1
Q
A
2
Q
CHAPTER 1
Which of the following lamps provides a continuous spectrum of radiant energy in the visible, near IR, and near UV regions of the spectrum:
- tungsten-filament
- hydrogen
- deuterium
- mercury vapor
A
1 - tungsten-filament
3
Q
Which of the following isolates light within a narrow region of the spectrum:
- photomultiplier tube
- monochromator
- photovoltaic cell
- detector
A
2 - monochromator
4
Q
Which of the following is not descriptive of a photomultiplier tube:
- emits electrons proportionally to initial light absorbed
- must be shielded from stray light
- cannot be used with a chopper
- amplifies the initial signal received
A
3 - cannot be used with a chopper
5
Q
Which of the following is false about a photomultiplier tube:
- converts radiant energy (light) to electrical energy (current)
- amplifies the current significantly
- has a very rapid response time
- is composed of an iron plate and a layer of selenium
A
4 - is composed of an iron plate and a layer of selenium
6
Q
Which type of photodetector employs a linear arrngement that allows it to respond to a specific wavelength resulting in complete UV/visible spectrum analysis:
- photomultiplier tube
- phototube
- barrier layer cell
- photodiode array
A
4 - photodiode array
7
Q
When performing spectrophotometer quality assurance checks, what is the holmium oxide glass filter used to assess:
- linearity
- stray light
- absorbance accuracy
- wavelength accuracy
A
4 - wavelength accuracy
8
Q
In spectrophotometric analysis, what is the purpose of the reagent blank:
- correct for interfering chromogens
- correct for lipemia
- correct for protein
- correct for color contribution of the reagents
A
4 - correct for color contribution of the reagents
9
Q
In regard to bichromatic analysis, which of the following is false:
- absorbance is measured at the spectral absorbance peak for a blank and the sample using the same wavelength
- eliminates background interferences
- sample concentration determined from difference in two measured absorbances
- functions as a reference blank for each sample
A
1 - absorbance is measured at the spectral absorbance peak for a blank and the sample using the same wavelength
10
Q
The bandpass of a spectrophotometer is 10nm. If an instrument is set at 540 nm, the wavelength that are permitted to impinge on the sample will be within what wavelength range:
- 530-540 nm
- 530-550 nm
- 535-545 nm
- 540-550 nm
A
3 - 535-545 nm
11
Q
Which of the following is not a problem inherent in turbidemetry:
- variation in particle size of samples
- variation in particle size of standards
- rate of aggregation or settling of particles
- need to maintain a constant and specific temperature
A
4 - need to maintain a constant and specific temperature
12
Q
Which of the following may be associated with reflectance spectrophotometry as it relates to the dry reagent slide technique:
- light projected to the slide at 180 degree angle
- dye concentration directly proportional to reflectance
- unabsorbed, reflected light detected by photodetector
- reflectance values are linearly proportional to transmission values
A
3 - unabsorbed, reflected light detected by photodetector
13
Q
Fluorometers are designed so that the path of the exciting light is at a right angler to the path of the emitted light. What is the purporse of this design:
- prevent loss of emitted light
- prevent loss of the excitation light
- focus emitted and excitation light upon the detector
- prevent excitation light from reaching the detector
A
4 - prevent excitation light from reaching the detector
14
Q
Which of the following represents a primary advantage of performing fluorometric over absorption spectroscopic methods of analysis:
- increased specificity and increased sensitivity
- increased specificity and decreased sensitivity
- purity of reagents used not as critical
- ease of performing assays
A
1 - increased specificity and increased sensitivity
15
Q
Which of the following may be associated with bioluminescence:
- light emission produced due to enzymatic oxydation of a substrate
- less sensitive than direct fluorescent assays
- electron excitation caused by radiant energy
- employs a radioactve label
A
1 - light emission produced due to enzymatic oxydation of a substrate
16
Q
Nephelometry is based on the measurement of light that is:
- absorbed by particles in suspension
- scattered by particles in suspension
- produced by fluorescence
- produced by excitation of ground-state atoms
A
2 - scattered by particles in suspension
17
Q
Which of the following instruments is used in the clinical laboratory or in reference laboratories to detect beta and gamma emissions:
- fluorometer
- nephelometer
- scintillation counter
- spectrophotometer
A
3 - scintillation counter
18
Q
Which of the following best describes chemiluminescence:
- electron excitation caused by radiant energy
- enzymatic oxidation of a substrate produces light emission
- chemical energy excites electrons that emit light upon return to ground state
- employs a fluorescent label that produces light
A
3 - chemical energy excites electrons that emit light upon return to ground state
19
Q
In assaying an analyte with a single-beam atomic absorption spectrophotometer, what is the instrument actually measuring:
- intensity of light emitted by teh analyte on its return to the ground state
- intesnity of light that the analyte absorbs from the hollow-cathode lamp
- intensity of light that the analyte absorbs from the flame
- intensity of the beam from the hollow-cathode lamp after it has passed through the analyte-containing flame
A
4 - intensity of the beam from the hollow-cathode lamp after it has passed through the analyte-containing flame
20
Q
What is the function of the flame in atomic absorption spectroscopy:
- absorb the energy emitted from the metal analyte in returning to ground state
- supply the thermal energy needed to excite the metal analyte
- bring the metal analyte to its ground state
- supply the light that is absorbed by the metal analyte
A
3 - bring the metal analyte to its ground state
21
Q
Most atomic absorption spectrophotometers incorporate a beam chopper and a tuned amplifier. The purpose of these components is to avoid errors that would be caused by:
- variations in flame temperature
- deterioration of the hollow-cathode lamp
- stray light from the hollow-cathode lamp
- measurement of light emitted by the analyte
A
4 - measurement of light emitted by the analyte
22
Q
In potentiometry, which of the following is considered the standard electrode:
- hydrogen electrode
- calcium electrode
- potassium electrode
- copper electrode
A
1 - hydrogen electrode
23
Q
In an electrolytic cell, which of the following is the half-cell where reduction takes place:
- anode
- cathode
- combination electrode
- electrode response
A
2 - cathode
24
Q
Mercury covered by a layer of mercurous chloride in contact with saturated potassium chloride solution is a description of which of the following types of electrodes:
- sodium
- calomel
- calcium
- silver/silver chloride
A
2 - calomel
25
When a pH-sensitive glass electrode is not actively in use, in what type of solution should it be kept:
1. tap water
2. physiologic saline solution
3. the medium recommended by the manufacturer
4. a buffer solution of alkaline pH
3 - the medium recommended by the manufacturer
26
When measuring K+ with an ion-selective electrode by means of a liquid ion-exchange membrane, what antibiotic will be incorporated into the membrane:
1. monactin
2. nonactin
3. streptomycin
4. valinomycin
4 - valinomycin
27
Which of the following is false about ion-selective electrode analysis of sodium:
1. uses a glass membrane
2. errors occur from protein buildup on the membrane
3. membrane coated with valinomycin
4. principle based on potentiometry
3 - membrane coated with valinomycin
28
What are the principles of operation for a chloride analyzer that generates silver ions as part of its reaction mechanism:
1. potentiometry and amperometry
2. amperometry and polarography
3. coulometry and potentiometry
4. amperometry and coulometry
4 - amperometry and coulometry
29
When quantifying glucose using an amperometric glucose electrode system, which of the following is not a component of the system:
1. product oxidation produces a current
2. hydrogen peroxide formed
3. hexokinase reacts with glucose
4. platinum electrode
3 - hexokinase reacts with glucose
30
To calibrate the pH electrode in a pH/blood gas analyzer, it is necessary that:
1. the barometric pressure be known and used for adjustments
2. calibrating gases of known high and low concentrations be used
3. the calibration be performed at room temperature
4. two buffer solutions of known pH be used
4 - two buffer solutions of known pH be used
31
The measurement of CO2 in blood by means of a PCO2 electrode is dependent on the:
1. passage of H+ ions through the membrane that separates the sample and the electrode
2. change in pH because of increased carbonic acid in the electrolyte surrounding the electrodes
3. movement of bicarbonate across the membrane that separates the sample and the electrode
4. linear relationship between PCO2 in the sample and measured pH
2 - change in pH because of increased carbonic acid in the electrolyte surrounding the electrodes
32
The measurement of oxygen in blood by means of a PO2 electrode involvs which of the following:
1. wheatstone bridge arrangement of resistive elements sensitive to oxygen concentration
2. direct relationship between amount of oxygen in the sample and amount of current flowing in the measuring system
3. change in current resulting from an increase of free silver ions in solution
4. glass electrode sensitive to H+ ions
2 - direct relationship between amount of oxygen in the sample and amount of current flowing in the measuring system
33
Which of the following blood gas parameters are measured directly by the blood gas analyzer electrochemically as opposed to being calculated by the instrument:
1. pH, HCO3, total CO2
2. PCO2, HCO3, PO2
3. pH, PCO2, PO2
4. PO2, HCO3, total CO2
3 - pH, PCO2, PO2
34
Which of the following statements is false about anodic stripping voltammetry (ASV):
1. based on peotentiometry
2. occurs in an electrochemical cell
3. involvs preconcentration of the analyte by electroplating
4. used to measure lead
1 - based on peotentiometry
35
Which of the following methods allows for the separation of charged particles based on their rates of migration in an electric field:
1. rheophoresis
2. electrophoresis
3. electroendosmosis
4. ion exchange
2 - electrophoresis
36
Which of the following techniques is based on electro-osmotic flow:
1. capillary electrophoresis
2. zone electrophoresis
3. iontophoresis
4. isoelectric focusing
1 - capillary electrophoresis
37
Which of the following is not a type of support media used for serum protein electrophoresis:
1. agarose gel
2. cellulose acetate
3. acrylamide
4. celite
4 - celite
38
In serum protein electrophoresis, when a buffer solution of pH 8.6 is used, which of the following characterized the proteins:
1. exhibit net negative charge
2. exhibit net positive charge
3. exhibit charge neutrality
4. migrate towards the cathode
1 - exhibit net negative charge
39
Which of the following characteristics will a protein have at its isoelectric point:
1. net negative charge
2. net positive charge
3. net zero charge
4. mobility
3 - net zero charge
40
What dye may be used for staining protein bands following electrophoresis:
1. fat red 7B
2. sudan black B
3. ponceau S
4. oil red O
3 - ponceau S
41
When electrophoresis is performed, holes appear in the staining pattern, giving the stained protein band a doughnut-like appearance. What is the probable cause of this problem:
1. protein denatured and will not stain properly
2. ionic strength of the buffer was too high
3. protein reached its isoelectric point and precipitated out
4. protein concentration was too high
4 - protein concentration was too high
42
What is the purporse of using ampholytes in isoelectric focusing:
1. maintain the polyacrylamide gel in a solid state
2. maintain the protein sample in a charged state
3. maintain the pH of the buffer solution
4. establish a pH gradient in the gel
4 - establish a pH gradient in the gel
43
Which of the follwoing is not associated with silver stains:
1. reactive to nanogram concentrations of proteins
2. polypeptides stain a variety of colors
3. not as sensitive as Coomassie brilliant blue
4. preconcentration of CSF not necessary
