MSQ quality assessment

1.The tourniquet cannot be left on for more than __ minute(s) 1. :-) 1 2. 2 3. 3 4. 4 2.Failure to remove the needle when blood starts entering the tissues may result in a(n) 1. syncope 2. hemoconcentration 3. :-) compression nerve injury 4. lymphostasis 3.Hemolysis of a blood sample during blood collection may be due to: 1. leaving the tourniquet on too long. 2. having the patient pump their fist. 3. :-) using a 25 gauge needle. 4. venipuncture performed with vacuum collection system.

4.Hemoconcentration is/may be due to 1. :-) having patient pump fist repeatedly. 2. releasing tourniquet after one minute. 3. cleansing site with alcohol. 4. drawing from medial cubital vein.

5.Which of the following will be used when a serum sample is required: 1. EDTA 2. Heparin 3. Sodium Citrate 4. :-) Clot Activator

6-Which of the following identifiers would be appropriate to accurately identify the patient: 1. :-) patient name and identification number 2. patient name and room number. 3. physician's name and room number 4. patient and physician's names

7.Which of the following samples will be utilized for plasma electrolytes? 1. EDTA 2. Sodium Citrate 3. :-) Heparin 4. Clot activator 8.All of the following tests can be performed on an EDTA sample EXCEPT 1. white blood cell count

2. erythrocyte sedimentation rate 3. differential 4. :-) glucose

9.According to the patient bill of rights patient's have the right to get which of the following items of information from the phlebotomist: 1. know what the laboratory tests will be used for. 2. their diagnosis. 3. how the test results will be used to treat them. 4. :-) your name and role in their care.

10.Blood culture contamination rates should not exceed: 1. 1% 2. 2% 3. :-) 3% 4. 4%

11.Blood alcohol levels must be collected in which of the following tubes: 1. :-) Gray 2. Green 3. Lavender 4. Red

12.A three hour glucose tolerance test has been ordered. In order for all samples to be collected and tested at a later time which of the following additves must be used? 1. Heparin 2. :-) Sodium Fluoride and Potassium Oxalate 3. EDTA 4. Sodium Citrate

13.Which of the following collection methods will result in the BEST sample for analysis by the laboratory? 1. Syringe and butterfly 2. :-) Vacuum collection system 3. Capillary puncutre on finger 4. Capillary puncture on heel

14.Leakage of blood into the tissues due to the needle partially being inserted into a vein will result in a/an: 1. hemoconcentration 2. lymphostasis 3. infection 4. :-) hematoma

15-You have left the tourniquet on for more than the recommended time period. Which of

the following analytes will be falsely increased in the blood? 1. sodium 2. :-) potassium 3. glucose 4. LDH

16.Which of the following additives is used for a prothrombin time? 1. EDTA 2. Heparin 3. :-) Sodium Citrate 4. Sodium fluoride

17.Which of the following stopper colors is used exclusively for the erythrocyte sedimentation rate? 1. :-) Black 2. Tan 3. Royal Blue 4. Gray

18.You have collected the EDTA tube before the heparin tube. Which of the following will be excessively decreased? 1. :-) Calcium 2. Glucose 3. Sodium 4. Potassium

19.Failure to completely fill the sodium citrate tube will result in a 1. shortened PT 2. :-) prolonged PTT 3. decrease sodium 4. increased potassium

20.Which of the following is the correct way to finish up a venipuncture procedure? 1. Release tourniquet, remove needle, apply pressure, release tube from holder 2. Release tube from holder, release tourniquet, remove needle, apply pressure. 3. :-) Remove tourniquet, release tube from holder, remove needle, apply pressure. 4. Release tourniquet, remove needle, release tube from holder, apply pressure. 1. Which of the following statements is true concerning human blood? a) The blood of all normal humans contains red and white cells, platelets, and plasma. b) Some human populations normally lack the ability to produce plasma. c) Proteins are not normal components of human blood.

