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BOC Book > Electrolytes (Chemistry) > Flashcards

Electrolytes (Chemistry) Flashcards

1
Q

Select the test which evaluates renal tubular function.

A) IVP
B) creatinine clearance
C) osmolarity
D) microscopic urinalysis

A

C) osmolarity

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2
Q

A patient had the following serum results

Na+: 140. mEq/L (140. mmol/L)
K+: 4.0 mEq/L (4.0 mmol/L)
glucose: 95. mg/dL (5.2 mmol/L)
BUN: 10. mg/dL (3.57 mmol/L)

Which osmolality is consistent with these results?

A) 188
B) 204
C) 270
D) 390

A

C) 270

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3
Q

The degree to which the kidney concentrates the glomerular filtrate can be determined by:

A) urine creatinine
B) serum creatinine
C) creatinine clearance
D) urine to serum osmolality ratio

A

D) urine to serum osmolality ratio

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4
Q

Osmolal gap is the difference between:

A) the ideal and real osmolality values
B) calculated and measured osmolality values
C) plasma and water osmolality values
D) molality and molarity at 4 degrees C

A

B) calculated and measured osmolality values

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5
Q

Quantitation of Na+ and K+ by ion-selective electrode is the standard method because:

A) dilution is required for flame photometry
B) there is no lipoprotein interference
C) of advances in electrochemisty
D) of the absence of an internal standard

A

C) of advances in electrochemisty

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6
Q

What battery of test is most useful in evaluating an anion gap of 22 mEq/L (22 mmol/L)?

A) Ca2+, Mg2+, PO4, 3-, and pH
B) BUN, creatinine, salicylate and methanol
C) AST, ALT, LD and amylase
D) glucose, CK, myoglobin and cryoglobulin

A

B) BUN, creatinine, salicylate and methanol

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7
Q

A patient with myeloproliferative disorder has the following values:

Hgb: 13 g/dL (130 mmol/L)
Hct: 38%
WBC: 30 x 10^3/uL (30 x 10^9/L)
Platelets: 1000 x 10^3 uL (1000 x 10^9/L)
serum Na+: 140 mEq/L (140 mmol/L)
serum K+: 7 mEq/L (7 mmol/L)

The serum K+ should be confirmed by:

A) repeat testing of the original serum
B) testing freshly drawn serum
C) testing heparinized plasma
D) atomic absorption spectrometry

A

C) testing heparinized plasma

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8
Q

Serum “anion gap” is increased in patients with:

A) renal tubular acidosis
B) diabetic alkalosis
C) metabolic acidosis due too diarrhea
D) lactic acidosis

A

D) lactic acidosis

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9
Q

The anion gap is useful for quality control of laboratory results for:

A) amino acids and proteins
B) blood gas analyses
C) sodium, potassium, chloride, and total CO2
D) calcium, phosphorus and magnesium

A

C) sodium, potassium, chloride, and total CO2

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10
Q

The buffering capacity of blood is maintained by a reversible exchange process between bicarbonate and:

A) sodium
B) potassium
C) calcium
D) chloride

A

D) chloride

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11
Q

Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?

A) chloride
B) calcium
C) potassium
D) sodium

A

D) sodium

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12
Q

A potassium level of 6.8 mEq/L (6.8 mmol/L) is obtained. Before reporting the results the first step the technologist should take is to:

A) check the serum for hemolysis
B) rerun the test
C) check the age of the patient
D) do nothing, simply report our the result

A

A) check the serum for hemolysis

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13
Q

The solute that contributes the most to the total serum osmolality is:

A) glucose
B) sodium
C) chloride
D) urea

A

B) sodium

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14
Q

A sweat chloride result of 55 mEq/L (55 mmol/L) and a sweat sodium of 52 mEq/L (52 mmol/L) were obtained on a patient who has a history of respiratory problems. The best interpretation of these results is:

A) normal
B) normal sodium and an abnormal chloride test should be repeated
C) abnormal results
D) intermediate results

A

D) intermediate results

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15
Q

Which of the following is true about direct ion selective electrodes for electrolytes?

