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MLT Clinical Chemistry > Unit 6 Review > Flashcards

Unit 6 Review Flashcards

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1
Q

The alpha cells of the islets of Langerhans of the pancreas produce:

A

Glucagon

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2
Q

All of the following are tests of exocrine pancreatic formation EXCEPT:

A

Insulin

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3
Q

The gold standard for evaluating pancreatic exocrine function is:

A

Secretin/cholecystokinin

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4
Q

Slide #2 in the fecal fat procedure measuries:

A

Fatty acids, soaps, and neutral fats

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5
Q

Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent:

A

Neutral fats

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6
Q

Which test of exocrine pancreatic function is noninvasive and can differentiate pancreatic insufficiency in children with cystic fibrosis?

A

Fecal elastase

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7
Q

Insulin and C-peptide levels are important in diagnosing:

A

Insulinomas

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8
Q

The marker for colorectal and pancreatic carcinoma is:

A

CA 19-9

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9
Q

Which enzyme serves as the activator for the remaining pancreatic enzymes?

A

Trypsin

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10
Q

Ranson’s indicators of Severity in acute pancreatic include all of the following tests EXCEPT:

A

Alanine transaminase

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11
Q

Complications of acute pancreatitis include all of the following EXCEPT:

A

Hypotriglyceridemia

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12
Q

Which disorder is related to mucus accumulation, recurrent infection with unusual pathogens, and increased inflammation in the lungs?

A

Cystic fibrosis

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13
Q

A neoplasm that blocks the exocrine and endocrine functions of the pancreas is:

A

Somatostatinoma

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14
Q

Laboratory evidence of which protein is diagnostic of cystic fibrosis?

A

Cystic fibrosis transmembrane conductance regulator protein

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15
Q

The most common cause of chronic pancreatitis is:

A

Chronic alcohol abuse

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16
Q

Serial sampling for cardiac biomarkers is described as:

A

Drawing blood samples periodically, usually at prescribed time intervals over the course of the patients admission

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17
Q

Risk factors for the development of coronary heart disease include which of the following?

A

Hypertension, abdominal obesity, low HDL-C, high serum levels of CRP, and elevated levels of homocysteine

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18
Q

Atherosclerosis is described as:

A

Hardening of the arteries that occurs over a period of many years dues in part to the abdominal accumulation of lipids

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19
Q

Which of the following statements summarize the significance of CRP in the arterial wall?

A

It predicts the severity of atherosclerosis and is able to bind to damaged membranes and lipids

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20
Q

The atherogenic effect of homocysteine is:

A

The toxic effect of homocysteine on the endothelial lining of the arteries, which causes plaque formation

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21
Q

Which of the following is a cause of hyperhomocysteinemia?

A

Deficiency of one of the B complex vitamins

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22
Q

Which of the following tropinis have been demonstrated in patients with muscular dystrophy, and end-stage renal disease (ESRD)?

A

Cardiac troponin T

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23
Q

The role of cardiac biomarkers is includes which of the following?

A

Diagnosis, monitoring, risks stratification and therapeutic management

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24
Q

The albumin cobalt-binding test is used to measure which of the following?`

A

Ischemia modified albumin

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25
Q

Which of the following represents the correct sequence for the rise and fall of myoglobin `

A

Myoglobin, CK-MB, cTnI

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26
Q

NT-pro-BNP consists of 76 amino acids and is described as a:

A

The natriuretic peptide that is the inactive form

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27
Q

Which of the following statements is TRUE about cTnI?

A

Cardiac forms are never expressed in skeletal muscle

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28
Q

Myoglobin is a good cardiac marker because it:

A

Diffuses into the blood more quickly than CK-MB

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29
Q

In which of the following disorders is measurement of brain type natriuretic peptide (BNP) clinically useful?

A

Congestive heart failure

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30
Q

Which of the following cardiac biomarkers is a better biomarker of plaque instability?

A

MPO

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31
Q

The presence of heterophilic antibodies, rheumatoid factor, increased blood levels of Hb and circulating cTnI autoantibodies can result in which of the following?

A

False positive and/or false negative result for cTnI assays

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32
Q

What is the clinical usefulness of measuring serum adiponectin?

