Prepare for ASCP-MLT Exam with Latest ASCP-MLT Dumps Questions

1. The red portion of the NFPA diamond represents fire hazards.

The fire classification system for NFPA is as follows:

0 - Will not burn

1 - Must be preheated for ignition; flashpoint above 200°F (93°C)

2 - Must be moderately heated for ignition, flashpoint above 100°F (38°C)

3 - Ignition may occur under most ambient conditions, flashpoint below 100°F (38°C)

4 - Extremely flammable and will readily disperse through air under standard conditions, flashpoint below 73°F (23°C)

A laboratory labels its secondary containers of hazardous chemicals using a color-coded system, with a different color representing each different type of hazard. The coding system follows the color-coding used by the National Fire Protection Agency's "fire diamond." What hazard would be represented by the red section on the hazard label?

2. Acute hemolytic transfusion reactions are most commonly due to ABO-incompatible blood being transfused to a recipient with naturally occurring ABO alloantibodies (anti-A, anti-B, anti A,B).

Acute intravascular hemolysis as the result of a blood transfusion is most often associated with which of the following causes?

3. Porphobilinogen

4. Hybridization is a technique used to determine presence of target DNA or RNA by adding a synthetic strand that binds by complementary base pairing to the target.

Microbiology

In molecular diagnostic testing, hybridization employs complementary base pair binding of a synthetic strand to DNA or RNA.

5. 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?

6. Incompatiblity involving the ABO blood group system can cause the most severe type of transfusion reaction.

The cause of the most severe life-threatening hemolytic transfusion reactions is:

7. The recommended disinfectant for blood and body fluid contamination is:

8. The image shown in this question is depicting a rosette formation. Here the red blood cells are surrounding and adhering to the outside of the white blood cell.

What is the best description of the phenomenon seen in this illustration?

9. 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?

10. High triglycerides may be caused by disorders such as type 2 diabetes, hypothyroidism, Cushing's sydnrome, liver disease, uremia, dysglobulinemia, nephrotic syndrome, and alcoholism can cause hypertriglyceridemia.

A 46-year old known alcoholic with liver damage is brought in the ER unconscious. One would expect his lipid values to be affected in what way?

11. Anything that can cause significant turbidity in a blood sample, such as high leukocyte count or lipemia can potentially interfere with the accuracy of a spectrophotometric hemoglobin assay.

Hematology

Which of the following may interfere with the accurate measurement of hemoglobin?

12. Which of the following tests detect LTBI:

13. Hemolytic anemia, myelodysplasia, and liver disease may each fit this peripheral blood picture. Each of these conditions can display peripheral blood macrocytosis. It is easy to observe the overall larger size of the red blood cells in this image compared to the normal lymphocyte also present.

When macrocytes are present, they should be examined for their shape (round vs. oval), the hemoglobin content (central pallor), and whether or not there are any inclusions present in the cell.

Iron deficiency would not be the correct answer in this case, since this condition is associated with microcytosis instead.

The complete blood count was obtained from a patient recently admitted to the emergency room. The red blood cell indices obtained revealed an MCV of 115 femtoliters (fL) (normal range 80 - 90 fL). The patient met the criteria for a peripheral blood smear examination. A representative field is shown on the right.

Which of the following conditions may be indicated by the results seen on this peripheral blood smear?

14. Listeria monocytogenes is the correct answer. The motility agar is showing motility at the top of the tube, but not deeper; typical of this catalase-positive, gram positive bacillus. Streptococcus agalactiae would be catalase negative and a coccus. Erysipelothrix rhusiopathiae would be H2S-positive and catalase negative. Escherichia coli is a gram negative bacillus.

This Gram-positive bacillus grew as a diffusely beta-hemolytic colony from a newborn. It was catalase positive and had tumbling motility on a hanging drop preparation. This is how it appeared on triple sugar iron agar and motility medium.

What is the most likely diagnosis?

15. 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)?

16. As magnification DECREASES, the opening of the iris diaphragm will...

17. An international, nonprofit organization that establishes standards of best current practice for clinical laboratories is

18. Alpha-fetoprotein is a substance typically used in the triple test during pregnancy and for screening chronic liver disease patients for hepatocellular carcinoma.

