CC Flashcards
Which if of the following refers to the chylomicrons?
A. Cathode
B. Anode
A. Cathode
It is the main storage lipid in humans (found in adipose tissue); constitutes 95% stored fat:
A. Cholesterol
B. Phospholipid
C. Fatty acids
D. Triglycerides
D. Triglycerides
Which of the following apoproteins is responsible for the receptor binding for IDL and the Chylomicron remnant produced in fat transport?
A. Apo A1
B. Apo C
C. Apo E
D. Apo B
C. Apo E
Which of the following apoproteins is inversely related to risk for coronary heart disease and is a surrogate marker for HDL?
A. Apo A-1
B. Apo B48
C. Apo B100
D. Apo E
A. Apo A1
Apo B48- chylomicrons
Apo B100- LDL, VLDV
Apo E- IDL
Which of the following would be most adversely affected by non fasting sample?
A. HDL
B. LDL
C. Cholesterol
D. Triglycerides
D. Triglycerides
Which type of lipids are steroids derived from?
A. Glyceride
B. Nonglyceride
C. Fatty Acid
D. Complex
B. Nonglyceride
Which of the following blood samples would serve the best to assay lipoproteins because this anticoagulant preserve lipoproteins?
A. EDTA plasma sample
B. Heparin plasma sample
C. Citrate plasma sample
D. Fluoride plasma sample
A. EDTA plasma sample
Which of the following lipoproteins is considered the smallest of all lipoproteins and is composed of 50% protein?
A HDL
B. Chylomicrons
C. Triglycerides
D. LDL
A. HDL
Which of the following is a rare autosomal recessive disorder characterized by the absence of VLDL, LDL and chylomicrons?
A. Bassen-Kornzweig syndrome
B. Tangier Disease
C. Anderson’s disease
D. Sitosterolemia
A. Bassen-Koenzweig Synderome
ApoB is absent
Which of the following is a rare autosomal recessive disorder characterized by the absence of HDL?
A. Bassen-Kornzweig syndrome
B. Tangier Disease
C. Anderson’s disease
D. Sitosterolemia
B. Tangier disease
Apo A is absent
Which of the following is a rare autosomal recessive disorder characterized by the absence of chylomicrons?
A. Bassen-Kornzweig syndrome
B. Tangier Disease
C. Anderson’s disease
D. Sitosterolemia
C. Andersons disease
Apo B48 is absent
At what serum glucose concentration would glucose begin to appear in the urine?
A. 50 mg/dl
B. 75 mg/dl
C. 100 mg/dl
D. 170 mg/dl
D. 170 mg/dl
Renal threshold: 160-180 mg/dl
Sodium renal threshold?
A. 50 mmol/L
B. 75 mmol/L
C. 100 mmol/L
D. 120 mmol/L
D. 120 mmol/L
Renal threshold: 110-130 mmol/L
The Dubowski method for glucose utilizes:
A. Arsenomolybdic acid
B. Orthotoluidine
C. G6PD
D. Mutarotase
B. Orthotoluidine
(Condensation reaction)
Which of the following is the most specific enzymatic method for glucose determination (employing G6PD as a second coupling step)?
A. Glucose oxidase
B. Glucose dehydrogenase
C. Hexokinase
D. Pyruvate Kinase
C. Hexokinase
What form of sugar in the liver is converted to glucose?
A. Starch
B. Cellulose
C. Glycogen
D. Amylopectin
C. Glycogen
Type 1 DM
I. Detectable C-peptide
II. Undetectable C-peptide
III. Most common in childhood/teens
IV. Most common in advancing age
A. I and III
B. III and IV
C. II and III
D. II and IV
C. II and III
There is low/no insulin for C-peptide to be detectable.
What is the Critical Value for hyperglycemia?
A. >200 mg/dl
B.>300mg/dl
C. >400mg/dl
D. > 500mg/dl
D.> 500mg/dl
A fasting blood sugar result of equal or greater then ____ is diagnostic for diabetes mellitus
A. 90mg/dl
B. 126mg/dl
C. 110mg/dl
B. 126mg/dl
90mg/dl- normal
110 mg/dl— impared
Which of the following methods is used as the primary reference method in the determination of HBA1c?