A) whole blood specimens are acceptable
B) elevated lipids cause falsely decreased results
C) elevated proteins cause falsely decreased results
D) elevated platelets cause falsely increased results

A

A) whole blood specimens are acceptable

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16
Q

Sodium determination by indirect ion selective electorde is falsely decreased by:

A) elevated chloride levels
B) elevated lipid levels
C) decreased protein levels
D) decreased albumin levels

A

B) elevated lipid levels

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17
Q

A physician requested that electrolytes on a multiple myeloma patient specimen be run by direct ISE and not indirect ISE because:

A) excess protein binds Na in indirect ISE
B) Na is falsely increased by indirect ISE
C) Na is falsely decreased by indirect ISE
D) excess protein reacts with diluent in indirect ISE

A

C) Na is falsely decreased by indirect ISE

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18
Q

Which percentage of total serum calcium is nondiffusibile protein bound?

A) 80-90%
B) 51-60%
C) 40-50%
D) 10-30%

A

C) 40-50%

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19
Q

The best method for ionized calcium involves the use of:

A) valinomycin incorporated into a semipermeable membrane that allows for change in current
B) ion selective electrode that detects change in potential when Ca2+ binds reversibly to the membrane
C) 8-hydroxyquinoline selective membrane that bins with Ca2+ to prevent other ions which may change potential
D) biuret reaction that removes protein prior to binding with arsenazo ions to cause change in voltage

A

B) ion selective electrode that detects change in potential when Ca2+ binds reversibly to the membrane

20
Q

The regulation of calcium and phosphorous metabolism is accomplished by which of the following glands?

A) thyroid
B) parathyroid
C) adrenal glands
D) pituitary

A

B) parathyroid

21
Q

A hospitalized patient is experiencing increased neuromuscular irritability (tetany). Which of the following tests should be ordered immediatley?

A) calcium
B) phosphate
C) BUN
D) glucose

A

A) calcium

22
Q

Which of the following is most likely to be ordered in addition to ionized calcium to determine the cause of tetany?

A) magnesium
B) phosphate
C) sodium
D) vitamin D

A

A) magnesium

23
Q

A reciprocal relationship exists between:

A) sodium and potassium
B) calcium and phosphate
C) chloride and CO2
D) calcium and magnesium

A

B) calcium and phosphate

24
Q

Fasting serum phosphate concentration is controlled primarily by the:

A) pancreas
B) skeleton
C) parathyroid glands
D) small intestine

A

C) parathyroid glands

25
Q

A low concentration of serum phosphorus is commonly found in:

A) patients who are receiving carbohydrate hyperalimentation
B) chronic renal disease
C) hypoparathyroidism
D) patients with pituitary tumors

A

A) patients who are receiving carbohydrate hyperalimentation

26
Q

The following serum laboratory results were obtained:

decreased albumin
decreased calcium
increased creatinine
increased phosphorus
increased magnesium

These results are most compatible with:

A) multiple myeloma
B) primary hyperparathyroidism
C) chronic renal failure
D) secondary hyperparathyroidism

A

C) chronic renal failure

27
Q

Total iron-binding capacity measures the serum iron transporting capacity of:

A) hemoglobin
B) ceruloplasmin
C) transferrin
D) ferritin

A

C) transferrin

28
Q

The first step in the quantitation of serum iron is:

A) direct reaction with appropriate chromogen
B) iron saturaiton of transferrin
C) free iron precipitation
D) separation of iron from transferrin

A

D) separation of iron from transferrin

29
Q

A patient’s blood was drawn at 8 am for a serum iron determination. The result was 85 ug/dL (15.2 umol/L). A repeat specimen was drawn at 8 pm; the serum was stored at 4 degrees C and ran the next morning. The result was 40 ug/dL (7.2 umol/L). These results are most likely due to:

A) iron deficiency anemia
B) improper storage of the specimen
C) possible liver damage
D) the time of day the second specimen was drawn

A

D) the time of day the second specimen was drawn

30
Q

An elevated serum iron with normal iron binding capacity is most likely associated with:

A) iron deficiency anemia
B) renal damage
C) chronic anemia
D) septicemia

A

C) chronic anemia

31
Q

Decreased serum iron associated with increased TIBC is compatible with which of the following disease states?

