Clinical Chemistry Final Exam Review

anode

In electrophoresis, the electrode having a positive charge is the:

a) indicating electrode

b) anode

c) reference electrode

d) cathode

Sodium fluoride

Which of the following additives is recommended for preservations of glucose in blood samples to prevent glycolysis?

a) Citrate

b) Heparin

c) Sodium fluoride

d) EDTA

Insulin

Which of the following hormones acts to lower the concentrations of glucose in the blood?

a) Adrenalin

b) Insulin

c)Glucagons

d)All of above

a) Chylomicrons

The least dense lipoprotein is:

a) Chylomicrons

b)VLDL

c)LDL

d) HDL

conversion of glucose to glycogen

Glycogenesis means:

a)

formation of glucose from non-carbohydrate sources

b)

conversion of glucose to glycogen

c)

conversion of glucose to lactate and pyruvate

d)

breakdown of glycogen to glucose

hexokinase

The reference method for glucose determination is:

a)

glucose oxidase

b)

o-toluidine

c)

hexokinase

d)

none of the above

decrease

If a blood specimen was collected in red top tube and left uncentrifuged at room temperature, the glucose value would:

a)

not be affected unless the blood was lipemic

b)

decrease

c)

increase

d)

not be affected unless the blood was hemolyzed

hexokinase

The reaction ATP+glucose → gluc -6- phosphate + ADP is catalyzed by the enzyme:

a)

phophorylase

b)

hexokinase

c)

glucose-6-phosphatase

d)

glucose oxidase

glycerol and fatty acids

Triglycerides are composed of:

a)

phospholipids and alcohol

b)

steroids and fatty acids

c)

glycerol and fatty acids

d)

formaldehyde and alcohol

coronary artery disease

The quantitation of HDL is thought to be significant in the risk assessment of:

a)

cirrhosis

b)

pancreatitis

c)

hepatitis

d)

coronary artery disease

buiret reaction

The most widely used procedure for determining total protein which is based on the reaction of peptide bonds with cupric ions in an alkaline solution is:

a)

buiret reaction

b)

Lowery procedure

c)

BCG procedure

d)

Kjeldahl technique

nitrogen

The element that distinguishes proteins from carbohydrates and lipids is;

a)

oxygen

b)

carbon

c)

nitrogen

d)

hydrogen

peptide bonds

Amino acids are linked in proteins resulting in the primary structure of proteins by:

a)

peptide bonds

b)

sulfide bonds

c)

ester bonds

d)

hydrogen bonds

albumin

The protein found in the highest concentration in serum is:

a)

alpha globulin

b)

beta globulin

c)

gamma globulin

d)

albumin

albumin

As a result of protein electrophoresis, which of these protein fractions would be found nearest the anode?

a)

gamma globulin

b)

alpha-1 globulin

c)

albumin

d)

alpha-2 globulin

isoelectric point

The pH value at which the sum of the electric charges on a protein equals zero is referred to as the:

a)

equalization point

b)

balanced point

c)

isoelectric point

d)

cation point

all of the above

Which of the following functions may be ascribed to proteins?

a)

act as catalysts

b)

form antibodies

c)

transport other compound on the blood

d)

all of the above

PKU

Which of the following is an example of an amino acid metabolism disorder?

a)

Niemann-Pick

b)

Tay - Sachs

c)

PKU

d)

Gaucher's disease

pancreas

Blood Glucose is maintained at fairly constant levels by:

a)

stomach

b)

intestines

c)

pancreas

d)

liver

hepatic coma

Blood ammonia levels are used primarily to identify what clinical entity?

a)

pancreatic cancer

b)

Crigler-Najjar syndrome

c)

Wilson's disease

d)

hepatic coma

azotemia

Increased levels of NPN in the serum with no clinical symptoms yet seen in the patient is know as:

a)

azotemia

b)

icterus

c)

uremia

d)

osuria

urea

The main product of protein metabolism is:

a)

uric acid

b)

ammonia

c)

creatinine

d)

urea

creatinine

The waste product of muscle metabolism which is excreted into the urine is:

a)

uric acid

b)

creatinine

c)

ammonia

d)

urea

gouty arthritis

Determination of serum uric acid is useful in the diagnosis of:

a)

thyroid disease

b)

pancreatic disease

c)

rheumatic arthritis

d)

gouty arthritis

ammonia

A major source of error for BUN methods utilizing urease is:

a)

ammonia

b)

ketoacids

c)

heparin

d)

alcohol

neutral

At isoelectric point, the charge on a serum protein is:

a)

ionic

b)

neutral

c)

positive

d)

negative

HDL

Which of the following is commonly known as the "good" cholesterol?

a)

