Question 1

What complex makes up transferrin?

Accepted Answer

A)  Apo-B·Transferrin 
B)  Apotransferrin·Fe3+ 
C)  Lipoprotein A·Transferrin 
D)  Apotransferrin·Fe2+ 
A)  Apo-B·Transferrin 
B)  Apotransferrin·Fe3+ 
C)  Lipoprotein A·Transferrin 
D)  Apotransferrin·Fe2+ B

Question 2

What is the required oxidation state (valence) of iron that enables it to bind to a chromogen in most spectrophotometric assays?

Accepted Answer

A)  +1 
B)  +2 
C)  +3 
D)  -3 
A)  +1 
B)  +2 
C)  +3 
D)  -3 B

Question 3

Which of the following specimens is appropriate to determine the concentration of lead in body fluids?

Accepted Answer

A)  Serum 
B)  Cerebrospinal fluid 
C)  Whole blood 
D)  EDTA plasma 
A)  Serum 
B)  Cerebrospinal fluid 
C)  Whole blood 
D)  EDTA plasma C

Question 4

Which of the following statements is correct when procuring specimens for measuring porphyrin compounds?

Accepted Answer

A)  Do not expose the blood specimen to air for prolong period of time. 
B)  You must add 0.5 N hydrochloric acid to urine specimens to preserve it while storing. 
C)  It not necessary to collect the specimen in low actinic glassware. 
D)  Protect the specimen from light. 
A)  Do not expose the blood specimen to air for prolong period of time. 
B)  You must add 0.5 N hydrochloric acid to urine specimens to preserve it while storing. 
C)  It not necessary to collect the specimen in low actinic glassware. 
D)  Protect the specimen from light.

Question 5

Which of the following laboratory test groups and results best reflects a patient with iron deficiency anemia?

Accepted Answer

A)  Serum iron, decreased; serum TIBC, increased; transferring saturation, decreased 
B)  Serum iron, increased; serum TIBC, increased; transferrin saturation, increased 
C)  Serum lead, increased; serum TIBC, increased; transferrin saturation, increased 
D)  Serum iron, decreased; serum TIBC, decreased; transferrin saturation, decreased 
A)  Serum iron, decreased; serum TIBC, increased; transferring saturation, decreased 
B)  Serum iron, increased; serum TIBC, increased; transferrin saturation, increased 
C)  Serum lead, increased; serum TIBC, increased; transferrin saturation, increased 
D)  Serum iron, decreased; serum TIBC, decreased; transferrin saturation, decreased

Question 6

Which of the following porphyria's best reflect this patient's symptoms and laboratory results?
A 42-year-old white South African male presents to his clinician experiencing acute neurological attacks and sensitivity of his skin to sunlight. The patient's urine showed PBG>ALA. Urine porphyrins analysis revealed elevation of urinary coproporphyrinogen III.

Accepted Answer

A)  ALA-dehydratase deficient porphyria 
B)  Acute intermittent porphyria 
C)  Erythropoietic protoporphyria 
D)  Variegate porphyria 
A)  ALA-dehydratase deficient porphyria 
B)  Acute intermittent porphyria 
C)  Erythropoietic protoporphyria 
D)  Variegate porphyria

Question 7

A 30-year-old male with ALA-dehydratase deficient porphyria (ADP) may present with which of the following clinical features?

Accepted Answer

A)  Severe chest pain, shortness of breath, and rapid heart rate (tachycardia) 
B)  Abdominal pain and neurological dysfunction 
C)  Photosensitivity and cutaneous lesion 
D)  Bulging eyes, goiter in the neck, and heat intolerance 
A)  Severe chest pain, shortness of breath, and rapid heart rate (tachycardia) 
B)  Abdominal pain and neurological dysfunction 
C)  Photosensitivity and cutaneous lesion 
D)  Bulging eyes, goiter in the neck, and heat intolerance

Question 8

Which of the following compounds initially condenses to form aminolevulinic acid?

