Deck 10: Introduction to Clinical Chemistry

Question 1

The first step in the laboratory determination of serum cholesterol is to ensure that all cholesterol present is in the free form.This is accomplished with the use of:

A) cholesterol esterase.
B) glycerol.
C) cholesterol oxidase.
D) lipase.

Answer 1

cholesterol esterase.

Question 2

The term for the condition associated with elevated serum potassium is:

A) hyponatremia.
B) hypernatremia.
C) hypokalemia.
D) hyperkalemia.

Answer 2

hyperkalemia.

Question 3

The term chloride shift refers to the:

A) exchange of chloride with sodium to maintain electrical neutrality.
B) exchange of chloride with bicarbonate between red blood cells and plasma.
C) contribution of chloride to serum osmolality.
D) kidney's excretion of chloride by the renal tubules.

Answer 3

exchange of chloride with bicarbonate between red blood cells and plasma.

Question 4

The primary form of nonprotein nitrogen in the blood is:

A) urea.
B) creatinine.
C) cystatin C.
D) creatine.

Question 5

Which of the following methods is not used to quantitate glucose levels?

A) Glucose oxidase
B) Glucose dehydrogenase
C) Clinitest
D) Hexokinase

Question 6

Which of the following laboratory tests assist in the diagnosis of heart failure?

A) BNP
B) Fibrinogen
C) CRP
D) D-dimer

Question 7

Osmolality measures:

A) the number of sodium ions in plasma.
B) the number of sodium ions in urine or plasma.
C) total concentration of all ions and molecules in serum or urine.
D) total concentration of all ions and molecules in plasma.

Question 8

Which of the following conditions is least likely to contribute to an increased serum uric acid level?

A) Chemotherapy
B) Renal disease
C) Liver disease
D) Gout

Question 9

Estimation of the blood glucose level over the previous 4 to 6 weeks is determined with which test?

A) HbA1c
B) Ketones
C) Clinitest
D) Microalbumin

Question 10

An adult male has a serum BUN of 56 mg/dL and a creatinine of 0.8 mg/dL.These results are consistent with:

A) decreased GFR.
B) prerenal azotemia.
C) renal azotemia.
D) postrenal azotemia.

Question 11

A major benefit of point-of-care testing (POCT)for blood glucose is that it:

A) allows for immediate intervention.
B) does not require oversight by the laboratory.
C) can only be performed by laboratory personnel.
D) eliminates the need for glucose testing in the laboratory.

Question 12

Fasting lipid profile results for a 48-year-old male with diabetes are as follows: total cholesterol: 298 mg/dL,HDL cholesterol: 26 mg/dL,and triglycerides: 320 mg/dL.The patient has no evidence of coronary artery disease (CAD).What is the recommended course of action?

A) The LDL is normal, and no action is indicated.
B) The LDL is elevated, and the therapeutic goal is to decrease it to less than 100 mg/dL.
C) The LDL is elevated, and the therapeutic goal is to decrease it to less than 130 mg/dL.
D) The LDL is elevated, and the therapeutic goal is to decrease it to less than 160 mg/dL.

Question 13

Which of the following hormones lowers the blood glucose level by promoting glucose entry into cells?

A) Cortisol
B) Glucagon
C) Insulin
D) Thyroxine

Question 14

The anticoagulant of choice for glucose testing when analysis is not performed promptly is:

A) EDTA.
B) sodium fluoride.
C) lithium heparin.
D) sodium citrate.

Question 15

Contributory factors to which form of diabetes include a genetic predisposition and autoimmune destruction of pancreatic b cells?

A) Type 1
B) Type 2
C) Gestational diabetes mellitus
D) Stress-induced hyperglycemia

Question 16

Determination of plasma sodium with an ion-selective electrode (ISE)will be altered if the specimen is lipemic (increased plasma lipids)in which manner?

