1. Which of the following statements about platelet transfusions is true?

A. Are indicated in all patients with platelets <50 x 109/L

B. Will raise the platelet count in the recipient for 5–7 days
C. Must be cross-matched
D. Are usually given as a pool of five individual donations

2. On Neubauer’s chamber platelets are counted in

A. 5 RBC squares
B. 4 WBC squares
C. 8 RBC squares
D. A and B

3. Which of the following statements about chronic lymphocytic leukaemia (CLL) is not
true?
Is associated with an increased risk of developing other cancers
A. Affects children more commonly than adults
B. Causes generalized suppression of the immune system
C. Is frequently asymptomatic when first diagnosed
4. Identify the cell by the arrow.
A. Normal RBC
B. Lymphocyte
C. Nucleated RBC
D. Pappenheimer Bodies
 5. For a forward pipetting technique, press pipette to the………..stop first
A. First stop
B. third stop
C. Last stop
D. either the first or the last

6. Patient position such as standing or supine can affect the following except
A. electrolytes.
B. Calcium.
C. Haemoglobin.
D. Blood gases.

Use the case presented below to complete questions 7 to 9

A 15-year-old boy, admitted in a comatose state. His mother stated that he had complained of
excessive thirst from about a week previously. She thought he had lost weight over the past
few weeks. On the day of admission, he had vomited repeatedly and become drowsy.
Examination: Comatose, with deep and rapid breathing. Breath smelled of acetone. Signs of
dehydration were present: loss of skin tugor, dry mouth, sunken eyes. Pulse 110, BP 90/50.
Dip-stick test on urine showed glucose 3+, ketones 4+, pH 5.
Plasma: Na= 130 mmol/l, K= 5.8mmol/L, Cl =100mmol/L, Urea= 18mmol/L,
Creatinine =140umol/l, Glucose =32 mmol/l, pH =7.05, pCO2=2.0 kPa, SBC =5
mmol/l, BExcess -26 mmol/L

7. What type of acid-base disturbance is present?

A. respiratory acidosis
B. metabolic acidosis
C. mixed acid base balance
D. Compensated metabolic acidosis

8. Comment on anion gap

A. Decreased
B. No change
C. Increased
D. Insufficient information for calculation

9. What is/are the likely reason(s) for the elevated urea and creatinine?
A. renal failure
B. pre-renal failure
C. Low GFR
 D. Dietary reasons

10. In the absence of xylene the following agents can be used, except
A. Methyl salicylate
B. Citric fruits oils
C. Clove oil
D. Propan-2-ol

11. Manual tissue processing has the following disadvantages, except

A. Proper agitation of reagent not achieved
B. More evaporation of reagents
C. Process is tedious and requires constant attention
D. When the number of tissue blocks is limited
12. Only one of these statements is true of picric acid containing fixatives
A. Bouin’s fluid contains saturated alcoholic picric acid
B. Rossman’s fluid contains saturated aqueous picric acid
C. Bouin’s fluid preserves nuclear morphology well
D. Tissues fixed in Bouin’s fluid require post fixation treatment
13. Trichomonas vaginalis may inhabit the
A. small intestine
B. large intestine
C. prostrate
D. none of the above

14. This virus causes gastrointestinal conditions particularly in children

A. Rotavirus
B. Rubella virus
C. Influenza A virus
D. All of the above

15. During AIDS, HIV infects

A. CD3 lymphocytes
B. CD4 lymphocytes
C. CD8 lymphocytes
D. B-lymphocytes

16. Which of the following is the most specific technique for the diagnosis of HIV/AIDS
infection?
A. Northern blot
B. Western blot
 C. ELISA
D. Immuno-electrophoresis

17. Quality control and standardization in the medical laboratory does not include this:
A. Preventive maintenance of all instruments
B. Control of all reagents
C. An updated technical manual
D. Continuing Professional Development for the laboratory manager only

18. For safe blood transfusion this is used as a preservative

A. LISS
B. CPD-A
C. NaF
D. EDTA

19. The clinical relevance of MCV > 100 fl include:

A. Thrombocythaemia
B. Smoking
C. Chemotherapy
D. Leukaemia

20. Automated blood cell separator devices (platelet apheresis) are now capable of
A. Collection of concurrent plasma components.
B. The use of in-process leukocyte reduction.
C. Collection of single platelet components
D. Collection of concurrent RBC components.

