Advanced Clinical Chemistry Final

The marker for colorectal and pancreatic carcinoma is

CA 19-9

Which of the following statements is correct regarding glycocholic and taurocholate acid?

They are bile acids synthesized in the liver

Which of the following cells contain cholecystokinin (CCK)?

I cells from the upper small intestingal mucosa

Which enzyme serves as the activator for the remaining pancreatic enzymes?

Trypsin

Complications of acute pancreatitis include all of the following EXCEPT

Hypotriglyceridemia

The alpha cells of the islets of langerhans of the pancreas produce

Glucagon

The structure of cholecystokinin (CCK) is described as

Linear polypeptide with multiple molecular forms

Which disorder is related to mucus accumulation, recurrent infection with unusual pathogens, and increased inflammation in the lungs?

Cystic fibrosis

A gastrinoma is classified as which of the following?

Neuroendocrine tumor (NET)

Transmural inflammation is associated with

Crohn's disease

The role of cardiac biomarkers includes which of the following?

Diagnosis, monitoring, risks stratification, and therapeutic management

NT-pro-BNP consists of 76 amino acids and is described as a

natriuretic peptide that is the inactive form

Which of the following represents the correct sequence for the rise and fall of myoglobin, CK-MB, and cTnI after an AMI?

Myoglobin, CK-MB, cTnI

Myoglobin is a good cardiac marker because it

Diffuses into the blood more quickly than CK-MB

Which of the following cardiac biomarkers is a better biomarker of plaque instability?

MPO

Which of the following troponins have been demonstrated in patients with muscular dystrophy and end-stage renal disease (ESRD)?

Cardiac troponin T

The albumin cobalt-binding test is used to measure which of the following?

Ischemia modified albumin

Infusion of Nesiritide is documented to act as a confounder for which of the following assays?

Brain natriuretic peptide (BNP)

The troponin complex consists of which of the following?

Troponin M1, troponin M2, and troponin K

Which of the following statements summarizes the significance of CRP in the arterial wall?

It predicts the severity of atherosclerosis and is able to bind to damaged membranes and lipids

Which of the following is an advantage of POCT for cardiac biomarkers?

Rapid identification of AMI

Lp (a) is considered a risk factor for developing artherosclerosis due to which of the following?

It competes with plasminogen for binding sites, thus interfering with clot lysis and increasing the risk of acute myocardial infarction (AMI)

What is the clinical usefulness of measuring serum adiponectin?

Plasma adiponectin levels may predict cardiovascular events years in advance in a population without diagnosed cardiovascular disease

High blood levels of adiponectin are associated with

Reduced risk of heart attacks

Which of the following is a cause of hyperhomocysteinemia?

Deficiency of one of the B complex vitamins

Which of the following statements is TRUE about cTnI?

Cardiac forms are never expressed in skeletal muscle

A Model for End-Stage Liver disease staging system to predict prognosis in cirrhosis uses the following laboratory determinations EXCEPT

Aspartate transaminase

The first serological marker of Hepatitis B is

HBsAg

The two most significant sources of error in accurate ammonia determination are sample handling and

Ammonia contamination in the laboratory

Which of the statements regarding bilirubin metabolism is TRUE?

It is produced from the destruction of RBCs

Which of the following statements is correct when procuring specimens for measuring porphyrin compounds?

Protect the specimen from light

What is the primary storage form of iron?

Ferritin

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

Hydroxymethylbilane synthase

The term δ-bilirubin (delta) refers to

Bilirubin tightly bound to albumin

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

Uridine diphosphate (UDP) glucoronyl transferase

Which of the following specimens is appropriate to determine the concentration of lead in body fluids?

Whole blood

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

Lead

Protoporphyrins that chelate iron are called:

Heme

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

Ferrozine

Which of the following compounds initially condenses to form aminolevulinic acid?

Succinyl coenzyme A and glycine

Heme is defined as

Protoporphyrins that chelate iron

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

Hepatocytes

In the Jendrassik-Grof bilirubin, what converts purple azobilirubin to blue azobilirubin measured at 600nm?

Alkaline tartrate

Nonalcoholic steatohepatitis is characterized by all of the following EXCEPT:

AST greater than ALT

Viral hepatitis that results in the largest percentage of chronic hepatitis is

Hepatitis C

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 cytochromes plays a major role in the metabolism of drugs in the liver?

Cytochrome P450

Aceruoplasminemia 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 is an example of an antiarrhythmic drug that has a metabolite with very similar same pharmacological action?

