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MLT Clinical Chemistry > Unit 3 Review > Flashcards

Unit 3 Review Flashcards

1
Q

An isomer of glucose with the -OH group of the anomeric carbon C1 that is below the plane of the ring or on the right-hand side is:

A

Alpha-glucose

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2
Q

Which of the following carbohydrates is a polysaccharide?

A

Starch

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3
Q

Gluconeogenesis is:

A

The formation of the glucose from noncarbohydrate sources, for example, amino acids, glycerol, and lactate

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4
Q

Glycolysis is:

A

The conversion of glucose into lactate or pyruvate and then CO2 and H2O

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5
Q

Glycogen is stored in the:

A

Liver

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6
Q

Which of the following is the primary hypoglycemic hormone?

A

Glucagon

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7
Q

Which of the following hormones does NOT stimulate glycogenolysis?

A

Insulin

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8
Q

A patients low glucose, increased insulin, and increased C-peptide is caused by:

A

Insulinoma

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9
Q

The only hormone that causes a decrease in blood glucose levels is:

A

Insulin

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10
Q

Which of the following is characteristic of type 2 diabetes mellitus?

A

Obesity and physical inactivity

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11
Q

Which form of diabetes usually manifests itself early in life, and is associated with ketosis, low insulin levels, and autoantibodies to islet cells?

A

Type 1

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12
Q

All of the following are associated with gestational diabetes except:

A

Is diagnosed using the same glucose tolerance criteria as in nonpregnant women

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13
Q

All of the following are confirmatory of diabetes mellitus except:

A

Urine-glucose greater than 300 mg/dL

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14
Q

Complications of diabetes mellitus include all of the following except:

A

Hepatitis

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15
Q

Instructions for patients preparing for a glucose tolerance tests include all of the following except:

A

Caffeine and smoking are permitted before and during the test

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16
Q

A patient with an insulinoma may exhibit dizziness and fainting attributable to:

A

Hypoglycemia

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17
Q

What type of hypoglycemia is exhibited 8 hours after a meal?

A

Fasting

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18
Q

All of the following statements about clinical hypoglycemia are true except:

A

High fasting insulin levels must be present to make a diagnosis

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19
Q

Select the enzyme that is most specific for Beta-Delta glucose:

A

Glucose oxidase

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20
Q

The enzyme that catalyzes the reaction ATP + D-glucose —> ADP + D-glucose-6-phosphate is:

A

Hexokinase

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21
Q

In the hexokinase method for glucose determinations, the actual end product measured is the:

A

NADPH + H + produced from the reduction of NADP

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22
Q

Glucose concentration in serum is:

A

Higher than the concentration in whole blood

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23
Q

In a specimen collected for plasma glucose analysis, sodium fluoride:

A

Inhibits glycolysis

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24
Q

Which of the following 2-hour glucose results would be classified as impaired glucose tolerance?

A

160 mg/dL

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25
Q

The glucose concentration in normal cerebrospinal fluid is:

A

60-75% of the plasma glucose concentration

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26
Q

If a patients serum glucose is 100 mg/dL, what would you expect the cerebrospinal fluid glucose to read?

A

68 mg/dL

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27
Q

A sneaky diabetic tired to lower her glucose by working out and watching her diet 1 or 2 days before her appointment. The rest of the time she spent the day in front of the television and eating chocolates. What test could the doctor order to detect this type of behavior?

A

A glycosylated hemoglobin

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28
Q

Which statement regarding glycosylated hemoglobin is true?

A
  • All of the Above
  • It has a sugar attached to the N-terminal valine of the Beta-chain of the hemoglobin molecule
  • it is dependent upon the time averaged blood glucose over the lifespan of the RBC
  • levels below 7% indicate adequate regulation for 8-12 weeks prior to sampling
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29
Q

Of the following blood glucose levels, which would you expect to result in glucose in the urine?

A

200 mg/dL

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30
Q

The following glucose tolerance test values are indicative of what state?
Fasting: 85 mg/dL
1/2 hour: 135 mg/dL
1 hour: 139 mg/dL
2 hour: 130 mg/dL

A

Normal

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31
Q

Bile acids are synthesized in the liver from which lipid?

A

Cholesterol

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32
Q

Cholesterol is a:

A

Cuclopentanoperhydrophenthrene nucleus

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33
Q

What percentage of serum cholesterol in present in the form of esters?

A

60-75%

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34
Q

Which of the following lipid are derivatives of fatty acids comprised of 20C atoms including a 5 C cyclopentane ring?

A

Prostaglandins

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35
Q

Which of the following lipid fractions are very large molecules with a low density and give plasma a milky appearance when present in increased amounts?

