Unit 6 Review Flashcards
The alpha cells of the islets of Langerhans of the pancreas produce:
Glucagon
All of the following are tests of exocrine pancreatic formation EXCEPT:
Insulin
The gold standard for evaluating pancreatic exocrine function is:
Secretin/cholecystokinin
Slide #2 in the fecal fat procedure measuries:
Fatty acids, soaps, and neutral fats
Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent:
Neutral fats
Which test of exocrine pancreatic function is noninvasive and can differentiate pancreatic insufficiency in children with cystic fibrosis?
Fecal elastase
Insulin and C-peptide levels are important in diagnosing:
Insulinomas
The marker for colorectal and pancreatic carcinoma is:
CA 19-9
Which enzyme serves as the activator for the remaining pancreatic enzymes?
Trypsin
Ranson’s indicators of Severity in acute pancreatic include all of the following tests EXCEPT:
Alanine transaminase
Complications of acute pancreatitis include all of the following EXCEPT:
Hypotriglyceridemia
Which disorder is related to mucus accumulation, recurrent infection with unusual pathogens, and increased inflammation in the lungs?
Cystic fibrosis
A neoplasm that blocks the exocrine and endocrine functions of the pancreas is:
Somatostatinoma
Laboratory evidence of which protein is diagnostic of cystic fibrosis?
Cystic fibrosis transmembrane conductance regulator protein
The most common cause of chronic pancreatitis is:
Chronic alcohol abuse
Serial sampling for cardiac biomarkers is described as:
Drawing blood samples periodically, usually at prescribed time intervals over the course of the patients admission
Risk factors for the development of coronary heart disease include which of the following?
Hypertension, abdominal obesity, low HDL-C, high serum levels of CRP, and elevated levels of homocysteine
Atherosclerosis is described as:
Hardening of the arteries that occurs over a period of many years dues in part to the abdominal accumulation of lipids
Which of the following statements summarize the significance of CRP in the arterial wall?
It predicts the severity of atherosclerosis and is able to bind to damaged membranes and lipids
The atherogenic effect of homocysteine is:
The toxic effect of homocysteine on the endothelial lining of the arteries, which causes plaque formation
Which of the following is a cause of hyperhomocysteinemia?
Deficiency of one of the B complex vitamins
Which of the following tropinis have been demonstrated in patients with muscular dystrophy, and end-stage renal disease (ESRD)?
Cardiac troponin T
The role of cardiac biomarkers is includes which of the following?
Diagnosis, monitoring, risks stratification and therapeutic management
The albumin cobalt-binding test is used to measure which of the following?`
Ischemia modified albumin
Which of the following represents the correct sequence for the rise and fall of myoglobin `
Myoglobin, CK-MB, cTnI
NT-pro-BNP consists of 76 amino acids and is described as a:
The natriuretic peptide that is the inactive form
Which of the following statements is TRUE about cTnI?
Cardiac forms are never expressed in skeletal muscle
Myoglobin is a good cardiac marker because it:
Diffuses into the blood more quickly than CK-MB
In which of the following disorders is measurement of brain type natriuretic peptide (BNP) clinically useful?
Congestive heart failure
Which of the following cardiac biomarkers is a better biomarker of plaque instability?
MPO
The presence of heterophilic antibodies, rheumatoid factor, increased blood levels of Hb and circulating cTnI autoantibodies can result in which of the following?
False positive and/or false negative result for cTnI assays
What is the clinical usefulness of measuring serum adiponectin?
Plasma adiponectin levels may predict cardiovascular events years in advance in a population without diagnosed cardiovascular disease
Lp (a) is considered a risk factor for developing atherosclerosis due to which of the following?
It competes with plasminogen for binding sites,thus interfering with clot lysis and increasing the risk of acute myocardial infarction (AMI)
Which of the following is an advantage of POCT for cardiac biomarkers?
Rapid identification of AMI
Elevated blood levels of pregnancy-associated plasma protein A (PAPP-A) may suggest which of the following?
The presence of the an unstable ACS in patients without increased concentration of biomarkers of necrosis, such as cTn
Which of the following is an early biomarkers of acute myocardial infarction?
Heart-type fatty acid binding protein (H-FABP)
Infusion of Nesiritide is documented to act as a confounded for which of the following assays?
