Free Practice Questions for UKOM DIII TLM

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Key Facts: UKOM DIII TLM Exam

CBT

National computer-based examination format

ukomnakes.kemdiktisaintek.go.id

Lifetime

STR validity under UU No. 17 Tahun 2023

UU No. 17 Tahun 2023 tentang Kesehatan

PATELKI

Indonesian Association of Medical Laboratory Technologists

patelki.or.id

5 Core Areas

Diagnostic content clusters in this independent practice bank

KMK HK.01.07/MENKES/313/2020

UKOM DIII TLM evaluates laboratory competency in clinical chemistry, hematology, microbiology, immunoserology, and parasitology. This is an independent 96-question English-language MCQ practice bank by OpenExamPrep.

Sample UKOM DIII TLM Practice Questions

Try these sample questions to review concepts for the UKOM DIII TLM exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 96+ question experience with AI tutoring.

1A Medical Laboratory Technologist (Ahli Teknologi Laboratorium Medik / ATLM) receives a multi-test laboratory request for a hospitalized patient requiring blood culture, routine hematology (complete blood count), coagulation profile (PT/aPTT), and routine clinical chemistry. According to the standard CLSI and WHO recommended order of draw for evacuated tubes, which sequence should the ATLM follow to prevent cross-contamination?

A.Blood culture bottles -> Sodium citrate (light blue) -> Serum separator/clot activator (gold/red) -> K2-EDTA (lavender)

B.K2-EDTA (lavender) -> Sodium citrate (light blue) -> Serum separator (gold/red) -> Blood culture bottles

C.Serum separator (gold/red) -> Blood culture bottles -> Sodium citrate (light blue) -> K2-EDTA (lavender)

D.Sodium citrate (light blue) -> Blood culture bottles -> K2-EDTA (lavender) -> Serum separator (gold/red)

Explanation: According to CLSI GP41 and WHO phlebotomy guidelines, the correct order of draw is: (1) Blood cultures first to maintain sterility; (2) Sodium citrate tube (light blue) for coagulation studies; (3) Serum tubes with or without clot activator/gel (red/gold); (4) Heparin tubes (green); (5) EDTA tubes (lavender/purple); and (6) Glycolytic inhibitor tubes (gray). Drawing EDTA before serum or citrate causes cross-contamination of potassium and chelates calcium, distorting coagulation and chemistry tests.

2An ATLM notices visible pink-to-red discoloration in the serum following centrifugation of an un-anticoagulated blood tube, indicating in vitro hemolysis. Which clinical chemistry analyte is most severely falsely elevated as an immediate consequence of red blood cell lysis?

A.Serum Sodium (Na+)

B.Serum Potassium (K+)

C.Serum Glucose

D.Blood Urea Nitrogen (BUN)

Explanation: Potassium is predominantly an intracellular cation, with erythrocyte intracellular concentrations (~105-150 mEq/L) approximately 25 to 30 times higher than extracellular serum concentrations (3.5-5.0 mEq/L). Even minimal red blood cell lysis (hemolysis) releases massive amounts of intracellular potassium into the serum, producing marked pseudohyperkalemia that can prompt erroneous and dangerous clinical interventions.

3A patient's serum sample appears milky-white and turbid (grossly lipemic) due to a triglyceride concentration exceeding 1,200 mg/dL. In clinical chemistry spectrophotometric assays, what is the primary optical mechanism by which lipemia interferes with absorbance readings?

A.Competitive enzymatic inhibition of reagent chromophores

B.Quenching of fluorescent emission by high-density lipoproteins

C.Light scattering and non-specific light absorption across visible wavelengths

D.Irreversible oxidation of the detector photodiode array

Explanation: Lipemia is caused by elevated concentrations of large lipoprotein particles (principally chylomicrons and VLDL). These large particles physically scatter incident light across the entire ultraviolet and visible spectrum (turbidimetry/nephelometry effect). This light scattering falsely decreases the transmitted light reaching the photodetector, resulting in artificially high apparent optical density (absorbance) across colorimetric and spectrophotometric endpoints.

