which one(s) of the following viruses is/are ... - semmelweis

Which one of the following could be a complication of venous blood sampling?

a) Cramps b) Syncope c) Hematoma d) Seizures

Which one(s) of the following viruses is/are transferred through contact with infected

blood? a) Hepatitis A b) Hepatitis B and HIV c) Measles d) Mumps

What is the difference between serum and plasma? a) Fibrinogen is present in serum

b) Fibrinogen is absent in serum c) Fibrinogen is absent in plasma d) Fibrin is present in plasma

The citrate tube (light blue capped) is used primarily for the following purposes: a) The test of complete blood cells count b) The measurement of prothrombin time, APTT, TT

c) The determination of glucose concentration

d) For the determination of uric acid level

Which of the following laboratory parameters are affected by extensive physical activity? a) CK and GOT enzyme activities decrease, potassium levels increase

b) CK, GOT, potassium, lactate values increase, glucose levels decrease

c) Potassium levels decrease

d) CK and GOT values increase , lactate levels decrease

Which one of the following hormone has the highest peak in the morning? a) ACTH

b) TSH

c) Prolactin

d) Growth hormone

The reference interval of parameters following Gaussian distribution usually equals to: a) The mean ± SD

b) The mean ± 2SD

c) The median, range min-max.

d) Median, interquartile range

The normal pH value in a fresh urinary sample: a) pH 3-4 b) pH 5-6 c) is nearly equal to the blood pH (7.35-7.45) d) pH 8-9

The urinary reagent strips (dipstick) do not detect: a) The presence of nitrifying bacteria

b) The presence ketones

c) The presence of fungi

d) The presence of hemoglobin

Which sample is used for complete blood count by hematology analyzers? a) Tube with red top (native) b) Tube with blue top contains sodium-citrate c) Tube with purple/violet top contains EDTA-K2 d) Tube with black top contains citrate

Increased ESR (erythrocyte sedimentation rate), except: a) Pregnancy b) Rheumatoid arthritis c) Hemolysis d) Polycytaemia rubra vera

What is indicated by the MCV parameter in hematology? a) Mean corpuscular (cell) volume b) Average platelet volume

c) Average white blood cell volume d) Distribution of the size of the platelets

What is the unit of MCV? a) mL (milliliter) b) µL (microliter) c) fL (femtoliter)

d) g/L (gram per liter)

At which age should 190 g/L (19 g/dL) hemoglobin concentration and 0.60 (60%) hematocrit values should be considered as normal?

a) All ages

b) The first few days after birth

c) After 3-4 years of age

d) In adult women

Hematocrit is determined by: a) ELISA method

b) Measurement of enzymes in RBCs

c) Centrifugation

d) Freezing-point depression

In normal peripheral blood smear which one of the following cell types is absent? a) Segment

b) Eosinophil

c) Monocyte d) Myeloblast

In hemolytic anemia the characteristic laboratory alteration is:

a) Decreased haptoglobin concentration in serum

b) Increased haptoglobin concentration in serum

c) Does not change the haptoglobin level in serum

d) Decreased LDH activity and bilirubin level in serum

What is the common cause of microcyter hypochromic anemia? a) vitamin B12 deficiency b) Folic acid deficiency

c) Iron deficiency anemia

d) Presence of HbF

What is the common cause of macrocyter anemia? a) Deficiency of vitamin B6 b) Folic acid deficiency c) Excess vitamin B12 d) Iron deficiency

Which statement is correct for folate (folic acid) concentration? a) In plasma > in RBC b) In plasma < in RBC c) In RBC = in plasma d) There is no folate in RBC

What is that cut-off value for platelet counts that indicates high risk of bleeding? a) 100 g/L b) 50 G/l

c) 5 G/L d) 1G/L

Very high (800-1000 G/L) platelet count suggests: a) Septic condition b) Post-transfusion condition c) Essential thrombocythaemia

d) Disseminated intravascular coagulation (DIC)

Which type of leukemia is associated with Philadelphia chromosome (t9,22) genetic translocation? a) Acute lymphoblastic leukemia

b) Chronic myeloid leukemia

c) Acute monoblastic leukemia (AML FAB-M5)

d) Acute megakaryoblastic leukemia (AML FAB-M7)

What are the primary hemostasis laboratory tests? a) Bleeding time, platelet count and von Willebrand factor test

b) Fibrinogen concentration c) Prothrombin time

d) Protein-C and Protein-S levels

Which laboratory test(s) is/ are used to assess fibrinolysis? a) Bleeding time

b) Fibrin concentration

c) Prothrombin time d) D-dimer and fibrin degradation products (FDP)

Which coagulation factor has an important role in adhesion of platelets (primary hemostasis)? a) Factor V

b) Factor VIII

c) von Willebrand factor

d) Factor XI

If PT and APTT are abnormal, thrombin time normal and the mixing tests correct the abnormalities, what is the next step of investigation?

a) We measure factor VIII activity.

b) We measure fibrinogen level.

c) We examine the common pass-way factors (II, V, X.) d) We measure Factor XIII activity.

