MedTech Board Exam Study Notes
Complete Reviewer for the Medical Technology Licensure Examination (MTLE)
In This Guide
About the MedTech Board Exam
The Medical Technology Licensure Examination (MTLE) is administered by the Professional Regulation Commission (PRC) to assess competency for medical laboratory practice. The exam covers all major disciplines of clinical laboratory science.
Exam Subjects
- • Clinical Chemistry
- • Hematology
- • Clinical Microscopy
- • Blood Banking & Serology
- • Microbiology & Parasitology
- • Histopathology & Cytology
Exam Details
- • BS Medical Technology degree required
- • Passing score: 75%
- • No subject below 50%
- • Multiple choice format
Part 1: Clinical Chemistry
Carbohydrate Metabolism
Glucose Testing
- Fasting Blood Glucose (FBS): Normal: 70-100 mg/dL; Diabetes: ≥126 mg/dL
- Random Blood Glucose: Diabetes: ≥200 mg/dL with symptoms
- OGTT (75g): 2-hr value ≥200 mg/dL indicates diabetes
- HbA1c: Normal: <5.7%; Diabetes: ≥6.5%; Reflects 2-3 month average
Glucose Methods:
- • Glucose Oxidase: Specific, uses GOD-POD reaction
- • Hexokinase: Reference method, most accurate
- • O-toluidine: Direct method, hepatotoxic
Lipid Profile
Reference Ranges
Total Cholesterol
Desirable: <200 mg/dL
Borderline: 200-239 mg/dL
High: ≥240 mg/dL
LDL Cholesterol
Optimal: <100 mg/dL
"Bad" cholesterol
Atherosclerosis risk
HDL Cholesterol
Low: <40 mg/dL (M), <50 (F)
"Good" cholesterol
Protective effect
Triglycerides
Normal: <150 mg/dL
Fasting required
Pancreatitis risk if >500
Liver Function Tests
Enzymes
- ALT (SGPT): Liver-specific; hepatitis marker
- AST (SGOT): Liver, heart, muscle
- ALP: Bone, liver; biliary obstruction
- GGT: Most sensitive for liver disease
Other Tests
- Total Bilirubin: Direct + Indirect
- Direct (Conjugated): Obstruction
- Indirect (Unconjugated): Hemolysis
- Albumin: Synthesis function
Kidney Function Tests
- BUN (Blood Urea Nitrogen): 7-20 mg/dL; elevated in renal failure, dehydration
- Creatinine: 0.7-1.3 mg/dL (M), 0.6-1.1 (F); most reliable kidney marker
- BUN/Creatinine Ratio: Normal 10-20:1; >20:1 = prerenal; <10:1 = intrarenal
- eGFR: Estimated glomerular filtration rate; <60 = CKD
- Creatinine Clearance: 24-hour urine collection; gold standard for GFR
Cardiac Markers
- Troponin I/T: Most specific for MI; rises 3-6 hrs, peaks 12-24 hrs
- CK-MB: Rises 3-8 hrs; useful for reinfarction
- Myoglobin: First to rise (1-4 hrs); not cardiac-specific
- BNP/NT-proBNP: Heart failure marker; ventricular wall stress
Part 2: Hematology
Complete Blood Count (CBC)
Normal Values
Red Blood Cells
Male: 4.5-5.5 × 10¹²/L
Female: 4.0-5.0 × 10¹²/L
Hemoglobin
Male: 14-18 g/dL
Female: 12-16 g/dL
Hematocrit
Male: 42-52%
Female: 37-47%
Platelets
150-400 × 10⁹/L
Thrombocytopenia <150
WBC
4.5-11.0 × 10⁹/L
Leukocytosis >11
RBC Indices
MCV: 80-100 fL
MCH: 27-31 pg
MCHC: 32-36 g/dL
Anemias Classification
Microcytic (MCV <80)
- • Iron deficiency
- • Thalassemia
- • Sideroblastic
- • Chronic disease
Normocytic (MCV 80-100)
- • Acute blood loss
- • Hemolytic anemia
- • Aplastic anemia
- • Chronic disease
Macrocytic (MCV >100)
- • B12 deficiency
- • Folate deficiency
- • Liver disease
- • Alcoholism
WBC Differential
Normal Values & Functions
- Neutrophils (40-70%): Bacterial infections; left shift = bands increase
- Lymphocytes (20-40%): Viral infections; T-cells, B-cells
- Monocytes (2-8%): Chronic infections; become macrophages
- Eosinophils (1-4%): Parasites, allergies
- Basophils (0-1%): Allergic reactions; contain histamine
Coagulation Studies
Screening Tests
- PT: 11-13 sec; extrinsic pathway; warfarin monitoring
- INR: 0.9-1.1 (normal); 2-3 (therapeutic)
- aPTT: 25-35 sec; intrinsic pathway; heparin monitoring
- Bleeding Time: 2-9 min; platelet function
Coagulation Cascade
- Intrinsic: XII → XI → IX → VIII → X
- Extrinsic: III (TF) + VII → X
- Common: X → V → II → I (Fibrin)
- Vitamin K-dependent: II, VII, IX, X
Part 3: Blood Banking & Immunohematology
ABO Blood Group System
