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***Medical Lab science review- Robert Harr 4th > Clinical Chemistry- Proteins, Electrophoresis, and Lipids > Flashcards

Clinical Chemistry- Proteins, Electrophoresis, and Lipids Flashcards

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1
Q
  1. Kjeldahl’s procedure for total protein is based
    upon the premise that:
    A. Proteins are negatively charged
    B. The pKa of proteins is the same
    C. The nitrogen content of proteins is constant
    D. Proteins have similar tyrosine and tryptophan
    content
A

C. The nitrogen content of proteins is constant

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2
Q
  1. Upon which principle is the biuret method based?
    A. The reaction of phenolic groups with CuIISO4
    B. Coordinate bonds between Cu+2 and carbonyl
    and imine groups of peptide bonds.
    C. The protein error of indicator effect producing
    color when dyes bind protein
    D. The reaction of phosphomolybdic acid with
    protein
A

B. Coordinate bonds between Cu+2 and carbonyl
and imine groups of peptide bonds.

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3
Q
  1. Which statement about the biuret reaction for
    total protein is true?
    A. It is sensitive to protein levels below 0.1 mg/dL
    B. It is suitable for urine, exudates, and transudates
    C. Polypeptides and compounds with repeating
    imine groups react
    D. Hemolysis will not interfere
A

C. Polypeptides and compounds with repeating
imine groups react

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4
Q
  1. Which of the following protein methods has the
    highest analytical sensitivity?
    A. Refractometry
    B. Folin–Lowry
    C. Turbidimetry
    D. Direct ultraviolet absorption
A

B. Folin–Lowry

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5
Q
  1. Which of the following statements regarding
    proteins is true?
    A. Total protein and albumin are about 10% higher
    in ambulatory patients
    B. Plasma total protein is about 20% higher than
    serum levels
    C. Albumin normally accounts for about one-third
    of the cerebrospinal fluid total protein
    D. Transudative serous fluid protein is about
    two-thirds of the serum total protein
A

A. Total protein and albumin are about 10% higher
in ambulatory patients

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6
Q
  1. Hyperalbuminemia is caused by:
    A. Dehydration syndromes
    B. Liver disease
    C. Burns
    D. Gastroenteropathy
A

A. Dehydration syndromes

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7
Q
  1. High serum total protein but low albumin is
    usually seen in:
    A. Multiple myeloma
    B. Hepatic cirrhosis
    C. Glomerulonephritis
    D. Nephrotic syndrome
A

A. Multiple myeloma

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8
Q
  1. Which of the following conditions is most
    commonly associated with an elevated level
    of total protein?
    A. Glomerular disease
    B. Starvation
    C. Liver failure
    D. Malignancy
A

D. Malignancy

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9
Q
  1. Which of the following dyes is the most specific
    for measurement of albumin?
    A. Bromcresol green (BCG)
    B. Bromcresol purple (BCP)
    C.Tetrabromosulfophthalein
    D. Tetrabromphenol blue
A

B. Bromcresol purple (BCP)

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10
Q
  1. Which of the following factors is most likely
    to cause a falsely low result when using the
    BCG dye-binding assay for albumin?
    A. The presence of penicillin
    B. An incubation time of 120 seconds
    C. The presence of bilirubin
    D. Lipemia
A

A. The presence of penicillin

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11
Q
  1. At pH 8.6, proteins are _________ charged and
    migrate toward the _________.
    A. Negatively, anode
    B. Positively, cathode
    C. Positively, anode
    D. Negatively, cathode
A

A. Negatively, anode

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12
Q
  1. Electrophoretic movement of proteins toward the
    anode will decrease by increasing the:
    A. Buffer pH
    B. Ionic strength of the buffer
    C. Current
    D. Voltage
A

B. Ionic strength of the buffer

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13
Q
  1. At pH 8.6, the cathodal movement of γ globulins
    is caused by:
    A. Electroendosmosis
    B. Wick flow
    C. A net positive charge
    D. Cathodal sample application
A

