Clinical Lab - MCQs

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When in healthy individuals there is a higher activity of MM-CK: a) children b) physical activity c) postprandial d) after alcohol consumption

b) physical activity

Which of the following laboratory parameters has better diagnostic reliability in evaluation of renal function: a) urea b) uric acid c) creatinine d) total protein

c) creatinine

Hemolytic anemia is caused by a deficiency of iron in the blood a) true b) not true

b) not true

In hypertonic dehydration the values of NA and MCV must be as follows: a) increased Na, decreased MCV b) decreased Na, increased MCV c) decreased Na, decreased MCV d) increased Na, increased MCV

a) increased Na, decreased MCV

For chronic granulocytic leukemia, differential count resembles: a) thrombellogram b) myelogram c) densitogram d) ionogram

b) myelogram

A 4 year old girl is brought to the ER due to fever. Lab data: WBC 5.2 g/l, Hgb 120g/L, PLT 200g/L; differential results: 58 segs-25 bands-10 lymphs-7 monos. > 1Which of the following best describes her results a) left shift b) anemia c) hiatus leukemicus d) leukoerythroblastic reaction > 2 The results are indicative off A) viral infection B) acute lymphocytic leukemia C) bacterial infection D) normal findings

> 1 d) leukoerythroblastic reaction > 2 c) bacterial infection

C-peptide is a laboratory marker for: a) insulin secretion b) tumor marker c) hormone regulating calcium homeostasis d) diabetes insipidus

a) insulin secretion

In hepatocytolysis the activity of ASAT and ALAT increases: a) 10 times or more above the upper reference limit b) between 100 and 200 times above the upper reference limit c) up to 2 times above the upper reference limit d) remains unchanged

a) 10 times or more above the upper reference limit

Indicate the reference limits of serum Na+ concentration in adults: a) 135 - 155 mmol/l b) 96-110 mmol/l c) 96-110 µmol/l d) 135 - 155 µmol/l

a) 135 - 155 mmol/l

Indicate the reference limits for fasting blood sugar levels in adults: a) 2.8 - 6.1 mmol/L b) 2.5 - 6.0 nmol/L c) 2.8 - 7.8 mmol/L d) 2.8 - 6.1 nmol/L

a) 2.8 - 6.1 mmol/L (mili not nano!)

Fructosamine is used as a test for blood glucose concentration for past period of: a) 20 days b) 8-10 weeks c) 1 week d) 6 months

a) 20 days

The reference limits of serum K + in adults are: a) 3.5 - 5.6 mmol/ l b) 0.77 - 1.36 mmol/ l c) 2.12 - 2.62 mmol/ l d) 3.5-5.6 μmol/ l

a) 3.5 - 5.6 mmol/ l

How many grams of glucose dissolved in water should the patient take for OGTT: a) 75 g b) 50 g c) 100 g d) 65 g

a) 75 g

Which of the following values of Haemoglobin are in the pathological range for men: a) < 140 g/l b) 140-180 g/l c) > 120 g/l d) 130 - 160 g/l

a) < 140 g/l

Which of the following values of the blood glucose are in the normal range in the postprandial test: a) < 7.7 mmol/l b) 7.78 - 9-99 mmol/l c) > 10.00 mmol/l d) 2.78 - 5.55 mmol/l

a) < 7.7 mmol/l

Proteinuria is estimated by measurement of: a) > 150 mg/24h in diuresis b) 100 mg/24h in diuresis c) < 130 mg/24h in diuresis d) 50 mg/24h in diuresis

a) > 150 mg/24h in diuresis

Which protein level confirms proteinuria : a) > 150 mg/24h in diuresis b) 100 mg/24h in diuresis c) < 130 mg/24h in diuresis d) 50 mg/24h in diuresis

a) > 150 mg/24h in diuresis

Which enzymes are markers for cholestasis: a) ALP and GGT b) CHE and amylase c) lipase and amylase d) ALP and ACP

a) ALP and GGT

Which of the following laboratory constellations confirms cholestasis: a) ALP, GGT b) LDH, ALP c) Cholinesterase, GGT d) AST, ALT

a) ALP, GGT (Varying degrees of jaundice and elevations of cholestatic enzymes (including ALP, GGT, and direct bilirubin) are seen in conditions that cause conjugated hyperbilirubinemia due to cholestasis.)

Which test can be used for control and treatment with direct anticoagulants (heparin) a) APTT b) Fibrinogen c) PLT d) PT

a) APTT (activated Partial Thromboplastin Time)

Acute hepatocytolysis causes increased activity more than 10 times of: a) ASAT and ALAT b) ALP and ACP c) ALP and GGT d) LDH and ACP

a) ASAT and ALAT

In which of the answers are only cellular enzymes listed: a) AST, ALT, Creatinkinase b) Cholinesterase, ALP, amylase c) GGT, AST, Amylase d) LDH, ALT, Cholinesterase

a) AST, ALT, Creatinkinase

What are the two main types of thalassemia? a) Alpha and Beta Thalassemia b) Alpha and Delta Thalassemia c) Beta and Delta Thalassemia d) Gamma and Delta Thalassemia

a) Alpha and Beta Thalassemia

Which of the following laboratory parameters is used as a tumor marker: a) Alpha fetoprotein b) TSH c) ASAT d) Alkaline phosphatase

a) Alpha fetoprotein

Which screening test is used for evaluation of the platelet and the vascular phase of hemostasis ? a) Bleeding time b) aPTT c) PT d) Thrombin time

a) Bleeding time

Which laboratory tests are indicated in Iron deficiency anemia: a) CBC, morphology of erythrocytes, serum iron, ferritin, TIBC b) CBC, morphology of erythrocytes, serum iron, ferritin, Vit B12 c) CBC, morphology of erythrocytes, serum iron, folate, TIBC d) CBC, morphology of erythrocytes, serum iron, haptoglobin, TIBC

a) CBC, morphology of erythrocytes, serum iron, ferritin, TIBC

Which enzymatic test is the earliest indicator of myocardial infarction: a) CK-MB b) CK c) HBDH d) AST

a) CK-MB (enzymatic: CK MB Laboratory: Troponin I)

Sensitive marker for evaluation glomerular filtration is: a) Cystatin C b) Beta -2- microglobulin c) Urea d) Retinol-binding protein

a) Cystatin C

Anuria means: a) Diuresis <100 ml/ 24h b) Diuresis in the range 500 - 100 ml/ 24h c) Painful urination d) Diuresis exceeding 2000 ml/ 24h

a) Diuresis <100 ml/ 24h

What is the reference method for analysing total iron in serum? a) Flame Atomic Absorption Spectrometry b) ISE c) Colorimetric photometric method

a) Flame Atomic Absorption Spectrometry (suitable for measurement of a limited range of elements present at concentrations greater than approximately 1 μg ml−1 in biological fluids)

Which of the following parameters will differentiate dehydration from hyperhydration: a) Hematocrit b) Platelets c) Potassium d) Creatinine

a) Hematocrit

The main laboratory parameters for assessment of water-electrolyte balance are: a) Hematocrit, MCV, Na+, Total Protein, Osmolality b) Hematocrit, RBC, Na+, Osmolality c) Hematocrit, Urea, Osmolarity, Albumin d) Hematocrit, MCV, Na+, Total Protein, Glucose

a) Hematocrit, MCV, Na+, Total Protein, Osmolality

The basic laboratory parameters for body water balance assessment include: a) Hematocrit, MCV, Na+; Total protein, Albumin b) Erythrocyte count, glucose, Na+, albumin c) Albumin, hematocrit, urea, creatinine d) Erythrocyte count, Na+, glucose, cholesterol

a) Hematocrit, MCV, Na+; Total protein, Albumin (My guess)

The increased plasma D-Dimer concentration is a marker for: a) intravascular fibrinolysis b) intravascular hemolysis c) fibrinogen deficiency d) thrombin deficiency

a) intravascular fibrinolysis

laboratory tests for hemolytic anemia include: a) Hemoglobin electrophoreses, cytochemical test for HbS b) Hemoglobin concentration, immunoelectrophoresis, c) Cytochemical tests for blast cells, transferrin d) Morphology of cells in the bone marrow

a) Hemoglobin electrophoreses, cytochemical test for HbS

Iron deficiency anemia is characterized with: a) Hypochromia b) normochromic c) hyperchromia d) macrocytosis

a) Hypochromia

Jaundice is also known as: a) Icterus b) Hemophilia c) Anemia d) Hypercholesterolemia

a) Icterus

In the serum of the newborn there are: a) IgA, IgM, IgG b) IgM, IgG c) IgA, IgM d) IgA, IgG

a) IgA, IgM, IgG (only IgG crosses placenta, IgM first synthesized by newborns, IgA passes from mother to baby if it is breast fed and IgA also develops early in life (found in breast milk))

