AMT MT Final Exam | 100% Correct Answers | Verified | Latest 2024 Version

The three major phases of laboratory testing that a QA program should evaluate include a. mean, standard deviation, and coefficient of variation. b. pre-op, operative, and post-op. c. pre-analytical, analytical, and post-analytical. d. outpatient, inpatient, and non-patient. - c. pre-analytical, analytical, and post-analytical. The process by which test results achieve the same high levels of accuracy and precision that can be reproduced across measurement systems, laboratories and time is referred to as a. laboratory process control. b. laboratory calibration. c. laboratory standardization. d. laboratory verification. - c. laboratory standardization. What characteristics/functions do calibrators have? a. They contain a known amount of analyte being tested. b. They monitor the quality of reagents. c. They monitor the quality of the sample. d. They prevent equipment failure. - a. They contain a known amount of analyte being tested. An abrupt demonstrated change in the mean is a a. shift. b. trend. c. variance. d. deviation. - a. shift. Qualitative examinations are those that a. qualify for waived testing. b. produce non-numerical results. c. do not require quality control. d. do not require proficiency testing. - b. produce non-numerical results. A property of a test that is used to describe its quality (such as accuracy, precision, sensitivity, etc.) is a a. performance characteristic. b. performance enhancement. c. performance verification. d. performance specification. - a. performance characteristic Under CLIA law, the process of testing and adjusting an instrument or test system to establish a correlation between the measured response and the concentration or amount of the substance that is being measuredby the test procedure is a. calibration. b. calibration verification. c. a challenge. d. quality control. - a. calibration. What agency determines the complexity of a lab test system? a. CMS b. FDA c. CDC d. OSHA - b. FDA Certain moderate complexity microscopy tests (such as urine sediment evaluation and skin scrapings) commonly performed by healthcare providers in the office setting are classified as a. provider moderate complexity tests. b. provider exempt status. c. provider personnel testing. d. provider performed microscopy. - d. provider performed microscopy. Policies and procedures that are intended to promote the quality and validity of test data and ensure the reliability and integrity of data generated by analytical laboratories is known as a. CLIA Law. b. Quality Assurance Plan (QAP). c. Good Clinical Laboratory Practice (GCLP). d. Total Quality Management (TQM). - c. Good Clinical Laboratory Practice (GCLP). Devices based on electrophoretic principles are used in the clinical laboratory to perform all of the following except to a. measure quantities of various proteins in plasma, urine, and CSF. b. separate enzymes into their component isoenzymes. c. identify antibodies. d. measure molecules in a characteristic spectrum called the emission spectrum. - d. measure molecules in a characteristic spectrum called the emission spectrum. The chemistry methodology that is based on the fact that substances of clinical interest selectively absorb or emit electromagnetic energy at different wavelengths is a. flourometry. b. atomic absorption. c. spectrophotometry. d. photometry. - c. spectrophotometry. Given %T, how is absorbance calculated? a. log %T - 2. b. log %T + 2. c. 2 + log %T. d. 2 - log %T. - d. 2 - log %T. Prohibiting recapping of needles is an example of a. a workplace control. b. an engineering control. c. a best practice in the workplace. d. a human resources requirement. - a. a workplace control. The majority of all centrifuge accidents result from a. electrical malfunctions. b. faulty mechanisms. c. user error. d. crowded work conditions. - c. user error. Material Safety Data Sheets (M.S.D.S.) are now called a. Chemical Safety Sheets. b. Safety Data System. c. Material Data System. d. Safety Data Sheets. - d. Safety Data Sheets. In order for a laboratory to handle TB sputum and TB materials, the laboratory must operate at a a. biosafety level of 2+ or 3. b. biosafety level 4. c. location where air exchange is continuous. d. location where fume hood exhausts are monitored daily. - a. biosafety level of 2+ or 3. What is the molarity of an unknown HCL solution with a specific gravity of 1.10 and an assay percentage of 18.5%? (Atomic weights: H = 1.00794, Cl = 35.4527) a. 203.5 M b. 36.5 M c. 5.6 M