L1 CC Flashcards by Karl Dashley Atinen

Wastes of Lean:
1. Defects
2. Waiting
3. Motion
4. Emotion

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

C. 1, 2 and 3

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PLUMBISM - deleterious effect of gradual accumulation of ____ in body tissues, as a result of repeated exposure.

A. Arsenic
B. Cyanide
C. Lead
D. Mercury

C. Lead

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Black belts dedicate ____ of their time to quality improvement projects, proactively addressing process and quality problems.

A. 10%
B. 20%
C. 70%
D. 100%

D. 100%

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Green belts contribute ____ of their time to improvement projects while delivering their normal job functions.

A. 10%
B. 20%
C. 70%
D. 100%

B. 20%

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Black belts

A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

B. Project coaches or leaders

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Green belts

A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

C. Project team members

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Blue belts

A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used

A. Project sponsors or champions

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Black pleural fluid:

A. Hemothorax
B. Chylous material from thoracic duct leakage
C. Rupture of amoebic liver abscess
D. Aspergillus infection

D. Aspergillus infection

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Which set of results is consistent with uncompensated respiratory alkalosis?

A. pH 7.70 HCO3- 30 mmol/L pCO2 25 mm Hg
B. pH 7.66 HCO3- 22 mmol/L pCO2 20 mm Hg
C. pH 7.46 HCO3- 38 mmol/L pCO2 55 mm Hg
D. pH 7.36 HCO3- 22 mmol/L pCO2 38 mm Hg

B. pH 7.66 HCO3- 22 mmol/L pCO2 20 mm Hg

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Which set of results is consistent with uncompensated metabolic acidosis?

A. pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg
B. pH 7.30 HCO3- 16 mmol/L pCO2 28 mm Hg
C. pH 7.45 HCO3- 22 mmol/L pCO2 40 mm Hg
D. pH 7.40 HCO3- 25 mmol/L pCO2 40 mm Hg

A. pH 7.25 HCO3- 15 mmol/L pCO2 37 mm Hg

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A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?

A. Lesch-Nyhan syndrome
B. Modification of diet in renal disease
C. Maple syrup urine disease
D. Reye’s syndrome
E. Megaloblastic anemia

A. Lesch-Nyhan syndrome

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The two cations known to influence the activity of aminoglycosides are:

A. Sodium and potassium
B. Calcium and potassium
C. Calcium and magnesium
D. Sodium and magnesium

C. Calcium and magnesium

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Seventy (70) percent recirculated to the cabinet work area through HEPA; 30% balance can be exhausted through HEPA back into the room or to outside through a canopy unit:

A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

B. BSC Class II, A1

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Thirty (30) percent recirculated, 70% exhausted. Exhaust cabinet air must pass through a dedicated duct to the outside through a HEPA filter.
A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

C. BSC Class II, B1

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No recirculation; total exhaust to the outside through a HEPA filter.

A. BSC Class I
B. BSC Class II, A1
C. BSC Class II, B1
D. BSC Class II, B2

D. BSC Class II, B2

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The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity:

A. Choramphenicol
B. Penicillin
C. Sulfonamide
D. Vancomycin

D. Vancomycin

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Easy to define but DIFFICULT TO ESTABLISH AND MAINTAIN:

A. Accuracy
B. Precision
C. Sensitivity
D. Specificity

A. Accuracy

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Relatively EASY TO MEASURE AND MAINTAIN:

A. Accuracy
B. Precision
C. Sensitivity
D. Specificity

B. Precision

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Clinical Laboratory Standard Institute (CLSI) recommends that:

A. Bands should be included within the eosinophil count
B. Bands should be included within the basophil count
C. Bands should not be included within the neutrophil count, and reported as separate category
D. Bands should be included within the neutrophil count and not reported as separate category

D. Bands should be included within the neutrophil count and not reported as separate category

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Access to the laboratory is limited or restricted, and there must be a biohazard sign posted at the entrance of the laboratory:

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

A. BSL-1

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Access to the laboratory is limited when work is being conducted. The laboratory director is ultimately responsible for determining who may enter or work in the laboratory.

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

B. BSL-2

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Laboratory should be separated from the other parts of the building and be accessed through two self-closing doors. An ANTEROOM may be used for access.

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

C. BSL-3

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The BSL facility either is located in a separate building or is in an isolated zone within a building.

A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4

D. BSL-4

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What is used to zero the spectrophotometer before reading the test sample?

A. Calibrator
B. Sample blank
C. Reagent blank
D. Standard

C. Reagent blank

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This is used to zero an instrument during a test procedure: A. Calibrator B. Sample blank C. Reagent blank D. Standard

B. Sample blank

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease? A. Cathepsin-D B. CA-15-3 C. Retinoblastoma gene D. Estrogen receptor (ER)

B. CA-15-3

Which tumor marker is used to determine the usefulness of TRASTUZUMAB (HERCEPTIN) therapy for breast cancer? A. PR B. CEA C. HER-2/neu D. Myc

C. HER-2/neu

IgA in serum: A. Monomer B. Dimer C. Pentamer D. Any of these

A. Monomer

IgA in secretion: A. Monomer B. Dimer C. Pentamer D. Any of these

B. Dimer

Which of the following is a DISINFECTANT? A. Benzalkonium chloride B. Chlorhexidine gluconate C. Household bleach D. Hydrogen peroxide

C. Household bleach

Diluted bleach will inactivate HBV in ____ minutes and HIV in ____ minutes. A. 2 minutes, 8 minutes B. 8 minutes, 4 minutes C. 10 minutes, 2 minutes D. 8 minutes, 2 minutes

C. 10 minutes, 2 minutes

Calibration of centrifuges is customarily performed every ______. A. Daily B. Weekly C. Every 3 months (quarterly) D. Annually

C. Every 3 months (quarterly)

Centrifuges are routinely disinfected on a ____ basis. A. Daily B. Weekly C. Monthly D. Yearly

B. Weekly

Initial magnification: A. Ocular B. Objective C. Condenser D. Rheostat

B. Objective

Further magnification: A. Ocular B. Objective C. Condenser D. Rheostat

A. Ocular

Which of the following units would NOT be used for reporting glucose on a clinical chemistry laboratory report? A. mg/dL B. ounces/L C. mmol/L D. All are acceptable units

B. ounces/L

Convert 9.5 µg/dL thyroxine to SI unit: A. 123 µmol/L B. 123 nmol/L C. 125 nmol/L D. 145 µmol/L

B. 123 nmol/L

When measuring K+ with an ion-selective electrode by means of a liquid ion-exchange membrane, what antibiotic will be incorporated into the membrane? A. Monactin B. Nonactin C. Streptomycin D. Valinomycin

D. Valinomycin

Hydrogen ion concentration (pH) in blood is usually determined by means of which of the following electrodes? A. Silver B. Glass C. Platinum D. Platinum-lactate

B. Glass ## Footnote The pH electrode, a glass electrode, contains a specially designed thin piece of glass as a membrane. The glass membrane is made of silicon dioxide, added oxides and various metals. The membrane is selectively sensitive to hydrogen ions.