Which of the enzymes is used as a tumor marker: a) LDH b) AST c) ALT d) CHE

a) LDH

Which of the following laboratory features is typical for chronic myeloid leukemia: a) Left shift to Myeloblast b) increased D-dimers c) Leucopenia d) absolute lymphocytosis

a) Left shift to Myeloblast

Typical laboratory features in DBC (differential blood count) for chronic myeloid leukemia is: a) Left shift up to myelocyte b) Leukocytosis c) Neutropenia d) Absolute Lymphocytosis

a) Left shift up to myelocyte

A 28 year old woman came to the ER complaining of upper abdominal pain, nausea, fever, and difficult breath. She presented with increase heart beat rate. Which biochemical tests combination will order to make a DD between pancreatitis and myocardial infarction: a) Lipase, Amylase, CK, CK-MB, AST, Troponin I b) K, Na, CI, Lipase, ALP, CK, Uric Acid c) Ca, Ca++, Troponin I, Urea, Creatinine, Amylase d) CK, CK-MB, AST, ALT, LDH, ALP

a) Lipase, Amylase, CK, CK-MB, AST, Troponin I (Lipase,amylase and AST is for pancreatis, CK, CK-MB and Troponin I is for myocardial infraction)

The densitometry narrow-based peak is called: a) M-protein b) M-gradient c) Paraprotein d) All are correct

a) M-protein

What is the meaning of the term "paraproteinemia" a) Monoclonal gammopathy b) Polyclonal gammopathy c) Positive free hemoglobin in serum d) Monoclonal or polyclonal gammopathy

a) Monoclonal gammopathy

Laboratory markers for activating blood clotting are: a) PF 1+2, TAT b) fibrinogen c) platelet count d) PrC/S, ATIII

a) PF 1+2, TAT (Thrombin-antithrombin-complex)

Point out the wrong statement: a) PSA is never elevated in benign prostate adenoma b) PSA may increase immediately after prostate resection c) PSA is a tumor marker for recurrence of prostate cancer d) PSA is a specific tumor marker for prostate tumor malignancy

a) PSA is never elevated in benign prostate adenoma (Prostate specific antigen)

Which of the following screening tests shows the disturbance in extrinsic pathway of the first phase of coagulation: a) PT b) APTT c) TT d) Fibrinogen

a) PT (Prothrombin time)

Case No C - A 6-year-old boy had a 2 to 3 weeks history of fever at night and cervical adenopathy. Physical exam showed ageneralized lymphadenopathy. His lab data are: WBC 20.7 G/L; Hgb 109 g/L; PLT 123 G/L. Diff count results: 1 segs, -17 lymphs, -1 monos, -81 blasts. The bone marrow obtained on the patient in Case No Cwas hypercellular with 80% blasts that were fairly small and homogeneous. His blasts were peroxidase/SBB negative and PAS positive. Immunophenotyping showed positivity for CD10, CD19/20, and CD34; cells were negative for CD2/3; CALLA positive. These results are most consistent with: a) Precursor-B ALL, CALLA type b) T cell ALL

a) Precursor-B ALL, CALLA type

Laboratory tests with highest diagnostic reliability in hyperthyroidism are: a) TSH, FT4 b) FSH, LH c) TSH, LH d) FSH, FT4

a) TSH, FT4 (functional T4)

Which laboratory parameters include the basic lipid profile? a) Total Cholesterol, Triglicerides, HDL Cholesterol, LDL Cholesterol b) Apolipoprotein A and Total Cholesterol c) HDL Cholesterol, LDL Cholesterol d) Total Protein and Albumin

a) Total Cholesterol, Triglicerides, HDL Cholesterol, LDL Cholesterol

Autoantibodies against pancreatic islet cells (ICA) are laboratory markers for: a) Type 1 diabetes mellitus b) Type 2 diabetes mellitus c) Gestational diabetes d) Diabetes insipidus

a) Type 1 diabetes mellitus

What is the correct sequence of events leading to blood clotting: a) Vasoconstriction, platelet aggregation, coagulation b) Platelet aggregation, vasoconstriction, coagulation c) Vasoconstriction, coagulation, platelet aggregation d) Vasoconstriction, fibrinolysis, platelet aggregation

a) Vasoconstriction, platelet aggregation, coagulation

Which vitamin deficiency predisposes to haemorrhagic diathesis: a) Vit K b) Vit C c) Vit B12 d) Vit D

a) Vit K

In monoclonal gammopathy is observed: a) a sharp peak in the field of gamma globulins (M-gradient) b) overproduction of all classes of immunoglobulins c) in hypoproteinemia d) none of the above

a) a sharp peak in the field of gamma globulins (M-gradient) (probably)

Myoglobin as a lab marker for: a) acute myocardial infarction b) hepatitis c) malignancies d) control of the anticoagulant therapy

a) acute myocardial infarction (An iron- and oxygen-binding protein found in muscle tissue. Presence in the blood or urine can indicate muscle injury (e.g., in rhabdomyolysis or infarction). High concentrations can cause acute kidney injury.)

Which of the following hormones take part in the group of insulin antagonists: a) adrenaline b) progesterone c) aldosterone d) parathormone

a) adrenaline

A person with eosinophilia is most likely suffering from: a) allergies or parasitic infection b) anaemia c) an autoimmune disease d) diabetes

a) allergies or parasitic infection

Which is the biologically active form of Calcium in the blood circulation: a) ionized Ca b) protein bind Ca c) ionized and protein bind Ca d) Ceruloplasmin and Ca

a) ionized Ca

The largest cells in the blood that leave the bloodstream to become macrophages are the: a) eosinophils b) monocytes c) basophils d) neutrophils

b) monocytes

Which lab test might be ordered if suspected acute pancreatitis: a) Amylase b) Cholinesterase c) Gamma glutamyl transpherase d) Alkaline phosphatase

a) amylase (The best test for diagnosis of acute pancreatitis is lipase. If lipase is >3x the upper limit of normal, it is highly likely that the patient has acute pancreatitis. Amylase should not be ordered. Although amylase was the original preferred test for acute pancreatitis and is still widely used, it is less sensitive and specific than lipase and provides no additional clinical information.)

Coagulation factors that obstruct the clot lyses are: a) anti-fibrinolytic b) profibrinolytics c) procoagulants d) anticoagulants

a) anti-fibrinolytic

Calculating the ratio between urine and serum osmolality is useful for: a) assessment of homeostasis function of the kidneys b) assessment of cellular and humoral immunity c) assessment of hematuria d) quantitative assessment of urine sediment

a) assessment of homeostasis function of the kidneys

C-peptide is a laboratory marker for: a) assessment of the insulin secretion in type I diabetes b) tumor marker c) hormone regulating calcium homeostasis d) diabetes insipidus

a) assessment of the insulin secretion in type I diabetes

In which values of glucose-tolerance test is not disturbed: a) at fasting, at 60 minutes, at 120 minutes are in reference range b) at fasting is in the reference rage, at 60 minutes in pathological range, at 120 minutes in boundary range c) at 60 minutes and at 120 minutes > 11.1 mmol/l d) at 60 minutes < 8.9 mmol/l , at 120 minutes < 7.7 mmol/l

a) at fasting, at 60 minutes, at 120 minutes are in reference range

One of the main functions of calcium is: a) blood coagulation b) important constituent of nucleic acids, phospholipids, ATP, NADP c) responsibility of bringing oxygen from lungs to cells d) regulation of potassium movement through the myocardial cells

a) blood coagulation

GGT is located in: a) cell membrane b) cytoplasm c) mitochondrium d) cytoplasm and mitochondrium

a) cell membrane (Gamma gltuamyl transferease)

Hemostasis is: a) complicated, dynamic, self-regulating system b) a process of coagulation c) contraction of blood vessels with injury d) a complex of processes which make possible lysis of the clot

a) complicated, dynamic, self-regulating system

What do you expect to be the levels of iron and FIBC (free iron binding capacity) in iron deficiency anaemia? a) decreased iron, increased FIBC b) decreased iron, decreased FIBC c) increased iron, decreased FIBC d) increased iron, increased FIBC

a) decreased iron, increased FIBC

What is non-selective proteinuria: a) detection of high molecular weight proteins in the urine b) presence of Bence-Jones protein in the urine c) detection of low molecular weight proteins in the urine d) presence of lipids in the urine

a) detection of high molecular weight proteins in the urine

Which serum bilirubin fractions are elevated in cholestasis: a) direct bilirubin and total bilirubin b) indirect bilirubin and total bilirubin c) direct bilirubin and urobilinogen d) total bilirubin and urobilinogen

a) direct bilirubin and total bilirubin

How do erythrocyte indices (MCV, MCH) change in macrocytic hyperchromic anaemias (megaloblastic anaemia): a) elevated b) reduced c) normal

a) elevated

How do erythrocyte indices MCV, MCH, MCHC change in macrocytic hyperchromic anemias: a) elevated all b) decreased all c) do not change d) only MCV is decreased

a) elevated all

The plasma coagulation factors involved in intrinsic pathway are: a) factors XII, XI, IX, VIII b) factors III, VII c) factors V, X, I, II, XIII d) none of the above is correct

a) factors XII, XI, IX, VIII

The specimen required for the qualitative urinanalysis is: a) first or second mid-stream morning urine portion, after toilet b) diuresis urine c) urine collected with catheter d) all are correct

a) first or second mid-stream morning urine portion, after toilet

Elevated serum uric acid concentration occurs in: a) gout b) xanthinuria c) reduced protein intake d) overdose of uricosuric drugs

a) gout

Which lab parameter is not included in the main panel of the DIC: a) haemoglobin b) platelet count c) fibrinogen d) aPTT

a) haemoglobin (disseminated intravascular coagulation. A condition characterized by systemic activation of the clotting cascade, platelet consumption, and subsequent exhaustion of clotting factors that leads to widespread thrombosis and hemorrhage.)

