1.
HAMA antibodies occur as a result of:
Correct Answer
B. Patient exposure to mice or mouse proteins
Explanation
HAMA antibodies occur as a result of patient exposure to mice or mouse proteins. This means that the patient has been exposed to mice or products derived from mice, which has triggered an immune response and the production of HAMA antibodies. These antibodies can interfere with diagnostic tests and lead to false-positive results. It is important to consider this possibility when interpreting test results and to take precautions to minimize the risk of contamination with mouse proteins in laboratory settings.
2.
The ability of an assay to reproducibly hit a target concentration is referred to as:
Correct Answer
C. Precision
Explanation
Precision refers to the ability of an assay to consistently and reproducibly hit a target concentration. It measures the degree of agreement between repeated measurements or tests. A high precision means that the assay produces consistent and reliable results, even if they are not necessarily accurate. In other words, precision indicates the reliability or consistency of the assay in hitting the desired target concentration.
3.
Calibrators are samples from individuals known to be in the normal range that are used to check
instrumentation set-up.
Correct Answer
B. False
Explanation
Calibrators are samples of known concentration used to set analyzer or instrumentation parameters.
4.
Which of the following Westgard Rules primarily detect systematic error?
Correct Answer
B. 2-2s
Explanation
The Westgard Rules are a set of quality control rules used in laboratory testing to detect errors and ensure the accuracy of test results. The rule 2-2s is used to detect systematic errors, which are consistent errors that occur in a predictable manner. This rule flags results that are more than 2 standard deviations away from the mean in the same direction in two consecutive control measurements. By identifying systematic errors, laboratories can investigate and correct any issues that may be affecting the accuracy of their test results.
5.
When comparing an instrument to its peer group, which statistic provides the most useful information regarding its accuracy?
Correct Answer
A. Mean
Explanation
The mean provides the most useful information regarding accuracy when comparing an instrument to its peer group. The mean represents the average value of a set of data, which can give an indication of the instrument's overall performance. By comparing the mean of one instrument to the mean of its peer group, one can determine how accurate the instrument is relative to its peers.
6.
When comparing an instrument to its peer group, which statistic provides the most useful description of overall imprecision.
Correct Answer
C. CVR
Explanation
CVR, which stands for Coefficient of Variation Ratio, provides the most useful description of overall imprecision when comparing an instrument to its peer group. CVR is a statistical measure that compares the standard deviation to the mean. It is used to assess the relative variability of a dataset, taking into account the scale of the data. A higher CVR indicates greater imprecision, while a lower CVR indicates greater precision. Therefore, CVR is a valuable statistic for evaluating the overall imprecision of an instrument in comparison to its peers.
7.
Which of the following Westgard Rules primarily detect random error?
Correct Answer
D. A & c
Explanation
The Westgard Rules are a set of quality control rules used in laboratory testing to detect errors and ensure the accuracy of test results. The R-4s rule primarily detects random error, which refers to unpredictable variations in test results that can occur due to factors such as instrument malfunction or operator error. Similarly, the 1-3s rule also detects random error by flagging test results that deviate significantly from the mean. Therefore, both options "a & c" are correct as they both primarily detect random error.
8.
When a clot is detected in Beckman LX 20 pro, the system will do one retry to aspirate the sample. If the retry is successful, testing will continue and the missed test will be rescheduled. If the retry is unsuccessful, no sampling will occur from the sample.
Correct Answer
A. True
Explanation
When a clot is detected in the Beckman LX 20 pro, the system will attempt to aspirate the sample again. If the second attempt is successful, the testing will proceed as normal and any missed tests will be rescheduled. However, if the second attempt is unsuccessful, the system will not take a sample from the clot. Therefore, the statement is true.
9.
All the following Beckman reagent require a reagent transfer of Compartment "C" reagent into Compartment "A" EXCEPT
Correct Answer
D. ALP
Explanation
The reagent transfer of Compartment "C" reagent into Compartment "A" is required for all the following Beckman reagents: ALT, AST, CK, and TG. The only exception is ALP, which does not require this reagent transfer.
10.
Serum pH is a measure of the relative acidity or alkalinity of blood and is a reflection of the concentration of Hydrogen ions in blood. A high concentration gives a low pH (acid), while a low concentration gives a high pH (alkaline). What is the normal range for arterial pH?
Correct Answer
C. 7.35 to 7.45
Explanation
The normal range for arterial pH is 7.35 to 7.45. This range indicates a slightly alkaline pH, which is necessary for proper functioning of the body's systems. Any deviation from this range can indicate an imbalance in the body's acid-base balance and may require medical intervention.
