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CHEM 1 exam review part 1

Total questions: 57

Worksheet time: 31mins

Name
Class
Date
1.

Which two of the following directly affect an individual's arterial PO₂ levels? (Select TWO answers)

a)

Depth of inspiration

b)

Gas exchange between lungs and arterial blood

c)

Hemoglobin uptake of oxygen and hemoglobin concentration

d)

Metabolic rate

e)

Glomerular filtration rate (GFR)

2.

Which statement correctly describes how respiration is controlled?

a)

It is only regulated by oxygen levels in the lungs

b)

Central chemoreceptors respond to low CSF pH; peripheral chemoreceptors respond to low plasma pH and low PO₂

c)

Central chemoreceptors respond to high blood glucose; peripheral chemoreceptors respond to high blood pressure

d)

Respiration is controlled by kidney oxygen sensing

3.

Why is bicarbonate reabsorption by the kidney important?

a)

It helps raise blood potassium levels

b)

It prevents acidosis by maintaining blood pH

c)

It increases blood sugar

d)

It helps the lungs oxygenate the blood

4.

A patient has: HCO₃⁻ = 23 mmol/L and PCO₂ = 48 mmHg. What is the approximate blood pH using the Henderson-Hasselbalch equation?

a)

7.50

b)

7.40

c)

7.30

d)

7.20

5.

Which of the following factors directly affect oxygen levels in arterial blood? (Select all that apply)

a)

Hemoglobin levels

b)

Air temperature

c)

Alveolar gas exchange efficiency

d)

Blood flow and circulation

e)

Vitamin D levels

6.

The primary stimulus for automatic breathing regulation in the medulla oblongata is:

a)

Low oxygen

b)

Low temperature

c)

High carbon dioxide

d)

High blood sugar

7.

Right shift of the oxygen dissociation curve means hemoglobin holds oxygen more tightly.

a)

True

b)

False

8.

Which of the following can cause a right shift in the oxygen dissociation curve?

a)

Low temperature

b)

Low CO₂

c)

High 2,3-BPG

d)

High pH

9.

Which equation best describes the relationship between bicarbonate, CO₂, and blood pH?

a)

Beer-Lambert Law

b)

Henderson-Hasselbalch equation

c)

Michaelis-Menten equation

d)

Bohr effect equation

10.

Given: HCO₃⁻ = 24 mmol/L, PCO₂ = 40 mmHg. Using the Henderson-Hasselbalch equation, what is the pH?

a)

7.10

b)

7.25

c)

7.40

d)

7.55

11.

Which of the following are major forms of CO₂ transport in the blood? (Select all that apply)

a)

Bicarbonate (HCO₃⁻)

b)

Dissolved CO₂

c)

Bound to hemoglobin (carbaminohemoglobin)

d)

Carbon monoxide

12.

The respiratory system helps maintain acid-base balance by regulating oxygen levels.

a)

True

b)

False

13.

Which of the following is not a proper guideline for collecting an arterial blood gas sample?

a)

Use a heparinized syringe

b)

Analyze sample within 15 minutes or keep on ice

c)

Use venous blood for oxygen level testing

d)

Avoid air bubbles in the sample

14.

Which electrode is used to measure blood oxygen (PO₂)?

a)

Glass pH electrode

b)

Severinghaus electrode

c)

Clark electrode

d)

Thermocouple electrode

15.

Which part of an amino acid determines its unique identity and chemical properties?

a)

Amino group

b)

Carboxyl group

c)

R group (side chain)

d)

Alpha carbon

16.

Given glutamine has pKa values of 2.17 and 9.13, what is its isoelectric point (pI)?

a)

7.0

b)

5.65

c)

9.13

d)

2.17

17.

Which of the following is not involved in stabilizing the tertiary structure of a protein?

a)

Hydrogen bonds

b)

Disulfide bridges

c)

Hydrophobic interactions

d)

Phosphodiester bonds

18.

Which of the following is a mucoprotein?

a)

Hemoglobin

b)

Mucin

c)

Albumin

d)

IgG

19.

