Ministry of Health Ethiopian Health Professionals’ Licensure Examination Medical Laboratory Science Exam Nehase 2013/August 2021 FullName BOOKLET CODE: 021 SUBJECT CODE: 11 PART: ONE TIME ALLOWED: 2:30 HOURS GENERAL DIRECTIONS IN THIS EXAMINATION, THERE ARE A TOTAL OF 100 MULTIPLE CHOICE QUESTIONS. SELECT THE BEST ANSWER AND BLACKEN ONLY THE LETTER OF YOUR CHOICE ON THE SEPARATE ANSWER SHEET PROVIDED. FOLLOW THE INSTRUCTIONS IN THE ANSWER SHEET AND THE EXAMINATION PAPER CAREFULLY. USE ONLY PENCIL TO MARK YOUR ANSWERS. YOUR ANSWER MARK SHOULD BE HEAVY AND DARK COVERING THE ANSWER SPACE COMPLETELY. IF YOU CHANGE YOUR ANSWER, PLEASE ERASE IT COMPLETELY AND NEATLY. YOU ARE ALLOWED TO WORK ON THE EXAMINATION FOR 2:30 HOURS. WHEN TIME IS CALLED, YOU MUST IMMEDIATELY STOP WORKING, PUT YOUR PENCIL DOWN, AND WAIT FOR FURTHER INSTRUCTIONS. ANY FORM OF CHEATING OR AN ATTEMPT TO CHEAT IN THE EXAMINATION WILL RESULT IN AN AUTOMATIC DISMISSAL FROM THE EXAMINATION HALL AND CANCELLATION OF YOUR SCORE(S). PLEASE MAKE SURE THAT YOU HAVE WRITTEN ALL THE REQUIRED INFORMATION IN THE ANSWER SHEET BEFORE YOU START TO WORK ON THE EXAMINATION. YOUR ANSWER SHEET WILL NOT BE MARKED UNLESS YOUR QUESTION PAPER IS RETURNED. DO NOT TURN THIS PAGE OVER UNTIL YOU ARE TOLD TO DO SO.BOOKLET C¥ a aoe 2 SUBJECT CODE: 021 4. A laboratory technologi Ee ia a logist received blood sample collected from a 16-year-old male patient maintenance and eee spectrophotometer method. ‘The instrument was under ie whole blood Taste fier anaiaie sample was left at room temperature for more than two a yom be the effect of delayed analysis on glucose concentration? . ease glucose level due to glycolysis al room temperature (B) Decrease glucose level due to lipogenesis at room temperature (C) Decrease glucose level due to glycogenesis at room temperature (D) Decrease glucose level due to oxidation reaction ut room temperature A laboratory technologist collected blood specimen for ALP ‘measurement using clinical chemistry analyzer, The instrument prinied the enzyme activity result as 0.2mmol/L. The laboratory technologist was interested to report the result in pmol/L, w What is the enzyme activity result in pmol/L? (A) 20 mol/L. (B) 200 pmol/L A laboratory technologist measurement using spectrophotometric method. The react 6f 0.2 was recorded from 0.1 mg/dl of standard creatinine solution. Another unknown sam] was performed for creatinine measurement and an absorbance of 0.3 was recorded. (©) 2,000 pmol/L. (D) 20,000 pmol/L. + working in a clinical chemistry laboratory performed Creatinine tion was stable and an absorbance ple 2 What was the concentration of creatinine in the unknown sample? (A) 0.1 mg/dl. (©) 0.15 mgd (B) 0.06 mg/dL. (D) 0.21 mgidL 7. A Iaborstory technologist working in a clinical chemistry Isboratory collected blood specimen fram 2 78-year-old female patient for glucose measurement using ghicose oxidase test method. The technologist used an accelerator in the procedure to shorten the reaction time. ‘What was the role of the accelerator? (A). Accelerate the reaction by converting a- L glucose to f- L glucose (B) Accelerate the reaction by converting f- L glucose to a- L glucose (©) Accelerate the reaction by converting f- D glucose to a- D glucose (D) Accelerate the reaction by converting a- D glucose to f- D glucose ——_ re TER/AAU/MLS-1 -Mol/EHPLE-Medical Laboratory Science2013/2021BOOKLET CopE:; 11 SUBJECT CODE: 021 8. A 25-year-ol erlipid (lis ‘onnina ‘year-old man with \yperlipi Fequest paper to the cen confirmed hyperlipidemia by ‘ rought a Moratory to check his blood LDL cholesterol (LDL-C) level. The technologist collected laborat ect ‘blood specimen for the analys sure -C level directly using Biosystem lysis and measured LDL-C level directly using Biosys What method was used by the technologist? (A) By an empirical Friedewald method eS By ultracentrifugation to mask other cholesterols (©) By Precipitation of other cholesterol using polyanion (D) By masking other cholestcrols using polyclonal antibody o fe male patient brought a request paper for lipid profile tests to the laboratory. laboratory technologist collected blood specimen to perform the above tests. The results of the lipid profile tests showed high total cholesterol, low HDL cholesterol and high LDL. cholesterol. What is the most likely underlying discase of the patient? (A) Renal disease (©) Cardiovascular disease (B) Pulmonary disease (D) Gastro intestinal disease 10, A physician physically diagnosed « 45-year-old male patient