LEGEND - CC Flashcards by Marielle Tristine

On day 1, Level 1 control is at +3.2SD, and Level 2 is at +0.5SD. Which Westgard rule is violated and what is the most likely error?

A. 41s violation; gradual trend
B. 10x violation: persistent bias
C. 22s violation: systematic bias
D. 13s violation: outlier presence

D. 13s violation: outlier presence

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What parameter usually determines the acceptable range when referring to quality control results?

A. The mean value.
B. The range that includes 50% of QC values.
C. The central 60% of values.
D. The 95% confidence interval for the mean.

D. The 95% confidence interval for the mean.

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Which of the following best describes precision?

A. It is a measure of method accuracy.
B. It is a measure of method variability.
C. It is a measure of random variability.
D. It is a measure of a system’s degree of freedom from errors.

B. It is a measure of method variability.

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A medical technologist observes that a patient with obstructive biliary disease has elevated levels of lipoproteins rich in lipids, primarily unesterified cholesterol and phospholipids. Identify the abnormal lipoprotein.

A. Chylomicrons
B. VLDL
C. Lp(a)
D. LpX

D. LpX

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A patient is being evaluated for potential lead poisoning. Blood is drawn in a tan-stoppered plastic tube. What is the anticoagulant and its mechanism?

A. Sodium heparin; inhibits thrombin formation
B. K2EDTA; chelates calcium
C. Sodium citrate; chelates calcium
D. Lithium heparin; inhibits thrombin formation

B. K2EDTA; chelates calcium

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A medical technologist is performing a Modified Allen Test before an arterial puncture. The patient makes a fist, and both the radial and ulnar arteries are occluded. The patient releases the fist and the palm remains blanched. What is the correct interpretation and next step?

A. Test is positive; proceed with the radial artery puncture.
B. Test is negative; select a different site for the puncture.
C. Test is positive; use the ulnar artery for the puncture.
D. Test is negative; proceed with the radial artery puncture with caution.

B. Test is negative; select a different site for the puncture.

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A laboratory is validating a new method for albumin measurement. Which dye-binding method is considered most specific, sensitive, and precise?

A. Methyl orange
B. HABA
C. BCG (Bromcresol green)
D. BCP (Bromcresol purple)

D. BCP (Bromcresol purple)

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Which enzyme is commonly used as a marker for liver disease?

A. Amylase
B. Creatine kinase
C. Alanine aminotransferase
D. Lactate dehydrogenase

C. Alanine aminotransferase

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What type of blood specimen is most commonly used for clinical chemistry assays?

A. Whole blood
B. Plasma with anticoagulant
C. Serum
D. Capillary blood

C. Serum

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The preferred vein for venipuncture is:

A. Basilic vein
B. Cephalic vein
C. Median cubital vein
D. Femoral vein

C. Median cubital vein

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Which anticoagulant is used in lavender top tubes?

A. Heparin
B. Sodium citrate
C. EDTA
D. Sodium fluoride

C. EDTA

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LDH isoenzymes elevated in a “flipped” pattern often indicate:

A. Myocardial infarction
B. Pancreatitis
C. Viral hepatitis
D. Renal failure

A. Myocardial infarction

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Which form of bilirubin is non-polar and water insoluble?

A. Conjugated bilirubin
B. Hemobilirubin
C. Indirect bilirubin
D. Both B and C

D. Both B and C

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A certain procedure is classified as a waived test. What does this classification mean?

A. It is a high-complexity test requiring formal education in laboratory science.
B. It is a moderate-complexity test that is difficult to perform.
C. It is a test with the lowest level of regulation and care that does not require special training.
D. It is a test that requires sophisticated instrumentation and significant operator skill.

C. It is a test with the lowest level of regulation and care that does not require special training.

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A patient is undergoing an arterial blood draw for blood gas analysis. Why is a syringe preferred over an evacuated tube?

A. Because a tourniquet cannot be used.
B. To prevent the blood from clotting.
C. To remove any air trapped within the barrel.
D. Because of the pressure in an arterial blood vessel.

