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Question 1. Which of the following is the most appropriate order of draw for venipuncture when collecting a serum tube with clot activator? A) Light‑blue, green, serum, SST, red B) Red, serum, SST, green, light‑blue C) Serum, SST, green, light‑blue, red D) Green, serum, light‑blue, SST, red Answer: C Explanation: The recommended order is to draw serum tubes (plain or with clot activator) before coagulation‑activator tubes (SST), then heparin (green), followed by citrate (light‑blue), and finally the red top (no additive) to avoid cross‑contamination. Question 2. In spectrophotometry, the Beer‑Lambert law relates absorbance (A) to concentration (c). Which equation correctly expresses this relationship? A) A = ε · c · l B) A = ε / (c · l) C) A = c · l / ε D) A = ε · l / c Answer: A Explanation: The Beer‑Lambert law states that absorbance is directly proportional to the molar absorptivity (ε), the path length (l), and the concentration (c). Question 3. A laboratory implements Westgard rules for quality control. Which rule is most appropriate to detect a single out‑of‑control point that exceeds the mean by more than 3 standard deviations? A) 1 2 s rule B) 1 3 s rule C) 2 2 s rule D) R 4 s rule Answer: B Explanation: The 1 3 s rule flags any single control measurement that exceeds the mean by ±3 SD, indicating a likely analytical error.
Question 4. A patient’s fasting plasma glucose is 130 mg/dL. According to the ADA criteria, this result classifies the patient as having: A) Normal glucose tolerance B) Impaired fasting glucose (prediabetes) C) Diabetes mellitus D) Gestational diabetes Answer: C Explanation: A fasting plasma glucose ≥126 mg/dL meets the diagnostic threshold for diabetes mellitus. Question 5. Which of the following best describes the principle of the Jendrassik‑Grof method for total bilirubin determination? A) Oxidation of bilirubin to biliverdin measured at 450 nm B) Diazo reaction forming a colored azobilirubin measured at 600 nm C) Enzymatic conversion of bilirubin to bilirubin‑glucuronide measured at 520 nm D) Fluorescence quenching of bilirubin in alkaline medium Answer: B Explanation: The Jendrassik‑Grof method uses a diazo reagent that reacts with bilirubin to produce a pink‑purple azobilirubin complex measured spectrophotometrically. Question 6. Which cardiac marker rises earliest after myocardial infarction? A) Troponin I B) CK‑MB C) Myoglobin D) LDH Answer: C Explanation: Myoglobin is a small protein that appears in the blood within 1–2 hours after myocardial injury, earlier than CK‑MB and troponins. Question 7. The Friedewald equation estimates LDL‑C. Which variable is NOT part of the equation? A) Total cholesterol
C) Streptococcus pyogenes D) Enterococcus faecalis Answer: B Explanation: S. epidermidis is catalase‑positive, coagulase‑negative, and shows sensitivity to novobiocin, distinguishing it from S. aureus (coagulase‑positive) and other Gram‑positives. Question 11. Which selective medium is best for isolating Salmonella spp. from stool? A) MacConkey agar B) Mannitol Salt agar C) XLD (Xylose‑Lysine‑Deoxycholate) agar D) Sabouraud Dextrose agar Answer: C Explanation: XLD agar inhibits coliforms and allows Salmonella (red colonies with black centers) to be distinguished. Question 12. The Ziehl‑Neelsen stain is used to detect organisms with which cell wall characteristic? A) Thick peptidoglycan layer B) Mycolic acid‑rich, waxy cell wall C) Lipopolysaccharide outer membrane D) Endospore formation Answer: B Explanation: Acid‑fast organisms (e.g., Mycobacterium spp.) possess mycolic acids, retaining carbol‑fuchsin after acid decolorization. Question 13. Which of the following viruses is a member of the Flaviviridae family? A) Hepatitis B virus B) Influenza A virus C) Dengue virus D) Human papillomavirus
