MOCKBOARDS RECALL

CLINICAL CHEMISTRY RECALLS a. acid

b. buffer
1. Lactate dehydrogenase belongs to what enzyme class? c. salt
a. lyase d. base
b. transferase 10. Which of the following abnormal electrophoretic
c. hydrolase patterns best correlates with Bassen-Kornzweig
d. oxidoreductase syndrome?
a. increase in the pre-beta, beta and alpha bands
2. Which of the following conditions is cause for rejecting b. decrease in the alpha band and increase in the beta
an analytical run? band
a. Two consecutive controls greater than 2s above or c. decrease in the pre-beta and alpha bands
below the mean. d. decrease in the pre-beta and beta bands
b. One control above +1s and the other below -1s from
the mean. 11. Type of bilirubin that primarily causes jaundice in
c. Four controls steadily increasing in value but less than Dubin-Johnson syndrome
+/- 1s from the mean. a. alpha
d. Three consecutive controls greater than 1s above the b. delta
mean. c. conjugated
d. unconjugated
3. Which of the following is the primary reagent used in
the Jaffe method for creatinine? 12. The following are responsibilities of employers in
a. Sodium nitroprusside and phenol dealing with chemical hazards in clinical laboratories
b. Saturated picric acid and NaOH except:
c. Phosphotungstic acid a. make MSDS available to employees upon request
d. Alkaline copper II sulfate b. provide training to employees
c. ensure proper labelling and post appropriate warnings
4. The serum TSH level is almost absent in d. assess and supply information about chemical or
a. primary hypothyroidism physical hazards
b. primary hyperthyroidism
c. secondary hyperthyroidism 13. A cholesterol QC chart has the following data for the
d. euthyroid sick syndrome normal control:
x = 137 mg/dL
5. The statistical tool F-Test is used to determine if there Summation of x = 1.918 mg/dL
is a significant difference between ____ to detect ____ 2SD = 6 mg/dL
a. standard deviations, accuracy N= 14
b. means, precision The coefficient of variation for this set of controls is
c. means, accuracy a. 2.19%
d. standard deviation, precision b. 1.14%
c. 9.49%
6. Which of the following error-example is incorrectly d. 4.38%
matched?
a. random error-mislabeling a sample 14. Convert 25 g to mL
b. random error-changes in standard materials a. 21 mL
c. systematic error-improper calibration b. 15 mL
d. systematic error-sample instability c. 33 mL
d. 25 mL
7. Not true about proficiency testing
a. otherwise known as external quality assessment 15. Turbidity that is caused by the presence of
b. comparison of results to a reference value appreciable concentrations of exogenous triglyceride is
c. included as part of the analytical phase considered as
d. for of quality control a. pathologic.
b. artefactual.
8. Two consecutive outlier on opposite sides of the mean. c. physiologic.
a. 2-2s, systematic error d. abnormal.
b. 1-2s, random error
c. 2-1s, systematic error 16. This abnormal LDL lipoprotein, referred to as sinking
d. R-4s, random error pre-beta lipoprotein is associated with a higher risk for
atherosclerosis.
9. What substance yields hydroxyl ions when dissolved a. beta-VLDL
in water? b. LpX
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
c. LDL 25. Which of the following are considered as negative
d. Lp(a) acute phase reactants?
a. fibrinogen and haptoglobin
17. Extremely high plasma levels of ALP in the absence b. CRP and serum amyloid
of an elevated direct bilirubin. GGT or transaminases c. albumin and prealbumin
would most likely indicate which condition? d. alphal-antitrypsin and orosmucoid
a. Muscular dystrophy
b. Hypoparathyroidism 26. How much 95% ethanol is necessary to make 1 L of
c. Paget's disease or bone malignancy 70% ethanol?
d. Billiary Cirrhosis a. 0.74 L
b. 0.85 L
18. Which of the following electrolytes is involved in c. 0.75 L
neuromuscular activity? d. 0.84 L
a. sodium
b. chloride 27. Chief plasma cation, the main function of which is
c. bicarbonate osmotic pressure regulation.
d. calcium a. CI
b. К
19. A patient is admitted with biliary cirrhosis. If a serum c. Na
protein electrophoresis is performed, which of the d. Ca
following globulin fractions will be most elevated?
a. alpha-1 28. HbAIc determination is contraindicated in which of
b. alpha-2 the following conditions?
c. beta a.Thalassemia
d. gamma b. Gestational diabetes mellitus
c. Diabetes mellitus
20. Number of individuals required to establish a new d. PCOS
reference interval
a. 120 29.What are enzymes?
b. 10 a. proteins
c. 100 b. lipids
d. 20 c. carbohydrates
d.nucleic acids
21. Lipoprotein responsible for the transport of TAG
produced by the body. 30. Abnormal lipoproteins include
a. chylomicrons 1. IDL
b. LDL 2. Beta-VLDL
c. VLDL 3. Lp(a)
d. HDL 4. LpX
a. 1, 2 and 3 are correct
22. Which of the following best represents precision? b. I and 3 are correct
a. CV c. 1,2.3 and 4 are correct
b. Mean d. 2 and 4 are correct
c. Gaussian Curve
d. SD 31. According to Beer's law, the absorbance of a
substance is
23. Which variable is not directly proportional to a. directly proportional to the concentration.
absorbance? b. proportional to the square of the concentration.
a. path length c. inversely proportional to the square of the
b. concentration concentration.
c. transmittance d. inversely proportional to the concentration.
d. absorptivity
32. Which of the following is associated with turbidity in
24. How much 95% alcohol is required to make 200 mL serum?
of 5% alcohol? a. free fatty acids
a. 95.000 mL b. chylomicrons
b. 10.53 mL c. total lipids
c. 2.38 mL d. cholesterol
d. 3,800 mL

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
33. What enzymes are clinically significant in myocardial c. encoding.
infarction? d. microscopic examination.
a. LDH, ALT, AST, aldolase
b. AST, ALT, aldolase 42. What lipoprotein is the major carrier of cholesterol to
c. CK, AST, ALT peripheral tissues?
d. CK, AST, LDH a. HDL
b. LDL
34. In QC, a laboratory result that is more than 2SD from c. VLDL
the mean is expected to occur d. CM
a. 10% of the time.
b. 3% of the time. 43. Fasting Plasma Glucose = 115 mg/IL
c. 5% of the time. 2-Hour Plasma Glucose = 130 mg dL
d. 20% of the time. HbA1C= 6.0%
The results above indicate
35. Quality improvement concept that serves to make a. prediabetes, impaired fasting glucose.
laboratory procedures simple, fast and easy. b. diabetes mellitus.
a. lean c. normal results.
c. proficiency testing d. prediabetes, impaired glucose tolerance.
b. intralab OC
d. six sigma 44. Common cause of a falsely increased LD1 fraction.
a. liver disease
36. Electrolytes. when they participate in enzymatic b. specimen hemolysis
reactions, serve as c. congestive heart failure
a. activators d. drug toxicity
b. coenzymes
c. inhibitors 45. What is the proper conversion of 1 g to kg?
d. cofactors a. Divide by 100.
b. Multiply by 1000.
37. What axis of the LJ chart contains the independent c. Divide by 1000.
variables? d. Multiply by 100.
a. Y-axis
b. vertical axis 46. What is the conversion factor of T4?
c. ordinate a. 0.0595
d. abcissa b. 12.9
с. 0.357
38. A newborn is due for screening of certain metabolic d. 2.27
disorders. Which of the following is the best specimen
for such screening test? 47. Which of the following is a major risk factor for
a. arterial puncture coronary heart disease (CHD)?
b. blood spot on filter paper a. elevated level of HDL
c. skin puncture using capillary tubes b. Low level of LDL
d. venipuncture c. Hypercholesterolemia
d. hypertriglyceridemia
39. What is the most abundant NPN in blood?
a. Ammonia 48. A new machine in the clinical chemistry section
b. Creatinine arrived together with the corresponding reagents. Who
c. Uric acid should provide the MSDS?
d. Urea a. manufacturer
b. section head
40. What apolipoprotein is present in HDL and functions c. chief medical technologist employer
as its structural backbone? d. employer
а. Apo B
b. Apo C 49. What is the relationship of CV to precision?
c. Apo E a. correspondingly proportional
d. Apo A b. directly proportional
c. proportionately proportional
41. The following, if done repetitively, are ergonomic d. inversely proportional
hazards except e. all of these
a. centrifuging
b. pipetting.
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
50. Which of the following are hazards caused by liquid 58. pH = 7.30
nitrogen gas? pCO2 = 48 mmHg
a. burning sensation HC03 = 23 mmol/L
d. fire explosion What organ will compensate given the results above?
c. asphyxiation a. kidney
d. All of these b. lung
c. heart
51. Serum protein electrophoresis is most important in d. brain
determining the presence of
a. nephrotic syndrome. 59. Cortisol is an analyte that is affected by diurnal
b. liver cirrhosis. variation. It is highest in the______ and lowest in the
c. polyclonal gammopathy ____
d. monoclonal gammopathy a. morning: evening
b. evening: morning
52. The antibody titer of a patient against a certain c. morning: afternoon
pathogen is 112 mg/dL. What is the value expressed in d. evening: afternoon
SI unit?
a. 0.112 g/dI 60. Which is not a tropic hormone?
b. 1.12 g/L a. FSH
c. 0.0112 g/dI b. АСТН
d. 11.2 g/L c. LH
d. GH
53. A metal ion required for optimal enzyme activity is
known as 61. Proper arrangement of lipoproteins according to
a. coenzyme. decreasing protein content
c. catalyst. a. CM, LDL, VLDL, HDL
b. cofactor. c. CM, VLDL, LDL, HDL
d. activator. b. HDL, CM, LDL, VLDL
d. HDL, LDL, VLDL, CM
54. The following are true about delta check except
a. Most useful in detecting samples altered by IV dilution. 62. Which of the following cause/s hypokalemia in
b. Most useful in detecting mislabeled samples. vomiting?
c. Comparison of a patient's result to other patients' 1. entry of potassium into cells
results within the day. 2. renal wasting of potassium
d. Capable of detecting analytic errors. 3. extravasation of potassium from blood vessels
4. loss of gastric potassium
55. Conjugated bilinibin can be excreted out in urine a. 1 and 3 are correct
because b. 2 and 4 are correct
a. it is water-soluble. c. only 4 is correct
b. it undergoes photoisomerization. d. 1, 2, 3 and 4 are correct
c. it is water-insoluble.
d. it is carried by albumin. 63. Proper time of collection of a peak sample for TDM
a. shortly after the drug is administered.
56. The middle value of a set of numbers that are b. shortly before a drug is administered.
arranged according to their magnitude is known as c. in the morning as soon as patient wakes up
a. Arithmetic Mean d in the evening before the patient sleeps.
b. Geometric Mean
c. Median 64. This is evaluated in order to check and ensure that
d. Mode the instrument adheres to the Beer's Law.
a. Stary Light
57. Increased concentrations of ascorbic acid inhibit b. Wavelength Accuracy
chromogen production in which of the following glucose c. Linearity
methods? d. Absorbance Check
a. glucose oxidase
b. hexokinase 65. Decreased blood levels of T3 and T4 hormones
c. ortho-toluidine stimulate the hypothalamus to produce
d. ferricyanide a. TSH
b. ACTH.
c. TBG.
d. TRH.
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
66. This analyte is assayed to determine the c. liver disease.
completeness of a 24-hour urine sample. d. dehydration.
a. urea
b. albumin 75. Best sample for the diagnosis of acute toxicity with
c. creatinine elemental mercury.
d. glucose a. nail
b. 24-hour urine
67. Cushing's disease is associated with c. hair
a. hypersecretion of growth hormone d. whole blood
b. hypersecretion of ACTH
c. hyposecretion of growth hormone 76. Therapeutic Drug Monitoring (TDM) is based on the
d. hyposecretion of ACTH principles of
a. pharmacokinetics
68. What parameter is used to differentiate primary from b. pharmacodynamics
secondary hypothyroidism? c. pharmacology
a. Т3 d. pharmacy
b. TSH
c. T4 77. Which of the following statements is true about
d. TRH stimulation test partially compensated respiratory alkalosis?
a. Renal reabsorption of HCO3 is decreased.
69. An anticoagulant that prevents in vivo and in vitro b. More CO2 is eliminated through the lungs by
clotting. hyperventilation.
a. heparin c. HCO3 is higher than normal.
b. citrate d. pCO2 is higher than normal.
c. oxalate
d. EDTA 78. A patient who had increased ingestion of legumes is
expected to have an increased level of what NPN?
70. Tetany, which involves irregular muscle spasms, is a. ammonia
attributed to decreased blood concentration of what b. creatinine
clectrolyte? c. uric acid
a. magnesium d. urea
b. potassium
c. calcium 79. What substance makes the body alkaline?
d. sodium а. НСO3
b. H2O
71. Which of the following is incorrect? c. O2
a. uric acid: end-product of purine metabolism b. d. CO2
b. creatinine: end-product of muscle metabolism
c. urea: end-product of protein metabolism 80. Age group associated with the following serum
d. ammonia: end-product of lipid metabolism cholesterol cut-off points:
Moderate Risk: >220 mg/dL
72. LDH is added to the substrate mixture of which High Risk: >240 mg/dL
enzyme assay to cause rapid exhaustion of endogenous a. 30 to 39 years old
pyruvate? b. 2 to 19 years old
a. ALT c. 20 to 29 years old
b. AST d. 40 years old and above
c. ALP
d. СK 81. Which of the following analytes is/are decreased in
liver damage?
73. A patient who is due for lipid profile should be 1. albumin
instructed to fast for 2. ammonia
a. 10 hours 3. total protein
b. 12 hours 4. ALT
c. 8 hours a. 2 and 4 are correct
d. 14 hours b.1,2,3 & 4 are correct
c. 1 and 3 are correct
74. The following conditions cause hypoalbuminemia d. 1,2 & 3 are correct
except
a. nephrosis.
b. starvation.
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
82. A malignant tumor present in the ureter causes d. Polar and water-soluble
a. post-renal azotemia.
b. pre-renal azotemia. 91. What is the expected level of blood cholesterol in
c. renal azotemia. Grave's disease?
d. azotemia. a. variable
b. decreased
83. Hashish, the most potent form of marijuana, is a c. normal
resin that is derived from d. increased
a. coca plant.
b. poppy plant. 92. Convert 10 mL to uL
c. opium plant. a. 100 uL
d. cannabis plant. b. 1.000 uL
c. 100.000 uL
84. This pertains to the proportion of persons with a d. 10.000 uL
positive test who truly have the disease.
a. Diagnostic Sensitivity 93. Under what conditions should the sample for blood
b. Positive Predictive Value gas determination be maintained while it is in transport
c. Negative Predictive Value to the laboratory?
d. Diagnostic Specificity a. Anaerobic temp
b. Aerobic in ice water
85. Light that carries high energy but with short c. Anaerobic, in ice water
wavelength. d. Aerobic at room temperature
a. Ultraviolet Light
b. Infrared Light 94. Sample that is most reflective of the basal state is
c. Visible Light collected
d. Radio Light a. when the patient is asleep.
b. in the afternoon.
86. An enzyme that utilizes para-nitropheylphosphate as c. in the evening.
its substrate and reacts best at pH 9.6 would be mostly d. in the morning.
elevated in cases of
a. Pernicious anemia. 95. Which of the following hormones is important in
b. Paget's disease. regulating normal plasma osmolarity?
c. Prostatic carcinoma. a. Thyroxine
d. Pesticide poisoning. b. Aldosterone
c. Cortisol
87. Purpose of glycogenesis d. PTH
a. energy storage I
b. energy production 96. Long turnaround time is an error in the
c. energy distribution a. analytical phase.
d. energy utilization b. pre-analytical phase.
c. It is not considered an error
88. The detector of this instrument is positioned at a 90 d. post-analytical phase
deg angle from the incident light.
a. Photometer 97. Which of the following is not correct about secondary
b. Spectrophotometer hypothyroidism?
c. Nephelometer a. Involves a defect in the anterior pituitary gland.
d. Fluorometer b. Patient experiences cold intolerance.
c. Thyroid hormones are decreased.
89. The following autoantibodies are implicated in d. Level of TSH is elevated.
Hashimoto's thyroiditis except
a. Anti-microsomal Ab 98. Unless blood gas measurements are performed
b. Anti-thyroid peroxidase Ab immediately after sampling. in vitro glycolysis of the
c. Anti-TSH receptor Ab blood causes a
d. Anti-thyroglobulin Ab a. fall in pH and rise in pO2
b. rise in pH and pCO?
90. Which of the following does not describe conjugated c. rise in pH and a fall in pO2
bilirubin? d. fall in pH and a rise in CO2
a. Cannot be excreted in the urine
b. Reacts directly with the color reagent
c. Attached to glucuronic acid molecule
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
99. 3.5 mmol/L K+ is equivalent to
a. 0.35 mEq/L
b. 0.88 mEg/L 5. The waste product of muscle
c. 1.0 mEg/L
metabolism, which can be useful in
d. 3.5 mEq/L
evaluating glomerular function is
100. The major cation found in cells is
a. sodium. A. Isnulin
b. potassium.
c. chloride. B. Creatinine
d. calcium.
C. Urea
CLINICAL MICROSCOPY RECALLS D. Uric Acid
1. This physical property of urine offers

the simplest way to check concentration &

6. Which of the following causes
dilution funtion of kidney tubules:
post-renal proteinuria?
- SPECIFIC GRAVITY
I. Glomerular disorders

