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MEDL 279 Chemistry Review Part II

Total questions: 88

Worksheet time: 44mins

Name
Class
Date
1.

What does osmolality measure?

a)

The total concentration of dissolved particles in a solution

b)

The total volume of a solution

c)

The pH of a solution

d)

The color of a solution

2.

Which of the following is a direct method to measure osmolality?

a)

Freezing point depression

b)

Boiling point elevation

c)

Colorimetric analysis

d)

Titration

3.

Fill in the blank: The formula for calculated osmolality is _________.

a)

2Na+Glucose/18+BUN/2.8

b)

Na+K+Cl

c)

2K+Glucose/18+BUN/2.8

d)

Na+Glucose/18+BUN/2.8

4.

Magnesium levels increase in which condition?

a)

Renal failure

b)

Cardiac disorders

c)

Diabetes Mellitus

d)

Alcohol use

5.

Magnesium levels decrease in all of the following EXCEPT:

a)

Cardiac disorders

b)

Diabetes Mellitus

c)

Renal failure

d)

Use of diuretics, alcohol, and other drugs

6.

Which analysis methods are used for magnesium?

a)

Colorimetric and Atomic absorption

b)

Titration and Spectrophotometry

c)

Chromatography and Electrophoresis

d)

Immunoassay and ELISA

7.

Calcium combines with _______ in the bone.

a)

phosphate

b)

sulphate

c)

chloride

d)

carbonate

8.

Which hormone increases ionized Ca++?

a)

PTH

b)

Calcitonin

c)

Insulin

d)

Glucagon

9.

Hypercalcemia can be caused by all of the following EXCEPT:

a)

Hyperparathyroidism

b)

Cancer with bone metastasis

c)

Multiple myeloma

d)

Hypoparathyroidism

10.

Which method measures ionized Ca++?

a)

ISE

b)

Colorimetric

c)

Fluorometric

d)

Titration

11.

The majority of phosphate in the body is expressed as ________, and the lab only measures inorganic phosphorous PO4 only.

a)

phosphorous

b)

calcium

c)

magnesium

d)

potassium

12.

Phosphorous has an inverse relationship with which ion?

a)

Na+

b)

K+

c)

Ca++

d)

Mg++

13.

An increase in phosphorous levels can be caused by which of the following?

a)

Hypoparathyroidism

b)

Chronic renal failure

c)

Excess Vitamin D

d)

All of the above

14.

A decrease in phosphorous levels can be caused by ________ and impaired renal absorption.

a)

hyperparathyroidism

b)

hypoparathyroidism

c)

hyperkalemia

d)

hypokalemia

15.

Spectrophotometric methods for phosphorous analysis use ________ to combine with PO4 ions.

a)

molybdate

b)

sulphate

c)

chloride

d)

nitrate

16.

Over 65% of iron in the body is in the form of ________ for O2 transport.

a)

hemoglobin

b)

myoglobin

c)

ferritin

d)

transferrin

17.

Iron is transported in the body by which of the following?

a)

Transferrin

b)

Haptoglobin

c)

Hemopexin

d)

All of the above

18.

Iron is stored in the body as ________ and hemosiderin.

a)

ferritin

b)

albumin

c)

globulin

d)

myoglobin

19.

Serum iron analysis should avoid ________.

a)

hemolysis

b)

lipemia

c)

hyperglycemia

d)

alkalosis

20.

Ferritin is used to assess ________ storage and lab assessment of iron.

a)

iron

b)

calcium

c)

glucose

d)

potassium

21.

What is the formula for the Henderson-Hasselbalch equation?

a)

pH = pKa + log [HCO3]/[H2CO3]

b)

pH = pKa - log [HCO3]/[H2CO3]

c)

pH = pKa + [HCO3]/[H2CO3]

d)

pH = pKa - [HCO3]/[H2CO3]

22.

According to the Henderson-Hasselbalch equation, what should the ratio of [HCO3] to [H2CO3] be?

a)

20:1

b)

10:1

c)

2:1

d)

1:1

23.

