CHAPTER - 2
Clinical Laboratory Automation and Autoanalyzer's
Automation and General Concepts
1. What procedure is described as a
self-regulating process where the specimen is accurately pipetted by a
mechanical probe, mixed with reagent, and results are displayed digitally and
printed?
A) Work Simplification
B) Monostep Methodology
C) Automation
D) Folin-Wu Determination
Correct Answer: C
2. When volume of work increased in clinical
biochemistry,
there arose a need for:
A) Increased staffing
B) Work simplification
C) Multi-step cumbersome methods
D) Dialyzer introduction
Correct Answer: B
3. The efficiency of monostep methods was
further increased by the introduction of:
A) Manual mixing techniques
B) Inaccurate measuring devices
C) Automatic dispensers and diluters
D) Folin-Wu’s determination method
Correct Answer: C
4. Automation includes an element of feedback
which detects any tendency toward:
A) Reduced reagent consumption
B) Malfunction
C) Subjective errors
D) Increased labor
Correct Answer: B
5. Automated instruments work economically by
using smaller quantities of samples and:
A) Staff members
B) Quality controls
C) Reagents
D) Glassware
Correct Answer: C
6. According to the simple meaning of
automation, mechanization of duties performed by laboratory personnel includes:
A) Collecting, labeling, separating, and
preserving specimens
B) Organizing glassware, reagents, and
instruments
C) Pipetting specimen, standards,
calibrators, Q.C. sera
D) All of the above
Correct Answer: D
7. Which duty is generally NOT performed by the
various types of autoanalyzers, according to the sources?
A) Printing test reports
B) Preparing Q C data and charts
C) Instructing patients
D) Calculating test results
Correct Answer: C
8. The International Union of Pure and Applied
Chemistry (IUPAC) describes automation as the replacement of human manipulative
efforts and facilities by mechanical and instrumental devices regulated by:
A) Manual intervention
B) Cost-effective measures
C) Feedback of information
D) Digital displays
Correct Answer: C
9. Which of the following is an advantage of an
autoanalyzer?
A) Large number of samples can be tested in
a short time
B) Only one type of determination can be
performed
C) Only basic chemistry tests can be
performed
D) Increased need for staff members
Correct Answer: A
10.
By using techniques such as ELISA, EMIT, and Chemiluminescence, automation
makes it possible to determine concentrations of:
A) Hormones, drugs, tumor markers
B) Only blood glucose and urea
C) Only electrolytes
D) Protein-free filtrates
Correct Answer: A
11.
Although various types of autoanalyzers are expensive, they prove to be cost
effective because the amount of specimen required can be as low as:
A) 300 microliters
B) 100 microliters
C) 5 microliters
D) 20 ml
Correct Answer: C
12.
A major safety advantage of fully-automated analyzers is that laboratory staff
members do not come into contact with:
A) The keyboard
B) Bio-hazardous material (specimens and
reagents)
C) The printer paper
D) The bar code reader
Correct Answer: B
13.
Who introduced the first successful automated system?
A) L. T. Skeggs
B) Technicon
C) W.H.C. Walker
D) L.L. Tilzer
Correct Answer: A
14.
In what year did Technicon market the single channel continuous flow analyzer?
A) 1957
B) 1964
C) 1978
D) 1989
Correct Answer: A
15.
In early continuous flow analyzers, samples and reagents were separated by
means of:
A) Semi-permeable membranes
B) Air bubbles
C) Chemical washes
D) Vacuum pressure
Correct Answer: B
16.
What determined the relative proportions of sample and reagent in Continuous
Flow Analyzers?
A) Their individual flow rates
B) The volume of the heating bath
C) The time spent in the colorimeter
D) The temperature of the reaction
Correct Answer: A
17.
Which component of the single channel continuous flow analyzer functioned like
a push-button pipette?
A) The Sampler
B) The Probe
C) The Dialyzer
D) The Printer
Correct Answer: B
18.
The Proportioning Pump in a Continuous Flow Analyzer determined the relative
flow rates of:
A) Air bubbles only
B) Samples and all the reagents
C) Protein-free filtrate only
D) The common pathway
Correct Answer: B
19.
