Clin Chem B Final

Which of the following occur in both type 1 and type 2 diabetes mellitus?

a. Antibodies against islet cells

b. Association with HLA-Dr3/Dr4

c. Down-regulation of insulin receptor synthesis

d. Ketoacidosis

e. Osmotic damage

e. Osmotic damage

A 40-year-old woman complains of problems with swallowing both solids and liquids. She also complains of changes in her fingers. Physical examination reveals tapered fingers with digital infarctions and dilated vessels on her skin. A radiograph of her fingers reveals dystrophic calcification in subcutaneous tissue. There is no evidence of pulmonary or renal disease, the patient is diagnosed with CREST syndrome. Which of the following is a specific test for CREST syndrome?

a. Anti-double stranded DNA

b. Anti-acetylcholine receptor antibody

c. Anticentromere antibody

d. Antigliadin antibody

e. Anti-SS-A (Ro) antibody

c. Anticentromere antibody

25-year-old man has a history of chronic liver disease and a movement disorder. Physical examination also reveals a discoloration in Descemet's membrane in the cornea. Which of the following laboratory findings would most likely be reported?

Decreased serum ceruloplasmin

Increased iron saturation

Increased serum iron

Increased total serum copper

Normal serum prothrombin time

Decreased serum ceruloplasmin

A 30-year female patient presents to the clinic with complaint of generalized fatigue and a butterfly looking rash on the face. The patient also complained of photosensitivity. The physician suspects systemic lupus erythematosus (SLE) and dermatomyositis. Which of these lab test must the physician order to rule in or rule SLE?

Anti-double stranded DNA (anti ds-DNA)

Anti-Jo-1

Anti-centromere antibody

Anti-gliadin antibody

Bence jones Protein in urine

Anti-endomysia antibody

Anti-double stranded DNA (anti ds-DNA)

Which of the following tests is used to confirm a positive or indefinite enzyme-linked immunoabsorbent assay (ELISA) test for HIV?

Western Blot

CD4 T cell Count

HIV - viral load

p24 Capture Assay

Western Blot

A 6-year-old boy has an immunodeficiency syndrome associated with eczema, recurrent sinopulmonary infections, thrombocytopenia, and abnormalities involving immunoglobulins and cell-mediated immunity. Which of the following is the possible diagnosis of this patient?

Wiskott-Aldrich

Brutons -agammaglobinemia

Severe combined immunodeficiency

Common Variable immunodeficiency

Wiskott-Aldrich

Mr. James, a 50-year-old man complains of generalized itching, clayed

colored stool and yellowing of the sclera. Physical examination reveals

xanthelasma on both eyelids and an enlarged, nontender liver. Serum

alkaline phosphatase and γ-glutamyl transferase are markedly increased.Which of the specific test below will help you diagnose this patient condition?

Antiparietal cell

Antimitochondrial antibody

Anti-topoisomerase

Anti-Smith (Sm) antibody

Anti-double-stranded DNA antibody

Antimitochondrial antibody

A 30-year-old man has a history of greasy stools since childhood. He now presents with a vesicular rash on his right elbow. Which of the following labs is appropriate to order to help diagnose this patient?

Antigliadin - antibody

Anti-parietal cell Antibody

Anti-SS-A (Ro) antibody

Anti-ribonucleoprotein antibody

Anti-histone antibody

Antigliadin - antibody

A 20-year-old man presents with dyspnea and hemoptysis. This is shortly

followed by a sudden onset of acute renal failure with hematuria and RBC casts. The physician (you) suspects Goodpasture disease as a possible diagnosis. Which of these lab tests is specific for this diagnosis?

Anti-glomerular basement membrane antibody

Anti- histone antibody

Anti- Smith (Sm) antibody

Anti- SS-A (Ro) antibody

Anti-glomerular basement membrane antibody

A 45-year-old woman complains of generalized itching. Physical examination reveals xanthelasma on both eyelids and an enlarged, nontender liver. Serum alkaline phosphatase and γ-glutamyl transferase are markedly increased. The physician suspects primary biliary cirrhosis as a potent cause for patient symptoms. Which of these antibody lab tests is specific for the physician suspicion?

