clim chem exam 2

Which of the following is true concerning lithium?

It is used to treat manic depression.

Why do patients with Waldenström’s macroglobulinemia sometimes develop hyperviscosity syndrome?

All of these are correct (High concentrations of monoclonal IgM can be produced, IgM paraproteins can also cause cryoglubulinemia, The IgM can form pentamers.

Multiple myeloma is characterized by all of the following except

Multiple sclerosis

Which one of these protein structures is determined by arrangement of two or more polypeptides?

quaternary structure

A protein can be made up of a maximum of _________ different amino acids.

20

Which one of these protein structures is determined by the interaction of adjacent amino acids and the formation of hydrogen bonds?

secondary structure

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

Transferrin

Which of these proteins is associated with Down's syndrome, Trisomy 18 and neural tube defects?

alpha fetoprotein

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

Oligoclonal bands in the CSF are indicative of

a disease associated with the demyelation of the myelin sheath.

Board Review Question: A 24-hr urine specimen (total volume = 1136 mL) is submitted to the laboratory for quantitative urine protein. Calculate the amount of protein excreted per day if the total protein is 52 mg/dL

591 mg

A protein that is increased or normal in nephrotic syndrome is:

α₂-macroglobulin.

Board Review Question: Increased serum albumin concentrations are seen in which of the following conditions?

dehydration

Which ϒ-globulin is increased in allergies?

IgE

Which condition is associated with fusion of the β-ϒ bridging?

Cirrhosis

Which one of these protein structures is determined by the sequence of amino acids?

primary structure

Ceruloplasmin is an α₂-globulin that contains:

Copper

Board Review Question: Serum haptoglobin

can be separated into two distinct phenotypes by starch gel electrophoresis

Board Review Question: Most chemical methods for determining total protein utilize which of the following reactions?

biuret

Board Review Question: The biuret reaction for the analysis of serum protein depends on the number of

peptide bonds

Which one of these is a primary function of proteins in our body?

transport

Hyperalbuminemia is caused by:

Dehydration syndromes.

High serum total protein but low albumin is usually seen in:

Multiple myeloma.

Which of these conditions can cause hypoalbuminemia?

All of the above (liver disease, nephrotic syndrome, viral gastroenteritis

What distingishes one amino acid from another?

the radical group

Bromcresol Green (BCG) may be used in the dye-binding assay of:

Albumin

What links amino acids together?

peptide bonds

Which one of these protein structures is determined by the the way the protein chain folds back upon itself?

tertiary structure

In blood of healthy subjects, _____ are seen in CSF protein electrophoresis but not typically in serum protein electrophoresis.

tau band and prealbumin

_____ is found in abundance in body secretions.

IgA

Which of the following is true regarding prealbumin?

It functions to bind thyroid hormones

How many pyrrole rings are there in a porphyrin structure?

4

Board Review Question: The identification of Bence-Jones protein is best accomplished by

immunofixation

Board Review Question: The primary function of serum albumin in the peripheral blood is to

maintain colloid osmotic pressure

Board Review Question: Which of the following amino acids is associated with a sulfhydryl group?

cysteine

Board Review Question: Maple syrup urine disease is characterized by an increase in which of the following urinary amino acids?

valine, leucine, and isoleucine

Board Review Question: Bromcresol purple at a pH of 5.2 is used in a colorimetric method to measure

albumin

Which of these proteins removes heme from circulation?

Hemopexin

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

pernicious anemia

Which ϒ-globulin is found in secretions?

IgA

Essential amino acids

must be obtained from our diet

The structure of a protein that is determined by the sequence of amino acids in the polypeptide chain is the:

Primary structure.

What is the clinical significance of testing for prealbumin?

Low levels indicate compromised nutritional status

Which of the following conditions is associated with an elevated total protein?

Malignancy

Mary's total protein is 7.5 g/dL and her albumin is 4.2 g/dL. What is her A/G ratio?

1.3

The chemical bonds between amino acids in the primary structure of proteins are:

Peptide bonds.

Ceruloplasmin is an α₂-globulin that contains:

Copper

Which is the most abundant ϒ-globulin?

IgG

Which element does protein contain that is not present in carbohydrates or lipids?

nitrogen

A decrease in this protein will result in an emphysema-like condition.