Urines with large amounts of porphyrins will show what color?

a)

Blue

b)

Red or "port wine"

c)

Green

d)

Yellow

24.

In the Watson-Schwartz test, porphobilinogen will react with Ehrlich's reagent to form what color?

a)

Blue

b)

Green

c)

Red

d)

Yellow

25.

The Jendrassik-Grof method uses which substance as an accelerator?

a)

Caffeine-benzoate

b)

Sodium chloride

c)

Glucose

d)

Urea

26.

Direct bilirubin is also known as ______ and is ______ soluble.

a)

conjugated and is water soluble.

b)

unconjugated and is fat soluble.

c)

conjugated and is fat soluble.

d)

unconjugated and is water soluble.

27.

Indirect bilirubin is also known as ______ and is ______ in water.

a)

unconjugated and is insoluble in water.

b)

conjugated and is soluble in water.

c)

unconjugated and is soluble in water.

d)

conjugated and is insoluble in water.

28.

Which of the following can falsely increase bilirubin results in specimen collection?

a)

Extremely light sensitive

b)

Lipemia

c)

Hemolysis

d)

All of the above

29.

In pre-hepatic jaundice (hemolytic anemia), increase in RBC destruction leads to increase in ______ bilirubin.

a)

unconjugated

b)

conjugated

c)

direct

d)

mixed

30.

In hepatic jaundice (viral hepatitis, cirrhosis), what happens to unconjugated and conjugated bilirubin levels?

a)

Increase in both unconjugated and conjugated bilirubin.

b)

Decrease in both unconjugated and conjugated bilirubin.

c)

Increase in unconjugated but decrease in conjugated bilirubin.

d)

Decrease in unconjugated but increase in conjugated bilirubin.

31.

Conjugated and unconjugated bilirubin cannot be metabolized properly, therefore they back-up into the ________.

a)

plasma

b)

urine

c)

intestine

d)

liver

32.

What color may stool become due to a decrease in urobilinogen?

a)

clay colored

b)

bright red

c)

green

d)

black

33.

Which of the following is the gold standard for confirmation and screening in Toxicology/TDM?

a)

Immunochemical methods

b)

Gas Chromatography-Mass Spec

c)

FPIA

d)

EMIT methods

34.

How many half-lives does it take to reach a steady state for therapeutic monitoring?

a)

2

b)

3

c)

5 ½

d)

7

35.

Trough specimen is drawn immediately _______ the next dose.

a)

before

b)

after

c)

during

d)

with

36.

Which aminoglycoside is less toxic to kidneys?

a)

Gentamycin

b)

Tobramycin

c)

Chloramphenicol

d)

Digoxin

37.

Toxic levels of _______ can result in aplastic anemia.

a)

chloramphenicol

b)

paracetamol

c)

amoxicillin

d)

ibuprofen

38.

Lidocaine is measured using which laboratory methods?

a)

Immunoassay, HPLC

b)

ELISA, PCR

c)

Western blot, Electrophoresis

d)

Spectrophotometry, Colorimetry

39.

Which of the following is NOT an anticonvulsant?

a)

Carbamazepine

b)

Phenobarbital

c)

Lithium

d)

Phenytoin (Dilantin)

40.

Name one use of lithium in medicine.

a)

Used in treating manic depression

b)

Used as a painkiller for headaches

c)

Used to treat bacterial infections

d)

Used to lower blood sugar levels

41.

Theophylline is a type of:

a)

Anticonvulsant

b)

Psychotropic

c)

Bronchodilator

d)

Heavy Metal

42.

Severe toxicity of theophylline can cause which of the following?

a)

Cardiac arrhythmias

b)

Seizures

c)

Death

d)

All of the above

43.

Which laboratory method is used for both lidocaine and theophylline?

a)

HPLC

b)

ELISA

c)

Nephelometry

d)

Colorimetry

44.

