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CLCHEM1 Midterm Exam - Laboratory

Total questions: 75

Worksheet time: 38mins

Name
Class
Date
1.

Select the primary reagent used in the Jaffe method for creatinine.

a)

Alkaline copper II sulfate

b)

Saturated picric acid and NaOH

c)

Sodium nitroprusside and phenol

d)

Phosphotungstic acid

2.

Urea is produced from:

a)

The catabolism of proteins and amino acids

b)

Oxidation of purines

c)

Oxidation of pyrimidines

d)

The breakdown of complex carbohydrates

3.

Urea concentration is calculated from the BUN by multiplying by a factor of:

a)

0.5

b)

2.14

c)

6.45

d)

14

4.

Urinary urea measurements may be used for calculation of:

a)

Glomerular filtration

b)

Renal blood flow

c)

Nitrogen balance

d)

All of these options

5.

In the ultraviolet enzymatic method for BUN, the urease reaction is coupled to a second enzymatic reaction using:

a)

AST

b)

Glutamate dehydrogenase

c)

Glutamine synthetase

d)

ALT

6.

Which uric acid method is associated with negative bias caused by reducing agents?

a)

Uricase coupled to the Trinder reaction

b)

Ultraviolet uricase reaction coupled to catalase and alcohol dehydrogenase reactions

c)

Measurement of the rate of absorbance decrease at 290 nm after addition of uricase

d)

 Phosphotungstic acid using a protein-free filtrate

7.

Kjeldahl’s procedure for total protein is based upon the premise that:

a)

Proteins are negatively charged

b)

The pKa of proteins is the same

c)

The nitrogen content of proteins is constant

8.

Which of the following dyes is the most specific for measurement of albumin?

a)

Bromcresol green (BCG)

b)

Bromcresol purple (BCP)

c)

Tetrabromosulfophthalein

d)

Tetrabromphenol blue

9.

Which support medium can be used to determine the molecular weight of a protein?

a)

Cellulose acetate

b)

Polyacrylamide gel

c)

Agar gel

d)

Agarose gel

10.

Which of the following stains is used for lipoprotein electrophoresis?

a)

Oil Red O

b)

Coomassie Brilliant Blue

c)

Amido Black

d)

Ponceau S

11.

Which serum protein should be measured in a patient suspected of having Wilson’s disease?

a)

Hemopexin

b)

Alpha-1 antitrypsin

c)

Haptoglobin

d)

Ceruloplasmin

12.

A glycoprotein that binds with hemoglobin to facilitate the removal of hemoglobin by the reticuloendothelial system is:

a)

Haptoglobin

b)

Ceruloplasmin

c)

Transferrin

d)

Hemopexin

13.

A protein that is normally produced by the fetus but is found in increased amounts in the amniotic fluid in cases of spina bifida is:

a)

Alpha1-antitrypsin

b)

Alpha1-acid glycoprotein

c)

Alpha1-fetoprotein

d)

Alpha2-macroglobulin

14.

The formation of glucose from compounds like fatty acids, glycerol, and amino acids is called:

a)

Glycolysis

b)

Glycogenesis

c)

Glycogenolysis

d)

Gluconeogenesis

15.

The reference method for glucose determination is:

a)

Glucose dehydrogenase

b)

Hexokinase

c)

Glucose oxidase

d)

Copper reduction

16.

The preferred collection tube for preservation of glucose is:

a)

Calcium oxalate

b)

Sodium fluoride

c)

Lithium heparin

d)

Sodium citrate

17.

Carbohydrates general ratio of CHO is 1:2:1.

a)

True

b)

False

18.

Form of glucose that is absorbable by cells

a)

G3P

b)

G6P

c)

Hexokinase

d)

A1c

19.

Effect of THYROXINE on blood glucose level

a)

Increase

b)

Decrease

c)

NA

20.

