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ASCP MLT Exam: Practice Questions

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About the ASCP MLT exam

The ASCP Medical Laboratory Technician (MLT) exam assesses the knowledge required for intermediate-level medical laboratory roles. The American Society for Clinical Pathology (ASCP) administers the exam.

The exam consists of 100 multiple-choice questions and has a 2.5-hour time limit. Exam topics include blood banking, urinalysis, chemistry, hematology, immunology, microbiology, and laboratory procedures.

The exam fee is $225.

About these practice questions

These practice questions will help prepare you for the ASCP MLT exam.

This page contains 499 practice questions divided into the seven sections of the exam: 1. Blood banking, 2. Urinalysis and other body fluids, 3. Chemistry, 4. Hematology, 5. Immunology, 6. Microbiology, and 7. Laboratory operations.

All questions have been carefully designed to mimic the questions on the real exam, to help you prepare and get a passing grade.

Sections

  1. Blood banking
  2. Urinalysis and other body fluids
  3. Chemistry
  4. Hematology
  5. Immunology
  6. Microbiology
  7. Laboratory operations

Section 1: Blood banking

1.1) The _____________ effect is the phenomenon of stronger antigen expression with homozygous genotypes than heterozygous genotypes.
  1. dosage
  2. homozygous
  3. position
  4. prozone
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1.2) At which temperature do warm antibodies react with red blood cells?
  1. 15°C
  2. 21°C
  3. 37°C
  4. 55°C
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1.3) Which IgG subclasses are most efficient at activating complement?
  1. IgG1 and IgG3
  2. IgG1 and IgG4
  3. IgG1 and IgG4
  4. IgG2 and IgG3
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1.4) Which of these antibodies is clinically insignificant?
  1. Anti-Fya
  2. Anti-Jka
  3. Anti-P1
  4. Anti-s
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1.5) Lewis antibodies are almost always which class?
  1. IgA
  2. IgD
  3. IgG
  4. IgM
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1.6) Which IgG subclass is most abundant?
  1. IgG1
  2. IgG2
  3. IgG3
  4. IgG4
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1.7) Which antibody is only found in people with the Bombay blood group?
  1. Anti-D
  2. Anti-F
  3. Anti-H
  4. Anti-I
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1.8) Which maternal antibody is most commonly responsible for causing fetal neonatal alloimmune thrombocytopenia (FNAIT)?
  1. Anti-A₁
  2. Anti-Fy(a)
  3. Anti-HPA-1a
  4. Anti-Rh(D)
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1.9) Washed red blood cells are prepared by washing red cells with:
  1. acetic acid
  2. ethanol
  3. normal saline
  4. sodium hydroxide
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1.10) Which of these is a plasma derivative?
  1. Albumin
  2. Platelets
  3. Red blood cells
  4. White blood cells
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1.11) What is the purpose of the rosette test?
  1. To detect fetomaternal hemorrhage in postpartum women
  2. To screen for red blood cell antibodies in donated blood
  3. To screen for the West Nile virus in donated blood
  4. To test for blood group incompatibility before hematopoietic stem cell transplantation
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1.12) Which of these situations could result in hemolytic disease of the newborn?
  1. Rh+ mother, Rh+ fetus
  2. Rh+ mother, Rh− fetus
  3. Rh− mother, Rh+ fetus
  4. Rh− mother, Rh− fetus
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1.13) Which vacutainer tube is preferred for blood bank tests?
  1. Black
  2. Gray
  3. Green
  4. Pink
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1.14) Refer to the pedigree chart below: How many of the four children would be expected to have type AB blood?
  1. 0
  2. 2
  3. 3
  4. 4
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1.15) A patient has hemophilia A and needs injections of factor VIII. However, the patient's body has developed inhibitors to human factor VIII. Which form of factor VIII could be given to this patient instead?
  1. Activated
  2. Canine
  3. Porcine
  4. Recombinant
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1.16) How does anti-D immunoglobulin prevent Rhesus disease?
  1. By binding and neutralizing anti-D
  2. By destroying fetal red blood cells in the mother's bloodstream
  3. By physically blocking H1 receptors, thereby stopping anti-D from reaching its target
  4. By physically blocking the antigen binding site of IgD
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1.17) After release from prison, how long must ex-convicts wait before being eligible to donate blood?
  1. 3 months
  2. 6 months
  3. 9 months
  4. 12 months
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1.18) To donate blood, women need a hemoglobin level of at least:
  1. 2.5 g/dL
  2. 12.5 g/dL
  3. 22.5g/dL
  4. 32.5g/dL
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1.19) Which of these people should NOT donate blood?
  1. A breastfeeding mother with a six-week-old newborn
  2. Someone who had wisdom teeth removed a week ago
  3. Someone who received a measles immunization two months ago
  4. Someone with an aspirin allergy
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1.20) By what percentage does one unit of whole blood raise the hematocrit of a standard adult patient?
  1. 3%
  2. 6%
  3. 9%
  4. 12%
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1.21) In blood transfusions, what kind of red cells are given to patients who have a severe allergy to standard red cells?
  1. Frozen
  2. Irradiated
  3. Synthetic
  4. Washed
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1.22) Which of the following parasites causes transfusion-associated infections?
  1. Ancylostoma duodenale
  2. Giardia lamblia
  3. Plasmodium malariae
  4. Taenia saginata
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1.23) Which of these treatments should be avoided for patients with warm autoimmune hemolytic anemia (WAIHA)?
  1. Anti-D immunoglobulin injections
  2. Blood transfusion
  3. Corticosteroid administration
  4. Use of IV immunoglobulins
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1.24) Which of these conditions can the direct antiglobulin test detect?
  1. Hemolytic disease of the fetus and newborn
  2. Iron deficiency anemia
  3. Myeloma
  4. Sickle cell anemia
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1.25) Which of these recipients can safely receive fresh frozen plasma from a group O, Rh-positive donor?
  1. A, Rh-negative
  2. AB, Rh-negative
  3. AB, Rh-positive
  4. O, Rh-negative
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1.26) Which type of transfusion carries the highest risk of transfusion-associated sepsis?
  1. Fresh frozen plasma
  2. Platelets
  3. Washed erythrocytes
  4. Whole blood
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1.27) A patient requires an immediate transfusion but his blood type is unknown. The doctors should transfuse the patient with red blood cells from which donor?
  1. AB+
  2. AB−
  3. O+
  4. O−
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1.28) A patient at risk for transfusion-associated graft-versus-host disease needs a blood transfusion of red blood cells. The red blood cells for this patient should be:
  1. centrifuged
  2. frozen and deglycerolized
  3. irradiated
  4. saline washed
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1.29) Which blood type is most commonly used for intrauterine transfusions?
  1. AB+
  2. AB−
  3. O+
  4. O−
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1.30) Leukocytes are removed from transfusable blood components by a process called:
  1. leukoextraction
  2. leukorebation
  3. leukoreduction
  4. leukotransference
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1.31) TRALI is a transfusion complication where excess fluid builds up in which part of the body?
  1. Arteries
  2. Brain
  3. Intestines
  4. Lungs
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1.32) An AB− patient requires a blood transfusion but no AB− is available. Blood from which of these blood types could be given to the patient instead?
  1. A+
  2. AB+
  3. A−
  4. O+
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1.33) Which of the following statements about platelet donors is true?
  1. A platelet count is required on the first donation
  2. Donors who have ingested aspirin should be deferred for 48 hours
  3. The minimum interval between two platelet donations is 2 months
  4. The separation of platelets from blood is called plasmapheresis
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1.34) An apheresis donation is a donation:
  1. from a donor on a dialysis machine
  2. performed under general anesthetic
  3. taken from a leg vein instead of an arm vein
  4. where the donor gives specific blood components
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1.35) What percentage of African Americans express the U antigen on their red blood cells?
  1. 1%
  2. 12%
  3. 92%
  4. 98%
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1.36) What is the main enzyme responsible for synthesizing Lewis antigens?
  1. FUT1
  2. FUT2
  3. FUT3
  4. Glycosyltransferase
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1.37) What disease is associated with anti-i?
  1. Hemolytic disease of the newborn
  2. Hepatitis B
  3. Infectious mononucleosis
  4. Thalassemia
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1.38) Which phenotype is characterized by weakened expression of antigens in the Kell blood group system and the absence of Km and Kx antigens?
  1. Bombay
  2. Kell-null
  3. Lewis
  4. McLeod
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1.39) A 40-year-old woman needs two units of red blood cells. The antibody screen is positive. The results of the antibody panel are as follows: Which antibody most likely caused the positive result?
  1. Anti-C
  2. Anti-D
  3. Anti-E
  4. Anti-K
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1.40) What is the Lewis type of a person who has inherited the FUT3 gene but not the FUT2 gene?
  1. Le(a+b+)
  2. Le(a+b−)
  3. Le(a−b+)
  4. Le(a−b−)
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1.41) Which statement is true regarding the relationship between the U, S, and s antigens?
  1. A person who expresses the U antigen cannot express the S and s antigens
  2. A person who expresses the U antigen will also express the S and s antigens
  3. A person who lacks the U antigen cannot express the S or s antigens
  4. A person who lacks the U antigen will express the S and s antigens
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1.42) A 30-year-old woman requires an emergency blood transfusion. Her ABO group and Rh type are unknown. Which type of blood should she be given?
  1. Group AB, Rh-negative
  2. Group AB, Rh-positive
  3. Group O, Rh-negative
  4. Group O, Rh-positive
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1.43) Which genes code the MNS antigens?
  1. Cysteine-rich protein 1 and cysteine-rich protein 2
  2. Glycophorin A and glycophorin B
  3. Lamin A/C and lamin B1
  4. VASH1 and VASH2
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1.44) Which of these individuals is homozygous for the M allele?
  1. M+N+S+s+
  2. M+N+S–s+
  3. M+N+S–s–
  4. M+N–S+s+
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1.45) Whole blood is stored between:
  1. −12°C and −18°C
  2. −6°C and 3°C
  3. 2°C and 6°C
  4. 8°C and 16°C
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1.46) At what temperature are frozen red blood cells stored?
  1. −80°C
  2. −30°C
  3. –18°C
  4. 6°C
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1.47) What is the 4-hour rule in blood banking?
  1. Blood donors should not be kept waiting in the waiting room for more than 4 hours
  2. Blood donors should refrain from exercise four hours after donating blood
  3. Red blood cell units left out of refrigeration for more than 4 hours cannot be returned to the refrigerator
  4. Transfusions of red blood cell units should be completed within 4 hours of their removal from refrigeration
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1.48) What temperature is thawed plasma stored at?
  1. −20°C or colder
  2. −6°C to −18°C
  3. 1 to 6°C
  4. 20 to 24°C
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1.49) What is the 30-minute rule in blood banking?
  1. After a transfusion, the donor should sit in a quiet room for 30 minutes before going home
  2. Red blood cell units left out of a refrigerator for more than 30 minutes cannot be returned to the refrigerator
  3. The tourniquet should not be left on the patient's arm for more than 30 minutes
  4. Transfusions of red blood cell units should take no longer than 30 minutes
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1.50) 2.2% of fetal cells are reported on a Kleihauer-Betke test. What is the estimated volume of the fetal blood in the maternal circulation?
  1. 110 mL
  2. 160 mL
  3. 220 mL
  4. 270 mL
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1.51) What is the smallest fetomaternal hemorrhage (FMH) the rosette test can detect?
  1. 10 mL
  2. 20 mL
  3. 40 mL
  4. 50 mL
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1.52) After the Rh system, which blood group system is the second most common cause of hemolytic disease of the fetus and newborn?
  1. ABO
  2. Duffy
  3. Kell
  4. Lutheran
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1.53) If 1.5% of fetal cells are reported on a Kleihauer-Betke test, how many 300 µg vials of RhIG would the mother require?
  1. 1
  2. 2
  3. 3
  4. 4
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1.54) What is seen microscopically in a positive Kleihauer-Betke test?
  1. Blue maternal red blood cells and pale fetal red blood cells
  2. Granular maternal red blood cells and blue fetal red blood cells
  3. Pale maternal red blood cells and pink fetal red blood cells
  4. Pink maternal red blood cells and granular fetal red blood cells
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1.55) What volume of fetal red cells does the standard 300 mcg Rho(D) immune globulin dose cover?
  1. 15 mL
  2. 30 mL
  3. 45 mL
  4. 70 mL
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1.56) Which of these situations could be dangerous for a fetus?
  1. Both the father and mother are Rh-positive
  2. The father has blood type A and the mother has blood type B
  3. The father has blood type O and the mother has blood type AB
  4. The father is Rh-positive and the mother is Rh-negative
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1.57) Which of these causes a false positive on the rosette test?
  1. Infant is D-positive
  2. Infant is weak D-positive
  3. Mother is D-negative
  4. Mother is D-positive
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1.58) Coombs control cells are red blood cells coated with which antibody?
  1. IgA
  2. IgD
  3. IgE
  4. IgG
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1.59) Polyspecific antihuman globulin contains:
  1. anti-IgG and anti-C3d
  2. anti-IgG and anti-C5a
  3. anti-IgM and anti-C3b
  4. anti-IgM and anti-C5b
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1.60) In the indirect antiglobulin test, what happens to the red blood cells during the incubation phase?
  1. Agglutination
  2. Apoptosis
  3. Hemolysis
  4. Sensitization
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1.61) In antibody screens, what is the best pH for the incubation phase?
  1. 6.8–7.2
  2. 7.2–7.5
  3. 7.5–7.8
  4. 7.8–8.2
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1.62) Which blood type is used to make Coombs control cells?
  1. AB+
  2. AB−
  3. O+
  4. O−
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1.63) When performing an antiglobulin test, why must the lab technician wash the red blood cells before adding the AHG reagent?
  1. To ensure the antibodies bind to the antigens
  2. To neutralize excess AHG reagent
  3. To remove hemolyzed cells
  4. To remove unbound serum globulins
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1.64) What is the most serious transfusion reaction?
  1. Acute immune hemolytic reaction
  2. Delayed hemolytic reaction
  3. Febrile reaction
  4. Graft-versus-host disease
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1.65) What type of transfusion reaction is caused by the destruction of incompatible red blood cells?
  1. Anaphylactic
  2. Febrile non-hemolytic
  3. Hemolytic
  4. Simple allergic
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1.66) A patient returns to the hospital ten days after a blood transfusion with fever, dark urine, and mild jaundice. A complete blood count reveals the patient's hemoglobin level has dropped unexpectedly since the transfusion. What is the most likely cause?
  1. Autoimmune hemolytic anemia
  2. Delayed hemolytic transfusion reaction
  3. Graft-versus-host disease
  4. Iron overload
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1.67) Shortly after a blood transfusion is started, the patient experiences erythema and hives. What type of transfusion reaction is the patient experiencing?
  1. Acute hemolytic
  2. Delayed hemolytic
  3. Febrile nonhemolytic
  4. Urticarial
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1.68) Which transfusion reaction presents with cutaneous symptoms (itchy rash, hives, swelling of the lips) and severe respiratory symptoms?
  1. Acute hemolytic
  2. Anaphylactic
  3. Transfusion-associated circulatory overload (TACO)
  4. Transfusion-related acute lung injury (TRALI)
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1.69) Initial testing shows a patient's red blood cells have a 1+ reactivity with anti-D reagent. Further testing demonstrates moderate agglutination after the addition of antihuman globulin. What is the most likely condition in this patient?
  1. Autoimmune hemolytic anemia
  2. Hemolytic disease of the newborn
  3. Hereditary spherocytosis
  4. Weak D
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1.70) RhAG and RhCE are proteins on which cells?
  1. Eosinophils
  2. Mast cells
  3. Red blood cells
  4. T cells
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1.71) DCe/dCe is an example of which Rh nomenclature?
  1. Fisher-Race
  2. ISBT
  3. Rosenfield
  4. Wiener
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1.72) Which blood type has no Rh antigens?
  1. Rh-null
  2. R₀R₀
  3. r'r'
  4. rr
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1.73) Which two genes produce the Rh antigens?
  1. DCE and DHCE
  2. RH1 and RH2
  3. RHA and RHAG
  4. RHD and RHCE
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1.74) A person is Rh-positive if they have which antigen on their red blood cells?
  1. RhC
  2. Rhc
  3. RhD
  4. RhE
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1.75) What is the most common blood type in the US?
  1. AB+
  2. B−
  3. O−
  4. O+
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1.76) Refer to the blood typing test results below.
anti-A anti-B anti-D Rh type
+ O + DCe/dce
What is the patient's blood type?
  1. A+
  2. A−
  3. B+
  4. B−
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1.77) What percentage of group A individuals belong to the A₁ subgroup?
  1. 20%
  2. 40%
  3. 60%
  4. 80%
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1.78) A blood sample is tested with anti-A antibodies and anti-B antibodies. No clots form. What is the blood type?
  1. A
  2. AB
  3. B
  4. O
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1.79) In blood typing, anti-A may be dyed what color as a quality control measure?
  1. Blue
  2. Green
  3. Red
  4. Yellow
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1.80) A blood donor is tested with Rh antisera. The results are as follows:
anti-D anti-C anti-E anti-c anti-e
+ + + + +
What is the donor's most probable Rh genotype in Fisher-Race notation?
  1. DCe/DcE
  2. DCe/dCE
  3. DcE/DCE
  4. Dce/dCE
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1.81) A blood donor is tested with Rh antisera. The results are as follows:
anti-D anti-C anti-E anti-c anti-e
0 + 0 + +
What is the donor's Rh genotype?
  1. dCe/dCe
  2. dcE/dcE
  3. dce/dCe
  4. dce/dce
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1.82) A blood donor is tested with Rh antisera. The results are as follows:
anti-D anti-C anti-E anti-c anti-e
0 0 + + +
What is the donor's Rh genotype in Wiener notation?
  1. r'r'
  2. rr"
  3. rry
  4. ryry
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1.83) A blood donor is tested with Rh antisera. The results are as follows:
anti-D anti-C anti-E anti-c anti-e
0 0 0 + +
What is the donor's Rh genotype?
  1. dCe/dCe
  2. dcE/dcE
  3. dce/dCe
  4. dce/dce
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Section 2: Urinalysis and other body fluids

