BOC chemistry
reverse phase high-performance liquid chromatography is being increasingly utilized in therapeutic drug monitoring. The term reverse phase implies that the column eluant is: a. pumped up the column b. more polar than the stationary phase c. always nonpolar d. less polar than the stationary phase
B
reverse phase high-performance liquid chromatography is being increasingly utilized in therapeutic drug monitoring. The term reverse phase implies that the column eluant is: a. pumped up the column b. more polar that the stationary phase c. always nonpolar d. less polar than the stationary phase
B
the regulation of calcium and phosphorus metabolism is accomplished by which of the following glands? a. thyroid b. parathyroid c. adrenal glands d. pituitary
B
Lactate dehydrogenase, malate dehydrogenase, isocitrate dehydrogenase, and hydroxyburate dehydrogenase all: a. are liver enzymes b. are cardiac enzymes c. catalyze oxidation-reduction reactions d. are class III enzymes
C
Maple syrup urine disease is characterized by an increase in which of the following amino acids? a. phenylalanine b. tyrosine c. valine, leucine and isoleucine d. cystine and cysteine
C
On electrophoresis at alkaline pH, which of the following is the slowest migrating hemoglobin? a. Hgb A b. Hgb S c. Hgb C d. Hgb F
C
Quantitation of Na+ and K+ by ion-selective electrode is the standard method because: a. dilution is required for flame photemetry b. there is no lipoprotein interference c. of advances in electrochemistry d. of the absence of an internal standard
C
Select the test which evaluates renal tubular function: a. IVP b. creatinine clearance c. osmolarity d. microscopic urinalysis
C
Serum concentrations of vitamin B12 are elvated in: a. pernicious anemia in relapse b. patients on chronic hemodialysis c. chronic granulocytic leukemia d. Hodgkin disease
C
The anion gap is useful for quality control of laboratory results for: a. amino acids and proteins b. blood gas analyses c. sodium, potassium, chloride, and total CO2 d. calcium, phosphorus, and magnesium
C
The biuret reaction for the analysis of serum protein depends on the number of: a. free amino groups b. free carboxyl groups c. peptide bonds d. tyrosine residues
C
The combination of increased capillary fragility and prolonged bleeding time suggests a deficiency in: A. thromboplastin B. prothrombin C. platelets D. fibrinogen
C
The drug procainamide is prescribed to treat cardiac arrhythmia. What biologically acitve liver metabolite of procainamide is often measured simultaneously? a. phenobarbitol b. qunidine c. N-actyl procainamide (NAPA) d. lidocain
C
The epstien-barr virus is associated with which of the following? a. chickenpox b. Hodkin lymphoma c. Burkitt lymphoma d. smallpox
C
The identification of Bence Jones protein is best accomplished by: a. a sulfosalicylic acid test b. urine reagent strips c. immunofixation d. electrophoresis
C
The osmal gap is defined as measured Osm/kg minus the calculated Osm/kg. Normally, the osmol gap is less than: a. 10 b. 20 c. 40 d. 60
C
The principle excretory form of nitrogen is: A. amino acids B. creatinine C. urea D. uric acid
C
The principle of the reagent strip test for microalbuminuria is: a. a diazo reaction b. the protein error of indicators c. a dye-binding reaction d. the release of hydrogen ions to an indicator
C
The relative migration rate of proteins on cellulose acetate is based on: a. molecular weight b. concentration c. ionic charge d. particle size
C
The total iron binding capacity measures the serum iron transporting capacity of: a. hemoglobin b. ceruloplasmin c. transferrin d. ferritin
C
Transportation of 60%-75% of the plasma cholesterol is performed by: a. chylomicrons b. very low-density lipoproteins c. low-density lipoproteins d. high-density lipoproteins
C
Turbidity in serum suggests elevation of: a cholesterol b total protein c chylomicrons d albumin
C
What feature would not be expected in pseudo-Pelger-Huet cells? a. hyperclumped chromatin b. decreased granulation c. normal peroxidase activity d. abnormal neutrophils
C
What is the proper pH for the buffered solution used to perform serum protein electrophoresis? a. 5.6 b. 7.6 c. 8.6 d. 9.6
C
What substance gives feces its normal color? a. uroerythrin b. urochrome c. urobilin d. urobilinogen
C
Which of the following chemical determinations may be of help in establishing the presence of seminal fluid? a. lactic dehydrogenase b. isocitrate dehydrogenase c. acid phosphatase d. alkaline phosphatase
C
Which of the following diseases results from a familial absence of high density lipoprotein? a. Krabbe disease b. Gaucher disease c. Tangier disease d. Tay-Sachs disease
C
Which percentage of total serum calcium is nondiffusible protein bound? a. 80%-90% b. 51%-60% c. 40%-50% d. 10%-30%
C
eGFR calculated by the MDRD formula takes into account the age, BUN, race, albumin, and what else for its calculations? a. urea b. ammonia c. creatinine d. crystatin C
C
The preferred blood product for a bleeding patient with von Willebrand's disease is transfusion with:
Cryo, AHF
Creatinine clearance is used to estimate the: a. tubular secretion of creatinine b. glomerular secretion of creatinine c. renal glomerular and tubular mass d. glomerular filtration rate
D
High levels of________cholesterol appear to reduce the risk of atherosclerosis a. chylomicrons b. VLDL c. LDL d. HDL
D
In respiratory acidosis, a compensatory mechanism is the increase in: a. respiration rate b. ammonia formation c. blood PCO2 d. plasma bicarbonate concentration
D
In respitory acidosis, a compesatory mechanism is the increase in: a. respiration rate b. ammonia formation c. blood PCO2 d. plasma bicarbonate concentration
D
In the Jaffe reaction, creatinine reacts with: a. alkaline sulfasalazine solution to produce an orange-yellow complex b. potassium iodide to form a reddish-purple complex c. sodium nitroferricyanide to yield a reddish-brown color d. alkaline picrate solution to yield a orange-red complex