A. Electroendosmosis

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14
Q
  1. Which of the following conditions will prevent
    any migration of proteins across an electrophoretic
    support medium such as agarose?
    A. Using too high a voltage
    B. Excessive current during the procedure
    C. Loss of contact between a buffer chamber and
    the medium
    D. Evaporation of solvent from the surface of the
    medium
A

C. Loss of contact between a buffer chamber and
the medium

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15
Q
  1. Which of the following proteins has the highest pI?
    A. Albumin
    B. Transferrin
    C. Ceruloplasmin
    D. IgG
A

D. IgG

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16
Q
  1. Which of the following proteins migrates in the
    β region at pH 8.6?
    A. Haptoglobin
    B. Orosomucoprotein
    C. Antichymotrypsin
    D. Transferrin
A

D. Transferrin

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17
Q
  1. Which of the following is one advantage of
    high-resolution (HR) agarose electrophoresis
    over lower-current electrophoresis?
    A. High-resolution procedures detect monoclonal
    and oligoclonal bands at a lower concentration
    B. A smaller sample volume is used
    C. Results are obtained more rapidly
    D. Densitometric scanning of HR gels is more
    accurate
A

A. High-resolution procedures detect monoclonal
and oligoclonal bands at a lower concentration

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18
Q
  1. Which of the following conditions is associated
    with “β-γ bridging”?
    A. Multiple myeloma
    B. Malignancy
    C. Hepatic cirrhosis
    D. Rheumatoid arthritis
A

C. Hepatic cirrhosis

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19
Q
  1. Which support medium can be used to determine
    the molecular weight of a protein?
    A. Cellulose acetate
    B. Polyacrylamide gel
    C. Agar gel
    D. Agarose gel
A

B. Polyacrylamide gel

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20
Q
  1. Which of the following stains is used for
    lipoprotein electrophoresis?
    A. Oil Red O
    B. Coomassie Brilliant Blue
    C. Amido Black
    D. Ponceau S
A

A. Oil Red O

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21
Q
  1. Which of the following serum protein
    electrophoresis results suggests an acute
    inflammatory process?
A

C.

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22
Q
  1. Which of the following conditions is usually
    associated with an acute inflammatory pattern?
    A. Myocardial infarction (MI)
    B. Malignancy
    C. Rheumatoid arthritis
    D. Hepatitis
A

A. Myocardial infarction (MI)

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23
Q
  1. The electrophoretic pattern shown in the following
    densitometric tracing most likely indicates:
    A. α1-Antitrypsin deficiency
    B. Infection
    C. Nephrosis
    D. Systemic sclerosis
A

A. α1-Antitrypsin deficiency

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24
Q
  1. What is the clinical utility of testing for serum
    prealbumin?
    A. Low levels are associated with increased free
    cortisol
    B. High levels are an indicator of acute
    inflammation
    C. Serial low levels indicate compromised
    nutritional status
    D. Levels correlate with glomerular injury in
    patients with diabetes mellitus
A

C. Serial low levels indicate compromised
nutritional status

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25
Q
  1. Which serum protein should be measured in a
    patient suspected of having Wilson’s disease?
    A. Hemopexin
    B. Alpha-1 antitrypsin
    C. Haptoglobin
    D. Ceruloplasmin
A

D. Ceruloplasmin

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26
Q
  1. A patient with hemolytic-uremic syndrome
    associated with septicemia has a haptoglobin
    level that is normal, although the plasma free
    hemoglobin is elevated and hemoglobinuria is
    present. Which test would be more appropriate
    than haptoglobin to measure this patient’s
    hemolytic episode?
    A. Hemopexin
    B. Alpha-1 antitrypsin
    C. C-reactive protein
    D. Transferrin
A

A. Hemopexin

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27
Q
  1. Quantitative determination of Hgb A2 and Hgb F
    are best performed by:
    A. High-performance liquid chromatography
    B. Alkali denaturation
    C. Electrophoresis
    D. Direct bichromatic spectrophotometry
A