Increased concentrations of alpha-fetoprotein (AFP) in adults are MOST characteristically associated with:

19. The production of long, tapered phialides is one of the key identifying features of Trichoderma species. In contrast, Penicillium species, produce phialides with blunt ends.

The phialides of Beauveria species are geniculate, forming a zig-zag pattern.

The arrows in the image on the right point to single, long, tapered phialides that extend laterally from either side of the hyphae. This is an identifying feature of which of the fungi listed below?

20. G6PD deficiency causes an increased suseptibility to the oxidation of hemoglobin, which in turn, causes the precipitation of hemoglobin inside of the red blood cell.

Which one of the following conditions is associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency?

21. White top tubes are used for blood cultures.

Question options:

22. DAT (Direct Antiglobulin Test).

When AHG or Coombs serum is used to demonstrate that red cells are antibody coated in vivo, the procedure is termed:

23. Transport media are required for throat culture swabs but not for rapid strep tests.

24. 0-3.0 mg/L Average risk for CVD

>3.0 mg/L High risk for future CVD

If results are >10.0 mg/L, the patient should be evaluated for an acute inflammatory condition.

Chemistry

A high-sensitivity C-reactive protein (hs-CRP) test result of 5 mg/L (normal = < 1 mg/L) may indicate which of the following?

25. Hemolytic transfusion reactions seldom occur because the incidence of unexpected antibodies in random patients is relatively low, e.g., 3-5% is sometimes cited.

Being transfused with O Rh negative RBC is irrelvant if you have an unexpected antibody like anti-K or anti-c.

Incompatible red cells may "bleed out" but only if bleeding is brisk. Even then, a hemolytic

reaction may occur later once the patient's antibody rebounds and destroys remaining antigen-positive donor red cells.

It's true that some patients have only cold-reactive antibodies that will not react at body temperature. But this does not explain why warm-reactive red cell antibodies cause few reactions

Why do so few patients transfused with un-crossmatched red cells in an emergency experience a hemolytic transfusion reaction? Select the one best reason.

26. The role of the laboratory supervisor or manager is to

27. Ferritin and hemosiderin are considered storage forms of iron.

Which substance(s) is/are considered iron storage compounds?

28. Lower right image

Chains of large, lemon-shaped annelloconidia

29. Which of the following legislation was developed to protect the privacy of all patient information in the health care?

30. What has happened in a titer, if tubes #5-7 show a stronger reaction than tubes #1-4?

31. The results of this PT and aPTT are in normal range. These results can be reported and are not indicative of the need to: order a mixing study or request a redraw.

You have just performed stat PT and aPTT tests on your coagulation instrument.

Your results are as follows:

PT = 12 seconds (normal range 10-13 seconds)

aPTT = 24 seconds (normal range 21-34 seconds)

What would be your next step?

32. Calcium oxalates can be found in normal urine in varying pH levels. Ammonium biurate and triple phosphate can be found in normal alkaline urine. Leucine crystals are always abnormal, and can be found in maple syrup urine disease.

Which one of the following crystals is NOT found in normal urine?

33. Free T4 is affected the least by changes in plasma proteins during pregnancy.

Which of the following thyroid function assays is affected least by pregnancy:

34. 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?

35. Hb S migrates with D in alkaline and alone in acid electrophoresis.

The gel electrophoresis pattern for hemoglobin S shows which of the following migration patterns?

36. Albumin is a "negative" acute phase protein since it is found in decreased levels during acute phase response. Alpha-1-antitrypsin, fibrinogen, and ceruloplasmin are all "positive" acute phase proteins that are found in increased levels during acute phase response.

Which one of the following usually shows a decrease during an acute phase response?

37. Transmission-based precautions isolation categories include all of the following except:

38. The blood glucose value is critical; negative ketones is consistent with type 2 diabetes. An elderly type 2 diabetic patient is at risk for hyperosmolar non-ketotic coma and osmolality should be measured.

A measurement of urine glucose would not be useful at this point.

