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BOARD EXAM > CLINCHEMISTRY > Flashcards

CLINCHEMISTRY Flashcards

1
Q

Chain-of-custody procedures must be followed for:

a. Blood specimens for alcohol level determination
b. Routine urinalysis for glucose and ketones
c. Therapeutic drug threshold determinations
d. Throat swabs of group A beta streptococcus screening

A

A. Blood specimen for alcohol level determination

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2
Q

Calibration is defined as:
How close results are to one another

How close a test result is to the true value

Specimen that is similar to patient’s blood; known concentration of constituent

Comparison of an instrument measure or reading to a known physical constant

A

Comparison of an instrument measure or reading to a known physical constant

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3
Q

Thepreparation of a patientforstandard glucose tolerance testing shouldinclude:*

A high carbohydrate diet for 3 days

A low carbohydrate diet for 3 days

Fasting for 48 hours prior to testing

Bed rest for 3 days

A

high carbs diet for 3 days

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4
Q

A 25-year-old man became nauseated and vomited 90 minutes after receiving a standard 75carbohydratedose foranoralglucosetolerance test. Thebest course ofaction is to:

Give the patient a glass of orange juice and continue the test

Start the test over immediately with a 50 g carbohydrate dose

Draw blood for glucose and discontinue test

Place the patient in a recumbent position, reassure him and continue the

A

Draw blood for glucose and discontinue test

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5
Q

Which of the following values obtained during a glucose tolerance test is diagnostic of diabetes mellitus?

2-hour specimen = 150 mg/dl (8.3 mmol/L)

Fasting plasma glucose = 126 mg/dl (6.9 mmol/L)

Fasting plasma glucose = 110 mg/dl (6.1 mmol/L)

2-hour specimen = 180 mg/dl (9.9 mmol/

A

Fasting plasma glucose = 126 mg/dl (6.9 mmol/L)

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6
Q

Apatient withhemolyticanemiawill:

Show a decrease in glycated Hb value

Show an increase in glycated Hb value

Show little or no change in glycated Hb value d demonstrate an elevated HbA1

Demonstrate an elevated HbA1

A

Show a decrease in glycated Hb value

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7
Q

An increase in serum acetone is indicative of a defect in the metabolism of:

Carbohydrates

Fat

Urea nitrogen

Uric acid

A

Carbohydrate

*Increased in ketones is found when there is a decreased use of carbohydrates, such as diabetes

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8
Q

Oneinternational unitof enzymeactivityistheamountofenzymethatwill,underspecifiedreactionconditions ofsubstrateconcentration,pH andtemperature,causeutilizationofsubstrateattherateof:

1 mol/min

1mmol/min

1 μmol/min

1 nmol/min

A

1 umol/min

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9
Q

In spectrophotometric determination, which of the following is the formula for calculating the absorbance of a solution?

(absorptivity x light path)/concentration

(absorptivity x concentration)/light path

absorptivity x light path x concentration

(light path x concentration)/absorptivity

A

absorptivity x light path x concentration

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10
Q

(light path x concentration)/absorptivity

Feedback

A = abc
Absorbance = absorptivity x light path x concentration.

Highlevels of which lipoprotein class are associated with decreased risk of acceleratedatherosclerosis?

*

1/1

Chylomicrons

VLDL

LDL

HDL

The chemical composition of HDL corresponds to:

*

1/1

Trigyceride 60%, cholesterol 15%, protein 10%

Trigyceride 10%, cholesterol 45%, protein 25%

Triglyceride 5%, cholesterol 15%, protein 50%

Trigyceride 85%, cholesterol 5%, protein 2%

A9-month-old boy from Israel has gradually lost the ability to sit up, and develops seizures. He has an increased amount of a phospholipid called ganglioside in his neurons, and helacksthe enzymehexosaminidaseAinhisleukocytes. Thesefindings suggest:
Neimann-Pick disease

Tay-Sachs disease

Phenylketonuria

Hurler syndrome

A

Tay-Sachs disease

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11
Q

Inwhich of the following conditions does decreased activity of glucuronyl transferaseresultinincreased unconjugated bilirubin and kernicterus inneonates?

Gilbert disease

Rotor syndrome

Dubin-Johnson syndrome

Crigler-Najjar syndrome

A

Crigler-Najjar Syndrome

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12
Q

Which of the following enzymes of heme biosynthesis is inhibited by lead?

