ClinChem Flashcards
1
Q
Conversion of glucose to pyruvic or lactic acid
A
Glycolysis
2
Q
Production of glycogen from glucose
A
Glycogenesis
3
Q
Production of glucose from glycogen
A
Glycogenolysis
4
Q
Production of glucose from non-carbohydrate sources
A
Gluconeogenesis
5
Q
What is the end product of anaerobic glycolysis?
A
Lactic Acid
6
Q
Which sugars accounts for nearly all blood sugar and is the body’s major source of cellular energy?
A
Glucose
7
Q
What is the reference range for a glucose in an adult?
A
70-110 mg/dl
8
Q
Presence of sugar in the urine
A
Glucosuria
9
Q
High blood sugar. It is most often due to diabetes mellitus
A
Hyperglycemia
10
Q
A glycated protein that can be used to determine glycemic control over the past 2-3 weeks?
A
Fructosamine
11
Q
What is the main form of lipid storage in the body
A
Triglycerides
12
Q
Name two substances that play a role in the digestion of lipids
A
Lipase
Bile Salts
13
Q
What is the major site of cholesterol synthesis?
A
Liver
14
Q
Which lipoprotein transports most cholesterol?
A
Low Density Lipoprotein (LDL)
15
Q
What is the desirable level for HDL cholesterol
A
> 40 mg/dl
16
Q
Which lipid is the major component plaques in arteries?
A
LDL
17
Q
Made of one molecule of glycerol an d three molecules of fatty acid
A
Triglycerides
18
Q
Largest lipoproteins that transport exogenous triglycerides and account for the turbidity of serum following a meal
A
Chylomicrons
19
Q
What specimen is required for a lipid profile?
A
Serum collected after a 10-12 hour fast
20
Q
What causes a cream layer on top of plasma after overnight refrigeration
A
High levels of triglycerides or chylomicrons
21
Q
What might lead you to suspect that a specimen was non-fasting?
A
Lipemia
22
Q
Which element is found in protein but
not in carbohydrates or lipids?
A
Nitrogen (16%)
23
Q
What is the waste product of protein catabolism?
A
Urea
24
Q
What is the most common method for measuring serum total protein?
A
Biuret Method
25
What does low total protein cause in the patient?
Edema
26
What are the most common dyes used for direct analysis of a albumin?
Bromcresol Green
Bromcresol Blue
27
How is the concentration of globulins determines in a chemistry profile?
By subtracting albumin from total protein
28
The property of proteins to assume a positive, negative or neutral charge depending on the pH of the medium
Amphoterism
29
What is the name of the instrument used to quantitate protein fractions following serum protein?
Densitometer
30
Which protein fraction normally accounts for over half of the serum total protein?
Albumin
31
In electrophoresis of serum at pH 8.6, which fraction is the fastest moving?
Albumin
32
What causes increased albumin?
Dehydration
33
What causes decreased alpha-1 globulin?
Alpha 1 trypsin deficiency
34
What causes a decreased gamma globulin fraction?
Hypogammaglobulinemia
35
Which immunoglobulin is increased in Waldenstrom's macroglobulinemia?
IgM
36
Which band is normal in urine electrophoresis?
Albumin
37
A spike is observed in the gamma region on urine electrophoresis. What is present?
Bence Jones Protein
38
Name a band that is seen in normal CSF electrophoresis but not normal in serum protein electrophoresis?
Pre-albumin
39
Gamma globulins that precipitate in the col and present with multiple myeloma, rheumatoid arthritis, polycythemia, leukemia...
Cryoglobulins
40
An organic catalyst
Enzyme
41
An organic cofactor required for an enzymatic reaction?
Coenzyme
42
Slightly different forms of an enzyme that catalyze the same reaction
Isoenzyme
43
What specimen is required for most enzyme determination
Serum
44
What is the substrate for lipase?
Triglycerides
45
What is the substrate for amylase?
Starch
46
Which enzyme is most specific for acute pancreatitis?
Lipase
47
In which disease do the highest elevations of alkaline phosphatase occur?
Paget's Disease
48
With which clinical condition are the highest levels of CK seen?
Duchenne's muscular dystrophy
49
Which clinical condition results in the highest levels of LD?
Pernicious Anemia
50
What is the most specific cardiac marker?
Cardiac Troponin
51
What are the substrate for AST?