Direct hyperbilirubinemia is present in the following cases of jaundice, except of: a) hemolysis b) obstruction of the bile ducts c) drug-induced liver damage d) acute hepatocytolysis

a) hemolysis (indirect)

Which statement is not valid for DIC: a) hereditary disease b) characterized by diffuse intravascular thrombosis and secondary hemorrhagic diathesis c) can lead to multiple organ failure d) takes place in three phases

a) hereditary disease (DIC: S - Sepsis/Snakebites, T - Trauma (acute traumatic coagulopathy), O - Obstetric complications, P - Pancreatitis, M - Malignancy, T - Transfusion.)- acquired)

The clinical reliability of laboratory results requires: a) high clinical and analytical reliability b) variety of factors influencing the final value c) correct interpretation of laboratory parameters d) specific requirements for laboratory analysis

a) high clinical and analytical reliability

Sodium is increased and MCV is decreased at: a) hypertonic dehydration b) hypotonic dehydration c) isotonic dehydration d) hypotonic hyperhydratio

a) hypertonic dehydration

Magnesium deficiency may cause: a) hypocalcaemia and hypokalemia b) hyperthyroidism c) hypernatremia d) hyperosmolali

a) hypocalcaemia and hypokalemia

Flow cytometric analysis allows: a) immunophenotyping of leukemic blasts b) cytochemical analysis of cellular constituents c) evaluation of erythrocytes by volume d) evaluation of the synthesis of hemoglobin polypeptide chains

a) immunophenotyping of leukemic blasts

In which organs there is glycogen synthesis: a) central nervous system b) muscles c) erythrocytes d) pancreas

b) muscles

The reliable laboratory result: a) is a real evaluation of the actual value of the examined parameters in biological fluids and tissues and it presents useful information b) depend on the proper and timely collection c) is a function of a variety of factors d) is helpful for correct interpretation of laboratory parameters

a) is a real evaluation of the actual value of the examined parameters in biological fluids and tissues and it presents useful information

Hyperphosphatemia may be the result of: a) kidney failure b) rickets c) primary hyperparathyroidism d) malabsorption

a) kidney failure (A serum phosphate concentration > 4.5 mg/dL. Etiologies include hypoparathyroidism and chronic kidney disease. Associated with nephrolithiasis, metastatic calcifications, and hypocalcemia.)

The level of glycated haemoglobin for good control of diabetes is: a) lower than 7 % b) > 6.5 % c) lower than 6 % d) 6.0-6.5 %

a) lower than 7 %

DLC in chronic lymphocytic leukaemia is characterized by: a) lymphocytosis and the presence of Gumprecht shadows (smudge cells) b) neutrophilia and left shift c) left shift with eosinophilia and basophilia d) lymphocytosis and anisochromia

a) lymphocytosis and the presence of Gumprecht shadows (smudge cells) (Differential leukocyte count)

Typical morphological feature of pernicious anemia are: a) megalocytes b) microcytes c) microspherocytes d) echinocytes

a) megalocytes

Iron deficiency anemia is characterized with: a) microcytosis b) macrocytosis c) microspherocytosis d) megalocytosis

a) microcytosis

Bence-Jones proteinuria is observed in cases of: a) monoclonal gammopathy b) pyelonephritis c) glomerulonephritis d) nephrotic syndrome

a) monoclonal gammopathy (Bence-Jones protein can also be in your urine if you have monoclonal gammopathy of undetermined significance (MGUS). With this condition, your plasma cells make more of one kind of antibody than they should. But they don't form a tumor or make enough antibodies to do damage. MGUS doesn't generally need treatment.) (- Polypeptide consisting of one or two immunoglobulin light chains. Its detection in urine is suggestive of plasma cell disorders such as multiple myeloma or Waldenstrom's macroglobulinemia.)

Aspartate aminotransferase is a lab parameter for: a) muscle damage b) kidney disorders c) pregnancy d) rickets

a) muscle damage

Extended laboratory tests for hemolytic anemia include: a) osmotic resistance of erythrocytes, haptoglobin, bilirubin b) immunoelectrophoresis, ceruloplasmin, ferritin c) transferrin, ferritin, total protein d) morphology of cells in the bone marrow

a) osmotic resistance of erythrocytes, haptoglobin, bilirubin (Osmotic fragility test used to measure erythrocyte resistance to hemolysis) (Haptoglobin is primarily produced in the liver and is functionally important for binding free hemoglobin from lysed red cells in vivo, preventing its toxic effects. Because haptoglobin levels become depleted in the presence of large amounts of free hemoglobin, decreased haptoglobin is a marker of hemolysis.)

The enzyme Amylase is produced by: a) pancreas b) liver c) lien d) blood marrow

a) pancreas

Acute leukemias are characterized by. a) rapid and clonal proliferation in the bone marrow of lymphoid or myeloid progenitor cells b) slow and clonal proliferation with maturation of lymphoid or myeloid cells c) rapid and clonal proliferation: in the bone marrow of megaloblast d) slow and clonal proliferation with maturation of megakaryoblasts

a) rapid and clonal proliferation in the bone marrow of lymphoid or myeloid progenitor cells

Hyponatremia occurs in: a) renal retention of water and Na +, the water retention exceeding that of Na + b) renal loss of water and Na+, with water loss exceeding that of Na+ c) increased intake of Na + d) all are true

a) renal retention of water and Na +, the water retention exceeding that of Na + (In hyponatremia, one or more factors — ranging from an underlying medical condition to drinking too much water — cause the sodium in your body to become diluted.)

Which forms are possible to be found in peripheral blood smear: a) reticulocytes and erys. b) basophilic erythroblasts and erys. c) polychromatophilic erbls. and erys. d) basophilic erythroblasts and ret.

a) reticulocytes and erys.

What are the options to report the results of the prothrombin time (PT) test? a) sec, %, INR b) min, %, INR c) sec, g/L, INR d) sec, mmol/L, INR

a) sec, %, INR

Differential Blood Count contains information about following white blood cell types: a) segmented Neutrophils, Monocytes, Lymphocytes, Eosinophils, Plasmocytes, Basophils b) segmented Neutrophils, Monocytes, Erys. c) Neutrophils, Monocytes, Lymphocytes, Eosinophils d) Lymphocytes, Eosinophils, Plasmocytes, Basophils, Erys., etc.

a) segmented Neutrophils, Monocytes, Lymphocytes, Eosinophils, Plasmocytes, Basophils

Quantitative determination of total calcium, total phosphate and total magnesium is performed in: a) serum and diuresis (D24) b) serum and random urine c) citrated plasma and diuresis (D24) d) citrated plasma and random urine

a) serum and diuresis (D24)

Which of the following is a contraindication for conducting OGTT: a) serum glucose concentration two hours after feeding above 11.0 mmol / l b) borderline elevated fasting glucose levels c) evaluation of patients with unexplained retinopathy, nephropathy, neuropathy d) diagnosis of gestational diabetes

a) serum glucose concentration two hours after feeding above 11.0 mmol / l (but some say c.... i think both are theoretically correct... )

Which are the biological factors with permanent activity of the variation of the results: a) sex, race b) age c) body construction d) stress

a) sex, race might be b) - depending how you understand the question.... From class: factors affecting reliability of lab results preanalytically 1) pathological 2) permanent (sex, race, genetics) long acting (age, physical activity, pregnancy, way of living) short acting (circardian, menstrual cycle, food intake, stress, smoking...) (so seems a is what they want to hear but b makes more sense in my understanding of the question)

The differential blood count (DBC) provides information on: a) the distribution of WBC in %/ absolute number in peripheral blood b) maturation forms of RBC in %/ absolute number in peripheral blood c) the morphology of RBC in peripheral blood d) the distribution of WBC, RBC, PLT in %/ absolute number in peripheral blood

a) the distribution of WBC in %/ absolute number in peripheral blood

The serum is: a) the liquid phase of blood taken without anticoagulant and does not include fibrinogen b) the liquid phase of blood taken with an anticoagulant and does not include fibrinogen c) the liquid phase of blood taken without anticoagulant and includes fibrinogen d) the liquid phase of blood taken with an anticoagulant and includes fibrinogen

a) the liquid phase of blood taken without anticoagulant and does not include fibrinogen