Brain natriuretic peptide (BNP)
IL-6, protease-activated receptor signaling (PARS) and soluble CD40 ligand function to:
Induce adhesion of monocytes
High blood levels of adiponectin are associated with:
Reduced risk of heart attacks
The troponin complex consists of which of the following ?
Troponin MI, troponin M2, and troponin K
Bile formed in the liver is stored in the:
Gall Bladder
A breakdown product of bilirubin metabolism that is produced in the colon from the oxidation of urobilinogen by microorganisms is:
Urobilin
The enzyme system that catalyzes the conjugation of bilirubin is known as:
Uridine diphosphate (UDP) glucoronyl transferase
The cells that make up 70% of the liver’s mass are:
Hepatocytes
Which of the statements regarding bilirubin metabolism is TRUE?
It is produced from the destruction of RBCs
Which is a characteristic of unconjugated bilirubin?
It is not water-soluble
The term delta-bilirubin refers to:
Bilirubin tightly bound to albumin
Kernicterus is the abnormal accumulation of bilirubin in:
Brain tissue
What is the most common cause of unconjugated hyperbilirubinemia?
Neonatal physiologic jaundice
Which of the following would be classified as prehepatic jaundice?
Congestive heart failure
In obstructive liver disease, the following test results are found:
Feces: urobilinogen decreased;
urine: bilirubin: positive
Serum; conjugated bilirubin increased
The first serological marker of Hepatitis B is:
HBsAg
Alcoholic liver disease that follows six months to a year of moderate consumption, few lab abnormalities, and i s reversible with abstinence from alcohol is termed:
Alcoholic fatty liver
The reagent (accelerator) in the Jendrassik-Grof bilirubin procedure that makes indirect bilirubin water-soluble is:
Caffeine
If a total bilirubin is 4.0 mg/dL and the conjugated bilirubin is 2.5 mg/dL, the unconjugated bilirubin is:
1.5 mg/dL
In the Jendrassik-Grof bilirubin, what converts purple azobilirubin to blue azobiliriubin measured at 600 nm?
Alkaline tartrate
Viral hepatitis that results in the largest percentage of chronic hepatitis is:
Hepatitis C
The two most significant sources of error in accurate ammonia determination are sample handling and:
Ammonia contamination in the laboratory
The following disease is a recessive disorder of copper metabolism, which results in the accumulation of copper in the liver
Wilson’s Disease
An autosomal recessive disorder of iron metabolism, which is characterized by excessive iron absorption and accumulation in various tissues in the body, is termed
Hereditary hemochromatosis
A Model for End-stage liver disease staging system to predict prognosis in cirrhosis uses the following laboratory determinations EXCEPT:
Apartate transminase
Nonalcoholic steatohepatitis is characterized by all of the following EXCEPT:
AST greater than ALT
In which of the following disorders would the maternal serum level of alpha1-Fe to protein be elevated?
Neural tube defect
Which of the following statement is correct about PSA?
It is a single-chain glycoprotein consisting of 237 amino acids
Which of the following biomarkers is elevated in nonmucinous epithelial ovarian cancer?
CA 125
Which of the following is a sialyated Lewis group antigen associated with colorectal cancer?
CA 19-9
Which of the following biomarkers are elevated in advanced stages of breast cancer?
CA 15-3 and CA 549
Which tumor marker is associated with cancer of the urinary bladder?
Nuclear matrix protein
What is the clinical usefulness of measuring carcionembryonic antigen?
Monitoring for recurrence of colon cancer
Which of the following is used to assess the usefulness of trastuzumab (Herceptin) therapy for breast cancer?
HER-2/neu
Which type of hCG test would be most useful to assess a person suspected of having testicular cancer?
Plasma immunoassay for intact hCG and the Beta-hCG subunits
A markedly elevated serum AFP is associated with which of the following?
Hepatoma
Which of the following assays is recommended as a screening test for colorectal cancer in person over 50 years of age?
Occult blood test
Which of the following must be determined to calculate diagnostic specificity?
True-negative and false-positives
A new tumor marker assay for prostate specific antigen (PSA) is evaluated for diagnostic sensitivity by testing serum samples from patients who have been diagnosed as having prostate cancer. The following results were obtained:
Number of prostate cancer patients who tested positive by the new assay = 42 out 46
Number of patients who did not have cancer and tested negative by the new assay = 31 out of 32
What is the sensitivity of the new assay for PSA?
91.3%
Which statement below best describes the molecular difference between free PSA (PSA) and complex PSA (cPSA)?
Free PSA is not bound by compounds such as ACT, PCI, API, or AMG
The production of alpha fetal protein (AFP) in a healthy individual is best reflected by which of the following statements?
The production of AFP declines rapidly birth and healthy adults and children have negligible or undetectable levels in serum
The combination of squamous cell carcinoma antigen (SCCA) and CYFRA-21-I test results can be used to provide reliable laboratory data for the differential diagnosis of which disease?
Nonsquamous cell lung carcinoma
A new test for breast cancer is found to have a sensitivity of 85% and a specificity of 90%. If the prevalence of breast cancer is 3.5% in women over 45 years old, what is the predictive value of a positive test result (PV+) in this group?
23.6
Nuclear matrix protein-22 is a tumor marker designed for what purpose?
Test for reoccurrence of bladder cancer
Which of the molecular form(s) is/are measured by an intact beta-hCG assay?
The whole molecule
Diagnostic specificity is defined as which of the following?
The probability that a laboratory test will be negative in the absence of disease
The total bilirubin component os serum consists of direct bilirubin and indirect bilirubin. Distinguishing features of the direct bilirubin component include:
All are correct
Infective heart disease includes which of the following?
Endocarditis
Rheumatic fever
Which of the following are alternate names for unconjugated bilrubin?
Indirect
Insoluble
Tests for the pancreas exocrine function include
Fecal fat
CCK
Gastric analysis in the lab has been largely replaced by
Fiber optic endoscopy procures
As a result of excessive accumulation of bilirubin in the blood, certain body areas, such as the skin and sclera, take on a yellow-pigmented appearance. The condition that is characterized by this yellow pigmented appearance. The condition that is characterized by this yellow pigment is known as:
Jaundice
Lamellar body count reflects
Surfactant phospholipid packets
Blood in CSF is commonly observed after
Traumatic tap
Unconjugated bilirubin is formed in the RES and transported to the liver for excretion through the bile and is transported by
Albumin
Direct reacting bilirubin is
Bilirubin diglucuronide
The life span of the average RBC is 120 days, As a the red cells disintergrate, Hb is released and converted to the pigment bilirubin by the:
Liver
Which of the following is the single most common symptoms of congestive heart failure?
Fatigue
SHORT ANSWER: list 3 digestive pancreatic enzyme excretion and the functions of each
Amylase - carbohydrate digesting enzyme
Lipase - lipid digesting enzyme
Trypsin - proteolytic enzyme which continues digestion of proteins in the intestines
D-xylose absorption test is used to differentiate which of the following
Malabsorption from exocrine pancreatic insufficiency
Which of the following is extremely specific for cardia disease?
TnI
Ona worldwide basis, the most primary malignant tumors of the liver are related to:
Alcoholism
Which of the following is the correct time frame for TnT’s rise, peak and return to normal after a cardiac event?
3-12 hours
12-24 hours
7-2a days
Which of the following are alternate names for conjugated bilirubin?
Direct
Soluble
True or False: Rheumatic heart disease is easy to diagnose
True
The bilirubin level where brain damage can take place in a newborn is:
17 mg/dL
Ehrlich reagent is used in the measurement of
Bilirubin
Which of the following is the correct time frame for TnT’s rise, peak and return to normal after a cardiac event?
4-6 hours
10-24 hours
10 day
The marker of congestive heart failure is which of the following
BNP
True or False: Pancreatic activity is under both nervous and endocrine control
True
In the Crigler-Najjar Type II syndrome, the deficiency is with which enzyme?
UDPGT
Digestive pancreatic fluid is composed of which of the following?
Enzymes that digest the 3 major classes of food with an alkaline pH
An increase in total bilirubin with a normal concentration of direct bilirubin suggests:
Hemolytic disease
True or False: there is a single diagnostic laboratory test that will quickly and accurately assess cardiac function
FALSE
A complete obstruction of the common Billie duct would be characterized by which of the following laboratory results
- A, B and C
SHORT ANSWER: The following laboratory test results were obtains in a patient with severe jaundice, right upper quadrant abdominal pain, fever, and chills:
Serum alkaline phosphatase: 4 times normal
Serum cholesterol: increased
AST: normal/slightly increased
5’-nucleotidase increased
Total bilirubin 25 mg/dL
Conjugated bilirubin 19 mg/dL
Prothrombin time prolonged, but improves with a vitamin K injection
Based on the information, what classification would this jaundice by and what is the probably diagnosis?
