Chem :P

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

The best disinfectant to use on laboratory work surfaces is: ammonia soap and water Comet 10% bleach and water solution made fresh daily

10% bleach and water solution made fresh daily

Calculate the creatinine clearance for a 12 hour specimen using the following data: (No correction is needed for surface area. Please enter the number without units.) Urine volume=1440mLUrine creatinine=90mg/dLPlasma creatinine=1.8mg/dL C= U x VP

100

Calculate the creatinine clearance for a 12 hour specimen using the following data: (No correction is needed for surface area.) Urine volume=1440mLUrine creatinine=90mg/dLPlasma creatinine=1.8mg/dL C= U x VP 300 ml/min 100 ml/min 400 ml/min 200 ml/min

100 ml/min

To produce reliable results, blood specimens for lipid studies should be drawn after how many hours of fasting? 12-14 hours fasting no need to fast 2 hours 4-5 hours

12-14 hours fasting

If a sample is diluted 1/10 in tube one, then four fold serial dilutions are performed on the next 4 tubes (total of 5 tubes). What is the dilution factor in the 3rd tube? 40 64 6400 160

160

Calculate the LDL cholesterol, using the Friedewald equation, for an adult patient with the following results: Total cholesterol = 265 mg/dLHDL cholesterol = 21 mg/dLTriglyceride = 393 mg/dL

165

Calculate both the uncorrected and corrected creatinine clearance for a female patient: 5 feet 6 inches, 120 pounds, urine creatinine 170 mg/dL, collection time 24 hours, plasma creatinine 1.5 mg/dL, urine volume 2100 mL. Normally these results would be reported out in mL/min, but write your answer without units. What are your uncorrected and corrected results? 165, 193 160, 200

165, 193

As a screening test for Cushing's syndrome, the physician wishes to see whether a patient exhibits normal diurnal rhythm in his or her cortisol secretion. At what times have the specimens traditionally been drawn for plasma cortisol determination? 4 PM and 24 hours later 4 PM and 24 hours later 8 AM, 4 PM 6 AM, and 24 hours later

8 AM, 4 PM

When measuring total CO2 on a patient in diabetic ketoacidosis, who has started to compensate, the most likely result would be: 8 mmol/L 28 mmol/L 40 mmol/L 55 mmol/L

8 mmol/L

To maintain a normal pH of 7.4 in plasma, it is necessary to maintain a: 20:1 ratio of bicarbonate to dissolved carbon dioxide 10:1 ratio of dissolved carbon dioxide to bicarbonate 30:1 ratio of bicarbonate to dissolved carbon dioxide 10:1 ratio of bicarbonate to dissolved carbon dioxide

20:1 ratio of bicarbonate to dissolved carbon dioxide

To maintain a normal pH of 7.4 in plasma, it is necessary to maintain a: 10:1 ratio of bicarbonate to dissolved carbon dioxide 20:1 ratio of bicarbonate to dissolved carbon dioxide 30:1 ratio of bicarbonate to dissolved carbon dioxide 10:1 ratio of dissolved carbon dioxide to bicarbonate

20:1 ratio of bicarbonate to dissolved carbon dioxide You need a larger proportion of bicarbonate (because it is the portion doing the buffering)

In Congenital Adrenal Hyperplasia (female pseudohermaphroditism), two of the most common enzyme deficiencies are (select all that apply): 21 hydroxylase 21 ligase 11 beta hydroxylase 17 peroxidase

21 hydroxylase 11 beta hydroxylase

The speed of a centrifuge is expressed in revolutions per minute (rpm), and the centrifugal force generated is expressed in gravities as RCF. Using the formula to relate rpm to RCF, what is the relative centrifugal force (RCF) of a centrifuge that has a radius of 20 cm and is operated at 4000 rpm? 3578 x g 358 x g 7552 x g 75,000 x g

3578 x g

On my new microscope, the oculars are 10 X magnification and when I use the 40X objective the urine sediment elements will be magnified how many times? 4000 40 10 400

400

Sodium ions normally contribute approximately what percentage of the total serum osmolality? 92% 75% 15% 45%

45%

The most widely used cutoff for blood glucose levels for the determination of hypoglycemia is: 250 mg/dL 50 mg/dL 25 mg.dL 100 mg/dL

50 mg/dL

What is the probability associated with a control result that falls within +/- 1 SD of the mean? 68.2% 95.5% 34.1% 4.5%

68.2%

What is the blood pH when the partial pressure of carbon dioxide (pCO2) is 60 mmHg and the bicarbonate concentration is 18 mmol/L? 7.00 7.10 6.89 7.30

7.10

What is the pH of a whole blood sample if the bicarbonate = 13 mmol/L and the pCO2 = 31 mmHg? pH = 6.1 + log ([HCO3-]/[a X PCO2]) 7.40 7.24 7.56 6.97

7.24

What is the pH of a whole blood sample if the bicarbonate = 13 mmol/L and the pCO2 = 31 mmHg? pH = 6.1 + log [HCO3-] / [ PCO2 X a ] 7.24 7.40 7.56 6.97

7.24

During your OR rotation, a patient had a pCO2 of 38 mmHg, and a bicarbonate of 20 mmol/L. What is his pH? 7.34 7.63 7.24 7.56

7.34

Given a creatinine concentration of 525 mg/dL, collected over 12 hours, with a 1825-mL volume. Express in terms of concentration per volume of collection, using only numbers. (g/mL)

9.58

Characteristics of IgM include that it is: 900 000 daltons, first one secreted in an immune response, 10 binding sites largest concentration in serum, placental transfer, 150 000 daltons MW 165 00 dalton monomer but usually present as a dimer in secretions least in terms of serum concentration, has most effects in allergy and parasitic infections

900 000 daltons, first one secreted in an immune response, 10 binding sites

If a fasting glucose is 75 mg/dL, which of the following 2-hour postprandial glucose results would most closely represent normal glucose metabolism? 95 mg/dL 45 mg/dL 260 mg/dL 180 mg/dL

95 mg/dL

Type 1 diabetes mellitus may be described by all of the following except: 95% of all diabetes mellitus cases Ketoacidosis prone Characterized by presence of islet cell antibodies or insulin autoantibodies Associated with pancreatic islet b-cell destruction

95% of all diabetes mellitus cases

A 48-year-old smoker has hypertension and type 2 diabetes. He is overweight and is carrying most of his excess weight around his waist. He fasted for 12 hours. Then a red-top tube with a gel separator and an EDTA plasma tube were collected. From the serum tube, triglycerides measured 495 mg/dL and total cholesterol measured 227 mg/dL. From the plasma tube, HDL was measured using cyclodextrin masking of non-HDL fractions and the value was 29 mg/dL. The specimen was lipemic, but no chylomicrons were noted.Calculate the LDL using the Friedewald equation. 99 100 297 355

99

Which of the following hemoglobins has a glucose molecule attached to one or both of the N-terminal valines of the beta-polypeptide chains? A1c S A2 C

A1c

Hypertonic plasma stimulates osmoreceptors in the posterior pituitary to secrete which hormone that causes water retention in the kidneys? ADH or arginine vasopressin estradiol aldosterone PTH (parathyroid hormone)

ADH or arginine vasopressin

_______________ is a unique characteristic of adaptive immunity. Ability to remember a prior exposure to a pathogen Having similar response to all pathogens encountered The process of phagocytosis and ability to destroy a pathogen Ability to fight infection

Ability to remember a prior exposure to a pathogen

Which of the following is a major mineralocorticoid? ADH (AVP, vasopressin) Aldosterone Cortisol Inhibin A

Aldosterone

Measurement of Alkaline Phosphatase (ALP) in serum can be beneficial in the following diseases: All of the above Seminoma Paget's Disease Seminoma Metastases in the bone of liver

All of the above

How can normal cells become malignant? Viral infection Underexpression of tumor-suppressing genes Overexpression of oncogenes All of these answers are correct

All of these answers are correct

A complete obstruction of the common bile duct would be characterized by which of the following laboratory results? All of these answers are correct. Negative fecal urobilinogen and urobilin. Urine positive for bilirubin. Urine negative for urobilinogen (reads 0.2 EU on the dipstick)

All of these answers are correct.

Which of the following about Chronic infection by HBV is true? Occurs with reduced frequency when HBV is acquired as a perinatal infection Resolves spontaneously Among all age groups, 15-25% of these patients die prematurely as a result of chronic liver disease Occurs in 90% of acute infections

Among all age groups, 15-25% of these patients die prematurely as a result of chronic liver disease

Respiratory acidosis is characterized by: An excess of dissolved carbon dioxide An excess of bicarbonate A deficit of bicarbonate A deficit of dissolved carbon dioxide

An excess of dissolved carbon dioxide

Respiratory acidosis is characterized by: An excess of dissolved carbon dioxide An excess of bicarbonate A deficit of dissolved carbon dioxide A deficit of bicarbonate

An excess of dissolved carbon dioxide

For analysis of acid-base disturbances involving pulmonary dysfunction, the specimen of choice is: Arterial blood Venous blood Capillary blood Venous blood and capillary blood

Arterial blood

For analysis of acid‑base disturbances involving pulmonary dysfunction, the specimen of choice is: Venous blood Arterial blood Capillary blood Venous blood and capillary blood

Arterial blood

Which of the following cardiac markers if the most useful indicator of congestive heart failure? B-type naturetic peptide (BNP) Glycogen phosphoralase isoenzyme BB CK-MB Troponin

B-type naturetic peptide (BNP)

A 62-year-old female reports about 2 months of tiredness, feeling faint from "getting up too fast", and "memory problems". Results from the CBC and blood smear showed a borderline macrocytic anemia. The complete metabolic panel showed no abnormal results. The next step would be to evaluate for levels of which vitamins? C and B12 A and C B12 and Folate A and Folate

B12 and Folate

The most useful cardiac marker for diagnosing and monitoring congestive heart failure (CHF) is ____________ ?

BNP

A patient with glomerulonephritis is most likely to present with the following serum results: creatinine decreased phosphorus decreased BUN (urea) increased calcium increased

BUN (urea) increased

What is the name chemical dye that binds Albumin creating a conjugate that we measure in this assay?

Bromocresol green reacts w/ albumin at pH 4.2 to form a complex that is measured at 630nm

Which of the following is associated with anaphylaxis? Acitvation of complement Increase in cytoxic T cells Buildup of IgE on mast cells Large amount of circulating IgG

Buildup of IgE on mast cells

Mannose-binding protein in the lectin pathway is most similar to which classical pathway component? C3 C1rs C1q C4

C1q

Which of the following complement components is a chemotactic factor as well as a potent anaphylatoxin? C5a MBL Factor D Properdin

C5a

Which of the following is the "membrane attack complex" of complement activation? C4, C2, C3 C3, C4 C5b, C6, C7, C8, C9 C1q, C1r, C1s

C5b, C6, C7, C8, C9

Ovarian cancer (peritoneal inflammation)

CA 125/HE4

Each of these protein markers may be elevated in multiple myeloma except: beta-2 microglobulin CA-125 monoclonal intact immunoglobulin molecules free monoclonal light chains

CA-125

Breast Cancer

CA15-3/BR 27-29

Which of the following are examples of tumor markers? CEA β-HCG Creatinine CA-125

CEA β-HCG CA-125

The area of the immunoglobulin molecule referred to as the hinge region is located between which domains? VH and CH3 CH1 and CH2 CH2 and CH3 CH3 and VL

CH1 and CH2

The quantitation of the high-density lipoprotein cholesterol level is thought to be significant in the risk assessment of

CHD (coronary heart disease)

Which isoenzyme of creatine kinase (CK) is primarily found in cardiac muscle? CK-MM CK-MB CK-BC CK-BB

CK-MB

A positive ANA with the pattern of anti-centromere antibodies is MOST frequently seen in patients with: rheumatoid arthritis Systemic Lupus erythematosis CREST subset of sclerosis Sjogrens syndrome

CREST subset of sclerosis

Which of the following is a positive acute phase protein, increasing rapidly as a sensitive, but nonspecific indicator of inflammation or infection? C-reactive protein albumin transferrin alpha-1-antitrypsin

CRP

A known diabetic is admitted to the Emergency Room in ketoacidosis. Which of the following would be consistent with this diagnosis? Decreased, pH, decreased anion gap, increased plasma bicarbonate Decreased pH, increased anion gap, decreased plasma bicarbonate Increased pH, increased anion gap, increased plasma bicarbonate Increased pH, decreased anion gap, decreased plasma bicarbonate

Decreased pH, increased anion gap, decreased plasma bicarbonate

In the diazotized sulfanilic acid procedure utilizing the addition of an accelerator such as caffeine, sodium benzoate and acetate, or a surfactant, what results is likely if the specimen is hemolyzed when drawn? Decreased total bilirubin Decreased calcium Increased albumin Decreased CO2

Decreased total bilirubin

In a patient suspected of having primary myxedema, one would expect the following serum results: total T4 ____________ , Free thyroxine ___________ , and _______________ thyroid-stimulating hormone. Increased, increased, normal Decreased, decreased, increased Decreased, increased, decreased Increased, decreased, normal

Decreased, decreased, increased

Albumin levels in a patient with chronic hepatocellular disease will be ______, because ______. Increased, liver synthesis function is enhanced Decreased, albumin undergoes increased proteolysis in the liver Increased, there is more demand for albumin to transport UCB Decreased, liver synthesis function is diminished

Decreased, liver synthesis function is diminished

Two individuals with similar height and build, similar age, and common patient history were given a bolus dose of 20mgs of the same drug. After 3 additional doses of 15mg every 4 hours, given at the exact same time, person 1 had a serum concentration of 50 ng/dL, and person 2 had a serum concentration of 30 ng/dL. From the list below, please select the two most likely reasons for the discrepancy. Differing Ages Differing cytochrome p450 systems Different rates of absorption in each individual Incorrect administration of the drug

Differing cytochrome p450 systems Different rates of absorption in each individual

Given the following glucose data, the next step would be to: Patient, straight 950 mg/dL Patient, 1:5 600 mg/dL Controls acceptable Linearity 500 mg/dL Contact the physician immediately Dilute the specimen 1:10 and reassay Check the wavelength calibration Do a spectral/wavelength check on the instrument

Dilute the specimen 1:10 and reassay

A doctor requests a stat ABG on the following patient. 39 yo female with COPD recently coded and is now having respiratory distress (fluid accumulation in the lungs). Two months ago she underwent radical mastectomy of the left breast. She is not currently on anti-coagulation therapy. Determine the best course of action: Evaluate whether the best draw site for this patient is the radial, brachial, or femoral artery and correctly collect the ABG, in serum. Evaluate whether the best draw site for this patient is the radial, brachial, or femoral artery and correctly collect the ABG, in lithium heparin. Do not draw from the left arm. Do not draw the patient, they have too many contraindications. Consult with the clinician. Evaluate whether the best draw site for this patient is the radial, brachial, or femoral artery and correctly collect the ABG, in calcium citrate.

Evaluate whether the best draw site for this patient is the radial, brachial, or femoral artery and correctly collect the ABG, in lithium heparin. Do not draw from the left arm.

he floor calls the lab after AM rounds have been completed. They would like to add some testing to a specimen already processed and resulted. Indicate True or False for each of the floor's requests:You can run a Total Calcium off of the previous specimen drawn for a CBC? True False

False

The floor calls the lab after AM rounds have been completed. They would like to add some testing to a specimen already processed and resulted. Indicate True or False for each of the floor's requests: The floor says, "I forgot to order a Hepatic Function Panel. I am going to be in so much trouble with the doctor if I don't get this completed. Can you please run the HFP off this morning's CBC sample?"You can run the HFP off of the CBC sample from this morning. True or False?

False ALT, AST, GGT if included, will all be affected by EDTA (chelating cofactors) and will be falsely lower. Must draw a new sample in a Li-Hep tube.

Of the following colligative properties, which one is most commonly used in clinical laboratories to measure osmolality? Increased osmotic pressure Freezing point depression Boiling point elevation Decreased vapor pressure

Freezing point depression

Substances known to interfere with the Jaffe method for creatinine include all of the following except: GGT ascorbic acid glucose ketone bodies

GGT

The enzymatic method for plasma/serum glucose measurements that is considered to be the reference method is: Alkaline potassium ferricyanide Glucose oxidase o-Toluidine Glucose hexokinase

Glucose hexokinase

Which test may be performed to assess the average plasma glucose control that an individual maintained during the previous 8-12 weeks? Urine glucose Glycated hemoglobin (HbA1c) Plasma glucose Two-hour postprandial glucose (2 hr PP)

Glycated hemoglobin (HbA1c)

Anti-glomerular basement membrane antibody is MOST often associated with this condition: SLE Goodpasture's syndrome Celiac disease Chronic active hepatitis

Goodpasture's syndrome

Which of the following is a rare autoimmune cause of glomerularnephritis, characterized by rapid onset of blood and protein in the urine, and elevated plasma creatinine levels? About 60% of these patients also have signs and symptoms of pulmonary disease. Goodpasture's syndrome Type 1 Diabetes mellitus Myashenia gravis Multiple sclerosis

Goodpasture's syndrome

Rheumatic heart disease is a result of infection with which of the following organisms? Pseudomonas aeruginosa Staphyloccus aureus Group A beta-hemolytic streptococcus Chlamydia pneumoniae

Group A beta-hemolytic streptococcus

The type of hepatitis found in the US that is transmitted principally by the enteric route is: HAV HBV HCV HDV

HAV

What is the single most useful serological marker for Hepatitis A, which remains elevated in an individual for 3-6 months following an acute infection? HAV IgM HAV Total HBsAg HAV PCR testing

HAV IgM

An individual is considered chronically infected with Hepatitis B, if which of the following markers is present for more than six months? anti-HCV HBsAg anti-HAV IgM IgM anti-HBc

HBsAg

Individuals with a positive IgM anti-HDV will also have a positive: anti-HAV IgM anti-HBC IgM anti-HCV HBsAg

HBsAg

Hepatitis D requires co-infection with Hepatitis B in order to infect a host's hepatocytes. What part of the Hepatitis B virus's infection machinery does Hepatitis D acquire? HDV incorporates HBcAg onto its icosohedral capsid HDV's genes are activated by HBV's protein X HDV uses the envelope of Hepatitis B HDV requires HBV's gene for DNA polymerase for replication

HDV uses the envelope of Hepatitis B

Pregnant women with ____________, particularly those in the second or third trimester, are at increased risk of acute liver failure, fetal loss and mortality. Up to 20-25% of pregnant women can die if they get ____________ in third trimester.(Fill in the blank) HEV HDV superinfection HAV HBV

HEV Pregnant women with hepatitis E, particularly those in the second or third trimester, are at increased risk of acute liver failure, fetal loss and mortality. Up to 20-25% of pregnant women can die if they get hepatitis E in third trimester.