D. Because of the pressure in an arterial blood vessel.

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A total protein assay forms a violet-colored chelate between Cu²⁺ ions and peptide bonds. What method is described?

A. Kjeldahl method
B. Lowry method
C. Biuret method
D. Refractometry

C. Biuret method

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During serum protein electrophoresis in a patient with emphysema, a specific band is absent. What protein and band are missing?

A. Albumin; Albumin band
B. Alpha-1-fetoprotein; Alpha-1-globulin band
C. Alpha-1-antitrypsin; Alpha-1-globulin band
D. Haptoglobin; Alpha-2-globulin band

B. Alpha-1-fetoprotein; Alpha-1-globulin band

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Two consecutive control values exceed 2SD on the same side of the mean on a Levey-Jennings chart. What does this indicate?

A. Random; 1₃s violation
B. Random; 1₂s violation
C. Systematic; 2₂s violation
D. Systematic; 1₂s violation

C. Systematic; 2₂s violation

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A physician is assessing a patient’s risk of cardiovascular disease. Which test should be requested?

A. HsCRP test
B. Iron test
C. Copper test
D. Serum electrophoresis

A. HsCRP test

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What magnesium-dependent enzyme is inhibited by the additive in a gray-stoppered tube?

A. Phosphofructokinase
B. Hexokinase
C. Pyruvate kinase
D. Enolase

D. Enolase

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What anticoagulant is present in a black-stoppered tube and what is its primary purpose?

A. Sodium citrate; coagulation
B. K2EDTA; blood bank
C. Sodium citrate; sedimentation rates
D. Lithium heparin; chemistry

C. Sodium citrate; sedimentation rates

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A laboratory is establishing a new reference interval. What is the minimum number of study individuals required?

A. As few as 20
B. 10 to 40
C. 120 to 700
D. 700 or more

C. 120 to 700

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A physician orders tests to evaluate nutritional status. Which protein should be measured and what condition increases it?

A. Albumin; dehydration
B. Transthyretin; renal failure
C. A1AT; inflammation
D. CRP; acute infection

B. Transthyretin; renal failure

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A painful deep-vein venipuncture caused tingling in the patient’s hand. Which vein was likely punctured and why is it risky?

A. Cephalic vein; proximity to the brachial artery
B. Median cubital vein; tendency to roll
C. Basilic vein; near the median nerve and brachial artery
D. Femoral artery; used only by physicians

C. Basilic vein; near the median nerve and brachial artery

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Which protein is regarded as the indicator of congestive heart failure? A. Haptoglobin B. NMP C. BNP D. Ferritin

C. BNP

What is the main characteristic of a “STAT” collection order? A. It is collected and analyzed as soon as possible. B. It is typically a routine specimen. C. It is given the highest priority. D. It is delivered to the lab within 45 minutes.

C. It is given the highest priority.

What is the normal range for a centrifuge's speed, beyond which excessive heat buildup can occur due to increased air friction? A. 1,000 to 2,000 × g RCF B. Up to 3000 RPM C. 5,000 RPM D. 10,000 RPM

B. Up to 3000 RPM

A laboratory uses a pipet with graduation marks that end above the tip and drains by gravity. What type of pipet is described? A. Serologic B. Ostwald-Folin C. Mohr D. Volumetric

C. Mohr

Which type of reagent grade chemical has specifications established by the American Chemical Society (ACS) and is suitable for most analytical procedures? A. Technical or Commercial Grade B. United States Pharmacopoeia (USP) Grade C. Chemically pure (CP) or Pure Grade Chemicals D. Analytic Grade

D. Analytic Grade

In the context of the CLSI order of draw, what is the correct sequence of tubes to be drawn? A. Coagulation tube, serum tube, sterile tube B. Sterile tube, coagulation tube, serum tube C. Serum tube, heparin tube, EDTA tube D. Heparin tube, EDTA tube, glycolytic inhibitor tube

B. Sterile tube, coagulation tube, serum tube

Which of the following statements about a TC pipet is correct? A. It is designed to contain and at the same time dispense the exact volume indicated. B. It holds a particular volume but does not dispense that exact volume. C. It has a continuous etched ring near the top. D. It is always a self-draining pipet.

