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CSMLS Practice Quiz

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Questions taken from Medical Laboratory Science courses of BCIT.
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Quiz by tiramisu_sarang, updated more than 1 year ago
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Created by tiramisu_sarang about 9 years ago
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Resource summary

Question 1

Question
Which naturally occurring antibody(ies) is(are) found in the serum of a group A Rh negative patient
Answer
  • anti-D
  • anti-B
  • anti-A,B
  • anti-D and anti-B

Question 2

Question
Holes are noted in a cryostat section of muscle. Which of the following is the most likely cause?
Answer
  • Improper adjustment of the antiroll plate.
  • Freezing the muscle in liquid nitrogen.
  • Too small a clearance angle.
  • Freezing the section in frozen isopentane in liquid nitrogen.

Question 3

Question
Which of the following is true regarding H&E staining using an automated stainer?
Answer
  • the staining should be checked daily only if you are preparing your own staining reagents
  • the staining should always be checked microscopically slide-by-slide
  • the staining should be microscopically checked daily using known control tissues
  • microscopic stain checks are not if you are purchasing your reagents

Question 4

Question
Which of the following is true of quality control materials for internal QC?
Answer
  • they must always have a known value directly traceable to a reference method
  • they should approximate the chemical and physical properties of the sample being tested
  • they should sit on the bench and continue to be used until the bottle is empty or values are > +2SD
  • they should be run daily for a week to collect values required to create Levey-Jennings plots

Question 5

Question
During a routine quality control check, a Kirby-Bauer disc susceptibility test is performed and the resulting zones of inhibition are too large. Which of the following is a possible cause of this result?
Answer
  • inoculum too dense
  • antibiotics stored at higher temperature than recommended
  • antibiotic discs applied immediately after inoculation of plate
  • agar depth too thick

Question 6

Question
Which antibody could be produced by an R1r individual transfused with R2R2 blood?
Answer
  • anti-e
  • anti-E
  • anti-C
  • anti-c

Question 7

Question
A good screening test for alcohol ingestion employs comparing the calculated osmolality with what other measurement?
Answer
  • the osmolar gap
  • freezing point depression osmometer measurement
  • vapor-pressure osmometer measurement
  • boiling point elevation osmometer measurement

Question 8

Question
When performing a D typing on a patient, a technologist observes that the Rh control is positive. As a result, which of the following would he perform next?
Answer
  • repeat D typing with high-protein antiserum
  • weak D test
  • full Rh phenotype
  • Direct Antiglobulin Test

Question 9

Question
When entering blood gas results manually into the LIS what should be done if a critical value warning appears when a pH value of 7.14 is entered?
Answer
  • follow the critical value protocol
  • immediately consult with the supervisor
  • check for decimal placement
  • look at previous results

Question 10

Question
Gram positive cocci in chains which grow as small translucent colonies surrounded by a clear zone of hemolysis were isolated from a throat swab. These colonies were found to be catalase negative and resistant to a 0.04 unit bacitracin disc. Which of the following tests would be most useful in identifying this organism?
Answer
  • susceptibility to optochin
  • tube coagulase test
  • antibody latex agglutination
  • Taxo A disc

Question 11

Question
What should be done with patient results that are outside reference intervals but are within the percent differences programmed into the delta check?
Answer
  • repeat the assay
  • phone the results to the doctor
  • release the results immediately after review
  • have the specimen recollected

Question 12

Question
What statement about the dry reagent strip blood test is true?
Answer
  • a non-hemolyzed trace is present when there are 1-2 RBC/high power field
  • test for blood is based on its reaction with oxidase
  • test for blood is positive for hemoglobin and myoglobin
  • salicylates cause a false positive reaction

