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Chemistry Flashcards

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1
Q

A patient with a hematologic malignancy is prescribed rasburicase to prevent unwanted side effects of chemotherapy. In the laboratory, it is an interfering substance in the measurement of what non-protein nitrogen?
A) Urea
B) Uric acid
C) Ammonia
D) Creatinine

A

B) Uric acid

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2
Q

Uric acid reagent may contain which of the following chemicals to minimize interference from bilirubin and ascorbic acid

A) Sodium carbonate and ascorbate peroxidase
B) Sodium cyanide and ascorbate peroxidase
C) Phosphotungstc acid and ascorbate oxidase
D) Potassium ferricyanide and ascorbate oxidase

A

D) Potassium ferricyanide and ascorbate oxidase

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3
Q

Which of the following is the best practice for specimen collection and handling of specimen for ammonia measurement?
A) Draw EDTA specimen, place on ice, centrifuge, separate serum from cells within 1 hour of collection, protect from light, test immediately.

B)Draw sodium heparin tube, place on ice immediately, centrifuge specimen in refrigerated centrifuge, separate cells from plasma within 20 minutes, and test immediately.

C) Draw specimen in a serum separator tube, preventing the need to separate serum from cells, centrifuge specimen, and test immediately.

D) Draw fasting specimen in a plasma separator tube containing lithium heparin, place on an ice pack, centrifuge at 20° C, test immediately.

A

B)Draw sodium heparin tube, place on ice immediately, centrifuge specimen in refrigerated centrifuge, separate cells from plasma within 20 minutes, and test immediately.

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4
Q

Given the following results, what is the most likely cause of this patient’s elevated
BUN?
BUN 45 mg/ dL
Creatinine 1.8 mg/dI
Uric Acid 7.0 mg/dI

A) Urinary tract obstruction
B) Chronic renal disease
C) Acute tubular necrosis
D) Congestive heart failure

A

D) Congestive heart failure

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5
Q

Which of the following statements concerning urea is true?
A) It is increased in the serum during acute episodes of gout.
B) It is increased in inherited deficiencies of urea cycle enzymes.
C) It is formed from amino groups (-NH2) and free ammonia.
D) It is generated in the liver from nucleic acid breakdown.

A

C) It is formed from amino groups (-NH2) and free ammonia.

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6
Q

Which of the following disorders is characterized by an increased level of urea accompanied by renal failure?
A) Postrenal azotemia
B)
Prerenal azotemia
C) Renal azotemia
D)
Uremia

A

D)
Uremia

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7
Q

Which of the following causes a decreased plasma urea concentration?
A) Acute glomerulonephritis
B)
Congestive heart failure
C)
Severe liver disease
D) Urinary renal calculiBoom

A

B)
Congestive heart failure

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8
Q

The estimated glomerular filtration rate (eGFR) is calculated based on age, gender, race, and what additional parameter?
A) Body surface area
B) Urine creatinine
C) 24-hour urine volume
D) Serum creatinine

A

D) Serum creatinine

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9
Q

Blood ammonia levels are used to evaluate which of the following conditions?
A) Hepatic encephalopathy
B) Chronic renal failure
C)
Acute renal failure
D) Uremic syndrome

A

A) Hepatic encephalopathy

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10
Q

Which of the following interfering substances causes falsely elevated creatinine results in the Jaffe reaction?
A) Bilirubin
B) Acetaminophen
C) Cephalosporin
D) Salicylate

A

C) Cephalosporin

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11
Q

The following results were obtained from a specimen:
Potassium
Glucose*
Sodium
Calcium
14.7 mmolL
100 mg/dL
135 mmol/L
0.2 mg/dL
What is the most likely explanation of these results?
A) Gross lipemia
B) Respiratory alkalosis
C) Unacceptable specimen
D) Severe hemolysis

A

C) Unacceptable specimen

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12
Q

The sweat chloride test is used as a screening test for what disorder?
A) Reye’s syndrome
B)
Hypoaldosteronism
C) Cystic fibrosis
D) Pyelonephritis

A

C) Cystic fibrosis

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13
Q

A patient in the emergency department has the following results:
Glucose 505 mg/dI
Potassium 6.2 mmol/L
COz 10 mmol/L
What action should be taken?
A) Call critical results to provider
B)Check the specimen integrity
C) Request recollect of specimen
D) Recalibrate the electrolytes

A

B)
Check the specimen integrity

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14
Q

When a mole of NaCl is added to a kilogram of water, which of the following changes occurs in its colligative properties?
A) The osmotic pressure is increased, and the freezing point is decreased.
B) The vapor pressure is increased, and the freezing point is decreased.
C) The freezing point is decreased, and the osmotic pressure is decreased.
D) The boiling point is decreased, and the osmotic pressure is increased.