21. Fermentation of the sugars in TSI is a Biochemical identification test for the
following EXCEPT;
A. E. coli
B. Klebsiella spp
C. Enterobacter spp
D. Pseudomonas spp

22. A 70years old man with episode of urinary retention has been wearing a catheter. A
culture of urine reveals a thin film of bacteria growth covering the entire blood agar
plate, and the Urease test was positive. The likely causative bacterium is;
A. E. coli
B. Staphylococcus aureus
C. Salmonella typhi
D. Proteus mirabilis

23. A bloody urine specimen may imply an infection of:

 A. Trichomonas vaginalis.
B. Wuchereria bancrofti.
C. Enterobius vermicularis.
D. Schistosoma haematobium.

24. The following are morphological characteristics of Fungi EXCEPT;

A. Hyphae
B. Mycelium
C. Spores
D. Chromatin Dot

25. Blood sample for blood gases is collected into

A. K2-EDTA tube
B. Fluoride oxalate tube
C. Lithium heparin tube
D. Na-EDTA

26. Factors to consider in selecting a plasma enzyme for diagnosis include all of the
following EXCEPT;
A. Sensitivity
B. Specificity
C. Half-life of the enzyme
D. Molecular weight of the enzyme

27. Each of the following parasite is transmitted by mosquitoes except

A. Leishmania donovani
B. Plasmodium vivax
C. Plasmodium falciparum
D. Wuchereria bancrofti

28. Pigs or dogs are the source of human infection by each of the following parasites
except
A. Echinococcus granulosis
B. Trichinella spiralis
C. Taenia solium
D. Ascaris lumbricoides

29. In malaria, the form of plasmodium that is transmitted from mosquito to human is the
A. Sporozoite
B. Gametocyte
C. Merozoite
D. Hypnozoite
CASE STUDY: Use the information below to answer questions 30 – 32.
A 23 year old female had her fasting plasma lipid checked by her family doctor because her
father had been admitted at the hospital and diagnosed of myocardial infarction, aged
44years. Her lipid profile results are as follows:

Analyte Results Reference ranges

Cholesterol 9.40 mmol/l 3.50 - 5.0 mmol/l
HDL-cholesterol 1.2 mmol/l 1.0 - 1.8 mmol/l
Triglycerides - 0.5 - 0.75 mmol/l

The biomedical scientist had the optical density of her triglycerides as 0.09, mean standard
absorbance 0.20 and standard concentration of 2.28mmol/l.

30. What is the triglycerides concentration from the above case study?
A. 5.03 mmol/L
B. 4.03 mmol/L
C. 1.03 mmol/L
D. 3.03 mmol/L

31. Calculate the [LDL] of the above patient

A. 7.93mmol/L
B. 8.20 mmol/L
C. 8.79mmol/L
D. 7.73 mmol/l

32. Very low density lipoprotein (VLDL) concentration of the patient is?
A. 1.67 mmol/L
B. 1.03 mmol/L
C. 1.20 mmol/L
D. 0.47 mmol/L

33. Each of the following statements concerning giardia lamblia is correct except
A. G. Lamblia has both a trophozoite and cyst stage in its life cycle
B. G. Lamblia is transmitted by the fecal oral route from both human and animal
sources
C. G. Lamblia causes hemolytic anemia
D. G. Lamblia can be diagnosed by the string test

34. Serum:
A. Comprises the liquid component of unclotted blood
B. Is suitable for measurement of fibrinogen levels
C. Can be used for analysis of most biochemical tests on blood
D. Is obtained by taking blood into an anticoagulant and then comprises the liquid phase
after centrifugation of the cellular elements
35. Serum electrolytes are accurately measured by which of the following methods
A. Cation selective electrode
B. Anion selective electrode
C. Iron selective electrode
D. Ion selective electrode

36. Causes of secondary hyperlipidaemia include

A. Hyperthyroidism
B. Alcohol
C. Addison’s disease
D. Hepatitis

37. Plasma creatinine

A. Assays may be subject to interference
B. Is a useful screening test for the presence of renal tubular disease
C. Is often reduced in patients with hepatic failure
D. Is unaffected by changes in diet

38. The most abundant Hgb found in adult is:

A. Hb A
B. Hb A2
C. Hb F
D. Hb C

39. One of these blood cells can be described as having a biconcave disc shape and very
vital in preventing tissue hypoxia:
A. Platelets
B. Neutrophil
C. Erythrocyte
D. Eosinophil