Answer: C Explanation: Dengue virus belongs to the Flaviviridae family; HBV is a hepadnavirus, influenza is an orthomyxovirus, HPV is a papillomavirus. Question 14. The most sensitive method for diagnosing Clostridioides difficile infection is: A) Toxigenic culture B) Enzyme immunoassay for glutamate dehydrogenase (GDH) C) Nucleic acid amplification test (NAAT) D) Stool leukocyte count Answer: C Explanation: NAAT detects toxin genes directly and has the highest sensitivity and specificity among available tests. Question 15. A patient presents with a thick, “eggshell” calcified lesion on chest X‑ray. Which parasite is most likely responsible? A) Ascaris lumbricoides B) Paragonimus westermani C) Schistosoma mansoni D) Taenia solium Answer: B Explanation: Paragonimus (lung fluke) can cause calcified cystic lesions resembling eggshells in the lung. Question 16. Which of the following antigens is used in the rapid plasma reagin (RPR) test for syphilis? A) Recombinant Treponema pallidum outer membrane protein B) Non‑treponemal cardiolipin‑cholesterol‑lecithin antigen C) Treponema pallidum whole‑cell lysate D) Flagellin protein of Treponema spp. Answer: B
Question 20. Which of the following is the primary function of complement component C3b? A) Lysis of Gram‑positive bacteria B) Opsonization of pathogens for phagocytosis C) Recruitment of neutrophils via chemotaxis D) Formation of the membrane attack complex (MAC) Answer: B Explanation: C3b covalently binds to microbial surfaces, tagging them for enhanced phagocytosis (opsonization). Question 21. In automated hematology analyzers, the principle of electrical impedance (Coulter principle) is used to count cells based on: A) Light scatter intensity B) Changes in electrical resistance as cells pass through an aperture C) Fluorescent labeling of specific antigens D) Magnetic susceptibility of iron‑containing cells Answer: B Explanation: The Coulter principle measures the change in electrical resistance caused by cells displacing electrolyte as they traverse a small aperture. Question 22. Which of the following is the most appropriate fixative for preserving nuclear detail in cytology specimens for a Pap stain? A) 10 % neutral buffered formalin B) Alcohol‑based (95 % ethanol) spray fixative C) Bouin’s solution D) Acetone Answer: B Explanation: Alcohol‑based spray fixatives rapidly preserve cytoplasmic and nuclear morphology, essential for Pap staining.
Question 23. The legal requirement for a medical technologist to report a positive HIV test in the Philippines is mandated by which act? A) R.A. 5527 B) R.A. 8504 C) R.A. 9165 D) R.A. 7719 Answer: B Explanation: R.A. 8504 (AIDS Prevention and Control Act) requires mandatory reporting of HIV‑positive results to the appropriate health authorities. Question 24. A urine specimen shows a specific gravity of 1.030, pH 5.0, and numerous calcium oxalate crystals. Which metabolic condition is most likely? A) Hyperuricosuria B) Hyperoxaluria C) Hypocitraturia D) Hypermagnesuria Answer: B Explanation: Calcium oxalate crystals are characteristic of hyperoxaluria, often seen with high dietary oxalate or intestinal malabsorption. Question 25. In cerebrospinal fluid (CSF) analysis, which finding is most characteristic of bacterial meningitis? A) Glucose 70 % of serum, protein normal, lymphocytic pleocytosis B) Glucose low, protein high, neutrophilic pleocytosis C) Glucose normal, protein slightly elevated, eosinophils present D) Glucose low, protein normal, lymphocytic pleocytosis Answer: B Explanation: Bacterial meningitis typically presents with low CSF glucose, markedly elevated protein, and a predominance of neutrophils.