A. HPLC
B. Affinity chromatography
C. Ion-exchange chromatography
D. Immunoassay
A.HPLC
Preferred method(routine)- Affinity chromatography
Where does TCA(Kreb’s cycle) happens?
A. Mitochondria
B. Deoxyribonucleic acid
C. Ribonucleic acid
D. Golgi aparatus
A. Mitochondria
Abnormality of the hypoxanthine guanine phosphoribosyl transferase indicate problems with ___ metabolism
A. Purines
B. Pyrimidines
C. Myscle
D. Amino acid
A. Purines
Lesch-Nyhan Syndrome(Uric Acid)
End color of phosphotungstic acid (Caraway method) for uric acid?
A. Red
B. Orange
C. Blue
D. Yellow
C. Blue
Orange-Jaffe(Creatinine)
Yellow—Fearon’s(Urea)
Creatinine is formed in the
A. Liver
B. Muscles
C. Brain
D. Kidney
B. Muscles
Muscled metabolism- Creatinine
Protein metabolism- Urea
Purine metabolism- Uric Acid
Amino Acid Deamination- Ammonia
Dont stop
Padayun
In the direct Jaffe method for creatinine, a____ tauter of creatinine picrate is formed when creatinine is mixed with alkaline picrate reagent.
A. Yellow-green
B. Blue- green
C.Mauve lavender
D. Red-Orange
D. Red-Orange
Creatinine is expressed in
A. Umol/L
B. mL/s
C. mmol/L
D.mL/min
A. umol/L
Neurotoxic product of amino acid deamination:
A. Ammonia
B. Urea
C. Uric Acid
D. Creatinine
A. Ammonia
Albumin level in ascites:(Kwashiorkur)
A. Increase
B. Decrease
B. Decrease
Decrease: Albumin, protein, calorie
Most specific myocardial infraction:
A. Troponin I
B. Myoglobin
C. AST
D. CK-MB
A. Troponin I
Rise: 3-6hrs
Peak- 12-18hrs
Back to normal: 5-10days
True about CRP
I. Elevated in bacterial infection
II. It may be used as cardiac marker
III. It is an acute inflammatory marker
IV. It is a chronic inflammatory marker
A. I and III
B. I, II and III
C. All of these
B. I, II and III
Which test is used as an indicator of congestive heart failure
A. CRP
B. BNP
C. BTP
D. CTX
B. BNP
BTP- CSF leakage, perilymphatic fistulas
CTX- bone resobtion
Which of the following tests is a good marker of nutritional value?
A. Immunoglobulin M
B. Prealbumin
C. Ceruloplasmin
D. Lp(a)
B. Prealbumin
Ceruloplasmin- Wilson’s (copper)
Lp(a)- risk of congenital heart disease
Which of the following formula refers to globin?
A. Total protein+ Albumin
B. Total protein - Albumin
C. Total protein x Albumin
D. Total protein / Albumin
B. Total protein - albumin
What protein fraction migrates the farthest TOWARDS the anode?
A. Albumin
B. Alpha globulins
C. Beta globulins
D. Gamma globulins
A. Albumin
The last step in enzymatic measurement for cholesterol involves which reaction?
A. Trinder reaction
B. Caraway reaction
C. Diazo reaction
D. Fearow’s reaction
A. Trinder reaction
Caraway reaction- Uric Acid(Blue)
Diazo reaction- Bilirubin
Fearow’s reaction-Urea(Yellow)
Jaffe- Creatinine
Berthelot’s- ammonia
How is tolburamide administered in tolbutamide tolerance test?
A. Intramuscularly
B. Intravenously
C. Subcutaneously
D. Percutaneouslt
B. Intravenously
Conjugated bilirubin
1. Cannot appear in Urine
2. Can appear in Urine
3. Direct Bilirubin
4. Indirect Bilirubin
A. 1 3
B 1 4
C 2 3
D 2 4
In which of the following disease states would you see an elevation in total bilirubin and conjugated bilirubin only?
