CC2 simulation

CC2 simulation

By Dexter Templonuevo

Multiple Choice

The reproducibility of measurements is referred to as:

• Accuracy

• Precision

• QC

• Reliability

Multiple Choice

The ability of an analytical method to measure only the analyte of concern:

• Sensitivity

• Specificity

• Precision

• Accuracy

Multiple Choice

The ability of a test to detect a given disease or condition:

• Diagnostic specificity

• Diagnostic sensitivity

• Positive predictive value

• Negative predictive value

Multiple Choice

Specimens must be centrifuged for approximately _ minutes at an RCF of 1,000g to 2,000 g but must avoid destruction of red cells that can result in hemolysis.

• 10 minutes

• 15 minutes

• 20 minutes

• 30 minutes

Multiple Choice

Serum samples should be analyzed within _ hours; to minimize the effect of evaporation, samples should be properly capped and kept away from areas of rapid airflow, light, and heat.

• 4

• 6

• 12

• 24

Multiple Choice

In cirrhosis, a predominant characteristic observed on an electrophoretic protein pattern is a(an):

• Increase in the alpha2 globulin factor

• Bridging effect between beta and gamma globulin

• Monoclonal band in the gamma globulin region

• Polyclonal band in the gamma-globulin region

Multiple Choice

Principle of enzyme data interpretation

i.     There is no truly “organ-specific” enzyme

ii.     Serial measurements provide most useful data; a single measurement can be misleading

iii.     “negative” (normal) results are useful

iv.     Enzyme data must be integrated with other information

• 1 and 3

• 2 and 4

• 1, 2, and 3

• 1, 2, 3, and 4

Multiple Choice

The Michaelis-Menten theory states which of the following?

•   E + S + I → ES + EI + ESI → E + P

• E + S ⇋ ES → E + P

•  E + S + I → ES + EI → E + P

• E ⇋ ES → E + P

Multiple Choice

When an enzyme assay involves the continuous measurements of change in concentration as a function of time, the mode of analysis is termed:

• Endpoint

• Kinetic

• Multipoint

• Spectrophotometric

Multiple Choice

When a reaction is performed in zero-order kinetics:

• The substrate concentration is very low

• The rate of reaction is directly proportional to the substrate concentration

• The rate of reaction is independent of the substrate concentration

• The enzyme level is high

Multiple Choice

Lactate dehydrogenase enzyme is a(an):

• Hydrolase

• Lyase

• Oxidoreductase

• Transferase

Multiple Choice

Which condition produces the highest elevation of serum LD?

• Pernicious anemia

• Myocardial infarction

• Acute hepatitis

• Muscular dystrophy

Multiple Choice

Which of the following enzyme has high specificity for the pancreas?

• Amylase

• Lipase

• ALT

• AST

Multiple Choice

The presence of this ALP isoenzyme in serum depends on the blood group and secretor status of the individual – B and O blood group, isoenzyme increases after consumption of a fatty meal.

• Liver ALP

• Bone ALP

• Placental ALP

• Intestinal ALP

Multiple Choice

The highest elevations of ALP activity occur in:

• Rickets

• Paget’s disease

• Osteomalaceia

• Hyperthyroidism

Multiple Choice

What is the effect of hemolysis in ACP value?

• Falsely increased

• Falsely decreased

• Variable

• No effect

​Hemoglobin and bilirubin in high concentration	​increased ACP
Failure to use anticoagulant, release of enzyme from platelet​	​increased ACP
​Fluoride, oxalate, and heparin	​decreased ACP
​Prolonged storage	​decreased ACP

Multiple Choice

In pesticide poisoning, cholinesterase activity is:

• Increased

• Decreased

• Variable

• No change

Multiple Choice

For the determination of amylase, which assay method is based on the measurement of the quantity of reducing substance formed?

• Amyloclastic

• Saccharogenic

• Chromogenic

• Continuous monitoring

Multiple Choice

The appearance of LD1/LD2 flipped pattern and the presence of CK-MB isoenzyme on electrophoresis highly suggestive of:

• Acute hepatitis

• Cirrhosis

• Muscular dystrophy

• Myocardial infarction

​ENZYME	ONSET	PEAK	ELEVATION
CK	4-8	12-24	3-4
CK-MB	4-8	24	2-3
​AST	8-12	24	5
LD	12-24	72	10

​Cardiac markers

​

CK-MB > AST > LD1 AND LD2

​

MYOGLOBIN > TROPONIN I/T > CK-MB > AST > LD1 AND LD2​

Multiple Choice

Hepatocellular damage may be best assessed by which of the following parameter?

• Serum ALT and AST

• GGT and ALP

• Bilirubin, GGT and ALP

• Ammonia and Urea

Multiple Choice

Bilirubin fraction that is covalently attached to albumin and contributes to the conjugated bilirubin value is:

• Direct

• Indirect

• Delta

• Bound

Multiple Choice

The danger of kernicterus is a certainty at bilirubin levels exceeding _ mg/dL.

• >5 mg/dL

• >10 mg/dL

• >15 mg/dL

• >20 mg/dL

Multiple Choice

In which of the following conditions does no activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates and eventually death within 18 months?

• Gilbert’s disease

• Crigler-Najjar syndrome

• Dubin-Johnson syndrome

• Intravascular hemolysis

Multiple Choice

Blood ammonia levels are usually measured to evaluate:

• Renal failure

• Acid-base status

• Hepatic coma

• Gastrointestinal malabsorption

Multiple Choice

Serum chemistry alterations in alcoholic liver disease, except:

• Increased ALT, bilirubin

• Increased Triglycerides, lipoproteins

• Increased albumin, transferrin

• Decreased glucose; increase ketone bodies

Multiple Choice

Which of the following laboratory findings may be associated with glomerulonephritis?

