Clinical Laboratory Science Exam Review
Course Introduction
Clinical Laboratory Science is an interdisciplinary field focused on the analysis of biological specimens to aid in the diagnosis, treatment, and prevention of diseases. This course provides an in-depth study of laboratory principles, including hematology, clinical chemistry, immunology, microbiology, molecular diagnostics, and transfusion medicine. Emphasizing both theoretical knowledge and hands-on laboratory skills, students learn to use sophisticated instrumentation and interpret results under stringent quality control protocols. The curriculum also explores ethical, legal, and safety considerations, preparing students for collaborative roles within healthcare teams and ensuring high standards in patient care.
Recommended Textbook
Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening
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27 Chapters
1413 Verified Questions
1413 Flashcards
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Chapter 1: Red Blood Cells and Platelet Preservation:
Historical Perspectives and Current Trends
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44 Verified Questions
44 Flashcards
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Sample Questions
Q1) What percentage of platelets is sequestered in the spleen as functional reserve after being released from the bone marrow?
A) 30%
B) 50%
C) 10%
D) 25%
Answer: A
Q2) Platelets are anucleated but are composed of organelles. Generally most of these organelles are composed of cytoplastic granules. When stimulated, which one of these granules would be most important in satisfying the metabolic need of the platelet?
A) Dense granules
B) Alpha granules
C) Lysosomes
D) Coarse granules
Answer: A
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Chapter 2: Basic Genetics
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Sample Questions
Q1) In Mendel's law of separation, the first-filial generation is:
A) recessive.
B) homozygous.
C) heterozygous.
D) autologous.
Answer: C
Q2) 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
Q3) A structural alteration of DNA in an organism that is caused by a physical or chemical agent is called:
A) transcription.
B) translation.
C) mutation.
D) cloning.
Answer: C
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Page 4
Chapter 3: Fundamentals of Immunology
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Sample Questions
Q1) What is responsible for recognition of the antibody-binding site to homologous antigen?
A) Phenotype
B) Solubility of antigen
C) Variable region of light/heavy chain
D) Complementarity
Answer: C
Q2) Opsonization is:
A) the coating of pathogens with factors that facilitate phagocytosis.
B) a major role of complement in immunity.
C) the binding of an opsonin, such as an antibody, to a receptor on the pathogen's cell membrane.
D) all of the above.
Answer: D
Q3) All of the following are true regarding IgM antibodies except:
A) IgM antibodies form against Kell.
B) IgM can bind to up to 10 antigens on a red cell.
C) IgM is 160 Å larger than IgG.
D) IgM is a pentamer.
Answer: A
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Chapter 4: Concepts in Molecular Biology
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Sample Questions
Q1) Gene transfer between two bacterial strains is an example of:
A) Mendel's law.
B) Griffith's transformation.
C) Oswald's principle of heredity transformation.
D) Chargaff's rules.
Q2) Which of the following best describes the principle of polymerase chain reaction (PCR)?
A) Migration of proteins in an electrical field
B) Amplification of RNA using two oligonucleotide primers that hybridize to opposite DNA strands
C) Amplification of DNA using two oligonucleotide primers that hybridize to opposite DNA strands, isolating a particular segment
D) Enzymatic cleavage of proteins for DNA sequencing
Q3) What is a disadvantage of using ethidium bromide (EB) as a dye in electrophoresis studies?
A) It is expensive.
B) It is mutagenic.
C) It is rare and difficult to obtain.
D) It fades quickly after use.
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Page 6
Chapter 5: The Antiglobulin Test
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Sample Questions
Q1) How many IgG molecules must be present on the red blood cell for a positive IAT to occur?
A) 10
B) 100
C) 50
D) 500
Q2) Which of the following is not a clinical application for a direct antiglobulin test?
A) HDN
B) HTR
C) AIHA
D) Heterophile detection
Q3) In preparing anti-IgG, how is excess antibody removed for titer adjustment?
A) Elution
B) Adsorption
C) Block titration
D) Dilution
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Chapter 6: The Abo Blood Group System
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Sample Questions
Q1) What substances are found in a group A secretor?
A) AH
B) H
C) BH
D) ABH
Q2) A<sub>1</sub> lectin agglutinates:
A) all cells except A<sub>2.</sub>
B) all subgroups of A.
C) cells not agglutinated by absorbed anti-A.
D) only A<sub>1</sub> cells.
Q3) All of the following are technical errors that could result in ABO discrepancies except:
A) a misidentified sample.
B) failure to warm reagents.
C) failure to add reagents.
D) clerical errors.
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8
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 clinical manifestation may be associated with the Rh-null syndrome?
A) Reticulocytosis
B) Stomatocytosis
C) Low hemoglobin
D) All of the above
Q3) Rh-immune globulin is effective is preventing which type of hemolytic disease of the newborn (HDN)?