A 70-year-old type 2 diabetic patient is comatose and in the emergency department. Stat blood glucose and serum ketones are ordered.

Blood Glucose: 650 mg/dL

Serum Ketones: Negative

What is the best conclusion?

39. On the red cell membrane, there is a bicarbonate / chloride exchanger. This exchanger allows for bicarbonate to leave the red cells while chloride is allowed inside.

In blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with:

40. 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

41. Black stopper tubes are used for glucose collections.

Question options:

42. Neutrophils are typically increased in urinary bacterial infections.

What type of white blood cell is seen MOST frequently in urine sediment with infections of the urinary system?

43. The document designed to protect phlebotomists from contacting hepatitis is the:

44. Serum amylase and lipase levels may be slightly elevated in chronic pancreatitis, but not diagnostic enough to predict chronic pancreatitis; wheras high levels are found only during acute pancreatitis episodes. In the later stages of chronic pancreatitis, normal to decreased levels of amylase and lipase are caused by the gradual inability of the pancreas to secrete the enzyme

All of the statements below regarding amylase and lipase in pancreatitis are TRUE EXCEPT:

45. Dce is found in 4% of whites and 44% of blacks.

DCe is found in 42% of whites and 17% of blacks.

DcE is found in 14% of whites and 11% of blacks.

dce is found in 37% of whites and 26% of blacks.

Blood bank

The most common Rh haplotype among whites is:

46. Only non-self antigens can be immunogenic. Self antigens are normally recognized by the immune system as part of the host, so an immune response does not normally occur. Non-self antigens are immunogenic since they have the potential to cause an immune response.

For a substance to be immunogenic it must be:

47. Select area to examine, WBC estimate

48. Microcontainer collection order of draw differs from regular peripheral blood collection order of draw. When performing a capillary draw, the lavender top container is obtained first. This decreases the possibility of clots in the container which would invalidate the results of the complete blood count test.

After the lavender is drawn, other containers with anticoagulants would be collected, and containers without anticoagulants would be collected last.

A phlebotomist must perform a skin puncture to obtain capillary specimens for a complete blood count (CBC), a plasma-based chemistry test, and a serum-based immunology test. The microcollection containers that will be used are lavender top containing EDTA anticoagulant, green top containing heparin anticoagulant, and gold top containing no anticoagulant.

Which microcollection container should be collected first?

49. The clue to the identification of the colony seen in the upper frame is the gram stain in the lower frame, in which are seen short, rounded, gram positive bacilli, many of which possess distinct spores. As the colonies grew aerobically, the presence of spores indicates Bacillus species. The colonies are spreading, smooth, yellow-white and non-hemolytic. The lack of hemolysis and the small size of the bacterial cells suggests a species other than Bacillus cereus, the species causing most human infections. The isolate was identified as Bacillus circulans, which is consistent with the gram stain morphology. Clostridium septicum also produces spores; however, this species is an anaerobe and would grow poorly if at all and not produce spores aerobically. Listeria monocytogenes and Lactobacillus species are gram positive bacilli; however, neither of these produce spores.

The colonies seen in the upper frame, grown after 48 hours incubation aerobically at 35°C,

and the accompanying gram stain in the lower frame are uncommonly associated with human disease, but have been associated with septicemia, bronchopneumonia, osteomyelitis and other infections, particularly in intravenous drug users.

The most likely identification is:

50. The renal threshold is the maximum amount of a substance that the kidney can prevent from entering into the urine.

UA & body fluids

The renal threshold is best described as:

51. A hapten is an incomplete antigen.

All of the following cellular antigens are important to an immunohematologist except:

52. To obtain a serum sample for a stat test on a patient receiving anticoagulant therapy, the recommended tube is:

Question options:

53. Troponin is potentially more specific for myocardial damage than CK-MB and stays elevated longer. It may eventually replace CK-MB as the standard marker of myocardial damage. In addition, troponin T has been known to be elevated in the setting of even mild degrees of renal failure. Troponin and CK-MB both tend to rise approximately 3 hours after a MI (hence why the correct answer is "A", since it is false); however, troponins can stay elevated up to 2 weeks as CK-MB tends to return to baseline around 36 hours.

