Chemistry BOR – Flashcards

Carbohydrates

Following overnight fasting, hypoglycemia in adults is defined as a glucose of:

Carbohydrates:

The following results are from a 21 year old patient with a back injury that appears otherwise healthy

whole blood glucose:   77 mg/dL

serum glucose:         88 mg/dL

CSF glucose:           56 mg/dL

Carbohydrates:

The preparation of a patient for standard glucose tolerance testing should include:

Carbohydrates:

If a fasting glucose was 90 mg/dL, what 2 hour post-prandial glucose would most closley represent normal glucose metabolism.

Carbohydrates:

A healthy person with a blood glucose of 80 mg/dL would have a simultaneously determined CSF glucose of:

Carbohydrates:

A 25 year old man became nauseated and vomited 90 mins after recieving a standard 75g carbohydrate dose for an oral glucose tolerance test. The best course of acton would be to:

Carbohydrates:

Cerebrospinal fluid for a glucose assay should be:

Carbohydrates:

What post-prandial glucose value demonstrates unequivocal hyperglycemia diagnostic for diabetes mellitus?

Carbohydrates:

Serum levels that define hypoglycemia in pre-term or low birth weight infants  are:

Carbohydrates:

A 45 year old woman has a serum glucose concentration of 95 mg/dL and a 2 hour post prandial glucose concentration of 105 mg/dL. The statement which best describes her is:

Carbohydrates:

Pregnant women with symptoms of thirst , frequent urination or unexplained weight loss should have which of the following test performed?

Carbohydrates:

In a fasting state the arterial and capillary blood glucose concentration varies from the venous glucose concentration by approximately how many mg/dL?

Carbohydrates: 

The conversion of glucose or other hexoses into lactate or pyruvate is called?

Carbohydrates:

Which value obtained during a glucose tolorance test are diagnostic of diabetes mellitus?

Carbohydrates:

The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding:

Carbohydrates:

Monitoring long term glucose control in patients with adult onset diabetes can best be accomplished by measuring :

Carbohydrates:

The patient with type 1, insulin dependant diabetes mellitus has the following results:

fasting blood glucose      150 mg/dl

hemoglobin A1c                8.5%

fructosamine                   2.5 mg/dL

after recieving these test results, the technologist concluded that the patient is in a:

Carbohydrates:

Total glycosylated hemoglobin levels in a hemolysate reflect the:

Carbohydrates:

Which of the following hemoglobin levels has glucose-6-phosphate on the amino-terminal valine of the beta chain?

Carbohydrates:

A patient with hemolytic anemia will:

Carbohydrates:

In using ion-exchange chromatographic methods, falsely increased levels of Hgb A_1C might be demonstrated in the presence of

Carbohydrates:

An increase in serum acetone is indicative of a defect in the metabolism of:

Carbohydrates:

An infant with diarrhea is being evaluated for a Carbohydrate intolerance. His stool yealds a postive copper reduction test and a Ph of 5.0. It should be concluded that:

Carbohydrates:

Samples are collected at the beginning of an exercise class and after 30 mins of aerobic activity. Which of the following would be most consistant with the post exercise sample?

Carbohydrates:

What is the best method to diagnose lactase deficency?

Acid base balance

The expected blood glucose result for a patient in chronic renal failure would match what pattern?

Acid base balance

Severe diarrhea causes:

Acid base balance

Thr following blood gas results were obtained:

Ph 7.18 (7.35-7.45)

PO₂= 86 mm Hg (25 - 29 mm Hg)

PCO₂= 60 mm Hg (35-45)

O₂ saturation =90%

HCO₃= 21 mmol/L(22-26)

TCO₂= 23 mmol/L

base excess -8 mmol/L

The patients results are compatible with what?

Acid base balance

Factors that contribute to a PCO₂ electrode requiring 60-120 seconds to reach equilibrium include the:

Acid base balance

An emphysema patient suffering from fluid accumulation in the alveolor space is likely to be in what metabolic state?

Acid base balance

At blood Ph 7.40, what is the ratio of bicarbonate to carbonic acid:

Acid base balance

The reference range for Ph of arterial blood measured at 37*C is:

Acid base balance

A 68 year old man arrives in the emergency room with a glucose level of 722 mg/dL and serum acetone  of 4+ undiluted. An arterial blood gas from this patient is likely to be:

Acid base balance

A patient is admitted to the emergency room in a state of metabolic alkalosis. What is consistant with this diagnosis:

Acid base balance

A person suspected of having metabolic alkalosis would have which of the following laboratory findings?

Acid base balance

Metabolic acidosis is described as :

Acid base balance

Respiratory acidosis is described as an:

Acid base balance

A common cause of respiratory alkalosis is

Acid base balance

Acidosis and alkalosis are best defined as fluctuations in blood Ph and CO₂ content due to:

Acid base balance

A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood had been exposed to room air for at least 30 mins. The following change in blood gases will occur:

Acid base balance

The following laboratory results were obtained:

Serum electrolytes

NA =                              136  (135 to 145 )

K=                                  4.4   (3.5 to 5 mEq/L)

Cl=                                  92   (98 - 108 mmol/L.)