Cholinesterase activity measurement provides information on: a) the synthetic function of the liver b) bilirubin metabolism c) excretory function of the liver d) detoxification function of the liver

a) the synthetic function of the liver (Serum cholinesterase (ChE) is an enzyme synthesised by hepatocytes and its serum levels reflect the synthetic function of liver.) ( but I also read somewhere that butyrylcholinesterase plays a role in the detoxifying function of the liver)

Which parameter has the highest diagnostic value in hyperthyroidism: a) thyroid-stimulating hormone b) follicle-stimulating hormone c) parathyroid hormone d) thyrotropin releasing hormone

a) thyroid-stimulating hormone

Creatine kinase (CK) is: a) transferase b) kinase c) oxydoreductase d) hydrolase

a) transferase

Main transport protein of iron in human plasma is: a) transferrin b) ceruloplasmin c) apoprotein d) albumin

a) transferrin

Hypokalemia occurs in: a) treatment with insulin b) hemolysis c) massive burns d) transfusion of expired blood

a) treatment with insulin (Insulin therapy lowers K+ concentration driving K+ into cells (both directly and indirectly by reversing hyperglycemia). Therefore, insulin therapy may cause severe hypokalemia, particularly in patients with a normal or low serum K+ concentration at presentation)

Thrombocytopenia or an increased tendency to bleed is a common consequence of acute leukaemia: a) true b) false

a) true

The osmolarity is calculated on the basis of the concentration of the following analytes: a) urea, glucose and sodium b) glucose, sodium and potassium c) chloride, sodium and potassium d) urea, creatinine and sodium

a) urea, glucose and sodium

The hemoglobin reference limits for women are: a) 120 - 180 g/l b) 120 - 160 g/l c) 120 - 140 g/l d) 140 - 180 g/l

b) 120 - 160 g/l (roughly puberty in females 12-16 (earlier than male, but overlap))

The glycated hemoglobin (HbA1c) is used as a test for blood glucose concentration for past period of: a) 20 day b) 8-10 weeks c) 1 week d) 6 months

b) 8-10 weeks

Fructosamine reference values are: a) < 8.2 % or < 10% b) < 350 mmol/l c) > 350 mmol/l d) > 400 mmol/l

b) < 350 mmol/l

Which of the following enzymes has the highest activity in the liver: a) AST b) ALT c) Amylase d) LDH

b) ALT (alanine amino transferase) (not 100% sure, but ALT is predominantly found in the liver and in almost all liver diseases (except alcoholic liver diseases & advanced fibrosis) ALT is higher than AST)

Which test is used for assessment of the final key phase of coagulation: a) Thrombin time b) APTT c) Hemoglobin d) Bleeding time

b) APTT

A 78-year-old woman with a history of hypertension and hypothyroidism presented with thrombocytopenia with a platelet count of 60x 10^9/l, as well as a hemoglobin of 102 g/I and WBC 4,3x10^9/l. Moderate splenomegaly was noted on physical examination. She underwent a bone marrow biopsy that demonstrated a population of blast cells with the following immunophenotype on flow cytometry: CD19+, CD20+, surface IgM+, CD23-, CD5-, CD10-, CD11c-, and CD103-, a) Chronic lymphocytic leukemia b) Acute lymphocytic leukemia B-type c) Acute lymphocytic leukemia T-type d) Diffuse large B-cell lymphoma

b) Acute lymphocytic leukemia B-type (I don't know how to differentiate B from T tho... let me know if you do please)

The main hormone regulating the amount of body water is: a) Parathyroid hormone b) Anti-diuretic hormone c) Thyroid hormones d) Insulin

b) Anti-diuretic hormone

Phosphor organic compounds specifically inhibit: a) ALP b) CHE c) Amylase d) CK

b) CHE (cholinesterase) (The organic phosphorous compounds (OPC) include both the military grade nerve agents and the organic phosphorous pesticides. The major mechanism of OPC toxicity is through inhibition of acetylcholinesterase in neuronal synapses leading to excess acetylcholine and overstimulation of target organ)

Which class of lipoproteins transports exogenous triglycerides: a) VLDL b) Chylomicrons c) HDL d) LDL

b) Chylomicrons

The final phase of blood clotting includes: a) Formation of prothrombin b) Formation of fibrin c) Activation of factor X d) Formation of thrombin

b) Formation of fibrin

Which laboratory indicators help to distinguish absolute from relative pathoproteinemia? a) HGB, RBC, ESR b) HGB, WBC, HCT X c) HGB, PLT, HCT d) HGB, RBC, HCT

b) HGB, WBC, HCT X (so.... seems like relative is due to Hyper/De-hydration and HCT changes, but in absolute HCT mostly in reference range. And Absolute also in case of inflammation or infection where WBC are higher.... so I think this one is the most fitting.... let me know if you know that I am wrong and why)

Which of the following does not belong to the basic laboratory tests for Iron deficiency anemia: a) CBC b) Haptoglobin c) Morphology of erythrocytes d) Reticulocytes

b) Haptoglobin (in haemolytic anaemia)

In serum during the infection process the immunoglobulins increase in sequences as follows: a) IgA, IgM, IgG b) IgM, IgA, IgG c) IgG, IgA, IgM d) IgA, IgG, IgM

b) IgM, IgA, IgG (for germans: Ich M.A.G das)

Which of the following criteria are valid when to reject a specimen as unacceptable for testing? a) Proper patient identification, storage and transport of samples to the laboratory b) Improper collection tube used, hemolyzed, lipemic or icteric sample, blood clotted with anticoagulant, sample improperly transported c) Carefully and strictly filled in examination form d) Strict observation of procedures of venous puncture, urine collection and collection of other biological samples

b) Improper collection tube used, hemolyzed, lipemic or icteric sample, blood clotted with anticoagulant, sample improperly transported

The expected laboratory constellation in isotonic dehydration is: a) Decreased MCV, osmolality in the reference range, increased total protein and hematocrit b) MCV and osmolality in the reference range, increased total protein, increased hematocrit c) MCV in the reference range, high osmolality, increased total protein and hematocrit d) MCV and osmolality

b) MCV and osmolality in the reference range, increased total protein, increased hematocrit (relative hyperproteinemia and haemoglobin elevation, not absolut )

Main morphological substrate of acute Leukaemias are: a) the youngest maturation forms of granulopoesis b) Parablasts/Paraleukoblasts c) Plasmocytes d) Basophils

b) Parablasts/Paraleukoblasts

Which chromosomal abnormality occurs in CML: a) Auer body b) Philadelphia (Ph) chromosome c) Trisomy of chromosome 21 d) Deletion of the short arm of chromosome 13

b) Philadelphia (Ph) chromosome

Indicate the correct medical decision limits regarding the glycated hemoglobin test a) Reference limits: 4-6%; Therapeutic control of diabetes mellitus:> 7% b) Reference limits: 4-6%; Therapeutic control of diabetes mellitus: < 7% c) Reference limits: 4-9%; Therapeutic control of diabetes mellitus: > 7% d) Reference limits: 4-6%; Therapeutic control of diabetes mellitus: <10%

b) Reference limits: 4-6%; Therapeutic control of diabetes mellitus: < 7%

Which of the following individual proteins is negative reactant of the acute phase: a) Fibrinogen b) Transferrin c) C-reactive protein d) Alfa-1 Antitrypsin

b) Transferrin

Elevated serum ALP activity typical by: a) heavy physical activity b) adolescents and pregnant women c) intake of carbohydrate-rich foods d) dehydration

b) adolescents and pregnant women

Main morphological substrate of acute leukaemias are: a) the youngest maturation forms of granulopoesis b) atypical blast cells (parablasts) c) Plasmoblasts d) Basophils

b) atypical blast cells (parablasts)

Which laboratory parameters would you test for if haemolytic anemia is suspected: a) Iron and TIBC b) bilirubin and haemoglobin electrophoresis c) Alkaline phosphatase and myeloperoxidase d) Vitamin B12 and folate

b) bilirubin and haemoglobin electrophoresis

Which of the following changes is not characteristic for the nephrotic syndrome? a) proteinuria above 5 g/ 24h b) bilirubinuria c) peripheral edema d) hypoalbuminemia

b) bilirubinuria

Laboratory tests for continuous blood glucose monitoring include: a) urinary sugar profile test b) blood sugar profile test c) postprandial test d) oral glucose tolerance tes

b) blood sugar profile test (A1C test)

Megaloblastic anemias are characterized by: a) bone marrow with erythroblastic microforms b) bone marrow with erythroblastic hyperplasia c) bone marrow with hypochromic erythroblasts d) there are no characteristic changes in the bone marrow

b) bone marrow with erythroblastic hyperplasia (An increase in the number of cells in an organ or tissue)

The diagnostic sensitivity of Creatinine can be increased: a) with multiple testing b) by conducting a Creatinine clearance c) with measurement in CSF d) with measurement in random urine

b) by conducting a Creatinine clearance

Smudge cells (Gumprecht shadows) in a peripheral blood smear are specific for: a) chronic myelogenous leukemia b) chronic lymphocytic leukemia c) acute lymphoblastic leukemia d) erythroleukemia

b) chronic lymphocytic leukemia (Smudge cells, also known as Gumprecht shadows, are not simple artifacts of slide preparation, but ragged lymphoid cells found mainly in peripheral blood smears from human patients with chronic lymphocytic leukemia.)

