LabCE wrong questions

A 56-year old female was taken to the emergency room by her employer's nurse. She last 35 pounds in 3 months; she was always thirsty; drinking a lot of water and running to the bathroom. The following are her lab results. pH: 7.11 pCO2: 21 mm Hg Serum glucose: 950 mg/dL Serum Osmolality: 365 mOsm/Kg Urine ketone: Strongly Positive Urine glucose: Strongly Positive What is most likely cause of this patient's symptoms?

Insulin-dependent diabetes mellitus

Which of the following statements about thyroid-stimulating hormone (TSH) is true?

It is decreased in hyperthyroidism

Which one of the following statements about acetaminophen metabolism is false?

It is metabolized in the kidney

Which of the following statements is FALSE regarding troponin as a marker of mycocardial infarction?

It rises much sooner after a myocardial infarction than CK-MB.

Analytical sensitivity of a method generally refers to:

Its ability to measure low concentrations of analytes.

Isoenzymes of alkaline phosphatase occur in:

Kidney, bone, intestines, liver

With the development of fetal lung maturity, which of the following phospholipid concentrations in amniotic fluid increases?

Lecithin

Which of the following adipocyte products is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores?

Leptin

In normal CSF the protein concentration as compared to that in the plasma is generally:

Less than 1%

All of the following are causes of hypernatremia EXCEPT

Low aldosterone production

Serum calcitonin is typically elevated in which of the following conditions?

Medullary carcinoma of the thyroid

Of the following, which has the longest half-life?

Phenobarbital

Follice-stimulating hormone is produced by:

Pituitary

Select the primary reagent used in the Jaffe method for creatinine.

Saturated picric acid and NaOH

How often is competency testing required in the first year of employment for staff member who is performing non-waived tested according to the Clinical Laboratory Amendments of 1988 (CLIA '88)?

Semiannually

Which of the following contributes most to serum osmolality?

Sodium

Which of the following body fluids is considered most unlikely to transmit a bloodborne pathogen such as hepatitis B virus or hepatitis C virus?

Sweat

What are the two general categories of nucleic acid amplification (NAA) techniques?

Target amplification and signal amplification

Estriol levels in conjunction with hCG, inhibin A (inhA), and alpha-fetoprotein (AFP) can be obtained during pregnancy to assess which of the following?

The risk of Down's syndrome

A jaundiced newborn's bilirubin values are as follows: Day 1 7:45 am 14 mg/dL Day2 7:15 am 13 mg/dL Day3 8:00 am 4 mg/dL What is the explanation for these test results?

The specimen was not protected from light and bilirubin broke down resulting in a false decreased value.

A clinical laboratory scientist is reviewing the results of comparative studies between laboratory plasma glucose results and patients' self-monitoring (whole blood) glucose results. Which results are expected?

The whole blood result is 11% lower.

All the following affect the relative centrifugal force of a centrifuge, except?

Time

What is the equation for an approximate Transferrin from TIBC?

Transferrin = 0.7 x TIBC

pH alteration of normal blood in a closed vessel standing at 37 degrees C for 1 hour is approximately:

0.04 - 0.08 pH units

Convert 0.9% NaCl to molarity.

0.15M

What is the maximum recommended amount of time a specimen without additive or anticoagulant should be allowed to clot before centrifugation?

2 Hours

A computer monitor should be set approximately how many inches away from the eyes?

20 - 40 inches

A phlebotomist is performing venipuncture on a small delicate hand vein should choose a needle with a guage number of a. 18 b 22 c 23 d 25

23

Troponin I is used frequently to assess acute myocardial infarction (AMI). If a patient has experienced an AMI, at what point (approximately) will the troponin I begin to increase and how long will it stay increased? a. b 6-10 hours, 1-2 days c 3-12 hours, 7-14 days d 3-6 hours, 1-2 days

3 - 12 hours, 7 - 14 days

A completed package for a category B substance must be able to survive a drop test from what height?

