Medical Laboratory Technology
Final Exam Questions
Course Introduction
Medical Laboratory Technology is a dynamic field focused on the analysis of bodily fluids, tissues, and cells to aid in the diagnosis, treatment, and prevention of diseases. This course provides foundational knowledge and practical skills in clinical chemistry, hematology, microbiology, immunology, and molecular diagnostics. Students learn to operate sophisticated laboratory equipment, follow rigorous safety protocols, and interpret laboratory data crucial for patient care. Emphasizing both theory and hands-on experience, the course prepares students to work effectively as part of a healthcare team, ensuring accurate results and maintaining high standards of quality in medical laboratories.
Recommended Textbook
Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening
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27 Chapters
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Chapter 1: Red Blood Cells and Platelet Preservation:
Historical Perspectives and Current Trends
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Sample Questions
Q1) The RBC membrane is relatively permeable to all of the following except:
A) chloride.
B) sodium.
C) bicarbonate.
D) water.
Answer: B
Q2) Which of the following best describes "integral" membrane proteins?
A) Reside at the cytoplasmic surface of membrane
B) Span the entire membrane surface
C) Form the red blood cell cytoskeleton
D) None of the above
Answer: B
Q3) What does the term autologous transfusion refer to?
A) A parent donating blood for his or her child
B) An individual donating blood for a friend
C) An individual donating blood for a relative
D) An individual donating blood for his or her own transfusion
Answer: D
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Chapter 2: Basic Genetics
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Sample Questions
Q1) All of the following are consistent with Mendel's basic rules of inheritance except:
A) the gene is transmitted through generations intact.
B) a pair of genes is always found in the same gamete.
C) different pairs of genes are assorted independently of each other.
D) a pair of genes is rarely found in the same gamete.
Answer: B
Q2) A father carries the Xg<sup>a</sup> trait and passes it on to all of his daughters but none of his sons. What type of inheritance does this represent?
A) Autosomal dominant
B) X-linked dominant
C) X-linked recessive
D) Autosomal recessive
Answer: B
Q3) What is meant by the term <i>autosomal</i>?
A) Trait is not carried on the sex chromosomes
B) Trait is carried on sex chromosomes
C) Trait is not expressed in the parents
D) Organism possesses different alleles for a given characteristic
Answer: A
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Page 4
Chapter 3: Fundamentals of Immunology
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Sample Questions
Q1) Only 5% of Kell-negative individuals will develop antibodies to Kell if exposed to the Kell antigen, whereas 50% to 70% of Rh(D)-negative individuals would produce antibodies to D upon exposure. What is the reason for this?
A) Difference in ABO type
B) Difference in immunogenicity
C) Phenotype
D) All of the above
Answer: B
Q2) At what temperature do IgM antibodies react?
A) 22°C
B) 37°C
C) 56°C
D) 42°C
Answer: A
Q3) All of the following are characteristics of monoclonal reagents except:
A) an absence of batch variation.
B) antibodies directed against a single epitope.
C) undetectable subgroups of A.
D) monoclonal antibodies with high affinities.
Answer: C
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Chapter 4: Concepts in Molecular Biology
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Sample Questions
Q1) Restriction endonucleases are characterized as being <i>palindromic</i>. What is meant by this term?
A) The recognition sequence is read in the same 5' to 3' direction on both strands of the double helix.
B) The recognition sequence is read in the same 3' to 5' direction on both strands of the double helix.
C) The recognition sequence is read in the same 5' to 3' direction on one side of the double helix.
D) The recognition sequence is read in the same 3' to 5' direction on one side of the double helix.
Q2) Restriction Fragment Length Polymorphism (RFLP) can be used for all but which of the following purposes?
A) In paternity cases to determine the source of a DNA sample
B) To measure recombination rates, which can lead to a genetic map with the distance between RFLP loci measured in centimorgans
C) In criminal cases to determine the source of a DNA sample
D) To determine the Rh status of an individual
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Chapter 5: The Antiglobulin Test
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Sample Questions
Q1) You are performing an IAT, and you are suspicious of the results. It appears there may be a weak alloantibody present. You decide to repeat the test, and at the LISS stage you decide to add an extra two drops of serum to each tube being tested. What can you expect to happen?
A) There would be no effect.