What is the proper pH for the buffered solution used to perform serum protein electrophoresis? A. 5.6 B. 7.6 C. 8.6 D. 9.6

C. 8.6

Coulometry is often used to measure: A. Chloride in sweat B. the pH in saliva C. Bicarbonate in urine D. Ammonia in plasma

A. Chloride in sweat

Amperometry is the principle of the: A. pCO2 electrode B. pO2 electrode C. pH electrode D. Ionized calcium electrode

B. pO2 electrode

Most automated blood gas analyzers directly measure: A. pH, HCO3 and % O2 saturation B. pH, pCO2 and pO2 C. HCO3, pCO2 and pO2 D. pH, PO2 and %O2 saturation

B. pH, pCO2 and pO2

An elevated anion gap may be caused by all of the following except: A. Uremia/renal failure B. Ketoacidosis in case of starvation or diabetes C. Alcohol or salicylate poisoning D. Hypoalbuminemia

D. Hypoalbuminemia

Laboratory examination of a 46-year-old male who presents with decreasing vision and photophobia finds a high anion–gap metabolic acidosis. These findings are most consistent with this individual having ingested: A. Cadmium B. Nickel C. Mercury D. Cobalt E. Methanol

E. Methanol

Which of the following conditions will cause an increased anion gap? A. Diarrhea B. Hypoaldosteronism C. Hyperkalemia D. Renal failure

D. Renal failure

In ketoacidosis, the anion gap would most likely to be affected in what way? A. Unchanged from normal B. Increased C. Decreased D. Balanced

B. Increased

Which of the following blood gas disorders is most commonly associated with an abnormal anion gap? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

A. Metabolic acidosis

Which formula is most accurate in predicting plasma osmolality? A. Na+2(Cl)+BUN+Glucose B. 2(Na)+2 (Cl)+Glucose+BUN C. 2(Na)+Glucose/18+BUN/2.8 D. 2(BUN)+Glucose/18+Cl/2.8

C. 2(Na)+Glucose/18+BUN/2.8

A laboratory worker splashes concentrated HCl in his eyes. The best safety measure is to: A. Wash the eye with dilute NaOH and call physician STAT B. Wash the eye with distilled water and call a physician STAT C. Wash the eye with dilute acetic acid and call a physician STAT D. Call the physician and wait for his advice

B. Wash the eye with distilled water and call a physician STAT

SITUATION: A medical laboratory science student in training accidentally splashed a few drops of an extraction reagent from an enzyme immunoassay kit for group A Streptococcus into her right eye, and felt an immediate burning sensation. What should she do first? A. Locate the MSDS sheet for the EIA test kit B. Go directly to the emergency department for treatment C. Go to the eye-wash station and rinse the eye thoroughly with water D. Report directly to her immediate supervisor

C. Go to the eye-wash station and rinse the eye thoroughly with water

When skin contact occurs, the best first aid is to flush the area with large amounts of water for at least____ minutes, then seek medical attention. A. 5 minutes B. 10 minutes C. 15 minutes D. 20 minutes

C. 15 minutes

The most important practice in preventing the spread of disease is: A. Wearing masks during patient contact B. Proper hand washing C. Wearing disposable laboratory coats D. Identifying specimens from known or suspected HIV-and HBV-infected patients with a red label

B. Proper hand washing

Which monochromator specification is required in order to measure the true absorbance of a compound having a natural absorption bandwidth of 30 nm? A. 50-nm bandpass B. 25-nm bandpass C. 15-nm bandpass D. 5-nm bandpass

D. 5-nm bandpass

If evacuated tubes are stored at low temperature: A. Decreased blood draw volume B. Increased blood draw volume C. Variable D. Cannot be determined

B. Increased blood draw volume

In situations where blood is drawn at high altitudes (>5,000 ft): A. Increased blood draw volume B. Decreased blood draw volume C. Variable D. Cannot be determined

B. Decreased blood draw volume

A triangle with an outline of a person inside the triangle in the hazards identification system indicates which type of hazard? A. Flammability B. Reactivity-stability hazard C. Special hazard information D. Health hazard

D. Health hazard

Skull and crossbones indicates which type of hazard: A. Carcinogens B. Flammables C. Exploding bombs D. Acute toxicities (fatal or toxic)

D. Acute toxicities (fatal or toxic)

A class ABC fire extinguisher contains: A. Sand B. Water C. Dry chemical D. Acid

C. Dry chemical

Carbon dioxide for extinguishers are suitable for use with the following hazards: A. Cloth and electrical B. Wood and flammable gas C. Flammable liquids and electrical D. Paper and natural gas

C. Flammable liquids and electrical

Red diamond or fire hazard, classified according to Flash Point: A. A to C B. A to D C. 1 to 10 D. 0 to 4

D. 0 to 4

Beer-Lambert law (Beer’s law) Mathematically establishes the relationship between concentration and absorbance in many photometric determinations Beer’s law is expressed as A = abc A (capital A) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

A. Absorbance

a (small a) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

B. Absorptivity constant

b (small b) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

D. Length of light path

c (small c) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

C. Concentration

Most automated blood gas analyzers directly measure: A. pH, HCO3 and % O2 saturation B. pH, pCO2 and pO2 C. HCO3, pCO2 and pO2 D. pH, PO2 and %O2 saturation

B. pH, pCO2 and pO2

Which of the following blood gas parameters are MEASURED DIRECTLY by the blood gas analyzer electrochemically as opposed to being calculated by the instrument? A. pH, HCO3-, total CO2 B. pCO2, HCO3-, pO2 C. pH, pCO2, pO2 D. pO2, HCO3-, total CO2

C. pH, pCO2, pO2

Metabolism of glucose molecule to pyruvate or lactate for production of energy A. Gluconeogenesis B. Glycogenolysis C. Glycogenesis D. Glycolysis

D. Glycolysis

Formation of glucose-6-phosphate from noncarbohydrate sources A. Gluconeogenesis B. Glycogenolysis C. Glycogenesis D. Glycolysis

A. Gluconeogenesis

Breakdown of glycogen to glucose for use as energy A. Gluconeogenesis B. Glycogenolysis C. Glycogenesis D. Glycolysis

B. Glycogenolysis

Conversion of glucose to glycogen for storage A. Gluconeogenesis B. Glycogenolysis C. Glycogenesis D. Glycolysis

C. Glycogenesis

Glucose is metabolized at room temperature at a rate of ____ mg/dL/hour and at 4C at a rate of ____ mg/dL/hour. A. 2, 7 B. 7, 2 C. 3, 8 D. 8, 3