Aspartate
A-ketoglutarate
52
Which disease state has the highest elevation of AST and ALT?
Acute Hepatitis
53
Which enzyme is sensitive indicator of alcoholism?
Gamma-glutamyltranspeptidase
54
Which enzyme would be helpful in establishing of bone disease?
Alkaline Phosphatase
55
Which enzymes would be helpful in establishing a diagnosis of muscle disorders?
CK
AST
LD
Aldolase
56
Name three substances that are elevated in the blood with renal disease
BUN/Urea
Creatinine
Uric Acid
57
The end product of protein metabolism
Urea
58
What is the formula for converting BUN to urea?
Urea = BUN x 2.14
59
Where is 98% of the body's creatine located
Muscles
60
The anhydride of creatine and is formed from creatine by splitting out of water
Creatinine
61
What reaction is used to measure creatinine
Jaffe Reaction
62
What is the least variable nitrogenous constituent of blood?
Creatinine
63
The end product of purine metabolism
Uric Acid
64
What reagent is commonly used to measure uric acid?
Uricase
65
An acute, often fetal encephalopathy and fatty degradation of the liver seen primarily in children
Reye's Syndrome
66
Which amino acid is increased in the blood of patients with phenylketonuria?
Phenylalanine
67
What may result if blood for PKU is drawn before 24 hours of age?
False negative
68
Which amino acids are increased in maple syrup urine disease?
Leucine
Isoleucine
Valine
69
The degradation product of heme
Bilirubin
70
Which protein transports bilirubin in the blood?
Albumin
71
What substances related to bilirubin metabolism are normally found in the urine?
Urobilinogen
72
Name the two types of bilirubin
Conjugated Bilirubin
Unconjugated Bilirubin
73
Which bilirubin fractions are analyzed in the laboratory?
Total and Direct
74
Which form of bilirubin can be excreted in the urine?
Direct Bilirubin
75
Name a source of error that can decrease the level of bilirubin in a specimen
Exposure to light
76
In hemolytic disease of the newborn, which bilirubin fraction is elevated?
Indirect
77
Which disorder results in highest levels of conjugated bilirubin?
Obstructive liver disease
78
What type of method used for most hormones?
Immunoassays
79
What is the pre-cursor in the biosynthesis of all steroid hormones?
Cholesterol
80
Which endocrine gland releases tropic hormones that regulate other endocrine glands?
Anterior Pituitary
81
What hormone stimulates production of sperm and eggs?
Follicle Stimulating Hormone
82
What hormone stimulates the thyroid to produce T3 and T4?
Thyroid Stimulating Hormone
83
What hormone stimulates the adrenal cortex to produce corticosteroids?
Adrenocorticotropic Hormone
84
What hormone produced in the hypothalamus and stored in pituitary that regulates reabsorption of water from the DCT?
Antidiuretic Hormone
85
What hormone produced in adrenal cortex that increases retention of Na and excretion of K and H?
Aldosterone
86
A tumor of adrenal medulla that produces large amounts of catecholamines and causes hypertension?
Pheochromocytoma
87
Produced in the ovaries that prepares the uterus for pregnancy and stimulates lactation
Progesterone
88
What is the major estrogen produced by the ovaries?
Estradiol
89
Which hormone are used to asses fetal well-being?
Estriol
90
Which hormone is used to detect pregnancy?
Human Chorionic Gonadotropin
91
Which hormone can be measured by a home testing kit to determine the time of ovulation?
Luteinizing Hormone
92
What further thyroid testing is recommended when the TSH is abnormal?
Free T4
93
Produced in the parathyroid glands that increases serum calcium and decreases phosphates
Parathyroid Hormone
94
Produced in the alpha cells in the pancreas that increases glucose levels
Glucagon
95
Substances that carry electric current when dissolved in water
Electrolytes
96
What are the major electrolytes?
Sodium
Potassium
Chloride
Bicarbonate
97
What is the major extracellular cation?
Sodium
98
What is the major intracellular cation?
Potassium
99
What is the major extracellular anion?
Chloride
100
What is the major intracellular anion?
Phosphate
101
Which hormone regulates the concentration of sodium?
Aldosterone
102
How are sodium and potassium usually measured?
Ion Selective Electrodes
103
What is the approximates ration of potassium between RBCs and serum?
20:1
104
What is the approximate ration of sodium to potassium in serum?
