Exam Simulator Chemistry Questions
All of the following statements are characteristics of the role of C-reactive protein (CRP) except? A) activates complement B) binds with factor H to initiate alternate complement pathway C) exhibits pro-inflammatory characteristics D) initiates opsonization
B) binds with factor H to initiate alternate complement pathway
Which of the following is true of genotyping screening in pharmacogenomics? A) genotype screening gives a better overall picture of drug metabolism than measuring metabolism with probe drug B) genotyping does not take into account drug interactions which can affect metabolism C) genotyping typically involves measuring only one mutation site or polymorphism D) genotyping typically involves measuring only one mutation site or polymorphism
B) genotyping does not take into account drug interactions which can affect metabolism
Which of the following cardiovascular risk markers is a more sensitive version of a test that is used to assess inflammation? A) oxidized-LDL B) hs-CRP C) ApoB/ApoA1 D) LpPLA2
B) hs-CRP
What assay is performed to diagnose congestive heart failure (CHF)?
B-type natriuretic peptide (BNP)
Which marker is the most useful for detection of gestation trophoblastic disease? A) CEA (carcinoembryonic antigen) B) AFP (alpha fetoprotein) C) hCG (human chorionic gonadotropin) D) CA-125 (cancer antigen 125)
C) hCG (human chorionic gonadotropin)
A patient who previously had an hs-CRP of 4 mg/L was put on statin and daily aspirin medication. She returns to the laboratory a month later, and her repeat hs-CRP is 2.3 mg/L. Which of the following is the most likely reason for the decrease in the test value? A) patient had an infection at the time of first visit B) lab test was preformed incorrectly C) medication lowered value D) CRP values fluctuate throughout the day
C) medication lowered value
Which of the following conditions would be suggested by a jaundiced patient experiencing a marked rise in alkaline phosphatase (ALP), conjugated bilirubin, and a slight rise in alanine aminotransferase (ALT)? A) cardiovascular disease B) hepatitis C) post-hepatic cholestasis D) renal failure
C) post-hepatic cholestasis
Mrs. Jones, a diabetic, is admitted to the hospital on November 25th. It appears that she has had an acute myocardial infarction (AMI), but did not feel the severe chest pain because of diabetic neuropathy. She has not felt well since November 20th and her physician believes she possibly had an AMI on November 20th.Assuming that the infarct was uncomplicated, which of the following cardiac biomarkers would most likely still be elevated and would assist in an AMI diagnosis? A) myoglobin B) creatinine kinase MB C) troponin T D) all of the above
C) troponin T Troponin T remains elevated after an AMI for 8-21 days
Each of the following hypothalamic hormones is correctly matched with the anterior pituitary hormone that is releases EXCEPT: A) TRH --> TSH B) GnRH --> LH and FSH C) CRH --> ACTH D) GHRH --> Oxytocin
D) GHRH --> Oxytocin Growth releasing hormone releases growth hormone
A three-hour glucose tolerance test includes what?
Four specimens: a fasting blood glucose, a specimen collected at one hour, a second specimen collected at two hours, and a third specimen collected three hours after drinking a 100-gram dose of glucose solution.
Site for CSF collection
L3-L4
Friedewald Calculation for LDL
LDL = total cholesterol - HDL - triglycerides/5 only valid if triglycerides is less than 400
Lecithin/sphingomyelin ratio
Test for fetal lung maturity
A hospitalized patient has a decreased serum copper level and increased urine copper level. This is MOST consistent with what?
Wilson's disease - causes the body to retain copper
What drug example would be a good candidate for therapeutic drug monitoring?
a drug that has a narrow therapeutic window
Cushing's syndrome
hypersecretion of cortisol
Deviations from Beer's Law are cause by what?
stray light Beer's Law -> absorbance = concentration
The measurement of 17-ketosteroids in urine is performed to assess PRIMARILY which organ(s)?
testes and adrenal cortex
What is the definition of bioavailability?
the fraction of the administered dose that eventually reaches its site of action
If a disease or disorder causes serum binding proteins (such as albumin) to decrease, what may occur if the dose of a highly protein-bound drug with a narrow therapeutic window is not adjusted?
the patient may experience toxic effects (high free drug fraction)
What conclusion can be made if a person has a cardiovascular risk marker that is abnormal?
the person has an increased probability of developing cardiovascular disease
A chemical reaction that is utilized by many different analytical methods involves what?
the reduction of NAD to NADH
If a healthy patient presents with an elevated potassium level while all other chemistry results are normal, what happened?
the sample was hemolyzed
What is a bronchodilator used to treat asthmatic patient?
theophylline
The pl of a protein is 9.2. This protein is placed in an electrical field where a buffer sets the pH at 10. What is happening during migration?
this protein will have a net negative charge and will migrate toward the anode, the positively charged electrode
function of very low density lipoproteins
to transport endogenous triglycerides
A Cytochrome P450 2D6 (CYP2D6) ultrarapid metabolizer (UM) would require ___________ dose of an active drug (non-prodrug) that is metabolized by CYP2D6 than a CYP2D6 extensive metabolizer (EM).
a higher dosage
When the body compensates for a respiratory or metabolic disorder, the MAIN goal is to achieve:
a normal pH
Cytokine
a soluble protein that regulates the immune response
Ammonia is best characterized as being:
a waste product of amino acid and protein metabolism
An automated method for measuring chloride which generates silver ions in the reaction is:
Amperiometric-coulometric titration
The production of neutral 17-ketosteriods is the measurement of what production?