B) The additional serum increases reaction strengths, because more possible antibody is added to the reaction.
C) Sensitivity of the test decreases, because you increased the ionic strength of the mixture.
D) You lowered the zeta potential, thus enhancing your results.
Q2) The inability to determine the ______________ of anti-C3b and anti-C3d individually is one of the difficulties with polyclonal reagents.
A) potency
B) titer
C) presence
D) volume
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Chapter 6: The Abo Blood Group System
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Sample Questions
Q1) What is the cause of polyagglutination in most cases?
A) Exposure of anti-T caused by bacterial contamination
B) Exposure of T antigen caused by bacterial contamination
C) Hypergammaglobulinemia
D) Exposure of I antigen caused by bacterial contamination
Q2) What substances are found in a group A secretor?
A) AH
B) H
C) BH
D) ABH
Q3) An AB male mates with an AB female. What could be the genotype of the offspring?
A) AB
B) AA
C) BB
D) All of the above
Q4) What is the biochemical structure of secreted A, B, and H substances?
A) Glycolipid
B) Glycoprotein
C) Sphingolipid
D) Ceramide
Page 8
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Chapter 7: The RH Blood Group System
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Sample Questions
Q1) What is the frequency of E antigen in the general population?
A) 85%
B) 15%
C) 98%
D) 30%
Q2) What is the basis of Rosenfield Rh terminology?
A) Each gene produces one product or antigen.
B) The positive (+) or negative (-) sign demonstrates the presence or absence of antigen on a red blood cell.
C) The Rh gene produces at least three factors within an agglutinogen.
D) The Rh gene produces at least five factors within an agglutinogen.
Q3) If an individual with a partial D expression is transfused with a normal Rh-positive unit of blood, a likely result will be:
A) the patient will develop an anti-D antibody.
B) the patient will form an antibody to the portion of Rh(D) protein that they are missing.
C) the patient will have an acute hemolytic transfusion reaction.
D) the patient will experience no consequence of receiving Rh-positive blood.
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Chapter 8: Blood Group Terminology and the Other Blood Groups
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Sample Questions
Q1) Which antibody is viewed to be clinically significant because of its association with HTR and HDN?
A) Anti-Bg<sup>a</sup>
B) Anti-Kn<sup>a</sup>
C) Anti-Di<sup>b</sup>
D) Anti-Ch<sup>a</sup>
Q2) How is the En<sup>a</sup> antigen related to the Wr(a-b-) phenotype?
A) En(a-) red blood cells are all Wr(a-b-)
B) En(a+) red blood cells are all Wr(a-b-)
C) All Wr(a-b-) red blood cells are also M-N-
D) En(a-) individuals lack MN-SGP
Q3) Alloanti-Lu<sup>b</sup> will react_______________ with Lu(a+b+) cells than/as with Lu(a-b+) cells.
A) stronger
B) weaker
C) the same
D) none of the above
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Page 10
Chapter 9: Detection and Identification of Antibodies
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Sample Questions
Q1) Why is it important for screening cells to be from individuals who have a homozygous expression of antigens?
A) Homozygous expression is directly related to clinically significant antibodies.
B) Stronger reactions are seen with heterozygous cells than with homozygous cells.
C) Weakly reacting antibodies may not agglutinate heterozygous cells.
D) All of the above
Q2) In interpreting an antibody screen, which of the following questions might be asked to decipher the class of antibody?
A) Is the autologous control positive or negative?
B) Is hemolysis present?
C) In what phase did the reaction occur?
D) Is rouleaux present?
Q3) How can neutralization aid in the identification of multiple antibodies?
A) Once antibody has been neutralized serum can be further tested in panel studies.
B) Neutralization inhibits all warm autoantibodies.
C) Neutralized serum can be used to phenotype patient cells.
D) All of the above
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Chapter 10: Pre-Transfusion Testing
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Sample Questions
Q1) What must be done prior to transfusion of non-group O blood to an infant?
A) Testing infant serum for anti-A and anti-B at IS
B) Testing infant serum for anti-A and anti-B at 37°C
C) Testing infant serum for anti-A and anti-B at AHG
D) None of the above
Q2) What is the most critical step in blood transfusion?