HDL

b)

chylomicrons

c)

VLDL

d)

LDL

100-126 mg/dL

The cutoff point for "Normal" fasting glucose values as established by the ADA:

a)

100 - 126 mg/dL

b)

126 - 200 mg/dL

c)

110 - 126 mg/dL

d)

80 - 200 mg/dL

Iron

Transferrin is a beta globulin responsible for transporting:

a)

thyroxine

b)

Free hemoglobin

c)

Copper

d)

Iron

microalbumin

The urine protein used to detect early stages of glomerular dysfunction in diabetic patients is:

a)

microalbumin

b)

hemopexin

c)

c-reactive protein

d)

prealbumin

HDL ≥ 60 mg/dL

Which of the following is a negative risk factor for coronary artery disease?

a)

HDL ≥ 60 mg/dL

b)

family history of CAD

c)

LDL ≥ 160 mg/dL

d)

hypertension

All of the above

What laboratory result would be diagnostic for diabetes mellitus?

a)

random glucose ≥ 200 mg/dL

b)

fasting glucose ≥ 126 mg/dL

c)

all of the above

d)

none of the above

chylomicrons

Which of the following analytes is not part of a routine lipid panel?

a)

triglycerides

b)

HDL

c)

chylomicrons

d)

LDL

hemoglobin A1c

What test is used to assess the average blood glucose level over a 3 month period?

a)

microalbumin

b)

glucose tolerance test

c)

hemoglobin A1c

d)

random glucose

C-reactive protein

Which acute phase protein will be elevated at the early onset of an inflammatory disease?

a)

alpha-1 antitrypsin

b)

haptoglobin

c)

C-reactive protein

d)

alpha-2 macroglobulin

both A and C

Which of the following describes an enzyme?

a)

catalyst

b)

carbohydrate

c)

protein

d)

both A and C

e)

both A and B

zero order kinetics

Enzyme activity should be measured during:

a)

any of the above, it doesn't matter

b)

second order kinetics

c)

zero order kinetics

d)

first order kinetics

Sodium

The primary extracellular cation is:

a)

chloride

b)

potassium

c)

sodium

d)

calcium

potassium

The cation present in the greatest concentration in the cell is:

a)

sodium

b)

potassium

c)

chloride

d)

phosphorous

potassium

Which of the following electrolytes would be significantly increased by slight hemolysis?

a)

potassium

b)

sodium

c)

bicarbonate

d)

chloride

valinomycin

When measuring potassium using an ion-selective electrode, the membrane is composed of:

a)

plastic

b)

valinomycin

c)

silver

d)

glass

homozygous Hgb S

Sickle Cell Anemia is associated with what genetic hemoglobin trait?

a)

homozygous Hgb S

b)

heterozygous Hgb S

c)

heterozygous Hgb C

d)

homozygous Hgb C

Hemoglobin

The majority of iron in the body (66%) is contained in:

a)

Hemoglobin

b)

Transferrin

c)

Hemosiderin

d)

Ferritin

Transferrin

The chemical compound that transports iron through the body is known as:

a)

Ferritin

b)

Transferrin

c)

Hemosiderin

d)

Hemoglobin

O2 saturation

Which of the following is not part of a routine iron profile?

a)

O2 saturation

b)

Ferritin

c)

Serum iron

d)

TIBC

will increase

What effect would hemolysis have on the serum LD result obtained on a sample?

a)

may increase or decrease

b)

will decrease

c)

no effect

d)

will increase

MM and MB

Heart muscle contains which of the following CK isoenzymes?

a)

MB only

b)

BB only

c)

MM and MB

d)

MM and BB

P3

Which amylase isoenzyme is absent in normal serum but present in the serum of the patient with acute pancreatitis?

a)

S2

b)

P3

c)

macroamylase

d)

S1

lipase

Which enzyme is produced by the pancreas?

a)

ALT

b)

AST

c)

CK

d)

lipase

CK

Which of the following enzymes would not be useful in assessing liver function?

a)

AST

b)

ALT

c)

CK

d)

all would aid in liver function assessment

amylase

Which of the following enzymes would increase in a patient with acute pancreatitis?

a)

CK

b)

LD

c)

ALT

d)

amylase

aldosterone

Which of the following analytes does not have an effect on calcium levels?

a)

aldosterone

b)

vitamin D

c)

parathyroid hormone

d)

calcitonin

ferritin

The primary storage form of iron is:

a)

ferritin

b)

haptoglobin

c)

apotransferrin

d)

hemosiderin

tissue or organ damage and necrosis

What does an increase in clinically significant serum enzyme levels indicate?