Androgen production
The name of a reaction between a single antigenic determinant and a individual combining site is:
affinity
What is decreased during an acute phase response?
albumin
Which analyte measurement is used to detect early nephropathy in a diabetic patient?
albumin
A patient that is on a vegetarian diet will most likey have what pH?
alkaline pH
What polypeptide chains are found in normal adult hemoglobin A?
alpha and beta
What band in serum protein electrophoresis cause haptoglobin appear in?
alpha-2 globulin band
What laboratory test is used to determine the presence of neural tube defects?
alpha-fetoprotein
What screening test is for neural tube defects?
alpha-fetoprotein
Hormonal variation throughout the menstrual cycle typically shows:
an abrupt rise in luteinizing hormone (LH) 3-36 hours prior to ovulation
Describe the principles of competitive radioimmunoassay procedures.
antibody will react equally with labeled and unlabeled antigen
ethylene glycol
antifreeze monohydrate calcium oxalate crystals
What is used t o determine if a person has had a recent infection with Strep pyogenes?
antistreptolysin (ASO)
Estriol levels in conjunction with hCG and AFP can be obtained during pregnancy to:
assess the risk of Down's syndrome
Which term described the dose of the drug in which 50% of the individuals will result in mortality? A) ED50 B) LD50 C) TD50 D) MD50
B) LD50
creatinine clearance equation
(urine creatinine/serum creatinine) x urine volume / (time (hr) x60)
What is the recommended storage temperature for the preservation of activity for MOST enzymes?
4C
How many distinct bands are separated during a standard serum protein electrophoresis?
5 albumin, a1, a2, beta, gamma
Approximately how many doses are required to obtain a steady state oscillation allowing for peak and trough levels to be elevated?
5 to 7
What percentage of dietary iron is normally absorbed daily?
5-10%
How long does it take for plasma concentrations to reach steady state when a patient's dose is given at intervals of the drug's half-life?
5-7 half lives
Following a myocardial infraction which of the following enzymes will be the first to become elevated: A) CK B) LDH C) GGT D) ALT
A) CK CK rises before LDH GGT and ALT are elevated in liver disorders
An electrolyte panel (lytes, chem-4) consists of: A) K, Na, Cl, CO2 (in form of bicarbonate) B) K,Na, Cl, Glucose C) K, Na, Cl, Creatinine D) K, Na, Cl, BUN
A) K, Na, Cl, CO2 (in form of bicarbonate)
What is the effect of aging with the hormones of the endocrine system? A) aldosterone decreases and norepinephrine increases B) aldosterone increases and norepinephrine increases C) aldosterone decreases and norepinephrine decreases D) aldosterone increases and norepinephrine decreases
A) aldosterone decreases and norepinephrine increases
What serum constituent is unstable if a blood specimen is left at RT for 8 hours before processing?
glucose
What enzyme is responsible for the conjugation of bilirubin?
glucuronyl transferase
Acute phase proteins generally fall into which category?
glycoproteins
Which analyte is MOST useful for monitoring long-term (~12 weeks) stability of blood glucose?
glycosylated hemoglobin (HbA1C)
CK-MB (CK-2)
greater than 5% or 10 IU/L followed by an LDH-1:LDH-2 flip is specific evidence of myocardial infarction CK-MB levels can be normal with an elevated total CK CK-MB and troponin levels can be elevated after an AMI
What decreases during intravascular hemolysis?
haptoglobin
False positive results for HIV antibody are most likely to occur in patients that:
have an autoimmune disorder
What casts appear following strenuous exercising?
hayline casts
What part of the body synthesized and secretes BNP?
heart
Which compound normally contains the majority of the body's total iron?
hemoglobin
An electrophoretic separation of lactate dehydrogenase isoenzyme that demonstrates elevation in LD-1 greater than LD-2 could be indicative of what?
hemolysis and myocardial infarction
A specimen for potassium was drawn in a tube without anticoagulant at 6 AM during a traumatic patient stick. The result were 6.0 mmol/L. Why are the results elevated?
hemolysis of the RBCs
What additive should be used for collection of a sample for blood gas analysis?
heparin
What type of anticoagulant is generally suitable for TDM analysis?
heparin
What two organs are associated with drug elimination?