Question 29. Which of the following is the most common cause of a false‑positive urine dipstick test for blood? A) Myoglobinuria B) Hematuria C) Ascorbic acid interference D) Nitrates Answer: A Explanation: Myoglobin released from muscle injury reacts with the dipstick’s peroxidase reaction, producing a false‑positive “blood” result. Question 30. The immunoglobulin class most involved in type II hypersensitivity reactions is: A) IgA B) IgE C) IgG D) IgM Answer: C Explanation: IgG antibodies bind to cell surface antigens, fixing complement and leading to cytotoxic (type II) reactions. Question 31. Which of the following statements regarding the ANA (antinuclear antibody) test by indirect immunofluorescence is TRUE? A) A homogeneous pattern is most specific for systemic sclerosis B) A speckled pattern suggests rheumatoid arthritis C) A centromere pattern is highly associated with limited scleroderma (CREST) D) A nucleolar pattern indicates drug‑induced lupus Answer: C Explanation: The centromere pattern correlates strongly with limited cutaneous systemic sclerosis (CREST). Question 32. In the processing of formalin‑fixed tissue, the step of “clearing” primarily serves to:
A) Remove water from the tissue B) Replace alcohol with a solvent compatible with paraffin C) Harden the tissue for sectioning D) Stain nuclei for microscopy Answer: B Explanation: Clearing agents (e.g., xylene) replace the dehydrating alcohol, making the tissue miscible with paraffin wax. Question 33. Which of the following antibiotics is most appropriate for treating a Streptococcus pyogenes (Group A) pharyngitis? A) Azithromycin B) Penicillin V C) Ciprofloxacin D) Vancomycin Answer: B Explanation: Penicillin V remains the first‑line therapy for Group A streptococcal pharyngitis due to its efficacy and narrow spectrum. Question 34. A 30‑year‑old male presents with a painless ulcer on the genitalia, followed by a non‑pruritic maculopapular rash. Which serologic test is most appropriate for early detection? A) VDRL B) FTA‑ABS C) Dark‑field microscopy of lesion exudate D) HIV ELISA Answer: C Explanation: Dark‑field microscopy can directly visualize Treponema pallidum in primary syphilis lesions before serologic antibodies develop. Question 35. Which of the following is the best indicator of renal tubular function? A) Serum creatinine
D) Improper storage of the test kit Answer: A Explanation: Fourth‑generation assays detect p24 antigen and antibodies, but very early infection (<2 weeks) may still be missed. Question 39. In the measurement of serum amylase, which isoenzyme is most specific for pancreatic injury? A) Salivary amylase B) P‑amylase (pancreatic) C) Liver amylase D) Intestinal amylase Answer: B Explanation: The pancreatic isoenzyme (P‑amylase) rises significantly in pancreatitis, whereas salivary isoenzyme elevations are less specific. Question 40. A patient undergoing long‑term phenytoin therapy is at risk for which type of anemia? A) Iron‑deficiency anemia B) Megaloblastic anemia due to folate deficiency C) Sideroblastic anemia D) Hemolytic anemia Answer: B Explanation: Phenytoin interferes with folate absorption, predisposing to folate‑deficiency‑related megaloblastic anemia. Question 41. Which of the following statements about the “rule of 3” in clinical chemistry is correct? A) It predicts that 3% of results will be out‑of‑range in a stable assay B) It states that the analytical coefficient of variation should be ≤3 % of the target value C) It is used to calculate dilution factors for high‑concentration samples D) It defines the acceptable analytical bias as ≤3 % of the reference range
Answer: B Explanation: The “rule of 3” suggests that analytical CV should be ≤3 % of the target concentration to ensure reliable results. Question 42. Which of the following parasites is transmitted via the fecal‑oral route and is distinguished from Entamoeba histolytica by the presence of ingested red blood cells? A) Entamoeba dispar B) Giardia lamblia C) Balantidium coli D) Entamoeba histolytica (correct answer: D is the one that actually ingests RBCs) Answer: D Explanation: E. histolytica trophozoites ingest erythrocytes, a key diagnostic feature differentiating it from the non‑pathogenic E. dispar. Question 43. The most appropriate method for quantifying serum cortisol in a patient suspected of Cushing’s syndrome is: A) Radioimmunoassay (RIA) B) ELISA measuring total cortisol C) High‑performance liquid chromatography (HPLC) with tandem mass spectrometry (MS/MS) D) Spectrophotometric assay based on cortisol‑binding globulin Answer: C Explanation: LC‑MS/MS provides high specificity and sensitivity for cortisol, essential for accurate assessment in Cushing’s syndrome. Question 44. In the context of the Philippine Medical Technology Act (R.A. 5527), which of the following is a mandatory requirement for licensure renewal? A) Completion of 20 hours of continuing professional development (CPD) every 2 years B) Submission of a research manuscript to a peer‑reviewed journal C) Passing a written re‑examination every 5 years D) Obtaining a new medical technology degree Answer: A
Question 48. Which of the following is the primary mechanism by which loop diuretics cause metabolic alkalosis? A) Increased renal excretion of bicarbonate B) Enhanced distal nephron H⁺ secretion C) Contraction alkalosis due to volume depletion D) Direct stimulation of carbonic anhydrase Answer: C Explanation: Loop diuretics cause volume contraction, leading to increased bicarbonate reabsorption and metabolic alkalosis. Question 49. The most definitive laboratory method for identifying Candida albicans from a clinical specimen is: A) Germ tube test at 37 °C B) CHROMagar Candida color differentiation C) PCR amplification of ITS region D) MALDI‑TOF mass spectrometry Answer: D Explanation: MALDI‑TOF provides rapid, accurate species‑level identification of yeasts, including C. albicans. Question 50. Which of the following statements regarding the “anion gap” is correct? A) Normal range is 5‑ 10 mEq/L when chloride is measured in mmol/L B) An elevated anion gap always indicates renal failure C) Albumin contributes significantly to the measured anion gap D) The gap is calculated as Na⁺ + K⁺ − Cl⁻ − HCO₃⁻ (K⁺ is optional) Answer: D Explanation: The anion gap formula includes sodium, optional potassium, chloride, and bicarbonate; albumin is a measured anion but not directly in the formula.