Bicarb=                           40  (22-26 mmol/L)

arterial blood:

Ph=                                 7.32  (7.35-7.45)

PCO₂=                                79  (35-45mmHg)

These results are most compatible with

Acid base balance

Select the test which evaluates renal tubular function

Acid base balance

A patient had the following serum results:

NA=          140

K=              4.0

glucose=     95

BUN=          10

Which osmolality is consistant with these results.

Acid base balance

The degree to which the kidney concentrates the glomerular filtrate can be determined by

Acid base balance

Osmolal gap is the difference between

Electrolytes

The most important buffer pair in plasma is the:

Electrolytes

Quantitation of NA and K by ion selective electrode is the standard method because:

Electrolytes

What battery of test is most useful in evaluating an anion gap of 22 mEq/L

Electrolytes

A patient with myeloproliferative disorder has the following values:

Hgb =            13

Hct=             38%

WBC=           30x10⁶

platelets =     100x10³

serum Na=     140

serum K=        7  what!!!

The serum K should be confirmed by

Electrolytes

Most of the carbon dioxide present in blood is in the form of :

Electrolytes

Serum anion gap is increased in patients with:

[image]

Electrolytes

The anion gap is useful for quality control of labratory results for:

Electrolytes

The buffering capaciy of blood is maintained by a reversible exchange process between bi-carbonate and ??

Electrolytes

In respiratory acidosis a compensitory mechanism is the increase in:

Electrolytes

Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?

Electrolytes

A potassium level of 6.8 is obtained. Before reporting the results, the first step the technologist should take is to

Electrolytes

The solute that contributes the most to the total serum osmolality is:

Electrolytes

A sweat chloride of 55 mEq/L and a sweat sodium of 52 mEq/L were obtained on a patient who has a history of respriatory problems. The best interpretation of these results is:

Electrolytes

What is true about direct ion selective electrodes for electrolytes?

Electrolytes

Sodium determination by indirect ion selective electrode is falsely decreased by:

Electrolytes

A physician requested that electrolytes on a multiple myeloma patient be run by direct ISE and not indirect because:

Electrolytes

What percentage of total serum calcium is non-diffusible protein bound?

Electrolytes

Calcium concentration in the serum is regulated by

Electrolytes

The regulation of calcium and phosphorus metabolism is accomplished by what gland?

Electrolytes

A patient has the following test results:

Increased serum calcium

decreased serum phosphate

increased levels of parathyroid hormone

The patient most likely has:

Electrolytes

A hospitalized patient is experiencing increased neuromuscular irritability (tetany). What test sholud be ordered immediatly?

Electrolytes

Which is most likely to be ordered in addition to serum calcium to determine the cause of tetany?

Electrolytes

;

A reciprocol relationship exist between:

Electrolytes

Fasting serum phosphate concentration is controlled primarily by the:

Electrolytes

A low concentration of serum phosphorus is commonly found in

Electrolytes

The following results were obtained:

Serum calcium increased

Serum alk phosphate decreased

Serum alk phosphatase norm or increased

urine calcium increased

urine alk phosphate increased

These results are compatible with:

Proteins and other nitrogen containing compounds

;

The primary function of serum albumin in the pheripheral blood is to:

;Proteins and other nitrogen containing compounds;

In a plural effusion caused by Streptococcus pneumoniae, the protein value of the pleural fluid as compaired to the serum value would probably be

;Proteins and other nitrogen containing compounds

;The first step in analyzing a 24 hour specimen for quantitive urine protein is:

;Proteins and other nitrogen containing compounds

;When performing a manual protein analysis on a xanthochromic spinal fluid , the technician should:

;Proteins and other nitrogen containing compounds

;The direction in which albumin mirates (toward the anode or cathode) during electrophoretic sepraton of serum proteins, at a Ph of 8.6 is determined by:

;Proteins and other nitrogen containing compounds

;the protein that has the highest dye-binding capacity is

Proteins and other nitrogen containing compounds;

pick out a serum protein electrophoresis pattern of albumin

Proteins and other nitrogen containing compounds

;The biuret reacton for the analysis of serum proteins depends on the number of

;Proteins and other nitrogen containing compounds

;In electrophoresis of proteins, when a sample is placed in an electric field connected to buffer of Ph 8.6 all of the proteins :

;Proteins and other nitrogen containing compounds;

The relative migration rate of proteins on cellulose acetate is based on:

Proteins and other nitrogen containing compounds

;The cellulose acetate electrophoresis at Ph 8.6 of serum proteins will show an order of migration beginning with the fastest migration as follows:

Proteins and other nitrogen containing compounds

;What amino acid is associated with sulfhydryl group

Proteins and other nitrogen containing compounds

;Maple syurp urine disease is characterized by an increase in which of the following urinary amino acids?

Proteins and other nitrogen containing compounds

;Increased serum albumin concentrations are seen in which of the following conditions

Proteins and other nitrogen containing compounds

;The following data was obtained from a cellulose acetate protein electrophoresis scan:

albumin area =;;;;;;;;; ;75 units

gamma globulin area; 30 units

total area;;;;;;;;;;;;;;;;; 180 units

total protein;;;;;;;;;;;;; ;6.5 g/dL

The gamma globulin content is?

;Proteins and other nitrogen containing compounds

A patient is admitted with billary cirosis. If a serum protein electrophoresis is performed, what globulin fraction will be most elevated?