B. 7, 2

Copper reduction method for glucose that uses arsenomolybdic acid: A. Folin-Wu B. Nelson-Somogyi C. Neocuproine D. All of these

B. Nelson-Somogyi

A method for the estimation of glucose in body fluids; glucose in the protein-free filtrate reduces cupric ion to cuprous ion. The cuprous ion then reduces PHOSPHOMOLYBDIC ACID to molybdenum blue which can be estimated colorimetrically. A. Dubowski method B. Folin-Wu C. Nelson-Somogyi D. Neocuproine

B. Folin-Wu

Which of the following is the reference method for measuring serum glucose? A. Somogyi–Nelson B. Hexokinase C. Glucose oxidase D. Glucose dehydrogenase

B. Hexokinase

Fluorophore-labeled thyroxine competes with patient thyroxine for antibody in homogeneous system. Antibody-bound labeled thyroxine rotates slowly, emitting lower energy light. A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA)

A. Fluorescent polarization immunoassay (FPIA)

Fluorogenic substrate–labeled TSH is competing with patient TSH for antibody in this homogeneous assay. Only unbound (leftover) labeled TSH reacts with the enzyme to form fluorescent product. There is a direct relationship between fluorescence and the amount of TSH present in the test sample. A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA)

B. Fluorescent substrate-labeled inhibition immunoassay

Peroxidase-labeled antibody binds with patient hormone (antigen) to form complex (similar to ELISA). Addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time. A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA)

C. Chemiluminescence

Similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone: A. Fluorescent polarization immunoassay (FPIA) B. Fluorescent substrate-labeled inhibition immunoassay C. Chemiluminescence D. Microparticle enzyme immunoassay (MEIA)

D. Microparticle enzyme immunoassay (MEIA)

Beta cell destruction, usually leading to absolute insulin deficiency: A. Type 1 diabetes B. Type 2 diabetes

A. Type 1 diabetes

May range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance: A. Type 1 diabetes B. Type 2 diabetes

B. Type 2 diabetes

Diabetics are younger (<18 years old when diagnosed) and thinner: A. Type 1 diabetes B. Type 2 diabetes

A. Type 1 diabetes

Usually older (>40 years old when diagnosed) and more likely to be obese: A. Type 1 diabetes B. Type 2 diabetes

B. Type 2 diabetes

Which one of the following values obtained are diagnostic of diabetes mellitus? A. 2-hour specimen = 150 mg/dL (8.3 mmol/L) B. Fasting plasma glucose = 126 mg/dL (6.9 mmol/L) C. Fasting plasma glucose = 110 mg/dL (6.1 mmol/L) D. 2-hour specimen = 180 mg/dL (9.9 mmol/L)

B. Fasting plasma glucose = 126 mg/dL (6.9 mmol/L)

In a person with IMPAIRED glucose metabolism, such as in type 1 diabetes, what is true about the blood glucose level? A. It increases rapidly after carbohydrates are ingested but returns to a normal level after 120 minutes. B. It increases rapidly after carbohydrates are ingested and stays greatly elevated even after 120 minutes. C. It does not increase after carbohydrates are ingested and stays at a low level until the next meal. D. It increases rapidly after carbohydrates are ingested but returns to a normal level after 30 minutes

B. It increases rapidly after carbohydrates are ingested and stays greatly elevated even after 120 minutes.

In a person with normal glucose metabolism, the blood glucose level usually increases rapidly after carbohydrates are ingested but returns to a normal level after: A. 30 minutes B. 45 minutes C. 60 minutes D. 120 minutes

D. 120 minutes

Which of the following 2-hour glucose challenge results would be classified as IMPAIRED GLUCOSE TOLERANCE? Two-hour serum glucose: A. 130 mg/dL B. 135 mg/dL C. 150 mg/dL D. 204 mg/dL

C. 150 mg/dL

Which of the following hemoglobin A1c results represents an IMPAIRED STATE according to the American Diabetes Association? A. 4.5% B. 5.5% C. 6.0% D. 6.5%

C. 6.0%

Glassware is usually calibrated at: A. 98F B. 72F C. 20C D. 37C

C. 20C

The fastest moving fraction in electrophoresis at pH 8.6 is: A. Albumin B. Alpha1 globulin C. Alpha2 globulin D. Beta globulin E. Gamma globulin

A. Albumin

If the usual Gaussian distribution exists, a one standard deviation on either side of the mean will include what percent of the values? A. 95% B. 68% C. 99% D. 34% E. 84%

B. 68%

When a range is set by taking the mean values plus or minus two standard deviation, the percentage of values of the normal population EXCLUDED from the acceptable range is: A. 1% B. 2.5% C. 5% D. 13.6% E. 15.9%

C. 5%

A delta check: A. Relates control difference from mean B. Reports patient value difference from previous analysis C. Evaluates statistical drift D. Estimates running mean of all patient values E. Flags abnormal results

B. Reports patient value difference from previous analysis

To determine if a 24-hour urine collection is complete, which of the following determinations may be helpful? A. Creatinine B. BUN C. Uric acid D. Protein E. Osmolality

A. Creatinine

The main waste product of protein metabolism is: A. Creatinine B. Urea C. Uric acid D. Ammonia E. Amino acids

B. Urea

The most sensitive marker of acute phase inflammation is probably: A. C3 complement B. C-reactive protein C. Fever D. Erythrocyte sedimentation rate

B. C-reactive protein

In lipoprotein electrophoresis, the dense band that doesn't migrate from the origin is: A. Chylomicrons B. LDL C. Beta-lipoproteins D. Cholesterol E. Phospholipids

A. Chylomicrons

RBC with membrane folded over: A. Aplastic anemia B. Iron deficiency anemia C. Hemoglobin C, hemoglobin SC disease D. Sickle cell anemia, thalassemia

C. Hemoglobin C, hemoglobin SC disease

Major structural protein in VLDL and LDL: A.Apo-A1 B.Apo-A2 C.Apo-B48 D.Apo-B100

D.Apo-B100

Structural protein in chylomicrons: A. Apo-A1 B.Apo-A2 C.Apo-B48 D. Apo-B100

C.Apo-B48

Which of the following apoproteins is inversely related to risk for coronary heart disease and is a surrogate marker for HDL? A. Apo A-I B. Apo B C. Apo B100 D. Apo E

A. Apo A-I

Rare autosomal recessive disorder characterized by complete absence of HDL: A. Tangier disease B. Anderson disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

A. Tangier disease

Abetalipoproteinemia, patients present with undetectable plasma apoB containing lipoproteins: A. Tangier disease B. Anderson disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

