Clinical Biochemistry PP Flashcards
1
Q
Increased level of unconjugated bilirubin in
newborns can be seen in:
a. Physiological jaundice in newborns.
b. Crigler-Najjar’s syndrome.
c. Inborn atresia of biliary ducts.
d. Hemolytical disease of newborns
e. Degradation of postpartum hematomas
A
ABDE
2
Q
Reaven’s syndrome is:
a. A synonym for metabolic syndrome.
b. Impairment of liver function due to salycylate intake.
c. Impaired glycosis, hyperuricemia, dyslipidemias.
d. In obese patients.
A
ACD
3
Q
Following hereditary diseases are commonly associated with liver damage:
a. Gilbert’s disease
b. Wilson’s disease
c. Deficiency of alpha-1 antitrypsin
d. Hemochromatosis
A
BCD
4
Q
Secondary hyperaldosteronism can be usually observed in:
a. Cardiac/heart insufficiency
b. Chronic liver disease
c. Dehydration
d. Nephrotic syndrome
e. Renal artery stenosis
A
ABCDE
5
Q
Increased level of cardiac troponin can be connected with:
a. Severe anemia
b. Contusion of myocardium in patients with polytrauma
c. Severe sepsis
d. Tachyarrhythmisas in thyreotoxicosis
A
ABCD
6
Q
Which of the following are increased in children?
Children in comparison with adults have higher serum values of:
a. Iron
b. Cholesterol
c. ACP
d. ALP (alkaline phosphatase)
e. Inorganic phosphate
A
CDE
7
Q
Impairment of renal tubules leads to:
a. Microalbumin
b. β2- microglobulins
c. Albumin in urine
d. Macroproteins in urine
A
A(?)B
8
Q
Alcohol intoxication leads to:
a. Increase of serum osmolality
b. Metabolic acidosis
c. Hyperuricemia
d. Hypoglycemia
A
ABCD
9
Q
Excretion of 3000 mmol of waste metabolites, 5500ml/day of urine production, urine osmolality of 350 mmol/kg:
a. Oliguria
b. Polyuria
c. We should know GFR to evaluate this case.
d. All metabolites are excreted.
Same questions different options:
a-‐ Value of glomerular filtration is necessary for evaluation
b-‐ Not all catabolites are excreted.
The state can be osseced as oliguria
c-‐ All catabolites are excreted
d-‐ The patient has polidypsia
A
First Question: B
Second Question: B
10
Q
Highest amount of myoglobin in AMI occurs at:
a. 12h
b. 36h
c. 72h
d. 3-6h
A
A
11
Q
Laboratory finding of hyperkalemia and hyperchloremic metabolic acidosis can be seen in:
a. Renal failure
b. Hyperaldosteronism
c. Hypoaldosternism or pseudohypoaldosteronism.
d. Treatment with ACE inhibitors.
A
ACD
12
Q
Main intracellular antioxidants:
a. Glutathione
b. Uric acid
c. Ascorbic acid
d. Homocystein
A
A
13
Q
Markers of osteoclastic activity:
a. Serum level of osteoclasts
b. Bone isoenzyme of ACP
c. Bone isoenzyme of ALP
d. Deoxypiridoline in urine
e. Hydroxyproline
A
BDE
14
Q
Evaluation of risk for atherosclerosis:
a. 1-2 weeks after AMI.
b. 6 weeks after AMI.
c. At any time.
d. After correction of troponin levels.
A
?
15
Q
Which meaning is true in iron deficiency?
a. Serum transferin is increased.
b. Serum transferin is decreased.
c. Serum ferritin is increased.
d. Serum ferritin is decreased.
A
AD
16
Q
Following tests continuously rise during pregnancy:
a. Plasma estriol.
b. Estriol elimination in urine.
c. Chorionic gonadotropin in serum.
d. Creatine kinase activity in serum.
A
AB
17
Q
- Electrophoretic pattern of chronic liver disease is:
a. Decreased albumin, increased alpha 1 and beta 2 globulins.
b. Beta-gamma bridging.
c. Decreased albumin, alpha 1, alpha 2 and beta 1 globulins, increased gamma-globulins.
d. Increased alpha 1 and alpha 2 globulins.
A
BC
18
Q
Aldosterone production is enhanced:
a. Isotonic dehydration
b. Hypertonic dehydration
c. Hypotension
d. ACTH
A
ACD
19
Q
Glomerular hematuria is confirmed by:
a. Urobilinogen in urine
b. Proteinuria
c. Finding of erythrocyte casts in urine
d. Leukocyturia
A
C
20
Q
The following enzymes are absent in humans:
a. Uricase
b. Xanthine oxidase
c. Urease
d. Glucose oxidase
A
ACD
21
Q
Treatment with ethanol is applied in the following intoxications:
a. Methanol
b. Ethylene glycol
c. Antituberculotic drugs
d. Paracetamol
A
AB
22
Q
In acute renal failure:
a. Serum urea increase is more pronounced than that of creatinine.
b. Serum creatinine rises more rapidly than urea.
c. GFR falls due to hypoperfusion of renal cortex.
d. Intense tubular resorption of water with urea is present.
A
A(?) BC
23
Q
Absorption of Vitamin B12 depends on:
a. Absorption of lipids.
b. Pancreatic functions.
c. Presence of intrinsic factor in stomach.
d. Presence of homocystein.
A
C
24
Q
Jaundice in viral hepatitis B is:
a. Observed before increase of ALT activity.
b. Present in 10% of population.
c. Observed before finding of urobilinogen in urine.
d. Caused by mixed hyperbilirubinemia.
A
BD
25
Bacterial inflammation is characterized by:
a. Increased procalcitonine concentration.
b. Plasma CRP > 100 mg/l.
c. Leukocytosis
d. Increased neopterine concentration.
BC
26
Increased gamma-glutamyltransferase is observed in:
a. Alcoholism
b. Liver steatosis
c. Biliary tract obstruction
d. Secondary liver cancer
ABCD
27
Pregnant women in the 3rd trimester we can
physiologically observe in blood:
a. Increased total cholesterol
b. Decreased albumin
c. Increased creatinine
d. Increased erythrocyte sedimentation rate
e. Decreased total leucocytes count
f. Increased ALP
g. Increased a1-antitrypsin
h. Increased uric acid
ABDFGH
28
The cause of hypokalemia can be administration of:
a. Aldosterone antagonists
b. ACE-inhibitors
c. Glucocorticoids
d. Furosemide
CD
29
29. Marker of increased bone resorption is:
a. Increased bone isoenzyme of alkaline phosphatase.
b. Increased loss of hydroxyproline in urine.
c. All above mentioned tests.
d. Increased level of osteocalcin in serum.
BD
30
30. Pseudohypoparathyroidism is characterized by:
a. Increased losses of inorganic phosphate into urine.
b. Hypokalemia
c. Increased level of parathyroid hormone.
d. Hypocalcemia
CD
31
31. During treatment of acid-base balance disorders the following parameter should be normalized:
a. Both pH and BE
b. pH
c. BE
d. BE in the case of metabolic disorder and pCO2 in respiratory disorders.
B
32
32. Lactic acidosis / metabolic acidosis:
a. Is accompanied with insufficient oxygenation of blood and tissue hypoxia.
b. Is corrected always by hydrogenocarbonate administration.
c. Can accompany diseases of liver, kidney, inborn errors of metabolism, leukemia, etc.
d. Can be caused by impaired lactate degradation.
ACD
33
33. Acute pancreatitis is accompanied with:
a. Hypocalcemia
b. Hypercalcemia
c. Normal activity of amylase
d. Hyperamylasemia
AD
34
34. Increased blood HCO3
- concentration:
a. Long lasting vomitus.
b. Chronic metabolic acidosis.
c. Chronic respiratory acidosis.
d. Acute metabolic alkalosis.
ACD
35
35. Following change(s) in serum can stimulate parathyroid hormone secretion:
a. Decrease of inorganic phosphate concentration.
b. Increase of ionized calcium concentration.
c. Decrease of ionized calcium concentration.
d. Increase of inorganic phosphate concentration.
CD
36
36. Treatment of diabetic ketoacidosis (by insulin) is usually accompanied by:
a. Decrease of ionized fractions of Ca and Mg.
b. Increase of ionized fractions of Ca and Mg.
c. Increase of serum concentration of K, P and Mg.
d. Decrease of serum concentration of K, P and Mg.
AD
37
37. Increased excretional fraction of water can be found:
a. In chronic renal failure.
b. In kidney tubular damage.
c. In acute renal failure.
d. In shock kidney.
AB
38
38. The following tests decrease in pregnancy:
a. Serum albumin
b. Serum urea
c. Glomerular filtration rate
d. Uricemia
AB
39
39. When we compare 2 (and more) results of one method (ex: CRP - other in the same patient, to
decide whether the result significantly … doesn’t change we should take into account:
a. Method precision and interindividual variability.
b. Method precision and intraindividual variability.
c. Method trueness and interindividual variability.
d. Method trueness and intraindividual variability.
B
40
40. Anemia of chronic diseases (ACD) is characterized by (measured in plasma):
a. Increased hepcidin.
b. Increased soluble transferrin receptors.
c. Decreased iron.
d. Decreased transferrin.
e. Decreased ferritin
ACD
41
41. Chronic alcohol abuse is accompanied with:
a. Increased activity of glutamil transferase.
b. Increased concentration of carbohydrate deficient transferring.
c. Increased volume of erythrocytes. (only if it’s referring to size- macrocytic anemia)
ABC
42
42. Protein S-100B:
a. Its increased concentration in serum has (negative) prognostic value in brain trauma.
b. Its decreased concentration in serum has (negative)
prognostic value in brain trauma.
c. Is increasingly produced when astrocytes are damaged.
d. Is increasingly produced when cortex neurons are damaged.
AC
43
43. Plasma urea concentration = 35 mmol/l:
a. Slightly elevated.
b. Highly Elevated.
c. Cannot be survided.
d. Indication for hemodialysis.
BD
44
44. Name the typical disturbance of acid-base balance in
terminal stadium of acute respiratory distress syndrome:
a. Respiratory acidosis
b. Metabolic Acidosis
c. Metabolic alkalosis
d. Hypo with not respond to oxygen treatment.
