CC Flashcards
A patient sample is assayed for fasting triglycerides and a triglyceride value of 1036 mg/dL. This value is of immediate concern because of its association with which of the following conditions?
A. Coronary heart disease
B. Diabetes
C. Pancreatitis
D. Gout
Pancreatitis.
Marked increases in triglyceride levels, between 1000 and 2000 mg/dL have been associated with increased risk for the development of pancreatitis.
Patients with Waldenström’s macroglobulinemia exhibit abnormally large
amounts of:
A. IgM
B. IgG
C. IgE
D. IgA
IgM
Waldenström’s primary macroglobulinemia (WM), or simply macroglobulinemia, is a B cell disorder characterized by the infiltration of lymphoplasmacytic cells into bone marrow and the presence of an IgM monoclonal gammopathy.
Patients with Waldenström’s macroglobulinemia exhibit abnormally large
amounts of:
A. IgM
B. IgG
C. IgE
D. IgA
IgM
Waldenström’s primary macroglobulinemia (WM), or simply macroglobulinemia, is a B cell disorder characterized by the infiltration of lymphoplasmacytic cells into bone marrow and the presence of an IgM monoclonal gammopathy.
Which test is the most sensitive in detecting early monoclonal gammopathies?
A. High-resolution serum protein electrophoresis
B. Urinary electrophoresis for monoclonal light chains
C. Capillary electrophoresis of serum and urine
D. Serum-free light chain immunoassay
D. Serum-free light chain immunoassay
Measurement of free light chains is recommended along with protein electrophoresis when testing for myeloma.
Free light chains are normally present in serum because L chains are made at a faster rate than H chains.
Which test is the most useful way to evaluate the response to treatment for multiple myeloma?
A. Measure of total immunoglobulin
B. Measurement of 24-hour urinary light chain concentration (Bence-Jones protein)
C. Capillary electrophoresis of M-protein recurrence
D. Measurement of serum-free light chains
Measurement of serum-free light chains
Unlike electrophoresis methods, serum free light chain assays are quantitative and an increase in free light chain production with an abnormal kappa:lambda ratio occurs earliest in recurrence of myeloma.
A sensitive, although not specific indicator of damage to the kidneys:
A. Urea
B. Creatinine
C. Proteinuria
D. Cystatin C
Proteinuria
At pH 8.6, proteins are charged and migrate toward the
A. Negatively, anode
B. Positively, cathode
C. Positively, anode
D. Negatively, cathode
Negatively, anode
For albumin assay, absorbance at 630 nm is less likely to be affected by bilirubin *0/2 or hemoglobin in the sample. Which dye gives a much greater absorbance change at 630 nm than it would at 500 nm?
A. НАВА (Hydroxyazobenzene-benzoic acid)
B. BCG (Bromeresol green)
BCG (Bromcresol green)
Which of the following dyes is the MOST SPECIFIC for measurement of albumin?
A. Bromeresol green (BCC)
B. Bromcresol purple (BCP)
C. Tetrabromosulfophthalein
D. Tetrabromphenol blue
Bromcresol purple (BCP)
BCP is more specific for albumin than BCG.
In what condition would an increased level of serum albumin be expected?
A. Malnutrition
B. Acute inflammation
C. Dehydration
D. Renal disease
Dehydration
Identification of which of the following is useful in early stages of glomerular dysfunction?
A. Microalbuminuria
B. Ketonuria
C. Hematuria
D. Urinary light chains
Microalbuminuria
Most abundant amino acid in the body:
A. Glutamine
B. Lysine
C. Phenylalanine
D. Tyrosine
Glutamine
Glutamine is the most abundant amino acid in the body, being involved in more metabolic processes than any other amino acid.
Retinol (vitamin A) binding protein:
A. Albumin
B. Alpha-antitypsin
C. Fibronectin
D. Prealbumin
Prealbumin.
Prealbumin is the transport protein for thyroxine and triiodothyronine (thyroid hormones); it also binds with retinol-binding protein to form a complex that transports retinol (vitamin
A) and is rich in tryptophan.
In nephrotic syndrome, the levels of serum
________ may increase as much as 10 times because its large size aids in its retention.
A. Alpha2-macroglobulin
B. Ceruloplasmin
C. Orosomucoid
D. Transferrin
Alpha2-macroglobulin
In nephrosis, the levels of serum a2-macroglobulin may increase as much as 10 times because its large size aids in its retention. The protein is also increased in diabetes and liver disease.
Use of contraceptive medications and pregnancy increase the serum levels by 20%.
Which of the following is a low-weight protein that is found on the cell surfaces of nucleated cells?
