CLINICAL
CHEMISTRY
1. The
process that encompasses all aspects of laboratory operating including patient
identification, specimen collection, equipment maintenance, and the reporting
of patient results:
a. Accuracy
b. Reliability
c. Quality
assurance
d. Quality control
2. The
process that monitor’s each laboratory analysis, using material with known
constituent concentrations, in order to ensure the accuracy of the test results
is:
a. Pooled
control
b. Quality
assurance
c. Quality control
d. Accuracy
monitoring
3. A
technique used to detect unlikely combination of values.
a. Previous
value check
b. Alert
check
c. Pattern recognition
d. Randomized
duplicate specimens
4. A
mean value of 100 and standards deviation of 1.8 mg/dL were obtained from a set
of glucose measurements on a control solution. The 95% confidence interval in
mg/dL would be:
a. 94.6-105.4
b. 96.4-103.6
c. 97.3-102.7
d. 98.2-101.8
5. The
following five sodium control value (mEq/L) were obtained:
140,
135, 138, 140, 142
Calculate the coefficient of variation.
a. 1.9%
b. 5.6%
c. 2.7%
d. 6.1%
6. This
test is used to compare means between two groups of data.
a. T-test
b. Pattern
recognition
c. F-test
d. Average
of normal
7. If
the sample population and the method used in the same as those described in the
manual, what is the minimum number of individuals that can be tested to obtain
the reference range, provided that no more than 2 results outside the expected
range?
a. 5
b. 15
c. 10
d. 20
8. The
pairest type of reagent water is:
a. Type
I
b. Type
II
c. Type III
d. All
9. Type
of extinguisher for Class C fires:
a. Water,
dry chemical, loaded stream
b. Carbon dioxide, dry chemical, halon
c. Metal
X
d. None
10. Chemicals
should be stored:
a. Alphabetically,
for easy accessibility
b. Inside
a safety cabinet with proper ventilation
c. According
to their chemical properties and classification
d. Inside
a fume hood, if toxic vapors can be released when opened
11. 20oC
= ___oF
a. 25
b. 53
c. 68
d. 86
12. 75oF
= ___oC
a. 15.5
b. 21.0
c. 23.8
d. 32.6
13. It
is used for nonviscous fluid, self-draining; small amount left in the tip
should not be blown out.
a. Volumetric pipet
b. Ostwald
Folin
c. Micropipattes
d. Pasteur
pipet
14. The
etched rings on the top of a pipette means:
a. The
pipette should be allowed to drain and the last drop should remain in the
pipette
b. The
last drop is to be known out after the pipettes drain
c. The
pipette is color coded
d. The pipette is a volumetric pipette
15. The
preferred length of the lancet for skin puncture should be ___ to avoid
penetrating the bone.
a. 1.75
mm
b. 2.0 mm
c. 2.25
mm
d. 2.5
mm
16. Specimens
that require chilling (4oC)
1. Ammonia
2. Lactic acid
3. Blood gases
4. Renin
a. 1 and 3
b. 2
and 4
c. 1,
2 and 3
d. 1,
2, 3 and 4
17. A
medical technologies on duty in the Clinical Chemistry section received a
sterile bottle containing CSF. What should he or she do first?
a. Centrifuge
the fluid
b. Measure
the volume
c. Put
it inside the freezer set at 2o degrees Celsius
d. should verify if it is the only bottle
collected from the patient
18. Analytical
testing performed outside the confines of the central laboratory, usually by
nonlaboratorian personnel (nurse, respiratory therapist etc.)