What module contained a semipermeable membrane and obtained batches of
protein-free filtrate?
A) Heating bath
B) Colorimeter
C) Sampler
D) Dialyzer
Correct Answer: D
20.
The Colorimeter module in the Continuous Flow Analyzer contained a flow through
cuvette attached with a:
A) Proportioning pump
B) Debubbler
C) Printer
D) Dialyzer
Correct Answer: B
21.
A major disadvantage of the single channel continuous flow analyzer was that:
A) It required minimal space
B) It occupied larger space in the
laboratory
C) It performed multiple determinations
simultaneously
D) It was inaccurate
Correct Answer: B
22.
Sequential Multiple Analyzer (SMA) 6/60 performed how many specimens per hour?
A) 6
B) 12
C) 60
D) 150
Correct Answer: C
23.
The 6 tests simultaneously reported by the SMA 6/60 included:
A) SGPT and SGOT
B) Urea and Glucose
C) Total proteins and Total bilirubin
D) Creatinine and Uric acid
Correct Answer: B
24.
The Sequential Multiple Analyzer (SMA) 12/60 was used to process 60 specimens
per hour and
reported how many tests simultaneously?
A) 6
B) 12
C) 20
D) 60
Correct Answer: B
25.
The Technicon SMA II/C System was designed to perform diagnostic assays for a
maximum of 20 biochemical parameters simultaneously at a processing rate of:
A) 60 samples per hour
B) 150 samples per hour
C) 220 samples per second
D) 800 samples per hour
Correct Answer: B
26.
All SMA autoanalyzers were primarily suitable for hospital pathology
laboratories belonging to which complexity level?
A) Low
B) Moderate
C) High
D) Clinical
Correct Answer: C
27.
The basis of computers in latest clinical chemistry analyzers is a miniaturized
transistor on a silicon chip called a:
A) Reagent probe
B) Microchip
C) Analogue converter
D) Digital display
Correct Answer: B
28.
The microprocessor is the central processing unit of a digital computer and it
is contained on a:
A) Reagent carousel
B) Single chip
C) Reaction turntable
D) Cuvette
Correct Answer: B
29.
Microprocessors control the precise timing of robotic arms ensuring proper
liquid handling and optical readings that match a given:
A) Sample tray
B) Cuvette
C) Filter wheel
D) Bar code
Correct Answer: B
30.
Discrete type of autoanalyzers were subsequently introduced and became
extremely popular because they suited laboratories of which complexity levels?
A) Low complexity only
B) High complexity only
C) Low, moderate and high complexity
D) Hospital pathology only
Correct Answer: C
31.
A specific feature of discrete type analyzers is that for every specimen and
reagent reaction a separate is used:
A) Filter
B) Cuvette
C) Flow cell
D) Dialyzer
Correct Answer: B
32.
Reading using two filters or wavelengths is called:
A) Monochromatic reading
B) Bichromatic reading
C) Reflectance reading
D) Nephelometric reading
Correct Answer: B
33.
Bichromatic reading makes it possible to get rid of interfering substances in
the sample, such as:
A) Hemoglobin, bilirubin and lipids
B) Sodium and potassium
C) Hormones and drugs
D) Standards and calibrators
Correct Answer: A
34.
How many open test programs can generally be selected through the keyboard on
discrete analyzers?
A) Only 6 to 12 fixed programs
B) Less than 50
C) More than 100
D) Exactly 88
Correct Answer: C
35.
The typical reagent quantity required for discrete analyzers is only:
A) 3-20 microliters
B) 200-500 microliters
C) 5 microliters
D) 20 ml
Correct Answer: B
Semi-Automated Discrete Analyzers
36.
Semi-automated discrete analyzers are called this because the initial stages of
a specimen analysis are performed by the:
A) Microprocessor
B) Laboratory technician
C) Specimen probe
D) Peristaltic pump
Correct Answer: B
37.
Which initial stage is performed by the laboratory technician in semi-automated
analysis?
