Exam 4 Megan F7 Questions: Geriatric, Pediatric, porphyrins, Hgb, Fe,

: Geriatric, Pediatric, porphyrins, Hgb, Fe, trace/toxic elements , and nutrition

Which could account for drug toxicity following a normally prescribed dose to the geriatric patient?

A. Decreased renal clearance

B. Slowing of drug absorption

C. Liver impairment

D. All of the above

D. All of the above

All of the following represent normal physiology of the newborn except:

A. Weight of 2.1 kg

B. Immature liver function and inability to eliminate excess bilirubin

C. Infants normally rapidly adapt by initiating active respiration

D. 4-6 months for the infant's body weight to double

A. Weight of 2.1 kg

Which of these statements are true?

A. Regular exercise can improve the quality of life among geriatric patients

B. Exercise can help prevent depression and other diseases

C. Proper nutrition is important along with exercise

D. All of these statements are true

D. All of these statements are true

Which test would be likely to show an increase in value in a geriatric patient?

A. Calcium

B. Testosterone

C. ANAs

D. Aldosterone

C. ANAs

True or False: It is easy to find healthy adults over 65, with no preexisting conditions to use to develop normal ranges

False

Which of the following conditions are related to acidosis in the pediatric patient?

A. Anoxia and trauma during delivery

B. Respiratory distress syndrome

C. Hyperammonemia caused by liver disease

D. Hyperventilation

A. Anoxia and trauma during delivery

Which of the following biomarkers are found in high concentrations in neonates as compared to adults?

A. Creatinine

B. Ammonia

C. Uric acid levels

D. Total immunoglobulins

B. Ammonia

What are special considerations that need to be taken to account with regards to neonatal blood collections (select all that apply):

A. Sample should always be kept on ice

B. Care should be taken to minimize evaporation of the sample from open tubes

C. Should be processed on large automation

D. Sample volume should be minimized to reduce blood loss

B. Care should be taken to minimize evaporation of the sample from open tubes

D. Sample volume should be minimized to reduce blood loss

Which of the following choices is false concerning blood obtained by heel stick (capillary) and venipuncture (venous)?

A. The chemical composition of the sera derived form each is identical

B. The capillary specimen is likely contaminated with interstitial fluid

C. Venous blood contains higher bilirubin and calcium concentrations

D. Capillary blood contains less concentrated proteins due to mixing with interstitial fluid

A. The chemical composition of the sera derived form each is identical

True or False: Specimens for porphyrin testing do not need to be protected from light

False

Match the porphyria with its symptom type:

Acute Intermittent Porphyria (AIP)

Neuropsychiatric

Match the porphyria with its symptom type:

Erythropoietic Protoporphyria (EPP)

Cutaneous

Match the porphyria with its symptom type: Variegate Porphyria (VP)

Neurocutaneous

Match the porphyria with its symptom type:

Congenital Erythropoietic Porphyria (CEP)

Cutaneous

Which statement about secondary porphyrinurias is not true?

A. Can be caused by liver disease and heavy metal poisoning

B. Inherited disorders of bilirubin metabolism

C. Are an inherited condition associated with increased excretion of urinary porphyrins

D. Not due to an inherited defect in heme synthesis

C. Are an inherited condition associated with increased excretion of urinary porphyrins

True or False: The aqueous solubility of porphyrins varies with the number of carboxylic acid substitutes present in that particular porphyrin compound

True

How many pyrrole rings make up a porphyrin ring?

A. 3

B. 4

C. 6

D. 10

B. 4

This is chelated to the porphyrin ring to form heme.

A. Calcium

B. Iron

C. Oxygen

D. Carbon dioxide

B. Iron

Which type of porphyria is not considered chronic?

A. Hereditary coproporphyria

B. Congenital erythroportic porphyria

C. Erythroportic porphyria

D. Porphyria cutanea tarda

A. Hereditary coproporphyria

Which of the following is a qualitative screening test for porphobilinogen that may be performed to aid in the diagnosis of the porphyrias?

A. Caraway test

B. Gutman test

C. Jendreassik-Grok test

D. Watson-Schwartz test

D. Watson-Schwartz test

The most common abnormalities in the structure of hemoglobin is:

A. Amino acid deletions

B. Elongated hemoglobin chains

C. Fused or hybrid chains

D. Amino acid substitutions

D. Amino acid substitutions

Put in the order of electrophoretic mobility (slowest to fastest) on cellulose acetate: Hgb F, A, C, S

Hgb C (slowest), Hgb S, Hgb F, Hgb A (fastest)

Which of the following hormones is responsible for the stimulation of ductal epithelial cell secretion of bicarbonate?

A. Gastrin

B. Secretin

C. Cholecystokinin (CCK)

D. Insulin

B. Secretin

If this area of the pancreas becomes affected by cancer, there is high potential that it will go undetected and lead to greater morbidity and mortality in the patient.

