The following results are from a 21 year old patient with a back injury who appears otherwise healthy: whole blood glucose: 77 mg/dL(4.2 mmol/L) serum glucose: 88 mg/dL(4.8 mmol/L) CSF glucose: 56 mg/dL(3.1 mmol/L) the best interpretati

- all values are consistent with a normal healthy individual.

The preparation of a patient or 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

a. a high carbohydrate diet for 3 days

A 25 year old man became nauseated and vomited 90 minutes after receiving a standard 75g carbohydrate dose for an oral glucose tolerance test. The best course of action is to:

draw blood for glucose and discontinue

A 45 year old woman has a fasting serum glucose concentration of 95 mg/dL and a 2 hour PPG of conc. of 105 mg/dL . The statement which best describes this patient's fasting serum glucose concentration is

normal; reflecting glycogen breakdown by the liver

Which one of the ff. values obtained during a glucose tolerance test are diagnostic of diabetes mellitus: a. 2 hour spcmn.= 150 mg/dL(8.3 mmol/L); b. fasting plasma glucose= 126 mg/dL (6.9 mmol/L); c. fasting plasma glucose=110 mg/dL (6.1 mmol/L)

b. fasting plasma glucose= 126 mg/dL (6.9 mmol/L)

Total glycosylated hemoglobin levels in a hemolysate reflect the:

average blood glucose levels of the past2-3 months.

A patient with hemolytic anemia will show what effect on the glycated Hgb value:

show a decrease in glycated Hgb value because this Hgb is directly related to the life of RBC

An infant with diarrhea is being evaluated for a carbohydrate intolerance. His stool yields a positive copper reduction test and a pH of 5.0. It should be concluded that:a. further test are indicated; b.results are inconsistent-repeat both test;

a. because copper reduction detects many reduction substances

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, low pyruvate; b.↑ lactic,↑ pyruvate

b. elevated lactic, elevated pyruvate

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.metabolic acidosis because of reduce excretion of acids

Severe diarrhea causes: a.metabolic acidosis; b.metabolic alkalosis; c.respiratory acidosis; d.respiratory alkalosis

a.metabolic acidosis because of excessive loss of bicarbonate

Metabolic acidosis is described as a(n): a.↑ in CO2 content and PCO2 with a decreased pH; b.decrease in CO2 with an ↑ pH; c.↑ in co2 content with an ↑ pH; d. decrease in CO2content and PCO2 with a decreased pH

d.decrease in CO2 content and PCO2 with a decreased pH

Respiratory acidosis is described as a(n):a.↑ in CO2 content and PCO2 with a decreased pH; b.decrease in CO2 with an ↑ pH; c.↑ in co2 content with an ↑ pH; d. decrease in CO2content and PCO2 with a decreased pH

a.increased in CO2 content and PCO2 with a decreased pH

A blood gas sample was sent to the lab on ice, and a bubble ws present in the syringe. The blood had been exposed to room air for at least 30 minutes. The ff.changes in blood gases will occur: a.CO2 content increased/PCO2 decreased; b.PO2↑/HCO3decreased

b. PO2 increased/HCO3 decreased

Since PCO2 is regulated by respiration, abnormalities that primarily alter the PCO2 are referred to as

respiratory acidosis (high PCO2) and respiratory alkalosis (low PCO2).

[HCO3-] is regulated primarily by renal processes. Abnormalities that primarily alter the [HCO3-] are referred to as

metabolic acidosis (low [HCO3-]) and metabolic alkalosis (high [HCO3-]).

In metabolic acidosis, this reduction in bicarbonate ions may result from

increased extracellular buffering of an increased acid load or less commonly; loss of bicarbonate ions in the urine.

The body responds to metabolic acidosis by trying to restore the PCO2 / [HCO3-] ratio. This is done by reducing the: a. PCO2; b. HCO3

a. PCO2. The reduction in PCO2 is accomplished by increasing alveolar ventilation

In Respiratory Acidosis, the elevation in PCO2 result from a reduction in

alveolar ventilation. Elevation in PCO2 is never due to an increase in CO2 production.

In response to the increase in [H+] and reduction of the pH, the body responds by trying to increase the plasma [HCO3-] to match the increase in PCO2 and thus maintain the PCO2/HCO3- ratio. This is accomplished via two mechanisms;

a) rapid cell buffering and b) an increase in net acid excretion.