d. 5.2 M - c. 5.6 M 1.10 * 0.185 = 0.2035 g/mL 0.2035 g/mL * 1000 = 203.5 g/L Molarity = (g/L) / molecular weight (MW) 203.5 / 36.5 = 5.6 M MCV = HCT * 10/(?) a. MCHC b. MCV c. RBC d. MCH - c. RBC A substage lens of the microscope that focuses light on the slide specimen is the a. condenser. b. aperture. c. C-mount. d. diaphragm. - a. condenser. The magnification of a microscope is determined by the a. high power objective multiplied by the low power objective. b. thickness of the condenser. c. powers of the eyepiece and objective. d. fine focus adjustment. - c. powers of the eyepiece and objective. You have just completed morning rounds when you realize that you have an unlabeled tube in your tray. You are certain you know what patient the tube belongs to. How should you proceed? a. After sorting the tubes you see what specimen is missing, discard the unlabeled tube and go recollect the specimen. b. After sorting the tubes, you see what specimen is missing so label your unlabeled tube with that patient's information. c. Discard the tube and hope know one realizes there is a missing specimen. d. Discard all your tubes and redraw everyone to make sure all the specimens are correct. - a. After sorting the tubes you see what specimen is missing, discard the unlabeled tube and go recollect the specimen. You are working in receiving and receive urine specimens with the following labels. Select the label that contains the required labeling elements for a primary specimen. a. Name: Jane Deer<br>DOB: 3-6-3<br>Room #: 123<br>Collect time/date: 0550 7/6/13 b. Name: Deer, JR<br>DOB: 3/6/2003<br>Location: clinic<br>Collect time/date: 0550 7/6/13 c. Name: Deer, Jane Ray<br>DOB: 3/6/2003<br>Hospital number: 234345<br>Collect time/date: 0550 7/6/2013 d. Name: Deer, Jane<br>DOB: 3/6/2003<br>Hospital number:<br>Collect time/date: 0500 7/6/2013 - c. Name: Deer, Jane Ray<br>DOB: 3/6/2003<br>Hospital number: 234345<br>Collect time/date: 0550 7/6/2013 A gel separator tube is received with orders for a direct antiglobulin test (DAT) and serum Glucose test. How should this request be handled? a. Centrifuge the specimen and aliquot some serum into another tube for chemistry. Then send the tube to blood bank for the DAT. b. Centrifuge the specimen once it has clotted and deliver it to chemistry for the serum glucose test. The DAT will need to be recollected because this is not the appropriate specimen. c. Have both tests recollected since this is not an appropriate specimen for either test. d. Send the specimen to blood bank first for the DAT and ask them to send it on to chemistry when they are through. - b. Centrifuge the specimen once it has clotted and deliver it to chemistry for the serum glucose test. The DAT will need to be recollected because this is not the appropriate specimen. Within what time frame should a urine specimen that does not contain preservative be processed for a routine urinalysis if it is stored at room temperature? a. Within one hour of collection b. Within two hours of collection c. Within four hours of collection d. Within five hours of collection - b. Within two hours of collection Which of the following actions is appropriate when a cerebrospinal fluid (CSF) specimen is delivered to the laboratory's specimen processing area? a. Refrigerate the specimens immediately. b. Deliver the specimens to the testing area along with routine specimens when it is convenient. c. Deliver the specimens immediately to the appropriate testing areas. d. Incubate the specimen until routine testing can take place. - c. Deliver the specimens immediately to the appropriate testing areas. Which of the following characterizes reversed-phase liquid-liquid chromatography? a. Mobile phase is nonpolar relative to the polar stationary phase b. Mobile and stationary phases are nonpolar c. Mobile and stationary phases are polar d. Mobile phase is polar relative to the nonpolar stationary phase - d. Mobile phase is polar relative to the nonpolar stationary phase The measurement of the decrease in intensity of an incident light beam as it passes through a solution of particles defines which of the following methods? a. Turbidimetry b. Nephelometry c. Chemiluminescence d. Bioluminescence - a. Turbidimetry Which of the following labels is used in the detection of electrochemiluminescence? a. Acridinium esters b. Dioxetane c. Tritium d. Ruthenium III - d. Ruthenium III POCT devices use a variety of analytical principles such as reflectance, spectrophotometry, fluorescence, and ________. a. ESI b. IFE c. RIA d. PCR - d. PCR