Anti-histone antibody

Antimitochondrial antibody

Anti-centromere antibody

Anti-histone

Anti-Smith (Sm) antibody

Antimitochondrial antibody

A 4-year-old boy has a disease characterized by the absence of

plasma cells and germinal follicles in lymph nodes and failure of pre-B cells to differentiate into mature B cells. Which of the following is a possible differential diagnosis?

Bruton's agammaglobulinemia

Ataxia telangiectasia

Common Variable immunodeficiency (CVID)

Wiskott-Aldrich syndrome

Selective IgA immunodeficiency

Severe combined immunodeficiency

Bruton's agammaglobulinemia

A 25-year-old man complains of recurrent swelling of the face. On

some occasions he also has difficulty breathing. Initial laboratory studies

show normal concentrations of complement C3 and factor B and a

decreased concentration of complement C4. Which of the following

additional studies is most indicated?

Hint ( Hereditary angioedema)

C1 esterase inhibitor assay

Chromosome study

Cutaneous skin test to rule out anergy

Quantitative immunoglobulin assay for IgG, IgA, IgM

C1 esterase inhibitor assay

A 56-year-old woman complains of problems swallowing solids and

liquids, color changes and pain in her hands, and problems with breathing. Examination reveals pursing of the lips, sclerodactyly and swelling of the fingers, and dry inspiratory crackles at both lung bases. which of these antibodies are you going to order to diagnose this patient?

Anti-topoisomerase ( Scl-70) antibody

Anti-double Stranded DNA antibody

Anti-histone antibody

Anti-centromere antibody

Anti - ribonuclear antibody

Anti-topoisomerase ( Scl-70) antibody

A patient is diagnosed with hepatocellular carcinoma. His lab result

shows hypoglycemia, normal PTH level, normal calcitonin level, ALT, ASTand Alkaline phosphatase are mildly elevated. The patient beta -cell and insulin production is normal. Which of the following lab test are you going to order to detect the cause of the patient hypoglycemia?

Hint: Growth factor secreting tumor

Erythropoietin (EPO)

Insulin - like growth factor

PTH-related peptide ( rPTH)

Human chorionic gonadotropins (HCG )

Antidiuretic hormone (ADH)

Insulin - like growth factor

A 36-year-old woman complains of problems with swallowing both

solids and liquids. She also complains of changes in her fingers. Physical

examination reveals tapered fingers with digital infarctions and dilated

vessels on her skin. A radiograph of her fingers reveals dystrophic

calcification in subcutaneous tissue. There is no evidence of pulmonary or renal disease. Which of this lab test is specific for the diagnosis and

management of this patient?

Hint: CREST syndrome

Anticentromere antibody

Antimitochondrial antibody

Anti-double stranded DNA

Anti-histone antibodies

Anti - topoisomerase ( Scl -70)

Anticentromere antibody

A 48-year-old man present to the clinic because of generalized fatigue,

jaundice, and lower extremities edema. patient works in a textile industry

where dyes is used constantly. physical examination of abdomen reveals

mild ascites. CT scan of the abdomen shows cirrhosis, nodules and fibrosis of the liver parenchyma. Which of these lab test is specific for diagnosing this patient condition ?

Hint: Hepatocellular Cancer

Alkaline phosphatase

Antimitochondrial antibody

Alpha-fetoprotein (AFP)

CA- 125

CA19-9

Alpha-fetoprotein (AFP)

A 44-year-old man has repeated sinus infections, a saddle-nose

deformity, nodular masses in the lungs, and glomerulonephritis with RBC

casts. The physician suspect Wegner granulomatosis as potential diagnosis. Which of these antibody tests are you going to order to diagnose Wegener granulomatosis?

Anti-double stranded DNA

Anti-mitochondria antibodies

Anti- Smith (Sm) antibodies

c-antineutrophil cytoplasmic antibody (c-ANCA)

p- antineutrophil cytoplasmic antibody (p-ANCA)

c-antineutrophil cytoplasmic antibody (c-ANCA)

A 25-year-old man who recently finished a course of penicillin for a

group A streptococcal pharyngitis, develops palpable purpura over his trunk and extremities along with hematuria and RBC casts. Which of these antibodies test are you going to order if you suspect polyangiitis

(polyarteritis)?