11.
Small changes in the body pH can be life threatening and these changes are regulated by buffers. Carbonic acid (H2CO3) and base bicarbonate (NaHCO3) are paired buffers that work to maintain homeostasis of body pH. What body systems control these buffers?
Correct Answer
C. H2CO3 Respiratory | NaHCO3 Renal
Explanation
The correct answer is H2CO3 Respiratory | NaHCO3 Renal. The respiratory system controls the levels of carbonic acid (H2CO3) by regulating the rate of breathing, which affects the amount of carbon dioxide (CO2) in the body. The renal system controls the levels of bicarbonate (NaHCO3) by reabsorbing or excreting it in the urine. Together, these two systems work to maintain the balance of carbonic acid and bicarbonate in the body, ensuring proper pH regulation.
12.
A 42-year-old man is admitted to the hospital with dehydration and hypotension.
Electrolytes show:
Na+
165 mEq/L
K+
4.0 mEq/L
CO2
32 mEq/L
Cl-
112 mEq/L
No arterial blood gas is obtained. Which statement best applies about this patient's acid-base status?
Correct Answer
D. Electrolytes indicate the presence of both metabolic acidosis and metabolic alkalosis.
Explanation
His anion gap is Na - (CO2 + Cl) = 165 - (32+112) = 21, indicating a metabolic acidosis. His bicarbonate gap is (Na - Cl - 39) = 165 - 112 - 39 = 14, which indicates a metabolic alkalosis. Note that it is not necessary to actually calculate a bicarbonate gap, since the elevated serum CO2 (32 mEq/L) in the presence of anion gap acidosis is enough to signify concomitant metabolic alkalosis. Of course without blood gas measurements you don't know which process is predominant, but it is clear from the electrolytes that both metabolic disorders are present. You don't need to measure albumin nor lactate to make this determination.
13.
Given the following arterial blood gas values:
pH: 7.56
PCO2: 31 mm Hg
HCO3: 27 mEq/l
PO2: 56 mm Hg
What is(are) the most likely acid-base state(s) in the patient?
Correct Answer
C. Respiratory alkalosis and metabolic alkalosis
Explanation
Based on the given values, the patient has a high pH (7.56) and a low PCO2 (31 mm Hg), indicating respiratory alkalosis. Additionally, the HCO3 level (27 mEq/l) is higher than normal, suggesting metabolic alkalosis. Therefore, the most likely acid-base state(s) in the patient are respiratory alkalosis and metabolic alkalosis.
14.
One or more of the following statements (A, B, C) about PO2 may be correct. Choose the single letter answer (a - e) that reflects which statement(s) is(are) correct.
A) If the lungs and heart are normal, then PO2 is affected only by factors that affect alveolar PO2.
B) In a person with normal heart and lungs, anemia should not affect PO2.
C) The reason PO2 falls with increasing altitude is because barometric pressure falls.
Correct Answer
E. A), B) and C) are correct.
Explanation
The correct answer is A), B) and C) are correct.
A) If the lungs and heart are normal, then PO2 is affected only by factors that affect alveolar PO2. This statement is correct because in a person with normal lung and heart function, the partial pressure of oxygen (PO2) in the blood is primarily determined by the oxygen levels in the alveoli of the lungs.
B) In a person with normal heart and lungs, anemia should not affect PO2. This statement is correct because anemia, which is a decrease in the number of red blood cells or a decrease in their ability to carry oxygen, does not directly affect the partial pressure of oxygen in the blood.
C) The reason PO2 falls with increasing altitude is because barometric pressure falls. This statement is correct because at higher altitudes, the atmospheric pressure decreases, leading to a decrease in the partial pressure of oxygen in the air. This decrease in oxygen pressure can affect the PO2 in the blood.
15.
Serum bilirubin measurement using Leica bilirubinometer should ideally be performed on neonates less than 4 weeks old or have not consumed any solid food.
Correct Answer
A. True
Explanation
The explanation for the given correct answer is that the measurement of serum bilirubin using Leica bilirubinometer is most accurate and reliable in neonates who are less than 4 weeks old or have not consumed any solid food. This is because bilirubin levels can vary in infants who are older or have started solid food, making the measurement less accurate. Therefore, to obtain the most reliable results, this test should ideally be performed on neonates within the specified age range or feeding status.
16.
What is the read time for this QuickVue urine HCG kit?
Correct Answer
A. 3 mins
Explanation
The correct answer is 3 mins. The QuickVue urine HCG kit has a read time of 3 minutes, which means that after adding the urine sample to the kit, the results can be read and interpreted after 3 minutes.
