Clinical Chemistry Rotational Exam

Select the principle of the tablet test for bilirubin in urine or feces:

Chemical coupling of bilirubin with a diazonium salt to form a purple color

Select the formula that gives the correct expression for creatinine clearance:

Creatinine clearance = U/P x V x 1.73/A

Which of the following would be indicative of partially compensated respiratory acidosis?

Decreased pH, increased PCO2, increased bicarbonate

Hypernatremia is associated with which of the following?

Diabetes insipidus

Which of the following is associated with hypernatremia?

Diabetes insipidus

In evaluating a patient who is exhibiting signs of drug toxicity, what must be considered?

Drug metabolites (e.g., N-acetylprocainamide) may need to be measured as well as the parent drug

Which of the following would likely be positive on a patient with tertiary syphilis?

FTA-ABS

The rapid agglutination test for the detection of rheumatoid factors utilizes:

Fc portion of the IgG molecule

Determine the anion gap given the information below: Na = 134 mmol/L Cl = 92 mmol/L HCO3- = 24 mmol/L

18 mmol/L

Which wavelength would be absorbed strongly by a red-colored solution?

450 nm

Which of the following is the appropriate reference range for fasting blood glucose?

65-99 mg/dL (3.61-5.50 mmol/L)

In absorption spectrophotometry:

Absorbance is directly proportional to concentration

Of the following enzymes, which are used for the diagnosis of acute pancreatitis?

Amylase (AMS) and lipase (LIP)

Which of the following is not a requirement for a quality control (QC) material?

Analyte concentration must be independent of the method of assay

Select the following that is associated with low serum iron levels and high total iron-binding capacity (TIBC):

Anemia associated with pregnancy

Which of the following antibodies would be the first to be detected in patient serum after infection with hepatitis B?

Anti-HBc

A homogenous pattern observed in the indirect fluorescent anti-nuclear antibody test is indicative of:

Antihistone antibodies

Which of the following is correct regarding serum urea?

BUN is elevated in prerenal as well as renal failure

Select the mechanism that is responsible for metabolic acidosis:

Bicarbonate deficiency

Which of the following happens when iron is in the oxidized (Fe3+) state?

Binding to transferrin and incorporation into ferritin

What is the elution order of volatiles in gas chromatography based on?

Boiling point

Which of the following tumor markers is used to measure the recurrence of breast cancer?

CA-15-3

Which of the following will peak first after an acute myocardial infarction?

CK

Specimen hemolysis would have the least effect on:

Calcium

Which of the following would cause erroneous oral glucose tolerance test (OGTT) results on a patient?

Carbohydrate intake is restricted to below 150 g/day for 3 days prior to the test

Of the following, which is the most common cause of Cushing's syndrome?

Overuse of cortiocsterioids

Which of the following accurately states the effect on a normal arterial blood sample after exposure to room air?

PO2 increased, PCO2 decreased, pH increased

Which enzyme deficiency causes phenylketonuria (PKU)?

Phenylalanine hydroxylase

A 47-year-old female's clinical symptoms include hair loss, fatigue, and heat intolerance. Her lab results showed abnormally low total T4 and free T4, along with a significantly elevated TSH. This is indicative of:

Primary hypothyroidsim

Glycated (glycosylated) hemoglobin:

Reflects the extent of glucose regulation in the 8 to 12-week interval prior to sampling

Which of the following is characteristic of type 1 diabetes mellitus?

Requires insulin replacement to prevent ketosis

What would be the result of a prolonged color reaction phase in one tube or well of an enzyme-linked immunosorbent assay (ELISA) test?

Result would be falsely increased

The Jaffe method for creatinine measurement uses which of the following reagent(s)?

Saturated picric acid and NaOH

Urea is produced from:

The catabolism of proteins and amino acids

What is the primary mechanism of compensation for metabolic acidosis?

Hyperventilation

Which of the following is the primary mechanism causing respiratory alkalosis?

Hyperventilation

Which of the following would most likely be true of patients with B cell deficiencies?

Increased bacterial infections

Which of the following is not a function of immunoglobulins?

Interacting with cytoxic T cells to lyse viruses

Which of the following is correct about glucose in cerebrospinal fluid?

Levels below 40 mg/dL occur in septic meningitis, multiple sclerosis, and cancer

Select the plot that is best for detecting all types of quality control errors:

Levy Jennings

Which of the following does not contribute to the osmolality of plasma?

Lipids

Elevated levels of protein are most commonly associated with which of the following?

Malignancy

Consider the following blood gas results: pH = 7.55 PCO2 = 55 mm Hg HCO3 = 40 mmol/L These results indicate:

Metabolic alkalosis

A patient has an antibody test for HIV performed and the result comes back negative. A week later, the physician has a PCR test for HIV performed on the same patient, which comes back positive. Which of the following provides the best explanation for the results?

The patient is in the "window phase" prior to antibody production

Which of the following is a characteristic of obstructive jaundice?

The ratio of direct to total bilirubin is greater than 1:2

A patient who does not fast prior to having a lipid profile performed would have a falsely elevated:

Triglyceride

Select the biochemical process that is promoted by insulin:

Uptake of glucose by cells

In the liver, bilirubin is converted to:

bilirubin diglucuronide

Kernicterus is an abnormal accumulation of bilirubin in the:

brain tissue

Confirmation testing on a sample for drugs of abuse would utilize which of the following methods?

Gas chromatography with mass spectroscopy (GC-MS)

Which of the following statements regarding creatinine is correct?

High serum levels result from reduced glomerular filtration rates

Secondary immune response results in high titers of which of the following?

IgG

Which is the first immunoglobulin to appear in primary immune response to an antigen?

IgM

Which of the following would be best for the identification of Bence Jones protein?

Immunofixation