40. Pick the odd cell type out of the following cells
A. Neutrophil
B. Lymphocyte
C. Eosinophil
D. Basophil

41. Which of the following component measurements is not part of FBC test?
A. RBC count
B. Haematocrit
C. Platelet function test
D. WBC and differential count

42. The concentration of sodium chloride in isotonic solution is:

A. 8.5%
B. 0.85%
C. 85%
D. 0.6%

43. A xylene reagent used in tissue processing that could not clear again because it had
lost its strength should be.
A. Disposed off in the drainage
B. Bottled for recycling
C. Left in the sun to evaporate
D. Mixed with more water and disposed off in the drainage

44. A cervical smear from a 24 –year-old pregnant woman contains sheets of cells with,
enlarged hyperchromatic nuclei; scattered mitotic figures; prominent nucleoli. These
cytologic changes are consistent with:
A. Decidual reaction
B. Trophoblastic cells
C. Reparative epithelium
D. Reserve cell hyperplasia

45. Which of the following can act as both a dehydrating agent and an indicator of the
water content of the last bath of 100% ethanol?
A. Hydrated copper sulphate
B. Copper
C. Anhydrous copper sulphate
D. Phenol
46. Which of these methods will lyse red blood cells of heavily blood stained smears?
A. Xylene’s method
B. Carnoy’s method
C. Formalin’s method
D. Chloroform’s method

47. The following are not universal solvents EXCEPT

i. Dioxane
ii. Tertiary butanol
iii. Tetrahydrofuran
iv. Trichloroethane
A. ii, & iv
B. ii
C. iii
D. iv

48. Which of the following statement is false about tissue processing?

A. Paraffin wax may be used repeatedly
B. Addition of rubber to wax aids the production of serial ribbons and greater adhesion
C. Water may be removed by heating wax to 100oCto 105oC
D. Heating wax to higher temperatures makes it softer

49. The expected colony count in suprapubic urine from a healthy individual is:
A. 0 CFU/mL
A. 100 CFU/mL
B. 1,000 CFU/mL
C. 100,000 CFU/mL

50. Anaerobic infections differ from aerobic infections in which of the following?
A. They usually respond favorably with aminoglycoside therapy
B. They usually arise from exogenous sources
C. They are usually polymicrobic
D. Gram stains of specimens are less helpful in diagnosis
51. A Biomedical Scientist is reading a Gram stain from a CSF and observes many
neutrophils and lancet-shaped gram-positive diplococcic. Which set of chemistry and
microbiological CSF results would most likely be seen in someone with this type of
infection?
CSF results WBC Glucose Protein
A increased increased increased
B decreased decreased decreased
C increased decreased increased
D decreased increased decreased
A. Result A
B. Result B
C. Result C
D. Result D

52. The concentration methods for diagnosis of blood parasites include all of the
following except
A. Cellulose Tape Preparation
B. Microhaematocrit centrifugation technique (Woo method)
C. Triple centrifugation technique
D. Knott’s concentration technique

53. An antibiotic used to suppress or kill contaminating fungi in media is:

A. Penicillin
B. Cycloheximide
C. Streptomycin
D. Amphotericin B

54. Indole production in bacteriological cultures containing E. coli is made possible by

the production of all the following except
A. Tryptophan
B. Ammonia
C. Indole
D. Hydrogen sulphide
55. Exposure to infectious agents results from
A. Accidental puncture with needles,
B. Avoiding spraying of infectious materials by syringe or spilling.
C. Proper hand washing
D. Prevention of centrifuge accidents

56. After food ingestion, there is an increase in the following analyte

A. Potassium
B. Cortisol
C. Triglycerides
D. Cholesterol

57. Reasons why stool may be sent to a chemical pathology laboratory for analysis
include
A. Examination for parasites
B. Testing for bilirubin
C. Faecal fat determination
D. Stone analysis

58. The general quantitative relationship that governs all absorption processes is known
as
A. Nernst law
B. Faraday’s law
C. Beer-Lambert law
D. Fluorometric law

59. Which of the following statements is false?

A. HLA antigens are used by the body’s immune system to detect foreign cells
B. Individuals with rarer types of HLA would result in an inconclusive testing during
parental testing
C. HLA testing is used to differentiate between related alleged fathers
D. HLA typing is based on the detection of HLA lipids found in all cells of the body.

