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Clinical Chemistry > 2019 & 2022 > Flashcards

2019 & 2022 Flashcards

1
Q

Specimen for blood gas analysis was received in the laboratory, which of the following criteria is correct?
a. On ice, with thin fibrin strand, no air bubbles
b. On ice, no clots, 4 air bubbles
c. On ice, no clots, no air bubbles
d. RT, no bubbles, no clots

A

C

Specimens for blood gas analysis are placed in ice to prevent O2 consumption. Presence of clots and bubbles may cause erroneous results.

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2
Q

Specimen collected from prolonged tourniquet application for potassium measured 7.0 mmol/L, what is the course of action?
a. Repeat test
b. Adjust value with sodium level
c. Test with freshly drawn specimen
d. Cancel test

A

C

Prolonged tourniquet application causes hemoconcentration

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3
Q

There is a need to use sodium fluoride as anticoagulant for specimen collection for plasma glucose analysis because the anticoagulant has the following properties.
a. Serves as coenzyme for hexokinase
b. Prevents reactivity for non-glucose reducing substances
c. Precipitates proteins
d. Inhibits glycolysis

A

D

NaF = anti-glycolytic agent and weak anticoagulant (therefore combined with oxalate);
prevents glycolysis for 48 – 72 hours Found in gray tops along with potassium oxalate which serves as the anticoagulant.

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4
Q

Patient undergone lab test after strenuous exercise. Which test will be affected:
1. AST
2. CPK
3. Glucose
4. TAGs

a. 1,2
b. 1,2,3
c. 3,4
d. 1,2,3,4

A

D

After exercise:
AST and CK are increased since they are enzymes sourced from the muscles.
Glucose and TAGs decreased because they are utilized for energy.

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5
Q

When making a calibration curve how many points or standards are needed to obtain a linearity?
a. 2
b. 3
c. 5
d. 10

A

B

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6
Q

. Protect the eyes?
1. Protective glasses
2. Eye goggles
3. Visor
4. Contact lens

A

All except contact lens

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7
Q

Proper waste disposal
a. Xylene in —
b. Radioactive drain in sink
c. Autoclave microbiologic sample
d. Blood in —-

A

C

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8
Q

Ideal quality control ___ must contain??
a. 95% confidence
b. 50%
c. 68%
d. 2+/-

A

A

Values are within 95% confidence of the mean. This equates to mean±2SD.

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9
Q

Which of the ff is used as a monochromator?
1. Colored filter
2. Quartz prism
3. Diffraction grating
4. Interfering filter

a. 1,2
b. 1,2,3
c. 2,3
d. 1,2,3,4

A

D

Monochromator: isolates a single atomic resonance line from the spectrum of lines emitted by the hollow cathode lamp

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10
Q

Uses light scatter which measure that amount of particle.
a. Turbidimetry
b. Fluorometry
c. AAS
d. Nephelometry

A

D

TURBIDIMETRY – determines amount of light blocked by particles in the sample
FLUOROMETRY – measures analyte which have the ability to absorb light of lower wavelength and transmit it at a higher wavelength
AAS – no excitation; dissociation of chemical bonds in neutral ground state
NEPHELOMETRY – determines the amount of light scattered by particles in solution

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11
Q

Wavelength measurement of UV light, visible light and Infrared light?
a. 720, 180, 380
b. 540, 290, 800
c. 180, 550, 720
d. 380, 180, 720

A

C

Higher frequency = shorter wavelength
Increasing frequency:
Radio wave→microwave→infrared radiation→visible light→UV→X-ray→ gamma rays
Uv- 200 -300 Visible- 400- 700 Infrared- 700

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12
Q

Which of the following analyzers offers random access?
a. Continuous flow
b. Centrifugal
c. Discrete
d. None of these

A

C

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13
Q

HbA1C value for DM using DCCT assay
a. >6 mmol/L
b. >6.5 mmol/L
c. >6%
d. >6.5%

A

D

HbA1C is reported in (%). Normal is <6% >6.5% is according to NGSP (National glycohemoglobin standardization program)

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14
Q

The polarographic glucose oxidase method is based on what principle?

A

Depletion of O2
Consumption of oxygen during enzymatic activity.
Enzyme: peroxidase
Oxygen consumed is directly proportional to glucose concentration in the sample.

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15
Q

Which of the following is NOT a function of glucagon?
a. Increased gluconeogenesis
b. Increased uptake of amino acid in the liver
c. Increased plasma amino acid
d. —-

A

C

Functions of glucagon: Gluconeogenesis Glycogenolysis
INCREASED uptake of amino acid in the LIVER for use in gluconeogenesis (not plasma, amino acid will decrease in plasma)

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16
Q

Conversion factor if glucose value is 75 mg/dL. What will be the result in SI unit?

A

0.0555
*note: memorize conversion factors
If reporting is asked: CU→SI, multiply (CUSIX) SI→CU, divide (SICUD)
CU: mg/dL SI: mmol/L
75 × 0.055 = 4.13 mmol/L

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17
Q

Serum glucose assay needs to be performed, the patient was extracted at 3 am then was left at 37 degrees until 4 am. Then glucose oxidase was performed at 4.30 am immediately after separating the serum from the cells. What will be the effect on glucose determination?
a. Decrease due to hemolysis
b. Decrease 20 mg/dL
c. Decrease 7%
d. —-

A

Decreased glucose
Serum must be separated from red cells within 1 hour to prevent substantial loss of glucose. Spin clotted blood with 30 mins of collection.
Glucose is metabolized at:
RT – 7mg/dL (0.4 mmol/L) per hour 4°C – 2mg/dL (0.1 mmol/L) per hour

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18
Q

Which of the following apolipoproteins are present in HDL?
1. Apo Al
2. Apo AIV
3. Apo CIII
4. Apo E

a. 1,2
b. 2,3
c. 1,2,3
d. AOTA

A

D

All are found in HDL

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19
Q

The triglycerides from chylomicrons are cleared or removed from circulation with what enzyme?
a. Hepatic lipase
b. Lipoprotein lipase
c. Hormone-sensitive lipase
d. Pancreatic lipase

A

B

Lipoprotein lipase a.k.a lipemia clearing factor removes chylomicrons from the circulation. Cleared after 6-8 hours after a meal.

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20
Q

TAGs > normal value FBS > normal value
Source of error??