Blood with sodium citrate is used for the investigation of: a) clinical - chemistry parameters b) coagulation parameters c) haematological parameters d) heavy metals

b) coagulation parameters

The main indication for the evaluation of the lipid profile is: a) assessment of glucose tolerance b) coronary risk assessment c) assessment of liver function d) assessment of coagulation status

b) coronary risk assessment

What do you expect to be the level of iron and FIBC (free iron binding capacity) in malignant and infectios diseases: a) low iron, increased FIBC b) decreased iron, decreased FIBC c) increased iron, decreased FIBC d) increased iron, increased FIBC

b) decreased iron, decreased FIBC

Increased pH of blood (alkalosis) leads to: a) increasing of iCa b) decreasing of iCa c) no difference

b) decreasing of iCa

Indicate a condition that is a possible cause of relative hyperalbuminemia: a) Pregnancy b) Dehydration

b) dehydration

"Disproteinemia" is used to indicate: a) hyperproteinemia b) disturbed ratio of protein fraction in electrophoresis c) euproteinemia d) hypoproteinemia

b) disturbed ratio of protein fraction in electrophoresis

A high reticulocyte count in the blood could indicate that there is a slow production of erythrocytes from the bone marrow a) true b) false

b) false

In granulocyte leukemoid reaction, the activity of granulocyte alkaline phosphatase is: a) not changed b) greatly increased c) greatly reduced d) depends on the number of the lymphocytes

b) greatly increased

In chronic myeloid leukemia, the alkaline phosphatase is: a) not changed b) greatly reduced c) greatly increased d) functionally active

b) greatly reduced (The activity of granulocyte alkaline phosphatase (GAF) is greatly reduced to zero.)

The ratio of the volume of red blood cells to the total volume of blood in CBC is expressed as: a) plasma b) haematocrit c) erythrocytes d) serum

b) haematocrit

In what cases there is high concentration of iron in serum: a) nephrotic syndrome b) haemolysis c) malabsorption d) lactation

b) haemolysis

Hypermagnesaemia is connected with: a) malabsorption syndrome b) haemolysis c) chronic ulcerative cholitis d) treatment with diuretics

b) haemolysis (magnesium levels can increase in haemolysis patients. RBCs contain 3x as much magnesium as compared to plasma --> rupture pours magnesium into plasma)

Hyperkalemia occurs in: a) treatment with insulin b) hemolysis c) metabolic acidosis d) primary hyperaldosteronism

b) hemolysis (but also - c) metabolic acidosis but more the other way around (hyperkalemia leading to metabolic acidosis ( hyperkalemia causes metabolic acidosis))

Factor IX deficiency causes: a) hemophilia A b) hemophilia B c) hemophilia C d) congenital immune deficiency

b) hemophilia B (H. A is factor VIII H. C is factor XI)

Hyperphosphataemia is usually associated with: a) hyperparathyroidism b) hypoparathyroidsim c) intoxication with Vit. D d) multiple mieloma

b) hypoparathyroidsim

Hypercholesterolemia is typical in: a) hyperthyroidism b) hypothyroidism c) hyperparathyroidism d) hypoparathyroidism

b) hypothyroidism

Sodium is decreased and MCV is increased at: a) hypertonic dehydration b) hypotonic dehydration c) isotonic dehydration d) hypotonic hyperhydratio

b) hypotonic dehydration

Thalassemia syndromes are due to: a) decreased hemoglobin synthesis b) imbalance between the synthesized polypeptide chains of Hb c) iron deficiency d) excessive intake of vitamin B12

b) imbalance between the synthesized polypeptide chains of Hb

Hypophosphatemia is caused by: a) hyperhydration b) inadequate intake, excessive loss or redistribution within the body c) low synthesis d) iron deficiency

b) inadequate intake, excessive loss or redistribution within the body

What is the effect of somatotropin hormone of the glucose blood level: a) decreases the glucose blood level b) increases the glucose blood level c) has no effect on the glucose blood level d) the effect depends on the age

b) increases the glucose blood level

The transaminases ASAT and ALAT have priority organ localization in: a) liver, lung, placenta b) liver, muscles, heart c) bones, erythrocytes, muscles d) heart, prostate, bones

b) liver, muscles, heart

Pregnancy and body weight are example for: a) a constant lab results variation b) long-term lab results variation c) short-term lab results variation d) circadian lab results variation

b) long-term lab results variation

The diagnostic sensitivity of Creatinine can be increased by: a) multiple Urea testing b) measurement the Creatinine clearance c) multiple Creatinine testing d) random urine testing

b) measurement the Creatinine clearance (Creatinine clearance can be used to approximate the GFR.)

Alkaline phosphatase does not increase in: a) rickets b) megaloblastic anemia c) cholelithiasis d) osteomyelitis

b) megaloblastic anemia

Cytochemical analysis is: a) determination of routine clinical-chemistry parameters in the blood b) microscopic examination of cell chemical components by selective staining for specific substrates and/or enzymes c) clinical-chemistry analysis of the chemical composition and activity of the cells d) microscopic examination of a native preparation of venous blood or bone marrow cells

b) microscopic examination of cell chemical components by selective staining for specific substrates and/or enzymes

Factors providing clot formation are called: a) profibrinolytics b) procoagulants c) anticoagulants d) antifibrinolytics

b) procoagulants (substances promoting blood coagulation. Includes factors V, VII, VIII, IX and X)

Which of the following conditions is an indication for serum calcium testing: a) impaired acid-base balance b) rickets and osteomalacia c) impaired glucose tolerance d) atherogenic risk assessment

b) rickets and osteomalacia

Which of the following conditions is an indication for serum calcium testing: a) disproteinemia b) screening for osteoporosis c) impaired glucose tolerance d) atherogenic risk assessment

b) screening for osteoporosis

What kind of specimen is used for clinical chemistry analyses: a) EDTA plasma b) serum c) sodium citrate plasma d) sodium fluoride plasma

b) serum

What specimen is used for determination of thyroid hormones? a) whole blood b) serum without hemolysis and lipemia c) cerebrospinal fluid d) citrate plasma without hemolysis and lipemia

b) serum without hemolysis and lipemia

What kind of biological material is used for determination of calcium: a) serum, EDTA plasma, 24 hours urine b) serum, plasma with Li heparin, 24 hours urine c) plasma with citrate, serum, random portion urine d) serum, plasma with Li heparin, first morning portion urine

b) serum, plasma with Li heparin, 24 hours urine

The activity of the Granulocyte alkaline phosphatase in leukemoid reaction is: a) in the reference range b) significantly increased c) significantly reduced d) not informative

b) significantly increased

In benign hyperimmunoglobulinemia: a) the concentration of the monocional protein is > 20 g /I b) the other classes of immunoglobulins are not suppressed c) plasma cell proliferation is found in the bone marrow d) Bence-Jones protein is found in the urine

b) the other classes of immunoglobulins are not suppressed (Criteria for distinguishing between "benign" hypergammaglobulinaemia and paraproteinemia: 1. monoclonal protein <20 g/l; 2. the other Ig classes are not suppressed; 3. in bone marrow no plasma cells proliferation is detected; 4. no Bence-Jones protein is detected)

In malignant hyperimmunoglobulinemias: a) the monoclonal protein concentration is < 15 g/ l b) the other classes of immunoglobulins are suppressed c) no monoclonal proliferation in the bone marrow d) Bence-Jones protein is not detected in the urine

b) the other classes of immunoglobulins are suppressed

Which changes are typical for hypotonic hyperhydration: a) the water enters the intracellular space, the MCV decreases b) the water enters the intracellular space, the MCV increases c) water moves to the extracellular space, the MCV increases d) water enters the extracellular space, the MCV does not change.

b) the water enters the intracellular space, the MCV increases

The level of TIBC is a direct indicator for the amount of: a) ferritin b) transferrin c) functional Iron d) hemosiderin

b) transferrin

The level of TIBC is a indirect indicator for the amount of: a) ferritin b) transferrin c) functional Iron d) hemosiderin

b) transferrin

The reference limits of the transaminases ASAT and ALAT are respectively: a) 0 - 200 U/L and 0 - 350 U/L b) 0 - 49 g/L and 0 - 35 g/L c) 0 - 49 U/L and 0 - 35 U/L d) 20 - 75 g/L and 25 - 100 g/L

c) 0 - 49 U/L and 0 - 35 U/L (but the other way around, ALAT higher upper value than ASAT)