Which of the following is most commonly associated with metabolic acidosis and respiratory alkalosis?

a)

Iron

b)

Salicylates

c)

Lead

d)

Arsenic

45.

What is the most common alcohol involved in acute poisoning?

a)

Ethanol

b)

Methanol

c)

Isopropanol

d)

Ethylene glycol

46.

Lead is classified under which type of acute poisoning?

a)

Heavy Metals

b)

Pesticides

c)

Alkaloids

d)

Gases

47.

Acetaminophen can cause liver damage due to accumulation of toxic metabolite after how many hours of ingestion?

a)

48 hours

b)

6 hours

c)

12 hours

d)

24 hours

48.

Antidote for acetaminophen poisoning is most helpful if given within how many hours?

a)

24 hours

b)

48 hours

c)

12 hours

d)

36 hours

49.

All NPNs (urea, creatinine, uric acid, and ammonia) are increased in the plasma in renal impairment. What is this condition called?

a)

Azotemia

b)

Hypokalemia

c)

Acidosis

d)

Hypercalcemia

50.

In cases of suspected renal impairment, what is the best lab evaluation?

a)

GFR (Glomerular Filtration Rate)

b)

Serum sodium

c)

Urine glucose

d)

Serum calcium

51.

What is the formula for creatinine clearance calculation?

a)

U creat/P creat X Volume 24hr urine/1440 (min/24hr)

b)

P creat/U creat X Volume 24hr urine/1440 (min/24hr)

c)

U creat/P creat X Volume 24hr urine/60 (min/hr)

d)

U creat/P creat X Volume 12hr urine/1440 (min/24hr)

52.

What is the source of creatinine in the body?

a)

From creatine in muscle

b)

From glucose in the liver

c)

From fatty acids in adipose tissue

d)

From hemoglobin breakdown

53.

Which substances can interfere with the Jaffe reaction for creatinine measurement?

a)

Glucose, ascorbic acid

b)

Sodium chloride, potassium iodide

c)

Calcium carbonate, magnesium sulfate

d)

Urea, albumin

54.

BUN increases in impaired renal function and rises more rapidly than which other substance?

a)

Serum creatinine

b)

Uric acid

c)

Glucose

d)

Calcium

55.

Which method is used for the colorimetric detection of urea?

a)

Urea reacts with diacetyl monoxime to form colored complex

b)

Urea reacts with Benedict's reagent to form colored complex

c)

Urea reacts with ninhydrin to form colored complex

d)

Urea reacts with Fehling's solution to form colored complex

56.

What is the normal BUN/creatinine ratio?

a)

10:1-20:1

b)

5:1-8:1

c)

25:1-35:1

d)

1:1-3:1

57.

Uric acid is the end product of which metabolism?

a)

Purine metabolism

b)

Pyrimidine metabolism

c)

Carbohydrate metabolism

d)

Protein metabolism

58.

Increase in plasma ammonia is toxic to which system?

a)

CNS (Central Nervous System)

b)

Musculoskeletal system

c)

Integumentary system

d)

Reproductive system

59.

Which of the following is NOT a cause of hyperammonemia?

a)

Advanced liver disease

b)

Cirrhosis

c)

Diabetes mellitus

d)

Viral hepatitis

60.

What hormone stimulates the pituitary to release TSH?

a)

TRH

b)

ACTH

c)

FSH

d)

GH

61.

Which hormone stimulates the thyroid to produce both thyroxine (T4) and triiodothyronine (T3)?

a)

TSH

b)

ACTH

c)

FSH

d)

GH

62.

In the tissues, T4 is converted to which physiologically active portion?

a)

T3

b)

T2

c)

T4 sulfate

d)

Reverse T3

63.

What percentage of T4 is bound to TBG, TBPA, and albumin?

a)

99.97%

b)

98.5%

c)

95%

d)

99.5%

64.

Which of the following is NOT a symptom of hyperthyroidism?

a)

A) Weight loss

b)

B) Heat intolerance

c)

C) Weight gain

d)

D) Nervousness

65.

What is the most common cause of hyperthyroidism?

a)

Grave's disease

b)

Hashimoto's thyroiditis

c)

Thyroid cancer

d)

Iodine deficiency

66.

Which of the following is associated with Hashimoto's Thyroiditis?

a)

Increase T3 and T4

b)

Decrease T3 and T4

c)

Decrease TSH

d)

No thyroid antibodies

67.

Symptoms of hypothyroidism include:

a)

Fatigue

b)

Weight gain

c)

Decreased mental and physical output

d)

All of the above

68.

Test for total T4 can be performed using which of the following methods?

a)

RIA or EIA

b)

ELISA only

c)

Western Blot

d)

PCR

69.

Free T4 is separated by ________ dialysis.

a)

equilibrium

b)

reverse

c)

osmotic

d)

pressure

70.

Direct T3 is measured by ________ or EIA.

a)

RIA

b)

ELISA

c)

PCR

d)

Western blot

71.

Male sex hormones, secondary sexual characteristics are called ________.

a)

Androgens

b)

Estrogens

c)

Insulins

d)

Thyroxines

72.

Androgens are secreted by the ________, adrenals and ovaries.

a)

testes

b)

pancreas

c)

thyroid

d)

pituitary

73.

Female sex hormones are called ________.

a)

Estrogens

b)

Testosterones

c)

Insulins

d)

Adrenalins

74.

Estradiol is responsible for ________ sexual characteristic.

a)

secondary

b)

primary

c)

tertiary

d)

quaternary

75.

Which hormone increases in fetal development and monitors the integrity of the fetal placental unit?

a)

Estrone

b)

Estriol

c)

Testosterone

d)

Aldosterone

76.

Aldosterone is produced in the ________ cortex of the adrenal gland.

a)

outer

b)

renal

c)

cerebral

d)

thymic

77.

Which disease is associated with increased sodium, decreased potassium, and hypertension?

a)

Addison's disease

b)

Conn's disease

c)

Cushing's syndrome

d)

Neuroblastoma

78.

Addison's disease is associated with which of the following?

a)

Increase sodium & chloride

b)

Decrease sodium & chloride

c)

Increase cortisol

d)

Increase hemoglobin

79.

Fill in the blank: Decrease ACTH in damage to hypothalamus or pituitary, ______ ACTH in adrenal damage.

a)

Increase

b)

Decrease

c)

No change in

d)

Fluctuating

80.

Cortisol is produced in the ______ cortex.

a)

adrenal

b)

cerebral

c)

renal

d)

thymic

81.

Which of the following is NOT a function of cortisol?

a)

Causes increase glucose through gluconeogenesis

b)

Inhibits protein synthesis

c)

Immunosuppressive and anti-inflammatory

d)

Increases potassium excretion

82.

Cushing's syndrome is associated with:

a)

Increase cortisol

b)

Decrease cortisol

c)

Increase aldosterone

d)

Decrease aldosterone

83.

Which hormone is produced in the adrenal medulla?

a)

Cortisol

b)

Epinephrine

c)

Gastrin

d)

Serotonin

84.

HVA is a metabolite of ______.

a)

dopamine

b)

serotonin

c)

acetylcholine

d)

norepinephrine

85.

Metanephrines and VMA are metabolites of which hormone?

a)

Cortisol

b)

Epinephrine

c)

Gastrin

d)

Serotonin

86.

Neuroblastoma is a fatal tumor in ______.

a)

children

b)

adults

c)

elderly

d)

infants

87.

Which assay is the best screen for pheochromocytoma?

a)

HVA in urine

b)

Metanephrines in urine

c)

VMA in urine

d)

Cortisol in urine

88.

Gastrin levels increase in which syndrome?

a)

Addison's disease

b)

Cushing's syndrome

c)

Zollinger-Ellison syndrome

d)

Conn's disease