cc module 6

Azotemia refers to: A. An increase in urea in blood B. An increase in creatinine in blood C. An increase in creatinine in urine D. A decrease in BUN in blood E. A decrease in BUN in CSF

A. An increase in urea in blood

When myocardial infarction occurs, the first enzyme to reach peak elevation is: A. CK B. AST C. LD D. ALT

A. CK

When a purified enzyme is used as a reagent, such as urease in the measurement of urea, the enzyme must be ________________ concentration so that the reaction follows _________________ kinetics. A. Excess; first B. Limited; first C. Excess; zero D. Limited; zero

A. Excess; first

Urea: A. Is synthesized from CO2 and ammonia B. Is synthesized in the liver from the breakdown of nucleic acids C. Is increased in serum during acute episodes of gout. D. Can produce Reye's syndrome when present in high amounts in blood

A. Is synthesized from CO 2 and ammonia

Monitoring of _______ in patients on chemotherapy due to leukemia, lymphoma or multiple myeloma is necessary to avoid nephrotoxicity. A. Serum uric acid B. Urea in urine C. Urine creatinine D. Serum creatinine E. BUN

A. Serum uric acid

The greatest tissue source of CK is: A. Skeletal muscle B. Thyroid C. Heart muscle D. Brain

A. Skeletal muscle

In the commonly used ("Caraway") colorimetric method for uric acid in serum, interference from other reducing substances such as ascorbic acid is minimized by the addition of: A. Sodium carbonate B. Sodium cyanide C. Phosphotungstic acid D. Urease

A. Sodium carbonate

Which of the following enzymes has multiple molecular forms (isoenzymes) whose clinical significance is used in diagnosis? A. Creatine kinase B. Lactate dehydrogenase, creatine kinase, and alkaline phosphatase C. Alkaline phosphatase D. Lactate dehydrogenase and creatine kinase only E. Lactate dehydrogenase

B. Lactate dehydrogenase, creatine kinase, and alkaline phosphatase

An elevated aldolase level and normal myoglobin is most indicative of: A. Portal cirrhosis B. Progressive muscular dystrophy C. Obstructive jaundice D. Acute muscle trauma

B. Progressive muscular dystrophy

The major cellular origin of acid phosphatase activity in serum is: A. Bone B. Prostate C. Pancreas D. Liver

B. Prostate

A toxic condition involving a very high serum level of urea and creatinine accompanied by failure of the three main functions of the renal system is referred to as: A. Acute renal failure B. Uremia C. Acute glomerulonephritis D. Azotemia.

B. Uremia

The abbreviated Modification of Diet in Renal Disease (MDRD) equation considers all of the following variables EXCEPT: A. Gender B. Urine creatinine concentration C. Ethnicity D. Serum creatinine concentration E. Age

B. Urine creatinine concentration

Which of the following methods of measuring enzyme activity utilizes an increase in absorbance at 340 nm as an indicator reaction? A. ALT(GPT) reaction B. "Reverse" LD reaction C. "Forward" LD reaction D. AST(GOT) reaction

C. "Forward" LD reaction

Which of the following enzymes requires chloride (Cl-) as an activator? A. Lipase B. Gamma glutamyl transferase (GGT) C. Amylase D. Cholinesterase

C. Amylase

When a purified enzyme is used as a reagent, such as urease in the measurement of urea, the enzyme must be ________________ concentration so that the reaction follows _________________ kinetics. A. Excess; zero B. Limited; zero C. Excess; first D. Limited; first

C. Excess; first

The most sensitive enzymatic indicator for liver damage from ethanol intake is: A. Aspartate aminotransferase (AST) B. Alkaline phosphatase C. Gamma-glutamyl transferase (GGT) D. Alanine aminotransferase (ALT)

C. Gamma-glutamyl transferase (GGT)

In the Szasz method for gamma glutamyl transferase (GGT), the typical receptor molecule is: A. Aminonitrobenzoate B. Gamma glutamyl p-nitroanilide C. Glycyl glycine D. Glutathione

C. Glycyl glycine

One International Unit is defined as one __________ of substrate converted to product per ___________. A. Nanogram; hour B. Microgram; minute C. Micromole; minute D. Micromole; hour E. Mole; minute

C. Micromole; minute

An elevated aldolase level and normal myoglobin is most indicative of: A. Obstructive jaundice B. Portal cirrhosis C. Progressive muscular dystrophy D. Acute muscle trauma