D
In the atomic absorption method for calcium, lanthanum is used: a. as an internal standard b. to bind calcium c. to eliminate protein interference d. to prevent phosphate interference
D
In the liver, bilirubin is converted to: a. urobilinogen b. urobilin c. bilirubin-albumin complex d. bilirubin diglucuronide
D
In using ion-exchange chromatographic methods, falsely increased levels of Hgb A1c might be demonstrated in the presence of: a iron deficiency anemia b pernicious anemia c thalassemias d Hgb S
D
In von Willebrand disease, platelets give an abnormal aggregation result in the presence of: a. adenosine diphosphate b. epinephrine c. collagen d. ristocetin
D
In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates? a. Gilbert disease b. Rotor syndrome c. Dubin-Johnson syndrome d. Crigler-Najjar syndrome
D
Increased serum albumin concentrations are seen in which of the following conditions? a. nephrotic syndrome b. acute hepatitis c. chronic inflammation d. dehydration
D
Isoenzymes are performed to improve: a. precision b. accuracy c. sensitivity d. specificity
D
Metabolic acidosis is described as an: a. increase in CO2 content and PCO2 with a decreased pH b. decrease in CO2 content with an increased pH c. increase in CO2 with an increased pH d. decrease in CO2 content and PCO2 with a decreased pH
D
Oligoclonal bands are present on electrophoresis of concentrated CSF and also on concurrently tested serum of the same patient . The proper interpretation is: a. diagnostic for primary CNS tumor b. diagnostic of MS c. CNS involvement by acute leukemia d. nondiagnostic for multiple sclerosis
D
Pellegra is a deficiency of what vitamin? a. A b. B1 c. thiamine d. niacin
D
Platelet aggregation will occur with the end production of: a. cyclooxygenease b. arachidonic acid c. prostacyclin d. thrombaxane A2
D
Pleural fluid from a patient with congestive heart failure would be expected to: a. contain bacteria b. have high protein content c. be purulent d. appear clear and pale yellow
D
Pregnant women with symptoms of thirst, frequent urination or unexplained weight loss should have which of the following tests performed? a. tolbutamide test b. lactose tolerance test c. epinephrine tolerance test d. glucose tolerance test
D
Rickets is associated with deficiency of which of the following vitamins? a. B1 b. C c. niacin d. D
D
Serum "anion gap" is increased in patients with: a renal tubular acidosis b diabetic alkalosis c metabolic acidosis due to diarrhea d lactic acidosis
D
Stray light can be detected in the spectrophotometer by utilizing a: a. mercury vapor lamp b. holmium oxide glass c. potassium dichromate solution d. sharp cutoff filter
D
The bicarbonate and carbonic acid ratio is calculated from an equation by: a. siggaard-anderson b. gibbs-donnan c. natelson d. henderson-hasselbalch
D
The buffering capacity of blood is maintained by a reversible exchange process between bicarbonate and: a. sodium b. potassium c. calcium d. chloride
D
The conversion of glucose or other hexoses into lactate or pyruvate is called: a. glycogenesis b. glycogenolysis c. gluconeogenesis d. glucolysis
D
The degree to which the kidney concentrates the glomerular filtrate can be determined by: a. urine creatine b. serum creatine c. creatine clearance d. urine to serum osmolality ratio
D
The enzme, wich exists cheifley in keletal muscle, heart and brain is grossly elevated in active muscular dystrophy, and rises early in myocardial infarction is: a. lipase b. transaminase c. lactate dehydrogenase d. creatinine kinase
D
The first step in analyzing a 24-hour urine specimen for quantitative urine protein is: a. subculture the urine for bacteria b. add the appropriate preservative c. screen for albumin using a dipstick d. measure the total volume
D
The first step in the quantitation of serum iron is: a. direct reaction with appropriate chromagen b. iron saturation of transferrin c. free iron precipitation d. separation of iron from transferrin
D
The following results were obtained in a creatinine clearance evaluation: Urine concentration: 84 mg/dL Urine volume: 1440 mL/24 hr Serum concentration: 1.4 mg/dL Body surface area: 1.6 m2 (average = 1.73 m2) The creatinine clearance in mL/min is: A 6 B 22 C 60 D 65
D
The function of the major lipid components of the very low density lipoproteins (VLDL) is to transport: a. cholesterol from peripheral cells to the liver b. cholesterol and phospholipids to peripheral cells c. exogenous triglycerides d. endogenous triglycerides
D
The hemoglobin that is resistant to alkali (KOH) denaturation is: a. A b. A2 c. C d. F
D
The method of choice for diagnosis of a protracket attack of porhpyra is: a. screening a fresh morning urine for porphobillinogen b. analysis of delta-aminolevulinic acid in a morning urine c. screening a fresh morning urine for porphryn d. HPLC analysis of porphobillinogen in a 24 hour urine
D
The most consistent analytical error involved in the routine determination of HDL-cholesterol is caused by: a. incomplete precipitation of LDL-cholesterol b. coprecipitation of HDL and LDL cholosterol c., inaccurate protein estimation of HDL cholesterol d. a small concentration of apo-B containing lipoproteins after precipitation
D
The most specific ezyme test for acute pancreatitis is: a. acid phosphatase b. trypsin c. amylase d. lipase
D
The most widely used methods for bilirubin measurement are those based on the: a. Jaffe reaction b. Schales and Schales method c. 8-hydroxyquinoline reaction d. Jendrassik-Grof method
D
The optimum storage temperature for platelets is:
D
The presence of oligoclonal bands in the CSF but not in the serum is associated with: a. spina bifida b. hydrocephalus c. Reye syndrome d. multiple sclerosis
D
A 2-year old child had a positive urine ketone. This would most likely be caused by: a. vomiting b. anemia c. hypoglycemia d. bilary tract obstruction
