8- Clinical Laboratory Tests

Question 1

Bense Jones (BJ) protein test aka

Answer 1

immunoglobulin light chain urine test

Question 2

BJ proteins are produced by

Answer 2

neoplastic plasma cells

Question 3

What can can detect BJ proteins

Answer 3

Only immunoelectrophoresis of urine

Question 4

what’s the normal amount of BJ protein in urine?

Answer 4

0

Question 5

BJ proteins in urine indicates abnormal growth of

Answer 5

plasma cells

Question 6

abnormal growth of plasma cells can be an indicator for

(what diseases)

Answer 6

• *- multiple myeloma
• chronic lymphocytic leukemia (CLL)
• lymphoma
• metastatic lytic bone lesions**
• Waldenström’s macroglobulinemia
• end-stage of renal failure
• amyloidosis

Question 7

BJ proteins are found in 50-80% of patients with

Answer 7

multiple myeloma

Question 8

a type of white blood cell normally responsible for producing antibodies is called

Answer 8

plasma cells

Question 9

a cancer of plasma cells is called

Answer 9

Multiple Myeloma

Question 10

In mm, a collections of abnormal plasma cells
accumulate in

Answer 10

bone marrow

Question 11

abnormal plasma cells interfere with the
production of normal ______

Answer 11

blood cells

Question 12

MM symptoms

Answer 12

CRAB:

C = Calcium (elevated)
R = Renal failure
A = Anemia
B = Bone lesions

Question 13

MM Clinical manifestations

Answer 13

bone pain
fractures
low RBC, WBC, platelets

kidney damage

nervous system symptoms

Question 14

in MM, fracture of the bone is due to

Answer 14

lytic processes

Question 15

In mm, kidneys can be damaged by the tubulopathic effects of

Answer 15

proteins or BJ light chains

Question 16

MM nervous system symptoms and signs includes:

Answer 16

stroke-like manifestations
numbness, weakness

Question 17

Human chorionic gonadotropin (HCG) is a hormone
produced by

Answer 17

placenta or malignant tumors

Question 18

Normally HCG is only found during

Answer 18

pregnancy

Question 19

Abnormal HCG can be found in

(which population)

Answer 19

males or non-pregnant females with certain disorders

Question 20

disorders that can lead to formation of HCG

Answer 20

• testicullar (seminoma) and ovarian cancers
• choriocarcinoma in females _{(malignant trophoblastic cancer, usually of the placenta)}
• some types of cancers: stomach, pancreas, lungs,
  liver
• teratoma

Question 21

Low HCG in a pregnant women indicates

Answer 21

• *- miscarriage
• death of baby or embryo
• ectopic pregnancy**

Question 22

High blood HCG can be used for screening for

Answer 22

Down’s syndrome

(weeks 15-20)

_{Not 100% accurate}

Question 23

2nd trimester screening chart

(picture)

Answer 23

Question 24

Schilling’s test is used to determine which deficiency

Answer 24

B12

Question 25

B12 deficiency can indicate

Answer 25

- megaloblastic anemia (e.g. pernicious anemia) - nervous system pathology - general malabsorption syndrome

Question 26

Schilling (B12) test is usuall performed in how many stages

Answer 26

4

Question 27

Schilling stage **I** is can detect

Answer 27

low B12 in diet (megaloblastic anemia)

Question 28

Schilling stage **II** is can detect

Answer 28

low intrinsic factor (chronic atrophic gastritis, gastrectomy pernicious anemia)

Question 29

Low intrinsic factor can be due to problems with the \_\_\_\_\_

Answer 29

stomach

Question 30

Schilling stage **III** is can detect

Answer 30

abnormal bacterial growth in ileum (Tropical sprue, Celiac disease, Crohn’s disease)

Question 31

Schilling stage **IV** is can detect

Answer 31

pancreas problems (malabsorption syndrome, pancreatitis)

Question 32

Toxicology screens are often ordered by

Answer 32

1. hospital emergency 2. sports 3. workplace

Question 33

hospital emergency uses toxicology test when patients are

Answer 33

- appear to be unconscious - demonstrate change in mental status - in dementia

Question 34

toxicology tests for the presence of

Answer 34

parent drugs or their metabolites