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MTAP 2 MIDTERM EXAM > CC 1 > Flashcards

CC 1 Flashcards

1
Q

Elevation of serum alkaline phosphatase may be seen in:

  1. Hepatobiliary Disease
  2. Growing Children
  3. Hyperparathyroidism
  4. Germ Cell Tumor of the Testicles

A. 1 and 2
B. 2 and 3
C. 1, 2, and 3
D. 1, 2, 3, and 4

A

1 and 2

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2
Q

The following statements are TRUE of Lactate Dehydrogenase:

  1. There is an elevated serum LD in Acute Myocardial Infarction.
  2. There is a decreased LD in Megaloblastic Anemia.
  3. There are 4 monomers in the LD isoenzyme structure.
  4. LD6 isoenzyme is seen only in patients with muscle disorders.

A. 1 only
B. 1 and 3
C. 1 and 4
D. 1, 2, 3, and 4

A

1 and 3

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3
Q

Amylase is an enzyme useful in the diagnosis of acute pancreatitis. Which of the following statements correctly describes amylase?

  1. Amylase is elevated in acute pancreatitis, mumps, parotitis, and perforated peptic ulcer.
  2. Amylase cleaved a1,6 glycosidic bonds of polysaccharides.
  3. It is the largest of all enzymes in terms of molecular weight.
  4. The P-type isoenzyme migrates fastest while the S-type isoenzyme migrates the slowest in amylase isoenzyme electrophoresis.

A. 1 only
B. 1 and 2
C. 1 and 3
D. 1 and 4

A

1 and 2

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4
Q

Which of the following statements is TRUE of the isoenzyme LD-2?

A. It is the slowest moving of LD isoenzymes on electrophoresis.
B. It is most positively charged fraction
C. It is a heat-labile fraction
D. It is present in greatest amount in normal heart tissue.

A

It is present in greatest amount in normal heart tissue.

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5
Q

Which of the following enzymes is considered a newborn screening marker?

A. Amylase
B. Aldolase
C. Cholinesterase
D. G-6-PD

A

G6PD

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6
Q

The clinical significance of an elevated acid phosphatase is:

A. Renal Disease
B. Pancreatic Disease
C. Bone Disease
D. Prostatic Disease

A

Prostatic Disease

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6
Q

A scanning of a CK isoenzyme fractionation revealed 2 peaks: a slow cathodic peak (CK-MM) and an intermediate peak (CK-MB). A possible interpretation of this pattern is:

A. Brain Tumor
B. Muscular Dystrophy
C. Myocardial Infarction
D. Viral Hepatitis

A

Myocardial Infarction

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6
Q

Tests for acid phosphatase detect levels of the enzyme from tissues such as:

A. Bone, Liver, Spleen, Kidney, Erythrocyte, Platelets

B. Bone, Liver, and Kidney

C. Muscle, Spleen, and Platelets

D. Liver, Spleen, Prostate, and Platelets

A

Liver, Spleen, Prostate, and Platelets

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7
Q

This enzyme is the most specific marker of acute pancreatitis and remains elevated for 48 hours in the blood circulation.

A

Lipase

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7
Q

Creatine kinase is frequently elevated in disorders such as acute myocardial infraction and

A. Duchenne Muscular Dystrophy
B. Acute Hepatitis.
C. Cirrhosis
D. Malignancy

A

Duchenne Muscular Dystrophy

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7
Q

Select the product formed from the forward reaction of AST:

A. Alanine and a-ketoglutarate
B. Aspartate and glutamine
C. Oxaloacetate and glutamate
D. Glutamate and NADH

A

Oxaloacetate and Glutamate

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7
Q

This enzymes which affects the cell membrane and microsomal fraction is a sensitive indicator of occult alcoholism.

A

GGT

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8
Q

Which two conditions can “physiologically” elevate serum alkaline phosphatase?

A. Rickets, Hyperparathyroidism
B. Growth, 3rd Trimester of pregnancy
C. Obstructive jaundice, Biliary Cirrhosis
D. Viral hepatitis, Infectious Mononucleosis

A

Growth, 3rd Trimester of pregnancy

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9
Q

Which of the following chemical determinations may be of help in establishing the presence of seminal fluid?

