CC practice test Flashcards
Which of the following conditions
is most consistently associated
with hypercholesterolemia?
A. Hypothyroidism
B. Malabsorption syndrome
C. Pancreatitis
D. Diabetes mellitus
Hypothyroidism
When using the Friedewald
equation to estimate LDL
cholesterol, the error becomes
unacceptably high at triglyceride
levels:
A. <200 mg/dL
B. >200 mg/dL
C. <400 mg/dL
D. >400 mg/dL
> 400 mg/dL
. A patient’s total cholesterol is 300
mg/dL, his HDL cholesterol is 50
mg/dL, and his triglyceride is 200
mg/dL. What is this patient’s LDL
cholesterol when calculated using
the Friedewald equation?
A. 200
B. 210
C. 290
D. 350
210
A fluorometer uses a secondary
monochromator to isolate the
wavelength emitted by the
A. gas discharge lamp
B. atomizer
C. ground-state atoms
D. excited molecules
excited molecules
Which lipoprotein is associated
with obstructive biliary disease
and familial LCAT deficiency?
A. B-VLDL
B. LpX
C. Lp(a)
D. LDL
LpX
Deficiency of which of the
following apolipoproteins causes
reduced clearance of triglyceriderich lipoproteins?
A. B-48
B. A-IV
C. C-II
D. Apo(a)
B-48
As part of a routine physical, a
fasting plasma glucose is
performed on a 45-year-old male
and the test result is 105 mg/dL.
How should this individual be
classified?
A. Normal for his age
B. Impaired fasting glucose
C. Type 1 diabetes mellitus
D. Type 2 diabetes mellitus
Impaired fasting glucose
What is the reference method for
non-protein nitrogenous
compounds?
A. GCMS
B. Tandem MS
C. MALDI TOF
D. IDMS
IDMS
Cigarette smoking will cause
falsely increased result in the
following methods for urea
EXCEPT:
A. Nesslerization
B. Berthelot
C. Conductimetric
D. Diacetyl monoxime
Diacetyl monoxime
Which of the following is the
common initial reaction in the
enzymatic methods for
creatinine?
A. Hydrolysis of creatinine
B. Hydrolysis of creatine
C. Phosphorylation of creatine
D. Oxidation of sarcosine
Hydrolysis of creatinine
Which of the following is
measured in the creatininase–CK
coupled?
A. Increased absorbance of
NADH at 340 nm
B. Decreased absorbance of
NAD at 340 nm
C. Increase in color intensity
of the oxidized chromogen
D. Decrease in color intensity
of the oxidized chromogen
Decreased absorbance of
NAD at 340 nm
Which of the following would be
consistent with pre-renal
azotemia?
A. BUN/Creatinine ratio >20:1
with normal creatinine
B. BUN/Creatinine ratio >20:1
with elevated creatinine
C. BUN/Creatinine ratio <10:1
D. Increased creatinine
clearance
BUN/Creatinine ratio >20:1
with normal creatinine
Dyes used in serum protein
electrophoresis include the
following EXCEPT:
A. Ponceau S
B. Amido black
C. Coomassie blue
D. Bromcresol green
Bromcresol green
Which of the following is
associated with
hyperalbuminemia?
A. Malnutrition
B. Nephrotic syndrome
C. Liver disease
D. Dehydration
Dehydration
Which of the following are α2-
globulins?
1. Haptoglobin
2. Inter-α-trypsin inhibitor
3. Ceruloplasmin
4. α-fetoprotein
A. 1 and 3
B. 2 and 4
C. 1, 2, and 3
1 and 3
In iron deficiency anemia, serum
iron and transferrin are
respectively:
A. Decreased, increased
B. Increased, decreased
C. Decreased, decreased
D. Increased, increased
Decreased, increased
if a hemolyzed serum is used in
electrophoresis, an additional
band will be seen between:
A. β and γ zones
B. α2 and β1 zones
C. α1 and α2 zones
D. β1 and β2 zones
α2 and β1 zones
What is the characteristic
densitometric pattern associated
with hepatic cirrhosis?
A. α1 and α2 peaks
B. sharp γ peak
C. β-γ bridging
D. α1 flat curve
β-γ bridging
Which of the following is used as
a negative predictor of myocardial
infarction within the first 4 hours?
