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LE 5 Flashcards

1
Q

What substance is responsible for the color of stool?
A. Stercobilinogen
B. Heme
C. Ferrobilin
D. Fecobilinogen

A

A. Stercobilinogen

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2
Q

True regarding HBsAg:
A. often persists beyond 6 months
B. disappears completely during symptomatic phase of the disease
C. rarely persists beyond 6 months
D. none of the above are true

A

C. rarely persists beyond 6 months

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3
Q

What kind of gamma globulins are usually seen in increased amounts in serum during autoimmune hepatitis?
a. IgG
b. IgA
c. IgE
d. IgD

A

a. IgG

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4
Q

Interpret the following serology result:
HBsAg (+)
Anti HBs (-)
Anti HBc (IgG)
HBeAg (+)
Anti HBe (-)
A. Susceptible
B. Vaccinated
C. Acute HBV infection
D. Chronic HBV infection

A

D. Chronic HBV infection

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5
Q

Interpret the following serology result:
HBsAg (-)
Anti HBs (-)
Anti HBc (IgM)
HBeAg (-)
Anti HBe (-)
A. Vaccinated
B. Window period
C. Uninfected, susceptible individual
D. NOTA

A

B. Window period

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6
Q

Which natriuretic peptide is mostly secreted by the ventricles
a. BNP
b. ANP
c. CNP
d. DNP

A

a. BNP

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7
Q
  1. Interpret the following serology profile:
    HBsAg (+),
    Anti-HBs (-),
    Anti-HBc IgM (+),
    HBeAg (+),
    Anti-HBe (-)
    A. Susceptible
    B. Chronic HBV infection
    C. Vaccinated
    D. Acute HBV infection
A

D. Acute HBV infection

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8
Q
  1. Genome analysis showed no viral mutations. Is this patient infective?
    HBsAg (+),
    Anti-HBs (-),
    Anti-HBc IgG (+),
    HBeAg (-),
    Anti-HBe (+)
    A. Yes
    B. No
    C. Maybe
A

B. No

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9
Q
  1. Which is more specific and sensitive for MI than total Creatine Kinase?
    A. CK-BB
    B. CK-MM
    C. NOTA
    D. CK-MB
A

D. CK-MB

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10
Q
  1. Which of the following is true regarding CRP?
    A. NOTA
    B. A level of 2 mg/dl confers a high risk for CVD
    C. It is not very specific
    D. Lowering CRP levels decreases Cardiovascular risk
A

A. NOTA

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11
Q
  1. Referring to AST and ALT as “Liver Function Tests” is a bit of a misnomer. Why?.
    A. AST and ALT are actually indicators of hepatocellular coagulation activity
    B. NOTA
    C. Increased AST and ALT indicate liver injury, so technically it is more appropriate to call it “Liver Damage Tests”
    D. AST and ALT are both not exclusive to the liver and can be seen in the muscle.
A

C. Increased AST and ALT indicate liver injury, so technically it is more appropriate to call it “Liver Damage Tests”

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12
Q
  1. For diagnosing acutely ill patients presenting to emergency service with shortness of breath, to distinguish HF from lung diseases such as emphysema.
    A. Cardiac natriuretic peptide
    B. Homocysteine
    C. cTnI
    D. CK
A

A. Cardiac natriuretic peptide

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13
Q
  1. True or False: A normal liver function test 100% means that the patient has no liver injury.
    a. True
    b. False
A

b. False

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14
Q
  1. Approximately how long has it been since this patient was exposed to Hepatitis A?

Fecal HAV (+)
Anti HAV IgM (-)
Anti HAV IgG (-)

A. This patient is vaccinated and uninfected
B. 18-24 weeks
C. 8-10 weeks
D. 2-4 weeks

A

D. 2-4 weeks

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15
Q
  1. When did this patient contract Hepatitis B? (assume that the patient is not a carrier)

HBsAg (-),
Anti-HBs (-),
Anti-HBc IgG (+),
HBeAg (-),
Anti-HBe (-)

A. A long time ago
B. This patient is unvaccinated and has not contracted HBV yet
C. This patient is vaccinated and has not contracted HBV yet
D. Very recently (less than 2 weeks after infection)