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Antigliadin antibody

anti-parietal cell antibody

c-anti-cytoplasmic neutrophilic antibody ( c-ANCA)

p-anti-cytoplasmic neutrophilic antibody (p -ANCA)

p-anti-cytoplasmic neutrophilic antibody (p -ANCA)

Which of this molecular marker is associated with chronic myelogenous leukemia?

Translocation (8;14)

Translocation (9;22)

Translocation (14;18)

Translocation (15;17)

Translocation (9;22)

Cancer antigen 125 (CA 125) is a tumor marker associated with the following cancers?

Breast Cancer

Colon Cancer

Lung Cancer

Ovarian Cancer and Endometrial Carcinoma

Ovarian Cancer and Endometrial Carcinoma

Which of the following test is useful in the detection and management of carcinoma of the prostate?

Prostatic acid phosphatase

Total Prostatic acid phosphatase

Human chorionic gonadotropins

Alpha-fetoproteins

Total Prostatic acid phosphatase

Reye syndrome causes an increase in transaminases

Hint: causes increase in ammonia and transaminases (ALT and AST )

True

False

True

Which of the following will cause an increase in lactate dehydrogenase?

Diffuse liver cell necrosis

Acute myocardial infarction

Disseminated malignancy

RBC hemolysis

Dysgerminoma

All of the above

All of the above

A 50-year-old man present to the clinic because, malaise, fatigue and

constipation and general weight loss of 10 lbs in the last 2 months which is unintentional. Physical examination of the abdomen reveals mild tenderness in the left lower quadrant upon palpation, Digital rectal examination reveals positive FOBT. CT scan of the abdomen reveals mass in the sigmoid colon consistent with colon cancer. Which of these laboratory test is more specific for the diagnosis of colon cancer.

Carcinoembryonic antigen (CEA)

Alpha-fetoprotein (AFP)

CA 125

CA -19-9

Prostate specific antigen (PSA)

Carcinoembryonic antigen (CEA)

Which of the following is used as a marker for alcohol consumption ?

Gamma Glutamyltransferase (GGT)

Creatinine Kinase

Lactate dehydrogenase

Lipase

Gamma Glutamyltransferase (GGT)

Which of the following is a tumor marker for medullary thyroid carcinoma?

CA19 -9

Calcitonin

Alpha-fetoprotein (AFP)

CA125

CEA

Calcitonin

Increased alpha(α)- fetoprotein (AFP) can be seen in which of the following conditions?

Open neural tube defect

Anencephaly

Myelomeningocele

Omphalocele

Trachea esophageal fistula

All of the above

All of the above

Which of this test is used to detects antibodies to several

streptococcal antigens

Antistreptolysin O (ASO) titer

Streptozyme

Anti-DNAase B titer

Anti-cytoplasmic Antigen (ANCA)

Streptozyme

Patient with symptomatic acute hepatitis B.

- HbsAg −, HbeAg HBV DNA −, Anti-HBc IgM +, Anti-HBc IgG −, Anti-HBs −

- HbsAg +, HbeAg HBV DNA +, Anti-HBc IgM +, Anti-HBc IgG −, Anti-HBs −

- HbsAg −, HbeAg HBV DNA −, Anti-HBc IgM −, Anti-HBc IgG +, Anti-HBs +

- HbsAg −, HbeAg HBV DNA −, Anti-HBc IgM −, Anti-HBc IgG −, Anti-HBs +

- HbsAg +, HbeAg HBV DNA −, Anti-HBc IgM −, Anti-HBc IgG +, Anti-HBs −

- HbsAg +, HbeAg HBV DNA +, Anti-HBc IgM −, Anti-HBc IgG +, Anti-HBs −

HbsAg +, HbeAg HBV DNA +, Anti-HBc IgM +, Anti-HBc IgG −, Anti-HBs −

Which of this test is used to diagnose a patient with lactose

intolerance?