A. hsCRP
B. Myoglobin
C. Troponin I
D. Homocysteine
Myoglobin
The following proteins are used to
evaluate glomerular filtration rate
EXCEPT:
A. Cystatin C
B. β2-microglobulin
C. β Trace Protein
D. Atrial natriuretic peptide
Atrial natriuretic peptide
Which of the following represents
proteolytic fragments of collagen I and is used as a biochemical
marker of bone resorption?
A. Neuronal Thread Protein
B. Cross-linked C Telopeptide
C. Amyloid β42
D. Atrial natriuretic peptide
Cross-linked C Telopeptide
Which of the following is the
ultimate reference method for
protein based on the
measurement of nitrogen
content?
A. Kjeldahl method
B. Biuret method
C. Folin-Ciocalteau (Lowry)
method
D. Ninhydrin method
Kjeldahl method
A BUN result of 15 mg/dL is
obtained by a technologist. What
is the equivalent urea
concentration?
A. 32.1 mg/dL
B. 5.36 mg/dL
C. 2.5 mg/dL
D. 3.21 mg/dL
32.1 mg/dL
Which of the following are positive
acute-phase reactants?
1. α1-antitrypsin
2. Haptoglobin
3. C-reactive protein
4. Fibrinogen
A. 1 and 3
B. 2 and 4
C. 1, 2, and 3
D. 1, 2, 3, and 4
1, 2, 3, and 4
What clinical manifestation would
be consistent with a densitometric
pattern that shows a marked
decrease in the α1-globulin peak
area?
A. Pulmonary emphysema
B. Acute inflammation
C. Nephrotic syndrome
D. Agammaglobulinemia
Pulmonary emphysema
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
Hollow-cathode lamp
Which of the following represents
an enzyme’s catalytic
mechanism?
A. E + S → ES → E → P
B. E + P → EP → E → S
C. E + S + P → ESP
D. ESP → E + S + P
E + S → ES → E → P
Which of the following is NOT
associated with pronounced AST
elevation?
A. Acute hepatocellular
disorders
B. Circulatory collapse
C. Myocardial infarction
D. Biliary obstruction
Biliary obstruction
Which of the following enzyme
assays is subject to end product
inhibition by inorganic
phosphorus?
A. Forward LD
B. Reverse CK
C. GGT
D. ALP
ALP
What is the substrate used in the
Bowers-McComb assay?
A. α-naphthylphosphate
B. β-glycerophosphate
C. phenylphosphate
D. p-nitrophenylphosphate
p-nitrophenylphosphate
Increased sodium loss in urine
can occur with the following
conditions, EXCEPT:
A. Addison’s disease
B. Salt-losing nephropathy
C. Renal failure
D. Thiazide diuretic use
Renal failure
Which of the following is the most
routinely used method for serum
sodium determination?
A. AAS
B. FEP
C. ISE
D. Albanese-Lein
ISE
High serum chloride values are
associated with:
A. Prolonged vomiting
B. Diabetic ketoacidosis
C. Compensated respiratory
acidosis
D. Metabolic acidosis
Metabolic acidosis
What do the following results
suggest?
Serum calcium – elevated;
serum inorganic
phosphate – decreased;
urine calcium – elevated;
urine
inorganic phosphate – elevated
A. Hypovitaminosis D
B. Paget disease
C. Renal failure
D. Hyperparathyroidism
Hyperparathyroidism
What is the reagent used in the
Fiske-Subbarow method?
A. o-cresolphthalein
complexone
B. Arsenazo III
C. 8-hydroxyquinoline
D. Ammonium molybdate
Ammonium molybdate
Which of the following conditions
is associated with
hypophosphatemia?
A. Lymphoblastic leukemia
B. Vitamin D deficiency
C. Renal failure
D. Intravascular hemolysis
Vitamin D deficiency
Calculate the plasma osmolality
given the following information:
glucose – 124 mg/dL; BUN – 22
mg/dL; sodium – 138 mmol/L;
potassium – 5 mmol/L; chloride –
105 mmol/L; bicarbonate – 25
mmol/L.
