Intro clincal chem exam 3

The normal role of PSA is what?

 

aBind and activate anti-chymotrypsin in the blood

 Promote growth of epithelial cells in the prostate

 Liquefy semen to promote the swimming movements of sperm

Cleave alpha-2-macroglobulin in the blood

C

Which of the following is extremely important for a cancer test?

 

All of these

 Sensitivity

Positive predictive value

Negative predictive value

A

The fecal occult blood test (FOBT) involves which of the following?

 

All of these

Antibody binding of hemoglobin

Oxidation of a plant compound called guaiac 

ELISA for detection of CEA in stools

C

Elevated CA-125 levels are most often an indication of which cancer?

 

Pancreatic cancer

Colon cancer

Ovarian cancer

Prostate cancer

C

Which of the following best describes the biochemical activity of PSA?

 

Glucagon receptor

 Intracellular adhesion molecule

Hormone receptor

Serine protease

D

Which of the following is extremely important for a cancer test?

 

Negative predictive value

 Sensitivity

Positive predictive value

All of these

D

Which of the following is NOT true for CEA?

 

It is produced on all surfaces of intestinal cells

Its levels tend to be elevated in smokers

It is an intracellular adhesion molecule

It is highly glycosylated

A

Which of the following markers typically requires testing of biopsied material rather than serum?

 

CEA

CA19.9

CA 125

HER-2

D

Which of the following is NOT an assay that would typically be used as a test for HER-2 in breast biopsies?

 

Sandwich ELISA

Immunohistochemical assay

Ligand binding assay

Fluorescence in situ hybridization (FISH)

A

T/F concentration of tumor markers usually correlates with tumor volume

True

In clinical application of tumor markers, which is least reliable?

diagnose

guide treatment

monitor treatment

determine recurrence

D

Sensitivity is

ability to identify patients who truly have disease

ability to identify patients without the disease

=true neg/ (tn + fp)

=true pos/ (tp + tn)

A

PSA has 4 oligosaccharide side links (7% carbohydrate by weight), Hense PSA is a ____

Lipoprotein

glycoprotein

miRNA

cell adhesion molecule

B

PSA has a biochemical activity with

tyrosine kinase

toll like receptor

glycogen synthase kinase

serine protease

D

in carcinogen of the prostate, PSA acts on various molecules. Which molecule contributes to cause transformation of prostate epithelial cells

IGF1

IGFBP3

TGF-beta

Interferon-gamma

C

In serum, PSA can exist in different forms. Which is not a PSA form in the blood?

free

complexed to anti-chymotrypsin (ACT)

complexed to alpha-2-macroglobulin (A2M)

complexed to MUC16

D

T/F in cancer patients, more free form of PSA is present in serum vs attached form (bound)

False

PSA value can fluctuate because of

prostatitis

biopsy evaluation of urethra

digital rectal examination

benign prostatic hyperplasia (BPH)

All of above

E

____ is produced by prostate epithelai cells, and has 80% sequence homology with PSA. Hence, is considered as other prostate cancer marker

Prostate-specific membrane antigen (PSMA)

human kallikrein 2 (hK2)

PCA3

IL-10

B

TSH is secreted by the _________________?

 

Hypothalamus gland

Pituitary gland

 Thyroid

 Adrenal gland

B

What is the most common type of laboratory assay that is widely used to assess thyroid hormone concentrations, such as FT4?

 

Ultrafiltration

 immunoassay

 Estimation based on a formula

 Potentiometry

B

TRH is secreted by the _________________?

 

Pituitary gland

 Adrenal gland

 Thyroid

 Hypothalamus gland

D

Excessive amounts of thyroid hormones cause _______________.

 

Decreases metabolism

 Hypothyroidism

 Hyperthyroidism

 Grave’s Disease

C

Hyperthyroidism is diagnosed by which of the following?

 

Decreased T4 and increased T3

 Increased T4 and increased T3

 Increased T4 and decreased T3

 Decreased T4 and decreased T3

B

A deficiency of thyroid hormone production causing reduced metabolism is ____________.

 

Euthroidism

 Hyperthyroidism

 Thyrotoxicosis

 Hypothyroidism

D

Excessive amounts of thyroid hormones cause _______________.

 

Decreases metabolism

 Grave’s Disease

 Hypothyroidism

 Hyperthyroidism

D

Hypothyroidism is diagnosed by which of the following?

 

Increased T4 and increased T3

 Increased T4 and decreased T3

Decreased T4 and decreased T3

Decreased T4 and increased T3

C

A disorder of the thyroid caused by autoimmune reaction to TSH receptor is _________?