A

D. Very recently (less than 2 weeks after infection)

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16
Q
  1. What can we infer from this lab result?
    Anti-HCV (+)
    HCV RNA (+)
    a. The patient also has a Hepatitis D infection
    b. The patient is currently infected with Hepatitis C
    c. The patient was infected in the past with Hepatitis C
    d. The patient has severe Hepatitis C
A

b. The patient is currently infected with Hepatitis C

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17
Q
  1. What do natriuretic peptides do in response to increased blood volume?
    a. Lower blood pressure
    b. Increase blood pressure
A

a. Lower blood pressure

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18
Q
  1. What is considered a function of the liver?
    a. Involved in digestion
    b. AOTA
    c. Storage of coagulation factors
    d. Protein synthesis
A

b. AOTA

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19
Q
  1. What type of hepatitis virus replicates only in the presence of hepatitis B?
    a. Hepatitis D
    b. Hepatitis C
    c. Hepatitis A
    d. Hepatitis E
A

a. Hepatitis D

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20
Q
  1. Where specifically does heme breakdown into bilirubin occur?
    a. In macrophages as part of the reticuloendothelial system
    b. Inside the cytosol of type A hepatocytes
    c. In the kidney glomeruli
    d. In the entrance of the portal ducts
A

a. In macrophages as part of the reticuloendothelial system

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21
Q
  1. What is the most common cause of acute liver injury?
    a. Bacteria
    b. Radiation
    c. Poisoning
    d. Virus
A

d. Virus

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22
Q
  1. Bile salts are NOT present in urine in normal individuals
    a. True
    b. False
A

a. True

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23
Q
  1. How long does it take for troponin to first appear in the blood?
    a. 3-4 hours
    b. 10 days
    c. 3-4 days
    d. 18-24 hours
A

a. 3-4 hours

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24
Q
  1. True regarding HBsAg
    a. Rarely persists beyond 6 months
    b. Often persists beyond 6 months
    c. Disappears completely during symptomatic phase of the disease
    d. None of the above
A

a. Rarely persists beyond 6 months

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25
Q
  1. True regarding anti HBc IgM
    a. None of the above
    b. Indicates chronic HBV infection
    c. All of the above
    d. Usually appears last compared to IgG
A

a. None of the above

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26
Q
  1. Which of the following may directly or indirectly influence the disease course/prognosis of a hepatitis infection?
    a. Antigenic subtype
    b. All of the above
    c. The predominant subtype that y
A

b. All of the above

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27
Q
  1. Which of the following is true regarding troponins?
    a. They are structural proteins in the skeletal muscle
    b. They are two main cardiac types
    c. AOTA
    d. Cardiac troponins are mainly bound t
A

c. AOTA

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28
Q
  1. During seroconversion of HBeAg to anti HBe, what could happen?
    a. NOTA
    b. ALT may increase
    c. AST may increase a 100x
    d. Jaundice intensifies
A

d. Jaundice intensifies

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29
Q
  1. Which serologic markers may be the only one present during the “window period?”
    a. HBcAg
    b. Anti HBc IgM
    c. Anti HBs IgM
A

b. Anti HBc IgM

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30
Q
  1. True or False: CK from brain crosses the blood-brain barrier
    a. True
    b. False
A

a. True

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31
Q
  1. Which of the following is CORRECT about ALP
    a. It is present in bone disease
    b. It is more specific to the liver than AST
    c. The normal range in males is 13-35 U/L
    d. Appears in plasma many days before clinical signs
A

a. It is present in bone disease

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32
Q
  1. What problems does myoglobin have as a cardiac marker?
    a. It is not specific to heart muscle
    b. Its molecular weight is low
    c. It is not sensitive to myocardial damage
    d. It appears later than CK-MB
A

b. Its molecular weight is low

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33
Q
  1. Which of the following is true regarding Natriuretic Peptide:
    a. They were released when ventricles are strained
    b. They are used to protect risk for heart failure
    c. They were initially thought to originate from the brain
    d. All of the above
A

a. They were released when ventricles are strained

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34
Q
  1. A patient with an ALT level of 75 U/L most likely has:
    a. No problem as that is a normal level
    b. Acute hepatitis
    c. Non - alcoholic steatohepatitis
    d. Alcoholic hepatitis
A

c. Non - alcoholic steatohepatitis

● High serum levels in acute hepatitis (300-1000U/L)
● Moderate elevation in alcoholic hepatitis (100-300U/L
● Minor elevation in cirrhosis, hepatitis C and non-alcoholic steatohepatitis (NASH) (50-100U/L)

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35
Q
  1. Homocysteine is a marker implicated in what?
    a. All of the above
    b. Vascular injury
    c. Disruption of the elastic lamina
    d. Smooth muscle hypertrophy
A

a. All of the above

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36
Q
  1. CK MB returns to baseline at around:
    a. 4 hours
    b. 1-2days
    c. 10 days
    d. 10 hours
A

b. 1-2days

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37
Q
  1. Can you diagnose Acute MI without biochemical evidence of heart injury?
    a. I am not sure
    b. No, it’s not possible
    c. Yes, but it’s rare
A

c. Yes, but it’s rare

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38
Q
  1. What makes a good cardiac marker?
    a. It remains in myocytes long after injury
    b. Detectable in low concentrations
    c. High levels have no correlation with tissue
    damage
    d. It is present in many different tissues
A

b. Detectable in low concentrations

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39
Q
  1. True regarding HBcAg:
    a. None of the above are true
    b. All of the above
    c. Expressed on the surface of the nucleocapsid
    d. Remains within hepatocytes
A

b. All of the above

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40
Q
  1. Interpret this serology profile:

HBsAg (-),
Anti-HBs (+),
Anti-HBc (-),
HBeAg (-),
Anti-HBe (-)

a. Acute infection with HBV
b. A highly infective individual
c. A person in the window period
d. A vaccinated individual

A

d. A vaccinated individual

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41
Q
  1. Heme proteins are majorly found in:
    a. Dendritic cells
    b. Adipocytes
    c. Senescent red cells
    d. Skin
A

c. Senescent red cells

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42
Q
  1. Which of the following processes occurs last?
    a. Unconjugated bilirubin is transported to the liver via albumin
    b. Glucuronic acid is removed by bacteria in the intestine
    c. Urobilinogen is converted to urobilin
    d. Heme is converted into bilirubin
A

c. Urobilinogen is converted to urobilin

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43
Q
  1. In hepatitis B patients, the first viral serologic marker to be detected is:
    a. HBeAg
    b. Anti HBs
    c. HBsAg
    d. Anti HBc
A

c. HBsAg

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44
Q
  1. Is this patient highly infective?

HBsAg (+),
Anti-HBs (-),
Anti-HBc IgG (+),
HBeAg (+),
Anti-HBe (-)

a. Yes
b. No
c. Maybe

A

a. Yes

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45
Q
  1. Alkaline Phosphatase is:
    a. A nonspecific marker of liver disease
    b. Primarily released by osteoclasts
    c. Decreased in hepatocellular carcinoma
    d. Normal when the level is 200 u/L
A

a. A nonspecific marker of liver disease

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46
Q
  1. True or False. A small fraction of urobilinogen is excreted in urine
    a. True
    b. False
A

a. True

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47
Q
  1. The patient is:

HBsAg (-)
Anti HBs (-)
Anti HBc (-)
HBeAg (-)
Anti HBe (-)

a. Chronically infected with HIV
b. Vaccinated against HBV infection
c. Susceptible to HBV infection
d. Acutely infected with HBV

A

c. Susceptible to HBV infection

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48
Q
  1. Which of the following processes occurs first?
    a. Urobilinogen is reabsorb into the portal blood
    b. Glucuronic acid is removed by bacteria in the intestine
    c. Unconjugated bilirubin is transported to the liver via albumin
    d. Urobilinogen is converted to Urobilin
A

c. Unconjugated bilirubin is transported to the liver via albumin

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49
Q
  1. True regarding HBeAg
    a. Low amounts means the patient is highly infective
    b. NOTA
    c. An index of viral replication
    d. Accessory sugar of HBV
A

c. An index of viral replication

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50
Q
  1. What exactly is the utility of hs-CRP?
    a. Predictor of response to therapy
    b. NOTA
    c. Screening and risk prediction
    d. Determination of extent of myocardial damage
A

c. Screening and risk prediction

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51
Q
  1. True of Type 1 Diabetes except:
    a. Autoantibodies (GAD65, IA-2, IAA) may be present
    b. Frequency of 5%–10%
    c. Autoantibodies are absent
    d. C-peptide levels is very low or undetectable
A

c. Autoantibodies are absent

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52
Q
  1. The following statements are true about neural tube defects except
    a. in NTDs, AFP is decreased
    b. folic acid supplementation before conception reduces the recurrence of fetal NTDs
    c. failure of the neural tube to close by the 27th day after conception
    d. sporadic in 90% of cases and represent isolated defects with a multi- factorial origin, involving both genetic and nongenetic factors.
A

a. in NTDs, AFP is decreased

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53
Q
  1. During an evaluation of a woman with amenorrhea, you have the following lab results: hCG below 5mIU/ml, Prolactin, T4 and TSH normal, no withdrawal bleeding observed. What is an appropriate next step?
    a. Evaluate for adrenal hyperplasia
    b. None of the above
    c. Do imaging of the genital tract
    d. Treat for thyroid disease
A

c. Do imaging of the genital tract

54
Q
  1. Lactic acidosis is diagnosed by the presence of the following except:
    a. A low blood pH (<7.35)
    b. An elevated anion gap
    c. High blood lactate levels (>45 mg/dL or >5.0 mmol/L)
    d. None of the above
A

d. None of the above

55
Q
  1. During an evaluation of a man with infertility, you have the following lab results: oligospermia, reduced testosterone, normal FSH and LH, increased Prolactin. What can be a probable cause of these findings?
    a. Primary testicular failure
    b. None of the above
    c. Thyroid disease
    d. A hypothalamic-pituitary problem
A