Delta-aminolevulinate dehydratase

Porphobilinogen synthase

Uroporphyrinogen synthase

Bilirubin synthetase

A

Delta-aminolevulinate dehydratase

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13
Q

Lead inhibits 3 enzymes in the heme biosynthesis pathway, what are those enzymes?

A

delta-aminolevulinic acid dehydratase (ALAD), coproporphyrinogen oxidase, and ferrochelatase

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14
Q

Which of the following clinical disorders is associated with the greatest elevation of lactate dehydrogenase isoenzyme 1?

Pneumonia

Glomerulonephritis

Pancreatitis

Pernicious anemia

A

Pernicious anemia

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14
Q

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are both elevated in which of the following diseases?

Muscular dystrophy

Viral hepatitis

Pulmonary emboli

Infectious mononucleosis

A

Viral Hepatitis

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15
Q

In which of the following conditions would anormallevel of creatine kinase be found?

Acute myocardial infarct

Hepatitis

Progressive muscular dystrophy

Intramuscular injection

A

Hepatitis

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16
Q

A 10-year-old child is admitted to pediatrics with an initial diagnosis of skeletal muscle disease. The best confirmatory tests would be:

Creatine kinase and isocitrate dehydrogenase

Gamma-glutamyl transferase and alkaline phosphatase

Aldolase and creatine kinase

Lactate dehydrogenase and malate dehydrogenas

A

Aldolase and CK

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17
Q

Themostheat labile fraction of alkaline phosphatase is obtained from:

Liver

Bone

Intestine

Placenta

A

Bone

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18
Q

Cholinesterase levels are generally assayed to aid in diagnosis of:

Pancreatitis

Methamphetamine overdose

Organophosphate poisoning

Hepatobiliary disease

A

Organophosphate poisoning

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19
Q

lsoenzyme assays are performed to improve:

Precision

Accuracy

Sensitivity

Specificity

A

Specificity

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20
Q

Themain functionofserum albumininthe peripheralbloodisto:

Maintain colloidal osmotic pressure

Increase antibody production

Increase fibrinogen formation

Maintain blood viscosity

A

Maintain colloidal osmotic pressure

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21
Q

A characteristic of the Bence Jones protein that is used to distinguish it from other urinary proteins is its solubility:

In ammonium sulfate

In sulfuric acid

At 40-60°C

At 100°C

A

At 100°C

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22
Q

The identification of Bence Jones protein is best accomplished by:

Sulfosalicylic acid test

Urine reagent strips

Immunofixation electrophoresis

Immunoelectrophoresis

A

Immunofixation

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23
Q

A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is:

Ammonia

ALT

AST

GGT

A

Ammonia

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24
Q

In monitoring glomerular function, which of the following tests has the highest sensitivity?

Urine sodium

BUN/creatinine ratio

Creatinine clearance

Urea clearance

A

Crea Clearance

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25
Q

Which term describes a congenital disorder that is characterized by a split in the albumin band when serum is subjected to electrophoresis?

Analbuminemia

Anodic albuminemia

Prealbuminemia

Bisalbuminemia

A

Bisalbumin

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26
Q

Which ofthefollowing serum proteins migrate withthebeta-globulins on cellulose acetate atpH 8.6?

Ceruloplasmin

Hemoglobin

Haptoglobin

C3 component of complement

A

C3 component of complement

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27
Q

The expected blood gas results for a patient in chronic renal failure would match the pattern of:

Metabolic acidosis

Respiratory acidosis

Metabolic alkalosis

Respiratory alkalosis

A

Metabolic acidosis

28
Q

Selectthetest which evaluates renal tubular function.

IVP

Creatinine clearance

Osmolality

Microscopic urinalysis

A

Osmolality

29
Q

Theosmolalityofa urine or serum specimenismeasured by a changein the:

Freezing point

Sedimentation point

Midpoint

Osmotic pressure

A

Freezing point

30
Q

The hormone that triggers ovulation is:

Follicle-stimulating hormone (FSH)

Luteinizing hormone (LH)

Thyroid-stimulating hormone (TSH)

Human chorionic gonadotropin (HCG)

A

Luteinizing hormone

31
Q

Duringanormal pregnancy, quantitative humanchorionicgonadotropin (HCG)levelspeakhow manyweeks afterthelast menstrualperiod?