1. Point of care testing (POCT)
2. Decentralized testing
3. Near-patient testing
4. Alternate site testing
a. 1
and 3
b. 2
and 4
c. 1,
2 and 3
d. 1, 2, 3 and 4
19. Beer’s
law states that the concentration of a substance is (1)___ proportional to the
amount of light absorbed or (2)___
proportional to the logarithm of the transmitted light.
a. Directly, inversely
b. Inversely
c. Both
directly proportional
d. Both
inversely proportional
20. The
more light absorbed, the higher the concentration of analyte in this technique
of measuring the amount of light absorbed by a solution.
a. Atomic
absorption
b. Fluorometry
c. Nephelometry
d. Spectrophotometry
21. The
process by which fluorescence of an analyte is reduced due to the excited
molecule losing some of its energy by interacting with other substances in
solution is known as:
a. Ionization
b. Quenching
c. Phosphorescence
d. Self-absorption
22. 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
d. Dry-slide analysis
23. Direct
injection of a sample into very small diameter tubing, thus minimizing lateral
diffusion best describes:
a. Automatic
clinical analysis
b. Centrifugal
analysis
c. Continuous-flow
analysis
d. Flow-injection analysis
24. Which
analyzer requires that the sample and reagent be pipeted inyo separate chambers
in a rotor prior to the chemical analysis being performed?
a. Centrifugal
b. Continuous
flow
c. DuPont
aca
d. Kodak
dry, slide
25. An
instrument that can analyze patient samples for only those tests specifically ordered
and can analyze stat samples by interrupting the normal sequence of patient
analyses is referred to as:
a. Batch
analyzer
b. Discrete analyzer
c. Multitest
analyzer
d. Random-access
analyzer
26. In
a chemical reaction, the amount of product formed is measured at 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
d. Ultraviolet
27. Dubowski
method for glucose utilizes:
a. Phosphomolybdic
acid
b. Arsenomolybdic acid
c. Ortho-toluidine
d. Potassium
ferricyanide
28. C-peptide
is formed during the conversion of pro-insulin to insulin. The amount of
circulating C-peptide provides reliable indicators for pancreatic and insulin
secretions (beta cell function). It is decreased in:
a. Insulinoma
b. Ingestion
of hypoglycemic drugs
c. Type 1 DM
d. Type
2 DM
29. CSF
glucose concentration is approximately ___ that of plasma concentration.
a. 50%
b. 60-70%
c. 80-100%
d. 65-85%
30. Every
1% change in the HBA1C value causes a change of approximately ___ in the plasma
glucose.
a. 10
mg/dL
b. 25 mg/dL
c. 15
mg/dL
d. 35
mg/dL
31. A
turbidimetric method used for the quantitation of total protein in urine and
cerebrospinal fluid specimens is:
a. Biuret
b. HABA
c. Coomassie
blue
d. SSA
32. Which
of the following nutritional markers has been found to be most sensitive and
helpful indicator of nutritional status in very ill patients?
a. Transthyretin
b. Transferrin
c. Albumin
d. Somatomedin
C
33. Patient
with Nephrotic Syndrome is expected to have which of the following results in
serum protein electrophoresis?
a. Decreased
in all fractions except albumin region
b. Decreased in all fractions except alpha
1 region
c. Decreased
in all fractions except alpha 2 region
d. Decreased
in all fractions except beta region
34. Decreased
serum albumin levels may be associated with:
a. Malnutrition
b. Liver
disease
c. Kidney
disease
d. Both
B and C
e. A, B and C
35. Which
of the following is a negative acute phase reactant?
a. Prealbumin
b. Ceruloplasmin
c. Albumin
d. Haptoglobin
36. A
protein that precipitates in acid solution but redissolves upon heating best
describes:
a. Albumin
b. Bence Jones
c. Haptoglobin
d. Transferrin
37. Which
dye may be used to stain serum protein fractions following electrphorosis?
a. Amido
black
b. Ponceau
S
c. Fat
red
d. Both A and B
e. A,
B and C
38. The
method of choice for quantifying protein fractions following electrophoresis?
a. Densitometry
b. Fluorometry
c. Spectrophotometry
d. Nephelometry
39. The
acute-phase reactant that is able to inhibit enzymatic proteolysis is:
a. Alpha1
antitrypsin
b. Complement
c. Haptoglobin
d. Prealbumin
40. The
screening procedure useful in detecting PKU is:
a. Copper
reduction
b. Glucose
oxidase
c. Ferric
chloride
d. Nitroprusside
41. Which
of the following elevates carboxyhemoglobin?