Hemostasis tests are not justified: a) in thrombosis of unknown origin b) during investigation of re-occurrence of thrombosis c) for population screening d) in thrombosis of unusual location

Which factor deficiency/deficiencies is/are inherited X-linked chromosome? a) Factor II deficiency b) Factor VIII and Factor IX deficiencies c) Factor V deficiency d) Factor XIII deficiency

Which is the most important factor for platelet adhesion? a) Fibronectin

b) von Willebrand factor c) Tissue factor d) Free calcium ion

Which complex is produced at the first during hemostasis? a) Tenase complex (FVIIIa-FIXa) b) Prothrombinase complex (FXa-FVa)

c) Tissue factor -FVIIa complex (TF-FVIIa)

d) Thrombin-Antithrombin complex

Which disorder(s) is/are inherited in an X-linked way? a) von Willebrand factor deficiency

b) Haemophilia A and B

c) Factor XI deficiency

d) Afibrinogenaemia

What is the mechanism of action of dicoumarol? a) It is an antioxidant b) it inhibits absorption of calcium

c) It is antagonist to vitamin-K action

d) It prevents platelet aggregation

Base excess (BE in mmol/L) is: a) The base or acid quantity which is necessary for blood pH 7.4 (pCO2 = 40 mmHg) b) The base or acid quantity which is necessary for blood pH 7.0 and pCO2 30 mmHg c) The base or acid quantity which is necessary for blood pH 7.0 and pCO2 35 mmHg d) The base or acid quantity which is necessary for blood pH 7.0 and pCO2 40 mmHg

Interpret the following blood gas parameters: pH↑ pCO2↓ HCO3 normal Base excess normal

a) Metabolic acidosis

b) Respiratory acidosis

c) Metabolic alkalosis

d) Respiratory alkalosis Interpret the following blood gas parameters: pH↓ pCO2 normal HCO3↓ Base excess↓

a) Metabolic acidosis b) Respiratory acidosis

c) Metabolic alkalosis

d) Respiratory alkalosis

Hyperkalemia can be caused by: a) Vomiting b) Thrombocytopenia c) Kidney failure d) Liver failure

Serum potassium level 7.9 mmol/L may occur commonly in case of: a) Hemolysis b) Renal tubular dysfunction c) Hepatic insufficiency d) in vitro hemolysis + renal tubular dysfunction

What relationship is true for immunoglobulin in serum? a) IgG > IgM b) IgG < IgM c) IgG = IgM

d) IgG < IgA

Serum immunoglobulin levels in healthy adult population: a) IgA < IgM

b) IgA > IgM

c) IgG< IgA

d) IgG < IgM

Which laboratory parameter responds first (most quickly) to bacterial infection? a) WBC count

b) ESR (Erythrocyte sediment rate) c) PCT (Procalcitonin)

d) CRP (C-reactive protein)

Which statement is correct? a) Serum myoglobin is absolute specific for acute myocardial infarction (AMI).

b) Serum myoglobin levels are increased in skeletal muscle injuries.

c) Serum myoglobin level increases 1-2 days after AMI

d) Serum myoglobin level is low in anemia

Negative acute-phase protein: a) Amyloid

b) Procalcitonine

c) C-reactive protein

d) Albumin

Which one of the following autoantibodies is present in the majority of systemic autoimmune diseases? a) The red blood cell antibody b) Smooth muscle antibody

c) TSH receptor antibody

d) Antinuclear antibodies (ANA)

Oral glucose tolerance test procedure: a) 75 gram galactose in 300 mL water ingested in 5 minutes b) 75 gram lactose in 300 mL water ingested in 5 minutes c) 75 gram glucose in 300 mL water ingested in 5 minutes d) 75 gram anhydrous glucose in 300 mL water ingested in 2 hours

What means HbA1c? a) Glycated hemoglobin b) Fetal hemoglobin form c) A breakdown product of hemoglobin d) Abnormal hemoglobin form in thalassemia

The concentration of glycated hemoglobin (HbA1c) reflects: a) Daily blood glucose concentration, only

b) Blood glucose average concentration in the last 8-10 week c) The size of RBC d) The type of diabetes

What is the therapeutic target value of HbA1c in diabetic patients? a) < 5 % (31 mmol/mol) b) < 6% (42 mmol/mol)

c) < 7 % (53 mmol/mol)

d) < 8% (64 mmol/mol)

Lipemic serum sample (turbid to opaque) indicates: a) High triglyceride concentrations

b) High HDL-cholesterol concentrations

c) High LDL-cholesterol levels

d) High phospholipid levels

In which environment is the use of a POCT ammonia meter justified? a) In an intensive care unit b) In a laboratory

c) At home monitoring

d) All three answers are correct

In which environment is the use of a POCT lactate meter justified? a) In laboratory

b) In intensive care unit

c) In sport medicine e) All three answers are correct

Where are LDH and GPT enzymes localized in the cells? a) In the membranes

b) In the nucleus

c) In the mitochondria

d) In the cytoplasm

When are GOT (AST) and GPT (ALT) enzyme activities extremely high (up to 100-500 folds of the normal) in the serum?

