Medical Laboratory Science Exam Practice
Tests
Course Introduction
Medical Laboratory Science is an interdisciplinary field focused on the analysis of biological samples to aid in the diagnosis, treatment, and prevention of diseases. This course explores fundamental concepts in clinical chemistry, hematology, microbiology, immunology, and molecular diagnostics, emphasizing laboratory procedures, instrumentation, quality assurance, and data interpretation. Students will gain both theoretical knowledge and practical skills necessary for understanding laboratory operations, safety protocols, ethical considerations, and the critical role of laboratory professionals within healthcare teams. The curriculum is designed to prepare students for careers in medical laboratories and to support ongoing advancements in medical research and healthcare delivery.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 3rd Edition by Christine Dorresteyn
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Chapter 1: Introduction and Natural Immunity
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Sample Questions
Q1) All of the following are examples of natural immunity EXCEPT:
A) skin as a structural barrier
B) acute phase reactants
C) phagocytosis
D) antibodies
Answer: D
Q2) All of the following are considered part of natural immunity EXCEPT:
A) eosinophils
B) lymphocytes
C) acute phase reactants
D) neutrophils
Answer: B
Q3) Which of the following is true of NK cells?
A) They produce antibody.
B) They are capable of phagocytosis.
C) They have markers CD4 and CD16.
D) They kill tumor and virally infected cells.
Answer: D
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Chapter 2: Lymphoid System
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Sample Questions
Q1) T cells emerging from the thymus are:
A) MHC restricted
B) self-tolerant
C) antigen specific
D) all of these
Answer: D
Q2) A T cell that is rarely found in secondary lymphoid organs and recognizes a limited number of native epitopes is known as a(n):
A) helper T cell
B) gamma-delta T cell
C) cytotoxic T cell
D) alpha-beta T cell
Answer: B
Q3) Natural killer cells recognize and kill target cells that are:
A) opsonized with IgE
B) lacking expression of HLA-A,B,and C
C) lacking expression of HLA-DR,DP,and DQ
D) presenting antigen associated with HLA-A,B,or C
Answer: B
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Page 4
Chapter 3: Nature of Antigens and Major Histocompatibility Complex
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Sample Questions
Q1) A macromolecule that is capable of eliciting an immune response in an immunocompetent host is called a(an):
A) antigen
B) antibody
C) hapten
D) acute phase reactant
Answer: A
Q2) If a patient's red cells agglutinate with anti-A reagent antibody and the serum agglutinates B cells,what is the blood type?
A) type A
B) type B
C) type O
D) cannot determine
Answer: A
Q3) The use of an aluminum salt in the hepatitis vaccine is an example of a (an):
A) hapten
B) adjuvant
C) immunogen
D) carrier
Answer: B
Page 5
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Chapter 4: Antibody Structure and Function
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Sample Questions
Q1) The primary response is characterized by:
A) naive B cells recognizing antigens
B) memory B cells recognizing antigens
C) the production of large amounts of IgG
D) a very short lag period
E) a long duration of high titer
Q2) Which of the following is true of IgE?
A) It fixes complement.
B) It binds to mast cells.
C) It is found on mucosal surfaces.
D) It participates in agglutination reactions.
Q3) Which antibody agglutinates and fixes complement best?
A) IgA
B) IgM
C) IgG
D) IgE
Q4) Which region of the immunoglobulin molecule can bind antigen?
A) Fab
B) CL
C) CH
Page 6
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Chapter 5: Cytokines
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Sample Questions
Q1) Which of the following can be attributed to interleukin-6 (IL-6)?
A) stimulates red blood cell production
B) increases vascular permeability
C) inhibits antigen presentation by macrophages
D) increases activation of T and B cells
Q2) Which cells produce interleukin-1?
A) T helper cells
B) cytotoxic T cells
C) B cells
D) macrophages
Q3) What is the main action of interferon-gamma?
A) increased synthesis of acute phase reactants
B) stimulation of T cells
C) inhibition of T cell activity
D) activation of macrophages
Q4) When multiple cytokines act on the same cell,by definition they have:
A) pleiotropy
B) redundancy
C) synergism
D) antagonism
Page 7
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Chapter 6: Complement System
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Sample Questions
Q1) The C5 convertase of the classical pathway of complement activation is:
A) C3bBbP
B) C3bBb3bP
C) C4b2a3b
D) C4b2a
Q2) Formation of the membrane attack complex (C5b-C9)is stopped by which factor?
A) factor H
B) factor I
C) C1INH
D) S protein
Q3) Which factors are only associated with the alternative pathway?
A) factor B and factor D
B) factor D and C3
C) factor B and C2
D) C2 and MBL
Q4) Which of the following complement components has chemotactic activity?