a)

tissue or organ damage and necrosis

b)

increased glomerular filtration

c)

decrease in enzyme metabolism

d)

increased enzyme production

glass

When measuring sodium using an ion-selective electrode, the membrane is composed of:

a)

plastic

b)

glass

c)

valinomycin

d)

silver

substrate concentration

When measuring enzyme activity, the test procedure should be established so that which of the following is the rate-limiting factor?

a)

temperature

b)

enzyme concentration

c)

pH

d)

substrate concentration

Concentration of enzyme

In Zero order of Kinetics, the velocity of the reaction is influenced by:

a)

Concentration of substrate

b)

pH

c)

Concentration of enzyme

d)

temperature

electroneutrality

What term describes the balance of cations and anions in the body?

a)

electroneutrality

b)

isoelectric point

c)

electromagnetic balance

d)

osmotic balance

sepsis

An elevation of lactate in the serum can be an indication of what clinical entity?

a)

pancreatic cancer

b)

sepsis

c)

fever of unknown origin

d)

myocardial infarction

True

Approximately 45% of the body's calcium is ionized.

a) True

b) False

True

Iron deficiency is the most common cause of anemia.

True

False

4000 ml/hr

serum creatinine =1.5 mg/dL

urine creatinine =40 mg/dL

urine volume = 3600ml/24 hours

(hint = units for the answer are ml/hr)

Calculate the patient's creatinine clearance

2.lyases

Match the enzyme class with its primary function.

1.transferases

2.lyases

3.hydrolases

4.oxidoreductases

catalyze the removal of groups without hydrolysis

1.transferases

Match the enzyme class with its primary function.

1.transferases

2.lyases

3.hydrolases

4.oxidoreductases

catalyze the transfer of chemical groups

4.oxidoreductases

Match the enzyme class with its primary function.

1.transferases

2.lyases

3.hydrolases

4.oxidoreductases

catalyze an oxidation/reduction reaction between two substrates

3.hydrolases

Match the enzyme class with its primary function.

1.transferases

2.lyases

3.hydrolases

4.oxidoreductases

catalyze hydrolysis of various bonds

liver

Match the clinically significant enzyme with its primary organ function.

1.liver

2.brain

3.pancreas

aspartate aminotransferase

pancreas

Match the clinically significant enzyme with its primary organ function.

1.liver

2.brain

3.pancreas

amylase

brain

Match the clinically significant enzyme with its primary organ function.

1.liver

2.brain

3.pancreas

CK BB

pancreas

Match the clinically significant enzyme with its primary organ function.

1.liver

2.brain

3.pancreas

lipase

liver

Match the clinically significant enzyme with its primary organ function.

1.liver

2.brain

3.pancreas

ALT

lipid panel

A 52 year old man went to his physician for a physical. The patient had been a district manager for an automobile insurance company for the past 10 years and was 24 lbs overweight. His blood pressure was elevated and his blood chemistry results were listed below.

Na 151 high

K 4.5

Cl 106 high

HCO3 13 low

Total Protein 5.7 low

Albumin 1.6 low

Ca 7.9 low

Cholesterol 210 high

Uric acid 6.2

Creatinine 2.5 high

BUN 95 high

Glucose 88

Amylase152

Based on the abnormal results, what panel of testing would you order next?

VLDL=triglyceride/5

LDL= total cholesterol - HDL - VLDL

VLDL=100/5 = 20mg/dL

LDL=210 - 23 - 20= 167mg/dL

167 mg/dL

If this patient had a triglyceride of 100mg/dL and an HDL of 23mg/dL, what would be his calculated LDL value?

VLDL=triglyceride/5

LDL= total cholesterol - HDL - VLDL

VLDL= 476/5 = 95.2mg/dL

LDL= 210-23-95.2= 91.8mg/dL

91.8 mg/dL

If, however, his triglycerides were 476 mg/dL with an HDL of 23 mg/dL, what would his LDL value be?

(Na + K) - (Cl - HCO3)

(145+5.8)-(87+8) = 55.8

Calculate the Anion Gap:

Na 145

K 5.8

Cl 87

HCO3 8

Diabetes II

A 58 year old man with frequent urination was seen by his physician. The following lab results were obtained

Fasting plasma glucose 225mg/dL

Urine glucose 2+

Urine ketones negative

What is the diagnosis of this patient?

Diabetes I

Diabetes II

Hypoglycemia

Gestational diabetes

Hemoglobin A1C

What test should be used to monitor a patient with a Fasting glucose of 225 mg/dL, urine glucose 2+ ?

