Clinical Chemistry Practice Questions & Ratio

MEDICAL LABORATORY SCIENCE • CLINICAL CHEMISTRY PRACTICE QUESTIONS + ANSWERS & RATIONALIZATIONS • 2 mL of stock solution is added to 8 mL of solvent. What is the dilution, ratio, and total volume? a. 2:10, 2:8 b. 10:2, 8:2 c. 2:8, 2:10 d. 8:2, 10:2 → Solution: • • • • • • • • • Cryogenic materials: a. Cause asphyxiation b. Cause embrittlement of material c. Can explode due to increased pressure d. All of these Chemicals should be stored a. According to their chemical properties and classification b. Alphabetically, for easy accessibility c. Inside a safety cabinet with proper ventilation d. Inside a fume hood, if toxic vapors can be released when opens Proper PPE in the chemistry laboratory for routine testing includes: a. Impermeable lab coat with eye/face protection and appropriate disposable gloves b. Respirators with HEPA filter c. Gloves with rubberized sleeves d. Safety glasses for individuals not wearing contact lenses Which of the following are examples of nonionizing radiation? a. UV light and microwaves b. Gamma rays and x-rays c. Alpha and beta radiation → from radioactive decay d. Neutron radiation → from radioactive decay 1 L of 4 N NaOH (strong base) in a glass 1 L beaker accidentally fell and spilled on the laboratory floor. The 1st step is to: a. Call 911 b. Alert and evacuate those in the immediate are out of harms way c. Throw some kitty litter on the spill d. Squirt water on the spill to dilute the chemical e. Neutralize with absorbing materials in a nearby spill kit Which problem can be encountered in phlebotomy? a. Neurological b. Dermatological c. Anemia d. All of these Required fasting hours for lipid measurement. a. 6 hrs b. 8 hrs c. 10 hrs d. 12 hrs • • • • • • Most affected from supine to standing or just by prolonged standing: a. Iron b. Calcium c. Cortisol d. Aldosterone Most affected by diurnal variation a. Iron → 30% lower in evening b. ACTH → directly proportional to cortisol c. Aldosterone d. Growth Hormone → Cortisol - 50-80% lower in the evening ▪ Directly proportional with ACTH Which of the following is a cause of pseudohyperkalemia: I. Squeezing site of capillary puncture II. Pumping fist during venipuncture III. Tourniquet left for more than 1 minute a. I, II b. II, III c. I, II, III Which of the following are routinely measured electrolyte: I. Na II. K III. Cl IV. CO2 a. I, II, III b. I, II, III, IV A serum/plasma appeared milky and opaque. What is the value of triglycerides? a. 200 mg/dL → clear b. 300 mg/dL → turbid/hazy c. 400 mg/dL → lactescent d. 600 mg/dL Type 1 DM: I. Usually affect age of onset before 20 years old II. Usually leads to deficiency or absence of insulin III. Prone to ketosis IV. Destruction of B cells a. I, II b. I, III c. I, II, III, IV d. I, III, IV Need emergency treatment or response: I. Glycosuria II. Ketoacidosis III. Hyperkalemia a. I, II b. I, III c. II, III d. I, II, III Not included during inflammation a. Increase capillary permeability → acute inflammation b. Migration of lymphocytes → chronic inflammation c. Release of haptoglobin → acute inflammation d. CRP release → acute inflammation (1000x increased during inflammation) Non-invasive procedure using vaginal secretions to detect threatened abortion: a. AFP b. Fetal fibronectin → ↑ preterm labor c. B-hCG → ↓ threatened abortion, ↑ intact pregnancy → Threatened abortion - vaginal bleeding, placental intact, baby still alive 1 • • • • • • • • • • • • Used as a marker for nutrition a. Cystatin C b. Cross-linked C telopeptide c. Fibronectin d. Adiponectin → ↓ obesity Black urine upon standing: a. Alkaptonuria b. Phenylketonuria Which of the following does not belong to major LPP? a. VLDL b. HDL c. Lp (x) → abnormal d. LDL Creamy layer on top on serum? a. Chylomicrons b. LDL c. HDL Endogenous triglycerides? a. LDL b. HDL c. VLDL What analyte is measured by using this equation? TC - HDL - VLDL (TAG/5) a. LDL b. Chole c. CM d. TAG Major product of protein catabolism: a. Urea b. Uric acid c. Creatinine d. Ammonia Urea is reabsorbed in the circulation due to obstruction a. Pre renal azotemia b. None of the above c. Renal azotemia d. Post renal azotemia Which is not a product of catabolism and anabolism of nucleic acids and proteins? a. Urea → protein product b. Creatinine → product of creatine PO4 c. Glucose → gluconeogenesis (from proteins & NA) d. Uric acid → nucleic acid product Which of the following is used as an early biomarker in the diagnosis of acute kidney injury? a. NGAL → earliest biomarker b. Cystatin C → kidney function c. Creatinine d. Urine volume Which of the following does not belong to liver function tests? a. Bilirubin b. Enzymes c. Factor assay → only PT is measured d. Prothrombin Which of the following is involved in excretory and synthetic function of the liver? a. PT b. Bilirubin → bile pigment c. Albumin d. Transaminases • • • • • • • • • Which of the following is involved in hepatocellular damage and necrosis? a. PT b. Bilirubin c. Transaminase d. Albumin Use of wetting agent or incorrect pH ______ the amount of unconjugated bilirubin. a. Increases b. Decreases c. Does not affect Which of the following is an important part in enzyme function? a. Cofactor b. Coenzyme → act as 2nd substrate c. Activator → required for rxn True of enzymes: I. Catalyzes the transfer of chemical or functional group from one substance to another → transferase II. Catalyzes intramolecular rearrangement of the substrate compound → isomerase III. Increased activity intracellularly when red cells are damaged → increased activity extracellularly a. I, II b. I, III c. II, III d. I, II, III Structural change: a. Isomerase b. Ligase c. Transferase d. Oxidoreductase Moderate specificity to heart, liver, and skeletal muscle: a. LDH → least specific b. CK c. ALT d. AST Which enzyme is not a macroenzyme? a. ACP b. ALP c. G6PD d. Transferases Pathologic increase of amylase a. Duodenal perforation b. Acute pancreatitis → earliest marker c. Cirrhosis d. Hepatitis A condition of iron overload as demonstrated by an increased serum iron and TIBC or transferrin, in the absence of demonstrable tissue damage: a. Sideroblastic anemia → Defective heme synthesis leading to iron overload I n erythroblasts (dimorphic RBCs) b. Hemochromatosis → Dec TIBC, tissue damage c. Hemosiderosis → Minimal or no tissue damage, ↑ TIBC d. Crohn’s disease → Inflammatory bowel disease 2 • • • • • • • • • Causing hyponatremia due to water imbalance: I. Severe burn II. CHF III. SIADH IV. Pseudohyponatremia a. I, II b. II, III c. III, IV d. I, II, III, IV Which of the following is not a cause of hyponatremia due to increased sodium loss a. Diuretic use b. Hypokalemia c. Renal failure → increase water retention d. Severe burns Chronic renal failure: _______ loss of function a. Progressive b. Irreversible c. Reversible → acute renal failure Essential in acid-base balance I. K II. HCO3 III. Cl IV. Ca a. I, II b. II, III c. I, IV d. I, III Patient ingested ethanol, what other tests can support this situation? a. Detect anion gap b. Detect electrolytes c. Detect osmolal gap d. Detect serum osmolality Estimated osmolality equation a. Na + Glu + BUN b. Na + Glu x BUN c. 2 x Na + Glu + BUN d. 2 x BUN + Glue + Na What causes pseudohyperkalemia? I. Excessive fist clenching II. Prolonged tourniquet use III. Thrombocytosis a. I, II b. I, III c. I, II, III d. II, III Hormones involved in regulation of calcium a. PTH b. Vit. D c. Calcitonin d. All of these Causing hyponatremia due to water imbalance: I. Severe burn → excess sodium loss II. CHF → water retention III. SIADH IV. Pseudohyponatremia a. I, II b. III, IV • • • • • • • • • • • Buffer system in maintaining RBCs and H+ ions in the urine a. Phosphate b. Bicarbonate-carbonic acid In the Henderson-Hasselbach equation, what organ is represented by the numerator? a. Lungs → CO2 b. Kidneys → HCO3 Growth hormone is inhibited by: a. Glucose loading b. Thyroxine c. Insulin deficiency CASE: Neonate, no protein intake for 24 hours since birth, what is the thyroxine result compared to normal? a. Low b. High c. Normal → Thyroxine is responsible for most of metabolic processes. (protein metabolism, etc.) → 24 hr no protein = starvation ▪ starvation = thyroid hormones decreased due to decreased decreased transport proteins Not associated with neonatal hypothyroidism: a. Thyroiditis b. Mental retardation c. Cretinism Not associated with PCOS: a. Hirsutism → excessive hair growth b. Infertility c. Obesity d. Myxedema Luteinizing hormone function/characteristic: I. Non-specific function II. Produced by Leydig cells → for testosterone a. I, II b. None of these A steroid hormone that maintains pregnancy a. Progesterone b. hCG c. Estriol Drugs that are not included in TDM: I. ASA / Aspirin II. Acetaminophen / Paracetamol III. Ibuprofen → NSAID a. I, II b. I, II, III → I & II are included in toxicology Anti-asthmatic drugs: I. Theophylline → bronchodilator II. TheoDur → brand name of theophylline III. Digoxin → cardiotropic IV. Procainamide → cardiotropic a. I, II b. III, IV c. I, II, III d. I, II, III, IV Lithium is a(n): a. CNS depressant b. Anti-depressant c. CNS stimulant 3 • • Also known as ecstasy: a. Opiates b. Cocaine c. Phencyclidine d. Methamphetamine Drug that do not affect CNS a. Barbiturates b. Benzodiazepines c. Methotrexate → cancer drug d. Cannabinoids 4