2. Erythrocyte is another name for a:

a) red cell b) white cell c) platelet 3. Which of the following blood components provide the major defense for our bodies against invading bacteria and viruses? a) red cells b) white cells c) platelets

4. The relatively clear liquid medium which carries the other cells of blood is called: a) lipid b) antibody c) plasma

5. Which of the following are likely to increase in quantities when the body is under attack from bacteria? a) erythrocytes b) leukocytes c) thrombocytes

6. When blood clumps or forms visible islands in the still liquid plasma, it is called: a) clotting b) agglutination c) none of the above 7. Antigens are: a) found on the surface of red cells b) kinds of red cells that identify a blood type c) relatively large carbohydrate molecules d) a and b

8. Which of the following statements is true of antigen-antibody interactions? a) They are used by our bodies only to identify blood types. b) They are used to identify and reject microorganisms, such as viruses and bacteria, that invade our bodies. c) They are the way our blood clots when we are bleeding from an open wound. d) b and c 9. Most of the volume of normal human blood is composed of: a) red cells b) hemoglobin c) plasma d) white cells 1 a -2 a - 3 b -4 c- 5 b -6 b -7 a- 8 b- 9 c

Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver ?disease A. Amino transaminase B. Alkaline phosphatase C. Bilirubin D. Albumin Correct answer : D. Albumin .Albumin is significantly decreased in chronic liver diseases

Liver function Tests- Choose the correct answer

1 .In prehepatic jaundice( Bilirubin/Urobilinogen) is detected in urine )Urobilinogen( 2.In post hepatic jaundice( Bilirubin/Urobilinogen )is detected in urine )Bilirubin( 3 .Bilirubin/Biliverdin) is the first pigment to be formed ( ) Biliverdin( 4 .Both Bilirubin and urobilinogen are detected in urine in (hepatic/post hepatic )jaundice )Hepatic jaundice( 5.Vitamin K deficiency is not encountered in(prehepatic/post hepatic) jaundice )Prehepatic jaundice( 6.Serum( Albumin/Globulin) levels are increased in chronic liver disorders )Globulin( 7.Prothrombin time is( decreased /increased) in liver disorders )Increased( 8-Blood(Glucose/Galactose) level would increase in Galactose Tolerance test in a normal .individual )Glucose( 9-Blood( Glucose/Galactose) level would increase in Galactose Tolerance test in a patient .with liver disorder )Galactose(

11 .Serum total cholesterol level( increases /decreases) in obstructive jaundice )Increases( 11 .ALP/ALT) rises in obstructive liver disorders ( )ALP-Alkaline Phosphatase( 13 .ALP/ALT) rises in viral hepatitis ( )ALT- Alanine amino Transferase( .AST/ALT would rise more in alcoholism 14 )AST-Aspartate amino Transferase( 15.Pale/Dark) colored stools are observed in haemolytic jaundice( )Dark colored( 11.Pale/Dark) coloured stools are observed in obstructive jaundice ( )Pale- In fact Clay coloured( 17.Vitamin( B2/B12) is stored in liver )B12 ( 11).Normal blood ammonia level should be( 40-70 g/dl /10-40 g/dl )g/dl 71-41( 11 .Indirect/Direct) positive Van den Bergh reaction is observed in haemolytic jaundice( )Indirect positive( 21.Indirect/Direct) positive Van den Bergh reaction is observed in post hepatic jaundice ( )Direct positive( 21.In cirrhosis of liver( blood urea/ammonia )would be higher than normal )Blood Ammonia( 22 ).Normal prothrombin time is 14 (seconds/minutes )seconds 14( 23.Plasma fibrinogen level (decreases/increases) in advanced liver cirrhosis

Decreases(

what is the abnormalities in urine sample at room temp ?(physical &chemical examination)

1. SGOT/SGPT in an alcoholic patient is >2 because: a) SGOT is excessively released in alcoholic hepatitis b) SGPT is poorly synthesized due to pyridoxine deficiency c) Alcohol induced change in enzyme synthesis d) Observation is an artifact due to interference of alcohol with SGPT estimation 2. GGT/ALP ratio diagnostic of alcohol induced liver injury: a) 1 b) 1.5 c) 2 d) 2.5 e) 3 f) 3.5 3. GGT is synthesized from all except: a) Liver b) Pancreas c) Kidney d) Heart e) Biliary tract f) Lungs g) Spleen 4. An alcoholic after binge drinking is referred to you with his PT>16s and S.Bilirubin>5mg/dl, and Albumin>3 gm/dl, your comment as a hepatologist is that: a) Discrimination index is 60, his prognosis is good. b) Discrimination index is 70,his prognosis is good c) Discrimination index is 60,prognosis is bad d) Discrimination index is 70,prognosis is bad 5. All the following are synthesized in liver except: a) Prothrombin b) Alpha 1 antitrypsin c) Anti hemophilic factor d) Gamma globulins 6. All the following helps to determine the biliary origin of ALP except: a) GGT b) Amino peptidase c) 5- Nucleotidase d) LDH-1

