Practice Practicum Exam - CLS 4147 Clinical Chemistry Rotation
Board Review Question: Which of the following is the formula for calculating the unknown concentration based on Beer's law (A = absorbance, C = concentration)? (A unknown / A standard) x C standard C standard x A unknown A standard x A unknown (C standard) / (A standard) x 100
(A unknown / A standard) x C standard
Board Review: The following 5 sodium control values in unit (mEq/L) were obtained: 140, 135, 138, 140, 142 Calculate the coefficient of variation. 1.9% 6.1% 2.7% 5.6%
1.9%
An electrolyte panel was performed on a patient in the emergency room. The following values were reported:Sodium: 150 mEq/LPotassium: 5 mEq/LChloride: 110 mEq/LBicarbonate: 30 mEq/LThe anion gap (without using K) for this patient is: A.10B.15C.8D.17E.5
10
Board Review: The mean value of a series of hemoglobin controls was found to be 15.2 g/dL, and the standard deviation was calculated at 0.20. Acceptable control range for the laboratory is ±2 standard deviations. Which of the following represents the allowable limits for the control? 14.5 - 15.5 g/dL 15.0 - 15.4 g/dL 15.2 - 15.6 g/dL 14.8 - 15.6 g/dL
14.8 - 15.6 g/dL
Board Review: When 0.25 mL is diluted to 20 mL, the resulting dilution is: 1:20 1:60 1:40 1:80
1:80
How many milliliters of concentrated sulfuric acid (H 2S0 4), M.W. = 98 grams, specific gravity = 1.500, purity = 80%, are needed to make 400 mL of a 2N solution? A.26.1B.32.7C.65.3D.52.3
32.7
What is the correct distribution of the various calcium forms in blood? Equal parts of ionized, protein-bound, and bound to anions Majority protein-bound, with 10% free and 10% bound to anions 50% ionized, 40% protein-bound, 10% bound to anions Majority free, with 10% bound to proteins and 10% bound to anions
50% ionized, 40% protein-bound, 10% bound to anions Ionized calcium is an important measurement given its high percentage in blood.
Board Review Question: How many grams of sodium chloride are needed to prepare 1L of 0.9% normal saline? 0.9 1.8 9.0 18.0
9.0
Board Review: In quality control, ±2 standard deviations from the mean includes what percentage of the sample population? 75% 50% 98% 95%
95%
Board Review Question: A mean value of 100 mg/dL and a standard deviation value of 1.8 mg/dL were obtained from a set of glucose measurements. The 95% confidence interval in mg/dL would be: 94.6 - 105.4 96.4 - 103.6 97.3 - 102.7 98.2 - 101.8
96.4 - 103.6
Which of the following vitamins is NOT a water-soluble vitamin? A Folic acid B6
A
Portal cirrhosis is a chronic disease of the liver. Observed on an electrophoretic serum protein pattern, a predominant characteristic of this disease is: A.A bridging effect between the beta and gamma bandsB.An increase in the alpha2-globulin bandC.An increase in the albumin bandD.A monoclonal band in the gamma regionE.A polyclonal band in the gamma region
A bridging effect between the beta and gamma bands
deally, the best type of centrifuge that separates blood cells and plasma for analysis in the clinical laboratory is: A.A temperature-controlled centrifuge with fixed buckets and an angled rotorB.A non-temperature-controlled centrifuge with fixed buckets that only hold 1 mL blood tubesC.A non-temperature-controlled centrifuge with fixed buckets that hold 5-10 mL blood tubesD.A temperature-controlled centrifuge with spinning buckets that holds 5-10 mL blood tubes
A temperature-controlled centrifuge with spinning buckets that holds 5-10 mL blood tubes
A urine screening test for porphobilinogen is positive. The MOST likely disease state is: A.Porphyria cutanea tardaB.Acute porphyria attackC.Lead poisoningD.Erythrocytic protoporphyria
Acute porphyria attack
Board Review Question: Which of the following is an organ specific autoimmune disease? myasthenia gravis rheumatoid arthritis Addison's disease progressive systemic sclerosis
Addison's disease
____________ is the most common cause of acute pancreatitis. Uncontrolled diabetes Alcohol use Liver cancer E.coli infection
Alcohol use
Universal Precautions should be observed when working with: A.Drug usersB.Patients with AIDSC.HemophiliacsD.All patients
All patients
A protein that is normally produced by the fetus but is found in increased amounts in the amniotic fluid in cases of spina bifida is: A.Alpha1-fetoproteinB.HemopexinC.Alpha1-antitrypsinD.Alpha2-macroglobulinE.Alpha1-acid glycoprotein
Alpha1-fetoprotein
Which drug can be used to combat the effect of a type I hypersensitivity reaction? Antihistamine Antianalgesic Antibiotic Antiarrhythmic
Antihistamines Blocking the actions of histamines is the objective of drugs such as diphenhydramine and chlorpheniramine.