The amount of wavelength isolation is a function of the monochromator type and of which of the following? a. Width of entrance and exit slits b. Height of entrance and exit slits c. Width of entrance and height of exit slits d. Height of entrance and width of exit slits - a. Width of entrance and exit slits Which of the following is one of the most common clinical applications of GC-MS analysis? a. Drug testing b. Screening for genetic disorders c. Confirmation of inborn errors of metabolism d. Antiretroviral testing - a. Drug testing An immunoassay methodology using either europium or phycobiliproteins would use which detection method? a. Gamma counter b. Luminometer c. Fluorometer d. Photometer - c. Fluorometer What is the relationship between plasma creatinine and muscle mass? a. Inversely proportional b. Approximately equal c. Directly proportional d. Exactly equal - c. Directly proportional A high-protein diet may cause a a. prerenal plasma urea increase. b. postrenal plasma urea increase. c. prerenal plasma urea decrease. d. postrenal plasma urea decrease. - a. prerenal plasma urea increase. Catabolism of which of the following results in the formation of uric acid? a. Proteins b. Pyrimidines c. Porphyries d. Purines - d. Purines Jendrassik-Grof or Evelyn-Malloy are the most commonly used methods to measure a. Fructose b. Bilirubin c. Urea d. Cholesterol - b. Bilirubin The reference range of urobilinogen is a. 0.1-1.0 mg/dL every 2 hours. b. 0.1-1.0 μmol/L every 2 hours. c. 0.1-1.0 Ehrlich units every 2 hours. d. 0.1-1.0 Babson units every 2 hours. - c. 0.1-1.0 Ehrlich units every 2 hours. Which is used as the indicator enzyme in the measurement of ALT? a. LD b. AST c. ALP d. CK - a. LD Which of the following is the formation of glucose-6-phosphate from sources other than carbohydrates? a. Gluconeogenesis b. Glycolysis c. Glycogenolysis d. Glycogenesis - a. Gluconeogenesis With which enzyme does carbohydrate metabolism begin? a. Pancreatic amylase b. Lactate dehydrogenase c. Salivary amylase d. Phosphofructokinase - c. Salivary amylase A serum electrophoretic pattern showing a β-γ bridge would likely be from a patient with a. liver cirrhosis. b. nephritic syndrome. c. inflammation. d. myelomatosis. - a. liver cirrhosis. Which of the following associations of creatine kinase and disease condition is correct? a. CK-MM and Reye's syndrome b. CK-BB and muscular dystrophy c. CK-MB and inflammatory heart disease d. CK-MB and acute renal failure - c. CK-MB and inflammatory heart disease What is the protein portion of an enzyme? a. Holoenzyme b. Zymogen c. Apoenzyme d. Isoenzyme - c. Apoenzyme AST is classified as a(an) a. oxidoreductase. b. transferase. c. hydrolase. d. isomerase. - b. transferase. Elevations in ALP levels are seen in hepatobiliary and which other disorders? a. Kidney b. Lung c. Pancreas d. Bone - d. Bone Which enzyme catalyzes the interconversion of lactate and pyruvate? a. PK b. LD c. GP d. CK - b. LD Anterior pituitary hormones include LH, FSH, TSH, GH, and a. ACTH and cortisol. b. Inhibin and IGF-1. c. ACTH and prolactin. d. E2 and T3. - c. ACTH and prolactin Parathyroid glands increase or decrease PTH secretion in response to changes in levels of which of the following? a. Sodium b. Potassium c. Chloride d. Calcium - d. Calcium Growth hormone is an amphibolic hormone because it directly influences which processes? a. Both anabolic and catabolic b. Only anabolic c. Only catabolic d. Neither anabolic nor catabolic - a. Both anabolic and catabolic Which of the following lipoproteins transfers triglycerides from the intestine to the liver? a. CM b. LVDL c. LDL d. HDL - a. CM n most enzymatic methods for cholesterol measurement, cholesterol oxidase reacts with free cholesterol to produce which of the following? a. Cholesteryl esters b. NADH c. H2O2 d. Cholestenone - c. H2O2 Ionized calcium is measured on automated systems by which of the following methods? a. CPC b. AAS c. TLC d. ISE - d. ISE Which of the following is the immediate precursor to angiotensin II? a. Renin b. Angiotensinogen c. Angiotensin III d. Angiotensin I - d. Angiotensin I Which of the following is the method of choice for confirmation testing following a positive opiate drug screening result? a. AAS b. HPLC c. Immunoassay d. GC-MS - d. GC-MS Chronic exposure to organic mercury is cumulative because most of it is bound to which of the following? a. Adipose tissue b. Neuronal proteins c. Renal tubules d. Splenic tissue - b. Neuronal proteins Formic acid formed by the metabolism of methanol is responsible