A. 13 mmol/L
B. 13 mOsm/kg
C. 290 mOsm/kg
D. 290 mmol/L
290 mOsm/kg
Low anion gap may be caused by:
A. Decreased unmeasured
cations and increased
unmeasured anions
B. Increased unmeasured
cations and anions
C. Increased unmeasured
cations and decreased
unmeasured anions
D. Decreased unmeasured
cations and anions
Increased unmeasured
cations and decreased
unmeasured anions
The ratio of HCO3 and H2CO3
may be decreased by:
A. An increase in the
reclamation of HCO3
B. A decrease in pulmonary
ventilation
C. A decrease in the excretion
of HCO3
D. An increase in the rate of
respiration
A decrease in pulmonary
ventilation
Which of the following is the
compensatory mechanism in
respiratory acidosis?
A. Decreased renal
production of ammonia
B. Decreased bicarbonate
reabsorption
C. Increased CO2 retention
D. Increased bicarbonate
retention
Increased bicarbonate
retention
A patient’s arterial blood gas
results are: pH= 7.48; pCO2= 54
mmHg; HCO3-= 38 mmol/L.
These values are consistent with:
A. Uncompensated
respiratory alkalosis
B. Partially compensated
respiratory alkalosis
C. Uncompensated metabolic
alkalosis
D. Partially compensated
metabolic alkalosis
Partially compensated
metabolic alkalosis
Considering that hyperglycemia
normally suppresses GH
secretion, glucose administration
may be used for the diagnosis of:
A. Hypoadrenalism
B. Acromegaly
C. Cushing’s disease
D. Panhypopituitarism
Acromegaly
The following are common clinical
manifestations of hyperprolactinemia in females
EXCEPT:
A. Amenorrhea
B. Anovulation
C. Galactorrhea
D. Increased libido
Increased libido
Which of the following is one of the
clinical manifestations of
hypothyroidism in adults?
A. Myxedema
B. Cretinism
C. Exopthalmus
D. Weight loss
Myxedema
A patient has an elevated serum
T3 and free T4 and undetectable
TSH. What is the most likely
cause of these results?
A. Primary hyperthyroidism
B. Secondary
hyperthyroidism
C. Euthyroid with increased
TBG
D. Euthyroid sick syndrome
Primary hyperthyroidism
Which of the following is
considered the confirmatory test
for primary aldosteronism?
A. Metyrapone test
B. Cosyntropin test
C. PA/PRA ratio
D. Captopril suppression
Captopril suppression
Which of the following drugs
exerts its effect by relaxing the
smooth muscles of the bronchial
passages?
A. Acetaminophen
B. Lithium
C. Phenytoin
D. Theophylline
Theophylline
.A child presents with microcytic,
hypochromic anemia. A urinary
screen for porphyrins was
positive. Erythrocytic basophilic
stippling was noted on the
peripheral blood smear. Which of
the following laboratory tests
would be best applied to this
case?
A. Whole blood lead
B. Urinary thiocyanate
C. Blood carboxyhemoglobin
D. Serum iron
Whole blood lead
.Marked increase in
aminotransferases and slight
increase in ALP and GGT are
most consistent with:
A. Acute hepatitis
B. Alcoholic liver disease
C. Biliary obstruction
D. Hepatic tumor
Acute hepatitis
Which of the following classes of
compounds has a sedative effect
and as such is used to treat
anxiety?
A. Amphetamines
B. Opiates
C. Cannabinoids
D. Benzodiazepine
Benzodiazepine
Perform this conversion: 20 μL = ______ mL
a. 2
b. 0.02
c. 0.002
d. 0.2
0.02
Which set of results most accurately reMects severe renal disease?
a. Serum Creatinine, 2.0 mg/dL; Creatinine clearance, 120 mL/min; BUN, 14 mg/dL
b. Serum Creatinine, 1.0 mg/dL; Creatinine clearance, 110 mL/min; BUN, 17 mg/dL
c. Serum Creatinine, 3.7 mg/dL; Creatinine clearance, 44 mL/min; BUN, 88 mg/dL
d. Serum Creatinine, 1.0 mg/dL; Creatinine clearance, 95 mL/min; BUN, 43 mg/dL
Serum Creatinine, 3.7 mg/dL; Creatinine clearance, 44 mL/min; BUN, 88 mg/dL
Which of the following color codes corresponds to the needle gauge with
the largest lumen diameter?
