MLT 210 Flashcards Unit TWO
1. Required regulation of clinical laboratories is achieved by the:
A. Clinical Laboratory Improvement Amendments of 1988
B. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
C. College of American Pathologists (CAP)
D. American Hospital Association (AHA)
2. Nonanalytical factors in quality assessment include:
A. Qualified personnel
B. Established laboratory policies
C. Quality control charts
D. Both A and B
3. An example of a preanalytical error is:
A.
Specimen obtained from the wrong patient
B.
Lack of frequent preventative maintenance
C.
Reporting of laboratory results by phone
D.
Poorly trained phlebotomists
4. Quality assessment programs include:
A. Patient identification
B. Specimen procurement
C. Specimen transportation and processing procedures
D. All of the above
5. For testing of moderate complexity, quality control requires:
A. Using fresh reagent daily
B. Performing control procedures monthly
C. Performing control procedures using at least two levels of control
material each day of testing
D. Both A and C
6. A control specimen should be:
A. Carried through the entire test procedure
B. Treated exactly in the same way as any patient specimen
C. Assayed at least once a week
D. Both A and B
7. Accuracy describes:
A. How close a test result is to the true value
B. Comparison of an instrument measure or reading to a known physical
constant
C. How close the test results are to one another when repeated analyses of
the same material are performed
D. The purity of a substance
8. Sensitivity is defined as the:
A. Proportion of cases with a specific disease or condition that give a
positive test result
B. Proportion of cases with absence of the specific disease or condition that
gives a negative test result
C. Proportion of a population that has the disease
D. Number of patients with a normal test result who do not have the
disease
A
D
A
D
C
D
A
A
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MLT 210 Flashcards Unit TWO
9. How many data points are recommended as a minimum number to obtain
from 20 or more separate testing runs to estimate a mean value and precision
of an assay?
A. 10
B. 20
C. 40
D. 80
10. One way to determine a control range for a particular analysis is to:
A. Assay an aliquot of the control serum with the regular batch of assays
for 15 to 25 days
B. Treat a control sample exactly like an unknown specimen
C. Estimate the most reasonable value
D. Both A and B
11. Sources of variance or error include:
A. Age of a specimen
B. Procedural factors
C. Physical activity level of a patient
D. All of the above
12. Quality control can be monitored by using:
A. Levey-Jennings charts
B. Westgard rules
C. Bar graph information
D. Both A and B
B
13. The major benefits of laboratory automation include all of the following
except:
A. Reduction of medical errors
B. Improved safety for laboratory staff
C. Longer turnaround time of results
D. More reliable results
14. Which of the following is the sequence of major steps in automated
analysis that mimic manual techniques?
A. Specimen collection and processing, specimen and reagent measurement
and delivery, chemical reaction phase, measurement phase, and signal
processing and data handling
B. Specimen and reagent measurement and delivery, specimen collection
and processing, chemical reaction phase, measurement phase, and signal
processing and data handling
C. Specimen collection and processing, specimen and reagent measurement
and delivery, signal processing and data handling, chemical reaction
phase, and measurement phase
D. Signal processing and data handling, specimen collection and
processing, specimen and reagent measurement and delivery, chemical
reaction phase, and measurement phase
C
D
D
D
A
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MLT 210 Flashcards Unit TWO
15. The three most highly automated areas of the clinical laboratory are:
A. Microbiology, urinalysis, and hematology
B. Clinical chemistry, hematology, and urinalysis
C. Clinical chemistry, microbiology, and blood banking
D. Immunology, microbiology, and hematology
16. Leukocytes can be differentiated by:
A. Automated three-part differential
B. Automated five-cell differential
C. Digital imaging
D. All of the above
17. Systems for automated or semiautomated urinalysis chemical testing
systems use:
A. Visual reading
B. Reflectance photometers
C. Flow-cell analysis
D. Any of the above
18. The amplification of low levels of specific DNA sequences to higher
quantities suitable for further analysis is accomplished by:
A. Polymerase chain reaction (PCR)
B. Southern blot
C. Western blot
D. Microarrays
19. A laboratory test that is not performed in a traditional laboratory is called
a ____ test.