Which of the following is a glycoprotein?

a)

Myosin

b)

Mucin

c)

Transferrin

d)

Keratin

20.

"Salting out" refers to increasing protein solubility by adding salt.

a)

True

b)

False

21.

In the biuret method, which ion forms a violet complex with peptide bonds?

a)

Fe²⁺

b)

Cu²⁺

c)

Na⁺

d)

Mg²⁺

22.

At what wavelength do peptide bonds absorb UV light for protein estimation?

a)

260 nm

b)

540 nm

c)

280 nm

d)

200 nm

23.

Which of the following is not a component of a typical α-amino acid?

a)

A carboxyl group

b)

A nitrogenous base

c)

An amino group

d)

An R group (side chain)

24.

Which two processes are involved in protein synthesis?

a)

Replication and mutation

b)

Translation and respiration

c)

Transcription and translation

d)

Digestion and absorption

25.

Which level of protein structure involves hydrogen bonding between nearby amino acids to form α-helices and β-sheets?

a)

Primary

b)

Secondary

c)

Tertiary

d)

Quaternary

26.

Which of the following is an example of a conjugated protein?

a)

Albumin

b)

Keratin

c)

Lipoprotein

d)

Collagen

27.

Which of the following is an example of a conjugated protein?

a)

Albumin

b)

Keratin

c)

Lipoprotein

d)

Collagen

28.

In the Biuret method, what causes the violet color change indicating protein presence?

a)

Sodium ions binding to glucose

b)

Peptide bonds reacting with copper ions

c)

Ammonium ions reacting with base

d)

Protein denaturation in heat

29.

What does serum protein electrophoresis detect?

a)

Blood pH levels

b)

Monoclonal immunoglobulin spikes

c)

Hormonal imbalances

d)

Platelet function

30.

Why can proteins be measured at 200 nm?

a)

Because tyrosine absorbs light strongly there

b)

Because peptide bonds absorb UV light

c)

Because hemoglobin binds oxygen

d)

Because of metal ion interactions

31.

What is the role of mass spectrometry in protein analysis?

a)

Measures protein absorbance at 540 nm

b)

Separates proteins by electric charge

c)

Identifies proteins by mass-to-charge ratio

d)

Measures protein solubility

32.

If a patient is in metabolic acidosis, what compensatory mechanism would occur?

a)

Hypoventilation to retain CO₂

b)

Hyperventilation to reduce CO₂

c)

Renal retention of hydrogen ions

d)

Increased bicarbonate excretion

33.

Which of the following best explains the acid/base disorder seen in diabetic ketoacidosis (DKA)?

a)

Excess bicarbonate retention from kidneys

b)

CO₂ retention due to respiratory failure

c)

Ketone accumulation from fat metabolism lowers pH

d)

Chloride loss from vomiting raises pH

34.

A patient with emphysema is most likely to develop which acid/base imbalance?

a)

Metabolic acidosis

b)

Metabolic alkalosis

c)

Respiratory acidosis

d)

Respiratory alkalosis

35.

A patient with severe vomiting is at risk for:

a)

Metabolic acidosis due to loss of bicarbonate

b)

Respiratory alkalosis due to increased ventilation

c)

Metabolic alkalosis due to chloride loss and bicarbonate retention

d)

Respiratory acidosis due to airway obstruction

36.

Given the following ABG results, what is the interpretation? pH = 7.41 PCO₂ = 41 mmHg HCO₃⁻ = 25 mmol/L

a)

Respiratory acidosis, uncompensated

b)

Metabolic acidosis, partially compensated

c)

Normal acid/base status

d)

Respiratory alkalosis, fully compensated

37.

Interpret the following ABG values: pH = 7.49 PCO₂ = 30 mmHg HCO₃⁻ = 22 mmol/L

a)

Respiratory alkalosis, uncompensated

b)

Respiratory acidosis, fully compensated

c)

Metabolic alkalosis, partially compensated

d)

Respiratory alkalosis, fully compensated

38.