AB
45
45. Albumin does not transfer:
a. Free fatty acids
b. Calcium
c. Thyroxin
d. Iron
D
46
46. Paradoxical aciduria means:
a. Acid urine in metabolic alkalosis with hypokalemia.
47
47. Buffer base value in serum (Na + K – Cl) is increase in:
a. Metabolic alkalosis
48
48. Primary hyperparathyroidism is characterized by:
a. Hypophosphatemia
b. Hypercalcemia
c. Hypercalciuria
d. Hyperphosphaturia
ABCD
49
49. Methemoglobin:
a. Is produced by hemoglobin oxidation (ex: Fe (II) is converted to Fe (III)).
b. Originates during intoxication by nitrites, aniline dyes or sulfonamides.
c. May be increased in newborns due to immature reducing system
ABC
50
50. During diarrhea:
a. Hypertonic dehydration can occur
51
51. Depression of respiratory centre can occur in pCO2
values :
a. > 8 kPa
b. > 6 kPa
c. < 6 kPa
d. < 8 kPa
D
52
52. Global respiratory insufficiency is defined as:
a. Hypoxemia and hypercapnea.
b. Hypoxemia and hypocapnea.
c. Hypoxemia only.
d. Hypoxemia and respiratory acidosis.?
A D(?)
53
53. When hypokalemia is the most severe:
a. K+ = 2.5mmol/l, blood pH = 7.4
b. K+ = 2.5mmol/l, blood pH = 7.6
c. K+ = 3.5mmol/l, blood pH = 7.6
d. K+ = 2.5mmol/l, blood pH = 7.2
e. K+ = 2,5 mmol/l, blood pH = 7.0 → best possibility if available
DE
54
54. Primary hyperaldosteronism is characterized by:
a. Hypertension
b. Low rennin concentration.
c. High rennin concentration.
d. Hypertension, which responds to ACE-inhibitors.
AB
55
55. Physiological range of pCO2 in arterial blood is:
a. 4.7 – 6.0 kPa
56
56. Kidney tubular damage can be caused by:
a. Organic solvents.
b. Quicksilver and cadmium.
c. X-ray contrast substances.
d. Non-opiate analgesics (non-steroids and inflammatory drugs).
BCD
57
57. For detection of vital fetus danger in last trimester the following determination is indicated:
a. Fetal fibronectin in cervicovaginal secretion.
b. Serum estriol or its losses in urine.
c. hCG in serum or its losses in urine.
d. Alpha 1-fetoprotein in serum.
AB
58
58. Gilbert’s syndrome (juvenile intermittent …) is:
a. Can be diagnosed by long-lasting fasting test.
b. Characterized by increased concentration of unconjugated bilirubin.
c. Benign syndrome.
d. Does not have uroblinogen in urine.?
ABCD
59
59. Metabolic disturbances of acid-base balance are compensated or corrected by:
a. Lung function only.
b. Activity of lung and kidney (in the case of intact renal function, kidney must … primary cause of ABB disturbances.
c. GIT function only.
d. Renal function only.
B
60
60. Decreased activity of cholinesterase can be found in:
a. Organophosphate poisoning
b. Chronic hepatopathy
c. Nephrotic syndrome
d. Protein malnutrition
ABD
61
61. Plasma creatinine value 400 μmol/l:
a. Can be also caused by another disease than renal insufficiency (can have other causes but not diseases, like exercise, diet or drugs).
b. Is dangerous for the patient.
c. Is caused exclusively by renal insufficiency only if ...
d. Is always caused by renal insufficiency.
AB
62
62. Laboratory markers of chronic liver disease are:
a. Polyclonal hyperimmunoglobulinemia (can be used but are of low specificity).
b. Increased tranferrin concentration in serum.
c. Hypoalbuminemia
d. Decreased tranferrin concentration in serum.
ACD
63
63. Positive feedback is found between:
a. Glycemia and glucagon secretion.
b. Concentration of tyrosine in plasma and TSH secretion.
c. Glycemia and insulin secretion.
d. Inorganic phosphate in plasma and parathyroid
hormone secretion
CD
64
64. Highest glucose level is in:
a. Plasma of capillary blood.
b. Plasma of venous blood.
c. Full capillary blood.
d. Full venous blood.
A
65
65. For determination of creatinine clearance is true:
a. 24h urine is collected for creatinine determination.
b. 24h urine volume, patient’s body mass and height must be stated.
c. 3 days before the test and in the day of the test the patient restricts meat and avoids physical effort.
d. Blood is collected for creatinine determination.
ABCD
66
66. Urine pH increases:
a. In diabetics.
b. After diet with meat.
c. After vegetarian diet.
d. In urinary tract infection.
CD
67
67. What acid-base balance disorder would you diagnose with the help of the following graph (pH 7.1, pCO2
2.1 kPa, BE ECT = 23.9 mmol/l)?
a. Acute RAL
b. Acute MAC
c. Fully compensated RAL
d. Fully compensated MAC
D
68
68. Tubular proteinuria is typical for:
a. Intoxication with cadmium.
b. Diabetic nephropathy.
c. Intoxication with arsenic.
d. Intoxication with Amanita phalloides.
A
69
69. Imagine a method in that increased values are pathological. Diagnostic sensitivity of the method is
decreased when:
a. We increase cut-off value.
b. We decrease cut-off value.
c. There are more falsely negative results.
d. There are more falsely positive results.
AC
70
70. Iron is a component of:
a. Catalase
b. Cytochromes
c. Peroxidase
d. Alkaline phosphatase
ABC
71
71. Acidemia is accompanied by:
a. Release of potassium from cells.
b. Shift of dissociative curve of Hb to the right and improvement of O2 release in the tissues.
c. Activation of respiratory center.
d. Increase of ionized fractions of Ca 2+ and Mg2+.
ABCD
72
72. Alkalemia leads to:
a. Decreased stimulation of respiratory center.
b. Decreased of ionized calcium and magnesium in serum.
c. Worsening of oxygen release from oxyhemoglobulin.
d. Decrease of kalemia.
ABCD
73
73. Patient has high titers of antibodies against surface antigen of hepatitis B and high titers of antibodies against envelope antigen of hepatitis B virus. Which
statement is true?
a. It is an indicator of past hepatitis B.
b. The patient underwent seroconversion (and probably
is contagious).
c. The patient underwent seroconversion (and probably is not contagious).
d. The patient has undergone a successful against hepatitis B.
AC
74
74. In patients with Wilson’s disease (hepatolenticular
dystrophy) we can find:
a. Decreased ceruplasmin concentration in blood.
b. Increased concentration of free copper in serum.
c. Decreased loss of copper in urine.
d. Increased concentration of copper in serum.
e. Increased loss of copper in urine
ABE
75
75. If blood was not transported to the laboratory changes can occur:
a. Glycemia decreases.
b. Serum potassium and phosphate increases.
c. Serum potassium increases and phosphate decreases.
d. Serum potassium and phosphate decreases.
AB
76
76. C-peptide is a marker of:
a. Long-term diabetes compensation.
b. Endogenous production of insulin.
c. Possible onset of late complications of diabetes.
d. Acute inflammation.
B
77
77. Cystatin C is:
a. Low-molecular weight protein.
b. Increased in serum as a result of a decrease glomerular.
c. Increased in urine in the case of tubular cells damage.
d. Produced with a constant rate.
ABCD
78
78. The following findings in urine sediment are considered pathological:
a. Hyaline casts
b. Cystine crystals
c. Flat polygonal epithelial cells
d. Round epithelial cells
BD
79
79. Erythrocyte energy:
a. Aerobic
b. Anaerobic glycolysis
c. ….
d. Aerobic glycolysis
BD
80
80. Continuous metabolic alkalosis is caused by:
a. Depletion of extracellular fluid.
b. Chronic depletion.
c. Potassium depletion.
d. Increased aldosterone production.
ABCD
81
81. Uremia is a term for:
a. Increased level of uric acid in serum.
b. Increased level of urea in serum.
c. Finding of blood in urine.
d. Renal failure accompanied by clinical symptoms.
BD
82
82. Concentration of serum myoglobin is dependent on:
a. Physical activity before blood sampling.
b. Sex
c. Muscle mass.
d. None of the answers is correct.
ABC
83
83. To calculate corrected chloride, we have to know serum concentration of:
a. Albumin
b. Bicarbonates
c. Chlorides
d. Sodium
CD
84
84. Sodium concentration in strongly chylous serum by
use of ion selective electrode comparison with flame
photometry is:
a. Lower
b. Higher
c. Less accurate
d. More accurate
BD
85
85. You have just admitted a patient with acute myocardial infarction. In the process of determining the cause of this atherosclerosis complication, you would like to know concentrations of total cholesterol, HDL + LDL cholesterols and triglycerides. When can you take
the blood for determination of these risk factors?
a. At any time.
b. First 2 weeks (best 4 weeks) after myocardium infarction.
c. After normalization of plasma cardiac troponin level.
d. During 24 hours or after 3 months after myocardium infarction.
D
86
86. Gestational diabetes mellitus:
a. Can be related to deficiency of chromium.
b. Is related to hormonal changes during gestation.
c. Develops in the second half of pregnancy.
d. Develops in the first half of pregnancy.
ABC
87
87. Methanol intoxication is characterized by:
a. Brown skin color.
b. Increased osmolar gap.
c. Metabolic acidosis from increased anions.
d. Optic nerve damage.
BCD
88
88. AST/ALT ratio > 1 can be found in:
a. Active liver cirrhosis.
b. After heavy physical work.
c. Metastatic disease of liver.
d. Myocardial infarction.
ABCD
89
89. What acid-base balance disorder would you
diagnose with the help of the following English graph (pH 7.39, pCO2 4.0 kPa, BE ECT – 4.8
mmol/l)?
a. Acute RAL
b. Fully compensated RAL
c. Fully compensated MAC
d. Acute MAC
B
90
90. Characteristic finding in hyperparathyroidism: a. Hypocalcemia and hyperphosphaturia.
b. Hypercalcemia and hypophosphaturia.
c. Hypercalcemia and hyperphosphaturia.
d. Hypocalcemia and hypophosphaturia.
C
91
91. … of indications of hemolysis treatment is serum potassium level higher ... :
a. 8.5 mmol/l
b. 5.5 mmol/l
c. 6.5 mmol/l
d. 7.5 mmol/l
C
92
92. Which of the following possibilities can cause MAC?
a. Hypoalbuminemia
b. Intoxication with methanol or ethylene glycol.
c. Renal failure.
d. Decompensated liver cirrhosis.