A. High-performance liquid chromatography

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28
Q
  1. Select the correct order of Hgb migration on
    agarose or cellulose acetate at pH 8.6.
    A. – C→F→S→A +
    B. – S→C→A→F +
    C. – C→S→F→A +
    D. – S→F→A→C +
A

C. – C→S→F→A +

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29
Q
  1. Which of the following abnormal types of Hgb
    migrates to the same position as Hgb S on agarose
    or cellulose acetate at pH 8.6?
    A. Hgb C
    B. Hgb DPunjab
    C. Hgb OArab
    D. Hgb E
A

B. Hgb DPunjab

30
Q
  1. Which Hgb is a β-δ chain hybrid and migrates to
    the same position as Hgb S at pH 8.6?
    A. Hgb CHarlem
    B. HgbLepore
    C. Hgb GPhiladelphia
    D. Hgb DPunjab
A

B. HgbLepore

31
Q
  1. Select the correct order of Hgb migration on
    citrate agar at pH 6.2.
    A. – F→S→C→A +
    B. – F→A→S→C +
    C. – A→S→F→C +
    D. – A→C→S→F +
A

B. – F→A→S→C +

32
Q
  1. Which Hgb separates from Hgb S on citrate (acid)
    agar, but not agarose or cellulose acetate?
    A. Hgb DPunjab
    B. Hgb E
    C. Hgb CHarlem (Georgetown)
    D. Hgb OArab
A

A. Hgb DPunjab

33
Q
  1. Which statement best describes immunofixation
    electrophoresis (IEF)?
    A. Proteins are separated by electrophoresis
    followed by overlay of monospecific
    anti-immunoglobulins
    B. Proteins react with monospecific antisera
    followed by electrophoresis
    C. Antisera are electrophoresed, then diffused
    against patient’s serum
    D. Serum is electrophoresed; the separated
    immunoglobulins diffuse against specific
    antisera placed into troughs
A

A. Proteins are separated by electrophoresis
followed by overlay of monospecific
anti-immunoglobulins

34
Q
  1. In double immunodiffusion reactions, the
    precipitin band is:
    A. Invisible before the equivalence point is reached
    B. Concave to the protein of greatest molecular
    weight
    C. Closest to the well containing the highest level of
    antigen
    D. Located in an area of antibody excess
A

B. Concave to the protein of greatest molecular
weight

35
Q
  1. Which of the following statements regarding the
    identification of monoclonal proteins by IFE is
    true?
    A. The monoclonal band must be present in the
    γ region
    B. When testing for a monoclonal gammopathy,
    both serum and urine must be examined
    C. A diagnosis of monoclonal gammopathy is based
    upon quantitation of IgG, IgA, and IgM
    D. A monoclonal band always indicates a malignant
    disorder
A

B. When testing for a monoclonal gammopathy,
both serum and urine must be examined

36
Q
  1. Which of the following statements regarding
    paraproteins is true?
    A. Oligoclonal banding is seen in the CSF of greater
    than 90% of multiple sclerosis cases
    B. The Bence–Jones protein heat test is
    confirmatory for monoclonal light chains
    C. Light chains found in urine are always derived
    from monoclonal protein
    D. The IgA band is usually cathodal to the IgG
    precipitin band
A

A. Oligoclonal banding is seen in the CSF of greater
than 90% of multiple sclerosis cases

37
Q
  1. Which statement regarding IFE is true?
    A. Serum containing a monoclonal protein should
    have a κ:λ ratio of 0.5
    B. A monoclonal band seen with monospecific
    antiserum should not be visible in the lane where
    polyvalent antiserum or sulfosalicylic acid was
    added
    C. CSF should be concentrated 50- to100-fold
    before performing IFE
    D. When oligoclonal bands are seen in the CSF,
    they must also be present in serum to indicate
    multiple sclerosis
A

C. CSF should be concentrated 50- to100-fold
before performing IFE

38
Q
  1. Which test is the most sensitive in detecting early
    monoclonal gammopathies?
    A. High-resolution serum protein electrophoresis
    B. Urinary electrophoresis for monoclonal light
    chains
    C. Capillary electrophoresis of serum and urine
    D. Serum-free light chain immunoassay
A