Indicate the reference limits for ionized calcium in adults: a) 2,12 - 2,62 mmol/L b) 2,8 - 6,1 mmol/L c) 1,16 - 1, 32 mmol/L d) 1,5 - 3,2 nmol/L

c) 1,16 - 1, 32 mmol/L

The therapeutic range of INR in treatment with Vit K antagonists is: a) 1.0 - 2.0 b) 2.0 - 6.0 c) 2.0 - 4.0 d) 0.7 - 1.2

c) 2.0 - 4.0 (International Normalized Ratio) - (normal is always so averagely in the middle.... 2-4 is pretty much the middle)

Reference range for the fasting blood glucose test is: a) 3.8 - 6.2 mmol/l b) 2.8 - 7.8 mmol/l c) 2.8 - 6.1 mmol/l d) 2.8 - 6.9 mmol/l

c) 2.8 - 6.1 mmol/l

Which of the following values of the blood glucose are in the pathological range in the postprandial test: a) < 7.7 mmol/l b) 7.78 - 9.99 mmol/l c) > 10.00 mmol/l d) 2.78 - 5.55 mmol/l

c) > 10.00 mmol/l

High atherosclerotic risk is related to the following serum concentration of total cholesterol: a) up to 4.0 mmol/l b) from 1.71 to 2.28 mmol/l c) > 6.5 mmol/l d) up to 5.2 mmol/l

c) > 6.5 mmol/l

In viral hepatitis what can you find in urine: a) Bilirubin - positive, Urobilinogen - not increased b) Bilirubin - negative, Urobilinogen - increased c) Bilirubin - positive, Urobilinogen - increased d) Bilirubin - negative, Urobilinogen - not increased

c) Bilirubin - positive, Urobilinogen - increased

Tumor marker of first choice for metastatic breast cancer: a) CA 19-9 b) CA 125 c) CA 15-3 d) CEA

c) CA 15-3 (Carla owns 15 bras but only ever wears 3 - if at all)

A bone marrow biopsy shows 5% myeloblasts. The most likely diagnosis is: a) Acute myeloid leukemia b) Acute lymphoblastic leukemia c) Chronic lymphoblastic leukemia d) Chronic myeloid leukemia

c) Chronic lymphoblastic leukemia (Having at least 20% blasts in the marrow or blood is generally required for a diagnosis of AML. (In normal bone marrow, the blast count is 5% or less, while the blood usually doesn't contain any blasts.)) (According to the WHO classification, a finding of at least 20% blasts in the bone marrow is required for diagnosis of the majority of acute leukemias, and testing must be performed to detect the presence or absence of genetic anomalies.)

The water soluble fraction of bilirubin is: a) Indirect bilirubin b) Total bilirubin c) Direct bilirubin d) Unfractionated bilirubin

c) Direct bilirubin (= conjugated bilirubin)

Indicate the correct answer: a) Electrophoresis is a screening method for the fractionation of immunoglobulins b) Electrophoresis is a method for quantification of immunoglobulins c) Electrophoresis is a screening method for the fractionation of proteins d) Electrophoresis is a method for the quantification of albumin

c) Electrophoresis is a screening method for the fractionation of proteins

Which lab parameters are tested to assess glucose levels for past time period: a) ferritin and transferrin b) aPTT and PT c) HbA1C and fructosamine d) Hb and ceruloplasmin

c) HbA1C and fructosamine

Hyperbilirubinemia with predominant elevated indirect bilirubin is detected in: a) Bile obstruction b) Primary biliary cirrhosis c) Hemolytic anemias d) Acute hepatitis

c) Hemolytic anemias

Jaundice is caused by: a) Elevated uric acid in the blood b) High hemoglobin in the blood c) Increased bilirubin in the blood d) Increased potassium in the blood

c) Increased bilirubin in the blood

DBC in megaloblastic anemia shows the following characteristics EXCEPT a) Megakaryocytes b) Howell-Jolly bodies c) Increased reticulocytes d) Hypersegmented neutrophils

c) Increased reticulocytes (A Howell-Jolly body is a cytopathological finding of basophilic nuclear remnants (clusters of DNA) in circulating erythrocytes. During maturation in the bone marrow, late erythroblasts normally expel their nuclei; but, in some cases, a small portion of DNA remains.)

Which enzyme has increased activity in pernicious anemia: a) CK b) ALP c) LDH d) ALT

c) LDH (isoenzyme - 1)

Which cytochemical analysis helps to differentiate leukemoid reaction from CML: a) Nonspecific esterase b) Sudan Black c) Leukocyte alkaline phosphatase d) Periodic acid Schiff

c) Leukocyte alkaline phosphatase (Leukocyte alkaline phosphatase (LAP) activity can be used to differentiate a leukemoid reaction from chronic myelogenous leukemia. - leukemoid reaction: high LAP, CML: low LAP)

Which of the following statements about osmolality is true: a) Osmolality is the number of osmotically active particles in 1 liter of body water b) Osmolality is theoretically calculated by the formula: 2 (Na + K) + glucose + urea c) Osmolality is the number of osmotically active particles in 1 kg of body water d) Osmolality represents the part of the formed elements to the total amount of blood

c) Osmolality is the number of osmotically active particles in 1 kg of body water (number of solute particles (osmoles) per unit mass of solvent (mOsm/kg)) .... 1 liter water = 1 kg of water tho.... if you wanna argue your case by choosing that one

The tumor marker for screening of prostate cancer is: a) СА 19-9 b) СА 15-3 c) PSA d) β-HCG

c) PSA (Prostate Specific Antigen)

Screening tests for hemorrhagic diathesis are: a) ATIII, HC II b) f.VIII c) PT, APTT, TT, PLT, fibrinogen d) DBC

c) PT, APTT, TT, PLT, fibrinogen

Which parameters are included in the Complete Blood Count (CBC) test: a) RBC, WBC, PLT, Hb, Hct, MCV, MCH, MCHC, RDW and ESR b) RBC, WBC, PLT, Hb, Hct, MCV, MCH, MCHC and Differential blood count c) RBC, WBC, PLT, Hb, Hct, MCV, MCH, MCHC, RDW d) ESR and Differential count

c) RBC, WBC, PLT, Hb, Hct, MCV, MCH, MCHC, RDW

The extrinsic pathway of coagulation is activated by: a) Coagulation factor XII b) Fibrinogen c) The tissue thromboplastin d) Thrombin

c) The tissue thromboplastin

Which of the following clinical - laboratory parameters is an early indicator of myocardial infarction: a) CK b) MB CK c) Troponin d) LDH; HBDH

c) Troponin (earliest enzymatic: CK MB earliest Laboratory: Troponin I)

The earliest laboratory indicator of acute myocardial infarction is: a) AST b) CK-MB c) Troponin I d) LDH

c) Troponin I (earliest enzymatic: CK MB earliest Laboratory: Troponin I)

In the most of the cases Megaloblastic anaemia is due to: a) iron deficiency b) chronic diseases c) Vit. B12 and folate deficiency d) inherited enzyme deficiency

c) Vit. B12 and folate deficiency

Which dietary component(s) is/are needed for DNA synthesis, and... greatly influence the production of RBCs? a) calcium b) iron c) Vit. B12 and folic acid d) protein

c) Vit. B12 and folic acid

The lack of which components supplied with food slow down the maturation of the nuclei of the maturing blood cells: a) Calcium b) iron c) Vitamin B12 and/or folic acid d) Vitamin D and/or amino acids

c) Vitamin B12 and/or folic acid

Before treatment with standard heparin, which indicator will you test: a) Pt b) TT c) aPTT d) fibrinogen

c) aPTT

A 53-year old male had noticed the onset of easy fatigability and bruising. His CBC and subsequend bone marrow exam were abnormal. Lab data: WBC 78.0 g/L, Hb 73 g/L, PLT 59 g/L. DBC - Hiatus leucaemicus. What is the most likely diagnosis? a) chronic lymphocytic leukemia b) chronic granulocytic leukemia c) acute leukemia d) leukemoid reaction

c) acute leukemia

Iron is: a) a main extracellular ion b) a main intracellular ion c) an essential trace element d) the most important electrolyte

c) an essential trace element

What is the effect of aspirin on the processes of hemostasis? a) antifibrinolytic b) procoagulant c) anti-aggreagate d) fibrinolytic

c) anti-aggregate

Megaloblastic anemias are characterized by: a) bone marrow with erythroblastic microforms b) "blue bone marrow" c) bone marrow with hypochromic erythroblasts d) there are no characteristic changes in the bone marrow

c) bone marrow with hypochromic erythroblasts (not always hypochromic)

Hypertriglyceridemia is a risk factor for: a) chronic renal failure b) nephrolithiasis c) cardiovascular disease d) anemia

c) cardiovascular disease

What is the function of LDH enzyme: a) transportation of amino groups between alpha mino and alpha keto acid b) catalyze transport of macroenergy phosphates c) catalyse conversion pyruvate-lactate d) hydrolyze phosphate esters

c) catalyse conversion pyruvate-lactate (Lactate DeHydrogenase)

In which of the following diseases fasting glucose amount is over upper reference value: a) malabsorption b) insulinoma c) diabetes mellitus d) Addison's disease

c) diabetes mellitus

Which of the following methods is used for qualitative investigation of protein fractions: a) immunoelectrophoresis b) enzyme methods c) electrophoresis d) immunochemical methods

c) electrophoresis

PT is not prolonged in: a) overdosage of Vit K b) factor VII deficiency c) factor VIII defiency d) liver diseases

c) factor VIII defiency

Specify the natural substrates of plasmin: a) inhibitors of the plasminogen activators b) plasminogen activators c) fibrinogen and fibrin d) thrombin

c) fibrinogen and fibrin (i am confused tho...)