BCD
93
93. Three days before glucose tolerance test, the patient
should eat:
a. Diet has no influence on the result.
b. Diet enriched with fat.
c. High-saccharide diet.
d. Low-saccharide diet.
C
94
94. In comparison with adults, one-year old infant has higher upper reference limit of:
a. Urea
b. Alkaline phosphatase
c. α2-globulins
d. Bilirubin
BC
95
95. The main treatment goal in a patient with dyslipidemia is:
a. Increase HDL cholesterol over 1 mmol/l.
b. Decrease hypersensitive CRP under 1 mg/l.
c. Decrease LDL cholesterol under 4 mmol/l.
d. Decrease risk of cardiovascular disease.
D
96
96. Increased concentration of α1-fetoprotein (AFP) in serum can help us in diagnosis of:
a. Multiple myeloma
b. Primary liver cancer
c. Malignant teratoma
d. Metastatic liver cancer
BC
97
97. Ketone bodies in urine can be found as a result of:
a. Lactic acidosis of type B
b. Hypoxia
c. Long-lasting vomitus
d. Starvation
CD
98
98. Creatine kinase:
a. Is increased after epileptic paroxysm.
b. Is increased in myocardial damage.
c. Rises after physical activity.
d. Activity in serum is higher in women than in men.
ABC
99
99. Parametric way for determination reference ranges of laboratory method:
a. Use median and standard deviation for the calculation.
b. Use mean and standard deviation for the
calculation.
c. Need normal distribution.
d. Can be used in all methods.
BC
100
100. Hyperkalemia can be caused by:
a. Antagonists of aldosterone.
b. Furosemide
c. High doses of glucocorticoids.
d. ACE (angiotensin converting enzyme) inhibitors.
e. Renal failure
ADE
101
101. During decrease of glomerular filtration rate, increases serum level of:
a. Cystatin C
b. Creatinin
c. Myoblobin
d. β2 – microglobulin
ABCD
102
102. Electrophoretic type of acute inflammation can be found in patients with:
a. Malignant neoplasia
b. Bronchopneumonia
c. Sepsis
d. Acute myocardial infarction
ABCD
103
103. For glucose to be properly utilized we need:
a. Insulin
b. Inulin
c. Chromium
d. Glucagon
AC
104
104. Tubular proteinuria is typical for:
a. Intoxication with cadmium.
105
105. For adequate absorption and metabolism of Iron is important:
a. Ceruloplasmin
b. Prealbumin c. Transferrin
d. Vitamin C
ACD
106
106. Men compared to women have typical higher activity of:
a. Creatine kinase
b. Gamma glutamyl transferase
AB
107
107. Erythropoietin:
a. Is hemopoietic growth factor.
b. Is produced in kidneys.
c. Is glycoprotein that stimulates erythrocyte maturation.
ABC
108
108. Check values of laboratory results that can be considered as the cause of MAL:
a. Hypoalbuminemia
b. Normochloridemia during hypernatremia (decreased corrected chlorides).
c. Hyperchloridemia during significant hypernatremia (decreased corrected chlorides).
d. Hyperphosphatemia
ABC
109
109. Reference values of pH in arterial blood in an adult person are:
a. 7.36 – 7.44
110
110. Neuromuscular irritability is increased by:
a. None of above mentioned ions.
b. H+
c. Mg2+
d. Ca2+
A
111
111. In kidney failure usually increases serum concentration of:
a. Kallium
b. Magnesium
c. Anorganic phosphate
ABC
112
112. Examination of stool for occult bleeding:
a. Can be performed chemically (pseudoperoxidase reaction of hemoglobin) after 3 days diet.
b. Can be performed immunochemically (Ab against human globin), diet is not necessary.
c. Is a screening method for colorectal carcinoma.
ABC
113
113. All disturbances of ABB:
a. We try to correct to target pH.
b. We try to treat according to primary disease.
ABC
114
114. For determination of urine losses of urea (or for calculation of nitrogen balance) … to deliver:
a. 24h urine preserved by HCl.
b. 24h urine preserved by thymol in isopropanol.
c. 24 urine preserved by cooling.
d. 24h urine without any preservation.
A(?)BC(?)
115
115. Increased concentration of myoglobin in serum 4 hours after chest pain onset diagnosis of acute myocardial infarction.
a. Does not rule out.
b. excludes in persons with renal failure
c. confirms
d. confirms in persons with normal kidney function
only
A
116
116. Determination of microalbuminuria is indicated:
a. In the case of negative proteinuria by strip test in diabetics and hypertonics.
b. Independently on the result of protein determination in urine by a strip test.
c. Only in resting (night) urine.
d. In the case of positive proteinuria by strip test in diabetics and hypertonics.
A (C?)
117
117. Which meaning is correct is acute pancreatitis?
a. Serum trypsin is increased.
b. Serum calcium is decreased due to its binding to fatty
c. C-reactive protein is significantly increased.
ABC
118
118. Check possible causes of MAL:
a. Citrate dialysis
b. Secondary hyperaldosteronism
c. Hypoalbuminemia
d. Primary hyperaldosteronism
ABCD
119
119. Physiological saline solution (0,9% NaCl) has:
a. pH 7.0.
b. Na+ = 155 mmol/l.
c. Cl- = 155 mmol/L
ABC
120
120. Renal tubular cells damage is caused by:
a. Mercury
b. Cadmium
c. Thalium
d. Lead
AB
121
121. Urine stone formation from ammonia-magnesium
phosphate is supported by:
a. Alkaline urine
b. Urinary tract infection
AB
122
122. Marker of long-‐term compensation of diabetes is:
a. Glycated hemoglobin
b. Insulin concentration after a load with 75g of glucose
c. C-peptide
d. Fasting concentration of insulin.
A
123
123. Pernicious anemia:
a. Is caused by deficiency of vit. B12.
b. Is macrocytic.
c. Is often found in patients after gastrectomy.
ABC
124
124. Plasmatic glucose concentration in a fasting random sample of a patient without any complains was 8 mmol/l. Which statement is true?
a. Patient has diabetes mellitus.
b. We invite patient to control blood collection in another day.
c. We will perform o GTT.
d. We collect blood to determine glycemia in the same day.
B
125
125. When blood for acid-base balance and blood gases determination was preserved in laboratory on
thawing ice, the following changes can occur:
a. pH decreases
b. pO2 decreases
AB
126
126. Liver damage (liver necrosis) is characterized by:
a. Lower activity of cholinesterase.
b. Extreme increase of aminotransferases (10-100
times).
c. Higher activity of AST in comparison with ALT.
d. increased activity of cholinesterase
ABC
127
127. Calculate urinary protein loss per 24 hours when you have following results:
Total protein in serum 66 g/l
Total urinary protein 7.4 g/l
Urinary volume per 24h 1427 ml
Patient weight 83 Kg
Urinary protein loss write in grams per day with precision to 1 decimal point. Don’t write the unit itself (g/day) to the result.
a. 10.5 // 10.56
128
128. Hyperglycemia is caused by:
a. Adrenalin
b. Glucagon
c. Cortisol
ABC
129
129. The percentage of results from healthy population within reference ranges is:
a. 95%
b. 99%
c. The number is not defined, but it is usually more than a half.
d. 90%
A
130
130. Peripheral and central type of hypothyreosis can be distinguished by:
a. TSH level
131
131. Multiple myeloma can be accompanied by:
a. Renal amyloidosis
b. High erythrocyte sedimentation rate
c. Osteolytic centers
ABC
132
132. Risk of atherosclerosis increases in:
a. Patients with chronic renal failure
b. Diabetics
c. Hyperinsulinism
ABC
133
133. Oxygen release from blood to tissues is facilitated by:
a. Increase concentration of 2,3-diphosphoglycerate in
erythrocytes
b. Acidemia
c. Alkalemia d. Hyperkapnia
ABD
134
134. Parathormone action is to:
a. Decrease resorption of phosphates I renal tubules.
b. Release calcium from bones.
AB
135
135. Hemolysis increases serum activity of:
a. AST
b. Lactate dehydrogenase
c. Amylase
d. Creatine kinase
AB
136
136. In renal failure:
a. Is usually hyperkalemia.
b. Can be found hyperkalemia in some cases.
c. Is always anuria
d. Is usually hypercalcemia
AB
137
137. Falsely positive results cause:
a. Higher clinical specificity.
b. Lower clinical sensitivity.
c. Lower clinical specificity.
d. Higher clinical sensitivity.
C
138
138. Negative feedback exists between:
a. Glycemia and glucagon secretion.
b. Cortisol concentration in plasma and ACTH secretion.
c. Ionized calcium in plasma and parathormone secretion.
ABC
139
139. Determination of serum hCG (chorionic gonadotropin) concentration is used for:
a. Diagnosis of ectopic pregnancy.
b. Diagnosis of early spontaneous miscarriage.
c. Early diagnosis of pregnancy.
ABC
140
140. Hyperaldosteronism is typically accompanied with:
a. Hypokalemia
141
141. In case of suspicion on macroamylasemia we should send to laboratory:
a. Coagulable blood and first morning urine for determination of amylase.
b. Coagulable blood for serum amylase determination
only
c. Coagulable blood for pancreatic isoenzyme of amylase determination only
d. 24 hour urine for determination of urine amylase only
A
142
142. In patients with renal tubular acidosis type I (distal) is the following finding:
a. Alkaline urine
b. Hypokalemia
c. Tendency to formation of urine stones from calcium phosphate.
ABC
143
143. Bacterial meningitis can be distinguished by:
a. Low glucose, increase protein, CRP and lactate, pleocytosis with prevailing polynuclear cells.
b. Protein-cytological association.
AB
144
144. What statement is true?
a. Secretion of aldosterone is regulated by kidney through rennin and angiotensin.
b. Aldosterone is created by suprarenal cortex.
c. Aldosterone increases losses of potassium in urine.
ABC
145
145. In extrarenal cause of renal failure:
a. Urine osmolality greater than serum osmolality.
b. Sodium concentration in urine is less than 20
mmol/l.