α₁-antitrypsin.

Which of these proteins neutralizes leukocyte elastase and collagenase?

alpha 1 antitrypsin

Protein is approximately _______ nitrogen.

16%

Which of the following protein deficiencies causes liver cirrhosis?

Alpha-1-antitrypsin

Which of the following is true regarding proteins and enzymes?

Enzymes are found in lower concentrations than proteins seen on serum protein electrophoresis.

Which metal is involved in Wilson’s disease?

There is excess copper that can be deposited into the liver and central nervous system.

The heme moiety of hemoglobin is an example of a

prostetic group

Overexpression of one B-cell clone is termed

monoclonal gammopathy.

The definition of microalbuminuria is

a slightly above-normal level of urine albumin.

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

pernicious anemia

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

Unsaturated iron binding capacity

The biosynthesis of heme commences with which two compounds?

Glycine and succinyl CoA

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

transferrin

Board Review Question: A condition in which erythrocyte protoporphyrin is increased is:

iron-deficiency anemia

Protoporphyrins that chelate iron are called:

Heme

Board Review Question: A breakdown product of hemoglobin is

bilirubin

The globin portion of hemoglobin in normal adult humans is composed of which two amino acid chains?

Two alphas, two betas (a₂, b₂)

Which of the following is/are characterized by a normal white blood cell count?

Neither Hodgkin nor non-Hodgkin lymphoma

Hairy cell leukemia is so named because:

they have hairlike projections from the cytoplasm.

Free erythrocyte protoporphyrin levels are useful for assessing exposure to which of the following metals?

Lead

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

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

Protophorhyrin IX

Which direction does the partial pressure of oxygen in arterial or venous blood go when a blood gas sample is exposed to air?

They both go up

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?
Serum iron(µg/dL): Dec
TIBC (µg/dL): Inc
Transferrin saturation (%): Dec
Serum Ferritin (µg/L): Dec

Iron deficiency anemia

Which of the following are iron storage proteins?

Ferritin and transferrin

Board Review Question: A urine screening test for porphobilinogen is positive. The MOST likely disease state is

acute porphyria attack

_______________ is the most common leukemia found in children and adolescents.

Acute lymphocytic leukemia

Board Review Question: The hemoglobin that is resistant to alkali (KOH) denaturation is

F

Board Review Question: Zinc protoporphyrin or free erythrocyte protoporphyrin measurements are useful to assess blood concentrations of:

lead

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

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

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

Transferrin circulates as which of the following?

Apotransferrin-Fe³⁺

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

Transferrin

Which of the following regarding hemoglobin is true?

Each heme group binds one oxygen molecule.

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

Iron deficiency anemia

Which inherited hemoglobinopathy or anemia affects men more than women?

Glucose-6-phosphate dehydrogenase deficiency

Which is true concerning total iron binding capacity?

It determines the number of binding sites on transferrin

Which disease is characterized by greater than 20% nucleated cells of the bone marrow?

Acute myelogenous leukemia

What precursor cell type gives rise to all other hematopoietic cells?

Stem cell

Why are there different hemoglobin anemia cutoff concentrations for men and women?

Women naturally lose more hemoglobin due to menstruation.

Under alkaline conditions, __________ migrates between A and S.

hemoglobin F

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

Ferrozine

What is the unique quality that many porphyrin compounds possess that allows for their detection within body tissues and in a test tube?

They fluoresce and are detected by exposing them to EMR at a specific wavelength

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

A patient with acute intermittent porphyria is deficient in which enzyme?

Hydroymethylbilane synthase

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

A 30-year-old male with ALA-dehydratase deficient porphyria (ADP) may present with which of the following clinical features:

Abdominal pain and neurological dysfunction

What is the primary storage form of iron?

Ferritin

Which of the following porphyrias best reflects this patient's symptoms and laboratory results?
A 30-year-old male presents to his clinician with alcoholic liver disease, hyperpigmentation, blister formation, and fragile skin. The results of the liver function tests (AST and ALT) were abnormal. The patient's urine PBG/ALA was not increased. Urine porphyrins analysis reveals and elevation of uroporphyrinogen and heptacarboxylate.

  Porphyria cutanea tarda

Board Review Question: Urobilinogen is formed in the

intestine

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

iron-deficiency anemia