3 - not as sensitive as Coomassie brilliant blue
44
Which of the following is not associated with isoelectric focusing:
1. continuous pH gradient
2. migration of proteins with net charge of zero
3. seperation dependent on isoelectric point
4. zone electrohporesis
2 - migration of proteins with net charge of zero
45
Which of the follwoing is an electrophoretic technique employing a pH gradient that separates molecules with similar isoelectric points:
1. zone electrophoresis
2. high-resolution electrophoresis
3. isoelectric focusing
4. immunoelectrophoresis
3 - isoelectric focusing
46
To achieve the best levels of sensitivity and specificity, to what type of detector system could a gas chromatograph be coupled:
1. UV spectrophotometer
2. bichromatic spectrophotometer
3. mass spectrometer
4. fluorescence detector
3 - mass spectrometer
47
Which of the following instruments has a sample-introduction system, solvent-delivery system, column, and detector as componants:
1. atomic absorption spectrometer
2. mass spectrometer
3. high-performance liquid chromatograph
4. nephelometer
3 - high-performance liquid chromatograph
48
CHAPTER 2
What is the first type of cell produced by the developing embryo:
1. erythrocyte
2. granulocyte
3. lymphocyte
4. thrombocyte
1 - erythrocyte
49
What percentage of tissue located in the bone marrow cavities of adults is fat:
1. 10%
2. 25%
3. 50%
4. 75%
3 - 50%
50
Which of the following is not characteristic of pluripotent hematopoietic stem cells:
1. possess self-renewal ability
2. produce progenirtor cells committed to a single cell lineage
3. express the stem cell marker CD13
4. are morphologically unrecognizable
3 - express the stem cell marker CD13
51
In an adult, what are the two best areas for obtaning active bone marrow by aspiration:
1. vertebra, tibia
2. sternum, vertebra
3. anterior iliac crest, tibia
4. posterior iliac crest, sternum
4 - posterior iliac crest, sternum
52
What is the normal ratio of myeloid to erythroid precursors in bone marrow (M:E ratio):
1. 1:1
2. 1:3
3. 4:1
4. 8:1
3 - 4:1
53
Which of the following does not accurately describe hematopoietic growth factors:
1. bind to target cell receptors to express activity
2. action of majority is lineage restricted
3. may promote or suprress cell death
4. can stimulate or inhibit cell proliferation
2 - action of majority is lineage restricted
54
In the third month of gestation, what is the primary site of hematopoiesis:
1. liver
2. marrow of long bones
3. spleen
4. yolk sac
1 - liver
55
The mechanism that relays information about tissue oxygen levels to erythropoietin-producing sites is located in the :
1. brain
2. kidney
3. liver
4. spleen
2 - kidney
56
Antigen-independent lymphopoiesis occurs in primary lymphoid tissue located in the:
1. liver and kidney
2. spleen and lymph nodes
3. peyer's patches and spleen
4. thymus and bone marrow
4 - thymus and bone marrow
57
Programmed cell death is called:
1. necrosis
2. apoptosis
3. cellular senescence
4. terminal differentiation
2 - apoptosis
58
In what area of the bone marrow does hematopoiesis take place:
1. cords
2. endosteum
3. endothelium
4. sinuses
1 - cords
59
Bone marrow cellularity refers to the ratio of:
1. red cell precursors to white cell precursors
2. hematopoietic tissue to adipose tissue
3. granulocytic cells to erythrocytic cells
4. extravascular tissue to intravascular tissue
2 - hematopoietic tissue to adipose tissue
60
Interleukins and colony stimulating factors are cytokines produced by:
1. B lymphocytes and erythrocytes
2. erythrocytes and thrombocytes
3. monocytes and T lymphocytes
4. neutrohpiles and monocytes
3 - monocytes and T lymphocytes
61
What is the approximate total blood volume in an adult:
1. 1 L
2. 2L
3. 6L
4. 12L
3 - 6L
62
The myeloid progenitor cell can produce cells committed to:
1. granulocytic, erythrocytic, monocytic, or megakaryocytic lineages
2. granuylocytic, monocytic, lymphocytic, or megakaryocytic lineages
3. erythrocytic, granulocytic, monocytic, or lymphocytic lineages
4. erythrocytic, granulocytic, lymphocytic, or megakaryocytic lineages
1 - granulocytic, erythrocytic, monocytic, or megakaryocytic lineages
63
The largest hematopoietic cells in normal bone marrow are:
1. osteoblasts
2. osteoclasts
3. megakaryocytes
4. plasma cells
3 - megakaryocytes
64
When evaluating a bone marrow aspirate smear, which finding is considered abnormal:
1. a predominance of granulocyte precursors as compared to nucleated red cells
2. detection of stainable iron in macrophages and erythroid precursors with Prussian blue
3. an average of three megakaryocytes seen per low power field
4. the presence of 10% myeloblasts on the cell differential count
4 - the presence of 10% myeloblasts on the cell differential count
65
As most blood cell lines mature, which of the following is characteristic:
1. cell diameter increases
2. nucleus to cytoplasm ratio decreases
3. nuclear chromatin becomes less condensed
4. basophilia of the cytoplasm increases
2 - nucleus to cytoplasm ratio decreases
66
Which of the following describes thrombopoietin (TPO):
1. renal hormone that regulates marrow red cell production
2. marrow hormone secreted by developing megakaryoblasts
3. hormone produced by the liver that stimulates megakaryopoiesis
4. pituitary hormone that controls platelet sequestration by the spleen
3 - hormone produced by the liver that stimulates megakaryopoiesis
67
When the hepatic phase of fetal life is reactivated in an adult, hematopoliesis can be termed:
1. myeloid or medullary
2. myeloid metaplasia or extramedullary
3. myelophthisis or myelodysplasia
4. mesoblastic or mesenchymal
2 - myeloid metaplasia or extramedullary
68
What is the average life span of a normal red blood cell:
1. 1 day
2. 10 days
3. 60 days
4. 120 days
4 - 120 days
69
The Na+-K+ cation pump is an important mechanism in keeping the red blood cell intact. Its function is to maintain a high level of:
1. intracellulair Na+
2. intracellulair K+
3. plasma Na+
4. plasma K+
2 - intracellular K+
70
Which of the following depicts the structure of the hemoglobin molecule:
1. two heme groups, two globin chains
2. four heme groups, two globin chains
3. two heme groups, four globin chains
4. four heme groups, four globin chains
4 - four heme groups, four globin chains
71
Which of the following describes the process known as culling:
1. release of red cells from the bone marrow
2. binding of free hemoglobin by transport protein
3. incorporation of iron into protoporphyrin IX
4. removal of abnormal red cells by the spleen
4 - removal of abnormal red cells by the spleen
72
Hemoglobin forms that are incapable of oxygen transport include:
1. deoxyhemoglobin and oxyhemoglobin
2. oxyhemoglobin and carboxyhemoglobin
3. carboxyhemoglobin and methemoglobin
4. methemoglobin and deoxyhemoglobin
3 - carboxyhemoglobin and methemoglobin
73
The majortiy of iron found in an adult is a constituent of:
1. ferritin
2. myoglobin
3. hemoglobin
4. peroxidase
3 - hemoglobin
74
A senescent red blood cell is one that has:
1. been hemolyzed
2. lived its life span
3. become deformed
4. lost its mitochondria
2 - lived its life span
75
What red cell morphologic abnormality is described by the term poikilocytosis:
1. variations in size
2. deviations from normal shape
3. presence of inclusions
4. alterations in hemoglobin concentration
2 - deviations from normal shape
76
Howell-Jolly bodies are composed of:
1. DNA
2. iron
3. reticulum
4. RNA
1 - DNA
77
When spherocytes are reported, what is observed on the peripheral blood smear:
1. red cells without a central pallor
2. red cells with blunt projections
3. red cells with sharp projections
4. red cells with intracellulair rod-shaped crystals
1 - red cells without a central pallor
78
The red cells found in lead poisoning characteristically exhibit coarse granules coposed of _________ that are reported as \_\_\_\_\_\_\_\_\_\_.
1. precipitated hemoglobin; pappenheimer bodies
2. aggregated ribosomes; basophilic stippling
3. nuclear fragments; pappenheimer bodies
4. excess iron deposits; basophilic stippling
2 - aggregated ribosomes; basophilic stippling
79
Rouleaux of red blood cells when seen in the monolayer of a blood smear is characteristic of:
1. hyperplenism
2. hypogamamglobulinemia
3. cold hemagglutinin disease
4. multiple myeloma
4 - multiple myeloma
80
Which of the following statements about iron absorption is true:
1. absorption occurs in the ileum
2. the mucosal cell always absorbs the correct amount of iron to meet needs
3. absorption increases when erythropoietic activity increases
4. alkaline pH favors absorption
3 - absorption increases when erythropoietic activity increases
81
What term describes a mature red blood cell that contains iron granules or deposits:
1. siderosome
2. sideroblast
3. ringed sideroblast
4. siderocyte
4 - sideorocyte
82
Which of the following is associated with a shift to the left in the oxygen dissociation curve of hemoglobin:
1. decreased pH and elevated temperature
2. decreased oxygen affinity
3. decreased oxygen release
4. presence of 2,3-biphosphoglycerate (2,3-BPG)
3 - decreased oxygen release
83
Which of the following statements does not characterize erythropoietin (EPO):
1. transfroms the CFU-E into the earliest recognizable RBC precursor
2. increases the rate of red blood cell production by the bone marrow
3. shortens the maturation time of developing erythroid precursors
4. decreases stimulation of erythropoiesis when cellulair hypoxia increases
4 - decreases stimulation of erythropoiesis when cellulair hypoxia increases
84
Which of the following factors will result in an immediate increase in oxygen delivery to the tissues:
1. increased pH
2. high altitudes
3. increased hemoglobin binding of 2,3-BPG
4. increased renal release of erythropoietin
3 - increased hemoglobin binding of 2,3-BPG
85
Periods of intense erythropoietin activity cause premature release of marrow reticulocytes into the blood. Which of the following is not true of these early reticulocytes:
1. loss of residual RNA occurs immediately upon marrow release
2. circulate longer than usual before reaching maturity
3. may be termed shift or stress reticulocytes
4. show diffuse basophilia with Wright's stain
1 - loss of residual RNA occurs immediately upon marrow release
86
Which of the following inclusions is only visible with supravital staining:
1. basophilic stippling
2. cabot rings
3. heinz bodies
4. pappenheimer bodies
3 - heinz bodies
87
The presence of schistocytes on the peripheral blood smear is commonly associated with:
1. increased iron mobilization
2. increased red cell destruction
3. decreased erythropoietin activity
4. decreased red cell proliferation
2 - increased red cell destruction
88
Which of the following may be a sign of accelerated bone marrow erythropoiesis:
1. hypercellular marrow with a decreased number of RBC precursors
2. bone marrow M:E ratio of 6:1
3. nucleated red cells in the peripheral circulation
4. low erythrocyte, hemoglobin, and hematocrit levels
3 - nucleated red cells in the peripheral circulation
89
Microcytic, hypochromic red cells are most often associated with impaired:
1. DNA synthesis
2. RNA metabolism
3. hemoglobin synthesis
4. enzyme metabolism
3 - hemoglobin synthesis
90
When acanthocytes are found on the blood smear, it is usually the result of:
1. abnormal membrane permeability
2. altered membrane lipids
3. mechanical trauma
4. polymerization of hemoglobin molecules
2 - altered membrane lipids
91
Which erythrocyte metabolic pathway generates adenosine triphosphate (ATP) via glycolysis:
1. embden-meyerhof
2. hexose monophosphate
3. rapoport-luebering
4. methemoglobin reductase
1 - embden-meyerhof
92
Which of the following red blood cell precursors is the last stage to undergo mitosis:
1. pronormoblast
2. basophilic normoblast
3. polychromatophilic normoblast
4. orthochromic normoblast
3 - polychromatophilic normoblast
93
The major adult hemoglobin requires the synthesis of alpha-globin chains and:
1. beta-globin chains
2. delta-globin chains
3. epsilon-globin chains
4. gamma-globin chains
1 - beta-globin chains
94
Defective nuclear maturation commonly results in the production of red cells that are:
1. normocytic
2. hypochromic
3. macrocytic
4. microcytic
3 - macrocytic
95
The major storage form of iron is:
1. ferritin
2. transferrin
3. hemosiderin
4. hemachromatin
1 - ferritin
96
CHAPTER 3
The hemorrhagic problems associated with scurvey are due to a deficiency of \_\_\_\_\_\_\_\_\_\_, which is a cofactor required for collagen synthesis.