a. Yellow
b. Green
c. Blue
d. Black
Yellow
As part of a routine physical, a fasting plasma glucose is performed on a
50-year old female and the test result is 115 mg/dL. How should this
individual be classi\ed?
a. Normal for his age
b. Type 1 diabetes mellitus
c. Pre-diabetes
d. Type 2 diabetes mellitus
Pre-diabetes
Which arterial puncture site requires the performance of modi\ed Allen
test prior to use?
a. Radial artery
b. Femoral artery
c. Brachial artery
d. Ulnar artery
Radial artery
A blood sample from a 32-year old man was sent to the laboratory for
lipoprotein phenotyping. The results were: Triglyceride, 340 mg/dL;
Cholesterol, 180mg/dL; Pre-Beta LPP, increased; Chylomicrons absent;
Serum turbid. Considering the results, what is the lipoprotein phenotype?
a. Type 4
b. Type 2b
c. Type 3
d. Type 1
Calculate the LDL cholesterol level using the Fridewald equation: TC = 400
mg/dL; TG = 300 mg/dL; HDL-C = 100 mg/dL
a. 240 mg/dL
b. 300 mg/dL
c. 200 mg/dL
d. 160 mg/dL
240 mg/dL
Which of the following is used as a marker for congestive heart failure?
a. BNP
b. Homocysteine
c. Troponin I
d. hsCRP
BNP
In a micro pipet gravimetric calibration, the mean amount delivered is
determined to be 49.71 µL with a variance of 0.0081 µL. What is the
precision of this pipet expressed as coefficient of variation?
a. 0.29
b. 0.18
c. 0.016
d. 0.09
The plasma protein that serves to transport a large number of compounds
including bilirubin, calcium, drugs, and free fatty acids is:
a. Albumin
b. Immunoglobulin G
c. Haptoglobin
d. Prealbumin
Albumin
Aside from the average plasma glucose level, what is another factor that
can affect the HbA1c value?
a. Serum ketone bodies level
b. Increased triglyceride levels
c. Ascorbic acid intake
d. Red blood cell life span
Red blood cell life span
Whole blood glucose level is about ______ lower than plasma glucose.
a. 5%
b. 2-5 mg/dL
c. 10-15 mg/dL
d. 10-15 %
10-15 %
Hemolytic disease of a newborn results from maternal-fetal Rh
incompatibility. This produces physiological jaundice that is characterized
by:
a. Unconjugated hyperbilirubinemia
b. Combined hyperbilirubinemia
c. Bilirubinuria
d. Conjugated hyperbilirubinemia
Unconjugated hyperbilirubinemia
Arrange the following specimens according to the recommended order of
draw for capillary puncture: 1-Gold top tube, 2-EDTA tube, 3-Slide/smear, 4-
Mint green tube, 5 Blood gases
a. 3, 5, 2, 1, 4
b. 3, 5, 2, 4, 1
c. 5, 3, 2, 1, 4
d. 5, 3, 2, 4, 1
5, 3, 2, 4, 1
Which of the following is so-called “sinking pre-β lipoprotein” and is
associated with CHD due to its prothrombotic nature?
a. IDL
b. β-VLDL
c. LpX
d. Lp(a)
Lp(a)
Choosing an incorrect evacuated collection tube to obtain a blood
specimen is an example of ______________ error?
a. statistical
b. post-analytical
c. analytical
d. preanalytical
preanalytical
A new CA 125 test for ovarian cancer gave positive results in 28 of 30
malignant patients and negative results in 82 of 85 benign patients. What
are the sensitivity, speci\city, PPV, and NPV values respectively?
