L1 CC

Question 1

Wastes of Lean:
1. Defects
2. Waiting
3. Motion
4. Emotion

A. 1 and 3
B. 2 and 4
C. 1, 2 and 3
D. 1, 2, 3 and 4

Answer 1

C. 1, 2 and 3

Question 2

PLUMBISM - deleterious effect of gradual accumulation of ____ in body tissues, as a result of repeated exposure.

A. Arsenic
B. Cyanide
C. Lead
D. Mercury

Answer 2

C. Lead

Question 3

Black belts dedicate ____ of their time to quality improvement projects, proactively addressing process and quality problems.

A. 10%
B. 20%
C. 70%
D. 100%

Answer 3

D. 100%

Question 4

Green belts contribute ____ of their time to improvement projects while delivering their normal job functions.

A. 10%
B. 20%
C. 70%
D. 100%

Answer 4

B. 20%

Question 5

Black belts

A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

Answer 5

B. Project coaches or leaders

Question 6

Green belts

A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

Answer 6

C. Project team members

Question 7

Blue belts

A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

Answer 7

A. Project sponsors or champions

Question 8

Black pleural fluid:

A. Hemothorax
B. Chylous material from thoracic duct leakage
C. Rupture of amoebic liver abscess
D. Aspergillus infection

Answer 8

D. Aspergillus infection

Question 9

Which set of results is consistent with uncompensated respiratory alkalosis?

A. pH 7.70 HCO3- 30 mmol/L pCO2 25 mm Hg
B. pH 7.66 HCO3- 22 mmol/L pCO2 20 mm Hg
C. pH 7.46 HCO3- 38 mmol/L pCO2 55 mm Hg
D. pH 7.36 HCO3- 22 mmol/L pCO2 38 mm Hg

Answer 9

B. pH 7.66 HCO3- 22 mmol/L pCO2 20 mm Hg

Question 10

Which set of results is consistent with uncompensated metabolic acidosis?

A. pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg
B. pH 7.30 HCO3- 16 mmol/L pCO2 28 mm Hg
C. pH 7.45 HCO3- 22 mmol/L pCO2 40 mm Hg
D. pH 7.40 HCO3- 25 mmol/L pCO2 40 mm Hg

Answer 10

A. pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg

Question 11

A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?

A. Lesch-Nyhan syndrome
B. Modification of diet in renal disease
C. Maple syrup urine disease
D. Reye’s syndrome
E. Megaloblastic anemia

Answer 11

A. Lesch-Nyhan syndrome

Question 12

The two cations known to influence the activity of aminoglycosides are:

A. Sodium and potassium
B. Calcium and potassium
C. Calcium and magnesium
D. Sodium and magnesium

Answer 12

C. Calcium and magnesium

Question 13

Seventy (70) percent recirculated to the cabinet work area through HEPA; 30% balance can be exhausted through HEPA back into the room or to outside through a canopy unit:

A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 13

B. BSC Class II, A1

Question 14

Thirty (30) percent recirculated, 70% exhausted. Exhaust cabinet air must pass through a dedicated duct to the outside through a HEPA filter.
A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 14

C. BSC Class II, B1

Question 15

No recirculation; total exhaust to the outside through a HEPA filter.

A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 15

D. BSC Class II, B2

Question 16

The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity:

A. Choramphenicol
B. Penicillin
C. Sulfonamide
D. Vancomycin

Answer 16

D. Vancomycin

Question 17

Easy to define but DIFFICULT TO ESTABLISH AND MAINTAIN:

A. Accuracy
B. Precision
C. Sensitivity
D. Specificity

Answer 17

A. Accuracy

Question 18

Relatively EASY TO MEASURE AND MAINTAIN:

A. Accuracy
B. Precision
C. Sensitivity
D. Specificity

Answer 18

B. Precision

Question 19

Clinical Laboratory Standard Institute (CLSI) recommends that:

A. Bands should be included within the eosinophil count
B. Bands should be included within the basophil count
C. Bands should not be included within the neutrophil count, and reported as separate category
D. Bands should be included within the neutrophil count and not reported as separate category

Answer 19

D. Bands should be included within the neutrophil count and not reported as separate category

Question 20

Access to the laboratory is limited or restricted, and there must be a biohazard sign posted at the entrance of the laboratory:

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

Answer 20

A. BSL-1

Question 21

Access to the laboratory is limited when work is being conducted. The laboratory director is ultimately responsible for determining who may enter or work in the laboratory.

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

Answer 21

B. BSL-2

Question 22

Laboratory should be separated from the other parts of the building and be accessed through two self-closing doors. An ANTEROOM may be used for access.

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

Answer 22

C. BSL-3

Question 23

The BSL facility either is located in a separate building or is in an isolated zone within a building.

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

Answer 23

D. BSL-4

Question 24

What is used to zero the spectrophotometer before reading the test sample?

A. Calibrator
B. Sample blank
C. Reagent blank
D. Standard

Answer 24

C. Reagent blank

Question 25

This is used to zero an instrument during a test procedure:

A. Calibrator
B. Sample blank
C. Reagent blank
D. Standard

Answer 25

B. Sample blank

Question 26

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease?

A. Cathepsin-D
B. CA-15-3
C. Retinoblastoma gene
D. Estrogen receptor (ER)

Answer 26

B. CA-15-3

Question 27

Which tumor marker is used to determine the usefulness of TRASTUZUMAB (HERCEPTIN) therapy for breast cancer?

A. PR
B. CEA
C. HER-2/neu
D. Myc

Answer 27

C. HER-2/neu

Question 28

IgA in serum:

A. Monomer
B. Dimer
C. Pentamer
D. Any of these

Answer 28

A. Monomer

Question 29

IgA in secretion:

A. Monomer
B. Dimer
C. Pentamer
D. Any of these

Answer 29

B. Dimer

Question 30

Which of the following is a DISINFECTANT?

A. Benzalkonium chloride
B. Chlorhexidine gluconate
C. Household bleach
D. Hydrogen peroxide

Answer 30

C. Household bleach

Question 31

Diluted bleach will inactivate HBV in ____ minutes and HIV in ____ minutes.

A. 2 minutes, 8 minutes
B. 8 minutes, 4 minutes
C. 10 minutes, 2 minutes
D. 8 minutes, 2 minutes

Answer 31

C. 10 minutes, 2 minutes

Question 32

Calibration of centrifuges is customarily performed every ______.

A. Daily
B. Weekly
C. Every 3 months (quarterly)
D. Annually

Answer 32

C. Every 3 months (quarterly)

Question 33

Centrifuges are routinely disinfected on a ____ basis.

A. Daily
B. Weekly
C. Monthly
D. Yearly

Answer 33

B. Weekly

Question 34

Initial magnification:

A. Ocular
B. Objective
C. Condenser
D. Rheostat

Answer 34

B. Objective

Question 35

Further magnification:

A. Ocular
B. Objective
C. Condenser
D. Rheostat

Answer 35

A. Ocular

Question 36

Which of the following units would NOT be used for reporting glucose on a clinical chemistry laboratory report?

A. mg/dL
B. ounces/L
C. mmol/L
D. All are acceptable units

Answer 36

B. ounces/L

Question 37

Convert 9.5 µg/dL thyroxine to SI unit:

A. 123 µmol/L
B. 123 nmol/L
C. 125 nmol/L
D. 145 µmol/L

Answer 37

B. 123 nmol/L

Question 38

When measuring K+ with an ion-selective electrode by means of a liquid ion-exchange membrane, what antibiotic will be incorporated into the membrane?

A. Monactin
B. Nonactin
C. Streptomycin
D. Valinomycin

Answer 38

D. Valinomycin

Question 39

Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes?

A. Silver
B. Glass
C. Platinum
D. Platinum-lactate

Answer 39

B. Glass

The pH electrode, a glass electrode, contains a specially designed thin piece of glass as a membrane. The glass membrane is made of silicon dioxide, added oxides and various metals. The membrane is selectively sensitive to hydrogen ions.

Question 40

What is the proper pH for the buffered solution used to perform serum protein electrophoresis?

A. 5.6
B. 7.6
C. 8.6
D. 9.6

Answer 40

C. 8.6

Question 41

Coulometry is often used to measure:

A. Chloride in sweat
B. the pH in saliva
C. Bicarbonate in urine
D. Ammonia in plasma

Answer 41

A. Chloride in sweat

Question 42

Amperometry is the principle of the:

A. pCO2 electrode
B. pO2 electrode
C. pH electrode
D. Ionized calcium electrode

Answer 42

B. pO2 electrode

Question 43

Most automated blood gas analyzers directly measure:

A. pH, HCO3 and % O2 saturation
B. pH, pCO2 and pO2
C. HCO3, pCO2 and pO2
D. pH, PO2 and %O2 saturation

Answer 43

B. pH, pCO2 and pO2

Question 44

An elevated anion gap may be caused by all of the following except:

A. Uremia/renal failure
B. Ketoacidosis in case of starvation or diabetes
C. Alcohol or salicylate poisoning
D. Hypoalbuminemia

Answer 44

D. Hypoalbuminemia

Question 45

Laboratory examination of a 46-year-old male who presents with decreasing vision and photophobia finds a high anion–gap metabolic acidosis. These findings are most consistent with this individual having ingested:

A. Cadmium
B. Nickel
C. Mercury
D. Cobalt
E. Methanol

Answer 45

E. Methanol

Question 46

Which of the following conditions will cause an increased anion gap?

A. Diarrhea
B. Hypoaldosteronism
C. Hyperkalemia
D. Renal failure

Answer 46

D. Renal failure

Question 47

In ketoacidosis, the anion gap would most likely to be affected in what way?

A. Unchanged from normal
B. Increased
C. Decreased
D. Balanced

Answer 47

B. Increased

Question 48

Which of the following blood gas disorders is most commonly associated with an abnormal anion gap?

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Answer 48

A. Metabolic acidosis

Question 49

Which formula is most accurate in predicting plasma osmolality?

A. Na+2(Cl)+BUN+Glucose
B. 2(Na)+2 (Cl)+Glucose+BUN
C. 2(Na)+Glucose/18+BUN/2.8
D. 2(BUN)+Glucose/18+Cl/2.8

Answer 49

C. 2(Na)+Glucose/18+BUN/2.8

Question 50

A laboratory worker splashes concentrated HCl in his eyes. The best safety measure is to:

A. Wash the eye with dilute NaOH and call physician STAT
B. Wash the eye with distilled water and call a physician STAT
C. Wash the eye with dilute acetic acid and call a physician STAT
D. Call the physician and wait for his advice

Answer 50

B. Wash the eye with distilled water and call a physician STAT

Question 51

SITUATION: A medical laboratory science student in training accidentally splashed a few drops of an extraction reagent from an enzyme immunoassay kit for group A Streptococcus into her right eye, and felt an immediate burning sensation. What should she do first?

A. Locate the MSDS sheet for the EIA test kit
B. Go directly to the emergency department for treatment
C. Go to the eye-wash station and rinse the eye thoroughly with water
D. Report directly to her immediate supervisor

Answer 51

C. Go to the eye-wash station and rinse the eye thoroughly with water

Question 52

When skin contact occurs, the best first aid is to flush the area with large amounts of water for at least____ minutes, then seek medical attention.

A. 5 minutes
B. 10 minutes
C. 15 minutes
D. 20 minutes

Answer 52

C. 15 minutes

Question 53

The most important practice in preventing the spread of disease is:

A. Wearing masks during patient contact
B. Proper hand washing
C. Wearing disposable laboratory coats
D. Identifying specimens from known or suspected HIV-and HBV-infected patients with a red label

Answer 53

B. Proper hand washing

Question 54

Which monochromator specification is required in order to measure the true absorbance of a compound having a natural absorption bandwidth of 30 nm?

A. 50-nm bandpass
B. 25-nm bandpass
C. 15-nm bandpass
D. 5-nm bandpass

Answer 54

D. 5-nm bandpass

Question 55

If evacuated tubes are stored at low temperature:

A. Decreased blood draw volume
B. Increased blood draw volume
C. Variable
D. Cannot be determined

Answer 55

B. Increased blood draw volume

Question 56

In situations where blood is drawn at high altitudes (>5,000 ft):

A. Increased blood draw volume
B. Decreased blood draw volume
C. Variable
D. Cannot be determined

Answer 56

B. Decreased blood draw volume

Question 57

A triangle with an outline of a person inside the triangle in the hazards identification system indicates which type of hazard?

A. Flammability
B. Reactivity-stability hazard
C. Special hazard information
D. Health hazard

Answer 57

D. Health hazard

Question 58

Skull and crossbones indicates which type of hazard:

A. Carcinogens
B. Flammables
C. Exploding bombs
D. Acute toxicities (fatal or toxic)

Answer 58

D. Acute toxicities (fatal or toxic)

Question 59

A class ABC fire extinguisher contains:

A. Sand
B. Water
C. Dry chemical
D. Acid

Answer 59

C. Dry chemical

Question 60

Carbon dioxide for extinguishers are suitable for use with the following hazards:

A. Cloth and electrical
B. Wood and flammable gas
C. Flammable liquids and electrical
D. Paper and natural gas

Answer 60

C. Flammable liquids and electrical

Question 61

Red diamond or fire hazard, classified according to Flash Point:

A. A to C
B. A to D
C. 1 to 10
D. 0 to 4

Answer 61

D. 0 to 4

Question 62

Beer-Lambert law (Beer’s law)
Mathematically establishes the relationship between concentration and absorbance in many photometric determinations
Beer’s law is expressed as A = abc

A (capital A) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 62

A. Absorbance

Question 63

a (small a) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 63

B. Absorptivity constant

Question 64

b (small b) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 64

D. Length of light path

Question 65

c (small c) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 65

C. Concentration

Question 66

Most automated blood gas analyzers directly measure:

A. pH, HCO3 and % O2 saturation
B. pH, pCO2 and pO2
C. HCO3, pCO2 and pO2
D. pH, PO2 and %O2 saturation

Answer 66

B. pH, pCO2 and pO2

Question 67

Which of the following blood gas parameters are MEASURED DIRECTLY by the blood gas analyzer electrochemically as opposed to being calculated by the instrument?

A. pH, HCO3-, total CO2
B. pCO2, HCO3-, pO2
C. pH, pCO2, pO2
D. pO2, HCO3-, total CO2

Answer 67

C. pH, pCO2, pO2

Question 68

Metabolism of glucose molecule to pyruvate or lactate for production of energy

A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 68

D. Glycolysis

Question 69

Formation of glucose-6-phosphate from noncarbohydrate sources

A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 69

A. Gluconeogenesis

Question 70

Breakdown of glycogen to glucose for use as energy

A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 70

B. Glycogenolysis

Question 71

Conversion of glucose to glycogen for storage

A. Gluconeogenesis
B. Glycogenolysis
C. Glycogenesis
D. Glycolysis

Answer 71

C. Glycogenesis

Question 72

Glucose is metabolized at room temperature at a rate of ____ mg/dL/hour and at 4C at a rate of ____ mg/dL/hour.

A. 2, 7
B. 7, 2
C. 3, 8
D. 8, 3

Answer 72

B. 7, 2

Question 73

Copper reduction method for glucose that uses arsenomolybdic acid:

A. Folin-Wu
B. Nelson-Somogyi
C. Neocuproine
D. All of these

Answer 73

B. Nelson-Somogyi

Question 74

A method for the estimation of glucose in body fluids; glucose in the protein-free filtrate reduces cupric ion to cuprous ion. The cuprous ion then reduces PHOSPHOMOLYBDIC ACID to molybdenum blue which can be estimated colorimetrically.

A. Dubowski method
B. Folin-Wu
C. Nelson-Somogyi
D. Neocuproine

Answer 74

B. Folin-Wu

Question 75

Which of the following is the reference method for measuring serum glucose?

A. Somogyi–Nelson
B. Hexokinase
C. Glucose oxidase
D. Glucose dehydrogenase

Answer 75

B. Hexokinase

Question 76

Fluorophore-labeled thyroxine competes with patient thyroxine for antibody in homogeneous system. Antibody-bound labeled thyroxine rotates slowly, emitting lower energy light.