C. Bassen-Kornzweig syndrome

The largest lipoprotein molecule: A. LDL B. VLDL C. Chylomicron D. HDL

C. Chylomicron

What is the smallest lipoprotein molecule? A. Chylomicron B. LDL C. VLDL D. HDL

D. HDL

Which of the following laboratory values is considered a positive risk factor for the occurrence of coronary heart disease? A. HDL cholesterol >60 mg/dL B. HDL cholesterol <35 mg/dL C. LDL cholesterol <130 mg/dL D. Total cholesterol <200 mg/dL

B. HDL cholesterol <35 mg/dL

If testing is done in nonfasting samples, only total cholesterol (TC) and HDL-c can be measured. When TAG and LDL-c are being measured, FASTING becomes a requirement. A. 4 to 8 hours fasting B. 8 to 12 hours fasting C. 12 to 14 hours fasting D. 16 to 18 hours fasting

C. 12 to 14 hours fasting

Which of the following enzymes is found bound to HDL and LDL in blood plasma and acts to convert free cholesterol into cholesteryl esters? A. Cholesterol esterase B. Cholesterol oxidase C. Lecithin-cholesterol acyltransferase D. Lipase

C. Lecithin-cholesterol acyltransferase

According to the National Cholesterol Education Program, which lipid or lipoprotein class is more important for therapeutic decision making (diet and medication decisions)? A. Chylomicrons B. LDL C. HDL D. Cholesterol

B. LDL

What is the most appropriate fasting procedure when a lipid study of triglyceride, total cholesterol, HDL cholesterol, and LDL cholesterol tests are ordered? A. 8 hours; nothing but water allowed B. 10 hours; water, smoking, coffee, tea (no sugar or cream) allowed C. 12 hours; nothing but water allowed D. 16 hours; water, smoking, coffee, tea (no sugar or cream) allowed

C. 12 hours; nothing but water allowed

All of the following hormones increase serum glucose levels with the exception of: A. Glucagon B. Cortisol C. Epinephrine D. Insulin

D. Insulin

The most probable explanation for a patient who presents with an elevated osmolal gap, metabolic acidosis, and CALCIUM OXALATE crystals in the urine is: A. Methanol intoxication B. Ethanol overdose C. Ethylene glycol intoxication D. Cyanide poisoning

C. Ethylene glycol intoxication

Alkaline phosphatase values are expected to be increased in all of the following situations EXCEPT: A. Child undergoing a growth spurt B. During a time of increased bone remodeling C. After a myocardial infarction D. Paget’s disease

C. After a myocardial infarction

Which of the following analytes is helpful in distinguishing a condition affecting the liver from bone disease in the presence of an elevation of ALP? A. AST B. ALT C. ALP D. GGT

D. GGT

Assay methods for AST are generally based on the principle of the Karmen method, which incorporates a coupled enzymatic reaction using: A. Glutamic oxaloacetic transaminase B. Glutamic pyruvic transaminase C. Lactate dehydrogenase D. Malate dehydrogenase

D. Malate dehydrogenase

The typical assay procedure for ALT consists of a coupled enzymatic reaction using ____ as the indicator enzyme. A. Glutamic oxaloacetic transaminase B. Glutamic pyruvic transaminase C. Lactate dehydrogenase D. Malate dehydrogenase

C. Lactate dehydrogenase

Enzyme assay useful in forensic clinical chemistry: A. CK B. ACP C. ALT D. AST

B. ACP

Identify the enzyme deficiency responsible for type 1 glycogen storage disease (von Gierke’s disease). A. Glucose-6-phosphatase B. Glycogen phosphorylase C. Glycogen synthetase D. β-Glucosidase

A. Glucose-6-phosphatase

Which of the following abnormal laboratory results is found in von Gierke’s disease? A. Hyperglycemia B. Increased glucose response to epinephrine administration C. Metabolic alkalosis D. Hyperlipidemia

D. Hyperlipidemia

SIGNIFICANT WHEN DECREASED Pathological level is decreased from the normal values by as much as 80 to 90%. A. Amylase B. Lipase C. Cholinesterase D. Creatine kinase

C. Cholinesterase

In pesticide poisoning, cholinesterase activity is: A. Normal B. Decreased C. Increased D. Variable

B. Decreased

Which of the following DECREASES in liver disease? A. ALP B. ALT C. LD D. Cholinesterase

D. Cholinesterase

In addition to sodium bicarbonate, what other substance contributes most to the amount of base in the blood? A. Hemoglobin concentration B. Dissolved O2 concentration C. Inorganic phosphorus D. Organic phosphate

A. Hemoglobin concentration

Which of the following best represents the reference (normal) range for arterial pH? A. 7.35 – 7.45 B. 7.42 – 7.52 C. 7.38 – 7.68 D. 6.85 – 7.56

A. 7.35 – 7.45

What is the normal ratio of bicarbonate to dissolved carbon dioxide in arterial blood? A. 1:10 B. 10:1 C. 20:1 D. 30:1

C. 20:1

Select the anticoagulant of choice for blood gas studies. A. Sodium citrate 3.2% B. Lithium heparin 100 U/mL blood C. Sodium citrate 3.8% D. Ammonium oxacralate 5.0%

B. Lithium heparin 100 U/mL blood

Which electrolyte level best correlates with plasma osmolality? A. Sodium B. Chloride C. Bicarbonate D. Calcium

A. Sodium

Which of the following enzymes is considered most tissue specific? A. Creatine kinase (CK) B. Amylase C. Alkaline phosphatase (ALP) D. Alcohol dehydrogenase (ADH)

D. Alcohol dehydrogenase (ADH)

Which of the following enzymes is activated by calcium ions A. CK B. Amylase C. ALP D. LD

B. Amylase

Which of the following cardiac markers derived from neutrophils predicts an increased risk for myocardial infarction? A. Phospholipase A2 B. Glycogen phosphorylase BB C. Soluble CD40 ligand D. Myeloperoxidase

D. Myeloperoxidase

Which isoenzyme of ALP is most heat stable? A. Bone B. Liver C. Intestinal D. Placental

D. Placental

Which substrate is used in the Bowers–McComb method for ALP? A. p-Nitrophenyl phosphate B. β-Glycerophosphate C. Phenylphosphate D. α-Naphthylphosphate

A. p-Nitrophenyl phosphate

Which of the following buffers is used in the IFCC recommended method for ALP? A. Glycine B. Phosphate C. 2-Amino-2-methyl-1-propanol D. Citrate

C. 2-Amino-2-methyl-1-propanol

It is increased in hemolytic anemias: A. B1 B. B2 C. Both fractions D. None of these

A. B1

It is increased in bile duct obstruction: A. B1 B. B2 C. Both fractions D. None of these

B. B2

Increased in hepatitis: A. B1 B. B2 C. Both fractions D. None of these

C. Both fractions

Bilirubin that can appear in urine: A. Unconjugated bilirubin B. Conjugated bilirubin C. Both of these D. None of these