hepatic and renal
Increased concentrations of alpha-fetoprotein in adults are most characteristically associated with?
hepatocellular carcinoma
The primary mechanism responsible for glomerular filtration is:
hydrostatic differential in glomerular tufts
Which lipid abnormality is most closely linked to heart disease?
hypercholestrolemia
A low CSF glucose level is not associated with what?
hyperglycemia
A patient has the following test results: increased serum phosphorus levels, decreased serum calcium level, and decreased serum parathyroid (PTH) level. This patient most likely has what?
hypoparathyroidism
What is a condition in which therapeutic drug monitoring be used?
if the drug is chronically given
When should blood samples for trough drug levels be collected?
immediately before the next dose is given
What is the most common technique that is used by labs for therapeutic drug monitoring?
immunoassays
Troponin I levels
increase 3-12 hours stay increased for 7-14 days
Patients who develop severe sepsis or septic shock commonly have ___________ plasma lactate values.
increased
What is the relationship between lipids and heart disease?
increased levels of LDL-C indicates an increased risk for cardiovascular disease
Viral meningitis CSF
increased lymphocytes, normal glucose increased proteins
Bacterial Meningitis
increased neutrophils decreased glucose increased proteins bacteria would most likely be seen
Symptoms associated with nephrotic syndrome
increased proteinuria decreased serum albumin hyperproteinemia
A patient presents with an elevation of unconjugated bilirubin, normal serum alkaline phosphatase, normal liver enzymes, and no bilirubin in the urine. This combination would suggest what?
increased rate of hemolysis unconjugated bilirubin is a byproduct of RBC breakdown or hemolysis
What result would be MOST consistent with macro-amylasemia?
increased serum amylase and normal to low urine amylase values
A major action of angiotension 2 is?
increased vasoconstriction increases adrenal secretion of aldosterone increases blood pressure
What would you expect the serum iron and total iron binding capacity to be in a person with hereditary hemochromatosis?
increases serum iron decreased TIBC
When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to:
induce the sweat secretion
Relation regarding cardiovascular disease and adipose tissue.
inflammatory cytokines, synthesized and released by adipose tissue, contribute to the development of cardiovascular disease
Sodium fluoride is an excellent preservative for collecting glucose because it does what?
inhibits glycolysis
What hormone is mainly responsible for the entry of glucose into the cell for energy production?
insulin
type 2 diabetes mellitus
insulin levels may or may not be abnormal more common than type 1 it commonly occurs in adults
What is the most significant cause of decreased haptoglobin levels?
intravascular hemolysis
What is necessary for the absorption of Vitamin B12?
intrinsic factor
What method would be employed to collect sweat for chloride analysis?
iontophoresis
brain naturetic peptide/BNP
is released in response to a variety of cardiac stresses, particularly cardiac stretch
Acetaminophen metabolism
it is metabolized in the kidney
Troponin
it rises much sooner after a myocardial infaraction than CK-MB
When is a trough blood sample for the therapeutic drug monitoring usually obtained?
just before the next scheduled dose
Factors that promote casts in kidneys
larger than normal amount of plasma proteins entering the tubules decreased pH decreased urinary flow rate increased urine concentration
What adipocyte product is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores?
leptin
What represents a diagram of a spectrophotometer?
light source - monochromator - cuvette - detector - readout
What is most likely to interfere with the measurement of hemoglobin?
lipemia
What medication is primarily used in the treatment of bipolar disorder?
lithium
What conditions are associated with a polyclonal (broadbased) increase in gamma globulin?
liver disease chronic inflammation immune reaction
What assay results would you expect to see in hyperthyroidism?
low TSH high free T4
When measuring enzyme activity, if the instrument is operating 5C lower than the temperature prescribed for the method, how will the results be affected?
lower than actual
What may be seen in a CSF sample of a patient that has a subarachoid (intracranial) hemorrhage (SAH)?
macrophage containing hemosiderin
Antigen processing is primarily accomplished by what type of cell?
macrophages
An important metallic activator of alkaline phosphatase and creatinine kinase is?
magnesium
When evaluating the patterns of fluroscent anti-nuclear antibody (FANA) testing, cytoplasmic patterns indicate?
may demonstrate anti-mitochondrial antibodies seen in primary biliary cirrhosis
Serum calcitonin is typically elevated in which of the following conditions
medullary carcinoma of the thyroid
What assay, using 24 hour urine, is considered the BEST single screening test for pheochromocytoma?
metanephrines
What medication is considered an antineoplastic drug?
methotrexate
Uses of Nucleic Acid Tests for HIV infections
monitor the effectiveness of antiretroviral therapy obtain a baseline value prior to the start of antiretroviral therapy diagnose HIV infection
What condition would make a sample unsuitable for lactic acid testing?
movement of hand or arm during specimen collection
Creatinine excretion correlates best with what body parameter?
