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midterm exam > CC1 > Flashcards

CC1 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 testicle
A

1 and 2

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2
Q

The following statements are TRUE of LDH

  1. Elevated serum LDH in AMI
  2. Decreased LDH in Megaloblastic anemia
  3. 4 monomers in LDH
  4. LD6 isoenzyme is only seen in patients with multiple disorders
A

1 and 3

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3
Q

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

  1. Elevated in acute pancreatitis, mumps, parotitis, perforated peptic ulcer
  2. Amylase cleaves alpha1,6 glycosidic bonds of polysaccharides
  3. Largest of all enzymes interms of molecular weight
  4. P-type isoenzyme migrates fastest while S-type isoenzyme migrates slowest
A

1 and 2

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4
Q

Which of the following statements is TRUE of LD2 isoenzyme

A. slowest moving of LDH isoenzymes
B. Most positively charged
C. Heat-labile fraction
D. Present in greatest amount in normal heart tissue

A

D. Present in greatest amount in normal heart tissue

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5
Q

Which of the following enzyme is considered a newborn screening marker

A. amylase
B. aldolase
C. cholinesterase
D. G6PD

A
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6
Q

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

A. brain tumor
B. muscular dystrophy
C. MI
D. viral hepa

A

C. MI

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7
Q

Clinical significance of an elevated acid phosphatase is:

A. renal disease
B. pancreatic disease
C. bone disease
D. prostatic disease

A

D. prostatic disease

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8
Q

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

A. bone, liver, spleen, kidney, erythrocyte, platelets
B. bone, liver, kidney
C. muscle, spleen, platelets
D. liver, spleen, prostate, platelets

A

D. liver, spleen, prostate, platelets

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9
Q

Product of the forward reaction of AST

A. alanine & alpha keto-glutarate
B. aspartate and glutamine
C. oxaloacetate and glutamate
D. glutamate and NADH

A

C. oxaloacetate and glutamate

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10
Q

CK is frequently elevated in disorders such as AMI and:

A. duchenne muscluar dystrophy
B. acute hepa
C. cirrhosis
D. malignancy

A

A. duchenne muscluar dystrophy

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11
Q

Most specific marker of acute pancreatitis and remains elevated for 48 hours in the blood circulation

A. AST
B. Lipase
C. ALP
D. Amylase

A

B. Lipase

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12
Q

Occult alcoholism

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

A

C. GGT

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13
Q

Which 2 conditions can “physiologically” elevate serum alkaphos?

A. Rickets, hyperparathyroidism
B. Growth, 3rd trimester pregnancy
C. Obstructive jaundince, biliary cirrhosis
D. Viral hepa, IM

A

B. Growth, 3rd trimester pregnancy

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14
Q

Test that is most indicative of pancreatitis

A. Creatinine
B. LDH isoenzyme
C. beta-hydroxybutyrate
D. Amylase

A

D. Amylase

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15
Q

May be of help in establishing presence of seminal fluid

A. LDH
B. Isocitrate dehydrogenase
C. Acidphos
D. Alkaphos

A

C. Acidphos

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16
Q

Increased activity of LDH isoenzymes confined to fractions 4 and 5 is most likely associated with:

A. Pulmonary infarction
B. Hemolytic anemia
C. MI
D. Acute viral hepa

A

E. NONE

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17
Q

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

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

A

D. Placenta

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18
Q

Most sensitive enzymatic indicator for liver damage from ethanol intake is:

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

A

C. GGT

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19
Q

Serum sample drawn from the ER from a 42-year-old man yielded the ff lab results

A

Crush injury to the thigh

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20
Q

Catalyzes conversion of starch to glucose and maltose

A. Malate DH
B. CK
C. AMS
D. Isocitric DH

A

C. AMS

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21
Q

Catalyzes cleavage of fructose-1,6-diphosphate to glyceraldehyde-3-phosphate and dihydroxyacetone phosphate?

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

A

C. Phosphofructokinase

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22
Q

Flipped LD1 and LD2 pattern

A. MI
B. Viral hepa
C. pancreatitis
D. Renal failure

A

A. MI

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23
Q

Characteristic of LDH, Isocitrate DH, and dihydroxybutyrate DH?

A. Liver enzymes
B. Catalyze redox reactions
C. Cardiac enzymes
D. Class III enzymes

A

B. Catalyze redox reactions

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23
Q

Most heat labile fraction of alkaphos

A. Liver
B. Bone
C. intestine
D. Placenta

A

B

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23
Q

Sensitive and specific marker for acute pancreatitis

A. AMS
B. LPS
C. Both
D. Neither

A

B

24
Q

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

Which of the ff sources most contributes to the patient’s serum alkaphos activity?

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

A

B

25
Q

The reaction of LDH is dependent on what coenzyme systems?