a) In mushroom poisoning

b) In autoimmune disease c) In chronic renal failure

d) In chronic alcoholism

Which is the most specific marker for myocardial damage? a) Creatinine-kinase (CK) b) C-reactive protein (CRP) c) Myoglobin d) Troponin-I or Troponin-T

Which of the listed drug levels is recommended to be monitored in a lab? a) Oral antidiabetics b) Oral analgesics c) Cardiac glycosides - Digoxin d) Antihypertensives

Which enzyme can be used as a tumor marker? a) Neuron specific enolase (NSE)

b) Amylase c) Lipase d) Gamma glutamyl transferase (γ-GT)

The following is true in primary hyperthyreosis: a) High TSH and low fT4 levels b) High TSH and high fT4 levels

c) Low TSH and low fT4 levels

d) Low TSH and high fT4 levels

What is the reference range of the cerebrospinal fluid glucose concentration? a) Always higher than in the blood (the demand for energy due to brain cells)

b) Always the same as the blood (due to the free diffusion of glucose)

c) 60-70 percent of the actual blood glucose levels

d) Solely depends on the amount of CSF

The following enzyme is raised in obstructive jaundice: a) CK b) Amylase

c) Lipase

d) γ-GT

Which specific lab test is used to diagnose coeliac disease? a) Fecal fat test

b) D-xylose absorption test

c) Anti-neutrophil cytoplasmic antibody (ANCA) titer d) Tissue transglutaminase antibodies (tTG)

What tests are suggestive for alcoholic liver damage? a) GPT, γ-GT, ChE enzyme activities and lipid levels in serum

b) Alpha1-antitrypsin, ceruloplasmin and cupper concentration in plasma

c) Prothrombin time

d) Blood-pH and blood-gas analysis

What tests are suggestive for biliary duct obstruction? a) Serum protein electrophoresis

b) Prothrombin time (PT) and partial thromboplastin time (APTT)

c) Ammonium concentration in plasma d) γ-GT, AP enzyme activities and bilirubin levels in serum

Which tumor markers are elevated in ovarian cancer? a) Neuron specific enolase + alkaline phosphatase b) CA-125 + HE4 c) Catecholamines (epinephrine + norepinephrine) d) Thymidine kinase

Which abnormality is often seen in primary hyperaldosteronism (Conn

syndrome)? a) hyperkalemia b) hypokalemia c) hypercalcemia d) hypocalcemia

Which hormone is a tumor marker? a) TSH

b) Thyroxine c) Calcitonin d) Vasopressin

BRCA1 gene mutation is a risk factor for: a) Bone tumor b) Brain tumor

c) Breast and ovarian cancer

d) Kidney tumor

After an acute myocardial infraction serum myoglobin concentration peaks at: a) 0.5 hour

b) 1-2 hours c) 4-8 hours

d) 24-48 hours

Which one is correct for acromegaly? a) Serum growth hormone (GH) concentration is low

b) Serum GH level is normal

c) Serum IGF-I and GH levels are high

d) Serum LH and FSH concentration are high

Which laboratory test is informative in carcinoid tumors? a) Plasma PTH b) Urinary free cortisol c) Urinary 5-Hydroxyindoleacetic acid (5-HIAA, as metabolit of serotonin) d) Serum CEA

Which of the following parameters increase the most when the lying patient

stands up?

a) hemoglobin

b) renin

c) total protein

d) cholesterol

Which of the following parameters is correlated with age?

a) osmolality

b) BUN

c) IgA

d) ammonia

Which of the following parameters is not correlated with age?

a) cholesterol

b) chloride

c) total protein

d) alkaline phosphatase

Which of the following parameters decrease with age?

a) IgG

b) creatinine

c) albumin

d) potassium

Which of the following parameters has a peak value at noon?

a) iron

b) testosteron

c) hematocrit

d) norepinephrine

Capillary blood must be drawn from which part of the body under the age of 1?

a) side of the plant

b) heel

c) index finger

d) thumb

Which parameter is not increased in hemolysed samples?

a) lactate hydrogenase

b) potassium

c) alanin aminotransferase

d) aspartate aminotransferase

During which phase do most errors with lab tests occur?

a) pre-pre- analytical

b) analytical

c) post-analytical

d) post-post- analytical

What is the major source of pre-analytical errors?

a) environmental factors

b) mistake wrong indication ofduring lab tests requests

c) biological variability

d) sampling

Which of the following is the most frequent sampling error?

a) inappropriate tube

b) clots

c) insufficient volume

d) misindification

Which statement is false?

