MLS 421 Clinical Chemistry II Exam I Flashcards by Kyle Snyder

A peptide bond is:

(a) Amino group and carboxyl group bonded to the alpha-carbon.
(b) A double carbon bond.
(c) Tertiary ring of amino group and carboxyl group bonded to the alpha carbon.
(d) Two amino groups bonded to the alpha-carbon.

(a) Amino group and carboxyl group bonded to the alpha-carbon.

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Choose the protein fraction NOT produced by the liver:

(a) Beta globulin
(b) Alpha 2 globulin
(c) Gamma globulin
(d) Albumin
(e) Alpha 1 globulin

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The two components of conjugated proteins are:

(a) Light chains and heavy chains
(b) Albumin and globulin
(c) Fibrous and globular
(d) Complement and polypeptides
(e) Apoprotein and prosthetic group

(e) Apoprotein and prosthetic group

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Choose the following normal patient value for total protein in serum.

(a) 7.4 g/dL
(b) 3.2 g/dL
(c) 10.0 mg/dL
(d) 7.4 mg/dL

(a) 7.4 g/dL

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Amino acids feed into the central pathways of metabolism and the TCA (citric acid cycle) to produce:

(a) Nucleic acid
(b) Vitamins
(c) Energy
(d) Lipid

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Peptide bonds of protein bind with _______ ions of biuret reagent to produce a colored product.

(a) Cupric
(b) Ferrous
(c) Ferric
(d) Cuprous

(a) Cupric

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In the following pathological states, which of the following would demonstrate an increased total protein level?

(a) Nephrosis
(b) Multiple myeloma
(c) Cirrhosis
(d) Severe burns

(b) Multiple myeloma

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Increased serum albumin concentrations are seen in which of the following conditions?

(a) Dehydration syndromes
(b) Burns
(c) Nephrotic syndrome
(d) Liver disease

(a) Dehydration syndromes

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A glycoprotein that binds with hemoglobin to facilitate the removal of hemoglobin by the reticuloendothelial system is:

(a) Hemopexin
(b) Transferrin
(c) Ceruloplasmin
(d) C-reactive protein
(e) Haptoglobin

(e) Haptoglobin

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Serum protein electrophoresis is performed at a pH of ________ at which proteins will have a ________ net charge, and migrate towards to ________.

(a) 9.4, negative, cathode
(b) 6.8, negative, anode
(c) 8.6, positive, cathode
(d) 8.6, negative, anode

(d) 8.6, negative, anode

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Portal cirrhosis is a chronic disease of the liver. Observed on an electrophoretic serum protein patter, a predominant characteristic of this disease is:

(a) An increase in the alpha-2 globulin band
(b) An increase in the albumin band
(c) A monoclonal band in the gamma region
(d) A polyclonal band in the gamma region
(e) A bridging effect between the beta and gamma bands

(e) A bridging effect between the beta and gamma bands

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If serum proteins were immersed in a buffer of pH 8.6, which protein, albumin (pI = 4.7) or gamma globulin (pI = 7.6) would migrate the farthest by electrophoresis, and toward which electrode?

(a) Albumin/anode
(b) Gamma globulin/cathode
(c) Gamma globulin/anode
(d) Albumin/cathode

(a) Albumin/anode

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Highly sensitive C reactive protein is elevated in infection or inflammation.

(a) False
(b) True

(b) True

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This plasma protein transport T3 & T4, and is increased in Hodgkin’s disease and renal failure.

(a) Transthyretin
(b) Haptoglobin
(c) C-reactive protein
(d) Albumin

(a) Transthyretin

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Maple syrup urine disease is characterized by an increase in which of the following urinary amino acids?

(a) Phenylalanine
(b) Tyrosine
(c) Valine, leucine, and isoleucine
(d) Cystine and cysteine

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This method of protein detection measures a decrease in light scatter when an insoluble complex is formed with sulfosalicylic acid and trichloroacetic acid.

(a) Turbidimetry
(b) Refractometry
(c) Kieldahl
(d) UV absorption

(a) Turbidimetry

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After electrophoresis, quantitation of protein fractions are done by:

(a) Chromatography
(b) Densitometry
(c) Fractionation
(d) Spectrophotometry
(e) Electrophoresis

(b) Densitometry

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This type of electrophoresis is used to divide proteins into 12 zones allowing better differentiation of unusual bands.