B. Conjugated bilirubin

Errors in LDL-c become noticeable at triglyceride levels: A. Over 150 mg/dL B. Over 200 mg/dL C. Over 350 mg/dL D. Over 400 mg/dL

B. Over 200 mg/dL

Errors in LDL-c become unacceptably large at triglyceride levels: A. Over 150 mg/dL B. Over 200 mg/dL C. Over 350 mg/dL D. Over 400 mg/dL

D. Over 400 mg/dL

Friedewald formula is not valid for triglycerides: A. Over 150 mg/dL B. Over 200 mg/dL C. Over 350 mg/dL D. Over 400 mg/dL

D. Over 400 mg/dL

Which of the following values is the threshold critical value (alert or action level) for high plasma sodium? A. 150 mmol/L B. 160 mmol/L C. 170 mmol/L D. 180 mmol/L

B. 160 mmol/L

Which of the following values is the threshold critical value (alert or action level) for low plasma potassium? A. 1.5 mmol/L B. 2.0 mmol/L C. 2.5 mmol/L D. 3.5 mmol/L

C. 2.5 mmol/L

Which of the following is a marker for bone resorption? A. β-trace protein B. Adiponectin C. Fibronectin D. Crosslinked C-telopeptide

D. Crosslinked C-telopeptide

Which of the following is a marker for bone formation? A. Osteocalcin B. Tartrate resistant acid phosphatase (TRAP) C. Urinary pyridinoline and deoxypyridinoline D. Urinary C-telopeptide and N-telopeptide crosslinks (CTx and NTx)

A. Osteocalcin

The variants demonstrate a wide variety of cellular interactions including roles in cell adhesion, tissue differentiation, growth, and wound healing: A. Adiponectin B. Cystatin C. Fibronectin D. Troponin

C. Fibronectin

What substance may be measured as an alternative to creatinine for evaluating GFR? A. Plasma urea B. Cystatin C C. Uric acid D. Potassium

B. Cystatin C

Recently, it was established as an accurate marker of CSF leakage: A. Fibronectin B. Cystatin C C. Troponin D. β-Trace Protein

D. β-Trace Protein

A comatose 27-year-old woman is brought to the emergency room by paramedics, and the strong odor of bitter almonds is present. The differential diagnosis must include the possibility of poisoning by: A. Ethylene glycol B. Carbon monoxide C. Carbon tetrachloride D. Cyanide E. Arsenic

D. Cyanide

The odor of garlic may be on the breath, and a metallic taste in the patient’s mouth: A. Arsenic B. Cyanide C. Iron D. Mercury

A. Arsenic

Effect of excess lipids or proteins to sodium value measured by flame photometry and indirect ISE: A. Hypernatremia B. Hyponatremia C. Pseudohypernatremia D. Pseudohyponatremia

D. Pseudohyponatremia

Which of the following can cause cardiac arrest in the absence of warning symptoms or signs? A. Hypernatremia B. Hyponatremia C. Hyperkalemia D. Hypokalemia

C. Hyperkalemia

A patient presents with Addison disease. Serum sodium and potassium analyses are performed. What would the results reveal? A. Normal sodium, low potassium levels B. Low sodium, low potassium levels C. Low sodium, high potassium levels D. High sodium, low potassium levels

C. Low sodium, high potassium levels

The protein present in vaginal secretions that can identify patients who are at risk for preterm delivery is: A. Human chorionic gonadotropin B. Estrogen C. PAMG-1 D. Fetal fibronectin

D. Fetal fibronectin

The physician is concerned that a pregnant patient may be at risk for delivering prematurely. What would be the best biochemical marker to measure to assess the situation? A. Inhibin A B. Alpha1-Fetoprotein C. Fetal fibronectin D. Human chorionic gonadotropin

C. Fetal fibronectin

In the Henderson-Hasselbalch equation, the NUMERATOR denotes ____ functions. A. Brain B. Pituitary C. Lung D. Kidney

D. Kidney

In the Henderson-Hasselbalch equation, the DENOMINATOR denotes _____ functions. A. Brain B. Pituitary C. Lung D. Kidney

C. Lung

Urea is only a rough estimate of renal function and will not show any significant level of increased concentration until the GLOMERULAR FILTRATION RATE IS DECREASED BY AT LEAST ____. A. 30% B. 50% C. 60% D. 80%

B. 50%

Glucose measurements can be ____ mg/dL erroneously higher by reducing methods than by more accurate enzymatic methods. A. 1 to 5 mg/dL B. 5 to 15 mg/dL C. 20 to 25 mg/dL D. 30 to 35 mg/dL

B. 5 to 15 mg/dL

It is the result of POOR PERFUSION of the kidneys and therefore diminished glomerular filtration. The kidneys are otherwise normal in their functioning capabilities. Poor perfusion can result from dehydration, shock, diminished blood volume, or congestive heart failure. A. Pre-renal azotemia B. Renal azotemia C. Post-renal azotemia

A. Pre-renal azotemia

It is caused primarily by DIMINISHED GLOMERULAR FILTRATION as a consequence of acute or chronic renal disease. Such diseases include acute glomerulonephritis, chronic glomerulonephritis, polycystic kidney disease, and nephrosclerosis. A. Pre-renal azotemia B. Renal azotemia C. Post-renal azotemia

B. Renal azotemia

It is usually the result of any type of OBSTRUCTION in which urea is reabsorbed into the circulation. Obstruction can be caused by stones, an enlarged prostate gland, or tumors. A. Pre-renal azotemia B. Renal azotemia C. Post-renal azotemia

C. Post-renal azotemia

Which of the following conditions is the result of alpha1-antitrypsin level lower than 11 mmol/L? A. Emphysema B. Asthma C. Pulmonary edema D. Sarcoidosis

A. Emphysema

A patient with emphysema who has fluid accumulation in the alveolar sacs (causing decreased ventilation) is likely to be in which of the following acid-base clinical states? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis

B. Respiratory acidosis

Hepatocellular damage may be best assessed by which of the following parameters? A. Serum AST and ALT levels B. GGT and ALP C. Bilirubin, GGT, and ALP D. Ammonia and urea

A. Serum AST and ALT levels

Which of the following analytes is the best indicator of hepatobiliary damage? A. AST B. ALT C. ALP D. Bilirubin

C. ALP

Hirsutism, which can be quantified using a measurement technique known as the: A. Ferriman-Gallwey scale B. Liley graph C. T-score D. Z-score

A. Ferriman-Gallwey scale

This gland is called the “master gland” of the endocrine system. A. Pineal B. Pituitary C. Thymus D. Thyroid

B. Pituitary

This gland produces “fight or flight” hormones. A. Adrenal B. Pancreas C. Pituitary D. Thyroid

A. Adrenal

The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity: A. Choramphenicol B. Penicillin C. Sulfonamide D. Vancomycin