A) Anti-c
B) Anti-E
C) Anti-D
D) Anti-C
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Chapter 8: Blood Group Terminology and the Other Blood Groups
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214 Flashcards
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Sample Questions
Q1) Where might you expect anti-Yt<sup>b</sup> to react in antibody screening?
A) Immediate spin phase
B) 37<sup>°</sup>C phase
C) IAT phase
D) All of the above
Q2) 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
Q3) Which group of antigens below best represents the definition of high-frequency antigens?
A) Js<sup>b</sup>, Kp<sup>b</sup>
B) K, k
C) Kp<sup>a,</sup> Js<sup>a</sup>
D) Jk<sup>a,</sup> K
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Page 10
Chapter 9: Detection and Identification of Antibodies
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Sample Questions
Q1) When should multiple antibodies be suspected in a positive antibody screen?
A) The auto-control was positive.
B) Cells react at different phases and strengths.
C) Only the AHG phase is reactive.
D) None of the above
Q2) When might you suspect multiple antibodies in a patient's serum?
A) Pattern of reactivity not fitting a single antibody
B) Variation in phase of reactivity
C) Variation in antibody reactivity strength
D) All of the above
Q3) What is the purpose of saline washing in the antibody screen procedure?
A) Removal of bound IgG that would otherwise neutralize the AHG reagent
B) Removal of unbound IgG that would neutralize the AHG reagent
C) Stripping of the red blood cell membrane for alloantibody binding
D) Removal of unbound IgM that would neutralize AHG reagent
Q4) All of the following antigens are interacted by proteolytic enzymes except:
A) C.
B) Fy<sup>a</sup>.
C) M.
D) S.
Page 11
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Chapter 10: Pre-Transfusion Testing
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Sample Questions
Q1) The transfusion nurse calls the blood bank 5 minutes after a unit of packed cells were issued to say that the unit is not needed at this time. It is important for the nurse to bring the unit back immediately so that the temperature of the unit does not exceed:
A) 4°C.
B) 10°C.
C) 22°C.
D) 37°C.
Q2) An immediate spin crossmatch was performed using recipient serum and donor cells from a group AB unit. At immediate spin, the reaction was 4+. What is the reason for this positive reaction?
A) ABO incompatibility
B) An alloantibody
C) Positive DAT on donor cells
D) Positive DAT on recipient cells
Q3) What does MSBOS stand for?
A) Monetary surgical blood order supply
B) Minimum surgical blood order schedule
C) Military surgical blood order supply
D) Maximum surgical blood order schedule
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Page 12
Chapter 11: Overview of the Routine Blood Bank Laboratory
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36 Flashcards
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Sample Questions
Q1) Which of the following would lead to non-acceptance of a blood bank specimen?
A) Initials of phlebotomist not on specimen
B) A patient name spelled incorrectly
C) An erroneous Social Security number
D) All of the above
Q2) What additive is used to freeze blood for long-term storage at -65°C?
A) Glycerol
B) Glycine
C) Glutamic acid
D) Dextran
Q3) Why can the Rh-hr control be eliminated from donor processing?
A) An Rh-positive unit of blood typed as an Rh-negative would only be transfused to an Rh-positive patient.
B) An Rh-negative unit of blood typed as an Rh-positive would only be transfused to an Rh-negative patient.
C) An Rh-negative unit of blood typed as an Rh-positive would only be transfused to an Rh-positive patient.
D) None of the above
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Chapter 12: Other Technologies and Automation
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Sample Questions
Q1) 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
Q2) In performing an antibody screen by the solid phase technique, a monolayer of red blood cells is formed at the top of the microplate wells following the addition of indicator cells. This result should be interpreted as:
A) negative.
B) mixed-field.
C) positive.
D) weak positive.
Q3) Low ionic strength saline (LISS) is added to antibody screening methods for which of the following test systems?
A) Gel
B) SPRCA
C) Solid phase
D) None of the above
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Page 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) A patient who recently stopped taking clopidogrel (Plavix) needs to donate platelets. How long must the patient defer donation after completing the medication?
A) 24 hours
B) 48 hours
C) 7 days
D) 14 days
Q3) Leukoreduced packed RBCs must have an absolute white blood cell count of less than and contain at least what percent of original RBC mass?
A) 5 \(\times\) 10<sup>8</sup>/85
B) 5 \(\times\) 10<sup>6</sup>/85
C) 5 \(\times\) 10<sup>8</sup>/80
D) 5 \(\times\) 10<sup>6</sup>/80
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Chapter 14: Apheresis
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57 Flashcards
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Sample Questions
Q1) Antiplatelet medications have differing deferral time periods. Which of the following does not match?
A) Aspirin-48 hours
B) Plavix-14 days
C) Feldene-7 days
D) Ticlid-14 days
Q2) What is an example of a continuous flow centrifugation (CFC) instrument?