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Question	Answer
Following overnight fasting, hypoglycemia in adults is defined as glucose of: a. ≤70 mg/dL (≤3.9 mmol/L) b. ≤60 mg/dL (≤3.3 mmol/L) c. ≤55 mg/dL (≤3.0 mmol/L) d. ≤45 mg/dL (≤2.5 mmol/L)	d. ≤45 mg/dL (≤2.5 mmol/L)
The following results are from a 21 year old patient with a back injury who appears otherwise healthy: whole blood glucose: 77 mg/dL(4.2 mmol/L) serum glucose: 88 mg/dL(4.8 mmol/L) CSF glucose: 56 mg/dL(3.1 mmol/L) the best interpretati	- all values are consistent with a normal healthy individual.
The preparation of a patient or 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	a. a high carbohydrate diet for 3 days
If a fasting was 90 mg/dL, which of the following 2-hour postprandial glucose results would most closely represent normal glucose metabolism?,a. 55 mg/dL (3.0 mmol/L),b. 100 mg/dL (5.5 mmol/L),c. 180 mg/dL (9.9 mmol/L),d. 260 mg/dL (8.3 mmol/L)	c.100 mg/dL (5.5 mmol/L)
A healthy person with a blood glucose of 80 mg/dL (4.4 mm0l/L) would have a simultaneously determined CSF fluid glucose value of:a.25mg/dL;b.50 mg/dL;c.100 mg/dL;d.150mg/dL	b. 50 mg/dL (2.3 mmol/L)
A 25 year old man became nauseated and vomited 90 minutes after receiving a standard 75g carbohydrate dose for an oral glucose tolerance test. The best course of action is to:	draw blood for glucose and discontinue
Cerebrospinal fluid for glucose assays should be:a. refrigerated; b. analyzed immediately; c. heated to 56C;d. stored at room temperature after centrifugation	b. analyzed immediately
Which of the ff. 2 hour PPG values demonstrates unequivocal hyperglycemia diagnostic for diabetes mellitus?: a.160;b.170;c.180;d.200 mg/dL	d. 200 mg/dL (11.1 mmol/L)
Serum levels that define hypoglycemia in pre-term or low birth weight infants are:	lower than infants
A 45 year old woman has a fasting serum glucose concentration of 95 mg/dL and a 2 hour PPG of conc. of 105 mg/dL . The statement which best describes this patient's fasting serum glucose concentration is	normal; reflecting glycogen breakdown by the liver
Pregnant women with symptoms of thirst, frequent urination of unexplained weight loss should have which of the following test performed..	glucose tolerance test
In the fasting state, the arterial and capillary blood glucose concentration varies from the venous glucose concn. by approximately how many mg/dl (mmol/L)?	5 mg/dL (0.27 mmol/L) higher
The conversion of glucose or other hexoses into lactate or pyruvate is called:	glycolysis
Which one of the ff. values obtained during a glucose tolerance test are diagnostic of diabetes mellitus: a. 2 hour spcmn.= 150 mg/dL(8.3 mmol/L); b. fasting plasma glucose= 126 mg/dL (6.9 mmol/L); c. fasting plasma glucose=110 mg/dL (6.1 mmol/L)	b. fasting plasma glucose= 126 mg/dL (6.9 mmol/L)
The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding: a.1-3 weeks; b. 4-5 weeks; c. 6-8 weeks; d. 16-20 weeks	c. 6-8 weeks
Monitoring long term glucose control in patients with adult onset diabetes mellitus can best be accomplished by measuring:	hemoglobin A1c
Total glycosylated hemoglobin levels in a hemolysate reflect the:	average blood glucose levels of the past2-3 months.
Which of the ff. hemoglobins has glucose-6-phosophate on the amino-terminal valine of the beta chain: a.S; b.C; c. A2; d.A1c	d. A1c
A patient with hemolytic anemia will show what effect on the glycated Hgb value:	show a decrease in glycated Hgb value because this Hgb is directly related to the life of RBC
In using ion exchange chormatographic methods, falsely increased levels of Hgb A1c might be demonstrated in the presence of:	Hgb S
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.carbohydrates
An infant with diarrhea is being evaluated for a carbohydrate intolerance. His stool yields a positive copper reduction test and a pH of 5.0. It should be concluded that:a. further test are indicated; b.results are inconsistent-repeat both test;	a. because copper reduction detects many reduction substances
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, low pyruvate; b.↑ lactic,↑ pyruvate	b. elevated lactic, elevated pyruvate
What is the best method to diagnose lactase deficiency? a. H2 breath test; b.plasma aldolase level; c. LDH level; d. D-xylose level	a.H2 breath test
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.metabolic acidosis because of reduce excretion of acids
Severe diarrhea causes: a.metabolic acidosis; b.metabolic alkalosis; c.respiratory acidosis; d.respiratory alkalosis	a.metabolic acidosis because of excessive loss of bicarbonate
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.respiratory acidosis
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.20:1
The reference range for the pH of arterial blood measured at 37C is: a.7.28-7.34; b.7.33-7.37; c.7.35-7.45; d.7.45-7.50	c.7.35-7.45
A 68yr. old man arrives in the emergency room with a glucose level of 722 mg/dL(39.7 mmol/L) and serum acetone of 4+. An arterial blood gas from this patient is likely to be: a.low pH; b. high pH, c. low PO2; d. high PO2	a.low pH
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.high TCO2, increased HCO3
A person suspected of having metabolic alkalosis would have which of the following laboratory findings? a. CO2 content and PCO2 elevated, pH decreased; b. CO2 content decreased and pH elevated; c.CO2 content, PCO2 and pH decreased; d. CO2 content and pH↑	d.CO2 content and pH elevated
Metabolic acidosis is described as a(n): a.↑ in CO2 content and PCO2 with a decreased pH; b.decrease in CO2 with an ↑ pH; c.↑ in co2 content with an ↑ pH; d. decrease in CO2content and PCO2 with a decreased pH	d.decrease in CO2 content and PCO2 with a decreased pH
Respiratory acidosis is described as a(n):a.↑ in CO2 content and PCO2 with a decreased pH; b.decrease in CO2 with an ↑ pH; c.↑ in co2 content with an ↑ pH; d. decrease in CO2content and PCO2 with a decreased pH	a.increased in CO2 content and PCO2 with a decreased pH
A common cause of respiratory alkalosis is: a. vomiting; b.starvation; c.starvation; d.hyperventilation	d.hyperventilation
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 anhydrase	c.bicarbonate buffer
A blood gas sample was sent to the lab on ice, and a bubble ws present in the syringe. The blood had been exposed to room air for at least 30 minutes. The ff.changes in blood gases will occur: a.CO2 content increased/PCO2 decreased; b.PO2↑/HCO3decreased	b. PO2 increased/HCO3 decreased
The ff laboratory results were obtained: serum electrolytes: Na: 136 mEq/L (136mmol/L);K+: 4.4;Cl: 92; HCO3: 40; Arterial blood: ph: 7.32; PCO2 79 mmHG. The results are compatible with: a.respiratory alkalosis; b.respitatory acidosis;c.metabolic alkalosis	b.respiratory acidosis
is a change in the normal value of extracellular pH that may result when renal or respiratory function is abnormal or when an acid or base load overwhelms excretory capacity.	Acid-base disorder
Is a decrease in the blood pH below normal range of 7.35 -7.45	Acidemia
Elevation in blood pH above the normal range of 7.35 – 7.45	Alkalemia
Since PCO2 is regulated by respiration, abnormalities that primarily alter the PCO2 are referred to as	respiratory acidosis (high PCO2) and respiratory alkalosis (low PCO2).
[HCO3-] is regulated primarily by renal processes. Abnormalities that primarily alter the [HCO3-] are referred to as	metabolic acidosis (low [HCO3-]) and metabolic alkalosis (high [HCO3-]).
is an acid base disturbance characterized by a reduction in bicarbonate ions leading to an elevation in the PCO2/HCO3- ratio and thus an elevation in hydrogen ion concentration	Metabolic acidosis
In metabolic acidosis, this reduction in bicarbonate ions may result from	increased extracellular buffering of an increased acid load or less commonly; loss of bicarbonate ions in the urine.
Is the main buffer of nonvolatile or noncarbonic acids in the body	HCO3
The body responds to metabolic acidosis by trying to restore the PCO2 / [HCO3-] ratio. This is done by reducing the: a. PCO2; b. HCO3	a. PCO2. The reduction in PCO2 is accomplished by increasing alveolar ventilation
is an acid base disturbance characterized by an elevation in the partial pressure of dissolved CO2 leading to an elevation in the PCO2/[HCO3-] ratio which subsequently increases the hydrogen ion concentration	Respiratory Acidosis
In Respiratory Acidosis, the elevation in PCO2 result from a reduction in	alveolar ventilation. Elevation in PCO2 is never due to an increase in CO2 production.
In response to the increase in [H+] and reduction of the pH, the body responds by trying to increase the plasma [HCO3-] to match the increase in PCO2 and thus maintain the PCO2/HCO3- ratio. This is accomplished via two mechanisms;	a) rapid cell buffering and b) an increase in net acid excretion.
an acid base disorder characterized by an elevation in [HCO3-] above the normal range, which leads to a reduction in the PCO2/[HCO3-] ratio and subsequently a reduction in hydrogen ion concentration	Metabolic alkalosis.
This elevation in bicarbonate ions is due to an addition in alkali to the body which then cannot be excreted by the kidney.	Metabolic alkalosis is always associated with renal impairment of some kind because the kidney has a vast capacity in excreting excess alkali.
Please note, loss of acid from the body as occurs in vomiting induced metabolic alkalosis is equivalent	to adding alkali to the body.
In response to the reduction in [H+] and elevation in pH, the body responds by trying to increase the PCO2 to match the increase in [HCO3-] and thus maintain the PCO2/[HCO3] ratio. Elevation in PCO2 is accomplished by	lowering alveolar ventilation.
is caused by an elevation in the frequency of alveolar ventilation and more importantly tidal volume that result in an increase in minute ventilation.	Respiratory alkalosis. The increase in ventilation leads to the excretion of CO2 at a rate greater than that of cellular CO2 production.
There are two mechanisms responsible for this compensation to respiratory alkalosis;	1) rapid cell buffering and 2) a decrease in net renal acid excretion.
Compensatory response to metabolic disorders involves only	an alteration in alveolar ventilation.
Compensatory response to respiratory disorders is two-fold;	a fast response due to cell buffering and a significantly slower response due to renal adaptation.
Causes of elevated Anion gap acidosis is best remembered by the mnemonic KULT or the popular MUDPILES M = Methanol U = Uremia D = DKA (also AKA and starvation) P = Paraldehyde I = INH L = Lactic acidosis E = Ethylene Glycol S = Salycilate	K = Ketoacidosis (DKA,alcoholic ketoacidosis, starvation) U = Uremia (Renal Failure) L =Lactic acidosis T = Toxins (Ethylene glycol, methanol, paraldehyde, salicylate)
Select the best test which evaluates renal tubular function: a. IVP; b. creatinine clearance; c.osmolarity; d. microscopic urinalysis	c. osmolarity
The degree to which the kidney concentrates the glomerular filtrate can be determined by :a.urine creatinine; b. serum creatinine; c. creatinine clearance; d. urine to serum osmolality ratio	d. urine to serum osmolality ratio
Osmolal gap is the difference between: a.the ideal and real osmolality values; b. calculated and measured osmolality values; c. plasma and water osmolality values; d. molality and molarity at 4C	b.calculated and measured osmolality values
The most important buffer pair in plasma is the: a.phosphate/biphosphate pair; b.Hgb/imidazole pair; c.bicarbonate/carbonic acid pair; d. sulfate/bisulfate pair	c. bicarbonate/carbonic acid pair
Quantitation of Na+ and K+ by ion-selective electrode is the standard method because: a.dilution is required for flame photometry; b.there is no lipoprotein interference; c.of advances in electrochemistry; d. of the absence of internal standard	c.of advances in electrochemistry
What battery of test is most useful in evaluating an anion gap of 22 mEq/L(22mmol/L): a. Ca++, Mg++, PO-4, and pH; b.BUN,creatinine, salicylate, and methanol; c. AST, ALT,LD and amylase; d. glucose,CK,myoglocin and cryoglobulin	b. BUN,creatinine, salicylate and methanol
Most of the carbon dioxide present in blood is in the form of: a.dissolved CO2; b.carbonate; c.bicarbonate ion; d.carbonic acid	d.bicarbonate ion is the major component of CO2 in blood.
Serum anion gap is increased in patients with: a.renal tubular acidosis; b.diabetic alkalosis; c.metabolic acidosis due to diarrhea; c.lactic acidosis	d.lactic acidosis
is defined as the quantity of anions not balanced by cations. This is usually equal to 12 ± 4 meq/L and is usually due to the negatively charged plasma proteins as the charges of the other unmeasured cations and anions tend to balance out	Anion gap
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.sodium,potassium, chloride, and total CO2
The buffering capacity of blood is maintained by a reversible exchange process between bicarbonate and: a.sodium, b.potassium; c.calcium, d.chloride	d.chloride
In respiratory acidosis, a compensatory mechanism is the increase in: a.respiratory rate;b.ammonia formation; c.blood PO2; d.plasma bicarbonate concentration	d.plasma bicarbonate concentration
Which of the ff. electrolytes is the chief plasma cation whose main funnction is maintaining osmotic pressure? a.chloride. b.calcium; c.potassium; d. sodium	d.sodium
A potassium level of 6.8mEq/L(6.mmol/L) is obtained. Before reporting the results, the first step the technologist should take is to: a.check the serum for hemolysis; b.rerun the test; c.check the age of the patient; d.do nothing, simply report it out	a.check the serum for hemolysis
The solute that contributes the most to the total serum osmolality is: a.glucose; b.sodium; c.chloride; c. urea	b.sodium, the largest solute in osmolality
Which of the ff. is true about direct ion selective electrodes for electrolytes? a.whole blood specimens are acceptable; b. elevated lipids cause falsely decreased results; c.elevated proteins cause falsely decreased results;	a.whole blood specimens are accepted in direct ISE method
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.elevated lipid levels
Calcium concentration in the serum is regulated by: a.insulin; b.parathyroid hormone; c.thyroxine; d.viatmin C	b.parathyroid hormone
The regulation of calcium an phosphorus metabolism is accomplished by which of the ff. glands: a.thyroid; b.parathyroid; c.adrenal glands; d.pituitary	b.parathyroid
A patient has the ff. test results:↑ serum calcium levels,↓ serum phosphate levels,↑ levels of parathyroid hormone. This patient is most likely: a.hyperparathyroidism, b.hypoparathyroidism, c.nephrosis, c. steatorrhea	a.hyperparathyroidism
A hospitalized patient is experiencing ↑ nueromuscular irritability(tetany). Which of the ff. should be ordered immediately: a.calcium, b.phosphate, c.BU, d.glucose	a.calcium
Which of the ff. is most likely to be ordered in addition to serum calcium to determine the cause of tetany? a.magnesium, b.phosphate, c.sodium, d.vit.D	a.magnesium
A reciprocal relationship exists between: a.Na and K+, b. calcium and phosphate, c. chloride and CO2, d.calcium and magnesium	b.calcium and phosphate
Fasting serum phosphate concentration is controlled primarily by the: a.pancreas, b.skeleton, c.parathyroid glands, d.small intestines	c.parathyroid glands
A low concentration of serum phosphorus is COMMONLY found in: a.patients who ar receiving carbohydrate hyperalimentation, b.chronic renal dss., c.hypoparathyroidism, d.patients with pituitary tumors	a.patients who are receiving carbohydrate hyperalimentation is the MOST COMMON cause of low phosphate
The primary function of serum albumin in the peripheral blood is to: a.maintain colloidal osmotic pressure, b.increase anitbody production, c.↑ fibrinogen production, d.maintain blood viscosity	a.maintain colloidal osmotic pressure