D. Vancomycin

Drugs given for patients with asthma: 1. Digoxin 2. Procainamide 3. Theobromine 4. Theophylline A. 1 and 2 B. 1, 2 and 4 C. 3 and 4 D. 4 only

C. 3 and 4

Which route of administration is associated with 100% bioavailability? A. Sublingual B. Intramuscular C. Oral D. Intravenous

D. Intravenous

Which substance has the longest detection time? A. Amphetamines B. Cocaine C. Benzodiazepines D. Marijuana

D. Marijuana

Which of the following organs uses glucose from digested carbohydrates and stores it as glycogen for later use as a source of immediate energy by the muscles? A. Kidneys B. Liver C. Pancreas D. Thyroid

B. Liver

Due to chronic trauma induced by ill-fitting dentures: A. Hypertrophy B. Hyperplasia C. Dysplasia D. Metaplasia

B. Hyperplasia

Which of the following is not a classic symptom of type 1 diabetes? A. Polyuria B. Polydipsia C. Polyphagia D. Proteinuria

D. Proteinuria

Which of the following electrolytes is the chief cation in the plasma, is found in the highest concentration in the extravascular fluid, and has the main function of maintaining osmotic pressure? A. Potassium B. Sodium C. Calcium D. Magnesium

B. Sodium

Analysis of a serum specimen gives a potassium result of 6.0 mmol/L. Before the result is reported to the physician, what additional step should be taken? A. The serum should be observed for hemolysis; hemolysis of the red cells will shift potassium from the cells into the serum, resulting in a falsely elevated potassium value. B. The serum should be observed for evidence of jaundice; jaundiced serum will result in a falsely elevated potassium value. C. The test should be run again on the same specimen. D. Nothing needs to be done; simply report the result.

A. The serum should be observed for hemolysis; hemolysis of the red cells will shift potassium from the cells into the serum, resulting in a falsely elevated potassium value.

Calculation of the anion gap is useful for quality control for: A. Calcium B. Tests in the electrolyte profile (sodium, potassium, chloride, and bicarbonate) C. Phosphorus D. Magnesium

B. Tests in the electrolyte profile (sodium, potassium, chloride, and bicarbonate)

Ninety percent of the carbon dioxide present in the blood is in the form of: A. Bicarbonate ions B. Carbonate C. Dissolved CO2 D. Carbonic acid

A. Bicarbonate ions

Nitrogen is excreted principally in the form of: A. Creatinine B. Creatine C. Uric acid D. Urea

D. Urea

Creatinine clearance is used to assess the: A. Glomerular filtration capabilities of the kidneys B. Tubular secretion of creatinine C. Dietary intake of protein D. Glomerular and tubular mass

A. Glomerular filtration capabilities of the kidneys

The blood pH is: A. Alkaline B. Acidic C. Very acidic D. Neutral

A. Alkaline

In analyzing cardiac markers, which marker increases first? A. Myoglobin B. CK-MB fraction C. Troponin T D. Troponin I

A. Myoglobin

Which cardiac marker persists at the highest concentration for the longest length of time? A. Myoglobin B. CK-MB fraction C. Troponin T D. Troponin I

C. Troponin T

In the United States, the NGSP, with the Diabetes Control and Complications Trial (DCCT) ____ method, is used as a PRIMARY REFERENCE METHOD for measuring HbA1c. A. Immunoassay B. Electrophoresis C. Affinity chromatography D. HPLC

D. HPLC

PREFERRED METHOD of measuring HbA1c: A. Immunoassay B. Electrophoresis C. Affinity chromatography D. HPLC

C. Affinity chromatography

What is the confirmatory method for measuring drugs of abuse? A. HPLC B. Enzyme-multiplied immunoassay technique(EMIT) C. Gas chromatography with mass spectroscopy(GC-MS) D. TLC

C. Gas chromatography with mass spectroscopy(GC-MS)

Which of the following protein methods has the highest analytical sensitivity? A. Refractometry B. Folin–Lowry C. Turbidimetry D. Direct ultraviolet absorption

B. Folin–Lowry

In the Berthelot reaction, what contaminant will cause the urea level to be falsely elevated? A. Sodium fluoride B. Protein C. Ammonia D. Bacteria

C. Ammonia

Which of the following is the most common application of immunoelectrophoresis (IEP)? A. Identification of the absence of a normal serum protein B. Structural abnormalities of proteins C. Screening for circulating immune complexes D. Diagnosis of monoclonal gammopathies

D. Diagnosis of monoclonal gammopathies

A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease? A. Lesch-Nyhan syndrome B. Modification of diet in renal disease C. Maple syrup urine disease D. Reye’s syndrome E. Megaloblastic anemia

A. Lesch-Nyhan syndrome

The electrolytes sodium, chloride and bicarbonate, because they are present in high concentrations in the ECF, and contribute to over _ of serum osmolality. A. 8% B. 35% C. 68% D. 92%

D. 92%

Electrolytes for acid-base balance: A. Na+, Cl-, K+ B. Bicarbonate, K+, Cl- C. Bicarbonate, Cl- D. Ca2+ Mg2+

B. Bicarbonate, K+, Cl-

Electrolytes for coagulation: A. Na+, Cl-, K+ B. Bicarbonate, K+, Cl- C. Bicarbonate, Cl- D. Ca2+ Mg2+

D. Ca2+ Mg2+

Close wound: A. Abrasion B. Hematoma C. Laceration D. Puncture

B. Hematoma

Neuromuscular irritability, which may become clinically apparent as irregular muscle spasms, called TETANY is associated with: A. Hyponatremia B. Hypernatremia C. Hypocalcemia D. Hypercalcemia

C. Hypocalcemia

It is used to determine whether there is a statistically significant difference between the standard deviations of two groups of data. A. f test B. t test C. Variance D. Standard deviation index

A. f test

It is used to determine whether there is statistically significant difference between the means of two groups of data. A. f test B. t test C. Variance D. Standard deviation index

B. t test

Which of the following is considered as ENVIRONMENTAL POLLUTANTS? A. Elemental mercury B. Mercurous mercury C. Mercuric mercury D. Alkyl mercury

D. Alkyl mercury

1:3S 1. One observation exceeds 3 SD from the target value 2. Three observations exceed 1 SD from the target value 3. Imprecision or systematic bias 4. Not recommended A. 1 and 3 B. 2 and 4 C. 1 and 4 D. 1, 3 and 4

A. 1 and 3

8:1S 1. Range between two observations exceeds 4 SD 2. Eight sequential observations for the same QC sample exceed 1 SD 3. Imprecision 4. Bias trend A. 1 and 3 B. 2 and 4 C. 1, 3 and 4 D. 2, 3 and 4