Antistreptolysin -O titer (ASO)

Stool antigen test

Hydrogen breath test

Anti double Stranded DNA ( anti-dsDNA)

Hydrogen breath test

A patient diagnosed with carcinoid syndrome presents with flushing and Diarrhea due to serotonin production. Which of these test is used to diagnose carcinoid syndrome

- Increase urine 5-hydroxyindoleacetic acid (5-HIAA).

- Sweat chloride test

- δ-aminolevulinic acid (ALA)

- Calcitonin

Increase urine 5-hydroxyindoleacetic acid (5-HIAA).

A 35-year-old has a 3-month history of epigastric pain without radiation into the back. The stool is black and is positive for blood. He has a past history of gastric ulcer disease due to Helicobacter pylori. Which of the following tests would be the most cost effective and will identify the cause of his pain and provide an indicator on whether treatment is effective?

Radiolabeled urea breath test

Serologic test

Stool antigen test

Urease test on a gastric biopsy

Stool antigen test

A 75-year-old man with point tenderness in the lower vertebral column has an increased serum alkaline phosphatase. He does not smoke cigarettes. His stool guaiac is negative. Which of the following tests or procedures would be the most cost-effective step in the initial evaluation of this patient?

Colonoscopy

Digital rectal examination

Prostate-specific antigen

Radionuclide bone scan

Serum gamma glutamyl transferase

Digital rectal examination

A 45-year-old woman with rheumatoid arthritis has an increased serum total protein. The hyperproteinemia is most likely due to an increase in which of the following protein fractions?

Albumin

Immunoglobulin A

Immunoglobulin G

Immunoglobulin M

Immunoglobulin G

A newborn child has a seizure within 1 hour after birth. The serum glucose is 20 mg/dL. The mother had gestational diabetes mellitus and was in poor glycemic control throughout the pregnancy. Which of the following hormones is most likely responsible for hypoglycemia?

Cortisol

Glucagon

Insulin

Prolactin

Thyroxine

Insulin

A 62-year-old man, who lives alone, has pitting edema of his lower legs. The serum total protein concentration is decreased. He subsists primarily on bread and diet cola. A urinalysis is negative for protein. Which of the following best explains the pathogenesis of the hypoproteinemia?

Acquired hypogammaglobulinemia

Decreased intake of protein

Malignant plasma cell disorder

Nephrotic syndrome

Decreased intake of protein

A 25-year-old medical student returns from a trip to Mexico on spring

break. Three weeks later, he develops low-grade fever and jaundice.

Physical examination shows painful hepatomegaly. The urine is dark yellow and the stool is light-colored.

- % CB

% CB 20-50, Urine Bilirubin ↑, Urine UBG ↑↑, AST ↑↑, ALT ↑↑↑, ALP

↑, GGT ↑

In a 24-year-old man with a healing bone fracture, which of the following laboratory test results are expected?

Serum ALP Increased, Serum GGT Increased

Serum ALP Increased, Serum GGT Normal

Serum ALP Normal, Serum GGT Increased

Serum ALP Normal, Serum GGT Normal

Serum ALP Increased, Serum GGT Normal

A 45-year-old intensive care nurse complains of recurrent episodes of forgetfulness and tiredness. Laboratory studies show a serum glucose level of 25 mg/dL, an increase in serum insulin, and absent serum C-peptide. Which of the following is the most likely cause of her hypoglycemia?

Benign tumor of β-islet cells

Ectopic secretion of an insulin-like factor

Malignant tumor of α-islet cells

Patient injection of human insulin

Patient injection of human insulin

Which of the following occur in both type 1 and type 2 diabetes mellitus?

Antibodies against islet cells

Association with HLA-Dr3/Dr4

Down-regulation of insulin receptor synthesis

Ketoacidosis

Osmotic damage

Osmotic damage

A 3-year-old child has a recurrent history of fatty stools and respiratory infections. Physical examination reveals a polyp in the right nasal cavity. Which of the following tests should be ordered?

Chromosome analysis

Stool culture

Sweat chloride

Total serum immunoglobulin

Sweat chloride

A 58-year-old man has pain in the lower lumbar spine and pelvis. Initial

laboratory studies show a normocytic anemia and marked rouleaux of red blood cells. Serum blood urea nitrogen (BUN) is 70 mg/dL, and serum creatinine is 7 mg/dL. A bone marrow aspirate is performed and reveals sheets of malignant plasma cells. Which of the following additional laboratory findings is most likely to be reported?