A
A 21 year old woman had glucose in her urine with a normal blood sugar. These findings are most consistent with: a. renal glycosuria b. diabetes mellitus c. diabetes insipidus d. alkaline tide
A
A 68-year old man arrives in the ER with a glucose level of 722 mg/dL and a serum acetone of 4+ undiluted. An arterial blood gas from this patient is likely to be: a. low pH b. high pH c. low PO2 d. high PO2
A
A common cause of falsely increased LD1 fraction of lactic dehydrogenase is: a. specimen hemolysis b. liver disease c. congestive heart failure d. drug toxicity
A
A hospitalized patient is experiencing increased neuromuscular irritability (tetany). Which of the following tests should be ordered immediately? a. calcium b. phosphate c. BUN d. glucose
A
A lipemic serum is separated and frozen at —20°C for assay at a later date. One week later, prior to performing an assay for triglycerides, the specimen should be: a. warmed to 37 degrees C and mixed thoroughly b. warmed to 15 degrees C and centrifuged c. transferred to a glycerated test tube d. discarded and a new specimen obtained
A
A low concentration of serum phosphorous is commonly found in: a. patients who are receiving carbohydrate hyperalimentation b. chronic renal disease c. hypoparathyroidism d. patient with pituitary tumors
A
A low concentration of serum phosphorus is commonly found in: a. patients who are recieving carbohydrate hyperalimentation b. chronic renal disease c. hypoparathyroidism d. patients with pituitary tumors
A
A patient has life-threatening anemia due to warm autoantibodies. The patient's serum was reactive 2+ in the antiglobulin phase of testing with all cells on a routine panel. A technique that would be beneficial in preparing the patient's serum for compatibility testing is: a. autoabsorption using patients ZZAP treated cells b. autoabsorption using patients LISS treated cells c. absorption using enzyme treated cells from a normal donor d. absorption using methyldopa treated cells
A
A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would be consistent with this diagnosis? a. High TCO2, increased HCO3 b. Low TCO2, increased HCO3 c. High TCO2, decreased H2CO3 d. Low TCO2, decreased H2CO3
A
A patient with hemolytic anemia will: a. show a decreased glycated Hgb value b. show an increased glycated HbB value c. show little or no change in glycated Hgb value d. demonstrate an elevated Hgb A1
A
A test area of a urine reagent strip is impregnated with only sodium nitroprusside. This section will react with: a. acetoacetic acid b. leukocyte esterase c. beta-hydroxybutyric acid d. ferric chloride
A
After warming to 60 degrees C a cloudy urine clears. This is due to the presence of: a. urates b. phosphates c. WBCs d. bacteria
A
An active metabolite of amitriptyline is: A. nortriptyline B. protriptyline C. butrptyline D. norbutriptyline
A
An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state? a. respiratory acidosis b. respiratory alkalosis c. metabolic acidosis d. metabolic alkalosis
A
An increase in serum acetone is indicative of a defect in the metabolism of: a. carbohydrates b. fat c. urea nitrogen d. uric acid
A
An infant with diarrhea is being evaluated for a carbohydrate intolerance. His stool yields a positive copper reduction test and a pH of 5. It should be concluded that: a. further tests are indicated b. results are inconsistent - repeat both tests c. the diarrhea is not due to carbohydrate intolerance d. the tests provides no useful information
A
Antidiuretic hormone regulates the reabsorption of: a. water b. glucose c. potassium d. calcium
A
Aspirin affects platelet function by interfering with platelets' metabolism of: a. prostaglandins b. lipids c. carbohydrates d. nucleic acids
A
Assay of transketolase activity in blood is used to detect deficiency of: a. thiamine b. folic acid c. ascorbic acid d. riboflavin
A
Factors that contribute to a PCO2 electrode requiring 60-120 seconds to reach equilibrium include the: a. diffusion characteristics of the membrane b. actual blood PCO2 c. type of calibration standard d. potential of the polarizing mercury cell
A
Hemoglobin S can be separated from hemoglobin D by: a. electrophoresis on a different medium and acidic H b. hemoglobin A2 quantitation c. electrophoresis at higher voltage d. Kleihauer-Betke acid elution
A
In a pleural effustion caused by Strep. Pneumo, the protein value of the pleural fluid as compared to the serum value would probably be: a. decreased by 2 b. decreased by half c. increased by half d. equal
A
In bilirubin determinations, the purpose of adding a concentrated caffeine solution or methyl alcohol is to: a. allow indirect bilirubin to react with color reagent b. dissolve conjugated bilirubin c. precipitate protein d. prevent any change in pH
A
In which of the following disease states is conjugated bilirubin a major serum component? a. biliary obstruction b. hemolysis c. neonatal jaundice d. erythroblastosis fetalis
A
Microscopic analysis of a urine specimen yields a moderate amount of red blood cells in spite of a negative result for occult blood using a reagent strip. The technologist should determine if this patient has taken: a. vitamin C b. a diuretic c. high blood pressure medication d. antibiotics
A
Of the following disease, the one most often associated with elevation of lactate dehydrogenase isoenzymes 4 and 5 on electrophoresis is: a. liver disease b. hemolytic anemia c. myocardial infarction d. pulmonary edema
A
On an electronic cell counter, hemoglobin determinations may be falsely elevated due to the presence of: a. lipemia or elevated bilirubin concentration b. a decreased WBC or lipemia c. an elevated bilirubin concentration or rouleux d. rouleaux or lipemia
A
Phenobarbitol is a metabolite of: a. primidone b. phentoin c amobarbitol d. secobarbital
A
Platelet satelitosis is usually due to: a. abnormal proteins b. inadequate mixing of blood and anticoagulant c. hemorrhage d. poorly made wedge smear
A
Preanalytical variables in laboratory testing include: a. result accuracy b. report delivery to the ordering physician c. test turnaround time d. specimen acceptability
A
Severe diarrhea causes a. metabolic acidosis b. respiratory acidosis c. metabolic alkalosis d. respiratory alkalosis
A
Severe diarrhea causes: a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis
A
The area of the nephron that is impermeable to water is the: a. proximal convoluted tubule b descending loop of Henle c. ascending loop of Henle d. distal convoluted tubule
A
The buffer pH most effective at allowing amphoteric proteins to migrate toward the cathode in an electrophoretic system would be: a. 4.5 b. 7.5 c. 8.6 d. 9.5
A
The different water content of erythrocytes and plasma makes true glucose concentrations in whole blood a function of the: a. hematocrit b. leukocyte count c. erythrocyte count d. erythrocyte indices
A
The expected blood gas results for a patient in chronic renal failure would match the pattern of: a. metabolic acidosis b. respiratory acidosis c. metabolic alkalosis d. respiratory alkalosis
A
The first procedure to be followed if the blood gas instrument is out of control for all parameters is: a. recalibrate, then repeat control b. repeat control on the next shift c. replace electrodes, then repeat control d. report patient results after duplicate testing
A
The laboratory manager receives a complaint from the ICU about turnaround times for coagulation tests. The first step in problem solving should be: a gather data on current times by shift b talk to staff about various solutions c perform root cause analysis d draw a process map to send to the ICU explaining why it takes so long
A
The most specific method for the assay of glucose utilizes: a. hexokinase b. glucose oxidase c. glucose-6-phosphatase d. glucose dehydrogenase
A
The normal concentration of proteins in CSF, relative to serum protein is: a. less than 1% b. 5-10% c. 25-30% d. 50-60%
A
The precision of an instrument is validated by: a. running the same sample multiple times b. performing serial dilutions c. processing unknown specimens d. monitoring normal and abnormal controls
A
The primary fucntion of serum albumin in the peripheral blood is to: a. maintain colloidal osmotic pressure b. increase antibody production c. increase fibrinogen formation d. maintain blood viscosisty
A
The protein portion of an enzyme complex is called the: a. apoenzyme b. coenzyme c. holoenzyme d. proenzyme
A
The reason that an albumin creatinine ratio can be run on a random specimen is: a. creatinine corrects for over or under body hydration b. a first morning specimen may be too concentrated c. albumin corrects for over or under body hydration d. the reaction is sensitive to any level of albumin
A
The stain that selectively identifies phospholipid in the membranes of primary and secondary granules within myeloid cells is: a. Sudan black B b. leukocyte alkaline phophatase (LAP) c. periodic acid-Schiff (PAS) d. peroxidase
A
The test for adrenal cortical hyperfunction that has the greatest diagnostic sensitivity is measurement of: a. urinary free cortisol b. plasma cotrisol c. urinary 17-hydroxycortocosteroids d. plasma corticosterone
A
To prepare 25 mL of 3% acetic acid, how much glacial acetic acid is needed? a. 0.75 mL b. 1.5 mL c. 3.0 mL d. 7.5 mL
A
What is the best method to diagnose lactase deficiency? a. H2 breath test b. plasma aldolase level c. LDH level d. D-xylose test
A
When myocardial infarction occurs, the first enzyme to become elevated is: a. CK b. LD c. AST d. ALT
A
When using the sulfosalicylic acid test, false-positive protein results may occur in the presence of: a. ketones b. alkali c. glucose d. radiogrphic contrast media
A
Which of the following ezymes are used in the diagnosis of acute pancreatitis? a. amylase and lipase b. AST and ALT c. 5;n and GGT d. AST and lactate dehydrogenase (LD)
A
Which of the following factors is not relevent to therapeutic drug monitoring of the aminoglycosides, antibiotics and vancomycin? a. intestinal absorption b. nephrotoxicity c. ototoxicity d. renal function
A
Which of the following is most likely to be ordered in addition to serum calcium to determine the cause of tetany? a. magnesium b. phosphate c. sodium d. vitamin D
A
Which of the following methods is susceptible to the solvent displacing effect that results in falsely decreased electrolyte values? a. indirect ion-selective electrodes b. direct ion-selective electrodes c. spectrphotometric d. flourescence
A
Zinc protoporphyrin or free erythrocyte protoporphyrin measurements are useful to assess blood concentration of: a. lead b. mercury c. arsenc d. beryllium
A
Which of these affects skeletal muscle? a. Aldolase b. Alkaline Phosphatase (ALP) c. Gamma-glutamyltransferase d. 5-nucleotidase
A - Aldolase helps break down glucose for energy
The electrophoretic pattern of plasma sample as compared to a serum sample shows a: a. broad prealbumin peak b. sharp fibrinogen peak c. diffuse pattern because of the presence of anticoagulants d. decreased globulin fraction
B
The finding of a large amount of uric acid crystals in a urine specimen from a 6 month old boy: a. may actually be diaper fibers b. could indicate Lesch-Nyhan syndrome c. should not be reported d. may indicate improper feeding
B
The majority of angiotensin II is: a. increased in pituitary secretion of vasopressin b. increased vasoconstriction c. increased parathormone secretion by the parathyroid d. decreased adrenal secretion of aldosterone
B
The preparation of a patient for standard glucose tolerance testing should include: a. a high carbohydrate diet for 3 days b. a low carbohydrate diet for 3 days c. fasting for 48 hours prior to testing d. bed rest for 3 days
B
The prescence of which of the following isoenzymes indicates acute myocardial damage? a. CKMM b. CKMB d. CKBB d. none
B
The solute that contributes the most to the total serum osmolality is: a. glucose b. sodium c. chloride d. urea
B
The troponin complex consists of: a. troponin T, calcium and tropomyosin b. troponin C, troponin I and troponin T c. troponin I, actin and tropomyosin d. troponin C, myoglobin and actin
B
Upon development of a thin layer chromatogram for the drug analysis, all drug spots (including the standards) had migrated with the solvent front. The most probable cause for this would be: a. environmental temperature too warm b. incorrect aqueous to nonaqueous solvent mixture c. too much sample applied d. chromatogram dried too quickly
B
Urine specific gravity is an index of the ability of the kidney to: a. filter the plasma b. concentrate the urine c. alter the hydrogen ion concentration d. reabsorb sodium ions
B
When performing a manual protein analysis on a xanthochromic spinal fluid, the technician should: a. perform the test as usual b. make a patient blank c. centrifuge the specimen d.dilute the specimen with deionized water
B
Which factor is vitamin K dependent? a. XIII b. VII c. VIII d. Factor I
B
Which of the following elevates carboxyhemoglobin? a. nitrite poisoning b. exposure to carbon monoxide c. sulfa drug toxicity d. sickle cell anemia
B
Which of the following enzyme substrates is the most specific for prostatic acid phosphatase for quantitative endpoint reactions? a. p-nitrophenylphosphate b. thymolphthalein monophosphate c. beta-naphthol phosphate d. beta-glycerolphosphate
B
Which of the following enzymes catalyzes the conversion of starch to glucose and maltose? a. malate dehydrogenase b. amylase c. creatinine kinase d. isocitric dehydrogenase
B
Which of the following enzymes of heme biosynthesis is inhibited by lead? a. aminolevulinate synthase b. porphobilinogen synthase c. uroporphyrinogen synthase d. bilirubin synthetase
B
Which of the following is secreted by the placenta and used for early detection of pregnancy? a. follicle stimulating hormone (FSH) b. human chorionic gonadotropin (HCG) c. luteinizing hormone (LH) d. progesterone
B
Which of the following sets of results would be consistent with macroamylasemia? a. normal serum amylase and elevated urine amylase values b. increased serum amylase and normal urine amylase values c. increased serum and urine amylase values d. normal serum and urine amylase values
B
Which of the following steroids is an adrenal cortical hormone? A angiotensinogen B corticosterone C progesterone D pregnanetriol
B
Which of the following substances is the biologically active precursor of a fat soluble vitamin? a. biotin b. retinol c. folic acid d. ascorbin acid
B
Which of the following would be an example of a glucose-specific colorimetric method? a. alkaline ferricyanide b. glucose oxidase c. hexokinase d. o-toluidine
B
The principle of the tablet test for bilirubin in urine or feces is: a. the reaction between bile and 2,4-dichloronitrobenzene to a yellow color b. the liberation of oxygen by bile to oxidize orthotolidine to a blue-purple color c. chemical coupling of bile with a diazonium salt to form a brown color d. chemical coupling of bilirubin with a diazonium salt to form a purple color
D
The serum glucose concentration of a diabetic patient undergoing a 2-hour glucose tolerance test should return to the baseline (fasting level) after a minimum of: a. 30 minutes b. 60 minutes c. 90 minutes d. 120 minutes
D
The term used to describe reproducibility is: a. sensitivity b. specificity c. accuracy d. precision
D
These 2 factors that differentiate liver disease from Vitamin K deficiency are: a. II and VII b. IX and VII c. VIII and IX d. V and VII
D
Thrombocytopenia is characteristic of: a. classic von Willebrand disease b. hemphilia A c. Glanzmann thrombastenia d. May-Hegglin anomaly
D
Unless blood gas measurements are made immediately after sampling, in vitro glycolysis of the blood causes a: a. rise in pH and PCO2 b. fall in pH and a rise in PCO2 c. rise in pH and fall in PCO2 d. fall in pH and a rise in PCO2
D
What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens? a. cortisol b. catecholamines c. progesterone d. cholesterol
D
Which crystals appear as fine, silky needles? a. cholesterol b. leucine c. hemosiderin d. tyrosine
D
Which of the following can give a false-negative urine protein reading? a. contamination with vaginal discharge b. heavy mucous c. presence of blood d. very dilute urine
D
Which of the following clinical disorders is associated with the greatest elevation of lactate dehydrogenase isoenzyme 1? a. pneumonia b. glomerulonephritits c. pancreatitis d. pernicious anemia
D
Which of the following hemoglobins has glucose-6-phosphate on the amino-terminal valine of the beta chain? a. S b. C c. A2 d. A1c
D
Which of the following is the most common cause of an abnormality in hemotstasis? a. decreased plasma fibrinogen level b. decreased Factor VIII level c. decreased Factor IX level d. quantitative abnormality of platelets
D
Which of the following is the proper storage requirements for Granulocytes? a. 1 to 6 degrees C b. 10 to 18 degrees C c. room temperature with constant agitation d. room temperature, not agitated
D
Which of the following is vitamin K dependent? a. Factor XII b. fibrinogen c. antithrombin III d. Factor VII
D
Which of the following represents the end product of purine metabolism in humans? a. AMP and GMP b. DNA and RNA c. allantoin d. uric acid
D
White blood cell casts are most likely to indicate disease of the: a. bladder b. ureter c. urethra d. kidney
D
a common cause of resiptory alkalosis is: a. vommitting b. starvation c. asthma d. hyperventilation
D
cancer antigen-125 tumor marker is a tumor marker associated with: a. breast carcinoma b. colon cancer c. lung cancer d. ovarian and andometrial carcinoma
D
The biologically most active, naturally occurring androgen is:
testosterone
What is the most common technique used for therapeutic drug monitoring?
Immunoassay
In amniotic fluid, the procedure used to detect Rh isosensitization is: a. human amniotic placental lactogen (HPL) b. alpha-fetoprotein c. measurement of absorbance at 450 nm d. creatinine
C
Increased concentrations of ascorbic acid inhibit chromogen production in which of the following glucose methods? a. ferricyanide b. ortho-touidine c. glucose oxidase (peroxidase) d. hexokinase
C
Osmal gap is the difference between: a. the ideal and real osmolality value b. calculated and measured osmolality values c. plasma and water osmolality values d. molality and molarity at 4 degrees C
B
Refractive index is a comparison of: a. light velocity in solutions to light velocity in solids b. light velocity in air to light velocity in solutions c. light scattering by air to light scattering by solutions d. light scattering by particles in solution
B
Serum levels that define hypoglycemia in pre-term or low birth weight infants are: a. the same as adults b. lower than adults c. the same as normal full-term infant d. higher than a normal full-term infant
B
Sodium determination by indirect ion selective electrode is falsely decreased by: a. elevated chloride levels b. elevated lipid levels c. decreased protein levels d. decreased albumin levels
B
TSH is produced by the: a hypothalamus b pituitary gland c adrenal cortex d thyroid
B
Technical problems encountered during the collection of an amniotic fluid specimen caused doubt as to whether the specimen was amniotic origin. Which 1 one the following procedures would best establish that the fluid is amniotic in origin? a. measurement of absorbance at 450 nm b. creatinine measurement c. lectithin/sphingomyelin ratio d. human amniotic placental lactogen (HPL)
B
The HLA complex shows strong associated with which blood groups? a. MN b. Bg c. Duffy d. Rodgers
B
The direction in which albumin migrates during electrophoretic separation of serum proteins, at pH 8.6, is determined by: a. the ionization of the amine groups, yielding a net positive charge b. the ionization of the carboxyl groups, yielding a net negative charge c. albumin acting as a zwitterion d. the density of the gel layer
B
90% of the copper present in the blood is bound to: a. transferrin b. ceruloplasmin c. albumin d. cryoglobulin
B
A condition in which erythrocyte protoporphyrin is increased is: a. acute intermitten porphyria b. iron defiency anemia c. porphyria cutanea tarda d. acute porphyric attack
B
A patient with renal tubular acidosis would most likely excrete urine with a: a. high pH b. low pH c. neutral pH d. variable pH
B
A reciprocal relationship exists between: a. sodium and potassium b. calcium and phosphate c. chloride and CO2 d. calcium and magnesium
B
A serum sample demonstrates an elevated result when tested with the Jaffe reaction. This indicates: a. prolonged hypothermia b. renal functional impairment c. pregnancy d. arrhythmia
B
An antidiuretic hormone deficiency is associated with a: a. specific gravity around 1.031 b. low specific gravity c. high specific gravity d. variable specific gravity
B
Assays for free T4 measure hormone not bound to thyroxine-binding prealbumin, thyroxine-binding globulin and: a. thyrotropin releasing hormone b. albumin c. free T3 d. TSH
B
At blood pH 7.40, what is the ratio of bicarbonate to carbonic acid? a. 15:1 b. 20:1 c. 25:1 d. 30:1
B
CSF fluid for glucose assay should be: a. refrigerated b. analyzed immediately c. heated to 56 degrees C d. stored at room temp after centrifugation
B
Calcium concentration is the serum is regulated by: a. insulin b. parathyroid hormone c. thyroxine d. vitamin c
B
Decreased serum iron associated with increased TIBC is compatible with which of the following disease states? a. anemia of chronic disorder b. iron deficiency anemia c. chronic liver disease d. nephrosis
B
Diagnostic specificity is defined as the percentage of individuals: a. with a given disease who have a positive result by given test b. without a given disease who have a negative result by given test c. with a given disease who have a negative result by given test d. without a given disease who have a positive result by given test
B
During pregnancy, the form of estrogen measured in the urine is mostly: a. estradiol b. estriol c. estrone d. pregnandediol
B
Estrogen and progesterone receptor assays are useful in identifying patients who are likely to benefit from endocrine therapy to treat which of the following? a. ovarian cancer b. breast cancer c. endometriosis d. amenorrhea
B
Following ingestion of ethylene glycol (antifreeze) numerous crystals are found in the urine. The shape of the these crystals is: a. flat with notched corners b. oval/dumbell c. coffin-lid d. rosettes/rhomboid
B
Hemophilia B is a sex-linked recessive disorder that presents with a decrease in Factor: a. VIII b. IX c. X d. XI
B
If a fasting glucose was 90 mg/dL, which of the following 2-hour postprandial glucose results would most closely represent normal glucose metabolism? a. 55 mg/dL b. 100 mg/dL c. 180 mg/dL d. 260 mg/dL
B
In immunophenotyping by flow cytometry the emitting flourescence intesity is proportional to the: a. DNA content in the cell b. amount of cell surface antigen c. RNA content in the cell d. size of the cell nucleus
B
In the hexokinase method for glucose determination, the actual end product measured is the: a. amount of hydrogen peroxide produced b. NADH produced from the reduction of NAD c. amount of glucose combine with bromscresol purple d. condensation of glucose with an aromatic amine
B
In which of the following conditions would a normal level of creatinine kinase be found? a. acute myocardial infarction b. hepatitis c. progressive muscular dystrophy d. instramuscular injection
B
In which of the following metabolic diseases will urine turn dark brown to black upon standing? a. phenylketonuria b. alkaptonuria c. maple syrup disease d. aminoaciduria
B
Normal CSF has a relative abundance of which of the following proteins when compared to serum: a. transferrin b. prealbumin c. albumin d. fibrinogen
B
A 10-year-old child was admitted to pediatrics with an initial diagnosis of skeletal muscle disease. The best confirmatory test would be: a. creatine kinase and isocitrate dehydrogenase b. gamma-glutamyl transferase and alkaline phosphatase c. aldolase and creatine kinase d. lactate dehydrogenase and malate dehydrogenase
C
A blood specimen was found to be group A, Rh positive with a negative antibody screen. Six units of group A, Rh positive red cells blood were crossmatched and one unit was incompatible at the AHG phase. The same result was obtained when the test was repeated. What should be done first? a. repeat the ABO grouping on the incompatible unit using a more sensitive technique b. test a panel of red blood cells which posses low frequency antigens c. perform a DAT on the donor unit d. obtain a new specimen and repeat the crossmatch
C
A carbonate salt used to control manic-depressive disorders is: a. digoxin b. acetaminophen c. lithium d. phenytoin
C
A deficiency of protein C is associated with which of the following? a. prolonged activated partial thromboplastin time (APTT) b. decreased fibrinogen level (<100 mg/dL) c. increased risk of thrombosis d. spontaneous hemorrhage
C
A fresh urine sample is received for analysis for "porphyrins" or "porphyria" without further information of specifications. Initial analysis should include: a. porphyrin screen and quantitative total porphyrin b. quantitative total porphyrin and porphobilinogen screen c. porphyrin and porphobilinogen screen d. porphobilinogen screen and ion-exchange analysis for porphobilinogen
C
A patient has signs and symptoms suggestive of acromegaly. The diagnosis would be confirmed if the patient had which of the following? a. an elevated serum phosphate concentration b. a decreased serum growth hormone releasing factor concentration c. no decrease in serum growth hormone concentration 90 minutes after oral glucose administration d. an increased serum somatastin concentration
C
A physician requested that electrolytes on a multiple myeloma patient specimen be run by direct ISE and not indirect ISE because: a. excess protein binds NA in indirect ISE b. Na is falsely increased by indirecct ISE c. Na is falsely decreased by indirect ISE d. excess protein reacts with diluent in indirect ISE
C
A scanning of a CK isoenzyme fractionation revealed 2 peaks: a slow cathodic peak (CKMM) and a intermediate peak (CKMB). A possible interpreatation for this pattern is: a. brain tumor b. muscular dystrophy c. hyocardial infarction d. viral hepatitis
C
Acid urine that contains hemoglobin will darken on standing due to the formation of: a. myoglobin b. sulfhemoglobin c. methemoglobin d. red blood cells
C
Acidosis and alkalosis are best defined as fluctuations in blood pH and CO2 content due to changes in: a. Bohr effect b. O2 content c. bicarbonate buffer d. carbonic anydrase
C
An ammonia-like odor is characteristically associated with urine from patients who: a. are diabetic b. have hepatitis c. have an infection with Proteus sp d. have a yeast infection
C
An automated CK assay gives a reading that is above the limits of linearity. A dilution of the serum sample is made by adding 1 mL of serum to 9 mL of water. The instrument now reads 350 U/L. The correct report on the undiluted serum should be: a. 2850 U/L b. 3150 U/L c. 2500 U/L d. 3850 U/L
C
An elevated serum iron with normal iron biding capacity is most likely associated with: a. iron deficiency anemia b. renal damage c. pernicious anemia d. septicemia
C
At a pH of 8.6 the gamma globulins move toward the cathode, despite the fact that they are negatively charged. What is this phenomenon called? a. reverse migration b. molecular sieve c. endosmosis d. migratory inhibition factor
C
Coagulation factors affected by warfarin (Coumadin) drugs are: a. VIII, IX and X b. I, II, V and VII c. II, VII, IX, and X d. II, V and VII
C
Fasting serum phosphate concentration is controlled primarily by the: a. pancreas b. skeleton c. parathyroid gland d. small intestine
C
Fasting serum phosphate concentration is controlled primarily by the: a. pancrease b. skeleton c. parathyroid glands d. small intestine
C
Hairy cell leukemia (leukemic reticuloendotheliosis) is: a. an acute myelocytic leukemia b. a chronic leukemia of myelocytic origin c. a chronic leukemia of lymphocytic origin d. an acute myelocytic monocytic-type leukemia
C
In addition to carcinoma of the prostate, elevated prostate-specific antigen (PSA) can occur due to: a aspirin therapy b exogenous steroid use c benign prostatic hyperplasia d statin therapy (cholesterol lowering drug)
C
A 54-year-old man was admitted with pulmonary embolism and given streptokinase. Which of the following would be the most useful in monitoring this therapy? a. activated partial thromboplastin time b. bleeding time c. prothrombin time d. thrombin time
D
A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood had been exposed to room air for at least 30 minutes. The following change in blood gases will occur: a. CO2 content increased/PCO2 decreased b. CO2 content and PO2 increased/pH increased c. CO2 content and PCO2 decreased/pH decreased d. PO2 increased/HCO3 decreased
D
A cell surface marker that is expressed on neoplastic plasma cells and is helpful in diagnosis of myeloma is: a. CD19 b. CD20 c. CD45 d. CD138
D
A characteristic of the Bence Jones protein that is used to distinguish it from other urinary proteins is its solubility: a. in ammonium sulfate b. in sulfuric acid c. at 40-60 degrees C d. at 100 degrees C
D
A chemiluminescent EIA: a. measures absorption of light b. is less sensitive than radioisotopic reactions c. is monitored by the use of gamma counter d. is quantitated by the amount of light produced by the reaction
D
A drug that relaxes the smooth muscle of the bronchi and bronchioles: a. acetaminophen b. lithium c. phenytoin d. theophylline
D
A patient is admitted with biliary cirrhosis. If a serum protein electrophoresis is performed, which of the following globulin fractions will be most elevated? a. alpha-1 b. alpha-2 c. beta d. gamma
D
A patient with glomerulonephritis is most likely to present with the following serum results: a. creatinine decreased b. calcium increased c. phoshporous decreased d. BUN increased
D
A patient with glomerulonephritits is most likley to present with the following serum results: a. creatinine decreased b. calcium increased c. phophorous decreased d. BUN increased
D
A urine specimen collected on an apparently healthy 25-year-old man shortly after he finished eating lunch was cloudy but showed normal results on a multiple reagent strip analysis. The most likely cause of the turbidity is: a. fat b. white blood cells c. urates d. phosphates
D
Aldosterone is released by the adrenal cortex upon stimulation by: a. renin b. angiotensinogen c. angiotensin I d. angiotensin II
D
An antiepileptic agent used also as antiarrhythmic: A. Phenobarbital B. Diazepam C. Valproic acid D. Phenytoin E. Phensuximide
D
Bacteria are considered significant in the urine sediment when the: a. nitrite is positive b. protein is positive c. specimen is cloudy d. leukocytes is positive
D
Before unconjugated bilirubin can react with Ehrlich diazo reagent, which of the following must be added? a. acetone b. ether c. distilled water d. caffeine
D
Beriberi is associated with deficiency of vitamin: a A b C c niacin d thiamine
D
Blood samples were collected at the beginning of an exercise class and after thirty minutes of aerobic activity. Which of the following would be most consistent with the post-exercise sample? a. normal lactic acid, low pyruvate b. low lactic acid, elevated pyruvate c. elevated lactic acid, low pyruvate d. elevated lactic acid, elevated pyruvate
D
Carcinoembryonic antigen (CEA) is most likely to be produced in a malignancy involving the: a. brain b. testes c. bone d. colon
D
Cessation of urine flow is defined as: a. azotemia b. dysuria c. diuresis d. anuria
D
Clinical assays for tumor markers are most important for: a. screening for the presence of cancer b. monitoring the course of a known cancer c. confirming the absence of disease d. identifying patients at risk for cancer
D
Cocaine is metabolized to: a carbamazepine b codeine c hydrocodone d benzoylecgonine
D
What would you find in a case of primary hyperparathyroidism?
Elevated calcium and decreased phosphorous
What is the most common method for analyzing/confirming serum barbituates?
Gas Chromatography/Mass Spec
What is the osmolality equation?
Osmo = 2 x Na + [ glucose/20] + [BUN x 10]
A patient's electrolyte results are the following: Sodium = 145 mmol/L Chloride = 113 mmol/L Bicarbonate = 24 mmol/L Calculate the anion gap for this patient and choose the correct answer below. The correct answer is highlighted below 32 mmol/L 8 mmol/L 27.7 mmol/L 3.7 mmol/L
The anion gap, which is typically uses to evaluate an instrument's analysis process, is calculated with the following formula: Anion Gap = Sodium - (Chloride + Bicarbonate) In this case, the calculation would be: Anion Gap = 145 - (113 + 24) = 8 mmol/L *Normal Range for Anion Gap = 10-20 mmol/L
Which of the following is a bronchodilator used to treat a 39-year-old male asthmatic patient? The correct answer is highlighted below theophylline digoxin phenobarbital amitriptyline
Theophylline belongs to a class of medications called bronchodilators, used in treating asthma and other airway diseases. Digoxin is used to treat heart failure and abnormal heart rhythms (arrhythmias). Phenobarbital is a barbiturate which is used to help prevent seizures. Amitriptyline is an antidepressant medication.
What is the purpose of albuminuria testings?
To detect small concentrations before irreversible damage is done
True or False A low serum electrolyte value would result from a hemodilution
True
True or False cTnT is a regulator of myocyte contraction
True
Testing for the diagnosis of lead poisoning should include: a. erythrocyte protoporphyrin (EPP) b. urine delta-a,inolevulinic acid c. whole blood lead d. zince protoporphyrin (ZPP)
c
The protein that has the highest dye-binding capacity is
albumin
The fastest hemoglobin fraction is
hemoglobin F