D. Serum-free light chain immunoassay

39
Q
  1. Which test is the most useful way to evaluate the
    response to treatment for multiple myeloma?
    A. Measure of total immunoglobulin
    B. Measurement of 24-hour urinary light chain
    concentration (Bence–Jones protein)
    C. Capillary electrophoresis of M-protein recurrence
    D. Measurement of serum-free light chains
A

D. Measurement of serum-free light chains

40
Q
  1. Which of the following is more commonly
    associated with a nonmalignant form of
    monoclonal gammopathy (MGUS)?
    A. Bone marrow plasma cells comprise 20% of
    nucleated cells
    B. Monoclonal protein (M-protein) concentration
    is 3.5 g/dL
    C. M-protein is IgG
    D. Age greater than 60 at the time of monoclonal
    protein discovery
A

D. Age greater than 60 at the time of monoclonal
protein discovery

41
Q
  1. Capillary electrophoresis differs from agarose gel
    electrophoresis in which respect?
    A. A stationary support is not used
    B. An acidic buffer is used
    C. A low voltage is used
    D. Electroendosmosis does not occur
A

A. A stationary support is not used

42
Q
  1. Select the order of mobility of lipoproteins
    electrophoresed on cellulose acetate or agarose at pH 8.6.
    A. – Chylomicrons→pre-β →β→α+
    B. – β→pre-β→α→chylomicrons +
    C. – Chylomicrons →β→pre-β→α +
    D. – α→β→pre-β→chylomicrons +
A

C. – Chylomicrons →β→pre-β→α +

43
Q
  1. Following ultracentrifugation of plasma, which
    fraction correlates with pre-β lipoprotein?
    A. Very low-density lipoprotein (VLDL)
    B. Low-density lipoprotein (LDL)
    C. High-density lipoprotein (HDL)
    D. Chylomicrons
A

A. Very low-density lipoprotein (VLDL)

44
Q
  1. Select the lipoprotein fraction that carries most of
    the endogenous triglycerides.
    A. VLDL
    B. LDL
    C. HDL
    D. Chylomicrons
A

A. VLDL

45
Q
  1. The protein composition of HDL is what
    percentage by weight?
    A. Less than 2%
    B. 25%
    C. 50%
    D. 90%
A

C. 50%

46
Q
  1. Which apoprotein is inversely related to risk of
    coronary heart disease?
    A. Apoprotein A-I
    B. Apoprotein B100
    C. Apoprotein C-II
    D. Apoprotein E4
A

A. Apoprotein A-I

47
Q
  1. In familial β dyslipoproteinemia (formerly
    type III hyperlipoproteinemia), which lipoprotein
    accumulates?
    A. Chylomicrons
    B. VLDL
    C. IDL
    D. VLDL
A

C. IDL

48
Q
  1. Which of the following mechanisms accounts
    for the elevated plasma level of β lipoproteins
    seen in familial hypercholesterolemia (formerly
    type II hyperlipoproteinemia)?
    A. Hyperinsulinemia
    B. ApoB-100 receptor defect
    C. ApoC-II activated lipase deficiency
    D. ApoE3 deficiency
A

B. ApoB-100 receptor defect

49
Q
  1. Which enzyme deficiency is most commonly
    associated with familial hypertriglyceridemia
    associated with fasting plasma cholomicrons
    (formerly type I hyperlipoproteinemia)?
    A. β Glucocerebrosidase deficiency
    B. Post–heparin-activated lipoprotein lipase
    deficiency
    C. Apo-B deficiency
    D. Apo-C-III deficiency
A

B. Post–heparin-activated lipoprotein lipase
deficiency

50
Q
  1. Which of the following conditions is most
    consistently associated with secondary
    hypercholesterolemia?
    A. Hypothyroidism
    B. Pancreatitis
    C. Oral contraceptive therapy
    D. Diabetes mellitus
A

