (vWF). vWF acts as a bridge between a specific glycoprotein complex on the surface of platelets and collagen on the subendothelial surface. |
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Term
The autohemolysis test is MOST useful in the diagnosis of which condition?
A. pyruvate kinase
B. G6-P-D
C. sickle cell anemia
D. hereditary spherocytosis
E. autoimmune disease |
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Definition
D.
The autohemolysis test measures the amount of spontaneous hemolysis that occurs after 48 h of sterile incubation with glucose and ATP. In hereditary spherocytosis or hereditary elliptocytosis the RBC fragility is increased, which causes an increase in hemolysis earlier than in normal red blood cells. |
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Term
Acinetobacter species are similar to Neisseriaceae with the exception that Acinetobacter species are generally:
A. Gram-negative coccoid organisms
B. Brown on blood and chocolate agars
C. Oxidase negative
D. Coccoid-shaped organisms
E. Motile |
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Definition
C.
Acinetobacter species are similar to Neisseriaceae with the exception that Acinetobacter species are generally oxidase negative. Acinetobacter is an oxidase negative, non-motile, non-sporeforming cocco-bacillus that is usually found in soil, water, and in moist areas of the skin. Neisseria are gram-negative, nonmotile, diplococci, which commonly have a flattened or concave side and are usually oxidase positive. |
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Term
Which of the following species of hyaline molds produce conidia in chains?
A. Scopulariopsis species
B. Gliocladium species
C. Acremonium species |
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Definition
A.
Scopulariopsis species develop conidia in chains, while the conidia of Gliocladium species and Acremonium species are gathered in tight and loose clusters respectively. |
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Term
All of the following are true concerning the Erythrocyte Sedimentation Rate EXCEPT:
A. Can be used to follow the course of a disease
B. ESR is decreased during inflammatory conditions
C. Highest ESR values usually seen in Multiple Myeloma
D. Increased in rheumatoid conditions |
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Definition
B.
ESR is actually increased during inflammatory conditions. Therefore choice B is the correct answer as it is a false statement. |
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Term
Which one of the following statements concerning phagocytosis is FALSE?
A. Cells only phagocytize bacteria.
B. Membrane “reaches” out and surrounds the material to be internalized.
C. Once internalized the material is surrounded by phagosomes.
D. Only specialized cells are capable of phagocytosis.
E. Whole pathogenic organisms can be ingested. |
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Definition
A.
Cells do not only phagocytize bacteria, the can phagocytize other cells, cellular remnants, and other waste products as well. |
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Term
How would you CORRECTLY prepare 100 ml of 0.9% isotonic saline (NaCl: GMW = 58.45)?
A. 0.9 grams in 100 ml distilled water
B. 9.0 grams in 100 ml distilled water
C. 5.26 grams in 100 ml distilled water
D. 0.526 grams in 100 ml distilled water
E. 5.84 grams in 100 ml distilled water |
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Definition
A.
Concentrations of solutions can be shown as "percentages." This refers to the mass of solute, in grams, dissolved in a solvent to a volume of 100 ml. "Normal saline" is an aqueous solution of 0.9% NaCl. This means that normal saline can be prepared by measuring out 0.9 g of NaCl and diluting this amount of NaCl to a final volume of 100 ml in distilled water. |
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Term
A 29-year old pregnant woman had an outpatient glucose tolerance test. The patient was given a 100-gm dose of glucose and the following values were obtained:
Fasting 110 mg/dL
1 hr. 148 mg/dL
2 hr. 175 mg/dL
3 hr. 143 mg/dL
The MOST likely interpretation of this glucose tolerance would be:
A. Insulin dependent diabetes mellitus (IDDM)
B. Non insulin dependent diabetes mellitus (NIDDM)
C. Gestational diabetes mellitus (GDM)
D. Normal glucose tolerance test |
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Definition
C.
Normal blood values for a 100-gram oral glucose tolerance test used to screen for gestational diabetes are as follows:
Fasting: less than 95 mg/dL
1 hour: less than 180 mg/dL
2 hour: less than 155 mg/dL
3 hour: less than 140 mg/dL |
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Term
For a substance to be immunogenic it must be:
A. A linear molecule
B. A lipid
C. Less than 5,000 molecular weight
D. Recognized as non-self
E. A haptene |
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Definition
D.
