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CLINICAL CHEMISTRY 2 (PRELIM)

Total questions: 60

Worksheet time: 2hrs 0mins

Name
Class
Date
1.

A waste product of muscular metabolism

a)

Creatinine

b)

Uric Acid

c)

Urea

d)

Ammonia

2.

Plasma creatinine is ____ related to glomerular filtration rate

a)

Inversely

b)

Directly

3.

Creatinine if formed from these amino acids

a)

Lysine, Glutathione, Alanine

b)

HIstidine, Aspartic acid, Proline

c)

Methionine, Arginine, Glycine

d)

Threonine, Aspargine, Valine

4.

Cause of increase in Creatinine levels

a)

Hemodilution

b)

Myopathy

c)

Denutrition

d)

Heart failure

5.

Cause of decrease in Creatinine levels

a)

Severe Muscular Atrophy

b)

Old age

c)

Prolonged fasting

d)

Leukemia

6.

Strenuous exercise or fist clenching can result to a falsely increased creatinine result

a)

True

b)

False

7.

Dopamine and Lidocaine can falsely decrease creatinine result

a)

True

b)

False

8.

This method produces a Red-orange complex known as Janovski Complex

a)

Jaffe reaction

b)

Blauch & Koch

c)

Fearon Reaction

d)

Xanthydral Reaction

9.

An enzymatic method where Creatinine reacts with DNBA to form a purplish rose colored product

a)

3,5 Dinitrobenzoic Acid

b)

Creatinase Method

c)

Iminohydrolase

d)

Creatinine Aminohydrolase

10.

In this method, protein-free filtrate is first absorbed by hydrated aluminum silicate to remove interfering substances to measures the value of true creatinine.

a)

Folin-Wu

b)

Lloyd’s Method

c)

Berthelot Reaction

d)

Nesslerization

11.

Major excretory product of protein digestion

a)

Creatinine

b)

Uric Acid

c)

Urea

d)

Ammonia

12.

Urea is ________ in the kidney

a)

Reabsorbed

b)

Secreted

c)

Filtered

d)

Bothe a & b

e)

Both a & c

13.

This occurs when there is a lesion in the kidney

a)

Renal Azotemia

b)

Pre-renal Azotemia

c)

Post-renal Azotemia

d)

None of the above

14.

This is seen in kidney stones, prostatic enlargement, and tumor of the urinary tract

a)

Renal Azotemia

b)

Pre-renal Azotemia

c)

Post-renal Azotemia

d)

None of the above

15.

A clinical syndrome in a patient suffering from loss of renal function

a)

Hyperkalcemia

b)

Edema

c)

Azotemia

d)

Uremia

16.

In this method, urea reacts directly with xanthydral reagent to form dixanthydral urea

a)

Fearon Reaction

b)

Xanthydral Reaction

c)

Acid titration

d)

Nesslerization

17.

This measures the conductivity of a mixture where NH4+ and HCO3- are generated by the urease reaction.

a)

Conductivity Rate

b)

Urograph Method

c)

Ammonium sensing electrode

d)

NADH Consumption

18.

Normal value for serum urea

a)

5-10 mg/dL

b)

10-20 mg/dL

c)

20-40 mg/dL

d)

40-80mg/dL

19.

Adaptation of Nesslerization method for measuring urea

a)

Gentzkow-Masen

b)

Jaffe reaction

c)

Folin-wu

d)

DNBA

20.

Urea is stable in urine samples for up to

a)

2 days without preservative

b)

4 days with preservative

c)

6 days without preservative

d)

8 days with preservatives

21.

End-product of purine metabolism

a)

Creatinine

b)

Uric Acid

c)

Urea

d)

Ammonia

22.

Confirm diagnosis and monitor treatment of gout

a)

Creatinine

b)

Uric Acid

c)

Urea

d)

Ammonia

23.

High bilirubin concentration may ____ result in uric acid obtained by peroxidase methods

a)

Falsely decrease

b)

Falsely increase

c)

No effect

24.

High bilirubin concentration may falsely decrease result obtained by peroxidase method

a)

True

b)

False

25.

In Blaunch & Koch method, the uric acid concentration in the sample is proportional to the ___ in absorbance

a)

Increase

b)

Decrease

c)

No effect

26.

Method where the hydrogen peroxide produced is used to oxidize methanol to formaldehyde.

a)

Uricase-Hantzch reaction

b)

Polarographic Uricase method

c)

Differential UV Absorption

d)

Direct Redox Method

27.

The enzyme uricase may be extracted from

a)

Bacillus subtilis

b)

Candida albicans

c)

Bacillus fastidiousus

d)

Candida krusei

28.

Normal value for uric acid (female)

a)

2.6-6.0mg/dL

b)

35-72mg/dL

c)

2.8-4.28umol/L

d)

1.55-3.57umol/L

29.

Uric acid levels is increased in

a)

Liver disease

b)

Enzyme deficiency

c)

Purine-rich diet

d)

Toxemia of pregnancy

30.

Uric acid levels is increased in

a)

Lesch-Nyhan syndrome

b)

Over-treatment of allopurinol

c)

Fanconi syndrome

d)

Chemotherapy

31.

Conversion factor for Creatinine

a)

88.4

b)

0.357

c)

0.0595

d)

4.329

32.