AB
146
146. Which finding is suspect of metabolic alkalosis?
a. Na+ = 140 mmol/l, K+ = 3.0 mmol/l, Cl- ? 82
147
147. Which laboratory findings can be considered as a cause of MAC?
a. Hyperlactatemia
b. Mitochondria during signficant hyponatremia.?
c. Presence of ketonbodies. (ketoacidosis- ex: starving)
AC
148
148. Patients with decompansated liver cirrhosis usually
have:
a. Secondary hyperaldosteronism
b. Metabolic alkalosis
c. Metabolic acidosis
d. Respiratory alkalosis
ABCD
149
149. A tentative calculation of serum osmolality is:
a. Na + 2x urea + glucose
b. 2x Na + urea + glucose
c. Na + urea + glucose
d. Na + urea + 2x glucose
B
150
150. When hypernatremia occurs, sodium stores in organism can be:
a. decreased
b. increased
c. normal
d. evaluated according to natremia and hydratation.
ABCD
151
151. When intravascular hemolysis occurs:
a. Serum activity of lactate dehydrogenase is increased.
b. Serum concentration of haptoglobin decreases.
c. Haptoglobin creates complexes with hemoglobin.
ABC
152
152. Maximal clinical sensitivity is achieved when method has:
a. Also maximal analytical specificty.
b. Also maximal analytical sensitivity.
c. No false negative results.
d. No false positive results.
C
153
153. Fractional excretion of water increases in:
a. Interstitial nephritis
b. High water intake
c. Chronic glomerulopathies
ABC
154
154. Exudate in comparison with transudate has higher:
a. Protein
b. Cholesterol
c. Lactate
d. Glucose
ABC
155
155. Adenohypophysis does not produce:
a. Thyreotropin (TSH)
b. Thyreoliberin (TRH)
c. Melanotropin (MSH)
d. Melatonin
BCD
156
156. Increased unmeasured anions can be caused by:
a. Hyperlactatemia
b. Increased organic acids during some intoxications.
c. Increased ketone bodies in the blood.
ABC
157
157. At the end of pregnancy we observe the increase of:
a. Triglycerides
b. Uric acid
c. Cholesterol
d. Urea
ABC
158
158. Finding of metabolic acidosis with increased unmeasured anions is suspicious of:
a. Diabetic ketoacidosis
b. Ethylenglycole or methanol intoxication
c. Paracetamole or salicylate intoxication
d. Uremia
ABCD
159
159. Oliguria is supported by the following results:
a. Urine Na+ = 15 mmol/l
b. Serum urea = 40 mmol/l, Serum creatinine = 180
AB
160
160. Risk of atherogenesis is proportional to:
a. Decreased apo A-I/apo B ratio.
b. Degree of insulinoresistance.
AB
161
161. For preschool children is typical increased activity
of:
a. Alkaline phosphatase
162
162. For screening purposes we prefer method with:
a. The highest clinical sensitivity.
163
163. Liver produces:
a. Uric acid
b. Urea
c. Albumin
d. Transferrin
ABCD
164
164. When liver failure occurs:
a. Serum activity of cholinesterase decreases.
b. Serum urea concentration decreases.
c. Plasma ammonia concentration increases.
d. Mixed hyperbilirubinemia is present.
ABCD
165
165. Cholinesterase is produced in:
a. Liver
b. Muscle cells
c. Kidneys
d. Pancreas
AB
166
166. Blood for lactate determination has tube collected
into:
a. heparine
b. NaF + Na2EDTA
c. A teste tube without any addition
d. Citrate ?
BC(?)
167
167. Albumin in cerebrospinal fluid:
a. Determination of its concentration in CSF and in serum is important for examination of hematoencephalic barrier.
b. Penetrates through hematoencephalic barrier.
c. Albumin ratio of CSF/serum concentrations is used
for determination of CSF immunoglobulin origin.
ABC
168
168. Newborns of diabetic mothers have higher
occurrence of:
a. Hypertrophic newborns with tendency to
hypoglycemia after delivery
b. Intracranial hemorrhage
c. Respiratory distress syndrome
d. Inborn developmental errors
ABCD
169
169. Examination of BNP (brain natriuretic peptide) is indicated:
a. When hypernatremia occurs.
b. For screening of patients with latent heart failure.
c. When hyponatremia occurs.
d. After hypofysectomia.
B
170
170. For acute pancreatitis diagnosis we determine the following enzymes:
a. Lipase in serum
b. Elastase -1 (pancreatic) in stool – for chronic pancreatitis
c. Amylase in serum
d. Amylase in urine
ACD
171
171. Calcemia is evaluated together with:
a. Albumin
b. Magnesium
c. Inorganic phosphate
d. Blood pH
ABCD
172
172. Following change(s) in serum can stimulate parathormone secretion:
a. Decrease of inorganic phosphate concentration
b. Increased of ionized calcium concentration
c. Decrease of ionized calcium concentration
d. Increase of inorganic phosphate concentration
CD
173
173. Calculate urinary protein loss per 24 hours when you have following results:
Total protein in serum 71.9 g/l
Total urinary protein 2.4 g/l
Urinary volume per 24 hours 1461 ml
Patient weight 81 kg
Urinary protein loss write in grams per day with precision to 1 decimal point.
a. 3.5
174
174. Hypoalbuminemia accompanies:
a. Protein malnutrition
b. Dehydration
c. Chronic liver diseases
d. Nephrotic syndrome
ACD
175
175. Urine sample from 24h collection was sent to the laboratory for proteinuria determination. The concentration of protein in the urine was 2g/l and diuresis was 2000 ml. what are losses of protein into urine?
a. Protein loss cannot be calculated from these peaces of information.
b. 2 g/24h
c. 8 g/24h
d. 4 g/24h
D
176
176. Which conclusions are possible?
a. Hypoalbuminemic MAL
b. MAC caused by increased phosphates
c. Dilutional MAL
AB
177
177. After long-lasting physical load in serum increases: Physical exercise leads to increase of:
a. Lactate
b. ALT
c. AST
d. CK
ACD
178
178. Na+ = 135 mmol/L, K+ = 5 mmol/L, Cl- = 85 mmol/L
the patient has:
a. No disease, healthy
b. Metabolic acidosis
c. Metabolic alkalosis
C
179
179. For differentiation between CSF and other possible secretions (nasal, from ears) we indicate optimally:
a. Determination of beta2-microglobulin (BMG), in CSF its concentration is high.
b. Determination of beta2-microglobulin (BMG), in CSF its concentration is low.
c. Determination of beta trace protein (BTP), in CSF its concentration is high.
d. Determination of beta trace protein (BTP), in CSF its concentration is low.
C
180
180. Antioxidative effect is observed in:
a. Provitamin A
b. Lipoic acid
c. Vitamin C
d. Vitamin E
ABCD
181
181. Relate content of total body fluid depends on:
a. Sex
b. Antioxidant capacity of blood
c. Body constitution
d. Age
ACD
182
182. The form and severity of poison effect is dependent on:
a. On the form of poison.
b. Poison dose.
c. On the way of administration.
d. Optic properties of poison.
ABC
183
183. Achlorhydria of gastric juice causes impaired:
a. Lipolysis
b. Absorption of calcium
c. Proteolysis
d. Absorption of iron
BCD
184
184. Men have physiologically higher concentration of:
a. Creatinine kinase
b. ALT
c. Creatinine
d. HDL-cholesterol
AC
185
185. Essential trace elements are:
a. Cadmium
b. Chromium
c. Zinc
d. Selenium
BCD
186
186. High income of vitamin C can cause falsely negative result of urine strip test for:
a. Glucose
b. Nitrites
c. Blood
d. Bilirubin
AC
187
187. Metabolic syndrome is:
a. Impairment of renal function caused by paracetamol.
b. Impairment of liver function due to administration of salicylates.
c. Parallel finding of impaired glucose tolerance and dyslipidemia in obese patient.
d. Increased risk of atherosclerosis.
CD
188
188. Calculate urinary protein loss per 24h when you
have following results:
Total protein in serum 83.6 g/l
Total urinary protein 6.3 g/l
Urinary volume per 24 hours 1359 ml
Patient weight 52 kg
Urinary protein loss write in grams per day with precision to 1 decimal point itself (g/day) to the result.
a. 8.6
A
189
189. Renal type of glycosuria can be found in:
a. Type II diabetes mellitus
b. Fanconi’s syndrome
c. Decreased renal threshold for glucose.
d. Decreased glomerular filtration rate.
BC
190
190. Prerenal proteinuria can be caused by:
a. Fever
b. Cadmium poisoning
c. Intravascular hemolysis
d. Extensive crush of skeletal muscles.
e. Multiple myeloma with production of free light chains of immunoglobulins
CDE
191
191. C-reactive protein (CRP):
a. Is used for assessment of bacterial inflammation examination.
b. Is synthetized in liver after stimulation of interleukin 6.
c. Reacts more rapidly to presence of inflammation than erythrocyte sedimentation rate.
d. Is used for rheumatoid arthritis activity assessment.
ABCD
192
192. Acute intoxication with ethanol demonstrates by: a. Serum osmolality increase by 23 mmol/l with each 1g/l ethanol.
b. Significant serum osmolality increase.
c. Metabolic acidosis
d. The difference between measured and calculated
osmolality is not marked.
ABC
193
193. Check true statements:
a. Trueness + analytical specifity = precission
b. Trueness + accuracy = precission
c. Accuracy + precission = trueness
d. Trueness + precission = accuracy
D
194
194. “Negative acute phase reactants” are:
a. Albumin
b. Prealbumin
c. C-reactive protein
d. Orosomucoid
e. Transferrin
ABE
195
195. Increased serum concentration of myoglobin can be caused by:
a. Renal failure
b. Damage to skeletal muscles
c. Unstable angina pectoris
d. Acute myocardial infarction
ABD
196
196. Diference (Na+ - Cl-) in serum in healthy persons is approximately:
a. 40 mmol/l
b. 25 mmol/
c. 30 mmol/l
d. 50 mmol/l
A
197
197. Hemolysis interfers with determination of:
a. LD
b. Na+
c. K+
d. ALT
AC
198
198. Mixed (combined) disturbances of ABB are:
a. More common than simple disturbances of ABB.
b. Combination of 2 or more disturbances of ABB originated independently of each other.
c. Revealed by calculation of anion and cation columns.
d. Combination of original ABB disturbance and compensatory actions.
ABC
199
199. 10% glucose solution.
a. Is hyperosmolar in comparison with plasma.
b. Is isoosmolar with plasma.
c. Contains 10g glucose in 1 liter.
d. Must not be applied into a peripheral vein.