A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 76

A. Fluorescent polarization immunoassay (FPIA)

Question 77

Fluorogenic substrate–labeled TSH is competing with patient TSH for antibody in this homogeneous assay. Only unbound (leftover) labeled TSH reacts with the enzyme to form fluorescent product. There is a direct relationship between fluorescence and the amount of TSH present in the test sample.

A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 77

B. Fluorescent substrate-labeled inhibition immunoassay

Question 78

Peroxidase-labeled antibody binds with patient hormone (antigen) to form complex (similar to ELISA). Addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time.

A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 78

C. Chemiluminescence

Question 79

Similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone:

A. Fluorescent polarization immunoassay (FPIA)
B. Fluorescent substrate-labeled inhibition immunoassay
C. Chemiluminescence
D. Microparticle enzyme immunoassay (MEIA)

Answer 79

D. Microparticle enzyme immunoassay (MEIA)

Question 80

Beta cell destruction, usually leading to absolute insulin deficiency:

A. Type 1 diabetes
B. Type 2 diabetes

Answer 80

A. Type 1 diabetes

Question 81

May range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance:

A. Type 1 diabetes
B. Type 2 diabetes

Answer 81

B. Type 2 diabetes

Question 82

Diabetics are younger (<18 years old when diagnosed) and thinner:

A. Type 1 diabetes
B. Type 2 diabetes

Answer 82

A. Type 1 diabetes

Question 83

Usually older (>40 years old when diagnosed) and more likely to be obese:

A. Type 1 diabetes
B. Type 2 diabetes

Answer 83

B. Type 2 diabetes

Question 84

Which one of the following values obtained are diagnostic of diabetes mellitus?

A. 2-hour specimen = 150 mg/dL (8.3 mmol/L)
B. Fasting plasma glucose = 126 mg/dL (6.9 mmol/L)
C. Fasting plasma glucose = 110 mg/dL (6.1 mmol/L)
D. 2-hour specimen = 180 mg/dL (9.9 mmol/L)

Answer 84

B. Fasting plasma glucose = 126 mg/dL (6.9 mmol/L)

Question 85

In a person with IMPAIRED glucose metabolism, such as in type 1 diabetes, what is true about the blood glucose level?

A. It increases rapidly after carbohydrates are ingested but returns to a normal level after 120 minutes.
B. It increases rapidly after carbohydrates are ingested and stays greatly elevated even after 120 minutes.
C. It does not increase after carbohydrates are ingested and stays at a low level until the next meal.
D. It increases rapidly after carbohydrates are ingested but returns to a normal level after 30 minutes

Answer 85

B. It increases rapidly after carbohydrates are ingested and stays greatly elevated even after 120 minutes.

Question 86

In a person with normal glucose metabolism, the blood glucose level usually increases rapidly after carbohydrates are ingested but returns to a normal level after:

A. 30 minutes
B. 45 minutes
C. 60 minutes
D. 120 minutes

Answer 86

D. 120 minutes

Question 87

Which of the following 2-hour glucose challenge results would be classified as IMPAIRED GLUCOSE TOLERANCE?
Two-hour serum glucose:

A. 130 mg/dL
B. 135 mg/dL
C. 150 mg/dL
D. 204 mg/dL

Answer 87

C. 150 mg/dL

Question 88

Which of the following hemoglobin A1c results represents an IMPAIRED STATE according to the American Diabetes Association?

A. 4.5%
B. 5.5%
C. 6.0%
D. 6.5%

Answer 88

C. 6.0%

Question 89

Glassware is usually calibrated at:

A. 98F
B. 72F
C. 20C
D. 37C

Answer 89

C. 20C

Question 90

The fastest moving fraction in electrophoresis at pH 8.6 is:

A. Albumin
B. Alpha1 globulin
C. Alpha2 globulin
D. Beta globulin
E. Gamma globulin

Answer 90

A. Albumin

Question 91

If the usual Gaussian distribution exists, a one standard deviation on either side of the mean will include what percent of the values?

A. 95%
B. 68%
C. 99%
D. 34%
E. 84%

Answer 91

B. 68%

Question 92

When a range is set by taking the mean values plus or minus two standard deviation, the percentage of values of the normal population EXCLUDED from the acceptable range is:

A. 1%
B. 2.5%
C. 5%
D. 13.6%
E. 15.9%

Answer 92

C. 5%

Question 93

A delta check:

A. Relates control difference from mean
B. Reports patient value difference from previous analysis
C. Evaluates statistical drift
D. Estimates running mean of all patient values
E. Flags abnormal results

Answer 93

B. Reports patient value difference from previous analysis

Question 94

To determine if a 24-hour urine collection is complete, which of the following determinations may be helpful?

A. Creatinine
B. BUN
C. Uric acid
D. Protein
E. Osmolality

Answer 94

A. Creatinine

Question 95

The main waste product of protein metabolism is:

A. Creatinine
B. Urea
C. Uric acid
D. Ammonia
E. Amino acids

Answer 95

B. Urea

Question 96

The most sensitive marker of acute phase inflammation is probably:

A. C3 complement
B. C-reactive protein
C. Fever
D. Erythrocyte sedimentation rate

Answer 96

B. C-reactive protein

Question 97

In lipoprotein electrophoresis, the dense band that doesn’t migrate from the origin is:

A. Chylomicrons
B. LDL
C. Beta-lipoproteins
D. Cholesterol
E. Phospholipids

Answer 97

A. Chylomicrons

Question 98

RBC with membrane folded over:

A. Aplastic anemia
B. Iron deficiency anemia
C. Hemoglobin C, hemoglobin SC disease
D. Sickle cell anemia, thalassemia

Answer 98

C. Hemoglobin C, hemoglobin SC disease

Question 99

Major structural protein in VLDL and LDL:

A.Apo-A1
B.Apo-A2
C.Apo-B48
D.Apo-B100

Answer 99

D.Apo-B100

Question 100

Structural protein in chylomicrons:

A. Apo-A1
B.Apo-A2
C.Apo-B48
D. Apo-B100

Answer 100

C.Apo-B48

Question 101

Which of the following apoproteins is inversely related to risk for coronary heart disease and is a surrogate marker for HDL?

A. Apo A-I
B. Apo B
C. Apo B100
D. Apo E

Answer 101

A. Apo A-I

Question 102

Rare autosomal recessive disorder characterized by complete absence of HDL:

A. Tangier disease
B. Anderson disease
C. Bassen-Kornzweig syndrome
D. Sitosterolemia

Answer 102

A. Tangier disease

Question 103

Abetalipoproteinemia, patients present with undetectable plasma apoB containing lipoproteins:

A. Tangier disease
B. Anderson disease
C. Bassen-Kornzweig syndrome
D. Sitosterolemia

Answer 103

C. Bassen-Kornzweig syndrome

Question 104

The largest lipoprotein molecule:

A. LDL
B. VLDL
C. Chylomicron
D. HDL

Answer 104

C. Chylomicron

Question 105

What is the smallest lipoprotein molecule?

A. Chylomicron
B. LDL
C. VLDL
D. HDL

Answer 105

D. HDL

Question 106

Which of the following laboratory values is considered a positive risk factor for the occurrence of coronary heart disease?

A. HDL cholesterol >60 mg/dL
B. HDL cholesterol <35 mg/dL
C. LDL cholesterol <130 mg/dL
D. Total cholesterol <200 mg/dL

Answer 106

B. HDL cholesterol <35 mg/dL

Question 107

If testing is done in nonfasting samples, only total cholesterol (TC) and HDL-c can be measured. When TAG and LDL-c are being measured, FASTING becomes a requirement.

A. 4 to 8 hours fasting
B. 8 to 12 hours fasting
C. 12 to 14 hours fasting
D. 16 to 18 hours fasting

Answer 107

C. 12 to 14 hours fasting

Question 108

Which of the following enzymes is found bound to HDL and LDL in blood plasma and acts to convert free cholesterol into cholesteryl esters?

A. Cholesterol esterase
B. Cholesterol oxidase
C. Lecithin-cholesterol acyltransferase
D. Lipase

Answer 108

C. Lecithin-cholesterol acyltransferase

Question 109

According to the National Cholesterol Education Program, which lipid or lipoprotein class is more important for therapeutic decision making (diet and medication decisions)?

A. Chylomicrons
B. LDL
C. HDL
D. Cholesterol

Answer 109

B. LDL

Question 110

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

Answer 110

C. 12 hours; nothing but water allowed

Question 111

All of the following hormones increase serum glucose levels with the exception of:

A. Glucagon
B. Cortisol
C. Epinephrine
D. Insulin

Answer 111

D. Insulin

Question 112

The most probable explanation for a patient who presents with an elevated osmolal gap, metabolic acidosis, and CALCIUM OXALATE crystals in the urine is:

A. Methanol intoxication
B. Ethanol overdose
C. Ethylene glycol intoxication
D. Cyanide poisoning

Answer 112

C. Ethylene glycol intoxication

Question 113

Alkaline phosphatase values are expected to be increased in all of the following situations EXCEPT:

A. Child undergoing a growth spurt
B. During a time of increased bone remodeling
C. After a myocardial infarction
D. Paget’s disease

Answer 113

C. After a myocardial infarction

Question 114

Which of the following analytes is helpful in distinguishing a condition affecting the liver from bone disease in the presence of an elevation of ALP?

A. AST
B. ALT
C. ALP
D. GGT

Answer 114

D. GGT

Question 115

Assay methods for AST are generally based on the principle of the Karmen method, which incorporates a coupled enzymatic reaction using:

A. Glutamic oxaloacetic transaminase
B. Glutamic pyruvic transaminase
C. Lactate dehydrogenase
D. Malate dehydrogenase

Answer 115

D. Malate dehydrogenase

Question 116

The typical assay procedure for ALT consists of a coupled enzymatic reaction using ____ as the indicator enzyme.

A. Glutamic oxaloacetic transaminase
B. Glutamic pyruvic transaminase
C. Lactate dehydrogenase
D. Malate dehydrogenase

Answer 116

C. Lactate dehydrogenase

Question 117

Enzyme assay useful in forensic clinical chemistry:

A. CK
B. ACP
C. ALT
D. AST

Answer 117

B. ACP

Question 118

Identify the enzyme deficiency responsible for type 1 glycogen storage disease (von Gierke’s disease).

A. Glucose-6-phosphatase
B. Glycogen phosphorylase
C. Glycogen synthetase
D. β-Glucosidase

Answer 118

A. Glucose-6-phosphatase

Question 119

Which of the following abnormal laboratory results is found in von Gierke’s disease?

A. Hyperglycemia
B. Increased glucose response to epinephrine administration
C. Metabolic alkalosis
D. Hyperlipidemia

Answer 119

D. Hyperlipidemia

Question 120

SIGNIFICANT WHEN DECREASED
Pathological level is decreased from the normal values by as much as 80 to 90%.

A. Amylase
B. Lipase
C. Cholinesterase
D. Creatine kinase

Answer 120

C. Cholinesterase

Question 121

In pesticide poisoning, cholinesterase activity is:

A. Normal
B. Decreased
C. Increased
D. Variable

Answer 121

B. Decreased

Question 122

Which of the following DECREASES in liver disease?

A. ALP
B. ALT
C. LD
D. Cholinesterase

Answer 122

D. Cholinesterase

Question 123

In addition to sodium bicarbonate, what other substance contributes most to the amount of base in the blood?

A. Hemoglobin concentration
B. Dissolved O2 concentration
C. Inorganic phosphorus
D. Organic phosphate

Answer 123

A. Hemoglobin concentration

Question 124

Which of the following best represents the reference (normal) range for arterial pH?

A. 7.35 – 7.45
B. 7.42 – 7.52
C. 7.38 – 7.68
D. 6.85 – 7.56

Answer 124

A. 7.35 – 7.45

Question 125

What is the normal ratio of bicarbonate to dissolved carbon dioxide in arterial blood?

A. 1:10
B. 10:1
C. 20:1
D. 30:1

Answer 125

C. 20:1

Question 126

Select the anticoagulant of choice for blood gas studies.

A. Sodium citrate 3.2%
B. Lithium heparin 100 U/mL blood
C. Sodium citrate 3.8%
D. Ammonium oxacralate 5.0%

Answer 126

B. Lithium heparin 100 U/mL blood

Question 127

Which electrolyte level best correlates with plasma osmolality?

A. Sodium
B. Chloride
C. Bicarbonate
D. Calcium

Answer 127

A. Sodium

Question 128

Which of the following enzymes is considered most tissue specific?

A. Creatine kinase (CK)
B. Amylase
C. Alkaline phosphatase (ALP)
D. Alcohol dehydrogenase (ADH)

Answer 128

D. Alcohol dehydrogenase (ADH)

Question 129

Which of the following enzymes is activated by calcium ions

A. CK
B. Amylase
C. ALP
D. LD

Answer 129

B. Amylase

Question 130

Which of the following cardiac markers derived from neutrophils predicts an increased risk for myocardial infarction?

A. Phospholipase A2
B. Glycogen phosphorylase BB
C. Soluble CD40 ligand
D. Myeloperoxidase

Answer 130

D. Myeloperoxidase

Question 131

Which isoenzyme of ALP is most heat stable?

A. Bone
B. Liver
C. Intestinal
D. Placental

Answer 131

D. Placental

Question 132

Which substrate is used in the Bowers–McComb method for ALP?

A. p-Nitrophenyl phosphate
B. β-Glycerophosphate
C. Phenylphosphate
D. α-Naphthylphosphate

Answer 132

A. p-Nitrophenyl phosphate

Question 133

Which of the following buffers is used in the IFCC recommended method for ALP?

A. Glycine
B. Phosphate
C. 2-Amino-2-methyl-1-propanol
D. Citrate

Answer 133

C. 2-Amino-2-methyl-1-propanol

Question 134

It is increased in hemolytic anemias:

A. B1
B. B2
C. Both fractions
D. None of these

Answer 134

A. B1

Question 135

It is increased in bile duct obstruction:
A. B1
B. B2
C. Both fractions
D. None of these

Answer 135

B. B2

Question 136

Increased in hepatitis:
A. B1
B. B2
C. Both fractions
D. None of these

Answer 136

C. Both fractions

Question 137

Bilirubin that can appear in urine:

A. Unconjugated bilirubin
B. Conjugated bilirubin
C. Both of these
D. None of these

Answer 137

B. Conjugated bilirubin

Question 138

Errors in LDL-c become noticeable at triglyceride levels:

A. Over 150 mg/dL
B. Over 200 mg/dL
C. Over 350 mg/dL
D. Over 400 mg/dL

Answer 138

B. Over 200 mg/dL

Question 139

Errors in LDL-c become unacceptably large at triglyceride levels:

A. Over 150 mg/dL
B. Over 200 mg/dL
C. Over 350 mg/dL
D. Over 400 mg/dL

Answer 139

D. Over 400 mg/dL

Question 140

Friedewald formula is not valid for triglycerides:

A. Over 150 mg/dL
B. Over 200 mg/dL
C. Over 350 mg/dL
D. Over 400 mg/dL

Answer 140

D. Over 400 mg/dL

Question 141

Which of the following values is the threshold critical value (alert or action level) for high plasma sodium?

A. 150 mmol/L
B. 160 mmol/L
C. 170 mmol/L
D. 180 mmol/L

Answer 141

B. 160 mmol/L

Question 142

Which of the following values is the threshold critical value (alert or action level) for low plasma potassium?

A. 1.5 mmol/L
B. 2.0 mmol/L
C. 2.5 mmol/L
D. 3.5 mmol/L

Answer 142

C. 2.5 mmol/L

Question 143

Which of the following is a marker for bone resorption?

A. β-trace protein
B. Adiponectin
C. Fibronectin
D. Crosslinked C-telopeptide

Answer 143

D. Crosslinked C-telopeptide

Question 144

Which of the following is a marker for bone formation?

A. Osteocalcin
B. Tartrate resistant acid phosphatase (TRAP)
C. Urinary pyridinoline and deoxypyridinoline
D. Urinary C-telopeptide and N-telopeptide crosslinks (CTx and NTx)

Answer 144

A. Osteocalcin

Question 145

The variants demonstrate a wide variety of cellular interactions including roles in cell adhesion, tissue differentiation, growth, and wound healing:

A. Adiponectin
B. Cystatin
C. Fibronectin
D. Troponin

Answer 145

C. Fibronectin

Question 146

What substance may be measured as an alternative to creatinine for evaluating GFR?