4In the enzymatic determination of blood glucose, the reference hexokinase method is considered superior in analytical specificity to the glucose oxidase-peroxidase (GOD-PAP) method because:

A.Hexokinase is completely unaffected by severe hemolysis and hyperbilirubinemia

B.Hexokinase oxidizes beta-D-glucose directly without requiring glucose-6-phosphate dehydrogenase

C.Hexokinase yields a visible green end-product measurable at 700 nm without ultraviolet detection

D.The hexokinase reaction does not depend on a peroxidase-catalyzed chromogen step vulnerable to reducing substances like ascorbic acid

Explanation: In the GOD-PAP method, the second step uses peroxidase to couple hydrogen peroxide with phenol and 4-aminophenazone to form a quinoneimine dye. Reducing agents in serum—such as ascorbic acid (vitamin C), bilirubin, and uric acid—competitively react with H2O2, causing negative interference. In contrast, the hexokinase reference method couples phosphorylation with G6PDH reduction of NAD+ to NADH (measured at 340 nm), which bypasses peroxidase and is unaffected by reducing substances.

5A 48-year-old patient arrives at the Puskesmas laboratory for an Oral Glucose Tolerance Test (Tes Toleransi Glukosa Oral / TTGO) to evaluate suspected diabetes mellitus. What standard pre-test dietary preparation and carbohydrate load are recommended by PERKENI and WHO guidelines?

A.At least 3 days of unrestricted carbohydrate diet (>= 150 g/day), overnight 8-12 hour fast, and ingestion of 75 g anhydrous glucose in 250-300 mL water within 5 minutes

B.Strict carbohydrate restriction (< 50 g/day) for 48 hours, 4-hour fasting, and ingestion of 100 g glucose

C.Complete fasting for 24 hours prior to testing, followed by ingestion of 50 g glucose syrup over 30 minutes

D.Standard normal diet with no fasting requirement, followed by 75 g glucose administered with breakfast

Explanation: Standard WHO and PERKENI (Indonesian Society of Endocrinology) guidelines dictate that patients must maintain an unrestricted diet containing at least 150 g of carbohydrates daily for 3 consecutive days prior to the test, followed by an overnight fast of 8-12 hours. On the morning of the test, fasting blood is drawn, followed by consumption of 75 g of anhydrous glucose dissolved in 250-300 mL of water consumed within 5 minutes, with the timed post-load specimen collected precisely 2 hours later.

6An ATLM processes an EDTA whole blood sample for Glycated Hemoglobin (HbA1c) using ion-exchange high-performance liquid chromatography (HPLC). The patient is known to have Hemoglobin E (HbE) trait, highly prevalent in parts of Indonesia. Why might ion-exchange HPLC yield an erroneous HbA1c result in this patient?

A.HbE completely binds irreversible boronate ligands, preventing column washing

B.Hemoglobin variants co-elute with or alter the chromatographic retention peak of HbA1c

C.Variant hemoglobins lack an N-terminal valine on the beta chain

D.EDTA chemically degrades hemoglobin variants within 15 minutes of collection

Explanation: Ion-exchange HPLC separates hemoglobin species based on net surface charge differences. Hemoglobin variants (such as HbS, HbC, and HbE) have altered electrical charges that may cause them or their glycated adducts to co-elute with HbA1c or interfere with peak integration, leading to spuriously high or low results. In such patients, non-charge-dependent methods like boronate affinity chromatography or immunoassay are preferred.

7In the classic alkaline picrate method (Jaffé reaction) for measuring serum creatinine, what is the chemical basis of color development, and how do kinetic modifications minimize chromogen interference?

