simulation term 1 test

which factor deficiency will not be detected by the APTT

VII

VIII

V

II

a

what is the anticoagulant of choice for cell counting and morphological assessment

EDTA K3

starch

a pt recieved 2 units of O Rh pos un xm blood. a blood specimen for a xm was collected and two more units of blood were ordered. the following results were obtained as part of the xm request:

anti-A= 3+ mf

anti-B= 0

anti-A,B= 3+ mf

A1 cells= 0

B cells=4+

O cells=0

which of the following is the most likely explanation for the results?

Pt has multiple myeloma

There is more than one cell population

The patient is a rare subgroup of A

b

in an emergency situation where the patient’s ABO and Rh group have been determined and they require an immediate rbc transfusion. theres no time for a xm. what ABO/Rh should be used

blood of same ABO and Rh

what should be done when a hemolyzed sample is recieved for SPE

repeat test using new sample from same patient

dilute hemolyzed sample and procees with testing

reject specimen and request a new sample from the pt

perform test as usual, noting hemolysis on the report

c

which performance study in the method evaluation process assesses random variation

Linearity study

calibration study

method comparison study

precision study

d

a texhnologist is performing a manual wbc count and notices the sample is clotted. what action should be taken?

centrifuge the sample at a higher speed to remove clots.

perform the count using a different diluent to dissolve clots.

proceed with the count using the clotted sample

reject the sample and request recollection

d

why is specific gravity (SG) testing often included with urine pregnancy testing?

to detect the presence of proteins that might interfere with the test

to confirm the presence of hCG in the urine sample

to measure the hydration level of the patient

to ensure the urine sample is concentrated enough for accurate test results

d

what should the technologist do when a stat specimen is received for an APTT in an EDTA tube?

perform APTT as requested

request a repeat specimen

dilute the specimen 50% with isotonic saline

transfer specimen to a sodium citrate tube before testing

b

when performing microscopic urinalysis, which of the following is the best method to differentiate yeast from rbcs

use higher magnification to identify cell size differences

perform urine dipstick test for blood

examine for a distinct biconcave shape to id yeast

observe for budding forms to id yeast

d

what serum protein electrophoresis (SPE) pattern is commonly seen in cirrhosis

beta gamma bridging

what serum protein electrophoresis (SPE) pattern is commonly seen in hypogammaglobulinemia/agammaglobulinemia

decreased gamma globulin and sharp albumin peak

what serum protein electrophoresis (SPE) pattern is commonly seen in acute phase rxn/acute inflammatory response

elevated alpha 1 and alpha 2 globulins with a normal beta region

what serum protein electrophoresis (SPE) pattern is commonly seen in MGUS, monoclonal gammopathy, multiple myeloma

increased albumin with an M spike in the gamma rgn

group o patient requires a plasma tranfusion, but NO group O frozen plasma is available. Which Best describes acceptable alternative group(s) of plasma products

group A, B, AB are all acceptable alternatives

a decreased bicarb level in the blood without a change in PCO2 will result in what acid/base imbalance

metabolic acidosis

a wright’s stained peripheral blood smear shown. the bone marrow aspirate of this patient demonstrated an abundance of cells with this morphology. which of the following conditions is most likely associated with this sample?

multiple myeloma

what cell

sezary cell

which of the following actions should be taken in the event of a CSF spill

cover the spill with paper towels and soak with hypochlorite

clean up the specimen using a chemical spill kit

absorb the spill with paper towels which are then autoclaved

recover the precious specimen with a pipette for testing

a

which analyte requires a fasting specimen

potassium

creatinine

triglycerides

urea

triglycerides

how is a glucose value of 30.0 mmol/L interpreted

critical

what can reconstituting a lyophilized control vial with too much diluent result in

QC results lower than the expected range

No effect on QC results

accurate QC results w/in the expected range

QC results higher than the expected range

a

what is the plt count when an avg of 300 plta were counted on a hemocytometer where 20 uL of blood was added to 1.98 mL of ammonium oxalate

300 × 10^9/L

what effect does increasing the angle of the spreader slide have on the blood smear produced

thicker smear

what range must the control values fall between if a ctrl has a mean of 4.0 with a SD of 0.5 and the lab is using a 95.5% confidence interval

3.0 to 5.0

tube w a green stopper normally contains

heparin

if a pt has a normal APTT and abnormal PT, which coag factor is most likely deficient

V

VII

I

II

b

what is the primary purpose of using an internal standard in gas chromatography

to improve the resolution of chomatographic peaks

to calibrate the detector for consistent sensitivity

to correct for variations in sample volume or injection amount

to reduce the time required for analysis

c

what are 8-10 random, consecutive values all lying abv or all below the mean on a levy jennings chart called

shift

a plasma sample was analyzed using ion selective electrodes (ISE) and the following electrolyte results were obtained: [Na= 140 mmol/L; K+= 14.0 mmol/L; Cl-= 112 mm/L; HCO3-= 18 mmol/L]. What action should be taken next?