1. vitamin C
2. prothrombin
3. vitamin K
4. protein C
1 - vitamin C
97
The number of platelets an average megakaryocyte generates is approximately:
1. 25-50
2. 50-200
3. 200-500
4. 2000-4000
4 - 2000-4000
98
Which of the following is not a cause of thrombocytopenia:
1. splenomegaly
2. chemotherapy
3. increased thrombopoietin
4. aplastic anemia
3 - increased thrombopoietin
99
Platelets interactiv with and binding to other platelets is referred to as:
1. adhesion
2. aggregation
3. release
4. retraction
2 - aggregation
100
In platelet aggregation studies, certain aggregating agents induce a biphasic aggregation curve. This second phase of aggregation is directly related to:
1. formation of fibrin
2. changes in platelet shape
3. release of endogenous ADP
4. release of platelet factor 3
3 - release of endogenous ADP
101
A platelet aggregation agent that characteristically yields a biphasic curve when used in optimal concentration is:
1. arachidonic acid
2. collagen
3. epinephrine
4. ristocetin
3 - epinephrine
102
The operating principle of a platelet aggregometer is best described as:
1. aggregation on a foreign surface: platelet aggregation is directly proportional to the difference in platelet counts performed before and after platelet-rich plasma is passed through a column of glass beads
2. change in optical density: as platelets aggregate, the optical density of the platelet-rich plasma decreases
3. electrical impedance: platelet aggregates are counted as they pass through an aperature, temporarily interrupting the flow of current between two electrodes
4. pulse editing: editing electronically generated pusles can differentiate the number of free platelets versus platelet aggregates
2 - change in optical density: as platelets aggregate, the optical density of the platelet-rich plasma decreases
103
Of the following therapeutic agents, those considered to be antiplatelet medications are:
1. aspirin and Plavix
2. Coumadin and heparin
3. heparin and protamine sulfate
4. tissue plasminogen activator and streptokinase
1 - aspirin and Plavix
104
A potent inhibitor of platelet aggregation released by endothelial cells is:
1. epinephrine
2. prostacyclin
3. ristocetin
4. thromboxane A2
2 - prostacyclin
105
The reference value for mean platelet volume (MPV) is approximately:
1. 2-4 fL
2. 5-7 fL
3. 8-10 fL
4. 11-14 fL
3 - 8-10 fL
106
The platelet parameter PDW refers to the:
1. average platelet volume
2. cell weight versus density
3. capacity to adhere to foreign surfaces
4. variation in platelet cell size
4 - variation in platelet cell size
107
A normal histogram showing platelet size distribution is best described as:
1. bimodal, nonskewed peaks
2. left-skewed single peak
3. right-skewed single peak
4. single peak, Gaussian distribution
3 - right-skewed single peak
108
Which of the following is not a normal maturation stage for platelets:
1. megakaryoblast
2. promegakaryocyte
3. micromegakaryocyte
4. megakaryocyte
3 - micromegakaryocyte
109
The recommended type of microscopy for the performance of manual platelet counts is:
1. electron
2. dark field
3. light
4. phase contrast
4 - phase contrast
110
The size threshold range used by electrical impedance methods to count particles as platelets is:
1. 0-10 fL
2. 2-20 fL
3. 15-40 fL
4. 35-90 fL
2 - 2-20 fL
111
In storage pool disease, platelets are primarily deficient in:
1. ADP
2. platelet factor 3
3. thrombasthenin
4. thromboxane A2
1 - ADP
112
The anticoagulant required for routine coagulation testing is:
1. sodium heparin
2. sodium citrate
3. acid citrate dextrose
4. sodium fluoride
2 - sodium citrate
113
Which of the following is not synthesized in the liver:
1. factor VIII
2. plasminogen
3. protein C
4. von Willebrand factor
4 - von Willebrand factor
114
When thrombin binds to thrombomodulin on the endothelial cell surface, thrombin can:
1. activate the protein C pathway
2. activate factor V and factor VIII
3. convert fibrinogen to fibrin
4. stimulate platelet aggregation
1 - activate the protein C pathway
115
The coagulation factors having a sex-linked recessive inheritance pattern are:
1. factor V and factor VIII
2. factor VIII and factor IX
3. factor IX and factor X
4. von Willebrand factor and factor VIII
2 - factor VIII and factor IX
116
Prekallikrein deficiency is associated with:
1. prolonged aPTT that does not correct with a mixing study
2. autosomal dominant inheritance
3. increased risk of thrombosis
4. delayed bleeding at the incision site following surgery
3 - increased risk of thrombosis
117
Which of the following will not cause the thrombin time to be prolonged:
1. fibrin degradation products
2. heparin
3. factor I deficiency
4. factor II deficiency
4 - factor II deficiency
118
The expected screening test results for a patient with a fibrin stabilizing factor deficiency are:
1. prolonged prothrombin time
2. prolonged activated partial thromboplastin time
3. prolonged prothrombin time and activated partial thromboplastin time
4. normal prothrombin time and activated partial thromboplastin time
4 - normal prothrombin time and activated partial thromboplastin time
119
A patient on therapeutic warfarin will most likely have a:
1. normal PT/INR, increased aPTT, prolonged bleeding time, low platelet count
2. increased PT/INR, increased aPTT, normal bleeding time, normal platelet count
3. normal PT/INR, normal aPTT, normal bleeding time, normal platelet count
4. increased PT/INR, normal aPTT, prolonged bleeding time, low platelet count
2 - increased PT/INR, increased aPTT, normal bleeding time, normal platelet count
120
Which of the following complexes is not needed for blood coagulation to occur:
1. VIIa, tissue factor, Ca
2. IXa, VIII, Ca, PF3
3. Xa, V, Ca, PF3
4. XIIa, kallikrein, HMWK
4 - XIIa, kallikrein, HMWK
121
von Willebrand factor is a:
1. phospholipid required for multiple reactions in the coagulation sequence
2. plasma protein that binds platelets to exposed subendothelial collagen
3. plasma protein with procoagulant activity in the intrisic coagulation system
4. platelet membrane glycoprotein that attaches the platelet to the injured vessel wall
2 - plasma protein that binds platelets to exposed subendothelial collagen
122
Fibrin strands are cross-linked and the fibrin clot is stabilized by the activity of:
1. alpha2-antiplasmin
2. factor XIIIa
3. plasmin
4. thrombin
2 - factor XIIIa
123
Which of the following does not contribute to the activation of the fibrinolytic system:
1. XIIa
2. XIa
3. kallikrein
4. tissue plasminogen activator
2 - XIa
124
Which of the following enzymatically degrades the stabilized fibrin clot:
1. plasminogen
2. plasmin
3. prothrombin
4. thrombin
2 - plasmin
125
The activity of the lupus anticoagulant and anticardiolipin antibodies appears to be directed against:
1. factor V
2. factor VIII
3. factor IX
4. phospholipid
4 - phospholipid
126
Heparin inhibits clotting by:
1. chelating calcium ions
2. preventing activation of prothrombin
3. causing liver synthesis of nonfunctional factors
4. enhancing the action of antithrombin
4 - enhancing the action of antithrombin
127
The main regulatory protein of secondary hemostasis is:
1. antithrombin
2. protein C
3. alpha2-antiplasmin
4. tissue plasminogen activator
1 - antithrombin
128
Why is the activated partial thromboplastin time (aPTT) not the procedure of choice for detecting a platelet factor 3 (PF3) deficiency:
1. platelet-rich plasma is used for this test
2. the reagent contains a phospholipid substitute for PF3
3. PF3 is unstable in the reagent used for this test
4. PF3 does not function in the system being tested
2 - the reagent contains a phospholipid substitute for PF3
129
Measurement of the time required for fibrin formation when thrombin is added to plasma evaluates the:
1. fibrinogen concentration
2. prothrombin concentration
3. extrinsic clotting system
4. intrinsic clotting system
1 - fibrinogen concentration
130
Which of the following is not true of the international normalized ratio (INR):
1. INR is dependent on reagents and instrumentation used
2. INR is calculated using the PT ratio taken to the power of the ISI value
3. the world health organization recommends reporting the INR on patients on stable oral anticoagulant therapy
4. a therapeutic INR for a patient on Coumadin is between 2.0 and 3.0, but may be higher depending on the cause of the patient's underlying disease state
1 - INR is dependent on reagents and instrumentation used
131
A prolonged aPTT result is obtained on a patient diagnosed with acute disseminated intravascular coagulation (DIC). The patient has not yet been treated for this disorder. The most likely cause of the prolonged aPTT is:
1. in addition to DIC, the patient is deficient in a factor required for the extrinsic pathway
2. DIC is characterized by synthesis of less stable coagulation factors, which deteriorate rapidly in the circulation
3. systemic activation of the coagulation system depletes some factors more rapidly than the liver can synthesize them
4. the patient has been misdiagnosed; a prolonged aPTT indicates that the problem is deficient, not excessive, coagulation
3 - systemic activation of the coagulation system depletes some factors more rapidly than the liver can synthesize them
132
Which of the following test results is not characteristic of DIC:
1. decreased fibrinogen concentration
2. positive test for degredation products
3. decreased platelet count
4. increased antithrombin
4 - increased antithrombin
133
The principle of __________ methods depends on cleavage of synthetic substrates by an active serine protease:
1. chromogenic
2. photo-optical
3. mechanical
4. immunodiffusion
1 - chromogenic
134
Epsilon aminocaproic acid is the treatment of choice for:
1. von Willebrand disease
2. hemophilia A
3. DIC with secondary fibrinolysis
4. primary fibrinogenolysis
4 - primary fibrinogenolysis
135
A clot retraction defect is most likely due to:
1. lack of platelet receptor glycoprotein Ib
2. lack of platelet receptor glycoprotein IIb/IIIa
3. insufficient ADP in dense bodies
4. absence of von Willebrand factor
2 - lack of platelet receptor glycoprotein IIb/IIIa
136
Thrombocytosis is a characteristic of:
1. disseminated intravascular coagulation:
2. splenomegaly
3. polycythemia vera
4. idiopathic thrombocytopenic purpura
3 - polycythemia vera
137
In which of the following functions are the products released by vascular endothelial cells not involved:
1. inhibition of platelet aggregation
2. activation of the fibrinolytic system
3. conversion of thrombin from a procoagulant to an anticoagulant
4. cross-linkage of fibrin monomers
4 - cross-linkage of fibrin monomers
138
If a physician suspects a qualitative platelet defect, the most useful test to order is the:
1. platelet count
2. prothrombin time
3. 5.0 M urea solubility test
4. bleeding time
4 - bleeding time
139
The coagulation factors referred to as vitamin K-dependent are:
1. I, V, VIII, XIII
2. II, V, IX, XII
3. II, VII, IX, X
4. XI, XII, Fletcher, Fitzgerald
3 - II, VII, IX, X
140
A patient on warfarin therapy will be deficient in a functional amount of:
1. fibrinogen and prothrombin
2. stable and labile factors
3. protein C and protein S
4. fletcher and fitzgerald factors
3 - protein C and protein S
141
A 25-year-old male presents to his physician complaning of leg pain. The physician diagnoses a deep vein thrombosis and wants to determine the cause of the thrombotic episode. Which of the following conditions would not be associated with such a thrombotic episode:
1. factor V leiden and prothrombin 20210 mutations
2. hypofibrinogenemia and hyperhomocysteinemia
3. lupus anticoagulant and anticardiolipin antibodies
4. antithrombin and protein C deficiencies
2 - hypofibrinogenemia and hyperhomocysteinemia
142