Which of the following laboratory tests is incorrectly paired with the section where the work is normally done? Hemoglobin A1C: clinical chemistry Total hemoglobin level: hematology Blood cultures: microbiology Arterial blood gases: immunology
Arterial blood gases: immunology
Board Review Question: A patient with glomerulonephritis would present the following serum results; calcium increased BUN increased phosphorus decreased creatinine decreased
BUN increased
Which of these statements about diabetic ketoacidosis and hyperosmolal hyperglycemic nonketotic coma is NOT true? Both are associated with metabolic acidosis and ketosis. Both have high osmolality. Both occur with undiagnosed diabetes. Both are associated with thirst.
Both are associated with metabolic acidosis and ketosis. A low pH is due to the presence of ketoacids which do not occur in hyperosmotic coma.
Which of the following is true regarding turbidimetry and nephelometry? Turbidimetry is generally a more sensitive technique. Nephelometry measures the decrease in light relative to a reference (i.e., no light scattering). Both assays require precipitating antibodies. Turbidimetry measures the decrease in light scattered from a particle.
Both assays require precipitating antibodies. Turbidimetry measures the decrease in light scattered from a particle, while nephelometry is the production of light scattered from a particle.
Board Review Question: Which of the following serum proteins migrates with the beta-globulins on cellulose acetate at a pH of 8.6? C3 complement haptoglobin hemoglobin ceruloplasmin
C3 complement
Tumor-associated antigens composed of high-molecular-weight mucin-like glycoproteins include: A.CA 125 and CA 19-9B.PSA and AFPC.p53 and RbD.BRCA-1 and -2
CA 125 and CA 19-9
Board Review Question: The presence of which of the following isoenzymes indicates acute myocardial damage? none of these CK-MB CK-MM CK-BB
CK-MB
Nonsteroidal antiinflammatory drugs reduce the production of arachnidonic acid and series 4 leukotrienes by inhibiting COX-1. COX-2 and 5-LOX. glucagon. insulin.
COX-2 and 5-LOX. NSAIDS are widely used in clinical medicine as an antiinflammatory and vasodilator drugs.
Which of the following muscles are involuntary (i.e., the consciousness does not control contraction)? Skeletal muscle Cardiac muscle Smooth muscle Cardiac muscle and smooth muscle
Cardiac muscle and smooth muscle
____________ has a genetic basis, requiring that all newborns be tested. Cystic fibrosis Chronic obstructive pulmonary disease Pulmonary edema Pneumonia
Cystic fibrosis
Chronic fetal metabolic distress is demonstrated by: A.Decreased urinary estriol excretion and decreased maternal serum estriol Increased urinary estriol excretion and increased maternal serum estriol Decreased estrogen in maternal plasma and increased estriol in amniotic fluidIncreased estradiol in maternal plasma with a corresponding increase of estriol in amniotic fluid
Decreased urinary estriol excretion and decreased maternal serum estriol
Fanconi syndrome is a disease of: A.Defective proximal tubulesB.Defective distal tubulesC.Renal arteriosclerosisD.Obstructive uropathy
Defective proximal tubules
Which of the following is a common and underappreciated condition in the elderly? A.DehydrationB.AmyloidosisC.HyponatremiaD.Multiple myeloma
Dehydration
The following glucose tolerance test results are indicative of what state? Glucose values as assayed by glucose oxidase method are fasting, 130 mg/dL; 60 minutes, 225 mg/dL; and 120 minutes, 205 mg/dL. A.DiabetesB.NormalC.HyperinsulinismD.Addison's disease
Diabetes
A 21-year-old man with nausea, vomiting, and jaundice has the following laboratory findings:Total serum bilirubin8.5 mg/dL (normal 0-1.0 mg/dL)Direct serum bilirubin6.1 mg/dL (normal 0-0.5 mg/dL)Urine urobilinogenIncreasedUrine bilirubinPositiveAST200 U/L (normal 0-50 μ/L)ALP160 U/L (normal 0-150 μ/L)What disease state are these findings consistent with? A.Chronic liver diseaseB.Obstructive jaundiceC.Early hepatitisD.Hemolytic anemia
Early hepatitis
Which dyslipidemia is characterized by normal LDL, decreased HDL, and increased triglycerides? Apolipoprotein C-II deficiency Hyperapobetalipoproteinemia Familial hypertriglyceridemia Dysbetalipoproteinemia
Familial hypertriglyceridemia
In what form must a drug be in order to elicit a pharmacologic response? A.Bound to hemoglobinB.Bound to fatty acidsC.Bound to globulinsD.FreeE.Bound to albumin
Free
Which form of drugs is most available to reach target tissues? Protein-bound drug Free drug Ionized drug Bound and free drug
Free drug Unbound drugs can pass from the vascular space into the pores of a cell.
