Clinical Laboratory Science Question
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Course Introduction
Clinical Laboratory Science is an interdisciplinary course that explores the principles, techniques, and applications of laboratory analyses essential for diagnosing and monitoring diseases. Students learn about clinical chemistry, hematology, microbiology, immunology, and molecular diagnostics through both theoretical instruction and hands-on laboratory experience. The course emphasizes quality assurance, safety protocols, specimen handling, and the interpretation of laboratory results, preparing students for professional practice in hospital, research, or public health laboratory settings.
Recommended Textbook
Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening
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Page 2
Chapter 1: Red Blood Cells and Platelet Preservation:
Historical Perspectives and Current Trends
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Sample Questions
Q1) How is stroma-free hemoglobin solution prepared?
A) Outdated red blood cells are concentrated, and stroma is removed.
B) Outdated red blood cells are diluted with saline, and stroma is removed.
C) Outdated red blood cells are lysed, and stroma is removed.
D) None of the above
Answer: C
Q2) Regarding loss of RBC membrane deformability, all of the following are true except:
A) increase in ATP level.
B) decrease in ATP level.
C) increase in calcium level.
D) decrease in spectrin phosphorylation level.
Answer: A
Q3) Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?
A) Glycolysis
B) Luebering-Rapoport shunt
C) Pentose phosphate shunt
D) Methemoglobin reductase
Answer: B
Page 3
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Chapter 2: Basic Genetics
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Sample Questions
Q1) Which of the following best describes the process of mitosis?
A) Cell division by which only one-half of the daughter cells produced are identical to the parent cell
B) Cell division of germ cells by which two successive divisions of the nucleus produce cells that contain half the number of chromosomes of somatic cells
C) Cell division that produces two daughter cells having the same number of chromosomes as the parent
D) Cell division that produces four daughter cells (4n)
Answer: C
Q2) In the MN blood group system, a person who inherits an "M" allele and an "N" allele expresses both M and N antigens on the RBCs. Which of the following is true?
A) M is dominant to N.
B) N is dominant to M.
C) M an N are codominant alleles.
D) M and N are located on the same chromosome.
Answer: C
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Chapter 3: Fundamentals of Immunology
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Sample Questions
Q1) When antigen and antibody combine, they are held together by noncovalent forces. With the absence of a visible lattice, this stage is called______________ .
A) adhesion
B) sensitization
C) agglutination
D) inhibition
Answer: B
Q2) What substances are responsible for the activation of the alternate complement pathway?
A) Enzymes
B) Polysaccharides
C) Proteins
D) All of the above
Answer: B
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Page 5
Chapter 4: Concepts in Molecular Biology
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Sample Questions
Q1) The process of translation and transcription is referred to as:
A) the genetic code.
B) central dogma.
C) gene expression.
D) spectral analysis.
Q2) Single-stranded RNA can be transcribed into single-stranded DNA by what enzyme?
A) Polymerase
B) DNAse
C) Reverse transcriptase
D) Endonuclease
Q3) In this procedure, PCR products are blotted in a nylon filter and hybridized with specific probes that allow the distinction of the different known alleles.
A) Sequence-specific PCR
B) Sequence-specific oligonucleotide probe
C) Sequence-specific RFLP
D) Allele-specific PCR
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Chapter 5: The Antiglobulin Test
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Sample Questions
Q1) What is the purpose of washing cells in the AHG test?
A) To dilute serum
B) To remove all unbound protein
C) To remove all bound protein
D) To exclude a low-affinity antibody
Q2) 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
Q3) What effect does a low pH have on a saline AHG test?
A) Enhances antibody elution
B) Enhances the antigen-antibody complex
C) Increases hydrogen bonding
D) Increases bacterial contamination
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Chapter 6: The Abo Blood Group System
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Sample Questions
Q1) Why can anti-H sometimes be found in an A<sub>1</sub>B individual?
A) L-fucose does not attach to precursor substance.
B) The H gene is not inherited.
C) The specific immunodominant sugar blocks the presence of H antigen.
D) The individual does not secrete H substance in secretions.
