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Clinical chemistry > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Which type of chemical bond is the strongest?
a. covalent
b. hydrogen
c. ionic
d. Van der Waals

A

C. ionic

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2
Q

A reference range is ___ from the mean
a. +/-2 SD
b. 1/2
c. +/-3 SD
d. 4x

A

a. +/-2 SD

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3
Q

What does the blue diamond indicate on the NFPA label
a. fire hazard
b. reactivity
c. health hazard
d. specific hazard

A

c. health hazard

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4
Q

True or False: Proficiency testing can be used as competency testing

A

True

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5
Q

A ___ is determined by drawong many specimens and calculating the mean and SD. It allows health care providers to determine the extent of an abnormal test.
A. proficiency sample
B. symptom
C. basic metabolic panel
D. reference range

A

D. reference range

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6
Q

Which factors affect a chemical reaction:

A. enzymes
b. pressure
c. concentration
d. light
e. temp

A

all

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7
Q

___ is defined as the removal of contaminating substances from an object
a. autoclaving
b. decontamination
c. sterilization

A

b. decontamination

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8
Q

True or False: when a clinical lab test is highly sensitive, false neg results are at a minimum

A

true

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9
Q

Which type of pipette requires the user to “blow out” the remainder of the sample in the tip?
a. TD pipette
b. TC pipette
c. micropipette
d. MLA pipette

A

b. TC pipette

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10
Q

___ accredits clinical laboratories, using specific department-related checklists to inspect laboratories

A

CAP

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11
Q

___ governs activities of all laboratories in order to enhance the quality of lab services provided to pts. It mandates QA/QC and the training req’d for personnel (the more complex the testing, the higher the standards for personnel)

A

CLIA

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12
Q

___ accredits hospitals and other health care organizations

A

TJC

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13
Q

calibrated to hold onto a certain volume of liquid in the tip and requires it to be pushed out for accurate delivery
a. volumetric pipette
b. serologic TD
c. serologic TC

A

c. serologic TC

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14
Q

long glass tube w/ bubble in middle, each pipette has only one volume and no gradation
a. volumetric pipette
b. serologic TD
c. serologic TC

A

a. volumetric pipette

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15
Q

retains some liquid in the tip after dispersal
a. volumetric pipette
b. serologic TD
c. serologic TC

A

b. serologic TD

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16
Q

which type of immunoassay requires removal of free Ag through a wash step?
a. homogenous
b. heterogenous

A

b. heterogenous

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17
Q

absorbs high intensity UV and emits a longer wavelength of visible light
a. spectrophotometry
b. reflectance photometry
c. fluorometry
d. chemiluminescence
e. nephelometry
f. turbidimetry

A

c. fluorometry

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18
Q

amount of light scattered by particles is measured by a photodetector at 90 degree angle to the light source
a. spectrophotometry
b. reflectance photometry
c. fluorometry
d. chemiluminescence
e. nephelometry
f. turbidimetry

A

e. nephelometry

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19
Q

measures the amt of light blocked by suspension of particles
a. spectrophotometry
b. reflectance photometry
c. fluorometry
d. chemiluminescence
e. nephelometry
f. turbidimetry

A

f. turbidimetry

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20
Q

chemical energy emitted is proportional to analyte concentration
a. spectrophotometry
b. reflectance photometry
c. fluorometry
d. chemiluminescence
e. nephelometry
f. turbidimetry

A

d. chemiluminescence

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21
Q

absorption/transmission of light through a colored solution providing a means of measuring light absorbing particles
a. spectrophotometry
b. reflectance photometry
c. fluorometry
d. chemiluminescence
e. nephelometry
f. turbidimetry

A

a. spectrophotometry

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22
Q

filtered light is focused on a flat test surface. a portion of the light is absorbed while the remainder is reflected on a photodetector
a. spectrophotometry
b. reflectance photometry
c. fluorometry
d. chemiluminescence
e. nephelometry
f. turbidimetry

A

b. reflectance photometry

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23
Q

ion selective electrodes compare the voltage of the indicator (measuring) electrode to the voltage of what other electrode?