A. Plasma urea
B. Cystatin C
C. Uric acid
D. Potassium

Answer 146

B. Cystatin C

Question 147

Recently, it was established as an accurate marker of CSF leakage:

A. Fibronectin
B. Cystatin C
C. Troponin
D. β-Trace Protein

Answer 147

D. β-Trace Protein

Question 148

A comatose 27-year-old woman is brought to the emergency room by paramedics, and the strong odor of bitter almonds is present. The differential diagnosis must include the possibility of poisoning by:

A. Ethylene glycol
B. Carbon monoxide
C. Carbon tetrachloride
D. Cyanide
E. Arsenic

Answer 148

D. Cyanide

Question 149

The odor of garlic may be on the breath, and a metallic taste in the patient’s mouth:

A. Arsenic
B. Cyanide
C. Iron
D. Mercury

Answer 149

A. Arsenic

Question 150

Effect of excess lipids or proteins to sodium value measured by flame photometry and indirect ISE:

A. Hypernatremia
B. Hyponatremia
C. Pseudohypernatremia
D. Pseudohyponatremia

Answer 150

D. Pseudohyponatremia

Question 151

Which of the following can cause cardiac arrest in the absence of warning symptoms or signs?

A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypokalemia

Answer 151

C. Hyperkalemia

Question 152

A patient presents with Addison disease. Serum sodium and potassium analyses are performed. What would the results reveal?

A. Normal sodium, low potassium levels
B. Low sodium, low potassium levels
C. Low sodium, high potassium levels
D. High sodium, low potassium levels

Answer 152

C. Low sodium, high potassium levels

Question 153

The protein present in vaginal secretions that can identify patients who are at risk for preterm delivery is:

A. Human chorionic gonadotropin
B. Estrogen
C. PAMG-1
D. Fetal fibronectin

Answer 153

D. Fetal fibronectin

Question 154

The physician is concerned that a pregnant patient may be at risk for delivering prematurely. What would be the best biochemical marker to measure to assess the situation?

A. Inhibin A
B. Alpha1-Fetoprotein
C. Fetal fibronectin
D. Human chorionic gonadotropin

Answer 154

C. Fetal fibronectin

Question 155

In the Henderson-Hasselbalch equation, the NUMERATOR denotes ____ functions.

A. Brain
B. Pituitary
C. Lung
D. Kidney

Answer 155

D. Kidney

Question 156

In the Henderson-Hasselbalch equation, the DENOMINATOR denotes _____ functions.

A. Brain
B. Pituitary
C. Lung
D. Kidney

Answer 156

C. Lung

Question 157

Urea is only a rough estimate of renal function and will not show any significant level of increased concentration until the GLOMERULAR FILTRATION RATE IS DECREASED BY AT LEAST ____.

A. 30%
B. 50%
C. 60%
D. 80%

Answer 157

B. 50%

Question 158

Glucose measurements can be ____ mg/dL erroneously higher by reducing methods than by more accurate enzymatic methods.

A. 1 to 5 mg/dL
B. 5 to 15 mg/dL
C. 20 to 25 mg/dL
D. 30 to 35 mg/dL

Answer 158

B. 5 to 15 mg/dL

Question 159

It is the result of POOR PERFUSION of the kidneys and therefore diminished glomerular filtration. The kidneys are otherwise normal in their functioning capabilities. Poor perfusion can result from dehydration, shock, diminished blood volume, or congestive heart failure.

A. Pre-renal azotemia
B. Renal azotemia
C. Post-renal azotemia

Answer 159

A. Pre-renal azotemia

Question 160

It is caused primarily by DIMINISHED GLOMERULAR FILTRATION as a consequence of acute or chronic renal disease. Such diseases include acute glomerulonephritis, chronic glomerulonephritis, polycystic kidney disease, and nephrosclerosis.

A. Pre-renal azotemia
B. Renal azotemia
C. Post-renal azotemia

Answer 160

B. Renal azotemia

Question 161

It is usually the result of any type of OBSTRUCTION in which urea is reabsorbed into the circulation. Obstruction can be caused by stones, an enlarged prostate gland, or tumors.

A. Pre-renal azotemia
B. Renal azotemia
C. Post-renal azotemia

Answer 161

C. Post-renal azotemia

Question 162

Which of the following conditions is the result of alpha1-antitrypsin level lower than 11 mmol/L?

A. Emphysema
B. Asthma
C. Pulmonary edema
D. Sarcoidosis

Answer 162

A. Emphysema

Question 163

A patient with emphysema who has fluid accumulation in the alveolar sacs (causing decreased ventilation) is likely to be in which of the following acid-base clinical states?

A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis

Answer 163

B. Respiratory acidosis

Question 164

Hepatocellular damage may be best assessed by which of the following parameters?

A. Serum AST and ALT levels
B. GGT and ALP
C. Bilirubin, GGT, and ALP
D. Ammonia and urea

Answer 164

A. Serum AST and ALT levels

Question 165

Which of the following analytes is the best indicator of hepatobiliary damage?

A. AST
B. ALT
C. ALP
D. Bilirubin

Answer 165

C. ALP

Question 166

Hirsutism, which can be quantified using a measurement technique known as the:

A. Ferriman-Gallwey scale
B. Liley graph
C. T-score
D. Z-score

Answer 166

A. Ferriman-Gallwey scale

Question 167

This gland is called the “master gland” of the endocrine system.

A. Pineal
B. Pituitary
C. Thymus
D. Thyroid

Answer 167

B. Pituitary

Question 168

This gland produces “fight or flight” hormones.

A. Adrenal
B. Pancreas
C. Pituitary
D. Thyroid

Answer 168

A. Adrenal

Question 169

The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity:

A. Choramphenicol
B. Penicillin
C. Sulfonamide
D. Vancomycin

Answer 169

D. Vancomycin

Question 170

Drugs given for patients with asthma:
1. Digoxin
2. Procainamide
3. Theobromine
4. Theophylline

A. 1 and 2
B. 1, 2 and 4
C. 3 and 4
D. 4 only

Answer 170

C. 3 and 4

Question 171

Which route of administration is associated with 100% bioavailability?

A. Sublingual
B. Intramuscular
C. Oral
D. Intravenous

Answer 171

D. Intravenous

Question 172

Which substance has the longest detection time?

A. Amphetamines
B. Cocaine
C. Benzodiazepines
D. Marijuana

Answer 172

D. Marijuana

Question 173

Which of the following organs uses glucose from digested carbohydrates and stores it as glycogen for later use as a source of immediate energy by the muscles?

A. Kidneys
B. Liver
C. Pancreas
D. Thyroid

Answer 173

B. Liver

Question 174

Due to chronic trauma induced by ill-fitting dentures:

A. Hypertrophy
B. Hyperplasia
C. Dysplasia
D. Metaplasia

Answer 174

B. Hyperplasia

Question 175

Which of the following is not a classic symptom of type 1 diabetes?

A. Polyuria
B. Polydipsia
C. Polyphagia
D. Proteinuria

Answer 175

D. Proteinuria

Question 176

Which of the following electrolytes is the chief cation in the plasma, is found in the highest concentration in the extravascular fluid, and has the main function of maintaining osmotic pressure?

A. Potassium
B. Sodium
C. Calcium
D. Magnesium

Answer 176

B. Sodium

Question 177

Analysis of a serum specimen gives a potassium result of 6.0 mmol/L. Before the result is reported to the physician, what additional step should be taken?

A. The serum should be observed for hemolysis; hemolysis of the red cells will shift potassium from the cells into the serum, resulting in a falsely elevated potassium value.
B. The serum should be observed for evidence of jaundice; jaundiced serum will result in a falsely elevated potassium value.
C. The test should be run again on the same specimen.
D. Nothing needs to be done; simply report the result.

Answer 177

A. The serum should be observed for hemolysis; hemolysis of the red cells will shift potassium from the cells into the serum, resulting in a falsely elevated potassium value.

Question 178

Calculation of the anion gap is useful for quality control for:

A. Calcium
B. Tests in the electrolyte profile (sodium, potassium, chloride, and bicarbonate)
C. Phosphorus
D. Magnesium

Answer 178

B. Tests in the electrolyte profile (sodium, potassium, chloride, and bicarbonate)

Question 179

Ninety percent of the carbon dioxide present in the blood is in the form of:

A. Bicarbonate ions
B. Carbonate
C. Dissolved CO2
D. Carbonic acid

Answer 179

A. Bicarbonate ions

Question 180

Nitrogen is excreted principally in the form of:

A. Creatinine
B. Creatine
C. Uric acid
D. Urea

Answer 180

D. Urea

Question 181

Creatinine clearance is used to assess the:

A. Glomerular filtration capabilities of the kidneys
B. Tubular secretion of creatinine
C. Dietary intake of protein
D. Glomerular and tubular mass

Answer 181

A. Glomerular filtration capabilities of the kidneys

Question 182

The blood pH is:

A. Alkaline
B. Acidic
C. Very acidic
D. Neutral

Answer 182

A. Alkaline

Question 183

In analyzing cardiac markers, which marker increases first?

A. Myoglobin
B. CK-MB fraction
C. Troponin T
D. Troponin I

Answer 183

A. Myoglobin

Question 184

Which cardiac marker persists at the highest concentration for the longest length of time?

A. Myoglobin
B. CK-MB fraction
C. Troponin T
D. Troponin I

Answer 184

C. Troponin T

Question 185

In the United States, the NGSP, with the Diabetes Control and Complications Trial (DCCT) ____ method, is used as a PRIMARY REFERENCE METHOD for measuring HbA1c.

A. Immunoassay
B. Electrophoresis
C. Affinity chromatography
D. HPLC

Answer 185

D. HPLC

Question 186

PREFERRED METHOD of measuring HbA1c:

A. Immunoassay
B. Electrophoresis
C. Affinity chromatography
D. HPLC

Answer 186

C. Affinity chromatography

Question 187

What is the confirmatory method for measuring drugs of abuse?

A. HPLC
B. Enzyme-multiplied immunoassay technique(EMIT)
C. Gas chromatography with mass spectroscopy(GC-MS)
D. TLC

Answer 187

C. Gas chromatography with mass spectroscopy(GC-MS)

Question 188

Which of the following protein methods has the highest analytical sensitivity?

A. Refractometry
B. Folin–Lowry
C. Turbidimetry
D. Direct ultraviolet absorption

Answer 188

B. Folin–Lowry

Question 189

In the Berthelot reaction, what contaminant will cause the urea level to be falsely elevated?

A. Sodium fluoride
B. Protein
C. Ammonia
D. Bacteria

Answer 189

C. Ammonia

Question 190

Which of the following is the most common application of immunoelectrophoresis (IEP)?

A. Identification of the absence of a normal serum protein
B. Structural abnormalities of proteins
C. Screening for circulating immune complexes
D. Diagnosis of monoclonal gammopathies

Answer 190

D. Diagnosis of monoclonal gammopathies

Question 191

A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?

A. Lesch-Nyhan syndrome
B. Modification of diet in renal disease
C. Maple syrup urine disease
D. Reye’s syndrome
E. Megaloblastic anemia

Answer 191

A. Lesch-Nyhan syndrome

Question 192

The electrolytes sodium, chloride and bicarbonate, because they are present in high concentrations in the ECF, and contribute to over _ of serum osmolality.

A. 8%
B. 35%
C. 68%
D. 92%

Answer 192

D. 92%

Question 193

Electrolytes for acid-base balance:

A. Na+, Cl-, K+
B. Bicarbonate, K+, Cl-
C. Bicarbonate, Cl-
D. Ca2+ Mg2+

Answer 193

B. Bicarbonate, K+, Cl-

Question 194

Electrolytes for coagulation:

A. Na+, Cl-, K+
B. Bicarbonate, K+, Cl-
C. Bicarbonate, Cl-
D. Ca2+ Mg2+

Answer 194

D. Ca2+ Mg2+

Question 195

Close wound:

A. Abrasion
B. Hematoma
C. Laceration
D. Puncture

Answer 195

B. Hematoma

Question 196

Neuromuscular irritability, which may become clinically apparent as irregular muscle spasms, called TETANY is associated with:

A. Hyponatremia
B. Hypernatremia
C. Hypocalcemia
D. Hypercalcemia

Answer 196

C. Hypocalcemia

Question 197

It is used to determine whether there is a statistically significant difference between the standard deviations of two groups of data.

A. f test
B. t test
C. Variance
D. Standard deviation index

Answer 197

A. f test

Question 198

It is used to determine whether there is statistically significant difference between the means of two groups of data.

A. f test
B. t test
C. Variance
D. Standard deviation index

Answer 198

B. t test

Question 199

Which of the following is considered as ENVIRONMENTAL POLLUTANTS?

A. Elemental mercury
B. Mercurous mercury
C. Mercuric mercury
D. Alkyl mercury

Answer 199

D. Alkyl mercury

Question 200

1:3S
1. One observation exceeds 3 SD from the target value
2. Three observations exceed 1 SD from the target value
3. Imprecision or systematic bias
4. Not recommended

A. 1 and 3
B. 2 and 4
C. 1 and 4
D. 1, 3 and 4

Answer 200

A. 1 and 3

Question 201

8:1S
1. Range between two observations exceeds 4 SD
2. Eight sequential observations for the same QC sample exceed 1 SD
3. Imprecision
4. Bias trend

A. 1 and 3
B. 2 and 4
C. 1, 3 and 4
D. 2, 3 and 4

Answer 201

B. 2 and 4

Question 202

Because of its ANTITUSSIVE AND ANALGESIC PROPERTIES, it is one of the most frequently prescribed opiates in the world; it is frequently combined with nonopiate analgesic agents such as aspirin and acetaminophen.

A. Codeine
B. Heroin
C. Morphine
D. Oxycodone

Answer 202

A. Codeine

Question 203

All of the following are naturally occurring opiates except:

A. Morphine
B. Codeine
C. Heroin
D. Opium

Answer 203

C. Heroin

Question 204

Lyophilization:

A. 4 C
B. 40 C
C. -4 C
D. -40 C

Answer 204

D. -40 C

Question 205

Which of the following is a cause of metabolic alkalosis?

A. Late stage of salicylate poisoning
B. Uncontrolled diabetes mellitus
C. Renal failure
D. Excessive vomiting

Answer 205

D. Excessive vomiting

Question 206

Severe diarrhea causes:

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Answer 206

A. Metabolic acidosis

Question 207

The following conditions are all causes of alkalosis. Which condition is associated with respiratory (rather than metabolic) alkalosis?

A. Anxiety
B. Hypovolemia
C. Hyperaldosteronism
D. Hypoparathyroidism

Answer 207

A. Anxiety

Question 208

In salicylate overdose, what is the first acid-base disturbance present?

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Answer 208

D. Respiratory alkalosis

Question 209

A salicylate level is performed to detect toxicity caused by ingestion of excess:

A. Acetaminophen
B. Aspirin
C. Ibuprofen
D. Pseudoephedrine

Answer 209

B. Aspirin

Question 210

To calibrate the pH electrode in a pH/ blood gas analyzer, it is necessary that:

A. The barometric pressure be knownand used for adjustments
B. Calibrating gases of known high and low concentrations be used
C. The calibration be performed at room temperature
D. Two buffer solutions of known pH be used

Answer 210

D. Two buffer solutions of known pH be used

Question 211

Expression of one amount relative to another amount:

A. Concentration
B. Dilution
C. Ratio

Answer 211

C. Ratio

Question 212

The amount of one substance relative to the amounts of other substances in the solution:

A. Concentration
B. Dilution
C. Ratio

Answer 212

A. Concentration

Question 213

RELATIVE CONCENTRATIONS of the components of a mixture:

A. Concentration
B. Dilution
C. Ratio

Answer 213

B. Dilution

Question 214

It is defined as parts per hundred parts:

A. Percent
B. Ratio
C. Molarity
D. Normality

Answer 214

A. Percent

Question 215

Identify the result that is NOT electrolyte balanced. (compute the anion gap, results are in mmol/L)

A. Na+ 125, K+ 4.5, Cl- 100, CO2 content 10
B. Na+ 135, K+ 3.5, Cl- 95, CO2 content 28
C. Na+ 145, K+ 4.0, Cl- 90, CO2 content 15
D. Na+ 150, K+ 5.0, Cl- 110, CO2 content 30

Answer 215

C. Na+ 145, K+ 4.0, Cl- 90, CO2 content 15

Question 216

Which of the following conditions is characterized by primary HYPERaldosteronism caused by adrenal adenoma, carcinoma, or hyperplasia?