A) Reading end point
B) Pipetting of reagent and specimen
C) Displaying test results
D) Printing and memorizing results
Correct Answer: B
38.
Which function IS performed by the semi-autoanalyzer?
A) Pipetting of specimen
B) Reading end point (linear and nonlinear)
C) Mixing reaction mixture
D) Incubating reaction mixture
Correct Answer: B
39.
A specific feature of a semi-autoanalyzer is that it allows open biochemical
tests to be programmed directly through the:
A) Bar code reader
B) Host computer
C) Keyboard
D) Dry block
Correct Answer: C
40.
Semi-autoanalyzers offer a user friendly software and a:
A) Cathode Ray Tube (CRT) monitor
B) Backlit LCD display
C) Touch screen monitor
D) Continuous spectral range
Correct Answer: B
41.
Semi-autoanalyzers can perform statistical analysis and determine mean values,
SD., CV for control samples and plot:
A) Reaction curves
B) Sample flow rates
C) Levey - Jenning Charts
D) Absorbance versus wavelength plots
Correct Answer: C
42.
The semi-autoanalyzers are extremely suitable for which complexity level
laboratories?
A) Low
B) Moderate
C) High
D) Hospital pathology
Correct Answer: B
43.
In one version of semi-automated analyzers, cuvettes are handled by manual
operations, and the analyzer has a built-in dry block at:
A) 25°C
B) 30°C
C) 37°C
D) 42°C
Correct Answer: C
44.
Which semi-autoanalyzer utilizes automatic aspiration and is washed by a
peristaltic pump?
A) Stat Fax 2000
B) ERBA Chem 5 Plus
C) Metrolab 1600 plus
D) Humalyzer 2000
Correct Answer: C
45.
Most semi-autoanalyzers use advanced static photometers with approximately how
many filters?
A) 2
B) 4
C) 8
D) 12
Correct Answer: C
46.
Fully-automated discrete analyzers perform all the functions of
semi-autoanalyzers and also include:
A) Automatic dispensing of reagents
B) Automatic dispensing of samples
C) Automatic mixing of reaction mixtures
D) All of the above
Correct Answer: D
47.
Programmable sample probes in fully automated analyzers can pipette sample
volumes as low as:
A) 3 µl to 30 µl
B) 200 µl
C) 500 µl
D) 20 ml
Correct Answer: A
48.
What feature are reagent probes equipped with that continuously informs the
operator on residual reagent volumes at any point of time?
A) Reagent carousel
B) Bar code identification
C) Dynamic reagent monitoring
D) Level sensors
Correct Answer: C
49.
Advanced versions of fully automated analyzers offer the facility to clean each
cuvette with detergent and deionized water before use, which is called the:
A) Reagent carousel
B) Cuvette rinsing station
C) Thermal ring
D) ISE module
Correct Answer: B
50.
The two types of fully automated analyzers are:
A) Continuous flow and Random access
B) Batch analyzers and Random access
analyzers
C) Monochromatic and Bichromatic
D) SMA and Discrete
Correct Answer: B
51.
Batch analyzers, now considered out-dated, performed how many types of tests at
a time?
A) Multiple tests based on patient need
B) Only one type of test at a time
C) 6 to 12 fixed tests
D) Random access tests
Correct Answer: B
52.
Batch analyzers were not patient oriented, meaning they did not function
according to the:
A) Analytes being measured
B) Relative flow rates
C) Patient's tests
D) Specific code number for the test
Correct Answer: C
53.
Batch analyzers were not equipped with the facility for immediate reporting or
emergency testing, known as the:
A) Random access analysis
B) 'Stat' facility
C) Sequential mode
D) Batch mode
Correct Answer: B
54.
The definition of 'Random access analysis' states that any specimen can be
analyzed by any available process:
A) Only in sequence with other specimens
B) Only by batching similar tests
C) In or out of sequence with other
specimens
D) Only if the reagent volume is low
Correct Answer: C
55.
Examples of Batch analyzers include:
A) Dimension RxL and ERBA XL - 600
B) Erba-chem 10 and Clinicon corona
C) Hitachi 704 and Abbot Spectrum
D) Mini VIDAS and Immulite
Correct Answer: B
56.