for which of the following? a. Liver cirrhosis b. Optic neuropathy c. Renal tubular damage d. Severe CNS symptoms - b. Optic neuropathy Serum copper levels less than the reference interval and increased urinary levels describe which condition? a. Wilson's disease b. Addison's disease c. Cushing's syndrome d. Reye's syndrome - a. Wilson's disease Which of the following is a functional test used to assess fetal lung maturity? a. L/S ratio b. PG c. FSI d. Lamellar body counts - c. FSI Which of the following determinations is used to assess the total body lead poisoning burden? a. Zinc protoporphyrin b. 1,25-dihydroxyvitamin D c. GFR d. Whole blood lead - d. Whole blood lead Which of the following is a semi-synthetic opiate with 2-3 times the analgesic potency of its parent compound, morphine? a. Codeine b. Fentanyl c. Heroin d. Tramadol - c. Heroin The dose that would be predicted to produce a toxic effect in 50% of a population is represented by which of the following? a. ED<sub>50</sub> b. LD<sub>50</sub> c. TD<sub>50</sub> d. ID<sub>50</sub> - c. TD<sub>50</sub> Due to the variable cross-reactivity with immunoassays, positive results are considered to be presumptive positives with which class of drugs? a. MDMA b. THC c. Amphetamines d. Phencyclidine - c. Amphetamines The purposes of TDM are to ensure that the drug dosage provides the maximum therapeutic benefit and which of the following? a. Identify the standard dose b. Identify when the drug is outside the therapeutic range c. Determine the efficiency of absorption d. Determine the route of administration - b. Identify when the drug is outside the therapeutic range What is the final product of hepatic ethanol metabolism? a. Acetaldehyde b. Acetone c. Acetic acid d. Acetate - c. Acetic acid Which of the following is a good indicator of chronic malnutrition? a. Transferrin b. Transtryretin c. C-reactive protein d. Albumin - d. Albumin When conducting a manual leukocyte count, what area of the Neubauer hemacytometer is used to count cells? a. Center square only b. 4 corner squares c. 4 corner and center of center square d. All 9 squares - d. All 9 squares The average life span of an erythrocyte is 120 days; the aging cells are removed from the circulation by a. spleen. b. liver. c. pancreas. d. gallbladder. - a. spleen. You are reviewing a blood smear and come across the cells seen below. Based on this slide, what are the cells and what could the possible diagnoses be? a. Normal red blood cells, there is nothing wrong with this patient b. Elliptocyte that are seen in hereditary elliptocytosis c. Howell-Jolly bodies that are seen in has hemolytic anemia d. Stippled red blood cells that are seen in lead poisoning. - d. Stippled red blood cells that are seen in lead poisoning. What type of cell is a precursor of the non-nucleated mature red cells in the blood? a. Rouleaux b. Megaloblast c. Reactive cells d. Nucleated red cells - d. Nucleated red cells When held up to the light, a properly stained blood smear will have what color? a. Deep blue at the feathered edge b. Light pink-purple at the feathered edge c. Bright red at the feathered edge d. Light aqua at the feathered edge - b. Light pink-purple at the feathered edge In humans, a white blood cell is also known as a(n) a. carbinocyte. b. erythrocyte. c. thrombocyte. d. leukocyte. - d. leukocyte. Decreased leukocyte counts are seen in the CBC in cases of a. inflammation. b. metabolic intoxication. c. viral infections. d. anxiety. - c. viral infections. Microcytic/hypochromic anemia is most commonly caused by a. disseminated intravascular coagulation (DIC). b. lead poisoning. c. Vitamin B12 deficiency. d. iron deficiency. - d. iron deficiency. During the CBC differential, the tech has observed the erythrocytes are smaller than the nucleus of mature lymph and they have an increased central pallor. These erythrocytes will be described as a. normocytic, hyperchromic. b. normocytic, normochromic. c. microcytic, normochromic. d. microcytic, hypochromic. - d. microcytic, hypochromic. In simplified terms, iron deficiency anemia may result from the following a. Increased iron intake (either from inadequate diet or impaired absorption), decreased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or decreased iron requirements in infancy, pregnancy and lactation b. Increased iron intake (either from inadequate diet or impaired absorption), increased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or increased iron requirements in infancy, pregnancy and lactation c. Decreased iron intake (either from inadequate diet or impaired absorption), decreased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or decreased iron requirements in infancy, pregnancy and lactation d. Dec - d. Decreased iron intake (either from inadequate diet or impaired absorption), increased iron loss (generally from chronic bleeding from a variety of causes), an error of iron metabolism (sideroblastic anemias), and/or increased iron requirements in infancy, pregnancy and lactation Megaloblastic erythrocytes have an abnormal developmental sequence. As they develop, cells of the megablastic sequence have a more open or immature chromatin pattern in the nucleus, referred to as a. asynchronous maturation. b. iron deficiency anemia. c. thalassemias. d. sideroblastic anemias. - a. asynchronous maturation. Drabkin's hemoglobin reagent is no longer used because it contains a. cyanide. b. caustic. c. cobalt. d. carbon. - a. cyanide. Erythrocytes that are sickle shaped, drepanocytes, are also a. anisocytosis. b. poikilocytosis. c. echinocytic. d. stromatocytic. - b. poikilocytosis. What has been selected as the method of choice by the Clinical Laboratory Standards institute (CLSI) for measuring erythrocyte sedimentation rate (ESR)? a. Westergren method b. Erythrocyte sedimentation rate c. Reticulocyte count d. Rouleaux - a. Westergren method Which cytochemical stain is used to help distinguishing Acute Lymphocyte Leukemia from malignant lymphoma? a. Leukocyte alkaline phosphatase (LAP) b. Acid phosphatase c. Esterases d. Terminal Deoxynucleotidyl Transferase (TdT) - d. Terminal Deoxynucleotidyl Transferase (TdT) Which cytochemical stain is used in differentiating the cell lineage of malignant cells in the bone marrow that stains phospholipids, neutral fats, and sterols? a. Chloroacetate esterase b. Myeloperoxidase c. Specific esterase d. Sudan Black B - d. Sudan Black B A peripheral blood smear with a left shift has an increase in a. immature monocytes. b. reactive lymphocytes. c. immature neutrophils. d. mature lymphocytes. - c. immature neutrophils. Patient X was discovered to be a platelet clumper when using EDTA anticoagulant. A repeat platelet count was performed on a 3.2% buffered sodium citrate (blue top) evacuated tube with a 4.5 mL draw. The corrected platelet count should be multiplied by a factor of a. 1.1. b. 3.2. c. 4.5. d. 1.406. - a. 1.1. Critically low platelet counts are called to the doctor/nurse when the count is a. below 20 x 10<sup>9</sup>/L. b. above 120<sup>10</sup>/L. c. between 150-400 x 1,000/μL. d. between 150-400 x 10<sup>11</sup>/μL. - a. below 20 x 10<sup>9</sup>/L A slightly hazy body fluid is submitted for a manual cell count. It is diluted 1:100. All nine squares are counted on the hemocytometer, totaling 101 leukocytes. The reported leukocyte count should be a. 11.2 x 10<sup>9</sup>/L. b. 1.12 x 10<sup>9</sup>/L. c. 112 x 10<sup>6</sup>/L. d. 11.2 x 10<sup>6</sup>/L. - a. 11.2 x 10<sup>9</sup>/L. If one is doing an electrophoresis of hemoglobin and is using cellulose acetate at an alkaline pH of 8.6, permitting the flow of electrons from the cathode to the anode, which hemoglobin migrates the fastest to the anode? a. HbA b. HbS c. HbC d. HbD - a. HbA What is the difference between polymerase chain reaction (PCR) and reverse transcriptase PCR (rtPCR)? a. Following amplification, PCR generates a DNA product and rtPCR generates a RNA product. b. Substrate used for rtPCR is RNA instead of DNA. c. Deoxyribonucleotides is added to the reaction mixture of PCR versus ribonucleotides added to the rtPCR reaction mixture. d. None of the above. - b. Substrate used for rtPCR is RNA instead of DNA. On blood films prepared with Wright's stain, what is/are abnormally early released of the RBCs from the marrow into the peripheral blood and is indicated by the presence of nucleated RBCs or polychromatophilic macrocytes on blood films prepared with Wright's stain? a. Shift cells b. Absolute reticulocyte count c. Reticulocyte production index d. Westergren method - a. Shift cells Which genetic defect is found with chronic myelogenous leukemia and is detected through molecular tests? a. BCR/ABL1 b. RUNX1/RUNX1T1 c. BCR/MLL d. PML/RARA - a. BCR/ABL1 For cell counters using light scatter, the light is termed monochromatic. This means the light has only one a. wavelength. b. source. c. cell at a time. d. light receptor. - a. wavelength. The diluting solution used to carry electrical current in electrical impedance counters is a (an) a. elementalyte. b. hierogram. c. electrolyte. d. hirstite. - c. electrolyte. Flow