A. Cushing’s syndrome
B. Addison’s disease
C. Conn’s syndrome
D. Pheochromocytoma

Answer 216

C. Conn’s syndrome

Question 217

Single best hormone to determine whether ovulation has occurred; THERMOGENIC EFFECT, in which basal body temperature rises after ovulation. This effect is of clinical use in marking the occurrence of ovulation.

A. Estrogen
B. Progesterone
C. Testosterone
D. Thyroxine

Answer 217

B. Progesterone

Question 218

When encountering a patient with a fistula, the phlebotomist should:

A. Apply the tourniquet below the fistula
B. Use the other arm
C. Collect the blood from the fistula
D. Attach a syringe to the T-tube connector

Answer 218

B. Use the other arm

Question 219

Your inpatient is asleep when you arrive to draw blood. What do you do?

A. Call out the patient’s name softly and shake the bed gently.
B. Cancel the test and ask the nurse to resubmit the requisition.
C. Check back every 15 minutes until the patient has awakened.
D. Fill out a form stating that the specimen was not obtained and why.

Answer 219

A. Call out the patient’s name softly and shake the bed gently.

Question 220

Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?

A. Ask the patient to state her name; if it matches the requisition, continue.
B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.
C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed.
D. Tell the nurse that you will not collect the specimen and return to the lab.

Answer 220

B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.

Question 221

Which instrument requires a primary and secondary monochromator?

A. Spectrophotometer
B. Atomic absorption spectrophotometer
C. Fluorometer
D. Nephelometer

Answer 221

C. Fluorometer

Question 222

Which of the following is the reference method for measuring serum glucose?

A. Somogyi–Nelson
B. Hexokinase
C. Glucose oxidase
D. Glucose dehydrogenase

Answer 222

B. Hexokinase

Question 223

Gross hemolysis and extremely elevated bilirubin may cause ____ in HEXOKINASE results. (Bishop)

A. False increase
B. False decrease
C. No effect
D. Variable

Answer 223

B. False decrease

Question 224

The mean is:

A. Another term for the average
B. Most frequently occurring number in a group of values
C. Number that is midway between the highest and lowest values
D. A representation of a true analyte value

Answer 224

A. Another term for the average

Question 225

The median is:

A. Another term for the average
B. Most frequently occurring number in a group of values
C. Number that is midway between the highest and lowest values
D. A representation of a true analyte value

Answer 225

C. Number that is midway between the highest and lowest values

Question 226

The mode is:

A. Another term for the average
B. Most frequently occurring number in a group of values
C. Number that is midway between the highest and lowest values
D. A representation of a true analytic value

Answer 226

B. Most frequently occurring number in a group of values

Question 227

Bence Jones protein precipitates at temperatures between
____, and redissolves at near ____° C.

A. Precipitates at 100-120C, and redissolves at 60C
B. Precipitates at 10 to 20C, and redissolves at 100C
C. Precipitates at 80-100C, and redissolves at 60C
D. Precipitates at 40 to 60C, and redissolves at 100C

Answer 227

D. Precipitates at 40 to 60C, and redissolves at 100C

Question 228

Which of the following biochemical processes is promoted by insulin?

A. Glycogenolysis
B. Gluconeogenesis
C. Lipolysis
D. Uptake of glucose by cells

Answer 228

D. Uptake of glucose by cells

Question 229

Which type of analytical error can be prevented by a good quality control program?

A. Instrument not properly calibrated
B. Presence of interfering substances in sample
C. Presence of bubbles in the light path of a photometric method
D. Analyte concentration so high it depletes the active reagent

Answer 229

A. Instrument not properly calibrated

Question 230

An example of a pre-analytical (pre-examination) error is:

A. Malfunction of a microprocessor that affects accuracy in testing
B. Incorrect identification of a patient
C. Transposition of a numeric critical value in transmitting a report
D. Verbally reporting a laboratory result over the telephone

Answer 230

B. Incorrect identification of a patient

Question 231

An example of an analytical (examination) error is:

A. Malfunction of a microprocessor that affects accuracy in testing
B. Incorrect patient identification
C. Transposition of a numeric critical value in transmitting a report
D. Use of the wrong anticoagulant in the patient sample tube

Answer 231

A. Malfunction of a microprocessor that affects accuracy in testing

Question 232

An example of a post-analytical (post-examination) error is:

A. Malfunction of a microprocessor that affects accuracy in testing
B. Incorrect patient identification
C. Transposition of a numeric critical value in transmitting a report
D. Use of the wrong anticoagulant in the patient sample tube

Answer 232

C. Transposition of a numeric critical value in transmitting a report

Question 233

At temperature of 4C:

A. Decreased ALP and LD
B. Increased ALP and LD
C. Increased ALP and decreased LD
D. Decreased ALP and increased LD

Answer 233

C. Increased ALP and decreased LD

Question 234

Rare autosomal recessive disorder characterized by complete absence of HDL:

A. Tangier disease
B. Anderson disease
C. Bassen-Kornzweig syndrome
D. Sitosterolemia

Answer 234

A. Tangier disease

Question 235

Abetalipoproteinemia, patients present with undetectable plasma apoB containing lipoproteins:

A. Tangier disease
B. Anderson disease
C. Bassen-Kornzweig syndrome
D. Sitosterolemia

Answer 235

C. Bassen-Kornzweig syndrome

Question 236

Chylomicron retention disease presents in childhood with fat malabsorption and low levels of plasma lipids. This syndrome is distinct from abetalipoproteinemia, as only apoB-48 appears to be affected:

A. Tangier disease
B. Anderson’s disease
C. Bassen-Kornzweig syndrome
D. Sitosterolemia

Answer 236

B. Anderson’s disease

Question 237

Which of the following blood samples would serve best to assay lipoproteins because this anticoagulant acts to preserve lipoproteins?

A. EDTA plasma sample
B. Heparin plasma sample
C. Citrate plasma sample
D. Fluoride plasma sample

Answer 237

A. EDTA plasma sample

Question 238

Methylenedioxymethamphetamine (MDMA) or commonly known as:

A. Cannabis
B. Shabu
C. Meth
D. Ecstasy

Answer 238

D. Ecstasy

Question 239

THERAPEUTIC DRUG MONITORING
Anticoagulant suitable for most drug analysis.

A. Heparin
B. Citrate
C. Oxalate
D. EDTA

Answer 239

A. Heparin

Serum or plasma is the specimen of choice for the determination of circulating concentrations of most drugs.
Heparinized plasma is suitable for most drug analysis.
The calcium-binding anticoagulants add a variety of anions and cations that may interfere with analysis or cause a drug to distribute differently between cells and plasma.
As a result, ethylenediaminetetracetic acid (EDTA), citrated and oxalated plasma are not usually acceptable specimens

Question 240

Proper PPE in the chemistry laboratory for routine testing includes:

A. Impermeable lab coat with eye/ face protection and appropriate disposable gloves
B. Respirators w/ HEPA filter
C. Gloves w/ rubberized sleeves
D. Safety glasses for individuals not wearing contact lenses

Answer 240

A. Impermeable lab coat with eye/ face protection and appropriate disposable gloves

Question 241

Clinical signs and symptoms commonly include low birth weight (<2,500 g), skin hyperpigmentation (café au lait spots), and short stature.
Other manifestations can include skeletal disorders (aplasia or hypoplasia of the thumb), renal malformations, microcephaly, hypogonadism, mental retardation, and strabismus.

A. Diamond-Blackfan anemia
B. Fanconi anemia
C. Sideroblastic anemia
D. Thalassemia

Answer 241

B. Fanconi anemia

Question 242

Methylenedioxymethamphetamine (MDMA) or commonly known as:

A. Cannabis
B. Shabu
C. Meth
D. Ecstasy

Answer 242

D. Ecstasy

Question 243

A drug test is valid for _________.

A. Three months
B. Six months
C. One year
D. Two years

Answer 243

C. One year

Question 244

Biodegradable wastes like leftover food, used cooking oil, fish entrails, scale, fins, fruits, vegetable peelings, rotten fruits, and vegetables:

A. Orange
B. Red
C. Green
D. Black

Answer 244

C. Green

Question 245

Non-biodegradable wastes like paper or paper products (newspaper, tetra packs, etc.), bottles (glass and plastics), and packaging materials (Styropor, candy wrapper, aluminum cans):

A. Orange
B. Red
C. Green
D. Black

Answer 245

D. Black

Question 246

Radioactive wastes or medical equipment contaminated or exposed in radioactivity:

A. Orange
B. Red
C. Green
D. Black

Answer 246

A. Orange

Question 247

Pharmaceutical and chemical wastes:

A. Yellow
B. Yellow with black band
C. Red
D. Orange

Answer 247

B. Yellow with black band

Question 248

Infectious and pathological wastes such as used test strips, used beads or plates, used reaction pads or foils, used swabs, used gloves, used cord clamp, used plaster, used masks:

A. Yellow
B. Yellow with black band
C. Red
D. Orange

Answer 248

A. Yellow

Question 249

In the Hierarchy of Controls, which of the following is most effective in preventing exposures:

A. Personal protective equipment
B. Substitution of toxic substances
C. Hazard elimination
D. Engineering controls

Answer 249

C. Hazard elimination

Question 250

Use of which of the following is a method of substitution of a work-related hazard:

A. Sharp containers
B. Non-latex gloves instead of latex gloves
C. Patient lift equipment
D. Hand sanitizers

Answer 250

B. Non-latex gloves instead of latex gloves

Question 251

Aldosterone is involved in the reabsorption of:

A. Potassium
B. Sodium
C. Bicarbonate
D. Hydrogen ion

Answer 251

B. Sodium

Question 252

Following a head injury, which protein will identify the presence of CSF leakage through the nose?

A. Transthyretin
B. Myelin basic protein
C. Tau protein
D. C-reactive protein

Answer 252

C. Tau protein

Question 253

Second most prevalent protein in CSF:

A. Ceruloplasmin
B. Haptoglobin
C. Prealbumin
D. Transferrin

Answer 253

C. Prealbumin

Question 254

CSF GLUTAMINE
Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome?

A. Ammonia
B. Lactate
C. Glucose
D. Alpha-ketoglutarate

Answer 254

A. Ammonia

Question 255

The amount of amniotic fluid increases in quantity throughout pregnancy, reaching a peak of approximately ____ mL during the third trimester, and then gradually decreases prior to delivery.

A. 400 to 800 mL
B. 800 mL to 1,200 mL
C. 1,200 to 1,500 mL
D. 2,000 to 4, 000 mL

Answer 255

B. 800 mL to 1,200 mL

Question 256

A maximum of _ mL of amniotic fluid is collected in sterile syringes.

A. 10 mL
B. 20 mL
C. 30 mL
D. 50 mL

Answer 256

C. 30 mL

Question 257

Which pair does NOT match with respect to amniotic fluid?

A. Colorless – normal
B. Dark red-brown – fetal death
C. Dark green – hemolytic disease of the newborn
D. Blood-streaked – traumatic tap

Answer 257

C. Dark green – hemolytic disease of the newborn

Question 258

A pleural fluid submitted to the laboratory is milky in appearance. Which test would be most useful in differentiating between a chylous and pseudochylous effusion?

A. Fluid to serum triglyceride ratio
B. Fluid WBC count
C. Fluid total protein
D. Fluid to serum LD ratio

Answer 258

A. Fluid to serum triglyceride ratio

Question 259

In which condition is the highest level of serum gastrin usually seen?

A. Atrophic gastritis
B. Pernicious anemia
C. Zollinger-Ellison syndrome
D. Cancer of the stomach

Answer 259

C. Zollinger-Ellison syndrome

Question 260

Which is the reference method for determining fetal lung maturity?

A. Human placental lactogen
B. L/S ratio
C. Amniotic fluid bilirubin
D. Urinary estriol

Answer 260

B. L/S ratio

Question 261

Which test best correlates with the severity of HDN?

A. Rh antibody titer of the mother
B. Lecithin/sphingomyelin (L/S) ratio
C. Amniotic fluid bilirubin
D. Urinary estradiol

Answer 261

C. Amniotic fluid bilirubin

Question 262

Which of the following conditions is commonly associated with an exudative effusion?

A. Congestive heart failure
B. Malignancy
C. Nephrotic syndrome
D. Cirrhosis

Answer 262

B. Malignancy

Question 263

Family history of chromosome abnormalities, such as TRISOMY 21 (DOWN SYNDROME), amniocentesis may be indicated at:

A. 1 to 7 weeks gestation
B. 7 to 14 weeks gestation
C. 15 to 18 weeks gestation
D. 20 to 42 weeks gestation

Answer 263

C. 15 to 18 weeks gestation

Question 264

Basic unit for mass:

A. Mole
B. Milligram
C. Gram
D. Kilogram

Answer 264

D. Kilogram

Question 265

Basic unit for length:

A. Second
B. Millimeter
C. Meter
D. Kilometer

Answer 265

C. Meter

Question 266

The sex steroids are synthesized by all of the following, EXCEPT:

A. Hypothalamus
B. Ovaries
C. Testes
D. Adrenal gland

Answer 266

A. Hypothalamus

Question 267

The mechanism of action for tetracycline is inhibition of:

A. RNA synthesis
B. Cell wall synthesis
C. Protein synthesis
D. Membrane function

Answer 267

C. Protein synthesis

Question 268

What plasma protein functions to bind hemoglobin following intravascular hemolysis?

A. Albumin
B. Transferrin
C. Haptoglobin
D. C-reactive protein

Answer 268

C. Haptoglobin

Question 269

Preanalytical (preexamination) variables in laboratory testing include:

A. Result accuracy
B. Report delivery to the ordering physician
C. Test turnaround time
D. Specimen acceptability

Answer 269

D. Specimen acceptability

Question 270

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease?

A. Cathepsin-D
B. CA-15-3
C. Retinoblastoma gene
D. Estrogen receptor (ER)

Answer 270

B. CA-15-3

Question 271

Which tumor marker is used to determine the usefulness of TRASTUZUMAB (HERCEPTIN) therapy for breast cancer?

A. PR
B. CEA
C. HER-2/neu
D. Myc

Answer 271

C. HER-2/neu

Question 272

Employees should not work with radioisotopes if they are:

A. Wearing contact lenses
B. Allergic to iodine
C. Sensitive to latex
D. Pregnant

Stras

Answer 272

D. Pregnant

Question 273

The first thing to do when a fire is discovered is to:

A. Rescue persons in danger
B. Activate the alarm system
C. Close doors to other areas
D. Extinguish the fire if possible

Stras

Answer 273

A. Rescue persons in danger

Question 274

The NPFA classification symbol contains information on all of the following except:

A. Fire hazards
B. Biohazards
C. Reactivity
D. Health hazards

Stras

Answer 274

B. Biohazards

Question 275

The testing of sample from an outside agency and the comparison of results with participating laboratories is called:

A. External QC
B. Electronic QC
C. Internal QC
D. Proficiency testing

Stras

Answer 275

D. Proficiency testing

Proficiency Testing (External Quality Assessment)
External QA (not External QC)
PT or EQA is the testing of unknown samples received from an outside agency, and provides unbiased validation of the quality of patient test results. The laboratory accuracy is evaluated and compared with other laboratories using the same method of analysis.

Question 276

The classification of a fire that can be extinguished with water is:

A. Class A
B. Class B
C. Class C
D. Class D

Stras

Answer 276

A. Class A

Question 277

Employers are required to provide free immunization for:

A. HIV
B. HTLV-1
C. HBV
D. HCV

Stras

Answer 277

C. HBV

Question 278

The primary chemical affected by the renin-angiotensin-aldosterone system is:

A. Chloride
B. Sodium
C. Potassium
D. Hydrogen

Stras

Answer 278

B. Sodium

Question 279

A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?