Proteins and other nitrogen containing compounds

;What serum protein fraction is most likely to be elevaed in patients patients with nephrotic syndrome?

Proteins and other nitrogen containing compounds

Total protein; 7.3

albumin;;;;;;;; ;4.2

alpha-1;;;;;;;;; ;0.0;

beta;;;;;;;;;;;;; ;0.8

gamma;;;;;;;;;; ;1.4

;

Proteins and other nitrogen containing compounds

Total protein 8.9 (high)

albumin; 4.8

alpha1;; ;0.8

alpha2;;; 0.7

beta;;;; ; 0.8

gamma;;; 2.3 (high)

Proteins and other nitrogen containing compounds

Total protein; 6.1

albumin;;;;;;;;; ;2.3

alpha1;;;;;;;;;;;;; 0.2

alpha2;;;;;;;;;;;;; 0.5

beta;;;;;;;;;;;;;;;;; 1.2

gamma;;;;;;;;;;;;; ;1.9

;Proteins and other nitrogen containing compounds

;A charisteristic of bence jones protein that is used to distinguish it from other urinary proteins is its solubility:

Proteins and other nitrogen containing compounds

;The electrophrotic pattern of plasma sample as compaired to a serum sample shows a:

Proteins and other nitrogen containing compounds

;At;a Ph of 8.6 the gamma globulin move toward the cathode, dispite the fact that they are negatively charged. What is this phenomenon called?

Proteins and other nitrogen containing compounds

Total protein; ;7.8

albumin;;;;;;;;;;; 3.0

alpha1;;;;;;;;;;;;; 0.4

alpha2;;;;;;;;;;;; ;1.8 (high)

beta;;;;;;;;;;;;;;;; 0.5

gamma;;;;;;;;;;;;;;1.1

Proteins and other nitrogen containing compounds

Total protein 8.5

albumin;;;;;;;;; 4.3

alpha1;;;;;;;;;; ;0.3

alpha2;;;;;;;;;; ;0.7

beta;;;;;;;;;;;;;; 0.9

gamma;;;;;;;;;;; 2.3

Proteins and other nitrogen containing compounds

;

Analysis of CSF for oligoclonal bands is used to screen for what diease state:

;;;;;;;;;;;;;;;;;^{;( its not diagnostic)}

;Proteins and other nitrogen containing compounds

;

The identificaton of bence jones protein is best accomplished by:

Proteins and other nitrogen containing compounds

;Total iron binding capacity measures the serum iron transporting capacity of:

Proteins and other nitrogen containing compounds

;The first step in the quantitation of serum iron is:

Proteins and other nitrogen containing compounds

A patients blood was drawn at 08:00 am for a serum iron determination. The result was 85 ug/dL. A repeat specimen was drawn at 08:00 pm; the serum was stored at 4*C and run the next morning. The result was 40um/dL. These results were likely due to

Proteins and other nitrogen containing compounds

;;decreased ;serum iron associated with increased TIBC is compatible with what disease state

Proteins and other nitrogen containing compounds

;A patient has the following results:

serum iron 250( high)

TIBC 350

The best conclusion is this patient has

;Proteins and other nitrogen containing compounds

To assure an accurate ammonia level result the specimen should be

Proteins and other nitrogen containing compounds

;Erroneous ammonia levels can be eleminated by:

Proteins and other nitrogen containing compounds

;A critically ill patient becomes comatose.The;physician believes the coma is due to hepatic failure tha asssay most helpful would be:

Proteins and other nitrogen containing compounds

;A serum sample demonstrates an elevated result when tested with the jaffee reaction. This indicates

Proteins and other nitrogen containing compounds

;In order to prepare 100 ml of 15 mg/dL BUN working standards from a stock standard solution containing 500 mg/dL of urea nitrogen, the number of mL of stock solution that should be used

Proteins and other nitrogen containing compounds

;A patient with glomerulonenephritis is most likely to present with the following serum results:

Proteins and other nitrogen containing compounds

;An elevated serum iron with normal iron binding capacity is most likely associated with

Proteins and other nitrogen containing compounds

;

The principle excreatory form of nitrogen is:

Proteins and other nitrogen containing compounds

;

In the jaffee reaction cratinine reacts with:

Proteins and other nitrogen containing compounds

Creatinine clearance is used to estimate the

Proteins and other nitrogen containing compounds

A blood creatinine value of 5.0 is most likely to be found with what blood value?

Proteins and other nitrogen containing compounds

Technical problems encountered during collection of an amniotic fluid specimen caused doubt as to weather the specimen was amniotic in origin. What test should be done to best establish that the fluid is amniotic in orgin?

Proteins and other nitrogen containing compounds

Which of the following repersents the end product of purine metabloism in humans?

Proteins and other nitrogen containing compounds

Which of the following substances is the biologically active precursor of a fat soluable vitamine?

Proteins and other nitrogen containing compounds

The troponin complex consist of

Proteins and other nitrogen containing compounds

The presence of C-reactive protein in the blood is an indication of

Proteins and other nitrogen containing compounds

Oligoclonal bands are present on electrophoresis of concentrated CSF and also concurrently tested serum of the same patient. The interpretation is:

Proteins and other nitrogen containing compounds

draw a peptide bond

Proteins and other nitrogen containing compounds

90% of the copper present in the blood is bound to:

Proteins and other nitrogen containing compounds

Which of the following determinations is useful in prenatal diagnosis of open neural tube defects?

