ASCP-MLT Exam Dumps - MEDICAL LABORATORY TECHNICIAN - MLT(ASCP)
Which of the following organizations now provides the certification exam for laboratory professionals?
The laboratory employee with an 2-year associate degree who performs clinical testing is the:
Triglyceride blood concentrations change significantly when you eat, as opposed to relatively stable levels of cholesterol, HDL, or LDL circulating in the blood. Whenever you eat a meal that contains fat, your triglyceride levels rise, which is why it is important to have a patient fast before the sample is collected.
Which of the following lipid results would be expected to be FALSELY elevated on a serum specimen from a non-fasting patient?
Report the isolate as coagulase negative Staphylococcus is the correct answer because this is an isolate from a urine specimen with a coagulase negative Staphylococcus susceptible to novobiocin. Staphylococcus saprophyticus is resistant to novobiocin. Further testing is required to speciate coagulase negative Staphylococci but only if the specimen is from a sterile body site, not urine.
Gram positive cocci isolated from a catheterized urine culture on a 76-year-old male gave the following reactions:
Blood agar- creamy, white, opaque colonies
Catalase- positive
Slide coagulase- negative
Tube coagulase- negative
Novobiocin- susceptible
The next action the MLS should take is:
Pluripotential stem cells are ultimately capable of differentiating into all types of leukocytes.
Hematology
Pluripotential stem cells are capable of producing which of the following:
Sally is seeing her new primary care provider for the first time. When she signs in, she is asked to sign papers for the release of medical records, including her laboratory results. According to the Health Insurance Portability and Accountability Act (HIPAA), she must authorize release of records before _______________would be permitted to receive and review her records.
HbA1C is the recommended test for monitoring diabetic carbohydrate management. Microalbuminuria, low concentrations of urinary albumin, is measured to detect early renal impairment, at a stage where it is reversible with treatment.
What is the role of microalbuminuria testing?
All the following characteristics are accurate for the influence of Health Insurance Portability and Accountability Act (HIPAA) except
A laboratory scientist is working the night shift at a local hospital when the power goes out. What is the course of action to continue to provide laboratory results?
Which of the following disorders is characterized by increased production of chloride in sweat?
Multiple myeloma
Vitamin K is needed to produce certain coagulation factors, in particular factors II, VII, IX, and X. Deficiencies in these factors can lead to increased clotting times and can cause hemorrhagic disease.
A deficiency in which of these vitamins leads to increased clotting time and may result in hemorrhagic disease?
The red blood cell distribution width (RDW) increases as the severity of alpha thalassemia increases because of changing MCV as the bone marrow produces smaller cells. In addition, if Hemoglobin H bodies are present, they result in the formation of schiztocytes (RBC fragments) that can have an effect on the MCV and RDW.
The Red cell Distribution Width (RDW) in alpha thalassemia is
Isolation and detection of Gardnerella vaginalis from vaginal secretions is improved by which of the following?
Which of the following organizations has developed standards to maintain the performance of the clinical laboratory at the highest standards for quality care?
The correct response is option B: The Hepatitis B "e" Antigen (HBeAg). This antigen indicates the virus is actively replicating and therefore the patient is very infectious. The hepatitis B "e" antigen is present when the virus is actively replicating. In cases of unintentional needlesticks, infectivity is of highest concern. The risk for infection is greatest during phases of increased HBeAg serology. The Hepatitis B surface antigen is the first detectable marker, but if the patient is known to have Hepatitis B already, it would be relatively unhelpful to confirm the condition with another HBsAG test. The core antigen is not detectable because it is covered by the nuclear envelope. Antibody response patterns would not be very helpful either as the patient has already been diagnosed with acute Hepatitis B. IgG antibodies would indicate recovery, which is not the case for this patient and IgM antibodies indicating a recent or acute infection would only confirm what is already known. Recall, in cases of unintentional needlesticks, infectivity is of highest concern.