Hint: Multiple myeloma / monoclonal gammopathy

Decreased erythrocyte sedimentation rate

Decreased serum calcium level

Increased prothrombin time

Monoclonal protein spike on serum protein electrophoresis

Normal bleeding time

Monoclonal protein spike on serum protein electrophoresis

A 22-year-old woman has a history of intermittent, abdominal pain that

occurs after she has a glass of wine. Recently, after collecting a urine

specimen for culture, she notices that the urine color has changed from a yellow to a wine-red color after sitting on the window sill in her kitchen. Which of the following compounds is most likely responsible for the color change in the urine?

Hint: Acute intermittent porphyria (heme synthesis pathway - deficient

uroporphyrinogen synthase enzyme deficiency)

Hemoglobin

Myoglobin

Porphobilin

Urobilin

Uroporphyrin I

Porphobilin

Which of the following is most responsible for the hyperglycemia in diabetic ketoacidosis?

Anaerobic glycolysis

Decreased uptake of glucose in tissue

Gluconeogenesis

Glycogenolysis

Gluconeogenesis

A 36-year-old woman complains of problems with swallowing both solids and liquids. She also complains of changes in her fingers. Physical examination reveals tapered fingers with digital infarctions and dilated vessels on her skin. A radiograph of her fingers reveals dystrophic calcification in subcutaneous tissue. There is no evidence of pulmonary or renal disease.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibo

Anticentromere antibody

A 42-year-old man has repeated sinus infections, a saddle-nose deformity, nodular masses in the lungs, and glomerulonephritis with RBC casts. An antibody study is pending.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibody

c-Antineutrophil cytoplasmic antibod

A 16-year-old girl with a recent history of a severe sore throat presents with fever, dyspnea, and polyarthritis. Cardiopulmonary examination demonstrates a grade III pansystolic murmur heard at the apex and bibasilar inspiratory crackles. Based only on this history and physical examination findings, which of the following laboratory test findings is most likely present?

Increased antimitochondrial antibodies

Increased antistreptolysin O titers

Positive blood culture

Positive serum antinuclear antibody test

Increased antistreptolysin O titer

A 55-year-old woman complains of burning feet and a sore tongue. Examination reveals decreased vibratory sensation in both lower extremities and atrophy of the papillae of the tongue. A CBC shows pancytopenia with macrocytic indices and hypersegmented neutrophils in the peripheral blood.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibod

Antiparietal cell

A 55-year-old woman complains of generalized itching. Physical examination reveals xanthelasma on both eyelids and an enlarged, nontender liver. Serum alkaline phosphatase and γ-glutamyl transferase are markedly increased.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibo

Antimitochondrial antibody

A 25-year-old woman presents with morning stiffness involving both hands, photophobia, and left-sided chest pain that increases with inspiration. Physical examination reveals dullness to percussion in the left lower lobe. A chest radiograph confirms the presence of a left-sided pleural effusion. The serum antinuclear antibody test is positive and a speckled pattern is present in high titer. (Select two antibodies)

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

A 28-year-old man has a history of greasy stools since childhood. He now presents with a vesicular rash on his right elbow.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibod

Antigliadin antibody

A 23-year-old woman complains of droopy eyes at the end of the day and generalized muscle weakness and fatigue. She also complains of difficulty in swallowing solids and liquids, which seem to "get stuck" in the upper part of her esophagus.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibod

Anti-acetylcholine receptor antibody

A 23-year-old man presents with dyspnea and hemoptysis. This is shortly followed by a sudden onset of acute renal failure with hematuria and RBC casts.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibod

Anti-basement membrane antibody

A 55-year-old woman with rheumatoid arthritis complains of dry eyes and a dry mouth.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibody

p-Antineutrophil cytoplasmic Antibod

Anti-SS-A (Ro) antibody

A 56-year-old woman complains of problems swallowing solids and liquids, color changes and pain in her hands, and problems with breathing. Examination reveals pursing of the lips, sclerodactyly and swelling of the fingers, and dry inspiratory crackles at both lung bases.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibod

Anti-topoisomerase

A 22-year-old man complains of recurrent swelling of the face. On some occasions he also has difficulty breathing. Initial laboratory studies show normal concentrations of complement C3 and factor B and a decreased concentration of complement C4. Which of the following additional studies is most indicated?

