Clin Chem Exam 3

high bicarbonate, high pCO₂.

A patient with chronic bronchitis may have compensated respiratory acidosis characterized by

An abnormal result has high predictive value for lung maturity at birth.

Which is true regarding fetal lung maturity tests?

venous thrombosis.

D-dimer is a product of thrombosis. A normal d-dimer test rules out

Congestive heart failure

Which of the following diseases causes transudate-type pleural effusion?

A thrombus occurs in the vein; an embolus occurs in an artery.

What is the difference between an embolus and a thrombus?

All of these are correct. (vasoconstriction, free radical attack, inflammation)

Which factors mediate respiratory distress syndrome?

Smoking

What the most common cause of emphysema?

Emphysema

Which of the following respiratory diseases is associated with permanent lung damage?

Carbon dioxide

____________ is the major waste product that the lungs eliminate.

an electric current

Board Review Question: In the sweat test, the sweating stimulant is introduced to the skin by application of

HCO₃^-

Which of the following contributes the most to the serum total CO₂?

Isohydric shift.

The reaction that allows CO₂ to move from peripheral tissue cells to plasma, then to erythrocytes and O₂ from erythrocytes to plasma, and then into peripheral tissue cells is termed:

A shift in the curve to the right

An increase in temperature will result in a change to hemoglobin-oxygen dissociation curve. This change reflects which of the following?

Hysterical hyperventilation.

Respiratory alkalosis can be seen in patients with:

by simple diffusion

How does CO2 and O2 enter and leave the cells or the alveoli and enter the blood stream?

Cystic fibrosis

____________ has a genetic basis, requiring that all newborns be tested.

Pleural

Which fluid fills the cavity surrounding the lungs?

pilocarpine nitrate

Board Review Question: The stimulant that causes localized sweating for the sweat test is

HCO₃^-

Which of the following effects result from exposure of a normal arterial blood sample to room air?

Decrease whole blood pCO₂

Which of the following compensatory mechanisms is correct for a patient in respiratory acidosis?

PO₂ increased, PCO₂ decreased, pH increased

Which of the following effects result from exposure of a normal arterial blood sample to room air?

Influenza infection

Which disease is responsible for the most cases of pneumonia?

The movement of an uncharged, hydrophobic solute through a lipid bilayer.

Diffusion of gases in the body is defined as:

Alkalosis

Which of the following will shift the oxygen dissociation curve to the left?

the lungs

What is the location of the external convection process?

the circulatory system

What is the location of the internal convection process?

theophylline 

Board Review Question: A drug that relaxes the smooth muscles of the bronchial passages is

Salmonella

Which diarrhea-producing microorganism is found in contaminated meat such as uncooked chicken?

Which of the following is not associated with blood in the stools?

Which of the following is not associated with blood in the stools?

celiac disease.

Adherence to a gluten-free diet is useful for

Gastrin

Which analyte is important in the diagnosis of Zollinger-Ellison syndrome?

Both are true. (Tests are highly sensitive for celiac diseases, Tests are highly specific for celiac diseases.)

Which of the following is true regarding antibody tests for celiac disease such as anti-gliadin antibodies?

The suffix “ase” is converted to “ise.”

Regarding biochemical nomenclature, which of the following is false?

The patient should consume a high fat diet.

An important test for diarrhea is fecal fat. How should the patient be prepared prior to collection of the 24-hour stools?

all of the above (compartmentalize the GI system, allow the bolus to enter and leave sections of the GI tract, are under voluntary and involuntary control)

Sphincter muscles

parietal cells

Which cells secrete hydrochloric acid?

Assimilation of nutrients and elimination of waste

Which of the following represents two primary functions of the GI tract?

Peptic ulcer disease (PUD)

The consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin can lead to which of the following?

Helicobacter pylori and consumption of nonsteroidal anti-inflammatory drugs (NSAIDs).

Peptic ulcer disease (PUD) is associated with:

Crohn's disease.

Transmural inflammation is associated with:

small intestine

Which organ of the GI system has the greatest surface area due to the presence of villi?

CA 19-9.

The marker for colorectal and pancreatic carcinoma is:

pancreas

Which organ of the GI system is both an endocrine and exocrine gland?

gastic acid

This secretion helps reduce the solid components of food and sterilizes the upper gut

Enterochromaffin cells of the GI tract

What is the origin of carcinoid?

Neuroendocrine tumor (NET)

A gastrinoma is classified as which of the following?

peroxidase-like activity of hemoglobin

Board Review Question: The principle of the occult blood test depends on the

Urease

Which enzyme is produced by H. pylori to produce peptic ulcers?

Saliva and pancreas

What is the tissue localization of amylase isoenzymes?

Parietal: nitric acid

Which of the following cells of the stomach is incorrectly listed with its principal secreted product?

Secretion of cholecystokinin to increase gastric motility

Which of the following is not an important step in lipid digestion?

D-xylose test

Which test is used for detecting malabsorption?

Hypoalbuminemia

Which of the following laboratory results is consistent with protein-losing enteropathy (PLE)?

