Chemistry MLS review

Which of the following patients is most at risk for hyperosmolar nonketoic coma? A. a 60-year-old type 1 diabetic patient B. a 70-year-old type 2 diabetic patient C. a 15-year-old type 1 diabetic patient D. a 25-year-old type 2 diabetic patient

B

Which of the following therapeutic drugs suppresses the immune system to help prevent graft rejection? A. primidone B. cyclosporine C. digoxin D. disopyramide

B

Which of the following would be considered a normal cerebrospinal fluid glucose level if the serum glucose is 70 mg/dL? A. about 100 mg/dL B. about 45 mg/dL C. about 60 mg/dL D. about 70 mg/dL

B

Which of the following therapeutic drugs increases the force of myocardial muscle contraction? A. primidone B. cyclosporine C. digoxin D. disopyramide

C

Which risk marker has both positive and negative cardiovascular risk integrated into its measurement? A. LpPLA2 B. oxidized LDL C. Apo B-100/Apo-A1 D. hs-CRP

C

Which substance is used in the Jendrassik-Grof method to accelerate the reaction of unconjugated bilirubin with the diazo reagent? A. NADH B. N-butanol C. caffeine-benzoate D. acetic acid

C

pH alteration of normal blood in a closed vessel standing at 37˚C for 1 hour is approximately: A. 0.01 to 0.02 pH units B. 0.02 to 0.04 pH units C. 0.04 to 0.08 pH units D. 0.08 to 0.12 pH units

C

Why might serum ferritin (SF) alone be considered a less than optimal screening test for hereditary hemochromatosis (HH)? A. it is an acutepahse reactant that is frequently elevated in a variety of clinical conditions B. it does not assess an individual's iron status C. it is an expensive test to perform D. it is only performed in laboratories doing molecular assays

A

What is the cause of iron overload in sideroblastic anemia? A. absorption of excessive amounts of iron in the small intestine B. ingestion of excessive amounts of iron from diet or supplements C. inability of the body to excrete normal amounts of dietary iron D. failure of developing red blood cells to incorporate iron into portoporphyrin IX

D

Which of the following additives should be used for the collection of a sample for blood gas analysis? A. sodium citrate B. EDTA C. sodium oxalate D. heparin

D

Which of the following blood tests is used to evaluate liver function? A. acid phosphatase B. uric acid C. amylase D. alkaline phosphatase (ALP)

D

Which of the following choices is correct when describing the principles of competitive radioimmunoassay procedures? A. antibody will react preferentially with the labeled antigen B. antibody will react preferentially with the unlabeled antigen C. antibody will react with labeled antigen only D. antibody will react equally with labeled and unlabeled antigen

D

Which of the following conditions is associated with elevated serum uric acid levels: A. Cushing's syndrome B. pancreatitis C. hyperthyroidism D. gout

D

Which of the following drugs is listed as an anti-convulsants? A. lithium B. gentamicin C. tacrolimus D. phenobarbital

D

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

Which of the following is a liver enzyme that is instrumental in allowing glucose to enter the blood stream? A. glucose oxidase B. glucose-6-isomerase C. glucose-6-convertase D. glucose-6-phosphatase

D

Which of the following sites is used most often for CSF collection? A. ventricles B. L1-L2 C. subarachnoid D. L3-L4

D

Which of the following tests is the BEST screening test for neural tube defects? A. placental lactogen B. bilirubin C. estriol D. alpha-fetoprotein

D

Which of the following therapeutic drugs is an antiarrythmic agent? A. primidone B. cyclosporine C. digoxin D. disopyramide

D

Which of these blood levels will decrease during intravascular hemolysis? A. serum (plasma) LDH B. serum (plasma) bilirubin C. reticulocytes D. haptoglobin

D

Which one of the following is considered to be the most specific marker for adverse ventricular remodeling or volume overload of the heart? A. CKMB B. troponin C. myoglobin D. BNP

D

Why are small dense LDL molecules more atherogenic? A. small dense LDL molecules contain less cholesterol and phospholipid B. small dense LDL molecules increase the concentration of HDL-C in the blood C. small dense LDL molecules increase the concentration of adiponectin and inflammatory cytokines D. small dense LDL molecules have greater mobility in the endothelium and arterial wall