A

Plasma adiponectin levels may predict cardiovascular events years in advance in a population without diagnosed cardiovascular disease

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33
Q

Lp (a) is considered a risk factor for developing atherosclerosis due to which of the following?

A

It competes with plasminogen for binding sites,thus interfering with clot lysis and increasing the risk of acute myocardial infarction (AMI)

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34
Q

Which of the following is an advantage of POCT for cardiac biomarkers?

A

Rapid identification of AMI

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35
Q

Elevated blood levels of pregnancy-associated plasma protein A (PAPP-A) may suggest which of the following?

A

The presence of the an unstable ACS in patients without increased concentration of biomarkers of necrosis, such as cTn

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36
Q

Which of the following is an early biomarkers of acute myocardial infarction?

A

Heart-type fatty acid binding protein (H-FABP)

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37
Q

Infusion of Nesiritide is documented to act as a confounded for which of the following assays?

A

Brain natriuretic peptide (BNP)

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38
Q

IL-6, protease-activated receptor signaling (PARS) and soluble CD40 ligand function to:

A

Induce adhesion of monocytes

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39
Q

High blood levels of adiponectin are associated with:

A

Reduced risk of heart attacks

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40
Q

The troponin complex consists of which of the following ?

A

Troponin MI, troponin M2, and troponin K

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41
Q

Bile formed in the liver is stored in the:

A

Gall Bladder

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42
Q

A breakdown product of bilirubin metabolism that is produced in the colon from the oxidation of urobilinogen by microorganisms is:

A

Urobilin

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43
Q

The enzyme system that catalyzes the conjugation of bilirubin is known as:

A

Uridine diphosphate (UDP) glucoronyl transferase

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44
Q

The cells that make up 70% of the liver’s mass are:

A

Hepatocytes

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45
Q

Which of the statements regarding bilirubin metabolism is TRUE?

A

It is produced from the destruction of RBCs

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46
Q

Which is a characteristic of unconjugated bilirubin?

A

It is not water-soluble

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47
Q

The term delta-bilirubin refers to:

A

Bilirubin tightly bound to albumin

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48
Q

Kernicterus is the abnormal accumulation of bilirubin in:

A

Brain tissue

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49
Q

What is the most common cause of unconjugated hyperbilirubinemia?

A

Neonatal physiologic jaundice

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50
Q

Which of the following would be classified as prehepatic jaundice?

A

Congestive heart failure

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51
Q

In obstructive liver disease, the following test results are found:

A

Feces: urobilinogen decreased;
urine: bilirubin: positive
Serum; conjugated bilirubin increased

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52
Q

The first serological marker of Hepatitis B is:

A

HBsAg

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53
Q

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:

A

Alcoholic fatty liver

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54
Q

The reagent (accelerator) in the Jendrassik-Grof bilirubin procedure that makes indirect bilirubin water-soluble is:

A

Caffeine

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55
Q

If a total bilirubin is 4.0 mg/dL and the conjugated bilirubin is 2.5 mg/dL, the unconjugated bilirubin is:

A

1.5 mg/dL

56
Q

In the Jendrassik-Grof bilirubin, what converts purple azobilirubin to blue azobiliriubin measured at 600 nm?

A

Alkaline tartrate

57
Q

Viral hepatitis that results in the largest percentage of chronic hepatitis is:

A

Hepatitis C

58
Q

The two most significant sources of error in accurate ammonia determination are sample handling and:

A

Ammonia contamination in the laboratory

59
Q

The following disease is a recessive disorder of copper metabolism, which results in the accumulation of copper in the liver

A

Wilson’s Disease

60
Q

An autosomal recessive disorder of iron metabolism, which is characterized by excessive iron absorption and accumulation in various tissues in the body, is termed

A

Hereditary hemochromatosis

61
Q

A Model for End-stage liver disease staging system to predict prognosis in cirrhosis uses the following laboratory determinations EXCEPT:

A

Apartate transminase

62
Q

Nonalcoholic steatohepatitis is characterized by all of the following EXCEPT:

A

AST greater than ALT

63
Q

In which of the following disorders would the maternal serum level of alpha1-Fe to protein be elevated?