with azotemia and send blood sample to the laboratory assessment. The laboratory technologist analyzed the specimen for renal function tests. The technologist recorded 90 mg/dl urea and 1.20 mg/dL creatinine. Calculate blond urea nitrogen to creatinine ratio? (A) 13.50 (B) 35.04 (C) 70.46 (D)75.00 11 A 41-year-old male patient with history of tachycardia, hypertension and diabetic mellitus sas admitted to a hospital. Different chemistry tests and urinalysis were requested for him by the physician, The laboratory technologist analyzed both the specimens and reported the following result: high AST, high LDH, high CK-MB isoenzyme, high urea, high creatinine in serum and few WBC and RBC in urine. ition that eould cause the above alterations? (©) Pre-renal acute kidney injury (D) Post-renal acute kidney injury ‘What is the most likely cond (A) Renal acute kidney injury (B) Intrinsic acute kidney injuryBOOKLET CODE: 11 SUBJECT CODr: 9 12. A 46-year-old woman. with thyrotoxicosis, goiter, ophthalmopathy and dermopathy visitea the laboratory for thyroid function tests, The laboratory technologist collected, processed and analyzed the serum sample using chemiluminescence principle. Her laboratory finding showed high free T4 and T3, and low TSH. The thyroid stimulating immunoglobulins (TSIs) and TSH receptor antibodies were also positive, ‘What disease causes the above alterations? (A) Graves'disease (©) Hashimoto’s thyroiditis (B) Postpartum thyroiditis (D) Iodine deficiency disease 13-4 26-year-old woman with history of breast mass, breast pain and skin discoloration was referred to a regional laboratory for CA 15-3 tumor marker test. Then, the laboratory technologist collected and analyzed blood specimen using chemiluminescence immunoassay. Her laboratory result showed low level of CA 15-3 in serum, What condition is associated with the above result? (A) Malignant tumor (©) Freee breast . (B) Benign breast tumor (P) Last stage breast cancer 14. i lasma proteins level assessment amon, There is a project on pl n for research purpose. A laboratory technologist working in Youngsters, adults and elders total protein determination by Kjeldahl method. esearch laboratory performs a Which component of protein is determined by the used methoay © Nit ey cove ©) Salfor (B) Hydrogen in a hospital clinical chery jorking in a hospi chemistry laboratory perforn 15. A laboratory: eens sp ‘The result showed normal serum ¢1 in electrophoresis. serum protein ¢l ectrophoresis action values with similar patterns. 5 ’ ein fraction was observed i a B-Globulin Which serum prot a (A) al-Globulin ‘Globulin (B) «2-GlobulinOKLET CODE: tl 6 SUBJECT Cons A laboratory technologist working in @ given physiology research laboratory wants measure total carbondioxide (or bicarbonates) for research purpose. It was a new test for him, and untuckily could not find SOPs. Which activity should be done at the first step of the measurement? (A) Acidification or alkalization of the serum sample (B) Vaporization of the serum sample at 56°C temperature (C) Solubilization of the serum sample by inorganic solvents (D) Freezing of the serum sample at -20°C for at least half a day 10, A Inboratory technologist working in a hospital clinical chemistry laboratory received CSF sample of a 33-year-old female patient for potassium electrolyte test. The technologist measured CSF potassium level and reported the result without including the reference interval. What is the estimation value of CSF potassium level compared to plasma potassium level? (A). CSF and plasma potassium values are the same (B) CSF potassium is 70% of plasma potassium (©) CSF potassiun is 20% of plasma potassium (D) CSF potassium is 50% of plasma potassium, 2 +. A-hospital bought a new Clinieal Chemistry machine, During calibration of the machi inboratory technologist noticed that some analytes are measured after mixing the samy ie the ppeoprate reagents and then incubated for few minutes, The inal product will eee only for few minutes and finally will be deteriorated. He then calibrated the machine eee oerbanee after incubation exactly atthe beginning of product formation ea sna reed deterioration times. start of symhat was the typeof the method described in the above seenario? (A) End point method © Motne absorptivity method (B) Fixed kinetics method (D) Continuous monitoring method ap. a sS-yoar-old male patient brought a request paper for serum thyroid function tests from 8 ‘A laboratory technologist made ‘ eration axle, onl bom ate i Berpitiriate preparation when collect bloodKLET Copp, n 9 SUBJECT CODE: 021 32.A 45. 