A
200
200. Prostatic Specific Antigen (PSA).
a. Its a greater part is bound to protease inhibitors. b. Total to free PSA ratio is used to distinguish benign hyperplasia of prostate and prostatic carcinoma.
c. Benign hyperplasia is characterized by lower free to total PSA ration.
d. Is a serine protease that is produced by prostatic cells.
ABD
201
201. High activities of aminotrasnferases (AST,ALT) can be connected with:
a. Right-sided heart failure.
b. Paracetamol (acetaminophen) intoxication.
c. Amanita phaloides poisoning.
d. Acute viral Hepatitis.
ABCD
202
202. Before blood sampling for aminotransferases determination it is recommended:
a. To eliminate great physical activity.
b. Abstinence from alcohol
c. As possible shortest arm concentration.
d. Fasting for at least 14h.i
ABC
203
203. Increased alfa-fetoprotein in serum of women in
17th week of pregnancy is suspicious from:
a. Neural tube defects
A
204
204. Physiological icterus of neonates is characterized by:
a. Unconjugated bilirubin is increased with maximum value of 170 umol/l.
b. Conjugated nilirubin is increased with maximum value of 35 umol/l.
c. Emerges in 24-36h after delivery and lasts maximum of 1 week.
d. Urobilinogen is not present in urine.
ACD
205
205. The following organs are involved in sodium metabolism:
a. Neurohypophysis
b. Kidneys c. Lungs
d. Liver
ABCD
206
206. Buffer base value in serum (Na + K-Cl) is increase in:
a. Chronic respiratory acidosis
b. Metabolic alkalosis
c. Chronic metabolic alkalosis
A(?)BC
207
207. Lactic acidosis can be caused by:
a. Sprinter like muscle exercise in healthy person.
b. Heart failure
c. Carbone monoxide intoxication.
d. Liver disease
ABCD
208
208. Serum glucose during 0-GTT 5.0 mmol/l (time=0)
6,1 mmol/ (time=1h) and 8.1 mmol/l (time=2h).
a. Do not exclude diabetes.
b. Deflect an impairment of glucose absorption.
AB
209
209. Lactatemia > 13mmol/l:
a. is caused by impairment of lactate metabolism.
b. is usually by impaired liver function.
AB
210
210. Decrease of tranferrin level is observed in:
a. Protein malnutrition
b. Acute inflammation
c. Liver cirrhosis
ABC
211
211. Secretion of antidiuretic hormone (ADH) is caused by:
a. Overhydration
b. Thirsting
c. Hypertonic dehydration
d. Heart failure
BC
212
212. Among markers of nutritional status belong:
a. Prealbumin
b. Cholinesterase
c. Transferrin
d. Alpha, antitrypsin
ABC
213
213. For evidence of a hereditary disease by polymerase chain reaction we need:
a. DNA-polymerase
b. Reverse transcriptase
c. Part of gen (DNA) with known mutation
d. Nucleoside triphosphates
ACD
214
214. Decrease tranferrin level is observed in:
a. Iron deficiency
b. Acute inflammation
c. Liver cirrhosis
d. Protein malnutrition
BCD
215
215. During heart and lung arrest the following ABB disturbances develops:
a. Metabolic acidosis with lactate increase.
b. Metabolic acidosis with HCO3
- losses.
c. Metabolic alkalosis with potassium losses.
d. Respiratory acidosis with pCO2 increase.
AD
216
216. When hyponatremia occurs storage of sodium in
organism can be:
a. Decreased
b. Normal
c. Evaluated according to natremia and hydration.
d. Increased
ABCD
217
217. Catalytic concentration of enzyme is:
a. Enzyme activity (mol/s/l)
b. Mass enzyme concentration (g/l)
c. None of the answers is correct
d. Molar enzyme concentration (mol/l)
A
218
218. Blood for determination of acid base balance and blood gases was collected with: ?
a. pH decreases
b. pCO2 decreases
c. pO2 increases
d. pH increases
BD
219
219. Vasopressin is:
a. Synonym of antidiuretic hormone.
b. Synonym of angiotensin II.
c. Secreted by suprarenal cortex.
d. Natriuretic peptide (it is a peptide but not natriuretic)
A
220
220. After insulin treatment the following substances go intracellulary:
a. Glucose
b. Magnesium
c. Potassium
d. Inorganic phosphate
ABCD
221
221. Check possible causes of hyperchloremic MAC:
a. Administration of NaCl 0.9%
b. Bartter syndrome
c. Chronic renal failure
d. RTA (renal tubular acidosis)
ACD
222
222. Natriuretic peptides are:
a. Acute phase reactants (proteins).
b. Markers of nutritional status.
c. Important for sodium and water metabolism.
d. Important for evaluation of risk of heart failure.
CD
223
223. Discrepancy between chemic detection of blood in the urine (strip test) and urinary sediment … caused by:
a. Hemoglobin
b. Desinfectants
c. Vitamin C
d. Porphyrins
e. Late delivery of urine sample
f. Red beat
g. Myoglobin
ABCG
224
224. Alkalinising effect has administration of:
To alkalinize, we can use:
a. Potassium malate
b. Sodium lactate
c. Acetazolamide (carboanhydrase inhibition)
d. Solution saline (0.9% NaCl)
AB
225
225. Which conclusion(s) are possible?
a. MAL caused by increased unmeasured anions.
b. Hypochloremic MAC.
c. Hyperchloremic MAC.
d. MAC caused by increased unmeasured anions.
e. Hypoalbuminemic MAL
CDE
226
226. Main intracellular cation:
a. Calcium
b. Albumin
c. Potassium
d. Magnesium
C
227
227. Critical concentration for kernicterus (bilirubin encephalopathy) is:
a. 170 μmol/l of unconjugated bilirubin.
b. 340 μmol/l of unconjugated bilirubin.
c. 340 μmol/l of conjugated bilirubin.
d. 35 μmol/l of conjugated bilirubin.
B
228
228. Precise but inaccurate results are caused by:
a. Random errors
b. This combination does not exist
c. Systematic errors
d. Both types of errors
C
229
229. Fasting hypoglycemia is present in patients with:
a. Galactosemia
b. Liver cirrhosis
c. Intolerance of fructose
d. Glycogenosis
BD
230
230. Check correct statement(s):
a. RAL is compensated by bicarbonates retention and chlorides excretion.
b. RAC is compensated by retention of chlorides and excretion of bicarbonates.
c. RAC is compensated by bicarbonates retention and excretion of chlorides.
d. RAL is compensated by chlorides retention and excretion of bicarbonates.
CD
231
231. Functional renal failure can be caused by:
a. Hypoperfusion of renal cortex
b. Severe dehydration
c. Hypoperfusion of renal marrow
d. Shock
ABD
232
232. Biological half-lives of protein decrease in the following order (1-Hb, 2 – prealbumin, 3 –
transferrin, 4 – albumin):
a. 1-4-3-2
b. 1-3-4-2
c. 1-3-4-2
d. 1-2-3-4
A
233
233. Hyperoxaluria: a. Intoxication with ethylene glycol
b. Excessive intake of vit. C
c. Primary (essential) oxaluria
d. Vit. B6 deficiency
ABCD
234
234. As a result of impairment of renal tubular cells, typical findings in urine is:
a. Beta 2 microglobulin
b. Microproteins
AB
235
235. Urine changes its color due to:
a. Diet
b. Volume of fluid intake
c. Some drugs
ABC
236
236. Marker of renal function impairment:
a. Inability to produce concentrated urine after ADH administration
b. Stable urine osmolality value during the day
c. Loss of diurnal rhythm in GFR.
AB(?)C
237
237. Typical serum finding in primary hyperparathyroidism is:
a. Calcium 3.4 mmol/l, inorganic phosphate 0.4
mmol/l.
238
238. Significant increased value of measured osmolality than counted osmolality is seen in:
a. Ethanol intake
b. Ethylenglycol intoxication
239
239. Myoglobin in MI:
a. Is sensitive but not specific
b. Appears in blood sooner than troponin
240
240. Blood transfusion:
a. Hypocalcemia
241
241. Pleocytosis in cytologic examination of CSF:
a. Always pathological
b. Means more than 3 cells in 1 umol/l.
A
242
242. Urine pH in patients with urate stones should be maintained at:
a. 6-7
243
243. Inhibition of lithogenesis:
a. Mg2+
b. Citrate
244
244. Urinary stone formation from ammonia –
magnesium phosphate is supported by:
a. UTI
b. Alkaline urine
c. Hereditary impairment of phosphate secretion
d. Acidic urine
ABC
245
245. Patients with hepatic jaundice have in urine:
a. Both urobilinogen and bilirubin
b. No bile pigment
c. Only urobilinogen
d. Only bilirubin
A
246
246. Typical changes of laboratory examinations in smokers are: a. Microalbuminemia
b. Increased fibrinogen
c. Decreased vitamin C level
d. Increased carboxyhemoglobin concentration
BCD
247
247. What can cause MAC in a chronic kidney disease?
a. Hyperlactemia
b. Retention of sulphates
c. Hyperchloremia
d. Retention of phosphate
ABCD
248
248. Higher amylase in plasma than in urine is caused by:
a. Amylase binding to Ig-(Macroamylasemia)
b. Renal insufficiency
c. Obstruction of common biliary duct
d. Changes in enzyme production in chronic pancreatitis
AB
249
249. For chronic renal failure is typical:
a. Increased FE of sodium and potassium
250
250. Nephrotic syndrome in electrophoresis:
a. Increased B globulins
b. Decreased albumin
c. Increased alpha 2 globulin
ABC
251
251. Hypocalcemia and hypochloremia:
a. Overdose with furosemide or thiazides.
b. Barter syndrome
c. Pseudo barter syndrome
d. HyperaldosteronismBC
BC
252
252. Extrarenal cause of oliguria:
a. Urine sodium 15 mmol/l
b. Serum urea 40 mmol/l
c. Serum creatinine 180 umol/l
ABC
253
253. Physiological range of fractional excretion of potassium is:
a. 0.04-0.12%
b. 0.4-1.2%
c. 4-19%
d. > 20%
C
254
254. Difference between measured and calculated osmolality:
a. is increased in intoxication with alcohol or ethylene glycol.
b. Is caused by accumulation of substances that are not included in…
255
255. Secretion of gastric juice is stimulated by:
a. Gastrin
b. Alcohol
c. Nicotine
ABC
256
256. Potassium concentration in RBCs is:
a. 20x higher than in plasma.
b. Approximately 95 mmol/l.