A. Alpha2-macroglobulin
B. Beta2-microglobulin
C. C-reactive protein
D. Ceruloplasmin
Beta2-microglobulin
B2-microglobulin is a single polypeptide chain that is the light chain component of human leukocyte antigens (HLAs). It is found on the surface of nucleated cells and is notably present on lymphocytes. Increased plasma levels of B2-microglobulin are associated with renal failure, lymphocytosis, rheumatoid arthritis, and systemic lupus erythematosus.
BIOCHEMICAL MARKER OF BONE RESORPTION that can be detected in serum and urine:
A. Beta-trace protein
B. Crosslinked C-telopeptides (CTX)
C. Fibronectin
D. Troponin
Crosslinked C-telopeptides (CTX)
Cross-linked C-telopeptides (CTXs) are proteolytic fragments of collagen I formed during bone resorption (turnover).
CTX is a biochemical marker of bone resorption that can be detected in serum and urine.
Recently proposed new marker for the early assessment of changes to the glomerular filtration rate:
A. Adiponectin
B. Beta-trace protein
C. Cross-linked C-telopeptides (CTX)
D. Cystatin C
Cystatin C
“Gold standard” in the diagnosis of acute coronary syndrome (ACS):
A. Brain natriuretic peptide (BNP)
B. Cross-linked c-telopeptides
C. Myoglobin
D. Troponin
Troponin
ACUTE CORONARY SYNDROME/MYOCARDIAL INFARCTION
Cardiac troponin (cTn) represents a complex of regulatory proteins that include troponin / (cTnl) and troponin T (cTnT) that are specific to heart muscle.
cTnl and cTnT are the “gold standard” in the diagnosis of acute coronary syndrome (ACS). cTn should be measured in all patients presenting with symptoms suggestive of ACS, in conjunction with physical examination and ECG
Which test, if elevated, would PROVIDE INFORMATION about risk for developing coronary artery disease?
A ск-мв
B hs-CRP
C Myoglobin
D. Troponin
hs-CRP
HIGH-SENSITIVITY CRP
Considered a GOOD PREDICTOR TEST for assessing cardiovascular risk
CK-MB, TROPONIN AND MYOGLOBIN
Used to assess if a myocardial infarction HAS OCCURRED
If elevated, which laboratory test would support a diagnosis of CONGESTIVE HEART FAILURE?
A. Albumin cobalt binding
B. B-type natriuretic peptide
C. Homocysteine
D. Troponin
B-type natriuretic peptide
B-type (brain) natriuretic peptide (BNP) is used to determine if physical symptoms are related to congestive heart failure.
Which two tests detect swelling of the ventricles that occurs in congestive heart failure?
A. BNP and electrocardiogram
B. BNP and echocardiogram
C. Troponin T and electrocardiogram
D. Troponin I and echocardiogram
BNP and echocardiogram
DIAGNOSIS OF CONGESTIVE HEART FAILURE:
Until recently, this condition was diagnosed strictly on the basis of symptomatology and/or as a result of procedures such as echocardiography, but more recently a biomarker for this condition is the brain form or B-type natriuretic peptide (BNP), which has been approved as a definitive test for this condition and appears to be an excellent marker for early heart failure.
Which of the following laboratory tests is a marker for ISCHEMIC HEART DISEASE?
A. Albumin cobalt binding
B. CK-MB isoforms
C. Free fatty acid binding protein
D. Myosin light chain
Albumin cobalt binding
Albumin cobalt binding is a test that measures ischemia-modified albumin, which is a marker for ischemic heart disease.
Each lipoprotein fraction is composed of varying amounts of lipid and protein components. The beta-lipoprotein fraction consists primarily of which lipid?
A. Fatty acid
B. Cholesterol
C. Phospholipid
D. Triglyceride
Cholesterol
The beta-lipoprotein fraction is composed of approximately 50% cholesterol, 6% triglycerides, 22% phospholipids, and 22% protein.
The beta-lipoproteins, which are also known as the low-density lipoproteins (LDLs), are the principal transport vehicle for cholesterol in the plasma.
A commonly used precipitating reagent to separate HDL cholesterol from other lipoprotein cholesterol fractions:
A. Zinc sulfate
B. Trichloroacetic acid
C.Heparin-manganese
D. Isopropanol
Heparin-manganese
Either a dextran sulfate-magnesium chloride mixture or a heparin sulfate-manganese chloride mixture may be used to precipitate the LDL and VLDL cholesterol fractions. This allows the HDL cholesterol fraction to remain in the supernatant.