What is the effect of air exposure on a blood gas sample for PO₂, and why?

a)

PO₂ decreases due to oxygen leaving the sample

b)

PO₂ increases due to oxygen diffusing in from room air

c)

PO₂ remains unaffected

d)

PO₂ decreases due to CO₂ diffusion

39.

Which of the following describes the principle of the PO₂ electrode?

a)

Potentiometry – Measures pH change from CO₂

b)

Amperometry – Measures current from oxygen reduction

c)

Spectrophotometry – Measures light absorbance by hemoglobin

d)

Turbidimetry – Measures light scattering in plasma

40.

The PCO₂ electrode works by which principle?

a)

Fluorescence

b)

Amperometry

c)

Potentiometry

d)

Absorbance

41.

What causes pH to increase in a blood sample exposed to room air?

a)

CO₂ diffuses out, decreasing carbonic acid and H⁺

b)

Oxygen diffuses in, creating acid

c)

Loss of bicarbonate increases acidity

d)

Red cell lysis releases potassium

42.

What blood gas finding is characteristic of metabolic acidosis?

a)

pH <7.35, HCO3- <22, PCO2 normal or low

b)

pH >7.45, HCO₃⁻ >26, PCO₂ normal

43.

Which of the following is a common cause of respiratory acidosis?

a)

Severe diarrhea

b)

Emphysema

c)

Vomiting

d)

Hyperventilation due to anxiety

44.

Which compensatory mechanism is most immediate in metabolic acidosis?

a)

Renal bicarbonate retention

b)

Hypoventilation to retain CO₂

c)

Hyperventilation to reduce CO₂

d)

Increased chloride reabsorption

45.

A patient with prolonged vomiting will likely develop:

a)

Metabolic acidosis

b)

Metabolic alkalosis

c)

Respiratory alkalosis

d)

Respiratory acidosis

46.

What is the primary compensatory mechanism for respiratory alkalosis?

a)

Lungs retain CO₂

b)

Kidneys excrete bicarbonate

c)

Kidneys retain bicarbonate

d)

Lungs increase ventilation

47.

In salicylate poisoning, which acid-base disorder is commonly seen?

a)

Respiratory alkalosis only

b)

Metabolic alkalosis only

c)

Mixed respiratory alkalosis and metabolic acidosis

d)

Respiratory acidosis

48.

What is an acute phase reactant protein?

a)

A protein that only functions in digestion

b)

A protein that changes concentration in response to inflammation

c)

A protein that is only found in urine

d)

A protein that is produced only during pregnancy

49.

Which of the following is a negative acute phase reactant protein?

a)

Haptoglobin

b)

Fibrinogen

c)

C-reactive protein

d)

Albumin

50.

Which protein is a positive acute phase reactant and commonly used as a marker for inflammation?

a)

Albumin

b)

Myoglobin

c)

C-reactive protein (CRP)

d)

Transferrin

51.

A broad, diffuse elevation in the gamma region of an SPE (serum protein electrophoresis) is most consistent with:

a)

Hypoproteinemia

b)

Polyclonal gammopathy

c)

Albuminuria

d)

Monoclonal gammopathy

52.

A sharp, narrow spike in the gamma region of an SPE suggests:

a)

Liver disease

b)

Renal failure

c)

Monoclonal gammopathy

d)

Normal immune response

53.

Which protein is elevated in congestive heart failure (CHF)?

a)

Troponin I

b)

C-reactive protein

c)

BNP (Brain Natriuretic Peptide)

d)

Myoglobin

54.

What protein is the most specific diagnostic marker for acute myocardial infarction (heart attack)?

4 lines
55.

Which of the following would most likely produce a monoclonal spike on SPE?

a)

Chronic infection

b)

Autoimmune disease

c)

Multiple myeloma

d)

Cirrhosis

56.

CRP levels increase during acute inflammation.

a)

True

b)

False

57.

Albumin levels increase during acute inflammation.

a)

True

b)

False