ABO Antigens and Antibodies
| Blood Type | RBC Antigen | Serum Antibody | Can Donate To | Can Receive From |
|---|---|---|---|---|
| A | A | Anti-B | A, AB | A, O |
| B | B | Anti-A | B, AB | B, O |
| AB | A and B | None | AB only | Universal recipient |
| O | None (H) | Anti-A, Anti-B | Universal donor | O only |
Rh System
- Rh(D) antigen: Most immunogenic; Rh+ or Rh-
- Other Rh antigens: C, c, E, e
- Hemolytic Disease of Newborn (HDN): Rh- mother, Rh+ baby; anti-D crosses placenta
- Prevention: RhoGAM (anti-D immunoglobulin) at 28 weeks and postpartum
Pretransfusion Testing
Compatibility Testing Steps
- ABO/Rh typing: Forward (cells) and reverse (serum) grouping
- Antibody screen: Indirect antiglobulin test (IAT); detect unexpected antibodies
- Crossmatch: Major (donor cells + patient serum); Minor (patient cells + donor serum)
- Issue compatible units: Same ABO/Rh preferred
Transfusion Reactions
Acute Hemolytic
ABO incompatibility; fever, chills, back pain, hemoglobinuria
Febrile Non-hemolytic
WBC antibodies; fever, chills; most common
Allergic
Plasma proteins; urticaria, itching; antihistamines
TRALI
Donor WBC antibodies; pulmonary edema; within 6 hrs
Part 4: Microbiology
Bacteriology
Gram Stain Classification
Gram-Positive (Purple)
- Cocci: Staph aureus, Strep pyogenes, Enterococcus
- Bacilli: Bacillus, Listeria, Clostridium
- Thick peptidoglycan wall
- Retains crystal violet
Gram-Negative (Pink)
- Cocci: Neisseria (meningitidis, gonorrhoeae)
- Bacilli: E. coli, Pseudomonas, Salmonella
- Thin peptidoglycan, outer membrane
- LPS (endotoxin)
Culture Media
Blood Agar
Non-selective; hemolysis patterns
MacConkey Agar
Selective for GNB; lactose fermenters pink
Chocolate Agar
Neisseria, Haemophilus; enriched
Mannitol Salt
Staphylococcus; S. aureus yellow
EMB Agar
E. coli metallic green sheen
XLD Agar
Salmonella/Shigella; H2S black
Antibiotic Susceptibility
- Disk Diffusion (Kirby-Bauer): Zone of inhibition; S, I, R interpretation
- MIC (Broth Dilution): Minimum Inhibitory Concentration
- E-test: Gradient strip; MIC on scale
- MRSA: Methicillin-resistant S. aureus; mecA gene; vancomycin treatment
- ESBL: Extended-spectrum beta-lactamase; carbapenem treatment
Part 5: Clinical Microscopy & Urinalysis
Routine Urinalysis
Physical Examination
- Color: Yellow (urochrome); Red (blood, beets); Orange (pyridium)
- Clarity: Clear to turbid; WBCs, RBCs, bacteria cause cloudiness
- Specific Gravity: 1.005-1.030; concentration ability
Chemical Examination (Dipstick)
- pH: 4.5-8.0; diet affects
- Protein: Albumin; kidney disease
- Glucose: Diabetes if renal threshold exceeded
- Ketones: DKA, fasting, starvation
- Blood: Hematuria; hemoglobinuria; myoglobinuria
- Bilirubin: Conjugated only; liver disease
- Urobilinogen: Hemolysis increases
- Nitrite: Bacterial UTI (GNB)
- Leukocyte esterase: WBCs present; infection
Microscopic Examination
- RBCs: <3/HPF normal; glomerular = dysmorphic
- WBCs: <5/HPF normal; pyuria = UTI
- Epithelial cells: Squamous (contamination), Transitional, Renal tubular
- Casts: Form in tubules; Hyaline (normal), RBC (glomerulonephritis), WBC (pyelonephritis)
- Crystals: Uric acid (acidic), Triple phosphate (alkaline), Calcium oxalate (any)
- Bacteria: Usually contamination unless with WBCs
Part 6: Parasitology
Common Intestinal Parasites
Protozoa
- Entamoeba histolytica: Amoebic dysentery; trophozoite with RBCs
- Giardia lamblia: Watery diarrhea; pear-shaped trophozoite
- Cryptosporidium: AIDS patients; acid-fast oocysts
Helminths
- Ascaris lumbricoides: Largest roundworm; fertilized vs unfertilized ova
- Trichuris trichiura: Whipworm; barrel-shaped ova
- Hookworm: Anemia; ova with larvae
Blood Parasites
- Plasmodium falciparum: Malignant malaria; ring forms multiple in RBC
- Plasmodium vivax: Benign tertian; enlarged RBC with Schüffner's dots
- Plasmodium malariae: Quartan; band forms
- Diagnosis: Thick smear (screening), Thin smear (species ID)
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