Q2) The forward grouping of a patient showed no agglutination of patient cells with anti-A, anti-B, or anti-AB reagent antisera. The reverse grouping showed agglutination with A<sub>1</sub> and B cells. What is this person's ABO group?
A) A
B) B
C) AB
D) O
Q3) 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.
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Page 8
Chapter 7: The RH Blood Group System
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Sample Questions
Q1) In the Fisher-Race nomenclature what does "d" refer to?
A) Amorph
B) Silent allele
C) Absence of D
D) All of the above
Q2) Where is the Rh antigen located relative to the red blood cell membrane?
A) Integrally
B) Peripherally
C) Centrally
D) None of the above
Q3) When one or more D epitopes within the entire D protein is missing it is termed_______________.
A) weak D
B) C in trans to Rh(D)
C) D<sub>el</sub>
D) partial D
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Chapter 8: Blood Group Terminology and the Other Blood Groups
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Sample Questions
Q1) Anti-Wr<sup>b</sup> has been frequently observed in patients:
A) with paroxysmal cold hemoglobinuria.
B) with warm autoimmune hemolytic anemia.
C) taking penicillin.
D) with paroxysmal nocturnal hemoglobinuria.
Q2) Which of the following is known to enhance K antigen expression in the antihuman globulin test?
A) LISS
B) DTT
C) Albumin
D) Polyethylene glycol
Q3) All of the following are inconsistent with Xg<sup>a</sup> antibody characteristics except:
A) reactive at the IAT phase.
B) IgM immunoglobulins.
C) resistant to enzymes.
D) known to cause HTRs.
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Page 10
Chapter 9: Detection and Identification of Antibodies
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Sample Questions
Q1) What would be a realistic source of finding compatible units for a person with an antibody to a high-frequency antigen?
A) Random donor units
B) A donor of similar ethnic background
C) Siblings
D) Apheresis donors
Q2) When performing the elution procedure, the solution containing the recovered antibody is called:
A) neutralized serum.
B) the buffer.
C) the eluate.
D) absorbed serum.
Q3) What makes up an autologous control?
A) Patient serum and patient cells
B) Patient serum and screening cells
C) Patient cells and Rh control
D) None of the above
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Chapter 10: Pre-Transfusion Testing
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Sample Questions
Q1) 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
Q2) Why is the transfusion product tagged before it is issued and transfused?
A) To identify the patient
B) To verify compatibility results
C) To verify the donor number
D) All of the above
Q3) What is an abbreviated crossmatch?
A) A minor crossmatch
B) A type and screen plus an immediate spin crossmatch
C) A type and screen plus a minor crossmatch
D) A type and screen plus an immediate spin crossmatch using pooled screening cells
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Chapter 11: Overview of the Routine Blood Bank Laboratory
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Sample Questions
Q1) Which cells are used for a donor's antibody screen?
A) Screening cells (2 vials)
B) Pooled screening cells (2 donors)
C) Screening cells (3 vials)
D) Autologous cells
Q2) A positive DAT may be seen in:
A) warm autoimmune hemolytic anemia.
B) cold agglutinin syndrome.
C) hemolytic transfusion reaction.
D) all of the above.
Q3) 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
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Chapter 12: Other Technologies and Automation
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Sample Questions
Q1) The gel system has all of the following advantages over the traditional tube procedure except:
A) standardization in reading technique.
B) stability of the test reaction.
C) replicability of the test results.
D) different grading system.
Q2) 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
Q3) The washing procedure is applicable to which of the following serologic methods?
A) Solid phase and tube system
B) Gel technology and solid phase
C) Solid phase and affinity column
D) Gel technology and tube system
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14
Chapter 13: Donor Screening and Component Preparation
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Sample Questions
Q1) What is the minimal pH required for platelets?
A) 6.0
B) 6.2
C) 7.0
D) 7.2
Q2) What is the minimum hemoglobin level for a potential allogeneic donor?
A) 11 g/dL
B) 12 g/dL
C) 12.5 g/dL
D) 14 g/dL
Q3) What is the deferral period for a donor who has received a live attenuated vaccine for rubella?
