HARR (AMN-GIT-SEM)

Question 1

1. Which of the following statements about
   amniotic fluid bilirubin measured by scanning
   spectrophotometry is true?
   A. The 410-nm peak is due to hemoglobin and the
   450-nm peak is due to bilirubin
   B. Baseline correction is not required if a scanning
   spectrophotometer is used
   C. Chloroform extraction is necessary only when
   meconium is present
   D. In normal amniotic fluid, bilirubin increases
   with gestational age

Answer 1

A

Question 2

2. Which test best correlates with the severity
of HDN?
A. Rh antibody titer of the mother
B. Lecithin/sphingomyelin (L/S) ratio
C. Amniotic fluid bilirubin
D. Urinary estradiol

Answer 2

C

Question 3

3. Which is the reference method for determining
fetal lung maturity?
A. Human placental lactogen
B. L/S ratio
C. Amniotic fluid bilirubin
D. Urinary estriol

Answer 3

B

Question 4

4. Which of the following statements regarding
   the L/S ratio is true?
   A. A ratio of 2:1 or greater usually indicates
   adequate pulmonary surfactant to prevent
   respiratory distress syndrome (RDS)
   B. A ratio of 1.5:1 indicates fetal lung maturity in
   pregnancies associated with diabetes mellitus
   C. Sphingomyelin levels increase during the third
   trimester, causing the L/S ratio to fall slightly
   during the last 2 weeks of gestation
   D. A phosphatidylglycerol (PG) spot indicates the
   presence of meconium in the amniotic fluid

Answer 4

A

Question 5

5. Which of the following conditions is most likely
   to cause a falsely low L/S ratio?
   A. The presence of PG in amniotic fluid
   B. Freezing the specimen for one month at –20°C
   C. Centrifugation at 1,000 × g for 10 minutes
   D. Maternal diabetes mellitus

Answer 5

C

Question 6

6. Which of the following statements accurately
   describes hCG levels in pregnancy?
   A. Levels of hCG rise throughout pregnancy
   B. In ectopic pregnancy, serum hCG doubling time
   is below expected levels
   C. Molar pregnancies are associated with lower
   levels than expected for the time of gestation
   D. hCG returns to nonpregnant levels within
   2 days following delivery, stillbirth, or abortion

Answer 6

B

Question 7

7. Which of the following statements regarding
   pregnancy testing is true?
   A. β Subunits of human chorionic gonadotropin
   (hCG), thyroid-stimulating hormone (TSH),
   and follicle-stimulating hormone (FSH) are
   very similar
   B. Antibodies against the β subunit of hCG
   cross-react with luteinizing hormone (LH)
   C. A false-positive result may occur in patients with
   heterophile antibodies
   D. Serum should not be used for pregnancy tests
   because proteins interfere

Answer 7

C

Question 8

8. SITUATION: A pregnant female was seen by her
   physician who suspected a molar pregnancy. An
   hCG test was ordered and found to be low. The
   sample was diluted 10-fold and the assay was
   repeated. The result was found to be grossly
   elevated. What best explains this situation?
   A. The wrong specimen was diluted
   B. A pipeting error was made in the first analysis
   C. Antigen excess caused a falsely low result in the
   undiluted sample
   D. An inhibitor of the antigen–antibody reaction
   was present in the sample

Answer 8

C

Question 9

9. Most cases of Down syndrome are the result of:
   A. Nondisjunction of an E chromosome (E trisomy)
   B. Nondisjunction of chromosome 21 (G trisomy)
   C. A 14–21 chromosome translocation
   D. Deletion of the long arm of chromosome 21

Answer 9

B

Question 10

10. Which assay result is often approximately 25%
    below the expected level in pregnancies associated
    with Down syndrome?
    A. Serum unconjugated estriol
    B. L/S ratio
    C. Amniotic fluid bilirubin
    D. Urinary chorionic gonadotropin

Answer 10

A

Question 11

11. Which of the following statements about AFP is
    correct?
    A. Maternal serum may be used to screen for open
    neural tube defects
    B. Levels above 4 ng/mL are considered positive
    C. Elevated levels in amniotic fluid are specific for
    spina bifida
    D. AFP levels increase in pregnancies associated
    with Down syndrome

Answer 11

A

Question 12

12. First-trimester screening for Down syndrome can
    be performed using which markers?
    A. Alpha fetoprotein and unconjugated estriol
    B. Free β hCG and pregnancy-associated plasma
    protein A
    C. Intact hCG and dimeric inhibin A
    D. Dimeric inhibin B and α fetoprotein