30:1
105
What clinical condition results from very high or very low potassium levels?
Cardiac Arrythmias
106
Which disease is characterized by a high concentration of sodium and chloride in sweat?
Cystic Fibrosis
107
A topical drug used in the sweat test to stimulate sweat glands
Pilocarpine
108
What happens to CO2 if the sample is exposed to air?
Decreases
109
Which form of calcium is physiologically active?
Ionized
110
What is the reference method for total calcium?
Atomic Absorption
111
What is the most common cause of hypercalcemia?
Primary Hyperparathyroidism
112
What happens to calcium when phosphorus is increased?
Decrease
113
Which protein transports iron?
Transferrin
114
Where is most of the iron in the body?
Hemoglobin
115
Name two storage forms of iron
Ferritin
Hemosiderin
116
An intermediary in carbohydrate metabolism
Lactic acid
117
What specimen is required for blood gases?
Heparinized arterial blood
118
A volumetric pipette has an accuracy of?
1:1000
119
A pipette with bulb close to the delivery tip used for viscous fluids and is called
Ostwald-Folin
120
Which of the following is considered as the “gold standard” technique for drug analysis and why?
GC/MS because of its specificity and sensitivity.
121
In the non-enzymatic method for the determination of triglycerides is converted to glycerol and finally to formaldehyde. What is the method of choice for the determination of formaldehyde?
Hantzch
122
Which of the following has the symptoms of toxicity that mimics the cardinal signs of pheochromocytoma?
Mercury
123
Two consecutive values have fallen outside of the same 2s limit. This rule can apply to a single level during 2 consecutive runs or both levels of control during the same run. Which Westgard rule is described and what error does it suggest?
22s rule; Systematic error
124
Which of the following statements may be associated with the activity of insulin?
Stimulates glycogenesis in the liver
125
Which of the following is formed through anaerobic metabolism in the skeletal muscles during exercise?
Ammonia
126
What is the form of EDTA that is a di-potassium salt and has better stability?
Sequestrene
127
In neonatal thyroid screening, what thyroid condition is detected?
Hypothyroidism
128
An admitted patient has the following laboratory tests scheduled today: FBS, lipid profile, CBC, prothrombin time, and blood culture. What color tube sequence should be followed by the phlebotomist when collecting her blood sample?
Yellow, light blue, red, lavender
129
Given the laboratory results:
Blood pressure — Pulse — Urine metanephrines —
High
100 bpm
greater than 2 times the upper limit
Pheochromocytoma
130
What are the products formed by the forward reaction of aspartate aminotransferase?
Oxaloacetate and glutamate
131
Which among the following is the most sensitive indicator for liver damage from ethanol intake?
GGT
132
Analysis of CSF for oligoclonal bands is used to screen for which of the following disease states?
Multiple Sclerosis
133
Which of the following multi-rule combinations is considered the classic “Westgard Rules”?
12s/22s/R4s/41s/10x
134
Which of the following is the final volume of the solution divided by the amount of solute used?
Dilution factor
135
The process wherein ALP catalyzes the hydrolysis of 4-nitrophenylphosphate (4-NPP) follows what principle?
Kinetic Colorimetric
136
Which of the following conditions is caused by the leakage of blood out of a vein and under the skin during venipuncture and can cause discomfort or pain and can complicate further collections from that site?
Hematoma
137
What stimulates the thyroid gland to release thyroid hormones?
Pituitary Gland
138
A commonly used method for the quantitation of serum total proteins is the biuret procedure. What is responsible for the formation of the color produced in the biuret reaction?
The number of peptide bonds
139
The Kjeldahl technique is the reference method for the determination of serum total protein. What is the basis for this method?
Quantitation of the nitrogen content of protein
140
Which of the following methods for Urea measures the rate of disappearance of nicotinamide adenine dinucleotide?
UV enzymatic method
141
Ethanol, also known as “grain alcohol”, is one of the major substance abuse problems in the world. It could lead to blurry vision, incoordination, slurred speech and hangover. What metabolite is responsible for this hangover effects?
Acetaldehyde
142
Which among the following substances is most closely associated with the measurement of the pressure of dissolved CO2 (pCO2) in the blood?
Bicarbonate
143
Which glucose method can employ a polarographic oxygen electrode?
Glucose oxidase
144
Which of the following reagent systems contains the components sulfanilic acid, hydrochloric acid and sodium nitrite?