A. NAD/NADH
B. ATP/ADP
C. Fe2+/Fe3+
D. Cu/Cu2+

A

A

26
Q

Predominant AST isoenzyme in the healthy serum

A. Mitochondrial
B. Cytoplasmic
C. Either
D. Neither

A

B

27
Q

Serum from a patient with metastatic carcinoma of the prostate was separated from the clot and stored at room temp:

Upon seeing the results above, the MT should repeat the:

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

A

B

28
Q

Macroamylasemia

A. Normal serum AMS and elevated urine AMS
B. Increased serum AMS and normal urine AMS
C. Increased serum and urine AMS
D. Normal serum and urine AMS

A

B

29
Q

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

These can be best 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. Unconjugated hyperbilirubinemia, probably due to hepatocellular obstruction

A

D

30
Q

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

A. CK and isocitrate DH
B. LDH and CK
C. GGT and alkaphos
D. LD and MD

A

B

31
Q

Isoenzyme assays are performed to improve:

A. precision
B. accuracy
C. sensitivity
D. specificity

A

D. specificity

32
Q

Specimen preparation to perform alkaphos isoenzyme determination

A. Serum is divided into two aliquots; one frozen, one refrigerated
B. A. Serum is divided into two aliquots; one heated at 56degC, one unheated
C. No preparation
D. Protein-free filtrate is prepared first

A

B

33
Q

When temperature is increased from 25 to 37 degC in the AST reaction, the activity of the reaction:

A. is halved
B. doubled
C. tripled
D. reduced to 0

A

B

34
Q

Method to enhance differentiation of bone from liver alkaphos is to pretreat an aliquot of the serum

A. w/ tartaric acid
B. by heating at 56 degC
C. w/ bovine albumin
D. by PEG precipitation

A

B

35
Q

Associated with organophosphate poisoning

A. 5 nucleotidase
B. cholinesterase
C. G6PD
D. aldolases

A

B

36
Q

Associated with macro CK

A. Complex between CKBB and IgG
B. Complex between CKMM and IgA
C. Migrate between MM and MB fractions
D. A and C

A

D

37
Q

Normal serum GGT and elevated serum alkaphos may be suggestive of

A. heart disease
B. bone disease
C. liver disease
D. skeletal muscle disease

A

B

38
Q

Associated with CK isoenzymes

A. CK1 is referred to as CKMM
B. CK3 remains close to the origin during electrophoresis
C. CKMM is found in skeletal muscle
D. B and C

A

D

39
Q

In pesticide poisoning, there is a decrease in what enzyme

A. Alkaphos
B. cholinesterase
C. CK
D. LDH

A

B

40
Q

Alkaphos = slight increase
Aminotransferase = slight increase
Aspartate aminotransferase = slight increase
GGT = marked increase

This is most consistent with

A. acute alcoholic hepa
B. Chronic hepa
C. obstructive jaundice
D. liver hemangioma

A

A

41
Q

Most sensitive indication of liver function particularly in obstructive jaundice

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

A

ALP

42
Q

Serum CK is clnically significant in diseases of the

A. pancreas
B. liver
C. muscle
D. GIT

A

C

43
Q

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

A. permit colorimetric rxn
B. regulate pH
C. act as activator
D. inhibit competing enzymes

A

C

44
Q

Forward reaction in LDH

A. wacker
B. oliver-rosalki
C. tanzer-gilvarg
D. wrobleuski-la due

A

A

45
Q

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

A. GGT
B. LPS
C. AST
D. AMS

A

D

46
Q

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

A. CK1
B. CK2
C. CK3
D. ALL

A

C

47
Q

MacroCK is found in:

A. between CK1 and CK2
B. between CKBB and CKMB
C. between CK2 and CK3
D. cathodal to CK3

A

C

48
Q

Pyridoxal phosphate (vit B6) serves as ______ for aminotransferases

A. activator
B. inhibitor
C. prosthetic grp
D. all

A

C

49
Q

Directly measures urea

A. diacetyl monoxime
B. nesslerization
C. urease test
D. berthelot

A

A only

50
Q

Causes false low level of Jaffe reaxn for creatinine measurement

  1. glucose
  2. ascorbic acid
  3. bilirubin
  4. hgb

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

A

B

51
Q

Correlated w/ increased BUN levels

  1. acute renal failure
  2. congested heart failure
  3. low pro10 intake
  4. severe liver disease

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

A

B. 1 and 2

52
Q

Which of the ff statements are true?

  1. BUN is a better indicator of glomerular function than 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

C

53
Q

A patient has an elevated BUN and elevated creatinine levels and increased BUN/Crea ratio. Which of the ff conditions will agree w/ 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

C

54
Q

Uric acid formation in the liver is catalyzed by

A. deaminase
B. PK
C. xanthine oxidase
D. glutamate DH

A

C

55
Q

Creatinine clearance is based on the assumption that creatinine:

A. passes into the ultrafiltrate
B. is retained in the blood
C. is converted to creatinine
D. is passively reabsorbed by the kidney tubule

A

A

56
Q

Most common test for tubular secretion and blood flow

A. PSP test
B. PAH test
C. indigo carmine test
D. fishberg test

A

B

57
Q

1st step in analyzing a 24hr urine specimen for quantitative urine NPN is:

A. subculture the urine for bacteria
B. screen for albumin using a dipstick
C. add appropriate preservative
D. measure the total volume

A

D

58
Q

Most accurate and exogenous procedure in assessing glomerular filtration that utilizes extremely stable substance that is neither reabsorbed nor secreted by the tubules

A. creatinine clearance
B. mosenthal test
C. insulin clearance
D. fishberg test

A

C

midterm exam (4 decks)

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