Exam 1

Question 1

Serum gastrin test

Answer 1

used to diagnose Zollinger-Ellison syndrome (will be elevated)

Question 2

Urea Breath Test

Answer 2

used to diagnose peptic ulcer disease

Question 3

Elevated white blood cell count

Answer 3

supports diagnosis of IBS

Question 4

Stool occult blood (guaiac)

Answer 4

supports diagnosis of IBS (positive result)

Question 5

Erythrocyte sedimentation rate

Answer 5

supports diagnosis of IBS (increased) better test for chronic inflammation

Question 6

C-reactive protein

Answer 6

supports diagnosis of IBS (increased)

Question 7

Lactoferrin test

Answer 7

supports diagnosis of IBS and indicates inflammation in GI tract (positive result)

Question 8

Lactose tolerance test

Answer 8

used to detect lactase deficiency (present if blood glucose does not increase by 30 mg/dL)

Question 9

Alpha-1-antitrypsin (AAT)

Answer 9

used to diagnose protein-losing enteropathy

Question 10

CEA and CA19-9

Answer 10

tumor markers used for colon cancer

Question 11

SOB test

Answer 11

used to detect occult bleeding due to polyps

Question 12

Susceptible to Hepatitis B infection

Answer 12

HBsAg negative
anti-HBc negative
anti-HBs negative

Question 13

Acute infection to Hepatitis B

Answer 13

HBsAg positive
anti-HBc negative
anti-HBs negative

Question 14

Recovery/immune from Hepatitis B infection

Answer 14

HBsAg negative
anti-HBc positive
anti-HBs positive

Question 15

Immune (vaccination) to Hepatitis B

Answer 15

HBsAg negative
anti-HBc negative
anti-HBs positive

Question 16

Chronically infected with Hepatitis B

Answer 16

HBsAg positive
anti-HBc positive
anti-HBs negative

Question 17

Gilbert syndrome

Answer 17

reduction in the activity of UDP-glucuronosyltransferase due to insertion of two bases in the promoter region
increases indirect bilirubin

Question 18

Crigler-najjar syndrome

Answer 18

defective UDP-glucuronosyltransferase mutations due to the exchange of amino acids that cause frameshift mutations or nonsense mutation
increases indirect bilirubin

Question 19

Dubin Johnson syndrome

Answer 19

chronic and benign impaired biliary excretion of glucuronide and glutathione conjugates
increases direct bilirubin and GGT

Question 20

Pre-hepatic

Answer 20

indirect > direct
ex. hemolytic anemia, CHF

Question 21

Hepatic

Answer 21

direct > indirect
ALT/AST > ALP
ex. cirrhosis, Reye’s syndrome, hepatitis

Question 22

Post-hepatic

Answer 22

direct > indirect
ALT/AST < ALP
ex. gallbladder stones, tumors

Question 23

Hepatic panel can include:

Answer 23

bilirubin (total and direct)
total protein
albumin
ALT
AST
ALP
GGT
PTT
fibrinogen
ammonia

Question 24

Coagulation tests in hepatic disease/failure (loss of hepatic function)

Answer 24

increased prothrombin time
decreased fibrinogen

Question 25

Pre-analytical variables in ammonia analysis

Answer 25

EDTA or heparin anticoagulants
no hemolysis
must be placed on ice immediately after collection
centrifuge within 20 minutes of collection and separate plasma (freeze plasma to preserve ammonia in sample)

Question 26

Reagent in Jaffe reaction (creatinine)

Answer 26

picric acid

Question 27

Creatinine clearance formula

Answer 27

Ucreatinine x Uvolume/Pcreatinine x 1440 min

Question 28

Stage 1 kidney disease

Answer 28

normal or increased GFR (GFR > 90)

Question 29

Stage 2 kidney disease

Answer 29

mildly decreased GFR (GFR 60-89)

Question 30

Stage 3 kidney disease

Answer 30

moderately decreased GFR (GFR 30-59)

Question 31

Stage 4 kidney disease

Answer 31

severely decreased GFR (GFR 15-29)

Question 32

Stage 5 kidney disease

Answer 32

end-stage kidney disease
GFR < 15

Question 33

Decreases in uric acid (hypouricemia)

Answer 33

renal tubule not effectively reabsorbing uric acid
severe hepatocellular disease

Question 34

Increases in uric acid (hyperuricemia)

Answer 34

excessive purine intake
increased DNA catabolism (malignancies, megaloblastic anemia, increased niacin intake)
drinking too much alcohol
renal insufficiency
Lesh Nyhan syndrome
gout

Question 35

decreases in BUN levels

Answer 35

over-hydration/dilution
late pregnancy
decreased protein intake
severe liver disease