A phlebotomist at a local hospital recently had an accidental needle stick while drawing blood from a patient being treated for acute hepatitis B. Which serological marker from the patient would be of most value to the physician evaluating the phlebotomist's possible infection status?
The type of isolation category that always requires a HEPA mask or respirator to be worn is:
The liver is the primary target organ for the Hepatitis B virus (HBV). The inflammation caused by HBV can result in permanent liver damage, including cirrhosis, liver failure, and even hepatocellular carcinoma.
What is the primary target of the Hepatitis B virus?
Atherosclerosis is a hardening of an artery specifically due to the build up of plaque. The risk to patients with significant atherosclerosis is that eventually a narrowing of the artery (stenosis) can cause a reduction in oxygen delivery to tissues and plaque rupture can lead to an acute coronary event.
Atherosclerosis is a hardening of an artery specifically due to which of the following?
After collection all blood should be stored at 1 - 6oC, unless it is going to be used as a source of platelets.
A refrigerator used to store whole blood must be able to maintain a temperature in the ranges of:
Neutrophils, lymphocytes and macrophage/ monocytes can be found in all types of body fluid differentials. Bronchial cells can be found only in bronchial washings and BAL specimens. Mesothelial cells are found only in serous body fluids including pleural fluid, peritoneal fluid, and pericardial fluid.
Select the specific cells listed below that can be found in all types of body fluid.
1 SD = 68.3%, 2 SD = 95.5%, 3 SD = 99.7
As defined by a Gaussian distribution curve, what percentage of values would be expected to fall within two standard deviations of the mean:
A clinical laboratory scientist or medical laboratory scientist (or medical technologist in older terminology) may serve as all of the following except:
Using the formula on the right,
Cells/µL = 370 x 100 / 18 x 0.1
Cells/µL = 37000 / 1.8
Cells/µL = 20556 or 2.06 x 104
A sample of cerebrospinal fluid is diluted 1:100; the standard 9 squares of a hemocytometer are counted on each side for a total of 18 large squares.
Side 1-- 186 nucleated cells counted
Side 2-- 184 nucleated cells counted
total nucleated cells = 370
Using the standard hemocytometer formula shown on the right, what is the nucleated cell count per microliter (µL)?
In DNA complementary base pairing, guanine and cytosine pair and adenine and thymine base pair. Remembering the phrase "G-CAT" helps one recollect correct pairing.
Which nitrogen base would bind with a guanine nucleotide in forming double-stranded DNA?
The term affinity refers to the strength of attraction between a single antigenic determinant and a corresponding antigen binding site. The term avidity refers to the total strength of the attraction between an antibody and a multivalent antigen. The reaction between an IgM molecule (which has 10 antigen binding sites), and a multivalent antigen is therefore much stronger than that of an IgG antibody (which has only 2 antigen binding sites).
Avidity is best described by which of the following statements:
First, the RBC indices must be calculated. The MCV ((Hct/RBC) x 10) = 71 fL. Since the reference range for the MCV is 80-100 fL, this anemia would be classified as microcytic. The MCH ((Hgb/RBC) x 10) = 19.3 pg. Since the reference range for the MCH is 27-33 pg, this would be considered hypochromic. Finally, the MCHC ((Hgb/Hct) X 100) = 27%. Since the normal range for the MCHC is 33%-36%, this would indicate hypochromia which correlates with the MCH findings. The correct answer is therefore microcytic, hypochromic anemia.
A patient is admitted to the emergency room with lethargy and pallor. The CBC results are as follows:
RBC = 4.1 x 1012/L
Hemoglobin = 7.9 g/cL
Hematocrit = 29%
How would you classify this anemia?
Caffeine benzoate solution is used to split the unconjugated bilirubin protein complex releasing the bilirubin so that it can react with diazotised sulphanilic acid. The tartrate buffer creates an alkaline solution and converts the red acid bilirubin to a green coloured compound which can be measured spectrophotometrically.
Which substance is used in the Jendrassik-Grof method to accelerate the reaction of unconjugated bilirubin with the diazo reagent?