Diazo
145
What could likely be the result of an impaired generation of GnRH from the hypothalamus?
Hypogonadism
146
What part of the spectrophotometer is used to adjust the machine into 0% transmittance?
Zero control knob
147
When an acute myocardial infarction occurs, in what order (first to last) will the following enzymes become elevated in the serum?
1. AST
2. Lactate dehydrogenase
3. Creatine kinase
C-A-L (3-1-2)
148
Trinder’s reagent consisting for mercuric chloride, ferric nitrate, and hydrochloric acid may be used to quantitate which drug?
Salicylate
149
Which of the following sequence of procedures is correct during venipuncture?
Apply tourniquet, check for puncture site, insert the needle, pull the plunger
150
Serum protein electrophoresis is routinely performed on the serum obtained from a clotted blood specimen. What results would one get if a plasma specimen is used instead?
Electrophoresis will show an extra fraction in the beta-gamma region (INCREASED)
151
Which of the following statements is not true about anabolic steroids?
1. Toxic effects appear with short-term use of the drug 2. Utilized as a treatment for male hypogonadism
3. It is chemically related to testosterone
4. Toxic effects in males include hirsutism
1,4
152
Which of these steps is not essential in the enzymatic method for cholesterol determination?
Preliminary saponification of cholesteryl esters w/ warm KOH
153
Which of the following is not a characteristic of hemolytic jaundice?
1. Unconjugated serum bilirubin level increased 2. bilirubin level increased
3. Urinary urobilinogen level decreased
4. Fecal urobilin level decreased
2,3,4
154
In pediatric patients, parents must be asked to leave the room to avoid distractions during the venipuncture procedure. Potential venipuncture sites in pediatric patients include the medial backside of the wrist, the dorsum of the foot, the scalp, and the medial ankle.
First statement is false, second statement is true.
155
A “To-Contain” pipet is called as such for which of the following reasons?
It holds a particular volume but does not deliver the exact volume.
156
Which of the following conditions is caused by the leakage of blood out of a vein and under the skin during venipuncture and can cause discomfort or pain and can complicate further collections from that site?
Hematoma
157
Which of the following is the appropriate analyte to evaluate the sufficiency of renal function and the severity of kidney damage?
1. Creatinine 2. Urea
3. Uric acid 4. Ammonia
1, 2, 3 (Creatinine, Urea, Uric Acid)
158
What are the products formed by the forward reaction of aspartate aminotransferase?
Oxaloacetate and glutamate
159
Which of the following statements is not true about partially compensated respiratory alkalosis?
1. pCO2 is higher than normal
2. Bicarbonate is higher than normal
3. More CO2 is eliminated through the lungs by hyperventilation 4. Renal reabsorption of bicarbonate is decreased
1,2, 4
160
The Chemistry section head is having a demanding workload during her morning shift. She did not bother to separate the serum from the clot after spinning the gold top vacutainer tube and proceeded with the analysis. What could be the possible outcome of the result if the sample is to be tested for glucose and for what reason?
The result will have low amounts of glucose level since the blood cells have metabolized some of the glucose present in the serum.
161
Two consecutive values have fallen outside of the same 2s limit. This rule can apply to a single level during 2 consecutive runs or both levels of control during the same run. Which Westgard rule is described and what error does it suggest?
22s rule; Systematic error
162
A commonly used method for the quantitation of serum total proteins is the biuret procedure. What is responsible for the formation of the color produced in the biuret reaction?
The number of peptide bonds
163
The process wherein ALP catalyzes the hydrolysis of 4-nitrophenylphosphate (4-NPP) follows what principle?
Colorimetric
164
When present in increased concentration, which of the following apolipoproteins would be associated with a decreased risk of coronary artery disease?
Apo AI
165
Marsha is employed as Medical Technologist after passing the licensure exams. She is assigned within the Clinical Chemistry section and today she is tasked to run the tests in the analyzer. She proceeded to load the samples and two levels of controls. When the results were out, she noticed that the controls were outside of the control range. Upon investigation, she found out that a scheduled preventive maintenance activity was not performed the previous day. Marsha completes the preventive maintenance, recalibrates and does a re-run of the controls and samples. The results for the controls are now within range, Marsha documents the missed preventive maintenance and how the problem was resolved. Are Marsha’s actions part of the quality control program?