257
257. In acute prerenal failure is typical:
a. Decreased EF of water.
b. Decreased EF of sodium.
258
258. Increased urea concentration with normal concentration of creatinine in serum can be caused by:
a. Dehydration
b. Catabolism
B
259
259. Laboratory findings in CSF – proteinuria 2.1 g/l, glucose 0.3 mmol/l, lactate 4.1 mmol/l with total prevalence of neutrophils means:
a. Purulent bacterial meningitis
260
260. Concentration of ionized calcium decreases:
a. With increased pH.
b. Hyperphosphatemia
261
261. Gonosomal recessive type of heredity is characteristic for:
a. Duschene’s muscular dystrophy
b. Haemophilia A
c. Others: colour blindness, fibrin/storage diseases
ABC
262
262. Best marker of iodine depletion in the organism is:
a. Iodine losses in urine
263
263. Which statement(s) about hypoxia is /are correct?
a. Lactate MAC during hypoxia will be accompanied by increased UA.
b. When we find RAL, we have to think of hypoxia.
c. Hypoxia leads to MAC.
AB(?)C
264
264. Hypercalciuria can be caused by:
a. Malignancy
b. Primary (essential) hyperparathyroidism
c. Immobilization of the patient
ABC
265
265. Immunoglobulins in CSF: a. originate always from serum
b. can have origin in local synthesis in diseases of CNS accompanied with immune reaction
c. its origin is either serum or intrathecal synthesis
d. to determine its origin we use albumin quotient and
Reiber’s relation
BCD
266
266. NaHCO3
-:
a. Chronic renal failure with MAC.
b. MAC with hyperkalemia.
AB
267
267. Hematuria phase contraste:
a. Urine examination should be as soon as possible.
b. Distinguish glomerular from non-glomerular RBCs.
c. Distinguish eumorphic from dysmorphic cells.
ABC
268
268. Increased amylase in serum:
a. Exarcebation of chronic pancreatitis
b. Decreased GFR
c. Abdominal surgery
d. Complex amylase and Ig
ABCD
269
269. During dialysis, Ca2+:
a. Increases
b. Decreases
c. Remains the same
B
270
270. Fibrinogen: a. Its concentration positively correlates with ESR.
b. Decreases in chronic liver disease
c. Its reactant of acute inflammatory phase
d. It’s a coagulation factor
A(?)BCD
271
271. Which of the following treatments can lead to MAL?
a. Corticosteroids
b. Repeated blood transfusions
c. Furosemide
d. Antacids
ABCD
272
272. The following proteins belong among protease inhibitors: a. A1-antitrypsin
b. A2-macroglobulin
c. PSA
d. CRP
AB
273
273. Most dangerous for the patient with renal failure is:
a. Kalemia 8 mmol/l
b. Urea 40 mmol/l
c. BE 15 mmol/l by pCO2 4 kPa
d. Creatininemia 1000 umol/l
A
274
274. During examination of occult blood in stool by a common chemical method:
a. We search for colorectal cancer
b. Patient must not use non-steroid antilogistic drugs.
c. Patient must adhere diet without meat, blood and
iron for 3 … (heme)
d. Diet is not necessary. (globin)
ABC
275
275. Predominantly intracellular location has:
a. Magnesium
b. Phosphate
c. Potassium
d. Calcium
AB(?)C
276
276. When we have suspicion of microcytic hypochromic anemia we examine:
a. Concentration of vitamin B12 and folate.
b. Transferring and ferritin in serum.
c. Soluble transferring receptors.
d. Iron level in serum.
BCD
277
277. Clearenace of endogenous creatinine is:
a. More sensitive marker of renal disease than serum concentration.
b. Functional test of renal tubular cells
c. Abundant in serum creatinine exceeding 180 umol/l.
d. Measure of glomerular filtration rate.
ACD
278
278. The cause of hyperuricemia can be treated with:
a. Anticancer drugs
b. Thiazide diuretics
A
279
279. Erythrocytes contain high activity of:
a. AST
b. Lactate dehydrogenase
280
280. Following changes of laboratory results are linked with the physiological pregnancy:
a. Decrease of urea and creatinine in serum.
b. Increase of endogenous creatinine clearance.
c. Intermittent glycosuria and increased proteinuria.
d. Symptoms of hemodilution.
ABCD
281
281. Albumin is a transport protein for:
a. Zinc
b. Thyroxine
c. Calci
ABC
282
282. Serum glucose levels during o-GTT 5.0 mmol/l (time = 0) and 8.1 mmol/l (time = 2h).
a. Impaired glucose tolerance
283
283. Determination of oligoclonal IgG synthesis in CSF is indicated:
a. Diagnostics of sclerosis multiplex.
284
284. HLA antigens:
a. is a system of tissue compatibility.
b. of class I are on all cells except of erythrocytes.
c. of class II are related to some diseases.
d. of class II are only on some cells of immune system.
ABCD
285
285. Nitrites in urine are positive in:
a. Bacterial infection of urinary tract.
286
286. To calculate actual bicarbonate, you need values of:
a. pCO2
b. pH
287
287. Slightly decreased albumin and increased α1, α2
and β2 globulins are typical for:
a. Acute inflammationy
288
288. Hypothyroidism can be related to deficiency of the following trace elements:
a. Selenium
b. Iodine
AB
289
289. Ionized calcium increases in:
a. Nephritic syndrome
b. Hypoventilation
c. Acidosis
A(?)BC
290
290. Hemolytic jaundice is accompanied with the following finding:
a. Urobilinogen
291
291. Typical changes of laboratory results in neonates 2 days after birth when compared with adults are:
a. Fasting hypoglycemia.
b. Increased leucocytes, hemoglobin, hematocrit.
c. Hypogammaglobulinemia
d. Increased myoglobin and creatinine kinase.
ABCD
292
292. Hypothyreosis of central type is characterized by:
a. Low TSH
b. Increased loss of iodine in urine
c. Positive antibodies against thyreoglobulin
d. High TSH
A
293
293. Which statement(s) are correct?
a. Acute treatment of RAL can be breathing to and from a plastic bag.
b. Quick removal of hypercapnea in a patient with chronic bronchitis can lead to alkalemia.
c. Oxygenotherapy in a patient with hypercapnea with chronic bronchitis leads to deepening of hypercapnea.
d. The first sign of hypoxia can be RAL.
ABCD
294
294. In context with acute myocardial infarction:
a. Increased CRP.
b. Leucocytosis
c. (Falsely) positive reaction for blood urine … erythrocytes in urinary sediment.
d. Fasting hyperglycemia.
ABCD(?)
295
295. Decreased glomerular filtration rate leads to increased:
a. Myoglobin
b. Beta2-microglobulin
c. Alpha-amylase
d. Cystatin C
e. Free light chains of immunoglobulins
ABCDE
296
296. In pregnancy special care is needed for women with:
a. Diabetes mellitus
b. Blood group Rh- or O
c. Thyroid gland diseases
d. Anemia
ABCD
297
297. Among lithogenic substances belong:
a. Phosphate
b. Uric acid
c. Oxalates
d. Calcium
ABCD
298
298. Jaffé positive chromogens:
a. Are e.g: uric acid, glucose or ketone bodies.
b. Falsely increases measured value of serum
creatinine.
299
299. Which statements are correct?
a. LDL transports cholesterol to tissues.
b. HDL transports cholesterol to tissues.
c. HDL exchange with VLDL, IDL and LDL triglycerides and cholesterol esters.
d. In VLDL, IDL and LDL the main apoprotein is ApoB100.
ACD
300
300. Which doesn’t go through BBB?
a. CO2
b. Proteins
c. Lactate
d. Water
B
Lactate can cross bbb!
301
301. CSF appearance during bleeding:
a. Sanguinolent
b. Yellow
c. Blue
d. Xanthochrome
ABD
302
302. By duodenal juice, we can loose:
a. Hydrogenocarbonates
b. Weight
c. Fat
d. Chlorides
ABD
303
303. In diagnosis of AMI, which lab parameters do we use?
a. Cardiac troponins
b. AST
c. CK and CK-MB
d. LD activity
e. Myoglobin
AE
304
304. Cardiac troponins increase beyond AMI cut-off in:
a. Car accident
b. AMI
c. Kidney insufficiency
d. Myocarditis
e. Large injury to skeletal muscle
f. Antracyclines (chemotherapy drug with cardiotoxicity)
ABDF
305
305. About urea:
a. Has 1 carbon and 2 nitrogens.
b. In hepatorenal failure its concentration may be within reference limit.
c. Its serum concentration decreases in catabolism.
AB
306
306. Hypersideremia can be found in:
a. Aplastic anemia
b. Haemolytic anemia
c. Hepatocellular damage
d. Hemochromatosis
ABCD
307
307. Oligocytosis in cytologic examination of CSF means:
a. 30 and less cells in 1ul (newborns)
b. 3 and less cells in 1ul (adults)
308
308. Indication to administer 8.4% NaHCO3 are:
a. Severe MAC with hyperkalemia
b. Chronic renal failure with MAC
309
309. Treatment with glucocorticoids can induce:
a. Hyperglycemia
b. Hypokalemia
c. Metabolic alkalosis
ABC
310
310. Urine toxicological examination is true:
a. Can be choiced in unconscious patient without knowledge of the disease
b. The poison is usually concentrated in urine
c. Metabolites are also present in urine and thus the evaluation of the findings is contraindicated
AB
311
311. Calculate osmolal gap when we measured following results in the serum: sodium 150 mmol/l; Cl 180 mmol/l; Urea 18 mmol/l; Cr 230 umol/l; Glu 21; osmolality measured 450 mmol/kg.
Write result as a number without any decimal points, expressing mmol/kg. Don’t write the unit.
Osmolality = 2 x Na + Glucose + Urea
Osmolar gap = measured – calculated
a. 111
312
312. Calculate osmolal gap when we measured following results in the serum: sodium 128 mmol/l; Cl 84 mmol/l; Urea 5 mmol/l; Cr 160 umol/l; Glu 6; osmolality measured 276 mmol/kg.