Proteins and other nitrogen containing compounds

If you see a pre-albumin peak of about 4.5% on an electrophoresis you are looking at what kind of specimen

;Proteins and other nitrogen containing compounds

Serum concentrations of vitamin B12 are elevated in:

Proteins and other nitrogen containing compounds

Absorption of vitamine B12 requires the presence of:

Proteins and other nitrogen containing compounds

The procedure used to determine the presence of neural tube defect is:

Heme derivatives

;

The principle of the occult test depends upon the:

Heme derivatives

;

A breakdown product of hemoglobin is

Heme derivatives

;

Hemoglobin S can be separated from hemoglobin D by

Heme derivatives

On electrophoresis at alkaline Ph, which of the following is the slowest migrating hemoglobin

Heme derivatives

The hemoglobin that is resistant to alkali (KOH) denaturation is:

Heme derivatives

The

following bilirubin results are obtained on a patient

day 1;;; ;4.3

day2;; ;4.6

day3;;;; 4.5

day4;;;; 2.2

day5;;;; 4.4

day6;;; ;4.5

Given that the controls were within range each day, what is a probable explanation for the result on day 4:

Heme derivatives

Urobilinogen is formed in the :

Heme derivatives

In bilirubin determinations, the purpose of adding concentrated caffene solution or methyl alcohol is to

Heme derivatives

A total bilirubin is 3.1 and the conugated biliruben is 2.0 the unconjugated bilirubin is

Heme derivatives

The principle of the tablet test for bilirubin in urine or feces is:

Heme derivatives

Serial bilirubin determinations are charted:

day1 collected at 7 am tested at 8am;; ;14.0

day2 collected 7am tested 6pm;;;;;;;;;;;;; 9.0

day3 collected 6am tested 8 am;;;;;;;;;;;; 15.0

the best explaination for the result is

Heme derivatives;

;

In the liver, bilirubin is converted to:

Heme derivatives

In what disease state is conjugated bilirubin a major serum component?

Heme derivatives

Kernicterus is an abnormal accumulation of bilirubin in:

Heme derivatives

In what conditon does decreased activity of glucronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates

Heme derivatives

A 21 year old man with nausea, vomiting and jaundice has the following laboratory finding

total serum bilirubin;;;;;;;;;;;; 8.5

conjugated serum bilirubin;; 6.1

urine urobilinogen;;;;;;;;;;;;; ;; increased

fecal urobilinogen;;;;;;;;;;;;; ;; decreased

urine bilirubin;;;;;;;;;;;;; ;;;;; ; ;positive

AST;;; ;300 (high)

alkaline phosphaase;; ;170

Heme derivatives

biochemical profile

TP 7.3

alb 4.1

cal 9.6

pho 3.3

glu; 95

BUN 16 (high)

uric acid 6.0

creat;; ;1.2

total bili 3.7 (high)

alk phos; 275 (very high)

LD ;; 185

AST; 75 (high)

the results are most consistant with

;

Heme derivatives

;

A stool specimen that appears black and tarry should be tested for the presence of:

Heme derivatives

What substance gives feces its normal color?

Heme derivatives

A condition with erythrocyte protophrin is increased is:

Heme derivatives

;A serum sample was assayed for bilirubin at 10 am and the result was 12. The same sample retested at 3 pm. The result is now 8. The most likely explanation for this descrepancy is:

Heme derivatives

;

Which of the following elevates carboxy- hemoglobin

Heme derivatives

The reason carbon monoxide is so toxic is because :

Heme derivatives

Detection of carriers of hereditory coproporphyria should include analysis of:

Heme derivatives

A fresh urine sample is recieved for analysis for "porphyrins or porphyria" without further information or specifications. Initial analysis should include:

Heme derivatives

Which of the following enzymes of heme synthesis is inhibited by lead?

Heme derivatives

;

serum haptoglobin...

Enzymes

;

The most specific enzyme test for acute pancreatitis is:

Enzymes

;

What enzyme is used in the diagnosis of acute pancretitis?

Enzymes

What enzyme catalyzes the conversion starch to glucose and maltose

Enzymes

What set of results would be consistant with macroamylasemia

Enzymes

A physician suspects his patient has pancreatitis. What test would be most indicative of this disease...

Enzymes

;aspartate amino transferase (AST) is characteristically elevated in diseases of the..;

;

Enzymes

Amino transferase enzymes catalyse the:

Enzymes

;Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are both elevated in what disease?

;

;

Enzymes

;

The greatest activities of serum AST and ALT are seen in what:

Enzymes

;Malate dehydrogenase is added to the aspartate aminotransferase (AST) reaction to catalyze the conversion of :

Enzymes;

Given the following results :

ALP slight increase

AST marked increase

ALT marked increase

GGT slight increase.

this is most consistant with

Enzymes;

What clinical disorder is associated with the greatest elevation of lactate dehydrogenase isoenzyme:

Enzymes

;The enzyme, which exists in skeletal muscle, heart and brain, is grossley elevated in active muscular dystrophy and rises early in myocardial infarction is:

Enzymes

The enzyme present in almost all tissues that may be separated by electrophoresis into 5 components is

Enzymes

;A common cause of falsely increased LD₁ fraction of lactic dehydrogenase is:

Enzymes

;The presence of which of the following isoenzymes indicates acute myocardial damage?