4S-Year-olg male patient with chronie glomerulonephritis and long lasting extremities na SAME to the laboratory for Serum albumin and urinalysis tests. The | pone BISt received and analyzed the Sample and result was Serum creatinine of 1,7 mg/dl Ri 7-1 4p/aiy And serum albumin of 15g (RI; 30-459/1), What would happen to the concentration of urinary protein? (A) Iwill be normal (B) Iwill be decreased (©) Itwillbe increased ©) There will be no Protein 33. A laboratory technolo, ratory received semen Specimen of a 45. Pesimen (Wo hours. after eol ection but the semen ‘Was still clotted and the sperm cell ‘motility was abnormatiy, decreased, Proc i ologist? ich procedure was missed by the techn neem (B) Centrifugation (©)Smearing )Liguetacis i thnologist in a clinical ehemy it ior medical laboratory tec misty unit wants to Prepare an Bie cee solution for spectrophotometrc measure : nese to start his activity by purifying the water. in However, the technolo "ttOlopiet tthe type of instrument supposes to be used abou }¢ of instrument to'Be tse in thin, : ymmended type o! What is the reco: ease? 5 instient © Dratanen, 7 ol ai ada ©) Dedonizer gacstment (B). Flectrophores ‘ ‘strument rking at an advanced diagnostic. i _ raboalory aia Oe chenithy eine For thar ne van 35.4 performan check the Pyne and conto} solutions t> ‘niet, fe ye ‘© in prepare :BOOKLET cope: 11 10 37, A laboratory teshnologist working at repionslabortor year ; : ech! Year-old male patien for electrophoretic separation: TV rer the el Sample on the sample well and run the electrophoresis ae phoresis appara oi ti jectro] was accomplished, the technologist left the support HE a Separated substances start to diffuse. ceived r Which procedure should ize diffusion? =! ould be applied to minimize 4 ; r (A) Fixation = (©) Change electric caret (B) Change butter () Changing support medium . A researcher ata given core research laboratory wants 10 SeP#731° © a ae ae chromatographic technique. For that matte, the researcher wants 1 sete Oe es using ion exchange chromatography. The researcher wants the cationic proteins to be elut ‘out more than the anionic one. Which stationary phase should the researcher use in this ease? (A) Positively charged stationary phase (C) Cation exchangers (B) Positively charged solid phase {D) Anion exchanger | Tuberculosis Iymphadenitis is suspected fom an eight-year-old female patient and fine needle aspirated (FNA) sample is sent for Acid fist stining (AFS) to confirm Mycobacterium tuberculosis. Ate fxing the ENA sample on the microscopic slide, the Trboratory technologist performs the AFS staining correctly except forgetting to add the primary stain. i i look like? What will the microscopy result I 2 A) Blue tod ‘pacteria with ted background OD ped rod bacteria with blue background gram stain. After staining all 15 wound sample sno gram negative bacterium found where asKLET Copp; 11 rm SUBJECT CODE: 021 41.4 Tay ' is if the ae ie Blast inoculate car swab ino eltre media, The ae SVOBISt is to identify discrete colonies of each organism present in the specimen, What j (a) c the most “PPTOpriate media to be used for this purpose? By BOOKLET CODE; 11 20 SUBJECT CODE: 021 77. A 34-year-old patient who had autosomal recessive bleeding disorder came to a hospital laboratory for platelet count, and coagulation profile tests, The laboratory result of these tests revealed decreased platelet count but increased PT, APTT and TT, ‘What is the most likely cause of prolonged coagulation tests? (A) Afibrinogenemia (©) Hypofibrinogenemia (B) Dysfibrinogenemia (D) Hyperfibrinogenemia A 35-year-old female patient came to the laboratory with a request of PT and APT. The laboratory technician collected blood with the correct anticoagulant and performed the test according to the standard procedure. The result indicated prolonged PT and normal APTT. What is the possible cause of these results? (A) Lupus antibodies (C) Pre-kallikrein deficiency (B) Factor Vil deficiency (D) Von Willebrand disease A physician collected bone marrow biopsy fiom the iliac erest of a 5. diagnosed with CML. As soon as the bone marrow sample was ¢oll a ears and sent them to the laboratory. ‘The labora : prepared smears an ory techuoloriae hae and examined it microscopically and found bone marrow cellul gist stained the larity of 80%, ‘year-old patient What is the interpretation of the result? (A) The marrow is hypocellular (B) ‘The marrow 15 normocellular *) ‘The