B. 2 and 4

Because of its ANTITUSSIVE AND ANALGESIC PROPERTIES, it is one of the most frequently prescribed opiates in the world; it is frequently combined with nonopiate analgesic agents such as aspirin and acetaminophen. A. Codeine B. Heroin C. Morphine D. Oxycodone

A. Codeine

All of the following are naturally occurring opiates except: A. Morphine B. Codeine C. Heroin D. Opium

C. Heroin

Lyophilization: A. 4 C B. 40 C C. -4 C D. -40 C

D. -40 C

Which of the following is a cause of metabolic alkalosis? A. Late stage of salicylate poisoning B. Uncontrolled diabetes mellitus C. Renal failure D. Excessive vomiting

D. Excessive vomiting

Severe diarrhea causes: A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

A. Metabolic acidosis

The following conditions are all causes of alkalosis. Which condition is associated with respiratory (rather than metabolic) alkalosis? A. Anxiety B. Hypovolemia C. Hyperaldosteronism D. Hypoparathyroidism

A. Anxiety

In salicylate overdose, what is the first acid-base disturbance present? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

D. Respiratory alkalosis

A salicylate level is performed to detect toxicity caused by ingestion of excess: A. Acetaminophen B. Aspirin C. Ibuprofen D. Pseudoephedrine

B. Aspirin

To calibrate the pH electrode in a pH/ blood gas analyzer, it is necessary that: A. The barometric pressure be knownand used for adjustments B. Calibrating gases of known high and low concentrations be used C. The calibration be performed at room temperature D. Two buffer solutions of known pH be used

D. Two buffer solutions of known pH be used

Expression of one amount relative to another amount: A. Concentration B. Dilution C. Ratio

C. Ratio

The amount of one substance relative to the amounts of other substances in the solution: A. Concentration B. Dilution C. Ratio

A. Concentration

RELATIVE CONCENTRATIONS of the components of a mixture: A. Concentration B. Dilution C. Ratio

B. Dilution

It is defined as parts per hundred parts: A. Percent B. Ratio C. Molarity D. Normality

A. Percent

Identify the result that is NOT electrolyte balanced. (compute the anion gap, results are in mmol/L) A. Na+ 125, K+ 4.5, Cl- 100, CO2 content 10 B. Na+ 135, K+ 3.5, Cl- 95, CO2 content 28 C. Na+ 145, K+ 4.0, Cl- 90, CO2 content 15 D. Na+ 150, K+ 5.0, Cl- 110, CO2 content 30

C. Na+ 145, K+ 4.0, Cl- 90, CO2 content 15

Which of the following conditions is characterized by primary HYPERaldosteronism caused by adrenal adenoma, carcinoma, or hyperplasia? A. Cushing’s syndrome B. Addison’s disease C. Conn’s syndrome D. Pheochromocytoma

C. Conn’s syndrome

Single best hormone to determine whether ovulation has occurred; THERMOGENIC EFFECT, in which basal body temperature rises after ovulation. This effect is of clinical use in marking the occurrence of ovulation. A. Estrogen B. Progesterone C. Testosterone D. Thyroxine

B. Progesterone

When encountering a patient with a fistula, the phlebotomist should: A. Apply the tourniquet below the fistula B. Use the other arm C. Collect the blood from the fistula D. Attach a syringe to the T-tube connector

B. Use the other arm

Your inpatient is asleep when you arrive to draw blood. What do you do? A. Call out the patient’s name softly and shake the bed gently. B. Cancel the test and ask the nurse to resubmit the requisition. C. Check back every 15 minutes until the patient has awakened. D. Fill out a form stating that the specimen was not obtained and why.

A. Call out the patient’s name softly and shake the bed gently.

Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do? A. Ask the patient to state her name; if it matches the requisition, continue. B. Ask the patient’s nurse to attach an ID band and proceed when it is attached. C. Go to the nurses’ station, get an ID bracelet, attach it, and then proceed. D. Tell the nurse that you will not collect the specimen and return to the lab.

B. Ask the patient’s nurse to attach an ID band and proceed when it is attached.

Which instrument requires a primary and secondary monochromator? A. Spectrophotometer B. Atomic absorption spectrophotometer C. Fluorometer D. Nephelometer

C. Fluorometer

Which of the following is the reference method for measuring serum glucose? A. Somogyi–Nelson B. Hexokinase C. Glucose oxidase D. Glucose dehydrogenase

B. Hexokinase

Gross hemolysis and extremely elevated bilirubin may cause ____ in HEXOKINASE results. (Bishop) A. False increase B. False decrease C. No effect D. Variable

B. False decrease

The mean is: A. Another term for the average B. Most frequently occurring number in a group of values C. Number that is midway between the highest and lowest values D. A representation of a true analyte value

A. Another term for the average

The median is: A. Another term for the average B. Most frequently occurring number in a group of values C. Number that is midway between the highest and lowest values D. A representation of a true analyte value

C. Number that is midway between the highest and lowest values

The mode is: A. Another term for the average B. Most frequently occurring number in a group of values C. Number that is midway between the highest and lowest values D. A representation of a true analytic value

B. Most frequently occurring number in a group of values

Bence Jones protein precipitates at temperatures between ____, and redissolves at near ____° C. A. Precipitates at 100-120C, and redissolves at 60C B. Precipitates at 10 to 20C, and redissolves at 100C C. Precipitates at 80-100C, and redissolves at 60C D. Precipitates at 40 to 60C, and redissolves at 100C

D. Precipitates at 40 to 60C, and redissolves at 100C

Which of the following biochemical processes is promoted by insulin? A. Glycogenolysis B. Gluconeogenesis C. Lipolysis D. Uptake of glucose by cells

D. Uptake of glucose by cells

Which type of analytical error can be prevented by a good quality control program? A. Instrument not properly calibrated B. Presence of interfering substances in sample C. Presence of bubbles in the light path of a photometric method D. Analyte concentration so high it depletes the active reagent

A. Instrument not properly calibrated

An example of a pre-analytical (pre-examination) error is: A. Malfunction of a microprocessor that affects accuracy in testing B. Incorrect identification of a patient C. Transposition of a numeric critical value in transmitting a report D. Verbally reporting a laboratory result over the telephone

B. Incorrect identification of a patient

An example of an analytical (examination) error is: A. Malfunction of a microprocessor that affects accuracy in testing B. Incorrect patient identification C. Transposition of a numeric critical value in transmitting a report D. Use of the wrong anticoagulant in the patient sample tube

A. Malfunction of a microprocessor that affects accuracy in testing

An example of a post-analytical (post-examination) error is: A. Malfunction of a microprocessor that affects accuracy in testing B. Incorrect patient identification C. Transposition of a numeric critical value in transmitting a report D. Use of the wrong anticoagulant in the patient sample tube

C. Transposition of a numeric critical value in transmitting a report

At temperature of 4C: A. Decreased ALP and LD B. Increased ALP and LD C. Increased ALP and decreased LD D. Decreased ALP and increased LD