Question 13

Question
Both hemoglobin and myoglobin will react with the H2O2 on the pad, which gives a positive result. The colour of the urine (brown vs red) and microscopic examination (red cells) can be used to differentiate haemoglobin from myoglobin. Oxidizing reagents such as bleach can also cause a false positive reaction for blood test, however, salicylate is reducing reagent. Oxidase is used to test for urine glucose.
Answer
  • 7.3 x 10^9 /L
  • 8.2 x 10^9 /L
  • 8.6 x 10^9 /L
  • 7.6 x 10^9 /L

Question 14

Question
Which of the following antibodies would not show any reactivity when tested against a panel of reagent red blood cells which had been treated with ficin?
Answer
  • anti-K
  • anti-E
  • anti-Fya
  • anti-Jkb

Question 15

Question
What does staining leukemic cells for myeloperoxidase help to distinguish?
Answer
  • CLL from ALL
  • AML from ALL
  • AML from CML
  • CLL from CML

Question 16

Question
A suspect Enterobacteriaceae isoalte was inoculated to a TSI and decarboxylase test. The TSI showed K/A with gas. The decarboxylase showed: base: purple, turbid lysine: purple, turbid ornithine: purple, turbid These results indicate:
Answer
  • the organism is a non-fermentative bacillus
  • the organism is viable but does not decarboxylate the amino acid
  • the test is invalid and must be repeated
  • the organism is negative for lysine and ornithine

Question 17

Question
Given the following patient test results, what is the creatinine clearance? serum creatinine 100 μmol/L urine creatinine 8.64 mmol/L 24 hour urine volume 2000 mL BSA 1.73m^2
Answer
  • 16 ml/min
  • 120 ml/min
  • 16 ml/min/1.73m^2
  • 120 ml/min/1.73m^2

Question 18

Question
What happens to hemoglobin's affinity for oxygen when hemoglobin binds 2,3-DPG?
Answer
  • it decreases
  • it increases
  • it remains constant
  • it becomes saturated

Question 19

Question
The Philadelphia chromosome is predominately associated with which leukemia?
Answer
  • chronic lymphocytic leukemia
  • acute myeloblastic leukemia
  • chronic myelogenous leukemia
  • acute lymphoblastic leukemia

Question 20

Question
A technologist is performing a nitrate reduction test. When dimethyl-α-naphthylamine and sulfanilic acid were added, the medium did not change colour. What should the technologist do?
Answer
  • record the test result as positive
  • record the test result as negative
  • reincubate the tube overnight
  • add zinc to the tube

Question 21

Question
The alcian blue staining reactions of colonic epithelial goblet cells on serial sections from the same tissue block show the following staining results: Alcian Blue @ pH 1.0 1+ (stain intensity) Alcian Blue @ pH 2.5 3+ Alcian Blue @ pH 4.5 3+
Answer
  • The colonic epithelial goblet cells contain only carboxylated glycoproteins.
  • The colonic epithelial goblet cells contain neutral glycoproteins.
  • The colonic epithelial goblet cells contain only sulphated glycoproteins.
  • The colonic epithelial goblet cells contain both sulphated and carboxylated glycoproteins.

Question 22

Question
If QC was performed on a batch of Hugh-Leifson O-F (oxidative-fermentative) media, which of the following results would correspond with acceptable QC?
Answer
  • (open) (closed) Escherichia coli yellow yellow Pseudomonas aeruginosa yellow yellow Acinetobacter lwoffi yellow blue-green
  • (open) (closed) Escherichia coli yellow yellow Pseudomonas aeruginosa blue-green yellow Acinetobacter lwoffi blue-green blue-green
  • (open) (closed) Escherichia coli blue-green blue-green Pseudomonas aeruginosa yellow blue-green Acinetobacter lwoffi yellow yellow
  • (open) (closed) Escherichia coli yellow yellow Pseudomonas aeruginosa yellow blue-green Acinetobacter lwoffi blue-green blue-green

Question 23

Question
A 26 year old female out-patient presents to her physician with symptoms of uncomplicated cystitis. A culture of her urine grows gram positive cocci. What organism would these cocci likely represent?
Answer
  • Staphylococcus epidermidis
  • Staphylococcus saprophyticus
  • Streptococcus agalactiae
  • Staphylococcus aureus