In the Szasz method for gamma glutamyl transferase (GGT), the typical receptor molecule is: A.AminonitrobenzoateB.Gamma glutamyl p-nitroanilideC.Glycyl glycineD.Glutathione
Glycyl glycine
Board Review: Filters generally used in biological safety cabinets to protect the laboratory worker from particulates and aerosols generated by microbiology manipulations are: fiberglass HEPA APTA charcoal
HEPA
Board Review: Your friend calls and asks you to access his test results. Which of the following does this violate? CLIA HIPAA CAP The Joint Commission
HIPAA
Board Review Question: An example of an organ-specific disease with autoimmune antibodies is Hashimoto's thyroiditis rheumatoid arthritis Wegener's granulomatosus systemic lupus erythematosus
Hashimoto's thyroiditis
In the PCR method, how is denaturation accomplished? A.Addition of sulfonylureaB.FormamideC.HeatD.Alkali treatment
Heat
The body mass index is a calculation of which of the following measurements? A.Height and hydrostatic weightB.Height and skin fold thicknessC.Height and weightD.Height and bone density
Height and weight
Which test doubles as a marker for pregnancy and gonadal tumor? Testosterone Human growth hormone Human choriogonadotropin Estradiol
Human choriogonadotropin
Which of the following is secreted by the placenta and used for the early detection of pregnancy? A.Follicle-stimulating hormone (FSH)B.Luteinizing hormone (LH)C.Human chorionic gonadotropin (HCG)D.Progesterone
Human chorionic gonadotropin (HCG)
Secretion of hormones by the anterior pituitary is controlled by circulating levels of hormones from the target gland and hormones secreted by the: A.AdenohypophysisB.HypothalamusC.Posterior lobe of the pituitary glandD.Pineal glandE.Intermediate lobe of the pituitary gland
Hypothalamus
All of the following statements about partially compensated respiratory alkalosis are true EXCEPT: A.Renal reabsorption of HCO3 is decreasedB.Hypoventilation is the causative defectC.HCO3 is lower than normalD.pCO2 is lower than normalE.The pH is slightly higher than normal
Hypoventilation is the causative defect
Which lipoprotein particle has the lowest concentration in a nonfasting sample of a healthy subject? LDL IDL VLDL Calculated LDL from the Friedewald equation
IDL The intermediate density lipoprotein is short-lived and is largely absent in the blood of an individual with any lipid disorders. Those with a Frederickson's type III hyperlipidemia are characterized by high IDL cholesterol.
In a patient suspected of having primary hyperthyroid myxedema, one would expect the following serum results: T4 _______, TSH ________. A.Increased, decreasedB.Decreased, normalC.Increased, normalD.Decreased, increasedE.Decreased, decreased
Increased, decreased
Which method is used to measure lithium in blood? Ion selective electrodes (ISEs) Atomic absorption spectroscopy Anodic stripping analysis Mass spectrometry
Ion selective electrodes (ISEs) Monovalent electrolytes such as sodium, potassium, and lithium are measured by ion selective electrodes.