A

Did not meet fasting requirements???
Fasting for FBS is 6-8 hours
Fasting for lipid profile is 12-14 hours (9 hours may be acceptable).

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21
Q

calculate for LDL.
250 mg/dL total chol 50 mg/dL HDL
180 mg/dL TAGS

A

164 mg/dL
TAGs < 400mg/dL
Use Friedwald equation:
𝑳𝑫𝑳 = 𝑻𝑪 − 𝑯𝑫𝑳 − 𝑽𝑳𝑫𝑳 = 𝑻𝑪 − 𝑯𝑫𝑳 − 𝒑𝒍𝒂𝒔𝒎𝒂 𝑻𝑨𝑮𝒔
𝟓 (𝟐. 𝟏𝟕𝟓 𝒊𝒇 𝒎𝒎𝒐𝒍/𝑳)

For TAGs >400mg/dL, Use DeLong equation:
𝑳𝑫𝑳 = 𝑻𝑪 − 𝑯𝑫𝑳 − 𝑽𝑳𝑫𝑳 = 𝑻𝑪 − 𝑯𝑫𝑳 −
𝒑𝒍𝒂𝒔𝒎𝒂 𝑻𝑨𝑮𝒔
𝟔. 𝟓 (𝟐. 𝟖𝟐𝟓 𝒊𝒇 𝒎𝒎𝒐𝒍/𝑳)

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22
Q

Lipoprotein that migrates with pre-beta globulin?

A

VLDL
Origin: CM
Pre beta: VLDL
Broad beta: IDL
Beta: LDL
Alpha: HDL

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23
Q

CHOD-PAP method uses what enzyme to produce fatty acid and free cholesterol?

A

Cholesteryl esterase
a.k.a CE hydrolase
note: CHolesterol oxidase is used on the 2nd reaction pa of CHOD-PAP to generate H2O2

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24
Q

Which of the following proteins increase in response to infection, inflammation and tissue necrosis?
a. Albumin
b. Transferrin
c. CRP
d. NOTA

A

C

CRP is a POSITIVE acute phase reactant. It INCREASES during infection.
Albumin and Transferrin (and prealbumin) are NEGATIVE acute phase reactants. They DECREASE during infection.

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25
Q

Which of the following proteins serve as a carrier of vitamin A?
a. Transthyretin
b. Albumin
c. Ceruloplasmin
d. Fibrinogen

A

A

Transthyretin a.k.a Prealbumin carries vitamin A
Albumin – thyroid hormones, FA, B1 etc. Ceruloplasmin - copper

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26
Q

Dyes used for dye binding technique for albumin?
1. HABA
2. Methyl orange
3. BCG
4. BCP

a. 1,2
b. 3,4
c. None
d. All

A

D

HABA: 2,4 – hydroxyazobenzene benzoic acid
BCG: Bromocresol green
BCP: Bromocresol purple

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27
Q

Method that assess the amount of peptide bonds in the protein through the reaction with copper ion
a. Berthelot
b. Biuret
c. Ninhydrin
d. Salt precipitation technique

A

B

BERTHELOT: NH3 liberated is allowed to react with alkaline hypochlorite to form indophenol blue
NINHYDRIN: Used to detect peptide bonds and amino acid after paper Chromatography. Product is violet color from reaction of ninhydrin and primary amine.
SALT PPTION TECH: used to get albumin content by precipitating globulin.

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28
Q

Alpha-2 macroglobulins
1. Transferrin
2. Haptoglobin
3. Ceruloplasmin
4. C4
a. 1and3
b. 2and4
c. None of the above
d. All of the above

A

C

Alpha-2-macroglobulin: Haptoglobin Ceruloplasmin Alpha-2-ceruloplasmin

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29
Q

Adsorbent of Jaffe-Fuller’s Earth method

A

Floridin/Fuller Earth’s (aluminum magnesium silicate)

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30
Q

Cause of pre renal azotemia?
a. Chronic renal disease
b. Hemorrhage
c. Protein intake
d. Dehydration

A

B or C??
Prerenal azotemia – when circulation through the kidney is less efficient
(e.g congestive heart failure, hemorrhage, increase protein catabolism etc.)

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31
Q

What method measures concentration in serum and concentration urine?
a. GFR
b. Osmolality
c. Renal Function test
d. Measurement of NPNs

A

A

Glomerular filtration rate compares the concentration of substance in the urine with its concentration in the plasma
Osmolality = for renal blood flow

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32
Q

The physician requested for urea determination with glucose test using sodium fluoride as anticoagulant. Pwede ba magamit for urease determination? Indi na magpakuha ang patient liwat.
a. Pwede basta enough specimen
b. Perform urease determination in 30 mins
c. Incubate for 37 degrees
d. Repeat collection

A

D

Sodium fluoride is contraindicated for urea determination because it is inhibitory to enzymes.

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33
Q

Falsely elevated creatinine clearance
1. Patient collected midstream urine
2. Patient added water
3. Patient included his 1st morning urine
4. Patient did not include his 1st morning urine

A. 1,3
B. 1,4
C. 3 only
D. 4 only

A

C

1st morning urine is not a part of a 24- hour urine. Part pa yan ng urine kahapon, yung sunod mo na pagurinate dyan na mag.start ang 24-hr urine and ma.end the same time kung anong oras ka nagcollect ng first urine mo. ☺
Falsely DECREASED if the last part of urine was not collected

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34
Q

Chemotherapy in leukemia. After chemo, his physician ordered serum blood tests. What analyte would be most likely elevated?
a. Uric acid
b. Urea
c. Allantoin
d. Ammonia

A

A

Uric acid is elevated during chemotherapy and even in leukemia
Chemotherapy = increased cellular destruction (affected si nucleus)→ increased purine metabolism→increased uric acid
Leukemia = increased cell nuclei metabolism

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35
Q

NPN nga increased sa muscle mass
a. Ammonia
b. Creatinine
c. Creatine kinase
d. —

A

B

Non-enzymatic dehydration of creatine- PO4 to creatinine occurs in the MUSCLES, therefore creatinine is affected by muscle mass.
CK – an enzyme, not an NPN. Ammonia – not found in the muscle

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36
Q

Which is not true about GFR

A

Inulin test is the least accurate

Inulin (polymer of fructose) gives the most accurate result for GFR determination and the most ideal substance for GFR. It is an exogenous substance administered through IV