A) Phenotyping units to ensure compatibility with alloantibody
B) Following quality control procedures
C) Checking patient identification and compatibility of donor unit
D) Monitoring the temperature control of donor units
Q3) Why is it necessary to use single-donor screening cells instead of pooled screening cells for patient samples?
A) Pooled screening cells are devoid of Duffy antigens
B) Single-donor screening cells are free from HIV infection
C) Single-donor screening cells are complementary among each other
D) None of the above
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Chapter 11: Overview of the Routine Blood Bank Laboratory
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Sample Questions
Q1) In what department of the blood bank laboratory is knowledge of patient diagnosis, drug history, age, and transfusion history most important?
A) Donor processing
B) Main laboratory
C) Reference laboratory
D) Component preparation and storage
Q2) A group O whole blood unit collected from an outside facility was needed for a group A recipient. How can packed cells be made in the shortest time possible?
A) Red blood cell sedimentation
B) Refrigerated centrifugation
C) Vertical rotation
D) Filtration
Q3) It is December 1, 2012, and you irradiate an O-negative packed RBC that you have in inventory, which outdates January 5, 2013. What will the new outdate be for that unit?
A) December 2, 2012
B) December 3, 2012
C) December 29, 2012
D) January 5, 2013
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Chapter 12: Other Technologies and Automation
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Sample Questions
Q1) Which of the following substances may interfere with gel technology but not SPRCA technology?
A) Hemolysis
B) Lipemia
C) Icteric samples
D) All of the above
Q2) When performing an antibody screen by gel technology, the following steps are eliminated:
A) the AHG reagent and control checked cells.
B) the saline wash and control check cells.
C) the cells I and II and saline wash.
D) the centrifugation and saline wash.
Q3) Which of the following is a factor in possible false-negative or false-positive results when using the gel system to screen for antibodies?
A) Bacterial contamination
B) Temperature
C) Time
D) All of the above
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14
Chapter 13: Donor Screening and Component Preparation
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Sample Questions
Q1) A patient has a baseline platelet count of 30,000/µL. Upon receiving a platelet pool of 4 random platelets, what would you expect the post-transfusion platelet count to be?
A) 35,000/µL
B) 50,000/µL
C) 80,000/µL
D) 100,000/µL
Q2) Cryoprecipitate is indicated for all of the following disorders except:
A) hypofibrinogenemia.
B) hemophilia A.
C) Von Willebrand's disease.
D) hemophilia B.
Q3) A blood donor with a history of hepatitis B should be excluded:
A) only if they are jaundiced.
B) only if the disease has been active for the last 5 years.
C) permanently.
D) only if liver function tests are abnormal.
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Chapter 14: Apheresis
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Sample Questions
Q1) In plateletpheresis, which blood component is returned to the donor?
A) Red blood cells
B) Platelets
C) White blood cells
D) Options A and C
Q2) A person participating in a serial apheresis program would not:
A) donate more frequently than every 4 weeks.
B) lose more than 25 mL of red blood cells per week.
C) be monitored for weight loss.
D) donate every 72 hours.
Q3) Plasma exchange is most effective when_____ is considered the pathological substance.
A) IgG
B) IgM
C) IgA
D) IgE
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Chapter 15: Transfusion Therapy
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Sample Questions
Q1) What is the expiration on washed red blood cells?
A) 35 days
B) 24 hours
C) 42 days
D) 6 hours
Q2) What is the most efficient way to remove leukocytes from red blood cell units?
A) Leukoreduction filters
B) Centrifugation
C) Deglycerolizing
D) Washing
Q3) Why is the increase in hemoglobin and hematocrit evident more quickly in red blood cell transfusions than in whole blood transfusions?
A) Blood volume adjustment is less when red blood cells are transfused.
B) Blood volume adjustment is greater when red blood cells are transfused.
C) Whole blood takes longer to mix.
D) Whole blood is usually transfused through a porous filter.
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Chapter 17: Cellular Therapy
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Sample Questions
Q1) Physical or chemical damage of the transfused red blood cells can result in:
A) intravascular hemolysis.
B) extravascular hemolysis.
C) sepsis.
D) pulmonary edema.
Q2) Which of the following products may lead to sepsis in a patient when contaminated with Escherichia coli?
A) Packed red blood cells
B) Normal saline
C) Platelets
D) All of the above
Q3) A transfusion reaction investigation should include all of the following except:
A) diagnosis.
