Questions from ASCP forum

1. This is a platelet vessel wall interaction, bleeding time prolonged, platelet count decrease and
on peripheral smear the platelets are increase in size.
a. Von Willebrand Disease
b. Bernard- Soulier Disease (this is the answer)
c. Congenital afibrinogenemia
d. Glanzmann's thrombasthenia
2. Alpha hCG marker of malignancy:
a. Choriocarcinoma
b. Testicular Cancer
c. Pancreatic (answer)
d. Nonseminomatous
3. If the protein elevation from B1B2 and gamma are to merge together, what immunoglobulin
would I indicate?
a. IgM
b. IgA (answer)- this starts to form alpha2 end gamma
c. IgD
d. IgE
4. What are DAT applications?

5. What is RHOGAM, when are you going to give it and what will it do to the patient?

6. In an emergency, what blood type of blood would you give if the red cells are needed or plasma
is required and the blood type is unknown?

7. Would you phenotype a patient who had been transfused within the last 3 months?

8. Potassium is high but the blood sample is not hemolyzed, patient does not show symptoms
what do you think happened?

9. Control was high even after you repeat it, what’s the next step that you would do?

I would re run calibration

10. What is the isoagglutinations in type O?

11. Parasites that cause autoinfection in immunocompromised patient….

12. Storage Temperature and time for RBC, PLTS, CRYO, FFP…
a. RBC storage time – Storage temperature 1-6 degrees Celsius, shelf life 35days CPDA-1.
42days AS-1
b. Platelets storage time – Storage 20 – 24 degrees Celsius shelf life 5 days with agitation
c. Cryoprecipitate storage time - shelf life12 monts, after thawing transfuse within 6 hours
d. FFP storage time- Shelf life 12 months, after thawing, tansfuse within 24 hours.

13. What is the meaning of beta and gamma zone merge

Ans. Beta zon- total hemolysis, the colony or bacteria on Red blood Agar plate lyses the RBCs,
therefore surrounding of the colony appear as clear or transparent
14.
Which of the following index will be exchanged if moved out the buffy coat in Lipemia
specimen? (Lipemia can falsely elevate ALT and AST. Additionally, it can indicate that the patient
did not adequately fast for 12-18 hours before having the specimen collected. In this situation,
glucose and triglycerides will be elevated.)
a. Triclycerides
b. HDL (answer)
c. LDL or VLDL
d. CM
e. Chlolesterol
15. What is the truw Ca? How do you measure it
50% Ca is free + 40 % + bind to protein + 10 % bind to anion (phosphate etc.) = 100% total Ca
16. What does Hgb M mean?
Hgb M is methemoglobin. Normail patient Hgb M is about 1%
17. WBC: 22.0 could see dohle body, toxic granules. According to this case which is correc?
a. Bacterial infection
b. Vital infection
18. What is the specific test for E. coli?

19. Anti- F will not react with:

a. cDE CDE
b. Cde CdE
c. Cde Cde
d. eDe CDe
20. Which product we should use when the patient has fever when transfusion the blood?
a. WBC- reduce RBCs
b. Irradiated RBC
c. Wash RBC
21. What else could cross placenta except Anti-D (IgG)?
Ans. Bilirubin, Drugs, gases, hormone…
22. Blood culture in aerobic and an anaerobic bottle are negative, but in gram stain smear shows
gram positive bacteria. What should you do next?

23. After 2 days of blood culture, technician found gram positive cocci, what should you do next?
a. Report to doctor (answer)
b. Gram positive cocci culture
c. Maybe contaminated by skin when collecting specimen
24. What is the reason for Synovial Fluid Turbidly?
a. Crystals
b. Protein (answer)
c. immunoglobulin
25. Mother Rh(-), but DAT(+) her baby is Rh (-). What is the reason for discrepancy?
Ans. DAT(+) – baby RBC is sensitized by antibody.
26. Mother B Rh(-), Father AB Rh (+). Child 1 A Rh(-) Child 2 B Rh (+). Which is correct
a. Parental is rule out
b. Parental cannot rule out (answer)
c. Child 1 can rule out
d. Child 2 can rule out
27. Produce #1 detected 50/100 true positive and 100/100 true negative. Produce 2# detected
80/100 true positive and 70/100 true negative
a. Produce 1 is more sensitive
b. Produce 2 is more sensitive
c. Produce 1 is more sensitive and specific
d. Produce 2 is more sensitive and specific
28. TP/TP +FN =?
a. Sensitivity
b. Specificity
c. Precision
d. Variance
29. What might the following indicate? Urine: RBCS, WBCs, nitrite, bacteria.
a. Pyelonephritis- kidney infection caused by bacteria or virus
b. Glomerulonephritis- renal disease usually affects both kidneys. Blood or protein in urine.
c. Nephrotic syndrome - Nephrotic syndrome is a group of symptoms that include protein in
the urine, low blood protein levels, high cholesterol levels, high triglyceride levels, and
swelling
d. renal calculi - A kidney stone is a solid mass made up of tiny crystals.
30. Why is albumin the first protein to be detected in tests for renal failure?
a. It’s molecular size is large
b. Its molecular size is smallest
c. It is very negatively charged.
31. Cortisol excess will result in…. ( An excess ofcortisol can also lead to a decrease in insulin)
a. Hypernatremia - is a common electrolyte problem and is defined as a rise in serum sodium
concentration to a value exceeding 145 mmol/L
b. Hypokalemia - is a lower-than-normal amount of potassium in the blood.
c. Elevated glucose levels in blood
d. Decreased glucose level in blood. (answer)