a. Nitrite
poisoning
b. Exposure to carbon monoxide
c. Sulfa
drug toxicity
d. Sickle
cell anemia
42. CDC
reference method for determination of cholesterol:
a. Liebermann
Burchardt reaction
b. Salkowski
reaction
c. Cholesterol
oxidase reaction
d. Abell,
Levy and Brodie method
43. When
TAG and LDL-c are being measured, fasting becomes a requirement. Require
fasting of patients:
a. 2
to 4 hours
b. 4
to 6 hours
c. 6
to 8 hours
d. 12 to 14 hours
44. A
cholesterol QC chart has the following date for the normal control:
x = mean of data
x = 137 mg/dL Sx
= 1,918 mg/dL
2 SD = 6 mg/dL N =
14
The coefficient of variation
for this control is:
a. 1.14%
b. 4.38%
c. 2.19%
d. 9.49%
45. The
function of the major lipid components of the very low density lipoproteins
(VLDL) is to transport:
a. Cholesterol
from peripheral cells to the liver
b. Exogenous
triglycerides
c. Cholesterol and phospholipids to
peripheral cells
d. Endogenous
triglycerise
46. What
is the reference method for quantitation of lipoproteins (LPPs)
a. Liberman
Burchardt
b. Van
Handel and Zilversmith
c. Abell-Kendall
d. Ultracentrifugation
47. Which
of the following lipoproteins is the smallest of all the lipoproteins and is
composed of 50% proteins?
a. HDL
b. LDL
c. Chylomicrons
d. Triglycerides
48. It
is the major and product from the cetabolism of VLDL. It constitutes about 50%
of the total LPP in plasma:
a. CM
b. LDL
c. VLDL
d. HDL
49. Which
of the following would be most adversely affected by a nonfasting sample?
a. HDL
b. Cholesterol
c. LDL
d. Triglycerides
50. Method
of uric acid determination that has problem with turbidity and several common
drugs interface:
a. Colorimetric
b. Enzymatic
H2O2
c. Enzymic
UV
d. IDMS
51. Method
of urea determination that is inexpensive but lacks specificity:
a. Colorimetric and point
b. Enzymatic
c. Colorimetric
kinetic
d. IDMS
52. Method
of measurement of ceratinine that measures ammonia colorimetrically or with
ISE:
a. Colorimetric
and point
b. Enzymatic
c. Colorimetric
kinetic
d. IDMS
53. One
international unit of enzyme activity is the amount of enzyme that under
specified reaction conditions of substrate concentration, pH and temperature,
causes usage of substrate at the rate of:
a. 1 millimole/min
b. 1
nanomole/min
c. 1
micromole/min
d. 1
picomole/min
54. Which
of the following enzymes are classified as transferases?
1. ACP
2. ALP
3. PK
4. Glycogen
phosphorylase
a. 1,
2, 3 and 4
b. 1,
2 and 4
c. 1,
2 and 3
d. 1 and 2
e. 3
and 4
55. This
measures the amount of reducing sugars produced by the hydrolysis of starch by
the usual glucose methods. Classic reference method expressed in Somogyi units
a. Saccharogenic
b. Chromogenic
c. Amyloclastic
d. Coupled-enzyme
56. The
reference method for determination of lipase:
a. Tietz
and Fiereck
b. Peroxidase
coupling
c. Cherry Crandal
d. Kermen
57. When
an enzyme requires an inorganic substance such as zinc for activity, this
substance is termed as a(n):
a. Activator
b. Conezyme
c. Facilitator
d. Regulator
58. Which
of the following are considered primary tissue source of alkaline phosphatase?
a. Liver, bone, kidney
b. Liver,
heart, kidney
c. Kidney,
pancreas, heart
d. Prostate,
liver, bone
59. Which
of the following enzymes exhibits the least tissue specificity?
a. ACP
b. AST
c. CK
d. LD
60. Which
of the following may be associated with the creatine kinase isoenzymes?