Alkaline phosphatase, or ALP, is present in kidneys, liver, intestines, bone, and the placenta. The liver makes the largest amount of ALP. Some of the conditions associated with increased levels of ALP include: damaged liver cells, rapid bone growth (during puberty), bone diseases, or a disease that affects how much calcium is in the blood (hyperparathyroidism), and vitamin D deficiency.
Chemistry
Isoenzymes of alkaline phosphatase occur in:
P. vivax characteristically displays Schuffner's dots and often enlarged RBCs along with brownish granules. P. vivax can also have 12-24 merozoies in each cell, actually filling the entire RBC. This parasite also has very irreglar shapes often referred to as "Ameboid".
P. falciparum and P. malariae do not display Shuffner's dots, therefore could not be the correct choice.
P. ovale does display Shuffner's dots in all stages, but characteristically has about 8-12 merozoites in rosettes or irregular clusters inside the RBC. Also, P. ovale characteristically shows enlarged, ovoid RBCs with fimbriated edges.
Identify the parasite of a patient with suspected malaria who demonstrates the following findings on a blood smear:
- Enlarged RBCs, some with fine brownish granules
- > 15 parasites in some cells
- Ameboid structures
- Schuffner's dots
Microbiology
Matching: The detection of a distinct odor is often helpful in the presumptive identification of bacterial culture isolates. Match each of the odors listed with its corresponding bacterial species name.
1. Streptococcus anginosus (milleri)
2. Pseudomonas aeruginosa
3. Eikenella corrodens
4. Alcaligenes faecalis
The laboratory uses flammable chemicals for processing and staining patient specimens. One type of chemical used is ethanol. What is the proper way to store this chemical in the laboratory?
Any oxidase-positive organism can be excluded from the Enterobacteriaceae. The other characteristics are as a rule present in these organisms.
Which of the following is not true about members of the Enterobacteriaceae:
Which of the following is most likely to interact with arterial walls, leading to deposition of cholesterol, and initiating or worsening atherosclerosis?
Match each of the following:
1. Ratio of cellular area to total area in the bone marrow section.
2. Number of myeloid cells compared to nucleated erythroid cells.
3. Use low power to estimate their quantity and appearance.
4. Use Perls' Prussian blue stain.
Polyspecific antihuman globulin (AHG) reagent contains both anti-IgG and anti-C3d.
Polyspecific antihuman globulin (AHG) reagent used in antiglobulin testing should react with which one of the following?
Phase of reactivity is primarily at immediate spin (4+) and reactions get weaker at AHG (w+). There is no specific pattern of reactivity and the auto control is negative which rules out an autoantibody. This is a strong cold antibody which is still slightly present after incubation and washing.
Activation and binding of the antibody takes place at room temperature or colder. Eliminating this phase will prevent the antibody from binding. Cold antibodies usually are more of a nuisance to blood bankers and are not clinically significant.
When performing an antibody screen, both the screen cells are 4+ at immediate spin and W+ at AHG. The antibody panel shows 4+ reactions at immediate spin and W+ reactions at AHG and there is no specific match to the reaction pattern. The auto control is negative. What would be a logical next step?
Patients with antibody to the following antigen are immune to Hepatitis B:
Immunoassay is the most common technique that is used by clinical laboratories for therapeutic drug monitoring.
Most of the drugs commonly assessed with TDM can be measured on analytical platforms which utilize antibodies (in some form) for detection. Antibodies can be developed that recognize drugs. Although most drugs are much too small to evoke an immune response, scientists can conjugate drugs to immunogenic proteins to produce antibodies that recognize drug-specific epitopes.
Which of the following is the most common technique that is used by clinical laboratories for therapeutic drug monitoring?
What component is indicated for patients who receive directed donations from immediate family members to prevent transfusion-associated graft versus host disease (TA-GVHD)?