A. Provider-performed microscopy
B. Waived test
C. Moderately complex
D. Highly complex
20. Important characteristics of point-of-care (POCT) instruments include:
A. Rapid turnaround time
B. Easy portability with single-use disposable reagent cartridges or test
strips
C. Easy-to-perform protocol with one or two steps
D. All of the above
21. Laboratory information systems (LIS) can be applied to:
A. Specimen processing
B. Inventory control
C. Data entry on patients’ charts
D. All of the above
22. Computer hardware for an LIS system includes:
A. Central processing unit (CPU)
B. Random access-memory (RAM)
C. An operating system
D. Both A and B
B
D
B
A
B
D
D
D
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MLT 210 Flashcards Unit TWO
23. Computer interfaces are important to the laboratory for all of the
following reasons, except:
A. Transmission of tests results is faster
B. Accuracy of analytical testing is improved
C. Transposition of numbers errors are reduced
D. Charting of patient results can be direct
24. General functions of an LIS can include:
A. Bar code reading of specimens
B. Selection of tests from a test menu
C. Reporting of test results
D. All of the above
25. The applications of the LIS have grown from being exclusive to highvolume chemistry and hematology instrumentation to all of the other sections
of the laboratory and off-site locations. General functions of the LIS can
include patient identification, patient demographic data, test ordering,
specimen collection, specimen analysis, test results, and test interpretation.
The Clinical Laboratory and Standards Institute (CLSI) has developed
interrelated standards that address all of the following except:
A. Privacy of patient information
B. Specimen containers
C. Bar codes for specimen container identification
D. Laboratory automation systems operational requirements
26. Which of the following hormones lowers the blood glucose level by
promoting glucose entry into cells?
A. Cortisol
B. Glucagon
C. Insulin
D. Thyroxine
27. Contributory factors to this form of diabetes include a genetic
predisposition and autoimmune destruction of pancreatic beta (ß cells.
A. Type 1
B. Type 2
C. Gestational diabetes mellitus
D. Stress-induced hyperglycemia
28. Hypoglycemia is not a consequence of:
A. Insulinoma
B. Islet cell hyperplasia
C. Insulin resistance
D. Glycogen storage disease
29. The anticoagulant of choice for glucose testing when analysis is not
performed promptly is:
A. EDTA
B. Sodium fluoride
C. Lithium heparin
D. Sodium citrate
B
D
A
C
A
C
B
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MLT 210 Flashcards Unit TWO
30. A major benefit of POCT (point-of-care testing) for blood glucose is it:
A. Allows for immediate intervention
B. Does not require oversight by the laboratory
C. Can only be performed by laboratory personnel
D. Eliminates the need for glucose testing in the laboratory
31. Which of the following methods is not used to quantitate glucose levels?
A. Glucose oxidase
B. Glucose 6 phosphate dehydrogenase
C. Clinitest
D. Hexokinase
32. The adult reference range for fasting serum glucose is:
A. 40-75 mg/dL
B. 55-105 mg/dL
C. 60-95 mg/dL
D. 70-110 mg/dL
33. Estimation of the blood glucose level over the previous 4 to 6 weeks is
determined with the following test:
A. HbA1c
B. Ketones
C. Clinitest
D. Microalbumin
34. The term for the condition associated with elevated serum potassium is:
A. Hyponatremia
B. Hypernatremia
C. Hypokalemia
D. Hyperkalemia
35. The term chloride shift refers to the:
A. Exchange of chloride with sodium to maintain electrical neutrality
B. Exchange of chloride with bicarbonate between red blood cells and
plasma
C. Contribution of chloride to serum osmolality
D. Kidney’s excretion of chloride by the renal tubules
36. An increased anion gap may be due to:
A. Lactic acidosis
B. Hypercalcemia
C. Hypermagnesemia
D. Hypoproteinemia
37. Determination of plasma sodium with an ion-sensitive electrode (ISE)
will be altered if the specimen is lipemic (increased plasma lipids) in which
manner?
A. Increased with a direct ISE method
B. Increased with an indirect ISE method
C. Decreased with a direct ISE method
D. Decreased with an indirect ISE method
A
C
D
A
D
B
A
D
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MLT 210 Flashcards Unit TWO
38. The primary form of nonprotein nitrogen in the blood is:
A. Urea
B. Creatinine
C. Cystatin C
D. Creatine
39. An adult male has a serum BUN of 56 mg/dL and a creatinine of 0.8
mg/dL. These results are consistent with:
A. Decreased GFR
B. Prerenal azotemia
C. Renal azotemia
D. Postrenal azotemia
40. Which of the following conditions is least likely to contribute to an
increased serum uric acid level?