A. Biliary obstruction
B. Hemolytic anemia
C. Neonatal jaundice
D. Hepatitis
A. Biliary obstruction
Hemolytic anemia- ⬆️B1
Hepatitis-⬆️B1 ⬆️B2
Hepatocelluar damage may be best assessed by which of the following parameter?
A. Serum AST and ALT
B. Serum GGT, ALP
C. Bilirubin, GGT and ALP
D. Ammonia and Urea
A. Serum AST and ALT
Which test might be used to assess a person who is disoriented or confused?
A. Cholesterol
B. Ammonia
C. CRPs
D. Iron
B. Ammonia
Measurements of bilirubin in chemistry analyzers are based on
A. Nephelometry
B. Turbidimetry
C. Photometry
C. Photometry
Evelyn-Malloy-Methanol
Jendrassik-Grof- Caffiene
Which test might be ordered on a patient with abdominal pain to test for possible pancreatitis?
A. Amylase and lipase
B. Sodium and potassium
C. Cholesterol and triglyceride
D. C3 and C4
A. Amylase and lipase
Which of the following enzymes is the best indicator of pancreatic function?
A. AST
B. ALT
C. Amylase
D. Lipase
D. Lipase
Kinetic enzyme assays are best performed during which phase of an enzymatic reaction?
A. Linear phase
B. Lag Phase
C. Plateau phase
D. Any phase as long as temp and pH are constant
A. Linear phase
A farmer that is working in the field accidentally had a pesticide poisoning. Cholinesterase activity is tested, which of the following is the expected result?
A. Increased
B. Decreased
C variable result
D. Normal
D. Decreased cholinesterase
A patient sample is assayed for fasting triglycerides and a triglyceride value of 1036mg/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
C. Pancreatitis
Which of the following enzymes catalyzes the conversion if p-nitrophenyl phosphate to a colored p-niyrophen product?
A. AST
B. ALT
C. ALP
D. GGT
C. ALP
Bowers McComb
-PNPP
Paget’s syndrome
-Highest ALP
Which of the following buffers is used in the IFCC recommended method for ALP?
A. Acetic Acid
B. Tris-EDTA
C. 2-Amino-2methyl-1propanol(AMP)
D. Bicarbonate
C. AMP
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. Myocardial infraction
B. Viral hepatitis
C. Pancreatitis
D. Renal failure
A. Myocardial infraction
The enzyme which exist chiefly in skeletal muscle, heart, and brain, is grossly elevated in active muscular dystrophy and rises early in myocardial infraction is:
A. Lipase
B. Aspartate transaminase
C. Lactate dehydrogenase
D. Creatinine kinase
D. Creatinine kinase
CkMM- cathodal
CkBB- anodal
Which of the following clinical disorders is associated with the greatest elevation of lactate dehydrogenase?
A. Pneumonia
B. Glomerulonephritis
C. Pancreatitis
D. Pernicious anemia
D. Pernicious anemia
What is both an enzyme and a hormone?
A. Acetylcholinesterase
B. Renin
C. Corrisol
B. Renin
Chief plasma cation whose main function is maintaining osmotic pressure
A. Chloride
B. Calcium
C. Sodium
D. Potassium
C. Sodium (CATION)
Sample of choice for potassium measurement
A. Whole blood
B. Plasma
C. Urine
D. Serum
B. Plasma (heparin anticoagulant)
What is the most common cause of pseudohyperkalemia?
A. In vitro phenomenon
B. Diarrhea
C. Starvation
D. Blood transfusion
A. In vitro phenomenon
Due to hemolysis. Potassium gets to the plasma resulting to paeudohyperkalemia
What is the most common cause of pseudohyperkalemia?
A. In vitro phenomenon
B. Diarrhea
C. Starvation
D. Blood transfusion
A. In vitro phenomenon
Due to hemolysis. Potassium gets to the plasma resulting to paeudohyperkalemia
What is the sample of choice for measuring blood osmolality?