The microscopic features shown here represent Scopulariopsis species. In most instances, particularly if a patient does not have underlying immunologic or hematologic disease, Scopulariopsis species should be considered a contaminant when recovered from a sputum specimen. However, if there is clinical or X-ray evidence of mycotic pulmonary infection, additional daily induced sputum specimens should be obtained.
If Scopulariopsis species or any other hyaline mold is recovered from two or more successive specimens, its potential as a pathogenic agent should be considered. Scopulariopsis species have been reported as the agents of pulmonary fungus ball infections in patients with preexistent cavities and as a cause of pneumonia in patients with leukemia.
Invasive pulmonary disease by this agent has not been reported.
The fungus illustrated in this photomicrograph was recovered from an induced sputum specimen from a 74 year old man with chronic obstructive pulmonary disease. This isolate is most likely:
The deposition of plaques containing cholesterol and lipids on the innermost layer of the walls of large and medium-sized arteries is the defintion of atherosclerosis.
Arteriosclerosis is a more general term that describes a thickening and loss of elasticity of the walls of the arteries (hardening of the arteries). Atherosclerosis is a type of arteriosclerosis but is not synonymous with it.
Atherosclerosis is not the most common outcome for risk marker studies because it can be hard to measure. Infarcts, cardiac procedures, death, and 'events' are more common. Most humans have visible or measureable atherosclerosis by early middle age.
Chemistry
Which of the following is true concerning atherosclerosis?
Basophilic stippling is the term used to describe red blood cells that contain tiny particles of RNA within their cytoplasm. Basophilic stippling is associated with many conditions, but is strongly associated with lead poisoning.
Multiple small, dark blue particles scattered throughout the cytoplasm of erythrocytes is/are called:
Conversion of only the slant to a pink color in a Christensen's urea agar slant is produced by bacterial species that have weak urease activity. The reaction in the slant to the right is often produced by Klebsiella species, as an example. Strong urease activity is indicated by conversion of the slant and the butt of the tube to a pink color, as seen in the tube to the left. The slant only reaction in the right tube may be seen early on if only the slant had been inoculated; however, with a strong urease producer, both the slant and the butt would turn. Therefore, the reaction is dependent on the strength of urease activity. If the media had outdated for a prolonged period, either there would be no reaction or the appearance of only a faint pink tinge, either in the slant, the butt or both, again depending on the strength of urease production by the unknown organism.
The urease reaction seen in the Christensen's urea agar slant on the far right indicates:
Calculation:
Cells Counted (in this case the average of both sides) X dilution factor (in this case 100) / # of squares counted (in this case 9) X area of each square (1mm2) X 0.1mm (depth factor)
So, in this problem:
158 x 100 / 9 x 1 x 0.1mm = 17555.55/mm3 (can be converted to 17.5 x 109/L*)
*There are 1,000,000 mm3 in a liter (L). So 17555.55 X 1,000,000 = 17.5 x 109/L
A manual white blood cell count was performed by the hematology technologist. The cell counts for both sides were 152 and 164 respectively. All nine large squares were counted on each side. The dilution for this kit was pre-measured at 1:100. What should the technologist report as the white cell count?
Hepatitis B surface antigen, or HBs, is a protein that is present on the surface of the virus. The protein will be present via laboratory testing in the blood with acute and chronic HBV infections
Immunology
What sero-marker is the first marker to become positive in Hepatitis B and is associated with the infective stage?
Listeria are non-capsulated, non-acid-fast, ß-hemolytic, gram-positive bacilli that have a characteristic tumbling motility. They are found primarily in the environment and in the human GI tract. Since L. monocytogenes multiplies intracellularly, control of listeriosis requires cell-mediated immunity; thus, immunocompromised patients (such as newborns) are at high risk.
Which bacterial species is a common agent of neonatal bacteremia?
The agency within Department of Health and Human Services (DHHS) responsible for implementing CLIA'88 is:
The structures involved in the production of semen include the prostate, the seminal vesicles, and the bulbourethral gland, along with the testes and epididymis.
Semen is produced as a combination of secretions from the different regions of the male reproductive tract. Each fraction differs in chemical composition and function.
