Exam Simulator Chemistry Questions

All of the following statements are characteristics of the role of C-reactive protein (CRP) except? A) activates complement B) binds with factor H to initiate alternate complement pathway C) exhibits pro-inflammatory characteristics D) initiates opsonization

B) binds with factor H to initiate alternate complement pathway

Which of the following is true of genotyping screening in pharmacogenomics? A) genotype screening gives a better overall picture of drug metabolism than measuring metabolism with probe drug B) genotyping does not take into account drug interactions which can affect metabolism C) genotyping typically involves measuring only one mutation site or polymorphism D) genotyping typically involves measuring only one mutation site or polymorphism

B) genotyping does not take into account drug interactions which can affect metabolism

Which of the following cardiovascular risk markers is a more sensitive version of a test that is used to assess inflammation? A) oxidized-LDL B) hs-CRP C) ApoB/ApoA1 D) LpPLA2

B) hs-CRP

What assay is performed to diagnose congestive heart failure (CHF)?

B-type natriuretic peptide (BNP)

Which marker is the most useful for detection of gestation trophoblastic disease? A) CEA (carcinoembryonic antigen) B) AFP (alpha fetoprotein) C) hCG (human chorionic gonadotropin) D) CA-125 (cancer antigen 125)

C) hCG (human chorionic gonadotropin)

A patient who previously had an hs-CRP of 4 mg/L was put on statin and daily aspirin medication. She returns to the laboratory a month later, and her repeat hs-CRP is 2.3 mg/L. Which of the following is the most likely reason for the decrease in the test value? A) patient had an infection at the time of first visit B) lab test was preformed incorrectly C) medication lowered value D) CRP values fluctuate throughout the day

C) medication lowered value

Which of the following conditions would be suggested by a jaundiced patient experiencing a marked rise in alkaline phosphatase (ALP), conjugated bilirubin, and a slight rise in alanine aminotransferase (ALT)? A) cardiovascular disease B) hepatitis C) post-hepatic cholestasis D) renal failure

C) post-hepatic cholestasis

Mrs. Jones, a diabetic, is admitted to the hospital on November 25th. It appears that she has had an acute myocardial infarction (AMI), but did not feel the severe chest pain because of diabetic neuropathy. She has not felt well since November 20th and her physician believes she possibly had an AMI on November 20th.Assuming that the infarct was uncomplicated, which of the following cardiac biomarkers would most likely still be elevated and would assist in an AMI diagnosis? A) myoglobin B) creatinine kinase MB C) troponin T D) all of the above

C) troponin T Troponin T remains elevated after an AMI for 8-21 days

Each of the following hypothalamic hormones is correctly matched with the anterior pituitary hormone that is releases EXCEPT: A) TRH --> TSH B) GnRH --> LH and FSH C) CRH --> ACTH D) GHRH --> Oxytocin

D) GHRH --> Oxytocin Growth releasing hormone releases growth hormone

A three-hour glucose tolerance test includes what?

Four specimens: a fasting blood glucose, a specimen collected at one hour, a second specimen collected at two hours, and a third specimen collected three hours after drinking a 100-gram dose of glucose solution.

Site for CSF collection

L3-L4

Friedewald Calculation for LDL

LDL = total cholesterol - HDL - triglycerides/5 only valid if triglycerides is less than 400

Lecithin/sphingomyelin ratio

Test for fetal lung maturity

A hospitalized patient has a decreased serum copper level and increased urine copper level. This is MOST consistent with what?

Wilson's disease - causes the body to retain copper

What drug example would be a good candidate for therapeutic drug monitoring?

a drug that has a narrow therapeutic window

Cushing's syndrome

hypersecretion of cortisol

Deviations from Beer's Law are cause by what?

stray light Beer's Law -> absorbance = concentration

The measurement of 17-ketosteroids in urine is performed to assess PRIMARILY which organ(s)?

testes and adrenal cortex

What is the definition of bioavailability?

the fraction of the administered dose that eventually reaches its site of action

If a disease or disorder causes serum binding proteins (such as albumin) to decrease, what may occur if the dose of a highly protein-bound drug with a narrow therapeutic window is not adjusted?

the patient may experience toxic effects (high free drug fraction)

What conclusion can be made if a person has a cardiovascular risk marker that is abnormal?

the person has an increased probability of developing cardiovascular disease

A chemical reaction that is utilized by many different analytical methods involves what?

the reduction of NAD to NADH

If a healthy patient presents with an elevated potassium level while all other chemistry results are normal, what happened?

the sample was hemolyzed

What is a bronchodilator used to treat asthmatic patient?

theophylline

The pl of a protein is 9.2. This protein is placed in an electrical field where a buffer sets the pH at 10. What is happening during migration?