d. A hypothalamic-pituitary problem

56
Q
  1. In microscopic examination for sperm analysis, progressive motility (normal range 32% or above) is expressed as the percentage of sperm that move, in addition forward movement is graded. Sperm that move rapidly in a straight line with little yaw and lateral movement is graded as:
    a. Grade 1
    b. Grade 2
    c. Grade 3
    d. Grade 4
A

d. Grade 4

57
Q

During an evaluation of a man with infertility, you have the following lab results: azoospermia, reduced testosterone, increased FSH and LH. What is an appropriate next step?
a. Vasectomy
b. Chromosomal analysis
c. Orchiectomy
d. None of the above

A

b. Chromosomal analysis

58
Q
  1. During an evaluation of a woman with amenorrhea, you have the following lab results: hCG below 5mIU/ml, Prolactin, T4 and TSH normal, no withdrawal bleeding observed. What is an appropriate next step?
    a. Do imaging of the genital tract
    b. Treat for thyroid disease
    c. Evaluate for adrenal hyperplasia
    d. None of the above
A

a. Do imaging of the genital tract

59
Q
  1. Which of the following statements about diabetes is true?
    a. Wildly varying random glucose levels throughout the day is a worrisome issue
    b. Hypoglycemic symptoms with a plasma glucose level of ≤50 mg/dl (2.8 mmol/L) in an individual who is not receiving medications for diabetes is not a concern.
    c. After testing for FBS, no further confirmatory test is needed
    d. DKA is not an emergency and most cases are managed at home
A

a. Wildly varying random glucose levels throughout the day is a worrisome issue

60
Q
  1. During an evaluation of a man with infertility, you have the following lab results: azoospermia, reduced testosterone, increased FSH and LH. What can be a probable cause of these findings?
    a. Primary Testicular Failure
    b. Thyroid Disease
    c. Hypothalamic-Pituitary necrosis
    d. NOTA
A

a. Primary Testicular Failure

61
Q
  1. True of PROM except:
    a. Amniotic fluid is alkaline
    b. The vaginal pool aspirate can be tested with nitrazine paper to estimate pH visually
    c. A positive test is indicated by a yellow green color, and a negative one by a blue color
    d. It may be followed by chorioamnionitis, fetal pulmonary hypoplasia, and placental absorption. And neonatal respiratory distress
A

c. A positive test is indicated by a yellow green color, and a negative one by a blue color

62
Q
  1. True of glucagon EXCEPT:
    a. Promotes glycogenesis
    b. Fasting plasma glucagon concentrations are normally 25-50 pg/mL
    c. Synthesized in the pancreatic alpha cells and the L cells of the distal small bowel
    d. Released during stress and fasting states
A

a. Promotes glycogenesis

63
Q
  1. It is a non-reducing sugar composed of glucose and fructose connected by a glycosidic bond.
    a. None of the above
    b. Maltose
    c. Sucrose
    d. Lactose
A

c. Sucrose

64
Q
  1. Insulin is produced by:
    a. Delta cells
    b. Beta cells
    c. PP or F cells
    d. Alpha cells
A

b. Beta cells

65
Q
  1. This hormone induces Sertoli cells to synthesize and secrete androgen-binding protein into the lumen of the seminiferous tubule, and this maintains the high testosterone concentration required for normal spermatogenesis
    a. Inhibin
    b. LH
    c. FSH
    d. None of the above
66
Q
  1. Which of the following is true regarding the diagnosis of GSDs?
    a. Amniotic fluid analysis may be done for pregnant women
    b. All of the above
    c. When considering GSDs that involve muscle, rule out muscular dystrophies as well
    d. Blood glucose analysis may help in diagnosis
A

b. All of the above

67
Q
  1. A surge of LH happens during:
    a. Recruitment of oocytes
    b. Ovulation
    c. Selection of oocytes
    d. None of the above
A

b. Ovulation

68
Q
  1. Which of the following about HbA1c is true?
    a. It is usually collected in a violet top tube
    b. Directly related to complications to diabetes
    c. It is glucose that is bound to hgb
    d. NOTA
    e. AOTA
69
Q
  1. Which of the following is true regarding Pompe’s disease?
    a. Has broad clinical spectrum across all age groups
    b. The infantile form often leads to thymic complications
    c. Deficiency in the acid sucrase lysosomal enzyme
    d. NOTA
A

a. Has broad clinical spectrum across all age groups

70
Q
  1. During an evaluation of a woman with amenorrhea, you have the following lab results: hCG below 5mIU/mL, Prolactin, T4, TSH normal, no withdrawal bleeding observed but with high FSH and LH. What is the probable cause of these findings?
    a. NOTA
    b. The patient has a hydatidiform mole
    c. The patient has a primary ovarian failure
    d. The patient has an adrenal tumor
A