An 85-year-old male with slurred speech and paralysis on the right side of the body is seen in the emergency department. A stat D-dimer is ordered and is very high. The physician suspects a thromboembolic event based on the D-dimer, and needs to institue clot-dissolving therapy immediately. The most likely diagnosis and appropriate therapy for the patient is:
1. myocardial infarction; treat with aspirin
2. pulmonary embolism; treat with warfarin
3. deep vein thrombosis; treat with heparin
4. stroke; treat with tissue plasminogen activator
4 - stroke; treat with tissue plasminogen activator
143
CHAPTER 4
A hapten is:
1. half of an immunoglobulin molecule
2. a carrier molecule for an antigen that is not antigenic alone
3. an immunoglobulin functional only in the presence of complement
4. a determinant capable of stimulating an immune response only when bound to a carrier
4 - a determinant capable of stimulating an immune response only when bound to a carrier
144
Which of the following is characteristic of B cells:
1. phagocytic
2. participate in antibody-dependent cellular cytotoxicity (ADCC) reactions
3. contain surface immunoglobulins
4. secrete the C5 component of complement
3 - contain surface immunoglobulins
145
A lymphokine is:
1. a soluble mediator produced by granulocytes and affecting lymphocytes
2. a soluble mediator produced by lymphocytes
3. a soluble mediator produced by plasma cells
4. an antibody that reacts with lymphocytes
2 - a soluble mediator produced by lymphocytes
146
Monocytes and macrophages play a major role in the mononuclear phagocytic system. For an antibody-coated antigen to be phagocytized, what part of the antibody molecule fits into a receptor on the phagocytic cell:
1. Fc region
2. Fab region
3. Hinge region
4. variable region
1 - Fc region
147
Cell-mediated immunity is primarily mediated by:
1. B cells
2. T helper cells
3. plasma cells
4. dendritic cells
2 - T helper cells
148
The HLA complex is located primarily on:
1. chromosome 3
2. chromosome 6
3. chromosome 9
4. chromosome 17
2 - chromosome 6
149
HLA antigens are found on:
1. all nucleated cells
2. red blood cells only
3. solid tissue only
4. white blood cells only
1 - all nucleated cells
150
Which of the following is more likely to be diagnostic of an acute infection:
1. a total acute antibody titer of 2 followed by a convalescent titer of 16
2. a total acute antibody titer of 80 followed by a convalescent titer of 40
3. a total antibody titer of 80
4. an IgG antibody titer of 80
1 - a total acute antibody titer of 2 followed by a convalescent titer of 16
151
A young woman shows increased susceptibility to pyogenic infections. Upon assay, she shows a low level of C3. Which of the following statements is probably true:
1. she has a autoimmune disease with continual antigen-antibody activity causing consumption of C3
2. she has DiGeorge syndrome
3. she has decreased production of C3
4. she may produce an inactive form of C2, a precursor of C3
3 - she has decreased production of C3
152
What is the predominant type of antibody found in the serum of neonates born after full-term gestation:
1. infant IgA
2. infant IgG
3. infant IgM
4. maternal IgG
4 - maternal IgG
153
An important part of the nonspecific immune response is:
1. B cells
2. basophils
3. complement cascade
4. cytotoxic T lymphocytes
3 - complement cascade
154
The major class of immunoglobulin found in adult human serum is:
1. IgA
2. IgE
3. IgG
4. IgM
3 - IgG
155
Which class of immunoglobulin possesses delta heavy chains:
1. IgA
2. IgD
3. IgE
4. IgG
2 - IgD
156
Which class of immunoglobulin possesses 10 antigenic binding sites:
1. IgA
2. IgD
3. IgG
4. IgM
4 - IgM
157
Which class of immunoglobulin binds to basophils and mast cells to mediate immediate hypersensitivy reactions:
1. IgA
2. IgD
3. IgE
4. IgG
3 - IgE
158
Type I hypersensitivity is:
1. associated with complement-mediated cell lysis
2. due to immune complex deposition
3. mediated by activated macrophages
4. an immediate allergic reaction
4 - an immediate allergic reaction
159
When performing the enzyme-multiplied immunoassay technique (EMIT), how is the ligand in the patient's serum detected:
1. agglutinates by binding to antibody coated latex beads
2. binds to enzyme-labeled antibody
3. competes with enzyme-labeled antigen for binding to a specific antibody
4. forms antibody-antigen complex and precipitates
3 - competes with enzyme-labeled antigen for binding to a specific antibody
160
Severe combined immunodeficiency (SCID) is an:
1. immunodeficiency with decreased B cells and neutrophils
2. immunodeficiency with lymphocytopenia and eosinophilia
3. immunodeficiency with decreased or dysfunctional T and B cells
4. immunodeficiency with decreased lymphocytes and decreased complement concentration
3 - immunodeficiency with decreased or dysfunctional T and B cells
161
An example of immune injury due to the deposition of antigen-antibody complexes is:
1. acute glomerulonephritis
2. bee-sting allergy
3. contact dermitis
4. penicillin allergy
1 - acute glomerulonephritis
162
The serologically detectable antibody produced in rheumatoid arthritis (RA) is primarily of the class:
1. IgA
2. IgE
3. IgG
4. IgM
4 - IgM
163
In bone marrow transplantation, immuno-competent cells in the donor marrow may recognize antigens in the recipient and respond to those antigens. This phenomenon is an example of:
1. acute rejection
2. chronic rejection
3. graft versus host disease
4. hyperacute rejection
3 - graft versus host disease
164
Multiple myeloma is a:
1. lymphoproliferative disease of T cells
2. cancer of plasma cells characterized by increased antibody concentration
3. lymphoproliferative disease resulting in a decrease in antibody production
4. cancer of monocytes characterized by increased kappa and lambda chain synthesis
2 - cancer of plasma cells characterized by increased antibody concentration
165
Which one of the following describes a direct immunofluorescence assay:
1. conjugated reagent antigen reacts with antibodies to form antigen-antibody complexes
2. antigens react with unlabeled antibody forming antigen-antibody complexes that attach to labeled antibodies
3. a dye is attached to a molecule and it reacts with an immune complex to produce a color
4. conjugated reagent antibody reacts with antigen to form antigen-antibody complexes
4 - conjugated reagent antibody reacts with antigen to form antigen-antibody complexes
166
In individuals allergic to pollen, hyposensitization protocols may be initiated. These individuals receive injections of:
1. allergen
2. pooled human antisera
3. monoclonal antibody directed against human T cells
4. monoclonal antibody directed against human B cells
1 - allergen
167
After exposure to antigen, the first antibodies that can be detected belong to the class:
1. IgA
2. IgE
3. IgG
4. IgM
4 - IgM
168
Corneal tissue may be transplanted successfully from one patient to another because:
1. the cornea is nonantigenic
2. corneal antigens do not activate T cells
3. anticorneal antibodies are easily surpressed
4. the cornea occupies a priviliged site not usually seen by the immune system
4 - the cornea occupies a priviliged site not usually seen by the immune system
169
A kidney transplant from one identical twin to another is an example of a:
1. allograft
2. autograft
3. isograft
4. xenograft
3 - isograft
170
In Bruton disease, measurement of serum immunoglobulins would show:
1. elevated levels of IgE
2. elevated levels of IgG
3. normal levels of IgG and IgM but reduced levels of IgA
4. the absence of all immunoglobulins
4 - the absence of all immunoglobulins
171
Diagnosis of group A streptococci (Streptococcus pyogenes) infection is indicated by the presence of:
1. anti-protein A
2. anti-DNase B
3. anti-beta-toxin
4. C-reactive protein
2 - anti-DNase B
172
A molecule found in human serum sometimes used as a tumor marker is:
1. alpha-Fetoprotein
2. HBsAg
3. biotin
4. CD1
1 - alpha-Fetoprotein
173
Which cell is the principal source of interleukin 2:
1. B cell
2. T cell
3. monocyte
4. plasma cell
2 - T cell
174
Diagnostic reagents useful for detecting antigen by the coagglutination reaction may be prepared by binding antibody to killed staphylococcal cells via the Fc receptor of staphylococcal protein A. The class of antibody bound by this protein is:
1. IgA
2. IgD
3. IgG
4. IgM
3 - IgG
175
A major advantage of passive immunization compared to active immunization is that:
1. antibody is available more quickly
2. antibody persists for the life of the recipient
3. IgM is the predominant antibody class provided
4. oral administration can be used
1 - antibody is available more quickly
176
The strength with which a multivalent antibody binds a multivalent antigen is termed the:
1. affinity
2. avidity
3. reactivity
4. valence
2 - avidity
177
How does the secondary humoral immune response differ from the primary response:
1. the lag phase (the time between exposure to immunogen and production of antibody) is longer in the secondary immune response
2. IgM is the predominant antibody class produced in the secondary immune response
3. the antibody levels produced are higher in the secondary immune response
4. cytotoxic T lymphocytes play an important role in the secondary response
3 - the antibody levels produced are higher in the secondary immune response
178
After activation of the complement system, leukocytes and macrophages are attracted to the site of complement activation by:
1. C1
2. C5a
3. C8
4. IgM
2 - C5a
179
They type of immunity that follows the injection of an immunogen is termed:
1. artificial active
2. natural active
3. artificial passive
4. innate
1 - artificial active
180
The type of immunity that follows the injection of antibodies synthesized by another individual or animal is termed:
1. artificial active
2. natural adaptive
3. artificial passive
4. natural passive
3 - artificial passive
181
Innate immunity includes:
1. anamnestic response
2. antibody production
3. cytotoxic T cell activity
4. phagocytosis by polymorphonuclear cells
4 - phagocytosis by polymorphonuclear cells
182
The antibody most frequently present in systemic lupus erythematosus is directed against:
1. surface antigens of bone marrow stem cells
2. surface antigens of renal cells
3. nuclear antigen
4. myelin
3 - nuclear antigen
183
The rapid plasma reagin assay for syphilis does not need to be read microscopically because the antigen is:
1. cardiolipin
2. complexed with latex
3. complexed with charcoal
4. inactivated bacterial cells
3 - complexed with charcoal
184
The Venereal Disease Research Laboratory (VDRL) test for syphilis is classified as a:
1. agglutination reaction
2. flocculation reaction
3. hemagglutination reaction
4. precipitation reaction
2 - flocculation reaction
185
One cause of a false-positive VDRL test is:
1. Brucellosis
2. Treponema pallidum infection
3. Rocky Mountain spotted fever
4. Systemic lupus erythematosus
4 - Systemic lupus erythematosus
186
The portion of an antigen that binds to an antibody or T cell receptor is called a:
1. allergin
2. avidin
3. epitope
4. valence
3 - epitope
187
Identical antibodies produced from a single clone of plasma cells describes:
1. reagin
2. cold agglutinins
3. heterophile antibodies
4. monoclonal antibodies
4 - monoclonal antibodies
188
IgM antibodies react well in complement fixation (CF) tests. Because of this, CF tests for antibodies should;
1. be positive early in the course of the disease
2. be useful in identifying antibodies responsible for a delayed hypersensitivity reaction
3. be useful in identifying antibodies responsible for anaphylactic reactions
4. detect transplacental antibodies
1 - be positive early in the course of the disease
189
Which of the following serologic tests is commonly performed by an immunofluorescence method:
1. anti-HBs
2. antinuclear antibody (ANA)
3. antistreptolysin O (ASO)
4. C-reactive protein (CRP)
2 - antinuclear antibody (ANA)
190
A woman wants to donate blood. Her physical exam reveals the following: weight - 110 lb, pulse - 73 bpm, blood pressure - 125/75 mmHg, hematocrit - 35%. Which of the following exlusions applies to the prospective donor:
1. pulse too high
2. weight too low
3. hematocrit too low
4. blood pressure too low
3 - hematocrit too low
191
A potential donor has no exclusions, but she weighs only 95 pounds, What is the allowable amount of blood (including samples) that can be drawn:
1. 367 ml
2. 378 ml
3. 454 ml
4. 473 ml
3 - 454 ml
192
Donors who have received blood or blood products within 12 months of when they desire to donate are deferred to protect the recipient because the:
1. blood could have transmitted hepatitis (HBV or HCV) or HIV
2. blood may have two cell populations
3. donor may not be able to tolerate the blood loss
4. donor red cell hemoglobin level may be too low
1 - blood could have transmitted hepatitis (HBV or HCV) or HIV
193
Which of the following conditions would contraindicate autologous presurgical donation:
1. weight of 100 pounds
2. age of 14 years
3. hemoglin of 12g/dL
4. mild bacteremia
4 - mild bacteremia
194
Which of the following donors would be deferred indefinitely:
1. History of syphilis
2. history of gonorrhea
3. accutane treatment
4. recipient of human growth hormone
4 - recipient of human growth hormone
195
Which of the following viruses resides exclusively in leukocytes:
1. CMV
2. HIV
3. HBV
4. HCV
1 - CMV
196
A donor indicates that he has taken two aspirin tablets per day for the last 36 hours. The unit of blood:
1. may not be used for pooled platelet concentrate preparation
2. should not be drawn until 36 hours after cessation of aspirin ingestion
3. may be used for pooled platelet concentrate preparation
4. may be used for red blood cells and fresh-frozen plasma production, but the platelets should be discarded
3 - may be used for pooled platelet concentrate preparation
197
Which of the following best describes what must be done with a unit of blood drawn from a donor who is found to be at high risk of contracting acquired immune deficiency syndrome (AIDS):
1. hold unit in quarantine until donor diagnosis is clarified
2. use the blood for researach dealing with AIDS
3. properly dispose of unit by autoclaving or incineration
4. use the plasma and destroy the red blood cells
3 - properly dispose of unit by autoclaving or incineration
198
Which of the following is least likely to transmit hepatitis:
1. cryoprecipitate
2. RBC
3. plasma protein fraction (PPF)
4. platelets
3 - plasma protein fraction (PPF)
199
A pooled sera product from 16 donors has a repeatedly positive nucleic acid test (NAT) for HCV. The next action that should be taken is to:
1. permanently exclude all the donors in the pool
2. test each donor in the pool for HCV
3. label all the donors as HCV positive
4. confirm the positive using recombinant immunoblot assay (RIBA)
2 - test each donor in the pool for HCV
200
Although cryoprecipitate has primarily been used for treatment of hypofibrinogenemia and hemophilia A, it contains other blood proteins useful in the treatment of coagulopathies. Which of the following is not found in cryoprecipitate:
1. fibronectin
2. factor XIII
3. factor VIII:vW
4. antithrombin III
4 - antithrombin III
201
Even though it is properly collected and stored, which of the following will fresh-frozen plasma (FFP) not provide:
1. factor V
2. factor VIII
3. factor IX
4. platelets
4 - platelets
202
Blood needs to be prepared for intrauterine transfusion of a fetus with severe HDN. The red blood cell unit selected is compatible with the mother's serum and has been leuko-depleted. An additional step that must be taken before transfusion is to:
1. add pooled platelets and fresh-frozen plasma
2. check that the RBC group is consistent with the fathers's
3. irradiate the RBCs before infusion
4. test the RBC unit with the neonate's eluate
3 - irradiate the RBCs before infusion
203
The addition of adenine in an anticoagulant-preservative formulation aids in:
1. maintaning ATP levels for red cell viability
2. maintaning platelet function in stored blood
3. reducing the plasma K+ levels during storage
4. maintaining 2,3-BPG levels for oxygen release to the tissues
1 - irradiate the RBCs before infusion
204
The pilot tubes for donor unit #3276 break in the centrifuge. You should:
1. label the blood using the donor's previous records
2. discard the unit because processing procedures cannot be performed
3. discard the red cells and salvage the plasma for fractionation
4. remove sufficient segments to complete donor processing procedures
4 - remove sufficient segments to complete donor processing procedures
205
A satellite bag containing 250 mL of fresh plasma is selected for quality control of cryprecipitate production. Cryoprecipitate is prepared according to standard operating procedures. The final product has a total volume of 10 mL. The factor VIII assays are 1 IU/ml before and 9 IU/mL after preparation.
What is the percent yield of factor VIII in the final cryoprecipitate:
1. 11%
2. 25%
3. 36%
4. 80%
36%
206
A satellite bag containing 250 mL of fresh plasma is selected for quality control of cryprecipitate production. Cryoprecipitate is prepared according to standard operating procedures. The final product has a total volume of 10 mL. The factor VIII assays are 1 IU/ml before and 9 IU/mL after preparation.
Does this product meet AABB Standards for cryoprecipitate production:
1. yes
2. no; the percent recovery is too low
3. no, the final factor VIII level is too low
4. data are insufficient to calculate
1 - yes
207
A centrifuge used for platelet preparation has been returned after major repair. A unit of whole blood (450 mL; platelet count 200,000/uL) is selected for calibration of platelet production. The platelet-rich plasma (PRP) contains 250 mL with a platelet count of 300,000/uL. The final platelet concentrate prepared form the PRP contains 50mL with a platelet count of 900,000/uL.
What is the percent yield of platelets in the PRP form this unit:
1. 33%
2. 45%
3. 66%
4. 83%
4 - 83%
208
A centrifuge used for platelet preparation has been returned after major repair. A unit of whole blood (450 mL; platelet count 200,000/uL) is selected for calibration of platelet production. The platelet-rich plasma (PRP) contains 250 mL with a platelet count of 300,000/uL. The final platelet concentrate prepared form the PRP contains 50mL with a platelet count of 900,000/uL.
What is the percent yield of platelets in the final product from the PRP:
1. 30%
2. 45%
3. 50%
4. 60%
4 - 60%
209
A centrifuge used for platelet preparation has been returned after major repair. A unit of whole blood (450 mL; platelet count 200,000/uL) is selected for calibration of platelet production. The platelet-rich plasma (PRP) contains 250 mL with a platelet count of 300,000/uL. The final platelet concentrate prepared form the PRP contains 50mL with a platelet count of 900,000/uL.
Does this product meet AABB Standards for platelet concentrate production:
1. yes
2. no, the count on the final product is too low
3. no, the percentage recovery in the PRP is too low
4. data are insufficient to calculate
2 - no, the count on the final product is too low
210
A centrifuge used for platelet preparation has been returned after major repair. A unit of whole blood (450 mL; platelet count 200,000/uL) is selected for calibration of platelet production. The platelet-rich plasma (PRP) contains 250 mL with a platelet count of 300,000/uL. The final platelet concentrate prepared form the PRP contains 50mL with a platelet count of 900,000/uL.
The final product was prepared with a PRP spin time of 2 minutes at 2500 rpm. To increase the percent platelet yield in the final product, one would:
1. increase the time and/or rpm for the first spin
2. increase the time and/or rpm for the second spin
3. decrease the time and/or rpm for the first spin
4. decrease the time and/or rpm for the second spin
2 - increase the time and/or rpm for the second spin
211
When 2,3-BPG levels drop in stored blood, which of the following occurs as a result:
1. red blood cell K+ increases
2. red blood cell ability to release O2 decreases
3. plasma hemoglobin is stabilized
4. ATP synthesis increases
2 - red blood cell ability to release O2 decreases
212
The last unit of autologous blood for an elective surgery patient should be collected no later than _______ hours before surgery:
1. 24
2. 36
3. 48
4. 72
4 - 72
213
For which of the following patients would autologous donation not be advisable:
1. patients with an antibody against a high-incidence antigen
2. patients with uncompensated anemia
3. open heart surgery patients
4. patients with multiple antibodies
2 - patients with uncompensated anemia
214
It is generally asymptomatic but has a very high carrier rate (70-80% have chronic infections). About 10% of the carriers develop cirrhosis or hepatocellular carcinoma. These statements are most typical of which of the following transfusion-transmitted infections:
1. HAV
2. HBV
3. HCV
4. HEV
3 - HCV
215
Biochemical changes occur during the shelf life of stored blood. Which of the following is a result of this storage lesion:
1. increase in pH
2. increase in plasma K
3. increase in plasma Na
4. decrease in plasma hemoglobin
2 - increase in plasma K
216
It has been determined that a patient has posttransfusion hepatitis and received blood from eight donors. There is nothing to indicate that these donors may have been likely to transmit hepatits. What action must be taken initially:
1. defer all donors indefinitely from further donations
2. repeat all hepatitis testing on a fresh sample from each donor
3. notify the donor center that cellected the blood
4. interview all implicated donors
3 - notify the donor center that cellected the blood
217
The temperature range for maintaning red blood cells and whole blood during shipping is:
1. 0-4oC
2. 1-6oC
3. 1-10oC
4. 5-15oC
3 - 1-10oC
218
Platelets play an important role in maintaining hemostasis. One unit of donor platelets derived from whole blood should yield ______ platelets:
1. 5.5 X 106
2. 5 X 108
3. 5.5 X 1010
4. 5 X 1010
3 - 5.5 X 1010
219
The pH of four platelet concentrates is measured on the day of expiration. The pH and plasma volumes of the four units are as follows: pH 6.0, 45 mL ; pH 5.5, 38mL; pH 5.8, 40mL; pH 5.7, 41 mL. What corrective action is needed in product preparation to meet AABB standards for platelet production:
1. no corrective action is necessary
2. recalibrate pH meter
3. increase final plasma volume of platelet concentrates
4. decrease final plasma volume of platelet concentrates
3 - increase final plasma volume of platelet concentrates
220
During preparation of platelet concentrate, the hermetic seal of the primary bag is broken. The red blood cells:
1. must be discarded
2. may be labeled with a 21 day expiration date if collected in CPD
3. must be labeled with a 24 hour expiration date
4. may be glycerolized within 6 days and stored frozen
3 - must be labeled with a 24 hour expiration date
221
The blood bank procedures manual must be:
1. revised annually
2. revised after publication of each new edition of AABB standards
3. reviewed prior to a scheduled inspection
4. reviewed annually by an authorized individual
4 - reviewed annually by an authorized individual
222
Previous records of patients` ABO and Rh types must be immediately available for comparison with current test results:
1. for 6 months
2. 12 months
3. 10 years
4. indefinitely
2 - 12 months
223
Which of the following weak D donor units should be labeled Rh-positif:
1. weak D due to transmissible genes
2. weak D as position effect
3. weak partial D
4. all of the above
4 - all of the above
224
In order to meet the current AABB standards for leukocyte reduction to prevent HLA alloimmunization or CMV transmission, the donor unit must retain at least __________ of the original red cells and leukocytes must be reduced to less than \_\_\_\_\_\_\_\_\_\_\_.