Use the picture below to answer the question which follows:

60. What type of sample is this likely to be and what is the diagnosis?
A. This is a scotch tape slide demonstrating eggs of Enterobius vermicularis
B. This is a stool saline wet mount demonstrating eggs of Enterobius vermicularis
C. This is a modified formol-ether concentration (M-FEC) demonstrating eggs of
Enterobius vermicularis
D. None of the above

61. Hepatitis E virus (HEV) can cause epidemics of jaundice, more commonly seen in
developing countries. All of the following are the most common sources of HEV,
except?
A. Contaminated water
B. Raw or undercooked pork
C. Contaminated blood products
D. A sexual relationship with an infected individual

62. Which of the following statements is true for hepatitis causing viruses HAV, HCV,
HDV, and HEV?
A. They are transmitted via the fecal-oral route
B. They are transmitted via the parenteral route
C. They contain a single-stranded RNA genome
D. They contain a double-stranded DNA genome
63. A physician calls you from an outlying hospital to report that his patient has passed a
large, white, round worm with pointed ends that is about 8 inches long. He is
concerned this could be Echinococcus but the only parasite that matches this description is
A. Ascaris lumbricoides
B. Schistosoma mansoni
C. Strongyloides stercoralis
D. None of these

64. River blindness occurs due to infection by

A. Loa loa
B. Mansonella perstans
C. Mansonella streptocerca
D. Onchocerca volvulus

65. When performing a Kovac indole test, the substrate must contain:
A. Indole
B. Tryptophan
C. Ornithine
D. Paradimethylaminobenzaldehyde

66. The commonest opportunistic bacterial infection in HIV disease is

A. mycobacterial infection
B. Typhoid infection
C. candida infection
D. toxoplasmosis

67. Which type of culture media is used in microbiology laboratories to isolate Vibrio
spp.
A. Blood Agar
B. CLED
C. TCBS
D. DCA

68. Which of the following is GNID?

A. Gardnerella vaginalis
B. Neisseria gonorrhoea
C. Staphylococcus aureus
D. Streptococcus pneumoniae
69. The following are true with HLA typing and matching except.
A. HLA matching requires the availability of large numbers of HLA-typed donors.
B. HLA-matched platelets require the recruitment of specific donors.
C. HLA-matched platelets can only be obtained by apheresis.
D. Platelet apheresis is an easy and inexpensive procedure.

70. An acute lymphocytic leukaemia case (with suspected 9p21 rearrangement) was sent
to histopathology lab for molecular diagnosis. The best molecular diagnostic
technique will be
A. Fluorescent in-situ hybridization
B. Immunocytochemistry
C. Flow cytometry
D. Immune-PCR

71. Which of the following cytomorphologic feature depicts an inflammation in a smear?

A. None of the options
B. Cytoplasmic Vacuolation
C. Diffused nucleoli
D. Pyknosis

72. One difference that separates exudates from transudates is

A. Exudates have higher protein concentration
B. Exudates have lower cell concentration
C. Exudates have lower protein concentration
D. Exudates are useful parameters in cardiovascular disease

73. Pap smears are stained using one of these stains

A. Giemsa stain
B. May Grunwald- Giemsa stain
C. Pap stain
D. Wright’s stain

74. One is odd: The role of gynaecological cytology is

A. To detect malignant lesions
B. To assess hormonal function
C. To assess red blood cells
D. To identify vaginal infections
75. Which of the following cells does not undertake phagocytosis?
A. Neutrophils
B. Macrophages
C. T lymphocytes
D. Monocyte

76. Which of the following is not used in parental testing?

A. Red cell estimation
B. ABO blood group typing
C. Using human leukocyte antigen (HLA) antigens
D. Genetic testing

77. The lab has been using latex agglutination assay to detect Clostridium difficile in
stools, which identifies a nontoxin cell wall antigen. The lab is considering adoption
of an EIA method that detects Clostridium difficile toxin A. Which of the following
would provide the best comparison?
A. latex agglutination vs culture on cycloserine cefoxitin-egg-fructose agar
B. latex agglutination vs EIA vs cell culture cytotxin assay
C. EIA vs culture on cycloserine cefoxitin-egg-fructose agar
D. EIA vs cell culture cytotoxin assay

