Bishop CC Flashcards by Karl Dashley Atinen

Which of the following is not necessary for obtaining the spectrum of a compound from 190 to 500 nm?

a. Tungsten light source
b. Deuterium light source
c. Double-beam spectrophotometer
d. Quartz cuvettes
e. Photomultiplier

a. Tungsten light source

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Stray light in a spectrophotometer places limits on

a. Sensitivity
b. Upper range of linearity
c. Photometric accuracy below 0.1 absorbance units
d. Ability to measure in the UV range
e. Use of a grating monochromator

b. Upper range of linearity

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Which of the following light sources is used in atomic absorption spectrophotometry?

a. Hollow-cathode lamp
b. Xenon arc lamp
c. Tungsten light
d. Deuterium lamp
e. Laser

a. Hollow-cathode lamp

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Which of the following is true concerning fluorometry?

a. Emission wavelengths are always set at lower wavelengths than excitation.
b. The detector is always placed at right angles to the excitation beam.
c. All compounds undergo fluorescence.
d. Fluorometers require special detector
e. Fluorescence is an inherently more sensitive technique than absorption.

e. Fluorescence is an inherently more sensitive technique than absorption.

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Which of the following techniques has the highest potential sensitivity?

a. Phosphorescence
b. Fluorescence
c. Turbidimetry
d. Nephelometry
e. Chemiluminescence

e. Chemiluminescence

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Which electrochemical assay measures current at fixed potential?

a. Amperometry
b. Anodic stripping voltammetry
c. Coulometry
d. Analysis with ISEs
e. Electrophoresis

a. Amperometry

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Which of the following refers to the movement of buffer ions and solvent relative to the fixed support?

a. Iontophoresis
b. Isoelectric focusing
c. Electroendosmosis
d. Zone electrophoresis
e. Plasmapheresis

c. Electroendosmosis

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Reverse-phase liquid chromatography refers to

a. A nonpolar mobile phase and polar stationary phase
b. A polar mobile phase and nonpolar stationary phase
c. Distribution between two liquid phases
d. Size used to separate solutes instead of charge
e. Charge used to separate solutes instead of size

b. A polar mobile phase and nonpolar stationary phase

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Which of the following is not an advantage of CE?

a. Multiple samples can be assayed simultaneously on one injection
b. Very small sample size
c. Rapid analysis
d. Use of traditional detectors
e. Cations, neutrals, and anions move in the same direction at different rates

a. Multiple samples can be assayed simultaneously on one injection

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Tandem mass spectrometers

a. Are two mass spectrometers placed in parallel with each other
b. Are two mass spectrometers placed in series with each other
c. Require use of a gas chromatograph
d. Require use of an electrospray interface
e. Do not require an ionization source

b. Are two mass spectrometers placed in series with each other

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Which of the following is false concerning the principles of point-of-care testing devices?

a. They use principles that are identical to laboratory- based instrumentation.
b. Devices do not require quality control testing.
c. Biosensors have enabled miniaturization particularly amendable for point-of-care testing.
d. Onboard microcomputers control instrument functions and data reduction.
e. Whole blood analysis is the preferred specimen.

b. Devices do not require quality control testing.

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Which is the most sensitive detector for spectrophotometry?

a. Photomultiplier
b. Phototube
c. Electron multiplier
d. Photodiode array
e. All are equally sensitive

a. Photomultiplier

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Which of the following is Beer’s law?

a. A = e × b × c
b. %T = I/I0 × 100
c. E = hν
d. e = ΔpH × 0.59 V
e. Osmolality = j × n × C

a. A = e × b × c

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Which of the following correctly ranks electromagnetic radiation from low energy to high energy?

a. UV, visible, infrared, microwaves, x-rays, cosmic, gamma
b. Cosmic, gamma, x-rays, UV, visible, infrared, microwaves
c. Microwaves, infrared, visible, UV, x-rays, gamma, cosmic
d. UV, visible, infrared, cosmic, gamma, microwaves, x-rays
e. Visible, UV, infrared, cosmic, gamma, microwaves, x-rays

c. Microwaves, infrared, visible, UV, x-rays, gamma, cosmic

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What is the purpose of the chopper in an atomic absorption spectrophotometer?

a. Correct for the amount of light emitted by the flame
b. Correct for the fluctuating intensity of the light source
c. Correct for the fluctuating sensitivity of the detector
d. Correct for differences in the aspiration rate of the sample
e. Correct for the presence of stray light

a. Correct for the amount of light emitted by the flame

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Which of the following best describes the process of fluorescence?

a. Molecules emit a photon at the same energy when excited electrons return to the ground
state.
b. Atoms emit a photon when the electrons are excited.
c. Molecules emit a photon when the electrons are excited.
d. Molecules emit a photon at lower energy when excited electrons return to the ground state.
e. Molecules emit a photon at higher energy when excited electrons return to the ground state.

d. Molecules emit a photon at lower energy when excited electrons return to the ground state.

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Which is most accurate concerning ISEs?

a. Gas-specific membranes are necessary for oxygen and carbon dioxide electrodes.
b. The pH electrode uses a solid-state membrane.
c. The calcium electrode does not require a reference electrode.
d. The sodium electrode uses an ion-selective carrier (valinomycin).
e. The ISE for urea uses immobilized urease.

a. Gas-specific membranes are necessary for oxygen and carbon dioxide electrodes.

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Which of the following regarding MS is false?

a. Mass spectrometers can be used to sequence DNA.
b. Ions are formed by the bombardment of electrons.
c. Quadrupole and ion trap sectors separate ions according to their mass-to-charge ratio.
d. Each chemical compound has a unique mass spectrum.
e. MS detects for gas and liquid chromatography.

a. Mass spectrometers can be used to sequence DNA.

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Which of the following is not an objective of proteomics research?

a. Determining which genes are expressed and which genes are dormant
b. Identifying novel proteins as potential new biomarkers for disease
c. Identifying posttranslational modifications of proteins
d. Understanding the mechanism of diseases
e. Identifying specific gene mutations

e. Identifying specific gene mutations

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Which of the following procedures is not currently or routinely used for point-of-care testing devices?

a. Polymerase chain reaction
b. Immunochromatography
c. Biosensors
d. Colorimetric detection
e. Electrochemical detection

a. Polymerase chain reaction

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Which of the following statements is TRUE?

a. Steric exclusion chromatography is best suited for separating analytes based on their solubility in the mobile solvent.
b. Partition chromatography is most appropriate to identifying analytes that may be distributed
between two liquid phases.
c. In liquid–solid chromatography, the stationary phase separates analytes based on size, shape, and polarity.
d. Ion-exchange chromatography has a resin
phase that is soluble to water and separation of the mixture is based on magnitude and charge of ionic species.
e. The partition coefficient is measured and compared with standards in thin layer chromatography.

b. Partition chromatography is most appropriate to identifying analytes that may be distributed
between two liquid phases.

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In high-performance thin-layer chromatography (HPTLC), developed bands are compared with reference standard concentrations. Each band is measured by:

a. Mass spectrometer
b. Densitometer
c. Ruler
d. Buiret protein assay
e. Two-dimensional electrophoresis

b. Densitometer

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In which of the following components of a chromatography instrument does selective separation of a mixture occur?

a. Sample injection port
b. Quadrupole
c. Spectrometer
d. Column
e. Mass analyzer

d. Column

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True or False? In chromatography, the stationary phase is always of a solid matrix.

a. True
b. False

b. False

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Mass spectrometry identifies analytes based on:

a. Mass to charge ratio
b. Retention factor
c. Density of the band
d. Molecular weight
e. Solubility in the mobile phase

a. Mass to charge ratio

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Drugs of abuse are typically measured by:

a. Thin-layer chromatography
b. Liquid/liquid chromatography
c. Gas/liquid chromatography
d. Steric exclusion chromatography
e. HPLC

c. Gas/liquid chromatography

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PCR/ESI-TOF has the distinct advantage in pathogen identification because:

a. Requires the patient sample to be cultured and then analysis can be performed.
b. Can be used directly from patient specimens.
c. Uses the protein “finger print” to identify the pathogen.

b. Can be used directly from patient specimens.

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Which of the following is NOT a driving force for more automation?

a. Increased use of chemistry panels
b. High-volume testing
c. Fast turnaround time
d. Expectation of high-quality, accurate results

a. Increased use of chemistry panels

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Which of the following approaches to analyzer automation can use mixing paddles to stir?

a. Continuous flow
b. Centrifugal analysis
c. Discrete analysis
d. Dry chemistry slide analysis

c. Discrete analysis

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Which of the following types of analyzers offers random-access capabilities?

a. Discrete analyzers
b. Continuous-flow analyzers
c. Centrifugal analyzers
d. None of these

a. Discrete analyzers

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All of the following are primary considerations in the selection of an automated chemistry analyzer EXCEPT

a. The labor component
b. The cost of consumables
c. Total instrument cost
d. How reagents are added or mixed

d. How reagents are added or mixed

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An example of a modular integrated chemistry/immunoassay analyzer would be the

a. Aeroset
b. Dimension Vista 3000T
c. Paramax
d. Vitros

b. Dimension Vista 3000T

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Dwell time refers to the

a. Time between initiation of a test and the completion of the analysis
b. Number of tests an instrument can handle in a specified time
c. Ability of an instrument to perform a defined workload in a specified time
d. None of these

a. Time between initiation of a test and the completion of the analysis

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The first commercial centrifugal analyzer was introduced in what year?

a. 1970
b. 1957
c. 1967
d. 1976

a. 1970

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All of the following are advantages to automation EXCEPT

a. Correction for deficiencies inherent in methodologies
b. Increased number of tests performed
c. Minimized labor component
d. Use of small amounts of samples and reagents
in comparison to manual procedures

a. Correction for deficiencies inherent in methodologies

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Which of the following steps in automation generally remains a manual process in most laboratories?

