Clinical Chemistry Learning Guide Review Questions (Supplemental)
1. When a serum sample has intrinsic color that absorbs at the same wavelength used to detect the reaction product, what technique could help distinguish the color produced by the analyte from the intrinsic color of the sample? A. Blanking B. Immunoturbidimetry C. Ion selective electrode D. PETINIA
A
1. Which of the following sets of values for repeat analyses of a QC sample (target value of 50) reflects the best precision? A. 50, 51, 52 B. 50, 52, 54 C. 48, 50, 52 D. 44, 50, 53
A
2. In a test for albumin, all of the albumin reacts very rapidly with an excess of the dye BCP (bromcresol purple) to produce a colored complex. The detector is set to measure the product complex. What method is most suitable for this determination of albumin? A. Endpoint (end-up) B. Endpoint (end-down) C. Rate (rate-up) D. Rate (rate-down)
A
2. Which of the following analyses would best be done using a photometric rate reaction? A. Measurement of lipase activity B. Determination of albumin with the dye bromcresol green C. Determination of potassium in the presence of excess sodium D. None of these could be done using a rate reaction
A
2. Which type of analytical error can be prevented by a good quality control program? A. Instrument not properly calibrated B. Presence of interfering substances in sample C. Bubbles in the light path of a photometric method D. Analyte concentration so high it depletes the active reagent
A
3. If total cholesterol is 4.0 mmol/L, what is the value in conventional units? A. 154 mg/dL B. 102 mg/dL C. 40 mg/dL D. None of the above values
A
3. Transferrin reacts with a specific antibody to produce immune complexes. What method would be most suitable to measure the concentration of transferrin? A. Immunoturbidimetry B. Fluorescence C. Potentiometry D. None of the above
A
3. Which tests might be ordered on a patient with abdominal pain to test for possible pancreatitis? A. Amylase and lipase B. Sodium and potassium C. Cholesterol and triglyceride D. C3 and C4
A
1. Potentiometric methods are most useful for which of the following types of analytes? A. Proteins B. Electrolytes C. Drugs of Abuse D. Lipids
B
1. Which of the following is an example of a preanalytical error? A. Test method incorrectly calibrated B. Collection of blood in wrong kind of tube C. Presence of interfering substance in specimen D. Delay in sending the report to the provider
B
1. Which of the following tests is a good marker of nutritional status? A. Immunoglobulin M B. Prealbumin C. Ceruloplasmin D. Lp(a)
B
1. Which of the following units would not be used for reporting glucose on a clinical chemistry laboratory report? A. mg/dL B. ounces/L C. mmol/L D. All are acceptable units
B
2. The lipoprotein particle that is used to determine increased risk of coronary artery disease and to determine and monitor treatment for high cholesterol is...: A. HDL B. LDL C. VLDL D. Chlyomicrons
B
2. What would be the value of 150 mg/dL glucose reported in SI units? A. 1.61 mmol/L B. 8.25 mmol/L C. 0.367 mmol/L D. None of the above values
B
2. Which of the following sets of values for repeat analyses of a sample (target value of 100) shows the least bias? A. 100, 105, 110 B. 95, 100, 105 C. 90, 95, 100 D. 90, 100, 105
B
2. Which test might be used to assess a person who is disoriented or confused? A. Cholesterol B. Ammonia C. CRP D. Iron
B
3. Pretreatment is designed to do which of the following? A. Ensure concentration of analyte is in the measurable range B. Remove substances erroneously measured as analyte C. Adjust the wavelength of light used for analysis D. Introduce a fluorophore
B
3. Which type of analytical error is recognized by an HIL index? A. Instrument not properly calibrated B. Presence of interfering substances in sample C. Bubbles in the light path of a photometric method D. Analyte concentration so high it depletes the active reagent
B
4. If a screening TSH is high, which test is likely to be ordered next? A. Cholesterol B. Free T4 C. Ferritin D. Glucose
B
4. What is the best estimate of concentration of substance J in a sample whose absorbance is 0.50? A. Between 1 and 2 nmol/L B. Between 2 and 3 nmol/L C. Between 3 and 4 nmol/L D. Greater than 4 nmol/L
B
4. Which of the following would not be a typical methodology for a clinical chemistry test? A. Immunoturbidimetry B. Microscopy C. EMIT D. ISE
B
5. Which of the following analytes has the biggest allowable error budget based on CLIA accuracy ranges? A. Albumin B. Triglycerides C. Chloride D. Cholesterol
B
5. Which test is used as an indicator of congestive heart failure? A. CRP B. BNP C. Cholesterol D. Troponin E. Haptoglobin
B
6. When the kidneys are not functioning properly to filter blood and rid the body of wastes which of these test results would be most likely? A. GFR = 100 mL/min B. High blood creatinine C. High blood albumin D. Low blood BUN
B
2. Name five kinds of body fluids which might be used for testing in a clinical chemistry laboratory
Blood, urine, CSF, pleural, synovial, peritoneal, saliva, amniotic (any of these five)
1. Which of the following tests is the best monitor of diabetic glucose control over an 8 to 12 week period? A. Glucose B. Urine microalbumin C. Hemoglobin A1c D. Haptoglobin
C
1. Which of the following would not be a typical analyte in a clinical chemistry test? A. Calcium B. Protein C. Octane D. Cocaine
C
3. How should a laboratory verify the reference range it uses for a particular test? A. Call another laboratory B. Use the numbers from a textbook C. Test samples from healthy people D. Look on a medical internet site
C
3. Which test is the most specific for myocardial infection? A. CK-MB B. CK C. Troponin D. Myoglobin
C
4. A test result that exceeds 3 SD of the mean value for an analyte is found with a frequency of: A. 1 in 5 B. 1 in 20 C. 1 in 100 D. Never
C
4. What does method traceability mean? A. The calibration of a method is linear B. The method meets the required error budget C. The method's accuracy is linked to a certified method and/or material D. The method does not show matrix effects
C
3. Method A and method B for cholesterol both give a value of 200 mg/dL for a serum sample; however, the same QC material analyzed by method A gives 185 mg/dL and by method B gives 212 mg/dL. What might cause this? A. Method B is showing a matrix effect for the QC material B. Method A is showing a matrix effect for the QC material C. Both are showing a matrix effect for the QC material D. Any of the above answers may be correct
D
4. If the enzymatic activity of LD is 40 IU/L at 25 degrees C, what is the activity at 37 degrees C? A. 40 IU/L B. 59 IU/L C. 27 IU/L D. Impossible to tell from information provided
D
4. Which of these drug levels would be considered toxic? A. Alcohol at 80 mg/dL B. Valproic acid at 50 mcg/mL C. Digoxin at 2 ng/mL D. Acetaminophen at 250 mcg/mL E. Salicylate at 27 mg/dL
D
5. In which condition would TIBC be high? A. Hemochromatosis B. Chronic illness C. Malnutrition D. Iron deficiency
D
5. What type of additive is in a blood collection tube with a red cap? A. Lithium or sodium heparin B. Potassium EDTA C. Thrombin D. No additive
D
4. What option(s) might be employed if a test result is above the upper limit of the test measurement range? A. Manual Dilution followed by reanalysis of the diluted sample B.Automated Dilution and renanalysis of the sample C. Use of a reaction rate algorithm using two read windows for an enzyme assay D. Reporting the result as higher than the upper limit of the test method E. All of the above F. None of the above
E