A) anemia of chronic infection
B) iron deficiency anemia
C) chronic liver disease
D) nephrosis

A

B) iron deficiency anemia

32
Q

A patient has the following results:

serum ion: 250 ug/dL (44.8 umol/L)
reference range: 60-150 ug/dL (10.7- 26.9 umol/L)

TIBC: 250 ug/dL (62.7 umol/L)
reference range: 300-350 ug/dL (53.7-62.7 umol/L)

The best conclusion is that this patient has

A) normal iron status
B) iron deficiency anemia
C) chronic disease
D) iron hemochromatosis

A

D) iron hemochromatosis

33
Q

Serum and urine copper levels are assayed on a hospital patient with the following results:

Serum Cu: 20 ug/dL (3.1 umol/L)
Reference Range: 70-140 ug/dL (11.0-22.0 umol/L)

Urine Cu: 83 ug/dL (13.0 umol/L)
Reference Range: <40 ug/dL (<63 umol/L)

A) normal copper levels
B) Wilms tumor
C) Wilson disease
D) Addison disease

A

C) Wilson disease

34
Q

After a difficult venipuncture requiring prolonged application of the tourniquet, the serum K+ was found to be 6.8 mEq/L (6.8 mmol/L). The best course of action is to:

A) repeat the test using the same specimen
B) adjust the value base on the current serum Na+
C) repeat the test using freshly drawn serum
D) cancel the test

A

C) repeat the test using freshly drawn serum

35
Q

Serum from a patient with metastatic carcinoma of the prostate was separated from the clot and stored at room temperature. The following results were obtained:

Ca++: 10.8 mg/dL (2.7 mmol/L)
Reference Range: 8.8-10.3 mg/dL (2.2-2.6 mmol)

LD: 420 U/L
Reference Range: 50-150 U/L

Acid Phosphatase: 0.1 U/L
Reference Range: 0-5.5 U/L

The technician should repeat the:

A) LD using diluted serum
B) acid phosphatase with freshly drawn serum
C) LD with fresh serum
D) tests using plasma

A

B) acid phosphatase with freshly drawn serum

36
Q

The osmol gap is defined as measured Osm/Kg minus the calculated Osm/Kg. Normally th osmol gap is less than:

A) 10
B) 20
C) 40
D) 60

A

A) 10

37
Q

In the atomic absorption method for calcium, lanthanum is used:

A) as an internal standard
B) to bind calcium
C) to eliminate protein interference
D) to prevent phosphate interference

A

D) to prevent phosphate interference

38
Q

Which of the following methods is susceptible to the solvent displacing effect that results in falsely decreased electrolyte values?

A) indirect ion-selective electrodes
B) direct ion-selective electrodes
C) alkaline electrophoretic separation of ions
D) fluorescence

A

A) indirect ion-selective electrodes

39
Q

An automated method for measuring chloride which generates silver ions in the reaction is:

A) coulometry
B) mass spectroscopy
C) chromatography
D) polarography

A

A) coulometry

40
Q

Coulometry is often used to measure:

A) chloride in sweat
B) the pH in saliva
C) bicarbonate in urine
D) ammonia in plasma

A

A) chloride in sweat

41
Q

Valinomycin enhances the selectivity of the electrode used to quantitate:

A) sodium
B) chloride
C) potassium
D) calcium

A

C) potassium

42
Q

Magnesium carbonate is added in an iron binding capacity determination in order to:

A) allow color to develop
B) precipitate protein
C) bind with hemoglobin iron
D) remove excess unbound iron

A

D) remove excess unbound iron

43
Q

Which of the following calcium procedures utilizes lanthanum chloride to eliminate interfering substances?

A) o-cresolphthalein complexone
B) preicpitation with chloranilic acid
C) chelation with EDTA
D) atomic absorption spectrophotometry

A

D) atomic absorption spectrophotometry

44
Q

The osmolality of a urine or serum specimen is measured by a change in the:

A) freezing point
B) sedimentation point
C) midpoint
D) osmotic pressure

A

A) freezing point

45
Q

Which of the following applies to cryoscopic ossmometry?

A) temperature at equilibrium is a function of the number of particles in solution
B) temperature plateau for a solution is horizontal
C) freezing point of a sample is absolute
D) initial freezing of a sample produces an immediate solid state

A

A) temperature at equilibrium is a function of the number of particles in solution

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