A) C3b
B) C3a
C) C1qrs
D) C5b6789
Page 8
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Chapter 7: Safety and Specimen Preparation
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Sample Questions
Q1) Which of the following applies to recapping of needles?
A) It can be done carefully as long as gloves are worn.
B) A sheath can be placed back on the needle with the other hand.
C) Transport needles back to the lab for disposal.
D) Never manually recap a needle.
Q2) Which of the following is part of the federal Occupational Exposure to Bloodborne Pathogens Standard Act ?
A) All employees must practice universal precautions at all times.
B) Only workers who come in contact with patients need to wear gloves.
C) Taking a cup of coffee into the lab is okay as long as it doesn't spill.
D) A blood spill can be mopped up at the end of the day.
Q3) If you want to make 4 mL of a 1:20 dilution,how much serum would be needed?
A) 0.2 mL
B) 2 mL
C) 0.5 mL
D) 1 mL
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9
Chapter 8: Precipitation Reactions
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Sample Questions
Q1) An Ouchterlony immunodiffusion assay is set up and a line of precipitation is seen forming between the antigen and antibody wells.The lines of precipitation formed by two adjacent antigen wells cross each other,forming an X.The reaction described is called:
A) identity
B) non-identity
C) partial identity
Q2) Electrophoresis followed by diffusion of antibody from wells cut in the gel best describes which of the following?
A) immunofixation electrophoresis
B) immunoelectrophoresis
C) Ouchterlony diffusion
D) rocket immunodiffusion
Q3) In which of the following zones is a false-negative reaction likely?
A) prozone
B) zone of equivalence
C) postzone
D) all of the above
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Chapter 9: Agglutination
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Sample Questions
Q1) A serological reaction is set up in which the antigen is bound to a large carrier,the antibody is soluble,and they bind and form an insoluble complex that is detected macroscopically.What type of assay is described?
A) precipitation
B) agglutination
C) flocculation
D) neutralization
Q2) Coombs' reagent is used for what purpose?
A) to link small antigens on patient red cells
B) to enhance agglutination with IgG coated red blood cells
C) to enhance agglutination with IgM coated red blood cells
D) to cause a precipitation reaction with small amounts of antibody
Q3) The process by which particulate antigens such as cells aggregate to form larger complexes when specific antibody is present is called:
A) sensitization
B) precipitation
C) agglutination
D) flocculation
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11
Chapter 10: Labeled Immunoassays
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Sample Questions
Q1) An ELISA assay was performed on a patient's serum sample.What is the relationship of the amount of enzyme activity to the amount of patient analyte measured?
A) directly proportional
B) indirectly proportional
Q2) In the following equation,10 Ag* + 5 Ag + 3 Ab ---> Ag*Ab + Ag Ab + Ag* + Ag,the ratio of bound radioactive antigen to bound patient antigen is:
A) 2:1
B) 1:2
C) 3:1
D) 5:1
Q3) Which of the following is characteristic of noncompetitive enzyme immunoassays?
A) Binding sites for patient antigen are limited.
B) Washing in between steps is not necessary.
C) All patient antigen is allowed to react with binding sites.
D) Color is indirectly proportional to the concentration.
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12
Chapter 11: Molecular Techniques
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Sample Questions
Q1) What is meant by semi-conservative replication of DNA?
A) Only part of the molecule is reproduced at one time.
B) Each strand is the template for another strand.
C) One copy is the same and another copy is different.
D) DNA uses RNA to make new copies.
Q2) In order for a probe to hybridize to the target,which condition must be met?
A) The target must be double-stranded.
B) The target can only be RNA.
C) The target must have the same bases.
D) The target must have complementary bases.
Q3) Use of microarrays consisting of either DNA or RNA to identify an unknown nucleic acid best describes:
A) in situ hybridization
B) polymerase chain reaction
C) DNA chip technology
D) strand displacement amplification
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Chapter 12: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) Which is a difference between batch and random access analyzers?
A) Batch analyzers are not automated.
B) Random access analyzers only analyze one sample at a time.
C) Batch analyzers only do one type of analysis at a time.
D) Random access analyzers cannot be used for stat samples.
Q2) A mature cytotoxic T cell expresses which markers?
A) CD3,CD4,and CD8
B) CD4,CD3,and CD5
C) CD5,CD8,and CD3
D) CD8,CD3,and CD2
Q3) In most flow cytometers,labeled cells:
A) scatter the light and absorb fluorescence
B) absorb fluorescence and emit electronic impulses
C) scatter the light and emit fluorescence
D) absorb both fluorescence and light
Q4) A range of values that all produce a positive result is known as:
A) analytic sensitivity
B) reportable range
C) accuracy
D) precision
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Chapter 13: Hypersensitivity
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Sample Questions
Q1) Preformed mediators that are released during the activation phase of a type I hypersensitivity include which of the following?