32. What is the reason for this discrepancy or what would you do to resolve the discrepancy.
Patient cells Anti- A 3+, Anti- B 3+ Patient serum A cell 1+ B cells 0

33. This spiral- form organism is seen in urine and cultured on Fletcher’s media
a. Borrelia - is a genus of bacteria of the spirochete phylum
b. Leptospira - is a genus of spirochaete bacteria, including a small number of pathogenic and
saprophytic species. Spiral Shaped.
34. Organism that gives off a bleach like odor in culture?
a. Actinobacillus - a genus of gram-negative, immotile and nonspore-forming, oval to rod-
shaped bacteria occurring as parasites or pathogens in mammals, birds, and reptiles
b. Eikenella corrodens - is a fastidious gram-negative facultative anaerobic bacillus - the
colonies are small and greyish, they produce a greenish discoloration of the underlying agar
and smell faintly of bleach (answer)
35. Presence of rheumatoid factor in blood may result in false positive for what test?
Ans. VDRL - The VDRL test is a screening test for syphilis. It measures substances, called
antibodies that your body may produce if you have come in contact with the bacteria that cause
syphilis. This bacteria is called Treponema pallidum.
36. Diseases associated with the following results? Elevated TSH; Elevated T3; Elevated free T4
a. hypothyroidism - is disorder in which the parathyroid glands in the neck do not produce
enough parathyroid hormone (PTH).
b. Hyperthyroidism - means your thyroid makes too much thyroid hormone. Secretes excessive
amounts of the free (not protein bound, and circulating in the blood thyroid
hormones, triiodothyronine (T3) and/or thyroxine (T4) (ANSWER)
c. Pituitary tumor

37. If excess parathyroid hormone (PTH) is being released, what would you find in elevated amount
of serum?
a. Calcium - High levels of PTH cause serum calcium levels to increase and serum phosphate
levels to fall.
b. Potassium
 38. Mucoid, pink colonies on plate; produces gas; indole (+). On TSI tube you see yellow on the
slant and yellow in the deep. What organism is this? Indole positive test- Indole positive test-
appearance of pink layer on top (E.g. Escherichia Coli)
a. Salmonella
b. E.coli
c. Klebsilelle pneumonia - Gram-negative, non-motile, encapsulated, lactose fermenting,
facultative anaerobic, rod shaped bacterium
d. Klebdiella oxytoca - is a Gram-negative, rod-shaped bacterium that is closely related to K.
pneumoniae, from which it is distinguished by being indole-positive. K. oxytoca is
characterized by negative methyl red, positive VP, positive citrate, urea and TSI gas
production, is AA, and negative for TSI sulfide, DNAse,SIM motility and PAD.
39. PAD (+); indole (+); organism stain gram negative. What is it?
a. Proteus vulgaris – is indole positive, Gram negative
b. P. mirabilis – indole negative , gram negative
40. You see curved gram negative bacilli (rod shape). It was cultured from the GI tract of a person
with ulcers. What test would you do next to confirm its identity?
Ans. Urease.
41. Enzymes controls run on a machine give results around -3 standard deviations. Samples run on
the same machine give results less than 1 SD. What could be the problem?
a. Controls are expired
b. Controls were left a room temperature
42. HIV- 1 and HIV-2 combination ELISA test is positive in a patient with symptoms of immune
deficiency. Western blot was inconclusive for HIV-1. What do you do next? (Enzyme-linked
immunosorbent assay is a test that uses antibodies and color change to identify a substance )
a. Re run western blot for HIV-1
b. Do a CD4 cell count
c. Do HIV- 2 ELISA
d. Do HIV- 2 western blot (answer)
43. Steps to polymerase chain reaction (PCR)? PCR - is a biochemical technology in molecular
biology to amplify a single or a few copies of a piece of DNA across several orders of magnitude,
generating thousands to millions of copies of a particular DNA sequence.
a. Transduction, transcription, annealing
b. Annealing, denaturation
c. Denaturation, annealing, transcription (answer)
44. A radioallergosorbent test RAST test detects what?
Answer. IgE to particular antigen. RAST- is a blood test used to determine what substance a
person is allergic to.
45. After collecting blood sample in an EDTA tube you find that the hematocrite is very high (67%)
What would you do?
a. Collect blood again, but use less sodium citrate
b. Collect blood in heparin
c. Proceed with what you already.
 46. When you conduct a procedure using fluorescence it is important to protect yourself from the :
a. Cover light
b. Emitted light
c. Exciting light
47. Blood was collected on November 1. Blood was frozen in glycerol on November 5t. What should
the expiration date read?
a. November 1: 1 year from now
b. November 5: 1 year from now
c. November 1: 10 years from now
d. November 5: 10 years from now.
48. A person was successfully treated for syphilis 12 years ago. However he has just come in again
worried about having been reinfected. What would you look for in he blood?
a. TP-A
b. VDRL ( answer)
49. You suspect someone might have JKa, K ,and C antigen on their red cells. You figure out that
they don’t have Jka. You also test their serum and see the following. What would you conclude?
Reagent K cells reagent cells
Patient serum 0 4+
a. Confirm patient as aving K and C antigen on their red cells
b. Rule out c and confirm K on their red cells (answer)
c. Rule out C and K
d. Rule out C but cannot confirm the presence or absence of K.
50. Reagent strip detected no proteins but sulfosalicylic acid test (is used in urine tests to determine
urine protein content) did. Why?
a. Reagent strip is expired
b. Bence Jones protein in urine (Bence Jones proteins are a part of regular antibodies, called
light chain)
51. Fiber strands in urine resemble what under the microscope?
a. Waxy cast
b. Hyaline cast
c. WBC cast
d. Fine granular cast
52. Which of the following regulates myocyte contraction? (a refers to a contraction initiated by
the myocyte cell itself instead of an outside occurrence or stimulus such as nerve innervations )
a. Myoblobin – is an iron- and oxygen-binding protein found in the muscle tissue of vertebrates
in general and in almost all mammals
b. Cardiac troponins - T (cTnT) and troponin I (cTnI) are cardiac regulatory proteins that control
the calcium mediated interaction between actin and myosin.
c. Creatine kinase-MB (CK- MB)
53. HbA1c level cannot always be used to monitor glucose levels in conditions such as;
Answer: Sickle Cell Disease
 54. Western blot was run for HIV testing and the result as indeterminate. What should you do next?
a. Rune again
b. Do ELISA
55. What happens when there is intravascular hemolysis?
Answer. Decrease heptoglobin - Haptoglobin is an acute-phase reactant whose principal clinical
utility is in defining conditions of hemolysis.
56. A postpartum female with a history of transfusion test positive for Anti- D. What is your next
step?
a. Report result and Anti-D
b. Screen for additional antibodies (answer)
c. No further testing is required
d. Assume the anti- D is rhogam and report result
57. The same antibody was found in 3 different patients. The results of testing are listed below.
Which antibody is most likely to be present?
IS 37 AHG
Patient 1 0 2+ 0
Patient 2 2+ 0 0
Patient 3 0 0 2+
a. Anti – Jka
b. Anti- K
c. Anti- M
d. Anti- Leb
58. Difference between Citrobacter and Salmonella.

