Clinical Chemistry- Quiz 27 Trace and Toxic Elements, Vitamins

Board Review Question: Decreased serum iron associated with increased TIBC is compatible with which of the following disease states?

iron-deficiency anemia

Board Review Question: Beriberi is associated with deficiency of

thiamine

Board Review Question: Pellagra is associated with deficiency in which of the following vitamins?

niacin

Board Review Question: Magnesium carbonate is added in an iron-binding capacity determination in order to:

remove excess unbound iron

Board Review Question: The first step in the quantitation of serum iron is

separation of iron from transferrin

Given the following results, what is the total iron binding capacity?

118

The following laboratory results correlate with which of the following conditions? Iron- 250

Hereditary hemochromatosis

An anemic patient has the following laboratory test results. What additional laboratory testing is recommended to make a definitive diagnosis?

Methylmalonic acid

Which of the following vitamins is a fat-soluble vitamin?

K

The following laboratory results correlate with which of the following conditions? Iron- 50

Iron deficiency anemia

Absorption of vitamin B12 in the gastrointestinal tract requires the presence of which of the following?

Intrinsic factor

The following laboratory results correlate with which of the following conditions? Copper, Serum- 70

Wilson's disease

A deficiency of what vitamin will produce abnormal bone mineralization and eventually lead to osteomalacia?

Vitamin D

Given the following results, what is the percent saturation?

45%

Which of the following vitamins is an essential dietary requirement for pregnant women to prevent neural tube defects in the fetus?

Folate

Which of the following is the major transport protein of iron?

Transferrin

Lead exposure causes an increase blood concentration in which of the following analytes?

Zinc-protoporphyrin

A patient has small red blood cells and an MCV of 80. What is the most likely cause?

Iron deficiency anemia

Changes in vitamin B12 are most dramatic in tissues with the greatest rate of cell turnover because:

Deficiencies result in impaired DNA synthesis in any cell where chromosomal replication and division takes place.

A 25-year-old female visits her physician complaining of lethargy and wants to take a nap all of the time. Her physician orders laboratory tests and the results are shown below. Which of the following conditions best represent this patient's status?

Iron deficiency anemia

Coumadin (warfarin) acts on _________ to inhibit coagulation.

vitamin K

Insufficient amounts of vitamin A can lead to degenerative changes to the cornea, which leads to poor dark adaptation, or night blindness, also known as:

Nyctalopia.

Trace elements in biological fluids can be measured using which of the following instrumentation techniques?

Atomic absorption spectrometry

Decreased serum levels of vitamin B12 and folic acid are seen in patients with which of the following?

Sprue

Board Review Question: Scurvy is associated with deficiency of which of the following vitamins?

C

Board Review Question: Assay of transketolase activity in blood is used to detect deficiency of

thiamine

Board Review Question: An elevated serum iron with normal iron-binding capacity is most likely associated with

pernicious anemia

Board Review Question: Night blindness is associated with deficiency of which of the following vitamins?

A

Board Review Question: A patient's blood was drawn at 8 am for a serum iron determination. The result was 85 ug/dL. A repeat specimen was drawn at 8 pm; the serum was stored at 4 degrees Celsius and run the next morning. The result was 40 ug/dL. These results are most likely due to:

time of day the second sample was drawn

Board Review Question: 90% of the copper present in plasma is bound to

ceruloplasmin

Berylliosis in humans affects which of the following organs?

Lungs

Vitamin D deficiency leads to which of the following conditions?

Rickets

Which of the following statements best defines a metalloenzyme?

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

Which of these proteins prevents the loss of hemoglobin and its iron through the kidneys?

Haptoglobin.

__________ improves glucose metabolism.

Chromium

Coenzyme A (CoA) contains which of the following?

Pantothenic acid

Antimony is used to treat patients with which disease?

Schistosomiasis

Scurvy is a disease caused by a deficiency in which of the following?

Vitamin C

Which of the following are iron storage proteins?

Ferritin and transferrin

Board Review Question: Rickets is associated with deficiency of which of the following vitamins?

D

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

intrinsic factor

Board Review Question: A patient has the following results:

iron hemochromatosis

Aceruloplasminemia is associated with which of the following?

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

Which of the following compounds chelates iron and is the immediate precursor of heme formation?