In a pleural effusion caused by Strep. pneumoniae, the protein value of the pleural fluid as compared to the serum value would probably be: a.↓ by 2, b.↓ by 1/2, c.increased by 1/2, d. equal	b.decreased by 1/2
The first step in analyzing a 24-hr urine specimen for quantitative urine protein is: a.subculture the urine for bacteria, b.add the appropriate preservative, c.screen the albumin using a dipstick, d.measure the total volume.	d.measure the total volume
When performing a manual protein analysis on a xanthochromic spinal fluid, the technician should: a.perform the test as usual, c.make a patient blank, c.centrifuge the specimen, d.dilute the specimen with deionized water	b.make a patient blank
The direction in which albumin migrates during electrophoretic separation of serum proteins, at pH8.6, is determined by:a.the ionzation of amine groups,yielding to a net positive charge,b.the ionization of the carboxyl grous,yielding a net negative charge	b.the ionization of the carboxyl groups, yielding a net negative charge
The protein that has the highest dye-binding capacity is: a.albumin, b.alpha globulin, c.beta globulin, d.gamma globulin	a.albumin
The biuret reaction foro the analysis of serum protein depends on the number of: a.free amino groups, b.free carboxy groups, c.peptide pbonds, d.tyrosine residues	c.peptide bonds
In electrophoresis of protein, when the sample is paced in an electric field connected to a buffer of pH 8.6, all the proteins:a.have a positive charge, b.have a negative charge, c.are electrically neutral, d.migrate toward the cathode	b.have a negative charge
The relative migration rate of proteins on cellulose acetate is based on: a.molecular weight, b.concentration, c.ionic charge, d.particle size	c.ionic charge
The cellulose acetate electrophoresis at pH 8.6 of serum proteins will show an order of migration beginning with the fastest migration as follows:	albumin,alpha-1 globulin, alpha-2 globulin, beta globulin, gamma globulin
Which of the ff. amino acids is associated with sulhdryl group: a.cysteine, b.glycine, c.serine, d. tyrosine	a.cysteine
Maple syrup urine disease is characterized by an increase in which of the f. urinary amino acids: a.phenylalanine, b.tyrosine, c.valine,leucine and isoleucine, d.cystine and cysteine.	c.valine, leucine and isoleucine
Increased SERUM albumin concentrations are seen in which of the ff. conditions/ a.nephrotic syndrome, b.acute hepatitis, c.chronic inflammation, d.dehydration	d.dehydration due to loss of normal physiologic fluid balance
A patient is admitted with biliary cirrhosis. If a serum protein electrophoresis is performed, which of the ff. globulin fractions will be most elevated. a:alpha-1, b.alpha-2, c.beta, d.gamma	d.elevated polyclonal gamma-globulins with beta-gamma bridging due to increased IgA
Which of the ff. serum protein fractions is most likely to be elevated in patients with nephrotic syndrome: a.alpha-1 globulin, b.albumin, c.alpha-2globulin, d.beta and gamma globulin	c.Due to loss of albumin in nephrotic syndrome, increased alpha-2 is a compensatory mechanism
Reference value for total protein	6.0-8.0 g/dL (60-80 g/L)
Ref. value for albumin	3.6-5.2 g/dL (36-52 g/L)
Ref. value for alpha-1 globulin	0.1-0.4 g/dL (1-4 g/L)
Ref. value for alpha-2 globulin	0.4-1.0 g/dl (4-10 g/L)
Ref. value for beta globulin	0.5-1.2 g/dL (5-12 g/L)
Ref. for gamma globulin	0.6-1.6 g/dL (6-16 g/L)
A characteristic of the Bence Jones protein that is used to distinguished it from other urinary protiens is its solubility: a.in ammonium sulfate'b.in sulfuric acid, c. at 40-60C, at 100C	d.at 100C
The electrophoretic pattern of plasma sample as compared to a serum sample shows a: a.broad prealbumin peak, b.sharp fibrinogen, c.diffuse pattern because of the presence of anticoagulants, d.decreased globulin fraction	b.sharp fibrinogen peak. Anticoagulants prevent clotting
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.endosmosis. The inward flow of a fluid through a permeable membrane toward a fluid of greater concentration.
The electrophoresis pattern shows a sharp peak in the gamma-globulin region is referred to as what type of pattern?	monoclonal gammopathy and reflects the alteration of immunoglobulin synthesis found in the disease multiple myeloma. Approx, 75% or more of the patients this disease demonstrate this serum pattern
The primary material for laboratory testing in multiple sclerosis is	CSF
The major function of prealbumin is	transport of thyroxine
is the major transport protein for iron in the circulation and its normal values are 200-400 mg/dL	Transferrin
This protein is one of many protease inhibitors, acting to inhibit the proteolytic enzyme trypsin	Alpha1 antitrypsin
Hemoglobin released from disintegrating red cells is bound by	Haptoglobin
The serum protein electrophoresis shows elevation in the alpha1 and alpha2-globulin fractions and albumin are either normal or decreased is found in what conditions	Acute or Chronic inflammation. The major difference in the serum protein electrophoresis pattern is the increase in the gamma globulin fraction found in chronic inflammation. Normal or decreased gamma globulin is seen in acute inflammation
The serum protein electrophoresis shows a single broad band in place of the distinct separation between the beta and gamma globulin fractions is characteristic of what condition or disease	Cirrhosis. The bridging effect is due to enhanced production of IgA
The major role of electrophoresis in the study of immunoglobulin abrnormalities is	to bring to light various abnormal fractions seen in serum or CSF. Serum protein electrophoresis cannot be used to quantitate the levels of the various immunoglobulins
is an abnormal Hgb in which the sixth amino acid in the beta chain is valine instead of glutamic acid	Hemoglobin S
Analysis of CSF for oligoclonal bands is used to screen for which of the ff. disease states? a.multiple myeloma, b.multiple sclerosis, c.myasthenia gravis, d.von Willebrand disease	b. Multiple sclerosis. Pronounced banding in the gamma-globulin region is observed for CSF samples from these patients. These multiple bands are called oligoclonal bands
The identification of Bence Jones protein is best accomplished by: a.a sulfosalicylic acid test, b.urine reagent strips, c.immunofixation, d.electrophoresis	c.immunofixation. Monoclonal free kappa or lambda light chains seen
permits the detection and typing of monoclonal antibodies or immunoglobulins in serum or urine. It is of great importance for the diagnosis and monitoring of certain blood related diseases such as myeloma and Bence Jones protein	Immunofixation. The method detects by precipitation: when a soluble antigen (Ag) is brought in contact with the corresponding antibody, precipitation occurs, which may be visible with the naked eye or microscope. Immunofixation identifies (antibodies)
Total iron binding capacity measures the serum iron transporting capacity of: a.hemoglobin, b.ceruloplasmin, c. tansferrin, d.ferritin	c.transferrin
The first step in the quantitation of serum iron is:a.direct reaction with appropriate chromogen, b.iron saturation of transferrin, c.free iron precipitation, d.separation of iron from transferrin	d.separation of iron from transferrin
A Aeg's b;d was drawm at 8AM and 8PM for serum iron determination. The result was 85 ug/dL in AM and 40 ug/dL in PM. The results are more likely due to: a.iron def. anemia, b.improper storage of specimen, c.possible liver damage, d.the time of day	d.the time of day the second specimen was drawn. Serum iron levels vary throughout the day. Morning levels are generally assumed to be higher than afternoon or evening levels.
An elevated serum iron with normal iron binding capacity is most likely associated with: a.iron def. anemia, b.renal damage, c.pernicious anemia, d.septicemia	c.pernicious anemia. Ineffective erythropoiesis, high iron turnover
Decreased serum iron associated with incereased TIBC is compatible with which of the ff. disease states: a.anemia of chronic infecton, b.iron deficiency anemia, c.chronic liver disease, d. nephrosis	b.iron deficiency anemia.
is a disease that results from excessive amounts of iron in the body (iron overload).	Hemochromatosis (HH)
To assure an accurate ammonia level result, the specimen should be: a.incubated at 37C prior to testing, b.spun and separated immediately, tested as routine, c.spun, separated, iced, and tested immediately, d.stored at room temperature until tested	c.spun, separated, iced, and tested immediately
The extent to which measurement agree with the true value of the quantity being measured is known as: a.acceptable limits, b.accuracy, c.precision, d. reliability	b.accuracy
The reproducibility of test measurements is referred to as: a.accuracy, b.precision,c.quality control, d.reliability	b.precision
The middle value of a set of numbers that are arranged according to their magnitude is known as the	median
In a Guassian distribution, the ±2SD range includes the ff percentage values: a.31.6%, b.68.3%, c.95.5%, d.99.7%	c. 95.5%
Calculate the coefficient of variation when ±SD=±7 mg/dL and the mean = 89 mg/dL. a.6.4%, b.7.9%, c.12.7%, d.15.7%	b.7.9%. CV=SDx100/Mean
When establishing a reference range, it is most desirable to obtain specimens from at least the ff number of individuals: a.25, b.50, c.75, d.100	d.100
Which of the ff should be taken into consideration when establishing a reference range: a.age, b.sex, c.sampling time, d.both a and b, e.a,b,c	e. a,b,c
The process that monitors each laboratory analysis, using material with known constituent concentrations, in order to ensure the accuracy of test results is	quality control
The process that encompasses all aspects of laboratory operation including patient identification, specimen collection, equipment maintenance, and the reporting of patient results is	quality assurance
The more light absorbed, the higher the concentration of anlayte in this technique of measuring the amount of light absorbed by a soluiton	spectrophotometry
The visible region of the electomagnetic spectrum lies between	400 and 800nm.
In flame emission photometry the internal standard is used primarily to	correct for variations in the flame aspiration rate
When measuring pH, the external reference electrode is usually a: a.calomel electrode, b.glass electrode, c.hydrogen electrode, d.sodium electrode	a.calomel electrode
When measuring CO2, the dissolved CO2 gas in the specimen reacts with the ISE electrode to form a product which is measured as: a.bicarbonate ion, b.carbonic acid, c.hydrogen ion, d.silver chloride	c.hydrogen ion
The selective adsorption of molecules by a solid phase which is followed by their removal by a selected solvent system best describes: a.GC, b.GC/mass spectrometry, c.HPLC, d.TLC	c. HPLC
The chromatography system that employs the use of spectrophotometric, fluorescent, and electrochemical techniques for its detector system best describes:a.GC,b.GC/mass spectrometry,c.HPLC,d.TLC	b.GC/mass spectrometry
One sample sequentially following another through the system so that different analytical functions are being carried on simultaneously on more than one sample best describes:a.automatic clinical analysis, b.centrifugal analysis,c.continuous-flow analysis	c.continuous-flow analysis
Which system utilizes reflectance spectrophotemetry for measuring the color intensity of reactions: a.centrifugal analyzer, b.continuous-flow analyzer,c.DuPont aca,d.Kodak dry-slide analyzer	d.Kodak dry-slide analyzer
An instrument that can analyze patient samples for only those tests specifically ordered and analyze stat samples by interrupting the normal sequence of patient analyses is reffered to as: a.batch analyzer,b.discrete analyzer,c.random-access analyzer	c.random-access analyzer
In a chemical reaction the amount of product formed is measured at a specific intervals during a specified period and then related to the concentration of the analyte in the unknown. This type of measurement is known as:a.colorimetric,b.end-point,c.rate	c.rate
The primary structure of a protein is amino acids: a.in a helical formation, b.linked by covalent bonds, c.linked by peptide bonds, d.linked by S-S bonds	c.linked by peptide bonds
The zwitterion refers to an amino acid: a. that is positively charged, b.that is negatively charged, c.that has both positive and negative charges on the molecule at the same time	c.that has a positive and negative charges on the molecule at the same time.
The pH value at which the sum of the electric charges on a protein equals zero is referred to as the	isoelectric point
Which of the following functions may be ascribed to proteins: a. act as catalyst, b.form antibodies, c.provide structural support for the tissues, d.transport other compounds in the blood, e. all of the above	e. all of the above
A dye-binding technique commonly employed for the quantitation of serum albumin is: a.biuret, b.bromcresol green(BCG), c.Coomasie blue, d.sulfosalysilic acid	b. BCG
A turbidimetric method used for the quantitation of total protein in urine and CSF specimens is	sulfosalysilic acid
Decreased serum albumin levels may be associated with: a.malnutrition, b.liver disease,c.kidney disease,d.both b and c, e.a,b,c	e. a,b,c
Which of the ff. may be associated with AFP: a.measured in amniotic fluid, b.assay perfomed routinely by all clinical labs, c.used to detect neural tube defects, d. both a and c, e.a,b,c	d.both a and c
Which of the ff colorimetic methods may be used to quantitate total protein in CSF: a. BCG, b.Coomassie blue, c.sulfosalicylic acid	b.Coomassie blue
A protein that precipitates in acid solution but redissolves upon heating best describes: a.albumin, b.Bence Jones, c.haptoglobin, d.transferrin	b.Bence Jones protein
A patient has the ff. results: serum iron 250 ug/dL (NV:60-150), TIBC:350ug/dL (NV:300-350). The best conclusion is that this patient has:a.normal iron status,b.iron def. anemia,c.chronic dss.,d.iron hemochromatosis	d.iron hematochromatosis
Erroneous ammonia levels can be eliminated by all of the ff except:a.assuring water and rgnts. are ammonia free,b.separating plasma from cells and performing test analysis ASAP, c.drawing the spcmn in a prechilled tube and immersing the tube in ice	d.storing the specimen protected brom light until the analysis is done.
A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is: a.ammonia, b.ALT, c.AST,d.GGT	a.ammonia. Hyperammonemia to detect encelopathy
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.arrythmia	b. renal functional impairment
In order to prepare 100mL of 15mg/dL BUN working standard form a stock standard containing 500mg/dL or urea nitrogen, the number or mL of stock solution that should be used is: a.3mL, b.5mL, c.33mL, d.75mL	a. 3mL formula: (V1C1=V2C2)
A patient with glomerulonephritis is mos likely to present with the ff. serum results: a.creatinine decreased, b.calcium increased, c.phosphorus decreased, d. BUN increased	d. BUN increased
The principle excretory form of nitrogen is: a.amino acids, b.creatinine, c.urea, d.uric acid	c.urea is the metabolic product of protein catabolism
In the Jaffe reaction, creatinine reacts with: a.alkaline sulfasalazine soln 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 soln	d.alkaline picrate soln. to yield an orange-red complex
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.glomerular filtration rate is estimated by filtration markers such as creatinine clearance
Technical problems encountered during the collection of an amniotic fluid specimen caused doubt as to whether the specimen was amniotic in origin. Which 1 of the procedures would establish that the fluid is amniotic: a. measurement abs at 450nm, etc.	b.creatinine measurement