c. The patient has a primary ovarian failure

71
Q
  1. Which of the following is true regarding glycogen storage diseases?
    a. Usually confined to the liver and muscles but may cause effects in other organs
    b. Can be inherited either as an autosomal
    recessive pattern or linked to the X-chromosome
    c. Classified according to which enzyme is
    deficient or defective
    d. All of the above
A

d. All of the above

72
Q
  1. Which of the following is true regarding GSD Type VI
    a. Most common variant is Y-linked
    b. Affects the liver and rarely the heart
    c. Called His disease
    d. Most have a significantly shortened lifespan
A

b. Affects the liver and rarely the heart

73
Q
  1. True about C-peptide
    a. Used to differentiate between gestational and non-gestational diabetes
    b. It is usually in extremely low amounts in
    diabetes insipidus
    c. None of the above
    d. It is a worse indicator of B-cell function than peripheral insulin
A

c. None of the above

74
Q
  1. Which set of results is most likely in an adult male with primary testicular failure?
    a. Decreased LH, FSH, and testosterone
    b. Increased androstenedione, decreased
    testosterone, and normal FSH
    c. Increased LH, FSH, and decreased testosterone
    d. Decreased testosterone, androstenedione, and FSH
A

c. Increased LH, FSH, and decreased testosterone

75
Q
  1. During an evaluation of a woman with amenorrhea, you have the following lab results: hCG below 5mIU/ml, prolactin high, T4 and TSH normal. What is an appropriate next step?
    a. Do another pregnancy test
    b. Do imaging of the brain and surrounding structure
    c. None of the above
    d. Treat for thyroid disease
A

b. Do imaging of the brain and surrounding structure

76
Q
  1. Hypoglycemia can be due to the following except
    a. Insulin secreting beta cell tumors
    b. Autoantibodies to insulin in patients who have been treated with insulin
    c. Congenital hyperinsulinism
    d. NOTA
77
Q
  1. During pregnancy, hCG levels start to plateau and decline during
    a. The end of the first trimester
    b. Parturition
    c. The end of the second trimester
    d. Sexual intercourse
A

a. The end of the first trimester

78
Q
  1. This is considered as the more patent androgen
    a. Dehydroepiandrosterone (DHEA)
    b. Dihydrotestosterone (DHT)
    c. Androstenedione
    d. Testosterone
A

b. Dihydrotestosterone (DHT)

79
Q
  1. For type 1 diabetes, it is a single screening marker for detecting multiple antibody markers for beta cell destruction and more common in children
    a. Insulin autoantibodies (IAA)
    b. Antibodies to glutamic decarboxylase (GAD65)
    c. Autoantibodies to pancreatic alpha cells (APA1)
    d. Autoantibodies to zinc transporter B (ZnT8)
A

a. Insulin autoantibodies (IAA)

80
Q
  1. The diagnosis of diabetes requires the following criteria except
    a. Glycosylated hemoglobin (HbA1c) of 6.5% or greater on at least two occasions
    b. Fasting plasma glucose of 126 mg/dL (7.0 mmol/L) or greater on at least two occasions
    c. Casual plasma glucose level of 200 mg/dL (11.1 mmol/L) or greater
    d. Fasting plasma glucose is less than 100 mg/dL (5.6 mmol/L)
A

d. Fasting plasma glucose is less than 100 mg/dL (5.6 mmol/L)

81
Q
  1. A potential diabetes patient has a low C-peptide and insulin level. Which of the following is likely with this patient?
    a. None of the above
    b. The patient has type II diabetes
    c. The patient has type I diabetes
A

c. The patient has type I diabetes

82
Q
  1. What is the most common cause of secondary amenorrhea?
    a. None of the above
    b. A trophoblastic tumor
    c. Pregnancy
    d. Turner Syndrome
A

c. Pregnancy

83
Q
  1. In machines and analyzers, it is most common methodology used to analyze glucose:
    a. Glucose Oxidase System
    b. Hexokinase System
    c. None of the above
    d. Glucose Dehydrogenase System
A

a. Glucose Oxidase System

84
Q
  1. Which statement regarding glycosylated hgb is true?
    a. It has a sugar attached to the c - terminal end of the Beta Chain
    b. Will be abnormal within 4 days following an episode of hyperglycemia
    c. Reflects the extent of glucose regulation in the 8 to 12 - week interval prior to sampling
    d. Is a highly reversible aminoglycan
A

c. Reflects the extent of glucose regulation in the 8 to 12 - week interval prior to sampling