17.
What is the detection level of the QuickVue urine HCG test?
Correct Answer
B. 25mIU/L
Explanation
The detection level of the QuickVue urine HCG test is 25mIU/L.
18.
Which of the following statement is true?
Correct Answer
B. The osmolality of serum increases with dehydration and decreases with overhydration.
Explanation
Osmolality is a measure of the concentration of solutes in a solution. When someone is dehydrated, there is a decrease in the amount of water in the body, causing the concentration of solutes to increase. This leads to an increase in osmolality. On the other hand, when someone is overhydrated, there is an excess of water in the body, causing the concentration of solutes to decrease. This leads to a decrease in osmolality. Therefore, the correct statement is that the osmolality of serum increases with dehydration and decreases with overhydration.
19.
Maple syrup urine disease results from an inborn error of metabolism of certain types of amino acids. Which ones?
Correct Answer
B. Leucine, isoleucine, and valine
Explanation
Maple syrup urine disease is caused by a deficiency of the enzyme complex that breaks down the amino acids leucine, isoleucine, and valine. This leads to a buildup of these amino acids in the body, which can cause a sweet-smelling urine, neurological symptoms, and other health problems. Phenylalanine and tyrosine are not involved in this condition. Serine and threonine, any acidic amino acids, and cysteine and methionine are also not related to maple syrup urine disease.
20.
Sedentary persons who consume rich diets sometimes suffer gout, a condition which may cause toes to swell and joints to become painful due to an accumulation of:
Correct Answer
E. Uric acid
Explanation
Gout is a condition caused by the accumulation of uric acid in the joints. Uric acid is a waste product that is normally excreted by the kidneys. However, sedentary individuals who consume rich diets, particularly those high in purines (found in foods like red meat, seafood, and alcohol), may produce excessive amounts of uric acid and have difficulty excreting it. This can lead to the formation of urate crystals in the joints, resulting in inflammation, swelling, and pain. Therefore, uric acid is the correct answer in this context.
21.
What three changes will affect the results of the microscopic examination of urine if it is not tested within 2 hours?
Correct Answer
C. Increased bacteria, decreased RBCs, decreased casts
Explanation
If urine is not tested within 2 hours, the bacteria present in the urine can multiply, leading to increased bacteria. On the other hand, red blood cells (RBCs) and casts are fragile and can deteriorate over time, resulting in decreased RBCs and decreased casts. Therefore, the correct answer is increased bacteria, decreased RBCs, decreased casts.
22.
A strong odour of ammonia in a urine specimen could indicate:
Correct Answer
D. Urinary tract infection
Explanation
A strong odor of ammonia in a urine specimen could indicate a urinary tract infection. Ammonia is a byproduct of bacterial metabolism, and a strong odor could suggest the presence of bacteria in the urinary tract. Urinary tract infections are typically caused by bacteria entering the urethra and multiplying in the urinary tract, leading to symptoms such as frequent urination, pain or burning during urination, and cloudy or strong-smelling urine. Therefore, a strong odor of ammonia in a urine specimen is a potential indicator of a urinary tract infection.
23.
The principle of the urine reagent strip test for bilirubin is:
Correct Answer
A. Diazo reaction
Explanation
The correct answer is diazo reaction. The diazo reaction is a chemical reaction that is used to detect the presence of bilirubin in urine. In this reaction, the reagent strip contains a diazonium salt, which reacts with bilirubin to produce a purple color. This color change indicates the presence of bilirubin in the urine sample. The diazo reaction is a specific and sensitive test for detecting bilirubin and is commonly used in medical laboratories for diagnosing liver and gallbladder diseases.
24.
What is shown in the picture below?
Correct Answer
C. Starch
25.
What is shown in the picture below?
Correct Answer
C. Leucine
26.
The presence of xanthochromia in CSF specimen can be caused by all of the following EXCEPT
Correct Answer
C. A recent hemorrhage
Explanation
Xanthochromia in a CSF specimen refers to the presence of yellowish discoloration, indicating the breakdown of red blood cells. This can occur due to RBC degradation or a recent hemorrhage. Elevated CSF protein levels can also contribute to xanthochromia. However, immature liver function is not related to the presence of xanthochromia in CSF. Therefore, the correct answer is "A recent hemorrhage."
27.