Conversion factor for Uric Acid

a)

88.4

b)

0.357

c)

0.0595

d)

4.329

33.

Normal value of total NPNs in wholeblood

a)

20-35mg/dL

b)

25-50mg/dL

c)

250-400mg/L

d)

150-255mg/L

34.

Which of the following is a fasting specimen

a)

Uric acid

b)

Creatinine

c)

Urea

d)

All of the above

e)

None of the above

35.

Most accurate for GFR determination

a)

Creatinine clearance

b)

B-trace protein

c)

Inulin clearance

d)

Cystatine C

36.

Most common endogenous substance used for GFR determination.

a)

Creatinine clearance

b)

B-trace protein

c)

Inulin clearance

d)

Urea clearance

37.

Decreased Urea clearance may indicate

a)

Pregnancy

b)

Burns

c)

High cardiac output

d)

Hemorrhage

38.

Used to exclude nephrogenic diabetes insipidus.

a)

PSP Dye excretion test

b)

PAH clearance

c)

Water deprivation test

d)

Osmometry

39.

Used to confirm the diagnosis of distal renal tubular acidosis

a)

Specific gravity

b)

Osmolality

c)

Ammonium chloride test

d)

Inulin clearance

40.

Normal value for inulin clearance (Male)

a)

125mL/min

b)

115mL/min

c)

125mmoL/min

d)

115mmoL/min

41.

This substance is independent on the volume of blood perfusing the kidney and has been the reference method for ERPF determination.

a)

PAH clearance

b)

PSP Dye Excretion test

c)

Urea clearance

d)

Inulin clearance

42.

Normal value for PSP Dye excretion test

a)

60-86% excretion in 2hrs

b)

24-58% excretion in 2hrs

c)

80-94% excretion in 2hrs

d)

46-62% excretion in 2hrs

43.

A urinary osmolality <750 mOsmol/Kg H2O implies a normal concentrating ability of tubules.

a)

True

b)

False

44.

This is used to evaluate renal function and to differentiate between etiologies of polyuria.

a)

Osmometry

b)

U/S Osmol ratio

c)

Delta osmolality

d)

Specific gravity

45.

The concentration and dilution of kidney tubules are based on the degree of hydration or tonicity of extracellular fluid.

a)

True

b)

False

46.

What condition does U/S osmol ratio: <1.2 and Urine Na: > <1.2 Urine Na: >20 mEq/L suggests?

a)

Osmotic diuresis

b)

Glomerular impairment

c)

Water diuresis

d)

Acute tubular dysfunction

47.

What condition does U/S osmol ratio: <1 suggests?

a)

Osmotic diuresis

b)

Glomerular impairment

c)

Water diuresis

d)

Acute tubular dysfunction

48.

The principle of this method is NADH consumption which is measured at 340nm

a)

Creatinine Aminohydrolase Method

b)

Creatinine Iminohydrolase

c)

Coupled Creatinine Aminohydrolase

d)

3,5 Dinitrobenzoic Acid

49.

One adaptations of Jaffe reaction that is less specific as in it measures non-creatinine chromogens as well like glucose, proteins, acetoacetate, pyruvate, uric acid, fructose and ascorbic acid

a)

Fuller’s Earth Method

b)

Lloyd’s Method

c)

Folin-wu Method

d)

DNBA

50.

The H2O2 produced by the enzymatic reaction is coupled with peroxidase reaction using chromogens such as o-dianisidine, dimethyl aniline, p-amino phenazone

a)

Coupled Uricase Reaction

b)

Uricase-Hantzch Reaction

c)

Polarographic uricase Method

d)

Differential UV Absorption

51.

It is considered the most reliable test for renal pathology and screening test or index of overall renal function

a)

Creatinine

b)

Ammonia

c)

Uric Acid

d)

Urea

52.

It is a measure of the clearance if normal molecules that are not bound to protein and are freely filtered by the glomeruli neither reabsorbed nor secreted by the tubule

a)

CFG

b)

GFR

c)

RCF

d)

RGC

53.

Calculate for Creatinine Clearance: Serum creatinine = 2.6 mg/dL; Urine volume = 1100mL; Urine creatinine = 240mg/dL

a)

0.066

b)

0.657

c)

0.668

d)

0.068

54.

Calculate for Creatinine Clearance: Serum creatinine = 5.9 mg/dL; Urine volume = 800mL; Urine creatinine = 660mg/dL

a)

0.622

b)

62.157

c)

6.216

d)

0.006

55.

Preservative used for preserving NPNs in urine

a)

Boric acid

b)

Hydrochloric acid

c)

Acetic acid

d)

Thymol

56.

This makes up majority of the NPNs

a)

Urea

b)

Uric Acid

c)

Creatinine

d)

Ammonia

57.

Convert BUN = 2.89mg/dL to Urea (mg/dL)

a)

6.19

b)

0.62

c)

1.35

d)

0.14

58.

Convert Urea = 9.8mg/dL to BUN (mg/dL)

a)

4.58

b)

20.97

c)

0.46

d)

21.0

59.

In measuring creatinine, plasma or serum is preferred over whole blood because of the interference posed by chromogens in red blood cells

a)

True

b)

False

60.

Urine osmolality is the best method to determine maximal concentration and dilution of urine.

a)

True

b)

False