Board Review Question: 60% to 75% of the plasma cholesterol is transported by chylomicrons HDL LDL VLDL
LDL
_______________ is not a common sequela of poorly controlled diabetes. Neuropathy Nephropathy Cerebrovascular disease Liver cancer
Liver cancer Uncontrolled diabetes affects many systems, but it has less effect on the gastrointestinal system.
Androgen secretion by the testes is stimulated by: A.TestosteroneB.Luteinizing hormone (LH)C.GonadotropinsD.Follicle-stimulating hormone (FSH)
Luteinizing hormone (LH)
In ion-exchange chromatography, solute mixtures are separated by virtue of the: A.Magnitude and charge of ionic speciesB.Steric exclusion based on pore sizes of the columnC.Partition coefficient between the two liquidsD.Hydrophilic beads of cross-linked dextran
Magnitude and charge of ionic species
Which of the following causes erythroblastosis fetalis? A.Maternal immunization by fetal antigensB.Inadequate fetal pulmonary surfactantsC.Decreased amounts of amniotic fluidD.Immaturity of the fetal liver
Maternal immunization by fetal antigens
Which RNA molecule provides the blueprint for protein synthesis? Messenger Mitochondrial Transfer Ribosomal
Messenger Messenger RNA provides the sequences needed to encode specific amino acids that make up all proteins.
Board Review: Employees are guaranteed the right to engage in self-organization and collective bargaining through representatives of their choice, or to refrain from these activities by which of the following? Civil Rights Act Clinical Laboratory Improvements Act (CLIA) National Labor Relations Act Freedom of Information Act
National Labor Relations Act
Of little concern in most automated chemistry analyzers is: A.IncubationB.Water qualityC.Operator changeD.Carryover
Operator change
_____________ is most often due to excessive mechanical wear and tear. Rheumatoid arthritis Osteoarthritis Gout Ankylosing spondylitis
Osteoarthritis esults from degeneration of cartilage and bone
Prostatic acid phosphatase measurement has been replaced by: A.CPKB.PSAC.ALPD.RBC ACP
PSA
Which of the following statements is TRUE? A.Partition chromatography is most appropriate to identifying analytes that may be distributed between two liquid phases.B.Ion-exchange chromatography has a resin phase that is soluble to water and separation of the mixture is based on magnitude and charge of ionic species.C.In liquid-solid chromatography, the stationary phase separates analytes based on size, shape, and polarity.D.Steric exclusion chromatography is best suited for separating analytes based on their solubility in the mobile solvent.E.The partition coefficient is measured and compared to standards in thin-layer chromatography.
Partition chromatography is most appropriate to identifying analytes that may be distributed between two liquid phases
Which of the following electrophoretic media separates proteins primarily on the basis of molecular size? A.Salt fractionationB.Polyacrylamide gelC.Cellulose acetateD.Agarose
Polyacrylamide gel
Which of the following electrolytes would be increased in the serum if the blood specimen was hemolyzed? A.Potassium onlyB.Bicarbonate, potassium, and phosphateC.Potassium and phosphateD.Potassium, chloride, and phosphateE.Chloride and sodium
Potassium and phosphate
What is the first feature of nephrotic syndrome that results in manifestation of the other four classic signs? A.EdemaB.HypoalbuminemiaC.HyperlipidemiaD.ProteinuriaE.Lipiduria
Proteinuria
The majority of absorbed lead is take up by _____________ and inhibits heme synthesis: A.HepatocytesB.Red blood cellsC.MegakaryocytesD.Marrow stem cells
Red blood cells
Acetonitrile is a stable organic solvent that has a flash point under 100°F and is often used in liquid chromatography. Which of the following hazardous labeling is most appropriate? Red: 2, Blue: 3, Yellow: 0, White: blank Red: 4, Blue: 0, Yellow: 3, White: Oxidizer Red: 0, Blue: 2, Yellow: 2, White: Corrosive Red: 2, Blue: 1, Yellow: 1, White: Acid
Red: 2, Blue: 3, Yellow: 0, White: blank
What is the purpose of the 8-hydroxyquinoline in the cresolphthalein determination for calcium? A.Produce an alkaline pHB.Produce an acid pHC.Reduce Mg interferenceD.Color reagent
Reduce Mg interference
In the evaluation of a POCT system, data obtained from the POCT system and the main laboratory must be correlated. Which of the following analyses should be used when dealing with qualitative data? A.ModeB.SensitivityC.Standard deviationD.Mean
Sensitivity
Which activity can spread HIV or HBV from one person to another outside of the laboratory? A.Using a toiletB.Shaking handsC.Sexual contactD.Giving blood
Sexual contact
onWhich of the following statements describes optimal conditions for transport, handling, and storage of blood specimens for clinical chemistry testing? A.Specimen brought to lab within 6 hours after collection, stored at room temperature before centrifugation for up to 24 hoursB.Specimen brought to lab immediately, permitted to clot, serum separated and tested as soon as possibleC.Specimen brought to lab immediately, spun down and serum left to stand on clot until testedD.None of these represent optimal conditions
Specimen brought to lab immediately, permitted to clot, serum separated and tested as soon as possible
___________ can produce excess ketoacids, resulting in a metabolic acidosis. Alcoholic ketosis Starvation and diabetic ketosis Ingestion of toxic alcohols Sepsis
Starvation and diabetic ketosis Ketosis results from the immobilization of fatty acids due to the lack of glucose.