a) hemoglobin interferes with photometry

b) hemolysis interferes with chemical reactions

c) at 0,1 g/l free hemoglobin level the hemolysis is visible

d) serum levels of intracellular analytes increase

How can hemolysed samples be recognised? Mark the wrong answer!

a) measuring hemolysis index

b) adding LipoClear

c) inspecting the sample

d) measuring potassium levels

Capillary sampling. What should you pay attention to?

a) keep the capillary vertical during sampling

b) never rotate the sample several times

c) the first drop is the most preferable for measuring

d) forced massage can cause hemolysis

Which is the right order of tubes during sampling?

a) blood culture - sodium fluoride tube for blood glucose tests - native tube for

serum - citrate tubes for hemostasis test - heparin tube

b) blood culture - native tube for serum - heparin tube – sodium fluoride tube

for blood glucose tests - citrate tubes for hemostasis test

c) blood culture - native tube for serum - heparin tube - citrate tubes for

hemostasis test - sodium fluoride tube for blood glucose tests

d) blood culture – citrate tubes for hemostasis test – native tube for serum -

heparin tube – sodium fluoride tube for blood glucose tests

Which one is not a pre-analytical error?

a) lipemic sample

b) wrong request

c) random error

d) prolonged storage

What does TAT refers to in laboratories?

a) time between arrival of sample to the lab and the generation of the results

b) time needed for antitrombin degradation

c) half life of tyreoid antibodies

d) transcription time of thymine-adenine- thymine sequences

What is the lot number of reagents?

a) the amount of sample that the reagent is enough for

b) a number which shows that a measure is how reproducable

c) production number

d) expiration date

Which of the following expresses the rate of systemic error?

a) imprecision

b) bias

c) reproducibility

d) accuracy

What should be done in case of significant error?

a) the system cannot be used to measure

b) the systems status should be tested

c) in case of necessity: calibration

d) all three answers are correct

How is the testing done in batch mode?

a) one type of measurement is done first from all the samples

b) all the requested tests from one sample are initiated

c) emergency requests are done first

d) all answers are wrong

How is the testing done in STAT mode?

a) one type of measurement is done first from all the samples

b) all the requested tests from one sample are initiated

c) emergency requests are done first


Which result can be used for clinical decision making?

a) validated result

b) passed result by the technician

c) both answers are correct

d) both answers are wrong

Bias:

a) difference between the expected value and the real value

b) expresses the rate of random error



Accuracy

a) depends on reproducibility and bias

b) mean value of measurements divided by standard deviation



Part of internal quality control tasks :

a) applying Westgard-rules

b) calibration

c) daily / regular measurement of control samples of known concentrations


External quality control:

a) it is supervised by independent organisation

b) it is evaluated centrally

c) the laboratory is provided samples of unknown analyte levels


Sensitivity:

a) probability of having a negative test result in a healthy subject

b) probability of having a positive test result in a sick patient

c) probability that the tested patient is affected if test result is positive

d) probability that the tested patient is not affected if test result is negative

Specificity:





Positive predictive value





Negative predictive value:





ROC curve:

a) sensitivity on the x-axis and specificity on the y-axis

b) specificity on the x-axis, and sensitivity on the y-axis

c) 1-specificity on the x-axis, and sensitivity on the y-axis

d) 1-sensitivity on the x-axis, and specificity on the y-axis

Emergency lab tests:

a) they are provided only if they fall out of reference range

b) TAT time is higher than 1 hour

c) they are the same in every laboratory

d) passed results by the technician can be seen without validation

Which statement is true regarding alarm values:

a) They require immediate clinical decision

b) There is no unified guideline, it depends on the clinic sending the sample

c) They are critical values that should be communicated to the doctor

immediately

d) All answers are correct

Which statement is true regarding alarm values:

a) The reporter’s name and position should be documented

b) the written laboratory results are not needed for the decision making



Which test has low false negative results?

a) test with high sensitivity

b) test with high specificity

c) test with high positive predictive value

d) test with high negative predictive value

What happens if we decrease the cut off value of a test where the high values are

abnormal?

a) the sensitivity increases

b) the specificity increases

c) the sensitivity and specificity doesn’t change

d) all three answers are wrong

What kind of test is needed when false positive results have huge consequences?

a) test with high sensitivity

b) test with high specificity

c) test with high positive predictive value

d) test with high negative predictive value

What happens if we increase the cut off value of a test where the high values are

abnormal?

a) the sensitivity increases

b) the specificity increases

c) the sensitivity and specificity doesn’t change


Predictive value:

a) it depends on the specificity only

b) it depends on the sensitivity only

c) it depends on characteristics of tested population

d) it is not influenced by the prevalence of disease in the tested population

The reference range of female sex hormones depends on:

a) age

b) menstrual cycle

c) sexual maturity


What can a test result be compared to if the results reference range dependens

on the gestation time:

a) percentile

b) MoM (multiple of medians)

c) T-score and Z-score


ROC curve

a) Indicates the true positive rate and the false-positive rate at difference cut-off

values

b) The test is more accurate if the curves slope is closer to 45°



Z-score and T-score are used for the examination of :

a) liver

b) bowels

c) bone

d) lungs

Which of the following is absent in a properly collected healthy urine sample?