1. 85%, 5 X 108
2. 80%, 5 X 106
3. 75%, 5 X 105
4. 70%, 5 X 104
2 - 80%, 5 X 106
225
Which of the following tests is/are not performed during donor processing:
1. ABO and Rh grouping
2. HBs Ag
3. HIV-1-Ag
4. HBs Ab
4 - HBs Ab
226
A 70 kg man has a platelet count of 15000/uL, and there are no complicating factors such as fever or HLA sensitization. If he is given a platelet pool of 6 units, what would you expect his posttransfusion count to be:
1. 21 000-27 000/ul
2. 25 000-35 000/ul
3. 45 000-75 000/ul
4. 75 000-125 000/ul
3 - 45 000-75 000/ul
227
Which of the following tests on donor red blood cells must be repeated by the transfusing facility when the blood was collected and processed by a different facility:
1. confirmation of ABO group and Rh type of blood labeled D-negative
2. confirmation of ABO group and Rh type
3. weak D on D-negative
4. antibody screening
1 - confirmation of ABO group and Rh type of blood labeled D-negative
228
What is the required storage temperature for red blood cells, liquid:
1-6oC
229
What is the required storage temperature for red blood cells, frozen:
-65oC or colder
230
What is the required storage temperature for fresh-frozen plasma:
-18oC
231
What is the required storage temperature for cryoprecipitate:
-18oC
232
What is the required storage temperature for platelet concentrate:
20-24oC
233
What is the shelf life for red blood cells in CPDA-1:
35 days
234
What is the shelf life for fresh-frozen plasma:
1 year
235
What is the shelf life for cryoprecipitate:
1 year
236
What is the shelf life for fresh-frozen plasma, thawed:
24 hours
237
What is the shelf life for platelet concentrate in PL-732 (with agitation):
5 days
238
What is the shelf life for blood for transfusing therapy using the anticoagulant/preservative CPD (citrate phosphate dextrose):
21 days
239
What is the shelf life for blood for transfusing therapy using the anticoagulant/preservative CPDA-1 (citrate phosphate dextrose adenine):
35 days
240
What is the shelf life for blood for transfusing therapy using the anticoagulant/preservative AS-1 (Adsol):
42 days
241
What is the shelf life for blood for transfusing therapy using the anticoagulant/preservative EDTA:
Not an approved anticoagulant
242
A test for the hydrolysis of esculin in the presence of bile is especially useful in identifying species of the genus:
1. Abiotrophia
2. Corynebacterium
3. Enterococcus
4. Staphylococcus
3 - Enterococcus
243
The organism associated with a disease characterized by the presence of a pseudomembrane in the throat and the production of an exotoxin that is absorbed into the bloodstream with a lethal effect is:
1. Arcanobacterium haemolyticum
2. Staphylococcus aureus
3. Streptococcus pyogenes
4. Corynebacterium diphtheriae
4 - Corynebacterium diphtheriae
244
Enterotoxin produced by Staphylococcus aureus is responsible for causing:
1. Carbuncles
2. Enterocolitis
3. Impetigo
4. Scalded skin syndrome
2 - Enterocolitis
245
Abiotrophia, formerly knows as nutritionally variant streptococci, will not grow on routine blood or chocolate agars becasue they are deficient in:
1. hemin
2. pyridoxal
3. vitamine B12
4. thiophene-2-carboxylic hydrazide
2 - pyridoxal
246
Exfoliatin produced by Staphylococcus aureus is responsible for causing:
1. Enterocolitis
2. toxic shock syndrome
3. scalded skin syndrome
4. Staphylococcal pneumonia
3 - scalded skin syndrome
247
Streptococcus pyogenes can be presumptively identified using a:
1. PYR disk
2. ONPG disk
3. SPS disk
4. Optochin disk
1 - PYR disk
248
A gram positive coccus that is catalase positive, nonmotile, lysostaphin resistant, and modified oxidase positive is best identified as a member of the genus:
1. Micrococcus
2. Lactococcus
3. Pediococcus
4. Staphylococcus
1 - Micrococcus
249
Nocardia asteroidesi nfections in humans characteristically produce:
1. Carbuncles
2. draining cutaneous sinuses
3. septic shock
4. serous effusions
2 - draining cutaneous sinuses
250
Erysipelothrix infections in humans characteristically produce:
1. pathology at the point of entrance of the organism
2. central nervous system pathology
3. pathology in the lower respiratory tract
4. the formation of abscesses in visceral organs
1 - pathology at the point of entrance of the organism
251
In the Camp test, a single streak of a beta-hemolytic Streptococcus is placed perpendicular to a streak of beta-lysin-producing Staphylococcus aureus. After incubation, a zone of increased lysis in the shape of an arrowhead is noted; this indicates the presumptive identification of:
1. S. agalactiae
2. S. bovis
3. S. equinus
4. S. pyogenes
1 - S. agalactiae
252
Staphylococcus saprophyticus, a recognized pathogen, is a cause of:
1. furuncles
2. impetigo
3. otitis media
4. urinary tract infections
4 - urinary tract infections
253
The etiologic agent most commenly associated with septicemia and meningitis of newborns is:
1. Streptococcus agalactiae
2. Streptococcus bovis group
3. Streptococcus pneumoniae
4. Streptococcus pyogenes
1 - Streptococcus agalactiae
254
Which of the following is the most commonly isolated species of Bacillus in opportunistic infections such as bacteremia, post-traumatic infections of the eye, and endocarditis:
1. B. circulans
2. B. cereus
3. B. licheniformis
4. B. subtilis
2 - B. cerous
255
Loeffler's serum medium is recommended for the cultivation of:
1. Abiotrophia sp.
2. Corynebacterium diphtheriae
3. Leuconostoc sp.
4. Streptococcus agalactiae
2 - Corynebacterium diphtheriae
256
On Tinsdale agar, colonies of Corynebacterium diphtheriae are characterized by the observance of:
1. liquefaction of the agar surrounding the colonies on the medium
2. opalescent colonies with a white precipitate in the surrounding agar
3. black colonies on the culture medium surrounding by brown halos
4. pitting of the agar medium surrounding the colonies
3 - black colonies on the culture medium surrounding by brown halos
257
Precipitates of diphtheria toxin and antitoxin formed in agar gels are in vitro means for detecting toxigenic strains of Corynebacterium diphtheriae. The name of this test procedure is the:
1. D-test
2. Elek test
3. Hodge test
4. Nagler test
2 - Elek test
258
The etiologic agent of the disease erysipelas is:
1. Staphylococcus aureus
2. Streptobacillus moniliformis
3. Streptococcus agalactiae
4. Streptococcus pyogenes
4 - Streptococcus pyogenes
259
Staphylococcus aureus, when present, could most likely be recovered from a stool sample if the primary plating medium included:
1. Bismuth sulfite
2. phenylethyl alcohol
3. thiosulfate citrate bile salts sucrose
4. xylose-lysine-desoxycholate
2 - phenylethyl alcohol
260
A common member of the normal flora of the upper respiratory tract is:
1. Corynebacterium jeikeium
2. Lactobacillus
3. Staphylococcus epidermidis
4. Viridans streptococcus
4 - Viridans streptococcus
261
Streptococci obtain all their energy from the fermentation of sugars to:
1. formic acid
2. lactic acid
3. succinic acid
4. valeric acid
2 - lactic acid
262
Streptococci are unable to synthesize the enzyme:
1. catalase
2. kinase
3. hyaluronidase
4. lipase
3 - catalase
263
The beta-hemolysis produced by group A Streptococcus seen on the surface of a sheep blood agar plate is primarily the result of streptolysin:
1. H
2. M
3. O
4. S
4 - S
264
When an infection due to Streptomyces is suspected, isolates can be separated from most other bacteria by:
1. heat shocking the culture
2. incubating the culture at 25oC
3. incubating the culture at greater than 37oC
4. drying the specimen before inoculating the culture media
2 - incubating the culture at 25oC
265
The production of H2S is one characteristic used to differentiate which of the aerobic gram-positive bacilli:
1. Corynebacterium
2. Erysipelothrix
3. Lactobacillus
4. Nocardia
2 - Erysipelothrix
266
Growth in a 48 hour semisolid agar stab culture at room temperature reveals lateral filamentous growth away from the stab near the top of the medium. This observation is most characteristic of which organism:
1. Rhodococcus sp.
2. Corynebacterium urealyticum
3. Enterococcus faecalis
4. Listeria monocytogenes
4 - Listeria monocytogenes
267
A former species of Corynebacterium pathogenic for swine, horses, and cattle is also known to cause disease in compromised hosts. This organism when grown on culture media produces pale pink colonies that help to presumptively identify it as:
1. Arcanobacterium hemolyticum
2. Actinomyces naeslundii
3. Gardnerella vaginalis
4. Rhodococcus equi
4 - Rhodococcus equi
268
Which one of the following is not appropriate when describing Streptococcus pneumoniae:
1. bile-resistant
2. alpha-hemolytic
3. lancet-shaped, gram positive diplococcus
4. virulent strains are encapsulated
1 - bile-resistant
269
Nocardia can be differentiated from Actinomyces based on:
1. Nocardia being an obligate anaerobe
2. the partial-acid fast staining reaction of Actinomyces
3. the production of sulfur granules in cases of nocardiosis
4. Nocardia being catalase positive
4 - Nocardia being catalase positive
270
Enterococcus faecium is characteristically:
1. inhibited by the presence of bile in culture media
2. able to grow in the presence of high concentrations of salt
3. PYR negative
4. beta-hemolytic
2 - able to grow in the presence of high concentrations of salt
271
A negative PYR test is demonstrated by:
1. Enterococcus faecalis
2. Enterococcus faecium
3. Streptococcus pyogenes
4. Viridans streptococci
4 - Viridans streptococci
272
A gram stain of a sputum specimen from a patient with a suspected case of lobar pneumonia reveals many white blood cells and many gram positive cocci, which are primarily diplococci. Which of the following statements would be appropriate, given these findings:
1. a PYR test should be performed on the culture isolate
2. an Elek test should be performed on the culture isolate
3. an optochin test should be performed on the culture isolate
4. a hippurate hydrolysis test should be performed on the culture isolate
3 - an optochin test should be performed on the culture isolate
273
A child presented in August at the pediactric clinic with a superficial skin infection of the neck. The large, itchy lesions were cultured, and the diagnosis of impetigo was made. One of the etiologic agents os this clinical condition is:
1. Erysipelothrix rhusiopathiae
2. Corynebacterium diphteriae
3. staphylococcus saprophyticus
4. Streptococcus pyogenes
4 - Streptococcus pyogenes
274
An identifying characteristic of Staphylococcus aureus is:
1. DNase negative
2. coagulase negative
3. mannitol fermentation positive
4. growth inhibition in presence of increased salt
3 - mannitol fermentation positive
275
Which of the following organisms is able to hydrolyze sodium hippurate to benzoic acid and glycine:
1. Streptococcus agalactiae
2. Streptococcus pneumoniae
3. Listeria monocytogenes
4. Enterococcus faecalis
1 - Streptococcus agalactiae
276
Which of the following is not characteristic of Listeria monocytogenes:
1. CAMP test positive
2. catalase negative
3. esculin hydrolysis positive
4. motile
2 - catalase negative
277
Which of the following is not associated with Staphylococcus aureus:
1. Endotoxin production
2. clumping factor production
3. deoxyribonuclease production
4. hemolysin production
1 - Endotoxin production
278
Which of the following is a characteristic of staphylococci that would help in ther isolation from clinical specimens:
1. bile resistance
2. growth at 55oC
3. high salt tolerance
4. resistance to novobiocine
3 - high salt tolerance
279
Which of the following species of Bacillus is nonmotile:
1. B. cereus
2. B. subtilis
3. B. anthracis
4. B. thuringiensis
3 - B. anthracis
280
Which one of the following diseases involves erythrogenic toxin:
1. cutaneous anthrax
2. diptheria
3. impetigo
4. scarlet fever
4 - scarlet fever
281
Cultures of the posterior pharynx are most commonly submitted to the clinical laboratory for the detection:
1. Corynebacterium diphteriae
2. Staphylococcus aureus
3. Streptococcus pneumoniae
4. Streptococcus pyogenes
4 - Streptococcus pyogenes
282
Streptococcus sanguins, a viridans streptococcus, is most commonly associated with which of the follwoing clinical conditions:
1. otitis media
2. pharyngitis
3. relapsing fever
4. subacute bacterial endocarditis
4 - subacute bacterial endocarditis