II. Fanconi syndrome

2. A sperm motility grading of 2.0 is
III. Inflammation
interpreted as:
IV. Multiple myeloma
A. No forward progression

B. Slow forward progression with

7. The following situations may lead to a
noticeable lateral movement
positive result for blood using a reagent
C. Slower speed, some lateral
strip EXCEPT:
movement
A. Malaria
D. Rapid, Straight line motility
B. Strenuous exercise

C. Muscle destruction
3. Increase in this type of epithelial cell
D. High ascorbic acid
suggests tubular damage

A. Squamous epithelial cell

8. Patient Mario is suffering from ethylene
B. RTE
glycol poisoning. Which crystal is most
C. Transitional epithelial cell
likely seen as increased in his urine?
D. Cuboidal epithelial cell
A. uric acid

B. amorphous rates
4. The failure to convert phenylalanine to
C. calcium oxalate
_____ leads to phenylketonuria.
D. cholesterol
A. Cystine

B. Tyrosine
9. Statement I. Cortical nephrons are
C. Homogentisic acid
responsible primarily for removal of waste
D. Indican
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
products and reabsorption of nutrients. A. Neutrophils

Statement II. Juxtamedullary nephrons' B. Eosinophils

primary function is concentration of urine C. Red Blood Cells

⁃ Both statements are true D. Casts

10. A disease with a characteristic hops 15. Tiny, colorless, dumbbell-shaped

odor of urine: crystals were found in and alkaline urine

A. Phenylketonuria sediment. They most likely are:

B. Methionine Malabsorption A. Calcium oxalate

C. Tyrosinemia B. Calcium carbonate

D. Isovaleric Acidemia C. Amorphous phosphates

D. Calcium phosphates

11. The major constituent of casts: 16. Normal urine contain

A. Bence Jones Protein WBCs/HPF

B. Mucinoids A.1-2

C. Tamm-Horsfall protein B.1-3

D. Hyaline C.2-5

D.5-8

12. Polyuria is seen in all of the following

conditions, EXCEPT: 17. The ova of which parasite may be

A. Chronic nephritis found in the urinary sediment:

B. Nervous conditions A.T. vaginalis

C. Diabetes insipidus B. E. histolytica

D. Glomerulonephritis C.S. haematobium

D.T. trichiura

13. These are screening tests for

alkaptonuria EXCEPT 18. ADH increases the permeability of the

A. Ferric chloride tube test distal convoluted tubule and collecting

B. Benedict's test duct which results in

C. Ehrlich's test - for urobilinogen ⁃ Increase concentration of

D. Alkalinization of urine water lowering the volume of urine.

14. Hansel Stain is used to visualize what 19. The term used to describe disorders

microscopic sediment: that result from the disruption of normal

JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
metabolic pathway that causes increased A. Nephron

plasma concentration of unmetabolized B. Glomerulus

substances are coined as: C. Hepatocyte

A. Overflow type D. Tubules

B. Renal type

C. Both 25. The normal value of CSF protein is:

D. Neither A. 15-45 mg/dL

B. 15-45 g/dL

20. The principle of the protein error of indicators C. 70-110 mg/dL

reaction is that:
D. 70-110 g/dL
A. Protein changes the pH of the urine

B. Albumin accepts hydrogen ions from the indicator

26. Of the routine chemical tests performed on urine,
C. The indicator accepts ions from albumin which is the most indicative of renal disease?

D. Albumin changes the pH of the urine A. pH

B. Glucose

21. Which of the following dietary substances can cause C. Protein

a false negative fecal occult blood slide test?
D. Leukocyte esterase
A. Ascorbic acid

B. Fish
27. The reaction of p-dimethylaminobenzaldehyde in
C. Red meat acid buffer with urobilinogen is referred to as:

D. Fruits and vegetables A. Ehrlich's reaction

B. Jaffe's reaction

22. Fatty casts are seen in these conditions except: C. Rutherford's reaction

A. Crush injuries D. Griess' reaction

B. Allograft rejection

C. Toxic tubular necrosis 28. This method for determination of the

D. Diabetes mellitus specific gravity of urine utilizes the

comparison of the velocity of light in air

23. What part of the kidney is responsible for the bulk of with the velocity of light in a solution.
the bicarbonate reabsorption/generation?
A. Refractometer
A. Proximal renal tubule
B. Urinometer
B. Distal renal tubuleC. Descending loop of Henle
C. Harmonic Oscillation densitometry
D. Ascending loop of Henle
D. Reagent Strip

24. Major functional unit of the kidney is:

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
29. These are PRERENAL causes of a. Rare, Few, moderate, many per HPF

acute renal failure EXCEPT: b. Average no. per HPF

A. Hemorrhage c. Average no. per LPF

B. Burns d. Rare, few, moderate, many per LPF

C.Surgery

D. Tumors 34. Excessive fat metabolism, as seen In

diabetes mellitus, is indicated by the

30. A CSF sample has the following results: Elevated presence in the urine of
WBC count, lymphocytes and monocytes are present,
:A. Cholesterol
protein is moderately to markedly elevated, glucose
level is decreases, lactate level is >25 mg/dL and B. Triglyceride
pellicles are present. What is the suspected cause of C. Ketone bodies
meningitis in this scenario?
D. Glucose
⁃ Tubercular meningitis

35. A patient's urine specific gravity

31. CSF sample is submitted to the
reading using reagent strip is 1.030. What
laboratory and is being requested for
is the corrected specific gravity when the
gram stain and india ink. The results after
specimen contains 1 g/dl of protein and 2
the tests have been done are as follows:
g/dL of glucose and the temperature is
Gram stain=startburst pattern
23°C.
India=negative. What does this suggest?
A. 1.019
A. Presence of Cryptococcus neoformans
B. 1.023
B. Contamination
C. 1.030
C. Negative for Cryptococcus neoformans
D. 1.018
D. Invalid result

36. Increase in urine volume can be

caused by the following except:

A. Diabetes insipidus
32. Organic solid in urine:
B. Diabetes mellitus
A.Uric acid
C. Hyperglycemia
B.Creatinine
D. Acute tubular necrosis
C. Both

D. Neither
37. What are the most common renal

stones encountered in the clinical

33. What is the manner of reporting for
laboratory?
RTE cells in urine?
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
A. Calcium oxalate 42. The best single indicator of renal

B. Cystine abnormality with glomerular involvement

C. Uric acid is:

D. Calcium carbonate A. Glucose

B. Protein

38. Which of the following causes fruity C. Casts

odor of urine? D. WBC

A. Diabetes mellitus

B. Pseudomonas infection 43. Tubular Proteinuria/Disorders:

C. Contamination I. Multiple Myeloma

D. Tyrosinemia II. Fanconi Syndrome

III. Cadet Proteinuria/orthostatic

39. This glomerular disorder refers to the protenuria

disruption of electrical charges that IV. Toxic agents

produce the tightly fitting podocyte barrier V. Severe viral infections

resulting in massive loss of protein and THREE OF THESE

lipids.

A. IgA nephropathy 44. These yellow brown crystals are seen

B. Minimal change disease in various shapes including rhombic,

C. Membranous glomerulonephritis four-sided flat plates (whetstones),

D. Nephrotic syndrome wedges and rosettes and are seen in

patients with leukemia who are receiving

40. The normal pH range of urine chemotherapy.

is______ A. Cystine

Random urine: 4.5-8 B. Uric Acid

1st morning voided urine: 5-6 C. Calcium oxalate

D. Ammonium biurate

41. At a temperature of 32C, a urine

specific gravity using a urinometer 45. What is the best method to determine

calibrated at 20C, reads 1.015. If a the specific gravity of a patient's urine who

temperature correction is employed, what has been injected with radiographic

would the corrected specific gravity be? contrast media?

⁃ 1.019 A. Reagent strip

B. Refractometry
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
C. Urinometry B. urobilinogen,; amorphous phosphates

D. Harmonic Oscillation Densitometry C. urobilin; amorphous urates

D. uroerythrin; amorphous urates

46. Select the term used to describe a

decreased volume of amniotic fluid 51. What is the positive result in a

present in the amniotic sac cyanide-nitroprusside test?

A. Anhydramnios A. Red purple color

B. Oligohydramnios B. White precipitate

C. Hydramnios C. Blue color

D. Polyhydramnios D. White ring between two layers

47. The unit for reporting sperm count is

in: 52. It comprises half of total urinary

A.Million/ejaculate dissolved organic solids

B. Million/mL - sperm conc. A. Uric Acid

B. Urea

48. Reagent strip test for ketones react C. Creatinine

most strongly with: D. Electrolytes

A. Acetone

B. Beta-hydroxybutyric acid 53. These are the standard tests used to

C. Acetoacetic acid measure the filtering capacity of glomeruli.

D. Phenylketone A. Concentration Tests

B. Tubular Reabsorption Tests

49. Swollen or created red blood cells are C. Tubular Secretion Tests

sometimes mistaken as __ D. Clearance Tests

A. Yeasts

B. WBCs 54. Which of the following is true when a

C. pollen grain medical technologist is considering to

D. fat droplets perform microbiological test to a CSF

specimen?

50. What pigment is most evident in urine A. Use tube number 1, store at room temperature

specimens that have been refrigerated? B. Use tube number 2, store at room temperature

This pigment causes the precipitation of C. Use tube number 3, store at 2-8 degrees Celsius

_______ D. Use tube number 2, store at 2-8 degrees Celsius

A. urochrome; amorphous phosphates

JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
55. Which of the following is the correct renal blood flow? 60. Xanthochromia is termed to describe

- Affrent= entrance CSF supernatant that is:

⁃ Efferent =exit A. Pink

B. Orange

56. Which of the following is NOT an action of RAAS? C. Yellow

Renin-angiotensin-aldosterone system D.All of the above

⁃ Activated when there’s perceived blood flow in the

kidney
61. Created RBCs can be seen in urine

that is:
57. The urinary pH 2hours post prandial is
A. Hyposthenuric
expected to be:
B. Hypersthenuric
A. Alkaline
C. Highly Acidic
B. Acidic
D. Highly Alkaline
C. Neutral

D. Variable
62. All of the following may cause purple

staining of catheter bags, EXCEPT:

58. What can a medical technologist
A. Indicans
confirm from this laboratory result for
B. Klebsiella spp
protein:
C. Providencia spp.
Reagent strip: Negative
D. E. coli
SSA test: Positive

A. The urine is highly alkaline

63. The urine clarity is cloudy. How the
B. Presence of albumin
medical technologist describe urine?
C. The urine has high specific gravity
A. No visible particulates, transparent
D. Presence of protein other than albumin
B. Few particulates, print easily sees

through urine
59. What is the diluting fluid used in
C. Many particulates, print blurred through
performing WBC Count in a CSF
urine
specimen?
D. Print cannot be seen through urine
A. NSS

B. 3% Acetic Acid
64. The clinitest tablet contains the
C. Rees and Ecker fluid
following reagents, EXCEPT:
D. Turk's solution
A. glucose oxidase

B. sodium carbonate
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
C. copper sulfate B. Curschmann's spirals

D. sodium hydroxide C. Clara cells

D. Creola bodies

65. What is the reagent in Multistix strip

for nitrite? 70. This analyte in CSF is frequently tested among

patients with coma of unknown origin and is commonly
A. p-arsanilic acid elevated among children with Reye's syndrome.
B. p-DMABA A. Myelin Basic Protein
C. 2,4- dichloroaniline diazonium salt B. Lactate
D. hydroxytetrahydro benzoquinoline C. Glutamine

D. Enzymes
66. All of the following are factors involve in the
formation of casts in the urine, EXCEPT:
71. Casts should be reported as:
A. urinary stasis
A. average number per LPF
B. high solute concentration
B. rare, few, moderate, many per LPF
C. presence of protein
C. 0-2, 2-5, 5-10 per LPF
D. increased alkalinity
D. rare, few, moderate, many per HPF

67. Majority of disorders associated with

72. This refers to the sterile, inflammatory process that
the glomerulus are of what origin? affects the glomerulus and is associated with the finding
A. Genetic of blood, protein, and casts in urine.

B. Immune A. Pyelonephritis

C. Metabolic B. Renal calculi

D. None of the above C. Glomerulonephritis

D. Vasculitis

68. All of these are factors that influence

cast formation EXCEPT: 73. Normal specific gravity of urine is:

A. Decreased urinary pH 1.005-1.30

B. Increased urine output

C. Increase in solute concentration 74. Ictotest tablet is used to test the

D. Increased protein presence of:

A Blood

69. Clusters of columnar cells in sputum B. Bilirubin

associated with bronchial asthma. C. Urobilinogen

A. Charcot-leyden crystals D. Nitrite

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
75. Which of the following cells when 79. These urinary crystals appear as

found upon microscopic examination of colorless or yellowish needles or slender

the urine would be most Indicative of prisms occurring in sheaves or cluster.

kidney disease? A. Tyrosine

A. Squamous epithelial cells B. Calcium sulfate

B. Tubular epithelial cells C. Sodium urates

C. WBCs and bacteria D. Sulfonamide

D. RBCs

80. This urine crystal which may have

76. A patient's urine specimen appears six-sided shape is erroneously identified

turbld at 40°C and clear at boiling point as cystine. What is this crystal?

temperature. What is the most likely A. uric acid

protein that is present in the specimen? B. calcium carbonate

A. Albumin C. calcium oxalate

B. Hemoglobin D. tyrosine

C. Tamm-Horsfall protein

D. Bence Jones protein 81. This is the specific gland that releases ADH.

A. Anterior Pituitary gland

77. What is the molecular weight of plasma substances B. Posterior pituitary gland
that will NOT be filtered by the glomerulus?
C. Hypothalamus
A. greater than 70, 000
D. Adrenal gland
B. less than 70, 000

C. greater than 50, 000

82. A positive copper reduction test with negative
D. less than 50,000 glucose using urine dipstick indicates:

A. (+) reducing sugar, (+) glucose

78. Which of the following is (are) quality B. (+) reducing sugar, (-) glucose

control procedure(s) of reagent strips? C. (-) reducing sugar, (-) glucose

I. Strips must be checked with both positive and negative D. Invalid result
controls a minimum of once every 24 hours.

Il. Testing is performed when a new bottle of reagent

strips is opened. 83. All of the following are soluble in dilute acetic acid,
EXCEPT:
III. Distilled water is used as a negative control.
A.RBCs
IV. Resolve control results that are out of range by
further testing. B. WBCs

THREE OF THESE C. Amorphous phosphates

D. Carbonates
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
B. Uric acid

84. Urine tested with Clinitest exhibits a C.Magnesium ammonium phosphate (triple
phosphate)
pass through reaction and is diluted by
D. Cholesterol
adding 2 drops of urine to 10 drops of

water, this is a dilution of:

89. What is the type of cast that is
A 1:4
frequently referred to as renal fallure cast?
B. 1:5
A. broad cast
C. 1:6
B. waxy cast
D. 1:7
C. granular cast

D. hyaline cast
85. This specific gravity method is based

on the principle that the frequency of a

90. Which of the following causes false
sound wave entering a solution changes
positive reaction in blood reagent strip?
in proportion to the density of the solution
I. Strong oxidizing agents
A. Refractometry
II. Menstrual contamination
B. Harmonic Oscillation
III. Bacterial peroxidases
C. Urinometry
IV. Crenated cells
D. Reagent Strip
THREE OF THESE

86. The renal threshold for glucose is:

91. All of the following statements conform
160-180 mg/L
to proper handling and storage of reagent

strips, EXCEPT
87. Analyte tested in the reagent strip which utilizes the
double sequential enzyme reaction A. Reagent strips are packaged in opaque

A. Ketones containers with a desiccant to protect from

B. Bilirubin light and moisture

C. Protein B. Bottles should be opened in the

D. Glucose presence of volatile fumes.

C. Reagent strips should be stored at

room temperature below 30 degree

Celsius

88. Which of the following crystals is seen D. Care must be taken not to touch the

commonly in alkaline and neutral urine? chemical pads when removing the strips.