The _________ system is the strongest immunologic barrier to successful allogenic organ and HSC (Hematopoietic stem cell) transplantation. mHAs HLA GVHD MCH

HLA

Anti-thyroglobulin antibodies can be detected highest in the serum of patients having which of the following? multinodular goiter Hashimoto's thyroiditis thyroid carcinomas thyroid adenomas

Hashimoto's thyroiditis High titers of anti-Thyroglobulin antibody are seen in most patients with Hashimoto's. They can also be found in Graves' patients, but aren't found in multinodular goiter, thyroid adenomas, or thyroid carcinomas (not above the frequency found in normal persons which is about 5-10%.

In the Hazards Identification System for chemicals, four color-coded, diamond-shaped symbols are arranged to form a larger diamond shape. What type of hazard does the blue diamond positioned to the left identify? Contact Reactivity Health Flammable

Health

Calculate the LDL cholesterol, using the Friedewald equation, for an adult patient with the following results: Total cholesterol = 265 mg/dLHDL cholesterol = 21 mg/dLTriglyceride = 393 mg/dL For the patient in the previous question, concerning lifestyle, all of the following risk factors need to be assessed except: Heart surgery TLC diet If smoking, STOP Increase exercise

Heart surgery

Which of the following would cause an increase in the total bilirubin and only the unconjugated bilirubin fraction? Hepatic cirrhosis Hemolytic anemia Hepatitis Obstructive jaundice

Hemolytic anemia

A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would be consistent with his diagnosis? High TCO2, decreased H2CO3 Low TCO2, decreased HCO3 High TCO2, increased HC03 Low TCO2, decreased H2CO3

High TCO2, increased HC03 *Metabolic alkalosis means bicarb issue. So bicarb would have to be high for an alkalosis

A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would be consistent with his diagnosis? Low Total CO2, decreased H2CO3 High Total CO2, decreased H2CO3 High Total CO2, increased HC03 Low Total CO2, decreased HCO3

High Total CO2, increased HC03

All of the following are cardiac markers commonly used to diagnose and assess cardiac injury except: Homocysteine Myoglobin Troponin T or I CK MB

Homocysteine

Cholesteryl esterase is used in enzymatic assays of total cholesterol to: Hydrolyze fatty acids bound to the third carbon atom of cholesteryl esters. Oxidize Cholesterol to form peroxide. Reduce NAD+ to NADH Separate cholesterol from apolipoproteins A-I and A-II

Hydrolyze fatty acids bound to the third carbon atom of cholesteryl esters.

In familial hypercholesterolemia, the characteristic findings are elevated cholesterol with elevated __________________.

LDL

Elevated levels of what analyte occurs in two clinical settings, Type A (hypoxic - associated with decreased tissue oxygenation) and Type B (metabolic - associated with disease, drugs/toxins, or inborn errors of metabolism)? Lactic Acid GGT Creatine kinase Alkaline phosphatase

Lactic Acid

Measurement of glucose concentration in a fasting whole blood specimen will give a result that is: Equal to the concentration in plasma or serum specimen Unmeasurable because of a high concentration of red blood cells Less than the concentration in a plasma specimen Greater than the concentration in plasma or serum speicmen

Less than the concentration in a plasma specimen

Which of the following are characteristics of Type 2 diabetes mellitus? May have insulin resistance, relative insulin deficiency It is more common than Type 1 diabetes. It requires insulin therapy to control hyperglycemia. It is associated with obesity and more common in persons greater than 40 years old.

May have insulin resistance, relative insulin deficiency It is more common than Type 1 diabetes. It is associated with obesity and more common in persons greater than 40 years old.

Your lab has received a Phase I deficiency because the analytical balance is located in the middle of the lab on a workbench next to a centrifuge and underneath the air conditioner. What do you need to do to correct the deficiency? Move the balance to the acid storage room, with a fan to maintain constant temperature. No need to have a level surface, as the balance is self-leveling. Move the balance and the centrifuge to another room, with a fan to maintain constant temperature. Move the balance to a separate room, on a level surface, with no drafts, no vibrations, no corrosives and a constant temperature. Move the centrifuge to another bench, the balance should be ok after that.

Move the balance to a separate room, on a level surface, with no drafts, no vibrations, no corrosives and a constant temperature.

Which cardiac marker is sensitive for detecting AMI in the early stages, but is not specific to cardiac muscle, and is best used to rule out AMI, when normal, if event timing is known? Total CK Troponin Myoglobin CK-MB

Myoglobin

On an antibody, the antigen-binding site is at the __________________ end of both the heavy chain and the light chain and is called the ________________. C-terminal/paratope N-terminal/paratope C-terminal/epitope N-terminal/epitope

N-terminal/paratope

If a blood gas specimen is left exposed to the air for an extended period of time, which of the following changes will occur? PO2 and pH increase; PCO2 decreases PO2 increases; pH and PCO2 decrease PO2 decreases; PCO2 and pH increase PO2 and pH decrease; PCO2 increases

PO2 and pH increase; PCO2 decreases *Exposed to air = acts like the cap is off. CO2 in the sample is more concentrated that the CO2 in the atmosphere (CO2 in air is very very small amount). So CO2 leaves the sample and O2 from the atmosphere enters the sample.

Prostate Specific Antigen is a highly specific and sensitive marker for prostate cancer and is always diagnostic of underlying malignant disease. True False

PSA is notoriously non-specific and because of this must be carefully evaluated in light of the other lab values, imagery, clinical symptoms, and previous history.

The enzyme that converts p-nitrophenylphosphate (pNPP) to a yellow product shows very elevated results. Along with the appropriate clinical picture of bone pain and bond deformities, these results could indicate: Paget's disease Hepatobiliary obstruction Pregnancy Viral Hepatitis

Paget's disease

A patient was admitted with a severe metabolic acidosis and pH of 7.14. After two days, his pH is beginning to move towards normal levels. If his pH is now 7.32, we can conclude that the response is: Fully compensated Partially Compensated Uncompensated acidosis Uncompensated alkalosis

Partially Compensated

In an indirect immunofluorescent assay, what would be the outcome of missing a wash step after the antibody-enzyme conjugate is added? Results will be unaffected. Results will be falsely increased due to unbound conjugate producing more signal. It would be difficult to determine the effect. Results will be falsely decreased.

Results will be falsely increased due to unbound conjugate producing more signal.

Ammonia measurement is helpful in diagnosis and following patient's with: cystic fibrosis or muscular dystrophy primary glutaminosis or Crigler-Najjar syndrome Reye syndrome or inherited disorders of urea metabolism Dubin-Johnson disease or Reiter's syndrome

Reye syndrome or inherited disorders of urea metabolism

A patient presents to the ER complaining of persistent exhaustion, low stamina and overall weakness and loss of breath. A CBC, Urinalysis and CMP are ordered. If this patient is know to have recurring hemolytic anemia, please tell me what their bilirubin and urobilinogen results will look like in the Serum and Urine? (describe the results as Low, Normal, High, or cannot measure) Serum Total bilirubin ___ ? Direct bilirubin ___ ? Indirect bilirubin ___ ? Urine (by dipstick) Total bilirubin ___ ? Direct bilirubin ___ ? Indirect bilirubin ___ ? Urobilinogen ___ ?

Serum Total bilirubin ___ ? high Direct bilirubin ___ ? normal or slightly high Indirect bilirubin ___ ? high Urine (by dipstick) Total bilirubin ___ ? (cannot measure unconjugated bili in urine) Direct bilirubin ___ ? normal Indirect bilirubin ___ ? (cannot measure unconjugated bili in urine) Urobilinogen ___ ? high

Which of the following statements best describes the activity of insulin in the body? Decreases cell membrane permeability to glucose Increases blood glucose levels Decreases glucose uptake by muscle and fat cells Stimulates glycogenesis in the liver.

Stimulates glycogenesis in the liver.

A 17-year-old girl who was a known diabetic went out to dinner with the captain of the football team on her very first ever date, and neglected to take her insulin. She managed to get home by curfew, breath smelling fruity, before becoming comatose. Her parents rushed her to the hospital, where the following laboratory results were obtained on a blood specimen: Glucose 550 mg/dL (65-99 mg/dL)Sodium 123 mmol/L (135-145 mmol/L)Potassium 5.7 mmol/L (3.5-5.3 mmol/L)Chloride 92 mmol/L (99-109 mmol/L)Total CO2 5 mmol/L (22-31 mmol/L)pH 7.25 (7.35-7.45) The urine was positive for glucose and ketones. Ketone bodies in her urine most likely indicate which of the following? The body is using carbohydrates as the primary energy source. Carbohydrates have been ingested in excessive amounts. Muscle glycogen is being used as an auxiliary fuel source. Storage lipids are being used as the primary energy source.

Storage lipids are being used as the primary energy source.

Which of the following is associated with the proper storage of chemicals? All chemicals must be stored in alphabetical order for ease of handling. Large containers of liquid chemicals should be stored on a top shelf to allow easy visibility from below. Flammable chemicals should be stored in a fume hood. Store flammable and combustable liquids in approved flammable storage cabinets.

Store flammable and combustable liquids in approved flammable storage cabinets.

Which autoimmune disease is likely to show a rim (peripheral) pattern in an immunofluorescence (IF) microscopy test for anti-ds-DNA , and a speckled pattern for anti-Sm? Mixed connective tissue disease (MCTD) Rheumatoid arthritis Systemic Lupus erythematosis Scleroderma

Systemic Lupus erythematosis

Which of the following pairs are examples of the negative feedback mechanism? glucose-glucagon and FSH-LH T4-TSH and Cortisol-ACTH Estradiol-LH and aldosterone-ACTH LH-TSH and ADH-glucose

T4-TSH and Cortisol-ACTH

The three levels of dysfunction that may be evaluated in a patient with an endocrine problem are primary, secondary, and tertiary. The possible defective sites that correspond to these primary, secondary, and tertiary levels of dysfunction are, respectively: Pituitary, target gland, hypothalamus Target gland, pituitary, hypothalamus Pituitary, hypothalamus, target gland Hypothalamus, target gland, pituitary

Target gland, pituitary, hypothalamus

A 9-month old boy from Israel has gradually lost the ability to sit up, and develops seizures. He has an increased amount of a phospholipid called GM2-ganglioside in his neurons, and he lacks the enzyme hexosaminidase A in his leukocytes. These findings suggest:

Tay-sachs disease

Which of the following statements concerning carbohydrates is incorrect? The brain functions normally with a concentration of plasma glucose 65-99 mg/dL. The brain functions normally with a plasma glucose concentration of 20-30 mg/dL. Ethanol produces hypoglycemia by inhibiting gluconeogenesis. Individuals diagnosed with type 1 diabetes mellitus can experience hypoglycemia due to impairment of glucagon secretion.

The brain functions normally with a plasma glucose concentration of 20-30 mg/dL.

Which of the following is considered to be a deviation from Beer's law? The solute must have very high concentration. Incident radiation should be monochromatic. The only light being measured comes from the analytical radiant energy source. Solvent absorption must be insignificant compared to that of the solute.

The solute must have very high concentration.

Which two organs are considered the primary lymphoid organs where immunocompetent cells originate and mature? Thyroid and Peyer's patches Spleen and mucosal-associated lymphoid tissue (MALT) Thymus and bone marrow Lymph nodes and thoracic duct

Thymus and bone marrow

Which of the following is the best description of the sequence of events for thyroid hormone synthesis? Trapping of iodine, activation of iodine, organification, coupling of iodotyrosyl residues, and proteolysis of thyroblobulin with release of T3 and T4 Activation of iodine, trapping of iodine, coupling of iodotyrosyl residues, organification, and proteolysis of thyroglobulin with release of T3 and T4 Trapping of iodine, activation of iodine, couplinf of iodotyrosyl residues, proteolysis of thryoglobulin with release of T3 and T4, and organification Trapping of iodine, organification, activation of iodine, coupling of iodotyrosyl residues, and proteolysis of thyroglobulin with release of T3 and T4

Trapping of iodine, activation of iodine, organification, coupling of iodotyrosyl residues, and proteolysis of thyroblobulin with release of T3 and T4

Which of the following cardiac valves is located between the right atrium and right ventricle? Mitral valve Bicuspid valve Pulmonary valve Tricuspid valve

Tricuspid valve

Which of the following analytes has the highest specificity for cardiac injury? Total CK-MB AST Troponin Myoglobin

Troponin

Which cardiac marker is elevated for the longest period after myocardial infarction? CK-MB Alkaline phosphatase Myoglobin Troponin I

Troponin I

Sheehan's syndrome, caused by infarction following complication of postpartum hemorrhage, can result in pan hypopituitarism depending on the amount of tissue destroyed. True False

True Hypoxic brain trauma (usually associated with massive blood lose during childbirth). More common in third world country with substandard obstetrics care. Depends on amount of tissue destroyed. May result in failure to lactate and postpartum amenorrhea

All of the following cause a "shift to the right", and increase oxygen affinity for hemoglobin. - acidosis - hyperthermia - hypoventilation - increased 2-3 DPG level True False

True *All of the following cause a shift to the right, and decrease oxygen affinity for hemoglobin. We want this because in all these situations, we can utilize oxygen more

The concentration of urinary free cortisol is mainly a reflection of: Total serum cortisol Conjugated cortisol Protein-bound serum cortisol Unbound serum cortisol

Unbound serum cortisol

_________________ _______________ are used in making up reagent to a specific volume. These are certified to contain an accurate volume at the specified temperature. Reagents should not be stored in these. Volumetric flasks (Class A) Erlenmeyer flasks Glass beakers Graduated cylinders

Volumetric flasks (Class A)

________________ _______________ are used in making up reagent to a specific volume. These are certified to contain an accurate volume at the specified temperature. Reagents should not be stored in these. (glass pictured looks like upside-down umbrella) Glass beakers Graduated cylinders Volumetric flasks (Class A) Erlenmeyer flasks

Volumetric flasks (class A)

The glucose value of a normal 2-hour postprandial serum specimen, as compared to the reference range for a fasting serum glucose should be: Significantly lower than the normal fasting glucose level range Moderately greater than the normal fasting glucose level range Significantly greater than the normal fasting glucose level range Within the normal fasting glucose level range

Within the normal fasting glucose level range

A 52-year old male with high blood pressure, has the following test results on his fasting specimen. It can be concluded that the patient has: HDL Cholesterol 30 mg/dL LDL Cholesterol 82 mg/dL VLDL Cholesterol 22 mg/dL Triglyceride 110 mg/dL a. an increased risk of Coronary Heart Disease. b. a low risk for Coronary Heart Disease. c. been a vegetarian for more than 2 years. d. nothing can be concluded from these results.

a A low HDL puts them at risk because HDL is "healthy", cardioprotective lipoprotein that scavenges excess cholesterol in vessel walls. The other cholesterols are in normal range.

A patient with sustained hypertension has an elevated value for urinary catecholamine metabolites. The result could indicate: a pheochromocytoma. hypercortisolism. idiopathic hypotension. hypoaldosteronism.

a pheochromocytoma.

Confidence intervals used in Quality Control ranges refers to: a range around an experimentally determined statistic that has a known probability of including the true parameter. the number of independent observations in a given data set. a statistic used to describe the distribution or spread of data in a population. the value about which a population is centered.

a range around an experimentally determined statistic that has a known probability of including the true parameter.

The majority of the circulating ammonia in the body is found in low concentrations in red blood cells obtained from ingested carbohydrates a waste product of amino acid and protein breakdown in the gut obtained from hydrolysis of urea in the kidney

a waste product of amino acid and protein breakdown in the gut

Which of the following is/are advantage(s) of immunoassays for measuring analytes such as hormones? sensitive specific usually automated all of the above

all of the above

Cytotoxic hypersenstivity is seen in: all of the answers are correct hemolytic transfusion reactions hemolytic disease of the newborn febrile transfusion reactions

all of the answers are correct

Active acquired immunity may be developed by: toxins all of these answers are correct injections of killed microorganisms infection

all of these answers are correct

Safe laboratory practice dictates that: Pens and pencils used in the laboratory be kept away from the mouth. ll of these answers are correct. Bench top be washed with a disinfectant as needed and at the end of each shift. Hands be washed frequently, especially when leaving your work area. Laboratory coats not be worn outside the work area.

all of these answers are correct

Active acquired immunity may be developed by: infection all of these are correct toxins injections of killed microorganisms

all of these are correct

Which of the following solvents is (are) considered flammable? all of these substances are flammable ether toluene methanol

all of these substances are flammable

Which one of the following is not associated with elevated plasma uric acid concentration? Lesch-Nyhan syndrome Increased nucleic acid turnover excess dietary intake allopurinol overtreatment

allopurinol overtreatment

In the inflammatory process, hepatic synthesis of certain proteins is increased, hence the positive acute phase response. These increased proteins include: pre-albumin, complement, immunoglobulins, and haptoglobin pre-albumin, albumin, haptoglobin, and complement alpha-1-antitrypsin, haptoglobin, C3 and CRP albumin, CRP, haptoglobin, and ceruloplasmin

alpha-1-antitrypsin, haptoglobin, C3 and CRP

A peptide bond is formed when the alpha-amino group of one amino acid is links covalently with the: alpha-carboxyl of a second amino acid alpha-amino of a second amnio acid N-terminal residue delta-amino residue of a second amino acid

alpha-carboxyl of a second amino acid

All of the following are common heart diseases caused by infectious agents except: amoebic dysentary rheumatic fever infective endocarditis pericarditis

amoebic dysentary

A patient with hemolytic anemia will demonstrate: an elevated HgbA1 an erroneously decreased glycated Hgb value an erroneously increased glycated Hgb value little or no change in glycated Hgb value

an erroneously decreased glycated Hgb value

Which of these factors can cause a "shift to the left" of the hemoglobin‑oxygen dissociation curve: (a lower PO2 is required for hemoglobin to be 50% saturated)? an increase in pH an increase in temperatrue an increase in 2,3, DPG an increase in pCO2

an increase in pH

A jaundiced patient presents with the following lab results: elevated serum unconjugated bilirubin, normal serum alkaline phosphatase, normal serum AST/ALT, and negative urinary bilirubin. These results indicate: a viral infection in the liver. an increased rate of hemolysis. obstruction of the common bile duct. chemical damage to the liver.

an increased rate of hemolysis.

Type I hypersensitivity is known as: anaphylaxis hypersensitivity delayed hypersensitivity cytotoxic hypersensitivity cell-mediated hypersensitivity

anaphylaxis hypersensitivity

Renin cleaves ________________, a glycoprotein produced in the liver to form _________________. angiotensinogen/angiotensin I angiotensin/aldosterone aldosterone/ADH PTH/aldosterone

angiotensinogen/angiotensin I

TSH is secreted by the posterior pituitary. thyroid gland. hypothalamus. anterior pituitary.

anterior pituitary.