A

Chylomicrons

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36
Q

The lipoprotein fraction that has the highest ratio of liquid to protein is:

A

Chylomicrons

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37
Q

Acyl-cholesterol acyltransferase:

A

Converts free cholesterol to esterified cholesterol for storage

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38
Q

Which of the following is FALSE concerning blood cholesterol concentrations?

A

Increased cholesterol is associated with hyperthyroidism

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39
Q

Which of the following tests would be included in a routine lipid profile?

A

Cholesterol, LDL-cholesterol, HDL cholesterol, triglycerides

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40
Q

This first step in the enzymatic cholesterol reaction, which results in free cholesterol esterase, is:

A

Hydrolysis of cholesterol esters

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41
Q

The enzymatic determination of glycerol in triglycerides analysis usually involve conversion of glycerol to:

A

Glycerol phosphate

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42
Q

The serum of a freshly drawn blood sample is slightly turbid. This is probably because:

A

Triglycerides only are increased

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43
Q

In uncontrolled diabetes mellitus, cholesterol and triglycerides are:

A

Increased

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44
Q

The BORDERLINE range for cholesterol levels as determined by NCEP is:

A

200-240 mg/dL

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45
Q

Select the desirable cutoff for serum LDL cholesterol recommended by the National Cholesterol Education Porgram

46
Q

Which of the following test combinations indicates the highest risk for coronary heart disease?

A

Increased total cholesterol, decreased HDL cholesterol

47
Q

A 52-year old man went to his donor for a physical examination. The patient was overweight and had missed his last two appointments because of business dealings. His blood pressure was elevated, his cholesterol was 250 mg/dL, and his triglyceride was 170 mg/dL. A high-density lipoprotein (HDL) cholesterol test was performed and the result was 30 mg/dL (20-60 mg/dL). Which of the following would be this patients calculated low-density lipoprotein (LDL) cholesterol value?

48
Q

Which apolipoprotein has the ability to increase the risk of coronary heart disease?

49
Q

The Friedwald formula for estimating LDL cholesterol should NOT be used when:

A

Triglycerides a greater than 400 mg/dL

50
Q

HDL cholesterol + LDL cholesterol + Chylomicrons —> HDL. Which is NOT used as a precipitating reagent for determining cholesterol?

A

Sulfosalicylic acid

51
Q

Which of the following is a group of interrelated metabolic risk factors that appear to directly promote the development of atherosclerotic cardiovascular disease?

A

Metabolic syndrome

52
Q

Risk factors for coronary heart disease include all of the following except:

A

High HDL cholesterol

53
Q

The National Cholesterol Education Program ATP III goal for desirable HDL cholesterol is:

A

Greater than or equal to 60 mg/dL

54
Q

The following are criteria for Clinical Diagnosis of Metabolic Syndrome except:

A

Low fasting glucose

55
Q

Secondary causes of elevated LDL include all of the following except:

A

Hyperthyroidism

56
Q

Zero order kinetics results:

A

When all of the available sites on the enzyme are saturated with substrate

57
Q

The protein part of the enzyme molecule WITH the cofactor is called a(n):

A

Holoenzyme

58
Q

Ligases are a class of enzymes that catalyze:

A

The coupling of two molecules with the use of ATP

59
Q

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

A

Transferase

60
Q

Many enzymes in the blood plasma show maximum activity in which of the following pH ranges?:

61
Q

In competitive inhibition of an enzyme reaction:

A

The inhibitor binds to the enzyme at the same site as does the substrate

62
Q

The indicator reaction (what is actually measured) in Oliver-Rosalki is:

A

The reduction of NADP+

63
Q

Although a total lactate dehydrogenase (LD) determination performed alone yields little information as to the area of tissue destruction, an electrophoresis separation of LD isoenzyme may be useful. With what disorder is an increase in LD-5 and LD-4 associated?

A

Acute hepatic disease

64
Q

Aspartame aminotransferase is elevated is diseases involving the:

A

Heart Muscle

65
Q

Malate dehydrogenase (MD) is used in the aspartate transferase reaction mixture to convert:

A

Oxaloaccetate to L-malate

66
Q

In which liver disease is the DeRitis ratio (AST:ALT) usually less than or equal to 1?

A

Acute viral hepatitis

67
Q

The highest levels of alkaline phosphatase are seen in:

A

Obstructive liver disease q

68
Q

Which of the following would NOT show an increase in alkaline phosphatase?

A

Osteoporosis

69
Q

The most sensitive indicator of alcoholic liver disease is:

70
Q

Which of the following are the most common causes of acute pancreatitis?