Spermatozoa are produced in the testes. They mature in the epididymis. The testes also produce testosterone and inhibin.
Fluid from the seminal vesicles accounts for approximately 70% of semen volume. The seminal vesicles are the source of fructose in semen. Fructose is used by the spermatozoa as an energy source.
The prostate gland supplies about 20% of the volume of semen. Its fluids include acid phosphatase and proteolytic enzymes that lead to coagulation and subsequent liquefaction of semen. The prostate also contains most of the IgA found in semen.
The bulbourethral gland produces mucoproteins that make up about 5% of the volume of semen.
The pituitary gland is not directly involved in the production of semen; instead hormones are released which stimulate the production of sperm. The urethra is not involved in the production of semen.
Which of the following are directly involved in the production of semen?
The correct designation for a generalist laboratory professional with a bachelor's degree certified by the American Society for Clinical Pathology is
A patient has a WBC count of 4,000/mm3, a platelet estimation with 3 bizarre platelets/oil immersion field, hemoglobin, hematocrit, red cell count and indice values are within normal limits. Blue-staining inclusions are seen in the cytoplasm of many neutrophils. These inclusions fit the description of:
AHG must be added to the cells immediately following washing. Antibodies may elute from the cells if the cells are allowed to sit in saline without the addition of AHG.
Which one of the following may cause a FALSE-NEGATIVE result with antiglobulin techniques?
India ink can aid in the visualization of the polysacchride capsules of yeast such as Cryptococcus neoformans.
Micro
India Ink is used to:
Each of the drugs/drug classes listed above have been known to cause drug-induced hemolytic anemia, although cephalosporins are the MOST COMMON cause. Cephalosporins can cause drug-induced hemolytic anemia when a patient produces antibodies to the particular cephalosporin drug in the presence of red blood cells. The drugs can alter the membrane appearance of the red blood cells, causing the body to mistake them as foreign. Complement becomes activated due to these antibodies; red cells are then destroyed causing hemolytic anemia. Dark urine, caused by intravascular hemolysis, is one of the most common symptoms associated with this condition.
Which one of the following drugs/drug classes is the MOST COMMON cause of drug-induced hemolytic anemia?
Type I hyperlipoproteinemia is a form of hyperlipoproteinemia associated with deficiencies of lipoprotein lipase. Hyperlipoproteinemia type II is the most common form and is classified into type IIa and type IIb, depending on whether there is elevation in the triglyceride level in addition to LDL cholesterol. Hyperlipoproteinemia type III is associated with high chylomicrons and IDL. Hyperlipoproteinemia type IV is assoicated with high triglycerides. It is also known as hypertriglyceridemia. Hyperlipoproteinemia type V is similar to type I, but with high VLDL in addition to chylomicrons.
An obese adult with premature arteriosclerosis is seen in the clinic. When her serum is tested no chylomicrons are present, LDL are normal and VLDL are increased. There is an increase in triglycerides and slight increase in cholesterol. Lipoprotein electrophoresis reveals a heavy pre-beta band. She has no skin rash and uric acid is increased. This patient has a hyperlipoproteinemia with the MOST likely type of:
Serum ferritin is a good indicator of iron deficiency. However, it acts like an acute phase reactant, being elevated in a large number of conditions. Patients who have iron deficiency as well as another condition that elevates serum ferritin levels may therefore have normal or even elevated serum ferritin levels.
Which one of the following statements about serum ferritin are true:
The steps in the PCR process are:
1. Denaturation (Turning double stranded DNA into single strands.)
2. Annealing/Hybrization (Attachment of primers to the single DNA strands.)
3. Extension (Creating the complementary strand to produce new double stranded DNA.)
What is the first step of the PCR reaction?
What are the certification requirements for clinical laboratory professionals?
Fusarium species is the most likely associated with mycotic keratitis.