a. Chemical reaction phase
b. Specimen measurement and delivery
c. Reagent delivery
d. Preparation of the sample

d. Preparation of the sample

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Which of the following chemistry analyzers uses slides to contain the entire reagent system?

a. Vitros analyzers
b. ACA analyzers
c. Synchron analyzers
d. None of these

a. Vitros analyzers

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Reflectance spectrometry uses which of the following?

a. Luminometer
b. Tungsten–halogen lamp
c. Photomultiplier tube
d. UV lamp
e. Thermometer to monitor temperature in
reaction vessel

b. Tungsten–halogen lamp

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Modifications in microsampling and reagent dispensing improve which of the following phases
in clinical testing?

a. Physician ordering phase
b. Preanalytical phase
c. Analytical phase
d. Postanalytical phase
e. All of the above phases

c. Analytical phase

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Bidirectional communication between the chemistry analyzer and the laboratory information system has had the greatest impact on which of the following phases of clinical testing?

a. Preanalytical
b. Analytical
c. Postanalytical
d. All of the above
e. None of the above

c. Postanalytical

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The strength of binding between an antigen and antibody is related to the:

a. Goodness of fit between the epitope and the F(ab)
b. Concentration of antigen and antibody
c. Source of antibody production, because monoclonal
antibodies bind better
d. Specificity of the antibody

a. Goodness of fit between the epitope and the F(ab)

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In monoclonal antibody production, the specificity of the antibody is determined by the:

a. Sensitized B lymphocytes
b. Myeloma cell line
c. Sensitized T lymphocytes
d. Selective growth medium

b. Myeloma cell line

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Which unlabeled immune precipitation method in gel is used to quantitate a serum protein?

a. Radial immunodiffusion
b. Double diffusion
c. Counterimmuno
electrophoresis
d. Immunofixation electrophoresis

d. Immunofixation electrophoresis

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In immunofixation electrophoresis, discrete bands appear at the same electrophoretic location, one reacted with antihuman IgA (α chain specific) reagent and the other reacted with antihuman λ reagent. This is best described as:

a. An IgA λ monoclonal protein
b. An IgA λ polyclonal protein
c. IgA biclonal proteins
d. Cross-reactivity

b. An IgA λ polyclonal protein

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In nephelometry, the antigen–antibody complex formation is enhanced in the presence of:

a. Polyethylene glycol
b. High-ionic-strength saline solution
c. Normal saline
d. Complement

a. Polyethylene glycol

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Which homogeneous immunoassay relies on inhibiting the activity of the enzyme label when bound to antibody reagent to eliminate separating freelabeled from bound-labeled reagent?

a. CEDIA
b. EMIT
c. MEIA
d. ELISA

b. EMIT

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In flow cytometry, the side scatter is related to the:

a. Granularity of the cell
b. DNA content of the cell
c. Size of the cell
d. Number of cells in G0 and G1

a. Granularity of the cell

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You analyze the DNA content on a sample of breast tissue for suspected malignancy using flow cytometry and get the following results: DI = 2.5 and % cells in S phase = 29%. Based on these results you can conclude:

a. These results are consistent with a mostly diploid population
b. This is normal breast tissue
c. These results are likely indicative of a malignant breast tumor
d. The results are not consistent with one another; no information is gained

c. These results are likely indicative of a malignant breast tumor

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The nucleic acid technique in which RNA is converted to cDNA, which is then amplified, is known as:

a. RT-PCR
b. PCR
c. RFLP
d. In situ hybridization

a. RT-PCR

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The acute-phase reactant proteins include all of the following EXCEPT

a. Fibrinogen
b. α1-antitrypsin
c. Haptoglobin
d. Transferrin

d. Transferrin

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The three-dimensional spatial configuration of a single polypeptide chain as determined by disulfide linkages, hydrogen bonds, electrostatic attractions, and van der Waals forces is referred to as the

a. Tertiary structure
b. Primary structure
c. Secondary structure
d. Quaternary structure

a. Tertiary structure

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The plasma protein mainly responsible for maintaining colloidal osmotic pressure in vivo is

a. Albumin
b. Hemoglobin
c. Fibrinogen
d. α2-macroglobulin

a. Albumin

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A peptide bond is

a. A double carbon bond
b. Amino group and carboxyl group bonded to the alpha-carbon
c. A tertiary ring of amino group and carboxyl group bonded to the alpha -carbon
d. Two amino groups bonded to the alpha-carbon

b. Amino group and carboxyl group bonded to the alpha-carbon

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Nutritional assessment with poor protein caloric status is associated with

a. A low level of γ-globulins
b. A decreased level of prealbumin
c. An elevated ceruloplasmin concentration
d. An increased level of α1-fetoprotein

b. A decreased level of prealbumin

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In which of the following conditions would a Normal level of myoglobin be expected?

a. Multiple myeloma
b. Acute myocardial infarction
c. Renal failure
d. Crushing trauma received in a car accident

a. Multiple myeloma

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An immunofixation protein electrophoresis is performed on serum from a patient with the most common type of multiple myeloma. The resulting pattern revealed

a. Monoclonal bands of the IgM type
b. Oligoclonal bands
c. 𝗉-γ bridging
d. Monoclonal bands of the IgG type

d. Monoclonal bands of the IgG type

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The protein electrophoretic pattern of plasma, as compared with serum, reveals a

a. Fibrinogen peak between the 𝗉- and γ-globulins
b. Broad increase in the γ -globulins
c. Fibrinogen peak with the α2-globulins
d. Decreased albumin peak

a. Fibrinogen peak between the 𝗉- and γ-globulins

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The following pattern of serum protein electrophoresis is obtained:
albumin: decreased
α1- and α2-globulins: increased
γ -globulins: normal

This pattern is characteristic of which of the following conditions?

a. Cirrhosis
b. Acute inflammation (primary response)
c. Nephrotic syndrome
d. Gammopathy

b. Acute inflammation (primary response)

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Distinct oligoclonal bands in the γ zone on CSF protein electrophoresis are diagnostic of

a. Multiple sclerosis
b. Multiple myeloma
c. Waldenström’s macroglobulinemia
d. Myoglobinemia

a. Multiple sclerosis

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When a protein is dissolved in a buffer solution, the pH of which is more alkaline than the
pI, and an electric current is passed through the solution, the protein will act as

a. An anion and migrate to the cathode
b. A cation and migrate to the cathode
c. An anion and migrate to the anode
d. An uncharged particle and will not move

c. An anion and migrate to the anode

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High serum total protein with high levels of both albumin and globulins is usually seen in

a. Dehydration
b. Waldenström’s macroglobulinemia
c. Glomerulonephritis
d. Cirrhosis

a. Dehydration

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In a patient with nephrotic syndrome, the total protein levels in urine would be:

a. Normal.
b. Lower than normal.
c. Higher than normal.
d. Similar to levels in CSF total protein levels.
e. Lower albumin levels and higher levels of IgG.

c. Higher than normal.

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Isoelectric focusing is the type of electrophoresis used to phenotype for α1- antitrypsin deficiencies. When the protein is electrophoresed, it migrates to:

a. The site where the pH is the same as its pI.
b. The site where the molecular weight of the protein correlates with the pI.
c. The site where the protein’s net charge exceeds the pI.
d. The site where the protein’s net charge is less than the pI.
e. The site where the gel pore size inhibits further migration.

a. The site where the pH is the same as its pI.

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A CSF albumin–serum albumin ratio was reported at 9.8 in a patient. How is this best interpreted?

a. This ratio is in the normal range for the patient.
b. The blood–brain barrier may be compromised leading to increased plasma albumin present in
the CSF.
c. There is an analytical error as it is biologically unlikely to achieve this value.
d. This is diagnostic of fungal meningitis.
e. This is diagnostic of multiple sclerosis.

b. The blood–brain barrier may be compromised leading to increased plasma albumin present in
the CSF.

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Which of the following CSF proteins would be measured when investigating active demyelination in multiple sclerosis?

a. CSF albumin to serum albumin ratio
b. α1-Antitrypsin
c. Myelin basic protein
d. Ceruloplasmin
e. IgG

c. Myelin basic protein

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Which one of the following is not an NPN substance?

a. Allantoin
b. Ammonia
c. Creatinine
d. Urea

a. Allantoin

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Which compound constitutes nearly half of the NPN substances in the blood?

a. Ammonia
b. Creatine
c. Urea
d. Uric acid

c. Urea

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An urea N result of 9 mg/dL is obtained by a technologist. What is the urea concentration?

a. 3.2 mg/dL
b. 4.2 mg/dL
c. 18.0 mg/dL
d. 19.3 mg/dL

d. 19.3 mg/dL

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Prerenal azotemia is caused by

a. Acute renal failure
b. Chronic renal failure
c. Congestive heart failure
d. Urinary tract obstruction

c. Congestive heart failure

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A technologist obtains a urea N value of 61 mg/dL and a serum creatinine value of 2.5 mg/dL
on apatient. These results indicate

a. Congestive heart failure
b. Dehydration
c. Glomerular nephritis
d. Urinary tract obstruction

d. Urinary tract obstruction

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Uric acid is the final product of

a. Allantoin metabolism
b. Amino acid metabolism
c. Purine metabolism
d. The urea cycle

c. Purine metabolism

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Which one of the listed conditions is not associated with elevated plasma uric acid concentration?