e) Bilirubin

1.Non Specific Esterase(NSE) is seen in which type of leukaemia: a.) AML 3 b.) AML 0 c.) ALL d.) All of the above. Answer ( C ). Ref - Robbins. Explanation: Non specific esterases are produced by cells with leukocytic differentiation. Only AML4 (others as AML3,4,5) has the criteria fulfilled. AML0 has no differentiation, AML 6 is erythrocytic and AML 7 is megakaryocytic but has nearly 40-50% of myeloblasts so it can be NSE posititve.. So the Answer is (C). 2. True about BCG vaccine is: a) Danish 1331 strain. b) Diluent is distilled water c) Spirit is used for cleaning the area. d) It prevents adult tuberculosis. Answer A: Ref -Park and Park.Explanation. BCG is a live attenuated vaccine produced by Danish 1331 strain of My.Bovis attenuated by 239 serial subcultures in glycerine-potato medium over 13years. It is included in UIP given at birth,the freeze dried powder is made into a 0.5ml intrademal injection reconstituted with sterile normal saline,over left deltoid in the upper 1/3 after cleaning with distilled water avoiding spirits and antiseptics. It oes not prevent adult TB(secondary TB) due to immunfailure.BCG protects from TB meningitis and military TB only. 3.A child has TGA the mother has to be investigated for: a) Maternal diabetes b) PIH c) Heart diseases Answer: A. 4. Which of the following retinal diseases is transmitted as Autosomal dominant disorder: a) Best disease b) Gyrate atrophy c) LMB Answer: (A). Ref Yanoff Best disease (vitelliform macular degeneration) is a rare autosomal dominant disorder (Chr. 11q13), with macular degeneration presenting as

yellow egg yolk like appearance of macula due to lipofuschin accumilation. ERG shows reduced C wave.Gyrate atrophy is ornithine tranferase deficiency.Autosomal recessive inheritance Chr 10q.

5. Which of the anticancer drug causes hyperviscosity syndrome: a) Vinblastine b) L-Asparaginase c) 5-FU d) Methotraxate. Answer B. Reference Tripatti. L-Asp is derives from E.coli,it is specifically used in ALL,devoid of normal side effects of anticancer drugs as NO ALOPECIA,NO LECOPENIA,NO MUCOSAL DAMAGE. Remmember LASP(Leucopenia,Alopecia,Skin and mucosalloss Prevented). It causes liver damage,hyperviscosity,pancreatitis and CNS symptoms. 6. Chemotherapeutic agent producing SIADH is: a) Vincristine b) 5-FU c) Cyclophosphamide d) Bleomycin e) Gemcitabin Answer: A&C . Ref Harrison. Explanation- SIADH producing drugs are : Vasopressin,oxytocin,Chlorpropamide,Vincristine,cyclophosphamide,Carbamezapine ,Phenothiazine,MAO inhibitors,SSRIs,TCAs,Nicotine. 7.Leprosy affects all exept: a) Uterus b) Ovary c) Testes d) Eyes e) Nerves Answer A&B. Ref Harrison. Explanation. 8. Which of the following is least useful in multiple myeloma: a) X-ray b) Urine protein c) Bone scan d) Bone marrow biopsy Answer C. Bone scan as there is no new bone formation so ALP is also normal. 9. Cat eyes syndrome is seen in: a) Partial Trisomy 21 b) Partial Trisomy 22