78. The MOST frequently used specimen for chemical pathology assay is
A. Urine
B. Blood
C. Serum
D. Saliva

79. Consider these statements

A. Refrigeration of whole blood has no the effect on K+ concentration by reducing
the activity of the ATPase pump
B. Freezing of the blood samples will results in haemolysis and falsely elevate Na+
concentration
C. Blood for glucose estimation should be put into any tube.
D. The concentrations of many substances are the same in erythrocytes and the
surrounding plasma

80. Point of care testing:

A. Eliminates the need for training staff who use these instruments
B. Cannot be used to measure bilirubin
C. Is best established independently from the central biochemistry lab
D. Is less costly per unit test than analysis undertaken in the central laboratory

81. Hyponatraemia
A. Is usually due to excessive sodium losses
B. Is not commonly seen after surgery or trauma
C. In the syndrome of inappropriate secretion of ADH is associated with low urine
osmolality
D. May be due to hyperemesis

82. Electrolytes in the body includes all the following EXCEPT

A. Sodium.
B. Zinc.
C. Chloride.
D. Potassium.

83. Serum urea can change independently to renal diseases in all of the following
EXCEPT
A. High protein intake
B. Over hydration
C. Burns
D. Congestive heart failure
84. Low levels of alkaline phosphatase are found in
A. Hepatocellular diseases.
B. Cretinism.
C. Hyperparathyroidism.
D. Paget's disease

85. What is the major metabolically active storage form of Iron in the body
A. Haemosiderin
B. Ferritin
C. Transferin
D. Globulin

86. Hb A2 consists of
A. 3 alpha and 2 gamma chains
B. 2 alpha and 2 beta chains
C. 2 alpha and 2 delta chains
D. 2 alpha and 3 delta chains

87. The leucocyte responsible for parasite infection and allergic reaction is:
A. Lymphocyte
B. Eosinophil
C. Basophil
D. Neutrophil

88. The liquid portion of blood is referred to as:

A. Whole blood
B. Haematocrit
C. Plasma
D. Serum

89. Which of the following cell types should not be grouped with the others?
A. Neutrophil
B. Eosinophil
C. Platelet
D. Basophil

90. Mostly a full blood count blood is collected into one of the following stopper colours
A. Purple
B. Blue
C. Green
D. Yellow

91. Which of the following organizes and directs light through the specimen?
A. Ocular
B. Objective lens
C. Condenser
D. Optical tube

92. In disk diffusion susceptibility testing, as an antimicrobial agent diffuses away from
the disk, the concentration of antibiotic is:
A. increased
B. decreased
C. C unchanged
D. inoculum dependent

93. A sheep agar plate inoculated with 0.001 mL of urine grows 70 colonies of
Staphylococcus aureus. How many colony forming units per mL of urine should be
reported?
A. 70 CFU/ml
B. 700 CFU/ml
C. 7000 CFU/ml
D. 70000 CFU/ml

94. When stool examination is negative, the preferred specimen for the diagnosis of
paragonimiasis is:
A. bile drainage
 B. duodenal aspirate
C. sputum
D. rectal biopsy

95. Acceptable specimens for culture of anaerobic bacteria that cause disease include:
A. abscesses
B. gingival swabs
C. skin swabs
D. vaginal swabs

96. An organism previously thought to be nonpathogenic, Moraxella catarrhalis, is now

known to be associated with opportunistic respiratory infection and nosocomial
transmission. Characteristic identification criteria include:
A. oxidase negative
B. carbohydrates negative (asaccharolytic)
C. beta lactamase negative
D. gram-negative bacilli

97. All species of the genus Pseudomonas have the enzyme to oxidize:
A. naphthylamine
B. dimethylaminobenzaldehyde
C. glucopyranoside
D. tetramethyl-para-phenylenediamine

98. When using a control strain of Staphylococcus aureus, the biomedical scientist
notices that the zone around the oxacillin disk is too small. Which of the following is
the most likely explanation?
A. inoculation of the plates 10 minutes after preparing the inoculum
B. incubation of the Mueller-Hinton at 35ºC
C. use of 0.25 McFarland (instead of 0.5 McFarland ) standard to prepare inoculum
D. use of outdated oxacillin disks
99. Vibrio cholerae can be isolated best from feces/rectal swabs on:
A. eosin methylene blue (EMB) agar
B. Hektoen enteric (HE) agar
C. Salmonella Shigella (SS) agar
D. thiosulfate citrate bile salts sucrose (TCBS) agar

100. The factors affect / influence the rate of tissue processing excludes
A. Agitation
B. Heat
C. Viscosity of fluid
D. Pressure