A

reference electrode

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24
Q

a wavelength of 250nm falls into which category of electromagnetic radiation?
a. radio
b. microwave
c. ultraviolet
d. visible

A

c. ultraviolet

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25
Q

basic electrolytes (Na+, K+, Cl-) and hydrogen ions are most frequently measured using what methodology?
a. fluorometry
b. electrophoresis
c. chromatography
d. ion selective electrodes

A

d. ion selective electrodes

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26
Q

In flow cytometry side scatter is affected by:
a. cell granularity
b. cell surface area
c. internal complexity of cell
d. cell size
e. A and C
f. B and D

A

e. A and C

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27
Q

If a wavelength at about 600nm is transmitting a blue color, what color is it absorbing?
a. blue
b. orange
c. green
d. violet

A

b. orange

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28
Q

spectrophotometry is commonly used to measure analytes in ___

A

blood

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29
Q

mass spec is commonly used to monitor ___ (4)

A

therapeutic drugs, drugs of abuse, trace minerals, and vitamins

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30
Q

fluorometry is commonly used in flow cytometry to detection of ____ and ___ of ___

A

size, granularity, WBC

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31
Q

chemiluminescence is commonly used to detect ___ and ___

A

drugs and hormones

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32
Q

nephelometry is commonly used to detect ___

A

plasma proteins

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33
Q

ultraviolet light has ___ wavelengths than visible light and would therefore have ___ energy than visible light
a. longer, more
b. longer, less
c. shorter, less
d. shorter, more

A

d. shorter, more

34
Q

turbidimetry is similar to ___ whereas nephelometry is similar to ___ in that it detects particles in solution at an angle from transmitted light

A

absorption spectrophotometry, fluorometry

35
Q

in clinical lab, wavelength is most commonly measured in what unit?
a. micrometer (10^-6m)
b. nanometer (10^-9m)
c. centimeter (10^-2m)
d. angstroms (10^-10m)

A

b. nanometer (10^-9m)

36
Q

the analyte or chemical compound that absorbs light at a specific wavelength is called a ___

37
Q

True or False: fluorometry is more sensitive than spectrophotometry because the emitted fluorescence comes directly from the sample

38
Q

a substance fluoresces when it absorbs light at one wavelength and emits light at a ___ energy, or longer wavelength
a. higher
b. lower

39
Q

gamma rays have a very short wavelength. you would, therefore, expect them to have ___ frequency and energy
a. high
b. low
c. medium
d. no

40
Q

which of the following is the most common cause of a shift in a control chart?
a. poor placement in run
b. not refrigerating controls
c. outdated reagent
d. different control lot used

A

d. different control lot used

41
Q

a quality management system includes:
a. SOPs
b. CQI programs
c. statistical analysis
d. 12 essential steps
e. all of the above

A

e. all of the above

42
Q

an ___ control comes w/ a predetermined target value established by the manufacturer whereas an ___ control does not come with target values

A

assayed, unassayed

43
Q

uncontrollable variables in the preanalytical phase include all of the following except:
a. hemolysis
b. age of pt
c. diet/fasting
d. excersize

A

a. hemolysis

44
Q

reagent pumped nonstop using peristaltic pumps while injecting samples at regular intervals
a. centrifugal analyzer
b. continuous flow analyzer
c. discrete analyzer

A

b. continuous flow analyzer

45
Q

mixes reagents and sample by using centrifugal force, mixture read spectrophotometrically
a. centrifugal analyzer
b. continuous flow analyzer
c. discrete analyzer

A

a. centrifugal analyzer

46
Q

each specimen has its own reaction vessel with reagent
a. centrifugal analyzer
b. continuous flow analyzer
c. discrete analyzer

A

c. discrete analyzer

47
Q

Levey-jennings charts
a. are constructed using 2SD
b. are constructed using 5SD
c. do not contain useful info
d. are an old concept not used in laboratories today