a. CK-1
referred to as CK-MM
b. CK-3
remains close to the origin during electrophorosis
c. CK-MM
is found in skeletal muscles
d. Both
B and C
e. A,
B and C
61. Which
of the following enzymes is most useful in establishing the hepatic origin of
an elevated serum alkaline phosphatase?
a. Alanine
aminotransferase
b. Aspartate
aminotransferase
c. Ornithine
carbamyltransferase
d. Gamma-glutamyltranspeptidase
e. Lactate
dehydrogenase
62. In
the Bessey-Lowry-Brock method for determining alkaline phosphatase activity,
the substrate used is:
a. Monophosphate
b. Phenylphosphate
c. Disodium
phenylphosphate
d. Para-nitrophenylphosphate
63. Regan
isoenzyme has the same properties as alkaline phosphatase that originates in
the:
a. Skeleton
b. Intestine
c. Kidney
d. Placenta
64. Which
of the following may be classified as being a function of the liver?
a. Detoxification
of drugs
b. Excretion
of bile acids
c. Metabolism
of glucose
d. Synthesis
of proteins
e. All of the above
65. Increased
blood ammonia levels may be associated with:
a. Hepatic
encephalopathy
b. Neurological
changes
c. Coma
d. Both
B and C
e. A, B and C
66. Which
of the following methods estimates the urine sugar concentration by measuring
total reducing substances?
a. Copper
sulfate
b. Glucose oxidase
c. Hexokinase
d. Ferricyanide
67. A
patient with insulinoma may exhibit dizziness and fainting attributable to:
a. Acidosis
b. Ketosis
c. Hypoglycemia
d. Hyperglycemia
68. Precipitating
agents used to remove VLDL and HDL from serum so that only the HDL cholesterol
remains for measurement include all of the following, except:
a. Citrate/fluoride
b. Heparin/manganese
c. Phosphotungstate/magnesium
d. Dextran
sulfate
69. Which
electrolyte is significantly involved in the transmission of nerve impulse?
a. Iron
b. Phosphorus
c. Potassium
d. Sodium
70. The
composition of the electrode used to measure blood pH is:
a. Glass
b. Plastic
c. Platinum
d. Valinomycin
71. The
role of calciumin body metabolism is that of:
a. Structural
contribution to bone formation
b. An
activator of the coagulation system
c. Facilitating
transmission form of nerve impulse
d. Both A and B
e. A,
B and C
72. The
physiologically active form of calcium is:
a. Complexes
b. Ionized
c. Lipid-bound
d. Protein-bound
73. A
hospitalized patient is experiencing increased neuromuscular irritability
(tetany). Which of the following tests should be ordered immediately?
a. Calcium
b. Phosphorus
c. BUN
d. Glucose
74. The
formation of molybdenum blue complex is assocaited with the quantitation of:
a. Calcium
b. Iron
c. Magnesium
d. Phosphate
75. Which
of the following clinical disorders is/are associated with magnesium
deficiency?
a. Tetany
b. Convulsions
c. Abnormal
cardiac rhythm
d. Both
A and B
e. All
of the above
76. Increased
anion gap:
1. Uremia
2. Poisoning
by methanol
3. Ketoacidosis
4. Hypoalbuminemia
a. 1
and 3
b. 2
and 4
c. 1,
2 and 3
d. 1, 2, 3 and 4
77. Glucose
tolerance factor contains the following trace metal:
a. Copper
b. Chromium
c. Selenium
d. Zinc
78. The
following metal is most associated with the “dimentia of dialysis”:
a. Aluminum
b. Fluorine
c. Cadmium
d. Zinc
79. An
emphysema patient suffering from fluid accumulation in the alveolar spaces is
likely to be in what metabolic state?