2.1) What is nocturia?
  1. Blood in the urine
  2. Difficulty urinating
  3. Excessive urination at night
  4. Pain during a period
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2.2) What is the medical term for no urine production?
  1. Anuria
  2. Diuresis
  3. Micturition
  4. Voiding
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2.3) A urine sample is positive for hemoglobin and negative for glucose, leukocytes, and bacteria. The urine contains a normal level of urea. Which of these terms applies to the urine?
  1. Hematuria
  2. Hemoglobinuria
  3. Hemosiderinuria
  4. Urolithiasis
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2.4) Which abnormal urine condition is associated with diabetes?
  1. Anuria
  2. Dysuria
  3. Oliguria
  4. Polyuria
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2.5) Which part of the nephron filters blood?
  1. Collecting duct
  2. Distal convoluted tubule
  3. Glomerulus
  4. Loop of Henle
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2.6) What is the functional unit of the kidney?
  1. Glomerular tuft
  2. Glomerulus
  3. Loop of Henle
  4. Nephron
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2.7) Which kind of centrifuge has good cellular morphology preservation?
  1. Angle head
  2. Cytocentrifuge
  3. Microhematocrit
  4. Refrigerated
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2.8) A CSF specimen is centrifuged in a microhematocrit tube to give a supernatant. The supernatant is xanthochromic, which most likely indicates:
  1. the patient had a recent brain bleed
  2. the specimen has a low protein level
  3. the spinal tap was traumatic
  4. there are bacteria in the spinal fluid
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2.9) The presence of ten or more white blood cells in a cubic millimeter of urine is called:
  1. oliguria
  2. polyuria
  3. pyuria
  4. uraturia
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2.10) The sweat test diagnoses which disease?
  1. Cystic fibrosis
  2. Infection
  3. Muscular dystrophy
  4. Pneumonia
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2.11) How often should reagent strips be tested with controls?
  1. Daily
  2. Weekly
  3. Monthly
  4. Every three months
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2.12) Which of these tests requires a 24-hour urine specimen?
  1. Creatinine clearance
  2. Glucose tolerance
  3. HCG detection
  4. Urine cytology
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2.13) A UTI urine dipstick tests for:
  1. nitrates and alanine transaminase
  2. nitrites and leukocyte esterase
  3. phosphates and bilirubin
  4. sugars and hemoglobin A1C
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2.14) Midstream urine samples are most often used for:
  1. culture and susceptibility
  2. mononucleosis testing
  3. pregnancy testing
  4. routine urinalysis
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2.15) Which reagent tablet tests for the presence of glucose in urine?
  1. Acetest
  2. Clinitest
  3. Ictotest
  4. TCA
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2.16) Cloudy white urine is a sign of:
  1. a urinary tract infection
  2. excessive consumption of vitamin B6
  3. jaundice
  4. liver disease
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2.17) Which epithelial cells in urine sediment are the largest?
  1. Columnar
  2. Cuboidal
  3. Squamous
  4. Urothelial
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2.18) Which cast typically indicates nephrotic syndrome?
  1. Fatty
  2. Renal tubular epithelial cell
  3. Waxy
  4. White blood cell
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2.19) Amorphous urates:
  1. disappear if the urine is heated
  2. form blue sediment in acidic urine
  3. form white sediment in alkaline urine
  4. have a non-granular appearance
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2.20) What is the term for an elevated level of white blood cells in urine?
  1. Hematuria
  2. Pyelonephritis
  3. Pyuria
  4. Uremia
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2.21) If a patient has been fasting for a few days, which of the following would be found in their urine?
  1. Bacteria
  2. Blood
  3. Glucose
  4. Ketones
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2.22) Clue cells in urine are a sign of:
  1. bacterial vaginosis
  2. enlarged prostate
  3. interstitial cystitis
  4. pyelonephritis
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2.23) A 24-hour urine specimen has a volume of 1,500 mL and a total protein of 25 mg/dL. Calculate the urinary protein excretion in mg per 24 hours.
  1. 60
  2. 167
  3. 375
  4. 600
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2.24) What is the term for yellow cerebrospinal fluid?
  1. Hemorrhagic
  2. Hyperglycorrhachia
  3. Jaundiced
  4. Xanthochromic
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2.25) What is the medical term for pale or light-colored stools?
  1. Acholic
  2. Melenic
  3. Mucoid
  4. Steatorrheic
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2.26) A patient's cerebrospinal fluid has a lactate value of 40 mg/dL. This indicates which type of meningitis?
  1. Bacterial
  2. Fungal
  3. Tubercular
  4. Viral
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2.27) Which health condition is associated with calcium pyrophosphate crystals?
  1. Cystinosis
  2. Oxalosis
  3. Pseudogout
  4. Sarcoidosis
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2.28) Which of these is a normal pH for a sperm sample?
  1. 5.4
  2. 6.2
  3. 7.6
  4. 8.8
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2.29) What is the normal range for the pH of urine?
  1. 0.6–4.0
  2. 2.6–6.0
  3. 4.6–8.0
  4. 6.6–10.0
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2.30) What is the normal range for urine specific gravity?
  1. 1.003–1.035
  2. 2.003–2.035
  3. 3.003–3.035
  4. 4.003–4.035
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2.31) Which procedure is used to remove fluid from the pleural space?
  1. Amniocentesis
  2. Lumbar puncture
  3. Paracentesis
  4. Thoracentesis
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2.32) A patient has the following creatinine results:
Test Result
Urine creatinine concentration 220 mg/dL
Serum creatinine concentration 2.2 mg/dL
24-hour urine volume 1800 mL
Calculate the creatinine clearance.
  1. 125 mL/min
  2. 275 mL/min
  3. 350 mL/min
  4. 715 mL/min
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Section 3: Chemistry

