OAE - Clinical Chemistry Part 6

A. Acid

A substance that can yield a hydrogen ion (H+) or hydronium ion when dissolved in water:

a. Acid

b. Base

c. Base excess

d. Buffer

B. Base

A substance that can yield hydroxyl ions (OH-):

a. Acid

b. Base

c. Base excess

d. Buffer

D. Buffer

The combination of a weak acid or weak base and its salt; is a system that resists changes in pH:

a. Acid

b. Base

c. Base excess

d. Buffer

B. Occasionally

Mixed respiratory and nonrespiratory disorders ____ arise from more than one pathologic process.

a. Rarely

b. Occasionally

c. Frequently

d. Mostly

A. Respiratory acidosis

An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state?

a. Respiratory acidosis

b. Respiratory alkalosis

c. Metabolic acidosis

d. Metabolic alkalosis

C. Pituitary gland

Master gland:

a. Adrenal cortex

b. Adrenal medulla

c. Pituitary gland

d. Thyroid gland

A. Anterior pituitary gland

Adenohypophysis:

a. Anterior pituitary gland

b. Posterior pituitary gland

B. Posterior pituitary gland

Neurohypophysis

a. Anterior pituitary gland

b. Posterior pituitary gland

A. ACTH

b. FSH

d. LH

f. TSH

Tropic hormones (Select 4):

a. ACTH

b. FSH

c. GH

d. LH

e. Prolactin

f. TSH

C. GH

E. Prolactin

Direct effectors (Choose 2):

a. ACTH

b. FSH

c. GH

d. LH

e. Prolactin

f. TSH

B. GH

Also called somatotropin:

a. ACTH

b. GH

c. LH

d. Prolactin

A. Oral glucose loading

The definitive suppression test to prove autonomous production of growth hormone is:

a. Oral glucose loading

b. Somatostatin infusion

c. Estrogen priming

d. Dexamethasone suppression

D. Amino acids

All of the following inhibit growth hormone secretion except:

a. Glucose loading

b. Insulin deficiency

c. Thyroxine deficiency

d. Amino acids

A. Anterior pituitary gland

Prolactin is produced by the:

a. Anterior pituitary gland

b. Posterior pituitary gland

c. Adrenal cortex

d. Adrenal medulla

A. Vasopressin deficiency

Diabetes insipidus

a. Vasopressin deficiency

b. Vasopressin excess

D. TSH assay

Select the most appropriate single screening test for thyroid disease.

A. Free thyroxine index

B. Total T3 assay

C. Total T4

D. TSH assay

a. Primary hyperthyroidism

The serum TSH level is almost absent in:

a. Primary hyperthyroidism

b. Primary hypothyroidism

c. Secondary hyperthyroidism

d. Euthyroid sick syndrome

a. Primary hyperthyroidism

A patient has an elevated serum T3 and free T4 and undetectable TSH. What is the most likely cause of these results?

a. Primary hyperthyroidism

b. Secondary hyperthyroidism

c. Euthyroid with increased thyroxine-binding proteins

d. Euthyroid sick syndrome

D. All of these

Associated with neonatal hypothyroidism:

a. Cretinism

b. Growth retardation

c. Mental retardation

d. All of these

A. Aldosterone

Critical for sodium retention (volume), potassium, and acid-base homeostasis.

a. Aldosterone

b. Cortisol

B. Cortisol

Critical to blood glucose homeostasis and blood pressure:

a. Aldosterone

b. Cortisol

B. Catecholamine

First responders to stress by acting within seconds:

a. Aldosterone

b. Catecholamine

c. Cortisol

d. Estrogen

A. Excess secretion of pituitary ACTH

Which of the following is the mechanism causing Cushing's disease?

a. Excess secretion of pituitary ACTH

b. Adrenal adenoma

c. Treatment with corticosteroids

d. Ectopic ACTH production by tumors

C. Serum ACTH

Which test is used to distinguish Cushing's disease (pituitary Cushing's) from Cushing's syndrome caused by adrenal tumors?

a. Low-dose overnight dexamethasone suppression

b. Petronasal sinus sampling

c. Serum ACTH

d. Twenty-four-hour urinary free cortisol

A. Overnight low-dose dexamethasone suppression test

Which is the most widely used screening test for Cushing's syndrome?

a. Overnight low-dose dexamethasone suppression test

b. Corticotropin-releasing hormone stimulation test

c. Petronasal sinus sampling

d. Metyrapone stimulation test

A. Cholesterol

The parent substance in the biosynthesis of androgens and estrogens is:

a. Cholesterol

b. Cortisol

c. Catecholamines

d. Progesterone

B. Estradiol (E2)

Select the main estrogen produced by the ovaries and used to evaluate ovarian function.

A. Estriol (E3 )

B. Estradiol (E2 )

C. Epiestriol

D. Hydroxyestrone

D. Testosterone

The biologically most active, naturally occurring androgen is:

a. DHEA

b. Androstenedione

c. Epiandrosterone

d. Testosterone

A. Gastrin

Zollinger-Ellison (Z-E) syndrome is characterized by great (e.g., 20-fold) elevation of:

a. Gastrin

b. Cholecystokinin

c. Pepsin

d. Glucagon

C. Hirsutism

Which of the following conditions can be quantified using a measurement technique known as the Ferriman-Gallwey Scale?

a. Acromegaly

b. Cushing's syndrome

c. Hirsutism

d. PCOS

A. Acute toxicity

It is usually associated with a single, short term exposure to a substance, the dose of which is sufficient to cause immediate toxic effects:

a. Acute toxicity

b. Chronic toxicity

B. Chronic toxicity

It is usually associated with repeated frequent exposure for extended period for greater than 3 months and possibly years, at doses that are insufficient to cause an immediate acute response:

a. Acute toxicity

b. Chronic toxicity

D. Cigarette smokers

Levels of 8-9% carboxyhemoglobin saturation of whole blood are commonly found in which of the following situations?