a. Respiratory
acidosis
b. Metabolic
acidosis
c. Respiratory alkalosis
d. Metabolic
alkalosis
80. The
neurohypophysis is the:
a. Hypothalamus
b. Anterior pituitary
c. Pineal
gland
d. Thyroid
gland
e. Posterior
pituitary
81. The
anterior pituitary produces all of the following hormones, except:
a. ACTH
b. FSH
c. PTH
d. TSH
82. For
a hormone to be biochemically active and able to bind its receptor site, the
hormone must be:
a. Bound
to glucose
b. Bound
to lipoprotein
c. Bound
to protein
d. Free, not bound to protein
83. Which
amino acid is directly involved in thyroid synthesis?
a. Alanine
b. Glutamine
c. Threonine
d. Tyrosine
84. TSH
test is the most important thyroid function test. The best screening test. It
is increased in:
1. primary
hypothyroidism
2. hashimoto’s
thyroidism
3. thyrotoxicosis
due to pituitary tumor
4. primary
hyperthyroidism
a. 1
and 3
b. 2
and 4
c. 1,
2 and 3
d. 1, 2, 3 and 4
85. In
patients with developing subclinical hyperthyroidism, TSH levels will likely be
___, and fT4 will be likely ___.
a. Decreased, increased
b. Increased,
decreased
c. Decreased,
normal
d. Increased,
normal
86. Which
of the following tests may be used in the differential diagnosis of depression?
a. ACTH
stimulation test
b. Dexamethasone suppression test
c. Metapirone
inhibition test
d. Metyrapone
inhibition test
87. The
parent substance in the biosynthesis of androgens and estrogen is:
a. Cortisol
b. Catecholamines
c. Progesterone
d. Cholesterol
88. The
biologically most active, naturally occuring androgen is:
a. Androstenedione
b. Epiandrosterone
c. Dehydroepiandrosteron
d. Testosterone
89. The
amino acid that is the immediate precursor for the biogensis of the
catecholamine is:
a. Tryptophan
b. Threonine
c. Tyrosine
d. Phenylalanine
90. All
of the following biochemical changes are seen during pregnancy, except:
a. Decreased
albumin
b. Increased alkaline phosphatase
c. Increased
FSH and LH
d. Increased
estrogens
91. Major
actions of angiotensin II include:
a. Increased
pituitary secretion of rennin
b. Increased
parathyroid hormone secretion by the parathyroid
c. Increased
vasoconstriction
d. Decreased adrenal secretion of
aldosterone
92. Estrogen
and progestrogen receptor assays are useful in assessing prognosis in which of
the following?
a. Ovarian
cancer
b. Endometriosis
c. Breast
canser
d. Amenorrhea
93. Zinc
protoporphyrin or free erythrocyte protoporphyrin measurements are useful to
assess blood concentrations of:
a. Lead
b. Mercury
c. Arsenic
d. Beryllium
94. Pharmacological
parameters that determine serum drug concentration:
1. Liberation
2. Absorption
3. Distribution
4. Metabolism
5. Excretion
a. 1
and 3
b. 2
and 4
c. 1,
2, 3 and 4
d. 1, 2, 3, 4 and 5
95. A
cardiac glycoside that is used in the treatment of congenital heavy failure and
arrythmias by increasing the force and velocity of myocardial contraction is:
a. Digoxin
b. Acetaminophen
c. Lithium
d. Phenytoin
96. It
is used for treatment of petit mal (absence seizure) and grand mal.
a. Theophylline
b. Lithium
c. Valproic
acid (Depakene)
d. Digoxin
97. The
drug of choice for controlling petit mal (absence seizure).
a. Phenobarbital
b. Carbamazepine
c. Vancomycin
d. Ethosuximide (Zarontin)
98. All
of the following may be used to cleanse the skin when drawing blood for ethanol
analysis, except:
a. Alcohol
swab
b. Merthiolate
c. Soap
and water
d. Zephiran
99. Substances
with modified structures that are analogs of prescription pharmaceuticals or
abused are known as:
a. Designer
drugs
b. Generic drugs
c. Trade
drugs
d. Toxic
drugs
100.
Morphine is the major metabolism
of:
a. Cocaine
b. Heroin
c. Marijauna
d. Phnecyclidine