C. Progressive muscular dystrophy

A reaction rate assay measures enzyme ____________________; an endpoint assay measures enzyme ______________________. A. Concentration; activity B. Activity; concentration C. Concentration; concentration D. Activity; activity

D. Activity; activity

Of the following, the only clinically analyzed enzyme in the urine is: A. Alanine transferase B. Cholinesterase C. Acid phosphatase D. Amylase

D. Amylase

Given the following lab results, what is the most likely cause of this patient's BUN? BUN 45 mg/dL Creatinine 1.8 mg/dL Uric Acid 7 mg/dL pH 7.22 pCO 2 74.4 mm Hg pO 2 32.8 mm Hg O 2 sat. 51.3% A. Acute tubular necrosis B. Chronic renal disease C. Dialysis D. Congestive heart failure

D. Congestive heart failure

Which of the following best describes the correct collection and handling conditions for a blood ammonia measurement? A. Draw clot tube, separate serum from clot in refrigerated centrifuge, protect from light, freeze if not tested immediately B. Fasting patient, draw lithium heparin tube, place tube on an ice pack, centrifuge at 20° C, test immediately C. Fasting patient, draw clot tube, separate serum immediately, test immediately D. Draw sodium heparin tube, place in ice bath immediately, separate cells and plasma in refrigerated centrifuge, immediately remove plasma and freeze if analytical testing is delayed

D. Draw sodium heparin tube, place in ice bath immediately, separate cells and plasma in refrigerated centrifuge, immediately remove plasma and freeze if analytical testing is delayed

Which of the following enzyme tests is most affected by "hemolysis? A. Creatine kinase B. Gamma glutamyl transferase C. Alkaline phosphatase D. Lactate dehydrogenase

D. Lactate dehydrogenase

Correct The enzyme that is inhibited by hemoglobin is: A. Creatine kinase B. Cholinesterase C. Alkaline phosphatase D. Lipase

D. Lipase

The major causes of decreased plasma urea concentration include: A. Obstruction of urine flow by renal calculi B. Glomerular nephritis C. Tubular necrosis D. Low protein intake and sever liver disease E. Congestive heart failure

D. Low protein intake and sever liver disease

Which of the following is NOT considered a coenzyme? A. NADPH B. NADH C. Pyridoxal phosphate D. Magnesium

D. Magnesium

Prostatic acid phosphatase measurement has been A. RBC ACP B. CPK C. ALP D. PSA

D. PSA

Monitoring of _______ in patients on chemotherapy due to leukemia, lymphoma or multiple myeloma is necessary to avoid nephrotoxicity. A. Serum creatinine B. Urine creatinine C. BUN D. Serum uric acid E. Urea in urine

D. Serum uric acid

Urea can be measured in all of the following ways EXCEPT: A. Electrode to measure the rate of increase in conductivity as ammonium ions B. Isotope-dilution mass spectrometry C. Ammonium ions generated by the urease reaction leading to a detectable pH change D. The Caraway method

D. The Caraway method

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are both elevated in which of the following diseases? A. Myocardial infarction B. Muscular dystrophy C. Obstructive liver disease D. Viral hepatitis

D. Viral hepatitis

One International Unit is defined as one __________ of substrate converted to product per ___________. A. Nanogram; hour B. Microgram; minute C. Micromole; hour D. Mole; minute E. Micromole; minute

E. Micromole; minute

True or false? Serum urea levels are less affected by diet and metabolism than are serum creatinine levels. True False

False

True or false? Serum uric acid levels may be elevated in patients undergoing cancer chemotherapy. True False

True

True or false? In a "kinetic" or "rate" reaction, one spectrophotometric measurement is taken at the end of an incubation period.

false

True or false? An enzymatic method for creatinine on the Vitros (Kodak Ektachem) analyzer uses the reagent enzyme creatinine amidohydrolase.

true

True or false? Indirect urea methods begin with the hydrolysis of urea to ammonia

true

True or false? Indirect urea methods begin with the hydrolysis of urea to ammonia.

true

One extracellular enzyme whose serum activity is measured clinically is: A. Alkaline phosphatase B. Amylase C. Lactate dehydrogenase D. Creatine kinase

B. Amylase

Of the following drug therapies, which is MOST likely to interfere with the Jaffe chemistry for measuring creatinine? A. High water intake B. Cephalosporin C. Aspirin D. Acetaminophen E. Low water intak

B. Cephalosporin

Which of the following enzymes detects very early changes in liver cell damage? A. SGPT B. GGT C. ALT D. Cholinesterase E. ALP

B. GGT