85
Q
  1. Which of the following tests does not discern between reducing and non reducing sugars?
    a. None of the above
    b. Benedict’s test
    c. Fehling test
    d. Molisch Test
A

d. Molisch Test

86
Q
  1. Which of the following is characteristic of type 1 diabetes mellitus?
    a. Is the most common form of diabetes mellitus
    b. Usually occurs after age of 40
    c. Requires an oral glucose tolerance test for diagnosis
    d. Requires insulin replacement to prevent ketosis
A

d. Requires insulin replacement to prevent ketosis

87
Q
  1. During an evaluation of a woman with amenorrhea, you have the following lab results: hCG below 5mIU/ml, Prolactin normal, T4 and TSH high. What is an appropriate next step?
    a. Treat for thyroid disease
    b. Do another pregnancy test
    c. None of the above
    d. Do imaging of the brain and surrounding structures
A

d. Do imaging of the brain and surrounding structures

88
Q
  1. Which statement regarding gestational diabetes mellitus (GDM) is correct?
    a. Presents no increased health risk to the fetus
    b. Converts to diabetes mellitus after pregnancy in 60%-75% of cases
    c. Is diagnosed using the same oral glucose
    tolerance criteria as in nonpregnancy
    d. Is defined as glucose intolerance originating during pregnancy
A

d. Is defined as glucose intolerance originating during pregnancy

89
Q
  1. True of Diabetes Mellitus Type 2 except:
    a. Home blood glucose monitoring devices, are preferred compared to lab based plasma glucose determination
    b. In general, it is recommended that adults ages 45 be screened for diabetes every 3 years, but screening should be performed earlier and more frequently if the individual is at high risk.
    c. The preferred test is a fasting plasma glucose and HbA1c level.
    d. C-peptide are normal to high in Type 2 DM
A

a. Home blood glucose monitoring devices, are preferred compared to lab based plasma glucose determination

90
Q
  1. A female with severe excessive pubic and facial hair growth (hirsutism) should be tested for which of the following hormones?
    a. Testosterone
    b. Growth hormone
    c. Estrogen and progesterone
    d. Chorionic gonadotropin
A

a. Testosterone

91
Q
  1. True of Diabetic Ketoacidosis except:
    a. It is frequently associated with nausea, vomiting, abdominal pain, electrolyte disturbances, and severe dehydration
    b. The ratio of ß-hydroxybutyric acid to acetoacetic acid is greatly decreased
    c. Diabetes insipidus patients who are poorly controlled, particularly in the presence of extreme stress or severe acute illness, can also develop DKA
    d. It is a serious and potentially fatal hyperglycemic condition requiring urgent treatment
A

b. The ratio of ß-hydroxybutyric acid to acetoacetic acid is greatly decreased

92
Q
  1. What sets apart glycogen synthase deficiency from the glycogen storage diseases?
    a. It is technically not a glycogen storage
    disease in the literal sense since glycogen is
    not created or is deficient in this case
    b. nothing, they all share similar aspects
    c. it involves more than 10 enzyme deficiencies instead of just one
    d. It involves the kidneys and gallbladder
A

a. It is technically not a glycogen storage
disease in the literal sense since glycogen is
not created or is deficient in this case

93
Q
  1. The WHO 2010 standard method for counting sperm is:
    a. Via flow cytometric analysis
    b. Via electron microscopy
    c. None of the above
    d. Via a hemocytometer chamber
A

d. Via a hemocytometer chamber

94
Q
  1. A patient with seminiferous tubule failure would exhibit:
    a. None of the above
    b. Increased beta HCG
    c. Normal testosterone
    d. Polyspermia
A

c. Normal testosterone

95
Q
  1. True about Von Gierke’s disease:
    a. Large quantities of glycogen are stored primarily in the thyroid
    b. It is the most common GSD
    c. Creates a symptomatic protein problem
    d. Affects the glucose 1 phosphatase enzyme
A

b. It is the most common GSD

96
Q
  1. This hormone induces Leydig cells to synthesize testosterone
    a. FSH
    b. LH
    c. None of the above
    d. Inhibin
97
Q
  1. Glucagon is produced by
    a. Beta cells
    b. Delta cells
    c. Alpha cells
    d. PP or F cells
A

c. Alpha cells

98
Q
  1. The following are true on sample collection for sperm analysis EXCEPT:
    a. Longer periods of abstinence usually result in a higher semen volume and improved sperm motility
    b. The patient should be instructed to collect semen after 2 to 5 days of sexual abstinence
    c. The bladder should be evacuated before ejaculation occurs
    d. The semen should be delivered to the laboratory within 1 hours of collection and kept warms during transportation
A

a. Longer periods of abstinence usually result in a higher semen volume and improved sperm motility