A. Lesch-Nyhan syndrome
B. Modification of diet in renal disease
C. Maple syrup urine disease
D. Reye’s syndrome
E. Megaloblastic anemia

Answer 279

A. Lesch-Nyhan syndrome

Question 280

Seventy (70) percent recirculated to the cabinet work area through HEPA; 30% balance can be exhausted through HEPA back into the room or to outside through a canopy unit:

A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 280

B. BSC Class II, A1

Question 281

Thirty (30) percent recirculated, 70% exhausted. Exhaust cabinet air must pass through a dedicated duct to the outside through a HEPA filter.

A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 281

C. BSC Class II, B1

Question 282

No recirculation; total exhaust to the outside through a HEPA filter.

A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

Answer 282

D. BSC Class II, B2

Question 283

In ENTERIC ISOLATION, the technologist is required to wear:

A. Gown and gloves
B. Gown, mask and gloves
C. Gown, mask, gloves and shoe coverings
D. Mask

Answer 283

A. Gown and gloves

Question 284

Reverse isolation may be used for:

A. A patient with the measles
B. An adult patient with the flu
C. A patient with tuberculosis
D. A patient with severe burns

Answer 284

D. A patient with severe burns

Question 285

Which of the following plots is best for detecting all types of QC errors?

A. Levy–Jennings
B. Tonks–Youden
C. Cusum
D. Linear regression

Answer 285

A. Levy–Jennings

Question 286

Which of the following plots is best for comparison of precision and accuracy among laboratories?

A. Levy–Jennings
B. Tonks–Youden
C. Cusum
D. Linear regression

Answer 286

B. Tonks–Youden

Question 287

Which plot will give the earliest indication of a shift or trend?

A. Levy–Jennings
B. Tonks–Youden
C. Cusum
D. Histogram

Answer 287

C. Cusum

Question 288

Which of the following statistical tests is used to compare the means of two methods?

A. Student’s t test
B. F distribution
C. Correlation coefficient
D. Linear regression analysis

Answer 288

A. Student’s t test

Question 289

When the magnitude of error increases with increasing sample concentration, it is called:

A. Constant error
B. Proportional error
C. Random error
D. Bias

Answer 289

B. Proportional error

Question 290

Urea is produced from:

A. The catabolism of proteins and amino acids
B. Oxidation of purines
C. Oxidation of pyrimidines
D. The breakdown of complex carbohydrates

Answer 290

A. The catabolism of proteins and amino acids

Question 291

In the ultraviolet enzymatic method for BUN, the urease reaction is coupled to a second enzymatic reaction using:

A. AST
B. Glutamate dehydrogenase
C. Glutamine synthetase
D. Alanine aminotransferase (ALT)

Answer 291

B. Glutamate dehydrogenase

Question 292

Which product is measured in the coupling step of the urease-UV method for BUN?

A. CO2
B. Dinitrophenylhydrazine
C. Diphenylcarbazone
D. NAD+

Answer 292

D. NAD+

Question 293

Which of the following conditions is classified as a renal-type aminoaciduria?

A. Fanconi syndrome
B. Wilson’s disease
C. Hepatitis
D. Homocystinuria

Answer 293

A. Fanconi syndrome

Question 294

Which of the following protein methods has the highest analytical sensitivity?

A. Refractometry
B. Folin–Lowry
C. Turbidimetry
D. Direct ultraviolet absorption

Answer 294

B. Folin–Lowry

Question 295

Hyperalbuminemia is caused by:

A. Dehydration syndromes
B. Liver disease
C. Burns
D. Gastroenteropathy

Answer 295

A. Dehydration syndromes

Question 296

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

Answer 296

B. Bromcresol purple (BCP)

Question 297

At pH 8.6, proteins are ________ charged and migrate toward the ________.

A. Negatively, anode
B. Positively, cathode
C. Positively, anode
D. Negatively, cathode

Answer 297

A. Negatively, anode

Question 298

Which of the following proteins migrates in the beta region at pH 8.6?

A. Haptoglobin
B. Orosomucoprotein
C. Antichymotrypsin
D. Transferrin

Answer 298

D. Transferrin

Question 299

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

Answer 299

A. Hemopexin

Question 300

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

Answer 300

D. Serum-free light chain immunoassay

Question 301

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

Answer 301

D. Measurement of serum-free light chains

Question 302

In familial β dyslipoproteinemia (formerly type III hyperlipoproteinemia), which lipoprotein accumulates?

A. Chylomicrons
B. VLDL
C. IDL
D. VLDL

Answer 302

C. IDL

Question 303

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

Answer 303

B. ApoB-100 receptor defect

Question 304

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 lipasedeficiency
C. Apo-B deficiency
D. Apo-C-III deficiency

Answer 304

B. Post–heparin-activated lipoprotein lipasedeficiency

Question 305

Which of the following enzymes is considered most tissue specific?

A. Creatine kinase (CK)
B. Amylase
C. Alkaline phosphatase (ALP)
D. Alcohol dehydrogenase (ADH)

Answer 305

D. Alcohol dehydrogenase (ADH)

Question 306

Which of the following enzymes is activated by calcium ions

A. CK
B. Amylase
C. ALP
D. LD

Answer 306

B. Amylase

Question 307

Which substance is used in the CK assay to activate the enzyme?

A. Flavin adenine dinucleotide (FAD)
B. Imidazole
C. N-acetylcysteine
D. Pyridoxyl-5 ́-phosphate

Answer 307

C. N-acetylcysteine

Question 308

Select the coupling enzyme used in the kinetic AST reaction of Henry.

A. LD
B. Malate dehydrogenase
C. Glutamate dehydrogenase
D. G-6-PD

Answer 308

B. Malate dehydrogenase

Question 309

Which isoenzyme of ALP is most heat stable?

A. Bone
B. Liver
C. Intestinal
D. Placental

Answer 309

D. Placental

Question 310

Which substrate is used in the Bowers–McComb method for ALP?

A. p-Nitrophenyl phosphate
B. β-Glycerophosphate
C. Phenylphosphate
D. α-Naphthylphosphate

Answer 310

A. p-Nitrophenyl phosphate

Question 311

Which is normally the most abundant corticosteroid hormone secreted by the adrenal cortex?

A. Cortisol
B. Dehydroepiandrosterone
C. Aldosterone
D. Corticosterone

Answer 311

A. Cortisol

Question 312

Which assay using 24-hour urine is considered the best single screening test for pheochromocytoma?

A. Total urinary catecholamines
B. VMA
C. Homovanillic acid (HVA)
D. Metanephrines

Answer 312

D. Metanephrines

Question 313

Select the most appropriate single screening test for thyroid disease.

A. Free thyroxine index
B. Total T3 assay
C. Total T4
D. TSH assay

Answer 313

D. TSH assay

Question 314

Which statement about TSH and T4 in early pregnancy is correct?

A. TSH and thyroid hormones fall
B. TSH falls and thyroid hormones rise
C. TSH and thyroid hormones both rise
D. TSH rises and thyroid hormones fall

Answer 314

B. TSH falls and thyroid hormones rise

Question 315

Which route of administration is associated with 100% bioavailability?

A. Sublingual
B. Intramuscular
C. Oral
D. Intravenous

Answer 315

D. Intravenous

Question 316

Which substance has the longest detection time?

A. Amphetamines
B. Cocaine
C. Benzodiazepines
D. Marijuana

Answer 316

D. Marijuana

Question 317

The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity:

A. Choramphenicol
B. Penicillin
C. Sulfonamide
D. Vancomycin

Answer 317

D. Vancomycin

Question 318

Which specimen is the sample of choice for lead screening

A. Whole blood
B. Hair
C. Serum
D. Urine

Answer 318

A. Whole blood

Question 319

Which tumor marker is associated with cancer of the urinary bladder?

A. CA-19-9
B. CA-72-4
C. Nuclear matrix protein
D. Cathepsin-D

Answer 319

C. Nuclear matrix protein

Question 320

A blood sample is left on a phlebotomy tray for 4.5 hours before it is delivered to the laboratory. Which group of tests could be performed?

A. Glucose, Na, K, Cl, TCO2
B. Uric acid, BUN, creatinine
C. Total and direct bilirubin
D. CK, ALT, ALP, AST

Answer 320

B. Uric acid, BUN, creatinine

Question 321

Beer-Lambert law (Beer’s law)
Mathematically establishes the relationship between concentration and absorbance in many photometric determinations

Beer’s law is expressed as A = abc
A (capital A) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 321

A. Absorbance

Question 322

Beer-Lambert law (Beer’s law)
Mathematically establishes the relationship between concentration and absorbance in many photometric determinations

Beer’s law is expressed as A = abc
a (small a) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 322

B. Absorptivity constant

Question 323

Beer-Lambert law (Beer’s law)
Mathematically establishes the relationship between concentration and absorbance in many photometric determinations

Beer’s law is expressed as A = abc
b (small b) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 323

D. Length of light path

Question 324

Beer-Lambert law (Beer’s law)
Mathematically establishes the relationship between concentration and absorbance in many photometric determinations

Beer’s law is expressed as A = abc
c (small c) in Beer’s law is:

A. Absorbance
B. Absorptivity constant
C. Concentration
D. Length of light path

Answer 324

C. Concentration

Question 325

Expression of one amount relative to another amount:

A. Concentration
B. Dilution
C. Ratio

Answer 325

C. Ratio

Question 326

The amount of one substance relative to the amounts of other substances in the solution:

A. Concentration
B. Dilution
C. Ratio

Answer 326

A. Concentration

Question 327

RELATIVE CONCENTRATIONS of the components of a mixture:

A. Concentration
B. Dilution
C. Ratio

Answer 327

B. Dilution

Question 328

It is increased in hemolytic anemias:

A. B1
B. B2
C. Both fractions
D. None of these

Answer 328

A. B1

Question 329

It is increased in bile duct obstruction:

A. B1
B. B2
C. Both fractions
D. None of these

Answer 329

B. B2

Question 330

Increased in hepatitis:

A. B1
B. B2
C. Both fractions
D. None of these

Answer 330

C. Both fractions

Question 331

C-peptide is formed during the conversion of pro-insulin to insulin. The amount of circulating C-peptide provides reliable indicators for pancreatic and insulin secretions (β-cell function). It is decreased in:

A. Type 1 DM
B. Type 2 DM
C. Insulinoma
D. Ingestion of hypoglycemic drugs

Answer 331

A. Type 1 DM

Question 332

VERY LOW OR UNDETECTABLE C-peptide:

A. Type 1 diabetes
B. Type 2 diabetes
C. Both of these
D. None of these

Answer 332

A. Type 1 diabetes

Question 333

DETECTABLE C-peptide:

A. Type 1 diabetes
B. Type 2 diabetes
C. Both of these
D. None of these

Answer 333

B. Type 2 diabetes

Question 334

Blood alcohol concentration associated with mental confusion, dizziness, strongly impaired motor skills (staggering, slurred speech):

A. 0.09 to 0.25%
B. 0.18 to 0.30%
C. 0.27 to 0.40%
D. 0.35 to 0.50%

Answer 334

B. 0.18 to 0.30%

Question 335

Blood alcohol concentration associated with vomiting and impaired consciousness. The patient is unable to stand.

A. 0.09 to 0.25%
B. 0.18 to 0.30%
C. 0.27 to 0.40%
D. 0.35 to 0.50%

Answer 335

C. 0.27 to 0.40%

Question 336

Blood alcohol concentration associated with coma and possible death:

A. 0.09 to 0.25%
B. 0.18 to 0.30%
C. 0.27 to 0.40%
D. 0.35 to 0.50%

Answer 336

D. 0.35 to 0.50%

Question 337

A solution used to clean the site before routine venipuncture is:

A. 5.25% sodium hypochlorite.
B. 70% isopropyl alcohol.
C. 70% methanol.
D. Povidone–iodine.

Answer 337

B. 70% isopropyl alcohol.

Question 338

This antiseptic has been traditionally used to obtain the high degree of skin antisepsis required when BLOOD CULTURES are being collected:

A. 70% Ethyl alcohol
B. 70% Isopropanol
C. Hydrogen peroxide
D. Povidone–iodine

Answer 338

D. Povidone–iodine

Question 339

When drawing a blood alcohol specimen, it is acceptable to clean the arm with:

A. Benzalkonium chloride
B. Isopropyl alcohol
C. Methanol prep
D. Tincture of iodine

Answer 339

A. Benzalkonium chloride

Question 340

It is used for procedures that require maximum water purity for accuracy and precision:

A. Type I reagent water
B. Type II reagent water
C. Type III reagent water
D. Any of these

Answer 340

A. Type I reagent water

Question 341

Which of the following is a proper way to clean up a small blood spill that has dried on a countertop?

A. Moisten it with a disinfectant and carefully absorb it with a paper towel
B. Rub it with an alcohol pad, then wipe the area with a clean alcohol pad
C. Scrape it into a biohazard bag and wash the surface with soap and water
D. Use a disinfectant wipe and scrub it in ever increasing concentric circles

Answer 341

A. Moisten it with a disinfectant and carefully absorb it with a paper towel

Question 342

One international unit of enzyme activity is the amount of enzyme that will, under specified reaction conditions of substrate concentration, pH and temperature, cause utilization of substrate at the rate of:

A. 1 mol/min
B. 1 mmol/min
C. 1 μmol/min
D. 1 nmol/min

Answer 342

C. 1 μmol/min

Question 343

In familial hypercholesterolemia, the hallmark finding is an elevation of:

A. Low-density lipoproteins
B. Chylomicrons
C. High-density lipoproteins
D. Apolipoprotein A1

Answer 343

A. Low-density lipoproteins

Question 344

What substance gives feces its normal color?
A. Uroerythrin
B. Urochrome
C. Urobilin
D. Urobilinogen

Answer 344

C. Urobilin

Question 345

The most heat labile fraction of alkaline phosphatase is obtained from:

A. Liver
B. Bone
C. Intestine
D. Placenta

Answer 345

B. Bone

Question 346

Cholinesterase levels are generally assayed to aid in diagnosis of:

A. Pancreatitis
B. Methamphetamine overdose
C. Organophosphate poisoning
D. Hepatobiliary disease

Answer 346

C. Organophosphate poisoning

Question 347

A characteristic of the Bence Jones protein that is used to distinguish it from other urinary proteins is its solubility:

A. In ammonium sulfate
B. In sulfuric acid
C. At 40 to 60 °C
D. At 100 °C

Answer 347

D. At 100 °C

Question 348

A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is:

A. Ammonia
B. ALT
C. AST
D. GGT

Answer 348

A. Ammonia

Question 349

An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state?

A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis

Answer 349

A. Respiratory acidosis

Question 350

RENAL TUBULAR FUNCTION
Select the test which evaluates renal tubular function.

A. IVP
B. Creatinine clearance
C. Osmolality
D. Microscopic urinalysis

Answer 350

C. Osmolality

Question 351

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

Answer 351

D. Sodium

Question 352

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

A. Glucose
B. Sodium
C. Chloride
D. Urea

Answer 352

B. Sodium

Question 353

A delta check is a method that:

A. Determines the mean and variance of an instrument
B. Monitors the testing system for precision
C. Monitors patient samples day to day
D. Is determined by each laboratory facility

Answer 353

C. Monitors patient samples day to day

Question 354

Which of these attributes is the advantage for adding point-of-care testing?

A. Higher test accuracy
B. Lower costs
C. Faster TAT
D. More skilled test personnel

Answer 354

C. Faster TAT

Question 355

The primary advantage of point-of-care testing (POCT), also known as bedside testing or near patient testing is:

A. POCT can be performed by nonlaboratorians at a lower cost
B. The turn-around time for test results is faster
C. POCT bypasses costly regulatory requirements that apply to testing in a central lab
D. Testing is easier to perform, which reduces the cost of training

Answer 355

B. The turn-around time for test results is faster

Question 356

Which of the following is considered as ENVIRONMENTAL POLLUTANTS?