A. Calcium oxalate

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
92. What is the dimension of Makler standing at room temperature and convert

Counting Chamber used in seminal fluid nitrite to nitrate

analysis? C. The urine may not have remained in

(mm2= square millimeter) the bladder long enough for the nitrate to

0.12x0.1mm2 be converted to nitrite

D. The bacterial enzymes may have

93.These cells are smooth, colorless, reduced nitrate to nitrite and then

usually ovoid cells with doubly refractile converted nitrite to nitrogen, which will

walls give a negative nitrite result

A. Red cells

B. Bacteria 97. What is the fluid aspirated by paracentesis?

C. Yeast A. Pleural

D. WBCs B. Peritoneal

C. Pericardial

94. Griess' reaction is incorporated in the D. Synovial

dipstick reaction for:

A. Urobilinogen 98. What are the two indicators incorporated in the

reagent pad for pH?
B. Bilirubin
A. Methyl red and bromthymol blue
C. Nitrite
B. Methyl red and tetrabromphenol blue
D. Ketone
C. p-DMABA and bromcresol purple

D. Ethyl red and bromthymal blue

95. Most pathologic crystals are found in:

A. Acidic urine

B. Alkaline urine
99. In respiratory or metabolic acidosis not
C. Neutral urine
related to renal function disorders, the
D. Alkaline to neutral urine
expected urine is:

A. Alkaline
96. A negative nitrite test should never be
B. Neutral
interpreted as the absence of bacterial
C. Acidic
infection. The following are reasons for
D. Varied
this, EXCEPT:

A. There might be pathogens in the

100. Positive color for leukocyte reagent
specimen that do not form nitrite
strip is
B. Organisms may grow in specimen left
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
A. Yellow b. 4 weeks
c. 12 months
B. Purple d. No deferral *
C. Green
8. According to AABB standards, which of the following
D. Brown is the deferral for donors treated for nonhematologic
cancer?
a. 3 years
ISBB MOCK RECALLS b. 5 years *
1. Which of the following components should not be c. Indefinitely
prepared from RBs labeled as low - volume units? d. Permanently
I. RBCs
II. Platelets 9. What type of inheritance is expressed by hemizygous
III. FFP IV. Cryoprecipitate males and by both heterozygous and homozygous
A. One of these females?
B. Two of these a. Sex-Linked Dominant Inheritance *
C. Three of these * b. Sex-Linked Recessive Inheritance
D. All of these c. Either
d. Neither
2. Which of the following quality is intended to enable an
organization to attain higher levels of performance by 10. Which of the following refers to the physical
creating new or better features that add value by association between 2 genes that are located on the
removing deficiencies in the process, product, or service? same chromosome and are inherited together?
a. Quality control a. Linkage *
b. Quality assurance b. Crossing over
c. Quality management c. Haplotype
d.Quality improvement * d. None of these

3. Which of the following is performed to ensure the 11. Which of the following is the most frequent target
proper functioning of materials, equipment, and methods gene to identify a fetus at risk for Anemia of neonate?
during operations? a. RHCe
a. Quality control * b. RHD *
b. Quality assurance c. RHCE
c. Quality management d. None of these
d. Quality improvement
12. Which of the following blood group is considered as
4. Which of the following is the frequency of quality the most important in transplantation medicine?
control for Ambient platelet storage? a. ABO *
a. Daily b. Rh
b. Quarterly c. Lewis
c. Weekly d. A and B
d. Every 4 hours *
13. Which of the following may be the cause of
5.Which of the following is the frequency of quality weak/missing ABO red cell reactivity?
control for temperature of waterbaths? I. ABO subgroup
a. Daily II. Leukemia
b. Day of use III. Transfusion
d. Every 4 hours * IV. Transplantation
a. One of these
6. According to AABB standards, what is the deferral b. Two of these
period for a person who took Bovine insulin c. Three of these
manufactured in United Kingdom? d. All of these *
a. 1 year
b. 2 years 14. Which of the following are criteria used for
c. Permanently differentiation of weak B phenotypes?
d. Indefinitely * I. Strength and type of agglutination with anti-B, anti-A, B
and anti-H
7. According to AABB standards, what is the deferral for II. Presence or absence of ABO isoagglutinins in the
receipt of intranasal live attenuated flu vaccine? serum
a. 2 weeks III. Adsorption-elution studies with anti-B
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
IV. Molecular testing AHG test?
a. One of these a. Standardize antiglobulin sera
b. Two of these b. Confirm true negative antiglobulin reactions
c. Three of these c. Both *
d. All of these * d. Neither

15. Which of the following are the common sources of 22. Which of the following are the criteria for abbreviated
technical errors resulting in ABO discrepancies? cross match?
I. Incorrect or inadequate identification of blood a. The current antibody screen on the patient is
specimens, test tubes, or slides completely negative
II. Cell suspension either too heavy or too light b.There is no past history of clinically significant
III. Clerical errors or incorrect recording of results antibodies
IV. Missed observation of hemolysis c. Both of these *
a. One of these d. Neither of these
b. Two of these
c. Three of these 23. In urgent situations and the patient's blood type is
d. All of these * unknown, what component should be issued?
a. Group O Rh negative packed RBCs *
16. Which of the following was the first anticoagulant b. Group AB Rh negative packed RBCs
recommended for use? c. Group O Rh positive packed RBCs
a. Sodium citrate d. Group AB Rh positive packed RBCs
b. Sodium phosphate *
c. Citrate dextrose solution 24. Which of the following is the most common
d. None of these screening test for a possible fetal bleed in an RhD-
negative mother?
17. What type of hemolysis is usually caused by a. Rosette test *
antibodies directed against the ABO antigens? b. Kleihauer-Betke test
a. Intravascular hemolysis * c. Flow cytometry
b. Extravascular hemolysis d. None of the above
c. Either
d. Neither 25. According to AABB standards, a pretransfusion
specimen for testing and red cell transfusion is valid for
18. What type of hemolysis is caused by Rh antibodies? how many hours?
a. Intravascular hemolysis a. 24 hrs
b. Extravascular hemolysis * b. 36 hrs
c. Either c. 48 hrs
d. Neither d. 72 hrs *

19. Which of the following are true regarding 26. Which of the following blood types can donate
Duffy antibodies? plasma component during emergency cases?
I. They are associated with HDFN and both immediate a. A
and delayed transfusion reactions. b. B
II. They are usually IgM isotype reactive at room c. AB *
temperature and are detedted only in DAT. d. O
III. Clinically, antiFya is the most common alloantibody
encountered and can be observed in Fy (a-) individuals 27. Which of the following is the temperature
of all races. requirement for allogeneic donor?
a. I only a. less than or equal to 99.5 F *
b. Il and III b. less than or equal to 86.5 F
c. I and III * c. less than or equal to 96.5 F
d. I, II, and III d. less than or equal to 95.6 F
e. None of the above
20. Which of the following test is the single most
important in vitro immunologic reaction in blood banking? 28. Which of the following is the deferral for donors who
a. Precipitation received rubeola vaccine?
b. Flocculation a. 2 weeks *
c. Hemagglutination * b. 4 weeks
d. None of the above c. 1 month
d. 12 months
21. What is the purpose of the check cells in e. B & C
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
IV. washing with 1.5% saline
29. What is the ratio of ACD-A anticoagulant to blood in V. final wash of 0.2% dextrose in normal saline
a blood bag? a. I-II-V
a. 1.4:10 b. I-III-V *
b. 1.5:10 * c. II-IV-V
c. 1.6:10 d. III-IV-V
d. 1.7:10 e. I-II-III-IV-V
e. Either A or B
35. What is the purpose of adenine incorporated in the
30. Which of the following blood component is indicated CPD solutions?
for persons with anaphylactic transfusion reactions to a. increases ADP levels *
ordinary RBCs? b. reduce hematocrits from around 70% to 85% to
a. whole blood around 50% to 60%
b. leukocyte-reduced RBCs c. protects against storage-related hemolysis
c.washed RBCs * d. maintains pH during storage
d. Platelets e. None of the above
e. fresh frozen plasma

31. Which of the following statements is true regarding 37. Which of the following is the correct match with
the storage of blood components? regards to the change observed in RBC storage lesion?
I. Platelets: 20-24C without constant agitation I. Glucose-Increased
II. Granulocytes: 20-24C with constant agitation II. ATP-Decreased
III. Frozen Cryoprecipitate: - 18C IV. FVIII concentrate: III. Lactic acid- Decreased
1-6C IV. pH-Decreased
а. I and II a. I and III
b. III and IV * b. I and II
c. I, Il, and III c. II and III
d. I and IVY d. Il and IV *
e. I, II, III, IV e. I, II, III, IV

32. Which of the following statements are true? 38. According to the DOH manual on blood donation and
I. Whole blood will increase the hemoglobin by 1g/di and counselling, what is the deferral for a person who
hematocrit by 3% underwent corneal transplant?
II. RBC aliquots will increase the hemoglobin by 3g/ dl a. 1 year *
III. Irradiated RBCs will increase the hemoglobin by 3.5g b. 2 years
/ dI c. 3 years
IV. Leukoreduced RBCs will increase the hemoglobin by d. No deferral
1g/dI
a. Iand II 39. Which of the following is found on the glycoprotein
b. III and IV Band 3?
c. I, Il, and III a. Diego *
d. I and IV * b. Xg
e. I, II, III, and IV c. Cartwright
d. Scianna
33. All of the following are the true of the additive e. Knops
solutions, EXCEPT:
a. extends the shelf-life of RBCs to 42 days by adding 40. Which of the following are true regarding
nutrients Lewis antibodies?
b. allows for the harvesting of more plasma and platelets I. They are generally IgG and can cross the placenta
from the unit II. This antibodies do not cause Hemolytic Disease of the
c. produce an BC concentrate of lower viscosity that is Newborn
easier to transfuse III. Most Lewis antibodies agglutinate saline suspended
d. A and B RBCs
e. None of the above * IV. Lewis antibodies can bind the complement
a. I only
34. Which of the following is the proper removal of b. I and II
glycerol? c. Il and III
I. washing with 12% saline d. II, Ill, and IV *
Il. washing with 12.5% saline e. 1, II, III, and IV
III. washing with 1.6% saline
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
41. Which of these antigens are found in the hydatid cyst a. whole blood
fluid of individuals infected with b. packed RBC
Echinococcus granulosus c. platelets *
a. P1 d. FFP
b. Pk e. Cryoprecipitate
c. P2
d. A and C 49. All of the following viruses may cause transfusion-
e. A and B * associated diseases, EXCEPT
a. West Nile virus
42. Which of the following are true regarding I blood b. Cytomegalovirus
group system? c. Epstein-Barr Virus
I. I and i are not antithetecal antigens d. Parvovirus B19
II. Both I and i are high-prevalence antigens, but they are e. None of the above *
expressed in reciprocal relationship that is
developmentally regulated 50. Which of the following causes transmissible
III. Anti-I is a fairly rare antibody that gives strong spongiform encephalopathies?
reactions with cord RBs and i RBCs a. West Nile virus
IV. Anti-i is a common antibody found in virtually all sera d. Epstein-Barr virus
a. I only c. Creutzfeldt-Jakob disease *
b. I and II * b. Cytomegalovirus
c. Il and III e. Parvovirus B19
d. III and IV
e. I, II, III, and IV 51. Which of the following is the stimulus for the TNF-
alpha production?
44. Which of the following is defined as a reaction in a. lipopolysaccharide *
which signs and symptoms present within 24 hours of b. protein
transfusion? C. carbohydrate
a. Hyperacute transfusion reaction d.chemokines
b. Acute transfusion reaction e. none of the above
c. Delayed transfusion reaction
d. A and B 52. What is the function of Serum Amyloid A in plasma?
e. None of the above a. it plays a role in the metabolism of cholesterol *
b. activation of the complement by the classical pathway
45. Which of the following transfusion reactions presents C. opsonization
with body temperatures usually (2C or more above d. precipitation and agglutination
normal?
a. Transfusion-associated sepsis 53. Which of the following is a protein that was originally
b. Febrile nonhemolytic transfusion reaction discovered in the fruit fly Drosophila?
c. Allergic transfusion reaction a. Selectin
d. A and B b. Chemotaxin
e. A and C c. Lysosomes
d. Toll *
46. Which of the following blood component is indicated
to reduce HLA alloimmunization and CMV transmission 54. Which of the following receptors recognizes teichoic
a washed RBCs acid and peptidoglycan in gram-positive bacteria?
b. leukocyte-reduced RBCs a. TLR1
c. granulocyte pheresis b. TLR2 *
d. cryoprecipitate c. TLR3
e. B and C d. TLR4

47. Which of the following component is best indicated 55. Which of the following receptors recognizes
for patients with hemophilia B? lipopolysaccharide in gram-negative bacteria?
a.Fresh frozen plasma a. TLR1
b. Cryoprecipitate b. TLR2
c. Factor IX complex * c. TLR3
d.Immune globulin d. TLR4 *
e. None of the above
56. Which of the following organs mainly function to
48. Which of the following blood component is more respond to pathogens entering the respiratory and
prone to bacterial contamination alimentary tracts?
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
a. Tonsils * c. Anti-histone
b. Lymph nodes d. Anti-DNP
c. Spleen e. Anti-Sm
d. Peyer's patches
e. None of the above 65. Which of the following trypanosome is used as a
substrate for ds-DNA assay?
57. All of the following are the distinctive markers found а. Crithidia lucilae *
in pro-B cell, EXCEPT: b. Trypanosoma cruzi
a. CD19 C. Trypanosoma brucei
b. CD45R d. Leishmania
c. CD43 e. A and D
d. CD24
e. CD22 * 66. Which of the following is an organized mass of cells
which grows into the joint space and invades the
58. Coding for light chains occurs on what chromosome? cartilages?
a. chromosome 2 or 22 * a. rheumatoid factor
b. chromosome 1 and 11 b. lupus
c. chromosome 3 and 12 c. pannus *
d. chromosome 2 and 11 d. inflammation
e. chromosome 4 and 8 e. None of the above

59. All of the following are functions of IgG, 67. Which of the following is the major virulence factor of
EXCEPT group A streptococci?
a. provides immunity for the newborn a. Streptolysin 0
b. fixes complement b. Streptolysin S
c. Opsonization c. M protein
d. neutralizes toxins and viruses d. A and B
e. patrol mucosal surfaces * e. Streptokinase

60.1gM has how many functional binding sites? 68. Which of the following is the major cause of both
a. 5 gastric and duodenal ulcer?
b. 6 a. Helicobacter pylori *
d. 10 * b. Streptococcus pyogenes
e. 11 c. Yersinia pestis
c. 7 d. Campylobacter jejuni
e. Helicobacter jejuni
61. All of the following are functions of IgM, EXCEPT:
a. complement fixation 69. Which of the following is the protein ponsible for the
b. participates in agglutination reaction severity of the disease used by Helicobacter pylori?
c. triggers the classical complement pathway a. CagA protein*
d. toxin neutralization b. streptokinase
e. play a role in B-cell activation * c. urease
d. hyaluronidase
62. All of the following are true of IgA, EXCEPT: e. None of the above.
a. acts as a first line of defense
b. capable of fixing the complement * 70. Which of the following is currently the method choice
c. IgA2 is found as a dimer for detecting rickettsial infections?
d. it is found in the serum, milk, saliva, tears and sweat a. Culture
b. Biochemical testing
63. All of the following are true of IgD, EXCEPT: c. DNA amplification
a. plays a role in B-cell activation d. RNA amplification
b. regulates B-cell maturation and differentiation e. Serodiagnosis *
c. has unusually long hinge region
d. it is more susceptible to proteolysis 71. Which of the following is currently considered as the
e. None of the above * gold standard for detecting rickettsial antibodies?
a. indirect fluorescence assays
64. Which of the following is the most specific antibody b. microimmunofluorescent assays
for SLE? C. ELISA
a. Anti-ds-DNA * d. A and B *
b. Anti-ss-DNA e. A and c
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL

72. Most of the complement proteins are synthesized in 79. Which of the following refers to the initial force of
what organ? attraction that exists between a single Fab site on an
a. Liver * antibody molecule and a single epitope or determinant
d. Thymus site on the corresponding antigen?
b. Kidneys a. Avidity
e. C and D b. Affinity *
C. Bone marrow C. Cross-reactivity
d. Post zone
73. Which of the following complement pathway can be e. A and B
activated without the presence of an antibody?
a. Classical pathway 81. Which of the following method measures the
b. Alternative pathway reduction in light intensity due to reflection, absorption,
c. Lectin pathway or scatter?
d. Band C * a. Turbidimetry *
d. Immunofixation
b. Nephelometry
74. All of the following are the methods used for C. Radial immunodiffusion
detecting Aspergillus infections, EXCEPT: e. A and B
a. Ouchterlony immunodiffusion
b. Counterimmunoelectrophoresis 83. Which of the following are considered as the best
c. Enzyme immunoassay immunogens?
d. Radioimmunoassay * a. Carbohydrates
e. A and B b. Proteins
C. Polysaccharides
75. Who discovered the delayed type hypersensitivity d. B and C *
reaction? e. A and B
a. Robert Koch *
b. Louis Pasteur 84. Which of the following is a substance administered
C. Elie Metchnikoff with an immunogen to increase the immune response?
d. Edward Jenner a. hapten
e. None of the above b. epitope
c. epitope
76. Which of the following refers to the process of d. adjuvant
inoculating a susceptible person with material taken from e. antigen
a vesicle of a person who has smallpox?
a Variolation * 85. All of the following are antigen presenting cells,
b. Vaccination EXCEPT:
C. Immunization a. B-lymphocytes *
d. A and B b. monocytes
e. None of the above c. macrophages
d. neutrophils
77. What type of hypersensitivity reaction happens when
a cell-bound antibody reacts with antigen to release 86. All of the following are examples of naturally
physiologically active substance? acquired immunity, EXCEPT:
a. Туре I HSR * a. Placental transfer of antibody
b. Type II HSR b. Recovery from disease
C. Type III HSR c. Administration of antitoxin d.
d. Type IV HSR d. Vaccination
e. None of the above e. C and D *