Enzymes

In what of the following conditions would a normal level of creatine kinase be found:

acute myocardial infarct

;hepatitis

progressive muscular dystrophy

intramuscular injection

;Enzymes

Of the following diseases, the one most often associated with elevations of lactate dehydrogenase isoenzymes 4 and 5 on electrophoresis is.

Enzymes

;

When myocardial infarction occurs, the first enzyme to become elevated is:

Enzymes;

A scanning of a CK isoenzyme fractionation revealed 2 peaks: a slow cathode peak (CKMM) and an intermediate peak (CKMB). A possible interpretation for this pattern is:

Enzymes;

An electrophoretic separation of Lactate dehydrogenous isoenzymes that demonstrats an elevation in LD-1 and LD-2 in a flipped pattern is consistant with ...

Enzymes

An increased total serum lactate dehydrogenase (LD) activity, confined to fractions 4 and 5 is most likely to be associated with:

Enzymes

;A 10 year old child was admitted to pediatricts with an initial diagnosis of skeletal muscle disesase. The best confirmatory tests would be:

Enzymes

In the immunoinhibition phase of the CKMB procedure the:

Enzymes

;The presence of increased CKMB activity on a CK electrophoresis pattern is most likely found in a patient suffering from:

Enzymes

You;notice an elevated peak in the LD5 region of electrophoresis what is most likely condition

Enzymes;

Increased serum lactate dehydrogenas activity due to elevation of fast fraction (1 and 2) on electrophoretic separation is caused by:

Enzymes

A serum sample drawn in the emergency room from a 42 year old man yealded these values:

CK 185 (slightly high)

AST 123 high

CKMB 6 normal

what might account for these values

;

Enzymes;

Given the following results:

ALP marked increase

AST slight increase

AL slight increase

GGT marked increase.

This is most consistant with

Enzymes;

Given the following results:

ALP slight increase

AST slight incrase

ALT slight increase

GGT slight increase

Enzymes

;What specimen preparation is commonly used to preform the alkaline phosphatase isoenzyme determination

Enzymes

;

Reagan isoenzyme has the same properties as ALP that originates in the:

Enzymes

;The most labile fraction of alkaline phosphatase is obtained from:

Enzymes

The most sensitive enzymatic indicator for liver damage from ethanol intake is:

Enzymes

Isoenzyme assays are preformed to improve:

Enzymes

The protein portion of an enzyme is called:

Enzymes

Which of the following chemical determinations may be of help in establishing the presence of seminal fluid:

Enzymes;

What enzyme substrate for prostatic acid phosphatase is best for the "continuous monitoring method"

Enzymes

;Lactate dehydrogenase, malate dehydroenase, isocitrate dehydrogenase and hydroxybuterate dehydrogenase all:

Lipids and lipoproteins

;;High levels of what lipoprotein class are associated with decreased risk of accelerated atherosclerosis

Lipids and lipoproteins

;The most consistant analytical error involved in the routein determination of HDL-cholesterol is caused by:

Lipids and lipoproteins

;If LDL-cholesterol is calculated by the friedwald formula, what are the 2 measurements that need to be carried out by the same chemical procedure?

Lipids and lipoproteins

;The chemical composition of HDL cholesterol cooresponds to:

Lipids and lipoproteins

;In familial hypercholesterolemia the hallmark finding is an elevation of:

Lipids and lipoproteins

;Premature atherosclerosis can occcur when which of the following becomes elevated:

Lipids and lipoproteins

;Transportation of 60-75% of the plasma cholesterol is preformed by:

Lipids and lipoproteins

;What disease results from a familial absence of high density lipoproteins?

;Lipids and lipoproteins

;A 1 year old girl with a hyperlipoproteinemia and lipase deficency has the following lipid profile:

cholesterol 300

LDL: increased

HDL: decreased

Trig: 200

chylomicrons present

a serum specimen from this patient that was refrigerated overnight would most likely be

Lipids and lipoproteins

;Which of the following lipid results would be expected to be falsley elevated on a serum specimen from a nonfasting patient?

Lipids and lipoproteins

A nine month old boy from Isreal has gradually lost his ability to sit up, and develops seziures. He has an increased amount of phospholipid called GM2-ganglioside in his neurons, and he lacks the enzyme hexosaminidase A in his leukocytes. These findings suggest:

Lipids and lipoproteins

;In amniotic fluid, the procedure used to determine fetal lung maturity is:

Lipids and lipoproteins

The class of phopolipids surfactants the take a sharp rise at week 30 gestation on amniotic fluid analysis is thought to originate in what fetal organ system.

Lipids and lipoproteins

A fasting serum sample from an asymptomatic 43 year old woman is examined visually and chemically with the following results:

initial appearance of serum= milky

serum after overnight incubation=cream layer over turbid serum

trig 2,000

cholesterol 550

this sample contains predominatly

Lipids and lipoproteins

;Chylomicrons are present in which of the following dyslipidemias?