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37
Q

Which of the following diseases is the inability to transport bilirubin to hepatocyte?
a. Criggler-Najjar
b. Carcinoma of the hepatic duct
c. Dubin-Johnson
d. Rotor Syndrome

A

C

DUBIN-JOHNSON: inability to remove B2 in the hepatocyte because of deficiency of the MDR2/cMOAT (Canalicular Multidrug Resistance/ Multispecific Organic Anionic Transport Protein
CRIGGLER-NAJJAR: UDPGT def ROTOR: no known cause

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38
Q

Enzyme marker in alcoholism

A

GGT

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39
Q

Enzyme involved in conjugation of bilirubin

A

UDPGT : uridine diphosphoglucoronosyl transferase

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40
Q

DeRitis ratio (AST:ALT) < 1
a. Acute hepatitis
b. Hepatic cirrhosis
c. Chronic hepatitis
d. —

A

A

DeRitis ratio is LOW in acute or chronic viral hepatitis.
ALT is high.
Ratio of <1 (high ALT) indicates acute hepatocellular injury

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41
Q

If patient is in a coma and physician diagnosed him with hepatic failure. What assay is requested to assess for ______??

a. Ammonia
b. GGT
c. AST
d. ALT

A

C

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42
Q

Biliary obstruction…
Total bilirubin – increased
Conjugated bili – normal
Urine bili - increased
Fecal urobilin - decreased

What is inconsistent with the result?

a. Total bilirubin
b. Conjugated bilirubin
c. Urine bilirubin
d. Fecal urobilin

A

B

Biliary obstruction = post hepatic jaundice
Post hepatic jaundice: Increased conjugated bilirubin Decreased urine urobilinogen Steatorrhea

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43
Q

What would characterize if there is viral hepatitis?
a. Depression in serum of B2
b. Elevation in urobilinogen and urobilin in feces
c. Elevation in serum B1
d. Depression in urobilin excretion in urine

A

B

Due to decreased bilirubin conjugation

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44
Q

If total bilirubin is 7.6 mg/dL and B2 is 3.3, what is B1?
a. 3.3 mg/dL
b. 2.3 mg/dL
c. 10.9 mg/dL
d. 4.3 mg/dL

A

D

Total bili = B1 + B2

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45
Q

Which of the following enzymes is under the classification transferase?
1. Amylase
2. CK
3. ACP
4. SGPT

a. 1,3
B. 2,4
C. AOTA
D. NOTA

A

B

CK = 2.7.3.2 SGPT/ALT = 2.6.1.2
Amylase (3.2.1.1) and ACP (3.1.3.2) are hydrolases

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46
Q

Which of the following enzymes is specific for hepatobiliary disease?
a. ALP
b. CK
c.ACP
d. Amylase

A

A

ALP: INCREASED in Obstructive jaundice
CK and Amylase: present in liver or liver is not one of their tissue source
ACP: increased in prostate cancer, Chronic liver disease

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47
Q

Enzymes falsely decreased when exposed to light.
a. Amylase
b. Creatinine phosphokinase
c. Lactate dehydrogenase
d. SGPT

A

B

CK is a photosensitive enzyme therefore must be stored in a dark bottle and should not be exposed to light.

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48
Q

Cofactor of amylase?
a. Calcium
b. Chloride
c. Both A and B
d. None

A

B

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49
Q

What is the result of macroamylasemia between serum and urine?

A

Increased serum Amylase. Decreased urine Amylase
This is due to reduction in normal clearance.
Ig is complexed with AMS and becomes too large to be filtered.

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50
Q

Major buffer in the blood?

A

HCO3

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51
Q

Hypercalcemia present in;

  1. Hyperparathyroidism
  2. Hyperthyroidism
  3. Multiple myeloma
  4. Preganancy

a. 1and2
b. 3and4
c. 1, 2, and 3
d. NOTA

A

C

Hypercalcemia: CHIMPS
(cancer, hyperthyroidism, iatrogenic causes, MM, hyperparathyroidism, sarcoidosis)
Hypocalcemia: CHARD
(calcitonin, hypoparathyroidism, alkalosis, renal failure, vit D deficiency)

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52
Q

Na less than 135 mmol/L, increased water retention, water imbalance
a. Hyponatremia
b. Hypernatremia
c. Hypokalemia
d. Hyperkalemia

A

A

RR: 135-145 mmol/L (Torrento) <135: hyponatremia
>145: hypernatremia

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53
Q

What is the classification of thromboxane according to its chemical structure?
a. Amines
b. Polypeptides
c. Steroid
d. Eicosanoid

A

D

AMINES – catecholamines, thyroid hormones, melatonin
POLYPEPTIDES – ADH, insulin, glucagon STEROIDS – estrogen, androgen, glucocorticoids, mineralocorticoids, progestins
EICOSANOIDS – prostaglandins, prostacyclin, leukotrienes, thromboxanes
*Thromboxane is found in the eicosanoid pathway sa Hema☺

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54
Q

What hormone function is based on its ability to stimulate growth and activity of other endocrine glands?
a. Releasing
b. Inhibiting
c. Tropic
d. Effector

A

C

RELEASING – promotes pdxn of anterior pituitary hormones
INHIBITING – decreases hormone secretion of another organ
TROPIC – stimulate activity of other endo glands
EFFECTOR – produced by all other endo glands other than anterior pituitary and hypothalamus

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55
Q

Which is TRUE about PTH?
a. Decreased in pseudohypoparathyroidism
b. Differentiates primary and secondary hypoparathyroidism
c. Differentiates primary and secondary hypocalcemia
d. Screening test for ca metabolism disorder

A

B

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56
Q

Patient complains in his physician of fatigue, weight gain despite loss in appetite and cold intolerance. His T3, T4, TSH serum levels are tested.
Results:
T3 – DECREASED
T4 – DECREASED
TSH – INCREASED

a. Primary hypothyroidism
b. Secondary hypothyroidism
c. Primary hyperthyroidism
d. Secondary hyperthyroidism

A

A

Decreased metabolism leading to weight gain.
Cold intolerance – thyroid hormones are also responsible for maintaining normal body temp.
Secondary hypothyroidism: T3,T4 = decreased
TSH = decreased
Primary Hyperthyroidism: T3, T4 = increased
TSH = decreased
Secondary Hyperthyroidism:
fT4,TSH = increased due to pituitary lesion

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57
Q

What chemical or drug is not part or produced by the body?
a. Xenobiotics c. —-
b. Met-encephalin d. none of the above

A

A

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58
Q

Which of the following is not an opiate?