Answer 12

B

Question 13

13. When performing marker screening tests for
    Down syndrome, why are results expressed in
    multiples of the median (MoM) rather than
    concentration?
    A. Concentration is not normally distributed
    B. MoM normalizes for gestational age
    C. Some tests cannot be reported in mass units
    D. Mean cannot be determined accurately for these
    analytes

Answer 13

B

Question 14

14. Which statement regarding the fetal fibronectin
    test is true?
    A. A positive test is correlated with a low probability
    of delivery within 14 days
    B. The test should not be performed before
    week 24 or after the end of week 34
    C. The test is performed on amniotic fluid
    D. The test is used to identify amniotic fluid after
    rupture of the fetal membranes

Answer 14

B

Question 15

15. What is the term for sperm when the anterior
    portion of the headpiece is smaller than normal?
    A. Azoospermia
    B. Microcephaly
    C. Acrosomal deficiency
    D. Necrozoospermia

Answer 15

C

Question 16

16. What is the most common cause of male
infertility?
A. Mumps
B. Klinefelter’s syndrome
C. Varicocele
D. Malignancy

Answer 16

C

Question 17

17. Which of the following values is the lower
limit of normal for sperm concentration?
A. 15 million per mL
B. 40 million per mL
C. 60 million per mL
D. 100 million per mL

Answer 17

A

Question 18

18. Which morphological abnormality of sperm is
    most often associated with varicocele?
    A. Tapering of the head
    B. Cytoplasmic droplet below the neckpiece
    C. Lengthened neckpiece
    D. Acrosomal deficiency

Answer 18

A

Question 19

19. Which of the following stains is used to determine
sperm viability?
A. Eosin Y
B. Hematoxylin
C. Papanicolaou
D. Methylene blue

Answer 19

A

Question 20

20. Which of the following semen analysis results is
    abnormal?
    A. Volume 1.0 mL
    B. Liquefaction 40 minutes at room temperature
    C. pH 7.6
    D. Motility 50% progressive movement

Answer 20

A

Question 21

21. Which of the following sample collection and
    processing conditions will lead to inaccurate
    seminal fluid analysis results?
    A. Sample stored at room temperature for 1 hour
    before testing
    B. Sample collected following coitus
    C. Sample collected without an anticoagulant
    D. Sample collected without use of a condom

Answer 21

B

Question 22

22. When performing a seminal fluid analysis, what is
the upper limit of normal for WBCs?
A. 1 × 106/mL
B. 5 × 106/mL
C. 10 × 106/mL
D. 20 × 106/mL

Answer 22

A

Question 23

23. Which carbohydrate measurement is clinically
    useful when performing a seminal fluid analysis?
    A. Glucose
    B. Galactose
    C. Fructose
    D. Maltose

Answer 23

C

Question 24

24. Which condition is most often associated with
gastric ulcers?
A. Cancer of the stomach
B. H. pylori infection
C. Zollinger–Ellison (Z–E) syndrome
D. Pernicious anemia

Answer 24

B

Question 25

``` 25. In which condition is the highest level of serum gastrin usually seen? A. Atrophic gastritis B. Pernicious anemia C. Z–E syndrome D. Cancer of the stomach ```

Answer 25

C

Question 26

``` 26. In determining free HCl, the gastric fluid is titrated to pH ___. A. 6.5 B. 4.5 C. 3.5 D. 2.0 ```

Answer 26

C

Question 27

``` 27. Which test can identify persons with gastrinsecreting tumors who do not demonstrate a definitively increased plasma gastrin concentration? A. Secretin stimulation B. Pentagastrin C. Cholecystokinin–pancreozymin D. Trypsinogen ```

Answer 27

A

Question 28

``` 28. Which of the following tests would be normal in pancreatic insufficiency? A. Secretin stimulation B. D-Xylose absorption C. Twenty-four-hour fecal fat D. β Carotene absorption ```

Answer 28

B

Question 29

``` 29. Which of the following is commonly associated with occult blood? A. Colon cancer B. Atrophic gastritis C. Pernicious anemia D. Pancreatitis ```

Answer 29

A

Question 30

``` 30. Which test is most sensitive in detecting persons with chronic pancreatitis? A. Fecal trypsin B. Fecal chymotrypsin C. Fecal elastin-1 D. Plasma lipase ```

Answer 30

C