a. Allopurinol overtreatment
b. Gout
c. Lesch-Nyhan syndrome
d. Renal disease

a. Allopurinol overtreatment

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In the Jaffe reaction, a red-orange chromogen is formed when creatinine reacts with

a. Aluminum magnesium silicate
b. Creatininase
c. Phosphocreatine
d. Picric acid

d. Picric acid

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Substances known to increase results when measuring creatinine by the Jaffe reaction include all of the following EXCEPT

a. Ascorbic acid
b. Bilirubin
c. Glucose
d. α-Keto acids

b. Bilirubin

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Ammonia concentrations are usually measured to evaluate

a. Acid–base status
b. Glomerular filtration
c. Hepatic encephalopathy
d. Renal failure

c. Hepatic encephalopathy

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A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?

a. Lesch-Nyhan syndrome
b. Modification of diet in renal disease
c. Maple syrup urine disease
d. Reye’s syndrome
e. Megaloblastic anemia

a. Lesch-Nyhan syndrome

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When calculating creatinine clearance using the MDRD equation, which of the following factors are
considered?

a. Verification that the patient has been fasting
b. Identification of ethnicity
c. Body mass
d. Time of day of blood collection
e. Physical workout schedule of the patient

b. Identification of ethnicity

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True or False? Serum creatinine levels may be falsely elevated when a patient is taking cephalosporin.

a. True
b. False

a. True

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When measuring ammonia blood levels, which of the following might cause a false increase in this
analyte?
a. The patient had two cigarettes 15 minutes prior to blood draw.
b. The patient was fasting for hours prior to blood collection.
c. Immediately after phlebotomy, the blood sample was maintained on ice.
d. The patient had a steak dinner the night before the blood draw.
e. None of the above will falsely increase the blood ammonia levels

a. The patient had two cigarettes 15 minutes prior to blood draw.

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When a reaction is performed in zero-order kinetics

a. The rate of the reaction is independent of the substrate concentration
b. The substrate concentration is very low
c. The rate of reaction is directly proportional to the substrate concentration
d. The enzyme level is always high

c. The rate of reaction is directly proportional to the substrate concentration

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Activation energy is

a. Decreased by enzymes
b. The energy needed for an enzyme reaction to stop
c. Increased by enzymes
d. Very high in catalyzed reactions

a. Decreased by enzymes

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Enzyme reaction rates are increased by increasing temperatures until they reach the point of
denaturation at

a. 40–60°C
b. 25–35°C
c. 100°C
d. 37°C

a. 40–60°C

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An example of using enzymes as reagents in the clinical laboratory is

a. The diacetyl monoxime blood urea nitrogen
(BUN) method
b. The hexokinase glucose method
c. The alkaline picrate creatinine method
d. The biuret total protein method

b. The hexokinase glucose method

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Activity of enzymes in serum may be determined rather than concentration because

a. The amount of enzyme is too low to measure
b. The temperature is too high
c. There is not enough substrate
d. The amount of enzyme is too high to measure

a. The amount of enzyme is too low to measure

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The isoenzymes LD-4 and LD-5 are elevated in

a. Pulmonary embolism
b. Liver disease
c. Renal disease
d. Myocardial infarction

b. Liver disease

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Which CK isoenzyme is elevated in muscle diseases?

a. CK-MM
b. CK-BB
c. CK-MB
d. CK-NN

a. CK-MM

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Elevation of serum amylase and lipase is commonly seen in

a. Acid reflux disease
b. Acute appendicitis
c. Gallbladder disease
d. Acute pancreatitis

d. Acute pancreatitis

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The saccharogenic method for amylase determinations measures

a. The amount of product produced
b. The amount of substrate consumed
c. The amount of iodine present
d. The amount of starch present

a. The amount of product produced

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Elevation of tissue enzymes in serum may be used to detect

a. Tissue necrosis or damage
b. Inflammation
c. Infectious diseases
d. Diabetes mellitus

a. Tissue necrosis or damage

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Which of the following enzyme patterns is MOST diagnostic of Duchenne-type muscular
dystrophy?

a. Total CK level that is 5 to 10 times the ULN
b. Total CK level that is 25 times the ULN
c. Total CK level that is 50 to 100 times the ULN
d. Total CK level that is 1,000 times the ULN

c. Total CK level that is 50 to 100 times the ULN

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Which of the following preanalytical errors most commonly causes false increases in serum
enzyme measurements?

a. The patient was not fasting prior to blood draw.
b. The blood sample was not maintained on ice upon collection and during transport to the
laboratory.
c. The serum was not separated from red blood cells within 1 hour.
d. The patient smoked three cigarettes just prior to blood collection.
e. The blood sample was not protected from light upon collection and during transport to the
laboratory.

c. The serum was not separated from red blood cells within 1 hour.

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Which of the following hormones promotes gluconeogenesis?

a. Growth hormone
b. Hydrocortisone
c. Insulin
d. Thyroxine

b. Hydrocortisone

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Glucose oxidase oxidizes glucose to gluconic acid and

a. H2O2
b. CO2
c. HCO3
d. H2O

a. H2O2

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From glucose and ATP, hexokinase catalyzes the formation of

a. Acetyl-CoA
b. Fructose-6-phosphate
c. Glucose-6-phosphate
d. Lactose

c. Glucose-6-phosphate

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What is the preferred specimen for glucose analysis?

a. EDTA plasma
b. Fluoride oxalate plasma
c. Heparinized plasma
d. Serum

b. Fluoride oxalate plasma

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Hyperglycemic factor produced by the pancreas is

a. Epinephrine
b. Glucagon
c. Insulin
d. Growth hormone

b. Glucagon

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Polarographic methods of glucose assay are based on which principle?

a. Nonenzymatic oxidation of glucose
b. Rate of oxygen depletion measured
c. Chemiluminescence caused by the formation of ATP
d. Change in electrical potential as glucose is oxidized

b. Rate of oxygen depletion measured

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Select the enzyme that is most specific for 𝗉- d-glucose:

a. Glucose oxidase
b. Glucose-6-phosphate dehydrogenase
c. Hexokinase
d. Phosphohexose isomerase

a. Glucose oxidase

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Select the coupling enzyme used in the hexokinase method for glucose:

a. Glucose dehydrogenase
b. Glucose-6-phosphatase
c. Glucose-6-phosphate dehydrogenase
d. Peroxidase

c. Glucose-6-phosphate dehydrogenase

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All of the following are characteristic of von Gierke disease EXCEPT

a. Hypoglycemia
b. Hypolipidemia
c. Increased plasma lactate
d. Subnormal response to epinephrine

b. Hypolipidemia

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The preferred screening test for diabetes in nonpregnant adults is measurement of

a. Fasting plasma glucose
b. Random plasma glucose
c. Glycohemoglobin
d. Depends on the patient factors

d. Depends on the patient factors

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Following the 2012 ADA guidelines, the times of measurement for plasma glucose levels during
an OGTT in nonpregnant patients are

a. Fasting, 1 hour, and 2 hours
b. Fasting and 60 minutes
c. 30, 60, 90, and 120 minutes
d. Fasting, 30, 60, 90, and 120 minutes

a. Fasting, 1 hour, and 2 hours

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Monitoring the levels of ketone bodies in the urine via nitroprusside reagents provides a semi-quantitative measure of

a. Acetoacetate
b. 3-𝗉-Hydroxybutyrate
c. Acetone
d. All three ketone bodies

a. Acetoacetate

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A factor, other than average plasma glucose values, that can affect the HbA1c level is

a. Serum ketone bodies level
b. Red blood cell life span
c. Ascorbic acid intake
d. Increased triglyceride levels

b. Red blood cell life span

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Monitoring the levels of ketone bodies in the urine is

a. Considered essential on a daily basis for all diabetic patients
b. A reliable method of assessing long-term glycemic control
c. Recommended for patients with type 1 diabetes on sick days
d. Not recommended by the ADA

c. Recommended for patients with type 1 diabetes on sick days

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A urinalysis identifies a positive result for reducing sugars, yet the test for glucose (glucose oxidase reaction) was negative on the dipstick. What do these results suggest?

a. This is commonly observed with ascorbic acid interference.
b. This may suggest the patient has a deficiency in galactose-1-phosphate uridyl transferase.
c. This may suggest a pancreatic beta cell tumor.
d. This may suggest a deficiency in glycogen debrancher enzyme.
e. It is not possible to obtain these results and there is an analytic error in testing

b. This may suggest the patient has a deficiency in galactose-1-phosphate uridyl transferase.

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Urinalysis of a diabetic patient identified the following:
Year 1: Urine albumin was 15 mg/24 h
Year 2: Urine albumin was 56 mg/24 h
Year 3: Urine albumin was 156 mg/24 h

What do these clinical data suggest?

a. These levels of albumin in the urine are normal and no follow-up is necessary.
b. These levels of albumin in the urine suggest that kidney function is compromised and follow-up is necessary.
c. As these values of urinary albumin are not greater than 300 mg/24 h, the patient is not likely to have compromised kidney function.
d. An additional urinary albumin test is required in Year 4 to verify diminishing kidney function.

b. These levels of albumin in the urine suggest that kidney function is compromised and follow-up is necessary.

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Which of the following methods for lipoprotein electrophoresis depends on charge and molecular
size?

a. Polyacrylamide gel
b. Paper
c. Cellulose acetate
d. Agarose

a. Polyacrylamide gel

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Which of the following statements concerning chylomicrons is FALSE?

a. The major lipid transported by this lipoprotein is cholesterol.
b. This lipoprotein is produced in the intestinal mucosa.
c. The primary function is to carry dietary (exogenous) lipids to the liver.
d. It remains at the origin (point of application) during lipoprotein electrophoresis.

a. The major lipid transported by this lipoprotein is cholesterol.