A. Serum
B. Plasma
C. Whole blood
D. Urine
A. Serum (freezing point)
Osmolality can be defined as a measure of the concentration of a solution based on:
A. The number of particles present
B. The number of size of particles present
C. The density of particles present
D. The isoelectric point of a particle
A. The number of the particles present
The most method for electrolyte testing involves
A. Turbidimetry
B. Nephelometry
C. Potentiometry
D. Fluorometry
C. Potentiometry
Electrolyte testing= ISE
K+- valinomycin Gel
Na+ & pH- Glass
Nh4+- monactin, monnactin
pO2- Clark
pCo2- severynhaus
To maintain electrical neutrality in the red blood cell, bicarbonate leaves the ted blood cell and enters the plasma through an exchange mechanism with the which following
A. TCO2
B. Sodium
C. Chloride
D. Phosphate
C. Chloride
Which of the following is the correct collection and handling for the analysis of blood gases?
A. Plastic syringe, dry heparin, store on ice, assay within 1hr
B. Glass syringe, liquid heparin, store on ice, assay within 15 mins
C. Glass syringe, no additive, store on ice, assay within 15mins
D. Plastic syringe, dry heparin, store at room temperature, assay within 15 minutes
D. Plastic syringe, dry heparin, store at room temperature, assay within 15 minutes.
Blood gasses
What is the main reason that causes the following blood gas values
pH= 7.25
pCO2- 36mmHg
HCO3- 19mEq/L
A. Hypoventilation
B. Bicarbonate retention
C. Hyperventilation
D. Bicarbonate loss
D. Bicarbonate loss
Used to calibrate pH electrode
A. Distilled water
B. Tap water
C. Hyperventilation
D. Bicarbonate loss
Metabolic Acidosis
D. Bicarbonate loss
Used to calibrate pH electrode
A. Distilled water
B. Tap water
C. Buffers
C. Buffers
Uncompensated metabolic acidosis
A. pH 7.25, HCO3 15mmol/L, PCO2 37mmHg
B. pH 7.30. HCO3 16mmol/L, PCO2 30 mmHg
A. pH 7.45 , HCO3 22mmol/L, PCO2 40mmHg
A. pH 7.45, HCO3 25mmol/L, PCO2 40mmHg
A. pH 7.25, HCO3 15mmol/L, PCO2 37mmHg
Which is a sign of primary adrenal insufficiency
A. Acidosis
B. Hypertension
C. Hypokalemia
D. Hypercortisolism
A. Acidosis
Primary adrenal insufficiency
⬇️ALD, Cortisol, Na, BP, K+
What is the least sensitive marker for the diagnosis of pheochromacytoma?
A. Plasma metanephrine
B. Plasma catecholamines
C. Urine metaphrine
D. Vanillylmandelic acid
D. Vanillylmandelic acid
If a screening TSK is high, which test is likely to be ordered next?
A. Cholesterol
B. Free T4
C. Ferritin
D. Glucose
B. Free T4
Of the following, which will most likely interfere with quantification of thyroglobulin?
A. Antithyrogolobulin autoantibodies
B. Thyroid-stimulating antibodies
C. TSH receptor antibody
D. Thyroid peroxidase antibodies
A. Antithyroglobulin autoantibodies
The center of thyroid hormone production
A. Follicle
B. Parafollicle
C. Anterior pituitary gland
D. Posterior pituitary gland
A. Follicle
Parafollicle- calcitonin
GO GO GO PADAYUN
The pituitary gland is located in a small cavity in the ____ of the skull called sella turnica or turkish saddle
A. Lacrimal bone
B. Ethmoid bone
C. Sphenoid bone
D. External acoustic measure
C. Sphenoid bone
Ca concentration in the serum is regulated by
A. Insulin
B. Parathyroid hormone
C. Thyroxine
D. Vitamin C
B. Parathyroid Hormone
VitD ⬆️ Calcium
Calcitonin ⬇️Calcium
The majority of thyroxine (T4) is converted into the more biologically active hormone
A. Thyroglobulin
B. Thyroid-Stimulating hormone
C. Triiodothyronine (T3)
D. Thyrotropin-releasing hormone
C. Triiodothyronine (T3)
Which of the following is secreted by the placenta and used for the early detection of pregnancy?