A. Nicotine
B. Morphine
C. Heroine
D. Codeine

A

A

Opiates:
Heroin
Morphine
Codeine
Mothadone

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59
Q

Garlic odor breath?
a. Arsenic
b. Cyanide
c. Carbon monoxide
d. Lead

A

A

CYANIDE = bitter almonds odor CARBON MONOXIDE = cherry red face LEAD = hypochromic, normochromic anemia

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60
Q

Which of the ff is a measuring pipet?
1. Ostwald folin
2. Micropipette
3. Mohr
4. Kromer

A. 1,2,3
B. 2,3,4
C. 1,3,4
D. 3 only

A

B

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61
Q

A serum glucose sample was too high to read. A 1:5 dilution using saline was made (this is diluted sample A). Diluted sample A was tested but in the reading of the result, it was still too high to read. A further 1:2 dilution was made from diluted sample A. (this is dilution B). Dilution B was tested. To calculate the result, dilution B must be multiplied by one of the following dilution factors.

a. 10
b. 20
c. 8
d. 5

A

A

Rationale:
1st dilution = 5
2nd dilution = 2
5 x 2 = 10

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62
Q

Which of the following functions as a co-enzyme in transaminase reactions?

a. Pyroxidal phosphate
b. NAD/NADH
c. NAD/NADH and NADP/NADPH
d. NADP/NADPH

A

A

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63
Q

A fasting specimen was obtained from an asymptomatic patient, a 45 year old woman. Result of both physical and chemical exam revealed the following:
● Appearance of the serum after
centrifugation: milky
● Appearance of the serum after an
overnight refrigeration: cream layer over turbid serum
● Serum triglycerides: 2500 mg/dl
● Cholesterol:550mg/dl
What does the sample predominantly
contain?

a. Chylomicrons
b. High density lipoproteins
c. Chylomicrons and very-low
density lipoproteins
d. Very low density lipoproteins
and low density lipoproteins

A

D
Rationale:
Normal TAGS:50-160 mg/dl Normal chol: 140-200 mg/dl Since the patient fasted, we cannot consider increase in chylomicrons (exogenous TAGs) so we consider increase in VLDL, which is endogenous TAGs, and increase in LDL, which carries cholesterol)

64
Q

When storing blood samples, freezing of blood sample is avoided. One of the following is the reason for this:

a. Red cells will shrink
b. Red cells will rapture
c. Enzymes will be destroyed d. Electrolytes are lost

A

B

Rationale:
- Samples for enzyme
examination is usually refrigerated except CK which is frozen and LDH which is stored at RT
- Samples for electrolyte analysis is usually refrigerated

65
Q

Upon completion of a run cholesterol tests the MedTech recognizes that the controls are outside of the conference range. What is the appropriate course of action?

a. Run a new set of controls
b. Recalibrate instrument and run controls
c. Report the results without any other action
d. Run a new set of controls and repeat specimens

A

D

66
Q

Given the following data, what will be the concentration of LDL - cholesterol in mmol/L?
● Cholesterol = 350mg/dL
● Triglycerides = 450mg/dL
● HDL-cholesterol=85mg/dL

a. 5,05
b. 4,95
c. 6,75
d. 7,45

A

A

450/6.5 = 69.23 (VLDL)

Rationale:
LDL = Total chol – HDL – VLDL
VLDL = TAGs/6.5
VLDL = 450/6.5 = 69.23
LDL = 350-85-69.23 = 195.77 Convert to SI: 195.77 x 0.02586 = 5,05

67
Q

When coupled enzymatic reaction is employed to measure serum creatinine, one of the following reagent is not required:

a. Picric acid
b. Peroxidase
c. Chromogenic dye
d. Creatinine amidohydrolase e. Sarcosine oxidase

A

A

68
Q

Glycogenolysis is a process that converts stored glycogen into glucose. During intense exercise, where does glycogenolysis occur?

a. Adipose tissue
b. Pancreas
c. Skeletal muscles
d. liver

A

C

69
Q

Optimum temperature is an important factor to consider in enzyme analysis. The higher the temperature, the slower the reaction because movement of molecules are hindered by increased temperature.

a. Both statements are true
b. First statement is false while second statement is true
c. First statement is true while second statement is false
d. No correct choices
e. Both statement are false

A

C

Rationale:
Increased temperature will speed up reaction unless it reaches 50-60 degrees Celsius in which proteins are denatured

70
Q

For the determination of amylase activity, which of the assay methods below is based on the measurement of the quantity of reducing substances formed?

a. Chromolytic
b. Amylometric
c. Amyloclastic
d. Chronometric
e. Saccharogenic

A

E

71
Q

Which of the following statements is the reason for the toxicity of cyanide?

a. It combines with cytochrome oxidase
b. It is a protoplasmic poison
c. It has 200x the affinity to oxygen for hemoglobin binding site
d. It sensitizes the myocardium

A

A

Rationale:
Arsenic - protoplasmic poison
a. Carbon monoxide - It has 200x the affinity to oxygen for hemoglobin binding site

72
Q

Which of the following sets of serum enzymes would be most useful in the diagnosis of myocardial infarction?

A

AST, LD, CK

73
Q

One of these group of substances require a chain of custody in the handling of specimens:

a. Anabolic steroids
b. Caustic agents
c. Alcohols
d. Drug of abuse

A

D

74
Q

What cat-ionic substances are used to treat manic-depressive disorders?

a. Lithium
b. Magnesium
c. Potassium
d. phosphate

A

A

75
Q

In what condition increased albumin be observed?

a. Acute hepatitis
b. Dehydration
c. Chronic inflammation
d. Nephrotic syndrome

A

B

76
Q

One of the following statements describes delta bilirubin?

a. No correct choices
b. It is unconjugated and covalently bound to albumin
c. It is unconjugated
d. It is unconjugated and is irreversibly bound to albumin

A

B

77
Q

In the catabolism of bilirubin, this reduction product is partially reabsorbed from the intestine through the portal circulation for re-excretion in the liver. What is this product called?

a. Verdohemoglobin
b. Urobilin
c. Biliverdin
d. Urobilinogen
e. mesobilirubinogen

A

D

78
Q

Which of the following color coding for the NFPA fire diamond is mismatched?