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The lipoprotein that contains the greatest amount of protein is called

a. HDL
b. Chylomicrons
c. VLDL
d. LDL

a. HDL

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True or False? Pre-beta (VLDL) lipoproteins migrate further toward the anode on polyacrylamide gel than they do on cellulose acetate or agarose.

a. True
b. False

b. False

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Several enzymatic triglyceride methods measure the production or consumption of

a. NADH
b. Fatty acids
c. Glycerol
d. Diacetyl lutidine

c. Glycerol

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The most likely cause for serum/plasma to appear “milky” is the presence of

a. Chylomicrons
b. VLDL
c. LDL
d. HDL

a. Chylomicrons

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In the colorimetric determination of cholesterol using the enzyme cholesterol oxidase, the agent
that oxidizes the colorless organic compound 4-aminoantipyrine to a pink complex is

a. Hydrogen peroxide
b. Cholest-4-ene-3-one
c. NAD
d. Phenol

a. Hydrogen peroxide

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Which lipoprotein is the major carrier of cholesterol to peripheral tissue?

a. LDL
b. Chylomicrons
c. VLDL
d. HDL

a. LDL

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True or false? Increased levels of apo A-I are associated with increased risk of CAD.

a. True
b. False

b. False

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A patient is admitted to the hospital with intense chest pains. The patient’s primary care physician
requests the emergency department doctor to order several tests, including a lipid profile with cholesterol fractionation. Given the patient’s results provided below, what would be the LDL-C
for this patient?
Total cholesterol = 400 mg/dL; triglycerides =
300 mg/dL;
HDL-C = 100 mg/dL; LP electrophoresis, pending

a. 240 mg/dL
b. 160 mg/dL
c. 200 mg/dL
d. 300 mg/dL

a. 240 mg/dL

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A patient is admitted to the hospital with intense chest pains. The patient’s primary care physician requests the emergency department doctor to order several tests, including a lipid profile with cholesterol fractionation. Given the patient’s results provided below, what would be this patient’s LDL-C status?
Total cholesterol = 400 mg/dL;
triglycerides = 300 mg/dL;
HDL-C = 100 mg/dL;
LP electrophoresis, pending

a. Borderline
b. Optimal
c. Desirable
d. High

d. High

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As part of a lipoprotein phenotyping, it is necessary to perform total cholesterol and triglyceride determinations, as well as lipoprotein electrophoresis. The test results obtained from such studies were
* Triglyceride, 340 mg/dL (reference range, <150 mg/dL)
* Total cholesterol, 180 mg/dL (reference range, <200 mg/dL)
* Pre-beta-lipoprotein fraction increased
* Beta-lipoprotein fraction normal
* No chylomicrons present
* Serum appearance turbid

The best explanation for these results would be that the patient exhibits a phenotype indicative of

a. Type IV hyperlipoproteinemia
b. Type I hyperlipoproteinemia
c. Type II hyperlipoproteinemia
d. Type III hyperlipoproteinemia
e. Type V hyperlipoproteinemia

a. Type IV hyperlipoproteinemia

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Which of the following results is the most consistent with high risk of CHD?

a. 55 mg/dL HDL-C and 180 mg/dL total cholesterol
b. 35 mg/dL HDL-C and 200 mg/dL total cholesterol
c. 50 mg/dL HDL-C and 190 mg/dL total cholesterol
d. 20 mg/dL HDL-C and 250 mg/dL total cholesterol
e. 60 mg/dL HDL-C and 170 mg/dL total cholesterol

d. 20 mg/dL HDL-C and 250 mg/dL total cholesterol

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What is the presumed defect in most cases of familial type IIa hyperlipoproteinemia?

a. Defective receptors for LDL
b. Deficiency of hydroxymethylglutaryl (HMG)- CoA reductase
c. Deficiency of cholesterol esterase
d. Deficiency of LPL
e. Defective esterifying enzymes LCAT and ACAT

a. Defective receptors for LDL

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Hyperchylomicronemia (type I) in childhood has been associated with which of the following?

a. A deficiency of apo A-I
b. A deficiency of LCAT
c. A deficiency of LPL
d. A deficiency of apo C-II

d. A deficiency of apo C-II

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What is the major intracellular cation?

a. Potassium
b. Calcium
c. Magnesium
d. Sodium

a. Potassium

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What is the major extracellular cation?

a. Sodium
b. Chloride
c. Magnesium
d. Calcium

a. Sodium

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Osmolality can be defined as a measure of the concentration of a solution based on the

a. Number of ionic particles present
b. Number of dissolved particles
c. Number and size of the dissolved particles
d. Density of the dissolved particles

b. Number of dissolved particles

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Hyponatremia may be caused by each of the following EXCEPT

a. Hypomagnesemia
b. Aldosterone deficiency
c. Prolonged vomiting or diarrhea
d. Acute or chronic renal failure

a. Hypomagnesemia

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Hypokalemia may be caused by each of the following EXCEPT

a. Hypomagnesemia
b. Prolonged vomiting or diarrhea
c. Acidosis
d. Hyperaldosteronism

c. Acidosis

Hyperkalemia may be caused by each of the following EXCEPT

a. Alkalosis
b. Acute or chronic renal failure
c. Hypoaldosteronism
d. Sample hemolysis

a. Alkalosis

The main difference between a direct and indirect ISE is

a. Whole blood samples can be measured with the direct method and not with the indirect method
b. The type of membrane that is used
c. Direct ISEs use a reference electrode, whereas indirect ISEs do not
d. Sample is diluted in the indirect method, not in the direct method

d. Sample is diluted in the indirect method, not in
the direct method

Which method of analysis will provide the most accurate electrolyte results if a grossly lipemic sample is used?

a. Direct ISE
b. Indirect ISE
c. Flame emission photometry
d. Atomic absorption

a. Direct ISE

The most frequent cause of hypermagnesemia is due to

a. Acidosis
b. Increased intake of magnesium
c. Hypoaldosteronism
d. Renal failure

d. Renal failure

A hemolyzed sample will cause falsely increased levels of each of the following EXCEPT

a. Sodium
b. Potassium
c. Phosphate
d. Magnesium

a. Sodium

The largest portion of total body water is found in which tissue?

a. Intracellular fluid
b. Extracellular fluid
c. Intravascular extracellular fluid
d. Interstitial cell fluid
e. Plasma

a. Intracellular fluid

Osmoreceptors in the hypothalamus are key to regulating blood osmolality. Typically, a 1% to 2% shift in osmolality causes a change in circulating concentration of ADH.

a. Twofold
b. Fourfold
c. Eightfold
d. Tenfold

b. Fourfold

The quantitative relationship between changes in blood osmolality and the normal expected response by ADH is best described as a(n):

a. Indirect relationship
b. Direct relationship
c. Logarithmic relationship
d. There is no quantitative relationship

c. Logarithmic relationship

The sample of choice for measuring blood osmolality is:

a. Serum
b. Plasma
c. Whole blood
d. Serum or plasma may both be used

a. Serum

With increased water loss, burn patients are most likely to also experience:

a. Hypernatremia
b. Hyponatremia
c. Hypomagnesemia
d. Hypoosmolality

a. Hypernatremia

Which plasma electrolyte has the most narrow reference range and is MOST strictly regulated by
the body?

a. Sodium
b. Magnesium
c. Calcium
d. Chloride
e. Potassium

e. Potassium

True or False?
Red blood cells are key for oxygen transport, carbon dioxide transport, and maintaining electroneutrality in the blood.

a. True
b. False

a. True

The presence of dyshemoglobins will cause a calculated % SO2 result to be falsely (elevated, decreased) and a pulse oximeter % Spo2 value to be falsely (elevated, decreased).

a. Elevated, elevated
b. Decreased, decreased
c. Elevated, decreased
d. Decreased, elevated

a. Elevated, elevated

The anticoagulant of choice for arterial blood gas measurements is in the state.

a. Lithium heparin; dry
b. EDTA; dry
c. Potassium oxalate; liquid
d. Sodium citrate; dry

a. Lithium heparin; dry

At a pH of 7.10, the H+ concentration is equal to

a. 20 nmol/L
b. 80 nmol/L
c. 40 nmol/L
d. 60 nmol/L

b. 80 nmol/L

The kidneys compensate for respiratory alkalosis by (excretion, retention) of bicarbonate and (increased, decreased) excretion of NaH2PO4.

a. Excretion, decreased
b. Excretion, increased
c. Retention, increased
d. Retention, decreased

a. Excretion, decreased

The normal ratio of carbonic acid to bicarbonate in arterial blood is

a. 1:20
b. 7.4:6.1
c. 0.003:1.39
d. 20:1

a. 1:20

When arterial blood from a normal patient is exposed to room air:

a. pco2 decreases; po2 decreases
b. pco2 decreases; po2 increases
c. pco2 increases; po2 decreases
d. pco2 increases; po2 increases

c. pco2 increases; po2 decreases

A patient’s arterial blood gas results are as follows:
pH 7.37;
pco2, 75 mm Hg;
HCO3–, 37 mmol/L.

These values are consistent with

a. Compensated respiratory acidosis
b. Compensated nonrespiratory acidosis
c. Uncompensated respiratory alkalosis
d. Uncompensated nonrespiratory alkalosis

a. Compensated respiratory acidosis

A patient’s arterial blood gas results are as follows:
pH 7.48;
pco2, 54 mm Hg;
HCO3–, 38 mmol/L.