marrow is hypercellular es marrow is; filled with excess fat cells (p) The e vein of a 30-year-old female pay; plod from the vein of # len, iebotomist collected bloo sry technologist analyzed the sampje yo Compete 80, A phi ting. The laboratory ally increased valves in all the caer utomated blood re and observed abnor Parameters, hematology cause for the increased values? ecting blood edematous eae i i soon aS : io eile swith small gauge si2e the patient's arm for too long tourniquet o”OKLET CODE: 11 2 suBJECT CODE: 021 81. A physician sent a laboratory eae cine NSEe ee ea Tequest for anemic patient to rule out iron deficiency EY anticoagulated eva ants to prepare plasma from blood specimen ©! meee \cuated tube to measure plasma ferittin level. What i , A) S cEaue likely action of EDTA in preventing blood clotting? ® ee biting tissue factor (©) By inactivating thrombin eee ces (p) By inhibiting Factor SP Aniinfeatons distase epedalist, wosking in: a regions) Tee iaboratory, received peripheral blood films collected from field research for screening Of hhemoparasites. The epocaliee prepared a Giemsa stain working solution. After making, fixation, the technologist stained the blood films with Giemsa stain “What will happen in the staining process? (A) Eosin will bind with the nucleus of the cell (B) Acidic dyes binds with the nucleus of the cell (©) Acidic dyes binds with the cytoplasm of the cell (D)_ Methylene blue binds with the cytopilasin of the cell 3. A technologist took plod from a donor, immediately after donation, for performing blood typing. The technologist used anti-A and anti-B antiserum reagents for testing unknown cells of the donor's blood. What is the most appropriate techniave cased by the technologist? (A). Reverse tynine © ee aia (D) Serum typingSUBJECT CODE: 02 BOOKLET CODE: 11 n 85. A blood donation campaign Was prepared by blood bank staffs in a University. During sercening of students for selecting potential blood donors, fo out of 40 students were deferred. shat could be the most appropriate reason for their deferral? (A). History of blood transfusion 2 years ago (B) No evidence of chronic disease (C) Having (p) Hemoglobin levels! aweight of 750 Ke 2gidl a request for Rh blood grouping. laboratory with the result as Rb - mother came to the | laboratory technician reported ‘A 28-year-old pregnan completed, the | ‘After all procedures have bee? positive und in the mother’s RBC? ost Hikely antigen fo (C)RhE (D)Rhe ‘What is the m (B) BHD (A)RbC working in sereening of transfusion transmissible infections, is viIv.1/2 and p-24 antigen of this virus using fourth generation 1 procedure for ELISA testing, the technologist observed test and gets the same result, technologist, tibodies of the correc! gut He repented me A Jaboratory etect an the technologist should use? (©) Indirect ELISA (D) Unigold test confirmatory test that emergency department. A cross-match % test was he parame ABO. and Rh typing ror 12 sos of et TOR amassBOOKLET CODE: 11 24 SUBJECT CODE: 021 93.A laboratory technologist was using jammunochomatographic approach (0 check for pregnancy. The technologist ook urine sample from the client and added two drops of the sample to the sample area of the kit and observed two red lines oth on the C and T regions of the test kit. ‘What was pre-coated to the test band region with regard {0 the principle of this test? (A). antichCGAD (C) colloidal gold (B) hCG antigen (D) anti-hCG-hCG 04, A 30-year-old man visited a hospital with radialing tack pain and duodenal ulcer. The physician intended to screen. for possible reasons of H. pylori infection. However, the physician was not sure Ww Thich diagnostic test to use, and consulted a senior laboratory technologist to affirm the test type. Which diagnostic testis recommended to sereen the patient? (A) _H. pylori stool antigen test (C) H. Pylori DNA test (B) # Pylori antibody test (D) Urease test 95, A young man ad his wite visited the [oepital boraory 19 cheek for pregnancy status However, the man wi : himself or his wife. laboratory personnel, cassette, js not sure whether he was supposed to collect a urine sample from Then, he collected a urine sample from himself and gave it fo the “The result revealed two red lines both in the T and C regions of the test whet was the interpretation oF 8 result? (a). Reactive for pregnancy (B) Non reactive for pregnancy (C)_ Reactive for prostaie cancer ! (D) Reactive For hepatocellular careino 96, A laboratory technologist was oom! of HIV epl20 protein among