Lipids and lipoproteins

;The function of the major lipid components of the very-low density lipoproteins (VLDL) is to transport:

Lipids and lipoproteins

Turbitity is serum suggets an elevation of:

Endocrinology and Tumor markers

;

TSH is produced by the:

Endocrinology and Tumor markers

;

A patient has the following thyroid profile:

total t₄ decreased

free t₄ decreased

thyroid peroxidase antiboby positive

TSH decreased

Endocrinology and Tumor markers

A 45 year old woman complains of fatique, heat intolerance and hair loss. Total and free T4 are abnormally low. If the TSH showed marked elevation, this would be consistant with:

Endocrinology and Tumor markers

;The majoriy of thyroxine T₄ is converted into the more biologically active hormone:

Endocrinology and Tumor markers

;A 12 year old child with a decreased serum T4 is described as being somewhat dwarfed, stocky, overweight, and having corse features. Of the folllowing , the most informative additional laboratory test would be the serum:

Endocrinology and Tumor markers

;The screening test for congenital hypothyroidism is based upon:

;Endocrinology and Tumor markers

Which one of the following set of results is consistant with primary hypothyroidism (hasimoto Thyroiditis)

result A TSH decT4 dec antimicro;Ab pos

result B TSH inc T4 inc; Anti microAb pos;;;;

result C TSH nor T4 dec;;Ab;neg;;;;;;;;;;;;

result D TSH inc T4 dec;Ab; positive

;

Endocrinology and Tumor markers;

A 68 year old female patient tells her physician of being cold all the time and recent weight gain with no change in diet. The doctor orders a TSH level, and the laboratory reports a value of 8.7 (high) This patient most likely has:

Endocrinology and Tumor markers

;What hormone is secreted by the placenta and used for the early detection of pregnancy?

Endocrinology and Tumor markers

;During pregnancy the form of estrogen measured in urine is mostly:

Endocrinology and Tumor markers

Refer to the graph

sharp rise 1st month then down 1/4 and then level off:

The HCG levels in the graph most probably represent:

Endocrinology and Tumor markers

;

In the amniotic fluid, the procedure used to detect hemolytic disease of the newborn is:

Endocrinology and Tumor markers

;During the normal pregnancy, quantitative human chorionic gonadotropin (HCG) levels peak how many weeks after the last menstral period?

Endocrinology and Tumor markers

;Laboratory measures maternal serum alpha-fetoprotein (MSAFP) at 16-18 weeks gestation as a screen for fetal disorders. The 16-week MSAFP median for lab is 32ug/L . A 37 year old woman has an MSAFP level of 34 at her 16th week. This result is consistant with:

;Endocrinology and Tumor markers

;Which of the following steroids is an adrenal cortical hormone

[image]

Endocrinology and Tumor markers

;What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens.

Endocrinology and Tumor markers

;Biologically the most active , naturally occuring androgen is:

Endocrinology and Tumor markers

Plasma for cortisol determinations were collected at 7 am , after waking the patient and at 10 pm that evening . The cortisol level of the morning sample was higher than the evening sample. This is consistant with

Endocrinology and Tumor markers

;Night blindness is associated with deficiency of which vitamines

Endocrinology and Tumor markers

;Beriberi is associated with deficicency of vitamine :

Endocrinology and Tumor markers

;Scurvy is associated with deficicency of which of the following vitamines:

Endocrinology and Tumor markers

;Rickets is associated with what deficiency of what vitamine

Endocrinology and Tumor markers

;Pellagra is associated with deficency of what vitamine?

Endocrinology and Tumor markers

;The major action of angiotension II is

Endocrinology and Tumor markers

;The urinary excreation product measured as an indicator of epinephrine production is:

Endocrinology and Tumor markers

;What hormone regulates normal blood calcium levels?

Endocrinology and Tumor markers

The most common form (95%) of congenital adrenal hyperplasia is 21-hydroxylase deficiency, what is elevated in plasma?

Endocrinology and Tumor markers

;A diagnosis of primary adrenal insufficiency requires demonstration of:

Endocrinology and Tumor markers

The screen for adrenal cortical hyperfunction with the greatest sensitivity and specificity is :

Endocrinology and Tumor markers

A patient has signs and symptoms of acromegaly. The diagnosis would be confirmed if the patient had which of the following:

Endocrinology and Tumor markers;

Estrogen and progesterone receptor assays are useful in identifying patients who are likely to benifit from endocrine therapy to treat; which of the following

Endocrinology and Tumor markers;

Which of the following sample collections would give an acurate assesment of potental excess cortisol production (hypercortisolism)

Endocrinology and Tumor markers;

How is primary hypocortisolism (addisons disease) differentiated from secondary hypocortisolism (of pituitary origin)

Endocrinology and Tumor markers

Aldosterone is released by the adrenal cortex upon stimulation by:

Endocrinology and Tumor markers;

In developing the reference for a new EIA for CEA, the range for the normal population was broader that that publised by the vender. Controls are acceptible with narrow coefficient of variation, this may be explained by:

Endocrinology and Tumor markers

;Clinical assays for tumor markers are most important for

Endocrinology and Tumor markers

;Detection of which of the following substances is most useful to monitor the course of a patient with testicular cancer

Endocrinology and Tumor markers

;Increased concentrations of alpha-fetoprotein (AFP) in adults are most characteristically associated with

Endocrinology and Tumor markers;

Carcinoembryonic antien (CEA) is most likely to be produced in a malignancy involving the

Endocrinology and Tumor markers

;Which of the following is useful in the detection and managemant of carcinoma of the prostate

Endocrinology and Tumor markers

Which of the following statements most correctly describes the utility of clinical labaratory assays for tumor markers?