These values are consistent with

a. Compensated nonrespiratory alkalosis
b. Compensated respiratory alkalosis
c. Uncompensated respiratory alkalosis
d. Uncompensated nonrespiratory alkalosis

d. Uncompensated nonrespiratory alkalosis

In the circulatory system, bicarbonate leaves the red blood cells and enters the plasma through an
exchange mechanism with to maintain electroneutrality.

a. Chloride
b. Carbonic acid
c. Lactate
d. Sodium

a. Chloride

Hypoventilation can compensate for

a. Nonrespiratory acidosis
b. Mixed alkalosis
c. Mixed acidosis
d. Nonrespiratory alkalosis

a. Nonrespiratory acidosis

The hemoglobin oxygen binding capacity for a blood sample that is 100% saturated with O2 and
has a total hemoglobin value of 12 g/dL is approximately

a. 34 mL O2/dL
b. 4 mL O2/dL
c. 8 mL O2/dL
d. 17 mL O2/dL

d. 17 mL O2/dL

Carbonic acid concentration in blood plasma equals

a. 0.0307 mmol/L/mm Hg times the pco2 value in mm Hg
b. Apparent pKa of carbonic acid, 6.1, plus the
pco2 value in mmHg
c. pco2 value in mm Hg plus HCO3 – value in mm Hg
d. Bicarbonate concentration divided by the pco2 value in mm Hg

a. 0.0307 mmol/L/mm Hg times the pco2 value in
mm Hg

Oxygen content in blood reflects

a. po2 value
b. O 2Hb only
c. O 2 dissolved in blood plasma only
d. The patient’s total hemoglobin value
e. All of these

d. The patient’s total hemoglobin value

Extreme copper deficiency is seen in what fatal condition?

a. Menkes disease
b. Klinefelter’s syndrome
c. Meese disease
d. Kayser-Fleischer rings

a. Menkes disease

Suppose the controller on a GFAAS is defective and the furnace is running cold. What effect will this likely have on the number of photons absorbed in the measurements?

a. It will have little effect
b. It will increase the number of photons absorbed
c. It will decrease the number of photons absorbed
d. It is not a relevant question because AAS relies on emission of light from electronically excited atoms

c. It will decrease the number of photons
absorbed

Why would a clinical chemist develop an arsenic method that combines liquid chromatography with ICP-MS?

a. To eliminate interference by sodium from the analysis
b. To separate and quantitate several different arsenic-containing species in the same sample
c. To shorten the run time of the measurement
d. To lower the coefficient of variation for total arsenic measurements

b. To separate and quantitate several different arsenic-containing species in the same sample

Select the answer that designates three techniques widely used for elemental analysis, identified according to the initials for the techniques.

a. AAS, ICP-MS, AES
b. NMR, ICP-MS, AES
c. GC-MS, ICP-MS, AES
d. HPLC-ICP-MS, AAS, FTIR

a. AAS, ICP-MS, AES

One of the calcium isotopes (40Ca) has an atomic weight of 40. At what positions in a mass spectrum would singly and doubly charged ions of this isotope of calcium appear? Assume that singly charged Ca is listed first.

a. 40 and 80
b. 40 and 60
c. 40 and 20
d. 40 and 40

c. 40 and 20

What primary purposes does the torch serve in ICP-MS?

a. Vaporization, atomization, and ionization
b. Vaporization, atomization, and electronic excitation
c. Nebulization, atomization, and photon absorption
d. Droplet transport, vaporization, and ion detection

a. Vaporization, atomization, and ionization

Manganese toxicity resembles the following disease:

a. Parkinson’s disease
b. Wilson’s disease
c. Alzheimer’s disease
d. Menkes disease

a. Parkinson’s disease

Iron is physiologically active only in the ferrous form in

a. Cytochromes
b. Hemoglobin
c. Ferritin
d. Transferrin

b. Hemoglobin

A metal ion required for optimal enzyme activity is best termed a(an)

a. Cofactor
b. Accelerator
c. Coenzyme
d. Catalyst

a. Cofactor

Which trace metal is contained in glucose tolerance factor?

a. Copper
b. Chromium
c. Selenium
d. Zinc

b. Chromium

What metal may be used as a treatment for Wilson’s disease?

a. Fluorine
b. Copper
c. Molybdenum
d. Zinc

d. Zinc

The metal ion essential for the activity of xanthine oxidase and xanthine dehydrogenase is

a. Zinc
b. Iron
c. Molybdenum
d. Manganese

c. Molybdenum

The main purpose of porphyrins in the body is to

a. Contribute to the synthesis of heme
b. Carry oxygen to the tissue
c. Transport iron
d. Combine with free hemoglobin

a. Contribute to the synthesis of heme

The two main sites in the body for accumulation of excess porphyrins are

a. Liver and spleen
b. Heart and lung
c. Muscle and blood
d. Liver and bone marrow

d. Liver and bone marrow

The two main classes of porphyrias, according to symptoms, are

a. Congenital and acquired
b. Erythropoietic and hepatic
c. Neurologic and cutaneous
d. Hematologic and muscular

c. Neurologic and cutaneous

Porphobilinogen is most commonly quantitated in the urine by

a. Thin-layer chromatography
b. The Watson-Schwartz method
c. Ion-exchange column
d. Electrophoresis

c. Ion-exchange column

Extremely high levels of ALA and PBG in the urine with normal porphyrin levels in the feces and blood most likely indicate

a. Acute intermittent porphyria (AIP)
b. Erythropoietic porphyria (EP)
c. Hereditary coproporphyria (HCP)
d. Porphyria cutanea tarda (PCT)

a. Acute intermittent porphyria (AIP)

Inherited disorders in which a genetic defect causes abnormalities in rate and quantity of synthesis of structurally normal polypeptide chains of the hemoglobin molecule are called

a. Hemoglobinopathies
b. Thalassemias
c. Porphyrias
d. Molecular dyscrasias

b. Thalassemias

Increased intravascular hemolysis is indicated by a decrease in

a. Methemoglobin
b. Haptoglobin
c. Methemalbumin
d. Hemopexin

b. Haptoglobin

Which of the following abnormal hemoglobins, found frequently in individuals from Southeast Asia, migrates with hemoglobin A2 on cellulose acetate electrophoresis?

a. Hemoglobin Lepore
b. Hemoglobin D
c. Hemoglobin C
d. Hemoglobin E

d. Hemoglobin E

Which type of alpha-thalassemia results from deletion of three genes and produces a moderate hemolytic anemia?

a. Hemoglobin H disease
b. Hemoglobin Bart’s
c. Hydrops fetalis
d. Thalassemia trait

a. Hemoglobin H disease

The most effective way to quantitate hemoglobin A2 is by

a. Densitometry
b. Column chromatography
c. Citrate agar electrophoresis
d. Alkali denaturation test

b. Column chromatography

Serum or plasma myoglobin levels are used as

a. An early marker of acute myocardial infarction
b. Liver function tests
c. Lead poisoning indicator
d. Indicator of congestive heart failure

a. An early marker of acute myocardial infarction

Which of the following is the best test to differentiate beta-thalassemia minor from iron deficiency
anemia?

a. Solubility test
b. Hemoglobin electrophoresis (cellulose acetate, alkaline pH)
c. Hemoglobin A2 quantitation
d. Complete blood count

c. Hemoglobin A2 quantitation

Which is the correct sequence of electrophoretic migration of hemoglobins from slowest to fastest on cellulose acetate at an alkaline pH?

a. C, S, F, A
b. C, A, S, F
c. C, S, A, F
d. A, F, S, C

a. C, S, F, A

The primary route(s) of excretion for protoporphyrin (PROTO), uroporphyrin (URO), and coproporphyrin (COPRO) are

a. URO is excreted primarily in the urine, PROTO in the feces, and COPRO in either.
b. URO is excreted primarily in the feces, PROTO in the urine, and COPRO in either.
c. URO is excreted primarily in the urine, PROTO and COPRO in the feces.
d. URO is excreted primarily in the feces, PROTO and COPRO in urine.

a. URO is excreted primarily in the urine, PROTO in the feces, and COPRO in either.

Control of the rate of heme synthesis in the liver cells is achieved largely through regulation of the enzyme

a. ALA synthase
b. ALA dehydratase
c. PBG deaminase
d. Ferrochelatase

a. ALA synthase

The two main sites of production of heme are

a. Heart and lung
b. Liver and bone marrow
c. Muscle and blood
d. Liver and spleen

b. Liver and bone marrow

The relationship between precursors in the heme synthesis pathway and the type of porphyria
resulting from excess buildup of these precursors is

a. Excess of early precursors causes neurologic porphyrias and excess of late precursors causes cutaneous porphyrias.
b. Excess of early precursors causes cutaneous porphyrias and excess of late precursors causes
neurologic porphyrias.
c. Excess of early precursors causes both neurologic and cutaneous porphyrias, whereas excess of late precursors causes only cutaneous porphyrias.
d. Excess of early precursors causes both neurologic and cutaneous porphyrias whereas excess of late precursors causes only neurologic porphyrias.

a. Excess of early precursors causes neurologic porphyrias and excess of late precursors causes
cutaneous porphyrias.