 

Hashimoto’s thyroiditis

Sick euthyroid syndrome

Euthyroid disease

Grave’s disease

D

CEA is a colon cancer marker. What is not correct about CEA?

it is a glycoprotein

it is an intercellular adhesion protein

it is elevated in other cancers (breast, gastric)

it is not elevated in nonmalignant conditions (ulcerative colitis)

D

in colon cancer, epithelial cells are unpolarized, and CEA is released. Released CEA can be detected in

blood

lymph vessels

a and b

none

C

if a patient responds to chemotherapy, CEA will ______ in general

increase 10%

decrease 10%

increase 20%

decrease 20%

D

In fecal occult blood test (FOBT), colorless Guiac will turn _____ when hemoglobin is present

blue

orange

red

green

A

What is not correct about CA-125 (also known as MUC 16)

is an ovarian cancer marker

found on cells lining pelvic organs

is a glycoprotein

is a useful for early stage screening

D

CA-125 can be elevated by

endometriosis

ovarian cysts

a and b

none

C

which can be used to detect pancreatic cancer

CA 19-9

CA 15-3

CA 27.29

Calcitonin

A

Calcitonin is a marker for

melanoma

thyroid cancer

pancreatic cancer

bladder cancer

B

S100 is a marker for

melanoma

thyroid cancer (calcitonin)

pancreatic cancer

bladder cancer

A

commonly used breast markers are

estrogen receptor (ER)

progesterone receptor (PR)

human epidermal growth factor receptor (HER-2)

all

D

Tamoxifen is effective when ____ is present in breast cancer cell

estrogen receptor (ER)

progesterone receptor (PR)

human epidermal growth factor receptor (HER-2)

toll like receptor

A

trastzumab is effective in ____ postive breast tumor cells

estrogen receptor (ER)

progesterone receptor (PR)

human epidermal growth factor receptor (HER-2)

toll like receptor

C

Antibody-dependent cell cytotoxicity (ADCC) recruits this immune cell to kill tumor cells

B cells

T cells

NK cells

Microglia

C

in FISH assay, we detect a specific _____ of chromosomes with a fluorescence microscope

DNA sequence

RNA sequence

amino acid sequence

protein structure

A

low t4 and t3 _____ TSH

increases

decreases

no affect

A

corticosteroid or dopamine ____ anterior pituitary

stimulates

inhibits

does not affect

B

what is the function of thyroid hormones

regulation of metabolism

growth and development

increase catecholamine effect

all of above

D

T3 and T4 are highly protein bound. Which protein do T3 and T4 bind to?

BCG

TBG

HCG

PSA

B

which is most accurate reflection of thyrometabolic status

free T4 index

free T4

total serum T4

total serum T3

B

when measuring T4, this method is most accurate, but takes too long time

radioimmunoassay

immunoextraction

ultrafiltration

direct equilibrium dialysis

D

when measuring free T4 using radioimmunoassay, degree of binding of radiolabeled thyroxine analog is _____ proportional to free T4 concentration

directly

indirectly

B

too much thryoid replacement RX can cause _____ total serum T4

elevated

decreased

A

low total T4 and low T3 resin uptake confirms ____

hyperthyroidism

non-thyroid disease

hypothyroidism

stress

C

_____ Is used for diagnosis of primary hypothyroidism where ___ is elevated

TRH

TSH

HCG

T4

B

In TRH stimulation test, if pituitary is dysfunctioning, TSH after TRH challenge will

exaggerated

decreased

no response

none of above

C

autoimmunue against TSH receptor of thyroid triggers

graves disease

hashimoto’s disease

multiple sclerosis

lupus

A

what is not correct about CA-125 (also referred to as MUC 16)

is an ovarian cancer marker

found on cells lining pelvic organs

is a glycoprotein

is a useful for early stage screening

D

CA-125 can be elevated by

endometriosis

ovarian cysts

a and b

none

C

Which can be used to detect pancreatic cancer

CA 19-9

CA 15-3

CA 27.29

Calcitonin

A

Glycogenesis is storage of glucose in

spleen

liver

heart

pancreas

B

__cells release glucagon to breakdown of glycogen into glucose

alpha

beta

delta

gamme

A

After successful trick or treat trip, Mr. Jayhawk ate 5 candy bars in 5 minutes. This will stimulate the release of _____ from _____

glucagon / liver

glucagon /mpancreas

insulin / liver

insulin / pancreas

D

Mr. Larence worked from 7 am without having breakfast and lunch. The body will start glycogenolysis to breakdown ____ to ____

Glycogen / glucose

glucose / glycogen

insulin / glucose

glucagon / glucose

A

T/F type 1 diabetes is more common than type 2 diabetes

False

which is not correct about TID

its is an autoimmune disease

has normal range of insulin

lose of beta cells

loss on insulin synthesis

B

what is not correct about T2D

more common in childern or under 20

more common than T1D

is insulin independent

decreased insulin recpetors on cell surface

A

T/F Plasma sample is preferred to measure glucose than whole blood sample, due to glucose instability in blood

True

to avoid glucose instability in blood, we process the blood. Which is not a good method?