Which of the ff represents the end product of purine metabolism in humans: a.biotin, b.retinol, c.folic acid, d.uric acid	d.uric acid
Which of the ff substances is the biologically active precursor of a fat soluble vitamin: a.biotin, b.retinol, c.folic acid, d.ascorbic acid	b.retinol is one of the 3 biologically active forms of fat soluble vitamin A
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.TIC complex
The presence of C-reactive protein in the blood is an indication of: a.recent streptococcal infection, b.recovery from pneumococcal infection, c.an inflammatory process, d. a state of hypersensitivity	c.an inflammatory process. CRP is an acute phase protein increased in inflammation
Oligoclonal bands are present on electrophoresis of concentrated CSF and also on concurrently tested serum of the same patient. The proper intterpretation is: a.diagnostic for primary CNS tumor, b. diagnostic for multiple sclerosis,c.nondiagnostic for MS	c.nondiagnostic for multiple sclerosis.Oligoclonal proteins are produced in multiple sclerosis and other demyelinating diseases
90% of the copper present in the blood to: a. transferrin, b.ceruloplasmin, c. albumin, d.cryoglobulin	b.ceruloplasmin
Which of the ff. determinations is useful in prenatal diagnosis of open neural tube defects: a.amniotic fluid alpha-fetoprotein, b.amniotic fluid estriol, c.maternal serum estradiol, d.maternal serum estrone	a.amniotic fluid alpha-fetoprotein. AFP is the embryonic form of albumin
Normal CSF includes prealbumin, the fraction at a. 4.5%, b.54.5%, c.3.6%, d.6.5%	a.4.5%
Serum concentrations of vit. B12 are elevated in: a.pernicious anemia in relapse, b.patients on chronic hemodialysis, c.chronic granulocytic leukemia, d.Hodgkin disease	c.chronic granulocytic leukemia. Other choices are causes of B12 deficiency
Absorption of vit. B12 requires the presence of: a.intrinsic factor, b.gastrin, c.sevretin, d.folic acid	a.intrinsic factor
the procedure used to determine the presence of neural tube defects is: a.lecithin/sphingomyelin ratio, b.amniotic fluid creatinine, c.measurement of absorbance at 450 nm, d.alpha-fetoprotein	a.alpha-fetoprotein
The principle of the occult blood test depends upon the: a.coagulase ablility of blood, b.oxidative power of atmospheric oxygen, c.hydrogen peroxide in hemoglobin, d.peroxidase-like activity of hemoglobin	d.peroxidase-like activity of hemoglobin
A breakdown product of hemoglobin is: a.lipoprotein, b.bilirubin, c.hematoxylin, d.Bence Jones protein	b.bilirubin
Hemoglobin S can be separated from hemoglobin D by: a.eletrophoresis on a different medium and adidic pH, b.hemoglobin A2 quantitation, c.electrophoresis at higher voltage, d.Kleihauer-Betke acid elution	a.eletrophoresis on a different medium and adidic pH
On electrophoresis at alkaline pH, which of the ff is the slowest migrating hemoglobin: a.Hgb A, b.Hgb S, c.Hgb C, d. Hgb F	c.Hgb C
The hemoglobin that is resistant to alkali (KOH) denaturation is: a.A, b.A2, c.C, d.F	d.Hgb F
The ff bilirubin results are obtained on a patient: day1: 4.3mg/dL, day2:4.6, day3:4.5, day4:2.2, day5:4.4, day6:4.5. Given that the controls were within range each day, what is a probable explanation for the result on day 4:	specimen had prolonged exposure to light. Light-exposed bilirubin is oxidized and structurally altered
Urobilinogen is formed in the: a.kidney, b.spleen, c.liver, d.intestine	d.intestine
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.disslove conjugated bilirubin, c.precipitatd protein, d.prevent any change in pH	a.allow indirect bilirubin to react with color reagent
If the total bilirubin is 3.1mg/dL and the conjugated is 2.0, the unconjugated bilirubin is: a.0.5 mg/dL, b.1.1, c.2.2, d.5.1	b.1.1 mg/dL (18.8umol/L)
The principle of the tablet test for bilirubin in urine or feces is: a.the reaction between bile and 2,4-dichloronitobenzene to a yellow color, b.chemical coupling of bilirubin with a diazonium salt to from a purple color, c.chemical coupling of bile etc.	b.chemical coupling of bilirubin with a dizonium salt to form a purple color
A serum sample was assayed for bilirubin at 10AM, and the result was 12 mg/dL. The same sample retested at 3PM. The result now is 8mg/dL. The explanation of the discrepancy is: a.reagent has deteriorated, b.sample was exposed to light, c.calculation error	b.the sample was exposed to light
In the liver, bilirubin is converted to: a.urobilinogen, b.urobilin, c.bilirubin-albumin comples, d.bilirubin diglucoronide	d.bilirubin diglucoronide
In which of the ff disease states is conjugated bilirubin a major serum component? a.biliary obstruction, b.hemolysis, c.neonatal jaundice, d.erythroblastosis fetalis	a.biliary obstruction
Kernicterus is an abnormal accumulation of bilirubin in: a.heart tissue, b.brain tissue, c.liver tissue, d.kidney tissue	b.brain tissue
In which of the ff conditions does decreased activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates: a.Gilbert disease, b.Rotor syndrome, Dubin-Johnson syndrome, Crigler-Najjar syndrome	d.Crigler-Najjar syndrome
A stool specimen that appear black and tarry should be tested for the presence of: a.occult blood, b.fecal fat, trypsin, c.common bile duct stone, d.excess mucus	a.occult blood. bleeding from upper GI
What substance gives feces its normal color: a.uroerythrin, b.urochrome, c.urobilin, d.urobilinogen	b.urobilin. Bile pigments (uro-, meso-, stercobilin) in feces
A condition in which erythrocyte protoporphyrin is increased is: a.acute intermittent porphyria, b.iron deficiency anemia, c.porphyria cutanea tarda, d.acute porphyric attack	c.iron deficiency anemia. Correlation of disorder and high RBC zinc protoporphyrin
Which of the following elevates carboxyhemoglobin: a.nitrite poisoning, b.exposure to carbon monoxide, c.sulfa drug toxicity, d.sickel cell anemia	b.exposure to carbon monoxide. Normal hemoglobin is changed to abnormal derivative CO-Hgb.
The reason carbon monoxide is so toxic is because it: a.is a protoplasmic poison, b.combines with cytochrome oxidase. c.has 200 times the affinity of oxygen for hemoglobin binding sites, d.sensitizes the myocardium	c.has 200 times the affinity of oxygen for hemoglobin binding sites. CO prevents heme iron form binding with oxygen
Detection of carriers of hereditary coproporphyria should include analysis of: a.24-hour urine for porphobilinogen, b.fresh morning urine for delta-aminolevulinic acid, c.erythrocyte protopophyrin, d.24-hour urine for porphyrin	b.fresh morning urine for delta-aminolevulinic acid. Deficiency of ALA synthase which catalyzes the first step of porphyrin synthesis
are a group of organic compounds, many naturally occurring. One of the best-known porphyrins is heme, the pigment in red blood cells; heme is a cofactor of the protein hemoglobin: a.porphyrins, b. acetones, c. globins, d.amino acids	a.porphyrins. The name comes from the Greek word for purple
When the ferrous form of iron and protoporphyrin IX are complexed the structure is referred to as	Heme
made in the liver, is the serum protein responsible for the transport of iron.	Transferrin.Although several metals can bind transferrin,d highest affinity is for the ferric (Fe3+) form of iron.Transferrin can bind two moles of ferric iron. Cells take up the transported iron thru intraction of transferrin w/ cell-surface receptors
s the major protein used for intracellular storage of iron.	Ferritin. Ferritin without bound iron is referred to as apo-ferritin. Apo-ferritin is a large polymer of 24 polypeptide subunits.
is defined as a disorder in iron metabolism that is characterized by excess iron absorption, saturation of iron-binding proteins and deposition of hemosiderin in the tissues.	Hemochromatosis. The primary affected tissues are the liver pancreas and skin. Iron deposition in the liver leads to cirrhosis and in the pancreas causes diabetes.
The excess iron deposition leads to bronze pigmentation of the organs and skin. In fact, the bronze skin pigmentation seen in hemochromatosis, coupled with the resultant diabetes lead to the designation of this condition as	bronze diabetes.
he primary cause of hemochromatosis is the inheritance of an autosomal recessive allele. The locus causing hemochromatosis has been designated the HFE1 and is a major histocompatibility complex (MHC) class-1 gene located on what chromosome	chromosome 6. Normal HFE1 has been shown to form a complex with the transferrin receptor and in so doing is thought to regulate the rate of iron transfer into cells. A mutation in HFE1 will therefore, lead to increased iron uptake and storage.
Delta-aminolevulinic acid (ALA) is also called	5-aminolevulinic acid
The first reaction in heme biosynthesis takes place in the mitochondrion and involves the condensation of one glycine and one succinylCoA by the pyridoxal phosphate-containing enzyme, δ-aminolevulinic acid synthase (ALAS). There are two forms of ALAS:	ALAS1 is considered a house-keeping gene and is expressed in all cells. ALAS2 is an erythroid-specific form of the enzyme and is expressed only in fetal liver and adult bone marrow. The ALAS2 gene is located on the X chromosome.
Deficiencies in ALAS2(δ-aminolevulinic acid synthase 2) result a disorder called	X-linked sideroblastic anemia, XLSA. XLSA has also been called congenital sideroblastic anemia, hereditary sideroblastic anemia, hereditary iron-loading anemia, X-linked hypochromic anemia, hereditary hypochromic anemia, and hereditary anemia.
are erythroblasts with non-heme iron-containing organelles, called siderosomes.	Sideroblasts
the enzyme responsible for iron insertion into protoporphyrin IX, and on porphobilinogen deaminase.	ferrochelatase
Bilirubin and its catabolic products are collectively known as the	bile pigments.
Disorders that arise from defects in the enzymes of heme biosynthesis are termed	porphyrias. All of the porphyrias lead to excretion of heme biosynthetic byproducts that turn the urine red and when deposited in the teeth turn them reddish brown.
Kernicterus occurs in infants with severe unconjugated hyperbilirubinemia and in young adults with high serum levels of unconjugated bilirubin. The latter is the result of inherited deficiencies in the enzyme responsible for bilirubin conjugation	bilirubin UDP glucuronyl transferase (bilirubin-UGT).
Bilirubin encephalopathy is characterized by yellow discoloration of the basal ganglia in babies with intense jaundice and was first described over a century ago and was termed	kernicterus. Any increase in plasma bilirubin above 20mg/dL is considered dangerous in neonates.
plays a vital role in the disposition of bilirubin in the body by keeping the compound in solution and transporting it from its sites of production (primarily bone marrow and spleen) to its site of excretion which is the liver.	albumin
are condition that result from predominantly unconjugated hyperbilirubinemia	Gilbert syndrome and the Crigler-Najjar syndromes
are conditions that result from conjugated hyperbilirubinemia.	Dubin-Johnson syndrome and Rotor syndrome
is the most commonly occurring type of porphyria.	PCT (porphyria cutanea tarda ). Defects in hepatic uroporhyrinogen decarboxylase (UROD) results in type I porphyria cutanea tarda (PCT I), whereas deficiencies in the non-hepatic forms of UROD result in type II PCT (PCT II).
The most commonly occurring hepatic porphyria is	acute intermittent porphyria, AIP which is caused by a defect in porphobilinogen deaminase, (PBG deaminase). This enzyme is also called hydroxymethylbilane synthase or rarely uroporphyrinogen I synthase.
A term characterized by increased hair growth , also a symptom of the porphryias leading to appearance of fine hairs over the entire face and on the extremities.This symptom lends to the description of "werewolf syndrome" in many porphyria patients.	hypertrichosis
Normal disposition of bilirubin involves its transport to the liver where it is conjugated to the sugar molecule called:	glucoronic acid
A fresh urine sample is received for analysis for porphyrins or porphyria without further information or specifications. Initial analysis should include:a.porphyrin screen and quantitative total porphyrin, b.porphyrin and prophobilinogen screen,	b.porphyrin and porphobilinogen screen. Rapid initial screening should precede complex testing
Which of the ff enzymes of heme biosynthesis is inhibited by lead: a.aminolevulinate synthase, b.porphobilinogen synthase, c.uroporphyrinogen synthase, d. bilirubin synthetase	b.porphobilinogen synthase
Serum haptoglobin: a.is decreased in patients with tissue injury and neoplasia, b.in increased in patients with prosthetic heart valves, c.can be separated into distinct phenotypes by starch-gel electrophoresis, d.binds heme	c.can be separated into distinct phenotypes by starch-gel electrophoresis. Haptoglobin phenotyping for rare deficiency states
The most specific enzyme test for acute pancreatitis is: a.acid phosphatase, b.trypsin, c.amylase, d.lipase	d.lipase. There is an increase in the serum levels of amylase and lipase in acute pancreatitis. However, the elevated level of lipase persists longer than amylase. Elevated levels of lipase and amylase are seen in other intra-abdominal conditions
Which of the ff. enzymes are used in the diagnosis of acute pancreatitis: a.amylase and lipase, b.AST and ALT, c.5'-nucleotidase(5'N) and GGT, d.AST and LD	a.Amylase and lipase are hydrolases involved in the breakdown of starch and glycogen, and lipid metabolsim, respectively. Both enzymes are primarily located in the pancreas.
Which of the ff enzymes catalyzes the conversion of starch to glucose and maltose: a.malate dehydrogenase(MD), b.amylase(AMS), c.creatinine kinase(CK), d.isocitric dehydrogenase(ICT)	b. In the amyloclastic, saccharogenic and chromogenic methods for measurement of amylase, the substrate, starch is converted to glucose and maltose.
Which of the ff 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,	b.Macroamylasemia is an asymptomatic condition which results when the amylase molecule and immunoglobulins combine to form a complex. The comples is too large. Lack of renal clearance leads to an increased serum amlase and a decreased urine amylase.
A physician suspects his patient has pancreatitis. Which test(test) would be most indicative of this disease? a.creatinine, b.LD isoenzymes, c.beta-hydroxybutyrate, d.amylase	d.Amylase is present primarily in the pancreas. Pancreatitis results in the release of the enzyme into the serum. Beta-hydroxybutyrate is measured for diabetic acidosis and LD isonezymes are evaluated for disorders involving the heart and liver
The enzyme present in almost all tissues that may be separated by electrophoresis into 5 components is: a.lipase, b.transaminase, c.creatinine kinase, d.lactate dehydrogenase	d.Lactate dehydrogenase(LD) catalyzes the interconversion of lactic and pyruvic acids. Electrophoretically, using agarose or cellulose acetate medium, LD can be separated into 5 isoenzymes, LD1-LD5
Aspartate amino trasferase(AST)is characteristically elevated in diseases of the: a.liver, b.kidney, c.intestine, d.pancreas	a.AST is involved in the transfer of an amino group between aspartate and alpha-keto acids. AST is present in several tissues, with its highest concentrations in cardiac tissue, lover and skeletal muscle.
Amino transferase enzymes catalyze the: a.exchange of amino groups and sulfhydryl groups between alpha-amino and sulfur-containing acids, b.exchange of amino and keto groups between alpha-amino and alpha-keto acids	b.AST belongs to the class of transferase enzymes. Specifically, AST catalyzes the transfer of an amino group from aspartate to alpha-ketoglutarate forming oxaloacetate and glutamate