-H
- Posthepatic jaundice
- most probably is bile duct obstruction
The difference between a transudate and an exudates is which of the following?
Exudates are formed when there is an infection or a malignancy in the organ
The sweat chloride test is done to diagnose which of the following conditions?
Cystic fibrosis
Which type of hepatitis is considered to be a Supra- or co-infection?
D
Which type of hepatitis is considered to be a sexually transmitted disease?
B
The characteristics of hemolytic jaundice include:
- unconjugated serum bilirubin level greater than normal
- urinary urobilinogen level greater than normal
Which oft the following is the correct time frame for CK-MBs rise, peak and return to normal after a cardiac event?
4 hours
18 hours
2 days
The most common cause of chronic pancreatitis is
Alcoholism
When collecting a body fluid sample which departments gets which fluid tube #1
Chemistry #1
Hematology #2
Microbiology #3
Gastric analysis is used to detect
Hyper secretion characteristics of Zollinger-Ellison syndrome
SHORT ANSWER: an 8 year old Boy presented to the pediatrician with the complaint of frequent fevers and failure to grow. The child has 3 bouts of pneumonia during the past 2 years and was bothered by chronic bronchitis, which caused him to cough up copious amounts of thick, yellow, mucoid sputum. Despite a good appetite, especially salty foods, he only put on 2 lbs in the past 2 years and was of short, frail stature
Based on the patient history, (1) what is most likely disease? (2) what laboratory test would be most informative, and (3) what would the results most likely be for this test?
1- cystic fibrosis
2- sweat chloride test
3- Patients will have elevated levels of sodium in sweat
Lights criteria is used to classify
Exudates/transudates
SHORT ANSWER: A 58 year old presented to the ED with sudden onset of chest pain, left arm pain, dyspnea, and weakness while away from home on a business trip. Her prior medical history is not available, but she admits to being a 2-pack per day smoker for longer than 20 years
Cardiac markers were performed at admission and then 8 hours post admission with the following results
CK-MB = 1) 5.3 —2) 9.2
Myoglobin = 1) 76 — 2) 124
Troponin T = 1) <0.1 — 2) 1.3
Based on the results for myoglobin CK-MB and TnT would be expected if assayed at 4 PM on September 27?
Probable diagnosis = myocardial infarction
Myoglobin = retuned to normal
CK-MB = increased to same
TnT = decreased to returned to normal
Myocardial infarction can produce a CK isoenzyme profile that is similar to?
Strenuous exercise
The most common cause of atherosclerosis which causes coronary heart disease is
*all of the above
- smoking
- age
- hypertension
Congestive heart failure can be characterized by
Fluid accumulation in the lungs and throughout the body
Which for the following statement concerning cystic fibrosis is NOT correct?
Genetic screening usually unsuccessful
Congestive heart failure results from
Malignant hypertension
What are some examples of prehaptic jaundice?
Hemolytic anemia
CHF
Transfusion reactions
Certian drugs
What are some example of hepatic jaundice?
Gilberts syndrome
Rotor syndrome
Cirrhosis
Viral hepatitis
Hepatocellular carcinomas
What are some examples of posthepatic jaundice?
Common bile duct stones
Cancer of bile duct
Bile duct stricture
What are some ideal cardiac marker characteristics?
Heart specific
Highly sensitive
Differentiate between reversible and non reversible
Monitor therapy
Estimate size of infarct and prognosis
Stable and rapid to perform
Not found in patients without MI
Describe the qualitative fecal fat procedure
Slide 1: suspension of stool is examined microscopically for the presence of fat droplets stained orange or red spending on the dye (Sudan III, Sudan IV, or Oil Red O) only neutral fats are stained
Slide 2: specimen is mixed with acetic acid and heated to release the fatty acids by hydrolysis of the soaps and neutral fats
What is the hormone that is clinically useful for monitoring the treatment and progression of trophoblastic disease
Beta-hCG
Describe hemolytic liver disease
An increase in total bilirubin with a normal concentration of direct bilirubin