D

A hospitalized patient has a decreased serum copper level and increased urine copper level. This is MOST consistent with: A. Wilson's disease B. Addison's disease C. Parathyroid disease D. not clinically significant

A

A clinical laboratory scientist is reviewing the results of comparison studies between laboratory plasma glucose results and patients' self-monitoring (whole blood) blood glucose (SMBG) results. Which SMBG results are expected? A. whole blood result is 11% higher B. whole blood result is 11% lower C. plasma result is 11% lower D. the difference between results should be negligible

B

A major action of angiotensin 2 is: A. increased pituitary secretion of petressin B. increased vasoconstriction C. increased parathormone secretion by the parathyroid D. decreased adrenal secretion of aldosterone

B

Chylomicrons are primarily composed of: A. cholesterol B. triglycerides C. phospholipids D. proteins

B

A 64-year-old man lost 15 pounds, became weaker, and his face became fuller with a ruddy complexion. His laboratory test revealed: Serum cortisol 8 AM: 880 nmol/L, 135-635 nmol/L ref. range 4 PM: 828 nmol/L, 83-414 nmol/L ref range After these results, an overnight dexmethasone suppression test gave a cortisol level of 773 nmol/L. The MOST probable diagnosis for this patient is: A. congenital adrenal hyperplasia B. Addison's disease C. Cushing's syndrome D. Conn's syndrome

C

A patient presents with an elevation fo unconjugated bilirubin, normal serum alkaline phosphatase, normal bilirubin enzymes, and no bilirubin in the urine. This combination would suggest: A. viral infection of the liver B. chemical damage to the liver C. increased rate of hemolysis D. obstruction of common bile duct

C

Acute phase proteins generally fall into which category? A. glycoproteins B. immunoglobulins C. lipoproteins D. microglobulins

A

Calcium and phosphorus levels were determined for a 4-year-old patient as follows: Ca - 14 mg/dL Phosphorus - 1 mg/dL These results are MOST compatible with: A. hyperparathyroidism B. renal failure C. rickets D. hypervitaminosis

A

Which of the following is true of genotype screening in pharmacogenomics? A. genotype screening gives a better overall picture of drug metabolism than measuring metabolism with probe drugs 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 has no known impact on drug metabolism

B

Which of the following lipid results would be expected to be MOST falsely elevated on a serum specimen from a non-fasting patient? A. cholesterol B. triglyceride C. HDL D. LDL

B

A patient suffering from Celiac disease and Crohn disease (both inflammatory conditions of the GI tract) is given a new oral medication that has a narrow therapeutic window. Which of the following would be true? A. an oral medication is never effective for a patient that has these diseases. the drug must be given through IV B. toxicity in this patient is not likely since most of the drug won't be absorbed C. therapeutic drug monitoring (TDM) would be helpful to see how much drug has been absorbed D. serum drug levels obtained 15 minutes after the oral dose should confirm the drug was absorbed

C

A spectrophotometric scan of amniotic fluid may be valuable in the determination of which of the following: A. neural tube defects B. maternal hypertension C. hemolytic disease of the newborn D. maternal diabetes

C

Approximately how many doses are required to obtain a steady-state oscillation allowing for peak and trough levels to be evaluated? A. 1 to 2 B.. 3 to 4 C. 5 to 7 D. >10

C

Which of the following blood tests needs to be placed on ice immediately after collection? A. amylase B. sodium C. ammonia D. glucose

C

Which of the following medications is considered an antineoplastic drug? A. cyclosporine B. methotrexate C. clozapine D. tacrolimus

B

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

Which of the following drugs is listed as an antibiotic from the aminoglycides family? A. lithium B. gentamicin C. tacrolimus D. phenobarbital

B

Which of the following is most likely to interact with arterial walls, leading to deposition of cholesterol, and initiating or worsening atherosclerosis? A. large buoyant LDL B. small dense LDL C. LDL phenotype 'A' D. VLDL

B

A low CSF glucose is associated with all the following EXCEPT: A. hyperglycemia B. fungal meningitis C. amebic meningitis D. trichinosis meningitis