a. Red-flammability
b. White-oxidizer
c. Yellow- special hazard
d. blue-health

A

C

79
Q

A patient came to the clinical laboratory with a request for HbA1c. What will be the estimated average glucose if the HbA1c is 23%?

a. 650 mg/dL
b. 613.4mg/dL
c. 500 mg/dL
d. 625 mg/dL

A

B

Rationale:
HbA1C = (28.7 x 23) – 46.7 =613.4 mg/dl

80
Q

Electrophoresis was performed at pH 8.6 on an agarose gel. Which of the following will be the order of migration of the protein fractions beginning with the fastest to the slowest?

a. Albumin, alpha-2 globulin, alpha-1 globulin, beta globulin, gamma globulin
b. Albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, gamma globulin
c. Gamma globulin, beta globulin, alpha-2 globulin, alpha-1 globulin, albumin
d. Alpha-1 globulin, alpha-2 globulin, beta globulin, gamma globulin, albumin

A

B

81
Q

What is being measured if the nanometer is used?

a. Density
b. Specific gravity
c. Wavelength of radiant energy
d. Intensity of light

A

C

82
Q

Uric acid result of the patient was at 9.5mg/dL. Which of the following results with confer with the same pathologic condition in SI units?

a. 565
b. 650
c. 700
d. 450

A

A

Rationale:
Conversion factor: 0.0595

83
Q

What will be the A/G ratio when given the following data?
Total protein:Albumin
● O.D. of unknown = 0.45; O.D. of unknown = 0.25
● O.D. of standard = 0.29 ; O.D. of standard = 0.28
● Concentration of std = 50 g/L; concentration of std = 50 g/L

a. 1.07:1
b. 3.01:
c. 1.34:1
d. 2.5:1

A

C

Rationale:
Total: 0.45/0.29 x 50 = 77.59
Albumin: 0.25/0.28 x 50 = 44.64
Globulin = Total – Albumin
Globulin = 77.59-44.64 = 32.94
A/G: 44.64/32.94 = 1.34/1

84
Q

LDL-cholesterol will have the following chemical composition:

a. TAGS-10%;chol-45%;
b. TAGS-60%;chol-15%; protein - 10%
c. TAGS-5%;chol-15%; protein - 50%
d. TAGS-85%;chol-5%; protein - 2%

A

A

85
Q

Toxemia of pregnancy will show normal uric acid levels while Lesch- Nyhan syndrome uric acid levels will be elevated.

a. Only the second statement is true
b. Only the first statement is true
c. First statement is true while second statement is false
d. No correct choices
e. First statement is false while second statement is true
f. Both statements are false

A

D

86
Q

In renal disease, uric acid is increased because filtration and secretion is hampered. Uric acid determination is a very useful indicator of kidney function.

a. Both statements are false
b. First statement is true while second statement is false
c. Both statements are true
d. First statement is false while second statement is true

A

C

87
Q

A 45-year old woman has a fasting serum glucose concentration of 95% mg/dl and a 2-hour post-prandial glucose concentration of 105 mg/dL. Which of the following statements best describes this patient’s fasting serum glucose concentration?

a. Abnormal, indicating hypoglycemia
b. Normal, reflecting glycogen breakdown by the liver
c. Normal, reflecting glycogen by the skeletal muscle
d. Abnormal, indicating diabetes millitus

A

B

Rationale:
Normal FBS = <126 mg/dl Normal post-prandial = <200 mg/dl

88
Q

Proteins are dipolar or zwitterion compounds containing both positive and negative charges. In serum electrophoresis, when a barbital buffer of ph is 8.6 is used, what protein fraction migrates the fastest toward the anode?

a. Gamma globulin
b. Alpha-1 globulin
c. Alpha-2 globulin
d. Beta globulin
e. albumin

A

A

89
Q

What condition is being described when there is the inability to transport bilirubin from the sinusoidal membrane into the hepatocyte?

a. Mechanical obstruction of the canaliculi
b. Gilbert’s syndrome
c. Dubin-johnson syndrome
d. Crigler-najjar syndrome
e. Carcinoma of the common bile duct

A

B

90
Q

Monitoring long-term glucose control in patients with adult onset diabetes mellitus can best accomplished by which test?

a. Glucose tolerance test
b. 2-hour post prandial glucose
c. Fructosamine
d. hbA1c
e. Weekly fasting 7 am glucose

A

D

91
Q

A patient came to the lab for cholesterol and triglycerides determination. It was later found out that fasting period observed was only for 6 hours. With the results obtained below, which is the best interpretation of the results?

TAGS - 260 mg/dl (2.93 mmol/l)
Cholesterol - 120 mg/dl (3,10 mmol)

a. Both results are normal and not affected by the recent meal
b. Cholesterol is normal but the triglycerides are elevated, which may be attributed to the recent meal
c. Both results are elevated, indicating a metabolic problem in addition to non- fasting state
d. Both results are below normal despite the recent meal, indicating a metabolic pattern

A

B

Rationale:
Normal TAGs: 60-150 mg/dl Normal Chol: 140-200 mg/dl

92
Q

In forward reaction for LDH determination, lactate loses 2 electrons and becomes oxidized. NAD gains 2 electrons and is reduced.

a. First statement is true while second statement if false
b. No correct choices
c. Both statements are true
d. Both statements are false
e. First statement is false while second statement os true

A

D

Rationale:
LEORA = loss electrons, oxidized, reducing agent GEROA = gain electrons, reduced, oxidizing agent

93
Q

The 3 levels of dysfunction that may be evaluated in a patient with an endocrine dysfunction are primary, secondary and tertiary. What are the possible defective sites corresponding this level of dysfunction?

a. Pituitary, target gland, hypothalamus
b. Hypothalamus, target gland, pituitary
c. Pituitary, hypothalamus, target gland
d. Target gland, pituitary, hypothalamus

A

D

94
Q

When blood gas determination is requested, what anticoagulant is recommended for use?

a. Oxalate
b. Citrate
c. Heparin
d. No presservative

A

C

95
Q

One of the ff is not a symptom of hyperthyroidism:

a. Weight loss
b. Lethargy
c. Palpitation
d. Fine tremor of the outstretched hand

A

C

96
Q

Enzymes are protein catalysts of biologic origin. They increase the rate of a specific chemical reaction by lowering the activation energy needed for the reaction to proceed.

a. First statement is true while second statement is false
b. First statement is false while second statement is true
c. Both statements are true
d. Both statements are false
e. No correct choices

A

C

Rationale:
Enzymes act as catalysts for the many chemical reactions of the body. Enzymes increase the rate of a specific chemical reaction by lowering the activation energy needed for the reaction to proceed. They do not change the equilibrium constant of the reaction; but rather, enzymes affect the rate at which equilibrium occurs between reactants and products.