A.Creatinine is cleaved by alkaline picrate into ammonia and formaldehyde; color develops proportionally to peroxide concentration

B.Alkaline picrate oxidizes creatinine to creatine phosphate; end-point absorbance is measured after a 60-minute incubation

C.Creatinine reacts with picric acid in an alkaline medium to form a yellow-orange Janovski complex; kinetic measurement reads absorbance rate between 20-80 seconds before slow-reacting non-creatinine chromogens interfere

D.Creatinine forms an insoluble white precipitate with picrate that is quantified nephelometrically at 340 nm

Explanation: The Jaffé reaction involves the formation of a red-orange Janovski tautomer complex between creatinine and picric acid in an alkaline environment. Fast-reacting interferents (e.g., acetoacetate, acetone) react within the first 15-20 seconds, whereas slow-reacting pseudo-chromogens (e.g., glucose, protein, ascorbic acid) react after 80-100 seconds. Kinetic (two-point) rate monitoring between approximately 20 and 80 seconds captures true creatinine kinetics, significantly minimizing interference.

8An ATLM measures serum urea using the coupled enzymatic Berthelot / Urease-GLDH kinetic assay. What biochemical reaction is coupled to urease hydrolysis in the UV kinetic method?

A.Urease directly reduces ferricyanide to ferrocyanide in an alkaline solution

B.Urea is directly oxidized by peroxidase to generate a colored quinoneimine dye at 546 nm

C.Urease converts urea to uric acid, which is oxidized by uricase with hydrogen peroxide production

D.Urease hydrolyzes urea to ammonium and CO2; glutamate dehydrogenase (GLDH) converts ammonium and alpha-ketoglutarate to glutamate while oxidizing NADH to NAD+

Explanation: In the kinetic urease-GLDH method: (1) Urea + H2O --(urease)--> 2 NH4+ + CO2; (2) NH4+ + 2-Oxoglutarate + NADH --(GLDH)--> L-Glutamate + NAD+ + H2O. The rate of decrease in absorbance at 340 nm due to the oxidation of NADH to NAD+ is directly proportional to the concentration of urea in the specimen.

9In the International Federation of Clinical Chemistry (IFCC) standardized kinetic UV assay for serum Alanine Aminotransferase (ALT / SGPT), which coenzyme and secondary indicator enzyme system are utilized?

A.Pyridoxal-5-phosphate (P-5-P) as coenzyme, with Lactate Dehydrogenase (LDH) and NADH consumption at 340 nm

B.Thiamine pyrophosphate (TPP) as coenzyme, with Malate Dehydrogenase (MDH) and NADP+ reduction

C.Biotin as coenzyme, with Glucose-6-Phosphate Dehydrogenase (G6PD) and NADPH formation

D.Flavin adenine dinucleotide (FAD) as coenzyme, with Peroxidase and ABTS chromogen

Explanation: In the IFCC recommended ALT assay: (1) L-Alanine + 2-Oxoglutarate --(ALT + Pyridoxal phosphate)--> Pyruvate + L-Glutamate; (2) Pyruvate + NADH + H+ --(LDH)--> L-Lactate + NAD+. The rate of decrease in absorbance at 340 nm reflects NADH oxidation and is proportional to ALT activity. Pyridoxal-5-phosphate is the required cofactor for transamination.

10A neonatal serum sample is sent to the laboratory for total and direct bilirubin measurement. In the classic Jendrassik-Grof diazo method, what is the specific role of the caffeine-sodium benzoate accelerator reagent?

A.It precipitates direct conjugated bilirubin to allow exclusive measurement of indirect bilirubin

B.It dissociates unconjugated (indirect) bilirubin from albumin, allowing it to react with diazotized sulfanilic acid

C.It serves as a stabilizing surfactant that lowers reagent pH to 1.0

D.It oxidizes biliverdin into bilirubin for colorimetric amplification

Explanation: In the Jendrassik-Grof method, conjugated (direct) bilirubin is water-soluble and reacts rapidly with diazotized sulfanilic acid without an accelerator. Unconjugated (indirect) bilirubin is hydrophobic and tightly bound to albumin, preventing diazo coupling. Caffeine-sodium benzoate displaces unconjugated bilirubin from albumin, enabling it to react with the diazo reagent so that total bilirubin can be measured. Subtracting direct from total yields the indirect fraction.