3.1) Calculate the pH value of a buffer solution composed of 0.20 M acetic acid and 0.50 M acetate ion, given that the acid dissociation constant for acetic acid is 1.8 x 10⁻⁵.
  1. 2.55
  2. 3.48
  3. 4.82
  4. 5.14
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3.2) Which term means the conversion of glycogen to glucose?
  1. Gluconeogenesis
  2. Glycogenesis
  3. Glycogenolysis
  4. Glycolysis
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3.3) Hyperkalemia means high levels of which chemical element?
  1. Calcium
  2. Mercury
  3. Potassium
  4. Sodium
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3.4) What is the term for a sodium level of 130 mEq/L?
  1. Hyperkalemia
  2. Hypernatremia
  3. Hypokalemia
  4. Hyponatremia
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3.5) Angiotensin II stimulates the release of which hormone?
  1. Adrenaline
  2. Aldosterone
  3. Cortisol
  4. T4
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3.6) Angiotensin-converting enzyme converts angiotensin I to:
  1. aldosterone
  2. angiotensin II
  3. angiotensin III
  4. renin
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3.7) Jaundice is caused by a buildup of ___________ in the blood.
  1. bilirubin
  2. hemoglobin
  3. potassium
  4. uric acid
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3.8) Beriberi is a deficiency of which vitamin?
  1. Vitamin A
  2. Vitamin B1
  3. Vitamin C
  4. Vitamin D
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3.9) Night blindness is caused by a deficiency in which vitamin?
  1. Vitamin A
  2. Vitamin B12
  3. Vitamin B6
  4. Vitamin C
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3.10) Which type of jaundice is due to liver damage?
  1. Hepatocellular
  2. Neonatal
  3. Post-hepatic
  4. Pre-hepatic
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3.11) Which autoimmune disorder results in hypothyroidism?
  1. Celiac disease
  2. Hashimoto's disease
  3. Multiple sclerosis
  4. Myasthenia gravis
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3.12) The troponin complex consists of which three subunits?
  1. Troponin A, troponin C, and troponin M
  2. Troponin I, troponin II, and troponin III
  3. Troponin I, troponin T, and troponin C
  4. Troponin X, troponin Y, and troponin Z
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3.13) Which hormone promotes sodium retention?
  1. Aldosterone
  2. Angiotensin II
  3. Anti-diuretic hormone
  4. Renin
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3.14) Which of these hormones does the pituitary gland produce?
  1. Insulin
  2. Prolactin
  3. T4
  4. TRH
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3.15) Which gland produces thyroid-stimulating hormone?
  1. Parathyroids
  2. Pituitary
  3. Testes
  4. Thyroid
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3.16) Which gland produces melatonin?
  1. Hypothalamus
  2. Pancreas
  3. Pineal
  4. Thymus
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3.17) Which hormone is also known as epinephrine?
  1. Adrenaline
  2. Cortisol
  3. Testosterone
  4. Vasopressin
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3.18) Antidiuretic hormone stimulates the re-absorption of:
  1. glucose
  2. oxygen
  3. potassium
  4. water
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3.19) Cortisol levels are generally highest at what time of day?
  1. 8 am
  2. 12 pm
  3. 4 pm
  4. 8 pm
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3.20) Thyroid-stimulating hormone is also known as:
  1. thyroglobulin
  2. thyrotropin
  3. thyroxine
  4. triiodothyronine
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3.21) Which process converts glucose to energy?
  1. Gluconeogenesis
  2. Glycogenesis
  3. Glycogenolysis
  4. Glycolysis
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3.22) Amylase is an enzyme that breaks down:
  1. fat
  2. protein
  3. starch
  4. sugars
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3.23) Which enzyme breaks down protein in the stomach?
  1. Amylase
  2. Lipase
  3. Pepsin
  4. Trypsin
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3.24) Which monosaccharide is the main end product of carbohydrate digestion?
  1. Glucose
  2. Lactose
  3. Maltose
  4. Sucrose
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3.25) Which of these is colloquially known as bad cholesterol?
  1. Fat
  2. HDL
  3. LDL
  4. Triglyceride
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3.26) Which is the main type of estrogen during pregnancy?
  1. Estrone
  2. Estradiol
  3. Estriol
  4. Estetrol
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3.27) Which organ conjugates bilirubin?
  1. Kidneys
  2. Liver
  3. Pancreas
  4. Spleen
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3.28) Which two liver enzymes are transaminases?
  1. AST and ALP
  2. AST and ALT
  3. GGT and ALP
  4. GGT and ALT
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3.29) Deficiency of which mineral or vitamin causes pernicious anemia?
  1. Folate
  2. Iron
  3. Vitamin B12
  4. Vitamin B6
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3.30) Deficiencies of which two vitamins cause megaloblastic anemia?
  1. Vitamins A and C
  2. Vitamins B3 and B6
  3. Vitamins B9 and B12
  4. Vitamins C and D
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3.31) Which factor contributes to severe anemia in people with chronic renal failure?
  1. Blockage of the blood supply to the brain
  2. Decreased renal production of erythropoietin
  3. The inability of the intestines to absorb vitamin B12 and iron
  4. The inability of the pancreas to produce insulin
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3.32) In which thyroid disorder are both TSH and T4 elevated?
  1. Primary hyperthyroidism
  2. Primary hypothyroidism
  3. Secondary hyperthyroidism
  4. Secondary hypothyroidism
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3.33) A patient has nausea, vomiting and fever. The following are the results of her liver function tests:
Test Result Normal range
Total serum bilirubin 14.8 mg/dL 0.1–1.2 mg/dL
ALP 132 IU/L 44–147 IU/L
ALT 739 IU/L 19–25 IU/L
AST 838 IU/L 8–33 U/L
GGT 35 IU/L 5–40 IU/L
What is the most likely diagnosis?
  1. Acute hepatitis
  2. Cirrhosis
  3. Hemochromatosis
  4. Hepatocellular carcinoma
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3.34) A patient has severe abdominal pain and fever. The following are results from a liver function test:
Test Result Normal range
Total serum bilirubin 12.8 mg/dL 0.1–1.2 mg/dL
ALP 452 IU/L 44–147 IU/L
ALT 37 IU/L 19–25 IU/L
AST 45 IU/L 8–33 U/L
GGT 140 IU/L 5–40 IU/L
What is the most likely diagnosis?
  1. Autoimmune hepatitis
  2. Hepatitis A
  3. Obstructive jaundice
  4. Wilson's disease
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3.35) Low-carbohydrate diets may cause an increased amount of _____________ in urine.
  1. blood
  2. ketones
  3. leukocytes
  4. urobilinogen
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3.36) Patients with symptoms of thirst and frequent urination should receive which of the following tests?
  1. Basic metabolic panel
  2. Fasting blood glucose
  3. Prothrombin time
  4. Tissue transglutaminase IgA test
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3.37) Women who have had gestational diabetes have an increased risk of developing:
  1. ovarian cysts
  2. shingles
  3. type I diabetes
  4. type II diabetes
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3.38) Cholesterol belongs to the ___________ group of lipids.
  1. phospholipid
  2. steroid
  3. triacylglycerol
  4. wax
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3.39) The Smithline-Gardner formula calculates:
  1. creatinine clearance
  2. prothrombin time
  3. rheumatoid factor
  4. serum osmolality
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3.40) What is the Smithline-Gardner formula?
  1. (sodium×1.78) + (glucose/16) + (BUN/2.8)
  2. (sodium×1.8) + (glucose/16) + (BUN/3.2)
  3. (sodium×1.82) + (glucose/18) + (BUN/3.2)
  4. (sodium×2) + (glucose/18) + (BUN/2.8)
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3.41) Which stain is used to stain glycogen?
  1. Gram's stain
  2. H&E
  3. Periodic Acid-Schiff
  4. Sudan IV
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3.42) Bromocresol purple and bromocresol green are dyes used to measure the levels of:
  1. Bence Jones protein
  2. albumin
  3. globulins
  4. immunoproteins
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3.43) Refer to the serum protein electrophoresis pattern below. Which serum protein is the arrow pointing to?
  1. Albumin
  2. Alpha-1 globulin
  3. Alpha-2 globulin
  4. Gamma globulin
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3.44) A patient has a potassium result of 7.2 mEq/L. Before reporting the result, the lab technician should:
  1. check the age of the patient
  2. check the serum for bacterial contamination
  3. check the serum for hemolysis
  4. test the serum for ketones
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3.45) The prothrombin time test is often used for patients taking which medication?
  1. Atorvastatin
  2. Metformin
  3. Sertraline
  4. Warfarin
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3.46) The sweat test measures the amount of _________ in sweat.
  1. chloride
  2. copper
  3. lead
  4. phosphatase
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3.47) The alpha-fetoprotein (AFP) test requires which type of sample?
  1. Blood
  2. Cerebrospinal fluid
  3. Feces
  4. Urine
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3.48) What does a hemoglobin A1c test measure?
  1. The amount of hemoglobin in the patient's blood
  2. The concentration of red blood cells in the patient's blood
  3. The patient's average blood glucose levels over the last three months
  4. The patient's blood glucose level at the time the sample drawn
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3.49) Which of these tests would most be affected if a patient ate a muffin and orange juice before a fasting blood test?
  1. Blood culture
  2. Cardiac enzymes
  3. Complete blood count
  4. Glucose
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3.50) When preparing a urine specimen for microscopic analysis, which of these steps comes first?
  1. Add one drop of stain to the tube
  2. Centrifuge the urine sample
  3. Place a coverslip over the sample
  4. Transfer one drop of the sediment to a microscope slide
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3.51) If a patient's urine is positive for ketones, the patient probably has:
  1. advanced liver disease
  2. heart disease
  3. pernicious anemia
  4. uncontrolled diabetes
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3.52) The following results were obtained from the urine of a 31-year-old woman:
Parameter Result
Color Pale yellow
Appearance Cloudy
Specific gravity 1.015
pH 6.0
Glucose Negative
Protein 1+
Bacteria Many
WBC casts Many
WBC/HPF 30
Which disease are these results most compatible with?
  1. Glomerulonephritis
  2. Pyelonephritis
  3. Renal calculus
  4. Vaginitis
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3.53) What is the normal range for the blood urea nitrogen (BUN) test?
  1. 6–20 mg/dL
  2. 20–36 mg/dL
  3. 36–60 mg/dL
  4. 60–80 mg/dL
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3.54) What is the normal range for fasting glucose?
  1. 0–50 mg/dL
  2. 50–70 mg/dL
  3. 70–100 mg/dL
  4. 100–125 mg/dL
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3.55) What is the normal ratio of bicarbonate to carbonic acid in blood?
  1. 20:1
  2. 80:1
  3. 200:1
  4. 800:1
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3.56) What is the normal range for total CO₂ levels in blood?
  1. 2–9 mEq/L
  2. 12–19 mEq/L
  3. 22–29 mEq/L
  4. 32–39 mEq/L
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3.57) What is the normal range for 24-hour urine volume?
  1. 40–80 mL
  2. 100–200 mL
  3. 200–800 mL
  4. 800–2,000 mL
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3.58) What is the normal range for AST in adult blood?
  1. 1–5 units/L
  2. 10–40 units/L
  3. 63–90 units/L
  4. 79–102 units/L
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3.59) What is the normal range for ALT in adult blood?
  1. 7–56 units/L
  2. 35–79 units/L
  3. 74–100 units/L
  4. 78–107 units/L
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3.60) What is a healthy level of triglycerides for an adult?
  1. <150 mg/dL
  2. 150 to 200 mg/dL
  3. 200 to 299 mg/dL
  4. 300 to 499 mg/dL
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3.61) What is the optimal LDL cholesterol level in adults?
  1. <100 mg/dL
  2. 100 to 200 mg/dL
  3. 200 to 300 mg/dL
  4. 300 to 400 mg/dL
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3.62) The normal value for glomerular filtration rate is _____ or above.
  1. 30
  2. 90
  3. 150
  4. 210
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3.63) What is the normal range for the specific gravity of urine?
  1. 0.930–0.955
  2. 0.955–0.980
  3. 0.980–1.005
  4. 1.005–1.030
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3.64) What is the role of the buffering system in the blood?
  1. Controlling blood glucose levels
  2. Maintaining pH balance
  3. Regulating hormone levels
  4. Transporting oxygen
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3.65) Which cardiac glycoside is used to treat congenital heart failure and arrhythmias by increasing cardiac output?
  1. Digoxin
  2. Furosemide
  3. Minoxidil
  4. Spironolactone
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3.66) Which type of acidosis best explains the arterial blood gas results below?
Test Result
pH 6.91
PaCO₂ 40 mmHg
Bicarbonate 16 mEq/L
  1. Compensated metabolic
  2. Compensated respiratory
  3. Uncompensated metabolic
  4. Uncompensated respiratory
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3.67) Emphysema can cause which abnormal state?
  1. Metabolic acidosis
  2. Metabolic alkalosis
  3. Respiratory acidosis
  4. Respiratory alkalosis
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3.68) Oxazepam is a metabolite of which type of medication?
  1. Antibiotics
  2. Antihistamines
  3. Benzodiazepines
  4. Statins
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3.69) Which liver enzyme is used to diagnose liver and bone diseases?
  1. ALP
  2. ALT
  3. AST
  4. GGT
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3.70) uPA a marker for which cancer?
  1. Bladder
  2. Breast
  3. Colorectal
  4. Ovarian
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3.71) Which of these tests indicates the health of the kidneys?
  1. ALT
  2. Bilirubin
  3. Creatinine clearance
  4. TSH
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3.72) A patient's serum gives the following results:
Test Result
TSH Normal
Calcium High
Phosphate Low
Parathyroid hormone High
The patient most likely has which disorder?
  1. Hyperparathyroidism
  2. Hyperthyroidism
  3. Hypoparathyroidism
  4. Hypothyroidism
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3.73) Creatinine clearance is used to estimate the:
  1. glomerular filtration rate
  2. glomerular secretion of creatinine
  3. renal glomerular and tubular mass
  4. tubular secretion of creatinine
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3.74) Elevation of which isoenzyme is typical of muscle disease?
  1. ALT
  2. CK-BB
  3. CK-MB
  4. CK-MM
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3.75) The following blood results are from a 55-year-old male suffering from headaches and fatigue:
Test Result
Glucose 81 mg/dL
HDL cholesterol 75 mg/dL
LDL cholesterol 80 mg/dL
Sodium 105 mEq/L
Creatinine 0.9 mg/dL
The blood test results suggest which disease?
  1. Hypercholesterolemia
  2. Hyponatremia
  3. Kidney disease
  4. Type II diabetes
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3.76) In the glucose oxidase reaction, glucose oxidase reacts with glucose, water, and oxygen to form:
  1. gluconic acid and hydrogen peroxide
  2. gluconic acid nitric acid
  3. glycogen and carbonic acid
  4. glycogen and sodium hydroxide
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3.77) Elevated serum acid phosphatase levels may indicate which of these diseases?
  1. Gout
  2. Kidney disease
  3. Liver disease
  4. Prostate cancer
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3.78) Estrogen and progesterone receptor testing are used to assess the prognosis and guide the treatment of:
  1. breast cancer
  2. endometriosis
  3. hepatoma
  4. ovarian cancer
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3.79) Which organ does the bile acid test assess?
  1. Bladder
  2. Kidney
  3. Liver
  4. Stomach
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3.80) Calculate the anion gap from the following results:
Test Result
Sodium 150 mEq/L
Chloride 90 mEq/L
Bicarbonate 20 mEq/L
  1. 40 mEq/L
  2. 80 mEq/L
  3. 220 mEq/L
  4. 260 mEq/L
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3.81) The anion gap is used to identify errors in the measurement of:
  1. electrolytes
  2. red blood cells
  3. urea
  4. white blood cells
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3.82) Use the results below to calculate the osmolal gap.
Test Result
Sodium 140 mEq/L
Glucose 90 mg/dL
BUN 28 mg/dL
Measured osmolality 301 mOsm/kg
  1. 1 mOsm/kg
  2. 3 mOsm/kg
  3. 6 mOsm/kg
  4. 9 mOsm/kg
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3.83) What does headspace gas chromatography analyze?
  1. Hydrogen
  2. Noble gases
  3. Oxygen and carbon dioxide
  4. Volatile organic compounds
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3.84) Glomerular filtration rate measures the health of which organ?
  1. Bladder
  2. Gallbladder
  3. Kidneys
  4. Liver
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3.85) In the second trimester of pregnancy, human chorionic gonadotropin (hCG) levels ________ and estrogen levels ________.
  1. decrease, decrease
  2. decrease, increase
  3. increase, decrease
  4. increase, increase
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3.86) Blood ammonia levels are usually measured to evaluate the health of which organ?
  1. Digestive tract
  2. Heart
  3. Liver
  4. Lungs
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3.87) The Friedewald equation estimates the level of:
  1. LDL cholesterol
  2. lipoproteins
  3. total cholesterol
  4. triglycerides
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3.88) Which condition is most consistent with the results below?
Test Result
Osmolality 290 mOsm/kg
Sodium 125 mEq/L
Total cholesterol 1,381 mg/dL
  1. Cushing's syndrome
  2. Hyperaldosteronism
  3. Hypothyroidism
  4. Pseudohyponatremia
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3.89) A patient has the following lipid panel results:
Test Result
Total cholesterol 160 mg/dL
LDL 100 mg/dL
VLDL 20 mg/dL
HDL 40 mg/dL
Triglycerides 150 mg/dL
Calculate the cholesterol ratio.
  1. 0.25
  2. 4
  3. 50
  4. 150
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3.90) If a blood sample has high levels of urea, it is also likely to have high levels of:
  1. albumin
  2. catalase
  3. creatinine
  4. fibrinogen
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3.91) The parathyroid hormone test investigates abnormal levels of which mineral?
  1. Calcium
  2. Iron
  3. Potassium
  4. Sodium
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3.92) Which tests are elevated in acute pancreatitis?
  1. ALP and GGT
  2. AST and LDH
  3. Amylase and lipase
  4. Pepsin and enterokinase
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3.93) Scurvy is caused by a deficiency of which vitamin?
  1. Niacin
  2. Thiamine
  3. Vitamin A
  4. Vitamin C
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3.94) What type of vitamins are thiamin, riboflavin, and niacin?
  1. Vitamin A
  2. Vitamin B
  3. Vitamin C
  4. Vitamin D
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3.95) A woman has symptoms of weakness and fatigue. The results of a serum electrolyte test are as follows:
Electrolyte Result
Sodium 140 mEq/L
Potassium 4.3 mEq/L
Chloride 65 mEq/L
Magnesium 2.0 mg/dL
Phosphate 3.9 mg/dL
Which of the results is abnormal?
  1. Sodium
  2. Potassium
  3. Chloride
  4. Magnesium
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3.96) Vitamin C is essential for the synthesis of:
  1. cholesterol
  2. collagen
  3. hemoglobin
  4. insulin
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3.97) Retinol, retinal, and retinoic acid are the three active forms of which vitamin?
  1. A
  2. B12
  3. B6
  4. C
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3.98) Rickets is caused by a deficiency of which vitamin?
  1. Vitamin A
  2. Vitamin B6
  3. Vitamin C
  4. Vitamin D
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3.99) Vitamin K:
  1. converts prothrombin to thrombin
  2. destroys fibrin which allows a clot to dissolve gradually
  3. is essential for the liver's production of prothrombin
  4. is water soluble
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3.100) Beta-carotene is a precursor to which vitamin?
  1. A
  2. B6
  3. B12
  4. K
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Section 4: Hematology