Secondary porphyrias not due to an inherited biochemical defect in heme synthesis can be distinguished from true porphyrias by measuring levels of

a. Urinary URO and COPRO
b. Urinary COPRO and blood lead
c. Urinary ALA and PBG
d. Fecal URO and urinary COPRO

c. Urinary ALA and PBG

Which hemoglobin is resistant to alkali denaturation in NaOH?

a. Hb S
b. Hb A
c. Hb C
d. Hb F

d. Hb F

A patient has an abnormal hemoglobin band that migrates with Hb S on cellulose acetate (pH 8.4)
hemoglobin electrophoresis. The solubility test is negative. What test should be performed next?

a. Blood film evaluation
b. HbA2 quantitation
c. Acid elution stain
d. Citrate agar (pH 6.2) electrophoresis

d. Citrate agar (pH 6.2) electrophoresis

Silent carriers of alpha-thalassemia are missing how many alpha genes?

a. 1
b. 2
c. 3
d. 4

a. 1

Which hemoglobin contains four gamma chains and has an extremely high affinity for oxygen?

a. Hb Barts
b. Hb Gower I
c. Hb Portland I
d. Hb F

a. Hb Barts

A patient with Southeast Asian heritage is found to have a mild microcytic anemia and a few
target cells. Hemoglobin electrophoresis on cellulose acetate at pH 8.4 reveals a major band
that migrates with Hb A2 and no HbA. On citrate agar electrophoresis, the band travels in the
position of Hb A. What is the most probable abnormal hemoglobin present?

a. Hb A
b. Hb E
c. Hb C
d. Hb D

b. Hb E

Open-loop negative feedback refers to the Phenomenon of

a. Negative feedback with a modifiable set point
b. Blood flow in the hypothalamic–hypophyseal portal system
c. Blood flow to the pituitary via dural-penetrating vessels
d. Negative feedback involving an unvarying, fixed set point

a. Negative feedback with a modifiable set point

The specific feedback effector for FSH is

a. Progesterone
b. Activin
c. Inhibin
d. Estradiol

c. Inhibin

Which anterior pituitary hormone lacks a stimulatory hypophysiotropic hormone?

a. Growth hormone
b. Prolactin
c. Vasopressin
d. ACTH

b. Prolactin

The definitive suppression test to prove autonomous production of growth hormone is

a. Oral glucose loading
b. Somatostatin infusion
c. Estrogen priming
d. Dexamethasone suppression

a. Oral glucose loading

Which of the following is influenced by growth hormone?

a. Lipolysis
b. IGF-I
c. IGFBP-III
d. All of these

d. All of these

What statement concerning vasopressin secretion is NOT true?

a. A reduction in effective blood volume overrides the effects of plasma osmolality in regulating
vasopressin secretion.
b. Vasopressin secretion is closely tied to plasma osmolality.
c. Changes in blood volume also alter vasopressin secretion.
d. All of these

d. All of these

What are the long-term sequelae of untreated or partially treated acromegaly?

a. An increased risk of colon and lung cancer
b. A reduced risk of heart disease
c. Enhanced longevity
d. Increased muscle strength

a. An increased risk of colon and lung cancer

TRH stimulates the secretion of

a. Prolactin
b. Prolactin and TSH
c. Growth hormone
d. TSH

b. Prolactin and TSH

Estrogen influences the secretion of which of the following hormones?

a. Luteinizing hormone
b. Growth hormone
c. Prolactin
d. All of these

d. All of these

What is the difference between a tropic hormone and a direct effector hormone?

a. Tropic and direct effector hormones are both similar in that both act directly on peripheral
tissue.
b. Tropic and direct effector hormones are both similar in that both act directly on another
endocrine gland.
c. Tropic hormones act on peripheral tissue while direct effector hormones act on endocrine glands.
d. Tropic hormones act on endocrine glands while direct effector hormones act on peripheral
tissues.

d. Tropic hormones act on endocrine glands while direct effector hormones act on peripheral
tissues.

A deficiency in vasopressin can lead to which of the following?

a. Euvolemic hypokalemia
b. Euvolemic hyponatremia
c. Diabetes insipidus
d. Primary hypothyroidism

c. Diabetes insipidus

When considering an endocrine cause for a patient’s hypertension, the ________ is the usual suspect.

Adrenal gland

When hypertension results from an endocrine disorder, what hormonal state is usually found: hormone underproduction or overproduction?

Overproduction

True or false? Major warning signs of adrenal disease include abnormal blood pressure, abnormal
electrolytes (potassium, acid–base status, urine dilution), and unexplained weight change.

True

________ is the common substrate from which all adrenal steroids are produced.

Cholesterol

True or false? When produced, free catecholamines (NE and EPI) are short-lived. They are best
measured in the urine, though catecholamine metabolites are best measured in the serum.

False

is responsible for epinephrine production.

Cortisol

A primary hyperaldosteronemic state is characterized by:

a. A urine potassium of 35 mmol/d.
b. A urine potassium of 21 mmol/d.
c. A spot urine test where the sodium levels are greater than potassium levels.
d. Within 3 hours of taking 50 mg of captopril, plasma aldosterone was low.
e. All of the above are characteristic of hypoaldosteronism.

a. A urine potassium of 35 mmol/d.

During a low dose (1 mg) dexamethasone suppression test, total cortisol levels measured in a patient at 8:35 am was 2.8 μg/dL. How is this interpreted?

a. The patient is normal.
b. The patient has Cushings’ syndrome.
c. The patient has a nonpituitary tumor causing
ectopic ACTH syndrome.
d. The patient has an ACTH-secreting pituitary
adenoma.

a. The patient is normal.

The most biologically active androgen in this list is:

a. DHEA
b. DHEAS
c. LH
d. FSH
e. Estrone

c. LH

Which amino acid is needed for the biosynthesis of norepinephrine and epinephrine?

a. Alanine
b. Phenylalanine
c. Isoleucine
d. Leucine
e. Serine

b. Phenylalanine

Which of the following describes catecholamines?

a. Hydrophobic
b. Degraded rapidly in nonneuronal cells by monamine reductase
c. Have long half-lives
d. Circulating blood catecholamines are 99% bound to albumin.
e. None of the above accurately describes catecholamines.

e. None of the above accurately describes catecholamines.

The collection of a 24-hour urine is used for measuring:

a. Creatinine clearance
b. Norepinephrine
c. Dopamine
d. All of the above may be measured in a 24-hour urine
e. All but one of the above may be measured in a 24-hour urine

d. All of the above may be measured in a 24-hour urine

If serum levels of estradiol do not increase after injection of hCG, the patient has

a. Primary ovarian failure
b. Pituitary failure
c. Tertiary ovarian failure
d. Secondary ovarian failure

a. Primary ovarian failure

If a patient had a luteal phase defect, which hormone would most likely be deficient?

a. Progesterone
b. Estrogen
c. hCG
d. FSH
e. Prolactin

a. Progesterone

Which of the following is the precursor for estradiol formation in the placenta?

a. Maternal testosterone
b. Fetal adrenal DHEAS
c. Maternal progesterone
d. Placental hCG
e. Fetal adrenal cholesterol

b. Fetal adrenal DHEAS

Which of the following target tissues is incapable of producing steroidal hormones?

a. Adrenal medulla
b. Placenta
c. Ovary
d. Testis
e. Adrenal cortex

a. Adrenal medulla

The parent substance in the biosynthesis of Androgens and estrogens is

a. Cortisol
b. Cholesterol
c. Catecholamines
d. Progesterone

b. Cholesterol

The biologically most active, naturally occurring androgen is

a. DHEA
b. Androstenedione
c. Epiandrosterone
d. Testosterone

a. DHEA

For the past 3 weeks, serum estriol levels in a pregnant woman have been steadily increasing.
This is consistent with

a. Fetal death
b. Hemolytic disease of the newborn
c. A normal pregnancy
d. Congenital cytomegalovirus infection

c. A normal pregnancy

Which of the following is secreted by the placenta and used for the early detection of pregnancy?

a. hCG
b. FSH
c. LH
d. Progesterone

a. hCG

Chronic fetal metabolic distress is demonstrated by

a. Decreased urinary estriol excretion and decreased maternal serum estriol
b. Decreased estrogen in maternal plasma and increased estriol in amniotic fluid
c. Increased estradiol in maternal plasma, with a corresponding increase of estriol in amniotic fluid
d. Increased urinary estriol excretion and increased maternal serum estriol

a. Decreased urinary estriol excretion and decreased maternal serum estriol

Androgen secretion by the testes is stimulated by

a. FSH
b. LH
c. Testosterone
d. Gonadotropins

b. LH

A deficiency in estrogen during the follicular phase will result in:

a. A failure of embryo implantation.
b. An increased length of the menstrual cycle.
c. A lack of Graafian follicle release from the ovary.
d. An incomplete development of the endometrium.

d. An incomplete development of the endometrium.

Which hormone is responsible for an increase in body temperature at the time of ovulation?

a. Progesterone
b. Estrogen
c. LH
d. FSH
e. Estradiol

a. Progesterone

A midcycle LH surge will stimulate which series of events?

a. An increase in FSH
b. A decrease in FSH
c. Anovulation
d. Amenorrhea
e. A decrease in progesterone production

b. A decrease in FSH

All of the following statements about iodine are true EXCEPT

a. Radioactive iodine treatment of Graves’ disease is effective in less than 40% of patients treated with this agent.
b. Iodine deficiency is one of the most common causes of hypothyroidism in the world.
c. T4 has 4 iodine molecules.
d. RAIU is often useful in determining the cause of thyrotoxicosis.

a. Radioactive iodine treatment of Graves’ disease is effective in less than 40% of patients treated with this agent.