HYPERGLYCEMIC AGENTS, except:

a)

Cortisol

b)

Epinephrine

c)

Insulin

d)

Thyroxine

21.

Oldest glucose method

a)

Copper reduction

b)

Ferric reduction

c)

Ortho-toluidine

d)

Glucose oxidase

22.

Employed in autoanalyzers

a)

Copper reduction

b)

Ferric reduction

c)

Glucose oxidase

d)

Hexokinase

23.

Endpoint result in Saifer Gernstenfield Method

a)

Blue

b)

Green

c)

Yellow

d)

Brown

24.

Increased levels of uric acid, bilirubin, and ascorbic acid can falsely elevate glucose results.

a)

True

b)

False

25.

Glucose oxidase only measures alpha-D-glucose.

a)

True

b)

False

26.

Patients with diabetes insipidus have ________ glucose levels.

a)

Increased

b)

Normal

c)

Decreased

27.

Autoantibodies associated with Type 2 DM

a)

Islet cell autoantibodies

b)

Insulin autoantibodies

c)

Both

d)

None

28.

The most predominant ketone in diabetic patients.

a)

Acetoacetate

b)

Hydroxybutyric acid

c)

Acetone

d)

All

29.

Renal threshold of glucose in mg/dL

a)

120

b)

140

c)

180

d)

200

30.

Deficient glucose-6-phosphatase

a)

GSD 1

b)

GSD 2

c)

GSD 3

d)

GSD 4

31.

Deficient amylo-1,6-glucosidase

a)

GSD 1

b)

GSD 2

c)

GSD 3

d)

GSD 4

32.

On which of the following can you obtain the highest results for 100-g OGTT?

a)

FBS

b)

1st hour

c)

2nd hour

d)

3rd hour

33.

Impaired fasting glucose

a)

<100 mg/dL

b)

100-125 mg/dL

c)

140-199 mg/dL

d)

>126 mg/dL

34.

An HbA1c result of 7.0 is suggestive of:

a)

Normal

b)

Pre-diabetes

c)

Impaired

d)

DM

35.

A patient who fasted for 14 hours can proceed OGTT testing.

a)

True

b)

False

36.

HbA1c of 8% is equivalent to what approximate mean plasma glucose?

a)

97 mg/dL

b)

212 mg/dL

c)

154 mg/dL

d)

183 mg/dL

37.

Positive result in this urine test is an early indication of renal disease.

a)

Urinalysis

b)

Creatinine

c)

Guaiac

d)

Micral

38.

Renal function electrolytes, except:

a)

Na

b)

K

c)

CO2

d)

None

39.

NPN reference method

a)

Enzymatic

b)

Electrode

c)

IDMS

d)

PCR

40.

Select all that applies: Inhibits urease enzyme

a)

Citrate

b)

Fluoride

c)

EDTA

d)

Heparin

41.

Kinetic measurement of urea and is used on many automated instruments

a)

GLDH coupled enzymatic

b)

Indicator dye

c)

IDMS

d)

Conductimetric

42.

Reference range for BUN

a)

10-14 mg/dL

b)

6-20 mg/dL

c)

0.5-1.0 mg/dL

d)

24-30 mg/dL

43.

70% eliminated; relatively insoluble in plasma

a)

Urea

b)

Uric acid

c)

Creatinine

d)

Ammonia

44.

Caraway method

a)

BUN

b)

BUA

c)

Creatinine

d)

Ammonia

45.

Jaffe method

a)

BUN

b)

BUA

c)

Creatinine

d)

Ammonia

46.

TRUE about GOUT

a)

Uric acid deposition in joints

b)

HGPRT deficiency

c)

Orange sand in diapers

d)

All

47.

Related to uric acid

a)

Adenine

b)

Guanine

c)

Both

d)

Pyrimidines

48.

Proteins as alpha-helix and beta-pleated sheets

a)

Primary

b)

Secondary

c)

Tertiary

d)

Quaternary

49.