B) current medication.
C) neocyte transfusion.
D) washed RBCs.
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Page 18
Chapter 18: Transfusion-Transmitted Diseases
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Sample Questions
Q1) Which two infectious agents share the same vector?
A) Rickettsia and Leishmania
B) Babesia and Borrelia
C) Borrelia and Plasmodium
D) Babesia and Trypanosoma
Q2) Which of the following findings is not part of the typical pattern of hepatitis A infection?
A) Anti-HAV IgM antibodies
B) Anti-HAV IgG antibodies
C) Virus in stool
D) Elevated ALT
Q3) The most sensitive test for the detection of HIV infection is the:
A) polymerase chain reaction.
B) Western blot.
C) immunofluorescence.
D) Southern blot.
Q4) A person with acute hepatitis B infection is immune to infection from other hepatitis viruses.
A)True
B)False
Page 19
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Chapter 19: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) Which of the following mother/infant blood types would be considered at risk for ABO hemolytic disease of the fetus and newborn?
A) Mother is group O; baby is group B.
B) Mother is group O; baby is group O.
C) Mother is group AB; baby is group B.
D) Mother is group A; baby is group O.
Q2) In the event of a clinically significant antibody found in the mother's serum, which of the following must be performed to determine its concentration?
A) Fetal screen
B) Antibody screen
C) Antibody titer
D) Elution
Q3) Why is suppression of erythropoiesis an advantage of exchange transfusions?
A) Reduces the production of compatible RBCs
B) Reduces the production of incompatible RBCs
C) Decreases the risk of iron overload
D) Clears nucleated RBCs from circulation
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Chapter 20: Autoimmune Hemolytic Anemias
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Sample Questions
Q1) What is the mechanism by which thiol reagents, such as dithiothreitol (DTT), disperse agglutination caused by cold-reactive autoantibody?
A) Dissociation of IgG molecules from the red blood cell with no damage to the membrane
B) Cleavage of the intersubunit disulfide bonds of dimeric IgG molecules
C) Cleavage of the intersubunit disulfide bonds of pentameric IgM molecules
D) Dissociation of IgM molecules from the red blood cell with no damage to the membrane
Q2) Why do clotted specimens yield positive DAT results with anti-C3 in the presence of a benign cold autoagglutinin?
A) Complement is inhibited due to calcium chelation
B) Complement can be activated in vivo
C) Complement can be activated in vitro
D) Complement is activated in the absence of fibrinogen
Q3) The onset of warm autoimmune hemolytic anemia (WAIHA) may be precipitated by:
A) pregnancy.
B) bacterial infection.
C) trauma.
D) all of the above.
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Page 21
Chapter 21: The Hla System
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Sample Questions
Q1) When the entire set of A, B, C, DR, DQ, and DP antigens are located on one chromosome, it is called a:
A) phenotype.
B) genotype.
C) haplotype.
D) karyotype.
Q2) A double-lung transplant is indicated in which of the following disorders?
A) Pneumonia
B) Pulmonary fibrosis
C) Primary hypertension
D) Cystic fibrosis
Q3) What is the main purpose of crossmatching before transplantation?
A) To identify antibody in the potential donor to antigen present on recipient cells
B) To identify antibody in the serum of the potential recipient to antigens present on donor tissues
C) To identify antigen in the recipient cells to antibody present in donor serum
D) To identify antigen present on donor tissues to antibody present in recipient serum
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22
Chapter 22: Relationship Testing
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Sample Questions
Q1) What is the major constituent of chromosomes?
A) Golgi bodies
B) Mitochondria
C) RNA
D) DNA
Q2) Given the gene frequencies of MS and NS, what is the genotype frequency (MS/NS), assuming the genotype could occur in two different ways: MS: 0.2578 or NS: 0.0628.
A) 0.0004
B) 0.0625
C) 0.0324
D) 0.0054
Q3) How is DNA testing advantageous to paternity cases?
A) It provides cloning capabilities in xenographic studies.
B) It provides visual insight into genetically inherited differences among individuals.
C) It provides insight into approximate time of conception.
D) It establishes a means of stem cell transplantation for related individuals.