A. Hypothyroidism

51
Q
  1. Which of the following is associated with Tangier
    disease?
    A. Apoprotein C-II deficiency
    B. Homozygous apo-B100 deficiency
    C. Apoprotein C-II activated lipase
    D. Apoprotein A-I deficiency
A

D. Apoprotein A-I deficiency

52
Q
  1. Which of the following statements is correct?
    A. Both HDL and LDL are homogenous
    B. There are several subfractions of LDL but
    not HDL
    C. There are several subfractions of HDL but
    not LDL
    D. There are several subfractions of both HDL
    and LDL
A

D. There are several subfractions of both HDL
and LDL

53
Q
  1. What is the lipid testing protocol for adults
    recommended by the National Cholesterol
    Education Program (NCEP) to evaluate risk for
    atherosclerosis beginning at age 20?
    A. Total cholesterol, fasting or nonfasting every year
    B. Total cholesterol, fasting, every 2 years
    C. Lipid profile, fasting, every 5 years
    D. LDL cholesterol, fasting, every 2 years
A

C. Lipid profile, fasting, every 5 years

54
Q
  1. What is the most appropriate fasting procedure
    when a lipid study of triglyceride, total cholesterol,
    HDL cholesterol, and LDL cholesterol tests are
    ordered?
    A. 8 hours; nothing but water allowed
    B. 10 hours; water, smoking, coffee, tea (no sugar
    or cream) allowed
    C. 12 hours; nothing but water allowed
    D. 16 hours; water, smoking, coffee, tea (no sugar
    or cream) allowed
A

C. 12 hours; nothing but water allowed

55
Q
  1. Treatment recommendations for patients with
    coronary heart disease are based upon
    measurement of which analyte?
    A. HDL cholesterol
    B. Apo-B100
    C. LDL cholesterol
    D. Total cholesterol
A

C. LDL cholesterol

56
Q
  1. What is the HDL cholesterol cutpoint recommend
    by NCEP?
    A. <30 mg/dL
    B. <40 mg/dL
    C. <30 mg/dL for males and < 40 mg/dL
    for females
    D. <45 mg/dL for males and < 50 mg/dL
    for females
A

B. <40 mg/dL

57
Q
  1. An EDTA blood sample is collected from a
    nonfasting person for a CBC. The physician
    collected the sample from the femoral vein because
    venipuncture from the arm was unsuccessful. He
    called the lab 15 minutes after the sample arrived
    and requested a lipid study including triglyceride,
    total cholesterol, HDL cholesterol, and LDL
    cholesterol. Which test results should be used to
    evaluate the patient’s risk for coronary artery
    disease?
    A. Total cholesterol and LDL cholesterol
    B. LDL cholesterol and triglyceride
    C. Total cholesterol and HDL cholesterol
    D. Total cholesterol and triglyceride
A

C. Total cholesterol and HDL cholesterol

58
Q
  1. Which of the following diseases is caused by a
    deficiency of sphingomyelinase?
    A. Gaucher disease
    B. Fabry disease
    C. Niemann–Pick disease
    D. Tay–Sachs disease
A

C. Niemann–Pick disease

59
Q
  1. Which method is considered the candidate
    reference method for triglyceride measurement?
    A. Glycerol kinase-ultraviolet
    B. CDC modification of van Handel and Zilversmit
    C. Hantzsch condensation
    D. Glycerol kinase coupled to peroxidase
A

B. CDC modification of van Handel and Zilversmit

60
Q
  1. Which of the following enzymes is common to all
    enzymatic methods for triglyceride measurement?
    A. Glycerol phosphate oxidase
    B. Glycerol phosphate dehydrogenase
    C. Glycerol kinase
    D. Pyruvate kinase
A

C. Glycerol kinase

61
Q
  1. Select the reagent needed in the coupling enzyme
    reaction used to generate a colored product in the
    cholesterol oxidase method for cholesterol.
    A. Cholestahexaene
    B. H2O2
    C. 4-Aminoantipyrine
    D. Cholest-4-ene-3-one
A