muscle mass
What cardiac biomarker rises within 1-3 hours after chest pain, peaks in 2-6 hours, and is usually normal within 24 hours?
myoglobin
What is the EARLIEST biochemical marker of myocardial infarction?
myoglobin
Proteins in a buffer that sets the pH at 8.6 will become ________________ charged and migrate to the _______________
negatively, anode
The property MOST responsible for the migration of proteins in an electrical field is what?
net surface charge
Are oral glucose tolerance tests (OGTT) performed routinely?
no, discouraged for routine use
Leucine Crystals
oily, highly refractile, yellow to brown spheriods with radial concentric laminations
A male patient's urea nitrogen value is 15 mg/dl and his creatinine is 5mg/dl. If this patient is not undergoing dialysis, what conclusion would you draw from these results?
one of the values is an error
What types of lymphocytes express CD4?
only T-helper cells
Dietary iron and iron absorption
only a small percentage of dietary is absorbed and used
What does uncompensated metabolic alkalosis look like?
pH elevated without an elevation in pCO2
What is a cause of hypomagnesemia?
pancreatitis
The biuret reaction for the analysis of serum protein depends on the number of what?
peptide bonds
What drug is an anti-convulsant?
phenobarbital
Follicle-stimulating hormone (FSH) is produced by?
pituitary gland
What is another name used to designate a fully committed B-lymphocyte
plasma cell
What macroscopic finding is MOST consistent with the microscopic finding of casts?
positive protein
A liquid ion-exchange membrane electrode using the antibiotic valinomycin is MOST selective for what?
potassium
The presence of slight visible hemolysis will significantly increase what serum electrolyte?
potassium
Bence Jones proteins and heat precipitation test
precipitate between 40-60C but redissolve at 100C
Urinalysis finding that correlate with the presence of yeast infection?
presence of glucose white blood cells turbid urine
The selectivity of an ion-selective electrode is determined by what?
properties of the membrane used
What is the most accurate observation about osmotic pressure?
proportional to concentration of solute particles
When collecting a specimen for vitamin A, what special precaution needs to be taken?
protect the specimen from light
High sensitivity C-reactive protein
protein produced primarily by the liver in response to inflammation marker for chronic inflammation and measured to predict risk of cardiovascular disease
What are apolipoproteins?
proteins that are on the surface of lipoprotein molecules that bind enzymes or transport specific proteins and direct lipoproteins to their sites of metabolism
What condition is caused by an increased plasminogen activator inhibitor 1 (PA-1) and fibrinogen often present in metabolic syndrome?
prothrombotic state
The primary purpose of neutrophil granules is to:
provide microbicidal action
What term could be used to describe an analyzer that can test specimens out of sequence?
random access
What best describes serum hCG levels during pregnancy?
rapid rise in levels during first trimester; slow decline and possible level-off throughout remainder of pregnancy
L/S ratio determination of amniotic fluid is useful is assessing the probability of what?
respiratory distress syndrome
Glucagon
responsible for increasing glucose levels in the blood increases glycogenolysis
Insulin
responsible for the entry of glucose into the cell increases glycogenesis
What is considered the major transport protein for vitamin A?
retinol-binding protein
Patients with Cushing's disease typically exhibit:
serum cortisol overproduction
Quantitative methods for the determination of albumin
serum protein electrophoresis nephelometry colorimetric spectrophotometry
How should ammonia be transported to the lab?
should be transported in an ice slurry
What analyte would not be significantly increased in a plasma sample as a result of hemolysis?
sodium
C-reactive protein (CRP) is often used as a marker of inflammation. However, it has low ___________?
specificity
Sudan III stain
stains unabsorbed fat. for malabsorption Dx
What is gastrin's role in digestion?
stimulates gastric acid-HCl secretion
What test can be used as a confirmatory test for proteinuria?
sulfosalicyclic acid test
What is the isoelectric point?
the pH at which the molecule is electrically neutral
A HbA1C result for a diabetic patient is 6.0%. What conclusion can be made regarding this patient's carbohydrate management?
the patient is compliant with diet and medication
What factor would least affect an orally administered drug's absorption and/or distribution in the body?
the position of the patient when the drug is taken (sitting vs. standing)
Specific Gravity measured by the reagent strip method
the reagent strip method is based on the relationship between ionic concentration and specific gravity urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen
What is the typically finding for determine the endpoint for the initial or iron-depletion phase of treatment for hereditary hemochromatosis (HH)?
the serum ferritin decreases to between 20 to 50 ng/mL
Pharmacokinetics
the study of drug movement throughout the body
Zero order kinetics
the substrate concentration is in excess and the reaction rate is dependent on the enzyme concentration
CYP450 enzymes
they are able to make compounds more water soluble and therefore enhanced excretion
What procedure is important to implement when a test for lead is collected by finger puncture that would NOT be necessary prior to an antecubital venipuncture?
thoroughly washing patient's hands with soap and water
Calcitonin
thyroid gland
TIBC is an indirect measurement of
transferrin
Total iron-binding capacity measures the serum iron transporting capacity of:
transferrin
Which protein is also known as prealbumin because it migrates before albumin in the customary electrophoresis of serum or plasma proteins?
transthyretin (thyroxine binding prealbumin)
Chylomicrons are primarily composed of:
triglycerides
Lipemia in a fasting serum sample is most likely caused by an increase in serum levels of what?
triglycerides
What lipid result would be expected to be FALSELY elevated on a serum specimen from a non-fasting patient?
triglycerides
What is the MOST specific biochemical marker of myocardial infraction?
troponin
What cells of urine would be most indicative of kidney disease?
tubular epithelial cells
Nephelometry is based on the principle of:
turbidity resulting from specific antigen-coated latex particles agglutinated by corresponding antibodies
What condition is indicated by the following arterial blood gas results?Bicarbonate = 32 mmol/L (Normal = 22 - 29 mmol/L) pCO2 = 65 mm Hg (Normal = 35 - 45 mmHg) pH = 7.28 (normal = 7.35 - 7.45)
uncompensated respiratory acidosis
What purine base is found in RNA and not in DNA?
uracil
What urine chemical reagent strip test is based on Ehrlich-aldehyde reactions?
urobilinogen
The ultimate end product of both epinephrine and norepinephrine metabolism is:
vanillylmandellic acid (VMA)
The deficiency in what fat soluble vitamin is associated with night blindness?
vitamin A
Pharmokinetics
what the body does to the drug
lead poisoning
while lead distributes to all tissues, the central nervous system, kidney, and bone marrow are particularly susceptible to lead toxicity whole blood lead measurement is the best test for detecting lead toxicity lead levels below 5ug/dl in children do not prompt ongoing monitoring
What cast is characteristically associated with acute pyelonephritis?
white cell
Cell counts on CSF specimens should be performed within what time frame following collection of the CSF sample?
within one hour
Cells seen in the microscopic examination of the urine of a 30 year old female which are smaller than RBC's but much the same shape are probably:
yeast cells
What microscopic techniques is best suited for direct examination of the infectious agents of syphilis?
dark-field microscopy - allows for spirochetes to be seen
What changes in potassium and sodium result may occur with diuretic use?
decrease in both
Enzyme Multiplied Immunoassay Technique (EMIT)
A non-separation immunoassay based on an enzyme label
Formula for calculating transferrin saturation
(serum iron/TIBC) x 100
What is the half-life of IgG? Why is the duration of the half-life significant?
18-23 days; it binds with neonatal Fc receptor
What transferrin saturation level would be indicative to investigate further for hereditary hemochromatosis (HH)?
45%
What is blood alcohol concentration limit in the US?
80 mg/dl
What is considered a normal urine osmolality?
800 mOsm or higher is considered normal when patients were deprived of fluid for 12 hours
Anti-nuclear antibodies?
95% of patients with SLE will test positive for ANAs
A physician needs to prescribe a drug to a patient but the drug has a narrow therapeutic window. He is concerned about possible toxic effects. To assess the upper concentration of such a drug, which time for drawing the specimen do you think makes the most sense? A) approximately one hour after an oral dose B) 2-4 hours after an IV injection of a drug C) before any drug is given D) right before the next dose of the drug is given
A) approximately one hour after an oral dose
Which one of the following serum constituents is increased following strenuous exercise? A) creatinine B) total lipids C) sodium D) iron
A) creatinine
Lancefield antigens that are found on organisms from the Streptococcus anginosus group?
A, F, G
All of the following are causes of hypernatremia EXCEPT: A) excessive water loss B) low aldosterone production C) decreased water intake D) increased sodium intake or retention
B) low aldosterone production aldosterone stimulates sodium reabsorption in the distal tubules of the nephrons
Which of the following lipid results would be expected to be the MOST falsely elevated on a serum specimen from a non-fasting patient? A) cholesterol B) triglycerides C) HDL D) LDL
B) triglycerides
Detection of a fruity odor in a fresh urine sample may be indicative of which of the following EXCEPT: A) starvation B) malabsorption C) bacterial infection D) diabetes mellitus
C) bacterial infection
What cells are responsible for the humoral immune response?
B lymphocytes involves antibody production
The properties of enzymes are correctly described by which of the following statements? A) Enzymes activity is not altered by heat denaturation B) enzymes are protein catalysts of biological origin C) enzymes are stable proteins and unaffected by pH changes D) enzymes affect the rate of a chemical reaction by raising the activation energy needed
B) enzymes are protein catalysts of biological origin
All of the following anticoagulants will produce a significant effect on calcium levels in plasma, EXCEPT? A) EDTA B) heparin C) oxalates D) citrates
B) heparin heparin prevents coagulation by forming complexes with antithrombin III
high levels of lipoprotein-associated phospholipase A2 are associated with: A) decreased cardiovascular risk B) increased cardiovascular risk C) increased renal failure risk D) increased liver failure risk
B) increased cardiovascular risk
All of the following are possible medical complications for an individual diagnosed with metabolic syndrome, EXCEPT: A) fatty liver disease B) renal disease C) brain tumor D) sleep apnea
C) brain tumor
What leukocytes is most directly associated with antibody production?
B-cells
Which markers are currently used to differentiate heart failure from lung disease?
BNP and NT-proBNP
Which risk marker has both positive and negative cardiovascular risk integrated into its measurement? A) LpPLA2 B) oxidized LDL C) Apo B-100/Apo A-1 D) hs-CRP
C) Apo B100/Apo A-1
Flow cytometry is a useful tool in the study of all of the following disorders EXCEPT? A) HIV B) Leukemia C) Viral hepatitis D) Lymphoma
C) Viral hepatitis
Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity?
adiponectin
All of the following statements about fluorometry are true, EXCEPT: A) fluorometry is more sensitive than spectrophotometry B) both excitation and emission spectra are characteristics of the analyyte C) fluorescence is indirectly proportional to the analyte being measures D) fluorometers typically utilize monochromators or optical filters
C) fluorescence is indirectly proportional to the analyte being measures
Which assay would help rule out ovarian cancer?
CA 125
What tumor markers are elevated in more advanced stages of breast cancer?
CA 15-3 and CA 549
Tumor marker associated with ovarian cancer
CA-125
Which tumor marker is used for colorectal cancer?
CEA
What cardiac biomarker could detect a recent reinfarction?
CK-MB
What tests are used to diagnose acute coronary syndrome and/or acute myocardial infarction?
CK-MB TnI TnT
What two biomarkers are not specific to cardiac muscle and may be elevated in patients with injury to muscle other than cardiac muscle?
CK-MB and myoglobin
Which three genetic variations in enzymes are most often linked to differences in drug metabolism?
CYP2D6 CYP2C9 CYP3A4
Initial step in the process of phagocytosis?
Chemotaxis
All of the following statements are true regarding the hepatic system and drug metabolism, EXCEPT? A) changes in hepatic status will affect the concentration of circulating drug eliminated B) hepatic disease states characterized by a loss of functional tissue may result in slower rates of clearance C) hepatic disease states characterized by a loss of functional tissue may result n a longer drug half-life D) metabolism of acetaminophen by the MFO system is altered by alcohol and makes it less toxic
D) metabolism of acetaminophen by the MFO system is altered by alcohol and makes it less toxic
An increase in creatinine is most commonly associated with what?
decreased glomerular filtration
Increases in the MB fraction of CK is associated with: A) Liver disease B) bone disease C) kidney failure D) myocardial infraction
D) myocardial infarction CK-MB (muscle, brain) CK-MM (muscle) CK-BB (brain)
Plasma creatinine concentration is dependent on all of the following EXCEPT: A) relative muscle mass B) renal function C) rate of creatinine turnover D) sodium concentration
D) sodium concentration
All of the listed disorders are organ non-specific autoimmune diseases EXCEPT: A) SLE B) Systemic sclerosis (SSc) C) rheumatoid arthritis (RA) D) Hashimoto's disease
D) Hashimoto's disease
That portion of an enzyme which when separated from its cofactor is called an: A) holoenzyme B) isoenzyme C) coenzyme D) apoenzyme
D) apoenzyme
Which of the following is NOT required for a diagnosis of hereditary hemochromatosis (HH)? A) >50% transferrin saturation in females or >60% saturation in males B) presence of HFE mutations or other genetic mutations associated with iron metabolism C) increased ferritin D) biopsy of liver and/or bone marrow
D) biopsy of liver and/or bone marrow
Serum alkaline phosphatase (ALP) activity is derived from all of the following organs EXCEPT: A) bone B) intestines C) placenta D) brain
D) brain
8-Hydroxyquinoline and Ortho-Cresolphthalein complexone (CPC) reagent is commonly used in the determination of: A) phosphorus B) magnesium C) chloride D) calcium
D) calcium
The nitrite portion of the test strip can be used to do all of the following EXCEPT: A) monitor antibiotic therapy B) detect a bladder infection in an early stage in pregnant women C) screen individuals with recurrent infections D) detect metabolic bye-products often seen in diabetic patients
D) detect metabolic bye-products often seen in diabetic patients
Which of the following is a cause of metabolic alkalosis? A) late stage of salicylate poisoning B) uncontrolled diabetes mellitus C) renal failure D) excessive vomiting
D) excessive vomiting
A deficiency in which of these vitamins leads to increased clotting and may result in hemorrhagic disease? A) Riboflavin B) pyridoxine C) Vitamin C D) Vitamin K
D) vitamin K - needed to produce certain coagulation factors
What serological tests would be used for the diagnosis of Q-fever?
EIA or indirect immunoflurescence
What is the confirmatory test for syphilis?
FTA-ABS
Zollinger-Ellison syndrome
Gastrin-secreting tumor associated with ulcers increase in gastrin
Unconjugated bilirubin is conjugated in the liver with which of the following substances to become water soluble?
Glucuronic acid
What condition is associated with elevated serum uric acid levels?
Gout
What sero-marker is the first marker to become positive in Hepatitis B and is associated with the infective stage
HBs antigen
What test is a more reliable method of monitoring long-term diabetes control?
HgB A1C
A major macrophage-activating cytokine is:
IFN-gamma (interferon gamma)
What immunoglobulin classes is chiefly responsible for the degranulation of mast cells and basophils?
IgE
What immunoglobulin is associated with anaphylactic shock?
IgE
What characteristic differentiates a secondary immune response form a primary immune response?
IgG is the predominant antibody class produced in the secondary immune response compared to the primary immune response
Which three hormones are known to regulate serum Ca2+ by changing their secretion rate in response to changes in ionized Ca2+?
PTH, vitamin D, and calcitonin
Iontophoresis
Process of infusing water-soluble products into the skin with the use of electric current, such as the use of the positive and negative poles of a galvanic machine used for CF diagnosis
What are acute phase proteins?
Proteins that are synthesized by the liver in response to infection, illness, and tissue injury. alpha-1 antitrypsn CRP fibrinogen
Rocky Mountain Spotted Fever
Rickettsia rickettsii IFA testing
What disease state is thyroid stimulating hormone decreased?
decreased in hyperthyroidism
What is the primary target of HIV?
T-helper cells
Therapeutic drug monitoring
The process of measuring drug levels to identify a patient's drug exposure and to allow adjustment of dosages with the goals of maximizing therapeutic effects and minimizing toxicity.
Calcitonin is synthesized by which cells in the body?
Thyroid C cells
What hormones stimulate glucogenogenesis, the formation of glucose from noncarbohydrate sources such as amino acids, glycerol, and fatty acids?
Thyroxine (T4) Cortisol Glucagon
What lymphocyte subtype controls autoimmunity in the peripheral blood?
Treg - immunoregulatory CD4+ T cells function is to maintain self-tolerance
Which troponin protein binds to tropomyosin?
Troponin T (TnT)
Below are the laboratory results on a 20-year-old overweight male. His waist circumference is 41 inches and blood pressure is 105/70. Fasting Blood Glucose: 130 mg/dL Triglycerides: 190 mg/dL HDL: 50 mg/dL The National Heart, Lung, and Blood Institute (NHLBI) and American Heart Association (AHA) have created a set of parameters to define the presence of metabolic syndrome. Does this patient meet the criteria for metabolic syndrome diagnosis?
Yes he meets the NHLBI and AHA criteria for metabolic syndrome
Pheochromocytoma
a benign tumor of the adrenal medulla that causes the gland to produce excess of free catecholamines, metanephrines, vanillylmandelic acid
Zinc deficiency in the elderly is often caused by:
decreased intake and absorption
Whole blood glucose values are _________ plasma glucose values?
about 11% lower
What is the cause of iron overload in hereditary hemochromatosis?
absorption of excessive amounts of iron in the small intestine
The ketone component that is measured by the nitroprusside reaction is:
acetoacetic acid
beta-hydroxybutyrate is formed as the result of an accumulation of what?
acetyl-coA = major role in metabolism of carbohydrates, lipid, and protein metabolism
What form of immunity is expected to provide long-term protection after HBV is administered to an immunocompetent person?
active
Ion selective electrodes, for pH determinations, are called selective rather than specific because they actually measure the what?
activity of one ion much more than other ions present
What affect may bacterial contamination have on urine pH?
bacteria may make the pH more alkaline
Which disease/condition is associated with a deficiency in thiamine?
beriberi (deficiency in vitamin B1)
The immunoassay procedure for serum hCG utilizes antisera against which subunit of hCG?
beta
Most of the carbon dioxide in the blood is in what form?
bicarbonate
Elevation in conjugated bilirubin is most likely to be found in what conditions
biliary obstruction
What substance can cause a false positive result for blood on the urine chemical reagent strip?
bleach in the collecting bottle
In the condition kernicterus, the abnormal accumulation of bilirubin occurs in what tissue?
brain
Estrogen (ERs) and progesterone (PRs) receptors used as tumor markers are most commonly employed to provide prognostic information about?
breast cancer
What are the expected results of the laboratory markers in iron deficiency anemia?
decreased serum iron increased transferrin decreased ferritin decreased percent saturation increased total iron binding capacity
Define specific gravity
density of a solution compared to density of water
Which substance is used in the Jendrassik-Grof method to accelerate the reaction of unconjugated bilirubin with the diazo reagent?