Accepted Answer

A)  Coproporphyrinogen and urobilinogen 
B)  Glutamic acid and alanine 
C)  Acetylcholine and epinephrine 
D)  Succinyl coenzyme A and glycine 
A)  Coproporphyrinogen and urobilinogen 
B)  Glutamic acid and alanine 
C)  Acetylcholine and epinephrine 
D)  Succinyl coenzyme A and glycine

Question 9

The addition of sufficient Fe3+ to saturate iron binding site of transferrin is referred to as which of the following?

Accepted Answer

A)  Total iron binding saturation 
B)  Unsaturated iron binding capacity 
C)  Serum transferrin saturation 
D)  Total iron index 
A)  Total iron binding saturation 
B)  Unsaturated iron binding capacity 
C)  Serum transferrin saturation 
D)  Total iron index

Question 10

A 40-year-old male patient with hemochromatosis often presents to his clinician with which of the following triad of symptoms?

Accepted Answer

A)  Bronzing of the skin, cirrhosis, and diabetes 
B)  Polyuria, polydipsia, and polyphagia 
C)  Yellowing of the sclera of the eyes, shortness of breath, and chest pain 
D)  Abdominal pain, chest pain, and grayish-blue lips 
A)  Bronzing of the skin, cirrhosis, and diabetes 
B)  Polyuria, polydipsia, and polyphagia 
C)  Yellowing of the sclera of the eyes, shortness of breath, and chest pain 
D)  Abdominal pain, chest pain, and grayish-blue lips

Question 11

Free erythrocyte protoporphyrin levels are useful for assessing exposure to which of the following metals?

Accepted Answer

A)  Lead 
B)  Chromium 
C)  Zinc 
D)  Copper 
A)  Lead 
B)  Chromium 
C)  Zinc 
D)  Copper

Question 12

What is the unique quality that many porphyrin compounds possess that allows for their detection within body tissues and in a test tube?

Accepted Answer

A)  They emit gamma radiation that can be detected using a radiation sensor. 
B)  They fluoresce and are detected by exposing them to EMR at a specific wavelength. 
C)  They absorb heat and can be detected using a thermal sensor. 
D)  They emit an odor that is characteristic of the particular type of porphyrin. 
A)  They emit gamma radiation that can be detected using a radiation sensor. 
B)  They fluoresce and are detected by exposing them to EMR at a specific wavelength. 
C)  They absorb heat and can be detected using a thermal sensor. 
D)  They emit an odor that is characteristic of the particular type of porphyrin.

Question 13

Total iron binding capacity (TIBC) is equal to:

Accepted Answer

A)  The sum of the serum iron and unsaturated iron binding capacity (UIB
C) . 
B)  The sum of the serum iron and serum ferritin. 
C)  The sum of the serum transferrin and transferrin saturation. 
D)  Serum iron minus unsaturated iron binding capacity (UIB
C) . 
A)  The sum of the serum iron and unsaturated iron binding capacity (UIB
C) . 
B)  The sum of the serum iron and serum ferritin. 
C)  The sum of the serum transferrin and transferrin saturation. 
D)  Serum iron minus unsaturated iron binding capacity (UIB
C) .

Question 14

Which of the following chromogens will produce a colored complex with iron?

Accepted Answer

A)  Biuret 
B)  Ferrozine 
C)  Molybdic acid 
D)  8-hyroxyquinoline 
A)  Biuret 
B)  Ferrozine 
C)  Molybdic acid 
D)  8-hyroxyquinoline

Question 15

Which of the following compounds chelates iron and is the immediate precursor of heme formation?

Accepted Answer

A)  Uroporphyrinogen 
B)  Coproporphyrinogen I 
C)  Protophorhyrin IX 
D)  Urobilinogen 
A)  Uroporphyrinogen 
B)  Coproporphyrinogen I 
C)  Protophorhyrin IX 
D)  Urobilinogen

Question 16

Heme is defined as:

Accepted Answer

A)  Protoporphyrins that chelate iron. 
B)  Protoporphyrins that chelate lead. 
C)  Ferricheme associated with hydroxide. 
D)  The reduced form of a porphyrin. 
A)  Protoporphyrins that chelate iron. 
B)  Protoporphyrins that chelate lead. 
C)  Ferricheme associated with hydroxide. 
D)  The reduced form of a porphyrin.