The major fraction of organic iodine circulating in the blood is: A.DiiodotyrosineB.TetraiodothyronineC.ThyroglobulinD.Triiodothyronine
Tetraiodothyronine
Which of the following explains a mixed acid-base disorder where the pH is near normal? The presence of a respiratory acidosis and respiratory alkalosis The presence of a metabolic acidosis and metabolic alkalosis The presence of a respiratory acidosis and metabolic alkalosis The presence of a respiratory acidosis and metabolic acidosis
The presence of a respiratory acidosis and metabolic alkalosis A respiratory acidosis and metabolic alkalosis or a respiratory alkalosis and metabolic acidosis have abnormal pCO 2 and bicarbonate that could completely compensate for each other, resulting in a normal pH.
Which MI marker is the most specific and sensitive and remains elevated for 14 days or more? A.LD1B.CK-MBC.Troponin TD.CK-MB isoform
Troponin T
Which cardiac marker is elevated for the longest period after myocardial infarction (MI)? A.CK-MBB.MyoglobinC.Troponin TD.Troponin I
Troponin T
Which nucleotide is not found in DNA? Thymine Uracil Adenine Guanine
Uracil In RNA, uracil replaces thymine whereby a hydrogen is substituted for the methyl group.
Board Review Question: Given the following results: ALP: slight increase ALT: marked increase AST: marked increase GGT: slight increase This is most consistent with : liver hemangioma obstructive jaundice chronic hepatitis acute hepatitis
acute hepatitis
A patient is exposed to a foreign chemical antigen resulting in the production of an antibody. This is an example of innate immunity. adaptive immunity that is humoral-mediated. adaptive immunity that is cell-mediated. All of these are correct.
adaptive immunity that is humoral-mediated. Chemical agents elicit a B-cell or humoral-mediated antibody production.