4.1) Which type of immunoglobulin is the Donath-Landsteiner antibody?
  1. IgA
  2. IgD
  3. IgG
  4. IgM
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4.2) Paroxysmal cold hemoglobinuria is most commonly seen in:
  1. children
  2. elderly people
  3. newborns
  4. pregnant women
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4.3) What word means the production of lymphocytes?
  1. Lymphadenitis
  2. Lymphedema
  3. Lymphocytopenia
  4. Lymphopoiesis
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4.4) Which term means a condition where red blood cells are of different sizes?
  1. Anisocytosis
  2. Erythrocytosis
  3. Heterocytosis
  4. Pinocytosis
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4.5) In which disorder, commonly known as iron overload, does the body store too much iron?
  1. Hemochromatosis
  2. Polycythemia vera
  3. Thalassemia
  4. Von Willebrand disease
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4.6) Factor I is also known as:
  1. fibrinogen
  2. proaccelerin
  3. prothrombin
  4. tissue thromboplastin
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4.7) In which disease does overactive clotting lead to uncontrolled bleeding?
  1. Disseminated intravascular coagulation
  2. Hemophilia
  3. Thrombocytopenia
  4. Von Willebrand Disease
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4.8) Which leukemia best correlates with these results?
Test Result
WBC 2.3 x 10⁹/L
RBC 3.2 x 10¹²/L
Platelets 35 x 10⁹
Blasts in bone marrow: 41%
  1. Acute lymphoblastic
  2. Acute monoblastic
  3. Chronic myelogenous
  4. Chronic myelomonocytic
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4.9) Blood tests reveal high levels of lymphoblasts and low levels of red blood cells and platelets. Which type of leukemia best fits these results?
  1. Acute lymphocytic leukemia
  2. Acute myeloid leukemia
  3. Chronic lymphocytic leukemia
  4. Chronic myeloid leukemia
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4.10) A patient is positive for the Philadelphia chromosome and negative for acute lymphoblastic leukemia. What is the most likely diagnosis?
  1. Chronic lymphoblastic leukemia
  2. Chronic myeloid leukemia
  3. Pernicious anemia
  4. Thalassemia
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4.11) Auer rods are characteristically found in which leukemia?
  1. Acute lymphocytic
  2. Acute myeloid
  3. Chronic lymphocytic
  4. Chronic myeloid
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4.12) Which marker helps distinguish acute lymphocytic leukemia from malignant lymphoma?
  1. Acid phosphatase
  2. Human chorionic gonadotropin
  3. Leukocyte alkaline phosphatase
  4. Terminal deoxynucleotidyl transferase
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4.13) Leukocyte alkaline phosphatase (LAP) staining was performed on a blood specimen. The specimen was scored as follows:
Score Neutrophils
0 95
+1 3
+2 2
+3 0
+4 0
Which condition best explains the result?
  1. Chronic myeloid leukemia
  2. Leukemoid reaction
  3. Leukocytosis
  4. Leukopenia
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4.14) Blood tests reveal high levels of lymphocytes. Under a microscope, the lymphocytes look small and abnormal. Which type of leukemia best fits these results?
  1. Acute lymphocytic leukemia
  2. Acute myeloid leukemia
  3. Chronic lymphocytic leukemia
  4. Chronic myeloid leukemia
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4.15) Which type of acute myeloid leukemia is characterized by minimal maturation of myeloid cells?
  1. FAB M1
  2. FAB M2
  3. FAB M3
  4. FAB M4
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4.16) Which of these patients has anemia?
HCT RBC (x10¹²/L) Hemoglobin (g/dL)
Patient 1 50% 4.6 14.1
Patient 2 41% 6.2 16.8
Patient 3 38% 4.8 10.6
Patient 4 42% 7.2 13.5
  1. Patient 1
  2. Patient 2
  3. Patient 3
  4. Patient 4
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4.17) Which type of anemia best correlates with the following test results?
Test Result
Hemoglobin 5.7 g/dL
Hematocrit 25%
Ferritin 736 ng/mL
Iron 314 mcg/dL
Transferrin 813 mg/dL
Transferrin saturation 75%
  1. Anemia of chronic diseases
  2. Hemolytic anemia
  3. Iron-deficiency anemia
  4. Sideroblastic anemia
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4.18) What abnormal form of hemoglobin causes sickle cell anemia?
  1. HbA
  2. HbA2
  3. HbF
  4. HbS
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4.19) Which anemia best fits these results?
Test Result
Hemoglobin 7.9 g/dL
Neutrophil count 452/mm³
Platelet count 23,100/mm³
  1. Aplastic anemia
  2. Folic acid deficiency
  3. Hemolytic anemia
  4. Pernicious anemia
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4.20) Which of these anemias is hypochromic and microcytic?
  1. Hemolytic
  2. Megaloblastic
  3. Sickle cell
  4. Thalassemia
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4.21) Vitamin B9 and B12 deficiencies cause the body to produce which type of abnormal red blood cells?
  1. Megaloblasts
  2. Sickle cells
  3. Spherocytes
  4. Stomatocytes
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4.22) What is the most common type of anemia?
  1. Aplastic
  2. Induced related
  3. Iron deficiency
  4. Sickle cell
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4.23) Pernicious anemia can be distinguished from folate deficiency by the:
  1. bone marrow findings
  2. mean cell volume
  3. presence of autoantibodies to intrinsic factor
  4. presence of hypersegmented neutrophils
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4.24) Along with the mean cell volume, which other test is used to morphologically classify anemias?
  1. Hematocrit
  2. Hemoglobin
  3. Red blood count
  4. Red cell blood distribution width
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4.25) Which of these results best correlates with sickle cell anemia?
  1. Hgb 10.0 g/dL, Hct 10%, WBC 8.0×10⁹/L
  2. Hgb 11.0 g/dL, Hct 31%, WBC 11.0×10⁹/L
  3. Hgb 5.0 g/dL, Hct 17%, WBC 13.0×10⁹/L
  4. Hgb 8.0 g/dL, Hct 42%, WBC 10.0×10⁹/L
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4.26) Which of these hematocrit values correlates with untreated pernicious anemia?
  1. 29%
  2. 43%
  3. 64%
  4. 81%
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4.27) What is the most severe type of thalassemia?
  1. Alpha thalassemia major
  2. Alpha thalassemia minor
  3. Beta thalassemia major
  4. Beta thalassemia minor
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4.28) Which of these conditions causes high iron levels and a decreased total iron binding capacity (TIBC)?
  1. Anemia of chronic disease
  2. Hemochromatosis
  3. Iron deficiency anemia
  4. Sickle cell anemia
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4.29) New methylene blue reagent is used to stain:
  1. Heinz bodies
  2. eosinophils
  3. platelets
  4. reticulocytes
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4.30) When a smear is too red, neutrophil granules look:
  1. blue-red
  2. brilliant red
  3. indistinct
  4. light blue
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4.31) Identify the false statement about the preparation of reticulocyte smears.
  1. Reticulocyte smears are used to determine the number of white blood cells in a sample
  2. The dyes used can be new methylene blue or brilliant cresyl blue
  3. The stain and the cells must be left to react for 15 minutes before making the smear
  4. The staining technique is called supravital staining
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4.32) What color is lipemic plasma?
  1. Brownish-yellow
  2. Clear red
  3. Milky
  4. Straw-colored
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4.33) What does the blood differential test measure?
  1. The number of all cells
  2. The number of red blood cells
  3. The percentage of each type of white blood cell
  4. The volume percentage of red blood cells
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4.34) Which test counts the number of immature red blood cells in a blood sample?
  1. Differential
  2. Osmotic fragility test
  3. Red blood cell count
  4. Reticulocyte count
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4.35) Which of these is needed to prepare defibrinated blood?
  1. Filter paper
  2. Glass beads
  3. UV light
  4. Vacuum pump
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4.36) Which cytochemical stain is used to diagnose hairy cell leukemia?
  1. Chloroacetate esterase
  2. Leucocyte alkaline phosphatase
  3. Myeloperoxidase
  4. Tartrate-resistant acid phosphatase
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4.37) Calculate the corrected reticulocyte percentage from the following results.
Test Result
RBC (cells/L) 4.7×10¹²
WBC (cells/L) 4.5×10⁹
PLT (cells/L) 310×10⁹
Hct 30% (normal Hct = 45%)
Reticulocyte count 1.5%
  1. 0.5%
  2. 1%
  3. 1.5%
  4. 2%
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4.38) Capillary blood composition most closely resembles:
  1. arterial blood
  2. lymph fluid
  3. tissue fluid
  4. venous blood
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4.39) The hemoglobin solubility test is a screening test for which disease?
  1. Chronic lymphocytic leukemia
  2. Polycythemia vera
  3. Secondary myelofibrosis
  4. Sickle cell anemia
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4.40) What are Howell-Jolly bodies?
  1. Aggregates of beta-globin chains
  2. Basophilic iron deposits
  3. Clumps of denatured hemoglobin
  4. Remnants of DNA
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4.41) Hematology analyzers use which principle for counting red blood cells?
  1. Campbell
  2. Coulter
  3. Stewart
  4. Thompson
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4.42) What does the international normalized ratio (INR) measure?
  1. How long blood takes to form a clot
  2. How long erythrocytes take to separate from plasma
  3. The average blood glucose level over the past 3 months
  4. The ratio of oxygen to carbon dioxide in the blood
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4.43) Which of these is a plasma protein involved in coagulation?
  1. Albumin
  2. Erythropoietin
  3. Fibrinogen
  4. Gamma globulin
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4.44) When setting up erythrocyte sedimentation rates, take care to ensure:
  1. a fasting specimen is used
  2. the ESR tubes are vertical
  3. the sample is completely thawed
  4. the water bath is exactly 37°C
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4.45) Which anticoagulant is used for red blood cell counts?
  1. EDTA
  2. Heparin
  3. Sodium citrate
  4. Sodium oxalate
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4.46) What is the hematocrit?
  1. The average mass of hemoglobin per red blood cell
  2. The rate at which red blood cells descend in a tube
  3. The time it takes for blood to clot
  4. The volume percentage of red blood cells in blood
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4.47) Calculate the corrected WBC count from the following results.
Test Result
Uncorrected WBC count 30,000/uL
Nucleated RBC/100 WBC 100
  1. 500/uL
  2. 10,000/uL
  3. 15,000/uL
  4. 18,000/uL
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4.48) Which test measures the oxygen-carrying capacity of red blood cells?
  1. CBC
  2. ESR
  3. Hct
  4. Hgb
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4.49) The icterus index is a measure of which color of serum?