283
Rust-colored sputum in cases of lobar pneumonia is cahracteristic of which of the following possible etiologic agents:
1. Corynebacterium jeikeium
2. Staphylococcus aureus
3. Streptococcus pneumoniae
4. Streptococcus pyogenes
3 - Streptococcus pneumoniae
284
A urine from a 23 year old female grew a catalse positive gram positive coccus, which would most likely be:
1. Staphylococcus saprophyticus
2. Enterococcus faecalis
3. Streptococcus bovis group
4. Streptococcus viridans
1 - Staphylococcus saprophyticus
285
Cystine-tellurite blood agar plates are recommended for the isolation of:
1. Corynebacterium diphteriae
2. Streptococcus agalactiae
3. Streptococcus pyogenes
4. Group D streptococci
1 - Corynebacterium diphteriae
286
The pulmonary form of anthrax is knows as:
1. valley fever
2. walking pneumonia
3. farmers' lung
4. woolsorters disease
4 - woolsorters disease
287
Pleomorphic gram positive bacilli in a gram stain best describes:
1. Bacillus antrhracis
2. Bacillus subtilis
3. Listeria monocytogenes
4. Corynebacterium pseudodiphtheriticum
4 - Corynebacterium pseudodiphtheriticum
288
An aerobic gram positive rod known to cause bacteremia in hospitalized immuno compromised patients is:
1. Bacillus anthracis
2. Corynebacterium jeikeium
3. Corynebacterium ulcerans
4. Corynebacterium urealyticum
2 - Corynebacterium jeikeium
289
A bone marrow transplant patient on immunosuppressive therapy developed a pulmonary abscess with symptoms of neurologic involvment. A brain abscess was detected by MRI, and aspirated material grew an aerobic, filamentous, branching gram positive organism, which stained weakly acid fast. The most liekly etiologic agent in this case would be:
1. Actinomyces israelii
2. Nocardia asteroides
3. Mycobacterium tuberculosis
4. Propionibacterium acnes
2 - Nocardia asteroides
290
Which of the following is catalase negative:
1. Bacillus
2. Corynebacterium
3. Leuconostoc
4. Listeria
3 - Leuconostoc
291
The retrovirus responsible for causing acruired immune deficiency syndrome is a member of the family:
1. Orthomyxoviridae
2. Paramyxoviridae
3. Retroviridae
4. Flaviviridae
3 - Retroviridae
292
The appearance of Koplik spots in the oral mucosa of patients is characteristic of infection with what viral agent:
1. hepatitis
2. measles
3. rabies
4. smallpox
2 - measles
293
Characteristics of this DNA hepatitis virus include infections spread by contaminated body fluids 50 to 180 day incubation period, and chronic infections:
1. HAV
2. HBV
3. HCV
4. HEV
2 - HBV
294
Which of the following has been declared eradicated by the World Health Organization:
1. smallpox
2. human T cell lymphotropic virus
3. hepatitis G virus
4. eastern equine encephalitis
1 - smallpox
295
Rotavirus is most common etiologic agent of:
1. acute nonbacterial encaphalitis in children
2. acute nonbacterial gastroenteritis in infants and young children
3. chronic nonbacterial pharyngitis in children and young adults
4. chronic nonbacterial retinitis in children
2 - acute nonbacterial gastroenteritis in infants and young children
296
Kaposi sarcoma is associated with infection by:
1. adenovirus
2. cytomegalovirus
3. hepatitis E virus
4. human herpes virus 8
4 - human herpes virus 8
297
The molecular receptor of the virus causing acquired immune deficiency syndrome is:
1. CD4
2. CD8
3. Fc receptor
4. complement receptor
1 - CD4
298
The type of cell culture that best suppports the growth of cytomegalovirus is:
1. HeLa cells
2. HEp-2 cells
3. human fibroblast cells
4. primary monkey kidney (PMK) cells
3 - human fibroblast cells
299
Which of the following viruses is predominently associated with respiratory disease and epidemics of keratoconjunctivitis:
1. adenovirus
2. molluscum contagiosum virus
3. norwalk virus
4. rotavirus
1 - adenovirus
300
A 25 year old patient presented with multiple vesicles around the mouth. Material from the lesions was obtained by needle aspiration and inoculated to MRC-5 cells. After 1 day, the cytopathic effect included foci of ballooned and lysed cells. These observations suggest infection with:
1. adenovirus
2. cytomegalovirus
3. epstein-barr virus
4. herpes simplex virus
4 - herpes simplex virus
301
The Sabin polio vaccine uses which of the following:
1. formalin-inactivated virus
2. attenuated viruses
3. recombinant viral antigens
4. DNA
2 - attenuated viruses
302
Which of the following is caused by a herpes virus:
1. cold sores
2. hemorrhagic fever
3. polio
4. rabies
1 - cold sores
303
Which of the following is not a general characteristic of a virus:
1. obligate intracellular parasite
2. does not produce ATP
3. genome is surrounded by a protein coat
4. can self-replicated in the appropriate host cell
4 - can self-replicated in the appropriate host cell
304
The viral disease shingles, which causes extreme tenderness along the dorsal nerve roots and a vesicular erpution, has the same etiologic agent as:
1. rubeola
2. vaccinia
3. varicella
4. variola
3 - varicella
305
The etiologic agents of many common colds are RNA viruses that grow better at 33oC than at 37oC. These viruses are:
1. adenovirus
2. orthomyxoviruses
3. paramyxoviruses
4. rhinoviruses
4 - rhinoviruses
306
Influenza A virus undergoes recombination events that produce new strains; this is referred to as:
1. antigenic drift
2. antigenic shift
3. reactivation
4. viral latency
2 - antigenic shift
307
Negri bodies may be found in brain tissue of humans or animals infected with:
1. adenovirus
2. filovirus
3. measles virus
4. rabies virus
4 - rabies virus
308
Molluscum contagiosum virus is a member of the:
1. Adenoviruses
2. Herpesviruses
3. Papovaviruses
4. pox viruses
4 - pox viruses
309
A clinical specimen is received in viral transport medium for viral isolation. The specimen cannot be processed for 72 hours. At what temperature should it be stored:
1. -80oC
2. -20oC
3. 4oc
4. 22oC
1 - -80oC
310
Arboviruses:
1. only infect humans
2. often cause hepatitis
3. typically infect lymphocytes
4. are transmitted by arthropods
4 - are transmitted by arthropods
311
Mumps is characterized by an infection of the:
1. central nervous system
2. parotid glands
3. pancreas
4. thymus
2 - parotid glands
312
Which of the following hepatitis viruses is typically transmitted by the fecal-oral pathway:
1. HAV
2. HBV
3. HCV
4. HGV
1 - HAV
313
Enteroviruses are most often associated with:
1. acute nonspecific febrile syndrome
2. bronchitis and pneumonia
3. lower respiratory tract infections
4. upper respiratory tract infections
1 - acute nonspecific febrile syndrome
314
The core window refers to the time:
1. during hepatitis B virus infection when anti-HBc IgM is the only serologic marker
2. during hepatitis B virus infection when HBc is the only serologic marker
3. during hepatitis A virus infection when HAc is the only serologic marker
4. during hepatitis C virus infection when the virus is latent
1 - during hepatitis B virus infection when anti-HBc IgM is the only serologic marker
315
Human herpesviruses 6 and 7 are associated with a childhood disease called:
1. chickenpox
2. measles
3. roseola
4. zoster
3 - roseola
316
A baby was admitted to the hospital in February for dehydration due to severe diarrhea. Cultures for bacterial pathogens revealed normal fecal flora at 24 hours. Which of the following additional tests would be most appropriate given the case history:
1. heterophile antibody test
2. rotavirus antigen assay of stool specimen
3. McCoy cell inoculation for cytomegalovirus
4. urine microscopic analysis for presence of CMV cellular inclusion bodies
2 - rotavirus antigen assay of stool specimen
317
Rhabdovirus is most noted for causing infections of the:
1. central nervous system
2. gastrointestinal tract
3. lower respiratory tract
4. upper respiratory tract
1. central nervous system
318
Jaundice is a common clinical symptom of which of the following viral disease:
1. hepatitis A
2. infectious mononucleosis
3. rabies
4. varicella
1 - Hepatitis A
319
An 18 year old male presents to his family physician complaining of sore throat and fatigue. The patient is found to have a fever and swollen cervical lymph nodes. A complete blood count and differential reveal lymphocytosis and many reactive lymphocytes. The physician should suspect an infection caused by:
1. adenoviruses
2. epstein-barr virus
3. parainfluenza virus
4. varicella-zoster virus
2 - epstein-barr virus
320
The poliovirus, an RNA virus is a:
1. adenovirus
2. coxsackie virus
3. enterovirus
4. rhinovirus
3 - enterovirus
321
The virus that causes hepatitis B is characterized as a:
1. defective DNA virus requiring delta virus to complete its replication cycle
2. DNA virus utilizing reverse transcriptase
3. nonenveloped DNA virus
4. single stranded RNA virus
2 - DNA virus utilizing reverse transcriptase
322
Hepatitis C virus infections:
1. are commonly diagnosed during the acute stage
2. are uncommon in the US
3. are most often acquired by contact with blood
4. seldom results in chronic infection
3 - are most often acquired by contact with blood
323
Characteristic cytopathic effect associated with respiratory syncytial virus is:
1. giant multinucleated cells
2. basophilic intranuclear inclusions
3. eosinophilic cytoplasmic inclusions
4. shrunken cells with multilobed nuclei
1 - giant multinucleated cells
324
The virus associated with warts is:
1. flavivirus
2. Morbillivirus
3. Mumps virus
4. Papillomavirus
4 - Papillomavirus
325
RNA dependant DNA polymerase is also called:
1. gyrase
2. neuraminidase
3. reverse transcriptase
4. transaminase
3 - reverse transcriptase
326
Coxsackie viruses are associated with :
1. gastrointestinal disease
2. hepatitis
3. myocarditis
4. the common cold
3 - myocarditis
327
The tubular cells of the human kidney shed which of the following viruses for prolonged periods:
1. Adenovirus
2. Cytomegalovirus
3. Epstein-barr virus
4. Rubella virus
2 - Cytomegalovirus
328
The togavirus known to produce fetal defects is:
1. Influenza
2. Rotavirus
3. Rubella
4. Varicella
3 - Rubella
329
An 8 week old infant was admitted to the hospital with symptoms of low birth weight, jaundice, and neurologic defects. Intranuclear inclusions were found in epithelial cells from the urine. The most likely diagnosis in this case would be infection by:
1. Cytomegalovirus
2. Epstein-Barr virus
3. Herpes simplex virus
4. Rubella virus
1 - Cytomegalovirus
330
The most common cause of cervical cancer is:
1. Cytomegalovirus
2. Enterovirus
3. Molluscum contagiosum
4. Papillomavirus
4 - Papillomavirus
331
Select the statement that is correct concerning the influenza A viruses:
1. humans are the only animal hosts for influenza A viruses
2. pandemics are characteristically produced by influenza A
3. the incidence of infection peaks in the summer months
4. they are DNA viruses
2 - pandemics are characteristically produced by influenza A
332
An example of a virus associated with latent infection is:
1. Influenza
2. Rotavirus
3. Rubella
4. Varicella-zoster
4 - Varicella-zoster
333
The use of cell cultures has enabled virologists to isolate and identify many clinically important viruses. However, because some viruses cannot be grown in cell cultures, these agents are best diagnosed by serologic testing. Such an agent is:
1. Cytomegalovirus
2. Hepatitis C virus
3. Herpes simplex virus 2
4. respiratory syncytial virus
2 - Hepatitis C virus
334
Which of the following is associated with the rubella virus:
1. it is a DNA virus
2. it is a member of the same taxonomic family as measles virus
3. it is known to produce defects in fetuses during the early stages of pregnancy
4. it is transmitted by an arthropod vector
3 - it is known to produce defects in fetuses during the early stages of pregnancy
335
Which of the following is not a step involved in virus replication:
1. attachment
2. mitosis
3. penetration
4. release
2 - mitosis
336
Which of the following opportunistic diseases is not closely associated with acquired immune deficiency syndrome:
1. Cryptococcosis
2. Cryptosporidiosis
3. Malaria
4. Mycobacteriosis
3 - Malaria
337
Although there have been no natural cases of this serious disease in about 30 years, which of the following is considered a potential bioterrorism disease:
1. Dengue
2. Ebola hemorrhagic fever
3. Shingles
4. Smallpox
4 - Smallpox
338