Which mode of operation for Random Access Analyzers involves completing all
tests on one sample before proceeding to the next sample?
A) Sequential mode
B) Sample orientation mode
C) Random access mode
D) Batch mode
Correct Answer: C
57.
The RAA mode that involves completing the greatest number of samples in the
shortest period of time is the:
A) Random access mode
B) Sequential mode
C) Sample orientation mode
D) Stat mode
Correct Answer: C
58.
Compared to Batch analyzers, Random Access Analyzers are equipped with a
reagent table facility for low temperature storage (8-15°C below ambient)
primarily to:
A) Facilitate faster reactions
B) Preserve the stability of the reagents
C) Clean the probes
D) Prevent carryover
Correct Answer: B
59.
What technology is used for bar code identification on RAA systems?
A) Sample rack system
B) Cuvette disk
C) Bar code identification of samples and
reagents
D) Autodilution facility
Correct Answer: C
60.
The Optional Ion Selective Electrode (ISE) module available for RAA determines:
A) Glucose and Urea
B) Total proteins and Albumin
C) Sodium, potassium and chlorides
D) SGPT and SGOT
Correct Answer: C
61.
Examples of Random Access Analyzers include:
A) Dimension RxL clinical chemistry system
B) ERBA XL - 600
C) Hitachi 704 and 705
D) All of the above
Correct Answer: D
62.
What is placed onto the specimen container to achieve specimen identification
in fully automated systems?
A) A level sensor
B) A bar-coded label
C) A reagent probe
D) A patient demographic card
Correct Answer: B
63.
The use of level sensors on the specimen probe restricts the penetration of
sample probes into specimens and eliminates:
A) Carryover
B) Spatter
C) Bar code reading
D) Rinsing cycles
Correct Answer: B
64.
In larger automated systems (such as Hitachi - 747), refrigerated reagent
storage is maintained at:
A) 37°C
B) 30°C
C) 4°C to 10°C
D) 42°C - 44°C
Correct Answer: C
65.
What type of device is commonly used in many automated systems for both reagent
and sample delivery?
A) Peristaltic pumps
B) Positive-displacement syringe devices
C) Rotating paddles
D) Vortex mixers
Correct Answer: B
66.
Which technique is mentioned for mixing reactants in specific
cells/thermo-cuvettes?
A) Magnetic stirring
B) Forceful dispensing
C) Use of ultrasonic energy
D) All of the above
Correct Answer: D
67.
Reused reaction vessels are washed and rinsed in deionized water, and then
dried by:
A) Pressurized air or vacuum
B) Heat from the heating bath
C) Centrifugal force
D) Manual wiping
Correct Answer: A
68.
For photometric and spectrophotometric readings, the three basic components
required are:
A) Bar code reader, processor, printer
B) Radiant energy source, means of spectral
isolation, and a detector
C) Level sensor, syringe device, reaction
vessel
D) Dialyzer, proportioning pump, heating
bath
Correct Answer: B
69.
What are used as detectors in most of the automated photometric systems?
A) Interference filters
B) Tungsten halogen lamps
C) Photodiodes and photomultiplier tubes
D) Movable gratings
Correct Answer: C
70.
Bichromatic reading is achieved by noting readings at two different
wavelengths, which helps eliminate interference due to:
A) High reagent volume
B) Hemolysis, turbidity, or high bilirubin
concentration
C) Substrate exhaustion
D) Baseline drift
Correct Answer: B
71.
Ion-selective methodology is used by many autoanalyzers primarily for the
determination of:
A) Glucose, urea, and creatinine
B) Hormones and tumor markers
C) Sodium, potassium, chlorides and lithium
D) Proteins and antibodies
Correct Answer: C
72.
Digital computers in automated systems convert analog signals from detectors to
digital form by:
A) Microprocessors
B) Algorithms
C) Analog-to-digital converters
D) Keyboard entry
Correct Answer: C
73.
