MLS 421 Clinical Chemistry II Exam III Flashcards
Which NPN fraction constitutes nearly half of the NPN substances in the blood?
(a) Ammonia
(b) Creatinine
(c) Uric acid
(d) Urea
(d) Urea
Creatinine levels are usually:
(a) 0.1 - 0.6 mg/dL
(b) 0.8 - 1.3 mg/dL
(c) 3.0 - 5.0 mg/dL
(d) 1.5 - 2.5 mg/dL
(b) 0.8 - 1.3 mg/dL
Creatinine is a by-product of ________ metabolism.
(a) Protein
(b) Adipose
(c) Muscle
(d) Nucleic acid
(e) Carbohydrate
(c) Muscle
A technologist obtains a BUN value of 61 mg/dL and serum creatinine value of 3.5 mg/dL on a patient. The BUN/Creatinine ratio indicates:
(a) Renal failure
(b) Liver failure
(c) Gout
(d) Prerenal failure
(a) Renal failure
Creatinine reacts with strong alkaline picrate to form a yellow-red compound. This reaction is:
(a) Nessler’s reaction
(b) Ehrlich’s diazo reaction
(c) Jaffe reaction
(d) Lieberman-Burchard reaction
(c) Jaffe reaction
Uric acid is an end product of:
(a) Muscle metabolism
(b) Nucleic acid catabolism
(c) Protein catabolism
(d) Lipid metabolism
(b) Nucleic acid catabolism
In the serum uric acid experiment, in the presence of ________ enzyme, uric acid liberates H2O2, and subsequently reacts with the chromogenic system to yield a colored compound.
(a) POD peroxidase
(b) GOD glucose oxidase
(c) Uricase
(d) Urease
(c) Uricase
Which of the following best describes the correct collection and handling conditions for a blood ammonia measurement?
(a) Fasting patient, draw clot tube, separate serum immediately.
(b) Draw clot tube, protect from light, freeze if not tested immediately.
(c) Fasting patient, draw EDTA tube, test immediately.
(d) Draw heparin tube, keep on ice, test immediately.
(d) Draw heparin tube, keep on ice, test immediately.
Ammonia levels are usually measured to evaluate this clinical presentation.
(a) Renal failure
(b) Glomerular filtration
(c) Acid base status
(d) Hepatic encephalopathy
(d) Hepatic encephalopathy
A patient with a toxic level of blood alcohol would cause which of the following:
(a) A decreased osmolal gap
(b) An increased osmolal gap
(c) An osmolal gap of zero
(d) No change in the osmolal gap
(b) An increased osmolal gap
Plasma osmolality can be calculated using which of the following?
(a) Glucose + 2(Na) - 2(BUN)
(b) Na + 2(HCO3) + BUN - Glucose
(c) 2(Na) + (Glucose/18) + (BUN/2.8)
(d) Na + Cl + K + HCO3
(c) 2(Na) + (Glucose/18) + (BUN/2.8)
A plasma specimen from a hospital patient is analyzed on an osmometer and reported as 400 mOsm/Kg. What is the most likely effect on this patient’s water distribution in the tissues?
(a) Edema
(b) No change
(c) Dehydration
(c) Dehydration
The amount of sodium excreted by the kidney is largely controlled by:
(a) Parathyroid hormone
(b) Calcitonin
(c) Aldosterone
(d) Antidiuretic hormone
(c) Aldosterone
An increase in aldosterone has the following regulatory effects on electrolytes in serum:
(a) Na: increased; K: increased
(b) Na: increased; K: decreased
(c) Na: decreased; K: increased
(d) Na: decreased; K: decreased
(b) Na: increased; K: decreased
The major intracellular cation is:
(a) Sodium
(b) Bicarbonate
(c) Chloride
(d) Magnesium
(e) Potassium
(e) Potassium
The major extracellular anion:
(a) Ketones
(b) Bicarbonate
(c) Chloride
(d) Hydroxyl ions
(c) Chloride
All of the following describe potassium except:
(a) Has no renal threshold.
(b) Increased serum level in acidosis.
(c) Major anion of intracellular fluid.
(d) Hemolysis causes false increase in serum levels.
(c) Major anion of intracellular fluid.
