Protein: Biochemical theory and physiology

Which risk marker has both positive and negative cardiovascular risk integrated into its measurement?

Apo B-100/Apo A-1

Which of the following tumor markers is associated with testicular cancer?

Beta hCG

All of the following statements are characteristic of the role of C-reactive protein (CRP) except?

Binds with factor H to initiate alternate complement pathway

Select the primary reagent components used in the Jaffe reaction for creatinine.

Saturated picric acid and sodium hydroxide

Which cardiac biomarker is a regulator of myocyte contraction?

cTnT

Which assay is recommended by the American Heart Association and the CDC as the inflammatory marker of choice in the evaluation of cardiac heart disease risk?

hs-CRP

Which of the following cardiovascular risk markers is a more sensitive version of a test that is used to assess inflammation?

hs-CRP

Select the statement that best describes high sensitivity CRP (hs-CRP) testing?

hs-CRP is a marker of chronic inflammation and measured to predict the risk of cardiovascular disease

What is the glomerular filtration rate for a patient with a serum creatinine of 2 mg/dL, if the urine creatinine was 124 mg/dL and the urine volume was 2.2 L/24 hrs?

p5 mL/min

The Emergency Department has collected blood test tubes for potassium, albumin, plasma hemoglobin, and acid phosphatase. Which of these test results will NOT be negatively affected if the blood tube is sent by the hospital's pneumatic tube system?

Albumin

Which one of the following usually shows a decrease during an acute phase response?

Albumin

A Comprehensive Metabolic Panel (CMP) consists of which group of tests?

Albumin, Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, AST, ALT, Alkaline Phosphatase, Total Protein, Total Bilirubin, Calcium

The laboratory test used to determine the presence of neural tube defects is:

Alpha-fetoprotein

Which of the following tests is the BEST screening test for neural tube defects?

Alpha-fetoprotein

Which of the following blood tests needs to be placed on ice immediately after collection?

Ammonia

All of the following laboratory tests are used to determine kidney function, EXCEPT?

Amylase

Which of the following tests should be collected in serum gel tube and goes to the chemistry department?

BUN

An increased serum level of which of the following analytes is MOST commonly associated with decreased glomerular filtration?

Creatinine

Which of the following analytes would be increased due to delay in centrifugation?

Creatinine

Which of the following blood tests is used to evaluate kidney function?

Creatinine

Which one of the following serum constituents is increased following strenuous exercise?

Creatinine

Which of the following tests would be used in the assessment of glomerular filtration?

Creatinine clearance

Which of the following tests would be useful in the assessment of glomerular filtration:

Creatinine clearance

A 45-year-old male of average height and weight had a serum creatinine of 1.5 mg/dL and urine creatinine was 120 mg/dL; the total volume of urine collected over a 24-hour period was 1,800 mL. Calculate the creatinine clearance for this patient in mL/min.

100

A 56-year-old woman with a history of high blood pressure and cardiovascular disease is evaluated by her physician due to her recent loss of appetite. The doctor reviews the following test results: Plasma creatinine = 2.4 mg/dL Urine creatinine = 65 mg/dL Urine volume (24 hrs) = 1400 mL What is the estimated glomerular filtration rate for this patient?

26.32 mL/min

Troponin I is used frequently to assess acute myocardial infarctions (AMI). If a patient has experienced an AMI, at what point (approximately) will the troponin I begin to increase and how long will it stay increased?

3-12 hours, 7-14 days

Ammonia is BEST characterized as being:

A waste product of amino acid and protein metabolism

Uric acid is the final breakdown product of what two purines?

Adenine and guanine

Which of the following tumor markers is associated with the liver?

AFP

A hepatic function panel A consists of which of the following tests?

AST, ALP, ALT, TP, Alb, Total bili, Direct bili

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

BNP and NT-proBNP

All of the following are currently used to diagnose acute coronary syndrome and/or acute myocardial infarction, EXCEPT?

BNP

Which one of the following is considered to be the most specific marker for adverse ventricular remodeling or volume overload of the heart?

BNP

Which of the following laboratory tests is used as an indicator of inflammation?

C-Reactive Protein (CRP)

The tumor marker associated with ovarian cancer is:

CA 125

While serum elevations are NOT generally seen in early stages, which of the following tumor markers are elevated in more advanced stages of breast cancer?

CA 15-3 and CA 549

After complaining to her physician about persistent pelvic pain and abdominal pressure, Mrs. Smith, had laboratory testing ordered. Since her physician would like to rule-out ovarian cancer, which of the following assays would be most helpful?

CA125

Which of the following tumor markers is associated with the colon?

CEA

Which of the following tumor markers is widely used for the detection of colorectal cancers?

CEA

Which tumor marker is used for colorectal cancer?

CEA

Following a myocardial infarction which of the following enzymes will be the first to become elevated:

CK

Which two of the following 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

All of the following statements concerning CK-MB (CK-2) are true EXCEPT:

CK-MB levels are normal in cardiac ischemia.

Which of the following is true of C-reactive protein (CRP) when being used to assess the risk of cardiovascular disease?

CRP levels are high in cardiovascular disease.