A. Chemotherapy
B. Renal disease
C. Liver disease
D. Gout
41. The first step in the laboratory determination of serum cholesterol is to
ensure that all cholesterol present is in the free form. This is accomplished
with the use of:
A. Cholesterol esterase
B. Glycerol
C. Cholesterol oxidase
D. Lipase
42. Fasting lipid profile results for a 48-year-old male with diabetes are as
follows: total cholesterol: 298 mg/dL, HDL cholesterol: 26 mg/dL, and
triglycerides: 320 mg/dL. The patient has no evidence of coronary artery
disease (CAD). What is the recommended course of action?
A. The LDL is normal, and no action is indicated.
B. The LDL is elevated, and the therapeutic goal is to decrease it to less
than 100 mg/dL.
C. The LDL is elevated, and the therapeutic goal is to decrease it to less
than 130 mg/dL.
D. The LDL is elevated, and the therapeutic goal is to decrease it to less
than 160 mg/dL.
43. Laboratory diagnosis of an acute myocardial infarction (MI) is most
accurately determined with which of the following two cardiac markers?
A. CK-MB and homocysteine
B. CRP (C-reactive protein) and cardiac troponin
C. Myoglobin and lactate dehydrogenase (LDH)
D. Myoglobin and cardiac troponin
A
B
C
A
C
D
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MLT 210 Flashcards Unit TWO
44. Which of the following laboratory tests assists in the diagnosis of heart
failure?
A. BNP
B. Fibrinogen
C. CRP
D. D-dimer
45. In bilirubin assays, conjugated bilirubin is referred to as ____ reacting
bilirubin.
A. Unconjugated
B. Total
C. Indirect
D. Direct
46. Which of the following enzymes is normally found in highest levels in
hepatocytes, or liver cells?
A. ALT
B. AST
C. GGT
D. Alkaline phosphatase
47. A reversal of the normal serum albumin/globulin (A/G) ratio occurs in
_____ disease.
A. Heart and lung
B. Kidney and bone
C. Heart and liver
D. Kidney and liver
48. The two enzymes used in the diagnosis of acute pancreatitis are:
A. AST and ALT
B. Amylase and lipase
C. Alkaline phosphatase and amylase
D. GGT and lipase
49. Which of the following is the least utilized role of a tumor marker?
A. Cancer screening
B. Cancer diagnosis
C. Monitoring of patients for a recurrence of cancer
D. Determination of the extent of tumor burden
50. The final result of primary hemostasis is:
A. Platelet plug
B. Constriction of a blood vessel
C. A blood clot
D. Promotion of bleeding to cleanse a wound
51. The final result of secondary hemostasis is:
A. Platelet plug
B. Constriction of a blood vessel
C. A blood clot
D. Promotion of bleeding to cleanse a wound
A
D
A
D
B
B
A
C
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MLT 210 Flashcards Unit TWO
52. An unbalanced hemostatic mechanism can produce:
A. Thrombosis
B. Bleeding
C. Inadequate number of platelets
D. Both A and B
53. A function or activity of platelets is to form an aggregate plug or platelet
mass that can physically slow down or stop blood loss.
A. True
B. False
54. A function or activity of platelets is to help activate and be a participant
in plasma coagulation.
A. True
B. False
55. A function or activity of platelets is to maintain the endothelial lining of
the blood vessels.
A. True
B. False
56. A function or activity of platelets is to secrete fibronectin.
A. True
B. False
57. A function or activity of platelets is to contain platelet factor 3 on or
within the plasma membrane of the platelets.
A. True
B. False
58. The protein “glue” that optimally binds platelets and collagen after
vessel injury is:
A. Fibronectin
B. von Willebrand’s Factor (VIII:vWF)
C. Factor II
D. Factor I
59. The formation of a blood clot relies on three major steps in which order?
A. Formation of thromboplastin, formation of thrombin, and formation of
fibrin
B. Formation of thrombin, formation of thromboplastin, and formation of
fibrin
C. Formation of fibrin, formation of thrombin, and formation of
thromboplastin
D. Formation of fibrin, formation of thromboplastin, and formation of
thrombin
60. The final end-product of fibrinolysis is:
A. Fibrinogen
B. Fibrin
C. Fibrin-split products
D. Plasmin
D
A
A
A
A
A
B
A
C
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MLT 210 Flashcards Unit TWO
61. Natural anticoagulants include:
A. Antithrombin III (AT-III)
B. Protein C
C. Protein S
D. All of the above
62. The appropriate anticoagulant for prothrombin time assay is:
A. EDTA
B. 3.2% sodium citrate
C. 3.8% sodium citrate
D. Heparin
63. Based on the following code, what is the correct order of blood draw for
a coagulation specimen?