A) Haemonetics V50
B) COBE Spectra
C) Fenwal Autopheresis-C
D) Haemonetics V30
Q3) Fresh frozen plasma (FFP) is not the optimal product for replacement fluids for a therapeutic plasma exchange procedure. For which patient is FFP the optimal product of choice?
A) Patient with liver disease
B) Patient with thrombotic thrombocytopenic purpura (TTP)
C) Patient scheduled to undergo an invasive procedure
D) All of the above
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16
Chapter 15: Transfusion Therapy
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97 Verified Questions
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Sample Questions
Q1) Which of the following Rh-negative patients may be transfused with Rh-positive units when few O-negative units are available in an emergency?
A) Pregnant woman
B) Middle-aged male
C) 25-year-old female
D) Neonate
Q2) A patient with severe hemolytic anemia had a pulse of 120 beats per minute and a respiratory rate of 37 breaths per minute. What blood component is indicated for this patient?
A) Plasma
B) Whole blood
C) Red blood cells
D) Platelets
Q3) All of the following are consistent with graft-versus-host disease (GVHD) except:
A) transplantation of immunocompetent T lymphocytes.
B) HLA incompatibility between graft and recipient.
C) transplantation of "immunologically naive" T lymphocytes.
D) an immunocompromised recipient.
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Chapter 17: Cellular Therapy
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Sample Questions
Q1) Which of the following is not characteristic of an anaphylactic reaction?
A) Hypotension
B) Abdominal cramps
C) Electrophoretic levels of IgA
D) Loss of consciousness
Q2) A transfusion reaction investigation should include all of the following except:
A) diagnosis.
B) current medication.
C) neocyte transfusion.
D) washed RBCs.
Q3) What is a common finding in a DHTR?
A) DIC
B) Jaundice
C) Renal failure
D) Hypotension
Q4) All of the following are symptoms of an allergic reaction except:
A) pruritus.
B) local erythema.
C) anemia.
D) hives.
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Chapter 18: Transfusion-Transmitted Diseases
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Sample Questions
Q1) HIV belongs to which family?
A) Flaviviridae
B) Retroviridae
C) Hepadnaviridae
D) Picornaviridae
Q2) A person infected with HIV-1 is diagnosed with AIDS-related condition (ARC). What antibodies will be present in the patient's serum at this stage?
A) Anti-p24
B) Anti-gp41
C) Anti-p26
D) Anti-p24 and anti-gp41
Q3) American Association of Blood Banks (AABB) Standards mandate the donor of blood or component given to a recipient who develops clinical or laboratory evidence of transfusion-associated hepatitis (TAH), HIV infection, or HTLV-I/II infection must be permanently deferred if the unit was:
A) a directed donation.
B) the only unit transfused.
C) one of four transfused to the recipient.
D) positive for cytomegalovirus.
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Page 19
Chapter 19: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) Which of the following best describes the principle of the Kleihauer-Betke test?
A) D-positive indicator cells form rosettes around maternal Rh-positive RBCs
B) D-positive indicator cells form rosettes around fetal Rh-positive red blood cells
C) Maternal hemoglobin is resistant to acid (alkali), appearing pink, whereas fetal cells appear as ghost cells
D) Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells
Q2) In order for the mother to be considered for Rh-immune globulin, her Rh type must be , and her newborn must be ___________.
A) Du-positive/Rh-positive
B) Rh-negative/Rh-positive
C) Du-negative/Du-negative
D) Rh-positive/Rh-negative
Q3) Cannulation of the umbilical vein under ultrasound guidance is known as:
A) cordocentesis.
B) amniocentesis.
C) apheresis.
D) pericardiocentesis.
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Page 20
Chapter 20: Autoimmune Hemolytic Anemias
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Sample Questions
Q1) A 5-year-old boy suffering from the measles complained of back pain, chills, and stomach pain. A visit to the doctor revealed hemoglobinuria, bilirubinemia, and hemoglobinemia. The child's hemoglobin level had fallen to 6 g/dL. A DonathLandsteiner test was performed and showed the following: control sample = no hemolysis; test sample = hemolysis. The results are consistent with what disorder?
A) Warm autoimmune hemolytic anemia
B) Cold hemagglutinin disease
C) Paroxysmal cold hemoglobinuria
D) Secondary cold AIHA
Q2) In the case of an AB-positive individual, what test must be performed to ensure that a warm-reacting autoantibody is not causing false-positive reactions?
A) Rh control
B) DAT
C) IAT
D) Rosette test
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Chapter 21: The Hla System
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Sample Questions
Q1) Which of the following is acceptable for cytotoxicity techniques?
A) EDTA
B) ACD
C) Serum
D) CPDA-1
Q2) Why is histocompatibility testing negated in both lung and heart transplants?
A) The donor must be living to perform HLA testing.