A

A patient has a fasting glucose (FPG) performed at an outpatient laboratory. He has fasted as instructed. FPG: 135 mg/dL What does this result indicate and what, if any, further action is recommended by the ADA? A. elevated FPG; needs further evaluation by a repeat or alternative test B. Decreased FPG; a repeat of the rest is recommended in one year C. sufficient documentation for diagnosis of diabetes D. needs no further evaluation; this is a normal FPG

A

How does Aspirin (salicylic acid) affect platelet function? A. inhibiting cyclooxygenase B. activates lipids C. inhibiting carbohydrates D. activating nucleic acid

A

In which of the following condition(s) would an INCREASED serum osmolality be an expected finding? A. dehydration and diabetes insipidus B. hyponatremia and dehydration C. increased arginine vasopressin hormone (AVP formerly ADH) secretion and in hyponatremia D. AVP and diabetes insipidus

A

Recently the American Diabetes Association (ADA) recommended reporting which of these values to correlate with HbA1C as a further indicator of glycemic control? A. estimated average glucose B. blood urea nitrogen C. microalbumin D. insulin

A

Serum calcitonin is typically elevated in which of the following conditions? A. medullary carcinoma of the thyroid B. hyperthyroidism C. glioblastoma D. adrenal adenoma

A

The most common testing method for vitamin B12 determination is by: A. protein binding radioimmunoassay (RIA) B. high-performance liquid chromatography (HPLC) C. 2,4-dinitrophenylhydrazine D. not assayed - prothrombin time is used as a functional indicator of vitamin D status

A

What changes in potassium and sodium serum results may occur with diuretic use? A. decrease in both B. increase in both C. increase in potassium and decrease in sodium D. decrease in potassium and increase in sodium

A

What is the cause of iron overload in hereditary hemochromatosis? A. absorption of excessive amounts of iron in the small intestine B. ingestion of excessive amounts of iron from diet or supplements C. inability of the body to excrete normal amounts of dietary iron D. failure of developing red blood cells to incorporate iron into portoporphyrin IX

A

What percentage of dietary iron is normally absorbed daily? A. 5% to 15% B. 25% to 35% C. 50% to 75% D. 75% to 100%

A

Which analyte may be falsely decreased due to a delay in transport time to the laboratory? A. glucose B. potassium C. magnesium D. LD

A

Which medication is PRIMARILY use in the treatment of bipolar disorder? A. lithium B. imipramine C. amitriptyline D. doxepin

A

Which of the following adipocyte products is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores? A. leptin B. resistin C. IL-6 D. angiotensinogen

A

Which of the following blood tests is used to determine prostate cancer? A. acid phosphatase B. uric acid C. amylase D. alkaline phosphatase (ALP)

A

Which of the following drugs is listed as an anti-depressant? A. lithium B. gentamicin C. tacrolimus D. phenobarbital

A

Which of the following is the correct calculation using the Friedwald calculation for LDL? A. LDL = total cholesterol - HDL - triglycerides/5 B. LDL = triglycerides/5 + HDL - total cholesterol C. LDL = total cholesterol + HDL - triglycerides/5 D. LDL = total cholesterol + HDL + triglycerides/5

A

Which of the following is the most common technique that is used by clinical laboratories for therapeutic drug monitoring? A. immunoassay B. electrophoresis C. atomic absorption D. ion selective electrode voltametry

A

Which of the following is true of C-reactice protein (CRP) when being used to assess the risk of cardiovascular disease? A. CRP levels are high in cardiovascular disease B. CRP levels are not affected by cardiovascular disease C. CRP level are low in cardiovascular disease D. CRP has little clinical utility for assessing cardiovascular disease

A

Which of the following therapeutic drugs controls seizures? A. primidone B. cyclosporine C. digoxin D. disopyramide

A

Which of the following would most likely occur as the result of hemodilution?A. low serum electrolyte values B. high serum electrolyte values C. increased anion gap D. electrolyte concentrations would remain the same