A

*both A and C above
- galstones or obstructing tumor
- acute alcohol ingestion or drug use

71
Q

Serum lipase catalyzes:

A

Hydrolysis of triglycerides to fatty acids and glycerol

72
Q

A substrate used in lipase reaction is:

A

Olive oil emulsion

73
Q

The best test for pancreatitis in the presence of mumps is:

A

A serum lipase test

74
Q

Serum chemistry results on a 53-year-old female are:
AST: 120 U/L (4-34 U/L)
ALT: 185 U/L (5-40 U/L)
ALP: 785 U/L (<165 U/L)
GammaGT: 225 U/L (5-24 U/L)
Total bilirubin: 10.8 mg/dL
Direct bilirubin: 8.6 mg/dL
Urine bilirubin: positive
Urine urobilinogen: Normal
Fecal urobilinogen: decreased
These results are consistent with a diagnosis of:

A

Biliary obstruction

75
Q

Mrs. Smith has the following chemistry results:
CK: moderately increased
LD: moderately increased
LD-1: increased
The probable diagnosis is:

A

Myocardial infarction

76
Q

A patients CK-MB is reported as 18 ug/L and the total CK is 560 IU/L. What is the CK relative index (CKI)?

77
Q

The prostatic fraction of acid phosphatase is inhibited by:

78
Q

Which of the following sets of results would be consistent with macroamylosemia?

A

Increased serum amylase and normal urine amylase values

79
Q

Cholinesterase catalyzes the conversion of:

A

Acetylcholine to choline and acetic acid

80
Q

Levels of this enzyme are useful in the diagnosis of a genetic defect, which leads to increased apnea (difficulty breathing) after surgery using succinylcholine choline

A

Cholinesterase

81
Q

THC (9-tetrahydrocannabinol) is the principal active metabolite of which of the following?

82
Q

Urine adulteration test strips are designed to detect which of the following?

A

*All of the above
- bleach
- Nitrites
- Creatinine

83
Q

which of the following cytochromes plays a major role in the metabolism of drugs in the liver?

A

Cytochrome P450

84
Q

Levels of 89% carboxyhemoglobin saturation of whole blood are commonly found in which of the following?

A

Fatal Carbon monoxide poisoning

85
Q

Imipramine is classified as:

A

Tricyclic antidepressant

86
Q

Which of the following classes of compounds has a sedative effect and is used to treat anxiety?

A

Benzodiazepines

87
Q

ID of the urinary metabolite benzolecgonine would be useful in determine the presence of which of the following compounds?

88
Q

The toxic effect of acetaminophen overdose is:

A

Hepatocystic necrosis

89
Q

The reason that carbon monoxide is so toxic is because it:

A

Has 200-250 times the affinity of oxygen for hemoglobin binding sites

90
Q

Which of the following biological fluids is the specimen of choice for screening and/or analyzing drugs of abuse?

91
Q

Possible risks of hepatocellular damage due to toxic blood levels of acetaminophen are evaluated based on blood levels and which of the following?

A

Time (hours) post ingestion

92
Q

Overexposure to compounds such as Marathon, Parathion, Diazinon, Sevin, and Fuadan insecticides may prompt a physician to order which of the following tests?

A

Pseudocholinesterase

93
Q

Ethanol metabolizes to which of the following acids?

94
Q

Screening methods for drug abuse testing requires which of the following assay characteristics?

A

They must be analytically sensitive

95
Q

Valium and Librium are examples of which of the following classes of drugs?

A

Benzodiazepines

96
Q

Which of the following proteins is a cooper transport protein that migrates in the alpha2-globulin region?

A

Ceruloplasmin

97
Q

Chromium in blood binds to which of the following proteins?

A

Chromodulin

98
Q

A person with Menke’s syndrome will have which of the following laboratory results?

A

Decreased blood copper

99
Q

Travel metals in biological fluids can be measured using which of the following instrumentation techniques?

A

Atomic absorption spectrometry

100
Q

Aceruplaminemia is associated with which of the following?

A

Descreased blood ceruloplasmin, increased copper deposition in the liver, and increased iron deposition in tissues

101
Q

Which of the following sets of laboratory results is associated with Wilsons disease?

A

Decreased plasma copper and plasma ceruloplasmin

102
Q

Antimony is used to treat patients with which disorder?

A

Schistosomiasis

103
Q

Which of the following substances when ingested can lead to an excessive amount of aluminum in blood and tissue?

A

Antacids and astringents

104
Q

Which of the following statements best defines a metalloenzyme?

A

A trace metal that is associated with an enzyme to serve as an essential component or cofactor

105
Q

Which of the following metals is an example of a trace metal?

106
Q

Berylliosis in humans affects which of the following organs?

107
Q

Which of the following has a large amount of aluminum present?

108
Q

What is the primary route of exposure in humans to mercury?

A

Inhalation of vapors

109
Q

What is the primary route of exposure in humans to mercury?

A

Inhalation of vapors

110
Q

Which of the following trace metals is classified as essential?

111
Q

What is the best test to assess a patient who has been exposed to beryllium?

A

Beryllium lymphocyte proliferation test (BeLPT)

MLT Clinical Chemistry (7 decks)

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