Question 1

Lp (a) is considered a risk factor for developing atherosclerosis due to which of the following?

Accepted Answer

A)  It competes with fibrinogen for binding sites, thus interfering with clot lysis and increasing the risk of acute myocardial infarction (AMI). 
B)  It is produced by macrophages and expressed in atherosclerotic lesions. 
C)  It activates complement. 
D)  It competes with plasminogen for binding sites, thus interfering with clot lysis and increasing the risk of acute myocardial infarction (AMI). 
A)  It competes with fibrinogen for binding sites, thus interfering with clot lysis and increasing the risk of acute myocardial infarction (AMI). 
B)  It is produced by macrophages and expressed in atherosclerotic lesions. 
C)  It activates complement. 
D)  It competes with plasminogen for binding sites, thus interfering with clot lysis and increasing the risk of acute myocardial infarction (AMI). D

Question 2

The atherogenic effect of homocysteine is:

Accepted Answer

A)  The toxic effect on the left ventricular wall of the heart. 
B)  The toxic effect of homocysteine on the adventitia or outer lining the arterial wall. 
C)  The toxic effect of homocysteine on the endothelial lining of the arteries, which causes plaque formation. 
D)  The nontoxic effect of homocysteine on the intima lining of the arteries. 
A)  The toxic effect on the left ventricular wall of the heart. 
B)  The toxic effect of homocysteine on the adventitia or outer lining the arterial wall. 
C)  The toxic effect of homocysteine on the endothelial lining of the arteries, which causes plaque formation. 
D)  The nontoxic effect of homocysteine on the intima lining of the arteries. C

Question 3

Which of the following is an early (i.e., rapidly in similar fashion to myoglobin) biomarkers of acute myocardial infarction?

Accepted Answer

A)  Unbound free fatty acid (FFAu) 
B)  Placental growth factor (PIGF) 
C)  Heart-type fatty acid binding protein (H-FABP) 
D)  CK-MB 
A)  Unbound free fatty acid (FFAu) 
B)  Placental growth factor (PIGF) 
C)  Heart-type fatty acid binding protein (H-FABP) 
D)  CK-MB C

Question 4

Which of the following is an advantage of POCT for cardiac biomarkers?

Accepted Answer

A)  Increased turn-around time for analysis 
B)  Delay in rule-out of an AMI 
C)  Rapid identification of AMI 
D)  Delay in risk stratification of an AMI 
A)  Increased turn-around time for analysis 
B)  Delay in rule-out of an AMI 
C)  Rapid identification of AMI 
D)  Delay in risk stratification of an AMI

Question 5

The presence of heterophile antibodies, rheumatoid factor, increased blood levels of hemoglobin and circulating cTnI autoantibodies can result in which of the following?

Accepted Answer

A)  High dose hook effect with select cTn assays 
B)  Modification of diagnostic cut off value for cTn assays 
C)  False positive and/or false negative result for BNP or NT-Pro BNP assays 
D)  False positive and/or false negative result for cTnI assays 
A)  High dose hook effect with select cTn assays 
B)  Modification of diagnostic cut off value for cTn assays 
C)  False positive and/or false negative result for BNP or NT-Pro BNP assays 
D)  False positive and/or false negative result for cTnI assays

Question 6

In which of the following disorders is measurement of brain type natriuretic peptide (BNP) clinically useful?

Accepted Answer

A)  Acute myocardial infarctions (AMIs) 
B)  Tachycardia 
C)  Congestive heart failure 
D)  Pericarditis 
A)  Acute myocardial infarctions (AMIs) 
B)  Tachycardia 
C)  Congestive heart failure 
D)  Pericarditis

Question 7

NT-pro-BNP consist of 76 amino acids and is described as a:

Accepted Answer

A)  A metabolite of BNP. 
B)  The storage form of BNP. 
C)  The catabolic product of ANP. 
D)  The natriuretic peptide that is the inactive form. 
A)  A metabolite of BNP. 
B)  The storage form of BNP. 
C)  The catabolic product of ANP. 
D)  The natriuretic peptide that is the inactive form.

Question 8

The role of cardiac biomarkers includes which of the following?

Accepted Answer

A)  Establish odds ratio, diagnosis, and treatment modalities 
B)  Tumor identifications, prognosis, appropriate drug therapy intervention 
C)  Diagnosis, monitoring, risks stratification, and therapeutic management 
D)  Determining life expectancy, staging diseases, population studies 
A)  Establish odds ratio, diagnosis, and treatment modalities 
B)  Tumor identifications, prognosis, appropriate drug therapy intervention 
C)  Diagnosis, monitoring, risks stratification, and therapeutic management 
D)  Determining life expectancy, staging diseases, population studies

Question 9

Infusion of Nesiritide is documented to act as a confounder for which of the following assays?