4 feet

How many distinct bands are separated during a standard serum protein electrophoresis?

5

Calculate the negative predictive value of an assay that yields the following results: True positive: 318 True negative: 304 False positive: 2 False negative: 16

78%

Calculate the sensitivity of an assay that yields the following results: True positive: 318 True negative: 304 False positive: 2 False negative: 16

79%

Calculate the accuracy of an assay that yields the following results: True positive: 318 True negative: 304 False positive: 2 False negative: 16

84%

Calculate the positive predictive value of an assay that yields the following results: True positive: 318 True negative: 304 False positive: 2 False negative: 16

91%

Which disease/condition is associated with a deficiency in thiamine?

Beriberi

A markedly elevated 5-hydroxyindolacetic acid (5-HIAA) determination is presumptive evidence for:

Carcinoid tumor

Which lipid does not serve as a source of fuel, but can be converted to steroid hormones?

Cholesterol

What is the term to describe the clinical syndrome caused by heart disease, represented by abnormal sodium and water retention and breathlessness, usually resulting in chest pain?

Congestive heart failure

An elevated level of which of the following hormones will inhibit pituitary secretion of adrenocorticotropic hormone (ACTH)?

Corisol

Which of the following would be increased due to delay in centrifugation?

Creatinine

Creatinine excretion correlates best with which of the following parameters?

Creatinine excretion is related to muscle mass and is fairly constant day to day for a given individual.

What are the expected results of the laboratory markers in iron deficiency anemia?

Decreased serum iron, increased transferrin, decreased ferritin, decreased percent saturation, and increased total iron-binding capacity.

What is the role of albuminuria?

Detect small urinary concentrations of albumin before there is irreparable damage.

At a 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. Results: Blood pressure: 128/82 mm Hg Weight: 230 lbs Height: 5' 11" Calculated BMI: 32.1 Waist circumference: 45 inches Fasting Blood Glucose: 120 mg/dL Triglycerides: 170 mg/dL HDL-C: 42 mg/dL Which one of the following statements regarding this patient is true if the physician uses the American Heart Association (AHA) and National Heart, Lung, Blood Institute (NHLBI) guidelines for metabolic syndrome evaluation?

Diagnosis of metabolic syndrome: waist circumference, triglyceride level, and fasting glucose meet the criteria

What is defined as the ability of the test to detect a given disease or condition?

Diagnostic sensitivity

Which condition is caused by deficient secretion of bilirubin into the bile canalicult?

Dubin-Johnson syndrome

Increases in blood ammonia levels would be expected in which of the following conditions:

End-stage cirrhosis

In hemoglobin synthesis, which enzyme is responsible for adding iron in the last step?

Ferrochelatase

Which of the following is true of genotype screening in pharmacogenomics?

Genotyping does not take into account drug interactions which can affect metabolism.

Hydrogen ion concentration in blood is usually determined by means of which of the following electrodes?

Glass

creatinine clearance is based on serum creatinine level and is used to measure what?

Glomerular filtration rate

Unconjugated bilirubin is conjugated in the liver with which of the following substances to be become water-soluble?

Glucuronic acid

The LD (lactate dehydrogenase) molecule is made of a combination of polypeptides that can be separated into isoenzymes that help determine the location of an elevated LD. LD 3 is found primarily in the lung, lymphocytes, spleen, and pancreas but what polypeptides makeup LD 3?

HHMM

Which assay is recommended by the American Heart Association (AHA) and the Centers for Disease Control and Prevention (CDC) as the inflammatory marker of choice in the evaluation of cardiac disease risk?

HS-CRP

Which of the following tests confirms the presence of Bence-Jones proteinuria?

Immunoelectrophoresis

Which of the following is considered an action of the hormone glucagon?

Increase glycogenolysis.

What would you expect the serum iron and total-binding capacity to be in a person with hereditary hemochromatosis?