A

a. are constructed using 2SD

48
Q

A troponin test is usually a critical test for which of the following reasons:
a. clinicians need a troponin result to asses diuretic status ASAP
b. determining if MI is present is essential for the next steps in managing a pt
c. b/c CHF has a sudden onset and can lead to death
d. Troponin tests typically take a long time to run so they should always be tested first

A

b. determining if MI is present is essential for the next steps in managing a pt

49
Q

Myocardial ischemia refers to which of the following?
a. Death of heart tissue
b. A procedure for restoring blood flow
c. A heart attack
d. Lack of oxygen to heart muscle tissue

A

d. Lack of oxygen to heart muscle tissue

50
Q

Which of the following is a contemporary, useful marker of myocardial damage?
a. Myoglobin
b. CK-MB
c. Troponin I
d. Lactate dehydrogenase (LD)

A

c. Troponin I

51
Q

A hospital laboratorian is given several different test samples to run. These include samples with tests for thyroid-stimulating hormone (TSH), blood urea nitrogen (BUN), complete blood count (CBC), and troponin. Given only this information, which test makes the most sense to process and run first?
a. CBC
b. BUN
c. Troponin
d. TSH

A

c. Troponin

52
Q

Which of the following markers is used predominantly for the assessment of congestive heart failure (CHF)?
a. Myoglobin
b. Brain natriuretic peptide (BNP)
c. Creatine Kinase MB isoform (CK-MB)
d. Troponin

A

b. Brain natriuretic peptide (BNP)

53
Q

Troponin-T rises about ________ hours after infarction peaking at about __________ hours post infarction and returns to normal in _________ days.

a. 4-6 hours : peaks at 24 hours : returns to normal 3-4 days
b. 4 hours : peaks at 18 hours : returns to normal 2 days
c. 5-6 hours : peaks at 12 hours : returns to normal 1 days
d. 3 - 6 hours : peaks at 12 - 16 hours : returns to normal 14 days
e. 4-6 hours : peaks at 10-24 hours : returns to normal 4 days

A

d. 3 - 6 hours : peaks at 12 - 16 hours : returns to normal 14 days

54
Q

A laboratorian is testing cardiac biomarkers on a patient who had a severe myocardial infarction (MI). In what order will the technologist see the markers go back to baseline? Place the markers in order of first to be undetectable, to the last analyte to be detected.

	Creatine kinase isoform (CK-MB)
	Troponin
	Myoglobin
A

myoglobin, creatine kinase isoform (CK_MB), troponin

55
Q

What is the specimen of choice for lipid studies?
a) EDTA
b) serum separator
c) Heparinized plasma
d) oxalate

A

b) serum separator

56
Q

Which of the following results are the most consistent with coronary heart disease?
a) 50mg/dl HDL and 190 total Chol
b) 20mg/dl HDL and 250 total Chol
c) 35mg/dl HDL and 200 total chol
d) 60mg/dl HDL and 170 total chol
e) 55mg/dl HDL and 180 total chol

A

b) 20mg/dl HDL and 250 total Chol

57
Q

What is the smallest and densest lipoprotein molecule?
a) LDL
b) chylomicron
c) HDL
d) VLDL

58
Q

Elevated levels of which lipoprotein are considered an independent risk factor for coronary heart disease?
a) LDL
b) Lp(a)
c) VLDL
d) HDL

59
Q

Which lipoprotein molecule is responsible for transporting cholesterol from the liver?
a) chylomicrons
b) HDL
c) VLDL
d) LDL

60
Q

When the triglyceride concentration is above 400mg/dL, an indirect measurement for LDL cholesterol is invalid.