Poliovirus is a member of the family:
1. Flaviviridae
2. Paramyxoviridae
3. Picornaviridae
4. Reoviridae
3 - Picornaviridae
339
Which of the following has not been successfully used to detect viruses in clinical specimens:
1. cytopathic effect
2. enzyme-linked immunosorben assay
3. growth on selective agar media
4. immunofluorescence
3 - growth on selective agar media
340
Which of the following diseases is not associated with herpes simplex virus:
1. cold sores
2. Encephalitis
3. genital herpes
4. thrush
4 - thrush
341
If 20% of the nucoletides in an organism are adenine, predict the percentage of nucleotides that are guanine:
1. 20%
2. 30%
3. 40%
4. 60%
2 - 30%
342
Which of the following is not required for DNA replication by PCR:
1. oligonucleotide primers
2. DNA polymerase
3. DNA ligase
4. deoxynucloetides
3 - DNA ligase
343
In naming restriction endonucleases, the first letter of the name comes from the:
1. bacterial genus
2. bacterial species
3. scientist who discovered it
4. geographic location of its discovery
1 - bacterial genus
344
A restriction enzyme recogniaes the sequence 5' CT ^ ATAG 3', and cuts as indicated. Predict the ends that would result on the complementary DNA strand:
1. 3' G 5' 3' ATATC 5'
2. 3' GA 5' 3' TATC 5'
3. 3' GATA 5' 3' TC 5'
4. 3' GATAT 5' 3' C 5'
3 - 3' GATA 5' 3' TC 5'
345
In the isolation of RNA, diethylpyrocarbonate (DEPC) is used to:
1. inhibit RNase
2. lyse the cells
3. precipitate the DNA
4. remove buffer salts
1 - inhibit RNase
346
Purification resins used to isolate DNA take advantage of the fact that DNA is:
1. double stranded
2. negatively charged
3. higher in concentration than RNA
4. higher molecular weight than RNA
2 - negatively charged
347
After performance of DNA electrophoresis, the isolated bands in the kilobase size range appear too close together. Which of the following can be done with the next run to improve the appearance/seperation of the bands in the samples:
1. increase the percent agarose concentration of the matrix
2. increase the running time of the electrophoresis assay
3. increase the sample volume applied to the gel
4. decrease the sample volume applied to the gel
2 - increase the running time of the electrophoresis assay
348
Which of the following is commonly used as a label in molecular tests:
1. biotin
2. DNase
3. RNase
4. I125
1 - biotin
349
Which of the folowing is not an example of target amplification:
1. reverse transcription-PCR
2. transcirption mediated amplification
3. branched chain DNA amplification
4. polymerase chain reaction
3 - branched chain DNA amplification
350
In forensic testing, DNA fingerprinting can identify individuals with high accuracy because:
1. human genes are highly conserved
2. only a small amount of sample is needed
3. human gene loci are polymorphic
4. DNA is stable and not easily contaminated
3 - human gene loci are polymorphic
351
The technique that makes ssDNA from an RNA template is called:
1. strand displacement amplification
2. polymerase chain reaction
3. ligase chain reaction
4. reverse transcription
4 - reverse transcription
352
Which of the following is characteristic of DNA chips:
1. allow detection and discrimination of multiple genetic sequences at the same time
2. thousands of oligonucleotide probes are labeled and placed on glass or silicon surfaces
3. unlabeled target sequences within the patient sample are detected by hybridization to labeled probes
4. all of the above
1 - allow detection and discrimination of multiple genetic sequences at the same time
353
The most useful feature of the molecules streptavidin and biotin is that they bind:
1. specifically to nucleic acids
2. only in neutral pH conditions
3. to each other with very high affinity
4. directly to DNA immobilized on nitrocellulose
3 - to each other with very high affinity
354
What is the theoretic estimation of the number of DNA target sequences present following 15 cycles of PCR:
1. 30
2. 210
3. 215
4. 220
3 - 215
355
Star activity for a restriction enzyme refers to:
1. an ability to cleave DNA at sequences different from their defined recognition sites
2. the enzyme's specificity for sites of methylation within the nucleotide sequence
3. the temperature and pH conditions at which the enzyme will function optimally
4. the percent increased accuracy of the enzyme when placed in ideal conditions of pH
1 - an ability to cleave DNA at sequences different from their defined recognition sites
356
What enzyme recognizes and cuts overlapping DNA sequences formed between mutant or normal probes and target sequences within samples:
1. restriction endonuclease
2. DNA ligase
3. cleavase
4. RNase H
3 - cleavase
357
If a DNA probe is added to nitrocellulose after the transfer step but before the blocking step, which of the following will occur:
1. the probe will nonspecifically bind to its DNA target
2. unoccupied spaces on the nitrocellulose will bind the probe
3. the DNA target on the nitrocellulose will be unable to bind the probe
4. bound probe will be washed away in the next wash step
2 - unoccupied spaces on the nitrocellulose will bind the probe
358
Which of the following items is not used in the preperation of a dNA probe for southern blotting using random hexamer primers:
1. template DNA
2. three unlabeled deoxynucleotides
3. dideoxynucleotides, with one of them labeled
4. DNA polymerase
3 - dideoxynucleotides, with one of them labeled
359
Which of the following is considered a high stringency condition for DNA probe protocols:
1. using wash buffer with highly acidic pH
2. washing the matrix with high salt buffer
3. radiolabeling the probe with 35S rather than 32P
4. washing the transfer membrane at high temperature
4 - washing the transfer membrane at high temperature
360
When compared to southern blot hybridization testing, PCR
1. is less sensitive to DNA degradation than southern blot
2. includes transfer of DNA onto a nylon membrane
3. requires no specialized equipment
4. is more labor intensive
1 - is less sensitive to DNA degradation than southern blot
361
Which of the following specimen types is not used routinely as source material for molecular genetic tests:
1. whole blood
2. buccal scrapings
3. aminocytes
4. rectal swabs
4 - rectal swabs
362
In the presence of salt, DNA is precipitated from solution by:
1. 10 mM Tris, 1 mM EDTA
2. 0.1% sodium dodecyl sulfate
3. alkaline buffers, such as 0.2 N NaOH
4. alcohols such as 95% ethanol or isopropanol
4 - alcohols such as 95% ethanol or isopropanol
363
TaqMan probes used to increase specificity of real time PCR assays generate a fluorescent signal:
1. at the beginning of each cycle during the denaturation step
2. when the probes bind to the template
3. when the probe is digested by 5' → 3' exonuclease activity during extension of primers
4. when the reporter fluorophor on the probe is seperated from the quencher molecule by a restriction enzyme
3 - when the probe is digested by 5' → 3' exonuclease activity during extension of primers
364
For the purpose of diagnosing genetic diseases, what component of whole blood is used for the extraction of DNA:
1. leukocytes
2. plasma
3. platelets
4. red blood cells
1 - leukocytes
365
Which of the following statements best describes characteristics of RNase:
1. it degrades mRNA but nor rRNA
2. it is found in large concentrations on hands
3. its activity can be eliminated by autoclaving
4. its activity occurs in a limited temperature range between 25 and 65oc
2 - it is found in large concentrations on hands
366
Which of the following is the least likely inhibitor of PCR:
1. heme
2. sodium heparin
3. DEPC
4. EDTA
4 - EDTA
367
Frequently, DNA probes are used to detect target sequences in northern or southern blots. Hybridization occurs between DNA probe and RNA or DNA on the blot, respectively. To ensure that only exactly matched complementary sequences have bound together, the blot is washed under stringent conditions. Stringency of the wash steps to remove unbound and mismatched probe can be increased by:
1. high temperature, high NaCl concentration, and high detergent solution
2. high tempearture, low NaCl concentration, and high detergent solution
3. high temperature, high NaCl concentration, and low detergent solution
4. low temperature, high NaCl concentration, and high detergent solution
2 - high tempearture, low NaCl concentration, and high detergent solution
368
In RNA, which nucleotide base replaces thymine of DNA:
1. adenine
2. cytosine
3. guanine
4. uracil
4 - uracil
369
The component parts of a dNTP include a purine or pyrimidine base, a:
1. ribose sugar, and one phosphate group
2. deoxyribose sugar, and three phosphate groups
3. ribose sugar, and two phosphate groups
4. deoxyribose sugar, and two phosphate groups
2 - deoxyribose sugar, and three phosphate groups
370
When comparing two dsDNA sequences of equal length, the strand that has a higher:
1. G + C content has a higher melting temperature
2. A + T content has a higher melting temperature
3. A + T content has more purines than pyrimidines along its length
4. G + C content has more purines than pyrmidines along its length
1 - G + C content has a higher melting temperature
371
Molecular typing of bacterial strains is based on restriction fragment length polymorphisms produced by digesting bacterial chromosomal DNA with restriction endonucleases. Which of the following techniques is used to seperate the large DNA fragments generated:
1. ribotyping
2. DNA sequencing
3. pulsed field gel electrophoresis
4. reverse transcription polymerase chain reaction
3 - pulsed field gel electrophoresis
372
Which of the following amplification methods does not employ isothermal conditions:
1. nucleic acid sequence based amplification
2. polymerase chain reaction
3. strand displacement amplification
4. transcription mediated amplification
2 - polymerase chain reaction
373
The coding region of a human gene is called:
1. exon
2. intron
3. SNP
4. VNTR
1 - exon
374
The central dogma is that DNA is used to make RNA, which is then used to make protein. In this scheme the two processes that are involved are termed:
1. replication and transcription
2. synthesis and encryption
3. transcription and translation
4. initiation and elongation
1 - replication and transcription
375
How many chromosomes are contained in a normal human somatic cell:
1. 22
2. 23
3. 44
4. 46
4 - 46
376
An ordered sequence of events makes up the cell cycle. Which of the following describes the correct sequence of events starting at G1:
1. G1, G2, S, M
2. G1, S, G2, M
3. G1, M, G2, S
4. G1, S, M, G2
2 - G1, S, G2, M
377
Purified DNA remains stable indefinitely when stored as:
1. small aliquots at 4oC
2. large aliquots at 25oC
3. small aliquots at -70oC
4. large aliquots at -20oC
3 - small aliquots at -70oC
378
An advantage of amplification technologies for clinical laboratories is that:
1. they require inexpensive test reagents
2. they lend themselves to automated methods
3. each target molecule sought requires a unique set of primers
4. contamination is not a concern when performing these assays
2 - they lend themselves to automated methods
379
The assay methods that detects the expression of a gene rather than the mere presence or structure of a gene is termed:
1. RT-PCR
2. TMA
3. multiplex PCR
4. ribotyping
1 - RT-PCR
380
Which of the following assays cannot be accomplished using PCR methods employing only Taq polymerase:
1. diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae infection
2. detection of single base pair gene mutations, such as in cystic fibrosis
3. detection of HLA-A, B and DR genotypes
4. determination of viral load for HCV
4 - determination of viral load for HCV
381
One method to prevent false positive PCR results includes the use of dUTP in the reaction mix, resulting in amplicons containing U in place of T. The enzyme used to decrease contamination is:
1. Uracil-N-glycosylase
2. Taq polymerase
3. S1 nuclease
4. DNase
1 - Uracil-N-glycosylase
382
The translocation resulting in the Philadelphia chromosome is detected by:
1. southern blot analysis only
2. cytogenic analysis only
3. PCR, southern blot, and cytogenetic analysis
4. RT-PCR, southern blot, and cytogenetic analysis
4 - RT-PCR, southern blot, and cytogenetic analysis
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