About the UKOM DIII TLM Exam

UKOM DIII TLM is the mandatory national exit examination for Medical Laboratory Technology (Teknologi Laboratorium Medis / Analis Kesehatan) students in Indonesia, required for obtaining the STR ATLM.

Exam sponsor: Komite Nasional Uji Kompetensi Mahasiswa Bidang Kesehatan. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The test evaluates specimen management, pre-analytical, analytical, and post-analytical phases, internal quality control, and clinical result interpretation.

Time Limit

Not published in official sources reviewed.

Passing Score

Not published in official sources reviewed.

Exam / Certification Fees

Rp 275,000 on the official registration page; verify the current cycle before payment.

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

24 of 96 practice questions

Kimia Klinik (Clinical Chemistry)

Phlebotomy order of draw, spectrophotometry, glucose and HbA1c, renal and hepatic panels, lipid profiles, cardiac biomarkers, and Westgard quality control rules.

23 of 96 practice questions

Hematologi & Hemostasis (Hematology & Hemostasis)

CBC parameters, red cell indices, peripheral blood smear morphology, abnormal leukocyte identification, coagulation tests (PT, aPTT), and erythrocyte sedimentation rate.

20 of 96 practice questions

Mikrobiologi & Bakteriologi Klinis (Clinical Microbiology)

Gram stain and acid-fast stain procedures, selective media, biochemical test batteries, antibiotic susceptibility testing, and laboratory biosafety.

14 of 96 practice questions

Imunoserologi & Toksikologi (Immunoserology & Toxicology)

ELISA and rapid lateral flow assays, hepatitis B seromarkers, HIV antibody detection algorithms, ABO and Rh blood grouping, and drug screening tests.

15 of 96 practice questions

Parasitologi Klinis & Sitohistoteknologi (Parasitology & Histotechnology)

Fecal parasite identification, malaria blood smears, microscopic examination of urine sediment, routine tissue processing steps, and hematoxylin-eosin staining.

Preparing for the UKOM DIII TLM Exam

What You Need to Know

Passing score: Not published in official sources reviewed.
Assessment: The test evaluates specimen management, pre-analytical, analytical, and post-analytical phases, internal quality control, and clinical result interpretation.
Time limit: Not published in official sources reviewed.
Exam / certification fees: Rp 275,000 on the official registration page; verify the current cycle before payment. Official sources

Using Our Practice Resources

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UKOM DIII TLM: Suggested Study Strategy

1Memorize the recommended CLSI order of draw for evacuated blood collection tubes to prevent additive cross-contamination.

2Understand Westgard multi-rules (1-2s warning, 1-3s, 2-2s, R-4s, 4-1s, 10-x) and appropriate corrective actions.

3Review peripheral blood smear morphological features of anemias (microcytic hypochromic, macrocytic) and leukemias.

4Know the principles of differential culture media (e.g. MacConkey, Blood Agar, TCBS) and key biochemical identification reactions.

Frequently Asked Questions

What is UKOM DIII TLM?

UKOM DIII TLM (Uji Kompetensi Program DIII Teknologi Laboratorium Medis) is the national licensing exit examination for medical laboratory technology students in Indonesia, required to earn the competency certificate and obtain the STR ATLM.

What is the STR validity period under UU No. 17 Tahun 2023?

Under UU No. 17 Tahun 2023 tentang Kesehatan, the Surat Tanda Registrasi (STR ATLM) issued by Konsil Kesehatan Indonesia (KKI) is valid for life (seumur hidup). The Surat Izin Praktik (SIP ATLM) must be renewed every 5 years with SKP fulfillment.

Which professional organization represents medical laboratory technologists in Indonesia?

Persatuan Ahli Teknologi Laboratorium Medik Indonesia (PATELKI) is the recognized professional organization for ATLM in Indonesia.

Is this practice exam official?

No. This practice bank is an independent English-language educational question bank created by OpenExamPrep for self-study and clinical reasoning review. It is not affiliated with or endorsed by PATELKI, AIPTLMI, or Kemdiktisaintek.