(a) Immunofixation
(b) Isoelectric focusing
(c) SDS Page
(d) High resolution protein electrophoresis
(e) Counter Immunoelectrophoresis

(d) High resolution protein electrophoresis

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Enzymes accelerate reactions by:

(a) Increasing the temperature of the reaction mixture
(b) Lowering the energy of activation (Ea) for a reaction
(c) Lowering the free energy for the overall reaction
(d) Shifting the equilibrium of a reaction

(b) Lowering the energy of activation (Ea) for a reaction

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Which condition does not produce an abnormal elevation of enzymes in the bloodstream?

(a) Injury or death of tissue cells
(b) Turnover of cells, breakdown, and replacement
(c) Inflammation
(d) Tissue necrosis

(b) Turnover of cells, breakdown, and replacement

Enzymes that catalyze the transfer of groups other than hydrogen bet2ween compounds are classified as belonging to which class of enzymes?

(a) Hydrolases
(b) Lyases
(c) Transferases
(d) Oxidoreductases

Which of the following enzymes has multiple molecular forms (isoenzymes) whose clinical significance is used in diagnosis?

(a) Aspartate amino transferase
(b) Lactate and dehydrogenase
(c) Lactate dehydrogenase, creatine kinase, and aspartate amino transferase
(d) Lactate dehydrogenase and creatine kinase
(e) Creatine kinase

(d) Lactate dehydrogenase and creatine kinase

Enzyme activity is affected by all of the following, EXCEPT?

(a) pH
(b) Temperature
(c) Light Exposure
(d) Presence of small ions: Mg, Ca

In competitive inhibition of an enzyme reaction:

(a) The inhibitor binds to the enzyme at the same site as does the substrate.
(b) Activity of the reaction can be decreased by increasing the concentration of the substrate.
(c) The inhibitor often has a chemical structure different than the substrate.
(d) Activity of the reaction can be increased by decreasing the temperature.

(a) The inhibitor binds to the enzyme at the same site as does the substrate.

To determine enzyme activity in the laboratory, which of the following must be in excess? (a) Enzyme concentration (b) Inhibitors (c) Activators (d) Substrate concentration

(d) Substrate concentration

When a reaction is performed in zero-order kinetics: (a) The enzyme levels is always high. (b) The rate of the reaction is independent of the substrate concentration. (c) The rate of reaction is directly proportional to the substrate concentration. (d) The substrate concentration is very low.

(b) The rate of the reaction is independent of the substrate concentration.

One international unit is defined as one ________ of substrate converted to product per ________. (a) Microgram; minute (b) Micromole; minute (c) Micromole; hour (d) Nanogram; hour (e) Mole; minute

(b) Micromole; minute

In this method to measure enzyme activity, the reaction progress is traced over several minutes, and the slope of the linear portion of the curve is used to determine enzyme activity. (a) Continuous monitoring (b) End point (c) Multiple point

(a) Continuous monitoring

How does the formation of NADH from NAD+ change the absorbance readings of the reaction at 340 nm? (a) Increases the absorbance readings (b) Decreases the absorbance readings (c) NADH cannot be formed from NAD+ (d) The absorbance does not change

(a) Increases the absorbance readings

AST is an example of what type of enzyme? (a) Ligase (b) Hydrolase (c) Transaminase (d) Lipase

Aspartate aminotransferase enzyme elevation are seen with: (a) Many tissues but its highest levels with hemolytic and pernicious anemia. (b) Acute pancreatitis (c) Many tissues including hepatic, skeletal muscle, cardiac, pulmonary disease. (d) Hepatobiliary and bone disease. (e) Early detection of liver disease.

Lactate dehydrogenase enzyme elevations are seen with: (a) Many tissues but its highest levels with hemolytic and pernicious anemia. (b) Many tissues including hepatic, skeletal muscle, cardiac, pulmonary disease. (c) Acute pancreatitis. (d) Early detection of liver disease. (e) Hepatobiliary and bone disease.

(a) Many tissues but its highest levels with hemolytic and pernicious anemia.

