MLS Comphrehensive Exam

  A solution of H₂SO₄ is labelled 4N.  In terms of molarity, how would the label read?         

• A.

  0.5 M

• B.

  2.0 M

• C.

  8.0 M

• D.

  16.0 M

The specimen of choice for the isolation of Bordetella pertussis from a suspected case of whooping cough is:  

• A.

  Blood

• B.

  Spinal Fluid

• C.

  Nasopharyngeal swab

• D.

  Throat Swab

As the hematology supervisor, you notice that a new tech,   Ima Fraid, fails to put on gloves before she demonstrates to a student how to make a manual blood smear.  The SOP clearly states that Universal Precautions are to be followed.  What action should you take?

• A.

  Verbally reprimand Ima immediately and stress the importance of wearing gloves to the student

• B.

  Wait until you write Ima's annual performance evaluation and mention it then

• C.

  Ask Ima to come to your office ASAP and discuss the necessity of following Universal Precautions

• D.

  Disregard the incident, as you're not aware that Ima has chapped hands or any open cuts

The normality of a solution containing 15 mEq of solute in every 10 ml is:

• A.

  0.015 N

• B.

  0.15 N

• C.

  1.5 N

• D.

  15.0 N

An inpatient had a fingerstick sample for glucose run on a glucometer with a result of 217 mg/dl.  Several minutes later, a Chemistry panel was drawn, and the chemistry analyzer’s glucose result was 231 mg/dl.  QC results were acceptable on both instruments.  What conclusion can be reached?

• A.

  Both results are acceptable

• B.

  The fingerstick sample was probably diluted with tissue fluid

• C.

  There was a delay in running the sample on the chemistry analyzer

• D.

  The patient drank orange juice just prior to the venipuncture

• E.

  Both samples should be rechecked, as they don't correlate

Individuals frequently become infected, simultaneously, with these two parasites pictured. They are:

• A.

  Trichostrongylus species and Trichuris trichiura

• B.

  Hookworm and Trichuris trichiura

• C.

  Hookworm and Capillaria heptica

• D.

  Ascaris lmbricoides and Trichuris trichiura

In the N-acetyl-L-cysteine - NaOH method of processing sputum specimens for mycobacterial culture, the N-acetyl-L-cystiene serves as a:

• A.

  Buffer

• B.

  Decontaminate

• C.

  Digestant

• D.

  PH stabilizer

A CAP survey report indicates that your calcium results are not acceptable.  You notice that all labs using reagents and calibrators from the same manufacturer as you are, also submitted unacceptable results.  You decide to accept the CAP target value as the accurate value.  In order to bring your calcium results into control you must:

• A.

  Change to another manufacturer for reagents and calibrators that gives acceptable calcium results on the CAP survey

• B.

  Keep your reagents and method, but change to calibrators that bring your calcium results within acceptable CAP limits

• C.

  Reassay your present calibrators. If using the new assay values gives acceptable calcium results, continue to use your present method and calibrators

• D.

  All of the above are acceptable

• E.

  None of the above are acceptable

A spinal fluid is sent down on an 80-year-old woman who is receiving immunosuppressive therapy.  The primary gram stain of the fluid reveals small gram pos rods and many pus cells.  The next day, a small translucent colony type was growing on sheep blood agar with a narrow zone of beta hemolysis.  Identification of this organism can be made by demonstration of  

• A.

  Metachromatic granules

• B.

  Hippurate hydrolysis

• C.

  Tumbling motility

• D.

  Capsule formation

The set of results that most accurately reflects severe renal disease is:                            serum creatinine         creatinine clearance   BUN             a.         1.0 mg/dL                    110 mL/min                 17 mg/dL             b.         2.0 mg/dL                    120 mL/min                 14 mg/dL             c.         1.0 mg/dL                    95 mL/min                   43 mg/dL             d.         3.7 mg/dL                    44 mL/min                   88 mg/dL

• A.

  A

• B.

  B

• C.

  C

• D.

  D

Fluorescence Polarization Immunoassay (FPIA) utilizes the principles of competitive antigen-antibody binding along with a specific fluorescent dye tag.  A high drug level monitored by this system would produce:

• A.

  Non-polarized fluorescence

• B.

  No fluorescence

• C.

  High fluorescence

• D.

  Low fluorescence

A total laboratory quality control program should include monitoring which of the following factors?

• A.

  Specimen collection and identification

• B.

  Quality of laboratory supplies

• C.

  Accuracy and precision of analysis

• D.

  Preventive maintenance of equipment and instruments

• E.

  All of the above

The following are true statements regarding the characteristics of Entamoeba histolytica and Entamoeba coli except:

• A.

  A mature cyst of E. coli usually has 8 nuclei, whereas the cyst of E. histolytica has 4

• B.

  Ingested RBCs may be present in the E. histolytica troph, but not in the E. coli troph

• C.

  The living troph from of E. histolytica is sluggish and non-progressive, whereas that of E. coli is progressively motile

• D.

  The karysomes of E. coli nuclei are large and eccentric, whereas the karyosomes of the E. histolytica nuclei are small and central

The presence of Burr Red Blood Cells is most commonly seen in:

• A.