Chemistry

Which of the following statements is FALSE regarding troponin?

54. In an evacuated tube, blood flow into the tube depends on:

Question options:

55. 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?

56. HbsAg is positive in acute and chronic Hepatitis B infections, since the antigen is found on the actual surface of the virus. HbeAg is present in the blood when the hepatitis B viruses are replicating, indicating an active infection. Anti-Hbc IgM is present due to the immune response to the presence of the hepatitis core antigen and indicates an acute infection. Anti-HBs is generally interpreted as indicating recovery and immunity from hepatitis B virus infection, according to the CDC.

Given the following results, what is the immune status of the patient?

HbsAg: positive

HbeAg: positive

Anti-HBc IgM: positive

Anti-HBs: negative

57. Set of comprehensive safety guidelines designed to protect patients and health care workers

58. The Westgard multi-rule 22S describes the scenario where two consecutive data points fall outside +2SD or -2SD. If this occurs, then the run must be rejected. This situation is most likely caused by a systematic error.

Which of the following describes the Westgard multi-rule 22S?

59. Epidemiology studies only infectious diseases that impact humans

60. The hepatitis B vaccine is a series of immunizations consisting of three injections of the hepatitis B antigen. The antigen causes the recipient of the injection to make antibodies against the antigen, hence why this is an example of active immunity.

Immunology

The hepatitis B virus vaccine was administered to MLS students during Orientation.

Which type of immunity is expected to develop and provide long-term protection?

61. Which of the following organizations now provides the certification exam for laboratory professionals?

62. If your reactions are strong at immediate spin (3+) and then get weaker at AHG (w+), it could mean the presence of a strong cold antibody.

Cold antibodies tend to be IgM and their optimum phase for reactivity is immediate spin. Incubation and washing of the sample may cause the agglutination that occurred at room temperature to break down. This would appear as a weaker reaction at AHG.

If the reaction strengths varied in each panel cell then that could be an indication that there are multiple antibodies present.

Your screen cells are 3+ at immediate spin and weak (W)+ at AHG. Your auto control is negative for both phases. Some of your antibody panel cells are 3+ at immediate spin and negative at AHG.

What should you suspect?

63. The patient's BUN is within normal range (5-20 mg/dL) while the creatinine is about five times the upper normal range (0.6-1.2 mg/dL). Gross elevations in creatinine are almost always accompanied by elevations in BUN when there is kidney impairment. Either the BUN or creatinine value in this case is incorrect. Both tests should be repeated.

A patient's BUN value is 15 mg/dl and his creatinine is 5 mg/dl. If this patient is not undergoing dialysis, what conclusion would you draw from these results?

64. Though it may not be required, TDM should still be used to confirm adequate dosing.

Genotyping does not make TDM redundant.

A PM will metabolize the drug more slowly and therefore will need lower doses. CYP2D6 metabolizes many different drugs; it is not associated with just one class of drugs. Anytime a drug is taken that competes for the same metabolizing enzyme as another drug, there is potential for the concentrations of both drugs to be increased.

A patient has been characterized as a CYP2D6 poor metabolizer (PM) after genotyping.

Which of the following statements is not true?

65. Streptococcus pyogenes is the correct answer. Streptococcus pneumoniae is alpha-hemolytic which demonstrate a green area of partial hemolysis around the colonies. Staphylococcus aureus will produce complete hemolysis but is catalase positive.

Streptococcus agalactiae is beta-hemolytic but only produces a partial clearing of the red blood cells in sheep blood agar.

Complete hemolysis of sheep blood agar as demonstrated by the image below would be seen in which of the following catalase-negative isolates?

66. Which of the following is NOT part of the magnification system of the microscope?

67. Which of the following genotypes cause beta thalassemia minor?

68. Leptin signals the hypothalamus that there are changes in fat stores.

Resistin increases insulin resistance and enhances adhesion molecules present on endothelial cells.

IL-6 responds to tissue injury. IL-6 increases insulin resistance by inhibiting insulin receptor signal transduction in liver cells. It also increases other inflammatory cytokines, interleukin-1 (IL-1) and TNF-a, and stimulates the liver to produce C-reactive protein (CRP).