Check the range to determine if the sample should be diluted and rerun for an accurate potassium result

The sample was slightly hemolyzed so request a new sample.

Suspect improper anticoagulant; check collection tube and redraw

Report the potassium result to the physician immediately

b

what is demonstrated by polarized microscopy

Luminescence

Phosphorescence

birefringence

fluorescence

birefringence

which of these inclusions CANT be seen on a romanowsky stained blood film

basophilic stippling

howell jolly bodies

heinz bodies

cabot rings

c

which of the following urinalysis results are discrepant

Moderate blood but no RBC in microscope

negative blood but pos protein

small blood but negative protein

negative blood but 10-15 rbcs /hpf

d

this test requires a specimen with a 9:1 ratio of blood to anticoagulant

glycohoglobin

ethanol

zinc

prothrombin time

d

given the following info what would be the calculated osmolality [Na= 135 mmol/L; Cl= 110 mmol/L; CO2 = 15 mmol/L; Glu= 5.0 mmol/L; Urea= 5.0 mmol/L; Ethanol= 35 mmol/L

280

which of the following conditions is cause for rejecting an analytical run?

one ctrl greater than 2SD

2 consecutive controls greater than 2SD units above and below the mean

3 consecutive controls greater than 1SD unit from the mean

4 ctrls increasing in value but less than 1SD unit from the mean

b

what is the area of the large square on one side of a hemocytometer

9 mm²

a 17 y o female requires two units of blood immediately and there is insufficient time to perform any testing. 2 yrs previous she tested group A Rh positive. Which of the following rbcs would be issued?

O neg

A pos

A neg

O pos

a

during analysis of a synovial fluid sample, a technologist notices the presence of crystals. what should the technologist do next?

reject the sample and request recollection

dilute the sample before testing to reduce crystal concentration

report the finding as normal

perform a polarized light microscopy to id the crystal type

d

which coag factor deficiency can be treated with vitamin K

XI

VIII

I

II

II

what cbc parameter will be increased when a lipemic sample is processed

MCHC

MCV

RDW

RBC

MCHC

what conditions should be suspected from the peripheral blood smear

iron deficiency anemia

in a cbc (complete blood count), which parameter reflects the percentage of total blood volume occupied by rbcs

HCT

a technologist is performing a coagulation test and notices that the specific volume is insufficient. what is the appropriate action?

request recollection of the specimen

which of the following is an important consideration when performing dipstick testing on urine?

the dipstick should be immersed in the urine sample for at least 5 mins

the urine sample should be collected at any time of the day

the dipstick should be stored directly in the urine sample for accurate results

the urine sample should be well mixed before testing

d

what is the significance of the presence of paraproteins in SPE

they indicate a normal variation in protein lvls

they suggest the presence of a monoclonal gammopathy, such as multiple myeloma

they are associated with acute inflammatory conditions

they indicate liver dysfunction or damage

b

plt count of 25 × 10^9/L is obtained on a sample. which of the following should be the technologist’s first action

telephone the result to the ward

repeat the count on a new specimen

repeat the count using a second instrument

verify the count microscopically

d

what is agreement between the best estimate of a quantity and its true value?

reliability

precision

accuracy

standard deviation

c

if you need to make a call for info, what should you do before you call

brush ur teef

prepare ur questions

make coffee

chew gum

b

a serum protein electrophoresis is performed. why does the technologist suspect that the sample used was plasma, not serum?

bc of a characteristic peak btw the beta and gamma regions

bc of a characteristic peak between the albumin and alpha 1 regions

bc of a characteristic peak between the alpha2 and beta region

bc of characteristic peak btw the alpha1 and alpha2 region

a

a listless 12 month old boy with a fever of 103 deg C was taken to the emergency department. he had been diagnosed with an ear infection 3 days earlier. A spinal tap was performed, but only one tube of CSF was obtained from the lumbar puncture. Which department should be the first to recieve the single tube of CSF

micro

the presence of schistocytes on an impedance analyser will cause a false increase in

WBC count

plt count

retic count

mean cell volume

b

what additional test is required when a retic count is ordered

red blood cell count

the cells seen below in the wright’s stained peripheral blood smear are diagnostic of which condition

sickle cell disease

a pt gives an APTT of 75 sec. An APTT mixing study is performed and the result is still 75 secs. whats the reason for these results?

Multiple factor deficiencies

factor I deficiency

factor IX deficiency

A circulating anticoagulant

d

blood products must be transfused a maximum of how many hours after issue

24

4

8

6

4