Microprocessors react to improper function by recording the site and nature of
the:
A) Calculated result
B) Malfunction
C) Printed output
D) Patient demographic data
Correct Answer: B
74.
Output data tested against preset criteria can be flagged and displayed if:
A) Linearity of a reaction has been
exceeded
B) A reaction is nonlinear
C) Substrate exhaustion has occurred
D) All of the above
Correct Answer: D
Immunoassay and Specialized Analyzers
75.
In heterogeneous immunoassays, various types of solid phases used in
autoanalyzers include
coated tubes and beads, magnetic and nonmagnetic microparticles, and:
A) Cuvette rinsing stations
B) Fiber matrices
C) Peristaltic pumps
D) Syringe devices
Correct Answer: B
76.
In the AxSYM system, what part of the sampling center holds patient's samples,
calibrators and controls?
A) Reagent pack carousel
B) Reaction vessel carousel
C) Sample cup segment
D) Processing probe
Correct Answer: C
77.
What does MEIA technology use to measure analytes?
A) Solution of suspended, sub-micron sized
latex particles
B) Fixed metal thermocuvettes
C) Diffraction grating photometers
D) Dry chemistry films
Correct Answer: A
78.
In the MEIA reaction sequence, the immune complex binds irreversibly to the:
A) Incubation well
B) Alkaline phosphatase
C) Glass fiber matrix
D) Substrate (MUP)
Correct Answer: C
79.
The rate of generation of 4-methylumbelliferone (MU) in the MEIA reaction is
proportional to:
A) Alkaline phosphatase activity
B) The concentration of the analyte
C) The volume of the wash buffer
D) The temperature of the processing center
Correct Answer: B
80.
What are FPIA and REA assays, which can also be analyzed by the AxSYM system,
based on?
A) Continuous flow analysis
B) Fluorescence Polarization and Radiative
Energy Attenuation
C) Electrochemical techniques
D) Colorimetric and potentiometric
reactions
Correct Answer: B
81.
The Hitachi '704' analyzer measures icteric, hemolytic, and lipemic indexes to
ensure that results are not affected by:
A) Quality control variations
B) Fixed reagent volumes
C) Such specimen conditions
D) Instrument malfunction
Correct Answer: C
82.
The BM/Hitachi 717 has a sample disk with 60 positions for routine samples and
50 positions for:
A) Calibrators, controls, and 'Stat'
samples
B) Reaction cuvettes
C) Reagent bottles
D) Flow cells
Correct Answer: A
83.
In the BM/Hitachi 717, the maximum incubation time is 10 minutes, during which
time up to how many readings can be taken?
A) 12
B) 35
C) 50
D) 60
Correct Answer: C
84.
In the operation of a centrifugal analyzer, the rotor is accelerated, causing
each sample and its respective reagent to be transferred by:
A) Vacuum pressure
B) Peristaltic pump
C) Centrifugal force
D) Positive displacement
Correct Answer: C
85.
Dry chemistry analyzers, such as the Kodak Ektachem 400, do not use wet
chemicals but incorporate them into thin films on a:
A) Disposable cuvette
B) Slide
C) Fiber matrix
D) Reaction wheel
Correct Answer: B
86.
The Beckman Array 360 system is integrated microcomputer-controlled system for
the quantitization of various proteins in human biological fluids using a
nephelometer to measure the rate of light-scatter formation resulting from an:
A) Enzyme-linked fluorescent assay
B) Immunoprecipitin reaction
C) MEIA reaction
D) End point assay
Correct Answer: B
87.
The Array 360 system is programmed with a standard antigen excess check mode to
discriminate between a reaction in antigen excess and one in:
A) Substrate exhaustion
B) Maximum scatter level
C) Antibody excess
D) Baseline drift
Correct Answer: C
88.
The Mini VIDAS analyzer performs determination of hormones, tumor markers, and
hepatitis markers by enzyme immunoassays based on:
A) Fluorescence Polarization Immunoassays
(FPIA)
B) Radiative Energy Attenuation (REA)
C) Chemiluminescence technique (ELFA)
D) Turbidimetry-Nephelometry
Correct Answer: C
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