59. Bilirulin: RGT strip (-), Icto test (+)?

60. Which of the following antigens gives enhanced reactions with its corresponding antibody
following treatment of the red cell with proteolytic enzymes?
a. Fya
b. E (answer)
c. S
d. M
61. Proteolytic enzyme treatment of red cells usually destroys which antigens?
a. JKa
b. E
c. Fya (answer)
d. K
62. Reagent strip detect no protein but sulfosalicylic acid test did. Why?
a. Reagent strip was expired
b. Bence Jones protein in urine
63. A blood sample is left on a phlebotomy tray for four hours before it is delivered to the
laboratory. Which group of test could still be performed?
a. Glucose, Na, K, Cl, PC02
b. Urine acid, BUN, creatin (answer)
c. Total and direct Bilirubin
d. CK, ALT, ALP, ACP
64. This suspicious form, that measure 25 um, was removed in an eye sample. It is associated with
which of the following disease?
Answer: Amoebic Keratitis - Amoebic infection of the cornea is the most serious corneal
infection, usually affecting contact lens wearers
65. Eosinophilia (most commonly seen as a result of allergic reaction, medication reaction, parasitic
infection) is commonly found in which of the following disorder(s):
Answer: Parasitic infection and allergic reactions.
66. All of the following are sources of serum alkaline phosphate except
a. Liver
b. Placenta
c. Intestine
d. Brain
67. Which of the following is detected primarily in the antiglobulin phase of the crossmatch:
a. Anti- Fya ( answer)
b. Anti- M
c. Anti- B
d. Anti- P1
Anti-M, B, P1- are typically IgM and may agglutinate saline suspended cells at room
temperature.
68. What to do with an eosinophil when encountered in a leukocyte alkaline phosphatase (LAP)
count?
69. What is the BNP test? A brain natriuretic peptide (BNP) test measures the amount of the
BNP hormone in your blood. BNP is made by your heart and shows how well your heart is
working. Normally, only a low amount of BNP is found in your blood
70. The most common cold agglutinin?
a. I
b. P1
c. M
71. Procedure for Lactic acid test…
Answer: blood needs to be collected and immediately chilled, separated within one hour
72. For synovial fluid to check mucin clot, what do you add?
Answer: the adding of acetic acid to normal synovial fluid, which causes clot formation The
compactness of the clot and the clarity of the supernatant fluid are the criteria on which the
result is based.