The method of choice for measurement of serum potassium is:
(a) Atomic absorption
(b) Colorimetric
(c) Jaffe
(d) ISE
(d) ISE
The anion gap is useful for quality control for laboratory results for:
(a) Calcium, phosphorus, and magnesium
(b) Sodium, potassium, chloride, and total CO2
(c) Blood gas analyses
(d) Amino acids and proteins
(b) Sodium, potassium, chloride, and total CO2
Identify the results that would have an increased anion gap:
(a) Na: 125; K: 4.5; Cl: 95; HCO3: 20
(b) Na: 135; K: 3.5; Cl: 95; HCO3: 28
(c) Na: 150; K: 5.0; Cl: 110; HCO3: 30
(d) Na: 145; K: 4.0; Cl: 90; HCO3: 25
(d) Na: 145; K: 4.0; Cl: 90; HCO3: 25
Chronic diarrhea and prolonged vomiting will cause the following:
(a) Hypochloremia, hypokalemia
(b) Hypochloremia, hyperkalemia
(c) Hyperchloremia, hypokalemia
(d) Hyperchloremia, hyperkalemia
(a) Hypochloremia, hypokalemia
Slight hemolysis can significantly increase the serum level of this major intracellular ion.
(a) HCO3
(b) Na
(c) K
(d) Cl
(c) K
All of the following contribute to the total anion content of serum except:
(a) Lactate
(b) Acetoacetate
(c) Iron
(d) Protein
(c) Iron
The chloride shift in blood takes place between chloride and:
(a) Sodium
(b) Potassium
(c) Bicarbonate
(d) Phosphate
(c) Bicarbonate
The colorimetric method to measure this electrolyte uses calmagite, formazan, or methyl thymol blue.
(a) Magnesium
(b) Phosphorus
(c) Calcium
(d) Sodium
(a) Magnesium
A patient has the following test results:
Serum Calcium: Increased
Serum Phosphorus: Decreased
Parathyroid Hormone: Increased
(a) Hyperparathyroidism
(b) Nephrosis
(c) Hypoparathyroidism
(d) Steatorrhea
(a) Hyperparathyroidism
The most common reason for high magnesium in the bloodstream is:
(a) Enemas
(b) Renal failure
(c) Hypertensive state
(d) Drug induced
(b) Renal failure
The three hormones that regulate serum calcium are:
(a) PTH, renin, and calcitonin
(b) PTH, vitamin D, and calcitonin
(c) PTH, vitamin D, and estrogen
(d) Erythropoietin, calcitonin, and estrogen
(b) PTH, vitamin D, and calcitonin
The specimen for ionized calcium determination should be kept:
(a) Anaerobic
(b) Aerobic
(c) In the dark
(d) On ice
(a) Anaerobic
Which electrolyte reacts with molybdate to form a molybdenum blue chromogen?
(a) Magnesium
(b) Chloride
(c) Phosphate
(d) Calcium
(c) Phosphate
Hypocalcemia can be seen with:
(a) Hyperparathyroidism
(b) Tumor secreting PTH
(c) Tetany
(d) Cancer with bone metastasis
(c) Tetany
Which of the following electrolyte measurements would be of clinical usefulness to the clinician who is treating patients for pregnancy-induced hypertension?
(a) Ionized calcium
(b) Potassium
(c) Magnesium
(d) Phosphorus
(c) Magnesium
Serum albumin levels are a good indicator of:
(a) Short-term protein and energy deprivation
(b) Chronic deficiency of protein intake
(c) Considerable weight loss
(d) None of the above
(b) Chronic deficiency of protein intake
A deficiency of which vitamin will produce abnormal bone mineralization and eventually osteomalacia?
(a) Vitamin K
(b) Vitamin D
(c) Niacin
(d) Vitamin B12
(b) Vitamin D
This vitamin is involved with hydroxylation of the collagen molecule, and in a deficiency results in bleeding gums and loose teeth, and in a toxicity will result in diarrhea and kidney stones.
(a) Vitamin K
(b) Vitamin C
(c) Vitamin D
(d) Vitamin A
(b) Vitamin C
Which of the following vitamins is NOT a water-soluble vitamin?
(a) Pantothenate - B6
(b) Vitamin K
(c) Folic Acid
(d) Riboflavin - B2
(b) Vitamin K
What is the storage form of iron?