a) nitrites

b) leukocytes

c) bilirubin


Which of the following can cause green-cyanic coloured urine?

a) melanin

b) bilirubin

c) chyluria

d) pseudomonas infection

Which of the following can’t cause red coloured urine?

a) nitrofurantoin

b) levodopa

c) myoglobin

d) senna

Which of the following doesn’t influence the glucose test of the urinary test

strip?

a) ascorbic acid

b) ketones

c) bacteria

d) fructose

Which ketone body can’t be measured with urinary test strip?

a) acetone

b) acetoacetate

c) beta-hidroxi- butirate

Which of the following conditions doesn’t increase the urinary bilirubin

concentration?

a) hemolysis

b) biliary obstruction

c) hepatitis


In which of the following conditions does the urinary urobilinogen decrease?

a) hemolysis

b) biliary obstruction

c) in the late stage of hepatic damage


Which of the following conditions causes pale/clay-colored stool?

a) pancreatic tumour

b) cholestasis

c) acute hepatic damage


Which of the following doesn’t influence the bilirubin test of the urinary test

strip?

a) ascorbic acid

b) urobilinogen

c) nitrite

d) blood

Which leukocyte enzyme is detected by the urinary test strip?

a) NADP-oxidase

b) esterase

c) hexokinase

d) enolase

Which of the following test is done mostly bedside?

a) hydrogen breath test

b) cystic fibrosis test

c) continuous blood glucose monitoring


Which statement is false regarding bedside testing?

a) it is faster than regular lab tests

b) supports immediate clinical decision making

c) quality control is not necessary

d) comfortable for the patient/doctor

Which analyte has no bedside test?

a) hemoglobin

b) anti-streptococcus antibody

c) glucose

d) cortisol

Which method is used when measuring glucose with test strip?

a) glucose-oxidase method

b) hexokinase method



Which of the following can cause brownish black coloured urine?

a) methemoglobin

b) lipiduria

c) etoxasan

d) ribaflavin

Which of the following can cause milky urine?

a) etoxasan

b) ribaflavin

c) chyluria

d) senna

Which of the following component(s) is/are responsible for the specific gravity of

urine?

a) urea

b) NaCl

c) phosphate salts


Which of the following urinary parameters can’t be detected by using the

available test strips?

a) specific gravity

b) urea

c) urobilinogen

d) leukocyte

Which of the following can alter the specific gravity of the urinary test strip?

a) glucose

b) protein

c) contrast agent


Which of the following can cause alkaline urine?

a) renal tubular acidosis

b) consumption of meat

c) methionine

d) metenamine – mandelate

Which of the following can alter the urinary protein of the urinary test strip?

a) pH change

b) contrast agents

c) turbidity


What is the detection principle of the measurement of blood with urinary test

strip?

a) chromogen binding of hemoglobin causes a colored substrate

b) GP6DH enzyme activity

c) hem peroxidase activity

d) measuring the potassium ion released from RBC

Which statement is false regarding biliary obstruction?

a) the stool is pale

b) urinary bilirubin concentration increases

c) serum CA19-9 can be increased

d) urinary urobilinogen concentration increases

Which of the following bacteria species doesn’t produce nitrite?

a) Klebsiella

b) Enterococcus

c) Enterobacter

d) Staphylococcus

Which statement is false regarding the detection of blood with fecal

immunochemical (FIT) test?

a) detects upper gastrointentinal bleeding as well

b) detects human hemoglobin only

c) uses antibodies against hemoglobin

What does SIRS stand for?

a) systemic inflammatory response syndrome

b) severe respiratory disorder

c) disorder of renal function

d) disorder of hepatic function

Laboratory alteration of SIRS can be:

a) WBC> 15 G/L

b) WBC <3 G/L

c) >10% bands


The sepsis continuum:

a) Sepsis - SIRS – severe sepsis – septic shock

b) SIRS – sepsis – septic shock – severe sepsis

c) SIRS – sepsis – severe sepsis – septic shock

d) Sepsis – SIRS – septic shock – severe sepsis

In serum electrophoresis, the proteins are separated by:

a) mass and size

b) absorbance and charge

c) mass and absorbance

d) size and charge

In acute phase reaction:

a) albumin/globulin ratio decreases

b) albumin level increases

c) haptoglobin level decreases

d) alpha-1 proteins level decrease

Positive acute phase protein:

a) α1 acidic glycoprotein

b) prealbumin

c) apoA1

d) albumin

Negative acute phase protein:

a) procalcitonin

b) proteinase inhibitors

c) iron

d) ferritin

Which is not a positive acute phase protein:

a) serum amyloid

b) albumin

c) C3 and C4

d) interleukin-6

Mark the wrong answer! FUO (fever of unknown origin)

a) is a type of fever, where the origin is still unknown after 3 weeks

b) can be caused by connecting tissue diseases

c) can be caused by infection

d) is mostly caused by tumour

Which is common in a bacterial infection:

a) granulocytosis

b) lymphocytosis

c) monocytosis


Which can influence the erythrocyte sedimentation rate?