cytometry cell counting is able to qualify and quantitate the subsets of lymphocytes. This ability is highly informative in the diagnosis of a. CLL only. b. leukemias. c. autoimmune diseases only. d. All of the Above. - b. leukemias. The active enzyme that is responsible for digesting fibrin or fibrinogen is a. Plasminogen. b. Plasmin. c. Fibrinolysis. d. Zymogen. - b. Plasmin. Which of the following factors belong in the intrinsic pathway? a. Factor I, factor II, factor V, factor X b. Factor I, factor II, factor V, factor VII c. Factor VIII, factor X, factor XI, factor XII d. Factor VIII, factor IX, factor XI, factor XII - D. Factor VIII, factor IX, factor XI, factor XII Warfarin/Coumadin Drug Therapy to prevent clots, aims for a controlled INR value of a. 10-13. b. 1-1.4. c. 2-3. d. 1.5-2.5. - c. 2-3. A platelet count above the normal reference range is termed a. thrombus. b. thrombocytosis. c. thrombolytic. d. This condition does not exist. - b. thrombocytosis. You are working in the coagulation department after service has just finished doing a 6 month preventive maintenance (PM) check on the coag analyzer that includes removing all current data in the analyzer. After the PM check, you run quality control (QC) for prothrombin time (PT) and activated partial thromboplastin time (aPTT). The QC for the aPTT is within 2 SD but the PT control is outside of 6 SD. In troubleshooting, what might the problem be? a. QC after maintenance is not really needed so if the pre maintenance QC is okay, then you can continue with patient testing. b. The ISI value that is currently in the instrument was set back to zero after maintenance and needs to be re-entered before patient testing is resumed. c. The controls must be contaminated so make up new controls and re-run just the PT test. d. It is normal for the PT to change after a preventive maintenance, so the range for the QA will need to - b. The ISI value that is currently in the instrument was set back to zero after maintenance and needs to be re-entered before patient testing is resumed. After an extended bleeding time for abnormal hemostasis, the next test(s) the surgeon would order would be a. platelet adhesion and platelet aggregation. b. activated partial thromboplastin time only. c. protime and activated partial thromboplastin time. d. protime only. - a. platelet adhesion and platelet aggregation. What has these characteristics: purpose is plasma factors; measures concentration and activity of fibrinogen in stage III; monitors coumarin therapy. a. Clot reaction b. Thrombin time c. Fibrinogen d. Platelet count - b. Thrombin time Which of the following results would be consistent with a factor XIII deficiency? Select one:a. Abnormal PT, Abnormal APTT, Normal Fibrinogen, Normal Thrombin b. Normal PT, Abnormal APTT, Abnormal Fibrinogen, Normal Thrombin c. Normal PT, Abnormal APTT, Normal Fibrinogen, Normal Thrombin d. Normal PT, Normal APTT, Normal Fibrinogen, Normal Thrombin - d. Normal PT, Normal APTT, Normal Fibrinogen, Normal Thrombin What measures factors II, VII, IX, and X? a. Prothrombin group b. Clot retraction group c. Thrombin group d. Fibrin group - a. Prothrombin group The activity of factor V in plasma deteriorates even when the plasma is frozen. It is the most unstable of the coagulation factors and is also known as a. stable factor. b. ionized calcium. c. labile coagulation factor. d. tissue factor. - c. labile coagulation factor. Thrombin is generated from a precursor of this substance and is involved in the common pathway of both the extrinsic and the intrinsic clotting pathways. What is synthesized by the liver through the action of Vitamin K? a. Tissue factor b. Thromboplastin c. Prothrombin d. Fibrinogen - c. Prothrombin You are running at prothrombin time (PT) and activated partial thromboplastin time (aPTT) for pre-op testing that came from an outpatient clinic. You get an alarm from your analyzer indicating that there is no endpoint clotting time. The patient has no history of bleeding problems and is on no medication that would cause excessive long coagulation times. The specimen was in a 3.2% sodium citrate tube that was received into the lab 20 minutes after it was collected and spun immediately upon arrival. What may be the cause for the failure to clot? a. The specimen needed to sit for at least 30 minutes before it is centrifuged. b. The specimen had a clot in it that was not detected upon arrival in the lab. c. The specimen should have been drawn in an EDTA tube for this testing. d. The specimen should have