a. Fatal carbon monoxide poisoning

b. Acute carbon monoxide poisoning

c. Nonsmoking residents of rural areas

d. Cigarette smokers

B. Morphine

Heroin is synthesized from what drug?

a. Diazepam

b. Morphine

c. Ecgonine

d. Chlorpromazine

B. Marijuana

THC (tetrahydrocannabinol) is the principal active component of what drug?

a. Benzodiazepine

b. Marijuana

c. Morphine

d. Codeine

D. Marijuana

Which substance has the longest detection time?

a. Amphetamines

b. Cocaine

c. Benzodiazepines

d. Marijuana

B. Ecstasy

Methylenedioxymethamphetamine (MDMA) is an illicit amphetamine derivative that is commonly referred to as:

a. Angel dust

b. Ecstasy

c. Marijuana

d. Shabu

A. 0.5 to 1 hour

Half-life of a circulating cocaine is

A. 0.5 to 1 hour

B. 1 to 2 hours

C. 2 to 3 hours

D. 3 to 4 hours

B. Cocaine

Identification of the urinary metabolite benzoylecgonine would be useful in determining exposure to which of the following drugs?

a. Codeine

b. Cocaine

c. Amphetamine

d. Propoxyphene

C. Cocaine

All of the following are CNS depressants except:

a. Barbiturates

b. Benzodiazepines

c. Cocaine

d. Methaqualone

C. Whole Blood

Of the following specimens, which would be appropriate for determining exposure to lead?

a. EDTA plasma

b. Serum

c. Whole blood

d. Cerebrospinal fluid

A. Arsenic

This toxin has high affinity to keratin, can be identified from hair and nails:

a. Arsenic

b. Cyanide

c. Lead

d. Mercury

C. Cyanide Overdose

Clues include the ODOR OF BITTER ALMONDS, the occurrence of an altered mental status and tachypnea in the absence of cyanosis, and an unexplained metabolic acidosis:

A. Arsenic toxicity

B. Carbon monoxide intoxication

C. Cyanide overdose

D. Iron poisoning

A. Arsenic toxicity

The ODOR OF GARLIC may be on the breath, and a METALLIC TASTE in the patient's mouth:

a. Arsenic toxicity

b. Carbon monoxide intoxication

c. Cyanide overdose

d. Iron poisoning

B. Ethanol

Most common drug of abuse:

a. Cocaine

b. Ethanol

c. Methanol

d. Marijuana

C. Liberation, absorption, distribution, metabolism, excretion

Select the five pharmacological parameters that determine serum drug concentration.

A. Absorption, anabolism, perfusion, bioactivation, excretion

B. Liberation, equilibration, biotransformation, reabsorption, elimination

C. Liberation, absorption, distribution, metabolism, excretion

D. Ingestion, conjugation, integration, metabolism, elimination

A. Varies with the drug, depending on its rate of absorption

Blood sample collection time for peak drug levels:

A. Varies with the drug, depending on its rate of absorption

B. Is independent of drug formulation

C. Is independent of the route of administration

D. Is 30 minutes after a bolus intravenous injection is completed

C. Shortly before drug administration

When is a blood sample for determination of the trough level of a drug appropriately drawn?

A. During the absorption phase of the drug

B. During the distribution phase of the drug

C. Shortly before drug administration

D. Two hours after drug administration

D. Intravenous

Which route of administration is associated with 100% bioavailability?

A. Sublingual

B. Intramuscular

C. Oral

D. Intravenous

C. Salicylate

For what colorimetric determination is the Trinder reaction widely used?

A. Acetaminophen

B. Propoxyphene

C. Salicylate

D. Barbiturate

D. Liver

Acetaminophen is particularly toxic to what organ?

a. Heart

b. Kidney

c. Spleen

d. Liver

B. Kidney

Increased trough levels of aminoglycosides in the serum are often associated with toxic effects to which organ?

A. Heart

B. Kidney

C. Pancreas

D. Liver

C. Tacrolimus

Which of the following drugs is used as an immunosuppressant in organ transplantation, especially in liver transplants?

a. Methotrexate

b. Amiodarone

c. Tacrolimus

d. Paroxetine

A. Theophylline

Which of the following drugs is used as a bronchodilator

a. Theophylline

b. Phenytoin

c. Amikacin

d. Clozapine

D. 3 and 4

Bronchodilators

1. Digoxin

2. Phencyclidine

3. Theophylline

4. Theobromine

a. 1 and 2

b. 1 and 3

c. 2 and 4

d. 3 and 4

B. Caffeine

Which of the following is a commonly encountered xanthine that could potentially interfere with the determination of theophylline?

a. Nicotine

b. Caffeine

c. Amphetamine

d. Procainamide

B. Lithium

Which of the following is used in the treatment of manic depression?

a. Potassium

b. Lithium

c. Calcium

d. Chloride

D. Vancomycin

The major toxicities of ____ are red man syndrome, nephrotoxicity, and ototoxicity.

a. Aminoglycosides

b. Cephalosporin

c. Penicillin

d. Vancomycin

B. Ethosuximide

The drug of choice for absence (petit mal) seizures unaccompanied by other types of seizures:

a. Carbamazepine (Tegretol)

b. Ethosuximide (Zarontin)

c. Primidone (Mysoline)

d. Valproic acid (Depakene)

D. 1, 2, and 3

Which of the following do not require TDM?

1. Salicylates

2. Acetaminophen

3. Ibuprofen

a. 1 and 2

b. 1 and 3

c. 2 and 3

d. 1, 2, and 3