Only non-self antigens can be immunogenic. Self antigens are normally recognized by the immune system as part of the host, so an immune response does not normally occur. Non-self antigens are immunogenic since they have the potential to cause an immune response. |
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Term
Fluorometers are designed so that the path of the exciting light is at right angle to the path of the emitted light. What is the purpose of this design?
A. Prevent loss of emitted light
B. Prevent loss of the excitation light
C. Focus emitted and excitation light upon the detector
D. Prevent excitation light from reaching the detector |
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Definition
D.
The angle is set at 90 degrees in fluorometers in order to only detect the emitted light from the sample substance after it has been excited with a light beam. This helps to avoid measuring the ultraviolet light emitted from the light beam itself. |
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Term
The sediment from a freshly collected urine specimen is examined microscopically. In addition to bacteria, what other finding from the list below would further indicate the presence of a urinary tract infection (UTI)?
A. 0 - 2 cuboidal epithelial cells/high power field (HPF)
B. > 100 white blood cells (WBCs)/ HPF
C. 10 - 20 squamous epithelial cells/ HPF
D. Rare hyaline cast/ low power field (LPF) |
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Definition
B.
The presence of white blood cells, especially in large quantities as in this case, is very indicative of urinary tract infections as the white cells are migrating to the urinary tract to fight the bacterial infection. |
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Term
For the ANA test to be positive what must be present in the nucleus of the interphase cell?
A. Strong staining
B. Centromeres
C. dsDNA
D. A clearly discernible pattern |
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Definition
D.
A clearly discernible pattern is correct.
The strength of the reaction doesn't matter, only that it is clearly discernible. Centromere and dsDNA are just some of the many different antigens, however, without the corresponding (cognate) antibodies from the patient sample there is no ANA pattern. Remember, to be ANA positive there must be a clearly discernible pattern in the nucleus of the interphase cells. |
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Term
Lipemia in a serum sample is most likely caused by an increase in serum levels of:
A. Cholesterol
B. Triglycerides
C. Protein
D. Phospholipids |
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Definition
B.
Lipemia is generally caused by an increase in VLDL (very low density lipoproteins), which are primarily composed of triglycerides. |
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Term
Which of the following is TRUE of a fully compensated metabolic acidosis?
A. pH will be decreased without a decrease in PCO2
B. pH will be decreased with a decrease in PCO2
C. pH will be decreased with an increase in PCO2
D. pH will be normal with a decrease in PCO2
E. pH will be normal with normal O2 |
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Definition
D.
The pH will be normal in a fully compensated form of any alkalsis or acidosis. In this case, the problem is metabolic, meaning a decrease in bicarbonate (alkaline) production which has lead to an acid pH of the blood. To compensate for this, the body uses the respiratory system to decrease the amount of acid, or PCO2 in the system to balance the pH into normal range. |
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Term
Which of the following is not a standard method for measuring the specific gravity of urine?
A. SP reagent strips
B. Osmolality
C. Refractometry
D. Hydrometry |
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Definition
B.
Osmolality is dependent on the number of particles of solute in a unit of solution and is often measured by freezing point depression. Specific gravity is usually directly related to osmolality, but is more easily measured. It provides a rough measure of the urine concentrating power of the kidney. |
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Term
Multiple ring forms are most frequently seen in which Plasmodium?
A. falciparum
B. vivax
C. malariae
D. ovale
E. barundi |
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Definition
A.
Multiple ring forms are most frequently seen in Plasmodium falciparum. The trophozoite develops into a schizont made up of multiple ring forms (also known as merozoites) via schizogony, or asexual replication. The schizont then matures which causes the rupture of the erythrocytes- releasing merozoites into the circulation which in turn infect other erythrocytes |
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Term
Atherosclerosis is a hardening of an artery specifically due to which of the following?
A. Build up of plaque
B. Aggregation of platelets
C. Hypercalcemia |
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Definition
A.
Atherosclerosis is a hardening of an artery specifically due to the build up of plaque. The risk to patients with significant atherosclerosis is that eventually a narrowing of the artery (stenosis) can cause a reduction in oxygen delivery to tissues and plaque rupture can lead to an acute coronary event. |
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