A) 2 weeks
B) 4 weeks
C) no deferral period
D) 8 weeks
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Chapter 14: Apheresis
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Sample Questions
Q1) What effect do steroids have on leukapheresis?
A) Decrease the vascular pool of granulocytes
B) Increase the vascular pool of granulocytes
C) Help to separate red blood cells from white blood cells, using specific gravity properties
D) Neutralize the effect of toxic granulation in neutrophils
Q2) Which cell type is densest in the white blood cell layer when anticoagulated blood is centrifuged?
A) Granulocyte
B) Monocyte
C) Lymphocyte
D) Platelets
Q3) What can be done to prevent the development of HLA alloimmunization and platelet refractoriness?
A) Test the donor for the presence of platelet antibodies.
B) Issue only cytomegalovirus-negative platelets.
C) Irradiate the platelet concentrate.
D) Reduce the number of leukocytes in the platelet product.
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Chapter 15: Transfusion Therapy
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Sample Questions
Q1) Vitamin K is essential for the carboxylation of which coagulation factors?
A) I, VII, IX, X
B) I, V, IX, X
C) II, VII, IX, X
D) II, VII, XI, XII
Q2) Cryoprecipitate AHF contains how much fibrinogen?
A) 500 to 750 mg
B) 50 to 100 mg
C) 150 to 250 mg
D) 250 to 400 mg
Q3) Which of the following statements concerning red blood cells prepared with additive solution 1 (AS-1) is true?
A) The shelf-life is 35 days.
B) The AS-1 unit contains more plasma than the CPDA-1 red blood cells.
C) Red blood cell mass is lower than that of CPDA-1 red blood cells.
D) The hematocrit is lower than CPDA-1 red blood cells.
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Chapter 17: Cellular Therapy
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Sample Questions
Q1) Immediate transfusion reaction procedures consist of all of the following except:
A) clerical check.
B) DAT.
C) serum haptoglobin.
D) visual check.
Q2) Which of the following can be added to blood prior to or during transfusion?
A) Mild antihistamines
B) Antibiotics
C) Ringer's lactate
D) 0.85% sodium chloride solution (USP grade)
Q3) The final bacterial culture was positive for hematopoietic progenitor cell batch. What must be done with this batch?
A) The batch must be discarded.
B) Broad spectrum antibiotics can be given to the patient and the batch infused.
C) Have a sensitivity done on the culture and administer the batch, as well as provide antibiotics to which the bacteria are sensitive to the patient.
D) The batch can be irradiated and then transfused.
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Chapter 18: Transfusion-Transmitted Diseases
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Sample Questions
Q1) Why are donors deferred for 6 months following receipt of blood products?
A) To permit adequate screening for transfusion-acquired viral infections
B) Because donation may cause recurrence of the condition that required transfusion
C) To allow clearance of all transfused cells in the donor
D) To allow donor recovery from the condition that required transfusion
Q2) Which test can reveal an asymptomatic patient with TAH?
A) BUN
B) AST
C) ALT
D) Amylase
Q3) Persons infected with the hepatitis C virus may develop what disease?
A) Chronic liver disease
B) Cirrhosis
C) Hepatocellular carcinoma
D) All of the above
Q4) A person with acute hepatitis B infection is immune to infection from other hepatitis viruses.
A)True
B)False
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Chapter 19: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) What immunoglobulin is capable of crossing the placenta?
A) IgG
B) IgM
C) IgA
D) All of the above
Q2) Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh hemolytic disease of the fetus and newborn (Rh HDFN)?
A) The plasma volume of the mother is tripled during the first pregnancy which dilutes anti-D.
B) The titer of anti-D is too low to cause destruction of fetal antigens.
C) The mother has not been immunized to the D antigen before placental separation.
D) None of the above
Q3) The most important serologic test for the diagnosis of HDFN is the___________ with anti-IgG reagents.
A) elution
B) IAT
C) DAT
D) fetal screen
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Chapter 20: Autoimmune Hemolytic Anemias
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Sample Questions
Q1) In a patient who has been recently transfused, a positive DAT may be due to:
A) alloantibody coating patient cells.
B) alloantibody coating transfused donor cells.