A) histamine
B) cyclooxygenase
C) leukotriene
D) prostaglandin
Q2) Which isotype of immunoglobulin is involved in a type I hypersensitivity?
A) IgE
B) IgA
C) IgG
D) IgM
Q3) All of the following are involved in killing of large parasites EXCEPT:
A) degranulation of mast cells
B) action of eosinophil basic protein
C) production of IgE
D) activation of complement
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Page 15
Chapter 14: Autoimmunity
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Sample Questions
Q1) An autoimmune disease characterized by pain and progressive destruction of the joints,weight loss,morning stiffness,and presence of an antibody directed against IgG best describes:
A) rheumatoid arthritis
B) lupus
C) hemolytic disease of the newborn
D) hemolytic anemia
Q2) A 54-year-old woman presents to her optometrist complaining that she has been having difficulty focusing on objects,both near and far.Her vision problems are getting progressively worse.She also thinks that her eyelids are drooping and she is thinking of getting plastic surgery to "put them back up." The optometrist cannot find a good reason for her vision problems but is able to fit her with glasses and recommends that she see a rheumatologist.The rheumatologist sends the women's blood for autoantibody testing,and the laboratory professionals report that the woman has autoantibodies against the acetylcholine receptor.This woman has:
A) myasthenia gravis
B) Goodpasture's syndrome
C) Addison's disease
D) multiple sclerosis
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Page 16
Chapter 15: Immunoproliferative Diseases
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Q1) Which best describes the difference between chronic and acute lymphocytic leukemias?
A) Chronic lymphocytic leukemias are exclusive of T-cell origin.
B) Acute lymphocytic leukemias have a high response rate to chemotherapy.
C) Chronic lymphocytic leukemias have a shorter survival time.
D) Acute lymphocytic leukemias progress more slowly.
Q2) A 55-year-old male presents with symptoms that include weakness,loss of appetite,and anemia.Immunofixation electrophoresis reveals a heavy IgM band.Which of the following is the most likely diagnosis?
A) SCID
B) multiple myeloma
C) Waldenström's macroglobulinemia
D) DiGeorge syndrome
Q3) Which immunoproliferative disorder is a cancer of the plasma cells and results in secretion of light chains into the urine?
A) multiple myeloma
B) Waldenström's macroglobulinemia
C) alpha heavy chain disease
D) DiGeorge syndrome
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Page 17
Chapter 16: Immunodeficiency Disease
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Sample Questions
Q1) A 1-year-old boy is evaluated for a suspected immune deficiency.He has a history since birth of eczema,recurrent rashes,and diarrhea.(Normal values are given in parentheses.)His WBC count is 6.75/uL (5.0-10.8 × 10<sup>3</sup> uL)with a normal differential.Platelet count is 35,000 (150,000-350,000/uL)and the platelets are small.His IgG is 750 mg/dL (600-1,500 mg/dL),IgM is 30 mg/dL (75-150 mg/d:),IgA is 475 mg/dL (50-125 mg/dL),and IgE is 750 mg/dL (10-50 mg/dL).The boy's blood is typed as O-positive,and he does not have anti-A or anti-B antibodies.Flow cytometry performed on his blood shows 11% (5-20%)CD19 and 50% (60-80%)CD3 cells with a normal ratio of CD4:CD8.T-cell function tests are abnormal.This boy most likely has:
A) Bruton's hypogammaglobulinemia
B) Wiskott-Aldrich syndrome
C) DiGeorge syndrome
D) ataxia telangiectasia
Q2) Which of the following diseases results in an acquired or secondary immunodeficiency?
A) HIV infection
B) Bruton's agammaglobulinemia
C) leukocyte adhesion deficiency
D) Wiskott-Aldrich syndrome
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Page 18
Chapter 17: Transplantation Immunology
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Sample Questions
Q1) Graft-versus-host disease results under which conditions?
A) when immunocompetent cells are placed in an immunocompromised host
B) when immunodeficient cells are placed in an immunocompetent host
C) any time tissue is not exactly matched in a transplant
D) only when adult cells are transplanted into a baby
Q2) When a complement-dependent cytotoxicity test was performed using standard antibodies to HLA A1,A3,B2,and B11,the following microscopic results were obtained: a majority of blue cells were seen with anti-A1,A3,and B11.Based on these results,what is the phenotype of the donor cells?