Endocrinology and Tumor markers

Cancer antigens 125 (CA 125) is a tumor marker associated; with:

Endocrinology and Tumor markers;

In addition to carcinoma of the prostate, elevated prostate specific antigen (PSA) can occur due to:

TDM and Toxicology

Blood specimens for digoxin assays should be obtained between 8 hours or more after drug administraton bcause:

TDM and Toxicology

;A drug has a half life of six hours. If a dose is given every six hours, a steady state drug level would usually be achieved in

TDM and Toxicology;

Free theraputic drug levels are usually higher when serum protein concentrations are below normal . In what condition would this most likely occur:

TDM and Toxicology

;Which of the following factors is/is not relevant to theraputic drug monitoring?

of the amino glycosides, antibiotics, and vancoumycin?

TDM and Toxicology

;The drug procainamide is prescribed to treat cardiac arrhythmia. What biologically active liver metabolite of procainomide is measured simultaneously?

TDM and Toxicology

;Cocaine is metabolized to

TDM and Toxicology

;The metabolite 11-nor-tetrahydrocannabinol-9-COOH can be detected by immunoassay 3-5 days after a single use of

TDM and Toxicology

;A three year old child was evaluated for abdominal pain and anorexia by a physician . A CBC revealed a hemoglobin of 9.8 and basophillic stippling of the RBCs . The doctor should order further test to check for poisioning from:

TDM and Toxicology

Zinc protoporphyrin or free protoporphrin measirements are useful to assess blood concentrations of:

TDM and Toxicology

A carbonate salt used to control manic depressive disorders is

TDM and Toxicology

An anti-epileptic (or anticonvulsant) used to control sezure disorders is

TDM and Toxicology

;A drug that relaxes smooth muscles of the bronchial passages is

TDM and Toxicology

A cardiac glycoside that is used in the treatment of congenital failure and arrhythmias by increasing the force and velocity of myocardial contraction is:

TDM and Toxicology

;A salicylate level is performed to detect toxicity caused by ingestion of excess:

TDM and Toxicology

;lithium therapy is widely used in the treatment of

TDM and Toxicology

Serum and urine copper levels are assayed on a hospital patient with the following results:

serum Cu 20ug/dL(low)

urine Cu 83 ug/dL(high)

this is most consistant with :

TDM and Toxicology

;

an active metabolite of amytriptyline is

TDM and Toxicology

;Phenobarbatol is a metabolite of

TDM and Toxicology

;Testing for the diagnosis of lead poisioning; should include

Quality Assesment

;Blood recieved in the labrotory for blood gas analysis must meet which of the following requirements?

Quality Assesment

;After a difficult veinapuncture requireing prolonged application of the tourniquiet, the serum K+ was found to be 6.8 mEq/L The best course of acton is to:

Quality Assesment

;Serum from a patient with metastatic carcinoma of the prostate was separated from the clot and stored at room temperture. The following results were obtained:

Ca 10.8

LD 420

ALP 0.1

The technician should repeat the :

Quality Assesment

;A lipemic serum is separated and frozen at -20*C for assay at a later date. One week later, prior to preforming an assay for triglycerides, the specimens should be:

Quality Assesment;

The different water content of erythocytes and plasma makes true glucose concentration in whole blood a function of the

Quality Assesment

In;a specimen collected for plasma glucose analysis, sodium flouride:

Quality Assesment;

As part of a hyperlipidemia screening program, the following results were obtained on a 25 year old woman 6 hours after eating:

trig 260

cholesterol 120

which of the following is the best interpretation of these results?

Quality Assesment;

Blood was collected in a serum tube on a patient who has been fasting since midnight. The time of collection was 7am . The labratory test which should be recollected is:

Quality Assesment

Arterial blood that is collected in a heparinized syringe but exposed to room air would be most consistant in which of the following specimens:

Quality Assesment

Specimens for blood gas determination should be drawn into a syringe containing:

Quality Assesment

Unless blood gas measurements are made immediatly after sampling , in vitro glycolysis of the blood causes a

Quality Assesment

Which of the following serum constituents is unstable if a blood specimen is left standing at room temperature for 8 hours before processing?

Quality Assesment;

An arterial blood specimen submitted for blood gas analysis was obtained at 08:30 am but was not receved in the laboratory until 11:am. the technologist should:

Quality Assesment

In monotoring glomerular function, which of the following test has the higest sensitivity?

Laboratory Mathematics

;If the PKa is 6.1, the CO₂ is 25, the salt equals the total CO₂ content minus the carbonic acid; the carbonic acid equals: 0.03X PCO₂ and PCO₂ = 40 it may be concluded that

Laboratory Mathematics

A 24 hour urine (total volume=1.136mls) is sbmited to the laboratoy for quantitive urine protein. Calculate the amount of protein excreted per day , if the total protein is 52 mg/dL

Laboratory Mathematics

The following results were obtained:

urine creatinine 90 mg/dL

serm creainine 0.90 mg/dL

patients total body surface: 1.3 M²

total volume urine 24 hours 1500 ml

;

Laboratory Mathematics

One international unit of enzyme activity is the amount of enzyme that will, under specified reacton conditions of substrate concentration, pH and temperature, cause utilization of substrate at the rate of

Laboratory Mathematics

;The bicarbonate and carbonic acid ratio is calculated from an equation by:

Laboratory Mathematics;

¹²⁵ I; has a physical half life of 60.0 days. A sample tested today had activity of 10,000 CPM/mL how many days from today will the count be 1250 CPM/mL

Laboratory Mathematics

In spectrophotometric determination, which of the following is the formula for calculating the absorbance of a soluton?