A) Increased with a direct ISE method
B) Increased with an indirect ISE method
C) Decreased with a direct ISE method
D) Decreased with an indirect ISE method

Question 17

An increased anion gap may be due to:

A) lactic acidosis.
B) hypercalcemia.
C) hypermagnesemia.
D) hypoproteinemia.

Question 18

The adult reference range for fasting serum glucose is ____ mg/dL.

A) 40-75
B) 55-105
C) 60-95
D) 70-110

Question 19

Laboratory diagnosis of an acute myocardial infarction (MI)is most accurately determined with which of the following two cardiac markers?

A) CK-MB and homocysteine
B) CRP (C-reactive protein) and cardiac troponin
C) Myoglobin and lactate dehydrogenase (LDH)
D) Myoglobin and cardiac troponin

Question 20

Hypoglycemia is not a consequence of:

A) insulinoma.
B) islet cell hyperplasia.
C) insulin resistance.
D) glycogen storage disease.

Question 21

Which of the following enzymes is normally found in highest levels in hepatocytes,or liver cells?

A) ALT
B) AST
C) GGT
D) Alkaline phosphatase

Question 22

MATCHING
Match the following terms with the correct description. Use an answer only once.
respiratory acidosis

A)decreased plasma bicarbonate
B)excess elimination of acid
C)acid-rich fluids are lost
D)decreased elimination of CO₂

Question 23

The two enzymes used in the diagnosis of acute pancreatitis are:

A) AST and ALT.
B) amylase and lipase.
C) alkaline phosphatase and amylase.
D) GGT and lipase.

Question 24

MATCHING
Match the following terms with the correct description. Use an answer only once.
metabolic acidosis

A)decreased plasma bicarbonate
B)excess elimination of acid
C)acid-rich fluids are lost
D)decreased elimination of CO₂

Question 25

Match the name of the tumor specific marker assay with an appropriate application.
CEA

A)suggests early recurrence of breast cancer
B)secreted in endodermal sinus tumors
C)detected in choriocarcinoma
D)found in 20% of smokers

Question 26

Match the name of the tumor specific marker assay with an appropriate application.
alpha fetoprotein

A)suggests early recurrence of breast cancer
B)secreted in endodermal sinus tumors
C)detected in choriocarcinoma
D)found in 20% of smokers

Question 27

A reversal of the normal serum albumin/globulin (A/G)ratio occurs in ____ disease.

A) heart and lung
B) kidney and bone
C) heart and liver
D) kidney and liver

Question 28

Match the name of the tumor specific marker assay with an appropriate application.
CA 27.29

A)suggests early recurrence of breast cancer
B)secreted in endodermal sinus tumors
C)detected in choriocarcinoma
D)found in 20% of smokers

Question 29

Match the name of the tumor specific marker assay with an appropriate application.
b-hCG

A)suggests early recurrence of breast cancer
B)secreted in endodermal sinus tumors
C)detected in choriocarcinoma
D)found in 20% of smokers

Question 30

Free T₄ is ____ and thyroid stimulating hormone is ____ in hypothyroidism.

A) increased; decreased
B) decreased; increased

Question 31

MATCHING
Match the following terms with the correct description. Use an answer only once.
metabolic alkalosis

A)decreased plasma bicarbonate
B)excess elimination of acid
C)acid-rich fluids are lost
D)decreased elimination of CO₂

Question 32

It is important to record the exact time and date in relation to the last dose of the drug when drawing a blood specimen for therapeutic drug monitoring.

Question 33

MATCHING
Match the following terms with the correct description. Use an answer only once.
respiratory alkalosis

A)decreased plasma bicarbonate
B)excess elimination of acid
C)acid-rich fluids are lost
D)decreased elimination of CO₂

Question 34

Which of the following is the least utilized role of a tumor marker?

A) Cancer screening
B) Cancer diagnosis
C) Monitoring of patients for a recurrence of cancer
D) Determination of the extent of tumor burden

Question 35

In bilirubin assays,conjugated bilirubin is referred to as ____ reacting bilirubin.

A) unconjugated
B) total
C) indirect
D) direct