87. Recovery from disease is an example of what type of

78. Which of the following method involves combining immunity?
soluble antigen with soluble antibody to produce a. Natural passive
insoluble complexes that are visible? b. Natural active *
a. Precipitation * c. Articicial active
b. Agglutination d. Artificial passive
c. Turbidimetry e. None of the above
d. Nephelometry
e. All of the above
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
88. All of the following are the first line of defense e. AFP
against infection, EXCEPT:
a. Intact skin 95. Which of the following is the tumor marker found in
b. Mucus nonseminomatous testicular cancer?
c. Shedding of cells that carry microbes a. hCg *
d. Saliva, tears, perspiration, urine b. PSA
e. None of the above * c. CEA
d. CA 19-9
89. All of the following are true of the primary granules of e. CA 125
neutrophils, EXCEPT:
а. it is also called azurophilic granules 96. All of the following are the routes of transmission of
b. contains enzymes such as myeloperoxidase, elastase HIV, EXCEPT:
and cathepsin G a. V intimate sexual contact
c. contain gelatinase and plasminogen activator* b. contact with blood or other body fluids
d. their granules have an antimicrobial activity c. Perinatally
e. None of the above d. airborne contact *
e. none of the above
90. All of the following are the process involved in 97. All of the following are the main structural genes of
phagocytosis, EXCEPT: HIV, EXCEPT:
a. Physical contact between the white blood cell and a. gag
foreign particle b. env
b. Formation of phagosome c. pol
c. Fusion with cytoplasmis granules to form a d. tat *
phagolysome e. None of the above
d. Digestion and release of debris to the outside
e. None of the above * 98. Which of the following is a chemokine receptor
required for HIV to enter T lymphocytes?
91. Which of the following parasites can shed antigen a. CXCR4
therefore the immune response is unable to harm the b. CCR5
offending organism c. CXCR6
a. Schistosoma haematobium d. CCR6
b. Entamoeba histolytica * e. A & B
c. Cyclospora cayetanensis
d. Cryptosporidium parvum 99. Which of the following has long been recognized as
e. Plasmodium falciparum the hallmark feature of AIDS?
a. CD4 lymphocytopenia *
92. Which of the following remains as the gold standard b. CD8 lymphocytopenia
technique for laboratory confirmation of malaria? c. CD4 lymphocytosis
a. ELISA d. CD8 lymphocytosis
b. Immunoblot e. A & B
c. Microscopic diagnosis *
d. Immunofluorescence 100. All of the following are the reliable indicators of HIV
e. A & C infection in Western Blot, EXCEPT:
a. gp41
93. Which of the following refers to the process where b. gp120
the malignant cells travel through the body causing new c. gp160
foci of malignancy until body function is disrupted that d: p24 *
death occurs?
a. tumor suppression HEMA MOCK RECALLS
b. metastasis *
c. dissemination PHASES OF HEMATOPOIESIS
d. invasion - Hematopoiesis is the process of blood cell
e. None of the above formation
o Occurs in multiple phases or stages
94. Which of the following is the tumor marker found in MESOBLAS HEPATIC MYELOID
ovarian cancer? TIC PHASE PHASE PHASE
a. CA 15-3 - Occurs - Takes - Starts
b. CA 125 * during place in during
c. CA 19-9 embry the the fetal
d. CEA onic LIVER period
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
develo during and month)
pment fetal continuo NOTE:
- Involve period us  LYMPHOID PHASE:
s in the - Liver is througho - Occurs in the BM
formati the one ut life - Production of lymphocytes
on of responsib - Occurs - Differentiates B-cells, T-cells and NK cells
blood le in the HEMATOPOIESIS
cells in producing bone
the RBCs, marrow  process of blood cell formation. It occurs in multiple
YOLK WBCs - BM: stages
sac and primary
- Primiti platelets site for  Mesoblastic, Hepatic, and Myeloid phase
ve - 1st month blood
MESOBLASTIC PHASE
phase: of cell in
 Gow gestation adult  Occurs during embryonic development and involves
er - Fetal (medulla in the formation of blood cells in the yolk sac
1 hemoglo ry
 Gow bin is the hematop  Yolk sac produces primitive erythroblast (Gower 1,
er major oiesis) Gower 2, Portland) which are the earliest precursor
2 hemoglob - Child  cells of RBCs
 Portl in that is long
an produced marrow HEPATIC PHASE·
d during the = red
hepatic marrow  Takes place in the liver during the fetal period and
phase - Adult responsible for producing RBCs, WBCs,
 Hemog hemogl
lobin obin:  and platelets. Occurs during the first month of
A major gestation
 Hemog hemoglo
bin MYELOID PHASE
lobin
A2 produce  Starts during the fetal period and continuous
d
throughout life
 Hemo
globin  Occurs in the bone marrow which is the primary site
A1 of blood cell formation in adults

Start 19-20 days  5-7 weeks 5th month of  Hematopoietic stem cells differentiates into RBCs,
(gestation) (gestation) gestation WBCs, and platelets
 Peaks: 3rd
to 4th LYMPHOID PHASE
month of
 Occurs in the bone marrow but specifically involves
life
the production of Lymphocytes
End 8-12 weeks 1-2 weeks Lifetime  Lymphoid stem cells will differentiates into B-cells,
(gestation) (after birth) (Yellow T-cells and NK cells during
marrow)

Blood Primitive  Erythroblas All blood

cells erythroblas ts cells
produ t  Granulocyt
ced o produce es (2nd
s by the month)
yolk sac  Monocytes
o earliest (5th month)
precurs  Megakaryo
or cell of cytes (2nd
RBC month)
 Lymphocyt
es (4th
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL

ADULT HEMATOPOIETIC TISSUE

 50% red marrow (child)
 Hematopoietic active tissue that are
found in the cavities of the bone

 50% yellow marrow (adult)

 Compose primarily by adipose tissue
or fat cells that is not hematopoietically
active
 Found mainly in the medullary cavities
of long bones and consist of adipocytes,
reticular cells and small number of
hematopoietic cells

 RETROGRESSION: the process of replacing

the active marrow by adipocytes
 Occurs naturally

76. Which of the following will most likely stimulate  Normal M:E ratio= 3:1-4:1 or 1.2:1-5:1
erythropoietin production by the kidneys?  Increased in: (overproduction of
myeloid cells)
 CML
a. Hyperbilirubinemia- excess bilirubin in the blood  Infections
caused by liver disease and breakdown  Erythroid hypoplasia

of RBCsb. Hypothermia- low body temperature  Normal:

 Polycythemia vera =
c. Hypoglycemia- low glucose due to excessive insulin
overproduction of RBCs
d. Hypoxia - deficiency of oxygen in the tissues is a
potent stimulus for erythropoietin  Decreased in: (decreased production of
myeloid cells and erythroid cells)
production. When the oxygen supply to the tissue is  Depression of leukopoiesis
low it will be detected by the kidney which can occur to
chemotherapy or radiation
and it releases more erythropoietin which stimulates the
therapy
bone marrow to produce more
 Normoblastic hypoplasia (e.g.
RBC. This responds to carrying oxygen capacity of the erythroleukemia)
blood and improve tissue
4. Which of the following stages of RBC maturation
oxygenation does enucleation is evident?
 Orthochromic normoblast
 A stage of erythrocyte maturation in
HEMATOPOIETIC HORMONES which the nucleus is extruded from the
Erythropoietin cells
- Produced primarily by the kidneys in response to  Cells becomes smaller and more
low oxygen level compact
- Primary source of EPO in the newborn:  Resulting cells = reticulocytes
LIVER
- Produced during hypoxic state (primary  Enucleation: process where in the
stimulus for the production of RBCs) nucleus extruded from the developing
- Prevents the apoptosis of erythroid precursors RBCs
- Induces hemoglobin synthesis  Occurs during the final stage of
- Promotes differentiation of CFU-E to erythrocyte maturation in the
differentiate into pronormoblast BM
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
pathway - Anaerobic glycolysis
RBC MATURATION SERIES - Supplies 90-95% ATP
Pronormoblast - Earliest recognizable RBC - A.K.A “Glycolytic pathway”
precursor - Occurs in the cytoplasm of
- Largest RBCs and other cells
- Note: It takes - Involves the breakdown of
approximately 3 days for glucose to produce energy
the pronormoblast to in the form of ATP
develop into - Glucose  Pyruvate
orthochromic
normoblasts Hexose - A.K.A. “Pentose phosphate
monophosphate pathway”/
Basophilic - Last stage with nucleus shunt Phosphogluconate pathway
normoblast  Last stage with - Aerobic glycolysis
RNA synthesis - Supplies 5-10% ATP
 According to - Purpose: Prevents oxidative
Henry’s denaturation of hemoglobin
hemoglobin is by H2O2
already appear on
this stage BUT it Methemoglobin - Maintains the iron in a
cannot detect on reductase pathway functional reduced state
the light (Ferrous iron)
microscopy - Specific to RBCs
 1st production - Responsible for converting
methemoglobin which
Polychromatophilic - Hemoglobin appear for cannot carry oxygen back
normoblast the 1st time to hemoglobin
- Muddy, light gray
appearance due to variable Rapoport-luebering - Production of 2,3-DPG
amounts of pink coloration shunt - Involves in the conversion
mixed with basophils of 1,3-DPG to 2,3-DPG
- Last stage capable of which binds to the
mitosis hemoglobin and reduces its
- Maturation time: 24 hours affinity to oxygen

Orthochromic - Nucleus is already pyknotic 39. Basophilic stippling are composed of:
normoblast - Last stage with nucleus  RNA
- Characterized by bizarre
looking nucleus  Basophilic stippling: blue-black fine
granules on the cytoplasm of RBCs
Polychromatophilic - Part of this phase occurs in
 Basophilic stippling is composed
erythrocyte the bone marrow, and the
of ribosomes which are
later part of the stage takes
place in the circulating aggregates of RNA and residual
blood mitochondria
- Last stage of Hb
synthesis RBC INCLUSIONS:
- RETICULOCYTE  - Abnormal structures that can be seen within the
retained in the BM for 2-3 cytoplasm of RBCs under the microscope that
days in the circulation can be indicative of various diseases or
conditions
Mature erythrocyte - Life span: 120 days
85. The red cell inclusion characteristically found on
71. Hemoglobinization can be 1st recognized in what lead poisoning are:
erythrocyte maturation stage?  Basophilic stippling
 Polychromatophilic normoblast Inclusion Characte Compos Clinical
ristic ition significance:
RBC METABOLIC PATHWAYS Howell- - Small, - Accelerated
Embden-Mayerhof - Major pathway jolly round or abnormal
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
bodies reddis erythropoiesis 91. The “dawn of neutrophilia” is seen in what stage
h-blue DNA - Megaloblastic of neutrophil maturation stage?
fragm anemia  Myelocyte
ents of - Alcoholism
nucleu  “Dawn of neutrophilia” is the initial response
s  Patien of neutrophils
ts with
- (+)Feu splene
lgen Neutrophil maturation
ctomy
stain 1 Myeloblast - Earliest recognizable blast

Cabot - Reddi - Megaloblastic 2 Promyelocyte - 1st appearance of primary

rings sh anemia granules/ azurophilic
violet - Lead granules
- Thin Mitotic poisoning
ring- spindle homozygous 3 Myelocyte - 1st appearance of
like thalassemia secondary/ specific
- Figure - Severe granules
of anemia - “Dawn of neutrophilia”
eight
(8) 4 Metamyelocyte - A.K.A juvenile cells
- Loop- - Indention of the nucleus is
shape <50% the width of the
d nucleus
appea - Kidney bean/ peanut
rance shaped nucleus

Pappenhe - Small - Refractory 5 Band cell - A.K.A. stab cell/ staff cell
imer faint anemia - 1st immature WBC to be
bodies basop - Sideroblastic released in the
(Wright’s hilic Iron anemia circulation
stain) coccoi - Iron overload - The youngest cell in the
d (hemosiderosi granulocytic series to
bodie s, normally appear in the
Siderobla s near hemochromat peripheral blood
stic the osis) - Indention of the nucleus
granules periph - Thalassemia is >50% the width of the
(Prussian ery of - Hemoglobino nucleus
blue) RBCs pathies - Sausage shape nucleus

6 Mature - Final stage

Basophili - Multip - FINE: neutrophil - Segmented nucleus with
c le,  Megaloblast small cytoplasmic
stippling unifor RNA ic anemia granules
m,  Thalassemi - Capable of phagocytosis
evenl a
y  Hemoglobin 89. The following precursor myeloid cells are
distrib opathies progressively maturing but can no longer divide,
uted  Alcoholism except:
dark  Pyrimidine- I. Myelocytes
blue 5- II. Metamyelocytes
granul nucleotidas III. Bands
es e deficiency IV. Promyelocytes
V. Stab cells (immune neutrophil that can still
- COARSE:
retain the ability to divide)
 Lead
poisoning  One of these
(PICA)
NEUTOPHIL POOL
Pool in the bone marrow
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
1. Mitotic/ proliferating pool
- Myeloblasts, promyelocytes, myelocytes 69. The ratio of iron to protoporphyrin in heme is:
(most mature to undergo mitosis)  1:4
- Cells undergo active division
HEMOGLOBIN STUDIES
2. Maturation/ Storage pool - FUNCTION: transport oxygen to the tissue and
- Metamyelocytes, bands, segmented carbon dioxide from the tissues to the lungs
neutrophils
 Hb compose of 4 heme 
- Cells can no longer divide, but
protoporphyrin and iron
progressively maturing
 4 globin chains
Pool in the peripheral circulation  1 molecule iron = 4 pyrrole rings
1. Circulating pool  1 Hb molecule is able to transport 4
- 90-95% moles of oxygen
- Freely circulating in the blood stream; - 1 gram Hb = 1.34mL of O2
continuously moving throughout the body - 1 gram Hb = 3.47mg iron
- Can quickly response to an infection or - Heme synthesis  takes place in the
injury by moving into the tissues mitochondria
- Globin synthesis  takes place in the
2. Marginating pool ribosome
- 5-10%
- Neutrophil are located in blood vessels,
OXYGEN DISSOCIATION CURVE
near the walls
- In contact with the endothelium A sigmoid curve that describe the relationship between
- They can quickly move to the tissues in oxygen content and partial pressure of oxygen
response to an infection or injury
 Shift to the - INCREASED oxygen affinity
92. The normal proliferation time of monocytes in the LEFT
bone marrow is approximately:  Shift to the - DECREASED oxygen affinity
 55 hours RIGHT
- During this time, the monocyte precursor  Bohr effect - Hemoglobin affinity as
cells undergoes several rounds of cell influenced by pH
division and differentiation giving a larger  Haldane effect - Hemoglobin affinity for oxygen
is influenced by carbon dioxide
size of monocytes
FACTORS affecting the oxyhemoglobin dissociation
curve:
“CADET”
MONOCYTES 1. Carbon dioxide
- In the bone marrow, they are located in the 2. Acidity (pH)
erythroblastic island and surrounded by 3. 2,3-DPG
developing erythrocytes and transfer iron 4. Exercise (increased exercise = increased acidity
(“Suckling pig phenomenon/ Nursing cell”) due to lactic acid)
 Nursing cell phenomenon is normal in 5. Temperature
fetal development
 Can be seen in premature infants and FACTORS INCREASED DECREASED
suffering from intrauterine growth Carbon Right Left
restriction disoxide
 Nursing cell in adult is less common pH Left Right
because this can be seen in severe 2,3-DPG Right Left
Temperature Right Left
anemia, thalassemia
NOTE: Hemoglobin F cause a shift to the LEFT
- NOTE: There is NO STORAGE POOL of
(Hereditary persistence of Hb F)
monocytes in the bone marrow
- Proliferation time in the BM: 55 hours
HEMOGLOBIN VARIANTS
- Mature monocytes spends about 12 hours in
1. Deoxyhemoglobin
peripheral blood before going into the tissues
2. Oxyhemoglobin
- The marginal pool of monocyte in the peripheral
- 2 forms of Hb
blood is 3-5 times greater than the circulating
- Protein found in RBCs
pool
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
- Deoxyhemoglobin it is not yet bound to oxygen  - NOT A TRUE HEMATOLOGIC
darker shade of red and lower affinity to oxygen DISORDER
- Oxyhemoglobin is already bound to oxygen and - Causes:
appears as brighter red color. Higher affinity to  Dehydration (diarrhea, vomiting,
oxygen burns, excessive perspiration,
anaphylaxis, diuretics)
3. Carboxyhemoglobin (200-240 times greater  Anxiety and burns
the affinity to Hb than oxygen)  Tobacco smoking (tobacco
 Treatment: Hyperbaric oxygen polycythemia)
4. Methemoglobin: Iron is in ferric state; has  Gaisbock’s syndrome
strong affinity with cyanide  A.K.A Spurious
 Can cause to cyanosis (bluish color) polycythemia/ Stress
5. Sylfhemoglobin: irreversible; associated with syndrome
oxidizing drugs (phenacetin, acetanilide),  Associated with smoking,
enterogenous cyanosis, and bacteremia (C. CVD, hypertension and
welchii/ C. perfringenes) diuretic therapy
 Typically affects the
10. All of the following Hb variants are considered elderly men
normal except:  Exact cause is
 Hemoglobin S UNKNOWN
 Not considered as a Hb variants because  Increase level of stress
it is genetic mutation causing sickle cell hormone  cortisol
disease
B. ABSOLUTE POLYCYTHEMIA
1. The most abundant white blood cell in the body: - Refers to true increased red cell mass
 Neutrophils and is associated with various causes
Made up of 40-60% of the total WBC - Absolute primary polycythemia: Bone
count marrow defect
Lymphocytes: 2nd most abundant  A.K.A. polycythemia vera
 Rare disorder characterized by
RBC DISORDERS overproduction of RBCs,
I. Polycythemia WBCs and platelets
- A.K.A Erythrocytes 9pancytosis) in the BM
- Associated with increased RBC count,  Cause by a mutation in the
hemoglobin and hematocrit JAK2 gene that controls the
- A hematocrit value of >52% in men production of blood cells in BM
and >50% in women is often  NORMAL M:E ratio
diagnostic of polycythemia  The bone marrow is
- Classification: Relative and Absolute hypercellular showing an
polycythemia overall increase in the
granulocytic, erythroid and
65. What is the expected M:E ratio of a patient with megakaryocytic cells
Polycythemia vera? (panhyperplasia)
 INCREASED  A chronic myeloproliferative
disorder
A. RELATIVE POLYCYTHEMIA  Patient management:
- Due to decrease in the plasma portion Therapeutic therapy
of the blood that gives the  Laboratory picture:
appearance of an increased red cell  ESR = DECERASED
mass in relation to the total blood  EPO = DECEREASED
volume
- Actual number of RBC in the blood is 95. All of the following conditions are associated
not increased. But the number of with absolute secondary polycythemia, except:
cells per unit volume of blood is i. Residence at high altitudes
increased ii. Chronic smoking