B. It holds a particular volume but does not dispense that exact volume.

Which type of centrifuge is used to separate layers of different specific gravities, such as lipoproteins? A. Horizontal or swinging bucket B. Fixed angle or angle head C. Ultracentrifuges D. Microcentrifuges

C. Ultracentrifuges

A patient's blood sample is hemolyzed. Which of the following analytes is likely to show a false increase? A. Albumin B. Cholesterol C. Glucose D. Potassium

D. Potassium

Which of the following analytes is anticipated to exhibit a diurnal variation, with its levels being lower in the evening? A. ACTH B. Growth hormone C. Acid phosphatases D. Prolactin

A. ACTH

What is the standard gauge for routine venipuncture in adults? A. 20 B. 21 C. 22 D. 23

B. 21

A patient is suspected of having colon cancer that produces an abnormal ALP isoenzyme. Which isoenzyme is mostly associated with this case? A. CK-MI B. Macro-CK C. Regan isoenzyme D. Nagao isoenzyme

C. Regan isoenzyme

Which of the following enzymes is considered a more specific and sensitive screening test for post-transfusion hepatitis? A. AST B. ALT C. ALP D. GGT

B. ALT

In the context of liver anatomy, which structure is a capillary-like blood vessel where blood from the hepatic artery and hepatic vein mix? A. Common hepatic duct B. Glisson's capsule C. Sinusoids D. Canaliculi

C. Sinusoids

In the Jendrassik-Grof method for bilirubin assay, what substance is added to convert the original purple color into blue for spectrophotometric measurement? A. Sulfanilic acid B. Sodium acetate C. Strong alkaline tartrate D. Hydrochloric acid

C. Strong alkaline tartrate

A patient is suspected of having acute pancreatitis. An enzyme rises within 4–8 hours, peaks at 24 hours, and remains elevated for 5 days to 2 weeks. Which enzyme is tested? A. Amylase B. Lipase C. AST D. ALT

B. Lipase

A medical technologist measures prothrombin time to evaluate liver synthetic ability. What is the recommended dosage for Vitamin K administration? A. 5 mg per day for 1–3 days B. 10 mg per day for 1–3 days C. 2 mg per day for 1–3 days D. 10 mg as a single dose

B. 10 mg per day for 1–3 days

A patient is monitored for a tumor marker associated with medullary thyroid cancer. Which tumor marker is this? A. AFP B. CA 125 C. Calcitonin D. CEA

C. Calcitonin

A patient with inherited unconjugated hyperbilirubinemia presents with bilirubin level of 2.5 mg/dL. What liver function alteration is described? A. Dubin-Johnson Syndrome B. Rotor Syndrome C. Gilbert Syndrome D. Crigler-Najjar Syndrome

C. Gilbert Syndrome

What medication is a common cause of potassium loss due to its inhibitory effect on the Na-K-ATPase pump? A. Aspirin B. Digoxin C. Chloramphenicol D. Insulin

B. Digoxin

In preparing a sample for a urobilinogen test, what reagent produces a red color? A. p-dimethylaminobenzaldehyde B. Sulfanilic acid C. Sodium nitrite D. Hydrochloric acid

A. p-dimethylaminobenzaldehyde

What red cell component causes false CK elevation when a hemolyzed sample is assayed? A. Myoglobin B. Hemoglobin C. Adenylate kinase D. Bilirubin

C. Adenylate kinase

A physician suspects bile duct carcinoma. Which abnormal ALP isoenzyme is most likely observed? A. Regan B. Kasahara C. Nagao D. CK-MB

C. Nagao

A patient with suspected adrenal gland tumor shows increased total metanephrines using the PISANO method. What condition is described? A. Adrenal insufficiency B. Pheochromocytoma C. Neuroblastoma D. Carcinoid tumor

B. Pheochromocytoma

Primary hyperaldosteronism is also known as: A. Cushing's syndrome B. Addison's disease C. Waterhouse-Friedrichsen Syndrome D. Conn's disease

D. Conn's disease

A child has a defect in the UDPGT enzyme gene and is treated with phototherapy. Which condition most closely resembles this scenario? A. Crigler-Najjar Syndrome Type II B. Crigler-Najjar Syndrome Type I C. Physiologic jaundice of the newborn D. Gilbert Syndrome

A. Crigler-Najjar Syndrome Type II

Which of the following is considered an inorganic cofactor needed for maximal enzyme activity? A. Apoenzyme B. Coenzyme C. Holoenzyme D. Cations and anions

D. Cations and anions

What method for measuring enzymatic activity involves making multiple measurements of absorbance change at specific time intervals? A. Continuous monitoring assay B. Fixed time assay C. Coupled enzymatic assay D. Colorimetric assay

A. Continuous monitoring assay

Which of the following conditions is characterized by a rise in AST and ALT, with ALT levels typically being higher than AST? A. Hepatic cirrhosis B. Acute hepatocellular injury C. Alcohol-induced liver disease D. Viral hepatitis

D. Viral hepatitis

Which buffer system is crucial for regulating blood pH and involves the interrelationship between the lungs and kidneys? A. Ammonia-Ammonium Buffer System B. Phosphate Buffer System C. Protein Buffer System D. Bicarbonate-Carbonic Acid Buffer System

D. Bicarbonate-Carbonic Acid Buffer System

What is the main action of vasopressin produced by the pituitary gland? A. Milk production B. Production of insulin growth factor-1 C. Stimulation of adrenocortical steroid secretion D. Water reabsorption and elevation of blood pressure

D. Water reabsorption and elevation of blood pressure

A child aged 8 develops non-inflammatory encephalopathy and fatty degeneration of the liver following a viral infection. This condition is strongly associated with the intake of what substance? A. Acetaminophen B. Salicylate C. Ibuprofen D. Antibiotics

B. Salicylate

The absence of urobilinogen in both urine and stool is a clinical finding that can be caused by what condition? A. Hemolytic anemia B. Post-hepatic jaundice C. Gilbert syndrome D. Crigler-Najjar syndrome

B. Post-hepatic jaundice

What are the primary tissue sources of amylase? A. Pancreas and salivary glands B. Liver and kidney C. Brain and nerve endings D. Heart and skeletal muscle

A. Pancreas and salivary glands

In the determination of potassium using flame emission photometry, when the electrolyte is exposed to the flame, it emits what characteristic color? A. Yellow B. Colorless C. Red D. Lilac

D. Lilac

The Malloy-Evelyn method for bilirubin determination utilizes which solubilizer? A. Caffeine sodium benzoate B. Sodium acetate C. Ascorbic acid D. 50% methanol

D. 50% methanol

A patient’s blood gas analysis results are as follows: pH 7.56; pCO₂ 25 mmHg; pO₂ 100 mmHg; HCO₃⁻ 22 mmol/L. Which medical condition is most likely responsible for these findings? A. Hypokalemia B. Prolonged storage C. Improper specimen collection D. Hyperventilation

D. Hyperventilation

In a state of uncompensated metabolic acidosis, which of the following laboratory parameters is observed to be within the normal range? A. pCO₂ B. HCO₃⁻ C. pH D. Total CO₂

A. pCO₂

A patient presents with elevated serum T3 and free T4 levels while TSH remains undetectable. What is the most probable cause? A. Primary hyperthyroidism B. Secondary hyperthyroidism C. Euthyroid with increased thyroxine-binding proteins D. Euthyroid sick syndrome

A. Primary hyperthyroidism

Which statement accurately describes a base? A. Substance that can yield hydrogen ion when dissolved in water decreasing pH. B. Substance that can yield hydroxyl ion when dissolved in water increasing pH. C. Substance that can yield hydrogen ion when dissolved in water increasing pH. D. Substance that can yield hydroxyl ion when dissolved in water decreasing pH.

B. Substance that can yield hydroxyl ion when dissolved in water increasing pH.

Which chemical inhibits placental alkaline phosphatase (ALP)? A. L-phenylalanine B. Levamisole C. L-homoarginine D. L-leucine

A. L-phenylalanine

Cushing’s syndrome is characterized by: A. Hyperaldosteronism B. Hypoaldosteronism C. Hypercortisolism D. Hypocortisolism

C. Hypercortisolism

What is the diagnostic marker for urinary bladder carcinoma? A. NMP B. BRCA-1 C. CA-125 D. CA-15-3

A. NMP

The “pink puffers” medical terminology refers to which specific clinical condition? A. Emphysema B. Chronic bronchitis C. Chronic asthma D. Rhinitis

A. Emphysema

A lipemic sample is observable when serum triglyceride levels exceed what specific value? A. 4.6 mmol/L B. 300 mg/dL C. 3.6 mmol/L D. 200 mg/dL

A. 4.6 mmol/L

Serotonin and melatonin are hormones produced by: A. Pineal gland B. Adrenal cortex C. Adrenal medulla D. Thyroid

A. Pineal gland

What is the single most important factor to consider in TDM? A. Type of specimen B. Timing of specimen C. Medical history of patients D. Drug concentration

B. Timing of specimen

In stages of ethanol impairment, mild euphoria with diminished inhibitions and some motor skill impairment occurs at what blood alcohol level? A. 0.01–0.05% B. 0.03–0.12% C. 0.18–0.30% D. 0.27–0.40%

B. 0.03–0.12%

What is the standard, statistically sound process to determine the initial mean and standard deviation for a new lot of control material? A. Use the mean and SD provided on the manufacturer’s assay sheet. B. Run the control material 10 times on the instrument. C. Run the control material at least 20 times over a period of 1 month and calculate statistics. D. Use the mean and SD from the proficiency testing (EQA) results of the previous lot.

C. Run the control material at least 20 times over a period of 1 month and calculate statistics.

Which of the following statements incorrectly describes hemolytic anemia in the context of hyperbilirubinemia? A. Red blood cell destruction is excessive causing unconjugated hyperbilirubinemia. B. All unconjugated bilirubin delivered into the hepatocyte are conjugated since liver conjugation is normal. C. Conjugated bilirubin is normal since there is no problem in excretion through bile canaliculi. D. There is increased urobilinogen in urine because of excessive red blood cell breakdown.

B. All unconjugated bilirubin delivered into the hepatocyte are conjugated since liver conjugation is normal.

Which of the following is NOT a result of angiotensin II formation? A. ADH is secreted from the anterior pituitary gland to increase water retention by decreasing urine output. B. Sympathetic activity is increased by stimulating thirst mechanism. C. Arteriolar vasoconstriction is stimulated to increase blood pressure. D. Sodium and chloride are reabsorbed in distal convoluted tubules and collecting ducts in response to potassium excretion.

A. ADH is secreted from the anterior pituitary gland to increase water retention by decreasing urine output.

A clinically significant hyponatremia is observed in which of the following plasma sodium concentrations? A. 129 mmol/L B. 131 mmol/L C. 134 mmol/L D. 148 mmol/L

A. 129 mmol/L

Which disorder is characterized by increased chloride production in sweat and what is the expected sweat chloride level? A. Hypoparathyroidism; >108 mmol/L B. Multiple myeloma; >150 mmol/L C. Cystic fibrosis; >60 mmol/L D. Wilson’s disease; >7.0 mmol/L

C. Cystic fibrosis; >60 mmol/L

In which condition would hypochloremia be expected? A. Respiratory alkalosis B. Metabolic acidosis C. Metabolic alkalosis D. Respiratory acidosis

C. Metabolic alkalosis

In the colorimetric method for chloride determination, which is displaced by chloride to produce a chromophore with ferric ions? A. Thiocyanate B. Mercury C. Ferric ions D. Potassium

A. Thiocyanate

Which method is employed for screening drugs of abuse? A. Immunoassays B. Gas Chromatography–Mass Spectrophotometry C. Differential spectrophotometry D. All of the above

A. Immunoassays

Which analyte(s) will produce a decrease in concentration at 11:00 PM? I. Aldosterone II. Prolactin III. ACTH IV. Insulin A. Only 1 option is correct B. 2 options are correct C. 3 options are correct D. All are correct

C. 3 options are correct

What reference material is regarded as the “primary standard” in a clinical chemistry laboratory? A. Secondary standard B. Ultrapure chemical C. Primary standard D. Standard Reference Material

D. Standard Reference Material

Which water classification is known as “autoclave wash water”? A. Type I B. Type II C. Type III D. Type IV

C. Type III

Centrifuges are required to be calibrated every: A. 6 weeks B. 12 months C. 4 months D. Month

B. 12 months

A green-colored solution is best absorbed at which specific wavelength? A. 580 nm B. 440 nm C. 650 nm D. 590 nm

C. 650 nm

What will be the absorbance of a 0.45 M solution with a 1 cm path length and a molar absorptivity of 0.32? A. 0.11 B. 0.13 C. 0.14 D. 0.16

C. 0.14

Which component of a spectrophotometer determines spectral purity? A. Exit slit B. Photodetector C. Light source D. Entrance slit

A. Exit slit

Which light source is commonly used for the UV region in spectrophotometric analysis? A. Incandescent tungsten lamp B. Hollow-cathode lamp C. Mercury arc lamp D. Tungsten-iodide lamp

C. Mercury arc lamp

What is the reference method for the determination of calcium and magnesium? A. FEP B. Electrochemistry C. HPLC D. AAS

D. AAS

In serum protein electrophoresis, which support medium is commonly employed for albumin and globulin separation? A. Filter paper B. Agarose C. Cellulose acetate D. Polyacrylamide

C. Cellulose acetate

Dengue IgM test results: True positive: 120/150; False positive: 8/400; False negative: 30/150; True negative: 392/400. What is the diagnostic specificity? A. 98% B. 97% C. 90% D. 95%

B. 97%

QC values for cholesterol were obtained (10 days). What is the mean of the given set of data? Day 1: 1.098 | Day 2: 1.087 | Day 3: 1.088 | Day 4: 1.056 | Day 5: 1.055 Day 6: 1.089 | Day 7: 1.045 | Day 8: 1.077 | Day 9: 1.088 | Day 10: 1.032 A. 1.02 B. 1.06 C. 1.08 D. None of the given options

C. 1.08

QC values for cholesterol were obtained (10 days). What is the standard deviation of the given set of data? A. 0.0232 B. 0.012 C. 0.034 D. None of the given options

A. 0.0232

Which autoantibody is present in adult patients with Type 1 diabetes mellitus? A. Anti-islet cell cytoplasmic antibody B. Insulin autoantibody C. Anti-glutamic acid decarboxylase antibody D. All of the given choices

C. Anti-glutamic acid decarboxylase antibody

What condition is described when total protein is high while albumin is low? A. Hepatic cirrhosis B. Nephrotic syndrome C. Multiple myeloma D. Glomerulonephritis

C. Multiple myeloma

Based on WHO OGTT procedure, which statement is incorrect? A. 61.25 g glucose load is given to a 35 kg 9-year-old male patient. B. Pregnant women with no risk factors for type 2 diabetes mellitus should be screened between 14-and 18-weeks’s gestation. C. Pregnant women with risk factors should be screened at initial prenatal visit. D. 75 g glucose load is the standard used in WHO routine OGTT procedure.

B. Pregnant women with no risk factors for type 2 diabetes mellitus should be screened between 14-and 18-weeks’s gestation.

Which glycogen storage disease is a sex-linked disorder characterized by deficiency of phosphofructokinase in the liver? A. Type I B. Type V C. Type VII D. Type VIII

D. Type VIII

What is the major apolipoprotein found on the surface of HDL that is also an LCAT activator? A. Apo A-I B. Apo A-II C. Apo C-II D. Apo B-100

A. Apo A-I

The sinking pre-beta lipoprotein that is thrombotic: A. LpX B. Beta-VLDL C. Lp(a) D. Chylomicron

C. Lp(a)

Which method is considered more specific than the Jaffe reaction for creatinine determination? A. Jaffe with adsorbent B. Creatininase–Hydrogen peroxide C. Creatininase–Creatine kinase D. IDMS

B. Creatininase–Hydrogen peroxide

LEGEND - CC Flashcards

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