AST and ALT are seen in which of the ff: a.muscular dystrophy, b.viral hepatitis, c.pulmonary emboli, d.alcoholic cirrhosis	a.AST and ALT levels are the highest in acute hepatocellular conditions,specifically acute viral hepatitis.The levels may be 100X the upper limit of normal.Slight increases of the aminotransferases are seen in cirrhosis and metatatic hepatic carcinoma
Malic dehydrogenase is added to the aspartate aminotransferase(AST) reaction to catalyze the conversion of: a.alpha-ketoglutarate to aspartate, b.alpha-ketoglutarate to malate, c.aspartate to oxalacetate, d. oxalacetate to malate	d.In the coupled reaction of AST measurement, malate dehydrogenase catalyzes the oxidation of oxaloacetate to malate in the indicator reaction
Given the ff results:ALP slight increase, AST marked increase, ALT marked increase, GGT slight increase. this is most consistent with:a.acute hepatitis, b.chronic hepatitis, c.obstructive jaundice, d.liver hemangioma	a.In acute hepatocelllar disorders, the serum levels of AST and Alt can be 100 times the upper limit of normal. Slight increases of the enzyme activities are seen in chronic hepatitis, hemangioma, and obstructive jaundice
Which of the ff clinical disorders is associated with the greatest elevation of lactate dehydrogenase isoenzyme1:a.pneumonia, b.glomeruonephritis, c.pancreatitis, d.pernicious anemia	Elevated serum levels of LD up to 50X the upper limit of normal are seen in pernicious anemia. The ineffective erythropoiesis results in the release of large quantities of LD1 and LD2. Increased levels of LD1 and LD2 may be seen in renal disease
an enzyme that is found in the cytoplasm of almost all body tissues, where its main function is to catalyze the oxidation of l-lactate to pyruvate. It is assayed as a measure of anaerobic carbohydrate metabolism	LDH LDH-1 - in the heart and red cells LDH-2 - in the reticuloendothelial system LDH-3 - in the lungs LDH-4 - in the kidneys, placenta, and pancreas LDH-5 - in the liver and striated muscle[2]
High levels of lactate dehydrogenase in cerebrospinal fluid are often associated with	bacterial meningitis
is often measured in HIV patients as a non-specific marker for pneumonia due to Pneumocystis jiroveci (PCP).	LDH. s one of several serum indicators of myocardial infarction and muscular dystrophies. Serum levels of LDH usually rise 12 to 18 hours after myocardial cell necrosis.
an enzyme that catalyzes the interconversion of lactate and pyruvate. It is widespread in tissues and is particularly abundant in kidney, skeletal muscle, liver, and myocardium. It has five isoenzymes denoted LD1 to LD5	lactate dehydrogenase (LD, LDH). The “flipped” pattern in which the serum LD1 level is greater than the LD2 level is indicative of an acute myocardial infarction. This pattern occurs within 12 to 24 hours after the attack.
The enzyme,which exists chiefly in skeletal 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.creatine kinase	d.CK catalyzes the reversible phosphorylation of creatine. The highest level are found in skeletal muscle, heart muscle and brain tissue. Transaminase and LD are not markedly increased in muscular dystrophy
A common cause of a falsely increased LD1 fraction of lactic dehydrogenase is : a.specimen hemolysis, b.liver disease, c.congestive heart failure, d.lactate dehydrogenase	a.RBCs contains 150X more LD activity than serum, mostly LD1 and LD2.Rupture of the RBC memebranes as in hemolysis will elevate the serum level of the enzyme. LD5 is increased in liver disorders and drug toxicity if the liver is involved.
The enzyme present in almost all tissues that may be separated by electrophoresis in 5 components is: a.lipase, b.transaminase, c.creatine kinase, d.lactate dehydrogenase	d.LD catalyzes the interconversion of lactic to pyruvic acids.Electrophoretically, using agarose or cellulose acetate medium, LD can be separated into 5 isoenzymes,LD1-LD5
The presence of which of the ff isoenzymes indicates acute myocardial damage: a.CKMM, b.CKMB, c.CKBB, d.none	b.The 3 CK isoenzymes are CK1 or CKBB, CK2 or CKMB, CK3 or CKMM. CKMB is primarily located in myocardial tissue. Damage to the myocardial will cause an elevation of the CKMB
In w/c of the ff conditions would a normal level of creatine kinase be found: a.acute myocardial infarct, b.hepatitis, c.progressive muscular dystrophy, d.intramuscular injection.	b.Creatine kinase(CK) is located in brain tissue and heart and skeletal muscle. Diseases involving the tissue site will increase the level the level of the enzyme activity. CK activity is not increased in hepatitis
Of the ff diseases, the one most often associated with elevations of lactate dehydrogenase isoenzymes 4 and 5 on electrophoresis is: a.liver disease, b,hemolytic anemia, c.myocardial infarction, pulmonary edema	a.liver disease. Elevations of serum LD4 and LD5 fractions are seen in liver and skeletal muscle diseases because the isoenzymes are located in tissues.LD1 and LD2 are elevated in hemolytic anemia and myocardial infarction.↑LD3 levels in pulmonary edema.
When myocardial infarction occurs, the first enzyme to become elevated is: a.CK, b.LD, c.AST, d.ALT	a.After an acute myocardial infarction(AMI), CK activity increases 4-6 hours after the symptoms, peaks at 12-24 hours and returns to normal within 48-72hrs.AST increases 6-8hrs after the infarction.Elevated levels of LD are noted 12-24hrs after symptoms.
A scanning of a CK isoenzyme fractionation revealed 2 peaks: a slow cathodic peak(CKMM) and an intermediate peak(CKMB). A possible interpretation for this pattern is:	c.Although, CKMB activity is more specific for the myocardium, CKMM is present in both skeletal and heart muscles. An increased of the isoenzyme activity may occur after a AMI. Only one peak would be present for a brain tumor and muscular dystrophy
An electrophoretic separation of lactate dehydrogenase isoenzymes that demonstrates an elevation in LD1 and LD2 in a "flipped" pattern is consistent with: a.myocardial infarction, b.viral hepatitis, c.pancreatitis, d.renal failure	a.The major LDH isoenzymes in the serum of healthy persons are LD2:29%-39% of the total activity and LD1:14%-26% of the enzyme activity.In MI the pattern is changed.The activity of LD1 is > LD2. The ratio of LD1 to LD2 is >2. The normal ratio is 0.45-0.74
Increased total serum lactic dehydrogenase(LD) activity, confined to fractions 4 and 5 is most likely to be associated with: a.pulmonary infarction, b.hemolytic anemia, c.myocardial infarction, d.acute viral hepatitis	d.LD4 and LD5 isoenzymes are located in the liver and skeletal muscle.LD5 is the predominant fraction in these tissues.Elevated levels of LD5 are seen with intrahepatic disorders.LD1 and LD2 are elvated in hemolytic anemia and myocardial infarction.
A 10yr. old child was admitted with an initial diagnosis of skeletal muscle disease. The best confirmatory test would be: a.CK and isocitrate dehydrogenase, b.GGT and ALP, c.aldolase and CK, d.LD and malate dehydrogenase	c.Increased levels of aldolase and CK are seen with skeletal muscle disease. The magnitude of the elevation is dependent on the type of skeletal muscle disease.
In the immunoinhibition phase of the CKMB procedure: a.M subunit is inactivated, b.B subunit is inactivated, c.MB is inactivated, d.BB is inactivated	In the immunoinhibition technique for CKMB determination, antibodies are directed against the M and B units of the enzymes. Anti-M inhibits all M activity but not B activity. CK activity is measured before and after inhibition.
The presence of increased CKMB activity on a CK electrophoresis pattern is most likely found in a patient suffering from:a.acute muscular stress ff strenous exercise, b.malignant liver dss., c.myocardial infarction, d.severe head injury	c.Of the CK isoenzymes, CKMB is located in the myocardial. The fraction is elevated with an acute myocardial infarction(AMI).CKMM is elevated in acute muscular stress ff strenous exercise. CKBB is increased in brain injury
Increased serum lactic dehydrogenase activity due to elevation of fast fraction(1 and 2) on electrophoretic separation is caused by: a.nephrotic syndrome, b.hemolytic anemia, c.pancreatitis, d.hepatic damage	b.LD1 and LD2 fractions are increased in hemolytic anemia due to the intramedullary hemolysis. LD5 is increased with hepatic damage.LD3 may be increased with acute pancreatitis.
A ff result obtained: CK:185U/L(15-160),AST:123U/L (0-48),CKMB:6U/L(2-12). W/c of the ff conditions might account for these values: a.crush injury to the thigh, b.cerebrovascular accident, c.pulmonary infarction, d.early acute hepatitis	a.Elevation of the levels of CK and AST is seen in muscle damage due to crush injury to the thigh.AST levels can increase up to 4-8X the upper limit of normal. In acute hepatitis, the AST level may be 100X the upper limit of normal.
Given the ff results:ALP marked increase, AST slight increase, ALT slight increase, GGT marked increase. This is most consistent w/ a.acute hepatitis, b.osteitis fibrosa, c.chronic hepatitis, d.obstructive jaundice	d.Obstructive jaundice is characterized by an increased ALP 3X the upper limit of normal and marked increase in GGT. The aminotransferases are slightly elevated owing to the fact that they are sensitive for acute hepatocellular conditions.
Given the ff results:ALK slight increase, AST slight increase, ALT slight increased, GGT slight increase.This is most consistent w/: a.acute hepatitis, b.chronic hepatitis, c.obstructive jaundice, d.liver hemangioma	b.Chronic hepatitis is a chronic inflammation of the hepatocytes that persist for at least 6 months.The serum enzyme levels may be variable depending on the condition.ALT,AST and ALP may be increased by 2 times the upper limit of normal. GGT is slightly ↑
What specimen preparation is commonly used to perform the ALP isoenzyme determination: a.serum is divided into 2 aliqouts, one is frozen and the other is refrigerated, b.serum is divided into 2 aliquots, one is heated at 56C and the other is unheated	b.The heat activation method of ALP isoenzyme separation involves heating an aliqout of the serum sample at 56C fro 10 minutes. An untreated aliquot of the sample along with the heated one are assayed for ALP activity
Regan isoenzyme has the same properties as ALP that originates in the a:skeleton, b.kidney, c.intestine, d.placenta	d.The Regan isoenzyme is an abnormal ALP isoenzyme. The carcinopalcental ALP has the properties similar to the placental enzyme, in that it is also heat stable(65C, 30min). It has been detected in lung, breast, ovarian and colon cancer.
The MOST heat labile fraction of ALP is obtained from: a.liver, b.bone, c.intestine, d.placenta	b.The major serum ALP isoenzymes are located in the liver, bone, intestine and placenta. Placenta ALP is most heat stable followed by the intestinal, liver and bone fractions in decreasing order of stability
the MOST sensitive enzymatic indicator for liver damage from ethanol intake is: a.ALT, b.AST, c.GGT, d.ALP	c.GGT levels are elevated in alcoholism. The levels may range from 2-3 times the upper limit of normal. ALT, AST, and ALP may be increased depending on the alcohol damage to the liver.
Isoenzyme assays are performed to improve: a.precision, b.accuracy, c.sensitivity, d.specificity	d.Isoenzymes are multiple forms of an enzyme that possess the ability to catalyze a reaction, but differ in structure.Since the isoenzyme fractions are located in various tissues, measurement of different fractions are considered more specific indicator.
The protein portion of an enzyme complex is called the: a.apoenzyme, b.coenzyme, c.haloenzyme, d.proenzyme	a.The haloenzyme is the active system formed by a protein portion called the apoenzyme and a cofactor which can be an activator if inorganic and a coenzyme if organic
W/c of the ff chemical determinations may be of help in establishing the presence of seminal fluid: a.LD, b.ICD, c.acid phosphatase, d.ALP	c.Approx. 20-30% of the seminal fluid is prostatic fluid.The composition of the prostatic fluid is acid phosphatase,citric acid and proteolytic enzymes. The activity of prostatic ACP may be measured in seminal fluid for medicolegal cases involving rape
W/c of the ff enzyme subtrates is the most specific for prostatic acid phosphatase for quantitative endpoint reactions: a.p-nitophenylphosphate, b.thymolphthalein monophophate, c.beta-naphthol-phosphate, d.beta-glycerophosphate	b.Thymolphthalein monophosphate is the most specific substrate of choice for quantitative endpoint reactions; however, p-nitrophenylphosphate is the preffered substrate for continuous monitoring.
Lactate dehydrogenase,malate dehydrogenase,isocitrate dehydrogenase, and hydroxybutyrate dehydrogenase all: a.are liver enzymes, b.are cardiac enzymes, c.catalyze oxidation-reduction reactions, d.are class III enzymes	c.These enzymes are dehydrogenases w/c are oxidoreductases.The oxidoreductases catalyze oxidation reduction rctn. between 2 substrates.They may be located in liver and heart;however they are in class1 according to the Enzyme Commission of the IUB system
High levels of w/c lipoprotein class are associated with decreased risk of accelerated atherosclerosis: a.chylomicrons, b.VLDL, c.LDL, d.HDL	d.HDL is the smallest and most dense lipoprotein. Its role in lipid metabolism removing cholesterol from the peripheral cells and transporting it to the liver for further metabolism.Because of these actions, HDL is thought to be anti-atherogenic.
The most consistent analytical error involved in the routine determination of HDL-cholesrerol is caused by: a.incomplete precipitation of LDL-cholesterol, b.a small conc. of apoB-containing lipoproteins after precipitation	b.Serum HDL has been routinely measured indirectly by a 2 step procedure. Precipitation of all of the non-HDL lipoproteins with a polyanion-divalent cation combination reagent and cenrifugation to obtain the supernatant containing only HDL
If the LDL cholesterol is to be calculated by the Friedewald formula, what are the 2 measurements that need to be carried out by the same chemical procedure? a.total cholesterol and HDL cholesterol, b.total cholesterol and triglyceride	a.In indirect measurement of LDL using Friedewald equation, values are needed for total cholesterol,HDL cholesterol and tirglyceride.Because LDL and HDL are measured based on their cholesterol content,it is necessary to determine total cholesterol and HDL
The chemical composition of HDL-cholesterol corresponds to: a.(TRIG 60%,CHOL15%,CHON10%), b.(TRIG 10%,CHOL45%,CHON25%),c.(TRIG 5%,CHOL 15%, CHON 50%), d.(TRIG 85%, CHOL 5%, CHON 2%)	c.HDL is the smallest and most dense of the lipoproteins.This is evidenced by its lipid content of 20% and protein concentration of 50%
In familial hypercholesterolemia, the hallmark finding is an elevation of: a.low-density lipoproteins, b.chylomicrons, c.high-density lipoproteins, d.apolipoprotein A1	a.Familial hypercholesterolemia is a genetic condition characterized by elevated serum cholesterol levels.The lack or deficiency of LDL receptors prevents the metabolism of LDL cholesterol,resulting in an increased LDL level
Premature atherosclerosis can occur when w/c of the ff becomes elevated: a.chylomicrons, b.prostaglandins, c.LDL, d.HDL	c.Artherosclerosis is characterized by a thickening and hardening of arterial walls by cholesterol plaques in lining of arteries. Elevated levels of cholesterol are assoc w/ development of plaques.↑ LDL levels are assoc. w/ development of atherosclerosis.
is an autosomal dominant disorder that causes severe elevations in total cholesterol and low-density lipoprotein cholesterol	Familial hypercholesterolemia (FH)
Transportation of 60%-75% of the plasma cholesterol is performed by: a.chylomicrons, b.VLDL, c.LDL, d.HDL	LDL transports about 70% of the total plasma cholesterol. Chylomicrons and VLDL transports tirglycerides
W/c of the ff diseases results from a familial absence of HDL: a.Krabbe disease, b.Gaucher disease, c.Tangier disease, d.Tay-Sachs disease	c.Tangier diss. results from a defect in the catabolism of Apo A-I, an essential apoprotein for HDL. In homozygotes, the plasma level for HDL is practically zero. The reduced HDL levels result from increased HDL catabolism
are created when a protein in the bloodstream, Apolipoprotein A1 (apoA1), combines with cholesterol and phospholipids: a.HDL, b.LDL, c.VLDL, d.Triglycerides	a.HDL
also known as "Familial alpha-lipoprotein deficiency" or Hypoalphalipoproteinemia is a rare inherited disorder characterized by a severe reduction in the amount of high density lipoprotein (HDL), often referred to as "good cholesterol"	Tangier disease.People with Tangier disease have defective ABCA1 transporters resulting in a greatly reduced ability to transport cholesterol out of their cells, which leads to an accumulation of cholesterol in many body tissues
Reduced blood levels of high-density lipoproteins is sometimes described as	Hypoalphalipoproteinemia
is a genetic disease in which a fatty substance (lipid) accumulates in cells and certain organs.	Gaucher's disease.It is caused by a hereditary deficiency of enzyme glucosylceramidase.The enzyme acts on fatty acid glucosylceramide. When enzyme is defective, glucosylceramide accumulates, particularly in white blood cells, most often macrophages
is a rare inherited disorder characterized by the near-total deficiency of the enzyme N-acetyl-beta-hexosaminidase A.The enzyme is reponsible for hydrolysis of the beta(1,4)-glycosidic bond between N-acetylgalactosamine and galactose in GM2 ganglioside	Tay–Sachs disease. In its most common variant (known as infantile Tay–Sachs disease), it causes a progressive deterioration of mental and physical abilities that commences around six months of age and usually results in death by the age of four.
is an autoimmune disorder in which the body attacks the adrenal glands, effectively shutting them down. Patients end up with a whole host of problems, including hypotension (from the lack of mineralocorticoids) and hypoglycemia(lack of cortisol)	Addison disease.
ACTH is derived from a bigger precursor molecule called	pro-opiomelanocortin(POMC).POMC is also a precursor for beta endorphin and melanocyte stimulating hormone(MSH).so if you make more POMC ,you'll make more beta endorphin and MSH.That's why patients w/ Addison dss have hyperpigmentation.
Which of the ff lipid results would be expected to be falsely elevated on a serum specimen from a nonfasting patient:a.cholesterol, b.triglyceride, c.HDL, d.LDL	b.Food intake can cause a transient increase in the triglyceride level by 50%. The LDL and HDL levels may be decreased by 10%-15% depending on the fat content of the meal.
In amniotic fluid, the procedure used to determine fetal lung maturity is: a.lecithin/sphingolyelin ratio, b.creatinine, c.measurement of absorbance at 450 nm, d.alpha-fetoprotein	a.The historical method to evaluate fetal lung maturity is the lecithin/sphingomyelin(L/S) ratio. Measurement of pulmonary surfactant is done to evaluate fetal lung maturiy. LECITHIN is the major component of the lung surfactant.
a non-lung phospholipid, has no role in the surfactant system. It serves as a control for the increase in lecithin that occurs around the 34-36th week of gestation.	Shingomyelin. Other amniotic fluid evaluations include measurement of creatinine for fetal age; alpha-fetoprotein (AFP) for neural tube disorder and absorbance at 450nm-bilirubin for fetal distress
The class of phospholipid that shows an increase in concentrations around the 34-36th week of gestation is thought to originate in what fetal organ system:a.cardiovascular, b.pulmonary, c.hepatic, d.placental	b. The phospholipids are produced by the Type II cells of the alveolar of the lungs
is a metabolic pathway that results in the generation of glucose from non-carbohydrate carbon substrates such as lactate, glycerol, and glucogenic amino acids.	Gluconeogenesis. It is one of the two main mechanisms humans and many other animals use to keep blood glucose levels from dropping too low (hypoglycemia).Other means of maintaining blood glucose levels is through degradation of glycogen (glycogenolysis)
Mixed hyperlipoproteinemia or type V hyperlipoproteinemia occurs primarily in adulthood and is characterized by markedly elevated triglycerides, elevated VLDL and chylomicrons. Because of markedly increased triglycerides level,the specimen integrity is:	Milky, and overnight refirgeration shows a creamy layer over turbid serum due to the chylomicrons and triglycerides
chylomicrons are present in which of the ff dislipidemias?: a.familial hypercholesterolemia, b.hypertriglyceridemia, c.deficiency in lipoprotein lipase activity, d.familial hypoalphalipoproteinemia	c.Lipoprotein lipase hydrolyzes triglycerides and chylomicrons during normal lipid metabolism. A deficiency in lipoprotein lipase results in markedly increased serum chylomicrons and triglycerides
The function of major lipid components of VLDL is to transport: a.cholesterol from peripheral cells to the liver, b.cholesterol and phopholipids to peripheral cells, c.exogenous triglycerides, d,endogenous triglycerides	d.In the endogenous pathway for lipid metabolism the hepatocytes can synthesize triglycerides from carbohydrates and fatty acids.The triglycerides are packaged in VLDL, and ultimately delivered to the circulation in that form.
Exogenous triglycerides are transported primarily by the: a.VLDL, b.HDL, c.LDL, d.chylomicrons	d.chylomicrons. HDL transports cholesterol from peripheral cells to the liver. LDL transports cholesterol and phospholipids to peripheral cells
Turbidity in serum suggest elevation of: a.cholesterol b.total protein c.chylomicrons d.albumin	c.Elevated levels of chylomicrons i serum or plasma will result in a turbid specimen. The large size of chylomicron will reflect the light, causing a turbid appearance
TSH is produced by the : a.hypothalums b.pituitary gland c.adrenal cortex d.thyroid	b.TSH is produced by the pituitary gland
A patient w/ increased TSH, decreased FT4, and total T4, positive microsmomal Ab is consitent with: a.hyperthyroidism b.hypothyroidism c.a normal thyroid d.Graves disease	b.primary hypothyroidism
Increased TSH, decreased free T4 and total T4, symptoms of cold intolerance and hair loss are consistent w/: a.Graves disease b.an adenoma of the thyroid c.thyrotoxicosis d.primary hypothyroidism	d.primary hypothroidism
The majority of thyroxine(T4) is converted into the more biologically active hormone: a.thyroglobulin b.thyroid-stimulating hormone(TSH) c.triiodothyronine(T3) d.thyrotropin-releasing hormone	c.T3 is more biologically active, 80% of T4 is converted into T3
A 2yr old child w/ a decreased serum T4 is described as being somewhat drwarfed,stocky,overweight, and having course features.Of the ff, the most informative additional lab test would be the serum: a.TBG b.TSH c.T3 d.cholesterol	b.Congenital hypothyroidism presents w/ very low thyroid hormones and is best confirmed by serum TSH
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.thyroid-stimulating hormone	b.>99% of T3 and T4 are bound to thyroxine-binging prealbumin, thyroxine-binding globulin, and albumin
The recommended initial thyroid function test for either a healthy, asymptomatic patient or a patient w/ symptoms w/c may be related to a thyroid disorder is: a.free T4 b.TSH c.total thyroxine (T4) d.triidothyronine(T3)	b.TSH is the American Thyroid Association's recommended screening test.
The screening test for congenital hypothyroidism is based upon: a.TSH level in the newborn b.thyroid-binding globulin level in newborn c.iodine level in newborn d.total thyroxine(T4) level in newborn	d. Neonates are screened using total T4
is the most common cause of hypothyroidism:	Hashimoto thyroiditis. Results with TSH increased, T4(free thyroxine) decreased and Antimicrosal antibody positive is consistent with primary hypothyroidism
A 68yr old female patient tells her physician of being "cold all the time"and recent weight gain, w/ no change in diet. The doctor orders a TSH level, and the lab reports a value of 8.7uU/mL (RR:0.5-5.0uU/mL).This patient most likely has:	Age, sex, physical complaint, with elevated TSH point to primary hypothryroidism
Which of the ff is secreted by the placenta and used for the early detection of pregnancy? a.FSH b.HCG c.LH d.progesterone	hCG is the primary marker for early pregnancy
During pregnancy, the form of estrogen measured in urine is mostly: a.estradiol b.estriol c.estrone d.pregnanediol	b.During pregnancy, the largest fraction of estrogen in urine is estriol
hCG levels peak at what week after the last menstrual period (LMP)	8-10 weeks
In amniotic fluid, the procedure used to detect hemolytic disease of the newborn is: a.measurement of absorbance at 450nm b.creatinine c.lecithin/sphingomyelin ratio d.estriol	a.The procedure "change in absorbance of amniotic fluid at 450nm" used to detect hemolytic disease of the newborn (HDN)
During a normal pregnancy, quantitative human chorionic gonadotropin (HCG) levels peak how many weeks after the last menstrual period: a. 3-4 b. 8-10 c. 14-16 d. 18-20	b.Serum hCG levels peak at 8-10 weeks.
Which of the ff steroids is an adrenal cortical hormone: a.angiotensinogen b.aldosterone c.epinephrine d.growth hormone	b.Aldosterone is a hormone produced by the adrenal cortex
What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens: a.cortisol b.cathecolamines c.progesterone d.cholesterol	d.All adrenal steroid hormones are enzymatically derived from cholesterol
The biologically most active, naturally occuring androgen is: a.androstendione b.cortisol c.epiandrosterone d.testosterone	d.Testosterone is the most biologically active androgen in the embryonic stage and later effects sperm production and secondary sex characteristics
Plasma for cortisol determinations were collected at 7AM, after waking the patient, and at 10PM that evening. The cortisol level of the morning sample was higher than evening sample.This is consistent w/:a.normal finding,b.Cushing syndrome,c.Addison dss.	a.The normal variation of serum cortisol is higher at 8AM than 4PM
(Also chronic adrenal insufficiency, hypocortisolism, and hypoadrenalism) is a rare, chronic endocrine disorder in which the adrenal glands do not produce sufficient steroid hormones (glucocorticoids and often mineralocorticoids)	Addison’s disease. It is characterised by a number of relatively nonspecific symptoms, such as abdominal pain and weakness, but under certain circumstances, these may progress to Addisonian crisis, w/c may include very low blood pressure and coma
is a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol.	Cushing syndrome.
Night blindness is associated with deficiency of which of the ff vitamins: a. A b. C c. nicain d. thiamine	a.A dficiency of vitamin A leads too night blindness, and if prolonged total blindness
Beriberi is associated with deficiency of vitamin: a. A b. C c. niacin d. thiamine	d. A deficiency of thiamine (vitamin B1)known as beriberi, may be seen with chronic alcoholism in the U.S.
Scurvy is associated with deficiency of which of the following vitamins: a. A b. C c.niacin d.thiamine	b. A deficiency of ascorbic acid( vitamin C) is called scurvy
Rickets is associated with deficiency of which of the ff vitamins: a. B1 b. C c.niacin d. D	d. A deficiency of vitamin D in children leads to rickets
Pellagra is associated with deficiency of which of the ff vitamins: a. A b. B1 c. thiamine d. niacin	d.A deficiency of niacin may be seen with chronic alcoholism, and is known as pellagra
The major action of angiotensin II is: a.increased pituitary secretion of vasopressin b.increased vasoconstriction c.increased parathormone secretion by the parathyroid d.decreased adrenal secretion of aldosterone	b.Angiotensin II is a vasoconstrictor and stimulates the adrenal cortex to produce aldosterone
The urinary excretion product measured as an indicator of epinephrine production is: a.dopamine b.dihydroxyphenylalanine (DOPA) c.homovanilic acid d.vanillymandelic acid (VMA)	d.Vanillylmandelic acid (VMA) is the major metabolite of epinephrine and norepinephrine. VMA is measured in 24-hour urine.
is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.	Rickets
Which of the ff hormones regulates normal blood calcium levels: a.thyroxine b.estriol c.parathyroid hormone d.growth hormone	c.Parathyroid hormone and vitamin D play a dominant role in calcium regulation
The most common form(95%) of congenital adrenal hyperplasia is 21-hydroxyalase deficiency, w/c is detected by elevated plasma: a.cortisol b.aldosterone c.17-OH-progesterone d.11-deoxycortisol	c.95% of congenital adrenal hyperplasia is associated with a deficiency of 21-hydroxylase. Increased 17-OH progesterone is seen if measured by the laboratory.
A diagnosis of primary adrenal insufficiency requires demonstration of: a.decreased urinary 17-keto-and 17-hydroxysteroids b.decreased cortisol production c.impaired response to ACTH stimulation d.increased urinary cortisol excretion after metyrapone	c.ACTH stimulation test, using synthetic ACTH, will differentiate primary from secondary adrenal insufficiency. Synthetic ACTH will not cause the adrenal gland to respond in primary insufficiency
The screen for adrenal cortical hyperfunction with the greatest sensitivity and specificity is: a.24-hour urine free cortisol b.plasma cortisol c.urinary 17-hydroxycorticosteroids d.plasma corticosterone	a.The 24-hour urine free cortisol is the most sensitive and specific screen for hypercotisolism
A patient has symptoms suggestive of acromgegaly. Te diagnosis would be confirmed if the patient had w/c of the ff: a.an elevated serum phosphate concn. b.no decrease in serum growth hormone concn. 90 minutes after oral glucose administration	b.Following an overnight fast, a 100 gram oral glucose load will cause a large drop in serum growth hormone in a normal individual, but will not suppress in patients with acromegaly
Estrogen and progesterone receptor assays are useful in identifying patients who are likely to benefit from endocrine therapy to treat w/c of the f: a.ovarian cancer b.breast cancer c.endometriosis d.amenorrhea	b.About 55%-65% of patients whose breast tumors demonstrate estrogen receptors(ER) respond well to endocrine therapy
W/c of the ff sample collections would give an accurate assessment of potential excess cortisol production(hypercortisolism): a.collected a plasma sample baseline, and another 1-hr after administration of metyrapone b.collect a24-hr urine free cortisol	b.Due to circadian variation, the 24 hour urine free cortisol(UFC) is an accurate measurement of active forms of cortisol
How is primary hypocortisolism(Addison disease) differentiated form secondary hypocorticolism (of pituitary gland): a.ACTH is decreased in primary and elevated in secondary b.ACTH is elevated in primary and decreased in secondary	b.Primary hypocorticolism=decreased cortisol/elevated ACTH; secondary hypocrticolism=decreased cortisol/decreased ACTH
Aldosterone is released by the adrenal cortex upon stimulation by: a.renin b.angiotensinogen c.angiotensin I d.angiotensin II	d.Angiotensin II directly stimulates the adrenal cortex to release aldosterone
In developing the reference for a new EIA for CEA, the range for the normal populations was broader than that published by the vendor. Controls are acceptable with a narrow coefficient of variation. This may explained by:	Inclusion of nonsmokers and smokers in the study population. Increased CEA levels are seen in patients with liver damage, heavy smokers and ff radiation and chemoteraphy