Question 51. A smear from a patient with suspected malaria shows ring‑forms inside red blood cells with a “band” shape. Which Plasmodium species is most likely? A) P. falciparum B) P. vivax C) P. malariae D) P. ovale Answer: B Explanation: P. vivax often displays larger ring forms and occasional “band” trophozoites in infected erythrocytes. Question 52. In the context of therapeutic drug monitoring (TDM), which anticonvulsant requires measurement of free (unbound) plasma concentrations due to high protein binding? A) Phenytoin B) Valproic acid C) Carbamazepine D) Phenobarbital Answer: B Explanation: Valproic acid is >90 % protein‑bound; free concentrations more accurately reflect pharmacologically active drug. Question 53. The most appropriate method for detecting Helicobacter pylori infection in a patient with dyspepsia is: A) Urea breath test B) Stool antigen ELISA C) Serology for IgG antibodies D) Endoscopic biopsy with rapid urease test Answer: A Explanation: The urea breath test provides a non‑invasive, highly sensitive and specific diagnosis of active H. pylori infection. Question 54. Which of the following is a characteristic of a type III hypersensitivity reaction?
B) Indirect bilirubin is the sum of conjugated and unconjugated fractions C) Direct bilirubin is water‑soluble and measured without a chemical reaction D) Indirect bilirubin is measured by the diazo method after bilirubin‑binding protein removal Answer: C Explanation: Direct (conjugated) bilirubin is water‑soluble and can be measured directly without a reaction; indirect (unconjugated) requires a chemical conversion. Question 58. In the context of blood component therapy, which product contains the highest concentration of clotting factors II, VII, IX, and X? A) Fresh frozen plasma (FFP) B) Cryoprecipitate C) Platelet concentrate D) Packed red blood cells (PRBC) Answer: A Explanation: FFP is plasma frozen within 8 hours of collection and retains all clotting factors, including the vitamin K‑dependent factors. Question 59. Which of the following is the most common cause of a false‑positive VDRL test? A) Recent vaccination B) Pregnancy C) Systemic lupus erythematosus (SLE) D) Antibiotic therapy Answer: C Explanation: Antiphospholipid antibodies present in SLE can cause a false‑positive non‑treponemal test like VDRL. Question 60. A 28‑year‑old woman presents with a painless ulcer on her labia majora and a positive dark‑field microscopy. Which serologic test should be performed to confirm the diagnosis and stage the disease? A) VDRL B) FTA‑ABS IgM
C) TPPA (Treponema pallidum particle agglutination) D) HIV ELISA Answer: C Explanation: TPPA is a specific treponemal test used to confirm syphilis after a positive dark‑field exam and to aid in staging. Question 61. Which of the following is the primary function of the spleen in the context of hematology? A) Production of erythropoietin B) Filtration of abnormal red blood cells and immune complex clearance C) Synthesis of clotting factors VII and IX D) Storage of platelets only Answer: B Explanation: The spleen removes senescent or abnormal RBCs and clears immune complexes, playing a crucial role in hematologic homeostasis. Question 62. In a patient with suspected hyperparathyroidism, which laboratory finding is most characteristic? A) Low serum calcium, high phosphate B) High serum calcium, low phosphate C) Normal calcium, elevated alkaline phosphatase D) Low PTH, high vitamin D Answer: B Explanation: Primary hyperparathyroidism leads to hypercalcemia and hypophosphatemia due to PTH‑mediated renal phosphate wasting. Question 63. Which of the following microorganisms is best identified by the Kato‑Katz thick‑smear technique? A) Entamoeba histolytica cysts B) Schistosoma mansoni eggs C) Giardia lamblia trophozoites