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Chapter 23: Quality Management
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Sample Questions
Q1) When a new assay is implemented, what measure is taken to determine equivalency?
A) Lot to lot testing of new and old lot numbers of reagent
B) Work-flow reorientation
C) Daily quality control
D) Calibration
Q2) Which of the following is an example of an external customer?
A) A night-shift medical technologist
B) A blood donor
C) An intravenous nurse
D) Housekeeping employee
Q3) As part of postemployment departmental training, a medical technologist was given 10 known blood samples to analyze for ABO specificity. This is referred to as:
A) recertification.
B) a competence assessment.
C) education.
D) a proficiency test.
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Chapter 24: Transfusion Safety and Federal Regulatory Requirements
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Q1) What is the purpose of a prelicense inspection by the CBER?
A) To order mandatory injunctions
B) To determine the firm's readiness for an unannounced inspection
C) To determine the firm's ability to operate in compliance with applicable regulations
D) None of the above
Q2) What protocol is followed for licensed products generated at a different site from the original licensed site or establishment?
A) Product license is automatically transferred from site to site.
B) An amendment is filed to the product license application.
C) A separate product license must be issued for each additional site.
D) None of the above
Q3) What is the primary focus of quality assurance?
A) To place blame on employees who make recurring errors
B) To amend the system, procedure, or standard operating procedures, if deemed faulty
C) To analyze post-market stability
D) To rewrite employee job descriptions as needed
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Chapter 24: Utilization Management
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Q1) A physician has ordered a 2-unit transfusion on an outpatient. When the outpatient arrives, the patient's hemoglobin is 12. What is the most appropriate action?
A) Cancel the transfusion and send the patient home.
B) Call the physician's office and inform them of their mistake.
C) Inform the pathologist or medical director and allow him to contact the physician.
D) Transfuse. A physicians order should not be questioned.
Q2) The focus of most blood utilization programs is:
A) the underutilization of blood products of a facility.
B) the overutilization of blood products by a facility.
C) to reduce cost.
D) to evaluate the need for ordering more product.
Q3) Targeted and discontinuous are subtypes of what review system?
A) Retrospective
B) Concurrent
C) Interpreted
D) Prospective
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Chapter 25: Laboratory Information Systems
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Sample Questions
Q1) Blood bank information systems should perform all of the following except:
A) verify donor testing results to ensure units are suitable for transfusion.
B) identify the location of all units at any given time.
C) recognize units that are outdated.
D) verify the accuracy of input demographic data.
Q2) Standard operating procedures must include computer functions that are part of the blood bank's technical procedures, such as the issuance of blood components.
A)True
B)False
Q3) Which of the following best describes software?
A) Physical pieces of equipment that can be seen and touched
B) The "core" of the information system
C) Programmed instructions that tell computer how to operate and manipulate the data
D) A mechanism for connecting one computer system to another through a telephone line
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Chapter 26: Medicolegal and Ethical Aspects of Providing
Blood Collection and Transfusion Services
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Q1) Plaintiffs have prevailed in TTAIDS multimillion-dollar medical malpractice suits against physicians for which of the following arguments?
A) There is a lack of standard protocol for implementing new HIV test kits.
B) The patient did not need a transfusion based on clinical data.
C) The patient did not give informed consent.
D) The patient was health illiterate and therefore could not comprehend the need for transfusion.
Q2) What kind of cases stimulated state legislature to enact protection for blood banks through so-called blood shield statutes?
A) TTAIDS
B) TTH
C) TT syphilis
D) TT sepsis
Q3) All of the following are emerging concerns of transfusion medicine except:
A) red blood cell substitute.
B) standards of preoperative blood collection and reinfusion.
C) crossover of autologous (unused) units.
D) antibody testing procedures.
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Chapter 27: Tissue Banking: A New Role for the Transfusion Service
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Q1) At a minimum, all but which of the following must be included on the tissue receipt records?
A) Tissue Identification Number (TIN)
B) Expiration date (if applicable)
C) Condition of the tissue and who received it/inspected it upon arrival
D) Donor's birth date
Q2) Records of tissue must be kept at least ________ after expiration
A) 2 years
B) 5 years
C) 10 years
D) indefinitely
Q3) Which of the following is generally excluded from the tissue bank?
A) Corneas
B) Liver
C) Heart valves
D) Skin
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