C1 esterase inhibitor assay

Chromosome study

Cutaneous skin testing to rule out anergy

Quantitative immunoglobulin assay for IgG, IgA, and Ig

C1 esterase inhibitor assay

A 3-year-old boy has a disease characterized by the absence of plasma cells and germinal follicles in lymph nodes and failure of pre-B cells to differentiate into mature B cells.

Ataxia telangiectasia

Bruton's agammaglobulinemia

Common variable immunodeficiency

DiGeorge's syndrome

Selective IgA immunodeficiency

Severe combined immunodeficienc

Bruton's agammaglobulinemia

A 23-year-old man presents with dyspnea and hemoptysis. This is shortly followed by a sudden onset of acute renal failure with hematuria and RBC cast.

Anti-acetylcholine receptor antibody

Anti-basement membrane antibody

Anticentromere antibody

Anti-double-stranded DNA antibody

Antigliadin antibody

Antiparietal cell

Antimitochondrial antibody

Anti-ribonucleoprotein antibody

Anti-Smith (Sm) antibody

Anti-SS-A (Ro) antibody

Anti-topoisomerase

c-Antineutrophil cytoplasmic antibod

Anti-basement membrane antibody

A 25-year-old man has an immunodeficiency disorder associated with a failure of mature B cells to differentiate into plasma cells.

Ataxia telangiectasia

Bruton's agammaglobulinemia

Common variable immunodeficiency

DiGeorge's syndrome

Selective IgA immunodeficiency

Severe combined immunodeficienc

Common variable immunodeficiency

A 20-year-old woman has an immunodeficiency associated with recurrent sinopulmonary disease, allergies, malabsorption, and giardiasis due to lack of a secretory component

Ataxia telangiectasia

Bruton's agammaglobulinemia

Common variable immunodeficiency

DiGeorge's syndrome

Selective IgA immunodeficiency

Severe combined immunodeficiency

Selective IgA immunodeficiency

A 5-year-old girl has an immunodeficiency associated with deficiency of adenosine deaminase leading to destruction of both B and T cells.

Ataxia telangiectasia

Bruton's agammaglobulinemia

Common variable immunodeficiency

DiGeorge's syndrome

Selective IgA immunodeficiency

Severe combined immunodeficiency

Severe combined immunodeficiency

A newborn baby boy has an immunodeficiency associated with tetany and cyanotic congenital heart disease. A chest radiograph shows an absent thymic shadow.

Ataxia telangiectasia

Bruton's agammaglobulinemia

Common variable immunodeficiency

DiGeorge's syndrome

Selective IgA immunodeficiency

Severe combined immunodeficienc

DiGeorge's syndrome

A 6-year-old boy has an immunodeficiency syndrome associated with eczema, recurrent sinopulmonary infections, thrombocytopenia, and abnormalities involving immunoglobulins and cell-mediated immunity.

Ataxia telangiectasia

Bruton's agammaglobulinemia

Common variable immunodeficiency

DiGeorge's syndrome

Selective IgA immunodeficiency

Severe combined immunodeficiency

Wiskott-Aldrich syndrome

Wiskott-Aldrich syndrome

A 10-year-old girl has an immunodeficiency syndrome associated with vessel abnormalities, cerebellar disease, and increased serum α-fetoprotein levels.

Ataxia telangiectasia

Bruton's agammaglobulinemia

Common variable immunodeficiency

DiGeorge's syndrome

Selective IgA immunodeficiency

Severe combined immunodeficiency

Wiskott-Aldrich syndrom

Ataxia telangiectasia

A 20-year-old man with acquired immunodeficiency syndrome (AIDS) has recurrent candidiasis and a Pneumocystis jiroveci pneumonia. Which of the following laboratory test results is expected?