2 to 4

8 to 10

14 to 16

18 to 20

A

8 to 10

32
Q

Serum hcg levels peak at ________ weeks after the last menstrual period

A

8 to 10 weeks

33
Q

24-hour homovanillic acid (HVA) is usually ordered to help in diagnosis of:

Cushing disease

Malignant neuroblastoma

Conn disease

Graves disease

A

Malignant neuroblastoma

34
Q

An antiepileptic (or anticonvulsant) used to control seizure disorders is:

Digoxin

Acetaminophen

Lithium

Phenytoin

A

phenytoin

35
Q

Facts lang ni. Urine is typically used to screen for drugs of abuse d/t to the convenience of sample and its ability to detect recent drug exposure

RMT 2024

A
36
Q

Which ofthe followingisnotapotentialsource of postanalytical (postexamination) errors?

Excessive delay in reporting or retrieving a test result

Interpretation of result

Verbal notification of test result

Labeling the specimen at the nurses’ station

A

lABELING THE SPX AT THE NURSES’ STATION

37
Q

The most important diagnosis and therapeutic management decision tool used to interpret test results is:

Statistical analysis

Reference intervals

Specimen acceptability

The age of a patient

A

Reference ranges

38
Q

A laboratory procedure manual should be available to personnel at the workbench and must include the following elements:

Clinical significance, frequency of test performance, quality control processes, calculations, and test interpretations

Step-by-step performance instructions, reference intervals, reagent storage location, specimen collection requirements

Limitation of test performance (interfering substances), corrective action if QC fails, critical values, and reagent preparation

Test principle, criteria for specimen rejection, list of individuals authorized to perform, and calibration procedures

A

Step-by-step performance instructions, ref intervals …

39
Q

Which of these attributesis the advantagefor adding point-of-caretesting?*

Higher test accuracy

Lower costs

Faster TAT

More skilled test personnel

A

Faster TAT

40
Q

The acceptable limit of error in the chemistry laboratory is 2 standard deviations. If you run the normal control 100 times, how many of the values would be out of the control range due to random error?

1

5

10

20

A

5

41
Q

Which of the following wavelengths is within the ultraviolet range?

340 nm

450 nm

540 nm

690 nm

A

340 nm

42
Q

In spectrophotometric analysis, what is the purpose of the reagent blank?

Correct for interfering chromogens

Correct for lipemia

Correct for protein

Correct for color contribution of the reagents

A

Correct for color contribution of the reagents

43
Q

To calibrate the pH electrode in a pH/ blood gas analyzer, it is necessary that:

The barometric pressure be known and used for adjustments

Calibrating gases of known high andl ow concentrations be used

The calibration be performed at room temperature

Two buffer solutions of known pH be used

A

Two buffer solutions of known pH be used

44
Q

Checking instrument calibration, temperature accuracy, and electronic parameters are part of

Preventive maintenance

Quality control

Function verification

Precision verification

A

Function verification

45
Q

To what class of enzymes does lactate dehydrogenase belong?

Isomerases

Ligases

Oxidoreductases

Transferases

A

Oxidoreductases

46
Q

Which of the following enzymes doesnotbelong to the class of enzymes known as the hydrolases?

Alkaline phosphatase

Aldolase

Amylase

Lipase

A

Aldolase

47
Q

If elevated, which laboratory test would support a diagnosis of congestive heart failure?

Homocysteine

Troponin

Albumin cobalt binding D. B-typenatriureticpeptide

B-type natriuretic peptide

A

B-type natriuretic peptide

48
Q

Which of the following enzyme activities can be determined by using a dilute olive oil emulsion substrate, whose hydrolyzed product is monitored as a decrease in turbidity or light scatter?

Alkaline phosphatase

Amylase

Lipase

Trypsin

A

Lipase

49
Q

In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what electrolyte?

Sodium

Potassium

Chloride

Phosphate

A

Chloride

50
Q

Which of the following organs uses glucose from digested carbohydrates and stores it as glycogen for later use as a source of immediate energy by the muscles?