97
Q

What 2 electrolytes show a reciprocal relationship?

a. Chloride and carbon dioxide
b. Calcium and magnesium
c. Calcium and phosphorus
d. Sodium and potassium

A

D

Rationale:
- Sodium vs potassium
- Calcium vs PHOSPHATE
- Chloride vs BICARBONATE
- Calcium and
Magnesium may also have a reciprocal relationship

98
Q

Why is the urine specimen commonly used for screening of drugs of abuse?

a. It is influenced by age and sex
b. It has a short detection window of 3 days
c. Drugs concentrate in the urine and analytically it is an easy sample to work with
d. Donor should be allowed to have anything for 10-20 minutes before sample collection to avoid any recent oral drug exposure

A

C

99
Q

Blood glucose was performed with the ff obtained data:
OD of standard - 0.35
OD of unknown - 0.42
Concen. of standard - 5,55 mmol/L

a. 125 mg/dL
b. 150 mg/dL
c. 140 mg/dL
d. 120 mg/dL

A

D

Rationale:
Blood glucose: 0.42/0.35 x 5.55 mmol/L = 6.66 mmol/L

6.66 /0.0555 = 120 mg/dL

100
Q

Gloves are designed to protect the user from contamination. One of the following is not an acceptable protocol for glove use.

a. A medtech assigned to collect naso-oro pharyngeal swabs changings gloves after obtaining samples from one patient to be able to attend to the next patient
b. A phlebotomist in full PPE fixing one of her false lashes because it has gotten out of place and is getting in the way of her vision immediately after blood collection.
c. A medtech in full PPE has to change gloves because it became heavily soiled with blood after a messy blood collection
d. A medtech inspecting her gloved hand after donning notices a tear in one of the fingers of the gloves, immediately changes them before proceeding to working on her blood samples

A

B

101
Q

This electrolyte will exhibit a red flame photometry:

a. Sodium
b. Chloride
c. Potassium
d. lithium

A

D

Rationale:
Sodium - yellow Potassium - potassium

102
Q

20 control samples for SGPT were run in a period of 20 days. If the values were: 35, 37, 34, 35, 36, 33, 37, 35, 33, 36, 35, 39, 40, 32, 35, 37, 35, 34, 33, 36, what would be the +/- 2 limit of confidence?

a. 33-37
b. 30-40
c. 31-39
d. 35-38

A

C

Rationale: Mean: 35.35 SD: 2.01

103
Q

What will be the concentration of creatinine in umol/L given the ff data:
Initial abs reading of unknown - 0.05
Final abs reading of unknown - 0.085
Initial abs reading of the standard - 0.07
Final abs reading of the standard - 0.12
Concen. of the standard - 1.5 mg/dL

a. 175
b. 150
c. 132.6
d. 100

A

C

Rational:
0.085-0.05 = 0.035
0.12-0.07 = 0.05
0.035/0.05 x 1.5 = 1.50 x 88.4 = 132.6

104
Q

The mean value of a series of BUN control values was found to be 15.2 g/dL, and the standard deviation was calculated at 0.20. Acceptable control rage of +/- 2 standard deviations. Which of the ff values represents the allowable limits for the control?

a. 14.5 - 15.5 g/dL
b. 14.8 - 15.6 g/dL
c. 15.0 - 15.4 g/dL
d. 15.2 - 15.6 g/dL

A

B

105
Q

What is the primary function of albumin in the peripheral blood?

a. Increase antibody production
b. Increase fibrinogen formation
c. Maintain blood viscosity
d. Maintain colloidal osmotic pressure

A

D

106
Q

Shift is an error that can appear in a QC chart. What would cause it?

a. Reagents that are still in use 6 months after it was opened
b. Deterioration of light source
c. Dispense system cannot deliver reagents or samples
d. Sample tubing is clogged with dirt

A

C

107
Q

A person is diagnosed with familial hypercholesterolemia. Which of the ff lipoprotein fraction would be elevated?

a. VLDL
b. Chylomicrons
c. IDL
d. HDL
e. LDL

A

E

108
Q

Proteins become denatured when subjected to mechanical agitation, heat or extreme chemical treatment. One of the following happens when protein is denatured:

a. There is increase in solubility
b. There is alteration in the tertiary structure
c. There is alteration in the primary structure
d. There is alteration in the secondary structure
e. There is breaking of the peptide bond

A

B

109
Q

Two standard deviations are the acceptable limits of error in the clinical chemistry laboratory. If a normal control is run 100 times, how many values would be out of control due to random error?

a. 20
b. 5
c. 10
d. 1

A

B

Rationale:
For every 20 samples, there is one that can be randomly out of control

110
Q

This metabolite when measured tends to underestimate the glomerular filtration rate:

a. Amylase
b. Urea and amylase
c. Urea
d. creatinine

A

C

Since Urea is filtered and reabsorbed

111
Q

Why is a reagent blank used in any analysis?

a. It will correct the absorbance from the use of icteric sample or hemolyzed specimen
b. It will correct the absorbance due to reagent used for analysis
c. It will correct the absorbance due to turbidity from the sample
d. All of these
e. None of these

A

B

112
Q

Which of the following is the formula for arithmetic mean?

a. Sum of values divided by the number of values
b. Number of values divided by the sum of values
c. Sum of values multiplied by the number of values
d. Square root of the sum of values

A

A

113
Q

Ammonia is released from metabolic reations that occur in skeletal muscle during exercise. They are used by the parenchymal cells of the liver to produce urea.

a. No correct choices
b. Both statements are false
c. First statement is true while second statement is false
d. Both statements are true
e. First statement is false while second statement is true

A

D

114
Q

A patient comes to the lab for blood analysis. While waiting for his turn for blood extraction, he smoked a stick of cigarettes for a while. Which of the following effects of smoking will be observed if blood extraction and analysis is performed?
I. Glucose level will be increased
II. Cholesterol and triglycerides will be increased
III. Growth hormone and cortisol will be increased
IV. No effect on leukocyte count

a. II and IV only
b. I,II, III
c. I and IV only
d. II,III, IV

A

B

Rationale:
According to torrento, leukocytes will be affected since neutrophils and monocytes are increased while eosinophils will be decrease

Increased in smoking: “TUNG2C3” Triglycerides
Urea
Nonesterified fatty acid Glucose
GH
Catecholamines Cortisol
Cholesterol

115
Q

When chemical agents act on enzymes this can cause enzymes to lose their activity. When enzyme activity is lost because of heat or agitation this is denaturation.

a. No correct choices
b. Both statements are false
c. First statement is true while second statement is false
d. Both statements are true
e. First statement is false while second statement is true

A

D

Rationale:
Chemical agents like anticoagulants can inactivate enzymes. Heat and agitation can cause denaturation of proteins leading to enzyme destruction

116
Q

What type of pipet is calibrated to deliver any amount of liquid within its capacity?

a. Volumetric pipet
b. Ostwald-folin pipet
c. Transfer pipet
d. Serological pipet

A

D

Rationale:
Serological pipet is a measuring pipet that can deliver any volume within its capacity while the rest are transfer pipets

117
Q

Which of the following statements correctly describes alkaline phosphatase?

a. It is optimally active at pH 4.8-6.0
b. It is primarily found in the cardiac muscle
c. It is decreased in the third trimester of a normal pregnancy
d. It is increased in obstructive jaundice
e. It is decreased in Paget’s disease

A

D

Rationale:

ALP is
- it is optimally active at ALKALINE pH
- it is primarily found in the LIVER, BONE, INTESTINE, PLACENTA
- it is increased in the third trimester of a normal pregnancy
- it is increased in pagets disease

118
Q

In the test for hemoglobin A1c, the blood sample is allowed to hemolyzed before the actual analysis. What does the total glycosylated hemoglobin levels in a hemolysate reflect?

a. Average blood glucose levels of the past 2-3 months
b. Blood glucose level at the time the sample is drawn
c. Hemoglobin A1c level at the time the is drawn
d. Average blood glucose levels for the past week

A

A

119
Q

Which of the following substances can potentially interfere with creatinine determination?
1. Ketoacids
2. Glucose
3. Ascorbic acid
4. cholesterol

a. 1,2,3 and 4
b. 1,2 and 3 only
c. 2 and 4 only
d. 4 only

A

B

Rationale:
Falsely increased: GUAA

Glucose
Uric acid Alpha-keto acids Ascorbate

120
Q

There is a second wave in the coronavirus infection. DOH mandates full PPE for all laboratory personnel on duty. Julie is preparing for her afternoon shift in the clinical laboratory and she has to go through the motions of following the prescribed protocols in wearing the PPE. One of the following is the correct order of wearing the PPE:

a. Wash hands, gown, gloves, mask, face shield
b. Was hands, mask, face shields, gown, gloves
c. Wash hands, gown, mask face shields gloves
d. Wash hands mask, gown gloves face shield

A

C

121
Q
  1. In the enzymatic colorimetric assay for ALT and AST, the measurement of enzyme activity is based on the reaction with dinitrophenylhydrazine. What reaction product will this color developer react with

a. Ester bond
b. Amino group
c. Keto acid
d. Phosphate group

A

C

122
Q

In determination of proteins, the quantitation of the nitrogen content is the basis for this method:

a. Kjeldahl
b. Biuret
c. Berthelot
d. Looney-Walsch

A

A

123
Q

One of the following anticoagulant may cause shrinking of the cells:

a. Fluoride
b. Potassium oxalate
c. Citrate
d. Ammonium oxalate

A

B

Rationale:
Potassium oxalate causes efflux of water from RBCs

124
Q

What do we call those autoantibodies that bind to receptor sites on thyroid cell membrane?

a. anti-TSH IgA
b. TS Ig
c. TSH IgE
d. TSH IgD

A

B

125
Q

One of the conditions below does not represent hepatic types of jaundice:

a. Gilbert’s syndrome
b. Crigler-najjar syndrome
c. Hepatitis
d. Neoplasm of the common bile duct
e. cirrhosis

A

D

126
Q

Hemolysis of serum samples maybe a source of elevated CK activity. Erythrocytes are virtually devoid of CK therefore presence of rbc’s in the serum cannot interfere with test results

a. Both statements are false
b. Both statements are true
c. First statement is true while second statement if false
d. No correct choices
e. First statement is false while second statement is true

A

C

Rationale:
RBCs have AK not CK but it may mimic CK activity in tests, increasing its value. That is why hemolyzed samples should not be used for testing CK

127
Q

Which of the following disorders is best characterized by laboratory findings that include increased serum levels of inorganic phosphorus, magnesium, potassium, uric, urea, and creatinine and decreased serum calcium and erythropoietin levels

a. acute glomerulonephritis
b. Renal tubular disease
c. Urinary tract infection
d. Nephrotic syndrome
e. Chronic renal failure

A

E

128
Q

Direct bilirubin is water-soluble conjugated post-hepatic bilirubin. Indirect bilirubin is the direct product of the breakdown of hemoglobin and is nonpolar

a. First statement is false while second statement is true
b. First statement is true while second is false
c. Both statements are true
d. Both statements are false

A

C

129
Q

A medical technologist working in the lab without complete PPE, accidentally spills serum samples on his working area. What is the best thing to do?

a. The medical technologist should wear gloves and mask only while inside the laboratory to protect him from lab hazards, in this case, spilled serum must be immediately cleaned with soap and water
b. The medical technologist should wear complete PPE while inside the laboratory to protect him from lab hazards, in this case spilled serum must be disinfected with 1% hypochlorite solution, and clean the working area
c. The medical technologist should not wear complete PPE as long as he is careful in handling the specimens, in this case, spilled serum must be cleaned with distilled water
d. The medical technologist should always wear complete PPE while inside the laboratory to protect him from lab hazards, in this case spilled serum must be disinfected with 10% hypochlorite solution, and clean the working area

A

D

130
Q

High levels of which lipoproteins class are associated with decreased risk of accelerated atherosclerosis

a. VLDL
b. LDL
c. Chylomicrons
d. HDL

A

D

131
Q

There is a differential UV absorption method for uric acid estimation. What is the basis for this method?

a. Coupling with hydrogen peroxide
b. UV absorption of uric acid
c. UV absorption of allantoin
d. Reaction of allantoin with a chromogen

A

B

132
Q

Increased concentrations of ascorbic acid inhibit chromogen production in which of the following glucose methods?