Globular proteins, except:

a)

Albumin

b)

Hemoglobin

c)

Antibodies

d)

None

50.

Dyes for SPE

a)

Coomasie Brilliant Blue

b)

Oil Red O

c)

PAS

d)

All

51.

Using Kjeldahl Technique, total serum protein is obtained by multiplying total protein nitrogen by:

a)

2.14

b)

88.4

c)

6.25

d)

1

52.

Used to measure protein in CSF or urine

a)

Turbidimetric

b)

Refractive index

c)

SG

d)

All

53.

Depends on the presence of 2 or more peptide bonds to form a purple complex with copper salts in alkaline solutions

a)

Kjeldahl

b)

Biuret

c)

SG

d)

Folin-Ciocalteu

54.

In SPE, at pH values greater than isoelectric point, the net charge on the protein is negative.

a)

True

b)

False

55.

Beta-globulins, except:

a)

Transferrin

b)

Hemopexin

c)

Haptoglobin

d)

None

56.

Good indicator of body's nutritional status

a)

AAT

b)

Antibodies

c)

Pre-albumin

d)

Hemoglobin

57.

Deficient in pulmonary emphysema

a)

Ceruloplasmin

b)

AAT

c)

Macroglobulin

d)

Orosomucoid

58.

Decreased in hemolytic anemia

a)

AAT

b)

Ceruloplasmin

c)

Haptoglobin

d)

Transferrin

59.

Earliest indicator of inflammation

a)

ESR

b)

Albumin

c)

AFP

d)

CRP

60.

Increased in AMI, angina, rhabdomyolysis, strenuous exercise, and acute renal failure

a)

Myoglobin

b)

Trop-I

c)

Trop-T

d)

Cystatin C

61.

Rises within 3-4 hours after onset of damage, peak at 10 to 24 hours, return to normal after 7 days

a)

Trop-I

b)

Trop-T

c)

Myoglobin

d)

Cystatin C

62.

Gold standard test for diagnosis of AMI

a)

Trop-I

b)

Trop-T

c)

Cystatin C

d)

Myoglobin

63.

Increased in spina bifida, HDN, hepatoma

a)

AAT

b)

AFP

c)

AST

d)

CRP

64.

Beta-gamma bridging in SPE

a)

Pulmonary emphysema

b)

Nephrotic syndrome

c)

Cirrhosis

d)

Inflammation

65.

Which of the following is not synonymous with POCT?

a)

Near-patient testing

b)

Ancillary testing

c)

Bedside testing

d)

None

66.

Test/s available on POCT devices

a)

Infectious disease markers

b)

Electrolytes

c)

Glucose

d)

All

67.

What is considered as the major advantage of POCT?

a)

Reduced TAT

b)

Decreased manpower needs

c)

Less traumatic

d)

Improved cost

68.

Subject to lowest level of regulation and includes tests such as dipstick, pregnancy test, and RBS monitoring

a)

PPMPs

b)

Moderate complexity

c)

High complexity

d)

Waived

69.

True or False. Majority of POCTs fall under moderate complexity category.

a)

True

b)

False

70.

Select all that applies. What are the desirable characteristics of POCT devices?

a)

Ease of use

b)

Portability

c)

Not interfaced with LIS

d)

Comparability to main laboratory method

71.

Proficiency testing falls under:

a)

Internal QC

b)

External QC

c)

QA

d)

All

72.

Greatest source of error in POCT

a)

Preanalytical

b)

Analytical

c)

Postanalytical

d)

Any

73.

True or False. Quality management program is not necessary for POCT since it can be done by any healthcare practitioner.

a)

True

b)

False

74.

True or False. Total quality management encompasses quality assurance, as well as internal and external quality control.

a)

True

b)

False

75.

Creatinine is formed from the:

a)

Oxidation of creatine

b)

Oxidation of protein

c)

Deamination of dibasic amino acids

d)

Metabolism of purines

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