Hypergammaglobulinemia

Increase in CD4 helper T cell/CD8 suppressor T cell ratio

Intact cellular immunity

Normal phytohemagglutinin assay

Normal skin reaction to intradermal injection of Candida

Hypergammaglobulinemia

Which of the following tests is used to confirm a positive or indefinite enzyme-linked immunoabsorbent assay (ELISA) test for HIV?

CD4 T cell count

HIV viral load

p24 capture assay

Western blot assay

Western blot assay

Which bacteria is associated with positive leukocyte esterase and negative nitrite test?

A. Escherichia coli

B. Klebsiella pneumoniae

C. Enterococcus or Staphylococcus saprophyticus

D. Proteus mirabilis

C. Enterococcus or Staphylococcus saprophyticus

Which test is used detects antibodies to several streptococcal antigens?

A. ANA

B. ASO titer

C. CRP

D. Rheumatoid factor

B. ASO titer

Which of the following best describes functional proteinuria?

A. Persistent proteinuria caused by glomerular disease

B. Proteinuria caused by multiple myeloma

C. Transient, benign proteinuria associated with exercise, fever, stress, or orthostatic changes

D. Proteinuria caused by tubular damage

C. Transient, benign proteinuria associated with exercise, fever, stress, or orthostatic changes

What is the most abundant immuonglobin?

A. IgA

B. IgM

C. IgG

D. IgE

C. IgG

Vertebra point tenderness in a 75 years old man. Which is most cost effect for diagnosis?

A. MRI

B. CT scan

C. PSA test

D. Digital rectal examination

D. Digital rectal examination

What test is used to diagnose carcinoid syndrome?

A. Serum AFP

B. Urine VMA

C. 24-hour urine 5-HIAA

D. Serum CA-125

C. 24-hour urine 5-HIAA

What is the most common cause of hyponatremia?

A. Diabetes insipidus

B. SIADH

C. Hyperaldosteronism

D. Hyperparathyroidism

B. SIADH

What is the function of renal-derived prostaglandins?

A. Constrict the afferent arterioles

B. Constrict the efferent arterioles

C. Vasodilate the afferent arterioles

D. Vasodilate the efferent arterioles

C. Vasodilate the afferent arterioles

Newborn with hypoglycemia is due to maternal gestational diabetes. Which is responsible for hypoglycemia in the newborn?

A. Fetal hypoinsulinemia

B. Maternal hypoglycemia

C. Fetal hyperinsulinemia

D. Fetal glucagon excess

C. Fetal hyperinsulinemia

What is the function of angiotensin II on the efferent arterioles of the kidney?

A. Dilates the efferent arteriole

B. Constricts the efferent arteriole

C. Dilates the afferent arteriole

D. Has no effect on renal arterioles

B. Constricts the efferent arteriole

A FENa

C. Prerenal azotemia with an increased BUN/creatinine ratio >20:1

Which of the following describes Syndrome X (metabolic syndrome)?

A. Must have all five diagnostic findings

B. Must have at least two diagnostic findings

C. Must have ≥3: increased triglycerides, decreased HDL, increased waist circumference, increased BP, and increased fasting glucose

D. Must have increased LDL and total cholesterol

C. Must have ≥3: increased triglycerides, decreased HDL, increased waist circumference, increased BP, and increased fasting glucose

Urine with an ammonia smell is most likely to have which pH?

A. Acidic

B. Neutral

C. Alkaline

D. pH is unaffected

C. Alkaline

What is the cause of tetany when there is decreased ionized calcium?

A. Acidosis

B. Alkalosis

C. Hyperkalemia

D. Hypernatremia

B. Alkalosis

What is the tumor marker for medullary thyroid cancer?

A. Thyroglobulin

B. TSH

C. Calcitonin

D. AFP

C. Calcitonin

What is the tumor marker for ovarian cancer?

A. CA 19-9

B. CEA

C. AFP

D. CA-125

D. CA-125

Which of the following is characteristic of Type III hyperlipoproteinemia?