Kidneys

Liver

Pancreas

Thyroid

A

Liver

51
Q

A ratio is:

The amount of one substance relative to the amounts of other substances in the solution

Relative concentrations of the components of a mixture

The gram-molecular mass (or weight) of a compound per liter of solution

Expression of one amount relative to another amount

A

Expression of one amount relative to another amount

52
Q

Concentration is:*

The amount of one substance relative to the amounts of other substances in the solution

Relative concentrations of the components of a mixture

The gram-molecular mass (or weight) of a compound per liter of solution

Expression of one amount relative to another amount

A

The amoun of one substance relative to the amount of other substance in the solution

53
Q

Nephelometry measures the light scatter of:

Ions

Macromolecules complexes

Antibodies

Soluble antigens

A

Macromolecules complexes

54
Q

Which of the following is the most common applicationof immunoelectrophoresis (IEP)?

Identification of the absence of a normal serum protein

Structural abnormalities of proteins

Screening for circulating immune complexes

Diagnosis of monoclonal gammopathies

A

diagnosis of monoclonal gammopathies

55
Q

The most important application of IEP of urine is:

Diagnosis of monoclonal gammopathy

Diagnosis of polyclonal gammopathy

Diagnosis of autoimmune hemolysis

Demonstration of Bence Jones (BJ) protein

A

Demonstration of Bence Jones (BJ) protein

56
Q

Which monochromator specification is required in order to measure the true absorbance of a compound having a natural absorption bandwidth of 30 nm?

50-nm bandpass

25-nm bandpass

15-nm bandpass

5-nm bandpass

A

5 nm bandpass

The narrower the bandpass, the greater the photometric resolution

57
Q

Which of the following conditions is associated with hypernatremia?

Diabetes insipidus

Hypoaldosteronism

Burns

Diarrhea

A

Diabetes insipidus

58
Q

Which formula is most accurate in predicting plasma osmolality?

Na + 2(Cl) + BUN + glucose

2(Na) + 2(Cl) + glucose + urea

2(Na) + (glucose ÷ 18) + (BUN ÷ 2.8)

Na + Cl + K + HCO3

A

2(Na) + (glucose ÷ 18) + (BUN ÷ 2.8)

59
Q

Identify the enzyme deficiency responsible for type 1 glycogen storage disease (von Gierke’s disease)

Glucose-6-phosphatase

Glycogen phosphorylase

Glycogen synthetase

β-Glucosidase

A

Glucose-6-phosphatase

60
Q

Which of the following abnormal laboratory results is found in von Gierke’s disease?

Hyperglycemia

Increased glucose response to epinephrine administration

Metabolic alkalosis

Hyperlipidemia

A

Hyperlipidemia

61
Q

Which test is the most sensitive in detecting early monoclonal gammopathies?

High-resolution serum protein electrophoresis

Urinary electrophoresis for monoclonal light chains

Capillary electrophoresis of serum and urine

Serum-free light chain immunoassay

A

Sreum-free light chain immunoassay

62
Q

Which test is the most useful way to evaluate the response to treatment for multiple myeloma?

Measure of total immunoglobulin

Measurement of 24-hour urinary light chain concentration (Bence–Jones protein)

Capillary electrophoresis of M-protein recurrence

Measurement of serum-free light chains

A

Measurement of serum-free light chains

63
Q

Which of the following mechanisms accounts for the elevated plasma level of β lipoproteins seen in familial hypercholesterolemia (formerly type II hyperlipoproteinemia)?

Hyperinsulinemia

ApoB-100 receptor defect

ApoC-II activated lipase deficiency

ApoE3 deficiency

A

Apo B-100 receptor defect

64
Q

Which enzyme deficiency is most commonly associated with familial hypertriglyceridemia associated with fasting plasma cholomicrons (formerly type I hyperlipoproteinemia)?

β Glucocerebrosidase deficiency

Post–heparin-activated lipoprotein lipase deficiency

Apo-B deficiency

Apo-C-III deficiency

A

Post-heparin-activated lipoprotein lipase deficiency

65
Q

Which of the following enzymes is considered most tissue specific?

Creatine kinase (CK)

Amylase

Alkaline phosphatase (ALP)

Alcohol dehydrogenase (ADH)

A

ADH

66
Q

Which statement about TSH and T4 in early pregnancy is correct?

TSH and thyroid hormones fall

TSH falls and thyroid hormones rise

TSH and thyroid hormones both rise

TSH rises and thyroid hormones fall

A

TSH falls and thyroid hormones rise

67
Q
A

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