A. Elemental mercury
B. Mercurous mercury
C. Mercuric mercury
D. Alkyl mercury

Answer 356

D. Alkyl mercury

Question 357

A comatose 27-year-old woman is brought to the emergency room by paramedics, and the strong odor of bitter almonds is present. The differential diagnosis must include the possibility of poisoning by:

A. Ethylene glycol
B. Carbon monoxide
C. Carbon tetrachloride
D. Cyanide
E. Arsenic

Answer 357

D. Cyanide

Question 358

The odor of garlic may be on the breath, and a metallic taste in the patient’s mouth:

A. Arsenic
B. Cyanide
C. Iron
D. Mercury

Answer 358

A. Arsenic

Question 359

This toxin has high affinity to keratin, can be identified from hair and nails:

A. Lead
B. Cyanide
C. Mercury
D. Arsenic

Answer 359

D. Arsenic

Question 360

Kayser-Fleischer ring in the cornea:

A. Cretinism
B. Hemochromatosis
C. Minamata disease
D. Wilson’s disease

Answer 360

D. Wilson’s disease

Question 361

Establishing a reference interval:
A new reference interval is established when there is no existing analyte or methodology in the clinical or reference laboratory with which to conduct comparative studies. It is a costly and labor-intensive study that will involve laboratory resources at all levels and may require from ____ to as many as ≈700 study individuals.

A. 20 study individuals
B. 50 study individuals
C. 100 study individuals
D. 120 study individuals

Answer 361

D. 120 study individuals

Question 362

**

Verifying a reference interval (transference):
This is done to confirm the validity of an existing reference interval for an analyte using the same (identical) type of analytic system (method and/or instrument). These are the most common reference interval studies performed in the clinical laboratory and can require as few as ____ study individuals.

A. 20 study individuals
B. 50 study individuals
C. 100 study individuals
D. 120 study individuals

Answer 362

A. 20 study individuals

Question 363

Gross hemolysis and extremely elevated bilirubin may cause ____ in HEXOKINASE results. (Bishop)

A. False increase
B. False decrease
C. No effect
D. Variable

Answer 363

B. False decrease

Question 364

Typically, a full Six Sigma improvement project takes ____ to complete.

A. 1 to 2 weeks
B. 3 to 4 months
C. 6 to 8 months
D. 1 to 2 years

Answer 364

C. 6 to 8 months

Question 365

Smaller scale improvement projects typically headed by ____ belts use the same Lean Six Sigma principles condensed over 1 week to improve more focused and limited processes.

A. White belts
B. Yellow belts
C. Purple belts
D. Black belts

Answer 365

C. Purple belts

Question 366

The sample of choice for measuring blood osmolality is:

A. Serum
B. Plasma
C. Whole blood
D. Serum or plasma may be used

Answer 366

A. Serum

Question 367

Glassware is usually calibrated at:

A. 98F
B. 72F
C. 20C
D. 37C

Answer 367

C. 20C

Question 368

Acid cleaning solution contains:

A. 10% HCl
B. Potassium dichromate in concentrated H2SO4
C. Potassium chlorate in concentrated H2SO4
D. Dilute solution of any acid

Answer 368

B. Potassium dichromate in concentrated H2SO4

Question 369

If a blood gas specimen is left exposed to the air for an extended period, which of the following changes will occur?

A. pO2 increases, pH and pCO2 decrease
B. pO2 decreases, pH and pCO2 increase
C. pO2 and pH increase, pCO2 decreases
D. pO2 and pH decrease, pCO2 increases

Answer 369

C. pO2 and pH increase, pCO2 decreases

Question 370

The first step to take when attempting to repair electronic equipment is to:

A. Check all electronic connections
B. Turn instrument off and unplug it
C. Reset all the printed circuit boards
D. Review instrument manual

Answer 370

B. Turn instrument off and unplug it

Question 371

Which of the following light sources is used in atomic absorption spectrophotometry?

A. Hollow-cathode lamp
B. Xenon arc lamp
C. Tungsten light
D. Deuterium lamp
E. Laser

Answer 371

A. Hollow-cathode lamp

Question 372

What test is best to assess kidney glomerular filtration?

A. Urea nitrogen
B. Creatinine clearance
C. PSP
D. Urine protein
E. Serum protein electrophoresis

Answer 372

B. Creatinine clearance

Question 373

The chloride shift in blood takes place between chloride and:

A. Sodium
B. Potassium
C. Bicarbonate
D. Calcium
E. Oxygen

Answer 373

C. Bicarbonate

Question 374

Physiologically active calcium is:

A. Protein bound
B. Complexed to oxalate
C. Complexed to citrate
D. Total calcium
E. Ionized calcium

Answer 374

E. Ionized calcium

Question 375

Symptom of hypocalcemia:

A. Stupor
B. Tetany
C. Vomiting
D. Dehydration
E. Tremors

Answer 375

B. Tetany

Question 376

In lipoprotein electrophoresis, the dense band that doesn’t migrate from the origin is:

A. Chylomicrons
B. LDL
C. Beta lipoproteins
D. Cholesterol
E. Phospholipids

Answer 376

A. Chylomicrons

Question 377

TSH is produced by the:

A. Hypothalamus
B. Pituitary gland
C. Adrenal cortex
D. Thyroid

Answer 377

B. Pituitary gland

Question 378

During pregnancy, the form of estrogen that predominates and may be useful in prenatal screening is:

A. Estradiol
B. Estriol
C. Estrone
D. Pregnanediol

Answer 378

B. Estriol

Question 379

A carbonate salt used to control manic-depressive disorders is:

A. Digoxin
B. Acetaminophen
C. Lithium
D. Phenytoin

Answer 379

C. Lithium

Question 380

The reason carbon monoxide is so toxic is because it:

A. Is a protoplasmic poison
B. Combines with cytochrome oxidase
C. Has 200 times the affinity of oxygen for hemoglobin binding sites
D. Sensitizes the myocardium

Answer 380

C. Has 200 times the affinity of oxygen for hemoglobin binding sites

Question 381

A 3-year-old child is evaluated for abdominal pain and anorexia by a physician. A CBC reveals a hemoglobin of 9.8 g/dl (98 g/L) and basophilic stippling of the RBCs. The doctor should order further tests to check for poisoning from:

A. Arsenic
B. Iron
C. Mercury
D. Lead

Answer 381

D. Lead

Question 382

Hepatocellular damage may be best assessed by which of the following parameters?

A. Serum AST and ALT levels
B. GGT and ALP
C. Bilirubin, GGT, and ALP
D. Ammonia and urea

Answer 382

A. Serum AST and ALT levels

Question 383

Which of the following analytes is the best indicator of hepatobiliary damage?

A. AST
B. ALT
C. ALP
D. Bilirubin

Answer 383

C. ALP

Question 384

Given the following results:
ALP: marked increased
AST: slight increased
ALT: slight increased
GGT: marked increased
This is most consistent with:

A. Acute hepatitis
B. Osteitis fibrosa
C. Chronic hepatitis
D. Obstructive jaundice

Answer 384

D. Obstructive jaundice

Question 385

A physician orders several laboratory tests on a 55-year-old male patient who is complaining of pain, stiffness, fatigue and headaches. Based on the following serum test results, what is the most likely diagnosis?
ALP: significantly increased
GGT: normal

A. Biliary obstruction
B. Cirrhosis
C. Hepatitis
D. Osteitis deformans (Paget disease)

Answer 385

D. Osteitis deformans (Paget disease)

Question 386

A 42-year-old male presents with anorexia, nausea, fever, and icterus of the skin and mucous membranes. He noticed that his urine had appeared dark for the past several days. The physician orders a series of biochemical tests. Based on the following test results, what is the most likely diagnosis?
ALP: slightly elevated
ALT: markedly elevated
AST: markedly elevated
GGT: slightly elevated
Serum total bilirubin: moderately elevated
Urine bilirubin: positive
Fecal urobilinogen: decreased

A. Acute hepatitis
B. Alcoholic cirrhosis
C. Metastatic carcinoma of the pancreas
D. Obstructive jaundice

Answer 386

A. Acute hepatitis

Question 387

Given the following results:
ALP: slight increased
AST: slight increased
ALT: slight increased
GGT: slight increased
This is most consistent with:

A. Acute hepatitis
B. Chronic hepatitis
C. Obstructive jaundice
D. Liver hemangioma

Answer 387

B. Chronic hepatitis

Question 388

Which of the following is a marker for bone resorption?

A. β-trace protein
B. Adiponectin
C. Fibronectin
D. Crosslinked C-telopeptide

Answer 388

D. Crosslinked C-telopeptide

Question 389

Which of the following is a marker for bone formation?

A. Osteocalcin
B. Tartrate resistant acid phosphatase (TRAP)
C. Urinary pyridinoline and deoxypyridinoline
D. Urinary C-telopeptide and N-telopeptide crosslinks (CTx and NTx)

Answer 389

A. Osteocalcin

Question 390

Which test is used as an indicator of congestive heart failure?

A. CRP
B. BNP
C. Cholesterol
D. Troponin
E. Haptoglobin

Answer 390

B. BNP

Question 391

As a cardiac biomarker, ________ has been used in conjunction with troponin to help diagnose or rule out a heart attack.

A. BNP
B. Myoglobin
C. Troponin
D. Adiponectin

Answer 391

B. Myoglobin

Question 392

The “gold standard” in the diagnosis of acute coronary syndrome (ACS):

A. Fibronectin
B. Cystatin C
C. Troponin
D. β-Trace Protein

Answer 392

C. Troponin

Question 393

Which of the following can cause cardiac arrest in the absence of warning symptoms or signs?

A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypokalemia

Answer 393

C. Hyperkalemia

Question 394

Recently, it was established as an accurate marker of CSF leakage:

A. Fibronectin
B. Cystatin C
C. Troponin
D. β-Trace Protein

Answer 394

D. β-Trace Protein

Question 395

Variants demonstrate a wide variety of cellular interactions, including roles in cell adhesion, tissue differentiation, growth, and wound healing:

A. Adiponectin
B. Fibronectin
C. Crosslinked C-telopeptide
D β-trace protein

Answer 395

B. Fibronectin

Question 396

The protein present in vaginal secretions that can identify patients who are at risk for preterm delivery is:

A. Human chorionic gonadotropin
B. Estrogen
C. PAMG-1
D. Fetal fibronectin

Answer 396

D. Fetal fibronectin

Question 397

Single best hormone to determine whether ovulation has occurred; THERMOGENIC EFFECT, in which basal body temperature rises after ovulation. This effect is of clinical use in marking the occurrence of ovulation.

A. Estrogen
B. Progesterone
C. Testosterone
D. Thyroxine

Answer 397

B. Progesterone

Question 398

In the United States, the NGSP, with the Diabetes Control and Complications Trial (DCCT) ____ method, is used as a PRIMARY REFERENCE METHOD for measuring HbA1c.

A. Immunoassay
B. Electrophoresis
C. Affinity chromatography
D. HPLC

Answer 398

D. HPLC

Question 399

PREFERRED METHOD of measuring HbA1c:

A. Immunoassay
B. Electrophoresis
C. Affinity chromatography
D. HPLC

Answer 399

C. Affinity chromatography

Question 400

Copper reduction method for glucose that uses arsenomolybdic acid:

A. Folin-Wu
B. Nelson-Somogyi
C. Neocuproine
D. All of these

Answer 400

B. Nelson-Somogyi

Question 401

A method for the estimation of glucose in body fluids; glucose in the protein-free filtrate reduces cupric ion to cuprous ion. The cuprous ion then reduces PHOSPHOMOLYBDIC ACID to molybdenum blue which can be estimated colorimetrically.

A. Dubowski method
B. Folin-Wu
C. Nelson-Somogyi
D. Neocuproine

Answer 401

B. Folin-Wu

Question 402

Glucose measurements can be ____ mg/dL erroneously higher by reducing methods than by more accurate enzymatic methods.

A. 1 to 5 mg/dL
B. 5 to 15 mg/dL
C. 20 to 25 mg/dL
D. 30 to 35 mg/dL

Answer 402

B. 5 to 15 mg/dL

Question 403

Urea is only a rough estimate of renal function and will not show any significant level of increased concentration until the GLOMERULAR FILTRATION RATE IS DECREASED BY AT LEAST ____.

A. 30%
B. 50%
C. 60%
D. 80%

Answer 403

B. 50%

Question 404

Reversal (low) albumin and globulin (A/G) ratio:

A. Liver cirrhosis
B. Liver cirrhosis and nephrotic syndrome
C. Liver cirrhosis, nephrotic syndrome and multiple myeloma
D. Nephrotic syndrome and multiple myeloma

Answer 404

C. Liver cirrhosis, nephrotic syndrome and multiple myeloma

Question 405

In ketoacidosis, the anion gap would most likely to be affected in what way?

A. Unchanged from normal
B. Increased
C. Decreased
D. Balanced

Answer 405

B. Increased

Question 406

Which of the following conditions will cause an increased anion gap?

A. Diarrhea
B. Hypoaldosteronism
C. Hyperkalemia
D. Renal failure

Answer 406

D. Renal failure

Question 407

Which of the following blood gas disorders is most commonly associated with an abnormal anion gap?

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Answer 407

A. Metabolic acidosis

Question 408

In the Henderson-Hasselbalch equation, the numerator denotes ____ functions.

A. Brain
B. Pituitary
C. Lung
D. Kidney

Answer 408

D. Kidney

Question 409

In the Henderson-Hasselbalch equation, the denominator denotes _____ functions.

A. Brain
B. Pituitary
C. Lung
D. Kidney

Answer 409

C. Lung

Question 410

The most common light source for fluorometry is:

A. Hydrogen lamp
B. Mercury lamp
C. Tungsten lamp
D. Xenon lamp

Answer 410

D. Xenon lamp

Question 411

When measuring K+ with an ion-selective electrode by means of a liquid ion-exchange membrane, what antibiotic will be incorporated into the membrane?

A. Monactin
B. Nonactin
C. Streptomycin
D. Valinomycin

Answer 411

D. Valinomycin

Question 412

To calibrate the pH electrode in a pH/ blood gas analyzer, it is necessary that:

A. The barometric pressure be known and used for adjustments
B. Calibrating gases of known high and low concentrations be used
C. The calibration be performed at room temperature
D. Two buffer solutions of known pH be used

Answer 412

D. Two buffer solutions of known pH be used

Question 413

Which of the following reagents can be used to measure protein in cerebrospinal fluid?

A. Biuret
B. Coomassie brilliant blue
C. Ponceau S
D. Bromcresol green

Answer 413

B. Coomassie brilliant blue

Question 414

Which term describes a congenital disorder that is characterized by a split in the albumin band when serum is subjected to electrophoresis?

A. Analbuminemia
B. Anodic albuminemia
C. Prealbuminemia
D. Bisalbuminemia

Answer 414

D. Bisalbuminemia

Question 415

Bisalbuminemia:

A. Acquired disorder
B. Congenital disorder

Answer 415

B. Congenital disorder

Question 416

Which of the following proteins is normally produced by the fetus but is found in increased amounts in the amniotic fluid in cases of spina bifida?

A. Alpha1-antitrypsin
B. Alpha1-acid glycoprotein
C. Alpha1-fetoprotein
D. Alpha2-macroglobulin

Answer 416

C. Alpha1-fetoprotein

Question 417

Which of the following disorders is NOT associated with an elevated blood ammonia level?

A. Reye syndrome
B. Renal failure
C. Chronic liver failure
D. Diabetes mellitus

Answer 417

D. Diabetes mellitus

Question 418

Which of the following enzyme activities can be determined by using a dilute olive oil emulsion substrate, whose hydrolyzed product is monitored as a decrease in turbidity or light scatter?

A. Alkaline phosphatase
B. Amylase
C. Lipase
D. Trypsin

Answer 418

C. Lipase

Question 419

Of the total serum osmolality, sodium, chloride, and bicarbonate ions normally contribute approximatelywhat percent?

A. 8
B. 45
C. 75
D. 92

Answer 419

D. 92

Question 420

A patient presents with Addison disease. Serum sodium and potassium analyses are performed. What would the results reveal?

A. Normal sodium, low potassium levels
B. Low sodium, low potassium levels
C. Low sodium, high potassium levels
D. High sodium, low potassium levels

Answer 420

C. Low sodium, high potassium levels

Question 421

What percentage of serum calcium is in the ionized form?