  1. Green
  2. Red
  3. White
  4. Yellow
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4.50) Which anticoagulant works by inactivating thrombin?
  1. EDTA
  2. Heparin
  3. Potassium oxalate
  4. Sodium citrate
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4.51) Why is ammonium oxalate added to blood samples before platelet counts?
  1. To force the blood to clot
  2. To lyse the red blood cells
  3. To prevent hemodilution
  4. To stain the platelets blue
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4.52) Which platelet function test measures the time it takes for platelets to form a clot and plug a hole in a tube?
  1. Closure time
  2. Lumiaggregometry
  3. Platelet aggregometry
  4. Viscoelastometry
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4.53) What is the preferred source of DNA for DNA testing?
  1. Plasma proteins
  2. Platelets
  3. Red blood cells
  4. White blood cells
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4.54) What is the term for the yellow discoloration of the skin and eyes due to high bilirubin levels?
  1. Hemolysis
  2. Icterus
  3. Intergeneric
  4. Lipemia
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4.55) Which of these diseases causes a low erythrocyte sedimentation rate?
  1. Bone marrow disease
  2. Carcinoma
  3. Leukemia
  4. Polycythemia
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4.56) The presence of schistocytes in the peripheral blood indicates which of the following processes?
  1. Extravascular hemolysis
  2. Intravascular hemolysis
  3. Iron deficiency anemia
  4. Megaloblastic anemia
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4.57) Which of these is higher in capillary blood than in venous blood?
  1. Calcium
  2. Carotene
  3. Glucose
  4. Total protein
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4.58) Leukocyte alkaline phosphatase (LAP) staining was performed on a blood specimen. The specimen was scored as follows:
Score Neutrophils
0 40
+1 40
+2 15
+3 5
+4 0
Calculate the LAP score.
  1. 25
  2. 45
  3. 65
  4. 85
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4.59) Leukocyte alkaline phosphatase (LAP) staining was performed on a blood specimen. The specimen was scored as follows:
Score Neutrophils
0 10
+1 40
+2 30
+3 10
+4 10
Which condition most likely explains the result?
  1. Chronic myeloid leukemia
  2. Leukemoid reaction
  3. Leukocytosis
  4. Leukopenia
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4.60) When preparing a blood smear, which of these could cause the blood smear to be too thin?
  1. A small drop size
  2. Holding the spreader at a high angle
  3. Spreading the blood too slowly
  4. Using transfused blood
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4.61) Which of these is a sign of a poorly prepared blood smear?
  1. Covers the majority of the slide
  2. Fills half to three-quarters the length of the slide
  3. Has a consistent thickness throughout
  4. Has feathered edges
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4.62) Bone marrow cells that contain the Philadelphia chromosome are most often found in which type of leukemia?
  1. Acute lymphocytic
  2. Acute myelogenous
  3. Chronic lymphocytic
  4. Chronic myelogenous
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4.63) What is the term for a platelet count of 120 × 10⁹/L?
  1. Anemia
  2. Polycythemia
  3. Thrombocytopenia
  4. Thrombocytosis
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4.64) In serum protein electrophoresis, which globulin is closest to the negative electrode?
  1. Alpha-1
  2. Alpha-2
  3. Beta-1
  4. Gamma
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4.65) A microscopic analysis of a patient's blood sample reveals neutrophils with six-lobed nuclei. Which illness does this indicate?
  1. Acute myelogenous leukemia
  2. Erythrocytosis
  3. Hemochromatosis
  4. Megaloblastic anemia
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4.66) A man has the following blood test results:
Test Result
Red cell count 5.4 × 10¹²/L
White cell count 6.5 × 10⁹/L
Platelets 660 × 10⁹/L
Which term applies to these results?
  1. Anemia
  2. Polycythemia
  3. Thrombocytopenia
  4. Thrombocytosis
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4.67) What is the term for a red cell count of 3.6 × 10¹²/L in men?
  1. Anemia
  2. Leukocytosis
  3. Leukopenia
  4. Polycythemia
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4.68) Which of the following clinical signs is characteristic of Bernard-Soulier syndrome?
  1. Abnormal aggregation with ADP
  2. Increased platelet count
  3. Large platelets
  4. Shortened bleeding time
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4.69) What is the term for a leukocyte count of 18.4 × 10⁹/L?
  1. Leukocytosis
  2. Leukodystrophy
  3. Leukopenia
  4. Leukorrhea
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4.70) Anticoagulant therapy is monitored by performing a:
  1. ESR
  2. FBS
  3. Hgb
  4. PT
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4.71) A prolonged PT and a prolonged PTT suggest a defect in which coagulation pathway?
  1. Common
  2. Extrinsic
  3. Fibrinolytic
  4. Intrinsic
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4.72) The partial thromboplastin time (PTT) test requires what type of blood sample?
  1. Coagulated
  2. Decalcified
  3. Defibrinated
  4. Frozen
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4.73) The result of a patient's partial thromboplastin time (PTT) test is >300 seconds. What is the most likely cause?
  1. The patient had a high-fat meal before the blood draw
  2. The patient has a vitamin K deficiency
  3. The sample was contaminated with heparin
  4. The sample was shaken vigorously
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4.74) Which red blood cell morphology is associated with folate (B9) deficiency?
  1. Macrocytic normochromic
  2. Microcytic hyperchromic
  3. Normocytic hyperchromic
  4. Normocytic hypochromic
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4.75) What two parameters are needed to calculate the mean corpuscular hemoglobin concentration (MCHC)?
  1. HCT and Hgb
  2. RBC and HCT
  3. RBC and Hgb
  4. RBC and WBC
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4.76) Which red blood cell index is the average amount of hemoglobin in a single red blood cell?
  1. MCH
  2. MCV
  3. RBC
  4. RDW
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4.77) What is the formula for calculating mean corpuscular volume (MCV)?
  1. (HGB / Hct) × 10
  2. (HGB / RBC) × 10
  3. (Hct / RBC) × 10
  4. RBC/10 × MCV
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4.78) A patient has the following hematology results:
Test Result
RBC 4.68×10¹²/L
Hemoglobin 133 g/L
Hematocrit 0.451
Calculate the patient's mean corpuscular hemoglobin (MCH).
  1. 0.035 pg
  2. 10.4 pg
  3. 28.4 pg
  4. 59.85 pg
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4.79) Which microscope objective is used first when examining a stained blood film?
  1. 10x
  2. 40x
  3. 50x
  4. 70x
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4.80) What color do red blood cells appear when stained with a Romanowsky stain?
  1. Green
  2. Purple
  3. Red
  4. Yellow
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4.81) A patient has the following test results:
Test Result
RBC 2.8 × 10¹²/L
WBC 13.1 × 10⁹/L
Janus kinase 2 (JAK2) mutation Positive
Which condition best fits these results?
  1. Acute lymphocytic leukemia
  2. Chronic lymphocytic leukemia
  3. Polycythemia vera
  4. Primary myelofibrosis
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4.82) A patient has symptoms of fatigue, weakness, and difficulty breathing. Blood tests reveal high iron, high ferritin, and a normal total iron binding capacity (TIBC). A peripheral blood smear shows red blood cells that are microcytic and hypochromic and have basophilic stippling. Pappenheimer bodies are also observed inside the red blood cells. What is the most likely diagnosis?
  1. Acute intermittent porphyria
  2. Porphyria cutanea tarda
  3. Sickle cell anemia
  4. Sideroblastic anemia
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4.83) A patient has a decreased factor VIII assay, a normal factor IX assay, and a prolonged aPTT. Which condition does the patient have?
  1. Acute lymphocytic leukemia
  2. Acute myeloid leukemia
  3. Hemophilia A
  4. Hemophilia B
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4.84) Which of these statements about capillary punctures is true?
  1. It is better to clean the skin with iodine than with alcohol
  2. The first drop of blood is the best to use
  3. The puncture must hit bone for it to be deep enough
  4. The puncture should be made at right angles to the fingerprint striations
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4.85) Which of these is a normal RBC result for men?
  1. 5.6 × 10⁶ cells/μL
  2. 6.9 × 10⁶ cells/μL
  3. 7.5 × 10⁶ cells/μL
  4. 8.3 × 10⁶ cells/μL
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4.86) Which of these red blood cell counts is normal?
  1. 2.2 × 10¹²/L
  2. 4.9 × 10¹²/L
  3. 8.9 × 10¹²/L
  4. 10.3 × 10¹²/L
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4.87) What is the reference range for serum albumin?
  1. 35–55 g/L
  2. 45–65 g/L
  3. 65–80 g/L
  4. 80–95 g/L
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4.88) What is the normal adult range for leukocyte count?
  1. 0.5–7.0 × 10⁹/L
  2. 2.5–9.0 × 10⁹/L
  3. 4.5–11.0 × 10⁹/L
  4. 6.5–13.0 × 10⁹/L
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4.89) When evaluating a blood smear under a microscope, a lab technician sees a white blood cell with no cytoplasmic granules. This white blood cell is most likely a:
  1. eosinophil
  2. lymphocyte
  3. monocyte
  4. neutrophil
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4.90) Which plasma protein helps maintain blood volume by pulling tissue fluid into capillaries?
  1. Albumin
  2. Fibrinogen
  3. Gamma globulin
  4. Prothrombin
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4.91) Which enzyme converts fibrinogen to fibrin?
  1. Renin
  2. Secretin
  3. Serotonin
  4. Thrombin
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4.92) What is the main type of hemoglobin in fetuses and newborn babies?
  1. Hemoglobin A
  2. Hemoglobin A2
  3. Hemoglobin F
  4. Hemoglobin S
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4.93) What is the major form of hemoglobin in adults?
  1. Hemoglobin A
  2. Hemoglobin F
  3. Hemoglobin H
  4. Hemoglobin S
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4.94) Blood clots are made of platelets and:
  1. fibrin
  2. fibrinogen
  3. prothrombin activator
  4. thrombin
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4.95) Plasma makes up around _____ of the total blood.
  1. 55%
  2. 65%
  3. 75%
  4. 95%
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4.96) Which hemoglobin variant is a tetramer of β chains and causes a form of alpha-thalassemia?
  1. Hb Barts
  2. HbA2c
  3. HbAS
  4. HbH
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4.97) Which hemoglobin variant is due to a variation in the β-globin gene, occurs mostly in people with African or Black American ancestry, and causes mild chronic hemolytic anemia?
  1. HbC
  2. HbE
  3. HbF
  4. HbA
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Section 5: Immunology