A

Which one of the following statements about acetaminophen is false? A. it is metabolized in the kidney B. it is largely metabolized in the liver to glucoronide and sulfonate conjugates C. a small amount is metabolized via cytochrome oxidase to a reactive benzoquinoneimine intermediate D. the benzoquinoneimine becomes toxic to the liver once glutathione becomes depleted

A

Which one of the following statements about serum ferritin is true? A. it is a sensitive indicator of iron deficiency B. elevation of serum ferritin is specific for hemochromatosis C. it is synonymous with transferrin D. it is a better test for bone marrow iron stores than a Prussian blue stain of marrow particles

A

Which dye-binding method uses an increase of absorbance at 595 nm to determine the total protein concentration of the specimen? A. bromophenol blue B. Coomassie brilliant blue 250 C. Amido black 10B D. Ponceau S

B

Which of the following blood tests is used to determine gout? A. acid phosphatase B. uric acid C. amylase D. alkaline phosphatase (ALP)

B

A patient has the following test results: increased serum phosphorus level, decreased serum calcium level, and decreased serum parathyroid hormone (PTH) level. This patient MOST likely has: A. hyperparathyroidism B. hypoparathyroidism C. hypercalcemia D. hypokalemia

B

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

Lipemia in a fasting serum sample is most likely caused by an increase in serum levels of: A. cholesterol B. triglycerides C. protein D. phopholipids

B

Sodium fluoride is an excellent preservative for collecting glucose specimens because it does which of the following? A. prevents interference with other substances B. inhibits glycolysis C. enhances chemical reactions D. inhibits certain clotting factors

B

The most common testing method for vitamin E determination is by: A. protein binding radioimmunoassay (RIA) B. high-performance liquid chromatography (HPLC) C. 2,4-dinitrophenylhydrazine D. not assayed - prothrombin time is used as a functional indicator of vitamin D status

B

The production of neutral 17-ketosteroids is a measure of which of the following? A. cholesterol production B. androgen production C. estrogen production D. growth hormone

B

The results which would be MOST consistent with macro-amylasemia are? A. normal serum amylase and elevated urine amylase B. increased serum amylase and normal to low urine amylase values C. increased serum and increased urine amylase values D. normal serum and normal urine amylase values

B

What is the cause of iron overload in secondary hemochromatosis? A. absorption of excessive amounts of iron in the small intestine B. ingestion of excessive amounts of iron from diet or supplements C. inability of the body to excrete normal amounts of dietary iron D. failure of developing red blood cells to incorporate iron into portoporphyrin IX

B

When evaluating a petient for a suspected Wilson's Disease diagnosis, low values of plasma ceruloplasmin would be expected along with: A. decreased urine copper B. increased urine copper C. normal urine copper D. increased serum copper

B

When the body compensates for a respiratory or metabolic disorder, the MAIN goal is to achieve: A. correct carbonic acid level, since it is the most important system in the body B. a normal pH C. normal pO2 and pCO2 for normal aspiration D. correct bicarbonate level, since it is the most important system in the body

B

Where are most acute phase proteins synthesized? A. bone marrow B. hepatocytes C. intestines D. spleen

B

Which cardiac biomarker is a regulator of myocyte contraction? A. myoglobin B. cTnT C. CK-MB D. CK-MB isoforms

B

Currently the MOST common method for the confirmation of serum barbituates is: A. immunoassay B. thin-layer chromatography C. gas liquid chromatography, mass spectrometry D. ultraviolet absorption spectroscopy

C

If a drug is given at intervals that are the same as its half-life, approximately how long will it take the drug to reach steady state? A. from the first dose B. about two half-lives to reach steady state C. about 5-7 half-lives to reach steady state D. it will never reach a steady state

C

In blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with: A. sodium B. potassium C. chloride D. phosphorus

C

Increases in blood ammonia levels would be expected in which of the following conditions: A. diabetes B. obstructive jaundice C. end stage cirrhosis D. myocardial infarction

C

The biuret reaction for the analysis of serum protein depends on the number of: A. free amino groups B. free carboxyl groups C. peptide bonds D. protein molecules