Question 24

Question
What should a technologist do if she obtains low results for all analytes in a specimen?
Answer
  • check the patient's diagnosis for over-hydration
  • change the wash reagent for the probe
  • check and see if the reagents have expired
  • look for sampling error such as a clot in the probe or specimen

Question 25

Question
What may cause wrinkles in sections during flotation?
Answer
  • What may cause wrinkles in sections during flotation?
  • floating the ribbon too slowly
  • having the water bath too hot
  • floating the ribbon for too short a time

Question 26

Question
How many units of packed red cells would be required to raise the hemoglobin of an average sized patient from 80 g/L to 110 g/L?
Answer
  • 7
  • 3
  • 1
  • 5

Question 27

Question
What does the D-dimer lab test detect?
Answer
  • degradation products of both fibrinogen and fibrin
  • fibrin degradation products
  • fibrinogen monomer
  • fibrinogen

Question 28

Question
A control slide is stained with H&E using an automated tissue stainer. Upon microscopic assessment following staining in Harris hematoxylin, the nuclei appear blue-purple with an obvious chromatin pattern. What would be the appropriate action at this stage?
Answer
  • prepare a new hematoxylin solution
  • accept the results and continue with the procedure for the rest of the slides
  • decrease the pH of the hematoxylin staining solution
  • increase the pH of the hematoxylin staining solution

Question 29

Question
A midstream urine is received in the laboratory from a recently discharged inpatient. The requisition indicates the date of collection as yesterday making the specimen 24.5 hours old but the specimen feels warm to the touch. What should the technologist do?
Answer
  • process the specimen following the usual protocol
  • call the floor to double-check the collection date
  • discard the specimen, send out a rejected specimen report
  • process the specimen with a warning about the delay in transportation

Question 30

Question
What would processing tissues through alcohol stations that are contaminated with water initially result in?
Answer
  • incomplete infiltration of the tissue with paraffin
  • excessive hardening of tissue
  • incomplete clearing of the tissue
  • incomplete fixation of the tissue

Question 31

Question
Every piece of equipment in the laboratory has a log which is used to document QC values during start-up. How can this log be used?
Answer
  • to ensure that start-up procedures are performed properly
  • to assist in trouble-shooting for random and systemic error
  • to force every technologist to perform tasks in a uniform manner
  • to prevent errors in the start-up procedure

Question 32

Question
Which of the following is recommended for the detection of penicillin resistance in Streptococcus pneumoniae?
Answer
  • beta-lactamase testing
  • penicillin 10 units
  • oxacillin 1 μg
  • nafcillin 10 μg

Question 33

Question
A cloudy cerebrospinal fluid has an increased leukocyte count and a decreased glucose concentration. What is the most probable type of meningitis in a patient with these CSF results?
Answer
  • tubercular
  • fungal
  • bacterial
  • viral

Question 34

Question
Which of the following contains only ferric iron?
Answer
  • myoglobin
  • oxyhemoglobin
  • methemoglobin
  • sulfhemoglobin

Question 35

Question
An immunocompromised 58-year-old female chemotherapy patient received two units of packed RBC. The patient died 3 days later, and the report from the autopsy revealed that her death was due to septic shock. The blood bags were cultured and the following results were noted. Growth of gram-negative rods on both the BAP and MAC Lactose neg Sucrose pos Citrate neg Indole neg VP neg H2S neg Urea pos motility @ 22°C pos motility @ 37°C neg
Answer
  • Enterobacter cloacae
  • Yersinia enterocolitica
  • Citrobacter freundii
  • Escherichi coli

Question 36

Question
A grossly lipemic specimen needs to be tested for potassium using a direct ISE method. How should the technologist proceed?
Answer
  • do the tests but note on the report that the lipemia will falsely decrease the results
  • airfuge the specimen before analysis
  • perform the testing as usual as lipemia will not affect the results
  • insist that the specimen be re-drawn after the patient has fasted