(a) Cytochromes
(b) Ferritin
(c) Hemoglobin
(d) Transferrin
(b) Ferritin
Which of the following incorporates copper in its structure and is associated with Wilson’s disease if it is deficient?
(a) Albumin
(b) Hemoglobin
(c) Creatine kinase
(d) Ceruloplasmin
(d) Ceruloplasmin
A deficiency of Vitamin K can result in which of the following?
(a) Beriberi
(b) Pellagra
(c) Night blindness
(d) Hemorrhage
(d) Hemorrhage
Which of the B vitamins is a critical component of the diet of a pregnant women to help avoid neural tube defects in the fetus?
(a) Alpha-fetoprotein
(b) Folate
(c) Thiamine
(d) Cyanocobalamin
(b) Folate
Which of the following forms of the Henderson-Hasselbalch equation is (are) correct?
(a) pH = 6.1 + log (HCO3/H2CO3) and pH = pKa + log (HCO3/H2CO3)
(b) pH = 6.1 + log (HCO3/H2CO3); pH = 6.1 + log (pCO2/HCO3); and pH = pKa + log (HCO3/H2CO3)
(c) pH = pKa - log (HCO3/H2CO3)
(a) pH = 6.1 + log (HCO3/H2CO3) and pH = pKa + log (HCO3/H2CO3)
The buffering capacity of blood is maintained by reversible exchange process between bicarbonate and:
(a) Calcium
(b) Potassium
(c) Chloride
(d) Sodium
(c) Chloride
Metabolic acidosis is described as a(n):
(a) Decrease in HCO3 & pCO2; decrease in pH.
(b) Increase in HCO3 & pCO2; decrease in pH.
(c) Decrease in HCO3; increase in pH.
(d) Increase in HCO3; increase in pH.
(a) Decrease in HCO3 & pCO2; decrease in pH.
The following laboratory results were obtained:
Serum Electrolytes
Sodium: 136 mEq/L
Potassium: 4.4 mEq/L
Chloride: 92 mEq/L
Bicarbonate: 40 mEq/L
Arterial Blood
pH: 7.32
pCO2: 79 mm Hg
(a) Respiratory acidosis
(b) Metabolic acidosis
(c) Metabolic alkalosis
(d) Respiratory alkalosis
(a) Respiratory acidosis
The reference range for pH in arterial blood is:
(a) 7.40 - 7.55
(b) 7.10 - 7.30
(c) 7.20 - 7.40
(d) 7.35 - 7.45
(d) 7.35 - 7.45
What is the major extracellular buffer?
(a) Ammonia
(b) Phosphate
(c) Carbonic acid/bicarbonate
(d) Protein
(e) Hemoglobin
(c) Carbonic acid/bicarbonate
A patient in metabolic alkalosis will initially compensate by:
(a) Increase renal excretion of H+
(b) Hypoventilation
(c) Hyperventilation
(d) Increase renal retention of bicarbonate
(b) Hypoventilation
A 22 year old female was brought into the emergency room in a comatose state from drug overdose. Blood gas data was as follows:
pH: 7.28
pCO2: 50 mm Hg (35 - 45 mm Hg)
HCO3: 20 mM/L (22 - 26 mM/L)
What is the patient’s acid base disturbance?
(a) Respiratory acidosis
(b) Metabolic acidosis
(c) Respiratory alkalosis
(d) Metabolic alkalosis
(a) Respiratory acidosis
What is the most probably acid/base imbalance in the patient described below?
26 year old male presents with the following signs and symptoms:
Extreme hysteria, hyperventilating, pulse 105 BPM
Lab data for ABGs:
pH = 7.60
pCO2 = 28 mm Hg
HCO3 = 26 mmol/L
pO2 = 100 mm Hg
(a) Respiratory acidosis
(b) Metabolic alkalosis
(c) Respiratory alkalosis
(d) Metabolic acidosis
(c) Respiratory alkalosis
The kidney compensation in acid base balance disorders include all EXCEPT:
(a) Excretion of acid through the bicarbonate buffer system.
(b) Excretion of acid through the phosphate buffer system.
(c) Adjusting bicarbonate reabsorption.
(d) Produce renin.
(d) Produce renin.