Procainamide

A blood sample for a trough drug level should be drawn:

Shortly before drug administration

The fractional extent to which a dose of drug reaches its site of action is referred to as

Bioavailability

Chromium in blood binds to which of the following proteins?

Chromodulin

Which of the following compounds is an anticonvulsant used to control tonic-clonic (grand mal) seizures?

Phenytoin

FK506 (tacrolimus) is classified as a (an):

Immunosuppressant

Steady state of a drug is typically achieved after:

Approximately seven half-lives

Which of the following classes of compounds has a sedative effect and is used to treat anxiety?

Benzodiazepines

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

Decreased blood copper

Following the entrance of a drug into the vascular compartment, it will be carried to all organs and fluid compartments. This statement describes which of the following?

Distribution

Berylliosis in humans affects which of the following organs?

Lungs

Carbamazepine, primidone, and valproic acid are all examples of:

Antiepileptic drugs

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

Antacids

Screening methods for drug abuse testing requires which of the following assay characteristics?

They must be analytically sensitive

Which of the following assays is recommended as a screening test for colorectal cancer in persons over 50 years of age?

Occult blood test

The term associated with indirect methods for assessment of vitamin status is termed:

Functional assays

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

Decreased vitamin B12, decreased folic acid

Niacin is converted to which of the following two cofactors?

Nicotinamide-adenine dinucleotide and nicotinamide-adenine dinucleotide phosphate

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

Beriberi

Retinol is formed from which of the following vitamins?

Preformed vitamin A

A new tumor marker assay for prostate specific antigen (PSA) is evaluated for diagnostic sensitivity by testing serum samples from patients who have been diagnosed as having prostate cancer. The following results were obtained:

Number of prostate cancer patients who tested positive by the new assay = 42 out 46

Number of patients who did not have cancer and tested negative by the new assay = 31 out of 32

What is the sensitivity of the new assay for PSA?

91.3%

Which molecular form(s) is/are measured by an intact β-hCG assay?

The whole molecule

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)

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

Beriberi

A deficiency of vitamin K (menaquinone) can result in which of the following?

Increased clotting time

Which of the following must be determined to calculate diagnostic specificity?

True-negatives and false-positives

Which type of hCG test would be most useful to assess a person suspected of having testicular cancer?

Plasma immunoassay for intact hCG and the β-hCG subunits

Nuclear matrix protein-22 (NMP) is a tumor marker designed for what purpose?

Test for recurrence of bladder cancer

Which tumor marker is associated with cancer of the urinary bladder?

Nuclear matrix protein

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

Measurement of vitamin B12 concentration in serum using an immunoassay is an example of which of the following?

Direct assay

A markedly elevated serum AFP is associated with which of the following?

Hepatoma

Vitamin D deficiency leads to which of the following conditions?

Rickets

Which of the following is a biomarker of Alkaptonuria?

Homogentisic acid

Which of the following hormones may be decreased in the geriatric population?

Testosterone

The following analytes decrease with age EXCEPT:

Total cholesterol

Which of the following is a disorder in which a bronchus or bronchi remains dilated after an infection or obstruction?

Bronchiectasis

Children with untreated phenylketonuria (PKU) may develop:

Mental retardation

Somatopause is associated with a decreased secretion of:

Growth hormone

Which of the following is a biological marker of sarcopenia?

Serum albumin

The sweat chloride test is designed to:

evaluate patients with possible cystic fibrosis (CF)

Which of the following enzymes is deficient in patients with maple syrup urine disease?

Branched chain ketoacid dehydrogenase

Currently, the Centers for Disease Control and Prevention (CDC) identifies children with lead levels above what level, as having an elevated lead level and requires further investigation?

5 µg/dL

Energy density is defined as:

The amount of energy stored from the conversion of ATP to ADP during the citrus acid cycle

Conditions linked to age-related bone loss include all of the following EXCEPT:

hypoparathyroidism

Which of the following disorders is exhibited by a parent who does harm to their child?

Munchausen syndrome by proxy

Which of the following specimen requirements is correct for blood lactic and pyruvic acid testing?

Specimen should be collected without a tourniquet, transported on ice and analyzed immediately

The aging kidney can be described as having:

a deceased number of nephrons

Which of the following genes is located on chromosome 7 and encodes a chloride channel of the same name that's on the surface of specialize cells throughout the body?

CFTR

Fulminate peptic ulcers, large amounts of gastric hypersecretion, and non-β-islet cell tumors of the pancreas characterize which of the following?

Zollinger -Ellison syndrome

Which of the following sugars is found in the feces of a patient with lactase deficiency?

Glucose

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

Vasoactive intestinal polypeptide