The fetus

a. Is not susceptible to damage from radioactive iodine therapy given to the mother
b. Does not develop a thyroid gland until the third trimester
c. Is dependent on thyroid hormone for normal neurologic development
d. Will be born with hypothyroidism in approximately 1 of 400 births in developed countries

c. Is dependent on thyroid hormone for normal neurologic development

The thyroid gland

a. Depends on TPO to permit iodination of the tyrosyl residues to make MIT and DIT
b. Is an ineffective iodine trap
c. Depends on TPO to permit the joining of two DIT residues to form T3
d. Usually functions independent of TSH levels

a. Depends on TPO to permit iodination of the tyrosyl residues to make MIT and DIT

The thyroid gland produces all of the following EXCEPT

a. Thyroglobulin
b. TSH
c. T3
d. T4

b. TSH

Hypothyroidism is generally associated with all of the following EXCEPT

a. TSH receptor antibodies
b. Depression
c. An elevation of TSH levels
d. TPO antibodies

a. TSH receptor antibodies

A 34-year-old woman presents with goiter, tachycardia, and weight loss of 2 months duration. TSH is undetectable and free T4 is high. All of the following tests are useful in diagnosing the cause
of the hyperthyroidism EXCEPT

a. TSH
b. TSH receptor antibodies
c. RAIU
d. FNA biopsy of the thyroid gland

d. FNA biopsy of the thyroid gland

A 65-year-old woman presents with fatigue,hypothermia, pericardial effusions, and hair loss.
Her thyroid function tests show a significantly elevated TSH and a low free T4. All of the following
laboratory test abnormalities may be associated with her underlying condition EXCEPT

a. Elevated WBC
b. An elevated cholesterol level
c. Anemia
d. Elevated CPK levels

a. Elevated WBC

A 26-year-old man presents with a 3-cm, right lobe, thyroid nodule and a normal TSH. What is the
next test that should be performed?

a. FNA of the nodule
b. Free T4 level
c. Thyroid ultrasound
d. Thyroid scan

a. FNA of the nodule

The following are treatment options for hyperthyroidism associated with Graves’ disease EXCEPT

a. Beta-blockers
b. PTU
c. Thyroid hormone
d. Radioactive iodine

c. Thyroid hormone

All of the following abnormalities might be expected in a severely ill patient EXCEPT

a. Low rT3
b. Low T4
c. Low T3
d. Low TSH

a. Low rT3

Of the following thyroid hormones, which is considered the most biologically active?

a. T3 bound to TBG
b. T4 bound to TBG
c. Free T4
d. Free T3
e. rT3

d. Free T3

The primary serum test to screen for thyroid disease is:

a. Free T4
b. rT3
c. Total T4
d. Autoimmune antibodies to thyroid tissue
e. TSH

e. TSH

Of the following, which will MOST likely interfere with quantitation of thyroglobulin?

a. Antithyroglobulin autoantibodies
b. Thyroid-stimulating antibodies
c. TSH receptor antibodies
d. Thyroid peroxidase antibodies

a. Antithyroglobulin autoantibodies

True or false? PTH and 1,25(OH)2D (vitamin D) are the principal hormones involved in the normal
physiologic regulation of calcium homeostasis.

True

The primary organs involved in the maintenance of calcium homeostasis are the intestine,________, and kidney.

Bone

Skin,________, and kidneys are involved in the Production of the active metabolite of vitamin D.

Liver

True or false? Cod liver oil is a source of vitamin D.

True

True or false? 1,25(OH)2D is the best blood test for determining adequacy of vitamin D stores in the body.

False

True or false? PTHrP is produced by some cancers and often leads to cancer-associated
hypercalcemia.

True

True or false? 1,25(OH)2D, due to 1- hydroxylase activity in macrophages, may be produced to
excess in granulomatous diseases and lymphoid disorders, leading to hypercalcemia.

False

In PHPT, the defect primarily lies in________. In secondary hyperparathyroidism, the defect primarily lies with the threat of________to the body.

Parathyroid, Hypocalcemia

Development of ________ is the primary complication of hypercalciuria (increased urinary excretion of calcium).

Kidney stones

is the most common cause of hypoparathyroidism.

Neck surgery

is a type of bone most rapidly lost in response to hypogonadism and glucocorticoid therapy

Trabecular bone

cells in bone are responsible for bone resorption, and cells are responsible for bone formation.

Osteoclasts, Osteoblasts

is the most prevalent metabolic bone disease in the United States.

Osteoporosis

True or false? Hormone replacement does not inhibit bone resorption in osteoporotic patients.

False

True or false? Teriparatide is the only drug currently approved by the FDA for the treatment of osteoporosis that directly stimulates bone formation(i.e., it is not an antiresorptive drug).

True

Which of the following enzymes would best aid in identifying hepatobiliary disease?

a. Alkaline phosphatase (ALP)
b. Aspartate aminotransferase (AST)
c. Alanine aminotransferase (ALT)
d. Ammonia

a. Alkaline phosphatase (ALP)

In which of the following types of cells does the conjugation of bilirubin take place?

a. Macrophages
b. Kupffer cells
c. Hepatocytes
d. Phagocytic cells

c. Hepatocytes

Which of the following enzymes is responsible for the conjugation of bilirubin?

a. UDP-glucuronyl transferase
b. Alkaline phosphatase
c. Glutamate dehydrogenase
d. Leucine aminopeptidase

a. UDP-glucuronyl transferase

Which of the following fractions of bilirubin is water soluble and reacts with a diazo reagent
without the addition of an accelerator?

a. Conjugated bilirubin
b. Unconjugated bilirubin
c. Total bilirubin
d. Indirect bilirubin

a. Conjugated bilirubin

Which form of hepatitis is caused by a DNA virus?

a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D

b. Hepatitis B

Which of the following enzymes is most useful in establishing the hepatic origin of an elevated
serum alkaline phosphatase?

a. 5′-Nucleotidase
b. Alanine aminotransferase (ALT)
c. Aspartate aminotransferase (AST)
d. Lactate dehydrogenase

a. 5′-Nucleotidase

Hepatitis E is likely to cause serious consequences in

a. Children
b. Pregnant women
c. Travelers in Third World countries
d. Older people

b. Pregnant women

Worldwide, most primary malignant tumors of the liver are related to

a. Alcoholism
b. Gallstones
c. Reye syndrome
d. Malaria

a. Alcoholism

The reagent p-dimethylaminobenzaldehyde is used to measure which of the following?

a. Ammonia
b. Total bilirubin
c. Urobilinogen
d. Alkaline phosphatase

c. Urobilinogen

Which of the following conditions would result in elevations in primarily conjugated bilirubin?

a. Dubin-Johnson syndrome
b. Physiologic jaundice of the newborn
c. Crigler-Najjar syndrome
d. Gilbert’s syndrome

a. Dubin-Johnson syndrome

A urinalysis dipstick test indicated that urobilinogen was absent. Which condition does this support?

a. Hepatocellular disease
b. Hepatitis A acute infection
c. Defective liver cell function
d. Biliary obstruction
e. This would support all of the above conditions

d. Biliary obstruction

Measuring serum ammonia levels has the potential to be fraught with preanalytical errors that may
interfere with achieving an accurate result. Of the following preanalytical steps, which is incorrect?

a. After phlebotomy, the patient’s blood should be immediately placed on ice.
b. The blood should be collected in a red clot tube without anticoagulant.
c. Hemolyzed samples should be rejected as this interferes by falsely increasing ammonia levels.
d. Lipemia may also interfere with plasma ammonia measurements.
e. All of the above are correct.

b. The blood should be collected in a red clot tube without anticoagulant.

A patient presents with elevated levels of IgG anti-HAV while levels of IgM anti-HAV are nondetectable. This patient is likely to:

a. Have an acute infection of HAV.
b. Have a chronic infection of HAV.
c. Have an immunity to HAV.
d. Be a carrier of HAV.

c. Have an immunity to HAV.

A serum TnT concentration is of most value to the patient with an MI when

a. The CK-MB has already peaked and returned to normal concentrations
b. The onset of symptoms is within 3 to 6 hours of the sample being drawn
c. The myoglobin concentration is extremely elevated
d. The TnI concentration has returned to normal concentrations

a. The CK-MB has already peaked and returned to normal concentrations

A normal myoglobin concentration 8 hours after the onset of symptoms of a suspected MI will

a. Essentially rule out an acute MI
b. Provide a definitive diagnosis of acute MI
c. Be interpreted with careful consideration of the TnT concentration
d. Give the same information as a total CK-MB

c. Be interpreted with careful consideration of the TnT concentration

Which of the following analytes has the highest specificity for cardiac injury?

a. AST
b. CK-MB mass assays
c. Total CK-MB
d. TnI

d. TnI

Which of the following newer markers of inflammation circulates in serum bound to LD and HDL?

a. hsCRP
b. CK-MB
c. cTnI
d. Lipoprotein-associated phospholipase A2

d. Lipoprotein-associated phospholipase A2

A person with a confirmed blood pressure of 125/87 would be classified as

a. Prehypertension
b. Normal
c. Stage 1 hypertension
d. Stage 2 hypertension

a. Prehypertension

Rheumatic heart disease is a result of infection with which of the following organisms?

a. Pseudomonas aeruginosa
b. Staphylococcus aureus
c. Group A streptococci
d. Chlamydia pneumoniae

c. Group A streptococci

Which of the following defects is the most common type of congenital CVD encountered?

a. Ventricular septal defects (VSD)
b. Tetralogy of Fallot
c. Coarctation of the aorta
d. Transposition of the great arteries

a. Ventricular septal defects (VSD)

Which of the following cardiac markers is the most useful indicator of congestive heart failure?

a. BNP
b. TnI
c. CK-MB
d. Glycogen phosphorylase isoenzyme BB

a. BNP

Which of the following is the preferred biomarker for the assessment of myocardial necrosis?

a. AST
b. CK
c. CK-MB
d. TnI

b. CK

Which of the following is NOT a feature of an ideal cardiac marker?

a. Ability to predict future occurrence of cardiac disease
b. Absolute specificity
c. High sensitivity
d. Close estimation of the magnitude of cardiac damage

a. Ability to predict future occurrence of cardiac disease

Calculate creatinine clearance, given the following information: serum creatinine, 1.2 mg/dL; urine
creatinine, 120 mg/dL; urine volume, 1750 mL/24 h; body surface area, 1.80 m2.

117 mL/min

Predict GFR in a 50-year-old woman who weighs 60 kg using the Cockcroft-Gault equation. Her serum creatinine level is 2.5 mg/dL.

2.26 mL/min

The measurement of serum cystatin C, a smallprotein produced by nucleated cells, is useful for

a. Detecting an early decrease in kidney function
b. Calculating creatinine clearance
c. Diagnosing end-stage renal disease
d. Monitoring dialysis patients

a. Detecting an early decrease in kidney function

The proximal tubule functions to

a. reabsorb urea.
b. concentrate salts.
c. form the renal threshold.
d. reabsorb 75% of salt and water.

d. reabsorb 75% of salt and water.