True
False
61
Q

Which pathway is involved in transporting dietary triglycerides from the small intestines towards the liver?
a) Endogenous pathway
b) LDL receptor pathway
c) Reverse cholesterol transport pathway
d) Exogenous pathway

A

d) Exogenous pathway

62
Q

Friedewald formula

A

LDL = Total Chol. — [HDL + (Triglycerides/5)]

63
Q

The optimal value for triglycerides is:
a) >60 mg/dl
b) <150md/dl
c) >200mg/dl
d) <100 mg/dl

A

b) <150md/dl

64
Q

The primary function of serum albumin in the peripheral blood is to:
A) maintain blood viscosity
B) increase antibody production
C) increase fibrinogen formation
D) maintain colloidal osmotic pressure

A

D) maintain colloidal osmotic pressure

65
Q

inhibitor binds to enzyme-substrate complex, slowing down overall enzymatic reaction
1. Competitive Inhibition
2. Noncompetitive Inhibition
3. Uncompetitive Inhibition

A
  1. Uncompetitive Inhibition
66
Q

Inhibitor and substrate compete for the active site on an enzyme
1. Competitive Inhibition
2. Noncompetitive Inhibition
3. Uncompetitive Inhibition

A
  1. Competitive Inhibition
67
Q

inhibitor binds at allosteric site, changing shape of enzyme’s active site
1. Competitive Inhibition
2. Noncompetitive Inhibition
3. Uncompetitive Inhibition

A
  1. Noncompetitive Inhibition
68
Q

Increased serum albumin concentrations are seen in which of the following conditions?
a) hepatic failure
b) nephrotic syndrome
c) dehydration
d) chronic inflammation

A

c) dehydration

69
Q

CK levels are the highest in which 3 major tissues
a. muscle, brain and heart
b. muscle, brain, and prostate
c. heart, brain, and GI tract
d. placenta, muscle, and heart

A

a. muscle, brain and heart

70
Q

What would you expect the LD isoenzymes to look like following an AMI?
a. normal
b. highly elevated
c. normal or slightly elevated
d. below normal

A

c. normal or slightly elevated

71
Q

Twenty different amino acids are found in the proteins of cells. What distinguishes these molecules?
a) the location of their carboxyl group
b) their ability to form peptide bonds
c) the location of their amino group
d) the composition of their side chains, or R-groups

A

d) the composition of their side chains, or R-groups

72
Q

When diagnosing hepatocellular disorders
a. ALT and AST are both non-specific
b. ALT is more specific than AST
c. ALT and AST are equally specific
d. AST is more specific than ALT

A

b. ALT is more specific than AST

73
Q

In diagnosing AMI, CK has been largely replaced by
a. troponin
b. AST
c. transferase
d. LD

A

a. troponin

74
Q

Enzymes that exist in multiple forms that are molecularly different but can act on the same substrate are called
a. apoenzymes
b. isoenzymes
c. haloenzymes
d. coenzymes

A

b. isoenzymes

75
Q

At a pH below its isoelectric point, a protein carries a ___ charge.

76
Q

Which of the following is not a method to identify isoenzyme fractions.
a. electrophoresis
b. latex agglutination
c. ion exchange chromatography
d. immunochemical assays

A

b. latex agglutination

77
Q

When diagnosing liver disease, one would expect an elevated
a. CK-MM
b. LD1 and LD2
c. ALT and AST
d. AMY

A

c. ALT and AST

78
Q

The reaction rate in an enzymatic reaction is affected by:
a. substrate concentration
b. enzyme concentration
c. pH
d. temperature

79
Q

Proteins, carbohydrates, and lipids comprise the three major biochemical compounds of human metabolism. Which element distinguishes proteins from carbohydrate and lipid compounds?
a) carbon
b) oxygen
c) nitrogen
d) hydrogen

A

c) nitrogen

80
Q

What CK fraction provides diagnostic evidence of a myocardial infarction?
a. LD5
b. LD 1
c. CK-BB
d. CK-MB

81
Q

In electrophoresis of proteins, when the sample is placed in an electric field connected to a buffer of high pH at 8.6, all of the proteins:
a) have a positive charge
b) have a negative charge
c) are electrically neutral

A

b) have a negative charge

82
Q

The main source of amylase in humans is
a. heart and liver
b. saliva and pancreas
c. liver and kidney

A

b. saliva and pancreas

Clinical chemistry (2 decks)

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