C. 4-Aminoantipyrine

62
Q
  1. What is the purpose of the saponification step used
    in the Abell–Kendall method for cholesterol
    measurement?
    A. Remove phospholipids
    B. Reduce sterol molecules structurally similar to
    cholesterol
    C. Convert cholesterol esters to free cholesterol
    D. Remove proteins that can interfere with color
    formation
A

C. Convert cholesterol esters to free cholesterol

63
Q
  1. Which of the following methods for HDL
    cholesterol is the reference method?
    A. Manganese–heparin
    B. Magnesium–phosphotungstate
    C. Magnesium–dextran
    D. Ultracentrifugation
A

D. Ultracentrifugation

64
Q
  1. Cholesterol esterase is used in enzymatic assays to:
    A. Oxidize cholesterol to form peroxide
    B. Hydrolyze fatty acids bound to the third carbon
    atom of cholesterol
    C. Separate cholesterol from apoproteins A-I
    and A-II by hydrolysis
    D. Reduce NAD+ to NADH
A

B. Hydrolyze fatty acids bound to the third carbon
atom of cholesterol

65
Q
  1. Which of the following reagents is used in the
    direct HDL cholesterol method?
    A. Sulfated cyclodextrin
    B. Magnesium sulfate and dextran sulfate
    C. Anti-apoA-I
    D. Manganese heparin
A

A. Sulfated cyclodextrin

66
Q
  1. What do “direct” or homogenous methods for
    LDL cholesterol assay have in common?
    A. They are inaccurate when plasma triglyceride is
    above 250 mg/dL
    B. All use a detergent to facilitate selective reactivity
    with reagent enzymes
    C. All use monoclonal antibodies to apo A1 and C
    D. All are free of interference from abnormal
    lipoproteins
A

B. All use a detergent to facilitate selective reactivity
with reagent enzymes

67
Q
  1. Lipoprotein (a), or Lp(a), is significant when
    elevated in serum because it:
    A. Is an independent risk factor for atherosclerosis
    B. Blocks the clearance of VLDLs
    C. Displaces apo-AI from HDLs
    D. Is linked closely to a gene for obesity
A

A. Is an independent risk factor for atherosclerosis

68
Q
  1. Which type of dietary fatty acid is not associated
    with an increase in serum LDL cholesterol
    production?
    A. Monounsaturated trans fatty acids
    B. Saturated fatty acids
    C. Monounsaturated cis fatty acids
    D. Monounsaturated trans Ω-9 fatty acids
A

C. Monounsaturated cis fatty acids

69
Q
  1. SITUATION: A lipemic specimen collected from
    an adult after a 12-hour fast was assayed for total
    cholesterol, triglycerides, and HDL cholesterol
    using a direct HDL method.

Following are the results:
Total cholesterol = 220 mg/dL
HDL cholesterol = 40 mg/dL
Triglyceride = 420 mg/dL

The physician requests an LDL cholesterol assay
after receiving the results. How should the LDL
cholesterol be determined?

A. Dilute the specimen 1:10 and repeat all tests;
calculate LDL cholesterol using the Friedewald
equation
B. Perform a direct LDL cholesterol assay
C. Ultracentrifuge the sample and repeat the HDL
cholesterol on the infranate. Use the new result
to calculate the LDL cholesterol
D. Repeat the HDL cholesterol using the
manganese heparin precipitation method. Use
the new result to calculate the LDL cholesterol

A

B. Perform a direct LDL cholesterol assay

70
Q
  1. A person has a fasting triglyceride level of
    240 mg/dL. The physician wishes to know the
    patient’s non-HDL cholesterol level. What
    cholesterol fractions should be measured?
    A. Total cholesterol and HDL cholesterol
    B. Total cholesterol and LDL cholesterol
    C. HDL cholesterol and LDL cholesterol
    D. Total cholesterol and chylomicrons
A

A. Total cholesterol and HDL cholesterol

***Medical Lab science review- Robert Harr 4th (63 decks)

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