Clinical assays for tumors 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	b.Tumor markers are useful for monitoring therapy, detecting recurrence and aiding in prognosis of tumors, but are not useful for screening the general population for cancer
Detection of w/c of the ff substances is most useful to monitor the course of a patient w/ testicular cancer: a.alpha-fetoprotein b.carcinoembryonic antigen c.prolactin d.testosterone	a.Most testicular tumors are germ cell tumors w/c are characterized by elevated serum levels of AFP.Measurement of serum AFP is used in the diagnosis,therapy and follow up of testicular cancer.The CEA is a marker for colon cancer.
Increased concentrations of alpha-fetoprotein(AFP)in adults are most characteristically associated w/: a.hepatocellular carcinoma b.alcoholic cirrhosis c.chronic active hepatitis c.multiple myeloma	a.AFP is an oncofetal glycoprotein marker for hepatocellular carcinoma.Elevated levels of AFP(<200ug/L) are seen in hepatitis and cirrhosis. However, in hepatocellular carcinoma, the levels can be greater than 1,000ug/L
Carcinoembryonic antigen(CEA)is most likely to be produced in malignancy involving the: a.brain b.testes c.bone d.colon	d.CEA is a marker for colon, gastrointestinal and lung cancer.Elevated serum levels of CEA are primarily seen with colon cancer.Although levels may be increased in individuals with benign conditions, the level of CEA elevation is greater for colon cancer
Which of the ff is useful in the detection and management of carcinoma of the prostate: a.total prostate-specific antigen b.prostatic acid phosphatase c.human chorionic gonadotropin d.alpha-fetoprotein	a.tPSA along with DRE is the recommended screen for prostate cancer in males over 50 years of age
Which of the ff statements most correctly describes the utility of clinical laboratory assays for tumor markers: a.tumor markers are useful to screen asymptomatic patients for tumors b.are highly specific c.are useful in tracking the efficacy of treatm	c.Markers are good for monitoring therapy and detecting recurrence of tumors
Cancer antigen 125(CA125) is a tumor marker associated w/ a.breast carcinoma b.colon cancer c.lung cancer d.ovarian and endometrial carcinoma	CA125 is elevated in 80% of epithelial cell ovarian cancer
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 (cholestero lowering drug)	c.PSA can be elevated due to BPH
The appropriate collection sequence of blood in vacuum tubes, as recommended by CLSI publication H3-A6,18 is as follows:	1) coagulation; 2) serum with clot activator, with or without gel separator; 3) heparin with or without gel separator; 4) ethylenediaminetetraacetic acid (EDTA) with or without gel separator; and 5) glycolytic inhibitor.
The CLSI currently recommends that tourniquet time should not exceed: a.2 minutes b.60 seconds c.30 seconds d.3 minutes	b.60 seconds; recently, it has been demonstrated that 30 seconds might be optimal for maximum tourniquet time.
Blood specimens for digoxin assays should be obtained between 8 hours or more after drug administration because: a.tissue and serum levels need to reach equilibrium b.serum digoxin concentration will be falsely low prior to 6hrs	a.Intestinal absorption of digoxin is variable, and tissue uptake is low;therefore, serum levels are measured 8 hrs after administration to permit tissue and serum levels to equilibrate
A drug has a half-life of 6 hours. If a dose is giben every 6 hours, a steady-state drug level would usually be achieved in: a.3-5 hours b.10-12 hours c.24-42 hours d.48-50 hours	c.A steady-state therapeutic drug level is achieved between 4 and 7 doses. Many variables affect when steady state is achieved
is the time it takes for the plasma concentration of a drug to reach half of its original concentration. More simply put, the half-life of a drug is how long it takes for half of it to be eliminated from the bloodstream.	A medication's half-life
Free therapeutic drug levels are usually higher when serum protein concentration are below normal.In w/c of the ff conditions would this most likely occur: a.acute inflammation b.nephrotic syndrome c.pregnancy d.multiple myeloma	b.Low serum protein means less of a drug is bound to protein.This may occur due to nephrotic syndrome, w/c causes significant protein loss and hypoalbuminemia
Which of the ff factors is not relevant to therapeutic drug monitoring (TDM) of the aminoglycosides, antibiotics and vancomycin: a.intestinal absorption b.nephrotoxicity c.ototoxicity d.renal function	a.These drugs are not administered orally
The drug procainamide is prescribed to treat cardiac arrhythmia.What biologically active liver metabolite of procainamide is often measured simultaneously: a.phenobarbitol b.quinidine c.N-acetyl procainamide(NAPA) d.lidocaine	c.NAPA is the active metabolite of procainamide
Cocaine is metabolized to: a.carbamazepine b.codeine c.hydrocodone d.benzoylecgonine	The primary metabolite of cocaine is benzoylecgonine,w/c is produced by the liver and eliminated in the urine.Benzoylecgonine is detected in drugs of abuse screens for cocaine.
The metabolite 11-nor-tetrahydrocannabinol-9-COOH can be detected by immunoassay 3-5 days after single use of: a.methamphetamine b.cocaine c.benzodiazepine d.marijuana	d11-nor-THC-COOH is the urinary metabolite of cannabinoids (marijuana and hashish)
A 3yr old child was evaluated for abdominal pain and anorexia by a physicina. A CBC revealed hgb of 9.8g/dL and basophilic stippling of RBCs.Doctor should order further test to check for poisoning from: a.arsenic b.iron c.mercury d.lead	d.Lead interferes with heme synthesis,w/c on a CBC may present as a decreased hgb,w/ basophilic stippling of RBCs.These findings in a child may indicate lead toxicity.WHOLE BLOOD LEAD is the RECOMMENDED test
Zinc protoporphyrin or free erythrocyte protoporphyrin measurements are useful to assess blood concentrations of: a.lead b.mercury c.arsenic d.beryllium	a.Erythrocyte zinc protorphyrin is a useful screen for lead toxicity
A carbonate salt used to control manic-depressive disorders is: a.digoxin b.acetaminophen c.lithium d.phenytoin	c.Lithium(carbonate) is used to treat manic depression or bipolar disorder
An antiepileptic (or anticonvulsant) used to control seizure disorders is: a.digoxin b.acetaminophen c.lithium d.phenythoin a.	d.Phenytoin(trade name Dilantin) is an anticonvulsant therapeutic drug used to treat seizure disorders
A drug that relaxes the smooth muscles of the bronchial passages is: a.acetaminophen b.lithium c.phenytoin d.theophylline	d.The action of the drug theophylline is bronchodilation and smooth muscle relaxation
A cardiac glycoside that is used in the treatment of congenital heart failure and arrhythmias by increasing the force and velocity of myocardial contraction is: a.digoxin b.acetaminophen c.lithium d.phenytoin	a.Digoxin at therapeutic serum levels(0.5-1.5)ng/mL) improves cardiac muscle contraction and rhythm
A salicylate level is performed to detect toxicity caused by ingestion of excess: a.acetaminophen b.aspirin c.ibuprofen d.pseudoephedrine	b.Salicylate levels are used to determine if aspirin(acetylsalicylic acid) toxicity is present. Toxic serum or plasma levels are generally >300ug/mL
Lithium therapy is widely used in the treatment of: a.hypertension b.hyperactivity c.aggression d.manic-depressive(bipolar) disorder	d.Lithium(carbonate)is used to treat manic depression or bipolar disorder
is the primary serum copper-bearing protein	Ceruloplasmin
is an autosomal recessive genetic disorder in which copper accumulates in tissues; this manifests as neurological or psychiatric symptoms and liver disease.	Wilson's disease or hepatolenticular degeneration.It is treated with medication that reduces copper absorption or removes the excess copper from the body, but occasionally a liver transplant is required.
An active metabolite of amitriptyline is: a.nortriptyline b.protriptyline c.butriptyline d.norbutriptyline	a.Nortriptyline is an active metabolite of amitryptyline and must be included in analysis for tricyclic antideprassants
Phenobarbital is a metabolite of: a.primidone b.phenytoin c.amobarbital d.secobarbital	a.Primidone is an inactive proform of phenobarbital
Testing for the diagnosis of lead poisoning should include: a.erythrocyte protoporphyrin (EPP) b.urine delta-aminolevulinic acid c.whole blood lead d.zinc protoporphyrin (ZPP)	c.Measurement of whole blood lead is the recommended test for children.In adults higher levels are significant;therefore other methods, such as erythrocyte protoporphyrin and delta-aminolevulinic acid, are acceptable for adults
Blood received in laboratory for blood gas analysis must meet w/c of ff requirements: a.on ice,thin fibrin strands only,no air bubbles b.on ice, no clots,fewer than 4 air bubbles c.on ice,no clots,no air bubbles d.room temperature,no clots,no air bubb	c.on ice,no clots,no air bubbles
After difficult venipuncture requiring prolonged application of tourniquet,serum K+ was found to be 6.8 mEq/L.Best course of action is: a.repeat test using same specimen b.adjust value based on current serum Na+ c.repeat test using freshly drawn serum	c.Use of tourniquet for over 1-3 minutes can cause elevation in protein and albumin,calcium, potassium, and hemoglobin
Serum from a patient w/ metastatic carcinoma of prostate was separated from clot and stored room temp.the ff results obtained acid phos 0.1U/L(RR:0-5.5U/L).technician should repeat: a.LD using diluted serum b.acid phosphatase w/ freshly drawn serum	b.Serum for acid phosphatase measurement should not be stored at RT.This ananlyte requires special collection(citrate10g/L) and storage(frozen) conditions tot help stabilized the ph at about 6.2
A lipemic serum is separated and froaen at -20C for assay at later date.One week later,prior to doing an assay for triglycerides,specimen should be: a.warmed to 37C and mixed thoroughly b.warmed to 15C and centrifuged c.transferred to glycerated test t	a.Frozen samples should be allowed to thaw at RT or in 37c water bath and should then be mixed thoroughly before analysis
The different water content of erythrocytes and plasma makes true glucose concentration in whole blood a function of the: a.hematocrit b.leucocyte count c.erythrocyte count d.erythrocyte indices	a.water content is higher in plasma than in whole blood
In a specimen collected for plasma glucose analysis, sodium fluoride: a.serves as a coenzyme of hexokinase b.prevents reactivity of non-glucose reducing substances c.precipitates proteins d.inhibits glycolysis	d.sodium fluoride exerts its preservative action by inhibiting the enzyme systems involved in glycolysis
As part of a hyperlipidemia screening program, the ff results were obtained on a 25 yr old woman 6hrs after eating:(trig:260mg/dL,chol:120mg/dL).w/c of the ff is the BEST interpretation of these results:	A high-fat diet increases the serum concentrations of triglycerides.Fasting overnight for 10-14hrs is optimal time for fsting around w/c to standardize blood collections, including lipids
Blood was collected in a serum separator tube on a patient who has been fasting since midnight.The time of collection was 7AM.The laboratory test w/c should be recollected is: a.triglycerides b.iron c.LD d.sodium	A high-fat diet increases the serum concentrations of triglycerides.Fasting overnight for 10-14hrs is optimal time for fsting around w/c to standardize blood collections, including lipids
Arterial blood that is collected in a heparinized syringe but exposed to room air would be most consistent w/ changes of ff specimens: a. sepcimen A (PO2 elevated,PCO2 decreased,pH elevated b. specimen B (PO2 decreased,PCO2 elevated,pH decreased)	The presence or exposure of excess gas(oxygen) in syringe used to collect blood gas specimens will cause diffusion of carbon dioxide out of the specimen,oxygen into specimen,and an increase pH
Specimens for blood gas determinations should be drawn into a syringe containing: a.no preservative b.heparin c.EDTA d.oxalate	b.Arterial specimens are best collected anaerobically with lyophilized heparin anticoagulant in sterile syringes
Unless blood gas measurements are made immediately after sampling, invitro glycolysis of the blood causes a: a.rise in pH and PCO2 b.fall in pH and a rise in PO2 c.rise in pH and fall in PO2 d.fall in pH and rise in PCO2	d.Failure to adequately chill blood gas specimens if not immediately analyzed will allow glucose metabolism, w/c increases carbon dioxide and lowers pH
Which of the ff serum constituents is unstable if a blood specimen is left standing at room temp. for 8hrs. before processing: a.cholesterol b.triglyceride c.creatinine d.glucose	d.Glucose decreases at a rate of 5%-7% per hour in whole blood at room temp.Glycosis will continue until the specimen is processed by centrifugation and serum and plasma is separated from the cellular components of blood.
An arterial blood specimen submitted for blood gas analysis was obtained at 8:30AM but was not received in the laboratory until 11AM.Technologist should: a.perform test immediately upon receipt b.request a new arterial specimen be obtained	b.The use of an incorrect tube type or collection of a specimen at an inappropriate time may also require specimen recollection.
In monitoring glomerular function, which of the ff tests has the highest sensitivity: a.urine sodium b.BUN/creatinine ratio c.creaitinine clearance d.urea clearance	c.Creatinine clearance offers the highest sensitivity in monitoring glomerular function of the test listed.
If the pKa is 6.1,CO2 content is 25mM/L,the salt equals the total CO2 content minus the carbonic acid;carbonic acid equals 0.03xPCO2 and PCO2=40mmHg,it may be concluded that: a.ph+601+log[(40-0.03/(0.03)] b.ph=6.1+log[(25-102)/(1.2)]	b.ph+601+log(salt/acid). Salt=total carbon dioxide content-carbonic acid
A 24hr urine specimen (total vol.=1,136mL0 is submitted to the lab. for quantitative urine protein.Calculate the amount of protein excreted per day, if total protein is 52mg/dL: a.591 mg b.487 mg c.220 mg d.282 mg	a.52mg/dl=0.52mg/mL.Therefore 0.52mg/mL x 1136mL=591 mg.
The ff results obtained: urine crea:90mg/dL,serum crea:0.90mg/dL,patient's total body surface:1.7m2,total urine vol in 24hrs:1500mL, the creatinine clearance in mL/min is: a.104 b.124 c.144 d.150	a.Creatinine clearance=(urine creatininexurine volume[ml/min]/serum creatinine) x 1.73/total body surface
One international unit of enzyme activity is the amount of enzyme that will, under specified reaction conditions of substrate concentration, pH and temperature,cause utilization of substrate at the rate of: a.1mol/min b.1mmol/min c.1umol/min d.1nmol/m	c.In 1961,the enzyme commission recommended the adoption of an international unit(IU) of enzyme activity.The IU was defined as the amount of enzyme that would convert 1umol of substrate per minute under standard conditions. 1IU=umol/min
The bicarbonate and carbonic acid ratio is calculated from an equation by: a.Siggard-Andersen b.Gibbs-Donnan c.Natelson d.Henderson-Hasselbalch	d. pH= pKa + log([salt]/[acid]); salt = bicarbonate; acid=carbonic acid.
125I has a physical half-life of 60 days. A sample tested today had activity of 10,000 CPM/mL.How many days from today will the count be 1250 CPM/mL? a. 60 b. 180 c. 240 d. 1250	b.t=1.44 x t1/2 x ln(original activity/remaining activity); t1/2=half life.
In spectrophotometric determination, which of the ff is the formula for calculating the absorbance of a solution: a.(absorptivity x light path)/concentration b.(absorptivity x concentration)/ light path c.absorptivity x light path x concentration)	c.Absorbance = molar absorptivity coefficient x light path x concentration. Therefore molar absorptivity = absorbance/light path x concentration