A

A) The osmotic pressure is increased, and the freezing point is decreased.

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15
Q

Given the following patient results, what is the calculated osmolality?
Sodium
140 mmolL
Potassium
5.0 mmol/L
Chlonde
100 mmol/L
COz
25 mmol/L
Glucose
90 mg/dL
BUN
14.0 mg/dL

Osmolality 316 mOsm/Kg
A) 290
B) 275
C) 301
D) 316

A

B) 275

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16
Q

Given the following results from a patient in the emergency department, what is the most likely explanation for the increased osmolality?
316 mOsm/Kg
Sodium
140 mmol/L
Potassium
5.0 mmo//L
Chloride
100 mmol/L
CO2
25 mmol/L
Glucose
90 mg/dL
BUN
14.0 mg/dI
Creatinine
1.1 mg/dL
Osmolality

A) Diabetic ketoacidosis
B) Alcohol intoxication
C) Saline contamination
D) Acute renal failure

A

B) Alcohol intoxication

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17
Q

What electrolyte will most likely be falsely elevated when analyzing a specimen from a patient who overdosed on bromide salt containing antacid medication?
A) Bicarbonate
B) Chloride
C) Sodium
D) Potassium

A

B) Chloride

18
Q

Which of the following will cause a decreased anion gap?
A) Hypoalbuminemia
B) Hypernatremia
C) Hypocalcemia
D) Hyperphosphatemia

A

A) Hypoalbuminemia

19
Q

What membrane is used to selectively bind potassium in the ion-selective electrode method?
A) Silicone
B) Potassium-sensitive glass
C) Valinomycin
D) Vancomycin

A

C) Valinomycin

20
Q

Given the electrolyte panel results, what is the anion gap?
Sodium
135, mmolI
Potassium
5.0 mmol/L
Chloride
100 mmol/L
Bicarbonate
25 mmol/L
A) 15
B) 5
C) 20
D) 10

A

A)15

21
Q

Which of the following cause(s) hypernatremia?
A) Acute renal failure and hypoadrenalism
B) Severe burns and excessive sweating
C) Use of diuretics and nephrotic syndrome
D) Syndrome of inappropriate ADH secretion

A

B) Severe burns and excessive sweating

22
Q

Hypokalemia may be seen in which of the following conditions?
A) Diuretic therapy
B) Acute renal failure
C) Addison’s disease
D
Diabetes mellitus

A

A) Diuretic therapy

23
Q

Hyponatremia, hypochloremia, and hypokalemia are seen in which of the following conditions?
A) Severe vomiting
B) Hyperaldosteronism
C) Renal tubular damage
D) Prolonged diarrhea

A

A) Severe vomiting

24
Q

A low plasma osmolality and low sodium concentration correlates with which of the following disorders?
A) Syndrome of inappropriate ADH
B) Diabetes mellitus
C) Diabetes insipidus
D) Dehydration

A

A) Syndrome of inappropriate ADH

25
Q

What is the purpose of the 8-hydroxyquinoline in the cresolphthalein determination for calcium?
A)
It is the substrate color reagent.
B) It acts as a cofactor in the reaction.
C) It is the end-product measured.
D) It prevents magnesium interference.

A

D) It prevents magnesium interference.

26
Q

Given the electrolyte panel results, what is the most likely explanation for these results?
Sodium
166 mmol/L
Potassium
5.0 mmol/L
Chloride
111 mmol/L
Bicarbonate 24 mmo/L
A) Fanconi’s syndrome
B)
Hyperaldosteronism
C) IV contamination
D) Diabetes insipidus

A

C) IV contamination

27
Q

What fraction of calcium circulates as free, ionized calcium?
A)50%
B) 45%
C)40%
D) 15%

A

B) 45%

28
Q

Which of the following conditions is associated with a low serum magnesium level due to decreased absorption?
A) Chronic alcoholism
B)
Addison’s disease
C) Hyperparathyroidism
D
Acute pancreatitis

A

D
Acute pancreatitis

29
Q

What is the principle of the method used in the determination of inorganic phosphorus?
A) Formation of ortho-cresolphthalein complexone
B) Use of ascorbic acid to reduce phosphomolybdate
C) Rate of phosphomolybdate formation at 340 nm
D) Measurement of phosphomolybdenum blue at 680 nm