A) HLA A1,B11
B) HLA B2 only
C) HLA A1,A3,B11
D) cannot be determined from these results
Q3) The type of rejection that occurs within minutes to hours due to preformed antibody is known as:
A) delayed rejection
B) chronic rejection
C) accelerated rejection
D) hyperacute rejection
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Page 19
Chapter 19: Tumor Immunology
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Sample Questions
Q1) Antibodies detected by reacting rickettsial antigens with specific antibody followed by use of an anti-immunoglobulin with a fluorescent tag could be used to diagnose:
A) Rocky Mountain spotted fever
B) Mycoplasma pneumonia
C) stomach ulcers
D) rheumatic fever
Q2) An ASO test was performed on the serum from a 10-year-old female patient with the following results: no hemolysis in the 1:10,1:20,1:40,and 1:80 tubes; and hemolysis in the 1:160,1:320,and 1:640 tubes.What conclusion can you draw from these results?
A) The titer is 1:640,and the patient may have glomerulonephritis.
B) The titer is 1:160,and the patient may have rheumatic fever.
C) The titer is 1:80,and the patient is normal.
D) The test is invalid and must be repeated.
Q3) Which of the following statements best describes Helicobacter pylori?
A) It is a gram-positive coccus that causes skin infections.
B) It is a gram-negative spiral that causes ulcers.
C) It lacks a cell wall and produces a lot of acid.
D) It can be detected by testing for cold agglutinins.
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Chapter 20: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) A 25-year-old pregnant female has serologic testing to determine if she has a toxoplasmosis infection.A low level of both IgM and IgG is found.On repeat testing 2 weeks later,the results are the same.What can be concluded from these results?
A) She has an active infection.
B) The baby will have serious central nervous system damage.
C) She was exposed to toxoplasmosis at some time in the past.
D) She has never been exposed to toxoplasmosis.
Q2) In an individual with AIDS,what is the most likely reason for a toxoplasmosis infection that invades the central nervous system?
A) The host produces a lot of antibody.
B) Cysts in the tissue become reactivated.
C) The individual ingests contaminated water.
D) The parasite has acquired new surface proteins.
Q3) When is antibody testing for Cryptococcal antibodies most useful?
A) in determining patient prognosis
B) in diagnosing immunocompromised patients
C) in ruling out the disease in young patients
D) as a screening test after exposure to the fungus
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Chapter 21: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) A 32-year-old heterosexual male presents to the physician with a 3-day history of multiple skin lesions located all over his body and on his mucous membranes.He hasn't felt well and has a low-grade fever.The patient cuts down trees in Massachusetts for a living.He is single,has had multiple sex partners,and does not use condoms.Here are the results of his laboratory tests: rapid plasma reagin = reactive 1:128; Treponema pallidum-particle agglutination assay = reactive; Borrelia burgdorferi IgM = < 1:8; Rickettsia rickettsii IgM < 1:8.This patient has:
A) primary syphilis
B) secondary syphilis
C) lyme disease
D) Rocky Mountain spotted fever
Q2) Which best describes the antibody called reagin found in syphilis?
A) It reacts with cardiolipin.
B) It is specific for treponemal antigen.
C) It appears in all patients within 7 days after exposure to syphilis.
D) It is detected by the FTA-ABS test.
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Chapter 22: Serology of Parasitic and Fungal Infections
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Sample Questions
Q1) A patient has the following EBV antibody profile: EBVCA IgM = neg; EBVCA IgG = pos; EBV-EA IgG = pos; EBV-NA IgG = pos.Which of the following is the correct interpretation of these data?
A) never infected with EBV
B) acute infection with EBV
C) recent convalescence from EBV
D) long-ago past infection with EBV
Q2) A 14-year-old boy presents to the physician complaining of sore throat,fatigue,and fever for the last week.A monotest was performed and was reported as positive.This boy has:
A) infectious mononucleosis
B) streptococcal pharyngitis
C) acute glomerulonephritis
D) common cold
Q3) Serologic test results indicating that a patient is a chronic carrier of hepatitis B would be which of the following?
A) HBsAb positive; HBsAg negative
B) HBcAb and HBsAb positive
C) HBsAb negative; HBsAg positive for 12 months
D) HBeAb and HBeAg negative
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Chapter 23: Spirochete Diseases
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Q1) Viral load testing is of most clinical utility in all of the following situations EXCEPT:
A) initial diagnosis of HIV infection when antibody tests are positive
B) monitoring patients during antiretroviral therapy
C) setting a baseline before antiretroviral therapy has begun
D) investigating a patient's sudden drop in T-cell count
Q2) A 22-year-old male sees his physician for an annual checkup.He reported having flu-like symptoms including fever,sore throat,and lymphadenopathy several months ago.He has lost about 10 pounds but otherwise feels fine.Since he reports that a former girlfriend told him she is HIV positive,the physician recommends testing.An ELISA test is positive,a Western blot is positive,and a CD4+ T-cell count is 500/\(\mu\)L.What do these results indicate?
A) He has AIDS.
B) He has recovered from HIV infection.
C) He is HIV positive but in a latent stage.
D) He has an opportunistic infection and not HIV.
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