Renal clearance is the

a. volume of plasma from which a substance is removed per unit of time.
b. volume of urine produced per day.
c. amount of creatinine in urine.
d. urine concentration of a substance divided by the urine volume per unit of time.

a. volume of plasma from which a substance is removed per unit of time.

Renin release by the kidney is stimulated by

a. increased dietary sodium.
b. increased plasma sodium concentration.
c. a decrease in extracellular fluid volume or pressure.
d. renal tubular reabsorption.

c. a decrease in extracellular fluid volume or pressure.

The set of results that most accurately reflects severe renal disease is

a. serum creatinine, 3.7 mg/dL; creatinine clearance, 44 mL/min; BUN, 88 mg/dL
b. serum creatinine, 1.0 mg/dL; creatinine clearance, 110 mL/min; BUN, 17 mg/dL
c. serum creatinine, 2.0 mg/dL; creatinine clearance, 120 mL/min; BUN, 14 mg/dL
d. serum creatinine, 1.0 mg/dL; creatinine clearance, 95 mL/min; BUN, 43 mg/dL

a. serum creatinine, 3.7 mg/dL; creatinine clearance, 44 mL/min; BUN, 88 mg/dL

Creatinine clearance results are corrected using a patient’s body surface area to account for
differences in

a. age.
b. muscle mass.
c. dietary intake.
d. sex.

b. muscle mass.

A patient is suffering from an acute bleed. What is the most accurate way to describe the
subsequent acute kidney injury?

a. Prerenal acute kidney injury
b. Renal acute kidney injury
c. Postrenal acute kidney injury
d. None of the above apply

a. Prerenal acute kidney injury

Laboratory findings in pancreatitis include all of the following EXCEPT

a. Increased lipase
b. Increased amylase
c. Increased cortisol
d. Increased triglycerides

c. Increased cortisol

Which of the following tests is a direct determination of the exocrine secretory capacity of the
pancreas?

a. Secretin/CCK test
b. Amylase
c. Quantitative fecal fat analysis
d. d-Xylose test
e. Lactose tolerance test

a. Secretin/CCK test

Which of the following statements concerning cystic fibrosis is NOT correct?

a. Genetic screening is usually unsuccessful
b. Occurs predominantly in populations of Northern European extraction
c. Frequently diagnosed by measurement of sweat chloride
d. Caused by a variety of mutations on chromosome 7
e. Affects males and females about equally

e. Affects males and females about equally

The proper time period for the collection of a fecal fat specimen is

a. 48 hours
b. 24 hours
c. 36 hours
d. 72 hours
e. 96 hours

d. 72 hours

Which of the following tests is only of the absorptive ability of the intestine?

a. Lactose tolerance test
b. d-Xylose test
c. Fecal fat (72-hour collection)
d. Serum carotenoids
e. Serum albumin

b. d-Xylose test

A serum albumin of less than 2.5 g/dL would be most indicative of

a. Intestinal disease
b. Pancreatitis
c. Peptic ulcer
d. Pancreatic carcinoma

a. Intestinal disease

Which of the following is accurate when describing or diagnosing Zollinger-Ellison syndrome?

a. Extreme hyposecretion of gastrin in the stomach
b. Extreme hypersecretion of gastrin in the duodenum
c. An increase in serum gastrin levels of 100 pg/mL following intravenous exposure to secretin
d. A decrease in serum gastrin levels of 100 pg/ mL following intravenous exposure to secretin
e. Is confirmed when the hydrogen breath test is positive

c. An increase in serum gastrin levels of 100 pg/mL following intravenous exposure to secretin

The d-xylose absorption test is particularly helpful in differentiating malabsorption of intestinal etiology from exocrine pancreatic insufficiency because:

a. d-Xylose is mostly absorbed in the stomach and then secreted via the kidney in its unaltered monosaccharide form.
b. d-Xylose is mostly altered in the small intestine to facilitate its absorption across this membrane
and metabolized by the liver so its metabolites may be excreted via the kidney.
c. d-Xylose is mostly absorbed, not typically found in the blood, unaltered in the small intestine, and excreted unaltered via the kidney.
d. None of the above describe why the d-xylose test is useful in identifying malabsorption diseases

c. d-Xylose is mostly absorbed, not typically found in the blood, unaltered in the small intestine, and excreted unaltered via the kidney.

Laboratory testing for the assessment of fetal lung maturity includes all of the following tests except

a. Acetylcholinesterase
b. L/S ratio
c. Fluorescence polarization
d. Foam stability
e. Lamellar body count

a. Acetylcholinesterase

Amniotic fluid

a. Is assessed by umbilical catheterization
b. Provides a cushion for the fetus
c. Is a mixture of maternal and fetal fluids
d. Provides a cushion for the fetus and is a mixture of maternal and fetal fluids
e. Provides a cushion for the fetus, is a mixture of maternal and fetal fluids, and is assessed by
umbilical catheterization

d. Provides a cushion for the fetus and is a mixture of maternal and fetal fluids

Lamellar body counts reflect

a. Surfactant phospholipid packets
b. Platelet count of the fetus
c. Platelet count of the mother
d. Meconium count of the fetus
e. All of these

a. Surfactant phospholipid packets

A xanthochromic CSF indicates

a. Viral meningitis
b. Traumatic tap
c. Bacterial meningitis
d. Cerebral hemorrhage
e. Multiple sclerosis

d. Cerebral hemorrhage

CSF glucose is measured to assess

a. Infection
b. Transport efficiency
c. Diabetes
d. Traumatic tap
e. Hemochromatosis

a. Infection

An IgG index of 0.8 is indicative of

a. Multiple sclerosis
b. CSF leakage
c. Fungal infection
d. Malignancy
e. Normal CSF

a. Multiple sclerosis

CF is characterized by

a. Elevated sweat chloride levels
b. Homozygous expression of an autosomal recessive trait
c. Pancreatic insufficiency
d. All of these
e. None of these

d. All of these

Synovial fluid

a. Is formed by plasma ultrafiltration and is rich in hyaluronic acid
b. Is formed by plasma ultrafiltration
c. Lubricates the pneumocytes
d. Is rich in hyaluronic acid
e. All of these

a. Is formed by plasma ultrafiltration and is rich in hyaluronic acid

Serous fluids

a. Are derived from serum
b. Provide lubrication and protection
c. Fill the potential space
d. Are derived from serum and provide lubrication and protection only
e. All of these

e. All of these

Pleural fluid exudates
a. Are characterized by a total protein F/P ratio of 0.7
b. Reflect primary involvement of the pleura
c. Are characterized by an increased LD F/P ratio
d. Are characterized by an increased cholesterol F/P ratio
e. All of these

e. All of these

Analysis of paracentesis fluid is performed to

a. Determine the cause of fluid presence and assess infection risk
b. Determine the cause of fluid presence
c. Assess infection risk
d. Determine lung involvement
e. All of these

d. Determine lung involvement

The most common cause of ascites is

a. Portal hypertension
b. Venous return
c. Parietal cell differentiation
d. Eccrine infection
e. Malignancy

a. Portal hypertension

When assessing the lipid profile to determine fetal lung maturity, it is critical to

a. Centrifuge the amniotic fluid at low speeds to properly avoid fractionation of the lipids.
b. Centrifuge the amniotic fluid at high speeds to properly fractionate the lipids.
c. Avoid centrifugation of amniotic fluid for this test.

a. Centrifuge the amniotic fluid at low speeds to properly avoid fractionation of the lipids.

What percentage of women will have invasive cancer at some time in their life?

a. 25%
b. 33%
c. 50%
d. 75%

b. 33%

Tumor marker tests are used to

a. Detect recurrent disease
b. Aid in staging of cancer
c. Monitor response to therapy
d. All of these

d. All of these

Tumor markers may be defined as

a. Biologic substances synthesized and released by cancer cells or substances produced by the
host in response to cancer cells
b. Analytic tests (e.g., immunoassays) used to mark cancer cells
c. Radioactive substances and chemicals used to help the physician identify cancer cells
d. None of these

a. Biologic substances synthesized and released by cancer cells or substances produced by the
host in response to cancer cells

Which of the following is an oncofetal antigen?

a. 𝗉-hCG
b. CA-125
c. AFP
d. PSA

c. AFP

What are the major limitations of tumor markers?

a. Cost
b. Sensitivity and specificity
c. Turnaround time
d. Imprecision

b. Sensitivity and specificity

The major clinical use for CA-125 is monitoring treatment response of

a. Ovarian carcinoma
b. Colorectal cancer
c. Prostatic cancer
d. Breast cancer

a. Ovarian carcinoma

The most common immunoassays used to measure PSA detect which form of the enzyme?

a. Free PSA
b. Total PSA
c. PSA complexed with α1-antichymotrypsin
d. PSA complexed with α2-macroglobulin

b. Total PSA

Which of the following enzymes is commonly used as a tumor marker?

a. LD
b. Lipase
c. Aldolase
d. Catalase

a. LD

A tumor marker used in the assessment of choriocarcinoma or hydatidiform mole is

a. 𝗉-hCG
b. CEA
c. AFP
d. IgG

a. 𝗉-hCG

A serum PSA is used for all of the following except

a. Monitoring response
b. Screening
c. Diagnosis
d. Detecting recurrence

c. Diagnosis

When measuring tumor markers in the clinical laboratory, which of the following has been
reported to contribute to 30% to 70% of the total amount of measurement error?

a. Preanalytical errors
b. Analytical errors
c. Hook effect
d. Using different immunoassay methods
e. Not comparing lot numbers between ELISA kits

a. Preanalytical errors

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