5.1) Which of these diseases is a viral infection of the liver?
  1. HIV
  2. Hepatitis B
  3. Syphilis
  4. Tuberculosis
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5.2) What is the most common type of lupus?
  1. Drug-induced lupus
  2. Lupus dermatitis
  3. Neonatal lupus
  4. Systemic lupus erythematosus
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5.3) Systemic lupus erythematosus (SLE) is most common in:
  1. baby boys
  2. baby girls
  3. men
  4. women
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5.4) Which process involves coating pathogens with antibodies to increase their susceptibility to phagocytosis?
  1. Agglutination
  2. Antiperistalsis
  3. Chemotaxis
  4. Opsonization
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5.5) Complement can be activated through three pathways: classical, lectin, and:
  1. alternative
  2. contemporary
  3. modern
  4. tertiary
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5.6) Which of these vaccines would most likely evoke the best and most long-lasting protective immune response?
  1. Attenuated
  2. DNA
  3. Extract
  4. Killed
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5.7) Which type of hypersensitivity is associated with allergies?
  1. I
  2. II
  3. III
  4. IV
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5.8) Which of these laboratory results is consistent with systemic lupus erythematosus?
  1. Platelet count: 700 × 10⁹/L
  2. Red blood cell count: 7.5 × 10¹²/L
  3. Serum creatinine: 1.9 mg/dL
  4. White blood cell count: 625 × 10⁹/L
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5.9) Which of these is NOT a test used to diagnose systemic lupus erythematosus?
  1. Antinuclear antibody test
  2. Complete blood count
  3. Skin test
  4. Urinalysis
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5.10) Which term means the total binding strength between an antibody with an antigen?
  1. Affinity
  2. Agility
  3. Apogamy
  4. Avidity
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5.11) What is the term for the part of an antibody that recognizes an antigen?
  1. Antitope
  2. Epitope
  3. Paratope
  4. Syntope
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5.12) Which type of bond joins light chains and heavy chains of antibodies together?
  1. Allene
  2. Disulfide
  3. Hydrogen
  4. Ionic
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5.13) How many antigen-binding sites do monomer antibodies have?
  1. 1
  2. 2
  3. 3
  4. 4
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5.14) Which class of antibody has γ chains?
  1. IgA
  2. IgD
  3. IgE
  4. IgG
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5.15) Developing B cells always make which antibody first?
  1. IgD
  2. IgE
  3. IgG
  4. IgM
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5.16) Which antibody class is a pentamer?
  1. IgA
  2. IgE
  3. IgG
  4. IgM
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5.17) Which antibody is the most abundant in the body?
  1. IgA
  2. IgD
  3. IgG
  4. IgM
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5.18) What is the main antibody in breast milk?
  1. IgA
  2. IgD
  3. IgE
  4. IgG
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5.19) Which antibody causes asthma?
  1. IgA
  2. IgE
  3. IgG
  4. IgM
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5.20) Which white blood cell is most likely to be elevated in acute appendicitis?
  1. Eosinophils
  2. Lymphocytes
  3. Monocytes
  4. Neutrophils
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5.21) A patient has symptoms of tiredness, joint pain, and headaches. The patient's percent of CD4+ cells is 6% of total leukocytes. The CD4+ cell count is 167 cells/µL of blood. These results are consistent with:
  1. AIDS
  2. Advanced HIV disease
  3. Antiphospholipid syndrome
  4. Immunodeficiency with hyper-IgM
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5.22) Which white blood cell secretes antibodies?
  1. Monocyte
  2. Neutrophil
  3. Plasma cell
  4. T cell
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5.23) Dendritic cells, macrophages, and which other cells present antigens to T helper cells?
  1. B cells
  2. Basophils
  3. Eosinophils
  4. Mast cells
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5.24) Which lymphocyte stimulates activity in antigen encounters?
  1. Helper T cell
  2. Killer T cell
  3. Memory cell
  4. Suppressor T cell
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5.25) Which of these cells is a granulocyte?
  1. Dendritic cell
  2. Macrophage
  3. Natural killer cell
  4. Neutrophil
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5.26) Which of these white blood cells has HLA class II molecules?
  1. B cells
  2. Eosinophils
  3. Naive T cells
  4. Neutrophils
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5.27) Carcinoembryonic antigen is a protein primarily associated with:
  1. cancer
  2. heart disease
  3. liver failure
  4. pregnancy
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5.28) Which type of hypersensitivity reaction is involved in acute interstitial nephritis (AIN)?
  1. Type I
  2. Type II
  3. Type III
  4. Type IV
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5.29) Calculate the absolute lymphocyte count from the following data.
Test Result
% lymphocytes 30%
WBC 2.5 × 10⁹ cells/L
  1. 0.75 cells/µL
  2. 1.25 cells/µL
  3. 750 cells/µL
  4. 1,250 cells/µL
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Section 6: Microbiology