C

The following BEST descrives serum hCG levels during pregnancy: A. rise in levels throughout pregnancy B. highest levels found at end of pregnancy C. rapid rise in levels during first trimester; slow decline and possible level-off throughout remainder of pregnancy D. slow rise in levels during first trimester; rapid rise during second trimester; slow decline during the third trimester

C

The most common testing method for vitamin C determination is by: A. protein binding radioimmunoassay (RIA) B. high-performance liquid chromatography (HPLC) C. 2,4-dinitrophenylhydrazine D. not assayed - prothrombin time is used as a functional indicator of vitamin D status

C

What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hours? A. 9.5 mL/min B. 13.6 mL/min C. 95 mL/min D. 136 mL/min =(urine creatinine X urine flow rate) / (plasma creatinine) urine flow rate = volume in mL/24 hours X h/60m

C

Which condition is caused by deficient secretion of bilirubin into the bile canaliculi? A. Gilbert's disease B. neonatal hyperbilirubinemia C. Dubin-Johnson syndrome D. Crigler-Najjar syndrome

C

Which of the following blood tests is used to determine acute pancreatitis? A. acid phosphatase B. uric acid C. amylase D. alkaline phosphatase (ALP)

C

Which of the following drugs is listed as an immunosuppressive drug? A. lithium B. gentamicin C. tacrolimus D. phenobarbital

C

Which of the following is considered a cause of hypomagnesemia (decreased levels of magnesium in the blood)? A. hypothyroidism B. hypoaldosteronism C. pancreatitis D. bone carcinoma

C

Which of the following parts of the body synthesizes and secretes BNP? A. kdiney B. liver C. heart D. adrenal gland

C

What condition is indicated by the following arterial blood gas results? bicarbonate = 32 mmol/L (normal = 22-29 mmol/L) pCO2 = 65 mmHg (normal = 35-45 mmHg) pH = 7.28 (normal= 7.35-7.45) A. healthy condition B. uncompensated metabolic acidosis C. compensated metabolic acidosis D. uncompensated respiratory acidosis

D

A young man is experiencing difficult breathing after fainting. The physician orders an arterial blood gas analysis which shows the following results: pH = 7.25 pCO2 = 62 mmHg pO2 = 70 mmHg HCO3- = 23 mmol/L Which condition is most likely afflicting this patient? A. metabolic alkalosis B. metabolic acidosis C. respiratory alkalosis D. respiratory acidosis

D

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 drugs 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 in a longer drug half-life D. metabolism of acetaminophen by the MFO system is altered by alcohol and makes it less toxic

D

Elevation of creatine kinase may be associated with: A. cerebrovascular accident (stroke) or vigorous exercise B. vigorous exercise or Duchenne muscular dystrophy C. Duchenne muscular dystrophy or cebrovascular accident (stroke) D. Duchenne muscular dystrophy or cebruvascular accident (stroke) or vigorous exercise

D

In a normal CSF the protein concentration as compared to that in the plasma is generally: A. less than 50% B. less than 30% C. less than 10% D. less than 1%

D

That portion of an enzyme which when separated from its cofactor is called a(n): A. holoenzyme B. isoenzyme C. coenzyme D. apoenzyme

D

The American Diabetes Association (ADA) recommends performing routine oral glucose tolerance test: A. on all individuals who are at increased risk for diabetes B. on all children under 5 years old C. on all pregnant patients D. OGTT use is discouraged for routine use

D

The function of the very low density lipoproteins (VLDL) is to transport: A. cholesterol from peripheral cells to the liver B. cholesterol and phospholipids to the peripheral cells C. exogenous triglycerides D. endogenous triglycerides

D

The laboratory test used to determine the presence of neural tube defects is: A. L/S ratio B. amniotic fluid creatinine C. sweat chloride test D. alpha-fetoprotein

D

The most common testing method for vitamin K determination is by: A. protein binding radioimmunoassay (RIA) B. high-performance liquid chromatography (HPLC) C. 3,4-dinitrophenylhydrazine D. not assayed - prothrombin time is used as a functional indicator of vitamin D status

D

What causes polyacrylamide gels to have greater resolution of proteins than agarose gels? A. polysaccharide composition B. electroendosmosis C. transparency D. varying pore size in each polyacrylamide layer

D