c) Partial Trisomy 13 d) Partial Trisomy 5 Answer A. Reference Nelson. Partial trisomy 21 causes Cat eye syndrome while Total trisomy 21 causes downs syndrome. Cat eye syndrome is associated with total anomalous venous return. 10. Finding in chronic DIC include all except: a) Increaded fibrinogen,antithrombin III and thrombin antithrombin complexes. b) Increased FDP and antithrombin III and decreased PT. c) Increased FDP,PT and thrombin antithrombin complexes. d) Increased FDP,PT and Platelets. Answer B. Reference Harrison. Explanation Findings in chronic DIC (thrombosis as DVT and SVT predominates) are: Modestly increased Prothrombin time(PT). Shortened or lengthened partial thromboplastin time(PTT) Normal thrombin time mostly. High,normal or low fibrinogen. High,normal or low Platelets. Increased FDP. Increased markers of DIC as thrombin antithrombin complexes,Prothtrombin fragment F1+F2 and activation marker on platelets. Note in acute DIC PT,APTT is prolonged and Fibrinogen,Platelets are decreased and FDP is increased and peripheral smear shows schistocytes. 11. Which of the following is not true of Vibrio O139: a) Produce disease indistinguishable from O1 b) Polysacharride capsule c) Isolated from chennai d) Replaced El tor as 8th epidemic in 1992. Answer: C.Ref Harisson. Explanatio it is isolated from Bengal in 1992. 12. Not true of vibrio cholerae: a) Non halophilic b) Grows in ordinary culture c) Survives well outside body Answer C. 13. A patient is in septicaemic shock which vasopressor is useful: a) Epinephrine b) Norepinephrine c) Phenylephrine d) Ephedrine Answer : B

his activity contains 18 questions.

Insulin causes the blood glucose levels to fall, but glucagon causes those levels to rise. The relationship between the two hormones would be said to be _____. synergistic permissive expressive antagonistic

The risk factors for type 2 diabetes mellitus include _____.

being overweight family history All of the options listed are correct. being a member of a high-risk population

The risk factors for type 1 diabetes mellitus include _____.

family history All of the options listed are correct. being overweight inactivity

Type 1 diabetes mellitus was previously called _____.

diabetes insipidus juvenile-onset diabetes

non-insulin-dependent diabetes adult-onset diabetes

Type 2 diabetes mellitus was previously called _____.

juvenile-onset diabetes non-insulin-dependent diabetes diabetes insipidus insulin-dependent diabetes

When a pregnant woman develops diabetes mellitus it is called _____.

type 1 diabetes mellitus diabetes insipidus gestational diabetes type 2 diabetes mellitus

Type 2 diabetes can be prevented or delayed through _____.

exercise lifestyle interventions weight loss All of the options listed are correct.

The primary risk factor for type 2 diabetes is _____.

viral infection being a member of a high risk population family history obesity

Having a high blood glucose level is called _____.

hyperglycemia diabetic ketoacidosis macrosomia hypoglycemia

Physical symptoms of type 1 diabetes include _____.

increased thirst unexplained weight loss All of the symptoms listed are correct. frequent urination

After a meal, blood glucose levels increase and stimulate the secretion of which hormone? glycogen pancreatisome glucagon insulin

Midmorning, blood glucose levels fall and stimulate the secretion of which hormone? glycogen glucagon insulin pancreatisome

Which is the most common form of diabetes?

diabetes insipidus They are all about the same frequency. type 2 diabetes mellitus type 1 diabetes mellitus

Type 1 diabetes _____.

lowers cells' sensitivity to insulin occurs only in adults occurs only with obesity involves the immune system attacking and killing pancreas cells that make insulin

Long-term complications of diabetes include _____.

impaired sensation in the hands and feet

increased risk for high blood pressure and atherosclerosis increased risk for kidney failure All the complications listed are correct.

A fasting blood glucose test level of _________________ is considered normal. 50 mg/dl to 69 mg/dl 70 mg/dl to 99 mg/dl 100 mg/dl to 125 mg/dl 126 mg/dl or higher on two separate tests

A fasting blood glucose test level of _________________ indicates diabetes. 50 mg/dl to 69 mg/dl 70 mg/dl to 99 mg/dl 100 mg/dl to 125 mg/dl 126 mg/dl or higher on two separate tests

A fasting blood glucose test level of _________________ indicates prediabetes. 50 mg/dl to 69 mg/dl 70 mg/dl to 99 mg/dl 100 mg/dl to 125 mg/dl 126 mg/dl or higher on two separate tests