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
iii. Panhyperplastic disorder  megaloblastic  iron deficiency
iv. Emphysemia anemia anemia
 One of these  thalassemia  renal disease
 sideroblastic  aplastic anemia
- Absolute secondary polycythemia: anemia  infection (fifth
Kidney defect disease)
 Due to increased levels of  infiltration of
EPO production malignant cells
 This may occur as a normal
response to hypoxia or as a Classification of Anemia based on MCV
result of inappropriate EPO Microcytic anemia MCV: <80fL
“TAILS”
production
 Thalassemia
 Causes:  Anemia of Chronic disease
 Residence of high  Iron deficiency anemia
altitudes (physiologic)  Lead poisoning
 Chronic pulmonary  Sideroblastic anemia
disease Normocytic anemia MCV: 80-
 Chronic congestive 100fL
heart failure Macrocytic anemia MCV: >100fL
 Heavy smoking a. Megaloblastic b. Non-
 Methemoglobinemia anemia megaloblastic
 Emphysemia (MCV: >115fL) (MCV: 101-
 Tumor in the kidney “VF-MEDP” 11fL)
(pathologic)  Vitamin B12 “CA”
deficiency  Chronic
II. Anemia  Folate liver
deficiency disease
 A decrease in RBCs, haemoglobin
 Myelodysplasia  Alcoholism
and haematocrit below the  Erythroleukemia
reference range for healthy  Drugs
individuals of the same age, sex and  Physiologic
race causes

 Mechanisms of anemia: Normocytic anemia (MCV: 80-100fL)

 Ineffective and insufficient Hemolytic anemia (increased Non-
erythropoiesis reticulocytes) hemolytic
 Blood loss and hemolysis (Normal/
decrease
64. Which of the following types of anemia is caused d
by an insufficient erythropoiesis? reticulocy
tes)
 Aplastic anemia
EXTRINSIC INTRINSIC  Aplasti
DEFECT DEFECT c
Megaloblastic  Impaired DNA synthesis  Immune Non-  Membrane anemi
anemia Vit.B12  foliate deficiency causes: immune defects a
Thalassemia  genetic disease that affect the causes:  Hemoglobi  Anemi
synthesis of haemoglobin  Autoi  MA nopathies a of
 destruction of RBCs in anemia mmun HA  Enzymopat Renal
e  Infe hies diseas
Sideroblastic  characterized by abnormal iron hemol ctio e
anemia accumulation in the ytic us  Myelop
mitochondria of red cell anemi age hthisic
precursor leading to decrease a nts anemi
erythropoiesis  Drug-  Dru a
induce gs  Infectio
INEFFECTIVE INSUFFICIENT d HA  Che n  5th
ERYTHROPOIESIS ERYTHROPOIESIS  (+) mic diseas
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
DAT al e  A genetic disorder that affects the BM
 Ven  Anemi and causes aplastic anemia
oms a of
 Bur chronic II. Fanconi anemia
ns inflam  A.K.A. Congenital Aplastic Anemia
mation
 Inherited form of bone marrow
failure
15. Reticulocytosis can be seen in the following
 Inheritance is autosomal recessive
conditions, except:
(rare)
 Aplastic anemia
 Type of anemia: Normocytic
90. An erythrocyte life span of 50 days would be  Signs and symptoms:
indicative of:  Low Birth Weight
 Iron deficiency anemia  Skin hyperpigmentation
(café au lait spots)
98. Which of the following antibiotics is known to  Short stature
cause aplastic anemia?  Renal malformations
 Chloramphenicol strabismus
 Suppression of BM functions
18. All of the following are acquired form of aplastic
 Chloramphenicol is not already use as a
anemia, except?
first line antibiotics because it causes
 Fanconi anemia
side effects
27. Pure red cell aplasia:
Anemia of Bone Marrow Failure
I. Due to defective/ reduced CFU-E
I. Aplastic anemia
II. Caused by a mutation in the JAK2 gene
 Characterized by pancytopenia
III. Also known as Diamond-Blackfan anemia
 Decrease reticulocytes
IV. Platelet count and WBC count are normal
 Lymphocytes are the only cells
 I, III, IV
predominant in the peripheral blood
 Symptoms:
 Fatigue
 Weakness
 Dizziness III. Diamond- Blackfan anemia
 Shortness of breath
 A.K.A Congenital Pure Red cell
 Clinical picture: Aplasia (decrease stem cell of RBCs
 Bleeding only)
 Anemia
 Defective or reduced CFU-E
 Infection
 Caused by the congenital mutation
 NO splenomegaly
in RPS19 gene
 Cell precursors are found in the BM
 Normocytic anemia with normal
WBC and platelet count
16. Majority of cases of aplastic anemia is caused by:
 UNKNOWN
51. Transient erythroblastopenia of childhood is a
 Idiopathic = 70-80%
form of:
 Pure red cell aplasia
CAUSES OF APLASTIC ANEMIA:
 Genetic defects
97. Parvovirus B19 infection can cause what type of
 Ionizing radiation
 Chemicals (benzene, Trinitrotoluene) anemia?
 Viruses (Parvovirus B19)  Normocytic, normochromic anemia
 Drugs (Chloramphenicol  most common)
 Inorganic arsenic 23. Hallmark findings in Leukoerythroblastic anemia
I. Myelophthisis
100. “Café au lait” spots is a common manifestation II. Presence of teardrop cells and nucleated
of which of the following aplastic anemia? RBCs
 Fanconi anemia III. Hepatomegaly and splenomegaly
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
IV. Reticulocytosis  Produced by microorganism
 I, II and III  Dietary source: Meat products
 Absorption is facilitated by Intrinsic
IV. Myelophthisic anemia factor (from parietal cells)
 Myelophthisis: Invasion of  Absorption takes place in ileum
abnormal cells  Numbness/ tingling on the hands and
 A.K.A. Leukoerythroblastic anemia feet
 Common finding in patients with  Difficulty in walking
carcinoma  Memory loss
 Results when bone marrow is  Causes:
replaced by abnormal cells (e.g.  Inadequate intake
metastatic tumor cells, leukemic  Increased demand/ need
cells, fibroblasts and inflammatory (pregnancy, lactation, growth)
cells)  Impaired absorption (food-
 Extramedullary hematopoisis cobalamin malabsorption)
 Unfavourable bone  Lack of intrinsic factor
marrow  environment for (pernicious anemia  most
haematopoiesis common cause)
 Blood picture:  Other causes:
 Decrease reticulocytes  D. latum infection
 Teardrop cells  Blind loop syndrome
 Nucleated RBC  A type of condition
 Immature myeloid cells wherein a portion of the
intestine are stenotic 
31. Factors commonly involved in producing anemia results of surgery/
in patient with chronic renal disease include: inflammation
 Inadequate erythropoiesis  Imerslund-grasbeck
syndrome (Vitamin B12
V. Anemia of Chronic Kidney disease malabsorption)
 Anemia is due to inadequate production  Defective in amionless
of erythropoietin by the kidneys receptor
 Rationale: without EPO, the BM is C. Folate deficiency
unable to increase the RBC production  Sources: Green leafy vegetables
in response to tissue hypoxia  Causes:
 Blood picture:  Inadequate intake
 Decrease EPO  Increased need
 Presence of Burr cells (uremia)  Impaired absorption
 Excessive loss due to renal
ANEMIA OF ABNORMAL NUCLEAR DEVELOPMENT dialysis
 Impaired DNA synthesis that affects the all  Alcoholism (interferences with
rapidly dividing cells of the body including skin, folate metabolism)
GIT and BM
 Vit.B12 and Folate are essential in the synthesis 63. Vitamin B12 deficiency can be best differentiated
of DNA with:
 Presence of neurologic symptoms
Differential diagnosis
A. Megaloblastic anemia FOLATE DEFICIENCY VITAMIN B12
 The root cause is impaired DNA DEFICIENCY
synthesis  Same CBC (pancytopenia, increased RDW, MCV
 This type of anemia is named after its and MCH, decreased reticulocytes count)
distinctive morphology due to the  Same blood picture
reduction in the number of cell divisions  Bone marrow picture (M:E ratio: Increased,
(megaloblastic) Hypercellular)

B. Vitamin B12 deficiency autoantibodies (-) autoantibodies (+)

JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
normal gastric analysis hypochlorhydria  Microcytic-hypochromic
stool analysis: stool analysis: POSITIVE RBCs
NEGATIVE for parasitic for D. latum ova  Anisocytosis
ova Iron studies:
 Decrease iron
D. Macrocytic Non-Megaloblastic Anemia  Increase TIBC, FEP
 Lacks hypersegmented neutrophil
and oval macrocytes in the peripheral 17. A peripheral blood smear shows hypochromic
blood and megaloblasts in the bone cells with grape-like inclusions within the RBCs on
marrow both wright stain and Prussian blue stain. These
 Physiologic cause: Newborn findings are consistent with:
 Pathologic cause:  Sideroblastic anemia
 Liver disease
 Chronic alcoholism
 Bone marrow failure 2) Sideroblastic anemia
 Due to defective IRON loading 
82. Macrocytosis is seen in the following conditions, accumulation in mitochondria of the
EXCEPT: erythroid precursor
 A. duodenale infection  Main culprit: due to defective heme
 Related to IDA synthesis caused by various diseases
 Inability of the BM to produce healthy
ANEMIA OF IRON AND HEME METABOLISM RBCs
 Mechanisms:  Can be Congenital or Acquired
 Deficiency of raw material (IDA)  Congenital: caused by genetic
 Defective release of stored iron from mutation by the destruction
macrophages (Anemia of Chronic heme biosynthesis
Inflammation)  Acquired: exposures to toxins,
 Defective utilization of iron within the Vit. B6 deficiency
erythroblast (Sideroblastic anemia, Lead  Treatment: Iron Chelation Therapy;
poisoning) Blood transfusion in severe cases
 Causes:
 Hereditary sideroblastic anemia
1) Iron Deficiency Anemia (IDA)  Acquired:
 Most common form of anemia  Primary sideroblastic
 Causes: anemia (Refractory RARS)
 Inadequate intake  Anti-TB drugs
 Increased body demand  Chloramphenicol
(pregnancy, growing children)  Alcoholism
 Impaired absorption  Lead
 Chronic blood loss (Hookworm  Chemo drugs
infection, Therapeutic phlebotomy
in polycythemia vera) 79. Which of the following iron regulatory molecule
 Classic symptoms: prevents phagocytized bacteria from using
 Glossitis (sore throat) intracellular iron?
 Angular cheilosis (inflamed cracks  Lactoferrin
at the corner of the mouth) 3) Anemia of Chronic inflammation
 Koilonichia  2nd most common type of anemia
 Pica  Associated with infections, inflammatory
 Pagophagia conditions or malignant diseases of
 Laboratory findings: more than 1 or 2 months duration
CBC count: (chronic)
 Decrease H/H, RBC, RBC  Most common anemia among
indices hospitalized patients
Peripheral blood:  Cause:
 Increase RDW
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 MOCKBOARDS RECALL
 Iron appears to be trapped in following markers?
macrophages
 HEPCIDIN, LACTOFERRIN and
FERRITIN plays an important role in the A. Morphology of RBCs
development of ACD
 Hepcidin: regulates the iron in B. Serum Iron
the body, particularly the
C. Serum Ferritin
absorption of iron in the
intestine and release of iron in D. Transferrin saturation
the macrophage
 Lactoferrin: prevents the
phagocytation of bacteria from
83. Increased iron binding capacity and reduced serum
utilizing intracellular iron 
iron is typical of:
greater affinity of iron than
transferrin a. Sideroblastic anemia
 Ferritin: it binds iron
b. Iron deficiency anemia
nd
75. The 2 most common form of anemia is: c. Anemia of chronic disorder
 Anemia of Chronic inflammation
d. hemochromatosis
DIFFERENTIAL DIAGNOSIS TESTS
Serum ferritin  Reflects the body’s tissue iron
stores  good indicator of iron 52. The first laboratory test to become abnormal in IDA
storage status
is:
 1st laboratory test to become
abnormal when iron stores A. Serum Iron
begin to decrease
 Increase: IDA B. Serum Ferritin

C. TIBC
Serum iron  Helpful in cases where the
diagnosis is not obvious from D. Transferrin saturation
other lab test

Free erythrocyte
protoporphyrin 66. Acquired form of porphyria:
Total Iron Binding  Indirect measurement of
Capacity (TIBC) A. Porphyria cutanea tarda
transferrin concentration
(measures the binding site) B. Porphyria variegate
 Decrease: Anemia of
Chronic Inflammation C. Gunther disease
 Increase: Iron deficiency
anemia D. Plumbism

Transferrin  Obtained through calculating

saturation the measurements of serum 2. Plumbism is associated with what heavy metal
iron and TIBC poisoning
 %Transferrin saturation =
serum iron/ TIBC x 100 a. copper

Zinc erythrocyte  Measures unused b. arsenic

protophyrin protoporphyrin c. lead
 Increased: IDA, lead
poisoning d. mercury

24. Anemia of chronic disease can be best differentiated

from IDA by which of the

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 MOCKBOARDS RECALL

19. Iron deficiency anemia may be distinguished from 25. the mechanism of anemia seen in beta thalassemia
anemia of chronic infection by which is primarily due to

of the following a. mutation in the amino acid sequence of globin chains

a. serum iron b. oxidation of ferrous iron to ferric iron in the

hemoglobin
b. red cell morphology
c. impaired rna synthesis
c. tibc
d. excessive production of alpha globin chains
d. red cell indices

22. the etiologic cause of hemolytic episodes seen in

21. the most reliable screening test which aids in the marchiafava-micheli syndrome is most
diagnosis of hemochromatosis is
probably due to

a. jak2 gene mutation

a. serum ferritin
b. ros19 gene mutation
b. serum iron
c. translocation of ph1 chromosome
c. transferrin saturation
d. absence of daf and mirl
d. tibc

41. most common cause of death among patients with

sickle cell disease 42. etiologic cause of paroxysmal nocturnal
hemoglobinuria is mot probably due to

a. jak2 gene mutation

a. vaso occlusive crisis
b. ros19 gene mutation
b. painful crisis
c. translocation of ph1 chromosome
c. infectious crisis
d. absence of daf and mirl
d. aplastic crisis

96. most common cause of death among patients with

sickle cell anemia 20. the waring blender syndrome is a type of anemia
caused by fragmentation of rbcs
a. vaso occlusive crisis
secondary to
b. hypothermia
a. gram neg septicemia
c. painful crisis
b. circulating thromboplastin like substances
d. s. pneumoniae infection
c. installation of prosthetic heart valves

d. adamts13 deficiency
32. most definitive diagnostic test for thalassemia

a. hb electrophoresis
78. what is the expected hematological finding in a
b. flow cytometry patient who suffered acute bleeding for 24 hours
c. cbc count with rbc indices a. decreased wbc
d. supravital staining
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 MOCKBOARDS RECALL
b. decreased platelets Chronic leukemia:

c. microcytic hypochromic anemia I. Insidious onset

d. normocytic normochromic anemia II. WBC count can be normal or increased

III. Blast are predominant in PBS

45. which mutation is shared by a large percentage of IV. Has a better prognosis than acute leukemia
patients with polycythemia vera, essential
thrombocythemia, and primary myelofibrosis a. I only

a. bcr/abl b. I and II only

b. jak2 v617f c. I, II, III

c. pdgfr d. I and IV

d. rps19

8. what influence does the philadelphia chromosome 37. A patient’s CBC report shows a markedly increased
have on prognosis of patients with cml WBC count with an absolute count of 80,000/uL. The
peripheral smear shows an increased number of
a. the disease is not predictive Segmenters and bands (left shift). This is highly
suggestive of CML. which of the following test would be
b. prognosis is better if ph1 chromosome is present most useful in confirming the suspected diagnosis?
c. prognosis is better if ph1 chromosome is absent a. LAP test
d. the disease will usually transform into acute leukemia b. Karyotyping for the identification of Philadelphia
chromosome