Protoporphyrin IX

A person with argyria will exhibit which of the following?

A permanent bluish-grey discoloration of the skin

Which is true concerning total iron binding capacity?

It determines the number of binding sites on transferrin.

Which of the following proteins incorporates copper into its structure?

Ceruloplasmin

The principal protein for transport of iron from the intestine to the liver, bone marrow, or spleen for storage is:

Transferrin.

Retinol is formed from which of the following vitamins?

Preformed vitamin A

Which disorder is associated with vitamin B1 (thiamin) deficiency?

Beriberi

A 40-year-old male patient with hemochromatosis often presents to his clinician with which of the following triad of symptoms?

Bronzing of the skin, cirrhosis, and diabetes

Zinc plays a vital role in the synthesis of which of the following?

Nucleic acid

Elevated blood levels of lead will result in a deficiency of which of the following enzymes?

Amino levulinic acid dehydratase

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

Inhalation of vapors

British anti-Lewisite (BAL) and succimer are two examples of compounds that are used to treat patients that ingest a large amount of certain trace metals. These compounds:

Chelate trace metals.

Which of the following functions as a chain-breaking antioxidant and is a peroxyl radical scavenger that protects LDL and polyunsaturated fats in membranes from oxidation?

α-tocopherol

Which of the following is described as a nervous system ailment because of a deficiency of thiamine?

Beriberi

Which of the following laboratory test groups and results best reflects a patient with primary hemochromatosis?

Serum iron, increased; serum TIBC, decreased; transferrin saturation, increased

Three natural forms of vitamin B6 are:

Pyridoxine (pyridoxol) (PN), pyridoxamine (PM), and pyridoxal (PL).

What is the primary storage form of iron?

Ferritin

Ingesting of large amounts of molybdenum creates a deficiency of which of the following trace elements?

Copper

Which of the following vitamins has the highest antioxidant properties?

Vitamin E

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

Antacids

The following statement best describes which of the terms listed below? The pathological condition that develops when iron intake falls below the amount required for red blood cell production and iron reserves become depleted.

Anemia

Which of the following trace elements is NOT classified as essential?

Silver

An individual who consumes massive amounts of vitamin C may develop kidney stones consisting of:

Uric acid.

Hemochromatosis is a disease best described as which of the following?

A genetically related disease in which the body accumulates excess amounts of iron

Board Review Question: Total iron=binding capacity measures the serum iron transporting capacity of

transferrin

A patient presents with the following symptoms:

• Loss of appetite

• Generalized weakness and irritability

• Abdominal pain and vomiting

• Bright red tongue (glossitis)

• Skin rash ("Casal's necklace")

Which of the following is associated with these symptoms?

Pellagra

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

Ceruloplasmin

Intracellular Chromium binds to which of the following proteins?

Chromodulin

A person who is deficient of chromium may develop which of the following?

Insulin resistance and glucose intolerance

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

Antacids and astringents

Which of the following compounds functions as a chelating agent used as a treatment modality for ingestion of trace element?

British anti-Lewisite (BAL)

Which of the following chromogens will produce a colored complex with iron using spectrophotometry?

Ferrozine

Vitamin E toxicity has been associated with which of the following?

An affliction of premature infants who have been exposed to high oxygen therapy and later developed retinopathy of prematurity (formerly retrolental fibroplasias)

Pellagra is associated with a deficiency of which of the following vitamins?

Vitamin B3

A patient with megaloblastic anemia would show which of the following?

Decreased vitamin B12, decreased folic acid

Which of the following statements is true regarding serum levels of arsenic?

Elevated levels of arsenic in serum can be detected for only a few hours (< 4) after ingestion.

Vitamins A, D, and K are classified as:

Fat-soluble.

Which of the following statement about selenium is FALSE?

It is not important for proper maintenance of health in humans.

Which form of mercury is the most toxic?

Methylmercury

The addition of sufficient Fe3+ to saturate iron binding site of transferrin is referred to as which of the following?

Unsaturated iron binding capacity

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

Decreased blood copper

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

Cobalt

Which of the following sets of laboratory results is associated with Wilson's disease?

Decreased plasma copper and plasma ceruloplasmin

A direct assay for measurement of plasma phylloquinone is useful to assess:

Vitamin K status.