A. Increased LDL with an LDL receptor defect

B. Increased IDL/remnants, ApoE defect, and palmar xanthomas

C. Increased chylomicrons with an ApoC-II defect

D. Isolated decrease in HDL

B. Increased IDL/remnants, ApoE defect, and palmar xanthomas

What factors increase uric acid?

A. Lead poisoning only

B. Diuretics only

C. Cell destruction only

D. Lead poisoning, polycythemia vera, diuretics, and cell destruction

D. Lead poisoning, polycythemia vera, diuretics, and cell destruction

Which test is used for testing patient with cystic fibrosis?

A. Serum chloride test

B. Urine chloride test

C. Sweat chloride test

D. Serum sodium test

C. Sweat chloride test

Patient with symptomatic acute hepatitis B will have which of the following test result ?

A. HBsAg−, HBeAg/HBV DNA−, Anti-HBc IgM−, Anti-HBc IgG+, Anti-HBs+

B. HBsAg+, HBeAg/HBV DNA+, Anti-HBc IgM+, Anti-HBc IgG−, Anti-HBs−

C. HBsAg−, HBeAg/HBV DNA−, Anti-HBc IgM−, Anti-HBc IgG−, Anti-HBs+

D. HBsAg+, HBeAg/HBV DNA−, Anti-HBc IgM−, Anti-HBc IgG+, Anti-HBs−

B. HBsAg+, HBeAg/HBV DNA+, Anti-HBc IgM+, Anti-HBc IgG−, Anti-HBs−

What is the function of C-peptide test?

A. Measures glucose tolerance

B. Diagnoses insulin resistance

C. Helps distinguish exogenous from endogenous insulin

D. Measures glucagon production

C. Helps distinguish exogenous from endogenous insulin

Which test for lactose intolerance?

A. Urea breath test

B. Stool antigen test

C. H+ breath test

D. Schilling test

C. H+ breath test

Which cancer is associated with paraneoplastic Cushing syndrome and hyponatremia?

A. Renal cell carcinoma

B. Hepatocellular carcinoma

C. Small cell lung cancer

D. Medullary thyroid carcinoma

C. Small cell lung cancer

Which test is used to evaluate kidney sodium reabsorption?

A. GFR

B. Creatinine clearance

C. FENa

D. BUN

C. FENa

Which laboratory marker is associated with alcohol consumption?

A. ALT

B. ALP

C. GGT

D. CK-MB

C. GGT

Reye syndrome is classically associated with:

A. Acetaminophen use in adults

B. Ibuprofen use in children

C. Aspirin use in children

D. Antibiotic use in children

C. Aspirin use in children

What is the definition of anuria in an adult?

A.

D.

Which protein is associated with Wilson disease?

A. Transferrin

B. Haptoglobin

C. Albumin

D. Ceruloplasmin

D. Ceruloplasmin

Which bacterium is associated with a positive leukocyte esterase test and a negative nitrite test?

A. Escherichia coli

B. Enterococcus

C. Klebsiella pneumoniae

D. Proteus mirabilis

B. Enterococcus

Which test is used to detect antibodies to several streptococcal antigens?

A. C-reactive protein (CRP)

B. Antistreptolysin O (ASO) titer

C. Rheumatoid factor

D. Antinuclear antibody (ANA)

B. Antistreptolysin O (ASO) titer

Which type of proteinuria is associated with conditions such as fever, exercise, or stress and is generally temporary?

A. Glomerular proteinuria

B. Tubular proteinuria

C. Functional proteinuria

D. Overflow proteinuria

C. Functional proteinuria

Which immunoglobulin is the most abundant in normal serum?

A. IgA

B. IgG

C. IgM

D. IgE

B. IgG

A 75-year-old man has point tenderness in the lower vertebral column and an increased serum alkaline phosphatase. Which is the most cost-effective initial diagnostic step?

A. Colonoscopy

B. Digital rectal examination

C. Radionuclide bone scan

D. Serum gamma-glutamyl transferase

B. Digital rectal examination

Which test is most useful for diagnosing carcinoid syndrome?

A. Serum AFP

B. Serum CA-125

C. Serum CA 19-9

D. Urinary 5-hydroxyindoleacetic acid (5-HIAA)

D. Urinary 5-hydroxyindoleacetic acid (5-HIAA)