Chronic Myelogenous Leukemia c. Flow cytometry for detection of surface antigens

 Primarily a disease of adults (between ages 30 and d. Lymph node biopsy for demonstrating of metastasis
50)

 A stem cell disorder affecting the granulocytic, 7. Acute leukemia affects what age group?
monocytic erythrocytic and megakaryocytic cell
lines a. Children

 The WBC count is usually 50,00 to 300,000/uL b. Adult

 Cause: due to Philadelphia chromosome or c. Geriatric

translocation between the long arms of
chromosome 9 and 22 d. All of the above

 Philadelphia chromosome (+) = Good prognosis 33. According to the FAB classification of neoplasms
there should be at least ____ blast to
 Lab findings:
diagnose AML
 Normocytic RBCs
a. >20%
 (+) basket cells
b. >30%
 Hypercellular bone marrow = INCREASED M:E
ratio c. >50%

 Lap score: DECREASED d. >70%

Leukemia
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 MOCKBOARDS RECALL
Characterized by uncontrolled proliferation of abnormal  Large, but varies
white blood cells
 Cytoplasm characteristic: basophilic and
 Several types of leukemia: numerous vacoules

 Acute lymphoblastic leukemia  Prognosis is poor

 Acute myeloid leukemia  Rarest type of ALL

 Chronic lymphocytic leukemia (FAB Classification)

 Chronic myeloid leukemia  M0 : Acute myeloblastic leukemia, minimally

differentiated

 M1 : Acute myeloblastic leukemia, without

Classification according to number of WBCs: maturation
1. Leukemic= WBC count is >15,000/uL  M2 : Acute myeloblastic leukemia, with maturation
2. Subleukemic= WBC count is <150,000/uL with  M3
immature/abnormal forms of WBCs
 Acute Promyelocytic leukemia
3. Aleukemic= <150,000/uL immature/abnormal
forms of WBCs  DIC is common

 (+) Faggot cells

The French-American-British (FAB) system classifies  Presence of “Bowtie appearance” of the

ALL Based on: bilobed nucleus

a. Cytochemical Staining  M4

b. Cytogenetic markers  Acute myelomonocytic leukemia (Naegeli

monocytic leukemia)
c. Surface markers
 Increased granulocyte, monocyte and
d. Morphology promonocyte in the PB

 M5
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL)  Acute monocytic Leukemia (Schilling’s
 Primarily disease of childhood & adolescents leukemia)

 25% childhood cancers  M5a→ POORLY differentiated

 75% childhood leukemia  M5b→ WELL Differentiated, PAS (+)

 Peak incidence of ALL in children is between 2-  M6

5years of age  Erythroleukemia (DiGuglielmo’s Syndrome
 Although ALL is rare in adults it increases with  Increased Erythroblast & Myeloblast in the PB
age and most adult patients are older than 50
years of age  M7

Types (FAB classification)  Acute Megakaryocytic Leukemia

 L1: Small lymphocyte, homogenous  (+ ) PAS,ECP and Platelet oxidase

 Most common acute leukemia in children

 Best prognosis Burkitt type ALL:

 L2: Largest lymphocyte, heterogenous a. L1

 L3; Burkitt Type b. L2

JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
c. L3 subtype of lymphoma that vary in their clinical
presentation and prognosis
d. L4

The Most definitive diagnostic test for detection of

Which of the following types of AML does DIC a Hodgkin’s lymphoma is:
common finding?
a. Bone marrow biopsy
a. M1
b. b. FISH
b. M2
c. Lymph node biopsy
c. M3
d. Cytochemical staining
d. M4

The following are the laboratory report of a 12 year old

Cytochemical stain that demonstrates ferric iron male patient:
a. Myeloperoxidase

b. PAS WBC count= 50,000/ul

c. Prussian blue The peripheral smear shows a shift to the left (w/o
d. Napthol AS-D Acetat blasts), dohle bodies, and toxic granulation are noted

AML and ALL can be best differentiated by using what Which of the following test is most helpful in ruling out
cytochemical stain? the diagnosis of the patient?

a. Bone marrow biopsy

a. PAS b. Molecular testing

b. SBB c. Flow cytometry

c. TDT (Terminal deoxynucleotidyl transferase) d. LAP test (Leukocyte Alkaline Phosphatase)

d. MPO
SPECIMEN COLLECTION

LYMPHOMA Maximum time for tourniquet application:

 Type of cancer that affects the lymphatic system a. 60 sec - RODAKS

which is part of the immune system b. 2min - TURGEON
 Represents a group of malignant tumors of the c. 3min
lymphoid tissue
d. 2.5 min
 Usually blood and bone marrow are NOT involved

 2 main type of lymphoma

Which of the following blood vessel has the thickest wall?
 Hodgkin's lymphoma → characterized by the
presence of abnormal cells (reed sternberg a. Vein
cells)
b. Artery
 Non- hodgkin’s lymphoma →MORE
COMMON (90% in all Lymphomas). many c. Capillary

d. All of the above

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 MOCKBOARDS RECALL
 Calcium is important especially in extrinsic
pathway for activation of clot
MACROSAMPLING (Venipuncture)
 Optimal concentration: 1.5 mg/mL of blood

 Ratio: Blood to Anticoagulant = 4:1

 Preferred sites: Median cubital vein, cephalic vein,
basilic vein  Inversion: 8x

 Sites with IV infusion 2 foms:

 If IV is running on both arms draw blood below  Dipotassium EDTA (K2EDTA) (plastic with
the IV line after the IV fluid has been stopped spray dried)--> does not dilute the sample
for 5min (Turgeon: 2-3 min) and must be noted
on the test result  VERSENE (Disodium salt)

 However obtaining blood spx from an IV line  Tripotassium EDTA (K3EDTA) (Liquid form) →
should be avoided because of the mixture of commonly used, dilutes the sample around 1-
fluid with the blood sample producing 2%
erroneous test results  SEQUESTRENE (Dipotassium salt)
 Alternative sites: Ankle vein, wrist area, back of the  Advantage: can preserve cellular morphology
vein, foot when blood smears are made within 2-3 hours
 Angle of the needle: 15-30 degree (25→ average) of collection

 Duration of tourniquet application: Less than 2 min  Disadvantage: Excessive EDTA Induces RBC
Shrinkage causing the Hematocrit and ESR to
 Factors to consider when selecting sites be falsely decreased

 Hematoma Effects of Excessive EDTA

 Burns  HEMATOCRIT - decreased

 Scars○ Edema  ESR - decreased

 Site on which a mastectomy was performed  MCV - decreased

 Site with IV infusion  MCHC increased

 PLATELET COUNT - decreased; platelet

satellitism phenomenon → use citrate
MICROSAMPLING
 (multiply by 1.1)
 The Method of collection for pediatric patients (<1
year old), geriatric patients, obese, Patient with  WBC MORPHOLOGY - cytoplasmic
thrombotic tendencies, severe burns and for POCT vacuolization of neutrophils and monocytes

 Preferred sites:

 Infants: medial or lateral plantar heel surface of 2. Citrate (Light blue top)
the big toe
 Inhibits blood clotting by binding the calci
 Adults: 3rd or 4th; margins of ear lobe Length
of lancet: 1.75mm (<2mm)  Blood to anticoagulant ratio = 9:1

ANTICOAGULANTS USED IN HEMATOLOGY  Additive 3.2% sodium citrate (0.109 M)

1. EDTA (Purple top)  Inversion: 4 times

 Most commonly used  For coagulation studies (PT, APTT)

 Additive: Ethylenediaminetetraacetic acid 48. Underfilled citrated tubes for coagulation studies will
cause a:
 Mode of action: Chelates calcium (to avoid clot)
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
a. Falsely shortened APTT and PT  Forms: Lithium heparin and Sodium heparin

b. Falsely prolonged APTT and PT

c. Falsely prolonged PT, normal APTT 67. Heparin should never be used for coagulation
studies because of its inhibitory
d. Falsely prolonged APTT, normal PT
effect on:

a. Antithrombin
50. Excessive probing of the vein during blood collection
will cause a: b. Thrombin

a. Falsely shortened APTT and PT c. Plasmin

b. Falsely prolonged APTT and PT d. Calcium

c. Falsely prolonged PT, normal APTT

d. Falsely prolonged APTT, normal PT 72. Which of the following anticoagulants used as an in
vivo and in vitro

anticoagulant?
3. Citrate (Black top)
a. EDTA
 Blood to anticoagulant ratio = 4:1
b. Citrate
 Additive = 3.8% buffered sodium citrate
c. Heparin
 Inversion: 4 timesFor Erythrocyte
Sedimentation Rate d. Oxalate

53. The anticoagulant of choice for modified 5. Oxalate (Gray top)

Westergren's erythrocyte sedimentation rate.
 Chelates calcium> Anticoagulant: Oxalate

 Antiglycolytic/preservative agent: NaF

a. EDTA
 Inhibits glycolysis for 3 days by forming a
b. Citrate complex with magnesium, and inhibiting the
magnesium- dependent enzyme, enolase.
c. Heparin
 Used in ESR (Wintrobe method)
d. Oxalate
 Ammonium oxalate and Potassium oxalate
does not shrink RBCs
4. Heparin (Green top)  Inversion: 8 times
 A mucopolysaccharide (mucoitin  Optimal concentration: 1-2 mg/mL of blood
polysulfuricacid) that inhibits coagulation by

 inactivation of thrombin
Order of draw
 Heparin accelerates the action of antithrombin
III, neutralizing thrombin, and

 preventing the formation of fibrin

 Both an in vivo and in vitro anticoagulant

 The only anticoagulant that has the least effect

in different tests

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 MOCKBOARDS RECALL
acid fumes plasma produces
blue background)
 Old stain
(methanol is  Protein
oxidized into abnormality
umic acid)
 Protein
abnormalities

 Heparinized
blood

 Very high WBC

count with many
blasts

 Low hematocrit

Methods for Counting

 Cross-sectional/crenellation - WBCs are

counted in consecutive fields as the blood film
is moved from side to side

 Longitudinal - Ideal for thin smear

Routine Hematology Test  Battlement - uses a pattern of consecutive
 Blood Smear Prep fields beginning near the tail on a horizontal
edge

Improved Neubauer Counting Chamber

 Consists of 2 identically ruled platform

 The space between the top of the platform and

the cover glass over it is 0.1 mm (depth)

 Each large square is 1 mm wide and 1 mm

Causes of Color DIversion
long; therefore the entire ruled area is 9 mm²
Too red Too Blue
 The volume of the entire ruled area on one
 Too acidic buffer  Too alkaline platform is 0.9 uL (wide x length x depth)
or stain (pH <6.4) buffer or stain
 The large central square has a volume of 0.1
(pH >6.8)
 Excess buffer uL
 Insufficient buffer
 Insufficient  The volume of each of the 25 smaller squares
staining time  Excessive is 0.004 uL
staining time
 Excessive
washing  Insufficient
73. The most commonly used dilution for RBC count is:
washing
 Thin smear
a. 1:100
 Thick smear.
 Chlorine Short drying b. 1:200
contamination of period
wash water c. 1:10
 Wash water too
 Exposure of alkaline d. 1:20
buffer/stain to
 Old smear (dried
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 MOCKBOARDS RECALL
74. Why is there a 15 minute waiting period before  Sources of Errors:
counting in the filled hemocytometer when doing manual
platelet count with ammonium oxalate?  Lipemic blood → use patient blank

a. to allow platelets to settle  High WBC count (most common) →

centrifuge then use supernatant
b. to reduce platelet clumping
 Abnormal Hb → dilute sample (1:1)
c. to stain the platelets Hemolyzed → no effect

d. to ensure complete agglutination of the RBCs Drabkin’s Reagent

 KCN: converts Hi → HiCN

RBC Diluting Fluid  (K3Fe[CN]6): oxidizes Ferrous iron to Ferric

iron
 Must be isotonic
 Non-ionized detergent (Sterox or Triton):
 NSS (aka Eagle’s fluid) - used in emergency liberates hemoglobin
solutions; ideal for excessive rouleaux
 KH2PO4 (NaCO3: original Drabkin’s) →
 Hayem’s fluid - initiates mold formation and shorten the time in converting hemoglobin to
rouleaux formation HiCN from 10 minutes to 3 minutes→ Random
 Toisson’s fluid - incorporated with stain (Methyl Recall: Time for mod. Drabkin’s reagent to
Violet) react

 Formol-Citrate (aka Dacie’s fluid) - best RBC 

diluting fluid 9. Which of the following conditions does Hemoglobin is

most likely decreased?

88. What is the dilution factor if the specimen was drawn a. High altitude
up to the 1.0 mark of an RBC pipette and diluent was b. Anemia
drawn up to the 101 calibration mark?
c. Healthy Male Patients
a. 50
d. Chronic smoking
b. 100 (1:100)

c. 150
Clinical Significance:
d. 200
 Increased: Polycythemia, dehydration (burns,
diarrhea)
Corrected WBC Count  Decreased: all types of anemia, leukemia
 Usually done when 5 or more nucleated RBCs Notes:
per 100 WBC are present in the blood smear
 After 50 years of age = slightly decrease
 CWC = Uncorrected WBC count x 100/nRBCs
+ 100  Hemoglobin is lower if lying down

Hemoglobin Determination  Increased in smokers

 Cyanmethemoglobin method  Increased among males

 reference method  Increased in high altitude

 HCN is the most stable Hb variant

 Sample: hemolyzed blood HEMATOCRIT DETERMINATION

 Absorption: 540 nm  AKA Packed Cell Volume

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 MOCKBOARDS RECALL
 Prone to parallax error B. MCHC

 Microhematocrit Method C. MCH

 Macrohematocrit Method D. RDW

 Sources of Error:

 INCREASE Hct = inadequate centrifuge, ERYTHROCYTE SEDIMENTATION RATE

including the buffy coat in the reading,
allowing the sample to stand too long after  Non-specific test used to detect and monitor
centrifuge inflammatory response

 DECREASE Hct = Excess anticoagulant,  Directly proportional to the red cell mass and
improper sealing of the tube inversely proportional to plasma

Macrohematocrit Method Microhematocrit Method  viscosity

 Affected by 3 factors: RBC, Plasma

 AKA Spun  May contain
composition and Technical factors
hematocrit large amount of
(Reference trapped plasma  Note: a tilt of 3 degrees can cause errors up to
Method) 30%
 Wintrobe tube
 Centrifugation:  Plasma composition - single most important
10,000-15,000 g  Length: 115 mm
factor determining ESR
for 15 mins  Centrifugation:
 High ESR and Low HCT is often diagnostic of
Length: 75 mm 3,000 RPM for 30

anemia
mins
 Inner bore: 1.2 STAGES OF ESR:
mm  Computation:
Height of PCV x 1. Lag phase (initial rouleaux) = 10 minutes
 Volume: 0.05 mL 100/Height of
whole blood 2. Decantation phase = 40 minutes
 Should be filled
with whole blood 3. Period of final settling = 10 minutes
approximately ⅔
of the tube
Faster ESR (Increase) Slower ESR (Decrease)
 Red band
(HEPARINIZED)  Anemia  Polycythemia
 Blue Band (Plain)  Macrocytes  More viscous plasma
RBC INDICES FORMULA  Less viscous plasma  Microcytes

 Longer tube  Albumin

 Wider tube  Sickle cells

 Slightly inclined tube  Decreased

temperature
 Increased
temperature  Excessive
anticoagulant
 Presence of bubbles

 Less blood in tube

49. Which of the following RBC indices is most useful in
differentiating IRON DEFICIENCY ANEMIA from
THALASSEMIA?
93. Which of the following tests is not included in routine
A. MCV CBC?