this protein will have a net negative charge and will migrate toward the anode, the positively charged electrode

function of very low density lipoproteins

to transport endogenous triglycerides

A Cytochrome P450 2D6 (CYP2D6) ultrarapid metabolizer (UM) would require ___________ dose of an active drug (non-prodrug) that is metabolized by CYP2D6 than a CYP2D6 extensive metabolizer (EM).

a higher dosage

When the body compensates for a respiratory or metabolic disorder, the MAIN goal is to achieve:

a normal pH

Cytokine

a soluble protein that regulates the immune response

Ammonia is best characterized as being:

a waste product of amino acid and protein metabolism

An automated method for measuring chloride which generates silver ions in the reaction is:

Amperiometric-coulometric titration

The production of neutral 17-ketosteriods is the measurement of what production?

Androgen production

The name of a reaction between a single antigenic determinant and a individual combining site is:

affinity

What is decreased during an acute phase response?

albumin

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

albumin

A patient that is on a vegetarian diet will most likey have what pH?

alkaline pH

What polypeptide chains are found in normal adult hemoglobin A?

alpha and beta

What band in serum protein electrophoresis cause haptoglobin appear in?

alpha-2 globulin band

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

alpha-fetoprotein

What screening test is for neural tube defects?

alpha-fetoprotein

Hormonal variation throughout the menstrual cycle typically shows:

an abrupt rise in luteinizing hormone (LH) 3-36 hours prior to ovulation

Describe the principles of competitive radioimmunoassay procedures.

antibody will react equally with labeled and unlabeled antigen

ethylene glycol

antifreeze monohydrate calcium oxalate crystals

What is used t o determine if a person has had a recent infection with Strep pyogenes?

antistreptolysin (ASO)

Estriol levels in conjunction with hCG and AFP can be obtained during pregnancy to:

assess the risk of Down's syndrome

Which term described the dose of the drug in which 50% of the individuals will result in mortality? A) ED50 B) LD50 C) TD50 D) MD50

B) LD50

creatinine clearance equation

(urine creatinine/serum creatinine) x urine volume / (time (hr) x60)

What is the recommended storage temperature for the preservation of activity for MOST enzymes?

4C

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

5 albumin, a1, a2, beta, gamma

Approximately how many doses are required to obtain a steady state oscillation allowing for peak and trough levels to be elevated?

5 to 7

What percentage of dietary iron is normally absorbed daily?

5-10%

How long does it take for plasma concentrations to reach steady state when a patient's dose is given at intervals of the drug's half-life?

5-7 half lives

Following a myocardial infraction which of the following enzymes will be the first to become elevated: A) CK B) LDH C) GGT D) ALT

A) CK CK rises before LDH GGT and ALT are elevated in liver disorders

An electrolyte panel (lytes, chem-4) consists of: A) K, Na, Cl, CO2 (in form of bicarbonate) B) K,Na, Cl, Glucose C) K, Na, Cl, Creatinine D) K, Na, Cl, BUN

A) K, Na, Cl, CO2 (in form of bicarbonate)

What is the effect of aging with the hormones of the endocrine system? A) aldosterone decreases and norepinephrine increases B) aldosterone increases and norepinephrine increases C) aldosterone decreases and norepinephrine decreases D) aldosterone increases and norepinephrine decreases

A) aldosterone decreases and norepinephrine increases

What serum constituent is unstable if a blood specimen is left at RT for 8 hours before processing?

glucose

What enzyme is responsible for the conjugation of bilirubin?

glucuronyl transferase

Acute phase proteins generally fall into which category?

glycoproteins

Which analyte is MOST useful for monitoring long-term (~12 weeks) stability of blood glucose?

glycosylated hemoglobin (HbA1C)

CK-MB (CK-2)

greater than 5% or 10 IU/L followed by an LDH-1:LDH-2 flip is specific evidence of myocardial infarction CK-MB levels can be normal with an elevated total CK CK-MB and troponin levels can be elevated after an AMI

What decreases during intravascular hemolysis?

haptoglobin

False positive results for HIV antibody are most likely to occur in patients that:

have an autoimmune disorder

What casts appear following strenuous exercising?

hayline casts

What part of the body synthesized and secretes BNP?

heart

Which compound normally contains the majority of the body's total iron?

hemoglobin

An electrophoretic separation of lactate dehydrogenase isoenzyme that demonstrates elevation in LD-1 greater than LD-2 could be indicative of what?

hemolysis and myocardial infarction

A specimen for potassium was drawn in a tube without anticoagulant at 6 AM during a traumatic patient stick. The result were 6.0 mmol/L. Why are the results elevated?

hemolysis of the RBCs

What additive should be used for collection of a sample for blood gas analysis?

heparin

What type of anticoagulant is generally suitable for TDM analysis?