6.1) Which of these could cause stain precipitation?
  1. Excessive buffer
  2. Excessive humidity in the air
  3. Insufficient staining time
  4. Use of aged staining solutions
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6.2) Which type of bacteria does the Ziehl-Neelsen stain identify?
  1. Acid-fast
  2. Facultative anaerobic
  3. Gram-negative
  4. Spore-forming
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6.3) Which two stains are routinely used in Pap stains?
  1. Hematoxylin and eosin
  2. Methenamine silver and mucicarmine
  3. Periodic acid-Schiff-diastase and azur
  4. Perl's Prussian blue and mucicarmine
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6.4) Giemsa's solution is a mixture of:
  1. eosin, methylene blue, and azure B
  2. eosin, safranin, and hematoxylin
  3. phloxine, methylene blue, and hematoxylin
  4. safranin, azure B, and hematoxylin
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6.5) In regressive staining, tissue sections are ___________ and then differentiated with dilute acid until the optimal endpoint is reached.
  1. dehydrated
  2. hydrated
  3. overstained
  4. sectioned
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6.6) Masson's trichrome staining stains muscle fibers which color?
  1. Black
  2. Green
  3. Pink
  4. Red
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6.7) What is the decolorizing agent in the Ziehl Neelsen stain?
  1. Absolute alcohol
  2. Acetone
  3. Acid alcohol
  4. Xylol
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6.8) Which Gram stain reagent acts as a mordant to bind the stain to the bacteria?
  1. Acetone
  2. Ethanol
  3. Iodine
  4. Safranin
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6.9) What term describes microorganisms that do not produce disease?
  1. Apathogens
  2. Aseptic organisms
  3. Nonpathogens
  4. Normal flora
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6.10) Which of these tests is used to differentiate between staphylococci and streptococci?
  1. Catalase test
  2. Coagulase test
  3. Oxidase test
  4. Urase test
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6.11) The Elek test tests for toxigenicity of which strain of bacteria?
  1. Bacillus anthracis
  2. Clostridium botulinum
  3. Corynebacterium diphtheriae
  4. Yersinia enterocolitica
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6.12) The Widal test is used to diagnose which bacteria?
  1. E. coli
  2. Proteus
  3. Salmonella
  4. Shigela
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6.13) Which Plasmodium species has a distinctive band-like or sash-like structure in the trophozoite stage?
  1. Falciparum
  2. Malariae
  3. Ovale
  4. Vivax
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6.14) Which of these tests can detect heterophile antibodies?
  1. ABO typing
  2. Indirect antiglobulin test
  3. Mononucleosis test
  4. Rh and antibody screen
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6.15) A sample for the respiratory syncytial virus (RSV) test is best collected using a:
  1. cough plate
  2. expectorated sputum
  3. nasal aspirate
  4. throat swab
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6.16) What color does the methylene blue strip turn when an anaerobic environment has been achieved in an anaerobic jar?
  1. Black
  2. Green
  3. Red
  4. White
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6.17) When giving specimens for culture and sensitivity, the patient should:
  1. be off antibiotics for several days before collection
  2. come to the lab first thing in the morning
  3. fast for 12 to 14 hours
  4. have all x-rays done before collection
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6.18) Why are specimens for anaerobic culture placed in anaerobic jars?
  1. To maximize spore formation
  2. To minimize exposure of the specimen to oxygen
  3. To minimize the exposure of the specimen to UV light
  4. To stop the specimen from escaping
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6.19) How many Risk Groups are microorganisms classified into?
  1. 2
  2. 3
  3. 4
  4. 5
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6.20) The oxidase test detects which enzyme?
  1. Cytochrome oxidase
  2. Heme oxygenase
  3. NADPH oxidase
  4. Tryptophan 2,3 dioxygenase
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6.21) Which fluorescent stain binds strongly to adenine–thymine-rich regions in DNA?
  1. Alexa Fluor
  2. DAPI
  3. GFP
  4. Rhodamine
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6.22) The VDRL test detects which bacterial infection?
  1. Candida
  2. Pneumonia
  3. Salmonella
  4. Syphilis
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6.23) What is the purpose of susceptibility testing?
  1. To determine if a patient has an allergy to a drug
  2. To determine the effectiveness of drug therapy
  3. To identify which antibiotic will kill a pathogen
  4. To identify which organism is in a specimen
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6.24) In vivo testing is useful for diagnosing:
  1. HIV
  2. Hepatitis A
  3. Rubella virus
  4. tuberculosis
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6.25) Which of these tests differentiates Staphylococcus aureus from other Staphylococcus species?
  1. Catalase
  2. Coagulase
  3. Oxidase
  4. Urase
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6.26) Which test detects antibodies to the Epstein-Barr virus?
  1. C-reactive protein test
  2. Influenza test
  3. Monospot test
  4. Rapid Group A Streptococcus test
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6.27) A urine culture was plated with a 0.001 mL loop. To report the colony count in colonies per mL, the number of colonies on the plate must be multiplied by:
  1. 100
  2. 200
  3. 1,000
  4. 2,000
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6.28) Which fluorescent dye glows green under blue light?
  1. Alexa Fluor
  2. DAPI
  3. GFP
  4. Rhodamine
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6.29) Given the results below, what is the minimum inhibitory concentration of the organism?
Volume of microbial-rich broth (mL) 200 200 200 200 200 200 200
Amount of antimicrobial agent (mg) 0 1 2 3 4 5 6
Result turbid turbid turbid turbid clear clear clear
  1. 3.33 mg/L
  2. 5 mg/L
  3. 20 mg/L
  4. 80 mg/L
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6.30) A minimum inhibitory concentration (MIC) assay is performed on an organism. Given the results below, what is the minimum inhibitory concentration of the organism?
Antibiotic concentration (μg/mL) 64 32 16 8 4 2 0
Result clear clear clear turbid turbid turbid turbid
  1. 2 μg/mL
  2. 4 μg/mL
  3. 8 μg/mL
  4. 16 μg/mL
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6.31) A bacteria that can metabolize peptones both aerobically and anaerobically but cannot ferment glucose, sucrose, or lactose would give what result on the Triple Sugar Iron test?
  1. A/K
  2. K/A
  3. K/K
  4. K/NC
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6.32) A lab technician observes mucoid colonies growing on a blood agar plate. This finding tells you that the organism:
  1. has a capsule
  2. has a permeable plasma membrane
  3. produces acetic acid
  4. produces beta-galactosidase
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6.33) Which of these bacteria lacks a cell wall?
  1. Archaebacteria
  2. Eubacteria
  3. Mycobacteria
  4. Mycoplasma
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6.34) Which of these bacteria is oxidase-positive?
  1. Acinetobacter
  2. Klebsiella
  3. Neisseria
  4. Proteus
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6.35) Which parasite is passed in the feces as a noninfective rhabditiform larva?
  1. Dipylidium caninum
  2. Hymenolepis nana
  3. Schistosoma mansoni
  4. Strongyloides stercoralis
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6.36) Staphylococcus aureus grows best in which type of environment?
  1. Aerobic
  2. Anaerobic
  3. Highly alkaline
  4. Microaerobic
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6.37) Which animal is the definitive host of T. gondii?
  1. Cat
  2. Deer
  3. Dog
  4. Pig
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6.38) What is the term for an organism that grows best at high salt concentrations?
  1. Capnophile
  2. Halophile
  3. Osmophile
  4. Xerophile
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6.39) Polioviruses, echoviruses, and coxsackieviruses are all:
  1. DNA viruses
  2. double-stranded RNA viruses
  3. enteroviruses
  4. enveloped viruses
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6.40) What is the term for round bacteria that grow in clusters?
  1. Bacillococci
  2. Diplococci
  3. Staphylococci
  4. Streptococci
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6.41) Toxoplasma gondii is a:
  1. bacteria
  2. mold
  3. protozoa
  4. virus
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6.42) The cell wall of bacteria is made predominantly of which substance?
  1. Cellulose
  2. Chitin
  3. Peptidoglycan
  4. Starch
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6.43) Which of the following incubation conditions is used to grow Streptococcus pneumoniae?
  1. At 35–37°C, over 3 days in chocolate agar or MacConkey agar, with 20% H₂
  2. At 35–37°C, overnight in media containing blood and sugar, with 5−10% CO₂
  3. At 42°C, over 2 days in media containing electrolytes and peptone water, and under microaerophilic conditions
  4. At 42°C, over 3 days in Luria Bertani agar, and under anaerobic conditions
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6.44) Which agar is used to isolate gram-positive bacteria, especially Staphylococcus species and Streptococcus species?
  1. Chocolate
  2. MacConkey
  3. Phenylethyl alcohol
  4. Thayer Martin
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6.45) What organisms grow on MacConkey agar?
  1. Acid-fast
  2. Gram-negative
  3. Gram-positive
  4. Non-acid fast
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6.46) Colistin-nalidixic acid agar selects for which type of bacteria?
  1. Bacteria that ferment lactose and sucrose
  2. Gram-negative
  3. Gram-positive
  4. Lac operon mutants
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6.47) What does modified Thayer-Martin agar contain that Thayer-Martin agar does not?
  1. Peptone water
  2. Potassium dihydrogen phosphate
  3. Trimethoprim lactate
  4. Vancomycin
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6.48) What is reducing media used for in microbiology?
  1. Cultivating organisms that only grow in blood
  2. Growing anaerobic bacteria
  3. Isolating fungi and yeasts
  4. Testing pathogens for antibiotic susceptibility
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6.49) Where should agar plates be stored before use?
  1. In a cupboard
  2. In a dry oven
  3. In the freezer
  4. In the fridge
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6.50) Bacteria are grown on a blood agar plate. The lab technician observes greenish-gray discoloration around each bacterial colony. Which type of hemolysis is this?
  1. Alpha
  2. Alpha-prime
  3. Beta
  4. Gamma
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6.51) What is the goal of streaking an agar plate?
  1. To accelerate the solidification of the agar medium
  2. To determine if the bacteria can ferment glucose, sucrose and/or lactose
  3. To determine the number of organisms in the sample
  4. To produce isolated colonies for further study
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6.52) What type of broth is used to differentiate between aerobes and anaerobes?
  1. Glucose
  2. Selenite F
  3. Thioglycolate
  4. Tryptic soy
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6.53) Which of these types of agar is used to isolate and differentiate species of Salmonella and Shigella?
  1. Hektoen enteric
  2. Chocolate
  3. CLED
  4. Thayer Martin
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6.54) CLED agar is used to isolate bacteria from which type of specimen?
  1. Blood
  2. Sputum
  3. Urine
  4. Vaginal swab
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6.55) What is the sequence of steps for Gram staining?
  1. Primary stain, decolorizing, counterstain, mordant
  2. Primary stain, decolorizing, mordant, counterstain
  3. Primary stain, mordant, counterstain, decolorizing
  4. Primary stain, mordant, decolorizing, counterstain
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6.56) In Gram staining, what will happen if the decolorizer is not left on long enough?
  1. All organisms will appear colorless
  2. All organisms will appear gram-negative
  3. All organisms will appear gram-positive
  4. No cells will appear on the slide
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6.57) After Gram staining, what color are gram-negative organisms?
  1. Dark blue
  2. Light blue
  3. Purple or brown
  4. Red or pink
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6.58) What is the Gram stain appearance of Clostridium perfringens?
  1. Gram-negative coccus
  2. Gram-negative rod
  3. Gram-positive coccus
  4. Gram-positive rod
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6.59) What color are gram-positive organisms after a Gram stain?
  1. Orange
  2. Purple
  3. Red
  4. Yellow
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6.60) What is the Gram stain appearance of Streptococcus pneumoniae?
  1. Gram-negative helical rod
  2. Gram-negative ovoid-shaped coccus
  3. Gram-positive crescent-shaped rod
  4. Gram-positive lancet-shaped coccus
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6.61) What is the Gram stain appearance of E. coli?
  1. Gram-negative coccus
  2. Gram-negative rod
  3. Gram-positive rod
  4. Gram-positive rod
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6.62) What is the term for a rod-shaped microorganism that appears red after Gram staining?
  1. Gram-negative bacillus
  2. Gram-negative cocci
  3. Gram-positive bacillus
  4. Gram-positive cocci
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6.63) Which acid-fast staining method is known as the hot method?
  1. Auramine-Rhodamine
  2. Fluorochrome
  3. Kinyoun
  4. Ziehl-Neelsen
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6.64) What is the term for bacterial cells used to start a new culture on a streak plate?
  1. Colonies
  2. Inoculum
  3. Prime culture
  4. T cells
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6.65) Which of these organisms is a strict anaerobe?
  1. Clostridium perfringens
  2. Escherichia coli
  3. Klebsiella pneumoniae
  4. Nocardia brasiliensis
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6.66) A man cuts his hand while doing yard work. The wound becomes infected. A Gram stain reveals the wound contains gram-positive cocci and gram-negative bacilli. Which media can be used to selectively isolate each organism?
  1. Columbia-CNA and Chocolate
  2. KV-laked agar and Thayer-Martin
  3. PEA and MacConkey
  4. Sheep blood and Chocolate
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6.67) Which bacteria correlates with the results below?
Agar Result
Blood agar Beta-hemolytic colonies
MacConkey agar Colorless colonies
Cetrimide agar Green colonies
  1. Escherichia coli
  2. Pseudomonas aeruginosa
  3. Staphylococcus aureus
  4. Streptococcus pyogenes
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6.68) Which parasite is 2 mm long, slender, and cylindrical?
  1. Ascaris lumbricoides
  2. Enterobius vermicularis
  3. Giardia lamblia
  4. Strongyloides stercoralis
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6.69) Based on the following test results, what is the most likely organism? Microscope: Cocci growing in clusters Gram stain: Gram-positive Catalase: Positive
  1. Bacillus
  2. Clostridia
  3. Staphylococcus
  4. Streptococcus
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6.70) An HIV-positive patient has symptoms of meningitis. An encapsulated budding yeast is found in a sample of the patient's spinal fluid. Which organism is this most likely to be?
  1. Candida albicans
  2. Cryptococcus neoformans
  3. Malassezia furfur
  4. Paracoccidioides brasiliensis
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6.71) Which bacteria correlates with the results below?
Agar Result
Blood agar Beta-hemolytic colonies
MacConkey agar Pink colonies
Eosin methylene blue agar Metallic green colonies
  1. Escherichia coli
  2. Salmonella enterica
  3. Staphylococcus aureus
  4. Streptococcus pneumoniae
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6.72) Which parasite is pear-shaped, 10–20 micrometers long, and has one or two transverse, claw-shaped median bodies?
  1. Ascaris lumbricoides
  2. Enterobius vermicularis
  3. Giardia lamblia
  4. Strongyloides stercoralis
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6.73) Which parasite is a small white worm with a pointed tail that resembles a pin?
  1. Ascaris lumbricoides
  2. Enterobius vermicularis
  3. Giardia lamblia
  4. Strongyloides stercoralis
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6.74) Which parasite is pear-shaped, is 7–30 µm long, and has five flagella?
  1. Dientamoeba fragilis
  2. Enterobius vermicularis
  3. Schistosoma hematobium
  4. Trichomonas vaginalis
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6.75) Which bacteria correlates with the results below?
Agar Result
Blood agar Beta-hemolytic colonies
MacConkey agar No growth
Mannitol salt agar Yellow colonies
  1. Escherichia coli
  2. Klebsiella pneumoniae
  3. Staphylococcus aureus
  4. Streptococcus pyogenes
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6.76) Which of these bacteria is a gram-negative, aerobic, oxidase-positive, motile rod?
  1. E. coli
  2. Proteus
  3. Pseudomonas
  4. Salmonella
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6.77) Which of these bacteria is gram-positive and forms spores?
  1. Bacillus anthracis
  2. Candida albicans
  3. Corynebacterium diphtheria
  4. Escherichia coli
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6.78) What virus causes hepatitis C?
  1. HAV
  2. HBC
  3. HCV
  4. HPC
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6.79) Which Streptococcus species causes post-streptococcal glomerulonephritis?
  1. S. aureus
  2. S. epidermidis
  3. S. pneumonia
  4. S. pyogenes
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Section 7: Laboratory operations