Yes, a quality control program includes reagents, controls, equipment and preventive maintenance.
166
In the peripheral tissues, the bicarbonate diffuses out of the red blood cell. To maintain electrical neutrality, this diffusion of bicarbonate is accompanied by a shift of chloride out of the red blood cells.
Both statements are true
167
Basic arterial blood gas collection rules state that we are only to use green-top, heparin- containing vacutainer tubes for ABG. Why?
Heparin is the only anticoagulant that doesn't alter the blood pH.
168
Basic arterial blood gas collection rules state that we are only to use green-top, heparin- containing vacutainer tubes for ABG. Why?I
Heparin is the only anticoagulant that doesn't alter the blood pH.
169
You are the assigned phlebotomist for the AM shift. Your first patient is to be tested for STAT serum potassium. The patient is bedridden and a little overweight so you had to do a bit of ‘probing’ in order to draw blood. You forwarded the specimen to the laboratory for processing. The serum potassium concentration had been reported as 5.9 mmol/L. This value was abnormally high when compared to the reference range for potassium. The medical technologist assigned in the clinical chemistry department did the test twice and the 2nd run yielded a result of 6.1 mmol/L. She releases the result and made sure she put “TEST DONE TWICE” in the remarks. Did the medical technologist make the right call by releasing the result after the 2nd run?
No, the probing of the vein could've contributed to hemolysis thereby falsely increasing values.
170
What is the ideal collecting device for arterial puncture?
1-3 mL, disposable, self-filling, plastic syringe
171
Which glucose method can employ a polarographic oxygen electrode?
Glucose oxidase
172
Glucose oxidase catalyzes the oxidation of glucose to gluconic acid and hydrogen peroxide. In the presence of the enzyme peroxidase, a reduced chromogen is oxidized to give a colored compound whose absorbance is measured spectrophotometrically. Which of the following chromogen-end color product is incorrectly matched?
O-toluidine—blue
173
Protein classes may be differentiated on the basis of their physical characteristics. What property distinguishes albumin from globulin?
Solubility in sulfosalicylic acid
174
In the visible light spectrum, the color red is in what nanometer range?
620—750 nm
175
What is the final concentration if a 2% solution is diluted to 1:100?
0.02%
176
The Kjeldahl technique is the reference method for the determination of serum total protein. What is the basis for this method?
Quantitation of the nitrogen content of protein
177
Which among the following substances is most closely associated with the measurement of the pressure of dissolved CO2 (pCO2) in the blood?
Bicarbonate
178
The Kjeldahl technique is the reference method for the determination of serum total protein. What is the basis for this method?
Quantitation of the nitrogen content of protein
179
Which of the following laboratory results characterizes menopausal period as experienced by women between the ages of 45-55 years old?
1. Increased FSH
2. Decreased LH
3. Decreased estradiol 4. Increased estrone
1,3,4
180
Which among the following conditions would present an increased serum anion gap?
Lactic acidosis
181
Which of the following methods for Urea measures the rate of disappearance of nicotinamide adenine dinucleotide?
GLDH coupled enzymatic
182
Mia, who had just given birth, has been drug-free for almost 2 months. Lately, she has been experiencing a myriad of symptoms such as hypothermia, palpitations, cold sweats, and nightmares. But she has been thinking of going back to her lifestyle of being reliant on certain drugs to make her forget about her newborn’s recent passing. Her baby had a number of complications, way beyond saving, which led to an untimely death. What could’ve been the substance that Mia was addicted to?
Heroin
183
What quadrant on the hazard labeling system by NFPA symbolizes “flammability hazard information”?
Red quadrant
184
In most cases, which among the following conditions is paralleled with hyperchloremia?
Hypernatremia
185
Jessa, a medical technologist, will dispense 0.5 mL serum to a test tube. What is the best pipette she must use
100-1000ul Micropipette
186
Serum is mixed with alkaline picrate and the rate of change in absorbance is measured. The detection of color formation is timed to avoid interference of non-creatinine chromogens. Which of the following methods for creatinine determination is described by this principle?
Jaffe-Kinetic Reaction
187
Uricase acts on uric acid to produce _____________, carbon dioxide and hydrogen peroxide. Hydrogen peroxide reacts with chromogen, ___________ and DHBS to yield quinoneimine, a red-colored complex. Which pair of words will complete the blanks?
allantoin; amino-4-antipyrine