heparin

What two organs are associated with drug elimination?

hepatic and renal

Increased concentrations of alpha-fetoprotein in adults are most characteristically associated with?

hepatocellular carcinoma

The primary mechanism responsible for glomerular filtration is:

hydrostatic differential in glomerular tufts

Which lipid abnormality is most closely linked to heart disease?

hypercholestrolemia

A low CSF glucose level is not associated with what?

hyperglycemia

A patient has the following test results: increased serum phosphorus levels, decreased serum calcium level, and decreased serum parathyroid (PTH) level. This patient most likely has what?

hypoparathyroidism

What is a condition in which therapeutic drug monitoring be used?

if the drug is chronically given

When should blood samples for trough drug levels be collected?

immediately before the next dose is given

What is the most common technique that is used by labs for therapeutic drug monitoring?

immunoassays

Troponin I levels

increase 3-12 hours stay increased for 7-14 days

Patients who develop severe sepsis or septic shock commonly have ___________ plasma lactate values.

increased

What is the relationship between lipids and heart disease?

increased levels of LDL-C indicates an increased risk for cardiovascular disease

Viral meningitis CSF

increased lymphocytes, normal glucose increased proteins

Bacterial Meningitis

increased neutrophils decreased glucose increased proteins bacteria would most likely be seen

Symptoms associated with nephrotic syndrome

increased proteinuria decreased serum albumin hyperproteinemia

A patient presents with an elevation of unconjugated bilirubin, normal serum alkaline phosphatase, normal liver enzymes, and no bilirubin in the urine. This combination would suggest what?

increased rate of hemolysis unconjugated bilirubin is a byproduct of RBC breakdown or hemolysis

What result would be MOST consistent with macro-amylasemia?

increased serum amylase and normal to low urine amylase values

A major action of angiotension 2 is?

increased vasoconstriction increases adrenal secretion of aldosterone increases blood pressure

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

increases serum iron decreased TIBC

When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to:

induce the sweat secretion

Relation regarding cardiovascular disease and adipose tissue.

inflammatory cytokines, synthesized and released by adipose tissue, contribute to the development of cardiovascular disease

Sodium fluoride is an excellent preservative for collecting glucose because it does what?

inhibits glycolysis

What hormone is mainly responsible for the entry of glucose into the cell for energy production?

insulin

type 2 diabetes mellitus

insulin levels may or may not be abnormal more common than type 1 it commonly occurs in adults

What is the most significant cause of decreased haptoglobin levels?

intravascular hemolysis

What is necessary for the absorption of Vitamin B12?

intrinsic factor

What method would be employed to collect sweat for chloride analysis?

iontophoresis

brain naturetic peptide/BNP

is released in response to a variety of cardiac stresses, particularly cardiac stretch

Acetaminophen metabolism

it is metabolized in the kidney

Troponin

it rises much sooner after a myocardial infaraction than CK-MB

When is a trough blood sample for the therapeutic drug monitoring usually obtained?

just before the next scheduled dose

Factors that promote casts in kidneys

larger than normal amount of plasma proteins entering the tubules decreased pH decreased urinary flow rate increased urine concentration

What adipocyte product is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores?

leptin

What represents a diagram of a spectrophotometer?

light source - monochromator - cuvette - detector - readout

What is most likely to interfere with the measurement of hemoglobin?

lipemia

What medication is primarily used in the treatment of bipolar disorder?

lithium

What conditions are associated with a polyclonal (broadbased) increase in gamma globulin?

liver disease chronic inflammation immune reaction

What assay results would you expect to see in hyperthyroidism?

low TSH high free T4

When measuring enzyme activity, if the instrument is operating 5C lower than the temperature prescribed for the method, how will the results be affected?

lower than actual

What may be seen in a CSF sample of a patient that has a subarachoid (intracranial) hemorrhage (SAH)?

macrophage containing hemosiderin

Antigen processing is primarily accomplished by what type of cell?

macrophages

An important metallic activator of alkaline phosphatase and creatinine kinase is?

magnesium

When evaluating the patterns of fluroscent anti-nuclear antibody (FANA) testing, cytoplasmic patterns indicate?

may demonstrate anti-mitochondrial antibodies seen in primary biliary cirrhosis

Serum calcitonin is typically elevated in which of the following conditions

medullary carcinoma of the thyroid

What assay, using 24 hour urine, is considered the BEST single screening test for pheochromocytoma?

metanephrines

What medication is considered an antineoplastic drug?

methotrexate

Uses of Nucleic Acid Tests for HIV infections

monitor the effectiveness of antiretroviral therapy obtain a baseline value prior to the start of antiretroviral therapy diagnose HIV infection

What condition would make a sample unsuitable for lactic acid testing?