Question 37

Question
How should a potassium value of 15 mmol/L be interpreted?
Answer
  • it is implausible and requires investigation
  • it is probably due to hemolysis
  • it is probably due to lipemia
  • it is physiologically possible but should be phoned after repeating

Question 38

Question
What is an appropriate disposal method for ammoniacal silver solutions?
Answer
  • boil off the liquid, then dispose the solute into chemical waste
  • allow the solution to dry, then scrape into chemical waste
  • reduce all the silver salts with formaldehyde and then dry the solute before discarding in general waste and pouring the liquid down the drain
  • pour the solution into saturated aqueous sodium chloride and then dispose according to regulations

Question 39

Question
What should be done when a laboratory reporting error is corrected?
Answer
  • the correct result should be called and identified as a corrected report followed by documentation of the call
  • all records of the original report should be discarded
  • the person who made the error and their reason for committing it should be found out before the result is corrected
  • the new result should be called and the nurse asked to discard all records of the original report

Question 40

Question
Which of the following mothers is a candidate for Rh immune globulin?
Answer
  • O pos mother with negative antibody screen; A pos newborn
  • O neg mother with negative antibody screen; A neg newborn
  • A neg mother with positive antibody screen (anti-S); A pos newborn
  • O neg mother with positive antibody screen (anti-D); A pos newborn

Question 41

Question
A standard with a transmission value of 50% and a concentration of 100 g/L is used to estimate an unknown specimen with a transmission value of 75%. What is the concentration of the unknown specimen in g/L?
Answer
  • 55
  • 150
  • 42
  • 67

Question 42

Question
Which of the following methods is the safest and most appropriate for disinfecting a cryostat where adequate ventilation is not available?
Answer
  • formaldehyde vapour
  • hypochlorite solution followed by water
  • glutaraldehyde solution
  • phenolic compound followed by absolute ethanol

Question 43

Question
A single tube of cerebrospinal fluid is received in the laboratory and the following tests are requested: total protein, albumin, IgG quantitation, microbial culture, Gram stain, leukocyte count and differential cell count. Where should the sample tube be sent first?
Answer
  • chemistry for protein analysis and fractionation
  • hematology for leukocyte count and differential cell count
  • aliquot small sample and send a portion to each department
  • microbiology for microbial culture and Gram stain

Question 44

Question
A patient is positive for anti-Fya, anti-Jkb and anti-K. How many units of blood will have to be screened to find two compatible units, given the following antigen frequencies? Fya positive = 60% Jkb positive = 70% K positive = 10%
Answer
  • 24
  • 48
  • 8
  • 18

Question 45

Question
Two levels of QC material and the Westgard 1 2S rule as a warning rule to check the other quality control rules are being used by a technologist. On the same run, one of your QC values is +2.1SD while the other QC value is -2.2SD. What action should be taken on the basis of these QC results?
Answer
  • troubleshoot for systemic error
  • troubleshoot for random error
  • these QC values should be regarded as warnings and the analysis continued
  • both QC values should be repeated and the rules reassessed

Question 46

Question
Which of the following would lead to an inpatient total serum calcium result of less than 1 mmol/L?
Answer
  • the specimen may be contaminated with heparin anticoagulant
  • the patient pumped their fist while the tourniquet was on
  • the tourniquet was likely left on for too long
  • the specimen may be contaminated with EDTA anticoagulant

Question 47

Question
What is the calculated serum osmolality in mOsm/kg given the following serum results? Sodium 145 mmol/L Potassium 4.2 mmol/L Chloride 104 mmol/L Bicarbonate 26 mmol/L Urea 5 mmol/L Glucose 10.3 mmol/L
Answer
  • 160
  • 15
  • 294
  • 305