a) level of alpha-globulins

b) level of fibrinogen

c) level of immunglobulins


Erythrocyte sedimentation rate

a) increases 24 hours after inflammation

b) is always decreased in anemia

c) is decreased by cortizol


Reference values of erythrocyte sedimentation rate

a) male <10 mm/hour, female <15 mm/hour

b) male <20 mm/hour, female <10 mm/hour

c) male <25 mm/hour, female <40 mm/hour

d) male <40 mm/hour, female <25 mm/hour

The correct citrate/blood ratio in the tube of the erythrocyte sedimentation rate

test:

a) 1:1

b) 1:2

c) 1:3

d) 1:4

How does citrate/blood ratio influence the erythrocyte sedimentation rate

(ESR)?

a) it doesn’t influence ESR

b) more citrate increases ESR

c) less citrate increases ESR


What should you note during the erythrocyte sedimentation rate test?

a) appropiate time should be devoted for the test

b) tube should be vertically positioned

c) the test should be performed at room temperatue


Mark the wrong answer! C-reactive protein

a) is a calcium binding protein of five subunits

b) enhances phagocytosis

c) only increases in bacterial infection

d) is measured by immunoassay in clinical diagnostic laboratories

Extensively increased levels during bacterial infection in blood samples:

a) CRP

b) procalcitonin

c) WBC

d) CRP + procalcitonin

Procalcitonin:

a) indicates systemic bacterial infection later than CRP

b) levels are increased in medullary thyreoid cancer without infection

c) is never produced by the lungs and bowels

d) is used to measure the condition of bone

Presepsin is the soluble form of:

a) CD14

b) CD26

c) CD64

d) CD163

Neopterin:

a) has a shorter half-life than that of IFN-gamma

b) levels are increased only after extensive antibody production

c) produced in association with humoral immune response

d) can help to differentiate between bacterial and viral infections

CSF Neutrophil granulocyte count is increased in:

a) Guillan-Barré syndrome

b) sclerosis multiplex

c) bacterial meningitis

d) viral meningitis

CSF Lymphocyte count is increased in:

a) viral meningitis

b) bacterial meningitis

c) empyema

d) brain abscess

Healthy liquor glucose level:

a) 1-2 mmol/l

b) 4-5 mmol/l

c) 2/3 of plasma glucose level

d) the same value as plasma glucose level

Contraindications of CSF sampling:

a) severe fever

b) increased intracranial pressure

c) diabetes

d) renal failure

During the primary immune response:

a) maximal IgM antibodies

b) maximal IgG antibodies

c) Increased WBC

d) Increased IgG

In case of suspicion of meningitis the required laboratory tests are:

a) in liquor: glucose, protein, WBC and urine glucose

b) in liquor: protein, WBC, hemoculture

c) in liquor: creatinin, WBC, protein, microbiology

d) in liquor: glucose, protein, WBC, microbiology and in blood: glucose and

albumin

CSF albumin levels in healthy adults:

a) liquor/serum albumin ratio 1:10

b) liquor/serum albumin ratio 1:200

c) 4 g/l

d) 40 g/l

Origin of liquor proteins in healthy adults: a) locally produced proteins

b) neurons

c) blood

d) unknown

When determining cell counts in liquor with a microscope WBCs and RBCs are

differentiated by the following procedure:

a) after measuring total cell count, WBCs are measured by peroxidase activity

b) after measuring total cell count, RBCs are lysed with the acetic acid of Türk

solution

c) after measuring total cell count, WBCs are lysed with the acetic acid of Türk

solution

d) after measuring total cell count, the level of hemoglobin in liquor is

measured

In arteficial bleeding of liquor:

a) the sample remains yellowish after centrifusion

b) after sampling, the bloody CSF cleares up in consecutive tubes

c) RBCs may decrease in size

d) ratio of RBC: WBC is 1:10

In pathological bleeding of liquor:

a) the glucose level in the liquor is largely decreased

b) after sampling, the bloody CSF cleares up in consecutive tubes

c) ratio of RBC: WBC is 1:700

d) the sample remains yellowish after centrifusion

The yellowish colour of centrifuged liquor can be caused by:

a) renal failure

b) increased WBC

c) hyperbilirubinaemia

d) arteficial bleeding

In case of suspicion of meningitis, while waiting for the transport, the liquor

sample :

a) must be stored at room temperature

b) must be put in the fridge

c) must be put in a 40 o C thermostat

d) must be frozen

The quantity of liquor sample should be taken from healthy adults

a) 1-2 ml

b) 2-3 ml

c) 10-15 ml

d) 30-40ml

What can be measured by flow cytometry?