movement of hand or arm during specimen collection

Creatinine excretion correlates best with what body parameter?

muscle mass

What cardiac biomarker rises within 1-3 hours after chest pain, peaks in 2-6 hours, and is usually normal within 24 hours?

myoglobin

What is the EARLIEST biochemical marker of myocardial infarction?

myoglobin

Proteins in a buffer that sets the pH at 8.6 will become ________________ charged and migrate to the _______________

negatively, anode

The property MOST responsible for the migration of proteins in an electrical field is what?

net surface charge

Are oral glucose tolerance tests (OGTT) performed routinely?

no, discouraged for routine use

Leucine Crystals

oily, highly refractile, yellow to brown spheriods with radial concentric laminations

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

one of the values is an error

What types of lymphocytes express CD4?

only T-helper cells

Dietary iron and iron absorption

only a small percentage of dietary is absorbed and used

What does uncompensated metabolic alkalosis look like?

pH elevated without an elevation in pCO2

What is a cause of hypomagnesemia?

pancreatitis

The biuret reaction for the analysis of serum protein depends on the number of what?

peptide bonds

What drug is an anti-convulsant?

phenobarbital

Follicle-stimulating hormone (FSH) is produced by?

pituitary gland

What is another name used to designate a fully committed B-lymphocyte

plasma cell

What macroscopic finding is MOST consistent with the microscopic finding of casts?

positive protein

A liquid ion-exchange membrane electrode using the antibiotic valinomycin is MOST selective for what?

potassium

The presence of slight visible hemolysis will significantly increase what serum electrolyte?

potassium

Bence Jones proteins and heat precipitation test

precipitate between 40-60C but redissolve at 100C

Urinalysis finding that correlate with the presence of yeast infection?

presence of glucose white blood cells turbid urine

The selectivity of an ion-selective electrode is determined by what?

properties of the membrane used

What is the most accurate observation about osmotic pressure?

proportional to concentration of solute particles

When collecting a specimen for vitamin A, what special precaution needs to be taken?

protect the specimen from light

High sensitivity C-reactive protein

protein produced primarily by the liver in response to inflammation marker for chronic inflammation and measured to predict risk of cardiovascular disease

What are apolipoproteins?

proteins that are on the surface of lipoprotein molecules that bind enzymes or transport specific proteins and direct lipoproteins to their sites of metabolism

What condition is caused by an increased plasminogen activator inhibitor 1 (PA-1) and fibrinogen often present in metabolic syndrome?

prothrombotic state

The primary purpose of neutrophil granules is to:

provide microbicidal action

What term could be used to describe an analyzer that can test specimens out of sequence?

random access

What best describes serum hCG levels during pregnancy?

rapid rise in levels during first trimester; slow decline and possible level-off throughout remainder of pregnancy

L/S ratio determination of amniotic fluid is useful is assessing the probability of what?

respiratory distress syndrome

Glucagon

responsible for increasing glucose levels in the blood increases glycogenolysis

Insulin

responsible for the entry of glucose into the cell increases glycogenesis

What is considered the major transport protein for vitamin A?

retinol-binding protein

Patients with Cushing's disease typically exhibit:

serum cortisol overproduction

Quantitative methods for the determination of albumin

serum protein electrophoresis nephelometry colorimetric spectrophotometry

How should ammonia be transported to the lab?

should be transported in an ice slurry

What analyte would not be significantly increased in a plasma sample as a result of hemolysis?

sodium

C-reactive protein (CRP) is often used as a marker of inflammation. However, it has low ___________?

specificity

Sudan III stain

stains unabsorbed fat. for malabsorption Dx

What is gastrin's role in digestion?

stimulates gastric acid-HCl secretion

What test can be used as a confirmatory test for proteinuria?

sulfosalicyclic acid test

What is the isoelectric point?

the pH at which the molecule is electrically neutral

A HbA1C result for a diabetic patient is 6.0%. What conclusion can be made regarding this patient's carbohydrate management?

the patient is compliant with diet and medication

What factor would least affect an orally administered drug's absorption and/or distribution in the body?

the position of the patient when the drug is taken (sitting vs. standing)

Specific Gravity measured by the reagent strip method

the reagent strip method is based on the relationship between ionic concentration and specific gravity urine chemical reagent strip method is not affected by the presence of x-ray contrast media in the urine specimen

What is the typically finding for determine the endpoint for the initial or iron-depletion phase of treatment for hereditary hemochromatosis (HH)?

the serum ferritin decreases to between 20 to 50 ng/mL

Pharmacokinetics

the study of drug movement throughout the body

Zero order kinetics

the substrate concentration is in excess and the reaction rate is dependent on the enzyme concentration

CYP450 enzymes

they are able to make compounds more water soluble and therefore enhanced excretion