a. 87.5%, 97.6%, 93.3%, 96.5%
b. 96.5%, 93.3%, 87.5%, 97.6%
c. 93.3%, 96.5%, 97.6%, 87.5%
d. 93.3%, 96.5%, 87.5%, 97.6%
93.3%, 96.5%, 87.5%, 97.6%
The times of measurement for plasma glucose levels during an OGTT in
non-pregnant patients being screened for type 2 DM are:
a. Fasting, 1 hour, and 2 hours
b. 30, 60, and 120 minutes
c. Fasting and 2 hours
d. Fasting, 30, 60, 120, and 180 minutes
Fasting and 2 hours
Liver function includes the synthesis of all of the following EXCEPT:
a. Albumin
b. Immunoglobulins
c. Glycogen
d. Coagulation factors
Immunoglobulins
Which of the following statements may be associated with the activity of
insulin?
a. Stimulates glycogenolysis
b. Promotes release of hepatic glucose into plasma
c. Elevates blood glucose levels
d. Stimulates glucose uptake by cells
Stimulates glucose uptake by cells
Which of the following statements is true about bilirubin?
a. The conjugated form of bilirubin is highly toxic to the nervous system when elevated.
b. All of the above.
c. Bilirubin is bound to albumin in plasma before conjugation in hepatocytes.
d. Bilirubin becomes conjugated to gluconic acid in the smooth endoplasmic reticulum.
Polarographic methods of glucose assay are based on which principle?
a. Change in electrical potential as glucose is oxidized
b. Nonenzymatic oxidation of glucose
c. Chemiluminescence caused by the formation of ATP
d. Measurement of the rate of oxygen depletion
Measurement of the rate of oxygen depletion
Which of the following correctly describes type 1 diabetes mellitus?
a. Requires an oral glucose tolerance test for diagnosis
b. Requires insulin replacement to prevent ketosis
c. Usually occurs after age 40
d. Is the most common form of diabetes mellitus
Requires insulin replacement to prevent ketosis
Which apolipoprotein is inversely related to risk of coronary heart disease?
a. Apoprotein E
b. Apoprotein B100
c. Apoprotein B48
d. Apoprotein A-I
Apoprotein A-I
Which of the following is used as a negative predictor of myocardial
infarction within the 1st 4 hours?
a. Troponin I
b. Myoglobin
c. hsCRP
d. Homocysteine
Myoglobin
How many milliliters of bleach in an original bottle are needed to prepare
100 mL of a 10% solution?
a. 0.1 mL bleach and 99.9 mL water
b. 1.0 mL bleach and 99 mL water
c. 90 mL bleach and 10 mL water
d. 10 mL bleach and 90 mL water
10 mL bleach and 90 mL water
What is the actual end product measured in the peroxidase-coupled
glucose oxidase reaction?
a. Intensity of color of quinoneimine dye
b. NADP produced from the oxidation of NADPH
c. Amount of H2O2 produced
d. NADPH produced from the reduction of NADP
Amount of H2O2 produced
Which of the following would be consistent with an A/G ratio of 0.8 and a
total protein level of 9.0 g/dL?
a. Albumin is increased, globulin is decreased
b. Albumin is decreased, globulin is increased
c. Both albumin and globulin are increased
d. Both albumin and globulin are decreased
Albumin is decreased, globulin is increased
A standard solution of glucose has a concentration of 125 mg/dL and
gives an absorbance of 0.20. Assuming a linear reaction, what is the
concentration of glucose in a patient’s serum that has an absorbance of
0.24?
a. 150 mgldL
b. 180 mg/dL
c. 138 mg/dL
d. 104 mg/d
150 mg/dL
Which of the following environmental factors affect evacuated tube draw
volume? 1. Ambient temperature 2. Humidity 3. Altitude 4. Light
a. 1, 2, 3, and 4
b. 1, 2, and 3
c. 2 and 4
d. 1 and 3
1 and 3
Which of the following analytes may become elevated if the patient
suddenly changes position from supine to upright just before blood
collection? 1. Calcium, 2. Prolactin, 3. Albumin, 4. Catecholamines
a. 2 and 4
b. 1, 2, and 3
c. 1 and 3
d. 1, 2, 3, and 4
1 and 3
All of the following are associated with high risk of premature coronary
heart disease EXCEPT:
a. High plasma apoB100
b. High plasma LDL cholesterol
c. High plasma HDL cholesterol
d. High total plasma cholesterol
High total plasma cholesterol
Variables that are included in the MDRD-IDMS estimated creatinine
clearance calculations include all of the following EXCEPT:
a. Gender
b. Weight
c. Age
d. Serum creatinine
Weight
Which of the following is associated with pre-renal azotemia?