C) antibodies to a drug coating donor cells.
D) none of the above.
Q2) A 28-year-old female with cold hemagglutinin disease has a positive DAT. When the DAT is repeated using monospecific reagent, which of the following is most likely to be detected?
A) IgM
B) IgG
C) C3d
D) C4d
Q3) 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) How is histocompatibility testing different from RBC testing?
A) Known serum is used to type antigens on test cells
B) Recipient serum is screened for the presence of antibodies
C) Crossmatch of donor cells and recipient serum is performed to determine compatibility
D) None of the above.
Q2) What kidney transplant strategy is satisfied through matching of the donor and recipient antigens?
A) Use of immunosuppressive agents
B) Reduction of graft "foreignness"
C) Induction of tolerance
D) None of the above
Q3) What is meant by the term public as applied to HLA antibodies?
A) Antibodies that detect a single HLA gene product
B) Binding to an epitope unique to one HLA gene product
C) Binding to epitopes shared by more than one HLA gene product
D) All of the above
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22
Chapter 22: Relationship Testing
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Sample Questions
Q1) 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
Q2) How many chromosomes does the developing child normally carry?
A) 23
B) 46
C) 16
D) 32
Q3) 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.
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23
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) How do internal assessments differ from compliance inspections?
A) Compliance inspections assess performance on quality indicators.
B) Internal assessments focus on meeting regulations.
C) Internal assessments are more frequent than compliance inspections.
D) Compliance inspections seek underlying causes of problems.
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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Sample Questions
Q1) Establishments that hold U.S. licenses for a biological product can:
A) ship products interstate and internationally for sale or exchange.
B) only ship and sell products interstate.
C) market multiple trademark for their product.
D) All of the above
Q2) 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
Q3) In what year did the FDA take over biologics regulation?
A) 1976
B) 1980
C) 1972
D) 1985
Q4) A drug is considered adulterated if the methods used to manufacture it do not conform with current good manufacturing processes.
A)True
B)False
25
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Chapter 24: Utilization Management
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Sample Questions
Q1) Which of the following is not part of a blood utilization review?
A) Retrospective review
B) Concurrent review
C) Interpreted review
D) Prospective review
Q2) Targeted and discontinuous are subtypes of what review system?
A) Retrospective
B) Concurrent
C) Interpreted
D) Prospective
Q3) 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
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26
Chapter 25: Laboratory Information Systems
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Sample Questions
Q1) Which of the following could be considered a final disposition of a unit?
A) Issued
B) Transfused
C) Available
D) Reserved
Q2) During the morning run, the computer system went offline for maintenance. This situation is appropriately referred to as, ________ and there should be a backup system in place.
A) break time
B) downtime
C) a disaster
D) backload
Q3) What information might be found in a blood bank computer system?
A) Inventory of blood components
B) Antibodies identified in a patient
C) The last date of donation for a blood donor
D) All of the above
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Chapter 26: Medicolegal and Ethical Aspects of Providing
Blood Collection and Transfusion Services
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Q1) What body of government is authorized to pass laws?
A) U.S. Congress
B) U.S. Supreme Court
C) state courts
D) all of the above
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) Why are physicians selected as the "respondent superior" in negligent cases?
A) Physicians give the order to transfuse.
B) Physicians are considered expert witnesses in transfusion-related deaths.
C) Federal regulations can be applied to medical malpractice.
D) None of the above
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Chapter 27: Tissue Banking: A New Role for the Transfusion Service
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Sample Questions
Q1) Which statement about autologous is true?
A) Autologous tissue has a different outdate than aoolgeneic tissue.
B) Autologous tissue is not regulated by the AATB.
C) The medical director can have autologous tissue reassigned to an allogeneic donor if it is not used by the autologous donor.
D) Autologous tissue should have the same shelf-life as allogeneic tissue under the same storage.
Q2) 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
Q3) Which of the following statements is false?
A) Bone can be sterilized and all living tissue removed prior to its use.
B) Bone must be HLA typed to the recipient prior to implantation.
C) ABO/RH is not relative to be bone transplantation.
D) Bone can be made into screws, chips, spacers, and wedges for patient use.
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