Rhesus prophylaxis (also called Rhogam) is used in the prevention of HDN. Which of the following is given to the mom to provide this prophylaxis? mother's RBCs coated with dad's antibody anti-D antibodies dad's RBCs Rh- compatible RBCs (ie same as the mom)

anti-D antibodies

Which serological marker of HBV (Hepatitis B Virus) infection indicates recovery and immunity? viral DNA polymerase HBsAg anti-HBS HBe antigen

anti-HBS

The serum of an individual who completed all doses of the Hepatitis B vaccine should demonstrate: anti-HBc anti-HBs all of the answers are correct anti-HBe

anti-HBs

A female patient presents with symptoms of fever, painful joints, muscle pain, tiredness and fatigue, and loss of appetite. Her initial lab results indicate anemia. A urinalysis indicates proteinuria, and hematuria. In the indirect fluorescent anti-nuclear antibody test, a speckled pattern may indicate the presence of which of the following antibodies? anti-histone anti-dsDNA anti-Sm anti-Scl-70

anti-Sm

A hemoflagellate, Crithidia luciliae, is used in a highly specific immunofluorescent assay for which of the following antibodies? anti-dsDNA anti-parietal cell anti-Scl-70 anti-histone

anti-dsDNA

The result of an anti-nuclear antibody test was a titre of 1:320 with a diffuse or homogenous pattern. Which of the following sets of results best correlate with these results after further specific antibody testing was done? anti-centromere antibody titre 1:80 anti-Sc-l70, anit-SS-A, and anti-SS-B anti-RNP titre 1:320 anti-dsDNA titre1:160, and a high titre of antibodies to histone

anti-dsDNA titre1:160, and a high titre of antibodies to histone

In pernicious anemia, which of the following antibodies is characteristically detected? antimitochondrial antibodies antiplatelet antibody antibodies to myelin basic protein anti-parietal cell

anti-parietal cell

Which of the following antibodies, if found with RF antibodies, increases the specificity of testing to 98%, providing a more accurate diagnosis of RA? antihistone anti-RNP antibodies to cyclic citrullinated peptides (anti-CCP) antinucleolar

antibodies to cyclic citrullinated peptides (anti-CCP)

A substance that causes a detectable immune response is called a/an: immunoglobulin antibody antigen/immunogen hapten

antigen/immunogen

Common causes of respiratory alkalosis include: anxiety, asthma, and early salycilate poisoning methanol poisoning, renal failure and emphysema diarrhea, vomiting, and ethylene glycol poisoning methanol poisoning, lactic acidosis, and ethylene glycol poisoning

anxiety, asthma, and early salycilate poisoning

Common causes of respiratory alkalosis include: methanol poisoning, renal failure and emphysema methanol poisoning, lactic acidosis, and ethylene glycol poisoning diarrhea, vomiting, and ethylene glycol poisnoning anxiety, asthma, and early salycilate poisoning

anxiety, asthma, and early salycilate poisoning

To assure that zero order kinetics is maintained in an enzyme reaction, the substrate concentration should be: at least 10-100 times the Km equal to the enzyme concentration equal to the Km lone-half of the Km

at least 10-100 times the Km

To determine if the complement cascade is functioning correctly, we can perform the CH50 and AH50 assays. The CH50 is defined as the reciprocal of the dilution that causes lysis of 50% of the cells used in the assay, and is used to check the functional capacity of the complete classical pathway. The AH50 checks the functionality of the alternative pathway. If both the AH50 and the CH50 test results are abnormal, it can be assumed that ________. the alternative pathway is working normally and the classical complement pathway is abnormal only the classical pathway is dysfunctional both the alternative and classical complement pathways are dysfunctional in their shared path both the alternative and classical pathways are functioning normally

both the alternative and classical complement pathways are dysfunctional in their shared path

In the liver, the small channels between adjacent hepatocytes that carry bile to the hepatic ducts and into the common bile duct are called: lobules. sinusoids. cords. canaliculi.

canaliculi.

Using the Friedewald equation calculate the LDL of a patient with a total CHOL of 360 mg/dL, HDL of 39 mg/dL, and TRIG of 890 mg/dL. The calculated LDL concentration is: cannot be calculated 242 mg/dL 143 mg/dL 242 mg/dL

cannot be calculated

What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens? cortisol cholesterol catecholamines progesterone

cholesterol

In Western countries, the most common cause of chronic pancreatitis in adults is pancreatic tumors. gallstones. infections. chronic alcohol consumption.

chronic alcohol consumption.

Decreased plasma albumin levels may be seen in: chronic liver disease. dehydration. halitosis. acute fluid loss.

chronic liver disease.

A patient presents with regular episodes of hypoglycemia. Which of the following is not a cause of this? insulinoma acute liver failure sepsis Tay-Sachs disease chronic renal failure

chronic renal failure

Exogenous triglycerides are transported in the plasma by which lipoprotein fraction? chylomicrons VLDL LDL HDL

chylomicrons

Aldosteronism (hyperaldosteronism) can be seen in all the following EXCEPT congestive cardiac failure obesity nephrotic syndrome cirrhosis of the liver adrenal hyperplasia

cirrhosis of the liver

One of the effects of cocaine, "a feeling of invincibility", is due to _____________. cocaine giving you the "munchies" cocaine binding dopamine re-uptake transporters inhibiting dopamine re-uptake cocaine increasing blood flow to the brain causing hyper perfusion cocaine taken in the form of "crack"

cocaine binding dopamine re-uptake transporters inhibiting dopamine re-uptake

Carcinoembryonic antigen (CEA) is most likely to be produced in a malignancy involving the: colon testes brain bone

colon

__________________ inhibitors bind at the enzyme substrate-binding site. Addition of more substrate can decrease inhibitor effect. No answer text provided. no-competitive uncompetitive compettitive

compettitive

The Michaelis-Menten (Km) constant is the: concentraiton of substrate at which the reaction proceeds at one-half the maximum enzyme velocity. concentration of substrate giving twice maximum enzyme velocity. temperature of the optimal enzyme velocity. pH of optimal enzyme activity.

concentraiton of substrate at which the reaction proceeds at one-half the maximum enzyme velocity.

Prerenal azotemia could be caused by: urinary tract obstruction chronic renal failure congestive heart failure acute renal failure

congestive heart failure

Important functions of the liver are: synthesize albumin, conserve bicarbonate synthesize cholesterol, synthesize immunoglobulins detoxification of drugs, synthesize insulin conjugate and excrete bilirubin, detoxification of drugs

conjugate and excrete bilirubin, detoxification of drugs

The renal juxtaglomerular apparatus secretes renin in response to a: increase in blood pressure or a decrease in Na in the tubular lumen increase in blood pressure and increase in Na in the tubular lumen decrease in blood pressure or an increase in Na in the tubular lumen decrease in blood pressure or a decrease in Na in the tubular lumen

decrease in blood pressure or a decrease in Na in the tubular lumen

Which set of results is consistent with a diagnosis of respiratory acidosis? (Which combination of increased and decreased?) Arterial pH Arterial PCO2 decreased decreased decreased increased increased increased increased decreased

decreased increased *Acidosis = pH low Respiratory acidosis ROME (Respiratory opposite) => low pH, high pCO2

The primary stimulus for the secretion of PTH is: decreased levels of ionized calcium elevated levels of total calcium decreased levels of phosphorus increased levels of magnesium

decreased levels of ionized calcium

Elevated chylomicrons are present in which of the following dyslipidemias? deficiency in lipoprotein lipase activity familial hypercholesterolemia hypertriglyceridemia familial hypoalphlipoproteinemia

deficiency in lipoprotein lipase activity

Hypoaldosteronism, burns (in the initial bodily response), and gastrointestinal losses are all causes of: deficits of body potassium excess body chloride gain excess sodium gain deficits of body sodium

deficits of body sodium

Sensitized T cells and activated macrophages are characteristic of: anaphylaxis reactions type II hypersensitivity type III hypersensitivity delayed hypersensitivity reactions

delayed hypersensitivity reactions

Analysis of CSF for oligoclonal bands is used to screen for which of the following disease states? demyelinating disorders (i.e. multiple sclerosis) multiple myeloma von Willibrand's disease myasthenia gravis

demyelinating disorders (i.e. multiple sclerosis)

Tissue injury in systemic rheumatic diseases such as SLE is thought to be caused by: deposition of immune complexes and complement activation cytolytic antibodies cytotoxic T cells IgE activity

deposition of immune complexes and complement activation

SLE can be distinguished from RA on the basis of which of the following: joint pain presence of antinuclear antibodies deposition of immune complexes in the kidney immune complex formation with activation of complement

deposition of immune complexes in the kidney

The classic antibody response pattern following infection with Hepatitis A is: detectable presence of IgG antibody only decrease in IgM antibody; increase in IgG antibody of IgG3 subtype detectable presence of IgM antibody only increase in IgM antibody; decrease in IgM antibody; increase in IgG antibody

detectable presence of IgM antibody only

Hypernatremia can be caused by a water loss greater than sodium loss as in: hypoaldosteronism, and acute renal failure SIADH and hypoaldosteronism congestive heart failure, and burns diabetes insipidus, and excessive sweating

diabetes insipidus, and excessive sweating

CASE STUDY- This question and two following questions: A 17-year-old girl who was a known diabetic went out to dinner with the captain of the football team on her very first ever date, and neglected to take her insulin. She managed to get home by curfew, breath smelling fruity, before becoming comatose. Her parents rushed her to the hospital, where the following laboratory results were obtained on a blood specimen: Glucose 550 mg/dL (65-99 mg/dL)Sodium 123 mmol/L (135-145 mmol/L)Potassium 5.7 mmol/L (3.5-5.3 mmol/L)Chloride 92 mmol/L (99-109 mmol/L)Total CO2 5 mmol/L (22-31 mmol/L)pH 7.25 (7.35-7.45) The urine was positive for glucose and ketones. What is the clinical condition of this patient, and what has caused the condition? respiratory acidosis/hypoventilation diabetic ketoacidosis/she took too much insulin diabetic ketoacidosis/she forgot to take her insulin metabolic alkalosis/vomiting and diarrhea

diabetic ketoacidosis/she forgot to take her insulin

The anion gap can be used to: diagnose metabolic acidosis adjust oxygen treatments monitor ketoacidosis QC instruments

diagnose metabolic acidosis adjust oxygen treatments monitor ketoacidosis

Extracellular redistribution of potassium occurs in all of the following situations EXCEPT: diabetic ketoacidosis massive intravasular hemolysis rhabdomyolysis diarrhea

diarrhea *process that quickly results in a massive shift of electrolytes by loss of fluids, versus the others which are internal shifts occurring more slowly

The measurement of plasma renin activity is an important aid in the: differential diagnosis between primary and secondary aldosteronism diagnosis of hyperparathyroidism diagnosis of argentaffinoma diagnosis of hyposecretion of antidiuretic hormone

differential diagnosis between primary and secondary aldosteronism

Prior to implementation of a new lab test, the analytical measurement range (AMR) (linearity) must be verified. This is to verify a value that can be: directly measured on a specimen without any dilution or concentration reported after specimen treatment reported up to a 1/100 dilution sent out to a reference laboratory for verification

directly measured on a specimen without any dilution or concentration

The energy of a photon is: directly proportional to the frequency and the wavelength. inversely proportional to the frequency and directly proportional to the wavelength. directly proportional to the frequency and inversely proportional to the wavelength. inversely proportional to the frequency and the wavelength.

directly proportional to the frequency and inversely proportional to the wavelength.

If zero order kinetics are followed, allowing the reaction to run twice the time will: halve the amount of product formed cause the product to be denatured have no effect on the amount of product formed double the amount of product formed

double the amount of product formed

According C.L.A.D.M.E., drawing a patient for therapeutic drug monitoring levels wouldn't be a good idea during the distribution phase of metabolism because ______________. drawing during this phase could cause a falsely high or falsely low results, since the drug has not reached steady state drawing during this phase, the drug is bound to a soluble moiety drawing during this phase will change the rate of absorption of the drug drawing during this phase will cause the patient harm

drawing during this phase could cause a falsely high or falsely low

Which of the following are indications for performing therapeutic drug monitoring? drug has a narrow therapeutic range desired effect is obtained drug interactions are suspected patient compliance is suspected secondary disease is affecting drug utilization

drug has a narrow therapeutic range drug interactions are suspected patient compliance is suspected secondary disease is affecting drug utilization

Which of the following disease states is suggested by the results in the previous question.? rheumatoid arthritis drug-induced systemic lupus erythematosous Grave's disease Myasthenia gravis

drug-induced systemic lupus erythematosous

A peripheral pattern (or rim) of staining of the nucleus on IIF is most likely caused by which of the following antibodies? Anti-SSA/Ro antibody Anti-Sm antibody ds-DNA Centromere antibody

ds-DNA

An unruly college student has gone on a summer adventure to China. He comes to your clinic as soon as he returns from Shanghai with a three week history of worsening nausea, vomiting, and jaundice. During his trip, he toured the countryside, enjoyed the many seafood and vegetable dishes locally, had multiple sexual partners, and occasionally used IV drugs. Which of these activities would put him at risk for a Hepatitis A infection? IV drug use touring the countryside eating seafood and vegetable dishes multiple sexual encounters

eating seafood and vegetable dishes

Leakage of water into the intercellular space due to loss of plasma protein or decreased cardiac function leads to: iron deficiency anemia hemolysis dehydration edema

edema

At a pH of 8.6 the gamma globulins migrate toward the cathode, even though they are negatively charged. What is thisphenomenon called? electroendosmosis reverse migration molecular sieve migratory inhibition factor

electroendosmosis

In a patient with suspected primary hyperthyroidism associated with Graves' disease, one would expect the following laboratory serum results: _______________ free T4 and/or free T3, and ________________ TSH. Thyroid-stimulating immunoglobulins (TSIs) are ususally ___________________ in this condition. elevated, undetectable, negative elevated, elevated, positive normal, elevated, positive elevated, undetecable, positive

elevated, undetecable, positive

Which of the following would be least likely to occur after obstruction of the common bile duct? elevation in serum conjugated bilirubin elevation in serum unconjugated bilirubin urinary bilirubin positive elevation of serum alkaline phosphatase

elevation in serum unconjugated bilirubin

Which of the following would be least likely to occur after obstruction of the common bile duct? elevation in serum unconjugated bilirubin elevation in serum conjugated bilirubin elevation of serum alkaline phosphatase urinary bilirubin positive

elevation in serum unconjugated bilirubin

The bulk of purines excreted as uric acid by the kidneys is from the degradation of : exogenous nucleic acids endogenous nucleic acids No answer text provided. dietary sources

endogenous nucleic acids

The function of the major lipid components of the very- low-density lipoproteins is to transport: endogenous triglycerides cholesterol and phopholipids to peripheral cells exogenous triglycerides cholsesterol from peripheral cells to the liver

endogenous triglycerides

The skin lesions and photosensitivity observed in patients with nonacute cutaneous porphyrias are the result of excess presence of porphyrins in the skin that generate oxygen radicals. autonomic neuropathy. excessive production of aminolevulinic acid (ALA). accumulation of porphyrins in the liver.

excess presence of porphyrins in the skin that generate oxygen radicals.

It is acceptable to smoke, eat and drink in the laboratory work areas. true false

false

Molecular fluorescence is frequently activated by the absorption of ultraviolet radiation. If quenching takes place in this sample the results would be falsely decreased. falsely increased. unchanged, quenching isn't something that affects this method. impossible to determine without more information.

falsely decreased.

Several malabsorption problems are chacterized by a condition known as steatorrhea, which is caused by an abnormal accumulation of _________ in the feces.

fat

An enzyme assay during which a single measurement is taken at the termination of the enzymatic reaction is referred to as a: continuous-monitoring assay terminator assay kinetic assay fixed-time assay

fixed-time assay

Type II Hypersensitivity is characterized by:cfood and medications. autoimmune disorders. hemolytic disease of the fetus and newborn. the Arthus reaction.

food and medications.

An osmometer which supercools the sample to determine osmolality is based on a colligative property of solutes called: freezing point depression vapor pressure elevation dew point boiling point elevation

freezing point depression

Hypersecretion of prolactin can cause: Addison's disease acromegaly galactorrhea Cushing's disease

galactorrhea

Exocrine acinar cells make 98% of the pancreatic mass. The Islets of Langerhans make up about 1%, and contain all of the following endocrine cells except: delta. alpha. gamma. beta.

gamma

Patients with Zollinger-Ellison syndrome usually present with very high levels of: renin gastrin aldosterone testosterone

gastrin

Clearance tests for urea and creatinine estimate: tubular excretion blood flow and pressure glomerular filtration rate concentrating ability

glomerular filtration rate

Which of the following can cause hypoproteinemia? dehydration glomerulonephritis malnutrition liver disease

glomerulonephritis malnutrition liver disease

The most specific method for for the measurement of plasma glucose utilizes: glucose hexokinase. glucose oxidase. glucose-6-phosphatase. glucose triaminase.

glucose hexokinase.

Type I glycogen storage disease, von Gierke's, is caused by a deficiency or absence of: glucose-6-phosphatase adenyl kinase hepatic phosphorylase cyclic AMP-dependent kinase

glucose-6-phosphatase

Glucose is stored in muscle and the liver as:

glycogen

The conversion of glucose or other hexoses into lactate or pyruvate is called (remember the 4 Gs of carbo metabolism in the liver?):

glycolysis

____________________ ______________ are narrow cylindrical vessels used to measure volumes of liquid when a high degree of accuracy is not essential. They are available in sizes ranging from 10 mL to 1000 mL. (glassware pictured looks like long tube) Volumetric flasks Vacuum flasks Graduated cylinders Florence flasks

graduated cylinders

Haptoglobin measurement is especially helpful in identifying _________________ ____________ which would show a _________________ haptoglobin level. sickle cell disorders/increased hemolytic disorders/decreased hemolytic disorders /increased hemolytic disorders/normal

hemolytic disorders/decreased

For analysis of acid‑base disturbances involving pulmonary dysfunction, the specimen of choice is: heparanized venous blood heparinized arterial blood whole blood capillary blood venous blood and capillary blood, anticoagulant doesn't make a difference

heparinized arterial blood

Increased concentrations of Alpha-fetoprotein (AFP) in adults are most characteristically associated with: multiple myeloma hepatocellular carcinoma chronic active hepatitis prostatic carcinoma

hepatocellular carcinoma

An example of using enzymes as reagents in methods for other analytes in the clinical laboratory is the: hexokinase glucose method biuret total protein method alkaline picrate creatinine method diacetlyl monoxime urea method

hexokinase glucose method

During centrifugation, particles travel in a constant manner along the tube while the tube is at right angles to the shaft. This results in a uniform distribution of sediment against the bottom of the tube. What type of centrifuge is described here? Ultrafuge Horizontal head Airfuge Angle-head

horizontal head

An insulinoma of the pancreas could be responsible for: elevated gastrin levels hyopglycemia elevated lipase levels hyperglycemia

hyopglycemia

A patient who has previously received multiple blood transfusions is at high risk for developing ____________ ___________ if they were to receive another transfusion. chronic rejection Arthus reaction acute rejection hyperacute rejection

hyperacute rejection

Which of the following are seen in Addison's disease: hypoglycemia, hyponatremia, hyperkalemia hyperglycemia, hypernatremia, hypokalemia hyperglycemia, hyponatremia, hyperkalemia hypoglycemia, hypernatremia, hypokalemia

hypoglycemia, hyponatremia, hyperkalemia

Causes of hypocalcemia include: hyperparathyroidism, chronic renal failure, and vitamin D intoxication hypoparathyroidism, vitamin D toxicity, and osteomalacia hyperparathyroidism, vitamin D intoxication, and malignant bone tumor hypoparathyroidism, rickets, and chronic renal failure

hypoparathyroidism, rickets, and chronic renal failure

Thyrotropin-releasing hormone is secreted from the: hypothalamus anterior pituitary thyroid none of the above

hypothalamus

Disorders producing insulin antagonists, and therefore secondary diabetes (hyperglycemia), include all the following except pheochromocytoma acromegaly glucagonoma Cushing's syndrome hypothyroidism

hypothyroidism Everything on this list causes hyperglycemia except low thyroid levels. Cushing's (hypercortisolism), pheochromocytoma (excess epi and norepi), acromegaly (excess HGH) - all antagonize insulin effect. Glucagon producing tumor (pancreatic alpha cells) also causes hyperglycemia.

A diagnosis of primary adrenal insufficiency requires demonstration of: decreased urinary 17-keto- and 17-hydroxysteroids impaired response to ACTH stimulation decreased cortisol production increased cortisol excretion after metyrapone

impaired response to ACTH stimulation

The most common cause of error in the creatinine clearance test is: improperly collected urine specimens miscalculation of chemical results variation in serum creatinine levels a diet high in vegetables

improperly collected urine specimens

The most common cause of error in the creatinine clearance test is: miscalculation of chemical results improperly collected urine specimens a diet high in vegetables variation in serum creatinine levels

improperly collected urine specimens

In a normal ECG, all heartbeats appear as a similar pattern equally spaced, and have three major parts, the P wave, QRS complex, and T wave. The P wave reflects the spirit of the fans at a Mariners game impulse that produces contraction of the ventricles impulse that produces atrial contraction electrical recovery of the ventricles

impulse that produces atrial contraction

Causes of injury of the endothelial lining of arteries that can lead to inflammation include all of the following except: increased HDL toxins oxidized LDL increased blood pressure

increased HDL

Which one of the following sets of results is consistent with primary hypothyroidism, (eg, Hashimoto thyroiditis)? increased TSH, decreased Free thyroxine, positive antithyroid peroxidase normal TSH, decreased Free thyroxine, negative antithyroid peroxidase decreased TSH, decreased Free thyroxine, positive antithyroid peroxidase increased TSH, increased Free thyroxine, positive antithyroid peroxidase

increased TSH, decreased Free thyroxine, positive antithyroid peroxidase

The renal compensatory responses to a metabolic acidosis are: hyperventilation increased bicarbonate reabsorption decreased H+ excretion This would do the opposite of what you want, decreasing pH. increased sodium excretion

increased bicarbonate reabsorption

The renal compensatory responses to a metabolic acidosis is: increased bicarbonate reabsorption increased sodium excretion decreased H+ excretion hyperventalation

increased bicarbonate reabsorption *RENAL compensation. hyperventilation is the respiratory compensation.

A tumor normally grows independent of normal growth signals and controls from 1 cell to a billion cells in 1 year with a decrease in metabolic rate when compared to normal cells from a group of 10 different cells, so it is polyclonal in origin

independent of normal growth signals and controls

HEp2 cells fixed on a slide are exposed to a patient's serum, than after washing, anti-human immunoglobulin labeled with a fluorochrome is added. The procedure described is called: fluorescent quenching indirect immunofluorescence fluorescent polarization fluorescent inhibition

indirect immunofluorescence

All of the following are routes of transmission for Hepatitis B, except: ingestion of contaminated food and water sharing razors human bite sexual intercourse

ingestion of contaminated food and water

The action of Sirolimus as an immunosuppressive drug is to: inhibit T-lymphocyte activation and proliferation by mTOR inhibition stimulate T cell proliferation increase T-cell activity block B cell function

inhibit T-lymphocyte activation and proliferation by mTOR inhibition

Which hormone functions to increase the cellular uptake of glucose? catecholamines cortisol glucagon insulin

insulin

What is the largest fluid compartment? plasma water intracellular fluid transcellular water interstitial fluid

intracellular fluid

Systemic lupus erythematosus (SLE): involves linear deposition of IgG in the kidney leading to renal failure is diagnosed solely on the presence or absence of anti-dsDNA antibodies involves lumpy deposition of IgG in the kidney leading to renal failure is diagnosed by demonstration of the presence of RF factor

involves lumpy deposition of IgG in the kidney leading to renal failure

Measurement of the resistivity of water is used to indicate its purity with regard to: resins microorganisms ionized inorganics organic materials

ionized inorganics

Patients who have received the following types of grafts are at risk for graft-versus-host disease (GVHD) except for recipients of: irradiated leukocytes liver transplants bone marrow transplants lung transplants

irradiated leukocytes

A chemical which causes a local inflammatory reaction is categorized as: sensitizer corrosive carcinogen irritant

irritant

A chemiluminescent EIA: is quantitated by the amount of light produced by a chemical reaction. is monitored by use of a gamma counter. measures absorption of light is less sensitive than radioisotopic reactions.

is quantitated by the amount of light produced by a chemical reaction.

A reaction with picric acid in an alkaline solution was performed on a patient sample (the Jaffee method). The analyte being tested for was abnormally high in the serum. The most likely pathology associated with this is: kidney disease. heart disease. COPD. viral hepatitis.

kidney disease.

Physiologically important buffers maintaining body pH include all the following EXCEPT lactate bicarbonate protein hemoglobin

lactate

Physiologically important buffers maintaining body pH include all the following EXCEPT: hemoglobin lactate bicarbonate phosphate protein

lactate

Serum "anion gap" is increased in patients with: renal tubular acidosis lactic acidosis metabolic acidosis due to diarrhea diabetic alkalosis

lactic acidosis

Refer to the following results from hepatitis testing on 3 different patients: HBsAg anti-HBc IgM anti-HAV Patient 1 neg neg pos Patient 2 pos pos neg Patient 3 neg pos neg From these test results, it can be concluded that patient 3 has: late acute Hepatitis B infection acute Hepatitis C infection chronic Hepatitis B recent Hepatitis A infection

late acute Hepatitis B infection

What are the three essential fatty acids that can not be made by the body?

linoleic, linolenic, arachidonic

In acute pancreatitis, the serum enzyme whose significant increase is diagnostically useful is: lipase lactate dehydrogenase aspartate transaminase creatine kinase

lipase

The more current kinetic methods for the quantitation of serum triglycerides employ enzymatic hydrolysis. The enzymatic hydrolysis of triglycerides may be accomplished by what enzyme? lipase amylase cholesterol esterase Glycerolkinase

lipase

Which of the following enzymes is used to hydrolyze 1,2-diglyceride to 2-monoglyceride and fatty acid? lipase creatinine kinase amylase ALT

lipase

A 23-year old male arrived at the emergency room complaining of severe, mid abdominal pain of 10 hours duration, nausea and vomiting. The following lab results were obtained: Total protein 7.5 gm/dL (5.5-7.5)Albumin 4.5 gm/dL (3.0-4.7)Total bilirubin 0.5 mg/dL (0.1-1.2)ALT 25 U/L (0-50)AST 20 U/L (10-75)GGT 500 U/L (0-65)ALP 70 U/L (38-110)Amylase 425 U/L (16-106)Lipase 250 U/L (7-60) Hemogram and routine urinalysis results were normal. Which of the above results are abnormal? lipase, amylase and ALP ALT, AST, and GGT Albumin, ALT, and AST lipase, amylase and GGT

lipase, amylase and GGT

Density gradient ultracentrifugation is used to separate protein complexes with different densities compared to most proteins. This applies mainly to ____________________________ that have lower density due to high lipid content. glycoproteins tetrapeptides lipoproteins hydrophilic proteins

lipoproteins

What is the general definition of autoimmunity? increase of tolerance to self-antigens increase in clonal deletion of mutant cells loss of tolerance to self-antigens manifestation of immunosuppression

loss of tolerance to self-antigens Loss of self tolerance means you now cease to recognize that you're harming self and treating them as foreign

In the presence of ACTH stimulation, an impaired adrenal gland would exhibit which type of response? ↓ cortisol ↑ cortisol ↑ epinephrine ↓ epinephrine

low cortisol

A 68-year-old man arrives in the emergency room with a plasma glucose level of 722 mg/dL and an elevated B-hydroxybutyrate. This patient would most likely also demonstrate which of the following blood pH results? normal pH high pH none of these answers is correct low pH

low pH

Extrarenal factors that increase the circulating urea concentration include all of the following except: dehydration reabsorption of blood protein after GI hemorrhage low protein diet high protein diet

low protein diet

When measuring enzyme activity, if the instrument is operating 5oC lower than the temperature prescribed for the method, the results will be: higher than expected varied, showing no particular pattern accurate lower than expected

lower than expected

Which of the following amino acids are considered to be ketogenic only? aspartate and asparagine lysine and leucine glutamate and histidine glycine and serine

lysine and leucine

Deficiencies of this analyte manifest as impairment of neuromuscular function; hyper-irritability, tetany, convulsions, and EKG changes. Low levels can occur with either normal or reduced calcium concentrations. magnesium albumin chloride sodium

magnesium

The primary function of albumin in the peripheral blood is to: increase antibody production maintain colloid osmotic pressure maintain blood viscosity increase fibrinogen synthesis

maintain colloid osmotic pressure

What is the main biological function of albumin?

maintain colloidal osmotic pressure/balance; transporting ligands

Calculate the LDL cholesterol, using the Friedewald equation, for an adult patient with the following results: Total cholesterol = 265 mg/dLHDL cholesterol = 21 mg/dLTriglyceride = 393 mg/dLFor the patient in the previous question, concerning lifestyle, all of the following risk factors need to be assessed except: marital status current cigarette smoking age and gender hypertension

marital status

The first step in analyzing a 24-hour urine specimen for creatinine clearance is: add the appropriate preservative measure the total volume subculture the urine for bacteria screen for albumin using a dipstick

measure the total volume

Elevated serum levels of the hormone calcitonin are usually associated with: small cell lung carcinoma congenital adrenal hyperplasia medullary carcinoma of the thyroid trophoblastic tumors

medullary carcinoma of the thyroid

A 50 year old male appeared in the ER after returning from foreign travel. His symptoms included persistent diarrhea (over the past 3 days) and rapid respiration (tachypnea). Blood gases were drawn. pH7.21pCO219 mm HgpO296 mm HgHCO3-7 mmol/LSO296% (calculated) (RI =>95%) What is the acid-base status of the patient?Why is the HCO3- level so low? Why does the patient have tachypnea? metabolic acidosis, loss of HCO3- through diarrhea, respiratory compensation to decrease serum pCO2 respiratory acidosis, loss of HCO3- through diarrhea, respiratory compensation to decrease serum pCO2 metabolic acidosis, loss of HCO3- through buffering, respiratory compensation to decrease serum pCO2 non-metabolic acidosis, loss of HCO3- through diarrhea, respiratory compensation to retain serum pCO2

metabolic acidosis, loss of HCO3- through diarrhea, respiratory compensation to decrease serum pCO2

Results Reference range pO2 88 88 - 94 mmHg pCO2 50 38 - 42 mmHg pH 7.44 7.38 -7.42 HCO3- 33 23 - 25 mEq/L BE +7 0 ± 2 mEq/L Describe the acid base status: metabolic acidosis metabolic alkalosis respiratory acidosis respiratory alkalosis

metabolic alkalosis

Which of the following correctly ranks electromagnetic radiation from low energy to high energy? microwaves, infrared, visible, UV, x-rays, gamma, cosmic cosmic, gamma, x-rays, visible, infrared, microwaves UV, visible, infrared, microwaves, x-rays, cosmicm gamma Visible, UV, infrared, cosmic, gamma, microwaves, x-rays

microwaves, infrared, visible, UV, x-rays, gamma, cosmic

In automated methods utilizing a bichromatic analyzer, dual wavelengths are employed to: minimize the effect of interference (i.e., hemolysis) improve precision faciltate dialysis monitor temperature changes

minimize the effect of interference (i.e., hemolysis)

True isoenzymes are different: enzymes which exhibit the same electrophoretic mobility molecular structures of an enzyme originating with gene encoding, that all catalyze the same reaction enzymes which exhibit the same enzymatic specificity

molecular structures of an enzyme originating with gene encoding, that all catalyze the same reaction

All of the following are causes of hypoproteinemia except: monoclonal gammopathies extensive burns renal disease inflammation of the digestive system

monoclonal gammopathies

All of the following are causes of hypoproteinemia except: renal disease inflammation of the digestive system monoclonal gammopathies extensive burns

monoclonal gammopathies

This densitometer scan of an electrophoretic pattern from a patient with bone pain, anemia, and leukopenia suggests: (giant extra spike in gamma protein region) cirrhosis alpha-1-antitrypsin deficiency acute inflammation monoclonal gammopathy

monoclonal gammopathy

In an indirect EIA, would the amount of color at the end be more, less or the same, if you forgot the washing step between the conjugate and the addition of substrate? more less the same

more

Creatinine clearance results can be corrected using a patient's body surface area to account for differences in: dietary intake age gender muscle mass

muscle mass

Anions carry a __________ charge and migrate towards the _______________. negative/anode positive/anode negative/cathode positive/cathode

negative/anode

With barbital buffer at pH 8.6, albumin in a serum protein electrophoresis, has a net _______________ charge and migrates towards the ________________. negative/cathode positive/anode negative/anode positive/cathode

negative/anode

Using an unabsorbable wavelength of light, the amount of light that gets scattered by complex formation is detected at a specific angle to the sample cuvette. This is called: nephelometry fluorometry spectrophotometry turbidimetry

nephelometry

A 17-year-old girl who was a known diabetic went out to dinner with the captain of the football team on her very first ever date, and neglected to take her insulin. She managed to get home by curfew, breath smelling fruity, before becoming comatose. Her parents rushed her to the hospital, where the following laboratory results were obtained on a blood specimen: Glucose 550 mg/dL (65-99 mg/dL)Sodium 123 mmol/L (135-145 mmol/L)Potassium 5.7 mmol/L (3.5-5.3 mmol/L)Chloride 92 mmol/L (99-109 mmol/L)Total CO2 5 mmol/L (22-31 mmol/L)pH 7.25 (7.35-7.45) The urine was positive for glucose and ketones. What is the most likely cause of her elevated plasma glucose? no insulin to facilitate transport of glucose into cells she took too much insulin vomiting/diarrhea food poisoning

no insulin to facilitate transport of glucose into cells

Which of the following may be safely pipeted by mouth? whole blood urine None of these answers is correct serum

none of these answers is correct

A 2-hours postprandial serum glucose specimen in an individual without pathology should be: normal significantly greater than the normal moderately greater than the normal significantly lower than the normal

normal

A blood specimen is drawn for lipoprotein electrophoresis. The test results obtained are: Serum appearance when recieved, turbid Triglyceride, 324 mg/dL (ref. range, 40-164 mg/dL)Total cholesterol, 185 mg/dL ( ref. range, less than 200 mg/dL) Alpha-lipoprotein fraction normalPrebeta-lipoprotein fraction increasedBeta-lipoprotein fraction normalChylomicrons fraction increased The best explanation for these results would be that the patient was____ __________, when the specimen was drawn.

not fasting

An International Unit of enzyme activity is defined as that amount of enzyme, under standard conditions, which will catalyze the reaction of: one micromole of substrate per minute. one millmole of substrate per minute. one micromole of enzyme per hour. one mole of substrate per second.

one micromole of substrate per minute.

Enhancement of phagocytosis by coating of foreign particles with serum proteins is called: chemotaxis agglutination opsonization solubilization

opsonization

Carbohydrate antigen 125 (CA 125) is a tumor marker associated with: bone cancer benign prostatic hyperplasia ovarian and endometrial cancer brain cancer

ovarian and endometrial cancer

Avidity may be defined as the: overall binding strength of antigen-antibody binding degree of hemolysis dilution of an antibody titer of an antigen

overall binding strength of antigen-antibody binding

Which set of results is consistent with uncompensated respiratory alkalosis? pH 7.56; HCO3- 32 mmol/L; PCO2 32 mmHg pH 7.66; HCO3- 25 mmol/L; PCO2 21 mmHg pH 7.46; HCO3- 38 mmol/L; PCO2 55 mmHg pH 7.36; HCO3- 22 mmol/L; PCO2 38 mmHg

pH 7.66; HCO3- 25 mmol/L; PCO2 21 mmHg

If the pKa is 6.1, and the total CO2 content is 25 mmol/L; the salt equals the total CO2 content minus the carbonic acid; and the carbonic acid equals 0.0306 X PCO2; and the PCO2 is 40 mmHg, it may be concluded that: pH = 6.1 + log [(25-0.0306) / (0.0306)] pH = 6.1 + log [(25 - 1.2) / (1.2)] pH = 6.1 + log [(1.2) / (1.2 - 25)] pH = 6.1 + log [(40-0.0306) / (0.0306)]

pH = 6.1 + log [(25 - 1.2) / (1.2)]

Which parameters are directly measured by most blood gas analyzers? pH, PCO2, and PO2 pH, PCO2, and HCO3- pH, H&H, PCO2 pH, PO2, and HCO3-

pH, PCO2, and PO2

Which parameters are directly measured by most blood gas analyzers? pH, pCO2 and pO2 pH, pCO2, and HCO3- pH, pO2, and HCO3- pH, H&H, pCO2

pH, pCO2 and pO2

Which parameters are directly measured by most blood gas analyzers? pH, pCO2, and HCO3- pH, pO2, and HCO3- pH, H&H, pCO2 pH, pCO2, and pO2

pH, pCO2, and pO2

The Clark electrode is used in most blood gas instruments to measure: pO2 amperometrically pH by conductimetry pCO2 coulometry pO2 potentiometrically

pO2 amperometrically

Patients diagnosed with diabetes mellitus type 1 or type 2 are at high risk for the development of chronic complications, including all of the following except: pancreatic carcinoma and bone pathology myocardial infarction and stroke nephropathy and end-stage renal disease retinopathy and blindness

pancreatic carcinoma and bone pathology

Which of the following hormones regulates blood calcium levels? parathyroid hormone growth hormone estriol thyroxine

parathyroid hormone

All of the following can be causes of systematic error except: phases of the moon changes in reagent lot change in calibrator lot inadequate storage of reagents

phases of the moon

The three ketone bodies include all of the following except: phenylalanine beta-hydroxybutyrate acetoacetate acetone

phenylalanine

Which of the following lipids functions as a surfactant in the lungs? cholesterol fatty acid phospholipid triglyceride

phospholipid

The three major types of membrane lipids are glycolipids, cholesterol, and ____________.

phospholipids

In todays UV-VIS spectrophotometric instrumentation, the most commonly used type of detector is the photomultiplier tube. mercury vapor lamp. interference filter. photvoltaic cell.

photomultiplier tube.

primary hypogonadism in females can be caused by all of the following except radiation/chemotherapy. Turner's syndrome. premature ovarian failure. pituitary tumor.

pituitary tumor.

The reduced form of a porphyrin is known as a: porphyrinogen. pyrrole ring. protoporphyrin. heme molecule.

porphyrinogen.

The _________ __________ supplies nutrient-rich blood to the liver from the ________ ________. celiac vein/respiratory system celiac vein/digestive system portal vein/cardiac system portal vein/digestive tract

portal vein/digestive tract

Hyperuricemia can be seen in all of the following conditions except: gout renal disease post hepatic jaundice leukemia

post hepatic jaundice

The cation with the highest intracellular concentration is: potassium magnesium sodium calcium

potassium

Valinomycin has a high affinity for ___________ and is used in an ion selective membrane to measure the electrolyte potassium sodium lithium magnesium

potassium

Which of the following electrolytes has no threshold level, is increased in a hemolyzed plasma sample, and is also increased in the blood in an acidosis? sodium potassium chloride lithium

potassium

The following are positive acute phase proteins except: prealbumin haptoglobin CRP AAT

prealbumin

Which of the following is the most useful in the assessment of protein nutritional status? transferrin haptoglobin hemoglobin prealbumin

prealbumin

A response to ACTH stimulation in which there is NO increase in plasma cortisol would be most likely in hypopituitarism (secondary Addison's disease) primary Addison's disease adrenocortical hyperplasia Cushing's disease

primary Addison's disease Addison's disease is caused by adrenal atrophy, formerly from tuberculosis and now most commonly from excess exogenous steroid administration (i.e. prednisone). Administration of ACTH does not stimulate cortisol release, in contrast to adrenal hyperplasia and disorders secondary to the pituitary (including Cushing's disease).

A male with elevated LH and FSH and low testosterone in serum may likely have partial androgen resistence secondary hypogonadism primary germ cell failure primary hypogonadism

primary hypogonadism Primary hypogonadism gives the laboratory picture of high LH and FSH with low testosterone. In secondary disease, all of these would be low. Elevated FSH with normal LH and testosterone suggest primary germ cell failure. Partial androgen resistance syndromes show increased LH and normal-to-high FSH and testosterone.

Increased thyroid stimulating hormone (TSH), decreased T3, and decreased T4 indicate pseudohypothyroidism secondary hypothyroidism primary hypothyroidism tertiary hypothyroidism nonspecific hypothyroidism

primary hypothyroidism

The analgesics drug class NSAIDs, non-steroidal anti-inflammatories (aspirin, ibuprofen, naproxen), work by blocking the action of the acidic lipids known as _________. salicylic acid prostaglandins barbiturates acetaminophen

prostaglandins

Proteins are excellent antigens because of their high molecular weight and structural complexity. Rank the other antigens listed in terms of immunogenicity from strong to weak? AA>haptens>protein> polysaccharides>steroids>nucleic acid>lipids haptens>protein>polysaccharides>steroids>nucleic acid>lipids>AA protein>polysaccharides>steroids>nucleic acid>lipids>haptens>AA haptens>protein>lipids>polysaccharides>steroids>nucleic acid>AA

protein>polysaccharides>steroids>nucleic acid>lipids>haptens>AA

Proteins are excellent antigens because of their high molecular weight and structural complexity. Rank the other antigens listed in terms of immunogenicity from strong to weak? AA>haptens>protein> polysaccharides>steroids>nucleic acid>lipids protein>polysaccharides>steroids>nucleic acid>lipids>haptens>AA haptens>protein>polysaccharides>steroids>nucleic acid>lipids>AA haptens>protein>lipids>polysaccharides>steroids>nucleic acid>AA

protein>polysaccharides>steroids>nucleic acid>lipids>haptens>AA

In congestive heart failure (CHF), lower cardiac output caused by left side failure will primarily result in: pulmonary edema only generalized edema poor blood supply to systemic circulation pulmonary edema and reduced blood flow to systemic circulation

pulmonary edema and reduced blood flow to systemic circulation

Uric acid is the final metabolic product of: amino acids allantoin purines the urea cycle

purines

Uric acid is the final metabolic product of: purines amino acids allantoin the urea cycle

purines

For spectrophotometric measurements in the UV range of the EMR spectrum, which of the following cuvettes are usually required? quartz glass borosilicate glass tinted glass

quartz

Type 2 diabetes is: less frequently seen than type 1 diabetes related to resistance to the action of insulin also known as insulin-dependent diabetes mellitus caused by destruction of pancreatic beta cells

related to resistance to the action of insulin

A patient with the following results most likely has: hyperkalemia hyperphosphatemia dilutional hyponatermia hypocalcemia decreased Total Protein normal AST slightly elevated ALT normal ALP normal GGT normal lipase slightly elevated Total Bili moderately elevated BUN decreased GFR below 60 mL/min decreased urine specific gravity renal disease cholestatic obstruction hepatitis pancreatitis

renal disease

Running the same sample multiple times on variable shifts and times and with different personal is a way to show: accuracy recovery studies reproducibility repeatability

reproducibility

A hospitalized patient's plasma glucose was 1045 mg/dL using a glucose hexokinase procedure. He was not diagnosed as diabetic and exhibited no symptoms of ketoacidosis. The most likely explanation for this value is that the: sample was drawn above an IV containing glucose. sample was left on cells for over 4 hours prior to analysis. patient was not fasting. patient is severely hypoglycemic

sample was drawn above an IV containing glucose.

If a microorganism overwhelms the body's natural defenses, a third line of defense exists. Acquired or adaptive immunity is also referred to as: non-specific immunity natural immunity specific immunity innate immunity

specific immunity

An example of pre-analytical error would be (select all that apply): specimens spun down in a centrifuge set at the wrong speed designated controls not run at required intervals incorrect values used for calibration curve material results to be sent to the physician improperly transcribed

specimens spun down in a centrifuge set at the wrong speed

The deficiency of which enzyme is diagnostic for Niemann-Pick disease? _______________

sphingomyelinase

Which of the following CHO is a polysaccharide? starch sucrose lactose glucose

starch

Which of the following affects pharmacokinetics (how the body treats or metabolizes drugs): state of health or disease gender age diet dosage

state of health or disease gender age diet dosage

In addition to carcinoma of the prostate, elevated prostate-specific antigen (PSA) can occur due to all of the following except: benign prostatic hyperplasia statin therapy (cholesterol lowing drug) digital rectal exam prior to blood draw sexual intercourse prior to blood draw

statin therapy (cholesterol lowing drug)

Reverse phase high-performance liquid chromatography is being increasingly utilized in the clinical laboratory. The term reversed implies that the stationary phase is nonpolar and the mobile phase is relatively polar. stationary phase is an ion-exchange resin. chromatography is performed using a series of stationary phases. mobile phase is less polar than the stationary phase.

stationary phase is nonpolar and the mobile phase is relatively polar.

The Lineweaver-Burk plot below shows the reciprocal of the measured velocity of an enzyme reaction plotted against the reciprocal of the substrate concentration. A true statement about this figure is: the straight line indicates that the enzyme reaction proceeds according to zero order kinetics the fact that the substrate concentration is plotted on both sides of the zero point indicates that the reaction is reversible the intercept of the line on the ordinate (y axis) can be used to calculate the Vmax the intercept on the ordinate (y axis) can be used to calculate the Michaelis-Menten constant

the intercept of the line on the ordinate (y axis) can be used to calculate the Vmax

The Lineweaver-Burk plot below shows the reciprocal of the measured velocity of an enzyme reaction plotted against the reciprocal of the substrate concentration. A true statement about this figure is the: the intercept on the abscissa (x axis) can be used to calculate the Michaelis-Menten constant the intercept of the line of the abscissa (x axis) can be used to calculate the Vmax the fact that the substrate concentration is plotted on both sides of the zero point indicates that the reaction is reversible the straight line indicates that the enzyme reaction proceeds according to zero order kinetics

the intercept on the abscissa (x axis) can be used to calculate the Michaelis-Menten constant

The Lineweaver-Burk plot below shows the reciprocal of the measured velocity of an enzyme reaction plotted against the reciprocal of the substrate concentration. A true statement about this figure is the: the straight line indicates that the enzyme reaction proceeds according to zero order kinetics the fact that the substrate concentration is plotted on both sides of the zero point indicates that the reaction is reversible the intercept on the abscissa (x axis) can be used to calculate the Michaelis-Menten constant the intercept of the line of the abscissa (x axis) can be used to calculate the Vmax

the intercept on the abscissa (x axis) can be used to calculate the Michaelis-Menten constant

Which of the following determines the direction of migration of albumin (i.e. toward cathode or anode) during electrophoretic separation of serum proteins, at pH 8.6? the ionization of the carboxyl groups, resulting in a net negative charge the density of the gel layer the ionization of the amine groups, resulting in a net positive charge the ionization of the carboxyl groups, resulting in a net positive charge

the ionization of the carboxyl groups, resulting in a net negative charge

Which of the following determines the direction of migration of albumin (ie, toward cathode or anode) during electrophoretic separation of serum proteins, at pH 8.6? the density of the gel layer the ionization of the carboxyl groups, resulting in a net negative charge the ionization of the amine groups, resulting in a net positive charge the ionization of the carboxyl groups, resulting in a net positive charge

the ionization of the carboxyl groups, resulting in a net negative charge

The term apoenzyme refers to: an inorganic cofactor an organic cofactor a non-protein molecule that may be necessary for enzyme activity the protein portion of the enzyme

the protein portion of the enzyme

The RIST assay for IgE serologies looks for _________. IgE antibodies in type II hypersensitivities specific antibodies to allergens total IgE immunoglobulin allergen specific IgE

total IgE immunoglobulin

In a diazo bilirubin procedure employing an accelerator such as methanol, or caffeine-sodium benzoate, which of the following would be measured? total bilirubin. urobilinogen. biliverdin. porphobiliogen.

total bilirubin.

Which of the following is the major plasma transport protein for iron? ceruloplasmin albumin haptoglobin transferrin

transferrin

Which of the following lipid results would be expected to be falsely increased on a specimen from a nonfasting patient? triglycerides cholesterol HDL LDL

triglycerides

The myocardium contains striated muscle fibers that alternate between contraction and relaxation. The regulatory proteins for the contractile proteins are called: myoglobin myosin troponins actin

troponins

"Standard precautions" refers to the OSHA/WISHA regulation that all blood, blood products, and body fluids be treated as if they are contaminated. true false

true

If an individual has taken one of the "Opiates" (opium, heroin, morphine, and codeine), it can be detected in urine for approximately 2 days. true false

true

Infection control is based on breaking the chain of infection at one or more points between the source of the infection, the mode of transmission, and the susceptible host. true false

true

The mucous membranes of the eyes and mouth are possible modes of transmission for infection, so splashes to the face and hand to face contact should always be avoided or prevented. true false

true

The responsibility for safety performance ultimately belongs to each individual. true false

true

Types II and III hypersensitivities are the only types with complement involvement. True False

true

The amino acid precursor for the catecholamines is: arginine tyrosine tryptophan leucine

tyrosine

An example of an amino acid related hormone is _________.

tyrosine thyroid hormone T3/T4 thyroid epinephrine

Which of the following should not be included in the differential diagnosis of hypercalcemia? primary hyperparathyroidism multiple myeloma vitamin D intoxication vitamin D-dependent rickets

vitamin D-dependent rickets Vitamin D dependent rickets is the only HYPOcalcemic disorder listed in these options. Everything else is related to hypercalcemia and should be ruled out when evaluating hypercalcemia.

During phase one of drug metabolism functional groups are unmasked or introduced to make a metabolite more soluble. In phase two of metabolism, endogenous molecules like glucuronic acid, sulfate, acetate, or amino acids are covalently attached. These are sometimes referred to as _________. insoluble moieties excretory additives lipid solubility conjugates water-soluble moieties

water-soluble moieties

In primary hyperparathyroidism, which of the following would be seen: ↑ serum Ca, ↑ alkaline phosphatase, ↓ urine phosphate ↓ serum Ca, ↓ alkaline phosphatase, ↓ urine phosphate ↑ serum Ca, ↑ alkaline phosphatase, ↑ urine phosphate ↓ serum Ca, ↓ alkaline phosphatase, ↑ urine phosphate

↑ serum Ca, ↑ alkaline phosphatase, ↑ urine phosphate

Liver diseases in which UDPG (uridyldiphosphate glucuronyl transferase) activity is decreased or absent will result in: ↑ conjugated bilirubin ↑ unconjugated bilirubin ↑ urine urobilinogen ↓ fecal urobilinogen

↑ unconjugated bilirubin

The anion gap, an estimate of anions not directly measured in serum, is correctly calculated by which one of the following formulae? (Na) + (Cl + HCO3) (Na) - (Cl + HCO3) (Cl) + (HCO3 + Na) (HCO3 - Na) - (Cl)

(Na) - (Cl + HCO3)

Given a 78% transmittance value, calculate the absorbance: Correct! 0.108 0.051 2.03 0.036

0.108

Pepsin cleaves Immunoglobulin G into: 4 J chains 2 Fab + 1Fc 1 (Fab')2 and fragmented Fc its heavy and light chains

1 (Fab')2 and fragmented Fc

A colorometric method calls for the use of 0.1 mL of serum, 5 mL of reagent, and 4.9 mL of water. What is the dilution of the serum in the final solution? 1 to 100 1 to 10 1 to 50 1 to 5

1 to 100

Plasma catecholamines are increased...1. by anxiety2. by exercise3. by stress4. in hyperglycemia 2 and 4 4 only all 1 and 3 1, 2, and 3

1, 2, and 3

In known hepatitis patients, what additional lab testing excluding serological testing will be used to monitor and evaluate progression to late stage chronic liver disease? (Please list at least 2 tests)

1. Total protein/albumin: decreases as disease state worsens. Lower levels (compared to repeated testing to establish a norm) will indicate disease progression. 2. Liver enzymes: greatly increased ALT is usually the first indication of hepatitis, when AST is even greater than ALT this is an indication of poor prognosis. GGT and ALP will also be elevated. Decrease in once acutely elevated liver enzymes, increased PT and PTT, decreased total protein and albumin, change in livers ability to conjugate bilirubin (shift in more unconjugated bilirubin than conjugated with increased total bilirubin).

What is the content of O2 that can be carried by one gram of hemoglobin? 1.34 ml O2 per gram of Hgb 13.4 ml O2 per gram of Hgb 1.34 L O2 per gram of Hgb 134 ml O2 per gram of Hgb

1.34 ml O2 per gram of Hgb

What is the protein concentration of the following sample if the 7.2 g/dL standard reads an absorbance (A) of 0.52?A = 0.140 => __________ g/dL

1.9 g/dL

A plasma CK sample was too high to read, so a 1:5 dilution using saline was made (dilution A). Dilution A was tested and again was too high to read. A further 1:2 of dilution A was made using saline (dilution B). To calculate the result, the dilution B value must be multiplied by: 10 8 5 20

10

CLRW, suitable for demanding quantitative chemistry procedures, will have a resistivity of ________ megohms/cm at 25 degrees C. 10 2.0 50 0.1

10

To achieve approximately 91% theoretical Vmax in an enzyme measurement system, what substrate concentration is required? the negative reciprocal of Vmax one-half the Km 10 X Km or greater one-half Vmax

10 X Km or greater

The plasma glucose is 200 mg/dL. The spinal fluid glucose would be expected to be,in mg/dL: 70 120 200 240

120

Calculate the CV for an alkaline phosphatase assay with a mean of 38 U/L, and an SD of 5 U/L. 13.2% 26.3% 7.6% 5.8%

13.2%

A glucose assay was performed with a single glucose standard of 400 mg/dL. If the standard had an absorbance of 1.425, calculate the concentration of a sample with an absorbance value of 0.681. 191 mg/dL 400 mg/dL 52 mg/dL 256 mg/dL

191

For the following, calculate the amount of hormone/drug, in µg/mL, that is present at 12 days: original concentration 16 µg/mL half-life 4 days 8 4 2 1

2

Papain digestion of an IgG molecule results in which of the following? 2 Fab' and 1 Fc' fragment 2 Fab and 2 Fc fragments F(ab')2 and 1 Fc' fragment 2 Fab and 1 Fc fragment

2 Fab and 1 Fc fragment

Immunoglobin-G, when treated with Papain, splits into three fragments known as: 1 fab fragment, 2 fc fragments 3 fab fragments 3 fc fragments 2 fab fragments, 1 fc fragment

2 fab fragments, 1 fc fragment

The structure of the immunoglobulin molecule consists of: 2 pairs of heavy and 2 pairs of light chains linked by disulfide bonds 4 heavy chains linked by disulfide bonds 4 light chains linked by disulfide bonds 2 heavy and 2 light chains linked by disulfide bonds

2 heavy and 2 light chains linked by disulfide bonds

The general equation most often used in the US for Calculated osmolality is: 2*Na + Urea + [Glucose]/18 + [ BUN ]/2.8 2*Na + 2*K + Urea 3*Na + [Glucose]/18 + [BUN]/2.8 2*Na + [Glucose]/18 + [ BUN ]/2.8

2*Na + [Glucose]/18 + [ BUN ]/2.8

To maintain a normal pH of 7.4 in plasma, it is necessary to maintain a: 20:1 ratio of bicarbonate to dissolved carbon dioxide 10:1 ratio of bicarbonate to dissolved carbon dioxide 30:1 ratio of bicarbonate to dissolved carbon dioxide 10:1 ratio of dissolved carbon dioxide to bicarbonate

20:1 ratio of bicarbonate to dissolved carbon dioxide

The normal serum osmolality is about: 400-500 mOsm/kg 275-295 mOsm/kg 50-100 mOsm/kg 3 times the urine osmolality

275-295 mOsm/kg

What is the relative centrifugal force (RCF) of a centrifuge that has a radius of 20 cm and is operated at 4000 rpm? 75,000 x g 7552 x g 3578 x g 358 x g

3578 x g

A hypertensive, hypokalemic patient with urinary sodium excretion of 50 mmol/day and plasma renin activity below the assay sensitivity has1. pheochromocytoma2. renal artery stenosis3. benign hypertension4. primary aldosteronism 1 and 3 all 1, 2, and 3 4 only 2 and 4

4 only

A young boy is admitted to the ED after ingesting an unknown dosage of illicit drug left on his parents table. The parents waited 6 hours to bring him in because they thought he might just "get better" on his own and were afraid of the legal implications. After much coaxing, they finally identify the drug, but they say they don't remember how much he ingested! Now that we know what drug to look for, we discover the boy's serum level is 0.5 ng/dL. If the half life of this drug is approximately 2 hours, what was the concentration of drug in the boy's system immediately following his ingestion (assuming it's a perfect world were absorption and metabolism dynamics were perfectly linear and predictable)? 1.5 ng/dL 4.0 ng/dL 2.0 ng/dL 3.0 ng/dL

4.0 ng/dL 4 *0.5 = 2 2*0.5 = 1 1*0.5=0.53 HalfLives

Enzyme reaction rates are increased by increasing temperatures until they reach a point of denaturation at: 40-60 degrees C 25-35 degrees C 100 degrees C 37 degrees C

40-60 degrees C

What is the PCO2 if the dCO2 is 1.8 mmol/L? 60 mmHg 24 mmHg 72 mmHg 35 mmHg

60 mmHg

Which of the following best characterizes chemiluminescent assays? These are only homogeneous assays. A chemical is oxidized to produce light. Tests can be manually read. Only the antigen can be labeled.

A chemical is oxidized to produce light.

During an evaluation of adrenal function, a patient had plasma cortisol determinations in the morning after awakening, and in the evening. Laboratory results indicated that the morning value was about 50% higher than the evening concentration. This is indicative of: Addison's disease Cushing's syndrome Hypopituitarism A normal finding

A normal finding

Hepatocellular carcinoma, hepatoblastoma, yolk sac (endodermal sinus) tumor, mixed germ cell tumors

AFP

The most clinically useful enzymes in the assessment of liver function are alkaline phosphatase, gammaglutamyl transferase, and AST and ALT AST and amylase ALT and lipase lipase and amylase

AST and ALT

Kidney allograft loss from intravascular thrombosis without cellular infiltration 5 days post-transplant may indicate which primary rejection mechanism? Accelerated humoral rejection acute cellular rejection Acute humoral rejection Hyperacute rejection

Accelerated humoral rejection

In post-pubertal adults, hypersecretion of growth hormone due to an adenoma of the pituitary leads to: Gigantism SIADH Acromegaly Dwarfism

Acromegaly

Please interpret the following results: HBsAg (positive)anti-HBc (positive)IgM anti-HBc (positive)anti-HBs (negative) Susceptible Chronically infected Immune due to natural infection Acutely infected

Acutely infected

A person having an abnormally low serum cortisol baseline level, is given ACTH. A subsequent serum cortisol measurement taken one hour after ACTH shows no change in the serum cortisol level. The most probable diagnosis of the patient is: Addison's disease Adrenal adenoma Cushing's syndrome Hypopituitarism

Addison's disease

Due to issues with infertility, a physician would like to determine when a woman ovulates. The physician orders serial assays of plasma progesterone. From these assays the physician can tell when ovulation occurs because: After ovulation, progesterone rapidly decreases Right before ovulation progesterone spikes After ovulation, progesterone rapidly increases Right before ovulation progesterone rapidly increases

After ovulation, progesterone rapidly increases

Ionized calcium can be free or bound in vivo. When evaluating patient serum calcium results, one must also consider the levels of: Phosphorus Magnesium PTH Albumin

Albumin

Both AFP and hCG exhibit serum elevations in: All of these answers are correct. normal pregnancy nonseminomatous testicular cancer ovarian germ cell tumors

All of these answers are correct.

Which of the following is characteristic of conjugated bilirubin? It reacts immediately with diazo reagent. It can be excreted in both bile and urine. All of these answers are correct. It is water soluble.

All of these answers are correct.

Which of the following viral infection can result in a chronic carrier state? HCV HBV All of these are correct HDV

All of these are correct

Clinical indications for monitoring ionized calcium include: All of these indications. Transfusion with citrate blood. Renal failure. Neonatal hypocalcemia.

All of these indications.

Which of the following statements is correct? A prosthetic group is a coenzyme permanently bound to an enzyme molecule. Apoenzyme + Prosthetic group = Holoenzyme All of these statements are correct. An enzyme without the prosthetic group attached is referred to as an apoenzyme.

All of these statements are correct.

A critically ill patient becomes comatose. The physician believes the coma is due to hepatic encephalopathy. The assay most helpful in this situation is: Ammonia GGT ALT AST

Ammonia

The Clark O2 electrode is an example of this type of electrode. Coulometric. Amperometric. Galvanic. Reference electrode.

Amperometric.

Respiratory acidosis is characterized by: An excess of bicarbonate A deficit of bicarbonate An excess of dissolved carbon dioxide A deficit of dissolved carbon dioxide

An excess of dissolved carbon dioxide

In combination with low levels of the complement component C3, the presence of which of the following antibodies is considered diagnostic for SLE? Anti-Scl-70 Anti-Jo-1 Anti-dsDNA Anticentromere

Anti-dsDNA

Diabetes insipidus is associated with depressed secretion of: Prolactin Oxytocin Growth hormone Antidiuretic hormone (ADH or AVP)

Antidiuretic hormone (ADH or AVP)

Which apolipoprotein is the major protein of HDL, and activates LCAT?

Apo A-1

Which of the following statements is true? In general, autoimmune diseases: Are more common in women. Affect about 1 person in every 1000 Tend to begin in childhood. Are an inevitable consequence of autoimmune responses.

Are more common in women.

The most common cause of acute coronary syndrome (ACS) is: Myocardial ischemia due to incomplete occlusion of a coronary artery Decreased output of the right side of the heart due to cardiac valve destruction Reduced outflow of blood from the left side of the heart Atherosclerosis in coronary arteries

Atherosclerosis in coronary arteries

Which cardiac marker is found in the ventricles of the heart, and can be useful in the diagnosis and monitoring of congestive heart failure? Ischemia Modified Albumin B-type Natiuretic peptide Myoglobin CK

B-type Natiuretic peptide

Hydatidiform moles and choriocarcinomas (gestational trophoblastic disease), testicular cancer, mixed germ cell tumors

BHCG

What population is particularly vulnerable to bilirubin levels? What is the disease called when these patients have high bilirubin?

Babies less than 2 months old are vulnerable to bilirubin levels. High bilirubin in infants can lead to Kernicterus when bilirubin moves from the bloodstream into brain tissue.

The first tumor marker was identified in urine in the 1850s. What was it? CA-125 Bence-Jones protein PSA CA 19-9

Bence-Jones protein

The most prominent heat labile form of alkaline phosphatase following the alkaline phosphatase isoenzyme test would be: Liver ALP Bone ALP Placenta Kidney

Bone ALP

Examples of automated dye binding methods for the measurement of serum albumin are bromocresol purple and __________. Bromocresol Green Biurate method Asenazo reaction Molybdate.

Bromocresol Green

Medullary thyroid carcinoma

Calcitonin

For glucose analysis, the serum must be separated from the cells because the: Hemoglobin absorbs at the same wavelength Cells metabolize glucose Clotting factors prolong the reaction Minerals are used up by the enzymes

Cells metabolize glucose

In pregnant women, those who take oral contraceptives, and newborn infants, the total thyroxine (T4) levels can be altered because of: Changes in binding capacity of thyroid hormone carrier proteins The presence of iodotyrosines in the serum Inappropriate iodine metabolism Changes in tissue use

Changes in binding capacity of thyroid hormone carrier proteins

If a STAT potassium came down to the lab and the results showed a value of 7.5 mmol/L, what should your course of action be before reporting this critical value? Check for hemolysis, rerun to verify results, report if no hemolysis and results verify Call the floor and remind them how to draw blood. No need to rerun the sample, call the critical. Find the phlebotomist from the previous shift who drew the sample and ask them if they hemolyzed it.

Check for hemolysis, rerun to verify results, report if no hemolysis and results verify

In the blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with: Chloride Sodium Phosphate Potassium

Chloride

In the blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with: Potassium Sodium Phosphate Chloride

Chloride

The anion with the highest extracellular concentration is: Bicarbonate Chloride Protein Phosphate

Chloride

Levels of which of the following analytes are utilized to evaluate/monitor the risk of developing coronary artery disease? Cholesterol/HDL cholesterol Lipase Creatine kinase Troponin

Cholesterol/HDL cholesterol

Neuroendocrine tumors/carcinoid

Chromogranin

Which one of the following is the primary cause of respiratory acidosis? Hyperventilation Overdose of antacids Chronic Obstructive Pulmonary Disease (COPD) Uncontrolled diabetes mellitus

Chronic Obstructive Pulmonary Disease (COPD)

The turbid, or milky appearance of serum after fat ingestion is termed postprandial lipemia. This lipemic appearance is caused by the presence of a transient elevation of which lipoprotein fraction? Chylomicrons VLDL IDL LDL HDL Lp(a)

Chylomicrons

Which of the following is decreased in serum during the active stages of SLE? anti-nuclear antibody immune complexes Complement (C3) anti-DNA

Complement (C3)

C.L.A.D.M.E. is an acronym that stands for _________. Compliance, Liberation, Absorption, Dosage, Moiety, Excretion Compliance, Liberation, Absorption, Distribution, Metabolism, Excretion Compliance, Liberation, Adsorption, Distribution, Metabolism, Excretion Coliberation, Limitations, Absorption, Dosage, Metabolism, Excretion

Compliance, Liberation, Absorption, Distribution, Metabolism, Excretion

Which of the following is the most common cause of adrenocortical insufficiency in newborns and what is the most common missing enzyme? Conn Syndrome/11 beta-hydroxylase Cushing Disease/G-6-PD Cushing's Syndrome/18- hydoxylase Congenital Adrenal Hyperplasia/21 alpha-hydroxylase

Congenital Adrenal Hyperplasia/21 alpha-hydroxylase

At PSHMC, the acronym R.A.C.E. is used in case of fire. Please indicate what the letter "C" stands for. Calm down. Choose to run away. Contain the smoke and fire - close doors. Contact your supervisor.

Contain the smoke and fire - close doors

Pituitary secretion of adrenocorticotropic hormone (ACTH) is inhibited by elevated levels of: Estradiol-17B Progesterone Aldosterone Cortisol

Cortisol

Which of the following is NOT a well-defined autoantigen? The TSH receptor Acetylcholine receptor Creatine kinase DNA

Creatine kinase

In which of the following conditions does a congenital deficiency of glucuronyl transferase cause an increase in unconjugated bilirubin concentration sufficient to cause kernicterus? Crigler-Najjar, type 1 Rotor's syndrome Gilbert's disease Dubin-Johnson syndrome

Crigler-Najjar, type 1

The Biuret reaction for total serum protein is based upon the reaction of Cu+2 ions with at least 2 peptide bonds Cu+2 ions and biuret with disulfide bonds Cu+2 with amino groups biuret with amino groups

Cu+2 ions with at least 2 peptide bonds

The Biuret reaction for total serum protein is based upon the reaction of Cu+2 with amino groups Cu+2 ions with at least 2 peptide bonds Cu+2 ions and biuret with disulfide bonds biuret with amino groups

Cu+2 ions with at least 2 peptide bonds

The cell marker used to identify mature B-cells is: MHC T4 antigens T8 antigens Cytoplasmic or surface immunoglobulin

Cytoplasmic or surface immunoglobulin

Sealed heparinized arterial blood was left at room temperature for 21 hours. The most likely changes in PO2 mmHg, PCO2 mmHg, and pH, respectively are: Decrease, decrease, decrease Decrease, increase, and decrease Increase, increase, increase Decrease, decrease, and increase

Decrease, increase, and decrease

A sealed heparinized arterial blood was left at room temperature for 2 hours. The most likely changes in Po2(mmHg), PCO2(mmHg), and pH, respectively are: Decrease, increased, decrease Decrease, increased, decreaseIncrease, increase, and increase Decrease, decrease, and decrease Decrease, decrease, and increase

Decrease, increased, decrease

A known diabetic is admitted to the Emergency Room in ketoacidosis. Which of the following would be consistent with this diagnosis? Decreased pH, increased anion gap, decreased plasma bicarbonate Increased pH, decreased anion gap, decreased plasma bicarbonate Increased pH, increased anion gap, increased plasma bicarbonate Decreased, pH, decreased anion gap, increased plasma bicarbonate

Decreased pH, increased anion gap, decreased plasma bicarbonate

Measurement of microalbuminuria is useful to monitor patients with ____________ that are at risk of developing _____________. Diabetes mellitus/nephropathy Minimal-change disease/proteinuria Multiple myeloma/light-chain Diabetes insipidus/hyperglycemia

Diabetes mellitus/nephropathy

Measurement of microalbuminuria is useful to monitor patients with ____________ that are at risk of developing _____________. Minimal-change disease/proteinuria Multiple myeloma/light-chain Diabetes insipidus/hyperglycemia Diabetes mellitus/nephropathy

Diabetes mellitus/nephropathy

What is the name of the chemical that binds bilirubin creating a new molecule that we measure in this assay? What wavelength does this new molecule absorb at?

Diazotized sulphanilic acid binds unconjugated bilirubin make a blue colored complex. 560nm

The SOP for method validation at your laboratory states that a method must have a precision value of < 5%. Given that the mean of your data are 89 mg/dL and 2 standard deviations is 14 mg/dL, should this method be put into use? Or should you perform more studies to increase precision? Do not put it into use, since it violates a parameter in the SOP for precision. Put it it into use, assuming all other parameters in the SOP have been met.

Do not put it into use, since it violates a parameter in the SOP for precision.

The following procedure has been routinely used for detection of Hepatitis B surface antigen (HBsAg) because of its high level of sensitivity: radial immunodiffusion hemagglutination counterimmunoelectrophoresis ELISA

ELISA

Diagnostic criteria for Diabetes Mellitus from the American Diabetes Association include all of the following except: Elevated microalbuminuria test Fasting plasma glucose greater than or equal to 126 mg/dL Random plasma glucose greater than or equal to 200 mg/dL Hemoglobin A1c greater then or equal to 6.5%

Elevated microalbuminuria test

When great accuracy is not required, _______________ __________ can be used. They contain liquids better than beakers do. (glass pictured roughly looks like triangle) Erlenmeyer flasks Volumetric flasks Vacuum flasks Test tubes

Erlenmeyer flasks

Factor H acts by competing with which of the following for the same binding site? Factor 1 Factor D Factor B C3B

Factor B

None of the following will impact electrolyte levels: dehydration, diarrhea, diabetes, or diuretics . True False

False

In the female reproductive cycle, LH stimulates folliculogenesis. True False

False In the female reproductive cycle, FSH stimulates folliculogenesis.LH surge stimulates ovulation.

Diagnostic criteria for Diabetes Mellitus from the American Diabetes Association include all of the following (select all that apply): Fasting plasma glucose greater than or equal to 126 mg/dL Random plasma glucose greater than or equal to 200 mg/dL Hgb A1C greater than or equal to 6.5% Fasting plasma glucose greater than or equal to 100 mg/dL

Fasting plasma glucose greater than or equal to 126 mg/dL Random plasma glucose greater than or equal to 200 mg/dL Hgb A1C greater than or equal to 6.5%

Rheumatoid factors are usually IgM with specificity for allotypic determinants located on the: Fc fragment of IgG Fab fragment of IgG J chain of IgM secretory component of IgA

Fc fragment of IgG

On protein electrophoresis at pH 8.6, IgM typically migrates in which region? Alpha-2 Gamma Beta Alpha-1

Gamma

Which of the following hormones promotes increased blood glucose levels (select all that apply)? Glucagon Cortisol Epinephrine Insulin

Glucagon Cortisol Epinephrine

Which of the following contributes the most to the serum total CO2? HCO3- Carbonium ion PCO2 dCO2

HCO3- *Bicarb is in a fight to maintain 20:1 ratio right, so it has to be the most abundant

Which lipoprotein particles are composed of only about 3-5% (by weight) triglyceride and 20-30% of plasma cholesterol?

HDL

Which of the following hepatitis viruses is transmitted via the fecal-oral (enteric) route? HDV HEV HCV HAV

HEV HAV

The following statements are true of Hepatitis C: Hep C chronic carriers can be at risk for hepatic cancer Hep C treatment requires genotyping Hep C treatment involves post exposure prophylaxis and is relatively inexpensive Hep C chronic carriers rarely have complications from the disease

Hep C chronic carriers can be at risk for hepatic cancer Hep C treatment requires genotyping

Which of the following Hepatitis viruses can occur only in the presence of Hepatitis B? Hepatitis E Hepatitis D Hepatitis A Hepatitis B

Hepatitis D

Which of the following is a biomarker of inflammation? High Sensitivity C-Reactive Protein (hsCRP) Homocysteine Vitamin D Apo-B

High Sensitivity C-Reactive Protein (hsCRP)

In terms of glucose metabolism, a patient with Cushing's Syndrome would tend to exhibit: Hpoglycemia Hyperglycemia A normal blood glucose level A decreased postprandial glucose

Hyperglycemia

Secretion of hormones by the anterior pituitary is controlled by the circulating levels of hormones from the target gland and hormones secreted by the: Intermediate lobe of the pituitary gland Hypothalamus Posterior lobe of the pituitary gland Adrenal medulla

Hypothalamus

The primary adaptive immune response is the production of _________ by B cells: IgD IgM IgG IgA

IgM

Which antibody is best at agglutination and complement fixation? IgG IgA IgD IgM

IgM

Which of the following best describes a hapten? Immunogenic only when coupled to a carrier Incomplete antigen that cause immune response Excellent participant in agglutination and precipitation reactions Has multiple determinant sites

Immunogenic only when coupled to a carrier

Which best describes the role of an anaphylatoxin? Increases production of interleukin-1. Increases vascular permeability. Coats cells to increase phagocytosis. Attracts WBCs to the area of antigen concentration.

Increases vascular permeability.

How are AST and ALT measured? Directly, measures the amount of Oxaloacetate or Pyruvate, respectively Indirectly, measures the change in absorbance at 340 nm Directly, measures the change concentration of P-5-P Indirectly, measures the change in absorbance at 540 nm

Indirectly, measures the change in absorbance at 340 nm

Please mark all the complications associated with ABG collection? Infection Hematoma Nerve damage Hyper perfusion All of these answers are correct.

Infection Hematoma Nerve damage

Which of the following analytes is distributed in the body in a number of different compartments, including hemoglobin, the tissues, myoglobin and a labile pool. It's major storage compound is ferritin. Iron Glucose Calcium Magnesium

Iron

The highest levels of gonadotropins in females occur: During menstruation During the luteal phase of the menstrual cycle Just before ovulation During the follicular phase of the menstrual cycle

Just before ovulation

Circulating levels of sodium are ultimately regulated by which of the following? Hemoglobin saturation. Diet. Gastrointestinal tract. Kidneys.

Kidneys.

The Michaelis-Menten constant is designated by: [S] Vmax Km 1/v

Km

To assess a deficiency of hGH in children with clinical signs, which of the following is given, and then hGH levels are drawn perodically over the next 120 mins? Catecholamines Estrogen L-Dopa pituitary gonadotropin

L-Dopa

An example of the enzyme class of oxidoreductases would be: Aspartate aminotransferase (AST) Aldolase Lactate dehydrogenase (LD) Amylase

LD

Premature atherosclerosis can occur when ____________________ becomes elevated.

LDL

The anticoagulant of choice for blood gas analysis is: Na-Flouride EDTA Li-Heparin Citrate

Li-Heparin

Acetaminophen (Tylenol) is particularly toxic to the: Liver and Kidney Pancreas and Kidney Brain and Heart Heart and Liver

Liver and Kidney

Creatine kinase is a dimer composed of two subunits. What are these two subunits? I and C M and C M and B B and N

M and B

In two or three sentences, please briefly describe why allelic polymorphism of HLA (variation in tissue antigens between humans) can be a problematic when tissue matching.

MHC genes encode for HLA molecules that are present on cells. Certain types of MHC allow our immune systems to recognize our own cells as self, preventing CD8 T cells from destroying them. If the HLA gene has variation, there is a certain likelihood that they won't function in the recipient to help aid in self recognition, therefore donor cells will be attacked by the recipient immune system.

The gas chromatograph (GC) or liquid chromatograph (LC) detector that unequivocally identifies compounds of interest is MS (mass spectrometer) EC (electron capture) FID (flame ionization detector) TC (thermal conductivity)

MS (mass spectrometer)

Activators are required by many enzymes. What metallic ion activator is required by both alkaline phosphatase and creatine kinase? Fuoride Magnesium Bromide Chloride

Magnesium

Lactate dehydrogenase (LD) catalyzes the following reaction: LDLactate +NAD------------> Pyruvate + NADH As the reaction is written, which of the following techniques can be used to assess LD activity? Measure the increase in absorbance at 340 nm as NADH is produced Measure the colorimetric product pyruvate Measure the increase in absorbance at 410 nm as NADH is produced Measure the decrease in absorbance at 340 nm as NADH is produced

Measure the increase in absorbance at 340 nm as NADH is produced

Lactate dehydrogenase (LD) catalyzes the following reaction: LDLactate +NAD------------> Pyruvate + NADH As the reaction is written, which of the following techniques can be used to assess LD activity? Measure the increase in absorbance at 340 nm as NADH is produced Measure the colorimetric product pyruvate Measure the decrease in absorbance at 340 nm as NADH is produced Measure the colorimetric product NAD

Measure the increase in absorbance at 340 nm as NADH is produced

In the plasma an excess in the concentration of bicarbonate with no change in the concentration of dissolved CO2 (cdCO2) from normal will result in: Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Metabolic acidosis

Metabolic alkalosis

In the plasma, an excess in the concentration of bicarbonate with no change in the concentration of dissolved CO2 (cdCO2) from normal will result in: Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Metabolic acidosis

Metabolic alkalosis

In the plasma, an excess in the concentration of bicarbonate with no change in the concentration of dissolved CO2 (cdCO2) from normal will result in: Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis

Metabolic alkalosis

For suspected pheochromacytoma, the recommended primary screening test on a 24 hour urine is: Dopamine Homovanillic acid (HVA) Metanephrines Dihydroxyphenylalanine (DOPA)

Metanephrines

A 40 yo patient has areas of punched out osseous destruction, osteoporosis, pathological fractures, no reactive sclerosis or expansion. He also has swelling, anemia, increased urinary calcium, Bence-Jones proteinuria, hyperglobulinemia (and uria), M spike on serum and urine ELP, and reversed AG ratio. What disease is described? Multiple Myeloma Osteomalcia Osteoblastoma Ewings Sarcoma

Multiple Myeloma

Destruction of the myelin sheath of axons caused by the synthesis of antibody in the central nervous system is characteristic of which autoimmune disease? Goodpasture's syndrome Multiple sclerosis Myasthenia Gravis Grave's disease

Multiple sclerosis

Which of the following should be used to check the absorbance accuracy or linearity of a detector response of a spectrophotometer? NBS neutral density filters mercury arc lamp didymium filter holmium oxide filters

NBS neutral density filters

Given the following results, the most likely diagnosis would be: ↑↑ = greatly increased ↑ = increased ↓ = decreased Serum ALP ↑ GGT ↑↑ AST ↑ ALT ↑ Bilirubin, total ↑ conjugated ↑↑ unconjugated N or ↓ Urine & Feces urobilinogen ↓ bilirubin ↑ Fecal urobilinogen ↓ Hepatitis Obstructive jaundice Hemolytic anemia None of the above

Obstructive jaundice

An example of a true prosthetic group, bound to the apoenzyme, a component of the aminotransferases is: pyridoxal phosphate (P-5'-P) ATP NADPH NAD

P-5'-P

If a blood gas specimen is left exposed to the air for an extended period of time, which of the following changes will occur? PO2 and pH increase,; PCO2 decreases PO2 and pH decrease; PCO2 increases PO2 increases; pH and PCO2 decrease PO2 decreases; PCO2 and pH increase

PO2 and pH increase,; PCO2 decreases

If a blood gas specimen is left exposed to the air for an extended period of time, which of the following changes will occur? PO2 increases; pH and PCO2 decrease PO2 decreases; PCO2 and pH increase PO2 and pH increase; PCO2 decreases PO2 and pH decrease; PCO2 increases

PO2 and pH increase; PCO2 decrease

What is the single most important factor that can minimize the hazards of biological specimens and hazardous chemicals Safer sharps devices Personal hygiene and handwashing Eye protection Biological safety cabinets

Personal hygiene and

Which of the following drugs would be correctly classified as an anti epileptic? Phenytoin Tobramycin Theophyline Digoxin

Phenytoin Tobramycin - antibiotic Theophyline - bronchodilator Digoxin - antiarrhythmic

Which analyte is filtered at the glomerulus, almost completely reabsorbed in the proximal tubules, and then can be secreted in the distal tubule in exchange for Na+, under the influence of aldosterone. Potassium Sodium Chloride Magnesium

Potassium

In HEV infections, fulminant Hepatitis associated with a high mortality rate occurs more commonly in: Homosexuals Infants Pregnant Women Males

Pregnant Women

Before the development of fluorescent immunoassays(ie the IMMUNOCAP) the following procedure was performed to test for antibodies to specific allergens: RAST RIST CREST CRP

RAST

The speed of a centrifuge is expressed in revolutions per minute (rpm), and the centrifugal force generated is expressed in gravities as RCF. What is the formula used to relate rpm to RCF? RCF = 1.118 x 10 -5 x r x (rpm)2 RCF = 1 - log % T rpm = r x RCF rpm = 1.18 x 10-5 x RCF

RCF = 1.118 x 10 -5 x r x (rpm)2

The speed of a centrifuge is expressed in revolutions per minute (rpm), and the centrifugal force generated is expressed in gravities as RCF. What is the formula used to relate rpm to RCF? rpm = r x RCF RCF = 1.118 x 10 -5 x r x (rpm)^2 rpm = 1.18 x 10-5 x RCF RCF = 1 - log % T

RCF = 1.118 x 10 -5 x r x (rpm)^2

Which of the following is not a requirement for an ideal cardiac biomarker? Specificity Rapid release from heart into circulation Rapid removal from circulation Sensitivity

Rapid removal from circulation

Low blood volume will induce synthesis of this hormone by the kidneys, which will cause increased secretion of aldosterone, which will ___________ kidney reabsorption of sodium followed by water: Erythropoietin/increase Insulin/increase Antidiuretic hormone (ADH, AVP)/decrease Renin/increase

Renin/increase

Which of the following responses characterizes a capture or sandwich enzyme assay? Requires two wash steps Less sensitive than competitive enzyme assays A limited number of antibody sites on solid phase Best for small antigens with a single determinant

Requires two wash steps

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

Respiratory acidosis

The following glucose oxidase method is used. How does the presence of increased levels of uric acid, or of a reducing agent such as ascorbic acid, affect the results of this assay? glucose oxidaseglucose + O2 ---------------------> gluconic acid + H2O2 peroxidaseH2O2 + chromogenic receptors -------------------> Oxidized colored chromogen + H2O Falsely decreased values by competing with the chromogen for H2O2 Results are falsely elevated by binding to additional chromogen Falsely elevated values by inhibiting peroxidase No affect on results

Results are falsely elevated by binding to additional chromogen

In the previous question, if the patient also showed a high titer of anti-dsDNA, what would be a likely diagnosis? RA (Rheumatoid arthritis) MG (Myasthenia gravis) MS (Multiple sclerosis) SLE (Systemic lupus erythematosus)

SLE (Systemic lupus erythematosus)

A speckled pattern in ANA testing indicates which of the following autoantibodies: histone SS-A, SS-B, Scl-70, or RNP nucleolar RNA dsDNA

SS-A, SS-B, Scl-70, or RNP

All of the following are examples of a bad arterial blood gas specimen except Inadequate volume Clotted sample Air contact Sample transported on ice slurry Non-steady state

Sample transported on ice slurry

Thyroid-releasing hormone (TRH) is given to a patient. Serum thyroid-stimulating hormone (TSH) levels are taken before and after the injection, and the values are the same--low. This patient probably has which of the following disorders? Primary hypothyroidism Primary hypothalamic disease Secondary hypothyroidism Tertiary hypothyroidism

Secondary hypothyroidism

The acronym used at PSHMC in case of a hazardous material spill, is SPILL. Please indicate what the S stands for: Secure the immediate area. Scream for help. Save the bottle. Stay clear of the supervisor.

Secure the immediate area.

Which of the following is false as applied to the safe handling of potentially hazardous biological materials? Since Vacutainer needles are disposable, they may be discarded in the patient's wastebasket. Sharp objects, including broken glass, should be discarded in a puncture-proof container. Protective eyewear/goggles should be worn whenever there is a chance of splashes to the face and eyes. Centrifuge lids should not be raised until the system has stopped completely

Since Vacutainer needles are disposable, they may be discarded in the patient's wastebasket.

After an acute pancreatitis attack, what happens to the lipase levels in the serum over time? Slight decrease within 8 hours, maximum decrease at 24 hours, back to normal within a week Slight increase within 8 hours, maximum increase at 24 hours, back to normal within 2 weeks Abrupt increase within 4 hours, starts decreasing at 48 hours, back to normal within 2 weeks Slight increase within 2 hours, maximum increase at 8 hours, back to normal within 24 hours

Slight increase within 8 hours, maximum increase at 24 hours, back to normal within 2 weeks

A person with a confirmed blood pressure of 150/95 would be classified as Stage 1 hypertension Prehypertension Stage 2 hypertension Normal

Stage 1 hypertension

Insulin may be described by all of the following except: Synthesized from preproinsulin Combines with insulin receptors on cells 50% of circulating insulin extracted by the liver on the first pass Synthesized by alpha cells in the pancreas

Synthesized by alpha cells in the pancreas

One of the first tests used in the laboratory diagnosis of patients with suspected ________________ is antinuclear antibodies (ANA). Acute Interstitial Nephritis Fanconi Syndrome Acute Myocardial Infarction Systemic Lupus erythematosis

Systemic Lupus erythematosis

A milky serum sample following a non fasting sample is most likely due to increased serum: LDL Triglycerides HDL both LDL and HDL

TAGs

Specific antibodies to which of the following thyroid antigens contributes to the development of Grave's disease? TSH receptor on thyroid follicular cells Anti-adrenal cortex antibody Anti-parathyroid antibody Anti-bodies which inhibit thyroid function

TSH receptor on thyroid follicular cells

Which of the following calcineurin inhibitor immunosuppressives is the drug of choice over cyclosporine for decreased kidney toxicity because it can be administered in lower doses with substantially higher potency? Tacrolimus (FK506) Azathioprine Methotrexate Sirolimus

Tacrolimus (FK506)

Which hypolipoprotinemia is characterized by splenomegaly, hyperplastic orange tonsils, and complete absence of HDL? __________________________

Tangier disease

A classic example of Type III, immune complex hypersensitivity is: Contact dermatitis The Arthus reaction Anaphylaxis Transfusion reaction

The Arthus reaction

Where did bilirubin come from (physiologically)?

The liver: RBCs are broken down in the RE, the protoporphyrin ring is converted to bilirubin which is released into circulation, binds albumin and goes to the liver. Kupffer cells of the liver are part of the RE, and the liver is the main location for the RE.

If a patient testing for viral hepatitis had these results:HBsAg (negative)anti-HBc (positive)anti-HBs (negative)There are a number of possible interpretations for these unclear results including stages of disease and/or testing issues. Please list one AND explain your answer.

The patient has recovered from an acute HBV infection as indicated by the presence of antibodies to the core antigen. This indicates the patient was exposed to the replicating virus. Exposure to the core of the virus does not occur in vaccination, that only exposes the surface antigens, therefore there had to be actual exposure to the real virus. 1. Resolved infection (most common). 2. False-positive anti-HBc, thus the person is susceptible. 3. "Low Level" chronic infection 4. Resolving acute infection.

Which of the following conclusions can be drawn about a patient whose total IgE level is determined to be 450 kU/L? (Reference Interval: >18 yrs = <214 kU/L) The patient may be subject to anaphylactic shock. The patient definitely has allergic tendencies. The patient will never have allergic reaction. No further antigen specific testing is required.

The patient may be subject to anaphylactic shock.

A patient is drawn for a non fasting lipid panel and upon separation of cells from serum, the serum is slightly turbid after refrigeration. 12 hrs later, the patient is drawn again (with no food in between). This sample also shows slight turbidity throughout the serum after separation and refrigeration. The turbidity could be indicative of dyslipidemia. This is the normal effect of storing a sample at 4 degrees C. The patient's turbid serum should have cleared in about 6-12 hours. This is likely from elevated triglycerides or cholesterol, rather than chylomicron.

The turbidity could be indicative of dyslipidemia. The patient's turbid serum should have cleared in about 6-12 hours. This is likely from elevated triglycerides or cholesterol, rather than chylomicron.

Please evaluate and give interpretation for the following portion of blood gas results: pH 7.10 pCO2 41 HCO3- 24 These values are not possible. Assume error. Respiratory Acidosis Compensated Metabolic Acidosis Metabolic Acidosis

These values are not possible. Assume error.

Which of the following is characteristic of variable domains of immunoglobulins? They are found only on H chains. They are the carboxy-terminal ends of the molecule. They represent the complement biding sites. They occur on both H and L chains.

They occur on both H and L chains.

Autoantibodies that bind to TSH receptor sites on thyroid cell membranes preventing thyroid-stimulating hormone from binding are: Thyroid-stimulating immunoglobulins Antimicrosomal antibodies Antithyroglobulins Thyroxine-binding globulins

Thyroid-stimulating immunoglobulins

The predominant form of thyroid hormone in the circulation is: Triiodothyronine Diiodotyrosine Thyroxine Thyroglobulin

Thyroxine

The predominant form of thyroid hormone in the circulation is: Thyroxine Thyroglobulin Triiodothyronine Diiodotyrosine

Thyroxine T4 is secreted in highest levels, and converted to T3 in the tissues.

Which of the following is the preferred biomarker for the assessment of myocardial necrosis? CK-MB AST TnI or TnT LD

TnI or TnT

What is the main use of serological testing to determine antibodies to islet cells in cases of type 1 diabetes mellitus? To diagnose Type 1 DM To screen for diabetes in susceptible people before beta cell destruction To rule out the presence of other autoimmune diseases To regulate levels of injected insulin

To screen for diabetes in susceptible people before beta cell destruction

In relation to a human, alloantigens would need to be considered in which of the following events? Oral administration of a live but heat-killed virus particle. Grafting skin from one area of the body to another. Vaccination with the polysaccahairde coat of a bacterial cell. Transplantation of a kidney from one individual to another.

Transplantation of a kidney from one individual to another.

The most sensitive and specific marker for Acute Myocardial Injury or Infarction is: Troponin I or T CK MB Myoglobin AST

Troponin I or T

An INDIRECT ISE measurement will potentially underestimate electrolyte measurements when the patient has an abnormally high lipid or protein content. Therefore there is a correction factor used in automated chemistry analyzers which have a pre-dilution step. True False

True

Presence of the Hepatitis B surface antibody (anti-HBs) in someone infected with the virus is generally interpreted as indicating recovery and immunity from hepatitis B virus infection. True False

True

A patient responding favorably to chemotherapy is most likely to have an elevated serum level of which analyte due to rapid turnover of cells? Uric Acid Creatine Urea Sodium

Uric Acid

Select the lipoprotein fraction that carries most of the endogenous triglycerides. VLDL HDL chylomicrons LDL

VLDL

Hypocalcemia may be caused by the following (select all that apply): Vitamin D deficiency Hypoparathyroidism Malignant tumor Decreased renal reabsorption of Ca2+

Vitamin D deficiency Hypoparathyroidism Decreased renal reabsorption of Ca2+

A patient with malabsorption problems is having a delayed clotting time. Which of the following could be the cause? Vitamin D deficiency Vitamin K deficiency Vitamin A deficiency Vitamin E deficiency

Vitamin K deficiency

The agency in Washington state which oversees safety and health in the workplace is called: CAP NCCLS OSHA WISHA

WISHA

Serum ceruloplasmin is generally lowest in: nephrotic syndrome Hodgkin disease Wilson's disease hepatitis

Wilson's disease

Which of the following is not considered to be a requirement for safely handling compressed gases: You can roll large cylinders on the floor horizontally Never store flammable liquids and compressed gases in the same area Empty tanks should be labeled "empty" Keep removable protection caps in place until cylinder is in use

You can roll large cylinders on the floor horizontally

The most efficient monochromator is a diffraction grating or prism. a glass filter or prism. a prism or interference filter. a phototube or photomultiplier.

a diffraction grating or prism.

A paraprotein is: a prosthetic group. a sidechain of a protein. a monoclonal immunoglobulin. immunoglobulin heavy chains.

a monoclonal immunoglobulin

The following is seen on an oral glucose tolerance test. This is consistent with: Fasting 120 mg/dL 1 hr 210 mg/dL 2 hr 175 mg/dL 3 hr 125 mg/dL a. normal glucose tolerance b. gestational diabetes c. diabetes mellitus d. impaired glucose tolerance

a. normal glucose tolerance

Increased organic compounds in a commercial reagent grade water system are an indication of a malfunctioning: activated carbon filter anionic exchange resin particulate filter cationic exchange resin

activated carbon filter

The area on the enzyme which binds the substrate is called the: active site regulatory site allosteric site reaction center

active site

If the _____ _____of an enzyme is inhibited, we call this _____ _____. active site, competitive inhibition. regulatory site, competitive inhibition. allosteric site, non-competitive inhibition. active site, non-competitive inhibition.

active site, competitive inhibition.

All of the following are classified as congenital cardiovascular defects except: acute coronary syndrome ventricular septal defects coarcation of the aorta tetralogy of Fallot

acute coronary syndrome

An individual with hepatomegaly, jaundice and elevated liver enzymes has the following laboratory results: IgM anti-HAV (Negative), HBsAG (positive), IgM anti-HBc (positive), and anti-HCV (negative). These findings support a diagnosis of: hepatitis C chronic hepatitis B hepatitis A acute hepatitis B

acute hepatitis B

Given the following results: AST marked increaseALT marked increaseGGT slight increaseALP slight increase These results are most consistent with: acute hepatitis. chronic hepatitis. obstructive jaundice. liver hemangioma>

acute hepatitis.

Given the following results: AST marked increaseALT marked increaseGGT slight increaseALP slight increase These results are most consistent with: chronic hepatitis. acute hepatitis. obstructive jaundice. liver hemangioma.

acute hepatitis.

A rise in CK-MB isoenzyme between 6-12 hours after onset of pain, and a peak at 12-24 hours is indicative of: diabetes mellitus acute myocardial infarction acute pancreatitis muscular dystrophy

acute myocardial infarction

For the previous question, which of the following is a likely diagnosis? hepatoma acute pancreatitis acute hepatocellular disease chronic pancreatitis

acute pancreatitis

Normally, in the male, synthesis of testosterone occurs in the Leydig cells (interstitial cells) of the testis, and is controlled by a hormone secreted by the_____________ and called_______. hypothalamus/ICSH thyroid gland/thyroxine adenohypophysis/ICSH neurohypophysis/FSH

adenohypophysis/ICSH

Aldosterone is released from by the ___________ ___________ upon stimulation by ____________: adrenal cortex/renin adrenal cortex/angiotensin II anterior pituitary/angiotensinogen posterior pituitary/angiotensin II

adrenal cortex/angiotensin II

In which of the following conditions is corticotropin produced with NO subsequent production of cortisol? Cushing's disease ectopic ACTH syndrome adrenal tumor adrenogenital syndrome (CAH)

adrenogenital syndrome (CAH) Adrenogenital syndrome (CAH) is characterized by deficiency of cortisol-synthesizing enzymes so that ACTH production is not regulated by feedback.

Nutritionally essential amino acids include all of the following except: isoleucine lysine alanine leucine

alanine

Unconjugated bilirubin is transported from the reticulolendothelial cells to the liver by: haptoglobin transferrin albumin bilirubin binding globulin

albumin

Hypochloremia may occur with all of the following except: prolonged vomiting aldosterone deficiency salt-losing renal disorders aldosterone excess

aldosterone excess

TSH is secreted by the: hypothalalamus thyroid gland posterior pituitary anterior pituitary

anterior pituitary

Localized buildup of fatty material in the wall of an artery is called a/an _____________________.

artheroma

Injection into an individual of preformed antibodies to Hepatitis A would hopefully confer what type of immunity on that individual? natural passive artificial passive natural active artificial active

artificial passive

Substances known to interfere with the Jaffe method for creatinine include all of the following: GGT ascorbic acid ketone bodies glucose

ascorbic acid ketone bodies glucose

The type of transplant with the least amount of "foreignness" is xenograft. allograft. autograft. isograft.

autograft.

In the total bilirubin assay, bilirubin reacts with diazotized sulfanilic acid to form: azobilirubin biliverdin urobilinogen bilirubin diglucuronide

azobilirubin

In the total bilirubin assay, bilirubin reacts with diazotized sulfanilic acid to form: azobilirubin, measured at 578nm biliverdin, measured at 450nm bilirubin diglucuronide, measured at 450nm urobilinogen, detected with Erlich's reagent

azobilirubin, measured at 578nm

Cocaine is metabolized to: benzoylecgonine. THC. hydrocodone. codeine.

benzoylecgonine.

Approximately 90-95 % of total CO2 transported in the blood is in the form of: physically dissolved CO2 carbominohemoglobin bicarbonate carbonic acid

bicarbonate

The majority of carbon dioxide in blood is present in which form? carbonic acid pCO2 dissolved CO2 bicarbonate ion

bicarbonate ion

Fecal urobilinogen levels may be markedly decreased due to increased serum bilirubin biliary cholestasis (obstruction) decreased intestinal reabsorption of urobilinogen hemolysis

biliary cholestasis (obstruction)

In which of the following disease states is conjugated bilirubin a major serum component? hemolytic disease of the newborn neonatal jaundice biliary obstruction hemolysis

biliary obstruction

In the procedure using diazotized sulfanilic acid without an accelerator such as caffeine, the results are greatly elevated. What disease state is indicated by these results? acute hemolytic episode Fanconi syndrome biliary or post hepatic obstruction Reye syndrome

biliary or post hepatic obstruction

Which of the following urine results is most apt to be changed by prolonged exposure to light? bilirubin pH protein ketones

bilirubin

In the liver, bilirubin is converted to: bilirubin glucuronide bilirubin-albumin complex urobilinogen urobilin

bilirubin glucuronide

Tacrolimus, a widely used immunosuppressant, has the following mode of action. binding FK506 and inhibiting calcineurin covers donor tissue with proteins to "hide it or look less foreign" causes host cell apoptosis turns off the complement cascade

binding FK506 and inhibiting calcineurin

Sequential enzyme reactions for cholesterol that employ both cholesterol esterase and cholesterol oxidase measure: both free cholesterol and cholesterol esters. all steroids present. only secosteriods. only the free cholesterol.

both free cholesterol and cholesterol esters.

Kernicterus is an abnormal accumulation of bilirubin in which of the following tissues? liver renal heart brain

brain

All of the following are common means of drug excretion (select all that apply). vomit breath biliary and fecal saliva renal sweat

breath biliary and fecal saliva renal sweat

Which of the following methods provides information about glucose metabolism over a3-month period? a. fasting glucose b. glucose oxidase c. glycated hemoglobin d. oral glucose tolerance

c. glycated hemoglobin

Which of the following is the "recognition unit" in the classical complement pathway? C1q C4 C3a C5

c1q

Which of the following complement components is common to both the classical and the alternate pathways? C4 C3 C2 C1

c3

The most popular stimulant in the world is __________. PCP cocaine caffeine methamphetamine

caffeine

Which analyte can be seen in decreased levels with rickets, steatorrhea, or acute pancreatitis? calcium glucose uric acid urea

calcium

All the following are true of IgM except that it ____________ . fixes complement is a primary response antibody can cross the placenta has a J chain

can cross the placenta

Of the total serum copper present in the blood, 95% is contained in: transferrin albumin cryoglobulin ceruloplasmin

ceruloplasmin

A potassium level of 7.2 mEq/L is measured by ISE on an instrument. Before reporting the results, the first step the technologist should take is to: check the specimen for hemolysis check the age of the patient rerun the specimen go ahead and report out the result

check the specimen for hemolysis

In terms of patient population, gangliogliomas mainly affect _________ and __________?

children, young adults

Which of the following electrochemical methods used in clinical applications for the determination of chloride in serum, plasma or sweat? coulometry voltammetry conductometry amperommetry

coulometry

Enzymes frequently assay to aid in the assessment of liver function include all of the following except: creatine kinase alkaline phosphatase gamma glutamyltransferase alanine aminotransferase

creatine kinase

Which serum parameter/s would not be of much value in assessing liver function? bilirubin levels ALT and AST creatinine concentration GGT and ALP

creatinine concentration

The acute phase reactant that responds the fastest and is the most sensitive indicator of acute inflammation is: haptoglobin complement C-reactive protein ceruloplasmin

crp

In a child with recurrent respiratory infections, elevated quantitative sweat chloride results are used to confirm the diagnosis of: Cushing disease diabetes mellitus Tay-Sach's disease cystic fibrosis

cystic fibrosis

Which of the following is an autosomal recessively inherited disease due to a defective gene on chromsome 7 that causes dysfunction of mucous and exocrine glands throughout the body? somatostatinoma diabetes mellitus cystic fibrosis acute pancreatitis

cystic fibrosis

In males, hypergonadotropic hypogonadism can be caused by all the following except disease or drugs. testicular damage from irradiation. enzymatic defects in androgen synthesis. testicular agenesis. damage to the pituitary. chromosomal defects.

damage to the pituitary.

Changing from a 1 cm wide cuvette to a 2 cm wide cuvette, the %T readings on the spectrophotometer would decrease have equal absorbance values fluctuate increase

decrease

The renal juxtaglomerular apparatus (JG) secretes renin in response to a: decrease in blood pressure or a decrease in Na in the tubular lumen increase in blood pressure or a decrease in Na in the tubular lumen decrease in blood pressure or an increase in Na in the tubular lumen increase in blood pressure and increase in Na in the tubular lumen

decrease in blood pressure or a decrease in Na in the tubular lumen

Enzymes accelerate a reaction rate by: shifting the equilibrium position of the reaction increasing the rate of the reaction in one direction only decreasing the amount of free energy of activation necessary for the reaction causing thermodynamically incompatible reactions to occur

decreasing the amount of free energy of activation necessary for the reaction

What are 2 modifiable risk factors for CAD (coronary artery disease)

diet, exercise

Maintenance of osmotic pressure and hydration of body fluid compartments is one of the functions of: electrolytes amino acids enzymes carbohydrates

electrolytes

Structures on cellular membranes that can be recognized as foreign by the immune system are called: immunoglobulins allografts haptens epitopes

epitopes

Which of the following hormones that helps with making new RBCs, is synthesized in the peritubular fibroblasts of the renal cortex? renin ADH (vasopressin, AVP) aldosterone erythropoietin

erythropoietin

Which of the following proteins migrate in the alpha-2 region on agarose gel electrophoresis at pH 8.6? C3 complement albumin transferrin haptoglobin

haptoglobin

A ________ _________ lamp is the radiant energy source used in atomic absorption spectrophotometry

hollow cathode

A trough specimen for therapeutic drug monitoring (TDM) is drawn: immediately prior to the next dose. before any medication regime is started. 6 hours after IV medication is given. after a minimum of 5 doses.

immediately prior to the next dose

The most common routine methods for measuring isoenzymes is: chromatography chemical inactivation electrophoresis immunoassay

immunoassay

Which of these factors that can cause a "shift to the left" of hemoglobin-oxygen dissociation curve: (a lower PO2 is required for hemoglobin to be 50% saturated): increased pH increased PCO2 increased 2, 3 DPG increased temperature

increased pH

In addition to the control of water homeostasis, vasopressin (ADH) also: increases blood pressure. control sperm growth. suppresses growth hormone (GH). induces estrogen secretion from the ovaries.

increases blood pressure.

A woman goes 3 days per week to a tanning bed for 29 minutes of UV exposure per visit. What stage of carcinogenesis is this? dissemination invasion induction in situ

induction

All of the following statements are correct about Hepatitis C virus except: is an enveloped RNA virus may cause a chronic infection is a member of the paramyxovirus family is routinely screened for in blood transfusions in the US

is a member of the paramyxovirus family

Hepatitis C differs from Hepatitis A because Hepatitis C: is associated with a high incidence of icteric Hepatitis is associated with a high incidence of the chronic carrier state has a highly stable incubation period is rarely seen in cases of post-transfusion Hepatitis

is associated with a high incidence of the chronic carrier state

Name one of the secondary endocrine organs.

kidney stomach pancreas liver uterus

A diet with adequate caloric intake, but low protein intake can lead to: marasmus Wilson's disease kwashiokor hypoglycemia

kwashiokor

The anticoagulant of choice for blood gas analysis is: lithium heparin EDTA Na fluoride citrate

lithium heparin

Which TRH challenge test result would be seen in a patient with secondary/pituitary hypothyroidism? ↓ T4 ↑ T4 ↑ TSH ↓ TSH

low TSH

A disaccharide formed from two glucose units is called: Sucrose Maltose Lactose Fructose

maltose

Determine the acid-base status of the following example: pH = 7.52 PCO2 = 44 HCO3 = 39 respiratory alkalosis metabolic acidosis respiratory acidosis metabolic alkalosis

metabolic alkalosis

Complement components are synthesized by all of the following except the: macrophages liver monocytes spleen

monocytes

The protein electrophoretic pattern of plasma, as compared with serum, demonstrates a: blip in the pattern in the alpha-2 region monoclonal protein spike in the gamma region broad hemoglobin band in the alpa-1 zone narrow fibrinogen band at the anodal end of the gamma region

narrow fibrinogen band at the anodal end of the gamma region

The protein electrophoretic pattern of plasma, as compared with serum, demonstrates a: narrow fibrinogen band at the anodal end of the gamma region monoclonal protein spike in the gamma region broad hemoglobin band in the alpa-1 zone blip in the pattern in the alpha-2 region

narrow fibrinogen band at the anodal end of the gamma region

Given the following results: AST slight increaseALT slight increaseGGT marked increaseALP marked increaseTotal bilirubin marked increase These results are consistent with: obstructive jaundice. osteitis fibrosa a chronic hepatocellular disorder. an acute hepatocellular disorder.

obstructive jaundice.

Fasting blood phosphate concentration is primarily controlled by the: cardiac hormones. parathyroid glands. pancreatic hormones. small intestine.

parathyroid glands.

Hirsutism can be associated with: polycystic ovarian syndrome estrogen hypersecretion feminizing tumors Asherman's Syndrome

polycystic ovarian syndrome

The patient has a port wine colored urine, intermittent bouts of abdominal pain and unexplained constipation, and mental disturbances. A positive result (red, magenta) for the screening procedure that utilizes Erlich's reagent (the Watson-Schwartz test) indicates the presence of: porphyrin porphobilinogen coproporphyrin heme

porphobilinogen

Physiologically important buffers maintaining body pH include all the following : bicarbonate protein phosphate hemoglobin lactate

protein phosphate hemoglobin

The appearance of anti-HBs, and often anti-HBe, with the persistence of anti-HBc, and the disappearance of HBsAg and HBeAg indicate: recovery and development of immunity in acute HBV progression to chronic HBV infection early acute infection of HBV carrier state of acute HBV

recovery and development of immunity in acute HBV

The disappearance of HBsAg and HBeAg, the persistence of anti-HBc, and the appearance of anti-HBs, and often the anti-HBe indicates: early acute HBV hepatitis carrier state of acute HBC hepatitis chronic HBV hepatitis recovery phase of acute HBV Hepatitis

recovery phase of acute HBV Hepatitis

Benedict's copper reduction method for glucose is based on the principle of the: reducing properties of glucose and other reducing substances reducing properties of copper production of O2 during the reaction consumption of O2 during the reaction

reducing properties of glucose and other reducing substances

The following results are most compatible with what condition? Serum electrolytes Sodium: 136 mEq/L (136 mmol/L) Potassium: 4.4 mEq/L (4.4 mmol/L) Chloride: 92 mEq/L (92 mmol/L) Bicarbonate: 40 mEq/L (40mmol/L) Arterial blood pH: 7.32 pCO2: 79 mm Hg respiratory acidosis respiratory alkalosis metabolic acidosis metabolic alkalosis

respiratory acidosis

Nephelometric procedures for protein analysis measure light of a non-absorbable wavelength that has been __________________ by formed aggregates such as antigen-antibody complexes. transmitted absorbed emitted scattered

scattered

Hypoalbuminemia occurs in liver disease due to decreased synthesis, or in renal disease due to increased loss. Hyperalbuminemia occurs only in a setting of: increased renal absorption severe dehydration acute inflammation increased rate of synthesis

severe dehydration

Extracellular fluid volume is normally largely governed by: urea sodium phosphate glucose

sodium

The cation with the highest extracellular concentration is: sodium potassium cholesterol magnesium

sodium

The ability of a procedure to measure only the component (s) it claims to measure is called: specificity precision sensitivity reproducibility

specificity

The 3D spatial configuration of a single peptide chain as determined by disulfide linkages, hydrogen bonds, and electrostatic attractions is called the _____________ structure. quaternary secondary primary tertiary

tertiary

Which of the following tests is least useful for the diagnosis of Graves' disease? thyroglobulin high sensitivity TSH the TRH stimulation test free serum thyroxine (FT4)

the TRH stimulation test TSH assays that are sensitive to 0.1 IU/L can be used to distinguish hyper- from euthyroidism. The TRH stimulation test involves the administration of TRH and watching for blunted TSH response that occurs in Graves' disease. The free thyroxine index is the product of T4 and T3 uptake ad is often elevated in hyperthyroidism, as is the free T4 assay. Thyroglobulin is a protein that resides within the thyroid and its measurement is not routinely used.

Which of the following is the best indicator of an acute (current) infection with Hepatitis A virus? a sharp decline in the level of IgG antibodies to hepatitis A virus the presence of IgG antibodies to Hepatitis A virus the presence of IgM antibodies to Hepatitis A virus an immediate rise in both IgM and IgG antibodies to Hepatitis A virus

the presence of IgM antibodies to Hepatitis A virus

The bicarbonate ion concentration may be calculated from the total CO2 and PCO2 blood levels by using which of the following formulas? total CO2 - (0.03 X PCO2) 0.03 X (PCO2 - total CO2) (total CO2 + 0.003) X PCO2 (0.03 X PCO2) - total CO2

total CO2 - (0.03 X PCO2)

The bicarbonate ion concentration may be calculated from the total CO2 and PCO2 blood levels by using which of the following formulas? total CO2 - (0.0306 X PCO2) (0.0306 X PCO2) - total CO2 0.0306 X (PCO2 - total CO2) (total CO2 + 0.00306) X PCO2

total CO2 - (0.0306 X PCO2)

The largest fluid compartment in the body is the intracellular fluid. True False

true

Catabolism of proteins and amino acids results in the creation of _____________, which is predominately cleared by the kidneys. ammonia creatinine urea uric acid

urea

Which compound makes up nearly half of the NPN substances in the blood? uric acid urea creatinine creatine

urea

Gout is a pathological condition characterized by deposition of what analyte in the joints and the body tissues? uric acid phosphorous calcium urea

uric acid

Case study: A 26-year-old, jaundiced, medical laboratory scientist. The following abnormal laboratory results were obtained: Patient Results Reference Interval ALP 112 U/L (38-110 U/L)ALT 640 U/L (5-50 U/L)AST 520 U/L (5-50 U/L)GGT 170 U/L (5-65 U/L)LD 584 U/L (100-200 U/L)Direct bilirubin 5.2 mg/dL (0.0-0.4 mg/dL)Total bilirubin 9.0 mg/dL (0.1-1.5 mg/dL) All other routine chemistry results were normal.Routine urinalysis was unremarkable except for 3+ bilirubin. From what disease is this patient suffering? post-hepatic obstruction viral or toxic hepatitis myocardial infarction hemolytic anemia

viral or toxic hepatitis

The outermost layer of the adrenal cortex is called the ________ _________ and synthesizes _____________, which has effects on the distal renal tubules. zona americanus/triiodothyronine zona fasciculata/glucocorticoids zona glomerulosa/aldosterone zona reticularis/androgens and estrogens

zona glomerulosa/aldosterone

Some enzymes are originally secreted in a structurally inactive form called a/an: zymogen holoenzyme apoenzyme coenzyme

zymogen


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