Blood with EDTA anticoagulant is used for the investigation of: a) clinical-chemistry parameters b) coagulation parameters c) haematological parameters d) heavy metals

c) haematological parameters

Hyperbilirubinemia with a predominant increase in unconjugated bilirubin is found in: a) bile duct obstruction b) primary biliary cirrhosis c) hemolytic anemias d) acute hepatitis

c) hemolytic anemias (bilirubin from haemolysis is unconjugated (conjugation happens in liver))

Hypernatremia occurs in: a) renal retention of water and Na +, the water retention exceeding that of Na + b) renal loss induced by diuretics c) increased intake of Na + d) all are true

c) increased intake of Na + (insufficient free water intake, often in combination with excess water loss.)

What is the transferrin: a) reserve iron b) main form for iron storage c) individual protein for iron transport d) functional iron

c) individual protein for iron transport

Hyperglycemia is not observed in: a) diabetes mellitus b) myocardial infarction c) insulinoma d) CNS damage

c) insulinoma (A neuroendocrine tumor arising from beta cells of the pancreas. Associated with hypoglycemia with pathologically high insulin levels due to overproduction of insulin.)

Erythrocyte microforms are characteristic of: a) megalocyte anemia b) acute leukemia c) iron deficieney anemia d) anemia in liver diseases

c) iron deficieney anemia

Serum transferrin is reduced in inflammatory processes because: a) anemia develops during infection b) the transport of the iron is disrupted c) it is a "negative" reactant of the acute phase d) of gut inflammation

c) it is a "negative" reactant of the acute phase

Fibrinogen is decreased in: a) diabetes b) pregnancy c) liver diseases d) inflammation

c) liver diseases

Diabetes Mellitus is due to: a) decreased amount in insulin antagonists b) renal loss of glucose c) low or missing level of insulin in blood d) decreased gastro-intestinal resorbtion of glucose

c) low or missing level of insulin in blood (i guess this is the closest.... but early stages of DM2 have ^^ insulin..... dk)

A typical morphological feature of pernicious anemia are: a) microcytes b) normocytes c) megalocytes d) microspherocytes

c) megalocytes

The type of white blood cells that often arrives at the site of infection first, is a granulocyte, and contains granules that stain light purple is a: a) basophils b) eosinophils c) neutrophils d) monocytes

c) neutrophils

Absolute hyperalbuminemia is observed in: a) glomerulonephritis b) nephrotic syndrome c) no absolute hyperalbuminemia is known d) gastrointestinal diseases

c) no absolute hyperalbuminemia is known (well.... super rarely... and if it is absolute hyperalbuminemia at all its mostly iatrogenic)

What kind of biological material is used for coagulation analysis: a) EDTA plasma b) serum c) plasma with citrate d) plasma with Li heparin

c) plasma with citrate

The evaluation of serum ferritin is an indicator for the amount of: a) functional Iron b) transferrin c) reserve Iron d) hemosiderin

c) reserve Iron

Drinking coffee and smoking a cigarette before taking blood for testing is an example of: a) a constant lab results variation b) long-term lab results variation c) short-term lab results variation d) circadian lab results variation

c) short-term lab results variation

Mark the right answer for urine collection (diuresis): a) collection after morning toilet b) collection of the whole urine from the first to the last portion c) the first portion is eliminated, the last is collected d) urine collection till the vessel is full

c) the first portion is eliminated, the last is collected

aPTT is used for evaluation of: a) the deficiency of f. VII b) the treatment with Vit K antagonists c) the intrinsic pathway of the coagulation d) fibrinolysis

c) the intrinsic pathway of the coagulation

Indicate the correct procedure for performing a glucose tolerance test a) three-fold determination of blood sugar at 0, 60 and 120 min, after ingestion of 75 g of glucose dissolved in water before collection of the first sample b) three-fold determination of blood sugar at 0, 60 and 120 min, after ingestion of 75 g of glucose dissolved in water before collecting the third sample c) three-fold determination of blood sugar at 0, 60 and 120 minutes, after ingestion of 75 g of glucose dissolved in water, immediately after collection of the first sample d) three-fold determination of blood sugar at 0, 80 and 120 minutes, after ingestion of 70 g of glucose dissolved in water, immediately after collection of the fist sample,

c) three-fold determination of blood sugar at 0, 60 and 120 minutes, after ingestion of 75 g of glucose dissolved in water, immediately after collection of the first sample

The lipid profile includes the following laboratory parameters: a) total cholesterol, LDL-cholesterol, glucose, fibrinogen b) total cholesterol, AST,ALT, LDL-cholesterol c) total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides d) total cholesterol, TSH, FT3, FT4

c) total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides

TIBC is reduced in inflammatory processes because: a) anemia develops during infection b) the distribution of iron is impaired c) transferrin is a "negative" reactant of the acute phase d) ferritin is a "negative" reactant of the acute phase

c) transferrin is a "negative" reactant of the acute phase

What is the specimen for evaluation of hemostasis parameters: a) venous blood with anticoagulant heparin b) venous blood with anticoagulant EDTA c) venous blood with anticoagulant sodium citrate d) capillary blood with anticoagulant sodium fluoride

c) venous blood with anticoagulant sodium citrate

The hemoglobin reference limits for men are: a) 120 - 180 g/l b) 120 - 160 g/l c) 120 - 140 g/l d) 140 - 180 g/l

d) 140 - 180 g/l (roughly puberty in males 14-18 (later than female, but overlap))

High atherosclerotic risk is related to the following serum concentration of LDL cholesterol: a) up to 3.4 nmol/l b) from 1.71 to 2.28 mmol/l c) > 3.4 mmol/l d) > 6.2 mmol/l

d) > 6.2 mmol/l

Which of the laboratory tests are indicated for the differential diagnosis of jaundice: a) Total bilirubin, direct bilirubin b) ASAT, ALAT c) ALP, GGT d) All answers are correct

d) All answers are correct

Which of the following individual proteins is a positive acute phase reactant: a) Transferrin b) Prealbumin c) Albumin d) C-reactive protein

d) C-reactive protein

Low serum activity of which enzyme has clinical significance: a) CK b) LDH c) ALP d) CHE

d) CHE (cholinesterase)

Which of the following leukemias is likely to show an extreme leukocytosis and thrombocytosis a) Acute lymphoblastic leukemia b) Acute monoblastic leukemia c) Chronic lymphocytic leukemia d) Chronic myeloid leukemia

d) Chronic myeloid leukemia

In the vitamin B12 deficiency, in the blood cells is disturbed: a) Iron absorption b) Synthesis of folic acid c) Production of an internal factor d) DNA synthesis

d) DNA synthesis

Elevated serum ferritin and low TIBC are typical for: a) Fe deficiency anemia b) Anemia of chronic disease c) Megaloblastic anemia d) Hemolytic anemia

d) Hemolytic anemia

The HbA1c test is not applicable in diabetic patients with: a) Type 1 diabetes mellitus b) Type 2 diabetes mellitus c) Gestational diabetes d) Hemolytic anemia

d) Hemolytic anemia (HbA1C may be a screening test for hemolysis in non-diabetic patients with hemolytic anemia, but in diabetic population with hemolytic disease it is considered to be a very poor marker for both, overall glycemia and haemolysis.)