• Elevated urine protein

• Red cells and casts in urine

• Increased serum creatinine and urea

• Both A and C

• A, B, and C

Multiple Choice

The primary extracellular cation is:

• Calcium

• Chloride

• Potassium

• Sodium

Multiple Choice

All given conditions are associated with hypernatremia except:

• Diabetes insipidus

• Hyperaldosteronism

• Prolonged diarrhea

• SIADH

Multiple Choice

The cation present in the greatest concentration in the cell is:

• Chloride

• Phosphorus

• Potassium

• Sodium

Multiple Choice

Potassium functions for the heart contraction, neuromuscular excitability, ICF volume regulation and hydrogen ion centration. The single most important analyte in terms of an abnormality being immediately life-threatening. All conditions are associated with hyperkalemia except:

• Severe dehydration

• Acidosis

• Vigorous exercise

• Diarrhea

Multiple Choice

When measuring potassium using an ion-selective electrode, the membrane is composed of:

• Glass

• Plastic

• Platinum

• Valinomycin

Multiple Choice

In cystic fibrosis, which electrolytes are elevated?

• Calcium and chloride

• Chloride and sodium

• Sodium and potassium

• Potassium and chloride

Multiple Choice

To maintain the electroneutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with which of the following?

• Potassium

• Sodium

• Chloride

• Phosphate

Multiple Choice

Effects of vitamin D on calcium metabolism:

• Increased absorption from intestine

• Increased reabsorption from kidney tubule

• Increased resorption from bone

• All of these

Multiple Choice

What is the reference method for determining calcium in serum?

• Atomic absorption spectrophotometry

• Colorimetric analysis

• Indirect potentiometry

• Flame photometry

Multiple Choice

1.      The anion gap is useful (among other things) as an inexpensive measure of quantity control for which of the following analytes?

• Blood gas analyses

• Sodium, potassium, chloride, and total carbon dioxide

• Calcium, phosphorus, and magnesium

• AST, ALT, GGT and ALP

​AG = Na - (Cl + HCO3)

​AG = (Na + K) - (Cl + HCO3)​

​7-16 mmol/L

10-20 mmol/L​

Multiple Choice

1.      Formula for serum osmolarity:

• (2Na+) + (Glucose/20) + (BUN/3)

• (Na+/3) + (2 Glucose) + (BUN/20)

• Na+ + 3Glucose + 2BUN

• Na+ - (Cl- + total CO2)

Multiple Choice

Select the anticoagulant of choice for the blood gas studies: 

• Sodium citrate, 3.2%

• Lithium heparin

• Sodium citrate, 3.8%

• Ammonium oxalate

Multiple Choice

Which of the following changes will occur with a blood gas sample exposed to room air? 

• pH increased

• pCO2 increased

• pO2 decreased

• ionized calcium increased

​open tube	​entry of oxygen	​increased O2 and pH, decreased CO2
​closed tube	​oxygen utilized by cell	​decreased O2 and pH, increased CO2

Multiple Choice

Which of the following is directly measured by blood gas analyzers?

• pH, pCO2, pO2

• pH, pO2, and oxygen saturation

• pH, HCO3

• pH and pCO2 only

Multiple Choice

Which body tissues play an important role in maintaining the blood pH?

• Liver and lung

• Liver and kidney

• Lung and kidney

• Kidney and pancreas

Multiple Choice

What is the normal ratio of bicarbonate to dissolved carbon dioxide in arterial blood blood?

• 1:10

• 10:1

• 20:1

• 1:20

Multiple Choice

An excessive loss of carbon dioxide through hyperventilation is the primary cause of:

• Respiratory acidosis

• Respiratory alkalosis

• Metabolic acidosis

• Metabolic alkalosis

Multiple Choice

A patient with emphysema who has fluid accumulation in the alveolar sacs (causing decreased ventilation) is likely to be in which of the following acid-base clinical states?

• Respiratory acidosis

• Respiratory alkalosis

• Metabolic acidosis

• Metabolic alkalosis

Multiple Choice

All the following are steroid hormones, except? 

• Progesterone

• Testosterone

• Aldosterone

• Epinephrine

Multiple Choice

Thyroid hormones are derived from which of the following?

• Histidine

• Cholesterol

• Tyrosine

• Phenylalanine

Multiple Choice

In patients with primary hypothyroidism, TSH levels will likely be __, and T4 will be likely __.

• Decreased, increased

• Increased, decreased

• Decreased, normal

• Increased, normal

Multiple Choice

Effect(s) of an increase in Antidiuretic hormone (ADH) or vasopressin:

• Fluid loss

• Fluid retention

• Low serum sodium

• Both B and C

Multiple Choice

1.      Quantification of Human Chorionic Gonadotropin (HCG) is useful in which of the following clinical findings?

 i.     Threatened abortions

ii.     Hydatidiform moles

iii.     Choriocarcinoma

iv.     Testicular tumors

• 1 and 3

• 2 and 4

• 1, 2, and 3

• 1, 2, 3, and 4

Multiple Choice

Select the five pharmacological parameter that determine serum drug concentration.

• Absorption, anabolism, perfusion, bioactivation, excretion

• Liberation, equilibration, biotransformation, reabsorption, elimination

• Liberation, absorption, distribution, metabolism, excretion

• Ingestion, conjugation, integration, metabolism, elimination

Multiple Choice

Digoxin, procainamide, and quinidine are drugs that may be classified as: 

• Aminoglycosides

• Antidepressants

• Anticonvulsants

• Cardioactive