Separated quickly to plasma using centrifugation

high temperature

acidification with citrate

addition of na-fluoride

B

fasting plasma glucose test requires ___ fasting and glucose levels of __is considered positive for diabetes

2hr / 126mg/dL

4hr / 180mg/dL

8hr / 126mg/dL

8hr / 180mg/dL

C

which is not correct about oral glucose tolerance test (OGTT)

no food or drink overnight

drinks 75 g glucose solution

measure blood samples 0 hr, and 2 hr post glucose solution

140mg/dL is considered positive for diabetes

D

urine glucose tests are not preferred because

it is less accurate than blood samples

it is semi quantitative

glucose is found in urdine when serume is over 180

all of above

D

diabetes insipidus is characterized by hight urin output, which is determined by

urine osmolarity

serum osmolarity

urine viscosity

serum viscosity

B

which hormone is administered during water deprivation test for Diabetes insipidus?

insulin

Vasopressin or antidiuretic hormone

glucose

glucagon

B

whivh of the following is effect for t1d

metformin

insulin

DPP

Sulfonylureas

B

Urine glucose test are not preferred because ____

it is less accurate than blood samples

it is semi-quantitative

glucose is found in urine when serum glucose is over 180 mg/dL

all of above

D

Which ECG segment is monitored for AMI

T-P

P-R

R-S

S-T

D

which ECG indicated STEMI

A

High____ assay can identify patient without the disease

cost

speed

specificity

sensitivity

C

Major challenge of heart attack kinetics is not knowing the time zero. In other words, patients who had a heart attack did not feel a classic symptom. Why is that?

heart does not feel pain

random events with varying levels short-circuiting other nerves

Discomfort can come and go and be thought as minor

all of the above

D

troponin and tropomyosin regulate the ___ dependent interaction necessary for striated muscle contraction

na

k

ca

co2

C

__binds the complex to tropomyosin providing structural anchorage

TnT

TnI

TnC

none of above

A

this is unique gene enables to distinguish TnT expressed cardiac cells from skeletal cells

addistionla 11aa on N-terminal

addistionla 11aa on C-terminus

addistionla 31 aa on N-terminus

addistionla 31aa on C-terminus

A

Which condition does not elevate total creatine kinase?

acute myocardial infraction

renal failure

hypotension

skeletal muscle injury

C

CK-BB is found in

skeletal muscle

cardiac muscle

brain tissue

lymph node

C

BNP level less than ___ pg/ml and NT proBNP level less than ___ pg/ml are indicative that heart failure is unlikely

100/200

100/300

200/300

200/500

B

What is correct about C-reactive protein (CRP)?

hexameric protein

Enhanced phagocytosis by T cells

Facilitates complement binding

M.W. 10 kDa

C

in general, high levels of hs-CRP (> 3.0 mg/L) are predictive of

lower survival rate

no new coronary events

stable angina

reduced stroke risk

A

what is not correct about fibrinogen?

glycoprotein

hexameric protein

2 different protein chains

source of fibrin in coagulation cascade

C

t/f immunoglobulins are part of innate immunity

False

Which test uses antibodies against nucleic acids and nucleoproteins as described below

ANA

ANCA

ESR

ELISA

A

In ANCA test, Abs to PR-3 will shown as ____ staining

perinuclear

cytoplasmic

nucleus

lysosomal

B

Which antibody is important to diagnose vascular inflammation

RF

ANA

ANCA

IgA

C

RF is an antibody response directed against ____ region of IgG

Fc

Fab

light chain

variable chain

A

Which assay measures turbidity of samples using light scattering when testing RF

ELISA

HPLC

Agglutination tets

Nephelometry

D

this cell has 100-150 possible autoantigens and used for FANA test

Caco-2

Hep-2

T24

Raw264.7

B

ESR examines inflammation by measuring ___ after placing anti-coagulated blood in tube

sedimentation rate

cytokine level

WBC cound

LDH

A

Which cytokine cannot be a neutralizing target for RA therapy?

TNF-a

IL-1

IFN-g

IL-10 (anti-inflammatory)

C

which of the following is monitored in T4 (total) and T3 (resin uptake) during the pregnancy?

increased T4 / Increased T3

increased T4 / Decreased T3

Decreased T4 / increased T3

Decreased T4 / Decreased T3

B

HCG can interfere with TSH, as they have similar structure. However ___ of TSH is unique can rendered its specific physiological activities

alpha unit

beta unit

gamma unit

delta unit

B

which activity inhibits hypothalamus activity

cold exposure

actue psychosis

circadian rhythms

severe stress

D

low concentration of iodide (I-) will increase T3 secretion from thyroid

true

false

A

Which of the following values obtained after a Fasting test or OGTT is above the appropriate cut-point for diagnosis of DM?

 

Fasting specimen = 110 mg/dL

 

2 hr specimen = 80 mg/dL

 

2 Hr specimen = 125 mg/dL

 

Fasting specimen= 138 mg/dL

D