A. Follicle-stimulating hormone (FSH)
B. Human chorionic gonadotropin (HCG)
C. Luteinizing hormone
D. Progresterone
B. Human chorionic gonadotropin (HCG)
During pregnancy, the form of estrogen measures in urine is mostly
A. Estradiol
B. Estriol
C. Estrone
D. Pregnanediol
B. Estriol E3
The biologically most active, naturally occurring androgen is
A. Androstenedione
B. Cortisol
C. Epiandeosterone
D. Testosterone
D. Testosterone
Plasma cortisol determinations were collected at 7am, after waking the patient and at 10PM that evening. The cortisol level of the morning sample was higher than the evening sample. This is consistent with
A. Normal
B. Cushing syndrome
C. Addison disease
D
A. Normal finding ⬆️AM⬇️PM
Cushing syndrome ⬆️AM⬆️PM
Addison disease ⬇️AM⬇️PM
Hypopituitarism ⬇️AM ⬇️PM
What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens
A. Cortisol
B. Catecholamines
C. Progesterone
D. Cholesterol
D. Cholesterol
- Which of the following statements best describes the predominant feedback system associated with endocrinology?
A. Decreased levels of circulating hormones directly result in the production of hormone from the target organ
B. Increased circulating levels of hormones directly result in the production of releasing factor from the hypothalamus
C. Increased circulating levels of hormones directly result in the production of inhibiting factor from the hypothalamus
D. Normal levels of circulating hormones directly result in the production of hormone from the target organ
C. Increased circulating levels of hormones directly result in the production of inhibiting factor from the hypothalamus
Thyroid hormones are derived from
A. Histidine
B. Cholesterol
C. Tyrosine
D. Phenylalanine
C. Tyrosine
Trophic hormones are produced by the _____, and releasing factors are produced by the ____
A. Hypothalamus ; pituitary
B. Pituitary; hypothalamus
C. Specific endocrine glands ; hypothalamus
D. Pituitary; target gland
B. Pituitary; hypothalamus
Lead toxicity is acquired via
1 Skin contact
2 animal bites
3 inhalation
4 Ingestion
1,2,4
Which of the following does not contain alcohol?
A. Soju
B. Wine
C. Brandy
D. Root beer
D. Root beer
How is ethanol formed
A. Fermentation of sugar
B. Oxidation of fats
C. Breakdown of purines
A. Fermentation of sugar
Oxidation of fats- ketones
Breakdown if purines- uric acid
Cocaine is metabolized to
A. Carbamazepine
B. Codeine
C. Hydrocodone
D. Benzoylecgonine
D. Benzoylecgonine
A drug that relaxes the smooth muscles of the bronchial passage
A. Acetaminophen
B. Lithium
C. Phenytoin
D. Theophyline
D. Theophyline & theobromine -anti asthmatic
Which of these drug levels would be considered toxic?
A. Alcohol at 80 mg/dL
B. Valporic acid at 50 ug/dl
C. Acetaminophen at 250 ug/dL
D. Salicylate at 27 mg/dL
C. Acetaminophen at 250 ug/dL
=Paracetamol >200 ug/dL
Which specimen is the sample of choice for lead screening?
A. Whole blood
B. Hair
C. Serum
D. Urine
A. Whole blood
Tan EDTA
Which of the following anticoagulants is generally suitable for most drug analyses (TDM)?
A. Heparin
B. EDTA
C. Citrate
D. Oxalate
A. Heparin
EDTA is for
-cyclosporine
-tacrolimus
Of the following, which will most likely interfere with quantification of thyroglobulin?
A. Antithyroglobulin autoantibodies
B. Thyroid-stimulating antibodies
C. TSH receptor antibodies
D. Thyroid peroxidase antibodies
A. Antithyroglobulin autoantibodies
A gaussian distribution is usually
A. Bell shaped
B. Rectangular
C. Bimodal
D. Skewed
A. Bell shaped
Which of the following set of values for repeat analyses of a QC sample (Target value: 50) reflects the best precision?