a. Tumors
b. Nephrolithiasis
c. Dehydration
d. Glomerulonephritis
Dehydration
Given the following information, interpret the creatinine clearance: 24-hour
urine volume: 1000 mL; serum creatinine: 2.0 mg/dL; urine creatinine: 200
mg/dL
a. High for a female patient
b. Low
c. Normal
d. High for a male patient
Low
Eight consecutive observations for the same level of control exceed 1SD in
the same direction. What do these results indicate?
a. Bias trend
b. Imprecision
c. Outlier
d. Random error
Bias trend
Which of the following are associated with hypouricemia? 1. Fanconi
syndrome, 2. Alcoholism , 3. Severe liver disease, 4. Chemotherapy with
cytotoxic agents
a. 1, 2, and 3
b. 1, 2, 3, and 4
c. 2 and 4
d. 1 and 3
1 and 3
What is the preferred capillary puncture site for newborn screening?
a. Big toe
b. Ear lobe
c. 3rd or 4th \nger
d. Medial or lateral plantar heel surface
Medial or lateral plantar heel surface
Which of the following would be consistent with pre-renal azotemia?
a. BUN/Creatinine ratio >20:1 with elevated creatinine
b. Increased creatinine clearance
c. BUN/Creatinine ratio >20:1 with normal creatinine
d. BUN/Creatinine ratio <10:1
BUN/Creatinine ratio >20:1 with normal creatinine
Which of the following cells synthesize C-reactive protein?
a. C cells of the thyroid
b. Endothelial cells
c. Hepatocytes
d. Plasma cells
Hepatocytes
The following Westgard control rules detect random error EXCEPT:
a. 12S
b. R4S
c. 22S
d. 13S
22S
A patient presenting with symptoms of jaundice, hepatic pain, and chalkyappearing stools had the following laboratory values: elevated conjugated
bilirubin, ALP, and GGT. These \ndings are most likely due to:
a. Hemolytic anemia
b. Cholestasis due to gallstones
c. Ineffective erythropoiesis
d. Reye syndrome
Cholestasis due to gallstones
The level of alpha-fetoprotein in serum from a nonpregnant patient can be
used to detect which of the following?
a. Myocardial infarction
b. Neural tube defects
c. Hepatocellular carcinoma
d. Emphysema
Hepatocellular carcinoma
Which of the following is NOT true about conjugated bilirubin?
a. Elevated in obstructive jaundice
b. Water-soluble
c. Excreted in urine
d. Assayed in the presence of accelerator
Excreted in urine
Which of the following represents the light chain of class I major
histocompatibility complex?
a. Serum amyloid A
b. β2-microglobulin
c. Bence-Jones protein
d. Complement C3
Bence-Jones protein
Which of the following is the reference method for protein based on the
measurement of nitrogen content?
a. Kjeldahl method
b. Biuret method
c. Folin-Ciocalteau (Lowry) method
d. Ninhydrin method
Kjeldahl method
Which of the following is measured in the UV method for uric acid?
a. Increase in absorbance of NADH at 340 nm
b. Decrease in absorbance of allantoin at 293 nm
c. Decrease in absorbance of NAD at 340 nm
d. Increase in absorbance of allantoin at 293 nm
Decrease in absorbance of allantoin at 293 nm
The densitometric pattern typical of nephrotic syndrome and protein-losing
enteropathy shows ____________ albumin and _____________ α2 peaks.
a. Increased, increased
b. Decreased, decreased
c. Decreased, increased
d. Increased, decreased
Decreased, increased
Which of the following statements regarding creatinine methods is
incorrect?
a. The kinetic Jaffe method prevents interference by non-creatinine chromogens.
b. The reference values for Jaffe method are higher than those for enzymatic methods.
c. Reaction of creatinine with alkaline picrate without adsorbent is highly specifc.
d. Fuller’s earth reagent improves the speci\city of the Jaffe reaction
Reaction of creatinine with alkaline picrate without adsorbent is highly specifc.