a) receptors

b) adhesion molecules

c) cytokines


Which cell surface marker is specific for stem cells?

a) CD25

b) CD34

c) CD40

d) CD136

MCV is calculated by using the following formula:

a) =Hb/Htc

b) =Htc/RBC

c) =Htc/Hb

d) =Hb/RBC

MCH is calculated by using the following formula:

a) =Hb/Htc

b) =Htc/RBC

c) =Htc/Hb

d) =Hb/RBC

MCHC is calculated by using the following formula

a) =Hb/Htc

b) =Htc/RBC

c) =Htc/Hb

d) =Hb/RBC

Which is the measuring principle of hematology analyzers?

a) radiofrequence resistence

b) electric impedence

c) optical based measurement


What does the LUC stand for? (measured by the ADVIA instrument) a) Little unstained cells

b) Lymphocyte-like unstained cells

c) Living unstained cells

d) Large unstained cells

What is the principle of reticulocyte detection? Transition to sphere and then …

a) reticulocyte DNA detection with fluorescent dye

b) reticulocyte RNA detection with fluorescent dye

c) reticulocyte protein detection with fluorescent dye

d) reticulocyte carbohydrate detection with fluorescent dye

CBC changes following 8 hours of storage at room temperature:

a) Increased MCV, increased hematocrit

b) Decreased WBC

c) RBC loose their biconcave shape


In which condition may cold agglutinin be present?

a) infectious mononucleosis

b) mycoplasma pneumonia

c) autoimmune diseases


In EDTA-induced platelet-agglutination:

a) doesn’t influence platelet count

b) platelet count is falsely low

c) platelet count is falsely high


Giant platelets:

a) they cause an elevation at the left side of the PLT histogram

b) they cause an elevation at the right side of the RBC histogram

c) they significantly increase RBC count

d) are counted as RBCs by the instrument

How does high levels of WBC count affect the platelet count?

a) it doesn’t affect it

b) it significantly increases it

c) it significantly decreases it

d) it slightly increases it

What can affect the determination of hemoglobin?

a) jaundice

b) heparinated blood

c) severe lipemia


Which falsely measured parameter can lead to a false hematocrit value?

a) RBC count

b) MCW



Which RBC may be counted as WBC by the instrument?

a) nucleated RBC

b) fragmented RBC

c) microcyte


Which of following parameters are decreased by hemolysis?

a) RBC

b) hematocrit



Which of the following parameters are increased by fragmentocytes?

a) RBC count

b) platelet count



Which of the following substrates can be used as tumor markers?

a) enzymes

b) serum proteins

c) hormones


CA19-9 is often used for monitoring which cancer?

a) prostate cancer

b) pancreatic cancer

c) ovarian cancer

d) breast cancer

CA125 is often used for monitoring which cancer?

a) prostate cancer

b) gastric cancer

c) ovarian cancer

d) pancreatic cancer


a) breast cancer

b) gastric cancer

c) pancreatic cancer

d) lung cancer


a) gastric cancer

b) lung cancer

c) breast cancer

d) ovarian cancer

S100 is often used for monitoring which cancer?

a) small cell lung cancer

b) neuroblastoma

c) testicular embrional carcinoma

d) melanoma

If a tumor marker has 90% sensitivity and 30% specifity, then:

a) it is suitable for general screening

b) it is suitable for monitoring



In which cancer can TPA be used without other tumor markers?


b) bladder cancer

c) neuroblastoma

d) melanoma

NSE can increase in which tumor?


b) neuroblastoma


TK1: a) has 5 isoenzymes

b) is usually measured with HPLC

c) activity and amount changes with cell cycle


TK1 can be used without other tumor markers in

a) prostate cancer

b) head-neck epithelial cancer

c) myeloma multiplex

d) colorectal cancer

Which method is used when measuring glicated protein–type tumor markers?

a) clinical chemistry method

b) immunoassay

c) electrophoresis

d) turbidimetry

TPA:

a) can be used for monitoring lung cancer

b) has prognostic value in superficial bladder cancer



Recommended frequency of tumor marker tests during monitoring

a) before therapy switch

b) new staging

c) 14-30 days after measuring an abnormal tumor marker level


Fasting blood glucose level is 8,2 mmol/l

a) the diagnosis is diabetes mellitus

b) oral glucose tolerance is needed for the diagnosis of diabetes mellitus

c) the diagnosis is IFG

d) the diagnosis is IGT

Fasting blood glucose level is 6,5 mmol/l


b) oral glucose tolerance test should be done

c) random blood glucose level should be measured

d) the diagnosis is IGT

An oral glucose tolerance tests result is 9 mmol/l after 2 hours


b) the diagnosis is IGT



An oral glucose tolerance tests result is 6,5 mmol/l after 2 hours a) the diagnosis is diabetes mellitus

b) the diagnosis is IGT



Which glicolysis enzyme is inhibited by sodium-fluorid?