A. 50, 51, 52
B. 50, 52, 56
C. 48, 50, 52
D. 44, 50, 53
A. 50, 51, 52
Which of the following sets of values for repeat analyses of a sample (Target value: 100) shows the least bias?
A. 100, 105, 110
B. 95,100,105
C. 90,95,100
D. 90,100,105
B. 95,100,105
How should a laboratory verify the reference range it uses for a particular test?
a. Call another laboratory
b. Use the numbers form a textbook
c. Test samples from healthy people
d. Look on a medical internet site
c. Test samples from healthy people
Establishing reference interval
- 120-700
Verifying a reference interval
- 40
First step in analytical phase
A. Test order
B. Patient preparation
C. Specimen collection
D. Specimen handling
A. Test order
Which are considered in pre-analytical quality assurance in relation to specimen management?
1 correctly separated or centrifuged
2 test done within specified timeframes
3 intact and seal
4 stored properly
1,2,4
Intact and seal- Transport
Which are considered in post-analytical quality assurance in relation to timeliness?
a. Turnaround times recorded and analyzed
b. Including laboratory care in patient surveys
c. Specimen collection explained to the patient
d. Results are accurately transcribed into the system
a. Turnaround times recorded and analyzed
Electrode that is constant
A. Glass electrode
B. Clarke electrode
C. Severinghaus electrode
D. Reference electrode
D. Reference electrode
Which type of blank is used to zero solutions before the test?
A. Reagent
B. Sample
C. Calibration
D. Procedural
A. Reagent blank
Sample blank- during the test
When a serum sample has intrinsic color that absorbs at the same wavelength used to detect the reaction product, what technique could help distinguish the color produced by the analyte from the intrinsic color of the sample?
A. Blanking
B. Immunoturbidimetry
C. Ion selective electrode
D. PETINIA
A. Blanking
Which of the following analyses would best be done using photometric rate reaction?
A. Measurement if lipase activity
B. Determination of albumin with the dye bromocresol green
C. Determination of potassium in the presence of excess sodium
A. Measurement of lipase activity
Pretreatment is designed to do which of the following?
A. Ensure the concentration of analyte is in the measurable range
B. Remove substances that could be erroneously measured as analyte
C. Adjust the wavelength of light used for analysis
D. Introduce a flourophore
B. Remove substances that could be erroneously measured as analyte
Which of the following would not be a typical methodology for a clinical chemistry test?
A. Immunoturbidimetry
B. Microscopy
C. EMIT
D. ISE
B. Microscopy
What does method traceability mean?
A. The calibration of a method is linear
B. The method meets the required error budget
C. The method’s accuracy is linked to a certified method and/or material
D. The method does not show matrix effects
C. The method’s accuracy is linked to a certified method and/or material
Which of the following is an example if a preanalytical error?
A. Test method incorrectly calibrated
B. Collection of blood in wrong kind of tube
C. Presence of interfering substances
D. Delay in sending the report to the provider
B. Collection of blood in wrong kind of tube
Which type of analytical error can be prevented by a good quality control program?
a. Instrument not properly calibrated
b. Presence of interfering substance in the sample
c. Presence of bubbles in the light path of a photometric method
d. Analyte concentration so high it depletes the active reagent
a. Instrument not properly calibrated
Not a physical hazard:
a. Freezing temperature
b. Noise
c. Non-ionizing radiation
d. Infectious aerosols
d. Infectious aerosols
Measurement technique to quantify hirsutism:
a. Tanner staging system
b. Ferriman-Gallwey score
c. Both A and B
d. None of the above
b. Ferriman-Gallwey score
Effects includes thickening of the cervical mucus, reduction of uterine contractions, and thermogenic effect, in which basal body temperature rises after ovulation.
a. Estrogen
b. Progesterone
c. Testosterone
d. None of the above
b. Progesterone