B) The cold ischemic time is too short.
C) The cold ischemic time is too long.
D) None of the above.
Q3) The MHC class I region encodes for all of the following genes except:
A) HLA-A
B) HLA-B
C) HLA-DR
D) HLA-C
Q4) What does "HLA" stand for?
A) Human lymphodenapathy
B) Human lymphocyte antibody
C) Human leukocyte antigen
D) Human liver antigen
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Chapter 22: Relationship Testing
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Sample Questions
Q1) What is the statistical basis of the Hardy-Weinberg principle?
A) Selection of mates is dependent on blood types and therefore is random.
B) Selection of mates is dependent on blood types and therefore is biased.
C) Selection of mates is independent of blood types and therefore is random.
D) Selection of mates is independent of blood types and therefore is biased.
Q2) Which of the following AABB standards must be met in paternity testing?
A) DNA testing using double-locus probes
B) Independent reading of electrophoretograms by two technologists
C) HLA and red blood cell antigen testing performed by two independent laboratories
D) All of the above
Q3) In paternity testing, which of the following systems is the first to be tested against samples drawn from the mother, alleged father, and child?
A) Rh
B) Red blood cell enzymes
C) ABO
D) Kell
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Chapter 23: Quality Management
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Sample Questions
Q1) All of the following are transfusion service quality assurance indicators used to monitor patient care except:
A) labeling errors on specimens sent to the blood bank.
B) reason for return of blood products.
C) number of therapeutic units drawn.
D) turnaround time on antibody identification.
Q2) 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.
Q3) Which of the following statements concerning equipment is true?
A) Requires software to function
B) Quality control is not needed for critical steps.
C) Frequency of testing is determined by manufacturer recommendations.
D) All equipment must be purchased from the manufacturer.
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Chapter 24: Transfusion Safety and Federal Regulatory Requirements
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Sample Questions
Q1) Biological products are defined as any virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component (or derivative allergenic products), or analogous product applicable to the prevention, treatment, or cure of disease or injuries of man. Which specific product was missing in the original PHS statute?
A) Vaccine
B) Blood component
C) Antitoxin
D) Virus
Q2) 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
Q3) Blood grouping reagents are considered medical devices according to the CBER. A)True
B)False
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Chapter 24: Utilization Management
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Sample Questions
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) An example of direct behavior influence when implementing intervention strategies would be:
A) discussion with a physician about his ordering practice.
B) an e-mail to the nursing staff about their roles in transfusing.
C) a communication tree to all med techs about new protocols of issuing a product.
D) All of the above
Q3) Which of the following is not part of a blood utilization review?
A) Retrospective review
B) Concurrent review
C) Interpreted review
D) Prospective review
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Chapter 25: Laboratory Information Systems
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Sample Questions
Q1) How does the blood bank information system aid the technologist in selecting RBCs for a patient who had previously developed anti-Jk<sup>a</sup>, but whose current antibody screen is negative?
A) Alerts the tech to previous phenotyping results
B) Reveals a history of anti-Jk<sup>a</sup>
C) Reveals a history of anti-Jk<sup>b</sup>
D) None of the above
Q2) A blood bank wishes to upgrade their computer system so that it will automatically interpret the ABO group based on the results of the forward and reverse grouping tests. This upgrade would be achieved through the:
A) applications software.
B) operating system software.
C) interface software.
D) none of the above.
Q3) Which of the following is a function of the operating system software?
A) Result entry of serologic tests
B) Transfer of information from the blood bank system to the HIS
C) Transfer of data onto a disk
D) Storage of data in the information system
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Page 27
Chapter 26: Medicolegal and Ethical Aspects of Providing
Blood Collection and Transfusion Services
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Sample Questions
Q1) All of the following injuries from component collection may be grounds for a civil suit except:
A) a hematoma.
B) nerve damage.
C) a sudden fall.
D) severe donor reaction.
Q2) Liability for negligence includes all of the following except:
A) there was a duty owed to the injured party.
B) the duty was not met; the injured party was harmed.
C) failure to meet the duty was indirectly responsible for harm suffered by injured party.
D) some measurable (compensable) harm occurred (called damage).
Q3) 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.
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Chapter 27: Tissue Banking: A New Role for the Transfusion Service
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Sample Questions
Q1) Records of tissue must be kept at least ________ after expiration
A) 2 years
B) 5 years
C) 10 years
D) indefinitely
Q2) Donors for cornea transplants must be tested for all but which of the following diseases prior to transplant?
A) HIV-1 and -2
B) Hepatitis B
C) Hepatitis C
D) Chlamydia trachomatis
Q3) If your facility is a member of and accredited by the Eye Bank Associates of America, there is no need to be monitored by the FDA.
Multiple Choice
Identify the choice that best completes the statement or answers the question.
A)True
B)False
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Page 29