Write result as a number without any decimal points, expressing mmol/kg. Don’t write the unit.
Osmolality = 2 x Na + Glucose + Urea
Osmolar gap = measured – calculated
b. 9
313
313. Zinc together with copper are active compounds in one antioxidant enzyme, which one?
a. Superoxiddismutase
A
314
314. Typical laboratory findings for intravascular hemolysis is: a. Reticulocytes in blood count b. Decreased haptoglobin
AB
315
315. Bilirubinemia 350 umol/l in 5 day old newborn:
a. is increased and demands therapeutic action
316
316. After repeated transfusions we can find
a. Hypokalemia
b.Metabolic alkalosis
c. Hypervolemia
d. metabolic acidosis
e. hyperkalemia
f. hypocalcemia
BCEF
317
317. If we have suspicion of lead poisoning, indication of determination of serum lead is
a. bad idea
Plasma is better!
Serum samples may not be appropriate to assess lead (Pb) concentrations because they may contain artificially higher Pb concentrations compared with those measured in plasma samples.
318
318. To estimate absolute cardiovascular risk we use in Europe
a. SCORE tables
319
319. Patient is considered to be infectious if
a. Both HBsAg and HBeAg are positive
320
320. For determination of losses of calcium, phosphates and magnesium it is appropriate to deliver a. 24h urine acidified by HCl addition
b. Single urine sample and simultaneously to determine creatinine in urine
c. 24h urine alkalized by sodium carbonate
d. 24h urine without conservation by any substance
AB
321
321. Natriuretic peptides in regulation of sodium in kidney have:
a. Opposite effect as Aldosterone
b. Opposite effect as Renin
322
322. Serum concentration of cardiac Troponin can be inscreased (>99th percentile): a. Myocardial Infarction
b. Polytrauma c. Exacerbation of chronic heart failure
ABC
323
323. The most sensitive and specific marker of iron deficiency is:
a. Increased soluble fraction of transferrin receptors
324
324. Tetany from decreased level of ionized calcium is often found in:
a. Metabolic alkalosis
b. Respiratory alkalosis
325
325. Hemolysis does not interfere with determination of:
a. Calcium
326
326. If we want to monitor relaps, we prefer method that has:
a. The highest possible clinical specificity
327
327. Which statement about hepcidin is not correct a. During sideropenia, increase of hepcidin synthesis in the liver occurs b. hepcidin is the main iron metabolism regulator in
mammals
c. mechanism of action of hepcidin is inactivation of ferroportin
d. overproduction of hepcidin ca contribute to anemia of chronic diseases pathogenesis
e. hepcidin is peptidic hormone produced by liver
A
328
328. Hypoglycemia can accompany
a. Chronic renal failure
329
329. Exocrine function of the pancreas can be assessed by:
a. elastase-1 determination in stool b. breath test with 𝐶13 -Triglyceride
330
330. The term biological exposure test (BET)
a. Determination of toxic substances or metabolites in biological materials collected from exposed human
331
331. 47 year old woman with body weight 97 kg and height 160 cm (BMI = 37,9 kg/m2), waist
circumference 104 cm, followed in outpatient metabolic department for atherogenic dyslipidemia and impaired fasting glucose. She doesn´t use any
hypolipidemic drugs nor othre medication yet.
Lab results (lipids, glucose)
S_ triaglycerides 3,5mmol/l ↑↑
S_ total cholesterol 5,9mmol/l ↑
S_ HDL-cholesterol 0,8mmol/l ↓
S_ LDL-cholesterol 3,8mmol/l ↑
P_ glucose (fasting) 6,0mmol/l ↑
Lab results (liver tests, special examinations)
S_ ALT 1,2μkat/l ↑
S_ GGT 4,0μkat/l ↑↑
S_ total bilirubin 12μmol/l-
S_ ALP 1,1μkat/l
B_ eyrthrocyte volume 93fl
S_ carbohydrate deficient transferrin (CDT) 1,1%
S_ iron 14,4μmol/l
S_ ferritin 199μg/l
S_ TSH 1,32mIU/l
S_ anti-HBs 640IU/l ↑↑
S_ anti-HBc, HBsAg, anti-HCV, anti-HAV negative
Electrophoresis of plasmatic proteins was without any pathological finding.
Patient had mononucleosis in youth, no other serious diseases. Abdominal ultrasound not conclusive (due to obesity), but gross pathology of liver and biliary tract was excluded.
What is the most probable cause of liver tests increase?
a. alcoholic liver steatosis
b. non-alcoholic liver steatosis
c. chronic active hepatitis B
d. hemochromatosis
e. infectious mononucleosis in youth
B
332
332. Check correct statements a. Compensation of MAL is limited by hypoxia
b. Compensation of MAC is limited by hypokapnia
c. Compensation of RAC is limited by urinary pH 4.5
ABC
333
333. Cystic fibrosis is: a. Characterized by repeated pneumonias b. A disease with AR type of heritability
c. Characterized by low elastase concentration in stool d. Characterized by chloride concentration in sweat > 20 mmol/l.
e. Characterized by chloride concentration in sweat < 20 mmol/l
ABCD
334
334. The most common cause of acute pancreatitis are:
a. Excessive eating and alcohol drinking b. Obstruction of biliary tract
335
335. The following picture in cerebrospinal fluid accompanies viral meningitis a. Lower CSF protein concentration than in purulent meningitis b. Lactate concentration below 3.5 mmol/l
AB
336
336. Which fatty acids (FA) belong to omega-3 group of FA? a. Docosahexaene
b. Eicosapentaene c. Alpha-Linolenic
ABC
337
337. 30 year old woman was admitted for epileptic paroxysm. Selected laboratory results: Total bilirubin 28umol/l
AST 2,16ukat/l
ALT 1,31 ukat/l
GGT 22ukat/l
ALP 2,1 ukat/l
Urea 2,2mmol/l
Creatinine 61 umol/l
Erythrocytes 3,3x1012/l
Hb 119g/l
Erythrocyte volume 106 fl
Which of the following possibilities explain the laboratory results:
a. alcohol abuse
b. acute viral hepatitis
c. biliary obstruction by stone
d. exacerbation of porphyria??
e. liver steatosis
A
338
338. Urine Na/K ratio < 1 can be found a. In hyperaldosteronism b. After heavy physical activity
c. In dehydration
ABC
339
339. Acidificative effect has infusion of a. Isotonic solution of NaCl b.acetazolamide (carbonanhydrase inhibitor)
c. 0,9% NaCl
ABC
340
340. Urine alkalization increases elimination of
a. Acidic compounds
b. Barbiturates
341
341. Which statement about hemochromatosis is not true
a. In hemochromatosis impaired iron absorption in GIT takes place
342
342. Tendency to hypocalcemia can be observed in
a. Hypoparathyroidism
b. Acute pancreatitis
c. Chronic renal failure
d. Hypovitaminosis D
ABCD
343
343. Plasma (lithium heparin) instead of serum is indicated in patients
a. using heparin
b. using warfarin
c. that are hemodialysed
d. with extreme leukocytosis
e. with extreme thrombocytosis
f. with coagulation disorder
ABCDEF
344
344. Autoantibodies are often found in hypothyroidism of
a. Accompanying Hashimoto’s Thyroiditis
b. Peripheral type
345
345. Patient with multiple transfusions got cramps
a. Calcium
b. Magnesium
346
346. Patients with decompensated liver cirrhosis
a. MAC
b. MAL
c. Secondary hyperaldosteronism
ABC
347
347. Acute phase reactants
a. Fibrinogen
b. alpha-1 antitrypsin
c. CRP
ABC
348
348. Extended prothrombin time can be found in a. Dicumarol derivatives treatment b. Chronic liver disease c. Lipid malabsorption
ABC
349
349. 52 year old man with diabetes type 2, taking metformin, was not feeling well since this morning, he had strong headaches, vomited, around 11 o’clock her wife noticed unusual behaviour, disorientation and confusion. At admission to hospital (13 o’ clock), patient was in come BP 150/90 mmHg, HF 90/min, BF 25/min, SpO2 97%, TT 39ºC. laboratory examination revealed following results: glycemia 8,0 mmol/l, lactate 2,0 mmol/l, minerals, parameters of ABB, liver and
kidney tests – everything without significant pathology, basic toxicology screening negative; blood counts: 29 thousand leucocytes/μl. Lumbar punction was performed and CSF examination with
following results: CSF glucose 0,1 mmol/l, CSF lactate 15 mmol/l, CSF protein 5,5 g/l; number of cells 14 000/μl (polynuclear cells are prevalent), spektrophotometry of CSF is negative. What is the right diagnosis?
b. subarachnoid bleeding
c. acute leukemia with CNS infiltration
d purenlent bacterial meningitis
D(?)
350
350. 65 year old man, with dyslipidemia (10 y. history of statin treatment), smoker for 40 years, started to
have symptoms of itredness, general weakness, headache. (…) lab results show increased creatine kinase and Na+ of 104 (very low). What is the most likely diagnosis:
a. Lung carcinoma
351
351. Acidification test with ammonia chloride is a
functional test of:
a. Renal tubules
b. Must not be performed in patient with liver disease
c. glomeruli
d. liver
AB
352
353. Patient with nephrotic syndrome a. Thrombophilia
b. Hypercholesterolemia
c. Hypoalbuminemia
d. Increased alpha 2 and Beta fractions of globulins
ABCD
353
354. Most sensitive lab marker of hemochromatosis
a. Increased transferrin saturation
354
355. 65 year old with acute myeloid leukemia is
undergoing aggressive high dose chemotherapy. On the 5th day … signs: dyspnea with tachycardia, RR 30/min, decreased Hb saturation, newly developed tachycardia…
a. Sepsis
355
356. Hypocalcemia can accompany
a. Ethylene glycol poisoning b. Chronic renal failure
356
357. 65 year old woman is hospitalised on neurology
ward due to LS syndrome (pain in lumbosacral spine), selected laboratory results are as follows:
S-total protein 103 g/l
s-albumin 33g/l
s-beta2-microglobulin 3,1mg/l slightly increased
b- erythrocytes 3,48x1012/l
b-Hb 113 g/l
b-hematocrit 0,232
other parameters are in reference ranges. What laboratory should be indicated preferentially to further explain laboratory results presented above?