A. Head

B. Body

C. Neck

D. Tail

D. Tail

Which of the following is not true regarding normal pancreatic fluid?

A. It is clear, colorless, and watery

B. It contains a high concentration of hydrochloric acid

C. It maintains an alkaline pH

D. It has the same concentration of potassium and sodium as serum

B. It contains a high concentration of hydrochloric acid

The hormone responsible for the release of bile into the intestine and the secretion of enzymes by the pancreas is:

A. Cholecystokinin (CCK)

B. Secretin

C. Ghrelin

D. Pancreatic Polypeptide (PP) Hormone

A. Cholecystokinin (CCK)

True or False: the exocrine function of the pancreas includes the production of insulin and glucagon

False

The recommended specimen requirement for steatorrhea is a:

A. 12-hour stool collection

B. 24-hour stool collection

C. 48-hour stool collection

D. 72-hour stool collection

D. 72-hour stool collection

True or False: In patients with exocrine pancreatic insufficiency, fecal fat is often decreased and fecal enzymes are increased

False

True or False: the Ampulla of Vater is were the pancreas and stomach join together

False

True or False: the Acinar cells produce hormones in the pancreas

False

Match the cell type with the hormone it secretes:

Alpha

Glucagon

Match the cell type with the hormone it secretes:

Beta

Insulin

Match the cell type with the hormone it secretes:

Delta

Somatostatin

Match the cell type with the hormone it secretes:

Gamma

Pancreatic Polypeptide Hormones

Match the cell type with the hormone it secretes:

Epsilon

Ghrelin

This test may be used because it is a non-invasive, indirect indicator of moderate and severe exocrine pancreatic dysfunction.

A. Fecal Fat - Sudan Staining

B. Fecal Chymotrypsin

C. Fecal Elastase-1

D. Cholecystokinin (CCK)

C. Fecal Elastase-1

True or False: there are no associated risks with using TPN for patients who need it

False

Marasmus

A diet deficient in protein and calories

Kwashiorkor

A diet deficient in protein but adequate in calories

True or False: since they are stored, water soluble vitamins have greater risk of toxicity

False

Which of these vitamins is water soluble (select all that apply):

A. Vitamin B6

B. Vitamin D

C. Vitamin A

D. Vitamin C

E. Vitamin K

A. Vitamin B6

D. Vitamin C

This deficiency in this vitamin is associated with hair loss, anorexia, and depression. It is often found in hair products and supplements. Taking supplements that contain this may cause interference with certain assays.

A. Vitamin A (retinol)

B. Vitamin B3 (niacin)

C. Vitamin C

D. Vitamin B7 (biotin)

D. Vitamin B7 (biotin)

Select the 2 most common tests run to differentiate the reason behind a diagnosis of Megaloblastic Anemia.

A. Folate

B. Vitamin D

C. Vitamin B6

D. Vitamin B12

A. Folate

D. Vitamin B12

If you had the following lab results, what would condition would you expect to see:

Transferrin increased, Ferritin decreased, % saturation decreased, TIBC increased

A. Iron overdose

B. Iron deficiency

C. Malnutrition

D. Chronic infection

B. Iron deficiency

Match the terms and their definitions:

Atomic Emission Spectroscopy & Atomic Absorption Spectroscopy

- determination of element quantity through the absorption of optical radiation by free atoms in the gas phase

- quantification of an element by measuring the intensity of emitted radiation from an aerosolized sample

Atomic Emission Spectroscopy: quantification of an element by measuring the intensity of emitted radiation from an aerosolized sample

Atomic Absorption Spectroscopy: determination of element quantity through the absorption of optical radiation by free atoms in the gas phase

This element is widely used in industrial & household ways, and interferes with enzyme activity. It is associated with encephalopathy, anemia, bone disease, and progressive dementia. It is excreted mainly in the urine.

A. Copper

B. Aluminum

C. Cadmium

D. Arsenic

B. Aluminum

An employee at a local glass blowing and manufacturing facility is admitted to the Psychiatric Hospital due to severe anxiety and constant bouts of compulsive laughing and crying. Given these symptoms, what kind of heavy metal toxicity should be expected?

A. Manganese

B. Mercury

C. Molybdenum

D. Selenium

A. Manganese

Over the decades, this element has been considered a toxic element, a carcinogen, essential element, and an anti-carcinogen. It is also involved in the metabolism of thyroid hormones.

A. Zinc

B. Selenium

C. Copper

D. Molybdenum

B. Selenium

This heavy metal has both an essential form and a toxic, non-essential form. When absorbed, it will be bound by transferrin and transported by albumin.

A. Chromium

B. Cadmium

C. Copper

D. Aluminum

A. Chromium