been kept at body temperature. - b. The specimen had a clot in it that was not detected upon arrival in the lab. The physician in the emergency department has a patient that might have a pulmonary embolism (PE) and calls you to ask what coagulation test would be the best to rule out this diagnosis. a. PT b. aPTT c. D-dimer d. Mixing studies - c. D-dimer A doctor's office calls needing help ordering tests for fibrinolysis but can not recall which test to order. You advise them of the tests for a. plasmin and plasminogen. b. fibrin. c. thrombus. d. procoagulant. - a. plasmin and plasminogen. A patient was admitted from the ED to the ICU with a preliminary diagnosis of severe sepsis. The phlebotomist was instructed to collect extra tubes while they had venous access to ensure that add-on testing could be ordered as needed in the next couple of hours. All of the needed tubes were labeled correctly, tested successfully, and the phlebotomist noted that the patient had a great vein. The clerical staff received two extra tubes and set those aside in a test tube rack at room temperature. One tube was a serum sample and the other was an EDTA whole blood tube that settled into plasma and red cells. After several hours the technologist went to process the two extra tubes and freeze the serum and plasma. She found that the serum tube showed hemolysis and the plasma tube did not. Which of the following explains these findings? a. The classical complement pathway was activated only in the serum tube resulting in for - a. The classical complement pathway was activated only in the serum tube resulting in formation of the MAC. An antigen is any _________________ that can bind specifically to an antibody. a. protein b. cell c. collagen d. molecule - d. molecule The stage of syphilis infection in which a patient does not exhibit any symptoms but is still potentially infectious is called a. secondary syphilis. b. latent syphilis. c. tertiary syphilis. d. congenital syphilis. - b. latent syphilis. A patient with rheumatoid arthritis has been undergoing treatment for the disease for several months. The rheumatologist has ordered two CRP levels (by latex agglutination) and the results are seen in the table below. Which of the following answers is the best interpretation of the CRP results provided? Sample 1-15-14 Qualitative POS Semi-quantitative 1:2 + 1:4 + 1:8 + 1:16 + 1:32 + 1:64 + 1:128 + 1:256 0 Sample 4-15-14 Qualitative POS Semi-quantitative 1:2 + 1:4 + 1:8 + 1:16 + 1:32 + 1:64 0 1:128 0 1:256 0 Select one: a. The inflammation from the RA is decreasing with treatment. b. The inflammation from the RA is increasing despite treatment. c. The treatment has been ineffective and the inflammation has not significantly changed. d. The concentration of rheumatoid factor has decreased due to treatment. - a. The inflammation from the RA is decreasing with treatment. Many tests for pregnancy are immunochromatographic cassette tests. Which of the following best describes the principle behind this type of test? a. β-hCG in the patient's sample binds to monoclonal anti-β-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. b. α-hCG in the patient's sample binds to monoclonal anti-α-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. c. β-hCG in the patient's sample binds to monoclonal anti-α-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. d. α-hCG in the patient's sample binds to monoclonal anti-β-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. - a. β-hCG in the patient's sample binds to monoclonal anti-β-hCG complexed to an indicator such as colloidal gold particles usually in the shape of a line or a plus sign. Toxin A/B produced by Clostridium difficile is a. detected in stool for a positive test. b. detected in serum only. c. detected only during the colonoscopy procedure. d. cannot be tested. - a. detected in stool for a positive test. A pediatrician contacted the laboratory to ask which test or tests would be most useful in the case of a child suspected of having complications following Strep throat. The technologist asked this physician some questions about what she was trying to determine and found that the pediatrician wanted the test or tests most likely not to miss potential antibodies produced against streptococcal antigens. Which of the following should the technologist recommend? a. Streptozyme test followed, if positive, by ASO b. ASO test followed, if positive, by Streptozyme c. Culture followed, if positive, by Rapid Strep cassette testing d. Rapid Strep cassette testing followed, if