MLS Treatment Planning & Management 3

Question 1

A patient with type 2 diabetes has an HbA1c of 9.8%. After 3 months of metformin therapy, repeat HbA1c is 9.1%. This result MOST likely indicates:

Accepted Answer

Partial response; consider adding a second agent

Answer

A 0.7% reduction with HbA1c still well above the 7% target suggests a partial response, supporting addition of a second antidiabetic agent.

Question 2

Which laboratory test is used to MONITOR patients receiving thiopurine therapy (azathioprine or 6-mercaptopurine) for inflammatory bowel disease?

Accepted Answer

Thiopurine methyltransferase (TPMT) activity and thiopurine metabolite levels

Answer

TPMT genotype/phenotype guides dosing, while 6-TGN and 6-MMP metabolite levels help optimize efficacy and identify toxicity or non-adherence.

Question 3

A post-cardiac surgery patient has a heparin-induced thrombocytopenia (HIT) score of 6 (high probability). The CORRECT immediate management is to:

Accepted Answer

Stop all heparin and start a direct thrombin inhibitor

Answer

HIT is an immune-mediated thrombotic disorder; all heparin must be discontinued immediately and replaced with a non-heparin anticoagulant such as argatroban or bivalirudin.

Question 4

A patient's serum lithium level is 2.4 mEq/L. Which clinical scenario would explain why toxicity symptoms are ABSENT despite a supratherapeutic level?

Accepted Answer

The sample was drawn in the distribution phase shortly after a dose

Answer

Lithium levels drawn within 1–2 hours of a dose reflect the distribution phase and are falsely elevated; trough levels at 12 hours post-dose are standard.

Question 5

Which platelet function test is used to guide antiplatelet therapy selection (aspirin vs. P2Y12 inhibitor) in high-risk cardiovascular patients?

Accepted Answer

Platelet aggregometry (LTA)

Answer

Light transmission aggregometry using ADP and arachidonic acid agonists assesses P2Y12 and COX-1 pathway inhibition to evaluate aspirin and P2Y12 inhibitor response.

(MLS) Medical Laboratory Scientist Practice Test

(MLS) Medical Laboratory Scientist Practice Test

MLS Treatment Planning & Management 3