7.1) A lab assistant makes a 1/6 dilution of serum in water. The assistant then performs a glucose test on the diluted serum. The result is 72 mg/dL. What result should the lab assistant report to the doctor?
  1. 12 mg/dL
  2. 72 mg/dL
  3. 432 mg/dL
  4. 720 mg/dL
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7.2) If 0.2 mL of a sample is added to 5 mL of diluent, what is the dilution factor?
  1. 4.8
  2. 5.2
  3. 25
  4. 26
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7.3) A molar solution is:
  1. 1 mL of solute in one mole of solution
  2. one gram of solute in 1 mL of solution
  3. one gram of solute in one mole of solution
  4. one mole of solute in 1 liter of solution
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7.4) A dilution ratio of 1:15 means what part specimen and what part diluent?
  1. 1 part specimen, 15 parts diluent
  2. 1 part specimen, 16 parts diluent
  3. 15 parts specimen, 1 part diluent
  4. 16 parts specimen, 1 part diluent
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7.5) If a dilution ratio of 7:10 is used to make an acetic acid solution and the final volume of the solution is 950 mL, what is the volume of the solute?
  1. 58 mL
  2. 101 mL
  3. 391 mL
  4. 559 mL
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7.6) What is one part chemical to five parts water expressed as a dilution factor?
  1. 3
  2. 4
  3. 5
  4. 6
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7.7) What is the dilution factor 1/5 expressed as a dilution ratio?
  1. 1:4
  2. 1:5
  3. 1:6
  4. 5:1
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7.8) 0.5 mol of solute is dissolved in 1 liter of solution. What is the concentration of the solution in mol/cm³?
  1. 0.0005
  2. 0.02
  3. 2
  4. 200
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7.9) Given a solute volume of 20 mL and a dilution factor of 3, calculate the volume of solvent needed.
  1. 40 mL
  2. 60 mL
  3. 120 mL
  4. 160 mL
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7.10) 100 mL of 20% hydrochloric acid can make how many mL of 4% hydrochloric acid?
  1. 50 mL
  2. 80 mL
  3. 100 mL
  4. 500 mL
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7.11) A lab technician has an 8% solution of hypochlorite and needs to make 700 mL of a 4% solution of hypochlorite. What volume of solute and solvent does the technician need to use?
  1. 300 mL of the 8% solution in 400 mL of solvent
  2. 350 mL of the 8% solution in 350 mL of solvent
  3. 400 mL of the 8% solution in 300 mL of solvent
  4. 450 mL of the 8% solution in 250 mL of solvent
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7.12) How many grams of sodium chloride are needed to make 300 mL of a 2% m/v solution?
  1. 2
  2. 4
  3. 6
  4. 20
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7.13) What does 5% w/v mean?
  1. 5 grams of solute dissolved in 100 mL of solution
  2. 5 grams of solute dissolved in 100 mL of solvent
  3. 5 mL of solute dissolved in 100 mL of solution
  4. 5 mL of solute dissolved in 100 mL of solvent
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7.14) A pH of 2 is how many times more acidic than a pH of 5?
  1. 3
  2. 6
  3. 256
  4. 1,000
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7.15) For data distributed normally, how many values are within two standard deviations from the mean?
  1. 50%
  2. 68%
  3. 83%
  4. 95%
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7.16) A mean value of 100 mg/dL and a standard deviation of 1.8 mg/dL were obtained from a set of glucose measurements. What range of results falls within 2 standard deviations from the mean?
  1. 94.6–105.4 mg/dL
  2. 96.4–103.6 mg/dL
  3. 97.3–102.7 mg/dL
  4. 98.2–101.8 mg/dL
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7.17) Which formula calculates the coefficient of variation?
  1. Mean / standard deviation
  2. Standard deviation / mean
  3. Standard deviation / variance
  4. Variance / mean
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7.18) What is the mean of 1, 10, 20, 50, 50, 80, 90 and 99?
  1. 45
  2. 50
  3. 55
  4. 60
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7.19) For data distributed normally, what percentage of cases is below the mean?
  1. 25%
  2. 50%
  3. 75%
  4. 100%
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7.20) The rounding rule for the mean states that:
  1. the answer should be rounded to a whole number
  2. the answer should be rounded to one decimal place greater than the raw data
  3. the answer should be rounded to two decimal places greater than the raw data
  4. the answer should have the same number of decimal places as the raw data
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7.21) The following values were obtained from a quality control test: 0, 0, 2, 2, 2, 3, 4, 5, 5, 7. Calculate the mean of these values.
  1. 3
  2. 3.25
  3. 3.5
  4. 3.75
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7.22) Which statistic is a measure of the amount of variation or dispersion of a set of values?
  1. Mean
  2. Median
  3. Mode
  4. Standard deviation
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7.23) To find the median of an even number of numbers, arrange the set in order and:
  1. subtract the smallest number from the largest number
  2. take the mean of the two middle numbers
  3. use the larger of the two middle numbers
  4. use the smaller of the two middle numbers
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7.24) What is the median of 1, 17, 2, 8, and 11?
  1. 2
  2. 5
  3. 8
  4. 11
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7.25) When incinerating medical waste:
  1. disinfect all articles beforehand
  2. ensure complete burning takes place
  3. ensure the temperature reaches at least 12,000°C
  4. sanitize all articles beforehand
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7.26) Used needles should be discarded in:
  1. a biohazard sharps container
  2. a glass disposal bucket
  3. a glass recycling bin
  4. the regular garbage
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7.27) Which of these is the most flammable?
  1. Acids
  2. Organic solvents
  3. Strong oxidizers
  4. Strong reducers
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7.28) Class B fires occur with:
  1. electrical equipment
  2. flammable liquids
  3. ordinary combustibles
  4. reactive metals
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7.29) CO₂ fire extinguishers are effective against which type of fire?
  1. Flammable gas
  2. Flammable liquid
  3. Paper
  4. Wood
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7.30) What is the term for a chemical that immediately damages human tissue on contact?
  1. Carcinogenic
  2. Combustible
  3. Corrosive
  4. Toxic
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7.31) A lab assistant accidentally drinks a beaker of Zenker's fluid. He says he feels a burning sensation in his mouth and throat. The lab manager phones 911. While waiting for the ambulance to arrive, which of these other first-aid measures should be taken?
  1. Give the lab assistant water to drink
  2. Place the lab assistant in the recovery position
  3. Take the lab assistant outside for fresh air
  4. Tell the lab assistant to rinse his eyes with water for several minutes
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7.32) In which of these situations should a lab technician remove their gloves?
  1. Before carrying specimens through a designated clean area
  2. Before loading the autoclave
  3. Before using a restroom
  4. For cleaning a chemical spill
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7.33) In which of these situations should safety goggles be worn?
  1. During blood collections
  2. During reagent and specimen preparation
  3. While inspecting reagent supplies
  4. While transporting sealed waste containers
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7.34) Which of these must be worn by staff visiting a patient in enteric isolation?
  1. Gown
  2. Hazard suit
  3. Lead apron
  4. Shoe covers
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7.35) The three basic protective measures against radiation are time, distance, and:
  1. lead
  2. radiation suit
  3. shielding
  4. speed
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7.36) What should be your first action if a patient's body fluid splashes into your eyes?
  1. Call 911
  2. Determine whether the patient has an infectious disease
  3. Flush the eyes with water
  4. Make an entry in the accident log book
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7.37) Universal precautions apply to which type of hazard?
  1. Bloodborne pathogens
  2. Dangerous chemicals
  3. Environmental hazards
  4. Radiation
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7.38) What is the single most important method of preventing infection?
  1. Proper handwashing
  2. Sneezing into your arm
  3. Thorough cleaning of equipment
  4. Wearing a lab coat
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7.39) Always keep picric acid:
  1. dry
  2. refrigerated
  3. ventilated
  4. wet
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7.40) How are ethers stored?
  1. In airtight bottles
  2. In the light
  3. In the refrigerator
  4. Underwater
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7.41) If the word 'Forbidden' is written in column 3 of a Hazardous Materials Table, it means the material should not be:
  1. discarded
  2. ingested
  3. transported
  4. used
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7.42) Which of these dilutions is the most effective disinfectant?
  1. 1% ethyl alcohol
  2. 10% ethyl alcohol
  3. 40% ethyl alcohol
  4. 70% ethyl alcohol
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7.43) Which of these chemicals would be the best choice to neutralize a weak acid spill in the laboratory?
  1. Acetic acid
  2. Boric acid
  3. Sodium bicarbonate
  4. Sodium hydroxide
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7.44) What is the first step when cleaning up a blood spill?
  1. Make a note in the incident logbook
  2. Pour disinfectant onto the spill
  3. Put on PPE
  4. Soak up the spill with paper towels
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7.45) Which concentration of bleach is used to decontaminate benchtops?
  1. 10%
  2. 20%
  3. 30%
  4. 50%
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7.46) Autoclave tape changes color when:
  1. organisms have been killed
  2. sterilization has taken place
  3. the autoclave is nearing the end of its warranty
  4. the autoclave reaches a specific temperature
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7.47) Autoclaves work on which principle?
  1. Cold sterilization
  2. Free-flowing steam
  3. Hot water
  4. Moist heat sterilization
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7.48) Superheating steam in an autoclave:
  1. diminishes its sterilizing capacity
  2. helps to dry out the equipment
  3. increases its sterilizing power
  4. will make the centrifuge spin faster
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7.49) What pressure and temperature do autoclaves use?
  1. 12 psi at 115°C
  2. 12 psi at 120°C
  3. 15 psi at 112°C
  4. 15 psi at 121°C
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7.50) What type of water does an autoclave use?
  1. Distilled water
  2. Mineral water
  3. Saltwater
  4. Tap water
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7.51) Which of these methods results in sterilization?
  1. Autoclaving
  2. Chemical disinfectants
  3. Freezing
  4. Soap and water
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7.52) At what temperature do hot air ovens sterilize glassware in 60 minutes?
  1. 100°C
  2. 121°C
  3. 140°C
  4. 160°C
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7.53) A reagent requires 1.26 grams of sodium carbonate. The lab technician should measure it with a:
  1. analytical balance
  2. desiccator
  3. pH meter
  4. single pan balance
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7.54) Which of these biomarkers can urine refractometers measure?
  1. The presence of nitrates in urine
  2. Urine hemoglobin concentration
  3. Urine osmolality
  4. Urine specific gravity
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7.55) Microscopes usually have which objective lenses?
  1. 10x, 40x, and 100x
  2. 10x, 50x, and 100x
  3. 20x, 40x, and 80x
  4. 20x, 50x, and 80x
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7.56) Which part of a microscope adjusts the light intensity?
  1. Iris diaphragm
  2. Numerical aperture
  3. Ocular lens
  4. Stage clip
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7.57) Which microscope is most used in clinical laboratories?
  1. Dark-field
  2. Florescent
  3. Light
  4. Phase-contrast
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7.58) What is the total magnification of a microscope if the eyepiece lens is 10x and the objective lens is 20x?
  1. 30x
  2. 200x
  3. 375x
  4. 525x
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7.59) Which pipette has a bulged-out portion in the middle?
  1. Mohr
  2. Pasture
  3. Serological
  4. Volumetric
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7.60) Pipettes marked TC are:
  1. allowed to drain freely
  2. marked with a double ring at the mouthpiece
  3. rinsed out after delivery
  4. used for toxic, corrosive liquids
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7.61) What type of filter in biological safety cabinets removes airborne particles such as bacteria and viruses?
  1. Electrostatic
  2. Fiberglass
  3. HEPA
  4. UV light
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7.62) Before turning on a centrifuge, make sure:
  1. all liquid specimen tubes are uncovered
  2. the centrifuge is balanced
  3. the centrifuge is on a slanted surface
  4. the cover is open
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7.63) The lab manual says to use a 10% bleach solution to decontaminate the centrifuge. However, no bleach is available. What would be the most suitable alternative?
  1. 70% ethanol
  2. Antibacterial soap and water
  3. Povidone-iodine
  4. Sodium bicarbonate
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7.64) Which device measures the RPM of a centrifuge?
  1. Ohmmeter
  2. Rheostat
  3. Tachometer
  4. Voltmeter
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7.65) What is the most common cause of excessive centrifuge vibration?
  1. Electrical interference
  2. Unbalanced tubes
  3. Uneven bench surfaces
  4. Variable voltage
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7.66) Which term means the ability of a procedure to detect only a substance of interest instead of other substances?
  1. Analytical sensitivity
  2. Analytical specificity
  3. Diagnostic sensitivity
  4. Diagnostic specificity
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7.67) Precision indicates the:
  1. closeness of a result to the first standard deviation
  2. closeness of a result to the median value
  3. closeness of a result to the true value
  4. repeatability or reproducibility of a procedure
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7.68) A screening test detects 700 cases of illness in 1,000 sick people and 400 cases of illness in 1,000 healthy people. Calculate the test's sensitivity.
  1. 30%
  2. 40%
  3. 60%
  4. 70%
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7.69) A test with low specificity is more likely to give:
  1. false negatives
  2. false positives
  3. true negatives
  4. true positives
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7.70) The quality control chart of an instrument shows ten consecutive data points on one side of the mean. What should you do?
  1. Accept the run
  2. Reject the run and follow the method's troubleshooting procedures
  3. Repeat the control sera on the next run
  4. Report the results with a disclaimer that they may be erroneous
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7.71) Below is a Levey-Jennings quality control chart representing the control values for 20 consecutive analyzes of serum creatinine levels. Which Westgard rule is violated in this chart?
  1. 10ₓ
  2. 1₂ₛ
  3. 4₁ₛ
  4. R₄ₛ
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7.72) How many Quality System Essentials (QSE) are there?
  1. 6
  2. 10
  3. 12
  4. 16
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7.73) Which of these practices is dangerous and should be avoided?
  1. Immediately performing first aid to someone who has been exposed to blood
  2. Recapping used needles using both hands
  3. Securing used sharps containers during transport
  4. Using plasticware instead of glass
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7.74) Class 1 hazardous materials are:
  1. explosive
  2. infectious
  3. poisonous
  4. radioactive
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7.75) Under the Occupational Safety and Health Act, employers have a responsibility to provide:
  1. a safe workplace
  2. extra training for disabled workers
  3. health insurance
  4. work breaks
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7.76) If a worker suffers an accident at work and has to be hospitalized, how soon must the employer notify OSHA?
  1. Immediately
  2. Within 12 hours
  3. Within 24 hours
  4. Within 8 hours
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7.77) In OSHA's hierarchy of controls, what is the most effective type of hazard control?
  1. Administrative controls
  2. Elimination
  3. Engineering controls
  4. Substitution
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7.78) Which GHS pictogram is optional?
  1. Environment
  2. Exclamation mark
  3. Flame over circle
  4. Gas cylinder
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7.79) What federal agency monitors the Occupational Safety and Health Act?
  1. Environmental Protection Agency (EPA)
  2. Food and Drug Administration (FDA)
  3. Occupational Safety and Health Administration (OSHA)
  4. United States Public Health Service (USPHS)
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