99
Q
  1. During an evaluation of a man with infertility, you have the following lab results: oligospermia, normal testosterone, FSH and LH, seminal fructose present, and normal spermatogenesis on biopsy. What is an appropriate next step?
    a. NOTA
    b. Administration of pituitary antagonists
    c. Surgery if with blockage of tubes
    d. Antithyroid drugs.
A

c. Surgery if with blockage of tubes

100
Q
  1. Macroscopic for semen analysis should be performed after liquefaction, which usually occurs in:
    a. Exactly 12 hours at room temp
    b. Less than 20 minutes at room temp
    c. Around 3 hours at room temp
    d. NOTA
A

b. Less than 20 minutes at room temp

101
Q
  1. Attaching to a poly-immunoglobulin receptor, secretory IgA finds its way into the lumens of glands via:
    a. Transcytosis
    b. Phagocytosis
    c. Osmosis
    d. Degranulation
A

a. Transcytosis

102
Q
  1. True regarding Phosphorus:
    a. Is normally unavailable in the diet
    b. None of the given statements are true
    c. Is excreted mainly in the proximal collecting tubules
    d. Is mostly absorbed in the stomach by osmosis
A

c. Is excreted mainly in the proximal collecting tubules

103
Q
  1. A man with a diagnosed parathyroid adenoma consults you concerning x-ray results. There seem to be lots of deposits of dense material in his lungs and soft tissues. Given his condition, these dense materials may likely be:
    a. Due to very high calcium levels in the blood
    b. Granulomas formed by an immunologic process
    c. Metastatic cancer
    d. Solidified mucus deposits
A

a. Due to very high calcium levels in the blood

104
Q
  1. Which of the ff is true regarding Addison’s disease?
    a. Due to a hypersecreting tumor
    b. Can be due to autoimmune destruction (a majority is) but can also be due to other
    causes
    c. Can not be related to other organ specific autoimmune disorders
    d. NOTA
A

b. Can be due to autoimmune destruction (a majority is) but can also be due to other
causes

105
Q
  1. The physiologically active form of calcium:
    a. Comprises around 10% of the total serum calcium in the body
    b. Is bound to plasma proteins
    c. Is bound to anions
    d. Is the free or ionized form
A

d. Is the free or ionized form

106
Q
  1. Lipoid hyperplasia is caused by a defect in the ____ gene:
    a. CYP11B2
    b. HSD3B2
    c. StAR
    d. CYP11B1
107
Q
  1. You do a skin prick test on a patient with a suspected allergy to hayseed. After a few minutes, a wheal and flare reaction appears on the skin. Which of the following is true?
    a. If the reaction measures 1mm, this is considered positive
    b. Measuring the wheal and flare increases reproducibility
    c. This test must be conducted with a positive and negative control
    d. Recording the exact reaction size is not necessary
A

c. This test must be conducted with a positive and negative control

108
Q

A patient consults you with a thyroid tumor. It is removed and the pathologist diagnoses it as a Medullary Thyroid Carcinoma. Which of the following statements are true?
a. If both basal and postpentagastrin or calcium-stimulating calcitonin are undetectable, residual tissue can be determined via calcitonin levels
b. Is higher in children <3 years of age.
c. MTC can be part of a Multiple Endocrine
Neoplasm (MEN) syndrome
d. All of the above.

A

a. If both basal and postpentagastrin or calcium-stimulating calcitonin are undetectable, residual tissue can be determined via calcitonin levels

109
Q
  1. The most common form of prolactin is the:
    a. Form bound to albumin
    b. Non-glycosylating monomer
    c. Unbound alpha sheet
    d. Monomer with three iodine molecules
A

b. Non-glycosylating monomer

110
Q
  1. Most sensitive metabolite in detecting pheochromocytoma:
    a. VMA
    b. HVA
    c. L-dopa
    d. metanephrine (plasma or urine)
A

d. metanephrine (plasma or urine)

111
Q
  1. The biologically active fraction of thyroxine in circulating blood is:
    a. Free thyroxine (Free T4)
    b. Reverse T4 (rT4)
    c. Triiodothyroxine (T3)
    d. Total thyroxine (Total T4)
A

a. Free thyroxine (Free T4)

112
Q
  1. The reference method for calcium determination is
    a. Atomic absorption spectrophotometry
    b. Gas chromatography (non-tandem)
    c. Indirect potentiometry
    d. GC-MS (Gas chromatography- mass
    spectrophotometry)
A

a. Atomic absorption spectrophotometry

113
Q
  1. The gold standard for measuring Growth Hormone Deficiency is:
    a. ELISA
    b. Dexamethasone Suppression test
    c. Mass Spectrometry/HPLC
    d. Insulin Ignorance test
A

d. Insulin Ignorance test

114
Q
  1. The specific term for Hypercortisolism due to an ACTH-secreting pituitary adenoma is
    a. Cushing’s Disease
    b. Cushing’s Syndrome
    c. Conn Syndrome
    d. MEN2A
A