  Uremia

• B.

  DIC

• C.

  Pernicious anemia

• D.

  Folic acid deficiency

In a disputed paternity suit, typings for ABO, Rh-hr, M, N and S are preformed.  The results of these typings done in duplicate are:                                                        Anti-A  Anti-B  Anti-A,B  Anti-D  Anti-M  Anti-N  Anti-S                                  Alleged father       4+       0           4+         3+         4+          0        0                                Mother                  0         4+         4+         3+         3+          0        3+                         Child                     0         0           0            0           3+         0        3+         Is the man the  father?                                                                                                                                                           

• A.

  Definitely yes

• B.

  Possibly

• C.

  Definitely no

• D.

  Unable to determine

When acetone-alcohol is inadvertently omitted from the gram stain procedure, Streptococci and Neisseriae will be stained respectively:

• A.

  Purple and pink

• B.

  Purple and purple

• C.

  Pink and pink

• D.

  Pink and purple

A urinary test that characteristically shows effects of interference in the presence of the crystals in these two fields is:                                         

• A.

  Reagent strip analysis for specific gravity

• B.

  Refractometer measurement for specific gravity

• C.

  Reagent strip for analysis of glucose

• D.

  Reagent strip for analysis of protein

A routine UA from urology was sent to the laboratory for analysis.  The urology department did a sp. gr. on the urine from the patient and got a 1.034 on their refractometer.  On the dipstick, the lab got a sp. gr. of 1.020, protein 2000 mg/dl and glucose of 2000 mg/dl.  This large discrepancy in sp. gr. would be resolved by:

• A.

  Adding .033 for each gm of protein and .004 for each gm of glucose

• B.

  Subtracting .003 for each gm of protein and .004 for each gm of glucose

• C.

  Multiplying .003 for each gm of protein and .004 for each gm of glucose

• D.

  Dividing .003 for each gm of protein and .004 for each gm of glucose

To differentiate between a coagulase negative Staph species and a Micrococcus species, which of the following tests should be set up?

• A.

  Bacitracin susceptibility

• B.

  Catalase

• C.

  Novobiocin susceptibility

• D.

  Trehalose utilization

Troponin I levels are first detectable after

• A.

  3-6 hours

• B.

  12-16 hours

• C.

  16-24 hours

• D.

  Greater than 24 hours

The preferred screening test for diabetes in nonpregnant adults is measurement of:

• A.

  Random plasma glucose

• B.

  Glycosylated hemoglobin

• C.

  Plasma glucose one hour after 50g carbohydrate load

• D.

  Fasting plasma glucose

22.          A stool culture from an adult appears to have 2 xylose negative colony types on the XLD agar.  One colony type retains the original color of the media and the other has black centers.  TSI/LIA results are as follows:                                                                           Isolate #1                                 Isolate #2                                     TSI                              K/A no gas or H₂S                  A/A gas & H₂S                                                                                                                                                 LIA                               K/A no gas                               R/A               Based on these data and additional biochemical testing, an important step is to:  

• A.

  Set up enteropathogenic E. coli agglutinations

• B.

  Set up Shigella agglutinations

• C.

  Set up Salmonella agglutinations

• D.

  Report culture as normal flora

In the Hazards Identification System, four color-coded, diamond shaped symbols are arranged to form a larger diamond shape.  What type of hazard does the blue diamond identify?

• A.

  Flammable

• B.

  Health

• C.

  Reactivity

• D.

  Protective equipment

FUN QUESTION- What is Heather Lai's Tech Code

What Enterobacteriaceae, other than Proteus, causes Lysine Iron Agar to develop a reaction of R/A?

• A.

  Providencia

• B.

  Citrobacter

• C.

  Arizona

• D.

  Edwardsiella

Antibodies to which of the following are the most frequent cause of febrile transfusion reactions:

• A.

  Platelets

• B.

  Red Blood Cells

• C.

  Granulocytes

• D.

  Plasma proteins

A patient seen in ER has a positive mono screen and atypical lymphocytes.  The most likely diagnosis is:

• A.

  CMV (cytomegalovirus)

• B.

  EBV (Epstein-Barr virus)

• C.

  Viral hepatitis

• D.

  Infectious lymphocytosis

During shipment, the temperature of whole blood should not rise above:

• A.

  5°C

• B.

  10°C

• C.

  15°C

• D.

  20°C

Safety precautions designed to minimize lab-acquired infections when working with Mycobacterium tuberculosis in a clinical lab would prevent spreading of these organisms by:

• A.

  Aerosol production

• B.

  Ingestion

• C.

  Superficial contact

• D.

  Contact with fomites

A unit of packed red cells was issued to oncology at 0900.  The patient’s IV infiltrated and the unit with the recipient set attached was placed in their refrigerator.  The blood was returned to Blood Bank at 1030 due to the fact that a subclavian catheter would be inserted later that day.  How should Blood Bank handle this unit of blood?

• A.

  Place in available inventory

• B.

  Outdate the unit at 0900 the next day

• C.

  Discard the unit

• D.

  Save unit for that patient after catheter is inserted