A. 30%
B. 50%
C. 60%
D. 80%

Answer 421

B. 50%

Question 422

Organs that affect calcium levels:

A. Heart, lungs and liver
B. Heart, lungs and kidney
C. Bone, intestines and heart
D. Bone, intestines and kidney

Answer 422

D. Bone, intestines and kidney

Question 423

Which of the following is NOT a colligative property of solutions?

A. pH
B. Freezing point
C. Osmotic pressure
D. Vapor pressure

Answer 423

A. pH

Question 424

If a blood gas specimen is left exposed to air, which of the following changes will occur?

A. pO2 and pH increase; pCO2 decreases
B. pO2 and pH decrease; pCO2 increases
C. pO2 increases; pH and pCO2 decrease
D. pO2 decreases; pH and pCO2 increase

Answer 424

A. pO2 and pH increase; pCO2 decreases

Question 425

How would blood gas parameters change if a sealed specimen is left at room temperature for 2 or more hours?

A. pO2 increases, pCO2 increases, pH increases
B. pO2 decreases, pCO2 decreases, pH decreases
C. pO2 decreases, pCO2 increases, pH decreases
D. pO2 increases, pCO2 increases, pH decreases

Answer 425

C. pO2 decreases, pCO2 increases, pH decreases

Question 426

ELECTRIC NEUTRALITY
In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what electrolyte?

A. Sodium
B. Potassium
C. Chloride
D. Phosphate

Answer 426

C. Chloride

Question 427

You receive a blood gas sample on a patient who is in the emergency room for assessment of unexplained vomiting for the past 4 days and abnormal respirations. Which of the following interpretations best describes the patient’s blood gas results?
pH: 7.50
pO2: 85 mm Hg
pCO2: 55 mm Hg
HCO3-: 35 mmol/L

A. Partially compensated metabolic acidosis
B. Partially compensated metabolic alkalosis
C. Compensated metabolic alkalosis
D. Compensated metabolic acidosis

Answer 427

B. Partially compensated metabolic alkalosis

Question 428

In salicylate overdose, what is the first acid-base disturbance present?

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

Answer 428

D. Respiratory alkalosis

Question 429

The most important practice in preventing the spread of disease is:

A. Wearing masks during patient contact
B. Proper hand washing
C. Wearing disposable laboratory coats
D. Identifying specimens from known or suspected HIV and HBV-infected patients with a red label

Answer 429

B. Proper hand washing

Question 430

The appropriate dilution of bleach to be used in laboratory disinfection is:

A. 1:2
B. 1:5
C. 1:10
D. 1:100

Answer 430

C. 1:10

Question 431

Where should alcohol and other flammable chemicals be stored?

A. In an approved safety can or storage cabinet away from heat sources
B. Under a hood and arranged alphabetically for ease of identification in an emergency
C. In a refrigerator at 28C to 88C to reduce volatilization
D. On a low shelf in an area protected from light

Answer 431

A. In an approved safety can or storage cabinet away from heat sources

Question 432

Slope = proportional SE = 1 (perfect correlation)
Y-intercept = constant SE = 0 (perfect correlation)
You validate a new assay using linear regression to compare assay calibrator results with the distributor’s published calibrator results. The slope is 0.99 and the y-intercept is +10%. What type of error is present?

A. No error
B. Random error
C. Constant systematic error
D. Proportional systematic error

Answer 432

C. Constant systematic error

Question 433

Which is a statistical test comparing means?

A. Bland-Altman
B. Student’s t-test
C. ANOVA
D. Pearson

Answer 433

B. Student’s t-test

Question 434

What is the primary goal of TQM?

A. Precise test results
B. Increased laboratory productivity
C. Improved patient outcomes
D. Reproducible test results

Answer 434

C. Improved patient outcomes

Question 435

Acanthocytes are found in association with:

A. Abetalipoproteinemia
B. G6PD deficiency
C. Rh deficiency syndrome
D. Vitamin B12 deficiency

Answer 435

A. Abetalipoproteinemia

Question 436

2 hour serum glucose:

a. 130 mg/dL
b. 135 mg/dL
c. 150 mg/dL
d. 250 mg/dL

Answer 436

c. 150 mg/dL

Question 437

Buffer used in the IFCC recommended method for ALP

Answer 437

2-Amino-2-methyl-1-propanol

Question 438

The follicles are sites of thyroid hormone synthesis and storage.
The thyroid gland also contains parafollicular cells, or C cells, which are responsible for the synthesis and secretion of calcitonin, a hormone important in

Answer 438

calcium metabolism

Question 439

Major systems in a flow cytometer include all of the following except:

A. Fluidics
B. Optics
C. Computerized electronics
D. Gating

Answer 439

D. Gating

Question 440

In flow cytometry, the term “gating” refers to:

A. Selection of a subpopulation of cells to count
B. Determining the fluorescent emission spectrumof cells of interest
C. Interference caused by binding of more than asingle antibody
D. Selecting the appropriate counting aperture

Answer 440

A. Selection of a subpopulation of cells to count

Question 441

The purest type of reagent water is:

A. Type I
B. Type II
C. Type III
D. All are equal

Answer 441

A. Type I

Question 442

How would 6.32 be rounded off to one less decimal place?

A. 6.32
B. 6.4
C. 7.0
D. 6.3

Answer 442

D. 6.3

Question 443

How would 15.57 be rounded off to one less decimal place?

A. 15.6
B. 15.5
C. 16.0
D. 15.0

Answer 443

A. 15.6

Question 444

Laser is an acronym for:

A. Light amplification by stimulated emission of radiation
B. Light augmentation by stimulated emission of radiation
C. Light amplification of stimulated energy radiation
D. Large-angle stimulated emission of radiation

Answer 444

A. Light amplification by stimulated emission of radiation

Question 445

Using serum electrophoresis, protein can be separated into how many fractions?

A. Three
B. Four
C. Five
D. Six

Answer 445

C. Five

Question 446

The concentration of human chorionic gonadotropin (hCG) is generally at a particular level in serum about 2 to 3 days after implantation. This is the concentration at which most sensitive laboratory assays can give a positive serum hCG result.
What is the lowest level of hormone for which most current serum hCG tests can give a positive result?

A. 25 mIU/mL
B. 50 mIU/mL
C. 100 mIU/mL
D. 100,000 mIU/mL

Answer 446

A. 25 mIU/mL

Question 447

A patient being treated for metastatic carcinoma was found to have a white cell count of 5×10^9/L with 5 metarubricytes (nucleated red cells) per 100 white WBCs. What is the corrected white cell count for this patient?

A. 2.1 × 10^9/L
B. 2.4 × 10^9/L
C. 4.8 × 10^9/L
D. 5.2 × 10^9/L

Answer 447

C. 4.8 × 10^9/L

Question 448

A white blood cell (WBC) count and WBC differential are performed. WBC count: 7.0 × 10^9/L; of 100 WBCs classified:
70% neutrophils
20% lymphocytes
7% monocytes
2% eosinophils
1% basophil

The absolute neutrophil cell count is:

A. 2.10×10^9/L
B. 3.55×10^9/L
C. 3.99×10^9/L
D. 4.9×10^9/L

Answer 448

D. 4.9×10^9/L

Question 449

Whih is not included in spectrometry?

a. FEP
b. EMITT
c. AAS
d. Fluorometry

Answer 449

b. EMITT

EMITT - Immunoassay

Question 450

A non-invasiive techniquw which has a limited use in some laboratory tests

a. Mass Spectrometry
b. Nuclear Magnetic Resonance Spectroscopy
c. Chemiluminescent Immunoassay
d. Enzyme multiplied immunoassay technique (EMIT)

Answer 450

b. Nuclear Magnetic Resonance Spectroscopy

Question 451

Light source most commonly used for visible to near infrared

a. Deutrerium lamp
b. Hollow Cathode lamp
c. Mercury lamp
d. Tungsten light bulb

Answer 451

d. Tungsten light bulb

Question 452

Which of the following is in the analytical phase of testing

a. Diabetes monitoring
b. Blood culture contamination
c. TAT
d. Adequancy of specimen information

Answer 452

a. Diabetes monitoring

b. Blood culture contamination - preana
c. TAT - post ana
d. Adequancy of specimen information - preana

Question 453

Used in monitoring and diagnosing a disease
I. Diagnostic sensitivity
II. Diagnostic specificity
III. Accuracy
IV. Precision

a. I, III
b. I, II
c. III, IV
d. all

Answer 453

b. I, II

Question 454

Procedure with minimal complexity, instrumentation amd personnel requirements so that the results can be quickly determined

a. Presumptive test
b. Screening test
c. Definitive test
d. Confirmatory test

Answer 454

a. Presumptive test

Question 455

Highly sensitive and specific test in which resuolts can be used as a legal evidence

a. Presumptive test
b. Screening test
c. Definitive test
d. Confirmatory test

Answer 455

c. Definitive test

Question 456

Preferred for individual assays of anti-convulsant/ anti-epilectic drug:

a. GC
b. HPLC
c. Immunoassay
d. None of these

Answer 456

c. Immunoassay

Question 457

In pharmacokinetics, the concentration ____ as the rate of elimination and distribution exceeds absorption.

a. Rises
b. Spuriously rises
c. declines
d. Spuriously declines

Answer 457

c. declines

Absorption > distribution and elimination: rise concentration
Absorption< distribuition and elimination: decline concentration

Question 458

BUN, glucose, electrolytes and osmolality determination have been performed on a patient suspected of ingesting ethanol. WHat can be done to diagnose thsi condition without requestig additional laboratory test?

a. Determine glycosylated hemoglobin
b. Determine anion gap
c. Determine osmolality
d. Determine the osmolal gap, which is the difference between the measured osmolality and the calculated osmolality

Answer 458

d. Determine the osmolal gap, which is the difference between the measured osmolality and the calculated osmolality

Question 459

In a tst for albumin, all the albumin reacts very rapildy with an excess of the dye Bromcresol purple (BCP) to produce a colored complex. The detector is set to measure the product complex. What method is most suitable for this determination of albumin?

a. Endpoint (end-up)
b. Endpoint (end-down)
c. Rate (rate-up)
d. Rate (rate-down)

Answer 459

a. Endpoint (end-up)

Question 460

The conversion factor 17.1 converts mg/dL of bilirubin into:

a. umol/L
b. mg/L
c. mmol/L
d. nmol/L

Answer 460

a. umol/L

Question 461

Convert 1 ug/dL of thyroxine to SI unit

a. 12.9 mmol/L
b. 12.9 nmol/L
c. 12.9 g/L
d. 12.9 mg/dL

Answer 461

b. 12.9 nmol/L

Conversion factor = 12.9

Question 462

Convert 10 g/dL of albumin to g/L

a. 10 g/L
b. 100 g/L
c. 1000 g/L

Answer 462

b. 100 g/L

Conversion factor = 10

Question 463

Which problem can be encountered in phlebotomy?

Neurological
Dermatological
Anemia
All of these

Answer 463

All of these

Question 464

Most affected from supine to standing or just by prolonged standing?

Iron
Calcium
Cortisol
Aldosterone

Answer 464

Calcium

Calcium and aldosterone are both affected (increase), hut it will take more time for aldosterone to increase while calcium will immediately increase due to sympathetic nervous system activating the arterioles to constrict

Question 465

Most affected by diurnal variation?

Iron
ACTH
Aldosterone
Growth hormone

Answer 465

ACTH

Iron - dec 30% in evening

ACTH is directly proportional to Cortisol = dec 50%-80% in the evening

Question 466

A serum/plasma appeared milky and opaque. What is the value of triglycerides?

200 mg/dL
300 mg/dL
400 mg/dL
600 mg/dL

Answer 466

600 mg/dL

Question 467

Type 1 DM
1. Usually affects age of onset before 20 years old
2. Usually leads to deficiency or absence of insulin
3. Prone to ketosis
4. Destruction of B cells

a. 1,2
b. 1,3
c. 1234
d. 134

Answer 467

c. 1234

Question 468

Need emergency treatment or response:
1. Glycosuria
2. Ketoacidosis
3. Hyperkalemia

a. 12
b. 13
c. 23
d. 123

Answer 468

c. 23

Question 469

Reagent of Folin Wu

Phosphomolybdic acid
Arsenomolybdic acid
O-toluidine
Ferric chloride

Answer 469

Phosphomolybdic acid

Question 470

Metabolism of glucose molecule to pyruvate

Glycogenolysis
Gluconeogenesis
Glycogenesis
Glycolysis

Answer 470

Glycolysis

Question 471

Screening test for non-pregnant women

75 OGTT
FBS
RBS
HBA1c

Answer 471

FBS

Question 472

Indicator or malnutrition

Transthyretin
Albumin
B trace protein
Transferrin

Answer 472

Transthyretin

Transthyretin = pre albumin (TRANSport protein for THYroxine and RETINol binding protein)

Albumin = nutritional status
B trace protein = indicator of CSF leakage
Transferrin = B protein that transports iron in ferric state

Question 473

Used to correct for the absorbance of the reagent. It is composed of the reagents without the analyte

Blanking technique
Patient blank
Reagent blank
Water blank

Answer 473

Reagent blank

Question 474

Class A fire

Carbon dioxide
Water
Dry chemicals
Halon
Metal X

Answer 474

Water

Question 475

Not included durung inflammation

a. increase capillary permeability
b. migration of lymphocytes
c. release of haptoglobin
d. CRP release

Answer 475

b. migration of lymphocytes

Question 476

Non-invasive procedure usig vaginal secretions to detect threatened abortion:

a. AFP
b. Fetal fibronectin
c. B-HCG

Answer 476

c. B-HCG

decreases during threatened abortion
increases during pregnancy

Threatened abortion: intact placenta but partially detached from uterus causing vaginal bleeding but baby is still alive

Question 477

Used as a marker for nutrition

a. Cystatin C
b. Cross-linked C telopeptides
c. Fibronectin
d. Adiponectin

Answer 477

c. Fibronectin

Question 478

Urea is reabsorbed in the circulation due to obstruction

a. Pre renal azotemia
b. Renal azotemia
c. Post renal azotemia
d. None of the above

Answer 478

c. Post renal azotemia

Question 479

Which of the following is used as an early biomarker in the diagnosis of acute kidney injury?

a. NGAL
b. Cystatin C
c. Creatinine
d. Urine volume

Answer 479

a. NGAL

Cystatin C - marker of kidney function

Question 480

Not belong to liver function test

Bilirubin
Enzymes
Factor assay
Prothrombin

Answer 480

Factor assay

Question 481

Involved in Excretory and Synthetic function of the liver

Prothrombin time
Bilirubin
Albumin
Transaminases

Answer 481

Bilirubin

Question 482

Involved in hepatocellular damage and necrosis

Prothrombin time
Bilirubin
Transaminase
Albumin

Answer 482

Transaminase

Question 483

Important part in enzyme function

Cofactor
Conezyme
Activator

Answer 483

Activator

Question 484

True of enzymes

1. catalyzes the transfer of chemical or functional group from one substance to another
2. catalyzes intramolecular rearrangemetn of the substrate compound
3. increased activity intracellularly when red cells are damaged

Answer 484

1. catalyzes the transfer of chemical or functional group from one substance to another
2. catalyzes intramolecular rearrangemetn of the substrate compound

1. function of transferase
2. function of isomerase
3. should be extracellularly

Question 485

Structural change

Isomerase
Ligase
Transferase
Oxidoreductase

Answer 485

Isomerase

Question 486

Moderate specificity to heart, liver and skeletal muscle

LDH
CK
ALT
AST

Answer 486

AST

LDH - least specific
CK - heart, skeletal, muscle and brain
ALT - high specific

Question 487

Which enzymme is not a macroenzyme?