Board Review Question: Which of the following is a glycolytic enzyme that catalyzes the cleavage of fructose-1,6=diphosphate to glyceraldehyde-3-phosphate and dihydroacetone phosphate? glucose-6-phosphate dehydrogenase phosphofructokinase aldolase pyruvate kinase
aldolase
Board Review Question: In bilirubin determination, the purpose of adding a concentrated caffeine solution or methyl alcohol is to prevent any change in pH precipitate protein allow indirect bilirubin to react with the color reagent dissolve conjugated bilirubin
allow indirect bilirubin to react with the color reagent
Board Review: CLIA was established to provide oversight to: waived point-of-care testing by nonlaboratory personnel research labs CAP-accredited labs any lab performing patient testing
any lab performing patient testing
Board Review: When hazardous chemicals are transferred from the original appropriately labeled container(s) to a secondary container for immediate use by the person performing the transfer, it: must be labeled with the identity or contents of the hazardous chemical(s) must be labeled with an emergency response phone number(s) does not require labeling must be labeled with hazard warnings related to the effect on involved target organs
does not require labeling
Board Review Question: The function of the major lipid components of the very low-density lipoproteins (VLDL) is to transport: cholesterol and phospholipids to peripheral cells endogenous triglycerides exogenous triglycerides cholesterol from peripheral cells to the liver
endogenous triglycerides
Board Review Question: In which of the following conditions would a normal level of creatine kinase be found? acute myocardial infarct progressive muscular dystrophy hepatitis intramuscular injection
hepatitis
Board Review Question: A patient has the following results: serum iron: 250 ug/dL (ref range: 60-150 ug/dL) TIBC: 350 ug/dL (ref range: 300-350 ug/dL) The best conclusion is that this patient has: normal iron status chronic disease iron hemochromatosis iron-deficiency anemia
iron hemochromatosis
Board Review: In addition to keeping the load close to your body and tightening your abdominal muscles when lifting heavy boxes of supplies, it is important to bend at the: waist; twist your body when lifting waist; lift with legs and buttocks knees and hips; lift with legs and buttocks knees and hips; lift with arms and back
knees and hips; lift with legs and buttocks
Board Review: Which action by the phlebotomist will comply with the College of American Pathologists (CAP) Patient Safety Goal "to improve patient and sample identification at the time of specimen collection" and The Joint Commission Patient Safety Goal to "improve the accuracy of patient identification"? match the name and room number on the patient's ID bracelet to the name and room number on the preprinted collection label label the collection tubes prior to the blood draw at the patient's bedside verify patient information by stating the patient's name when approaching the patient match the name and medical record number on the patient's ID bracelet to the name and medical record number on the preprinted collection label
match the name and medical record number on the patient's ID bracelet to the name and medical record number on the preprinted collection label
Board Review Question: The middle value of a data set is statistically known as the standard deviation mode median mean
median
Overexpression of one B-cell clone is termed polyclonal gammopathy. oligoclonal gammopathy. monoclonal gammopathy. immunoglobulin deficiency.
monoclonal gammopathy. Monoclonal gammopathy can be either malignant or benign.
Board Review Question: Which of the following is an important cellular mediator of immune complex tissue injury? neutrophil eosinophil monocyte basophil
neutrophil
The _____________ test is most useful for diagnosis of gestational diabetes. fasting blood glucose oral glucose tolerance hemoglobin A1c urinary albumin
oral glucose tolerance
Upon receiving an arterial specimen for blood gases in the laboratory, you observe that it was not maintained under strict anaerobic conditions. You refuse to analyze the specimen. You base your decision on the premise that the following parameters have been altered: A.pH decreased, pCO2 increased, pO2 decreasedB.pH decreased, pCO2 decreased, pO2 increasedC.pH increased, pCO2 increased, pO2 decreasedD.pH increased, pCO2 decreased, pO2 increased
pH increased, pCO2 decreased, pO2 increased
Board Review: According to OSHA, what type of warning sign should be posted in an area where an immediate hazard exists and where special precautions are necessary? yellow, and black "Caution" sign red, black and white "Danger" sign green and white "Safety Instruction" sign orange and black "Biohazard" sign
red, black and white "Danger" sign
Board Review Question: A benefit of micro-assays include: reduced reagent requirements increased analytical reliability increased diagnostic specificity reduced number of repeated tests
reduced reagent requirements
Board Review: To prevent injury, a safe lab work practice is to: store well-wrapped food in the supply refrigerator secure long hair and jewelry wear contact lenses for eye protection wear comfortable, rubber-bottomed, open-weaved shoes
secure long hair and jewelry
Which disinfectant inactivates HIV and HBV? sodium hypochlorite phenol iodine alcohol
sodium hypochlorite
Board Review: A paper or electronic report of lab results must include: the pathologist's signature the test price the name of the person who collected the specimen the name and address of the testing laboratory
the name and address of the testing laboratory
Board Review Question: What substance gives feces its normal color? urochrome uroeryhtrin urobilin urobilinogen
urobilin
Board Review: Safety glasses, face shields or other eye and face protectors must be worn when: present in technical work area processing specimens using a splash barrier working with caustic or toxic materials viewing microbiology culture plates
working with caustic or toxic materials
Which liver marker is the most sensitive for alcoholism? Alanine aminotransferase Lactate dehydrogenase γ-Glutamyl transferase Alkaline phosphatase
γ-Glutamyl transferase