Detection of CA 125 in peritoneal fluid is indicative of:
Correct Answer
B. Ovarian cancer
Explanation
Detection of CA 125 in peritoneal fluid is indicative of ovarian cancer. CA 125 is a tumor marker that is often elevated in women with ovarian cancer. It is used to monitor the response to treatment and detect recurrence of the disease. Therefore, the presence of CA 125 in peritoneal fluid suggests the presence of ovarian cancer.
28.
Which analyte will be falsely elevated due to hemolysis?
Correct Answer
D. LDH
Explanation
LDH (lactate dehydrogenase) is an enzyme found in red blood cells. When hemolysis occurs, the red blood cells break open and release LDH into the bloodstream, leading to falsely elevated levels of LDH. Glucose, LDL (low-density lipoprotein), and calcium are not directly affected by hemolysis.
29.
What type of sample can be used to test for protein?
Correct Answer
D. All of the above
Explanation
All of the above samples can be used to test for protein. CSF (cerebrospinal fluid) is a clear fluid that surrounds the brain and spinal cord, and it can be tested for protein levels. Urine can also be used to test for protein, as the presence of protein in urine can indicate various health conditions. Serum or plasma, which are components of blood, can also be tested for protein levels. Therefore, all three samples - CSF, urine, and serum/plasma - can be used to test for protein.
30.
In a hemolytic crisis, bilirubin levels are________________.
Correct Answer
B. Increased
Explanation
In a hemolytic crisis, bilirubin levels are increased. This is because hemolysis, the breakdown of red blood cells, releases large amounts of bilirubin into the bloodstream. Bilirubin is a yellow pigment that is produced when red blood cells are broken down, and it is normally processed by the liver and excreted in the bile. However, in a hemolytic crisis, the liver may not be able to keep up with the increased bilirubin production, leading to elevated levels in the blood.
31.
The pH of the urine specimen was 8.0. What is the likely crystal seen above?
Correct Answer
C. Triple pHospHate
Explanation
The pH of the urine specimen is 8.0, which is alkaline. Triple phosphate crystals are commonly found in alkaline urine. Therefore, the likely crystal seen above is triple phosphate.
32.
ALP is elevated in the following disorder?
Correct Answer
B. Paget's disease
Explanation
Paget's disease is a condition characterized by abnormal bone remodeling, leading to weak and brittle bones. ALP (alkaline phosphatase) is an enzyme that is involved in bone formation and is typically elevated in Paget's disease due to increased bone turnover. Addison's disease is a hormonal disorder affecting the adrenal glands, Scleroderma is a connective tissue disorder, and Diabetes insipidus is a condition characterized by excessive thirst and urination, none of which are typically associated with elevated ALP levels.
33.
Which of the following enzymes is most specific for diagnosis of a Myocardial Infarction?
Correct Answer
C. Troponin
Explanation
Troponin is the most specific enzyme for the diagnosis of a Myocardial Infarction. Troponin is a protein found in cardiac muscle cells, and its levels in the blood increase after damage to the heart muscle, such as during a heart attack. Elevated troponin levels indicate myocardial injury, making it a reliable marker for diagnosing a myocardial infarction. CK (creatine kinase), CK-MB (creatine kinase-MB), and CRP (C-reactive protein) are also used in the diagnosis of heart conditions, but troponin is considered the most specific enzyme for detecting myocardial infarction.
34.
Hyperkalemia can cause all of the following EXCEPT.
Correct Answer
C. Decreased Vitamin D absorption
Explanation
Hyperkalemia is a condition characterized by high levels of potassium in the blood. It can cause various symptoms and complications, including neuromuscular symptoms such as muscle weakness and heart arrhythmias. However, it does not directly affect the absorption of Vitamin D. Therefore, the correct answer is decreased Vitamin D absorption.
35.
Faeces gets its brown pigmentation from _________________.
Correct Answer
B. Stercobilin
Explanation
Faeces gets its brown pigmentation from stercobilin. Stercobilin is a breakdown product of bilirubin, which is a yellow pigment produced from the breakdown of red blood cells in the liver. As bilirubin is further metabolized and excreted in the intestines, it undergoes a chemical reaction that results in the formation of stercobilin. This pigment gives feces its characteristic brown color.
36.
What is shown in picture above?
Correct Answer
B. Waxy cast
Explanation
The picture above shows a waxy cast. Waxy casts are cylindrical structures that are smooth, have a homogeneous appearance, and have a waxy texture. They are formed when there is stasis or slowing down of urine flow in the kidney tubules. Waxy casts are often associated with chronic kidney disease and indicate severe damage to the renal tubules. They can be seen in the urine under a microscope and are an important diagnostic finding in assessing kidney function.
37.
What is the crystal shown in the picture above?