A. Lactate Dehydrogenase
B. Isocitrate Dehydrogenase
C. Acid Phosphatase
D. Alkaline Phosphatase

A

ACP

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9
Q

A physician suspects his patient has pancreatitis. Which test(s) would be most indicative of this disease?

A. Creatinine
B. LD isoenzyme
C. B-hydroxybutyrate
D. Amylase

A

Amylase

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9
Q

Increased total serum Lactate dehydrogenase (LD) activity, confined to fractions 4 and 5, is most likely to be associated with:

A. Pulmonary Infarction
B. Hemolytic Anemia
C. Myocardial Infarction
D. Acute Viral Hepatitis

A

Acute Viral Hepatitis

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9
Q

Regan isoenzyme has the same properties as alkaline phosphatase that originates in the:

A. Skeleton
B. Kidney
C. Intestine
D. Placenta

A

Placenta

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9
Q

Most sensitive enzymatic indicator for liver damage from ethanol intake:

A. ALT
B. AST
C. GGT
D. ALP

A

GGT

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10
Q

A serum sample drawn in the emergency room from a 42-year old man yielded the following laboratory results:

CK: 185 Units (Normal = 15-160)
AST: 123 Units (Normal 0-48)
CK-MB: 6 Units (Normal 2-12)

Which of the following conditions might account for these values?

A. Crush injury to the thigh
B. Pulmonary Infarction
C. Cerebrovascular Accident
D. Early Acute Hepatitis

A

Crush injury to thigh

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11
Q

Which of the following enzymes catalyzes the conversion of starch to glucose and maltose?

A

Amylase

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12
Q

Which of the following is a glycolytic enzyme that catalyzes the cleavage of fructose 1,6-diphosphate to glyceraldehyde-3-phosphate and dihydroxyacetone phosphate?

A. Aldolase
B. Pyruvate Kinase
C. Phosphofructokinase
D. G6PD

A

Aldolase

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13
Q

An electrophoretic separation of lactate dehydrogenase isoenzymes that demonstrates an elevation in LD-1 and LD-2 in a “flipped pattern” is consistent with?

A

Acute Myocardial Infarction

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14
Q

Which of the following is a characteristic shared by lactate dehydrogenase, isocitrate dehydrogenase, and dihydroxybutyrate dehydrogenase?

A. They are liver enzymes
B. They catalyze oxidation-reduction reactions
C. They are cardiac enzymes
d. They are class III enzymes

A

They catalyze oxidation-reduction reactions

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15
Q

Most heat labile fraction of alkaline phosphatase is obtained from:

A

Bone

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16
Q

This is a sensitive and specific marker for acute pancreatitis:

A. AMS
B. LPS
C. BOTH
D. NEITHER

A

LPS

17
Q

A 48-year old woman with mild jaundice has the following serum enzyme results:

ALP (Untreated): 600 U/L (Adult: 0-150 U/L)
GGT: 230 U/L (Normal: 0-55 U/L)

ALP After 10 minutes:
Incubation at 56*C: 300 U/L (50% of original activity)
AST: 400 U/L (Normal: 0-50 U/L)

Which of the following sources most contributes to the patient’s serum alkaline phosphatase activity?

A. Bone
B. Liver
C. Placenta
D. Regan Isoenzyme

A

Liver

18
Q

In the assay of lactate dehydrogenase (LD), the reaction is dependent on which of the following coenzyme systems?

A. NAD/NADH
B. ATP/ADP
C. Fe++/Fe+++
D. Cu/Cu++

A

NAD/NADH

19
Q

Predominant AST isoenzyme in the healthy serum is:

A

Cytoplasmic AST

20
Q

Serum from a patient with metastatic carcinoma of the prostate was separated from the clot and stored at room temperature. The following results were obtained;

LDH: 420 U/L (Reference: 50-150 U/L)
ACP: 0.1 U/L (Reference: 0-5.5 U/L)

Upon seeing the results above, the Medical Technologist should repeat the:

A. LD using diluted serum
B. Acid phosphatase with freshly drawn serum
C. LD with fresh serum
D. Test using serum

A

Acid phosphatase with freshly drawn serum

21
Q

A 10-year old child was admitted to pediatrics with an initial diagnosis of skeletal muscle disease. The best confirmatory test would be:

A. CK and Isocitrate Dehydrogenase
B. LDH and CK
C. GGT and ALP
D. LD and MD

A

NONE (Aldolase and CK)

21
Q

Which of the following sets of results would be consistent with macroamylasemia?

