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MEDL 279 Chemistry Review Part I

Total questions: 96

Worksheet time: 48mins

Name
Class
Date
1.

Which color top tube is used for most serum tests?

a)

Red or Yellow top tubes

b)

Blue top tubes

c)

Green top tubes

d)

Purple top tubes

2.

Which tube is used for ammonia and blood gases and must be received in the lab on ice?

a)

Green top Heparin tube

b)

Red top tube

c)

Blue top Citrate tube

d)

Yellow top SPS tube

3.

What is the purpose of the sodium fluoride gray top tube?

a)

Glucose testing

b)

For liver function tests

c)

For coagulation studies

d)

For blood typing

4.

What effect does hemolysis have on potassium (K+) levels in a blood sample?

a)

A false increase in K+

b)

A false decrease in K+

c)

No effect on K+ levels

d)

A true decrease in K+

5.

What is the fasting range for blood glucose?

a)

70-110 mg/dL

b)

120-160 mg/dL

c)

40-60 mg/dL

d)

150-200 mg/dL

6.

Which hormone decreases serum glucose and stimulates uptake by cells?

a)

Insulin

b)

Glucagon

c)

Cortisol

d)

Adrenaline

7.

Which hormone increases glucose and stimulates gluconeogenesis?

a)

Cortisol

b)

T3 & T4

c)

Insulin

d)

Glucagon

8.

Which hormones increase glucose and stimulate glycogenolysis?

a)

Cortisol

b)

T3 & T4

c)

Insulin

d)

Glucagon

9.

OGTT testing of a standard 75g dose, with a result of >200 mg/dL is diagnostic of which disease?

a)

Hypertension

b)

Diabetes Mellitus

c)

Hyperthyroidism

d)

Anemia

10.

Which enzyme is most sensitive and often used as a reference method for glucose measurement?

a)

Glucose oxidase

b)

Hexokinase

c)

Amylase

d)

Lipase

11.

How long is fasting required before lipid collection?

a)

6 hours

b)

8 hours

c)

12 hours

d)

24 hours

12.

Non-fasting may cause turbid serum with a layer of ________ on the top.

a)

chylomicron

b)

albumin

c)

bilirubin

d)

globulin

13.

What percentage of LDL is present in transported forms of lipoproteins?

a)

20-35%

b)

60-70%

c)

5-12%

d)

40-50%

14.

Which lipoprotein class transports exogenous triglycerides?

a)

Chylomicron

b)

VLDL

c)

LDL

d)

HDL

15.

Enzymatic methods measure free ________.

a)

cholesterol

b)

glucose

c)

urea

d)

bilirubin

16.

Proteins are synthesized and catabolized in which organ?

a)

Liver

b)

Heart

c)

Lungs

d)

Kidney

17.

Proteins are made up of which elements?

a)

Carbon, Hydrogen, Oxygen, and Nitrogen

b)

Carbon, Hydrogen, and Sulfur

c)

Oxygen, Nitrogen, and Phosphorus

d)

Hydrogen, Oxygen, and Calcium

18.

What are the basic form of proteins?

a)

Amino acids

b)

Fatty acids

c)

Nucleotides

d)

Monosaccharides

19.

Protein breakdown in the body results in the production of what two substances?

a)

Urea and ammonia

b)

Glucose and oxygen

c)

Fatty acids and glycerol

d)

Carbon dioxide and water

20.

Which method is the reference method for measuring nitrogen content in proteins?

a)

Kjeldahl method

b)

Biuret method

c)

Lowry method

d)

Bradford method

21.

The Biuret reaction depends on the presence of how many peptide bonds?

a)

2

b)

1

c)

>2

d)

6

22.

Which dye is used in the dye-binding method for albumin analysis?

a)

Bromcresol green (BCA)

b)

Coomassie Brilliant Blue

c)

Safranin

d)

Crystal Violet

23.

In electrophoresis, the migration direction of proteins in an electrical field is determined by what?

a)

Proteins surface charge

b)

Proteins molecular weight

c)

Buffer pH only

d)

Temperature of the room

24.

What is the formula for calculating LDL using the Friedewald Calculation?

a)

LDL = Total Cholesterol - [HDL - (TG/5)] in mg/dL

b)

LDL = HDL Cholesterol + [ TG/5]- (Total Cholesterol)

c)

LDL = Total Cholesterol + [HDL + (TG/5)] in mg/dL

d)

LDL = Total Cholesterol - [HDL + (TG/5)] in mg/dL

25.

Which protein has the smallest molecular weight and migrates most rapidly in electrophoresis?

a)

Albumin

b)

Globulin

c)

Fibrinogen

d)

Hemoglobin

26.

At a pH of 8.6, what are the major bands observed in protein electrophoresis?

a)

Albumin, alpha-1, alpha-2, beta, and gamma

b)

Albumin, alpha-1, alpha-2, beta, and delta

c)

Pre-albumin, albumin, beta, and gamma only

d)

Albumin, alpha-1, alpha-2, and gamma only

27.

Which gel types are most commonly used as support media in urine protein electrophoresis?

a)

Agarose gel, cellulose acetate

b)

Polyacrylamide gel, starch gel

c)

Nitrocellulose membrane, polyvinylidene fluoride

d)

Silica gel, alumina gel

28.

Which stains are used in urine protein electrophoresis?

a)

Amido black, ponceau S, Coomassie brilliant blue

b)

Sudan III, Oil Red O, Nile blue

c)

Periodic acid-Schiff, Alcian blue, Toluidine blue

d)

Giemsa, Wright, Leishman

29.

What type of sample should be collected for protein electrophoresis to avoid a fibrinogen peak?

a)

Plasma samples (serum will result in fibrinogen peak)

b)

Serum samples (plasma will result in fibrinogen peak)

c)

Whole blood samples

d)

Urine samples collected after centrifugation

30.

Which organ produces albumin, alpha-1, alpha-2, and beta globulins?

a)

Liver

b)

Kidney

c)

Pancreas

d)

Spleen

31.

Which system produces gamma globulins?

a)

Immune system

b)

Digestive system

c)

Respiratory system

d)

Nervous system

32.

Which plasma protein is the largest plasma fraction?

a)

Albumin

b)

Globulin

c)

Fibrinogen

d)

Prothrombin

33.

A decrease in albumin can be caused by which of the following?

a)

Lower liver synthesis

b)

Malnutrition or absorption

c)

Nephrotic syndrome

d)

Severe burns

e)

All of the above

34.

Ceruloplasmin transports which metal in the blood?

a)

Copper

b)

Iron

c)

Zinc

d)

Magnesium

35.

Beta globulin acts as carrier proteins for which substances?

a)

Iron (transferrin) and lipids (lipoproteins)

b)

Glucose and insulin

c)

Calcium and potassium

d)

Oxygen and carbon dioxide

36.

An increase in LDL and iron deficiency anemia is associated with which type of globulin?

a)

Alpha globulin

b)

Beta globulin

c)

Gamma globulin

d)

Delta globulin

37.

Gamma globulin increases in chronic inflammation, cirrhosis or viral hepatitis, collagen disease, and ________.

a)

monoclonal paraproteins

b)

hypothyroidism

c)

iron deficiency anemia

d)

nephrotic syndrome

38.

A decrease in gamma globulin is seen in ________ or acquired immune deficiency.

a)

congenital

b)

bacterial infection

c)

allergic reaction

d)

autoimmune disease

39.

Enzymes are organic catalysts responsible for the reactions that occur in the ________.

a)

body

b)

atmosphere

c)

ocean

d)

rock

40.

Which of the following does NOT affect enzyme reactions?

a)

A) Concentrations

b)

B) pH

c)

C) Temperature

d)

D) Blood pressure

41.

Zero-order kinetics in enzymes means that the amount of enzyme activity is the only ________ factor.

a)

rate-limiting

b)

catalytic

c)

inhibitory

d)

cofactor

42.

Total CK increases in which of the following conditions?

a)

Muscle damage

b)

Liver failure

c)

Kidney stones

d)

Diabetes

43.

Name the three different CK isoforms mentioned in the text.

a)

CK-BB (Brain), CK-MM (Skeletal muscle), CK-MB (Cardiac muscle)

b)

CK-AB (Liver), CK-MN (Kidney), CK-BM (Lung)

c)

CK-CC (Cartilage), CK-AA (Adipose), CK-EE (Eye)

d)

CK-LL (Liver), CK-SS (Skin), CK-TT (Thyroid)

44.

Troponin T (TnT) increases the serum 4 hours after AMI and peaks at ________ hours.

a)

12-14

b)

4-6

c)

24-36

d)

48-72

45.

TnT is cardiac specific whereas ______ can be present due to other skeletal muscle injuries.

a)

CK-MB

b)

Troponin I

c)

Myoglobin

d)

BNP

46.

Which enzyme is the first to increase in cardiac marker evaluation after MI?

a)

AST

b)

LD

c)

CK-MB

d)

ALT

47.

AST rises in ______ hours and returns to normal in 4-6 days after MI.

a)

24-48

b)

6-8

c)

12-16

d)

72-96

48.

LD is elevated in 48-72 hours after MI and returns to normal in ______ days.

a)

10-14

b)

2-4

c)

13-18

d)

20-25

49.

Which of the following is NOT a condition where LD (Lactate Dehydrogenase) is increased?

a)

Liver disease

b)

Muscle trauma

c)

Osteoblastic tumors

d)

Pernicious anemia

50.

LD converts pyruvate to lactate while oxidizing ______ to NAD.

a)

NADH

b)

FADH2

c)

ATP

d)

Glucose

51.

AST (Aspartate transaminase) is found in which of the following tissues?

a)

Cardiac muscle

b)

Liver

c)

RBCs

d)

All of the above

52.

ALT (Alanine transaminase) increases in ______ disease.

a)

liver

b)

kidney

c)

lung

d)

heart

53.

GGT (Gamma-glutamyl transferase) increases in which of the following conditions?

a)

Liver disease

b)

Alcoholics

c)

Both liver & alcoholics

d)

None of the above

54.

ALP (Alkaline phosphatase) is increased in which bone disorders?

a)

Paget's disease, Osteoblastic tumors, Rickets

b)

Osteoporosis, Osteomalacia, Osteogenesis imperfecta

c)

Rheumatoid arthritis, Gout, Scurvy

d)

Osteoarthritis, Fibromyalgia, Lupus

55.

Which enzyme shows an increase in the liver but NOT in the bone?

a)

5'NT

b)

ALP

c)

AST

d)

ALT

56.

Amylase is produced in which glands?

a)

Salivary glands and pancreas

b)

Thyroid gland and adrenal gland

c)

Pituitary gland and pineal gland

d)

Sweat glands and sebaceous glands

57.

The highest increase in amylase is seen in which condition?

a)

Obstructive jaundice

b)

Pancreatitis

c)

Mumps

d)

Hepatitis

58.

Decrease in amylase is seen in obstruction of salivary glands as seen in which disease?

a)

Mumps

b)

Diabetes mellitus

c)

Pancreatitis

d)

Cystic fibrosis

59.

Urinary amylase remains elevated longer than serum amylase in which condition?

a)

Pancreatitis

b)

Cholecystitis

c)

Appendicitis

d)

Gastritis

60.

Lipase is more specific for which condition?

a)

Acute pancreatitis

b)

Hepatitis

c)

Myocardial infarction

d)

Organophosphate poisoning

61.

Which enzyme shows the highest elevations in metastasizing carcinoma of the prostate?

a)

ACP (Acid Phosphatase)

b)

ALP (Alkaline Phosphatase)

c)

LDH (Lactate Dehydrogenase)

d)

AST (Aspartate Transaminase)

62.

Tartrate-resistant portion of ACP is elevated in which leukemia?

a)

Hairy cell leukemia

b)

Acute lymphoblastic leukemia

c)

Chronic myeloid leukemia

d)

Acute myeloid leukemia

63.

Presence of ACP in seminal fluid is used as a metric in which type of cases?

a)

Rape cases

b)

Murder cases

c)

Robbery cases

d)

Kidnapping cases

64.

Decrease in serum cholinesterase can help to diagnose which type of poisoning?

a)

Organophosphate poisoning

b)

Cyanide poisoning

c)

Lead poisoning

d)

Arsenic poisoning

65.

Myoglobin is produced by which tissue?

a)

Muscle

b)

Nerve

c)

Epithelial

d)

Connective

66.

Which marker is highest in hepatitis but is liver specific?

a)

AST

b)

ALT

c)

LD

d)

CK-MB

67.

ALP is slightly elevated in which condition?

a)

Hepatitis

b)

Diabetes

c)

Asthma

d)

Hypertension

68.

Which marker is liver specific and shows the highest increase in alcoholism?

a)

ALP

b)

5'NT

c)

GGT

d)

BNP

69.

An increase in which enzyme is more specific for acute pancreatitis?

a)

Lipase

b)

Amylase

c)

Alkaline phosphatase

d)

Aspartate transaminase

70.

BNP increases in which condition?

a)

CHF (Congestive Heart Failure)

b)

Diabetes Mellitus

c)

Asthma

d)

Osteoarthritis

71.

What is the major cation of extracellular fluid?

a)

Sodium

b)

Potassium

c)

Calcium

d)

Magnesium

72.

What is the reference range for sodium in mM/L?

a)

135-145 mM/L

b)

120-130 mM/L

c)

150-160 mM/L

d)

100-110 mM/L

73.

Which of the following is NOT a cause of hyponatremia?

a)

Cushing's

b)

Dehydration

c)

Hyperaldosteronism

d)

Hyperkalemia

74.

What is the reference range for potassium in mM/L?

a)

3.5-5.0 mM/L

b)

2.0-3.0 mM/L

c)

5.6-7.0 mM/L

d)

1.0-2.5 mM/L

75.

Name one cause of a false increase in potassium levels due to specimen collection.

a)

Hemolysis

b)

Fasting before collection

c)

Low platelet count

d)

Using a plastic tube

76.

Hypokalemia and hyperkalemia may cause which type of symptoms?

a)

Heart arrhythmias and/or neuromuscular symptoms including weakness and paralysis

b)

Increased bone density and joint pain

c)

Improved vision and hearing

d)

Rapid hair growth and skin thickening

77.

Which of the following is NOT a cause of hyperkalemia?

a)

Diabetic acidosis (metabolic)

b)

Intravascular hemolysis

c)

Severe burns

d)

Dehydration

78.

What is the major anion of extracellular fluid?

a)

Chloride

b)

Sodium

c)

Potassium

d)

Bicarbonate

79.

What is the reference range for chloride in mM/L?

a)

98-106 mM/L

b)

80-90 mM/L

c)

110-120 mM/L

d)

60-70 mM/L

80.

Hypochloremia can be caused by which of the following?

a)

Diabetic acidosis

b)

Chronic pyelonephritis

c)

Prolonged vomiting

d)

All of the above

81.

Hyperchloremia is associated with excess loss of ________.

a)

Bicarbonate (Bicarb)

b)

Potassium

c)

Calcium

d)

Sodium

82.

Which method is used for the analysis of chloride using a solid-state membrane?

a)

ISE Stolid State membrane using silver chloride

b)

Colorimetric method using diphenylcarbazone

c)

Gravimetric method using barium sulfate

d)

Titration with potassium chromate indicator

83.

An increase in sweat chloride is seen in which condition?

a)

Diabetes

b)

Cystic fibrosis

c)

Renal failure

d)

Hyperaldosteronism

84.

The chloride shift involves the movement of which ion out of the RBC?

a)

Na+

b)

K+

c)

HCO3-

d)

Cl-

85.

CO2 + HCO3- + H2CO3 = ________

a)

Total CO2

b)

Partial pressure of CO2

c)

Oxygen content

d)

Bicarbonate level

86.

Which of the following is NOT a method for CO2 analysis?

a)

Volumetric

b)

Colorimetric

c)

PCO2 electrode

d)

Spectrophotometric

87.

What is the calculation that reflects differences between unmeasured cations and anions called?

a)

Anion Gap

b)

Osmolal Gap

c)

Base Excess

d)

Serum Creatinine

88.

Which of the following is a major unmeasured cation?

a)

Albumin

b)

K+

c)

Na+

d)

Phosphate

89.

Which of the following is NOT a major unmeasured cation?

a)

K+

b)

Ca++

c)

Mg++

d)

Albumin

90.

Which of the following is a major unmeasured anion?

a)

A) Ca++

b)

B) Albumin

c)

C) K+

d)

D) Mg++

91.

Fill in the blank: The formula for calculating the anion gap is ___ .

a)

[(Na+) + (K+)] - [(Cl-) + (HCO3-)]

b)

[(Na+) - (Cl-) + (HCO3-) + (K+)]

c)

[(Na+) + (Cl-)] - [(K+) + (HCO3-)]

d)

[(Na+) + (HCO3-)] - [(Cl-) + (K+)]

92.

What is the reference range for anion gap with potassium result?

a)

10-20 mM/L

b)

2-6 mM/L

c)

20-30 mM/L

d)

0-5 mM/L

93.

Normal CSF glucose levels are approximately what percentage of plasma levels?

a)

60-65%

b)

25-50%

c)

60-85%

d)

40-65%

94.

A patient with a A1c result of 6.1% would be classified as what?

a)

Pre-diabetic

b)

Healthy

c)

Uncontrolled diabetic

d)

Hypertensive

95.

The electrophoresis pattern shown would represent what condition?

a)

Cirrhosis

b)

Monoclonal gammopathy

c)

Nephrotic syndrome

d)

Normal

96.

The electrophoresis pattern shown would represent what condition?

a)

Nephrotic syndrome

b)

Cirrhosis

c)

Normal

d)

Hypogammaglobulinemia

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