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 MOCKBOARDS RECALL
A. Differential count D. 82.5%

B. Platelet count

C. Hemoglobin/Hematocrit BONE MARROW EXAMINATION

D. Reticulocyte count  Preferred site of collection: POSTERIOR

SUPERIOR ILIAC CREST - for BM biopsy and
aspiration
94. What is the expected ESR result of a patient who  Anterior superior iliac crest - for patient who can
has polycythemia vera? only supine
A. Increased  Tibia - for children below 2 years old
B. Decreased  Bone marrow biopsy - should be done before
C. Normal aspiration to avoid any disruption of marrow
architecture at the site; needle used - Jamshidi
D. Variable needle

 Bone marrow aspiration - to identify the types and

proportions of hematologic cells and to look for
RETICULOCYTE COUNT
morphologic variance; needle used - University of
 Marker of effective RBC production of bone marrow Illinosis sternal needle
in response to hemolysis and loss of RBC
 DRY TAP: the inability to aspirate marrow into the
 Supravital stain: syringe

 Brilliant Cresyl Blue  M:E ratio: Myeloid to erythroid ration (3:1-4:1)

 New Methylene Blue - recommended by

NCCLS
LEUKOCYTE ALKALINE PHOSPHATASE
 Formula: Reticulocytes (%) = no. of retics/1000
 Used to differentiate Leukemoid reaction from CML
RBC x 100
 Principle: Neutrophil are the only WBC that normally
 INCREASED: Hemolytic anemia, Newborn, SDA,
contain various amount of alkaline phosphatase
IDA, Thalassemia
 Anticoagulant used: heparin
 DECREASED: bone marrow failure (Aplastic
anemia), megaloblastic anemia, Parvovirus B19  Normal value: 30 to 185
 NORMAL VALUE: 0.5-1.5%

INCREASED DECREASED
ABSOLUTE RETICULOCYTE COUNT  Multiple myeloma  CML
 Reflects the actual number of reticulocytes ARC =  Aplastic anemia  PNH
(reticulocyte count (%) x RBC count)/1000
 Leukemoid reaction  Sickle cell anemia

 Intoxication  Sideroblastic anemia

Compute for the Absolute Reticulocyte Count:
 Polycythemia vera
No. of reticulocytes: 15 per OIF
 Infection
RBC count = 5.5 x 1012 /L
 Pregnancy (3rd
A. 1.5% trimester)
B. 15%

C. 8.25% HEMOGLOBIN S DETERMINATION

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 MOCKBOARDS RECALL
Dithionite Solubility Test

 Screening test for sickling hemoglobin SECONDARY HEMOSTASIS

 Principle: RBCs are lysed by saponin -->  Coagulation present

Sodium dithionite binds and removes oxygen
from the test environment --> Hemoglobin S
polymerizes forming tactoid crystals making the STEPS IN PRIMARY & SECONDARY HEMOSTASIS
solution turbid Positive test: TURBIDIT
I. Vasoconstriction
 Cause of False positive:
II. Platelet adhesion (vWF-Gp Ib-IX complex)
 Presence of other sickling hemoglobin
(Hb C- Georgetown and Hb C- Harlem)  When vascular injury occurs, platelets come in
contact with subendothelium and adhere to
 Hyperlipidemia portions of it
 Hypergammaglobulinemia  Platelet adhesion occurs due to the presence
HEMOGLOBIN F DETERMINATION of von Willebrand factor being deposited on
injured tissues
Alkaline Denaturation Test Acid Elution Test
 vWF binds to Gp Ib-IX complex on the platelet
 Test by Singer  AKA Kleihauer-Betke membrane
method
 Reagent: Potassium III. Platelet Activation and secretion
Hydroxide  Used to detect fetal
red cells in maternal
circulation 77. Aspirin affects platelet function by interfering with
platelet metabolism of:
 Reagent: Citric acid
and PO4 buffer A. Prostaglandins
 Standard test for B. Phospholipids
quantitating
Fetomaternal C. Cycloxygenase
hemorrhage
D. AOTA
 Maternal RBC = ghost
cells
 Platelet (disk shape) = spherocyte
 Fetal RBC =appears
as rose pink in color  ADP & calcium = phospholipade A2

 Phospholipase A2 = arachidonic acid

HEMOSTASIS  Arachidonic acid = prostaglandin
 Process that retains the blood within the  Prostaglandin = thromboxane A2
vascular system during the period of injury
 Thromboxane A2 = platelet aggregation &
 Localized the reaction involved to the site of vasoconstriction
injury and appears and re-establishes blood
flow to the injuried vessels IV. Platelet aggregation (Gp IIb-IIIa)

V. Fibrin plug formation

VI. Platelet aggregation = initiated by GpIIb-IIIa complex

PRIMARY HEMOSTASIS VII. Fibrin plug formation = fibrin clotis stabilized by

coagulation factor XIII
 Vasoconstriction

 Platelet clump together

JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
84. Activity of the following clotting factors are affected B. The patient must refrained from consuming of
by coumarin drugs except: aspirin for 7 days before testing

a. Factor II C. After collection, the specimen can be frozen for

transport to the laboratory
b. Factor VII
D. All of these are important
c. Factor IX

d. Factor V
QUALITATIVE PLATELET DISORDERS:
HEREDITARY
86. A patient who has been receiving a broad-spectrum Adhesion defects
antibiotic is found to have a prolonged PT, after running
a couple of factor assays, both factor X and Factor VII BSS  Lack of
levels are decreased. The PT corrected when mixed with expression of GP
normal plasma. What is the possible cause of this? Ib-IX

a. Inherited factor deficiency  Large platelets

b. Circulating anticoagulants  Autosomal

Recessive
c. Vitamin K deficiency
 Lab Findings:
d. Antibiotic interferes with the activation of coagulation prolonged BT;
factor Platelet
aggregation
studies: Ristocetin
= abnormal
87. Hemorrhagic disease of the newborn is usually
caused by:
vWD  Lacks vWF
a. Iron deficiency
 Lab Findings:
b. Vitamin K deficiency Ristocetin =
abnormal;
c. Point mutation of the globin chains
Prolonged APTT,
d. Vitamin B12 deficiency BT, TT, CT

 Treatment:
DDAVP/cryopreci
43. Which of the following tests is useful when pitate
differentiating Bernard-Soulier syndrome and

Glanzmann’s thrombasthenia?

a. Bleeding time
Aggregation Defect
b. Platelet count
Glanzmann’s  Lack of Gp IIb-
c. PT and APTT thrombasthenia IIIa (necessary
d. Response to ADP, collagen, and EPI in an for aggregation)
aggregation assay  Autosomal
Recessive

44. When performing platelet aggregation assays, which  ADP, Collagen,

of the following is an important pre analytical factor? and EPI is
abnormal
A. The patient should have fasted overnight
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
 Clot retraction DIC (+) d-dimer
test - abnormal
Dilutional effects Due to massive blood
 BT - prolonged transfusion

ACQUIRED 60. TTP can be best differentiated from DIC by which of

the following markers?
ASPIRIN
A. Schistocytosis
 Most common acquired platelet disorder
B. D- dimer
 Inhibits the synthesis of cyclooxygenase ->
inhibits platelet aggregation C. Thromcytopenia

UREMIA D. None of the above

 Can be corrected with renal dialysis

MPDs 54. Wiskott-Aldrich syndrome

 platelet dysfunction is a common finding I. Decreased delta granules

II. Small platelets

QUANTITATIVE PLATELET DEFECTS III. Eczema is a common finding
Thrombocytopenia IV. Recurrent infection are evident

ITP A. I and II

PTP Develops after transfusion B. I, II, and III

of platelets
C. III and IV
TTP  AKA Moschowitz
D. All of these
syndrome
HEMOSTASIS
 Due to
ADAMTS13 Factors to Considered:
Deficiency
 Temperature
 Upshaw-
schulma  Hemolyzed sample - hemolyzed RBC will act
syndrome - like tissue thromboplastin activating

 Inherited TTp  plasma clotting factors

 Idiopathic TTP -  Glass surface - HMWK, PK, XII, and XI will be

autoimmune activated prematurely

 Secondary TTP  Short draw - causes falsely prolonged

- triggered by coagulation tests
inflammation,
 Consider the role of calcium
and malignancy
(inhibtion of
ADAMTS13)
CLOT RETRACTION TEST
HUS Common in children
 Screening test for platelet function
Due to infection (E.coli
0157-H7)  Useful index of platelet activity

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
 Clot retraction is poor when platele count is
<100,000/ul
80. Prothrombin time is most likely prolonged if the
 Abnormal result: Glanzmann’s Thrombasthenia, levels of fibrinogen is below _____
and Multiple myeloma
A. 80 mg/dL
 Qualitative test (test for the presence or
absence of retraction): Hirschboeck method B. 90 mg/dL

 (Castor oil method) C. 100 mg/dL

 Quantitative test (estimate the amount or D. 120 mg/dL

degree of retraction): Stefanini method and
MacFarlane method
12. The thromboplastin reagent used for Prothrombin
time is made of:
70. Which of the following test results would most likely A. Pig’s tissue
support the findings of a patient whose bleeding is due
to excessive heparin therapy? B. Sheep’s blood

A. Prolonged Thrombin time and Reptilase time C. Rabbit brain

B. Prolonged Thrombin but normal Reptilase Time D. Mice brain

C. Prolonged Reptilase time but normal Thrombin time

D. Both normal since Thrombin is only sensitive for 61. INR is most useful in:
fibrinogen deficiency
A. Monitoring of CVD

B. Detection of clotting factor deficiency of the extrinsic

 Bleeding time - screening test for primary pathway
hemostasis (test for platelet function)
C. Monitoring of liver disease
 Whole blood clotting time - for primary
D. Monitoring of Warfarin therapy
hemostasis

 Tourniquet test (ss CFT) - used to measure

capillary integrity 62. Reference interval for Prothrombin time
 Platelet aggregometry - for platelet aggregation A. 11.0 to 12.5 seconds
studies (ADP, Collagen, EPI, Ristocetin)
B. 22.0 to 30.0 seconds
 PT - For extrinsic and common pathway, used
to monitor oral anticoagulants C. 12.0 to 20.0 seconds

 APTT - for intrinsic and common pathway; D. 35.0 to 45.0 seconds

used to monitor heparin therapy

 Stypven time (aka Russel’s viper venom) - For

 Substitution test - also known as mixing studies
common pathway
 Fibrinosticon - screening test for DIC
 Thrombin time - affected heparin therapy; used
in bedside testing; sensitive in  Ethanol Gelation test - screening test for DIC
(used to detect fibrin monomers)
 detecting heparin inhibition
 Euglobulin clot lysis time - screening test for
 Reptilase time - for fibrinogen; NOT affected by
fibrinolytic activity
heparin
 Platelet neutralization test - used for the
***Thrombin time and Reptilase time is used to
detection of lupus anticoagulant
differentiate Factor I deficiency and Heparin Therapy

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
 Duckert’s test - for factor XIII; uses 5M Ura and 29. Which of the following is associated with multiple
1% monochloroacetic acid clotting factor deficiencies?

A. Dysfibrinogenemia

Which of the following clotting factor is not measured by B. Hemophilia

PT and APTT? Factor XIII
C. Severe liver disease

D. Lupus
Market of thrombosis and fibrinolysis:

a. D-dimer
30. The usual dilution of platelet poor plasma used in
b. Fibrinolysis Clauss Fibrinogen Assay is:

c. Fragment X, Y, E A. 1:5

d. Plasmin B. 1:10

C. 1:20

13. What is the reference interval for APTT? D. 1:25

A. 19-24 seconds

B. 10-14 seconds 36. Hemophilia A can be best differentiated from von

Willebrand's disease by which of the
C. 25-35 seconds
following tests?
D. 38-45 seconds
A. APTT

B. PT
3. MAPSS stands for:
C. Bleeding Time
A. Multi-linear Angle Polarized Scatter Spectrum
D. Tourniquet test
B. Multi-linear Angular Polarized Scatter Separation

C. Multi-angle Polarized Scatter Separation

40. Cell populations that a 3-differential hematology
D. Multi-angle Plot Scatter Separation analyzer can identify:

A. Granulocytes, monocytes, lymphocytes

28. PT= Prolonged B. Neutrophils, monocytes, lymphocytes
APTT = Prolonged C. Eosinophils, basophils, neutrophils
Platelet Count = decreased D. Monocytes, lymphocytes, blasts
D-dimer = positive

Which of the following disorders is most likely indicated? 46. A medical technologist performed a routine
A. Hemophilia A venipuncture from a patient suffering from

B. Von Willebrand's disease unknown condition. The physician requested an

electrolyte panel that consists of Sodium,
C. DIC
Potassium, and Ionized Calcium, and coagulation tests
D. TTP (PT and APTT). Upon extraction,

the MT noticed that the blood clotted in just a few

minutes on the light blue top (glass). The

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
MT recollected a new sample but this time, he uses a D. Factor XIII
plastic citrated tube and noticed that

the blood clotted again in few minutes. The MT however

opted to run the sample since it 58. The most common congenital bleeding disorder is:

was a STAT request. The following test result were A. Hemophilia A

obtained: B. Hemophilia B
Na = 145 mmol/L C. Lupus
K = 3.8 mmol/L D. Von Willebrand's disease
iCa = 3.5 mmol/L

Question: What is the best explanation of this 59. Which of the following accelerates the activity of
discrepancy (persistent clotting) of the sample antithrombin?
that was collected in the citrate tube? A. tPA
A. Expired tubes B. Heparin
B. Insufficient mixing of blood C. Aspirin
C. Underfilled tubes D. Coumadin
D. Hypercalcemia

70. The most useful test for the diagnosis of Multiple

Myeloma is:

55. Normal range of MPV A. Flow cytometry

A. 5.0 to 6.0 fL B. SSA

B. 12.0 to 14.0 fL C. Nephelometry

C. 1.0 to 4.0 fL D. Serum Protein Electrophoresis

D. 7.0 to 9.0 fL

56. The classic technology used by most hematology

analyzers is:
HPMTL MOCKBOARDS RECALL
A. Flow cytometry
1. What concentration of alcohol is indicated for
B. Electric impedance urine, bronchial and gastric aspirates if smears
cannot be made immediately?
C. Light scatter  95%
D. All of the above
2. What is the freezing agent used in cold knife
procedure?
 CO2 gas
57. Which of the following factors binds to platelets via
the Gp IIb/IIIa receptor? 3. Which of the following is recommended for
A. vWF staining triglycerides (neutral lipids)?
 Sudan IV
B. Fibrinogen
4. What cervical cell resembles fried egg with
C. Prothrombin
sunny side up?

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL
 Parabasal cells 16. What is the ratio of fixative to tissue in museum?
 50:1
5. What is the process by which tissues, most
commonly a paraffin embedded tissue is 17. Which of the following fixative is used for acid
trimmed and cut into uniformly thin slices in mucopolysaccharides and mucin?
section to facilitate studies under the microscope?  Lead fixatives
 Microtomy
18. Which of the following adhesive is widely used in
6. Juan Dela Cruz passed the March 2023 MTLE immunochemistry?
the age of 20, can he get a COR next year?  Poly-L-Lysine
 YES
19. Sections for electron microcopy are embedded
7. What are floaters? in:
 Small pieces of tissue that appear on  Plastic
a slide which have floated in during  Paraffin, gelatin and celloidin
processing can be destroyed by the beam
 Cleaning of water bath every of electron
samples because it cause cross  PLASTIC is resistant to the
contamination (carry-over) beam of electron

8. RA 5527 date of approval: 20. What is the temperature requirement for the wax
 June 21, 1969 bath of Autotechnicon?
 3C above the melting point of the wax
9. Which of the following mold is made up of series  Autotechnicon is a type of an
of interlocking plates resting on a flat metal base, automatic tissue processor
forming several compartments?
 Compound embedding unit 21. For prolonged fixation (e.g. museum
 ADVANTAGE: More preparations) volume of the fixing fluid should
compartments not be less than, that of the tissue:
 DISADVANTAGE: Tendency to  50-100x
exchange the label of the
samples 22. PRC Modernization Law
 RA 8981
10. What is the optimum decalcification temperature?
 18-30C 23. What is the color of fluorescence when
fluorescein is used as a fluorochrome in direct
11. Section 12 of RA 5527: immunofluorescence technique for solid tissue
 Removal of Board members biopsies?
 Apple-green
12. Elliot- Bench type processor is:
 An automatic tissue processor 24. In the absence of the Board Medial Technology,
who can take their place to administer the Oath
13. What is the recommended retention time for of the Profession?
pathology blocks?  A person authorized by the board
 20 years
25. What is the staining method used for the
14. Vectabond is used as a/ an? supravital staining of mitochondria?
 Adhesive (for frozen sections)  Alcoholic pinacyanol method

15. The secretion obtained at bronchoscopy are 26. What method uses 70% ethyl alcohol and 28%
collected either by aspiration into a glass suction ammonia water to remove formalin pigment?
apparatus or by washing the bronchi with cc of  Kardasewitch
saline:
 1-2 27. Which of the following stains of chromatin green
in the presence of an acid?
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
 Methyl green Francisco Pefanco = lyrics
Crisanto Almario = “Father of Medical technology”
28. Which of the following is used for fixing dry and Roselyn P. Villones = finalized the PAMET hymm
wet smears, blood smears and bone marrow
tissues? 38. How long do we store paraffin blocks?
 Methyl alcohol  10 years