ACP
ALP
G6PD
Transferase

Answer 487

G6PD

eg. ACP, ALP, Amylase, AST, CK, GGT, LDH, Lipase

Question 488

Pathologic increase of AMS

Duodenal perforation
Acute pancreatitis
Cirrhosis
Hepatitis

Answer 488

Acute pancreatitis

Duodenal perforation
Acute pancreatitis

AMS increase in both but AMS is earliest marker for Acute pancreatitis

Question 489

Bilirubin values decrease by ___ per hour of exposure to light

10-20%
20-40%
30-50%

Answer 489

30-50%

Question 490

Earliest biomarkers of AKI

a. NGAL
b. Cystatin C
c. LFABP
d. A and C
e. A and B

Answer 490

d. A and C

Question 491

Which of the following conditions will increase total T4 by increasing TBG?

a. Acute illness
b. Anabolic steroid use
c. Nephrotic syndrome
d. Pregnancy or estrogen

Answer 491

d. Pregnancy or estrogen

Question 492

Which statement about TSH and T4 in early pregnancy is correct?

a. TSH and thyroid hormones fall
b. TSH falls and thyroid hormones rise
c. TSH and thyroid hormones both rise
d. TSH rises and thyroid hormones fall

Answer 492

b. TSH falls and thyroid hormones rise

Question 493

A blood sample is left on a phlebotomy tray for 4.5 hours before it is delivered to the laboratory. Which group of tests could be performed?

A. Glucose, Na, K, Cl, TCO2
B. Uric acid, BUN, creatinine
C. Total and direct bilirubin
D. CK, ALT, ALP, AST

Answer 493

B. Uric acid, BUN, creatinine

Question 494

Which type of cancer is associated with the highest level of AFP?

A. Hepatoma
B. Ovarian cancer
C. Testicular cancer
D. Breast cancer

Answer 494

A. Hepatoma

Question 495

Which statement about TSH and T4 in early pregnancy is correct?

A. TSH and thyroid hormones fall
B. TSH falls and thyroid hormones rise
C. TSH and thyroid hormones both rise
D. TSH rises and thyroid hormones fall

Answer 495

B. TSH falls and thyroid hormones rise

Question 496

A patient has an elevated serum T3 and free T4 and undetectable TSH. What is the most likely cause of these results?

A. Primary hyperthyroidism
B. Secondary hyperthyroidism
C. Euthyroid with increased thyroxine-binding proteins
D. Euthyroid sick syndrome

Answer 496

A. Primary hyperthyroidism

Question 497

Select the most appropriate single screening test for thyroid disease.

A. Free thyroxine index
B. Total T3 assay
C. Total T4
D. TSH assay

Answer 497

D. TSH assay

Question 498

Thyroid hormones are derived from the amino acid:

A. Phenylalanine
B. Methionine
C. Tyrosine
D. Histidine

Answer 498

C. Tyrosine

Question 499

Which assay using 24-hour urine is considered the best single screening test for pheochromocytoma?

A. Total urinary catecholamines
B. VMA
C. Homovanillic acid (HVA)
D. Metanephrines

Answer 499

D. Metanephrines

Question 500

Most laboratories use which type of fire extinguisher?

A. Type A
B. Type B
C. Type C
D. Combination ABC

Answer 500

D. Combination ABC

Question 501

Creatinine concentration in the blood is affected by:

A. Muscle mass
B. Age and gender
C. Dietary protein intake
D. A and B

Answer 501

D. A and B

Question 502

The variants demonstrate a wide variety of cellular interactions including roles in cell adhesion, tissue differentiation, growth, and wound healing:

A. Adiponectin
B. Cystatin
C. Fibronectin
D. Troponin

Answer 502

C. Fibronectin

Question 503

Thyroid status is best assessed by measurement of:

A. TRH and TSH
B. Plasma TSH and T3
C. Plasma TSH and free T4
D. T3 and T4

Answer 503

C. Plasma TSH and free T4

Question 504

It is defined as parts per hundred parts:

A. Percent
B. Ratio
C. Molarity
D. Normality

Answer 504

A. Percent

Question 505

Which of the following fluids is not an ultrafiltrate of plasma?

A. Cerebrospinal fluid (CSF)
B. Peritoneal fluid
C. Pleural fluid
D. Synovial fluid

Answer 505

A. Cerebrospinal fluid (CSF)

Question 506

In patients with developing subclinical hypothyroidism, TSH levels will likely be ______, and fT4 will likely be ______.

A. Decreased, increased
B. Increased, decreased
C. Decreased, normal
D. Increased, normal

Answer 506

D. Increased, normal

Question 507

Hazards associated with LIQUID NITROGEN (CRYOGENIC MATERIAL) EXCEPT:

A. Fire or explosion
B. Asphyxiation
C. Pressure build-up and embrittlement of materials
D. Tissue damage similar to thermal burns
E. Shock

Answer 507

E. Shock

Question 508

Determines whether there is a significant difference between the standard deviations of two groups of data.

A. Mean
B. Median
C. f-test
D. t-test

Answer 508

C. f-test

Question 509

Acute-phase reactants:

A. CRP
B. CRP, haptoglobin
C. CRP, haptoglobin and α1-antitrypsin
D. CRP, haptoglobin, α1-antitrypsin and orosomucoid

Answer 509

D. CRP, haptoglobin, α1-antitrypsin and orosomucoid

Question 510

In patients with developing subclinical hyperthyroidism, TSH levels will likely be ______, and fT4 will likely be ______.

A. Decreased, increased
B. Increased, decreased
C. Decreased, normal
D. Increased, normal

Answer 510

C. Decreased, normal

Question 511

In patients with developing subclinical hypothyroidism, TSH levels will likely be ______, and fT4 will likely be ______.

A. Decreased, increased
B. Increased, decreased
C. Decreased, normal
D. Increased, normal

Answer 511

D. Increased, normal

Question 512

Which of the following types of analyzers offers RANDOM-ACCESS CAPABILITIES?

A. Discrete analyzers
B. Continuous-flow analyzers
C. Centrifugal analyzers
D. None of these

Answer 512

A. Discrete analyzers

Question 513

Best indication of OVERALL GLUCOSE HOMEOSTASIS:

A. Fasting blood glucose
B. Oral glucose tolerance test
C. Glycosylated hemoglobin
D. Fructosamine

Answer 513

A. Fasting blood glucose

Question 514

In a person with normal glucose metabolism, the blood glucose level usually increases rapidly after carbohydrates are ingested but returns to a normal level after:

A. 30 minutes
B. 45 minutes
C. 60 minutes
D. 120 minutes

Answer 514

D. 120 minutes

Question 515

Transferrin (siderophilin) is the major component of the ___ fraction.

A. Alpha1 globulin
B. Alpha2 globulin
C. Beta globulin
D. Gamma globulin

Answer 515

C. Beta globulin

Question 516

Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6.

A. – Chylomicrons, prebeta, beta, alpha +
B. – Chylomicrons, beta, prebeta, alpha +
C. – Beta, prebeta, alpha, chylomicrons +
D. – Alpha, beta, prebeta, chylomicrons +

Answer 516

B. – Chylomicrons, beta, prebeta, alpha +

Question 517

Which of the following laboratory values is considered a POSITIVE RISK FACTOR for the occurrence of coronary heart disease?

A. HDL cholesterol > 60 mg/dL
B. HDL cholesterol < 35 mg/dL
C. LDL cholesterol < 130 mg/dL
D. Total cholesterol < 200 mg/dL

Answer 517

B. HDL cholesterol < 35 mg/dL

Question 518

Which of the following is a true statement?

A. Tissue-specific enzymes, data can be interpreted by itself
B. Tissue-specific enzymes, data cannot be interpreted by itself
C. No truly tissue-specific enzymes, data can be interpreted by itself
D. No truly tissue-specific enzymes, data cannot be interpreted by itself, correlate with other laboratory results

Answer 518

D. No truly tissue-specific enzymes, data cannot be interpreted by itself, correlate with other laboratory results

Question 519

Prolactin is produced by the:

A. Anterior pituitary gland
B. Thyroid
C. Parathyroid
D. Ovary

Answer 519

A. Anterior pituitary gland

Question 520

If serum is allowed to remain on the clot for a prolonged period, which of the following effects will be noted?

A. Elevated level of serum potassium
B. Decreased level of serum potassium
C. Elevated level of glucose
D. None of these

Answer 520

A. Elevated level of serum potassium

Question 521

Overall effect of parathyroid hormone is to:

A. Raise serum ionized calcium and phosphorus
B. Lower serum ionized calcium and phosphorus
C. Raise serum ionized calcium level and lower serum phosphorus level
D. Lower serum ionized calcium levels and lower phosphorus level

Answer 521

C. Raise serum ionized calcium level and lower serum phosphorus level

Question 522

These red cell granules are composed of PRECIPITATED RIBOSOMAL PROTEIN and RNA:

A. Basophilic stipplings
B. Cabot rings
C. Heinz bodies
D. Howell-Jolly bodies

Answer 522

A. Basophilic stipplings

Question 523

Physical hazards except:

A. Ergonomic issues
B. Noise levels
C. UV light exposure
D. Infections agents/aerosols

Answer 523

D. Infections agents/aerosols

Question 524

Negative predictive value: Proportion without a disease who have a negative test result compared with all individuals who ____ a negative test result

a. may have
b. will have
c. have
d. could have

Answer 524

c. have

Question 525

Determine the sensitivity, specificity and predictive values in a new assay to detect influenza infection. It was developed and tested on 500 people; 200 people tested positive for the flue. Of these 200 positives, 185 were confirmed as being infected using the reference method. Of the remaining 300 people who tested negative, 6 were later shown to be infected with influenza.

Answer 525

DIagnostic Sensitivity = 96.86%
Diagnostic Specificity = 95.15%
PPV = 92.5%
NPV = 98%

TP 185
TN 294
FP 15
FN 6

Question 526

Acceptable limits of a control value must fall:

A. Within ±1 standard deviation of the mean
B. Between 1 and 2 standard deviations of the mean
C. Within ±2 standard deviations of the mean
D. Within ±3 standard deviations of the mean

Answer 526

C. Within ±2 standard deviations of the mean

Question 527

Loop-mediated isothermal amplification (LAMP) uses _____ primers and proceeds using a constant temperature coupled to a strand displacement reaction.

A. 2 primers
B. 3 primers
C. 4 primers
D. 5 primers

Answer 527

C. 4 primers

Question 528

Which of the following hormones involved in calcium regulation acts by decreasing both calcium and phosphorous?

A. PTH
B. Calcitonin
C. Vitamin D
D. Cortisol

Answer 528

B. Calcitonin

Question 529

It is used when rapid centrifugation of solutions containing small particles is needed:

A. Cytocentrifuge
B. Horizontal-head centrifuge
C. Fixed angle-head centrifuge
D. None of these

Answer 529

C. Fixed angle-head centrifuge

Question 530

A procedure with minimal complexity, instrumentation, and personnel requirements so that the results can be quickly determined:

A. Waived test
B. Nonwaived test
C. Definitive test
D. Presumptive test

Answer 530

D. Presumptive test

Question 531

The term PHARMACOKINETICS refers to the:

A. Relationship between drug dose and the drug blood level
B. Concentration of drug at its sites of action
C. Relationship between blood concentration and therapeutic response
D. The relationship between blood and tissue drug levels

Answer 531

A. Relationship between drug dose and the drug blood level

Question 532

The term PHARMACODYNAMICS is an expression of the relationship between:

A. Dose and physiological effect
B. Drug concentration at target sites and physiological effect
C. Time and serum drug concentration
D. Blood and tissue drug levels

Answer 532

B. Drug concentration at target sites and physiological effect

Question 533

At pH 8.6, proteins are _________ charged and migrate toward the _________.

A. Negatively, anode
B. Positively, cathode
C. Positively, anode
D. Negatively, cathode

Answer 533

A. Negatively, anode

Question 534

For individuals over 40 years old, there is MODERATE risk of developing coronary heart disease when cholesterol is greater than ____mg/dL.

A. 200 mg/dL
B. 220 mg/dL
C. 240 mg/dL
D. 260 mg/dL

Answer 534

C. 240 mg/dL

Question 535

A lab measures total bilirubin by the Jendrassik–Grof bilirubin method with sample blanking. What would be the effect of moderate hemolysis on the test result?

A. Falsely increased due to optical interference
B. Falsely increased due to release of bilirubin from RBCs
C. Falsely low due to inhibition of the diazo reaction by hemoglobin
D. No effect due to correction of positive interference by sample blanking

Answer 535

C. Falsely low due to inhibition of the diazo reaction by hemoglobin

Question 536

A nonprotein molecule necessary for enzyme activity:

A. Activator
B. Coenzyme
C. Cofactor
D. Isoenzyme

Answer 536

C. Cofactor

Question 537

Electrolytes for acid-base balance:
1. Bicarbonate
2. Chloride
3. Potassium
4. Sodium

A. 1 and 2
B. 1 and 3
C. 1, 2 and 3
D. 1, 2, 3 and 4

Answer 537

C. 1, 2 and 3

Question 538

Electrolytes for blood coagulation:

A. Potassium and magnesium
B. Calcium and chloride
C. Calcium and magnesium
D. Calcium and potassium

Answer 538

C. Calcium and magnesium

Question 539

Which of the following values is the threshold critical value (alert or action level) for low plasma potassium?

A. 1.5 mmol/L
B. 2.0 mmol/L
C. 2.5 mmol/L
D. 3.5 mmol/L

Answer 539

C. 2.5 mmol/L

Question 540

A biologically active form of ____ found in brewer’s yeast, known as glucose tolerance factor (GTF).

A. Chromium
B. Cobalt
C. Copper
D. Manganese

Answer 540

A. Chromium

Question 541

he role of the lungs and kidneys in maintaining pH is depicted with the Henderson-Hasselbalch equation. The numerator denotes _____ functions.

A. Heart
B. Kidney
C. Liver
D. Lung

Answer 541

B. Kidney

Question 542

The role of the lungs and kidneys in maintaining pH is depicted with the Henderson-Hasselbalch equation. The denominator denotes _____ function.

A. Heart
B. Kidney
C. Liver
D. Lung

Answer 542

D. Lung

Question 543

In an institution, a comprehensive program in which all areas of operation are monitored to ensure quality with the aim of providing the highest quality patient care:

A. Quality assessment
B. Quality assurance
C. Quality control
D. Quality systems

Answer 543

D. Quality systems

Question 544

A system that verifies the reliability of analytical test results through the use of standards, controls, and statistical analysis

A. Quality assessment
B. Quality assurance
C. Quality control
D. Quality systems

Answer 544

C. Quality control

Question 545

In the laboratory, a program that monitors the total testing process with the aim of providing the highest quality patient care:

A. Quality assessment
B. Quality control
C. Quality systems
D. All of these

Answer 545

A. Quality assessment

Question 546

Immunoassay method for thyroxine similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone:

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 546

D. Microparticle enzyme immunoassay (MEIA)

Question 547

Immunoassay method for thyroxine: addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time.

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 547

A. Chemiluminescence

Question 548

Immunoassay method for thyroxine: antibody-bound labeled thyroxine rotates slowly, emitting lower energy light.

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 548

B. Fluorescent polarization immunoassay (FPIA)

Question 549

Immunoassay method for thyroxine: fluorogenic substrate–labeled thyroxine competing with patient T4 for antibody in a homogeneous assay; only unbound, leftover labeled T4 reacts with enzyme to form fluorescent product.

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 549

C. Fluorescent substrate-labeled inhibition immunoassay

Question 550

In the calculation of the mean, what does “n” represent?

A. The sum of the values
B. The number of values in the set
C. The average of the values
D. The middle number of the set

Answer 550

B. The number of values in the set

Question 551

How many micrograms are in 10 mg?

A. 100
B. 1000
C. 10000
D. 100000

Answer 551

C. 10000

Question 552

How many grams are in 0.85 kg?

A. 8.5
B. 85
C. 850
D. 8500

Answer 552

C. 850

Question 553

Which of the following pairs of concepts are correctly matched

A. Sensitivity: prevent false negatives; specificity:prevent false positives
B. Sensitivity: prevent false positives; specificity:prevent false negatives
C. Sensitivity: precision; specificity: accuracy
D. Sensitivity: coefficient of variation; specificity: standard deviation

Answer 553

A. Sensitivity: prevent false negatives; specificity:prevent false positives

Question 554

Which of the following Westgard rules is indicative of random error?

A. 1:3S
B. 2:2s
C. 4:1s
D. 10:x

Answer 554

A. 1:3S

Question 555

A procedure with minimal complexity, instrumentation, and personnel requirements so that the results can be quickly determined:

A. Waived test
B. Nonwaived test
C. Definitive test
D. Presumptive test

Answer 555

D. Presumptive test