A. Normal serum amylase and elevated urine amylase value
B. Increased serum amylase and normal urine amylase values
C. Increased serum and urine amylase values
D. Normal serum and urine amylase values

A

⬆️ Serum Amylase, Normal Urine Amylase

22
Q

A 21-year old man with nausea, vomiting, and jaundice has the following laboratory findings:

See pic

These can be explained as representing:

A. Unconjugated hyperbilirubinemia probably due to hemolysis
B. Unconjugated hyperbilirubinemia probably due to toxic liver damage
C. Conjugated hyperbilirubinemia probably due to biliary tract disease
D. Conjugated hyperbilirubinemia probably due to hepatocellular obstruction

A

Conjugated hyperbilirubinemia probably due to biliary tract disease

23
Q

What specimen preparation is commonly used to perform the alkaline phosphatase isoenzyme determination?

A. Serum is divided into two aliquots, one is frozen and the other is refrigerated.
B. Serum is divided into two aliquots, one is heated at 56*C and the other is unheated.
C. No preparation is necessary since the assay uses EDTA plasma
D. Protein-free filtrate is prepared first.

A

Serum is divided into two aliquots, one is heated at 56*C and the other is unheated.

23
Q

Isoenzyme assays are performed to improve:

A. Precision
B. Accuracy
C. Sensitivity
D. Specificity

A

Specificity

24
Q

One method to enhance the differentiation of bone from liver alkaline phosphatase isoenzyme is to pre-treat an aliquot of the serum specimen:

A. With tartaric acid
B. By heating at 56*C
C. With bovine albumin
D. by PEG precipitation

A

By heating at 56*C

24
Q

As the temperature is increased from 25C to 37C in the aspartate aminotransferase reaction, the activity of the reaction:

A. Halved
B. Doubled
C. Tripled
D. Reduced to zero

A

Doubled

25
Q

Which of the following may be associated with organophosphate poisoning?

A

Cholinesterase

26
Q

Which of the following may be associated with macro-CK?

A. Complex between CK-BB and IgG
B. Complex between CK-MM and IgA
C. Migrates between the MM and MB fractions on electrophoresis
D. A and C are both correct

A

A and C are correct

27
Q

In an adult, a normal serum Gamma Glutamyl Transferase level with an elevated serum Alkaline Phosphatase may be suggestive of:

A. Heart disease
B. Bone Disease
C. Liver Disease
D. Skeletal muscle disease

A

Bone Disease

28
Q

Which of the following may be associated with the creatine kinase isoenzymes?

A. CK-1 is referred to as CK-MM
B. CK-3 remains close to the origin during electrophoresis
C. CK-MM is found in skeletal muscle.
D. Both B and C are correct

A

B and C are correct

29
Q

In pesticide poisoning, a decrease in enzyme activity is associated with:

A

Cholinesterase

30
Q

Refer to the table below:

ALP - Slightly Increase
Aminotransferase - Slightly Increase
AST - Slightly Increase
GGT - Markedly Increase

This is most consistent with:

A. Acute Alcoholic Hepatitis
B. Chronic Hepatitis
C. Obstructive Jaundice
D. Liver Hemangioma

A

Chronic Hepatitis

31
Q

Possibly, the most sensitive enzyme indicator of liver function particularly OBSTRUCTIVE JAUNDICE is:

A. ALP
B. ALT
C. GGT
D. LDH

A

ALP

32
Q

Serum Creatine Kinase is clinically significant in diseases of the:

A. Pancreas
B. Liver
C. Muscle
D. GIT

A

Muscles

33
Q

A metal ion is sometimes necessary in an enzymatic reaction to::

A. Permit the colorimetric rxn to occur.
B. Regulate pH
C. Act as an activator of the enzymes
D. Inhibit the competing enzymes

A

Act as an activator of the enzymes.