caffeine-benzoate = used to split the unconjugated bilirubin protein complex releasing the bilirubin so that it can react with acid
Parathyroid hormone is important in the regulation of what?
calcium and phosphate
Ionized calcium is currently measured by what method?
calcium ion selective electrodes
Vitamin D act as a hormone for what regulation?
calcium regulation activated vitamin D induces the absorption of calcium in the small bowel cells
What is a major property of antidiuretic hormone?
changes distal tubule water permeability
nephrotic syndrome
characterized by massive proteinuria caused by glomerular damage. corticosteroids are the mainstay transitional epithelial oval fat bodies
Process of Phagocytosis
chemotaxis, adherence, ingestion, digestion
In the blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what ion?
chloride
What lipid does not serve as a source of fuel, but can be converted to steroid hormones?
cholesterol
What lipid test is LEAST affected by the fasting status of the patient?
cholesterol
A broad based increase in the gamma band of electrophoresis indicates?
chronic inflammation
Waxy casts
chronic renal failure
Triple phosphate crystals
coffin lid apearance normal in alkaline urine
An increase in carcinoembryonic antigen (CEA) level is most closely associated with which organ?
colon
Atherosclerosis
condition in which fatty deposits called plaque build up on the inner walls of the arteries
Which dye-binding method uses an increase of absorbance at 595 nm to determine the total protein concentration of the specimen?
coomassie brilliant blue 250
An elevated level of what hormone will inhibit pituitary secretion of ACTH?
cortisol
What test would be used in assessment of glomerular filtration?
creatinine clearance
Measurement of the sodium and chloride concentration of sweat is the most useful test for the diagnosis of:
cystic fibrosis
Which nitrogen base would bind with a guanine nucleotide in forming double-stranded DNA?
cytosine
Atherosclerosis
deposition of plaque containing cholesterol and lipids on the innermost layer of the wall of large and medium sized arteries
What drug may be used to decrease iron levels in patients with iron overload?
desferrioxamine
What hormones increase or decrease glucose concentration by regulating glycogenolysis (converting of glycogen to glucose)?
glucagon epinephrine insulin
At medical examination, a 50-year-old Caucasian male expressed concern regarding diabetes. There is a history of type 2 diabetes, hypertension, and cardiovascular disease in his family. He has gained a few pounds each year and his physician notes abdominal obesity. His physician orders laboratory tests to evaluate his risk of cardiovascular disease.Vital Signs and Pertinent Laboratoy Results:Blood Pressure: 128/82 mm HgWeight: 230 lbsHeight: 5' 11''Calculated BMI: 32.1Waist Circumference: 45 inchesFasting Blood Glucose: 120 mg/dLTriglycerides: 170 mg/dLHDL-C: 42 mg/dLWhich one of the following statements regarding this patient is true if the physician uses the guidlines of American Heart Association (AHA) and National Heart, Lung, Blood Institute (NHLBI) for metabolic syndrome evaluation?
diagnosis of metabolic syndrome waist circumference triglyceride level fasting glucose
The most common methods for measuring bilirubin are based on the reaction of bilirubin with?
diazo reagent
Methodology of FISH
direct nucleic acid test that uses RNA northern blot or DNA southern blot to detect variations
What values would be expected with metabolic alkalosis?
elevated pH increased bicarbonate normal PCO2
What parameters are included in the diagnosis of the presence of the metabolic syndrome in adults?
elevated waist circumference elevated triglyceride level elevated fasting glucose
Increases in blood ammonia levels would be expected in which conditions:
end stage cirrhosis
Hemoglobin A1c is reported with what other value?
estimated average glucose
What lab assays are utilized for metabolic syndrome diagnosis?
fasting blood glucose triglycerides HDL-C
What additional fraction would be seen if plasma rather than serum was subjected to electrophoresis?
fibrinogen
What is found in plasma but absent in serum?
fibrinogen
In what trimester is there the greatest risk for the manifestation of complications in maternal rubella infection?
first trimester
What type of toxicology is primary concerned with medical and legal consequences of exposure to chemicals or drugs?
forensic toxicology
What is the principle for the biuret method for total protein analysis?
formation of violet-colored chelate between Cu2+ ions and peptide bonds
An adult's plasma cortisol of 22 ug/dl at 8:00am and 1o ug/dl at 4pm would be:
found in a healthy individual
Bioavaliability of an oral drug refers to:
fraction of the drug that is absorbed into system circulation
What form of calcium is biologically active?
free ionized calcium
What method for long-term diabetic monitoring is recommended for patients with sickle cell anemia?
fructosamine
What enzyme is the most sensitive indicator of long term liver damage associated with alcohol ingestion?
gamma-glutamyl transpeptidase (GGT)
Hydrogen ion concentration in blood is usually determine by means of what electrode?
glass