29. Which of the following method is normally 39. These are subpleural and subpericardial
utilized when a rapid diagnosis of the tissue in petechiae or echymoses observed in the tissues
question required and is especially of people who have been strangled or otherwise
recommended hen lipids and nervous tissue asphyxiated:
elements are to be determined?  Tach noire
 Frozen section  Tardieu spots  petechiae
 Fresh preparation  Marbling  trace of blood , it is
 Turn-around time: 30 minutes visible
 Lipids and nervous tissue are
heat sensitive 40. Which of the following is used as bluing agent?
a. Both
30. What stain is used to demonstrate plasma cells? b. Ammonia water (most commonly used
 Methyl-green pyronin bluing agent)
c. Potassium acetate
31. Tissue exposed to short burst carbon dioxide for d. Neither
few minutes will:
 Freeze 41. All of the following are components of Scott’s tap
water, EXCEPT:
32. Which of the following reagent fixes and  NaCl
dehydrates at the same time?
a. Neither 42. Which of the following is recommended for acid
b. Alcohol mucopolysaccharides?
c. Acetone  Lead fixatives
d. Both
43. Which of the following is recommended for
33. I. Rocking microtome is the most commonly preservation and storage of surgical,
used microtome postmortem and research specimens?
II. Sliding microtome uses diamond knife for  10% NBF
cutting
 Both are incorrect 44. Which of the following deals with the
 Rotary microtome is the MOST microscopic study of cells that have been
commonly use microtome desquamated from epithelial surface?
 Ultrathin microtome uses  Exfoliative cytology
diamond knife for cutting
45. The best fixatives for museums
34. LTO (License to Operate) validity of Clinical  Khisserling’s reagent
laboratory
 1 year 46. What is the temperature of cryostat for liver
sample?
35. Composition of Medical Technology board:  -5 to -15C
 1 Patho Chairman, 2 MT members
47. The epithelial of alveoli are made up of:
36. What is the most critical in microwave  Simple squamous
processing of tissues
 The size if the tissues 48. Which of the following is used at ice cold
temperature ranging from -5 to 4C?
37. Lyrics of PAMET hymm  Acetone
 Hector Gayares Jr.
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
49. Which of the following is the most widely used  Indicator of water content. Blue if
method of evisceration? water is present
 Virchow
 Virchow is the “Father of 58. What is the melting point of water soluble wax?
Cellular Pathology”  38-42C
 Technique: ‘one-by-one’ 
process of removing organ one 59. I. The plane wedge knife is approximately
by one 100mm
II. Both sides of plane wedge knife are
50. Which of the following is the most commonly biconcave
used fixative for electron microscopy?  I is correct while II is incorrect
 Osmium tetroxide (Secondary fixative)
 Glutaraldehyde (Primary fixative) 60. What is the optimal incubation time for linking
antibodies with peroxidase conjugates?
51. Which of the following is INCORRECT about  30-60 minutes at RT
formic acid in comparison with nitric acid as
decalcifying agent? 61. What is the best clearing agent in microwave
 Faster technique?
 Formic acid is slower compare  Isopropanol
to nitric acid
62. Which of the following is common among
52. I. Gelatin impregnation is used when diabetic patients and is sesh kebab in
dehydration is to be avoided appearance?
II. Impregnating agent to tissue 10:1  Candida albicans
 Impregnating agent: Tissue
(25:1) 63. Which of the following is used for methylene
 I is correct while II is incorrect blue-stained nerve preparations?
 Apathy’s medium
53. The amount of fixative must be approximately,
times the volume of tissue specimen 64. Best’s carmine is used for demonstration of:
 10-15  Glycogen

54. Required for hospital-based laboratory: 65. Gastrointestinal tract specimen in diagnostic
a. Both cytology should be processed within:
b. Coagulation studies  30 minutes
c. Arterial blood gas
d. Neither 66. Which of the following is NOT an Alum
hematoxylin?
 DOH A.O “2021-0037 New  Mallory
Rules and Regulations
Governing the Regulation of 67. Which of the following is not a tissue softener?
Clinical Laboratories in the  Ammonium hydroxide
Philippines”
68. It is the application of different color or stain to
55. What is the most sensitive oil soluble dye? provide contrast and background to the staining
 Sudan black of the structural components to be demonstrated
 Counterstaining
56. In tissue enzyme studies, the preferred and ideal
method to avoid complete or partial loss of 69. Which of the following natural dye is derived
enzymatic activities with the use of, sections: from lichens?
 Frozen  Orcein

57. What is the function of anhydrous copper sulfate  Cochineal dye= cochineal bugs
in dehydration?  Hematoxylin= the heartwood of
Palo de Campeche
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
(Haematoxylum campechianum),
the logwood tree native to 81. What is the fixative choice for lipid
Mexico and Central America. histochemistry
 Saffron= crocus sativus—  Osmic acid
commonly known as the "saffron
crocus." 82. Which of the following surgical procedure is the
simplest and least invasive test to obtain specific
70. Which of the following is used to remove types of tissue samples
chromate pigments?  Fine needle biopsy
 Acid alcohol
83. Which of the following microtome has the
71. It is the process by which the impregnated disadvantage of acquiring infection due to
tissues is placed into a precisely arranged aerosol?
position in a mold containing a medium which  Freezing
then is allowed to solidify
 Embedding 84. What is the penetration time of 10% NBF in
tissues?
72. Which of the following is used for the  1mm/hour
demonstration of Rickettsiae?
 Orth’s fluid 85. Which of the following hone gives the finest
result?
73. Which of the following is used to fixed brain for  Belgian
the diagnosis of rabies?
a. Acetone 86. Urgent biopsies fixed formalin is best fixed at
b. Neither what temperature?
c. Carrnoy’s  60C
d. Both
87. To these principles I hereby subscribe and
74. Which of the following is the father of cellular pledge to conduct myself at all times in a
pathology? manner befitting the, of my profession
 Rudolf Virchow  Dignity

75. Which of the following is used for fixing post 88. During inflammation, dolor is due to:
mortem tissues?  Pressure upon the sensory nerve by
 Formol-corrosive the exudate

76. Which of the following is the most commonly 89. Which of the following is recommended for
used method in determining the completeness of fixation of embryos and pituitary biopsies
decalcification  Bouin’s
 Chemical
90. Dexter’s laboratory, a free-standing secondary
77. The paddle strop is made up of laboratory is required to provide PT and aPTT
 Leather test
 Incorrect
78. Head of Clinical laboratory based on DOH A.O
2021-037 91. What is the purpose of 1% phenol in gelatin
 Pathologist impregnation?
 Prevents growth of mold
79. Sarcoma refers to the malignant tumors of, in
origin 92. Glacial acetic acid added to hematoxylin will:
 Connective tissue  Enhance nuclear staining

80. The tissue block from dry celloidin method is 93. What is the optimum working temperature of a
stored in, until ready for cutting cryostat machine?
 Gilson’s method  -18 to -20C
JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL
98. Which of the following involves the removal of
94. What is rHIVda? gross nicks on the knife edge to remove
 Rapid HIV Diagnostic Algorithm blemishes?
 The blood will be send to  Coarse honing
SACCL (Nation Reference
Laboratory for HIV) 99. Which of the following is used as a mordant in
 Purpose: To provide Heidenhain’s solution?
implementation policies and  Ferric ammonium sulfate
guidelines for the use of rapid
HIV diagnostic algorithm 100. Which of the following is the most rapid
(rHIVda) as the new HIV freezing agent?
confirmatory test in Certified  Liquid nitrogen
rHIVda Confirmatory Laboratory
(CrCL) facilities. MICRO-PARA MOCKBOARD RECALLS
s
95. Reference laboratory for Parasitology 1. what is the usual temperature of incubation for
 RITM bacterial culture?
External Quality Assessment Program (EQAP)
NEQAS- National External Quality Assurance 35°C - 37°C
Scheme 2. carriers of neisseria meningitidis may be detected by
National Reference plating specimens on selective media following collection
Laboratory (NRL)
from the
1. National Kidney hematology,
and Transplant immunohematology, Nasopharynx
Institute (NKTI) urinalysis, anatomic Neisseria meningitidis
pathology for renal and • meningitis
other unassigned organ • sepsis
systems, cellular-based • Found in the Upper Respiratory Tract
product testing • Thayer - martin agar
2. Lung Center of general clinical chemistry,
the Philippines anatomic pathology for
pulmonary and pleural 3. what is the intracellular that allows organisms to
diseases withstand extreme conditions
3. San Lazaro Infectious immunology,
Hospital/ SACCL HBsAg, HIV, HCV, syphilis Endospore
and other STI Fimbriae: aka PILI
4. East Avenue toxicology, micronutrient Endosperm: means of survival against harsh
Medical Center assays, environmental and environmental condition
occupational health, Murein: mainstains the shape of the cell
industrial and chemical
emergencies
4. The gram-positive bacteria possess the following
5. Research Microbiology and
characteristics, except:
Institute of Tropical Parasitology
Medicine (RITM) Outer membrane
6. Philippine Heart anatomic pathology for * Gram -positive bacteria has multilayered
Center cardiac diseases, cardiac peptidoglycan cell wall and teichoic acid
markers
5. organisms that require oxygen
96. Which of the following is not a nuclear fixative:
 Formalin with post chroming Aerobes

97. What is the expected result when rhodamine

conjugates are used as a fluorochrome?
 Orange-red fluorescence

JULIUS AZURIN GALOPE

 MOCKBOARDS RECALL

High Peptidoglycan content in the cell wall

* Has mycolic acid which is responsible for the acid
fastness of mycobacteria which means
they are able to retain certain dye even after being
treated by an acid alcohol

11.in culture, bacillus anthracis shows the following

characteristic/s

6. transport medium of feces or rectal swab for culture Medusa head

of enteric pathogens

Stuart's medium
Transport medium for rectal and stool sample:
• stuart's medium
• Amie's medium
• Cary Blair
• transgrow 12. Colorless, non-motile, does not produce H2S,
• JEMBEC
causes bacillary dysentery and is limited to
* Buffered glycerol-saline
gastrointestinal tract
• toxic to vibrio and Campylobacter
Shigella
7. In disk diffusion antimicropial susceptibility test, the
lowest concentration of the antibiotic that prevents
visible growth of the organisms:

The minimum inhibitory concentration

8.Chocolate agar is an example of

Enriched media

13, The following structure is or are found exclusively in

gram-negative cells:

Outer membrane and Lipopolysaccharides

14. Who discovered that "life's smallest structural units

are cells"

9. refers to any process that removes, kills, or

deactivates all forms of life (in particular referring to
microorganisms such as fungi, bacteria, viruses, and
spores

Sterilization

15. This is an organism with asymptomatic infection but

is able to transmit disease to another susceptible
organism

Carrier

10. Not a characteristic of the genus mycobacterium

JULIUS AZURIN GALOPE
 MOCKBOARDS RECALL

24. Which of the following laboratory test differentiates P.

aeroginosa and P. putida
Growth at 42°C

25. "Lumpy jaw" is caused by

16. Bacteria that are cold-loving Actinomyces
*Lumpy jaw is also known as actinomycoses or
Psychrophile "wooden tongue" caused by Actinomyces
bovis

26. Which of the ft. anficoagulant is used for bacterial

culture
SPS

27. Phase where active reproduction occurs

Log phase

28. This microorganism shows double zone of hemolysis

C. Perfringens
17. In which of the following phase where metabolic
29. Which of the following is used to identify S.
activities of surviving cells slow down and nutrients are
pneumonia
becoming limited
Optochin disk
Stationary phase
30. Etiologic agent of syphilis
T.palidum

51, Process in which packaged an non-packaged foods

(such as milk and fruit juice ) are treated with mild heat,
usually to less than 100°C (212F), to eliminate
pathogens and extend shelf-life
Pasteurization

52. M. Tuberculosis and B. Abortus are similar in that

they:
18. Which of the following specimen is cultured using a
Produce intracellular infections
quantitative isolation technique
* Mycobacterium and Brucella are intracellular
Urine
organisms
19. All of the following are pH indicators used in media to
53. Production of yellow pigment is a characteristic of
determine shifts except:
which species of Enterobacter
Methylene blue
E.sakasakii
20. Acinetobacter species are similar to other neisseria
54. Which of the following diseases occur after a
with the exception that
streptococcal infection
Oxidase negative
Rheumatic fever
21. What kind of organism grows on Lowenstein-Jenser
55. which of the following structures is involved in
agar
motility and DNA transfer in bacteria
Mycobacterium tuberculosis
Pili
22. Most significant microbicidal halogens used in clinic
56. Bacteria that grows on moderate temperatures are
and traditionally used as for both antiseptic and
called:
disinteorant purposes
Mesophiles
Halogen releasing compounds
57. Which of the following antimicrobial agents acts by
23. He demonstrated that routine handwashing can
inhibiting cell wall synthesis
prevent the spread diseases during the year 1846
Vancomycin
Ignaz Semmelweis

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 MOCKBOARDS RECALL
Clindamycin: inhibit protein synthesis in the 50s * Ticks, louse, or mites
ribosomal unit
Vancomycin: inhibits cell wall synthesis 70. Polymers of NAG and NAM are found in
Gentamicin: inhibits protein synthesis in the 30s Cell wall
ribosomal subunit
Erythromycin: inhibit protein synthesis in the 50s 71. Specimen of choice for Neisseria meningitisdis
ribosomal unit CSF

58. Staphylococcus aureus is differentiated from other 72. A gram stain performed on a sputum specimen
species of staphylococcus by: revealed gram-negative diplococci within PMNs.
Production of coagulase with the plasma Oxidase testing is positive and carbohydrate degradation
test is inert. The organism is:
59. Causes fever and pseudo membrane, white patchy Moraxella catarrhalis
spots on the pharynx and is a gram-positive bacilli. This • gram-negative diplococcus
is caused by: • upper RT of humans
C. diphtheria • biochemically inert
• does not ferment carbohydrates
60. Bordetella pertussis requires which of the following
Potato - blood-glycerol agar 73, "councilman bodies" are thought to be
*Aka Regan Lowe medium pathognomonic of:
Bordet Gengou medium Yellow-fever
• causative agent of whooping cough
74. The optimal time to collect blood culture where in
61. A positive lipase reaction is demonstrated by: there is the highest concentration of bacteria is present
Clostridium botulinum Before the fever spikes
* Clostridium perfringens - positive lecithinase reaction
75. Bacteria often store reserve materials in the form of
62. Type of transport associated with the entry of insoluble granules which function in the form of insoluble
dissolved oxygen, carbon dioxide, and water: granules which function in the storage of energy or as a
Simple diffusion reservoir of structural building blocks. These are called:
Inclusion bodies - storage vessels
63. Also called as the "whooping cough bacillus" where
in the preferred sample of choice for isolation is 76. The size of inoculating loop of quantization of urine
nasopharyngeal swab culture is:
Bordetella pertussis 0.01 ml

64. the lesion starts as a pruritic people that later 77. Parrot fever or "psittacosis" is caused by species of
becomes a vesicle, necrotic ulcer and black eschar the following genus:
Cutaneous anthrax Chlamydia

65. The pattern of hemolysis characterized by complete 78, gram positive bacilli, except
clearing of the blood around the bacterial growth Edwardsiella
Beta-hemolysis *Gram-negative bacilli
* Alpha-hemolysis: incomplete hemolysis Fresh water and marine environments
Gamma-hemolysis: absence of hemolysis
Beta-hemolysis: complete hemolysis 79. Negri bodies are cytoplasmic inclusions in nerve
cells found in:
66. Chocolate agar is used as primary medium in Rabies
Throat * Eosinophilic, cytoplasmic inclusion bodies that are
found in certain nerve cells
67. which of the following is selective and differential
medium 80. Toxin associated with scarlet fever
MAC Erythrogenic toxin
* Scarlet fever - bacterial infection caused by group
68, In young girls, S. saprophyticus is the cause of A streptococcus
UTI * Streptococcus pyogenes

69. Diseases caused by rickettsia are transmitted to 81. This is used to detect gas production in liquid
humans by: medium
An arthropod vector Durham tube
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 MOCKBOARDS RECALL
*Smaller test tubes inserted upside down in another
test tube 91. Toxins associated with staphylococcal scalded skin
syndrome is/are
82. A person who has ingested food contaminated with Exfoliative toxins
toxins manifest with double vision, inability to swallow *Dissolving the mucopolysaccharide matrix of the
and respiratory distress epidermis
Botulism
92, which phase shows reproduction rate equal to the
83. this organism is spore forming gram positive bacilli, equivalent death rate
non-motile: non-haemolytic, catalase positive Stationary phase
Bacillus anthracis
93. rice water stools are usually seen in infection with
84. A reliable test for distinguishing S. aureus from S. V. Cholerae
epidermisdis is the Salmonella: ped-soup stool
Coagulase test
94. what organism will give rise to a positive urea, move
actively by means of peritrichous flagella resulting to
swarming on solid media
Proteus

95. routine laboratory testing for T. pallidum involves;

Serologic analysis
85. Any process that destroys the non-spore - forming
96. How would you differentiate Vibrio parahaemolyticus
contaminants on living tissue is
from Vibrio cholera
Antiseptics
Sucrose
V. parahaemolyticos - green colonies
V. cholerae - yello colonies

97. This enzyme is produced by group A streptococci

which is hemolytic for RBCs of many animals
Streptolysin O
86. The sulfate dapsone is used for the treatment of: * Collagenase - breaks down collagen
Leprosy * Hyaluronidase - hydrolyzes hyaluronic acids

87. diseases which are epidemic over a large territory 98. Common manifestation of Group A-Beta hemolytic
are said to be: Streptococcus, except:
Pandemic Myocardial infarction

88. Kill an array of organisms including resistant virus, May we get that RMT in the year 2024.
and highly recommended for cleaning bodily fluids
Chlorine compounds
* corrosive
* discoloration
* irritation

89. contains true nucleus:

Eukaryotes

90. All are DNA viruses, except:

Togavirus
DNA viruses:

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