Trichophyton rubrum is a dermatophyte that commonly causes an itching, scaling skin infection of the feet, known as tinea pedis. Scedosporium apiospermum is commonly associated with sinusitis. Aspergillus niger typically causes otitis externa and can also be associated with sinusitis.
Which of the following species or organisms is the most likely to be the cause of mycotic keratitis (fungal eye infection)?
Anti-A, anti-P, anti-Leb, and anti-M all react best at 4o C as they are predominantly IgM antibodies. Other antibody group choices above include IgG antibodies such as anti-K, anti-s, anti-S, and anti-Fya, anti-Lub, etc. which react best at 37o C.
Which of the following groups of antibodies generally reacts most strongly at 4o C:
The federal government has categorized critical biological agents into three groups: A, B, and C. Those agents in category A are highest-priority because they can be easily disseminated or transmitted person-to-person.
The federal government has categorized critical biological agents into three groups: A, B, and C. Those agents in category A are highest-priority because they:
Bacterial contamination of platelets is most likely because they are stored at room temperature.
Bacterial contamination is MOST likely in which of the following blood products?
Because of the difficulty in culturing Epstein-Barr virus, and readily available heterophile antibody test and serology, it is rarely necessary to culture this virus in routine clinical practice.
Micro
Which one of the following viruses requires a complex lymphoblastoid cell culture, and is rarely if ever diagnosed by culture:
Amniotic fluid bilirubin is increased in association with the severity of hemolytic diseases of the newborn. As red blood cells lyse during these conditions, bilirubin builds up as a byproduct of the red cell destruction. The more red blood cells that are being destroyed in the baby, the more increased the bilirubin level will become.
Which one of the following tests BEST correlates with the severity of hemolytic disease of the newborn (HDN).
Though automated extraction machines have many benefits over manual methods the costs are high and generally require a high throughput of samples in order to justify the costs.
Automated extraction has many benefits over the traditional manual methods. The most important benefit is that the nucleic acid isolated is constantly consistent. There is a reduced amount of manipulation with dramatically decreases the chance of cross contamination. Also, automated extraction machines are considered moderate complexity and can be performed by a wider variety of laboratory professionals.
All of the following are considered benefits of automated isolation and extraction equipment EXCEPT:
What additional fraction would be seen if plasma rather than serum was subjected to electrophoresis:
According to OSHA, Hazard Communication 1910.1200 has the purpose of ensuring that the hazards of all chemicals produced or imported are evaluated, and that information concerning their hazards is transmitted to employers and employees.
Also known as the "Right To Know Law," which one of the following OSHA regulations first dealt with specific information related to the contents of chemicals used in the workplace?
Donor and recipient blood samples (samples utilized for pre-transfusion compatibility testing) must be kept for at least 7 days after transfusion. Blood samples must be available to investigate a transfusion reaction, if necessary.
Donor and recipient blood samples must be kept for at least how long after transfusion?
1. A
2. A
3. B
4. A
5. B
6. B
A cardiovascular risk marker is an analyte in a body fluid that can be measured by the clinical laboratory and has been associated with the development of cardiovascular disease. Examples of risk markers include: LDL-C, triglycerides, and hs-CRP.
A cardiovascular risk factor is a condition (not a laboratory analyte) that is associated with an increased risk of developing cardiovascular disease. Examples of risk factors include: smoking, obesity, diabetes and hypertension.
Determine if each of the following is a cardiovascular risk marker or a cardiovascular risk factor.
1. Smoking
2. Obesity
3. Low density lipoprotein (LDL)
4. Hypertension
5. Triglycerides
6. High sensitivity-C-reactive protein (hsCRP)
1. B
2. D
3. A
4. C
Red to Brown Urine: porphobilinogen, hematuria, myoglobinuria, etc.
Green: Food colorings; Increased carotene in the diet;
Pseudomonas aeruginosa infection
Yellow: bilirubin, bile pigments
White: phosphates, other crytals
Match urine color with substance that might have been responsible:
1. Phosphates
2. Bilirubin
3. Pseudomonas
4. Porphobilinogen