Question 17

A 25-year-old female visits her physician complaining of lethargy and wants to take a nap all of the time. Her physician orders laboratory tests and the results are shown below. Which of the following conditions best represent this patient's status?
$\begin{array}{|l|l|l|l|}
\hline\text { Serum iron $ (\mu \mathrm{g} / \mathrm{dL}) $} & \text {TIBC $ (\mu \mathrm{g} / \mathrm{dL}) $ }& \text { Transferrin saturation } (\%)& \text {Serum Ferritin $ (\mu \mathrm{g} / \mathrm{L}) $} \
\
\hline \text { Dec }&\text {  Inc }& \text { Dec }& \text { Dec} \
\hline
\end{array}$

Accepted Answer

A)  Thalassemia major 
B)  Iron deficiency anemia 
C)  Variegate porphyria 
D)  Hemochromatosis 
A)  Thalassemia major 
B)  Iron deficiency anemia 
C)  Variegate porphyria 
D)  Hemochromatosis

Question 18

The biosynthesis of heme commences with which two compounds?

Accepted Answer

A)  Glycine and succinyl CoA 
B)  Alanine and glycine 
C)  Glycerin and acetyl-CoA 
D)  Lysine and globulin 
A)  Glycine and succinyl CoA 
B)  Alanine and glycine 
C)  Glycerin and acetyl-CoA 
D)  Lysine and globulin

Question 19

Protoporphyrins that chelate iron are called:

Accepted Answer

A)  Hemin. 
B)  Hemoglobin. 
C)  Heme. 
D)  Hemosiderin. 
A)  Hemin. 
B)  Hemoglobin. 
C)  Heme. 
D)  Hemosiderin.

Question 20

A patient with acute intermittent porphyria is deficient in which enzyme?

Accepted Answer

A)  Coproporphyrinogen oxidase 
B)  Aminolevulinic acid synthase 
C)  Ferrochelatase 
D)  Hydroxymethylbilane synthase 
A)  Coproporphyrinogen oxidase 
B)  Aminolevulinic acid synthase 
C)  Ferrochelatase 
D)  Hydroxymethylbilane synthase

Exam 20: Iron, Porphyrins, and Hemoglobin

What complex makes up transferrin?

What is the required oxidation state (valence) of iron that enables it to bind to a chromogen in most spectrophotometric assays?

Which of the following specimens is appropriate to determine the concentration of lead in body fluids?

Which of the following statements is correct when procuring specimens for measuring porphyrin compounds?

Which of the following laboratory test groups and results best reflects a patient with iron deficiency anemia?

A 30-year-old male with ALA-dehydratase deficient porphyria (ADP) may present with which of the following clinical features?

Which of the following compounds initially condenses to form aminolevulinic acid?

The addition of sufficient Fe3+ to saturate iron binding site of transferrin is referred to as which of the following?

A 40-year-old male patient with hemochromatosis often presents to his clinician with which of the following triad of symptoms?

Free erythrocyte protoporphyrin levels are useful for assessing exposure to which of the following metals?

What is the unique quality that many porphyrin compounds possess that allows for their detection within body tissues and in a test tube?

Total iron binding capacity (TIBC) is equal to:

Which of the following chromogens will produce a colored complex with iron?

Which of the following compounds chelates iron and is the immediate precursor of heme formation?

Heme is defined as:

The biosynthesis of heme commences with which two compounds?

Protoporphyrins that chelate iron are called:

A patient with acute intermittent porphyria is deficient in which enzyme?

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The addition of sufficient Fe³⁺ to saturate iron binding site of transferrin is referred to as which of the following?