a. Cushing’s Disease

115
Q
  1. Primary Hyperaldosteronism is characterized by what?
    a. Potassium retention
    b. High Aldosterone/Renin Ratio (>50)
    c. Hypertension
    d. Commonly have severe hyponatremia
A

c. Hypertension

116
Q
  1. True or False. Most Pheochromocytomas are malignant.
    a. True
    b. False
117
Q
  1. What can be expected in a patient with adrenal crisis?
    a. vomiting and/or diarrhea
    b. Confusion
    c. All of the above
    d. Severe weakness
A

c. All of the above

118
Q
  1. True regarding Hashimoto Thyroiditis
    a. Occurs more in women
    b. Characterized by a delayed type hypersensitivity response
    c. Ultimately leads to decreased thyroid function
    d. All of the above
A

d. All of the above

119
Q
  1. A patient taking lithium for symptoms of bipolar type I can develop what?
    a. Hypercortisolism
    b. SIADH
    c. Hypothyroidism
    d. Hyperprolactinemia
A

c. Hypothyroidism

120
Q
  1. The traditional reference method for measuring FT4 is equilibrium dialysis?
    a. True
    b. False
121
Q
  1. The most sensitive test for the detection of congenital hypothyroidism
    a. Free T4 determination
    b. TSH determination
    c. T4/T3 determination
    d. TRH determination
A

b. TSH determination

122
Q
  1. Goodpasture syndrome involves which of the following? Except
    a. Anti - glomerular basement membrane
    b. Pulmonary hemorrhage
    c. Low amounts of urea in the serum
    d. Rapidly progressive glomerulonephritis
A

c. Low amounts of urea in the serum

123
Q
  1. Which of the following is true regarding Grave’s Disease?
    a. All of the above
    b. Mediated by destruction and loss of function of thyrocytes
    c. Patient’s present with heat intolerance among other symptoms
    d. Granuloma formation is mandatory for the diagnosis
A

c. Patient’s present with heat intolerance among other symptoms

124
Q
  1. A young child presents with salt wasting and virilizing symptoms, and is diagnosed with a capillary heel test to have the most common form of Congenital Adrenal Hyperplasia. This child most likely has:
    a. 21-hydroxylase deficiency
    b. 11-beta-hydroxylase deficiency
    c. 17-beta-hydroxylase deficiency
    d. 3-beta-hydroxysteroid deficiency
A

a. 21-hydroxylase deficiency

125
Q
  1. Which of the following statements correctly describe the action of PTH?
    a. PTH acts on the bone to decrease serum
    calcium concentration
    b. PTH acts on the liver to create enzymes that cleave protein-bound calcium
    c. In the context of a low serum calcium, PTH acts on the kidney to increase calcium reabsorption
    d. In the context of a high serum calcium, PTH stimulates RANKL to increase bone resorption
A

c. In the context of a low serum calcium, PTH acts on the kidney to increase calcium reabsorption

126
Q
  1. An X-linked receptor defect is one of the most common congenital causes of Nephrogenic Diabetes Insipidus.
    a. True
    b. False
127
Q
  1. In what conditions can conventional Calcium measurements be inaccurate, necessitating a correction?
    a. Nephrotic Syndrome
    b. Liver Disease
    c. All of the above
    d. Chronic Lymphocytic Leukemia
A

c. All of the above

128
Q
  1. Which of the following is NOT used to measure phosphorus?
    a. Reacting phosphorus to create a picrate solution
    b. Indirect Potentiometry
    c. Reacting phosphorus to create a
    phosphomolybdate complex
    d. Atomic Absorption Spectrophotometry
A

a. Reacting phosphorus to create a picrate solution

129
Q
  1. When and under what circumstances is it best to measure phosphorus in a patient?
    a. During the afternoon, before dinner
    b. In the evening, after dinner
    C. Any time of the day is optimal
    d. During a fasting specimen in the morning
A

a. During the afternoon, before dinner

130
Q
  1. You are consulted by a young patient diagnosed with Type 1 Diabetes Mellitus. Which of the following applies to her condition?
    a. None of the above
    b. Patients with her condition are always obese
    c. People with her condition usually present at an elderly age
    d. All of the above
    e. Infiltration of the pancreas by massive
    amounts of primarily B lymphocytes
A

e. Infiltration of the pancreas by massive
amounts of primarily B lymphocytes

131
Q
  1. In Myasthenia Gravis which of the following is true?
    a. The disease can be treated in a number of different ways
    b. AOTA
    c. Mediated by antibodies blocking acetylcholine receptors
    d. Manifests as progressive weakness
A

c. Mediated by antibodies blocking acetylcholine receptors

Clin Path (9 decks)

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