A markedly elevated 5-hydroxyindole acetic acid (5-HIAA) determination is presumptive evidence for:

Carcinoid tumor

An increase in carcinogen antigen levels is most closely associated with which of the following organs?

Colon

Which one of the following cardiac biomarkers could detect a recent reinfarction?

Creatine kinase MB (CK-MB)

Which of the following is found in plasma but absent in serum?

Fibrinogen

Increase in blood ammonia levels would be expected in which of the following conditions?

End stage cirrhosis

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

Fibrinogen

Acute phase proteins generally fall into which category?

Glycoprotein

Which of the following conditions is associated with elevated serum uric acid levels:

Gout

Which of the following parts of the body synthesizes and secretes BNP?

Heart

Increase concentration of alpha-fetoprotein (AFP) in adults are most characteristically associated with:

Hepatocellular carcinoma

Increased concentrations of alpha-fetoprotein (AFP) in adults are MOST characteristically associated with:

Hepatocellular carcinoma

Where are most acute phase proteins synthesized?

Hepatocytes

A high-sensitivity C-reactive protein (hs-CRP) test result of 5 mg/L (normal = < 1 mg/L) may indicate which of the following?

High risk for future CVD

When evaluating a patient for a suspected Wilson's Disease diagnosis, low values of plasma ceruloplasmin would be expected along with:

Increased urine copper

All of the following hormones stimulate gluconeogenesis, the formation of glucose from noncarbohydrate sources such as amino acids, glycerol, and fatty acids, Except?

Insulin

A characteristic of a good cardiac biomarker is that:

It can be detected even if it is present in a LOW concentration in the peripheral blood.

Which of the following statements about the test for C-reactive protein (CRP) is TRUE?

It is an indicator of an inflammatory condition

Which one of the following statements about urea is false?

It is decreased in dehydration

Which of the following statements is FALSE regarding troponin as a marker of myocardial infarction (MI)?

It rises much sooner after a myocardial infarction than CK-MB

In a normal CSF the protein concentration as compared to that in the plasma is generally:

Less than 1%

Tumor markers are especially valuable when used to:

Monitor response to cancer therapy

Creatinine excretion correlates best with which of the following parameters:

Muscle Mass

A patient is admitted to the hospital with acute chest pain, but which of the following cardiac markers will be elevated FIRST if the patient had a myocardial infarction?

Myoglobin

Which of the following cardiac biomarkers rises within 1 - 3 hours after chest pain, peaks in 2 - 6 hours, and is usually normal within 24 hours.

Myoglobin

Which of the following is the EARLIEST biochemical marker of myocardial infarction?

Myoglobin

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

One of the values is in error

Which of the following tumor markers is associated with the prostate?

PSA

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?

The medications lowered the hs-CRP value.

How should an ammonia specimen be transported to prevent alteration of the ammonia level in the blood plasma?

Place it into an ice slurry.

Which of the following analytes will be falsely increased due to hemolysis?

Potassium, Magnesium, Iron, Total Protein

Which of the following viral families contains DNA as its nucleic acid?

Poxviridae

All of the following conditions would be associated with an increased level of alpha-fetoprotein, EXCEPT?

Prostate Cancer

Which one of the following is not an acute phase protein?

Protein S

Which condition is caused by the increased Plasminogen Activator Inhibitor 1 (PAI-1) and fibrinogen often present in metabolic syndrome?

Prothrombotic state

Plasma creatinine concentration is dependent on all of the following EXCEPT:

Sodium concentration

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

Specificity

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

Sulfosalicylic acid test

Given the following laboratory results, what is the most likely diagnosis? HBsAg: Negative Anti-HBc: Negative Anti-HBs: Negative

Susceptible to Hepatitis B infection

Which of the following methods would be used to confirm the presence of Bence-Jones protein in the urine:

Urine protein electrophoresis or immunoelectrophoresis

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

The serum ferritin decreases to between 20 and 50 ng/mL

A physician calls the lab wanting to order a Hepatitis A IgG test but cannot find the code. What do you tell the physician?

There are no IgG-only tests for Hepatitis A, only a total with/without reflex to IgM

Which of the following is currently considered to be a good test for screening persons for HH due to its sensitivity and specificity for iron overload?

Transferrin saturation

All of the following specimen processing examples are considered processing errors that can have a negative impact on the test results, EXCEPT?

Transporting an ammonia specimen to the laboratory in an ice slurry.

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

Transthyretin

Which one of the following is the MOST specific biochemical marker of myocardial infarction?

Troponin

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?

Troponin T

Which troponin protein binds the troponin complex to tropomyosin? Please select the single best answer

Troponin T (TnT)

Which amino acid is the precursor for catecholamines as well as thyroid hormones?

Tyrosine

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

Uracil

What is the largest constituent of plasma nonprotein nitrogen:

Urea

Which if the following blood tests is used to diagnose gout?

Uric Acid

The following diagram demonstrates two Serum Protein Electrophoresis (SPEP) patterns from different patients. The pattern on the left is from a normal, healthy patient. The pattern on the right is from a patient with a particular disorder. What abnormality is suggested by the pattern on the right?

X-linked agammaglobulinemia