Decreased serum protein and albumin

A patient with suspected protein-losing enteropathy (PLE) would have which of the following laboratory results?

Gastric hypersecretion

Which of the following conditions occurs in patients with Zollinger-Ellison syndrome?

pancreas

Amylase, lipase, trypsin and chymostrypsin are all secreted by the

Elevated serum gastrin, increase in basal gastric acid output

Which of the following test results are correct for a patient with Zollinger-Ellison syndrome?

Vasoactive intestinal polypeptide

Which of the following GI peptides relaxes smooth muscles of gut, blood, and genitourinary system; increases water and electrolyte secretion; and stimulates the release of hormones from pancreas, gut, and hypothalamus?

Neutral fats.

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

The patient is lactose intolerant

The cutoff point for fasting serum glucose in the lactose tolerance test is > 30 mg/dL (> 1.7 mmol/L). Which of the following is the correct interpretation for a patient whose fasting serum glucose is < 20 mg/dL (<1.1 mmol/L)?

Stimulate the pancreas to secrete an increased volume of juice with high bicarbonate contents

Which of the following is the primary physiological role of secretin?

Celiac disease

Which of the following GI disorders is characterized by a modified gut immune function?

Glucose

Which of the following laboratory analytes is tested for a patient with suspected lactose intolerance?

I cells from the upper small intestinal mucosa

Which of the following cells contain cholecystokinin (CCK)?

occult blood

Board Review Question: A stool specimen that appears black and tarry should be tested for the presence of

colon

Where is the normal gut biota located?

Serum measurement of IgA, IgG CagA, and cytotoxin-associated gene A (CagA)

Which of the following clinical laboratory tests is useful for diagnosis of peptic ulcer disease (PUD)?

Measurement of 7á-hydroxy-4-cholesten-3-one

Which of the following is a useful clinical laboratory test for bile salt malabsorption?

intrinsic factor 

Board Review Question: Absorption of vitamin B12 requires the presence of:

Anti-hepatitis B IgM core antibody

Which of the hepatitis B antibodies is short-lived?

Low urine urobilinogen, high urine bilirubin

Which is the correct bilirubin pattern of results for prehepatic jaundice?

Ammonia and urea

What are the products of amino acid deamination by the liver?

Obstructive: alk phos, bilirubin; hepatocellular: ALT, AST

Which liver markers are considered obstructive and which are indicators of hepatocellular injury?

Synthesis of hemoglobin

Which of the following is not a function of the liver?

HBsAg: negative, antiHBsAg: positive, anti-HBc: negative

Which hepatitis B marker panel is consistent with someone having taken the hepatitis B vaccine?

γ-glutamyl transferase

Which liver marker is the most sensitive for alcoholism?

Near 100% sensitivity for liver cancer

Which of the following is false regarding alpha-fetoprotein?

network of veins that carry blood from the intestines to the liver

What is portal circulation?

1.5 mg/dL.

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

Hepatocytes.

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

Uridine diphosphate (UDP) glucoronyl transferase.

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

all of the above (excretion, detoxification, metabolism, storage)

What is/are the function(s) of the liver?

Wilson's disease

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

Bilirubin tightly bound to albumin

The term δ-bilirubin (delta) refers to:

Right Upper

Which abdominal quadrant is the liver located in?

HBsAg.

The first serological marker of Hepatitis B is:

sulfobromophtalein

Board Review Question: In the Malloy and Evelyn method for the determination of bilirubin, the reagent that is reacted with bilirubin to form a purple azobilirubin is

allow indirect bilirubin to react with the color reagent

Board Review Question: In bilirubin determination, the purpose of adding a concentrated caffeine solution or methyl alcohol is to

storing the specimen protected from light until the analysis is done

Board Review Question: Erroneous ammonia levels can be eliminated by all of the following except

acute hepatitis

Board Review Question: Given the following results:

• ALP: slight increase

• ALT: marked increase

• AST: marked increase

• GGT: slight increase

This is most consistent with :

sample exposure to light

Board Review Question: Serial bilirubin determination are charted below with the best explanation for the results due to

• Day 1, collected at 7 am, assayed at 8 am, result: 14.0 mg/dL

• Day 2, collected at 7 am, assayed at 6 pm, result: 9.0 mg/dL

• Day 3, collected at 6 am, assayed at 8 am, result: 15.0 mg/dL

brain tissue

Board Review Question: Kernicterus is an abnormal accumulation of bilirubin in

exchange of amino and keto groups between alpha-amino and alpha-keto acids

Board Review Question: Aminotransferase enzymes catalyze the

hepatobiliary disease

Board Review Question: Bile acid concentrations are useful to assess

Dubin-Johnson Syndrome

Which form of congenital hyperbilirubinemia is associated with increased direct bilirubin?

It a not water-soluble

Which is a characteristic of unconjugated bilirubin?

Feces: urobilinogen decreased; urine: bilirubin: positive; serum: conjugated bilirubin increased.

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

hepatic artery, portal vein, bile duct

In the liver lobule, each portal triad is made of a branch of:

Neonatal physiologic jaundice

What is the most common cause of unconjugated hyperbilirubinemia?

Urobilin.

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