Correct Answer
A. Calcium oxalate
Explanation
The crystal shown in the picture above is most likely calcium oxalate. This conclusion can be made based on the appearance of the crystal, which appears as a cluster of needle-like structures. Calcium oxalate crystals are commonly found in urine and can indicate the presence of certain medical conditions, such as kidney stones or urinary tract infections.
38.
Identify the structure indicated above.
Biochemical test result:
pH: 6.5
RBC: 3+
Leukocyte esterase: Neg
Glucose: Neg
Protein: Trace
Bilirubin: Neg
Nitrite: Neg
Correct Answer
C. Yeasts
Explanation
The given biochemical test results indicate a pH of 6.5, negative leukocyte esterase, negative glucose, trace protein, negative bilirubin, and negative nitrite. These results are consistent with a urinary tract infection caused by yeasts. Yeasts are fungi that can cause infections in the urinary tract, especially in individuals with compromised immune systems or those who have been on antibiotics. The presence of yeasts in the urine can be confirmed by microscopic examination, which may show budding yeast cells. Therefore, the structure indicated above is yeasts.
39.
G6PD deficiency is transmitted in a X-linked recessive trait.
Correct Answer
A. True
Explanation
G6PD deficiency is indeed transmitted in an X-linked recessive trait. This means that the gene responsible for G6PD deficiency is located on the X chromosome. Since males have only one X chromosome, they are more likely to be affected by the condition if they inherit the defective gene. Females, on the other hand, have two X chromosomes, so they can be carriers of the gene without showing symptoms. This pattern of inheritance is characteristic of X-linked recessive disorders.
40.
Bilirubin is photosensitive to
Correct Answer
C. Direct sunlight and artificial light
Explanation
Bilirubin is photosensitive to both direct sunlight and artificial light. This means that exposure to these types of light can cause a reaction or degradation of bilirubin. It is important to protect bilirubin from direct sunlight and artificial light in order to prevent any negative effects on its stability or function.
41.
Alcohol induces which of the following enzymes
Correct Answer
D. GGT
Explanation
Alcohol induces the enzyme GGT (gamma-glutamyl transferase). GGT is primarily found in the liver and is involved in the metabolism of glutathione, a molecule that helps protect cells from oxidative damage. Increased levels of GGT in the blood are often seen in individuals who consume alcohol excessively, indicating liver damage or disease. Therefore, alcohol can stimulate the production of GGT, leading to higher levels of this enzyme in the body.
42.
What is produced in the reaction of G6PD test which fluoresce under long wave UV-light?
Correct Answer
C. NADpH
Explanation
NADPH is produced in the reaction of G6PD test which fluoresces under long wave UV-light.
43.
Which of the following cause a white layer on the surface of serum/plasma when it is left to stand overnight?
Correct Answer
A. Chylomicrons
Explanation
When serum/plasma is left to stand overnight, chylomicrons can cause a white layer to form on the surface. Chylomicrons are a type of lipoprotein that transport dietary fats from the intestines to various tissues in the body. They are composed of triglycerides, cholesterol, and proteins. When chylomicrons are present in high levels, they can separate and rise to the top of the serum/plasma, forming a white layer. This phenomenon is known as lipemia and is often seen in individuals with conditions such as hyperlipidemia or pancreatitis.
44.
The principle of analysis for D10 analyser uses
Correct Answer
C. High pressure cation exchange chromatograpHy
Explanation
The D10 analyzer uses the principle of high pressure cation exchange chromatography for analysis. This technique involves separating charged molecules based on their interactions with a cation exchange resin. The sample is loaded onto the resin column, and the cations in the sample are exchanged with the cations on the resin. The analytes of interest are then eluted from the column by changing the pH or ionic strength of the eluent. This technique is commonly used for the separation and analysis of charged molecules in various fields including pharmaceuticals, environmental analysis, and biochemistry.
45.
Potassium level is higher outside the cell than inside.
Correct Answer
B. False
Explanation
The correct answer is False. The normal concentration of potassium is higher inside the cell than outside. This is because potassium ions are actively pumped into the cell by the sodium-potassium pump, which maintains the concentration gradient. This higher concentration of potassium inside the cell is important for various cellular processes such as maintaining membrane potential and regulating cell volume.
46.
The vendor's minimum clotting time recommendation for gel separation tube is 30 minutes.
Correct Answer
A. True
Explanation
The vendor recommends a minimum clotting time of 30 minutes for gel separation tubes. This means that the blood sample should be allowed to clot for at least 30 minutes before further processing or analysis.