Elevation in which of the following are MOST likely to indicate liver disease? (a) ALK phosphatase, creatinine, and uric acid (b) ALK phosphatase, creatinine, and serum potassium (c) Amylase, AST, ALT, and glucose (d) AST, ALT, and ALK phosphatase

(d) AST, ALT, and ALK phosphatase

Which of the following enzyme tests is most likely affected by hemolysis? (a) Lactate dehydrogenase (b) Creatine kinase (c) Alkaline phosphatase (d) Gamma glutamyl transferase

(a) Lactate dehydrogenase

Alkaline phosphatase enzyme elevations are seen with: (a) Many tissues including hepatic, skeletal muscle, cardiac, pulmonary disease. (b) Acute pancreatitis. (c) Hepatobiliary and bone disease. (d) Early detection of liver disease. (e) Many tissues but its highest levels with hemolytic and pernicious anemia.

This enzyme hydrolyzes at a pH of 10, Cofactors: Mg, Co, & Mn. Has a heat stable placental isoenzyme, and children have a much higher reference range for this enzyme due to bone growth. (a) Alanine transferase (b) Aspartate aminotransferase (c) Alkaline phosphatase (d) Lactate dehydrogenase (e) Gamma-glutamyl transferase

Which of the following enzymes detects very early changes in liver cell damage? (a) GGT (b) ALT (c) SGPT (d) ALP (e) Cholinesterase

(a) GGT

The major cellular origin of acid phosphatase activity in serum is: (a) Bone (b) Liver (c) Prostate (d) Pancreas

The greatest tissue source for Total CK is: (a) Heat muscle (b) Thyroid (c) Brain (d) Skeletal muscle

(d) Skeletal muscle

When myocardial infarction occurs, the first enzyme to reach peak elevation is: (a) LD (b) AST (c) CK (d) ALT

Which isoenzyme of creatine kinase (CK) is increase in cardiac muscle damage? (a) CK-MB (b) CK-BB (c) CK-BC (d) CK-MM

(a) CK-MB

In cardiac injury, which of the following serum enzyme levels will stay elevated the longest, 7 - 12 days? (a) CK-MB (b) LDH (c) AST (d) Alkaline phosphatase

(b) LDH

An LD flip, in assessing a possible myocardial infarction, refers to: (a) LD5 > LD1 (b) LD1 > LD5 (c) LD2 > LD1 (d) LD1 > LD2

(d) LD1 > LD2

Which cardiac markers is elevated for the longest period after myocardial infarction (MI)? (a) Troponin T (b) Troponin I (c) CK-MB (d) Myoglobin

(a) Troponin T

Which of the following cardiac markers is the most useful indicator of congestive heart failure? (a) B-natriuretic peptide (b) Glycogen phosphorylase isoenzyme BB (c) Fibrinogen (d) D-Dimer

(a) B-natriuretic peptide

A patient's CK-MB is reported as 18 ug/L and the total CK as 560 IU/L. What is the CK relative index? (a) 0.10% (b) 3.2% (c) 30.0% (d) 10.0%

(b) 3.2%

After a myocardial infarct, the CK isoenzyme will rise within _______, peak, and return to normal in ________. (a) 4 - 8 hours; 2 - 3 days (b) 20 - 24 hours; 4 days (c) 4 - 8 hours; 6 days (d) 8 - 12 hours; 10 days

(a) 4 - 8 hours; 2 - 3 days

What is the typical time course for plasma myoglobin following an acute MI? (a) Abnormal within 3 hours; peaks within 12 hours; returns to normal in 18 - 30 hours. (b) Abnormal within 3 hours; peaks within 6 hours; returns to normal in 12 hours. (c) Abnormal within 6 hours; peaks within 24 hours; returns to normal in 72 hours. (d) Abnormal before 1 hour; peaks within 3 hours; returns to normal in 8 hours.

(a) Abnormal within 3 hours; peaks within 12 hours; returns to normal in 18 - 30 hours.

Mrs. Smith has the following chemistry results: CK: moderately increased LDH: moderately increased LD-1: increased The probable diagnosis is: (a) Myocardial infarction (b) Cholecystitis (inflammation of the gallbladder) (c) Acute pancreatitis (d) Acute hepatitis