What procedure is important to implement when a test for lead is collected by finger puncture that would NOT be necessary prior to an antecubital venipuncture?

thoroughly washing patient's hands with soap and water

Calcitonin

thyroid gland

TIBC is an indirect measurement of

transferrin

Total iron-binding capacity measures the serum iron transporting capacity of:

transferrin

Which protein is also known as prealbumin because it migrates before albumin in the customary electrophoresis of serum or plasma proteins?

transthyretin (thyroxine binding prealbumin)

Chylomicrons are primarily composed of:

triglycerides

Lipemia in a fasting serum sample is most likely caused by an increase in serum levels of what?

triglycerides

What lipid result would be expected to be FALSELY elevated on a serum specimen from a non-fasting patient?

triglycerides

What is the MOST specific biochemical marker of myocardial infraction?

troponin

What cells of urine would be most indicative of kidney disease?

tubular epithelial cells

Nephelometry is based on the principle of:

turbidity resulting from specific antigen-coated latex particles agglutinated by corresponding antibodies

What condition is indicated by the following arterial blood gas results?Bicarbonate = 32 mmol/L (Normal = 22 - 29 mmol/L) pCO2 = 65 mm Hg (Normal = 35 - 45 mmHg) pH = 7.28 (normal = 7.35 - 7.45)

uncompensated respiratory acidosis

What purine base is found in RNA and not in DNA?

uracil

What urine chemical reagent strip test is based on Ehrlich-aldehyde reactions?

urobilinogen

The ultimate end product of both epinephrine and norepinephrine metabolism is:

vanillylmandellic acid (VMA)

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

vitamin A

Pharmokinetics

what the body does to the drug

lead poisoning

while lead distributes to all tissues, the central nervous system, kidney, and bone marrow are particularly susceptible to lead toxicity whole blood lead measurement is the best test for detecting lead toxicity lead levels below 5ug/dl in children do not prompt ongoing monitoring

What cast is characteristically associated with acute pyelonephritis?

white cell

Cell counts on CSF specimens should be performed within what time frame following collection of the CSF sample?

within one hour

Cells seen in the microscopic examination of the urine of a 30 year old female which are smaller than RBC's but much the same shape are probably:

yeast cells

What microscopic techniques is best suited for direct examination of the infectious agents of syphilis?

dark-field microscopy - allows for spirochetes to be seen

What changes in potassium and sodium result may occur with diuretic use?

decrease in both

Enzyme Multiplied Immunoassay Technique (EMIT)

A non-separation immunoassay based on an enzyme label

Formula for calculating transferrin saturation

(serum iron/TIBC) x 100

What is the half-life of IgG? Why is the duration of the half-life significant?

18-23 days; it binds with neonatal Fc receptor

What transferrin saturation level would be indicative to investigate further for hereditary hemochromatosis (HH)?

45%

What is blood alcohol concentration limit in the US?

80 mg/dl

What is considered a normal urine osmolality?

800 mOsm or higher is considered normal when patients were deprived of fluid for 12 hours

Anti-nuclear antibodies?

95% of patients with SLE will test positive for ANAs

A physician needs to prescribe a drug to a patient but the drug has a narrow therapeutic window. He is concerned about possible toxic effects. To assess the upper concentration of such a drug, which time for drawing the specimen do you think makes the most sense? A) approximately one hour after an oral dose B) 2-4 hours after an IV injection of a drug C) before any drug is given D) right before the next dose of the drug is given

A) approximately one hour after an oral dose

Which one of the following serum constituents is increased following strenuous exercise? A) creatinine B) total lipids C) sodium D) iron

A) creatinine

Lancefield antigens that are found on organisms from the Streptococcus anginosus group?

A, F, G

All of the following are causes of hypernatremia EXCEPT: A) excessive water loss B) low aldosterone production C) decreased water intake D) increased sodium intake or retention

B) low aldosterone production aldosterone stimulates sodium reabsorption in the distal tubules of the nephrons

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

B) triglycerides

Detection of a fruity odor in a fresh urine sample may be indicative of which of the following EXCEPT: A) starvation B) malabsorption C) bacterial infection D) diabetes mellitus

C) bacterial infection

What cells are responsible for the humoral immune response?

B lymphocytes involves antibody production

The properties of enzymes are correctly described by which of the following statements? A) Enzymes activity is not altered by heat denaturation B) enzymes are protein catalysts of biological origin C) enzymes are stable proteins and unaffected by pH changes D) enzymes affect the rate of a chemical reaction by raising the activation energy needed

B) enzymes are protein catalysts of biological origin

All of the following anticoagulants will produce a significant effect on calcium levels in plasma, EXCEPT? A) EDTA B) heparin C) oxalates D) citrates

B) heparin heparin prevents coagulation by forming complexes with antithrombin III

high levels of lipoprotein-associated phospholipase A2 are associated with: A) decreased cardiovascular risk B) increased cardiovascular risk C) increased renal failure risk D) increased liver failure risk

B) increased cardiovascular risk

All of the following are possible medical complications for an individual diagnosed with metabolic syndrome, EXCEPT: A) fatty liver disease B) renal disease C) brain tumor D) sleep apnea

C) brain tumor

What leukocytes is most directly associated with antibody production?

B-cells

Which markers are currently used to differentiate heart failure from lung disease?

BNP and NT-proBNP

Which risk marker has both positive and negative cardiovascular risk integrated into its measurement? A) LpPLA2 B) oxidized LDL C) Apo B-100/Apo A-1 D) hs-CRP

C) Apo B100/Apo A-1

Flow cytometry is a useful tool in the study of all of the following disorders EXCEPT? A) HIV B) Leukemia C) Viral hepatitis D) Lymphoma

C) Viral hepatitis

Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity?

adiponectin

All of the following statements about fluorometry are true, EXCEPT: A) fluorometry is more sensitive than spectrophotometry B) both excitation and emission spectra are characteristics of the analyyte C) fluorescence is indirectly proportional to the analyte being measures D) fluorometers typically utilize monochromators or optical filters

C) fluorescence is indirectly proportional to the analyte being measures

Which assay would help rule out ovarian cancer?

CA 125

What tumor markers are elevated in more advanced stages of breast cancer?

CA 15-3 and CA 549

Tumor marker associated with ovarian cancer

CA-125

Which tumor marker is used for colorectal cancer?

CEA

What cardiac biomarker could detect a recent reinfarction?

CK-MB

What tests are used to diagnose acute coronary syndrome and/or acute myocardial infarction?

CK-MB TnI TnT

What two biomarkers are not specific to cardiac muscle and may be elevated in patients with injury to muscle other than cardiac muscle?

CK-MB and myoglobin

Which three genetic variations in enzymes are most often linked to differences in drug metabolism?

CYP2D6 CYP2C9 CYP3A4

Initial step in the process of phagocytosis?

Chemotaxis

All of the following statements are true regarding the hepatic system and drug metabolism, EXCEPT? A) changes in hepatic status will affect the concentration of circulating drug eliminated B) hepatic disease states characterized by a loss of functional tissue may result in slower rates of clearance C) hepatic disease states characterized by a loss of functional tissue may result n a longer drug half-life D) metabolism of acetaminophen by the MFO system is altered by alcohol and makes it less toxic

D) metabolism of acetaminophen by the MFO system is altered by alcohol and makes it less toxic

An increase in creatinine is most commonly associated with what?

decreased glomerular filtration

Increases in the MB fraction of CK is associated with: A) Liver disease B) bone disease C) kidney failure D) myocardial infraction

D) myocardial infarction CK-MB (muscle, brain) CK-MM (muscle) CK-BB (brain)

Plasma creatinine concentration is dependent on all of the following EXCEPT: A) relative muscle mass B) renal function C) rate of creatinine turnover D) sodium concentration

D) sodium concentration

All of the listed disorders are organ non-specific autoimmune diseases EXCEPT: A) SLE B) Systemic sclerosis (SSc) C) rheumatoid arthritis (RA) D) Hashimoto's disease

D) Hashimoto's disease

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

D) apoenzyme

Which of the following is NOT required for a diagnosis of hereditary hemochromatosis (HH)? A) >50% transferrin saturation in females or >60% saturation in males B) presence of HFE mutations or other genetic mutations associated with iron metabolism C) increased ferritin D) biopsy of liver and/or bone marrow

D) biopsy of liver and/or bone marrow

Serum alkaline phosphatase (ALP) activity is derived from all of the following organs EXCEPT: A) bone B) intestines C) placenta D) brain

D) brain

8-Hydroxyquinoline and Ortho-Cresolphthalein complexone (CPC) reagent is commonly used in the determination of: A) phosphorus B) magnesium C) chloride D) calcium

D) calcium

The nitrite portion of the test strip can be used to do all of the following EXCEPT: A) monitor antibiotic therapy B) detect a bladder infection in an early stage in pregnant women C) screen individuals with recurrent infections D) detect metabolic bye-products often seen in diabetic patients

D) detect metabolic bye-products often seen in diabetic patients

Which of the following is a cause of metabolic alkalosis? A) late stage of salicylate poisoning B) uncontrolled diabetes mellitus C) renal failure D) excessive vomiting

D) excessive vomiting

A deficiency in which of these vitamins leads to increased clotting and may result in hemorrhagic disease? A) Riboflavin B) pyridoxine C) Vitamin C D) Vitamin K

D) vitamin K - needed to produce certain coagulation factors

What serological tests would be used for the diagnosis of Q-fever?

EIA or indirect immunoflurescence

What is the confirmatory test for syphilis?

FTA-ABS

Zollinger-Ellison syndrome

Gastrin-secreting tumor associated with ulcers increase in gastrin

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

Glucuronic acid

What condition is associated with elevated serum uric acid levels?

Gout

What sero-marker is the first marker to become positive in Hepatitis B and is associated with the infective stage

HBs antigen

What test is a more reliable method of monitoring long-term diabetes control?

HgB A1C

A major macrophage-activating cytokine is:

IFN-gamma (interferon gamma)

What immunoglobulin classes is chiefly responsible for the degranulation of mast cells and basophils?

IgE

What immunoglobulin is associated with anaphylactic shock?

IgE

What characteristic differentiates a secondary immune response form a primary immune response?

IgG is the predominant antibody class produced in the secondary immune response compared to the primary immune response

Which three hormones are known to regulate serum Ca2+ by changing their secretion rate in response to changes in ionized Ca2+?

PTH, vitamin D, and calcitonin

Iontophoresis

Process of infusing water-soluble products into the skin with the use of electric current, such as the use of the positive and negative poles of a galvanic machine used for CF diagnosis

What are acute phase proteins?

Proteins that are synthesized by the liver in response to infection, illness, and tissue injury. alpha-1 antitrypsn CRP fibrinogen

Rocky Mountain Spotted Fever

Rickettsia rickettsii IFA testing

What disease state is thyroid stimulating hormone decreased?

decreased in hyperthyroidism

What is the primary target of HIV?

T-helper cells

Therapeutic drug monitoring

The process of measuring drug levels to identify a patient's drug exposure and to allow adjustment of dosages with the goals of maximizing therapeutic effects and minimizing toxicity.

Calcitonin is synthesized by which cells in the body?

Thyroid C cells

What hormones stimulate glucogenogenesis, the formation of glucose from noncarbohydrate sources such as amino acids, glycerol, and fatty acids?

Thyroxine (T4) Cortisol Glucagon

What lymphocyte subtype controls autoimmunity in the peripheral blood?

Treg - immunoregulatory CD4+ T cells function is to maintain self-tolerance

Which troponin protein binds to tropomyosin?

Troponin T (TnT)

Below are the laboratory results on a 20-year-old overweight male. His waist circumference is 41 inches and blood pressure is 105/70. Fasting Blood Glucose: 130 mg/dL Triglycerides: 190 mg/dL HDL: 50 mg/dL The National Heart, Lung, and Blood Institute (NHLBI) and American Heart Association (AHA) have created a set of parameters to define the presence of metabolic syndrome. Does this patient meet the criteria for metabolic syndrome diagnosis?

Yes he meets the NHLBI and AHA criteria for metabolic syndrome

Pheochromocytoma

a benign tumor of the adrenal medulla that causes the gland to produce excess of free catecholamines, metanephrines, vanillylmandelic acid

Zinc deficiency in the elderly is often caused by:

decreased intake and absorption

Whole blood glucose values are _________ plasma glucose values?

about 11% lower

What is the cause of iron overload in hereditary hemochromatosis?

absorption of excessive amounts of iron in the small intestine

The ketone component that is measured by the nitroprusside reaction is:

acetoacetic acid

beta-hydroxybutyrate is formed as the result of an accumulation of what?

acetyl-coA = major role in metabolism of carbohydrates, lipid, and protein metabolism

What form of immunity is expected to provide long-term protection after HBV is administered to an immunocompetent person?

active

Ion selective electrodes, for pH determinations, are called selective rather than specific because they actually measure the what?

activity of one ion much more than other ions present

What affect may bacterial contamination have on urine pH?

bacteria may make the pH more alkaline

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

beriberi (deficiency in vitamin B1)

The immunoassay procedure for serum hCG utilizes antisera against which subunit of hCG?

beta

Most of the carbon dioxide in the blood is in what form?

bicarbonate

Elevation in conjugated bilirubin is most likely to be found in what conditions

biliary obstruction

What substance can cause a false positive result for blood on the urine chemical reagent strip?

bleach in the collecting bottle

In the condition kernicterus, the abnormal accumulation of bilirubin occurs in what tissue?

brain

Estrogen (ERs) and progesterone (PRs) receptors used as tumor markers are most commonly employed to provide prognostic information about?

breast cancer

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

decreased serum iron increased transferrin decreased ferritin decreased percent saturation increased total iron binding capacity

Define specific gravity

density of a solution compared to density of water

Which substance is used in the Jendrassik-Grof method to accelerate the reaction of unconjugated bilirubin with the diazo reagent?

caffeine-benzoate = used to split the unconjugated bilirubin protein complex releasing the bilirubin so that it can react with acid

Parathyroid hormone is important in the regulation of what?

calcium and phosphate

Ionized calcium is currently measured by what method?

calcium ion selective electrodes

Vitamin D act as a hormone for what regulation?

calcium regulation activated vitamin D induces the absorption of calcium in the small bowel cells

What is a major property of antidiuretic hormone?

changes distal tubule water permeability

nephrotic syndrome

characterized by massive proteinuria caused by glomerular damage. corticosteroids are the mainstay transitional epithelial oval fat bodies

Process of Phagocytosis

chemotaxis, adherence, ingestion, digestion

In the blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what ion?

chloride

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

cholesterol

What lipid test is LEAST affected by the fasting status of the patient?

cholesterol

A broad based increase in the gamma band of electrophoresis indicates?

chronic inflammation

Waxy casts

chronic renal failure

Triple phosphate crystals

coffin lid apearance normal in alkaline urine

An increase in carcinoembryonic antigen (CEA) level is most closely associated with which organ?

colon

Atherosclerosis

condition in which fatty deposits called plaque build up on the inner walls of the arteries

Which dye-binding method uses an increase of absorbance at 595 nm to determine the total protein concentration of the specimen?

coomassie brilliant blue 250

An elevated level of what hormone will inhibit pituitary secretion of ACTH?

cortisol

What test would be used in assessment of glomerular filtration?

creatinine clearance

Measurement of the sodium and chloride concentration of sweat is the most useful test for the diagnosis of:

cystic fibrosis

Which nitrogen base would bind with a guanine nucleotide in forming double-stranded DNA?

cytosine

Atherosclerosis

deposition of plaque containing cholesterol and lipids on the innermost layer of the wall of large and medium sized arteries

What drug may be used to decrease iron levels in patients with iron overload?

desferrioxamine

What hormones increase or decrease glucose concentration by regulating glycogenolysis (converting of glycogen to glucose)?

glucagon epinephrine insulin

At medical examination, a 50-year-old Caucasian male expressed concern regarding diabetes. There is a history of type 2 diabetes, hypertension, and cardiovascular disease in his family. He has gained a few pounds each year and his physician notes abdominal obesity. His physician orders laboratory tests to evaluate his risk of cardiovascular disease.Vital Signs and Pertinent Laboratoy Results:Blood Pressure: 128/82 mm HgWeight: 230 lbsHeight: 5' 11''Calculated BMI: 32.1Waist Circumference: 45 inchesFasting Blood Glucose: 120 mg/dLTriglycerides: 170 mg/dLHDL-C: 42 mg/dLWhich one of the following statements regarding this patient is true if the physician uses the guidlines of American Heart Association (AHA) and National Heart, Lung, Blood Institute (NHLBI) for metabolic syndrome evaluation?

diagnosis of metabolic syndrome waist circumference triglyceride level fasting glucose

The most common methods for measuring bilirubin are based on the reaction of bilirubin with?

diazo reagent

Methodology of FISH

direct nucleic acid test that uses RNA northern blot or DNA southern blot to detect variations

What values would be expected with metabolic alkalosis?

elevated pH increased bicarbonate normal PCO2

What parameters are included in the diagnosis of the presence of the metabolic syndrome in adults?

elevated waist circumference elevated triglyceride level elevated fasting glucose

Increases in blood ammonia levels would be expected in which conditions:

end stage cirrhosis

Hemoglobin A1c is reported with what other value?

estimated average glucose

What lab assays are utilized for metabolic syndrome diagnosis?

fasting blood glucose triglycerides HDL-C

What additional fraction would be seen if plasma rather than serum was subjected to electrophoresis?

fibrinogen

What is found in plasma but absent in serum?

fibrinogen

In what trimester is there the greatest risk for the manifestation of complications in maternal rubella infection?

first trimester

What type of toxicology is primary concerned with medical and legal consequences of exposure to chemicals or drugs?

forensic toxicology

What is the principle for the biuret method for total protein analysis?

formation of violet-colored chelate between Cu2+ ions and peptide bonds

An adult's plasma cortisol of 22 ug/dl at 8:00am and 1o ug/dl at 4pm would be:

found in a healthy individual

Bioavaliability of an oral drug refers to:

fraction of the drug that is absorbed into system circulation

What form of calcium is biologically active?

free ionized calcium

What method for long-term diabetic monitoring is recommended for patients with sickle cell anemia?

fructosamine

What enzyme is the most sensitive indicator of long term liver damage associated with alcohol ingestion?

gamma-glutamyl transpeptidase (GGT)

Hydrogen ion concentration in blood is usually determine by means of what electrode?

glass