a. Electrophoresis of serum proteins b. Cytologic and chemical examination of cerebrospinal fluid + oligoclonal bands
c. fecal haemoglobin quantitatively
d. alkaline phosphatase and its isoenzymes
e. determination of microalbuminuria
A
357
358. Patient admitted to hospital unconscious, BP
140/90, MAC, increased osmolality of 340 and BE of -22
a. Methanol or Ethylene Glycol intoxication
358
359. High income of vitamin C can cause during urine strip test:
a. positive blood (urine strip test) in absence pf erythrocytes in microscopic examination of urine
b. falsely positive result of protein
c. falsely negative result of glucose
d. falsely negative result of keton bodies
C
359
360. (…) laboratory results: (…) Patient looked very tired during examination and had slow hown psychological (…). What is the most probable cause for dyslipidemia in this man:
a. Secondary due to hypothyreosis
360
361. 20 years old man went on a trip. Did not eat properly and drunk 3 beers. He was tired, sclera
was yellow (…). Laboratory results reveal total bilirubin of 54, and conjugated bilirubin 3. What is the most likely diagnosis:
a. Gilbert’s syndrome
361
362. Low values of maternal α1-fetoprotein in the first
third of pregnancy:
a. are necessary to be compared with other results of biochemical screening (hCG, estriol, etc) a ultrasonography
b. are physiological, high α1-fetoprotein is typical for Down’s syndrome
c. are more frequently found in pregnant women older than 35 years
d. are suspicious from trisomia of chromose 21
ACD
362
363. Increased activity of aminotransferases (AST, ALT) can be caused by:
a. right-sided heart failure
b. acute viral hepatitis
c. shock
d. toxic liver damage
ABCD
363
364. Chromium is biogenic element that is necessary mainly for metabolism of:
a. pyrimidins
b. fatty acids
c. one carbon fragments d. glucose
e. purins
D
364
365. Which of the following marker(s) is (are) NOT considered as a risk factor of atherosclerosis?
a. LDL-cholesterol b. adiponectin
c. triglycerides
d. apolipoprotein B
e. total cholesterol
B
365
366. Calculate urinary protein loss per 24 hours when you have following results:
Total protein in serum 82,7g/l
Total urinary protein 8,9g/l
Urinary volume per 24 hours 1162ml
Patient weight 109kg
Urinary protein loss write in grams per day with precision to 1 decimal point (the result will look like e.g. 1,5). Don’t write the unit itself (g/day) to the
result.
Answer: 10.3 g/day
366
367. Typical finding in obstructive jaundice is:
a. increased serum activity of ALT
b. increased conjugated bilirubin in serum
c. increased seum activity of LD
d. increased serum activity of ALP
BD
367
368. 45 year old man with mild overweight (BMI 27,5) was preventively examined, without subjective problems, accidentally detected fasting venous plasma glycemia 8,8 mmol/l. next week he came for control blood draw (fasting again), that was 6,5 mmo/l. afterwards oral glucose tolerance tests (oGTT) with 75g glukozy p. os was realised, glycemia in venous plasma 2 hrs after glucose administration was 9,8 mmol
a. the patient has diabetes mellitus, diagnosis was done
only after oGTT results were available
b. the patent has diabetes mellitus, diagnosis was sure even without oGTT, that just confirmed this diagnosis
c. the patient has impaired fasting glucose (IFG), oGTT was not indicated
d. the patient has impaired glucose tolerance (IGT)
e. the patient should undergo oGTT immediately in the
beginning, the visit after a week was needless
D
368
369. Which anions hinder Ca and Mg absorption in small intestine?
a. iodides
b. nitrates
c. chlorides
d. phosphates
D
369
370. Calculate osmolal gap when we measured following results in the serum: sodium 123 mmol/l, chlorides 84 mmol/l, urea 16 mmol/l, creatinine 78 μmol/l, glucose 8 mmol/l, osmolality (measured) 402 mmol/kg.
Write result as number without any decimal points, express in mmol/kg. don’t write the unit itself (mmol/kg) to the result.
132 mmol/kg
370
371. Administration of ACE-inhibitors for hypertension treatment leads to:
a. increased losses of sodium into urine
b. increase of natremia
c. decrease of kalemia
d. increase of kalemia
AD
371
372. Typical signs of familiar hypercholesterolemia are:
a. tendon xanthomas
b. increased ratio of apoB/apo A
c. hypertriglyceridemia
d. decreased level of HDL-cholesterol
e. hypercholesterolemia (caused by increased count of LDL particles)
ABE
372
373. 55 year old obese patient, with treatment for type 2
DM. hyperventilation, BP 160/90 torr, urinary ketone bodies negative.
Na 140mmol/l
K 4,8mmol/l
Urea 6 mmol/l
Glucose 5 mmol/l
Ammonia 15 umol/l
Osmolality 295 mmol/kg
pH 7,25
BE – 13 mmol/l
pCO2 3,8kPa
pO2 10,5 kPa
What other laboratory examination you should
order?
a. paracetamol
b. alcohol
c. lactate
d. b-hydroxybutiric acid
e. etyleneglycol
C
373
374. Which from the following statement(s) are correct?
a. administration of sodium lactate leads to acidification of organism
b. plasmalyte is alkalifying solution
c. administration of sodium lactate does not lead to k alkalinisation when liver failure occurs
d. plamalyte is acidifying solution
B
374
375. Increased activity of creatine kinase can be caused by:
a. inflammation and injury of muscles
b. intensive physical activity
c. intramuscular injections
d. myocarditis
ABCD
375
376. As a marker of biliary duct obstruction we consider increased values of (in serum)
a. unconjugated bilirubin
b. GMT
c. ALP
d. AST
BC
376
377. Gilbert’s syndrome (defect of glucuronyltransferase) is typical with:
a. urobilinogen in urine
b. urobilinogen and bilirubin in urine
c. conjugated hyperbilirubinemia
d. unconjugated hyperbilirubinemia
D
377
378. During urinary infection the following results can be modified:
a. losses of creatinine in urine
b. pH of urine
c. losses of glucose in urine
d. losses of urea in urine
CD
378
380. During intoxication with paracetamol (acetaminophen):
a. N-acetylcysteine is used as an antidote
b. liver necrosis is the most important complication
c. serum paracetamol level should be determined not earlier than 4 hours after drug ingestion
d. plasma concentration of paracetamol is not important
ABC
379
381. Calculate urinary protein loss per 24 hours when you have following results:
Total protein 81.7g/l
Total urinary protein 4.9g/l
Urinary volume per 24 hour 919ml
Patient weight 108 kg
Urinary protein loss write in grams per day with precision to 1 decimal point (the result will look like e.g. 1,5). Don’t write the unit it self (g/day) to the
result.
ANswer: 4,5
380
382. 24 year old woman, without previous medical history, suddenly developed fever with febrilia about 39ºC, intermittently dyspnea. She was examined in emergency department with no further
clinical pathology. Mild signs of meningeal irritation. Patient was admitted to department of infectious diseases, where she looked very tired,
sleepy and febrile again. Blood pressure 110/80.
Laboratory results:
S-glucose 6,7mmol/l ↑
S-K 3,5mmol/l ↓
S-procalcitonin (PCT) 25,3 ug/l ↑↑↑
Lumbar punction was performed, cerebrospinal fluid was slightly sanguinolent and cloudy;
laboratory results:
CSF lactate 8,2mmol/l
CSF-glucose 0,2mmol/l
CSF total protein 5,2g/l
CSF polynuclears (count) 2200/ul
CSF mononuclears (count) 250/ul
CSF erythrocytes (count) 65/ul
The most probable cause is:
a. developing septic state, the probable cause is bacterial meningitis
b. contamination of cerebrospinal fluid with peripheral blood elements
c. severe serous, probably viral, meningoencephalitis
d. isolated bacterial meningitis without systemic inflammation
A
381
383. Calculate urinary protein loss per 24 hours when you have following results:
total protein in serum 75.5 g/l
total urinary protein 8.5 g/l
urinary volume per 24 hours 1688.7 ml
patient weight 75.8 kg
Urinary protein loss write in grams per day with precission to 1 decimal point (the result wil look like e.g.: 1,5). Don´t write the unit itself (g/day) to the result.
14,4
382
384. To calculate unmeasured anions, you have to know concentration of:
a. bicarbonates
b. chlorides
c. sodium and potassium
d. albumin and phosphates
ABCD
383
385. Diagnostic laboratory signs of metabolic syndrome are:
a. impaired glucose tolerance
b. hypertriglyceridemia
c. type 2 diabetes mellitus
d. low HDL-cholesterol concentration
e. impaired fasting glucose
ABCDE
384
387. In purulent (bacterial) meningitis:
a. cyto-protein dissociation
b. protein-cytological dissociation
c. granulocytes pleocytosis
d. protein-cytological association
CD
385
388. Hypocapnea
can be found in
a. Hepatal coma
b. Diabetic ketoacidosis
c. Salycilate poisoning
d. Chronic renal failure
ABCD
386
389. M protein has
a. Always light chains of the same type
b. Its presence causes changes in the ratio of free light chain in the serum
AB
387
390. Natremia value is always evaluated together with:
a. Albumin in serum
b. Chlorides in Serum
c. Hydration of Patient
ABC
388
391. Which preanalytical measure must be kept during urine collection for chemical evaluation and urine sed evaluation:
a. To prefer 1st morning urine sample
b. to deliver to the laboratory within 1
hour
AB
389
392. Physiological Pregnancy (especially 3rd trimester)
a. increased ALP activity + uric acid (from placenta)
b. Hypercoagulation state
AB
390
393 Higher concentration of ammonia in plasma can be found
a. decompensated liver cirrhosis
b. newborns with defect of urea cycle enzymes
a. acute liver failure
ABC
391
394. AMong autoimmune diseases belong
a. Type 1 DM
b. Hashimoto thyroiditis
c. celiac disease
ABC
392
395. in vagans (strict vegetarians) we can find following lab results
a. increased serum lipids
b. increase of homocysteine becasue of vitamin B12 deficiency
c. alkaline pH of urine
d. decreased Ca, Fe, Zn, I
ABCD
393
396 Steroids:
a. increase glucose
b decrease kalemia
c. increase neutrophils (immature form)
d. decrease lymphocytes
ABCD
394
396 Steroids:
a. increase glucose
b decrease kalemia
c. increase neutrophils (immature form)
d. decrease lymphocytes
ABCD