Accepted Answer

A)  Brain natriuretic peptide (BNP) 
B)  Atria natriuretic peptide (ANP) 
C)  Cardiac troponin T 
D)  Myoglobin 
A)  Brain natriuretic peptide (BNP) 
B)  Atria natriuretic peptide (ANP) 
C)  Cardiac troponin T 
D)  Myoglobin

Question 10

What is the clinical usefulness of measuring serum adiponectin?

Accepted Answer

A)  Plasma adiponectin levels may predict cardiovascular events years in advance in a population without diagnosed cardiovascular disease. 
B)  It is an early biomarker for AMI. 
C)  It is a cardiac biomarker for late presenting AMIs. 
D)  There are two forms of this protein, pregnancy, and acute coronary syndrome; thus, adiponectin can be used for either condition. 
A)  Plasma adiponectin levels may predict cardiovascular events years in advance in a population without diagnosed cardiovascular disease. 
B)  It is an early biomarker for AMI. 
C)  It is a cardiac biomarker for late presenting AMIs. 
D)  There are two forms of this protein, pregnancy, and acute coronary syndrome; thus, adiponectin can be used for either condition.

Question 11

Which of the following statements is TRUE about cTnI?

Accepted Answer

A)  Cardiac forms are never expressed in skeletal muscle. 
B)  Cardiac forms are expressed in skeletal muscle. 
C)  In fetal development, the cardiac and skeletal forms are co-expressed in skeletal and cardiac tissues. 
D)  It is the same as cardiac troponin C (cTn
C) . 
A)  Cardiac forms are never expressed in skeletal muscle. 
B)  Cardiac forms are expressed in skeletal muscle. 
C)  In fetal development, the cardiac and skeletal forms are co-expressed in skeletal and cardiac tissues. 
D)  It is the same as cardiac troponin C (cTn
C) .

Question 12

Which of the following represents the correct sequence for the rise and fall of myoglobin, CK-MB, and cTnI after an AMI?

Accepted Answer

A)  CK-MB, cTnI, myoglobin 
B)  cTnI, CK-MB, myoglobin 
C)  Myoglobin, CK-MB, cTnI 
D)  CK-MB, myoglobin, cTnI 
A)  CK-MB, cTnI, myoglobin 
B)  cTnI, CK-MB, myoglobin 
C)  Myoglobin, CK-MB, cTnI 
D)  CK-MB, myoglobin, cTnI

Question 13

Atherosclerosis is described as:

Accepted Answer

A)  Hardening of the arteries that occurs over a period of many years due in part to the abnormal accumulation of lipids. 
B)  Syndromes that encompass a continuum of clinical presentations ranging from unstable angina to non-Q-wave AMI. 
C)  A degenerative condition of the muscles. 
D)  An acute-phase reactant whose concentration in the blood rises dramatically in response to nonspecific inflammatory stimuli. 
A)  Hardening of the arteries that occurs over a period of many years due in part to the abnormal accumulation of lipids. 
B)  Syndromes that encompass a continuum of clinical presentations ranging from unstable angina to non-Q-wave AMI. 
C)  A degenerative condition of the muscles. 
D)  An acute-phase reactant whose concentration in the blood rises dramatically in response to nonspecific inflammatory stimuli.

Question 14

Elevated blood levels of pregnancy-associated plasma protein A (PAPP-A) may suggest which of the following?

Accepted Answer

A)  A presumptive diagnosis of heart failure in breathless patients. 
B)  A low risk factor for developing an acute coronary syndrome (ACS). 
C)  An S-T segment myocardial infarction (STEMI). 
D)  The presence of an unstable ACS in patients without increased concentration of biomarkers of necrosis, such as cTn. 
A)  A presumptive diagnosis of heart failure in breathless patients. 
B)  A low risk factor for developing an acute coronary syndrome (ACS). 
C)  An S-T segment myocardial infarction (STEMI). 
D)  The presence of an unstable ACS in patients without increased concentration of biomarkers of necrosis, such as cTn.

Question 15

Which of the following is a cause of hyperhomocysteinemia?

Accepted Answer

A)  Deficiency of one of the B complex vitamins 
B)  Excess of one the B complex vitamins 
C)  Deficiency of calcium 
D)  Deficiency of sodium 
A)  Deficiency of one of the B complex vitamins 
B)  Excess of one the B complex vitamins 
C)  Deficiency of calcium 
D)  Deficiency of sodium

Question 16

The albumin cobalt-binding test is used to measure which of the following?

Accepted Answer

A)  Microalbumin 
B)  Ischemia modified albumin 
C)  Albumin/globulin ration 
D)  Serum cobalt 
A)  Microalbumin 
B)  Ischemia modified albumin 
C)  Albumin/globulin ration 
D)  Serum cobalt

Question 17

Which of the following cardiac biomarkers is a better biomarker of plaque instability?

Accepted Answer

A)  MPO 
B)  CRP 
C)  Lp-PLA2 
D)  Leptin 
A)  MPO 
B)  CRP 
C)  Lp-PLA2 
D)  Leptin

Question 18

Myoglobin is a good cardiac marker because it:

Accepted Answer

A)  Diffuses into the blood more quickly than CK-MB. 
B)  Diffuses into the blood more slowly than CK-MB. 
C)  Doesn't diffuse into the blood at all when cardiac tissue dies. 
D)  Is an extremely large protein and therefore does not diffuse into the blood very easily. 
A)  Diffuses into the blood more quickly than CK-MB. 
B)  Diffuses into the blood more slowly than CK-MB. 
C)  Doesn't diffuse into the blood at all when cardiac tissue dies. 
D)  Is an extremely large protein and therefore does not diffuse into the blood very easily.

Question 19

High blood levels of adiponectin are associated with:

Accepted Answer

A)  Reduced risk of heart attacks. 
B)  Increased risk of heart attacks. 
C)  Increased risk of plaque rupture. 
D)  Stabilizing endothelial cell structure. 
A)  Reduced risk of heart attacks. 
B)  Increased risk of heart attacks. 
C)  Increased risk of plaque rupture. 
D)  Stabilizing endothelial cell structure.

Question 20

Risk factors for the development of coronary heart disease include which of the following?

Accepted Answer

A)  Tobacco smoking, elevated serum homocysteine, low serum LDL, and high serum levels of CRP 
B)  Tobacco smoking, low serum homocysteine, low serum LDL, and high serum levels of CRP 
C)  Hypertension, abdominal obesity, low HDL-C, high serum levels of CRP, and elevated levels of homocysteine 
D)  Walking at least one hour per day, low serum homocysteine, low serum CRP, and low serum levels of LDL-C 
A)  Tobacco smoking, elevated serum homocysteine, low serum LDL, and high serum levels of CRP 
B)  Tobacco smoking, low serum homocysteine, low serum LDL, and high serum levels of CRP 
C)  Hypertension, abdominal obesity, low HDL-C, high serum levels of CRP, and elevated levels of homocysteine 
D)  Walking at least one hour per day, low serum homocysteine, low serum CRP, and low serum levels of LDL-C

Exam 18: Cardiac Function

Lp (a) is considered a risk factor for developing atherosclerosis due to which of the following?

The atherogenic effect of homocysteine is:

Which of the following is an early (i.e., rapidly in similar fashion to myoglobin) biomarkers of acute myocardial infarction?

Which of the following is an advantage of POCT for cardiac biomarkers?

The presence of heterophile antibodies, rheumatoid factor, increased blood levels of hemoglobin and circulating cTnI autoantibodies can result in which of the following?

In which of the following disorders is measurement of brain type natriuretic peptide (BNP) clinically useful?

NT-pro-BNP consist of 76 amino acids and is described as a:

The role of cardiac biomarkers includes which of the following?

Infusion of Nesiritide is documented to act as a confounder for which of the following assays?

What is the clinical usefulness of measuring serum adiponectin?

Which of the following statements is TRUE about cTnI?

Which of the following represents the correct sequence for the rise and fall of myoglobin, CK-MB, and cTnI after an AMI?

Atherosclerosis is described as:

Elevated blood levels of pregnancy-associated plasma protein A (PAPP-A) may suggest which of the following?

Which of the following is a cause of hyperhomocysteinemia?

The albumin cobalt-binding test is used to measure which of the following?

Which of the following cardiac biomarkers is a better biomarker of plaque instability?

Myoglobin is a good cardiac marker because it:

High blood levels of adiponectin are associated with:

Risk factors for the development of coronary heart disease include which of the following?

Laboratory Basics

Safety in the Clinical Chemistry Laboratory

Laboratory Statistics, Method Development and QC

Instrumentation, Laboratory Automation, and Informatics

Immunoassays

Molecular Diagnostics

Carbohydrates

Lipids

Proteins

Enzymes

Nonprotein Nitrogen Questions

Body Water and Electrolyte Homeostasis

Blood Gases, PH, and Acid-Base Balance

Mineral and Bone Metabolism

The Endocrine System

Gastrointestinal Function

Pancreas

Liver

Iron, Porphyrins, and Hemoglobin

Therapeutic Drug Monitoring

Toxic Substances

Nutrition and Vitamins

Tumor Markers

Geriatrics

Pediatrics

Filters