1. Coagulation tubes with sodium-citrate anticoagulant tube (e.g., blue
stopper)
2. Blood culture tubes
3. Serum tubes with or without clot activator, with or without gel separator
(e.g., red, gold, and speckled stopper)
4. EDTA tubes (e.g., lavender stopper)
5. Heparin tubes with or without gel (e.g., green stopper)
6. Glycolytic inhibitor (e.g., gray stopper)
A. 2, 1, 3, 5, 4, 6
B. 1, 2, 3, 4, 5, 6
C. 2, 4, 6, 1, 3, 5
D. 3, 5, 1, 4, 6, 2
64. A prothrombin time assay should be conducted within ____ hours after
specimen collection
A. 2
B. 4
C. 8
D. 24
65. Most patients on warfarin therapy should maintain an international
normalized ratio (INR) of approximately ____ times of a normal value.
A. 0.5-1.5
B. 1-2
C. 2-3
D. 3-4
66. Match the following coagulation factors with the appropriate description
(use an answer only once).
A. Prothrombin
B. Hemophilia B
C. von Willebrand’s factor
D. Fibrinogen
66. Factor I
67. Factor II
68. Factor VIII
69. Factor IX
D
B
A
D
C
66. D
67. A
68. C
69. B
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MLT 210 Flashcards Unit TWO
70. The three groups of coagulation factors based on their properties.
A. Factors II, VII, IX, and X
B. Factors XI and XII, prokallikrein (Fletcher factor), and HMWK
(Fitzgerald factor)
C. Factors I, V, VIII, and XIII
70. Fibrinogen group
71. Prothrombin group
72. Contact group
73. Match the pathway with the appropriate description.
A. It is thought that tissue injury, following exposure to foreign substances
such as collagen, activates the pathway.
B. The pathway taken when tissue thromboplastin, a substance not found in
the blood, enters the vascular system and, in the presence of calcium and
factor VII, activates factor X.
73. Intrinsic pathway
74. Extrinsic pathway
75. A macroscopically turbid cerebrospinal fluid may indicate:
A. Blood clots
B. Increased white blood cell count
C. Presence of hemorrhage
D. Viral infection
76. If cerebrospinal fluid has a xanthochromic appearance, it can indicate
bleeding:
A. Within 30 minutes to 1 hour
B. Within 1 hour to 4 weeks
C. Between 12 hours and 2 weeks
D. Within the past month
77. When a leukocyte differential smear made from a cerebrospinal fluid
specimen with an elevated leukocyte count reveals an increase in
polymorphonuclear cells, it may be indicative of _____ infection.
A. Viral
B. Bacterial
C. Fungal
D. Parasitic
78. Cerebrospinal fluid specimens should be delivered to the laboratory:
A. Immediately
B. Within an hour
C. Within 12 hours
D. Within 24 hours
79. Serous fluids:
A. Have a composition that is unlike serum
B. Are contained within the closed cavities of the body
C. Are ultrafiltrates of plasma
D. Both A and B
70. C
71. A
72. B
73. A
74. B
B
B
B
A
D
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MLT 210 Flashcards Unit TWO
6SeroS 80. Serous fluid for laboratory examination should be collected in a(n):
A. Sterile container
B. EDTA tube for cell counts
C. Aseptic environment
D. All of the above
.Syno7 81. Synovial fluids should be collected:
A. Into an anticoagulated tube
B. Into a non-anticoagulated tube
C. Using a sterile needle and syringe
D. All of the above
8.Fecal 82. Fecal occult blood testing tests for:
A. Whole blood in the stool
B. Hemoglobin in fecal specimens
C. Presence of inflammation causing bleeding
D. Presence of infection
9.Th 83. The value of the fecal occult blood test is that it could determine the
cause of or aid in detecting:
A. Hypochromic anemia
B. Ulcerative disease
C. Neoplastic diseases
D. All of the above
10.Fal 84. False-positive fecal occult blood results can be caused by ingestion of:
A. Red meat
B. Horseradish
C. Apples and oranges
D. Both A and B
11.A fa 85. False-negative fecal occult blood can be caused by:
A. Beets and carrots
B. Chicken
C. Multivitamins
D. Vitamin C
12.The 86. The American Cancer Society recommends that ____ fecal specimen(s)
from ____ consecutive specimen(s) be collected for colorectal screening.
A. 1, 1
B. 2, 3
C. 3, 3
D. 4, 4
13.Se1 87. Semen specimens should be kept ____ before microscopic examination
for motility.
A. Frozen
B. At body temperature
C. At 4° C
D. At 72° F
D
D
B
D
D
D
B
B
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