a. Ortho-toluidine
b. Glucose oxidase-peroxidase
c. Hexokinase
d. Ferricyanide

A

B

Rationale:
Ascorbic acid will affect any reaction utilizing hydrogen peroxide

133
Q

When a MedTech is asked to reconstitute a 5 mL lyophilized control material, what glassware should be used to measure the volume of water to be added?

a. Volumetric pipet
b. Graduated cylinder
c. Beaker
d. Serologic to blow out pipet

A

A

Rationale:
For reconstituting control materials, it is best to use volumetric pipets

134
Q

One of the following is the basis for the UV technique in protein studies:

a. Carboxyl groups
b. Peptide bonds
c. Amino groups
d. Armatic rings
e. Imidazole groups

A

D

135
Q

Dye-binding methods are used for the quantitation of albumin in serum without preliminary extraction of the globulins. Of the dyes listed below, which one binds selectively with albumin?

a. Coomasie blue
b. Ponceau S
c. Amido black
d. Bromcresol green

A

D

136
Q

Which description below describes the science of toxicology?

a. it is the study of the effects of drugs and chemicals on living organisms
b. it is concerned with the absorption, distribution, metabolism, elimination, toxicity and specific mechanisms of drug action
c. it is concerned with the nature. effects, and detection of poisons.
d. it deals with the normal functions of living organisms and their parts

A

A

137
Q

This substance is a stimulant and is abused because it generates a sense of delight, elevate wakefulness and physical activity. It is also commonly known as poor man’s cocaine.

a. cocaine
b. cannabis
c. methamphetamine
d. opioids

A

C

138
Q

Which of the following electrolytes is the chief plasma cat-ion whose main function is to margin osmotic pressure?

a. Sodium
b. Calcium
c. Chloride
d. Potassium

A

A

139
Q

Lipoproteins can be separated into different fractions using electrophoresis. What is the most widely used support medium for this purpose?

a. agarose gel
b. paper
c. starch gel
d. agar gel

A

A

140
Q

Which of the following determinations can establish the presence of seminal fluid?

a. Alkaline phosphatase
b. Amylase
c. Lactate dehydrogenase
d. Acid phosphatase

A

D

141
Q

What is the deiodinated form of T4?

a. rT3
b. Diiodotyrosine
c. Thyroglobulin
d. Monoiodotyrosine

A

A

142
Q

The presence of increased CK-BB activity on a CK electrophoresis pattern is most likely found in patients who suffer from one of the following?

a. severe head injury
b. myocardial infarction
c. acute muscular stress
following strenuous exercise
d. malignant liver disease

A

A

143
Q

In quality control, +/-2 standard deviations from the mean includes what percent of the sample population?

a. 78
b. 95
c. 98
d. 50

A

B

144
Q

What part of the spectrophotometer functions to select the amount of light that will pass through the cuvette?

a. collimating lens
b. photocell
c. Monochromator
d. Read-out-device

A

C

145
Q

Carlo, a 25 year old physically fit person, submitted for a fasting blood glucose test His results read* 130 mg/dL. According to the WHO criteria, under what category will the patient be classified’?

a. impaired fasting glucose
b. normal glucose result
c. provisional diabetes mellitus
d. impaired glucose tolerance

A

D

Rationale:
<100 = normal
100-125 = impaired
>126 = provisional DM

146
Q

What analyte is used to detect the presence of neural tube defects?

a. alpha-fetoprotein
b. amniotic fluid creatinine
c. myoglobin
d. lecithin/sphingomyelin ratio

A

A

147
Q

What type of pipet is being described by the following statements?
1. it holds and delivers a specific volume
2. it does not bear a double etched ring
3. it is calibrated between two marks
4. the tip should not touch the vessel while the liquid is draining

a. oswald-folin pipet
b. transpette
c. volumetric pipet
d. mohr pipet

A

D

148
Q

Angelica is on her last trimester of pregnancy. Her attending physician requested for a 3 hour glucose tolerance test to rule out GDM. What will be the possible diagnosis when the following results were obtained?
blood sample plasma glucose in mg/dl fasting 100
1 hour 210
2 hour 150
3 hour 140

a. GDM is confirmed
b. repeat test for 2nd opinion
c. GDM is rules out
d. not possible

A

C

Rationale:
Fasting: >=105
1 hr >=190
2 hr >=165
3 hr >= 145

149
Q

A hospitalized patient is experiencing increased irritability. Which of the following test should be ordered immediately?

a. Magnesium
b. Chloride
c. Calcium
d. Phosphorus

A

C

150
Q

Atherosclerosis is a condition that causes hardening of the arteries due to build-up cholesterol plaques lining the artery overtime. Premature atherosclerosis can occur when which of the following becomes elevated?

a. high density lipoproteins
b. chylomicrons
c. low density lipoproteins
d. prostaglandins

A

C

151
Q

When is the time for extraction of the non-fasting sample in OGTT start?

a. after drinking the glucose solution
b. after waking up
c. before drinking the sample
d. 30 minutes after drinking the
glucose solution

A

A

152
Q

Which of the following tests is the best indicator of hypothyroidism?

a. thyroid stimulating hormone
b. thyroid binding globulin
c. reverse T3
d. free T4

A

A

153
Q

High serum levels of creatinine result from reduced glomerular filtration. Serum creatinine is a more sensitive measure of renal function than creatinine clearance.

a. No correct answer
b. First statement is true while second statement is false
c. First statement is false while the second statement is true
d. First and second statement is true,

A

D

Rationale:
Serum creatinine would only increase if there is great reduction of GFR and if there is severe damage in kidneys

154
Q

What transport medium transports sixty to seventy five percent of the plasma cholesterol?

a. HDL
b. Chylomicrons
c. LDL
d. VLDL

A

C

155
Q

What type of respirator helps reduce the concentration of microorganisms or particulates through the particulate filter?

a. Air-purifying respirators
b. Both of the choices
c. None of the choices
d. Atmosphere-supplying respirator

A

A

156
Q

When C-reactive protein is present in the blood, what does it indicate?

a. an inflammatory process
b. a recent streptococcal infection
c. a state of hypersensitivity
d. recovery from a pneumococcal infection

A

A

157
Q

What is the statistical term for the average value?

A. Mode
B. Median
C. Mean
D. Coefficient of variation

A

C

Clinical Chemistry (12 decks)

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