Which of the ff is the formula for calculating absorbance given the percent transmittance(%T) of a solution: a. 1-log(%T) b. log(%T)/2 c. 2 x log(%T) d. 2-log(%T)	d.Because the ff relationship is true, A=light stopped and T= light passed through, A and T are inversely related. They are also logarithmically related, because the absorption of light is a logarithmic function.
Which of the ff is the Henderson-Hasselbalch equation: a.pKa = pH + log([acid] / [salt]) b.pKa = pH + log([salt] / [acid]) c.pH = pKa = log([acid] / [salt]) d.pH = pKa = log([salt] / [acid])	d. The Henderson-Hasselbach equation describes the derivation of pH as a measure of acidity (using the acid dissociation constant, pKa) in biological and chemical systems.
The creatinine clearance(mL/min) is equal to: a.urinary creatinine(mg/L)/[volume of urine(mL/min) x plasma creatinine(mg/L)] b.[urinary creatinine(mg/L) x volume(mL/min)]/plasma creatinine(mg/L)]	b.Renal clearance test are used to assess kidney function. Renal clearance of a substance is a rate measurement that expresses the volume of blood cleared of that substance (typically creatinine) per unit of time. The unit for the clearance is mL/min.
An adult diabetic with renal complications has the ff results:sodium:133mEq/L,glucose:487mg/dL,BUN:84mg/dL,creatinine:5mg/dL: on the basis of these results, the calculated serum osmolality is: a.266mOsm/kg b.290mOsm/kg c.323mOsm/kg d.709mOsm/kg	c.Calculated osmolality(mOsm/kg)=(2 x sodium[mEq/L]) + (glucose[mg/dL]/18) + (BUN[mg/dL]/2.8)
Stray light can be detected in a spectrophotometer by utilizing a: a:mercury vapor lamp b.homium oxide glass c.potassium dicromate solution d.shap cutoff filter	d.Other distractors are methods to detect stray light
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 calcium analysis by AAS,lanthanum is added to bind with phosphate, thereby preventing interference by the formation of calcium phosphate
Which of the ff 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.spectrophotometric d.fluorescence	a.The electrolyte exclusion effect applies only to indirect methods and is caused by the solvent displacing effect of high concentrations of lipid and protein in the sample resulting in falsely decreased values
Upon development of a thin-layer chomatorgram for drug analysis all drug spots(including standards) had migrated with solvent front.Probable cause for this would be: a.environmental temperature too warm b.incorrect aqueous to nonaqueous solvent mixture	b.incorrect aqueous to nonaqueous solvent mixture
To detect barbiturate abuse when analyzing urine specimens, immunoassay is the method of choice for screening.the method of choice for confirmation is: a.nephelometry b.thin-layer chromatography c.gas chromatrography/mass spectrometry	c.In practice, a positive screening result for barbiturates obtained by immunoassay is confirmed by gas chromatography/mass spectrometry analysis of the urine specimen
reverse phase high-performance liquid chromatography is being increasingly utilized in therapeutic drug monitoring.The term reverse phase implies that the columeluant is: a.pumped up the column b.more polar than the stationary phase c.always nonpolar	b.Retention of an anlayte on a reversed-phase column depends on the relative amounts of polar and nonpolar character of the analyte.Retention on the reversed-phase packing material is favored by increased nonpolar content of the analyte
reverse phase high-performance liquid chromatography is being increasingly utilized in therapeutic drug monitoring.The term reverse phase implies that the columeluant is: a.pumped up the column b.more polar than the stationary phase c.always nonpolar	b.Retention of an anlayte on a reversed-phase column depends on the relative amounts of polar and nonpolar character of the analyte.Retention on the reversed-phase packing material is favored by increased nonpolar content of the analyte
When separating serum proteins by cellulose acetate electrophoresis, using Veronal buffer at ph 8.6,beta globulin migrates: a.faster than albumin b.slower than gamma globulin c.faster than gamma globulin d.faster than alpha-2 globulin	c.faster than gamma globulin
Hemoglobin s can be separated from hemoglobin D by which of the ff methods: a.agar gel electrophoresis at pH5.9 b.thin layer chromatography c.alkali denaturation d.ammonium precipitation	a.agar gel elctrophoresis at pH 5.9
What is the proper pH for the buffered solution to perform serum protein electrophoresis: a.5.6 b.7.6 c.8.6 d.9.6	c.8.6
The buffer pH most effective at allowing amphoteric proteins to migrate toward the cathode in an electophoretic system would be: a.4.5 b.7.5 c.8.6 d.9.5	a.Proteins are amphoteric substances,that is, they contain acidic and basic groups.Their overall(net) charge is highly positive at low pH values, 0 at a particular higher pH, and negative at still more alkaline pH values.
On electrophoresis,transient bisalbuminemia or a grossly widened albumin zone is associated with: a.dirty applicators b.presence of therapeutic drugs in serum sample c.endosmosis d.prestaining with tracer dye	b.Occasionally,a split albumin zone is observed in the rare benign genetically relation condition of bisalbuminemia.However,transient bisalbuminemia or a grossly widened albumin zone could be due to albumin-bound medications.
Which of the ff serum proteins migrate with the beta-globulins on cellulose acetate at pH8.6: a.ceruloplasmin b.hemoglobin c.haptoglobin d.C3 component of complement	d.The C3 component of complement migrates with beta-globulins on electrophoresis
An electrode has a sliver/silver chloride anode and a platinum wire cathode.It is suspended in KCl solution and separated from the blood to be analyzed by a selectively permeable membrane. such an electrode is used to measure w/c of the ff: a.pH,b.PO2	b.PO2 electrode
Hydrogen ion concentration(pH) in blood is usually determined by means of which of the ff electrodes: a.silver b.glass c.platinum d.paltinum-lactate	b.The pH electrode,a glass electrode,contains a specially designed thin piece of glass as a membrane.The glass membrane is made of silicon dioxide, added oxides and various metals.The membrane is selectively sensitive to hydrogen ions.
An automated method for measuring chloride which generates silver ions in the reaction is: a.coulometry b.mass spectroscopy c.chromatography d.polarography	a.Coulometry is an electrochemical technique used to measure amount of electricity passing between 2 electrodes in an electrochemical cell.Application of coulometry is titration of chloride w/ silver ions generated by electorlysis from silver wire @ anode
Coulometry is often used to measure: a.chloride in sweat b.the pH in saliva c.bicarbonate in urine d.ammonia in plasma	a.Coulometry is still used for chloride determinations in body fluids, such as sweat.However, chloride ion-selective electrodes(ISE) are commonly used today
In pH meter reference electrodes may include: a.silver-silver chloride b.quinhydrone c.hydroxide d.hydrogen	a.The reference pH electrode is often constructed of Ag and AgCl
Amperometry is the principle of the: a.PCO2 electrode b.PO2 electrode c.pH electrode d.Ionized calcium electrode	b.The PO2 electrode functions on the amperometric principle,which the measurement of electrical current at a constant voltage(or potential)
Most automated blood gas analyzers directly measure: a.pH,HCO3 and % O2 saturation b.pH,pCO2 and PO2 c.HCO3,PCO2, and PO2 d.pH,PO2 and %O2 saturation	b.pH,PCO2, and PO2 are directly measured by modern blood gas analyzers; other parameters are calculated
Blood PCO2 may be measured by: a.direct colorimetric measurement of dissolved CO2 b.a self-contained potentionmetric electrode c.measurement of C02-saturated hemoglobin d.measurement of CO2 consumed at the cathode	b.PCO2 electrode is a self-contained potentiometric cell.CO2 from sample or calibration matrix diffuses through selective membrane and dissolves in internal electrolyte layer.Carbonic acid is formed and dissociates,shifting the pH of the bicarbonate soln.
Valinomycin enhances the selectivity of the electrode used to quantitate: a.sodium b.chloride c.potassium d.calcium	c.Analyzers fitted with ion-selective electrodes usually contain potassium electrodes with liquid ion-exchange membranes that incorporate valinomycin.Valinomycin is a neutral carrier(ionophore) that binds potassium in the center of a ring of oxygen atoms.
Which blood gas electrode is composed of silver/silver chloride reference electrode and glass: a.PO2 b.pH c.PCO2 d.HCO3	c.PCO2 electrode
Most chemical methods for determining total protein utilize which of the ff reactions: a.molybdenum blue b.ferri-ferrocyanide c.resorcinol-HCL d.biuret	d.biuret
Bromcresol purple at a pH of 5.2 is used in a colorimetric method to measure: a.albumin b.globulin c.Bence Jones protein d.immunoprotein	a.albumin method
Magnesium carbonate is added in an iron binding capacity determination in order to: a.allow color to develop b.precipitate protein c.bind with hemoglobin iron d.remove excess unbound iron	d.Total iron binding capacity(TIBC)is the amount of iron that transferrin and other minor binding proteins are capable of binding.In measure of TIBC,molecules are saturated w/ iron.Magnesium carbonate is used to remove excess unbound by adsorption
The most specific method for the assay of glucose utilizes: a.hexokinase b.glucose oxidase c.glucose-6-phosphate d.glucose dehydrogenase	a.Most specific glucose method
Which of the ff would be an example of a glucose-specific colorimetric method: a.alkaline ferricyanide b.glucose oxidase c.hexokinase d.o-toluidine	b.Other distractors are not glucose specific methods
increased concentrations of ascorbic acid inhibit chromogen production in which of the ff glucose methods: a.ferricyanide b.ortho-toluidine c.glucose oxidase(peroxidase) d.hexokinase	c.Ascorbic acid interferes.this is a limitation of the glucose oxidase(peroxidase) reaction
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 combined w/ bromcresol purple d.condensation of glucose	b.NADH produced form the reduction of NAD
Which of the ff calcium procedures utilizes lanthanum chloride to eliminate interfering substances: a.0-cresolphthalein complexone b.pricipitation with chloranilic acid c.chelation with EDTA d.atomic absorption spectrophotometry	d.AAS measures calcium by determining its atomic absorption by electromagnetic radiation.One limitation of method is nonspectral interference w/c occurs when phosphates are present & complex w/ calcium.Use of lanthanum chloride has prevented interference.
Before unconjugated bilirubin can react with Ehrlich diazo reagent,which of the ff must be added: a.acetone b.ether c.distilled water d.caffeine	d.Unconjugated bilirubin solvent
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.Other distractors are not bilirubin
In Malloy and Evelyn method for determination of bilirubin,the reagent that is reacted with bilirubin to form a purple azobilirubin is: a.dilute sulfuric acid b.diazonium sulfate c.sulfobromophthalein d.diazotized sulfanilic acid	d.The diazo method of Malloy and Evelyn involves bilirubin reacting with diazotized sulfanilic acid to form azobilirubin
In the Jendrasik-Grof method for the determination of serum bilirubin concentration,quantitation is obtained by measuring the green color of: a.azobilirubin b.bilirubin diglucuronide c.urobilin d.urobilinogen	a.In Jendrassik-Grof method for bilirubin measurement,addition of caffeine plus diazotized sulfanilic acid and serum produces azobilirubin.Ascorbic acid,alkaline tartrate and dilute HCl are added to reaction mixture.Blue-green azobilirubin is measured.
In the Jemdrassik-Grof reaction for total bilirubin,bilirubin reacts with diazotized sulfanilic acid to form: a.diazo bilirubin b.biliverdin c.azobilirubin d.bilirubin diglucoronide	c.Azobilirubin is the chromophore measured in the Jendrassik-Grof reaction.Azobilirubin is formed by bilirubin in the presence of diazotized-sulfanilic acid.
In the assay of lactate dehydrogenase,which of the ff product is actually measured: a.NADH b.ATP c.lactic acid d.pyruvic acid	a.NADH
In the assay of lactate dehydrogenase(LD),the reaction is dependent upon which of the ff: a.NAD/NADH b.ATP/ADP c.Fe++/Fe+++ d.Cu/Cu++	a.Nicotinamide adenine dinucleotide is the coenzyme system for the LD assay.NADH is the reduced form and NAD is the oxidized form.The zoenzumes serve as a substrate for dehydrogenase reactions.
In competitive inhibition of an ezyme reaction,the: a.inhibitor binds to the enzyme at the same site as does the substrate b.inhibitor often has a chemical structure different to that of the substrate	a.Competitive inhibitors bind at the active site of enzymes and compete with the substrate for binding sites
The International Federation for Clinical Chemistry(IFCC) recommends the use of methods such as the Bessy-Lowry-Brock method for determning alkaline phosphatase activity.Substrate used in this type of method is: a.mohophosphate b.para-nitrophenylphospha	b.Alkaline phosphatase catalyzes the hydrolysis of para-nitrophenyl phosphate,forming phophate and free 4-nitophenyl(4-npp) which, under alkaline conditions, has a very intense yellow color.IFCC recommended methods use 4-npp as the substrate.
Which of the ff is a glycolytic enzyme that catalyzes the cleavage of fructose-1,6-diphosphate to glyceraldehyde-3-phosphate and dihydroxyacetone phosphate: a.aldolase b.phophofructokinase c.pyruvate kinase d.glucose-6-phosphate dehydrogenase	a.Aldolase catalyzes the splitting of fructose-1,6-diphosphate to glyceraldehyde-3-phosphate, and important reacton in the glycolytic breakdown of glucose to lactate.
The substance that is measured to estimate the serum concentration of triglycerides by MOST methods is: a.phopholipids b.glycerol c.fatty acids d.pre-beta lipoprotein	b.There are several enzymatic methods for measuring serum triglyceride.The first step of the coupled reactions involves the hydrolysis of triglycerides by lipase to produce glycerol and fatty acids.Glycerol is a reactant in one of 2 enzymatic sequences
Which of the ff methods for quantitation of high-density lipoprotein is MOST suited for clinical laboratory use: a.Gomori procedure b.homogeneous c.column chromatography d.agarose gel electrophoresis	b.homogeneous
A chemiluminescent EIA: a.measures absorption of light b.is less sensitive than radioisotopic reactions c.is monitored by the use of a gamma counter d.is quantitated by the amount of light produced by the reaction	d.Chemiluniscent labels are based on the emission of light produced during a chemical reaction.These labels are very useful because they provide very low levels of detection(2x10^20mol/L) with little or no background interference.
The osmolality of a urine or serum specimen is measured by a change in the: a.freezing point b.sedimentation point c.midpoint d.osmotic pressure	a.Osmometry of serum and other body fluids is commonly measured by freezing-point depression, using a freezing point osmometer
Which of the ff applies to cryoscopic osmometry: a.temperature at equilibrium is a function of number of particles in solution b.temperature plateau for a solution is horizontal c.freezing point of a sample is absolute	a.The osmolality of a solution does not depend on the the kind of particles but only on the number of particles, therefore it is called a colligative property
Assay of transketolase activity in blood is used to detect deficiency of: a.thiamine b.folic acid c.ascorbic acid d.riboflavin	a.Transkelotase is decreased in thiamine deficiency.Low values of it have also been found in chronic alcoholism
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 450nm d.creatinine	c.The "optical density Delta 450" determination is a graphical calculation to estimate the amount of bilirubin in aminiotic fluid.Bilirubin has a maximal absorbance of 450nm

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