A

Neural tube defect

64
Q

Which of the following statement is correct about PSA?

A

It is a single-chain glycoprotein consisting of 237 amino acids

65
Q

Which of the following biomarkers is elevated in nonmucinous epithelial ovarian cancer?

A

CA 125

66
Q

Which of the following is a sialyated Lewis group antigen associated with colorectal cancer?

A

CA 19-9

67
Q

Which of the following biomarkers are elevated in advanced stages of breast cancer?

A

CA 15-3 and CA 549

68
Q

Which tumor marker is associated with cancer of the urinary bladder?

A

Nuclear matrix protein

69
Q

What is the clinical usefulness of measuring carcionembryonic antigen?

A

Monitoring for recurrence of colon cancer

70
Q

Which of the following is used to assess the usefulness of trastuzumab (Herceptin) therapy for breast cancer?

A

HER-2/neu

71
Q

Which type of hCG test would be most useful to assess a person suspected of having testicular cancer?

A

Plasma immunoassay for intact hCG and the Beta-hCG subunits

72
Q

A markedly elevated serum AFP is associated with which of the following?

A

Hepatoma

73
Q

Which of the following assays is recommended as a screening test for colorectal cancer in person over 50 years of age?

A

Occult blood test

74
Q

Which of the following must be determined to calculate diagnostic specificity?

A

True-negative and false-positives

75
Q

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?

A

91.3%

76
Q

Which statement below best describes the molecular difference between free PSA (PSA) and complex PSA (cPSA)?

A

Free PSA is not bound by compounds such as ACT, PCI, API, or AMG

77
Q

The production of alpha fetal protein (AFP) in a healthy individual is best reflected by which of the following statements?

A

The production of AFP declines rapidly birth and healthy adults and children have negligible or undetectable levels in serum

78
Q

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?

A

Nonsquamous cell lung carcinoma

79
Q

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?

A

23.6

80
Q

Nuclear matrix protein-22 is a tumor marker designed for what purpose?

A

Test for reoccurrence of bladder cancer

81
Q

Which of the molecular form(s) is/are measured by an intact beta-hCG assay?

A

The whole molecule

82
Q

Diagnostic specificity is defined as which of the following?

A

The probability that a laboratory test will be negative in the absence of disease

83
Q

The total bilirubin component os serum consists of direct bilirubin and indirect bilirubin. Distinguishing features of the direct bilirubin component include:

A

All are correct

84
Q

Infective heart disease includes which of the following?

A

Endocarditis
Rheumatic fever

85
Q

Which of the following are alternate names for unconjugated bilrubin?

A

Indirect
Insoluble

86
Q

Tests for the pancreas exocrine function include

A

Fecal fat
CCK

87
Q

Gastric analysis in the lab has been largely replaced by

A

Fiber optic endoscopy procures

88
Q

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:

A

Jaundice

89
Q

Lamellar body count reflects

A

Surfactant phospholipid packets

90
Q

Blood in CSF is commonly observed after

A

Traumatic tap

91
Q

Unconjugated bilirubin is formed in the RES and transported to the liver for excretion through the bile and is transported by

A

Albumin

92
Q

Direct reacting bilirubin is

A

Bilirubin diglucuronide

93
Q

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:

A

Liver

94
Q

Which of the following is the single most common symptoms of congestive heart failure?

A

Fatigue

95
Q

SHORT ANSWER: list 3 digestive pancreatic enzyme excretion and the functions of each

A

Amylase - carbohydrate digesting enzyme
Lipase - lipid digesting enzyme
Trypsin - proteolytic enzyme which continues digestion of proteins in the intestines

96
Q

D-xylose absorption test is used to differentiate which of the following

A

Malabsorption from exocrine pancreatic insufficiency

97
Q

Which of the following is extremely specific for cardia disease?

A

TnI

98
Q

Ona worldwide basis, the most primary malignant tumors of the liver are related to:

A

Alcoholism

99
Q

Which of the following is the correct time frame for TnT’s rise, peak and return to normal after a cardiac event?

A

3-12 hours
12-24 hours
7-2a days

100
Q

Which of the following are alternate names for conjugated bilirubin?

A

Direct
Soluble

101
Q

True or False: Rheumatic heart disease is easy to diagnose

A

True

102
Q

The bilirubin level where brain damage can take place in a newborn is:

A

17 mg/dL

103
Q

Ehrlich reagent is used in the measurement of

A

Bilirubin

104
Q

Which of the following is the correct time frame for TnT’s rise, peak and return to normal after a cardiac event?

A

4-6 hours
10-24 hours
10 day

105
Q

The marker of congestive heart failure is which of the following

A

BNP

106
Q

True or False: Pancreatic activity is under both nervous and endocrine control

A

True

107
Q

In the Crigler-Najjar Type II syndrome, the deficiency is with which enzyme?

A

UDPGT

108
Q

Digestive pancreatic fluid is composed of which of the following?

A

Enzymes that digest the 3 major classes of food with an alkaline pH

109
Q

An increase in total bilirubin with a normal concentration of direct bilirubin suggests:

A

Hemolytic disease

110
Q

True or False: there is a single diagnostic laboratory test that will quickly and accurately assess cardiac function

A

FALSE

111
Q

A complete obstruction of the common Billie duct would be characterized by which of the following laboratory results

A
  • A, B and C
112
Q

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

A
  • Posthepatic jaundice
  • most probably is bile duct obstruction
113
Q

The difference between a transudate and an exudates is which of the following?

A

Exudates are formed when there is an infection or a malignancy in the organ

114
Q

The sweat chloride test is done to diagnose which of the following conditions?

A

Cystic fibrosis

115
Q

Which type of hepatitis is considered to be a Supra- or co-infection?

A

D

116
Q

Which type of hepatitis is considered to be a sexually transmitted disease?

A

B

117
Q

The characteristics of hemolytic jaundice include:

A
  • unconjugated serum bilirubin level greater than normal
  • urinary urobilinogen level greater than normal
118
Q

Which oft the following is the correct time frame for CK-MBs rise, peak and return to normal after a cardiac event?

A

4 hours
18 hours
2 days

119
Q

The most common cause of chronic pancreatitis is

A

Alcoholism

120
Q

When collecting a body fluid sample which departments gets which fluid tube #1

A

Chemistry #1
Hematology #2
Microbiology #3

121
Q

Gastric analysis is used to detect

A

Hyper secretion characteristics of Zollinger-Ellison syndrome

122
Q

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?

A

1- cystic fibrosis
2- sweat chloride test
3- Patients will have elevated levels of sodium in sweat

123
Q

Lights criteria is used to classify

A

Exudates/transudates

124
Q

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?

A

Probable diagnosis = myocardial infarction
Myoglobin = retuned to normal
CK-MB = increased to same
TnT = decreased to returned to normal

125
Q

Myocardial infarction can produce a CK isoenzyme profile that is similar to?

A

Strenuous exercise

126
Q

The most common cause of atherosclerosis which causes coronary heart disease is

A

*all of the above
- smoking
- age
- hypertension

127
Q

Congestive heart failure can be characterized by

A

Fluid accumulation in the lungs and throughout the body

128
Q

Which for the following statement concerning cystic fibrosis is NOT correct?

A

Genetic screening usually unsuccessful

129
Q

Congestive heart failure results from

A

Malignant hypertension

130
Q

What are some examples of prehaptic jaundice?

A

Hemolytic anemia
CHF
Transfusion reactions
Certian drugs

131
Q

What are some example of hepatic jaundice?

A

Gilberts syndrome
Rotor syndrome
Cirrhosis
Viral hepatitis
Hepatocellular carcinomas

132
Q

What are some examples of posthepatic jaundice?

A

Common bile duct stones
Cancer of bile duct
Bile duct stricture

133
Q

What are some ideal cardiac marker characteristics?

A

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

134
Q

Describe the qualitative fecal fat procedure

A

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

135
Q

What is the hormone that is clinically useful for monitoring the treatment and progression of trophoblastic disease

A

Beta-hCG

136
Q

Describe hemolytic liver disease

A

An increase in total bilirubin with a normal concentration of direct bilirubin

MLT Clinical Chemistry (7 decks)

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