Which one of the following does not contribute to clot formation? a) Calcium b) Thrombin c) Tissue factor d) Heparin

d) Heparin

The antibodies of the primary immune response are: a) IgG b) IgD c) IgA d) IgM

d) IgM

Which value defines high atherogenic risk: a) Total cholesterol > 5.0 mmol/L b) HDL cholesterol > 1.15 mmol/L c) Total cholesterol < 6.2 mmol/L d) LDL cholesterol > 4.0 mmol/L

d) LDL cholesterol > 4.0 mmol/L

What is the first recognizable maturation form of platelet cell line: a) Myeloblast b) Megaloblast c) Monoblast d) Megakarioblast

d) Megakarioblast

Flowcytometry is NOT: a) An effective method for analyzing the structural and functional characteristics of blood cells b) Method for the quantitative measurement of specific antigen markers expressed on and in blood cells c) Method for immunophenotypic characterization of blast cells d) Method for staining of blood cells

d) Method for staining of blood cells

Proteinuria above 3.5 g/24h is typical for: a) Alport syndrome b) Diabetic nephropathy c) IgA nephropathy d) Nephrotic syndrome

d) Nephrotic syndrome

The total and direct bilirubin are not indicators for: a) Liver and biliary tract diseases b) Hemolytic anemias c) Congenital defects of bilirubin secretion d) Nephrotic syndrome

d) Nephrotic syndrome

Mark the erroneous statement: a) PSA may be elevated in benign prostate adenoma b) PSA may increase shortly after prostate resection c) PSA is a tumor marker for diagnosis of prostate cancer recurrence d) PSA is an absolutely specific tumor marker for prostate tumor malignancy

d) PSA is an absolutely specific tumor marker for prostate tumor malignancy (erroneous = wrong (lovely word))

Which of the following conditions is an indication for calcium testing: a) Violation of the BGA b) Disturbance of water-electrolyte balance c) Atherogenic risk assessment d) Rickets and osteomalacia

d) Rickets and osteomalacia

The CK activity must not investigated after: a) surgical intervention b) injection c) palpation of glandulae prostate d) X-Ray

d) X-Ray (CK is released when there is muscle damage of any kind and a cancer or sth like that of the pancreas might lead to higher CK levels as well (produced there))

Fibrinolysis is: a) complicated, dynamic, selfregulating system b) a process of coagulation c) contraction of blood vessels with injury d) a complex of processes which make possible lysis of the clot

d) a complex of processes which make possible lysis of the clot

Possible causes for hemorrhagic diathesis are: a) decreased count or impaired function of platelets b) vascular disorders c) disorders affecting plasma coagulation factors and fibrinolysis d) all listed

d) all listed (Bleeding disorders are a group of heterogeneous conditions characterized by defects in hemostasis that lead to an increased susceptibility to bleeding (also known as hemorrhagic diathesis). They are classified into disorders of primary hemostasis (when caused by a platelet abnormality), disorders of secondary hemostasis (when caused by defects in the extrinsic and/or intrinsic pathway of the coagulation cascade), and hyperfibrinolysis (when there is increased clot degradation))

Which of the following may be the cause for DIC: a) sepsis b) cancer c) complication of pregnancy d) all of these conditions could lead to DIC

d) all of these conditions could lead to DIC

Hematological laboratory parameters in Acute leukemias are most often characterized by. a) normochromia, normocytosis. leukopenia with left shift, thrombocytosis b) hypophosobatem, anisocytosis: megaloblastic transformation c) reticulocytosis, basophilicaly punctured erythrocytes, poikilocytosis d) anemia, thrombocytopenia moderate leukocytosis and presence of blasts cells

d) anemia, thrombocytopenia moderate leukocytosis and presence of blasts cells:

Acute leukemias most often are characterized by: a) anemia, thrombocytosis, leucopenia and left shift b) anemia, reticulocytosis, leucopenia and erythroblasts c) anemia. Leukocytosis, lymphocytosis and left shift d) anemia, thrombocytopenia, leukocytosis and atypical "blast" cells

d) anemia, thrombocytopenia, leukocytosis and atypical "blast" cells

Microalbuminuria is a laboratory marker for: a) assessment of type II diabetes mellitus b) assessment of the risk of developing diabetic retinopathy c) assessment of type I diabetes mellitus d) assessment of the risk of developing diabetic nephropathy

d) assessment of the risk of developing diabetic nephropathy (Early symptom of diabetic nephropathy and hypertensive nephropathy)

Red blood cells are: a) blood cells that pass through the vessel wall b) blood cells that supply body defence c) blood cells that are included in the coagulation process d) blood cells that carry oxygen

d) blood cells that carry oxygen

Indicate the correct answer for the total serum protein test, regarding to the biological material required for testing and the reference limits for interpretation a) blood without anticoagulant, 60-83 mmol/L b) blood with anticoagulant EDTA, 60- 83 g/ L c) blood with anticoagulant sodium citrate, 60-83 mmol/L d) blood without anticoagulant, 60-83 g/ L

d) blood without anticoagulant, 60-83 g/ L (serum, in g/L)

In what cases in healthy individuals the activity of alcaline phosphatase (ALP) is over 1000 U/L: a) physical activity b) postprandial c) in stress d) children

d) children

Which laboratory feature is not typical for iron deficiency anemia: a) decreased serum iron level b) decreased serum ferritin level c) decreased MCH in red blood cells d) decreased total iron-binding capacity

d) decreased total iron-binding capacity

Which of the following lab parameters does not reflect the first phase of the DIC: a) PF1+2, TAT, FPA, FM b) аРТТ, TT c) platelet count d) differential blood count

d) differential blood count (disseminated intravascular coagulation. A condition characterized by systemic activation of the clotting cascade, platelet consumption, and subsequent exhaustion of clotting factors that leads to widespread thrombosis and hemorrhage.)

Which of the following parameters does not indicate chronic liver failure: a) low serum albumin b) prolonged prothrombin time c) elevated serum bilirubin d) elevated serum acid phosphatase activity

d) elevated serum acid phosphatase activity

Which of the following individual proteins are positive reactants of the acute phase: a) prealbumin, albumin b) transferrin, albumin c) thromboplastin, kallikrein d) fibrinogen, CRP

d) fibrinogen, CRP

The lysis of blood glucose is called: a) ketonuria b) glucosuria c) gluconeogenesis d) glucolysis

d) glucolysis (glycolysis)

Morphological substrate of acute leukemias are: a) atypical leukemic cells b) erythropoietic stem cells c) Philadelphia chromosome d) hairy lymphocytes

d) hairy lymphocytes jk (just kidding) it is: a) atypical leukemic cells

Investigation of alkaline phosphatase activity (ALP) is informative for: a) transportation of amino groups between alpha amino and alpha keto acids b) catalyze transport of macroenergy phosphates c) catalyse conversion piruvate-lactate d) hydrolyze phosphate esters

d) hydrolyze phosphate esters

Which of these cells did not develop from a myeloblast? a) basophil b) neutrophil c) eosinphil d) lymphocyte

d) lymphocyte

Hyperkalemia occurs in: a) insulin treatment b) treatment with diuretics (salidiuretics) c) vomiting, diarrhea d) massive burns

d) massive burns ( but also: All potassium-sparing diuretics can cause hyperkalemia. Several groups of patients are at particularly high risk of developing hyperkalemia if they take potassium-sparing diuretics)

What is the morphology of the erythrocytes in Iron deficeincy anaemia: a) macrocytic, hypochromic b) normocytic, normochromic c) macrocytic, hyperchromic d) microcytic, hypochromic

d) microcytic, hypochromic

The laboratory result is a function of many factors influencing the final value: a) biological factors b) pathological factors c) factors in preanlytical stage d) pathological, biological, preanalytical, analytical and post-analytical factors

d) pathological, biological, preanalytical, analytical and post-analytical factors

Which of the following pathological conditions is not among the main indications for examination of Alkaline phosphatase: a) differential diagnosis of jaundice b) rickets c) bone diseases d) prostate cancer

d) prostate cancer

Serum acid phosphatase activity is increased in: a) stroke b) acute appendicitis c) myocardial infarction d) prostate cancer

d) prostate cancer (The main indication is a suspicion of cancer or postoperative recurrence of the prostate gland.)

Which are the biological factors with temporarily activity of the variation of the results: a) sex, race b) age c) body construction d) stress

d) stress

Which of the following procedures is wrong? a) conversation with the patient b) selection of vein without haematoma and intravenous infusion c) strangulation of the arm for a short time d) tapping and massaging of the vein

d) tapping and massaging of the vein

The plasma is: a) the liquid phase of blood without anticoagulant and fibrinogen b) the liquid phase of blood with anticoagulant, not containing fibrinogen c) the liquid phase of blood without anticoagulant, containing fibrinogen d) the liquid phase of blood, with anticoagulant, containing fibrinogen

d) the liquid phase of blood, with anticoagulant, containing fibrinogen

For follow up of malignant tumor are used specific: a) pathogens b) Ab to the corresponding pathogen c) blood group titers d) tumor markers

d) tumor markers

If massive tissue destruction increases: a) alkaline phosphatase b) glucose c) total protein d) uric acid

d) uric acid

For the quanlitative investigation of urine is necessary: a) first morning portion of urine, after toilet b) diuresis for fixed time c) to take the urine with catheter d) to take the urine in fasting

if it is qualitative - a if it is quantitative - b don't know which one they wanted here


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