Increased iron and decreased TIBC

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:

Increased rate of hemolysis.

What is the mechanism of action for methotrexate?

Inhibits DNA synthesis

Which of the following describes the Westgard multi-rule R4S?

One data point is + 2SD and a consecutive data point is - 2SD

A male patient's urea nitrogen value is 15 mg/dL and his creatinine is 5 mg/dL. If this patient is not undergoing dialysis, what conclusion would you draw from these results?

One of the values is in error

Which of the following is considered a cause of hypomagnesemia (decreased levels of magnesium in the blood)?

Pancreatitis

How should healthcare passwords be managed?

Passwords should be memorized.

What would be following Schilling test results indicate: Part 1: 2 % excretion of radioactive vitamin B12 (normal: 5-35%) Part 2: 8 % excretion of radioactive vitamin B12 after intrinsic factor was given with vitamin B12 (normal: 7-10%)

Pernicious anemia

What is the BEST type of microscopy for performing manual platelet counts?

Phase contrast

Which analyte measurement is used to detect early nephropathy in a diabetic patient?

Albumin

Which protein is represented by the band labeled by the number 4 on the SPE scan?

Albumin

Which of the following statements is true regarding cardiovascular disease and adipose tissue?

A state of abnormal lipids and lipid levels found in metabolic syndrome contribute to the development of cardiovascular disease.

Which of the following analytes would be increased due to a delay in centrifugation?

ALT

What describes the cardiac tissue death (necrosis due to lack of oxygen caused by obstruction of circulation?

Acute myocardial infarction

What is the effect on aging on the hormones of the endocrine system?

Aldosterone decreases and norepinephrine increases.

Which of the following statements about diagnosising gestational diabetes is true?

All non-diabetic pregnant women should be screened at 24 to 28 weeks of gestation.

The laboratory test used to determine the presence of neural tube defects is

Alpha-fetoprotein

What is the term to describe chest pain caused by an inadequate supply of oxygen to heart myocardium?

Angina

Which of the following apolipoproteins contributes the greatest mass to the structure of high-density lipoprotein (HDL)?

Apo A

That portion of an enzyme which when separated from its cofactor is called a(n):

Apoenzyme

Which of the following medications is considered an antineoplastic drug?

Methotrexate

Creatinine excertion correlates with which of the following parameters:

Muscle Mass

What is the term used to describe inadequate blood supply that decreases availability of oxygen to the myocardium?

Myocardial ischemia

When testing for ethanol, what is actually measured in the enzymatic reaction that is proportional to ethanol concentration?

NADH

Enzyme-multiplied immunoassay techniques (EMIT) differ from all other types of enzyme immunoassays in that:

No separation of bound and free antigen is required.

The following steps were used in a procedure to identify M. kansasii: 1 Extraction 2 Denaturization 3 Hybridization 4 Hydrolysis of excess reagent 5 Detection of acridinium ester Which of the following methods has been described?

Nucleic acid probes

Cholesterol is used by the body for which of the following functions?

Precursor of hormone synthesis

What accelerates the rate of lipase activity in the body?

Presence of bile salt

What is the focus of both Lean principles and the Six Sigman methodology?

Process improvement

All of the following are characteristic of type 2 diabetes mellitus EXCEPT:

Requires insulin therapy to control hyperglycemia.

All of the following are characteristics of type 2 diabetes mellitus EXCEPT

Requires insulin therapy to control hyperglycemia.

A 3 year old boy was brought unconscious to the emergency room. Arterial blood gas results were as follows: pH = 7.07 pCO2 = 90 mm Hg HCO3 = 23 mmol/L The patient is most likely suffering from

Respiratory acidosis

Which of the following does the most to minizime aerosol production during centrifugation?

Using stoppered centrifuge tubes or a cover over the rotor chamber.

The deficiency in which fat-soluble vitamin is associated with night blindness?

Vitamin A