positive, by culture - a. Streptozyme test followed, if positive, by ASO A patient tests negative for rheumatoid factor. The patient does have symptoms consistent with rheumatoid arthritis. The physician should a. Do further testing because the RF test is negative in approximately 25% of patients who have the disease. b. Change the diagnosis to something other than RA because the RF test is positive in 100% of patients with the disease. c. Ask the laboratory to repeat the test on a second sample immediately because the only way to diagnose RA is through the use of the RF. d. Ask the laboratory to repeat the test on a plasma sample because the test should NOT be done on serum. - a. Do further testing because the RF test is negative in approximately 25% of patients who have the disease. Clostridium difficile is the leading cause of a. the common cold. b. adult respiratory syndrome. c. food poisoning. d. nosocomial diarrhea. - d. nosocomial diarrhea. Which of the following best describes what is occurring in the slide latex agglutination test for rheumatoid factor when the test is positive? a. Patient produced rheumatoid factor binds to the IgG bound to the carrier particles producing agglutination. b. Reagent IgG binds to the patient's red cells if they have produced rheumatoid factor inhibiting agglutination. c. Patient produced rheumatoid factor binds to reagent antigens bound to the slide and then latex particles adhere and show color if RF is present. d. Murine IgM binds to the patient IgG that has bound to the latex particles in the test, producing agglutination. - a. Patient produced rheumatoid factor binds to the IgG bound to the carrier particles producing agglutination. The type of fluorescent immunoassay that is based on the change in polarization of fluorescent light emitted from a labeled molecule when it is bound by antibody and is a competitive assay in which unlabeled antigen in the patient sample competes with labeled antigen for a limited number of antibody binding sites is a. FPIA. b. RIBA. c. chemiluminescence. d. FANA. - a. FPIA. Which technique is used to detect antigen-antibody reactions that can be seen with a fluorescent microscope? a. Enzyme Immunoassay (EIA) b. Fluorescent Antibody (FA) c. Direct Immunofluorescent Assay (DFA) d. Enzyme-linked immunosorbent assay (ELISA) - c. Direct Immunofluorescent Assay (DFA) The diseases known as mono or kissing disease, actually infectious mononucleosis, is caused by a. Hepatitis D virus. b. Pseudomonas aeruginosis c. the Epstein-Barr virus. d. the parainfluenza virus. - c. the Epstein-Barr virus. One of the most commonly used tests for antinuclear antibodies is a. indirect immunofluorescence. b. equine serum agglutination. c. a skin test. d. reverse polarization. - a. indirect immunofluorescence. A 42-year-old white female presents with a long history of on-again, off-again fevers, painful joints, loss of appetite, confusion, proteinuria and a facial rash resembling a butterfly across her nose and cheeks. The physician has performed testing previously but now orders an indirect immunofluorescence ANA test. The results are seen below: Pattern of Staining Seen: Speckled; Peripheral Antibody Suspected in Patient'sSerum: Sm;ds DNA Which of the following conclusions should the physician reach? Select one: a. This patient has ANA results consistent with systemic lupus erythematosus. b. This patient has ANA results consistent with scleroderma. c. This patient has ANA results consistent with Sjögren's syndrome. d. This patient's ANA results are inconclusive. - a. This patient has ANA results consistent with systemic lupus erythematosus. A Weil-Felix Reaction assay was once used commonly to test for febrile agglutinins that indicated evidence of infection with several Rickettsial diseases. The antigens used in this assay are derived from a. Proteus vulgaris b. Brucella spp. c.Escherichia coli d. Salmonella typhi - a.Proteus vulgaris. If a screening test for HIV, such as an ELISA test, is positive, which of the following would be the recommended confirmatory test? a. Western blot b. Viral culture c. Ouchterlony d. Antinuclear antibody - a. Western blot A mother who had received no prenatal care delivered a slightly underweight, 2 week premature, otherwise healthy looking baby boy. The physician ordered a rubella titer for both IgM and IgG specific antibodies on the neonate. The results of the titers are shown below: Antibody Tested For:IgG 1:1 POS 1:2 POS 1:4 POS 1:8 POS 1:16 POS 1:32 POS IgM 1:1 NEG 1:2 NEG 1: 8 NEG 1:16 NEG 1:32 NEG