Hemoblobin A1C

Hemoglobin A1C

GTT

ketones

hemoglobin=>hemoglobin breakdown (spleen)=>transferrin

Transferrin=> Red blood cells in Bone marrow =>______=>_______=>_______=>

b)

for glassware washing

Type III water can be used in the laboratory:

a)

for general laboratory testing

b)

for glassware washing

c)

in preparations of controls

d)

has no use in the laboratory

c)

Henderson-Hasselbalch

What is this equation called?

pH = pka + log [A-]/[HA]

a)

Beer's Law

b)

Dilution Converstion

c)

Henderson-Hasselbalch

d)

Hasselbalch-Henderson

d)

a serologic pipette with a double ring indicates that it is a "blow-out" pipette

Which of the following statements concerning laboratory glassware is true?

a)

graduated cylinders can be used to measure the amount of water required to reconstitute a lyophilized standard.

b)

a volumetric flask can be used to deliver a critical volume

c)

a volumetric pipette should be "blow-out" in order to deliver an accurate volume.

d)

a serologic pipette with a double ring indicates that it is a "blow-out" pipette

True

When performing a water purity check using a flowmeter, the amount of electrical resistance increases as the purity of the water increases.

True or False

c)

according to their chemical properties and classification.

Chemicals should be stored:

a)

Inside a safety cabinet with proper ventilation

b)

Alphabetical, for easy accessibility

c)

according to their chemical properties and classification.

d)

Inside a fume hood, because toxic vapor can be released

b)

Absorbance increases as concentration increases

In spectrophotometry:

a)

Absorbance decreases as concentration increases

b)

Absorbance increases as concentration increases

c)

The color of the solution being measured decreases as concentratio increases

d)

Percent transmittance increases as concentration increases

b)

precision

The term that means reproducibility among replicate determination of a sample is:

a)

reliability

b)

precision

c)

standard deviation

d)

accuracy

2%

The mean of a series of results is 100 mg/dL and the standard deviation is 2 mg/dL. The percent coefficient of variation would be:

a)

0.5%

b)

4%

c)

2%

d)

1%

b)

125 mg/dL

Assuming a testing procedure follows Beer's Law, if the concentration of a standard is 250 mg/L with and absorbance reading of 0.50, and the absorbance of the unknown is 0.25 what is the concentration of the unknown?

a)

500 mg/dL

b)

125 mg/dL

c)

175 mg/dL

d)

325 mg/dL

b)

most frequently occurring variable in the data set

Mode is defined as the:

a)

middle value of data

b)

most frequently occurring variable in the data set

c)

average of all test results

d)

difference between the highest and lowest values in a data set

False

Your standard curve has the following values: 50 mg/dL, 75 mg/dL, 100 mg/dL, 125 mg/dL. You obtain a patient value of 136 mg/dL. This result will be valid because it is within the linearity limits of the test procedure.

True or False

d)

coefficient of variation

The formula (SD/ X) x 100 is for:

a)

specificity

b)

variance

c)

sensitivity

d)

coefficient of variation

a)

0.000

The transmittance of 100% represents the following absorbance:

a)

0.000

b)

2.000

c)

1.000

d)

0.097

a)

An antibody which is directed against multiple epitopes on the antigen

The definition of a Polyclonal Antibody is

a)

An antibody which is directed against multiple epitopes on the antigen

b)

An antibody recognizing singular epitopes

c)

An antibody in which each line produces 1 specific antibody

d)

An antibody which binds to hydrogen bonds

c)

light transmittance decreases with increasing concentration

Which statement is true concerning spectrophotometry?

a)

absorbance increases as path length increases

b)

absorbance increases as concentration decreases

c)

light transmittance decreases with increasing concentration

d)

all of the above are true

True

Accuracy is the agreement of results with the true value for substances in a given specimen.

d)

The dissociation of week acids and bases and the effect on pH

What does the the following equation explain?

pH = pka + log [A-]/[HA]

a)

The ration of conjugate base to the week acid.

b)

solving the concentration of pH

c)

The relationship between transmittance and absorbance.

d)

The dissociation of week acids and bases and the effect on pH

c)

3

An instrument has 17 tests it can possibly analyze and can perform 3 tests at one time. The immediate test repertoire on this instrument is:

a)

20

b)

17

c)

3

d)

14

a)

batch capability

A term used to describe an instrument's ability to perform the same test simultaneously on several different patient samples is:

a)

batch capability

b)

sequential

c)

discrete

d)

throughput

d)

pH

Colligative properties of solutions include all of the following except:

a)

freezing point

b)

vapor pressure

c)

boiling point

d)

pH

False

The formula for sensitivity is:

TN/TN + FP x 100

True or False

b)

To extend the primers

Taq's role in the PCR reaction is the following

a)

To cleave the bonds between base pairs

b)

To extend the primers

c)

To interpret the nicks between probe pairs

d)

To enhance the bonds between base pairs