Laboratory Mathematics

;

Which of the following is the henderson Hasselbach equaton?

Laboratory Mathematics;

An adult diabetic with renal complications has the following results:

Na 133

glu 487

BUN 84

creat 5

In the basis of these results the calculated serum osmolality is:

;

Laboratory Mathematics

look at the figure on page 120

it is a right angle with a positive straight slope that starts 1/5 of the was up the Y axis

The above figure shows the reciprocal of the measured velocity of an enzyme reaction plotted aginst the reciprocol of the substrate concentration.

True statements about this figure include:

Laboratory Mathematics;

The following results were obtained in a creatinine clearance evaluation

urine concentration 84

urine volume 1440

serum concentration 1.4

body surface area 1.66

Laboratory Mathematics

;In the international system of units , serum urea is expressed in millimoles per liter:

urea NH₂CONH₂

atomic weight N=14, C=12, O= 16, H+1

a serum containing;28 mg/dL would be equivalent to what concentration of urea.

Laboratory Mathematics

;The uria nitrogen concentration of a serum sample was measured to be 15 mg/dL

urea;; NH₂CONH₂

atomic weight N=14, c=12. O=10, H=1

he urea concentration of the sample in mg/dL is

Laboratory Mathematics

The osmol gap is defined as measured Osm/kg minus the calculated Osm/kg. Normally , the osmol gap is less than

Laboratory Mathematics

;Normally the bicarbonate concentration is abut 24 mEq/L and the carbonic acid concentration is about 1.2; pK =6.1,log 20=1.3. using the equation pH =pK + log [salt/acid] calculate the pH

Instrumentation:

Stray light can be detected in a spectrophotometer by using a :

Instrumentation:

In the atomic absorption method for calcium, lanthanum is used:

Instrumentation:

;Which of the methods is susceptible to solvent displacing effect that results in falsely decreased electrolyte values.

Instrumentation:

Upon development of a thin layer chromatography for drug analysis all drug spots (including the standards) had migrated with the solvent front. The most probable cause for this would be:

Instrumentation:

To detect barbiturate abuse when analyzing urine specimens , immunoassay is the method of choice for screening. The method of choice for confirmation is:

Instrumentation:

Reverse phase high performance- liquid chromatography is being increasingly utilized in theraputic drug monitoring . The term reverse phase implies that the column eluant is:

Instrumentation:

When separating serum proteins by cellulose acetate electrophoresis, using Veronal buffer at Ph 8.6 beta globulin migrates:

Instrumentation:

Hemoglobin S can be separated from Hemoglobin D by which of the following methods?

Instrumentation:

What is the proper Ph for the buffered solution used to preform serum protein electrophoresis?

Instrumentation:

The buffer Ph most effective at allowing amphoteric proteins to migrate toward the cathode in an electrophoretic system would be?

Instrumentation:

On electrophoresis , transient bisalbuminemia or a grossley widened albumin zone is associated with?

Instrumentation:

Which of the following serum proteins migrate with the beta globulins on cellulose acetate at Ph 8.6?

Instrumentation:

An electrode has a silver/silver chloride anode and a platinum wire cathode. It is suspended in KCL soultion and separated from the blood to be analyzed by a selectively permeable membrane. Such an electrode is used to measure what?

Instrumentation:

Hydrogen ion concentration (Ph); in blood is usualy determined by means of which of the following electrodes?

Instrumentation:

An automated method for measuring chloride which generates silver ions in the reaction is:

Instrumentation:

Coulometry is often used to measure?

Instrumentation:

In a Ph meter reference electrodes may include...

Instrumentation:

Amperometry is the principle of the ...

Instrumentation:

Most automated blood gas analyzers directly measure:

Instrumentation:

Blood PCO₂ may be measured by:

Instrumentation:

Valinomycin enhances the selectivity of the electrode used to quantitate:

Instrumentation:

Which blood gas electrode is composed of silver/silver chloride reference electrode and glass?

Instrumentation:

Most chemical methods for determining total protein utilize which reactions?

;

;Instrumentation:

Bromcresyl purple at Ph 5.2 is used in a colormetric method to measure:

Instrumentation:

Magnesium carbonate is added in an iron binding capacity determination in order to:

Instrumentation:

The most specific method for the assay of glucose utilizes:

Instrumentation:

What would be an example of a "glucose- specific" colormetric method?

Instrumentation:

Increased concentrations of ascorbic acid inhibit chromogen production in which glucose method?

Instrumentation:

In the hexokinase method for glucose determination, the actual end product measured is the

Instrumentation:

What calcium procedure utilizes lanthanum chloride to eliminate interfering substances?

Instrumentation:

Before unconjugated biliruben can react with Ehrlich diazo reagent, which of the following must be added

Instrumentation: