MCQs

Question 1

1. Which of the following describes the chemical characteristic of an antibody?
   a. carbohydrate
   b. lipid
   c. protein
   d. electrolyte
   e. ligand

Answer 1

c. protein

Question 2

2. An ELISA can be characterized as a:
   a. homogenous competitive binding immunoassay
   b. heterogenous competitive binding immunoassay
   c. heterogenous immunometric assay
   d. homogenous immunometric assay

Answer 2

c. heterogenous immunometric assay

Question 3

3. Heterophilic antibody interferences with immunoassays can occur when:
   a. patients have received antibody-based imaging reagents
   b. patients are exposed to mouse antigens by having mice in their living space
   c. patients have been given mouse monoclonal antibody-derived therapeutic agents
   d. all of the above

Answer 3

d. all of the above

Question 4

4. In quantitative immunoassays the single most important factor responsible for success or failure is:
   a. specificity
   b. affinity
   c. titer
   d. monoclonal property
   e. antibody absorption

Answer 4

a. specificity

Question 5

5. Substances that are known to interfere with immunoassays are
   a. compounds that are chemically similar to the antigen
   b. sample matrix
   c. heterophile antibodies that react with the reagent antibody
   d. hemoglobin
   e. all of the above

Answer 5

e. all of the above

Question 6

6. A heterogeneous, competitive binding immunoassay requires all of these except
   a. labelled antigen
   b. separation of the bound label
   c. excess antibody
   d. a large antigen with multiple binding sites

Answer 6

d. a large antigen with multiple binding sites

Question 7

7. Which of the following is not an effective countermeasure to investigate
   the presence of a human anti-mouse antibody
   a. add mouse IgG
   b. dilute the sample
   c. check other laboratory tests for medical consistency of the result
   d. use an alternative vendor for the assay
   e. increase the incubation time for the assay

Answer 7

e. increase the incubation time for the assay

Question 8

8. What is the definition of point-of-care testing?
   a. Testing conducted close to the site of patient care
   b. Bedside testing
   c. Portable testing in an ambulance or helicopter
   d. All of the above

Answer 8

d. All of the above

Question 9

9. What are the advantages of POCT?
   a. Larger sample
   b. Faster turnaround time for test results
   c. Less expensive than core lab testing
   d. More precise than core lab instrumentation

Answer 9

b. Faster turnaround time for test results

Question 10

10. Which of the following are true?
    a. POCT results can lead to wrong treatment, and care should be taken to guarantee quality.
    b. POCT devices are so simple that they pose no risk to the patient if incorrectly performed or a wrong answer is generated.
    c. POCT results are used only for screening patients, and results are always confirmed by a lab method.
    d. Clinicians can purchase POCT devices from a local pharmacy without having to comply with laboratory regulations if the tests are used only on their own patients in an office practice.

Answer 10

a. POCT results can lead to wrong treatment, and care should be taken to guarantee quality.

Question 11

11. Limitations of POCT devices include which of the following?
    a. Ability of physicians to rapidly treat patients
    b. Environmental and drug interferences with rapid methods
    c. Ease of use and training of the operator
    d. Small sample volumes

Answer 11

b. Environmental and drug interferences with rapid methods

Question 12

12. What are examples of quality improvement performance monitors for point of-
    care testing?
    a. documentation of quality control (QC)
    b. expired reagents and QC/reagent bottles and kits dated appropriately
    c. temperature checks for storage of point-of-care reagents, QC, and
    devices
    d. handling changes in lots for QC and reagents according to manufacturer
    recommendations
    e. all of the above

Answer 12

e. all of the above

Question 13

13. Which of the following proteins is a protease inhibitor?
    a. C-reactive protein
    b. alpha 1 antitrypsin
    c. Transferrin
    d. Haptoglobin
    e. Fibrinogen

Answer 13

b. alpha 1 antitrypsin

Question 14

14. Which of the following is a negative acute-phase protein?
    a. alpha 1 antitrypsin
    b. Haptoglobin
    c. Ceruloplasmin
    d. Orosomucoid
    e. None of the above

Answer 14

e. None of the above

Question 15

15. Which of the following is associated with “beta-gamma” bridging?
    a. Multiple myeloma
    b. Malignancy
    c. Hepatic cirrhosis
    d. Rheumatoid arthritis

Answer 15

c. Hepatic cirrhosis

Question 16

16. Hypoproteinemia would be found in cases of
    a. Multiple myeloma
    b. Dehydration
    c. Vomiting
    d. Nephrotic syndrome

Answer 16

d. Nephrotic syndrome

Question 17

17. Prealbumin found in lower level in :
    a. Liver disease.
    b. Nephrotic syndrome.
    c. Malnutrition.
    d. All of the above.

Answer 17

d. All of the above.

Question 18

18. Which one of the following assays is least helpful in diagnosing Cushing syndrome?
    a. Cortisol following 1 mg of dexamethasone given the previous evening
    b. Cortisol drawn at midnight
    c. 24-hour urine-free cortisol
    d. a.m. cortisol

Answer 18

d. a.m. cortisol

Question 19

19. Which one of the following plasma assays is most helpful in diagnosing pheochromocytoma?
    a. Total catecholamines
    b. Plasma free metanephrines
    c. Epinephrine
    d. Norepinephrine
    e. Dopamine

Answer 19

b. Plasma free metanephrines

Question 20

20. A hyperpigmented patient presents with hypotension, hypoglycemia, hyponatremia, hyperkalemia, and acidosis. What is the most likely diagnosis?
    a. Cortisol resistance
    b. Addison disease
    c. Isolated mineralocorticoid deficiency
    d. ACTH deficiency
    e. Apparent mineralocorticoid excess

Answer 20

b. Addison disease

Question 21

22. What is the cause of icteric interference?
    a. urea
    b. albumin
    c. bilirubin
    d. immunoglobulin

Answer 21

c. bilirubin

Question 22

21. What is the source of hemolytic interference?
    a. white blood cells
    b. red blood cells
    c. platelets
    d. plasma

Answer 22

b. red blood cells

Question 23

23. Which of the following is a primary cause of lipemic interference?
    a. HDL
    b. IDL
    c. LDL
    d. VLDL

Answer 23

d. VLDL

Question 24

24. Which samples are likely to require ultracentrifugation?
    a. icteric samples
    b. haemolytic samples
    c. lipemic samples
    d. all of the above

Answer 24

c. lipemic samples