a) phosphofructokinase

b) hexokinase

c) enolase

d) glucose-6- phosphate dehydrogenase

Which method can be used for measuring blood glucose in laboratories? a) glucose oxidase method




Which method used for measuring blood glucose is influenced by ascorbic acid? a) glucose oxidase method




EDTA plasma can’t be used for measuring blood glucose in which method?

a) glucose oxidase method




NADPH is monitored in vitro in which method?

a) glucose oxidase method




Urinary glucose detection is influenced by:

a) ascorbic acid

b) disinfectant

c) bacterial contamination


C-peptid level is decreased in:

a) Insulinoma

b) type 1 diabetes mellitus

c) type 2 diabetes mellitus

d) renal failure

Insulin level is increased in:

a) later phase of type 2 diabetes mellitus

b) polycystic ovary syndrome

c) insulinoma


HOMA-index

a) expresses homocystein – cholesterol ratio

b) high values are an indication for insulin resistance

c) low values are an indication for insulin resistance

d) refers to ovaric cancer

Which HLA subtype is the most frequent in diabetic patients?

a) HLA-DR1

b) HLA-DR2

c) HLA-DR3

d) HLA-DR4

Autoantibody present in type 1 diabetes mellitus:

a) Islet cell autoantibodies

b) Glutamate acid decarboxilase autoantibodies

c) Tirosin-phosphatase IA-2 autoantibodies


Which test is suitable for detecting diabetic complications

a) detecting Glutamate acid decarboxilase autoantibodies

b) measuring C-peptid levels

c) measuring insulin levels


Mark the wrong answer! Long-term complication of diabetes:

a) neuropathy

b) atherosclerosis

c) diabetic ketoacidosis

d) nephropathy

Mark the wrong answer! Short-term complication of diabetes:

a) lactic acidosis

b) hyperglicemic, hiperosmolar condition without ketosis

c) retinopathy

d) hypoglycemia

In which condition can ketone bodies appear in urine?

a) fasting

b) disturbed carbohydrate metabolism

c) disturbed lipid metabolism


Characteristic for diabetic ketoacidosis

a) hypervolaemia

b) hyperosmolality

c) increased bicarbonate


Generation of HbA1c:

a) ketoamine is produced during a reversible process

b) it is catalysed by the glucokinase enyzme

c) mostly depends on blood glucose level at constant hemoglobin

concentrations


Method which can be used for measuring HbA1c:

a) HPLC

b) immunochemistry method



Which is the IFCC unit of HbA1c level?

a) U/l

b) g/dl

c) mmol/mol

d) mmol/l

Measurement of HbA1c is influenced by:

a) abnormalities with the quantity of Hb

b) abnormalities with the quality of Hb

c) RBC abnormalities


What is the eAG value?

a) avarage HbA1c value

b) avarage glucose estimated from HbA1c value

c) renal function estimated from creatinin level

d) Hba1c value expected on the basis of age

Fructose-amine

a) It’s unit indicates the amount of glucose in mmol that binds to 1g albumin

b) has a shorter half-life than that of HbA1c

c) it’s measurement is interfered by the same factors as of HbA1c


The most common inborn errors:

a) are detected using dried filter blood spots taken on the first week of birth

b) screening is on the 6th week together with vaccination

c) screening uses clinical chemistry methods nowadays


In mass spectrometry the separation is based on:

a) mass and absorbance

b) mass and molecule size

c) mass and charge

d) mass and light scattering

Mass spectrometry can be used in: a) clinical toxicology

b) screening inborn errors of metabolism

c) identification of bacteria


Hyperlipoproteinaemia is frequent in:

a) familiar disturbed fat metabolism

b) nephrosis syndrome

c) diabetes mellitus


Cholesterol

a) detection is only allowed from fasting blood sample

b) the level will be decreased, if it is not taken in fluorid containing tube

c) can be detected from serum and plasma

d) it is mostly unbound in the blood

Component, which can be found in LDL lipoprotein:

a) triglyceride

b) cholesterol – ester

c) apolipoprotein


Most often used auxiliary enzyme in cholesterol measurement in clinical

laboratories:

a) cholesterol – esterase

b) cholesterol – oxidase



Chronic strangulation / venous compression increases:

a) cholesterol level

b) triglyceride level



Falsely low triglyceride level is caused by:

a) high bilirubin level

b) high creatinin level

c) high ascorbic acid level


When should one measure the cholesterol / triglyceride levels?

a) cardiovascular disease in the patient’s history

b) patient younger than 50 years has arcus corneae

c) monitoring the effect of cholesterol-lowering drug


Frequently associated with metabolic syndrome:

a) hyperuricaemia

b) low HDL cholesterol level

c) hypertriglyceridaemia


which one(s) of the following viruses is/are ... - semmelweis

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