Adipose tissue and liver cells produce angiotensinogen, a precursor of angiotensin II. Besides increasing blood pressure, angiotensin II may stimulate adipose cell formation and thus increase adipose mass.

Which one of the following adipocyte products is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores?

69. A patient with tuberculosis would be placed in:

70. Serum calcitonin is normally produced by the C cells of the thyroid. It functions to reduce serum calcium by inhibiting release of calcium from bone. It is a peptide with a molecular weight of 3400, and has a half life of approximately 12 minutes. It is characteristically elevated in medullary carcinoma of the thyroid. Since medullary carcinoma often occurs as an autosomal disorder, family members of patients with this condition should be screened for serum calcitonin.

Serum calcitonin is typically elevated in which of the following conditions:

71. Provide the equivalent measurement for 1 centimeter.

Question options:

72. Small, dense LDL is most likely to interact with arterial walls, leading to deposition of cholesterol, and initiating or worsening atherosclerosis. Small, dense LDL is associated with more than a three-fold increase in the risk of coronary heart disease.

Large, buoyant LDL is less atherogenic than small, dense LDL.

The LDL phenotype A is normal. It is the so called 'B' pattern that is associated with increased risk.

Which of the following is most likely to interact with arterial walls, leading to deposition of cholesterol, and initiating or worsening atherosclerosis?

73. 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?

74. Gram-positive bacteria retain the primary crystal violet stain that is applied in the Gram stain because of the cross-linking of the thick peptidoglycan layer in their cell walls. Their cell walls contain less lipids than that of a gram-negative bacteria, and this reduces the permeability of their cell wall to the organic solvents that are used as a decolorizer. When the counterstain is added, it may enter the gram-positive cell, but does not change the color

of the cells.

A thick peptidoglycan is MOST often associated with which of the following types of bacteria?

75. What is the first thing a phlebotomist should do in the event of an accidental needle stick?

76. Bacitracin susceptibility is a presumptive test for the identification of Lancefield group A Streptococcus.

Which of the following is a presumptive test for the identification of Lancefield group A Streptococcus:

77. 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?

78. Know what you are handling - read label carefully.

What is the first thing you do before you handle or open a chemical:

79. Class C fires involve:

Question options:

80. In which of the following laboratory situations is a verbal report permissible?

81. Neutrophils reside in the peripheral circulation for only 7-8 hours ( approx. 7.5 hours) before entering the tissues and body cavities. This process is called diapedesis.

Hematology

How long are healthy neutrophils expected to reside in the peripheral blood of an adult?

82. What is the best description of the purpose of the Commission on Office Laboratory Accreditation (COLA) pertaining to the clinical laboratory?

83. There are many causes of CSF lymphocytosis. Lymphocytosis is seen in viral, fungal, and

tuberculous infections, although a predominance of neutrophils may be present in the early stages of these infections. Lumbar puncture to obtain CSF samples is often contraindicated in those with a suspected brain abscess.

CSF lymphocytosis is associated with all of the following except:

84. The intended response is Vitamin B12 and folate deficiencies. Each of these conditions lead to a megaloblastic production of the red blood cells in the bone marrow. Since vitamin B12 and folate are needed in order to produce a synchronous development of the nucleus with the cytoplasm in hematologic cells, oval-macrocytosis often occurs if these nutrients are not in adequate supply within the body. This can also affect neutrophils, allowing for the characteristic hypersegmented nucleus.

The photographic field contains several oval-macrocytes and a hypersegmented neutrophil with greater than 5 nuclear segments. Oval macrocytes are most commonly associated with pernicious anemia and malabsorption syndromes leading to vitamin B12 and folic acid deficiencies.

Clinical information relating to chronic infection, aplastic anemia, and other hematologic maligancies provide the context for the presence of the oval macrocyte.

Macrocytic erythrocytes and hypersegmented neutrophils are not present in thalassemias or in Pelger-Huet anomaly (hyposegmented neutrophils).

Conditions suggested by the macrocytes and the neutrophil in the photograph to the right

include which of the following?