34
Q

The forward reaction in LDH determination is used in this method:

A. Wacker
B. Oliver-Rosalki
C. Tanzer-Gilvarg
D. Wrobleuski-La Due

A

Wacker (Lactate ➡️ Pyruvate)

35
Q

Smallest enzyme found in the plasma hence normally present in the urine.

A

Amylase

36
Q

The CK isoenzyme that is predominantly found in the serum of healthy individuals is:

A

CK-MM (CK3)

37
Q

In electrophoresis, Macro CK is found:

A. Between CK1 and CK2
B. Between CK-BB and CK-MB
C. Between CK2 and CK3
D. Cathodal to CK3

A

Between CK2 and CK3

38
Q

Pyridoxal Phosphate (Vitamin B6) serves as ____ aminotransferases.

A. Activator
B. Inhibitor
C. Prosthetic Group
D. All of these

A

Prosthetic Group

39
Q

Which of the following analytical methods DIRECTLY measures urea?

  1. Diacetyl monoxime
  2. Nesslerization
  3. Urease Test
  4. Berthelot

A. 1 only
B. 1 and 3
C. 2 and 4
D. 1, 2, 3, and 4

A

Diacetyl Monoxime

40
Q

Which of the following cause false low level of Jaffe reaction for creatinine measurement?

  1. Glucose
  2. Ascorbic Acid
  3. Bilirubin
  4. Hemoglobin

A. 1 and 2
B. 2 and 3
C. 3 and 4
D. 1 and 4

A

Bilirubin and Hemoglobin

41
Q

Which of the following are correlated with increased BUN levels?

  1. Acute Renal Failure
  2. Congested Heart Failure
  3. Low Protein Intake
  4. Severe Liver Disease

A. 1 only
B. 1 and 2
C. 1, 2, and 4
D. 1, 2, 3, and 4

A

1 and 2

42
Q

Which of the following statements are TRUE?

  1. BUN is a better indicator of glomerular function that creatinine.
  2. Creatinine is a better indicator of glomerular function than BUN.
  3. BUN is minimally influenced by high protein intake.
  4. Creatinine is minimally influenced by high protein intake.

A. 1 and 3
B. 1 and 4
C. 2 and 3
D. 2 and 4

A

2 and 4

43
Q

A patient has an elevated BUN and elevated creatinine levels and increased BUN/Creatinine ratio. Which of the following conditions will agree with the said laboratory data?

  1. End stage renal disease
  2. Presence of kidney stones
  3. Tumors in the ureter
  4. Severe dehydration

A. 1 only
B. 1 and 2
C. 2 and 3
D. 2 and 4

A

2 and 3

44
Q

Uric acid formation in the liver is catalyzed by:

A. Deaminase
B. Pyruvate Kinase
C. Xanthine Oxidase
D. Glutamate Dehydrogenase

A

Xanthine Oxidase

45
Q

Creatinine clearance is based on the assumption that creatinine:

A. Passes into the ultrafiltrate
B. Is retained in the blood
C. Converted to creatinine
D. Is passively reabsorbed by the kidney tubule

A

NONE (creatinine not excreted nor reabsorbed by the renal tubules)

46
Q

The first step in analyzing a 24-hour urine specimen for quantitative urine NPN is:

A. Subculture the urine for bacteria
B. Screen for albumin using a dipstick
C. Add the appropriate preservative
D. Measure the total volume

A

Measure the total volume

46
Q

Most common test for tubular secretion and blood flow is:

A. PSP Test
B. PAH Test
C. Indigo Carmine Test
D. Fishberg Test

A

PAH Test

47
Q

The most accurate and exogenous procedure in assessing glomerular filtration that utilizes extremely stable substance that is neither reabsorb nor secreted by the tubules:

A. Creatinine Clearance.
B. Mosenthal Test
C. Inulin Clearance
D. Fishberg Test

A

Inulin Clearance

MTAP 2 MIDTERM EXAM (5 decks)

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