A

C) Rate of phosphomolybdate formation at 340 nm

30
Q

What is the preferred anticoagulant for the measurement of plasma calcium?
A)
Fluoride
B) Heparin
C) Citrate
D) EDTA

A

B) Heparin

31
Q

What is the patient’s creatinine clearance given the following data?
Serum creatinine
Uriné creatinine
24-hour urine volume
Patient’s BSA
0.6 mg/dI
102 mg/dL
1650 mL
1.93 m₴
A) 195 mL/min
B)93 mL/min
C) 175 mL/min
D)130 mg/dL

A

C) 175 mL/min

32
Q

What is the patient’s 24-hour creatinine excretion given the following laboratory results?
Urine creamine
* 24-hour urine volume
102 mg/dL
1650 mL
A)1.7 gm/day
B) 0.8 gm/day
C) 14.4 gm/day
D) 8.8 gm/day

A

A) 1.7 gm/day

33
Q

A patient with signs and symptoms of a urinary tract infection has the following urinalysis results. What is the most likely explanation for the discrepant results?
Protein
Negative
Leukocyte Esterase
Positive
Blood
Positive
Nitrite
Negative
WBCs

RBCs
5-10/hpf
Bacteria
Many/hpf
Casts
1 hyaline/lpf
A) The protein should always be positive in the presence of casts.
B) Hemoglobinuria was present; hematuria was absent.
C) Gram-positive cocci were present; gram-negative rods were absent.
D) The leukocytes lysed in the hypotonic urine specimen.

A

C) Gram-positive cocci were present; gram-negative rods were absent.

34
Q

A patient with oliguria has the following urinalysis results. These laboratory results correlate with which of the following disorders?
Protein
3+
Leukocyte Esterase*
Positive
Blood *
Positive
Nitrite
Negative
WBCs
10-20/hpf
RBCs
50-100/hpf
Bacteria
Present
Casts
1-5 RBC/pf
A) Acute glomerulonephritis
B) Acute pyelonephritis
C) Chronic renal failure
D) Nephrotic syndrome

A

A) Acute glomerulonephritis

35
Q

What is the primary renal defect in Fanconi syndrome?
A) Defective distal tubules
B) Defective proximal tubules
C)
Obstructive uropathy
D) Renal arteriosclerosis

A

B) Defective proximal tubules

36
Q

Which of the following laboratory tests are used in the evaluation of renal tubular disorders?
A) B2-microglobulin
B) Microalbumin
C) Myoglobin
D)
Cystatin C

A

A) B2-microglobulin

37
Q

A patient with edema, who has swelling of the legs, ankles, and feet, has the following urinalysis results. These laboratory results correlate with which of the following disorders?
Protein 4+
Leukocyte Esterase
Negative
Blood
Negative
Nitrite
Negative
Crystals
Cholesterol Present
Casts
1-2 fatty/lpf
A) Acute pyelonephritis
B
Chronic renal failure
C) Nephrotic syndrome
D) Acute glomerulonephritis

A

C) Nephrotic syndrome

38
Q

Azotemia, hyperphosphatemia, hypocalcemia, and anemia are associated with which of the following renal disorders?
A) Acute glomerulonephritis
B) Nephrotic syndrome
C)
Fanconi syndrome
D) Chronic renal failure

A

D) Chronic renal failure

39
Q

These microscopic findings correlate with which of the following renal disorders?
A) Urinary tract infection
B) Nephrotic syndrome
C) Vaginal yeast infection
D) Menstrual contamination

A

A) Urinary tract infection

40
Q

What is the flow of blood and urine through the nephron?
A)
Afferent arteriole, distal convoluted tubule, ascending loop of Henle, descending loop of Henle, proximal convoluted tubule, collecting duct,
* efferent arteriole
B) Efferent arteriole, proximal convoluted tubule, descending loop of Henle, ascending loop of Henle, distal convoluted tubule, collecting duct, afferent arteriole
C) Afferent arteriole, proximal convoluted tubule, descending loop of Henle, ascending loop of Henle, distal convoluted tubule, collecting duct, efferent arteriole
D) Efferent arteriole, distal convoluted tubule, ascending loop of Henle, descending loop of Henle, proximal convoluted tubule, collecting duct, afferent arteriole

A

C) Afferent arteriole, proximal convoluted tubule, descending loop of Henle, ascending loop of Henle, distal convoluted tubule, collecting duct, efferent arteriole

Clinical Chemistry (7 decks)

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