Question 48

Question
100 values on a healthy population have Gaussian distribution and give the following values: mean 50 IU/L and SD 5 IU/L. Which of the following statement is true about this population?
Image:
46725054-31c1-4258-a61d-8d81d1f46948 (image/jpeg)
Answer
  • 95% had values between 45 and 55 IU/L
  • 97.5% had values > 60 IU/L
  • 5% were not healthy
  • 2.5% had values <40 IU/L

Question 49

Question
Which of the following assays has the poorest precision? Analyte Mean (mmol/L) Standard Deviation Calcium 2.5 0.3 Potassium 4.0 0.4 Sodium 140 4.0 Chloride 100 2.5
Answer
  • Calcium
  • Potassium
  • Sodium
  • Chloride

Question 50

Question
Blood from a newborn has low thyroxine (T4) and elevated TSH compared to reference ranges for that age. These results are most consistent with
Answer
  • congenital hypopituitarism
  • congential primary hypothyroidism
  • congential secondary hypothyroidism
  • a normal response to pregnancy induced changes in maternal thyroid function

Question 51

Question
A pediatric renal transplant patient had a suprapubic urine collection performed. In the lab, a technologist plated the specimen following protocol with a 0.1 mL calibrated loop. At 18 hours there are 8 colonies of a coliform growing on the plate. What colony count would be reported?
Answer
  • 8 X 10^6 CFU/L
  • <10 X 10^4 CFU/L
  • 800,000 CFU/L
  • 80,000 CFU/L

Question 52

Question
Which of the following is/are true about a cryostat
Answer
  • The cryostat is a microtome in a refrigerated cabinet used to cut fixed tissue.
  • Is usually maintained at -35°C
  • Is a potential infection hazard
  • All of the above

Question 53

Question
A technologist did the following to a frozen section of liver. the section was taken through to 70% alcohol, treated with saturated Oil red O in 70% alcohol, rinsed with 70% alcohol, then the nuclei were stained with Harris hematoxylin. The technologist then dehydrated, cleared and mounted the sections in Permount. What results should she see under microscopic observation if unsaturated fats were present in the frozen section.
Answer
  • blue-purple nuclei
  • red lipids, blue-purple nuclei
  • red lipids and cytoplasm, blue-purple nuclei
  • the mounted sections would be unstained

Question 54

Question
You have been asked to freeze a muscle for Muscle Histochemistry. You place isopentane into liquid nitrogen until it has begun to freeze you then place the muscle into the isopentane. The result of your actions are which of the following?
Answer
  • large ice crystal artefacts
  • over frozen tissue
  • properly frozen tissue
  • the tissue is ruined

Question 55

Question
When testing your patient sample, you find all 3 screen cells positive at IAT phase. When an antibody panel is done, all cells except one are positive. The patient auto control is negative. Which of the following is the most likely explanation for this reaction pattern?
Answer
  • antibody to a high-frequency antigen
  • antibody to a low-frequency antigen
  • warm reacting autoantibody
  • cold reacting autoantibody

Question 56

Question
Chem 7, 9, 12, 17, 18, 24, 29, 34, 36, 37, 40, 43, 46, 47, 50 Micro 5, 10, 16, 20, 22, 23, 32, 33, 35, 43, 51 Hem 13, 15, 19, 27, 43 Transfusion 1, 6, 8, 14, 26, 40, 44, 55 AP 2, 3, 21, 25, 28, 30, 38, 42, 52, 53, 54 QC 3, 4, 5, 22, 28, 31, 45, 48, 49 Calculation 13, 17, 26, 40, 44, 47, 48, 49, 51 Situational/Troubleshoot 2, 8, 9, 11, 24, 25, 29, 37, 39, 43 Tricky 1, 16, 17, 28, 30, 36, 40, 49, 51, 52, 53 This is a categorization of all the questions in this quiz. Hopefully, this will give you an idea of which area you may need to focus on (if any).
Answer
  • Blank 1
  • Blank 2
  • Blank 3
  • Blank 4
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