C. Increased ALP and decreased LD

Rare autosomal recessive disorder characterized by complete absence of HDL: A. Tangier disease B. Anderson disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

A. Tangier disease

Abetalipoproteinemia, patients present with undetectable plasma apoB containing lipoproteins: A. Tangier disease B. Anderson disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

C. Bassen-Kornzweig syndrome

Chylomicron retention disease presents in childhood with fat malabsorption and low levels of plasma lipids. This syndrome is distinct from abetalipoproteinemia, as only apoB-48 appears to be affected: A. Tangier disease B. Anderson's disease C. Bassen-Kornzweig syndrome D. Sitosterolemia

B. Anderson's disease

Which of the following blood samples would serve best to assay lipoproteins because this anticoagulant acts to preserve lipoproteins? A. EDTA plasma sample B. Heparin plasma sample C. Citrate plasma sample D. Fluoride plasma sample

A. EDTA plasma sample

Methylenedioxymethamphetamine (MDMA) or commonly known as: A. Cannabis B. Shabu C. Meth D. Ecstasy

D. Ecstasy

THERAPEUTIC DRUG MONITORING Anticoagulant suitable for most drug analysis. A. Heparin B. Citrate C. Oxalate D. EDTA

A. Heparin ## Footnote Serum or plasma is the specimen of choice for the determination of circulating concentrations of most drugs. Heparinized plasma is suitable for most drug analysis. The calcium-binding anticoagulants add a variety of anions and cations that may interfere with analysis or cause a drug to distribute differently between cells and plasma. As a result, ethylenediaminetetracetic acid (EDTA), citrated and oxalated plasma are not usually acceptable specimens

Proper PPE in the chemistry laboratory for routine testing includes: A. Impermeable lab coat with eye/ face protection and appropriate disposable gloves B. Respirators w/ HEPA filter C. Gloves w/ rubberized sleeves D. Safety glasses for individuals not wearing contact lenses

A. Impermeable lab coat with eye/ face protection and appropriate disposable gloves

Clinical signs and symptoms commonly include low birth weight (<2,500 g), skin hyperpigmentation (café au lait spots), and short stature. Other manifestations can include skeletal disorders (aplasia or hypoplasia of the thumb), renal malformations, microcephaly, hypogonadism, mental retardation, and strabismus. A. Diamond-Blackfan anemia B. Fanconi anemia C. Sideroblastic anemia D. Thalassemia

B. Fanconi anemia

Methylenedioxymethamphetamine (MDMA) or commonly known as: A. Cannabis B. Shabu C. Meth D. Ecstasy

D. Ecstasy

A drug test is valid for _________. A. Three months B. Six months C. One year D. Two years

C. One year

Biodegradable wastes like leftover food, used cooking oil, fish entrails, scale, fins, fruits, vegetable peelings, rotten fruits, and vegetables: A. Orange B. Red C. Green D. Black

C. Green

Non-biodegradable wastes like paper or paper products (newspaper, tetra packs, etc.), bottles (glass and plastics), and packaging materials (Styropor, candy wrapper, aluminum cans): A. Orange B. Red C. Green D. Black

D. Black

Radioactive wastes or medical equipment contaminated or exposed in radioactivity: A. Orange B. Red C. Green D. Black

A. Orange

Pharmaceutical and chemical wastes: A. Yellow B. Yellow with black band C. Red D. Orange

B. Yellow with black band

Infectious and pathological wastes such as used test strips, used beads or plates, used reaction pads or foils, used swabs, used gloves, used cord clamp, used plaster, used masks: A. Yellow B. Yellow with black band C. Red D. Orange

A. Yellow

In the Hierarchy of Controls, which of the following is most effective in preventing exposures: A. Personal protective equipment B. Substitution of toxic substances C. Hazard elimination D. Engineering controls

C. Hazard elimination

Use of which of the following is a method of substitution of a work-related hazard: A. Sharp containers B. Non-latex gloves instead of latex gloves C. Patient lift equipment D. Hand sanitizers

B. Non-latex gloves instead of latex gloves

Aldosterone is involved in the reabsorption of: A. Potassium B. Sodium C. Bicarbonate D. Hydrogen ion

B. Sodium

Following a head injury, which protein will identify the presence of CSF leakage through the nose? A. Transthyretin B. Myelin basic protein C. Tau protein D. C-reactive protein

C. Tau protein

Second most prevalent protein in CSF: A. Ceruloplasmin B. Haptoglobin C. Prealbumin D. Transferrin

C. Prealbumin

CSF GLUTAMINE Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome? A. Ammonia B. Lactate C. Glucose D. Alpha-ketoglutarate

A. Ammonia

The amount of amniotic fluid increases in quantity throughout pregnancy, reaching a peak of approximately ____ mL during the third trimester, and then gradually decreases prior to delivery. A. 400 to 800 mL B. 800 mL to 1,200 mL C. 1,200 to 1,500 mL D. 2,000 to 4, 000 mL

B. 800 mL to 1,200 mL

A maximum of _ mL of amniotic fluid is collected in sterile syringes. A. 10 mL B. 20 mL C. 30 mL D. 50 mL

C. 30 mL

Which pair does NOT match with respect to amniotic fluid? A. Colorless – normal B. Dark red-brown – fetal death C. Dark green – hemolytic disease of the newborn D. Blood-streaked – traumatic tap

C. Dark green – hemolytic disease of the newborn

A pleural fluid submitted to the laboratory is milky in appearance. Which test would be most useful in differentiating between a chylous and pseudochylous effusion? A. Fluid to serum triglyceride ratio B. Fluid WBC count C. Fluid total protein D. Fluid to serum LD ratio

A. Fluid to serum triglyceride ratio

In which condition is the highest level of serum gastrin usually seen? A. Atrophic gastritis B. Pernicious anemia C. Zollinger-Ellison syndrome D. Cancer of the stomach

C. Zollinger-Ellison syndrome

Which is the reference method for determining fetal lung maturity? A. Human placental lactogen B. L/S ratio C. Amniotic fluid bilirubin D. Urinary estriol

B. L/S ratio

Which test best correlates with the severity of HDN? A. Rh antibody titer of the mother B. Lecithin/sphingomyelin (L/S) ratio C. Amniotic fluid bilirubin D. Urinary estradiol

C. Amniotic fluid bilirubin

Which of the following conditions is commonly associated with an exudative effusion? A. Congestive heart failure B. Malignancy C. Nephrotic syndrome D. Cirrhosis

B. Malignancy

Family history of chromosome abnormalities, such as TRISOMY 21 (DOWN SYNDROME), amniocentesis may be indicated at: A. 1 to 7 weeks gestation B. 7 to 14 weeks gestation C. 15 to 18 weeks gestation D. 20 to 42 weeks gestation

C. 15 to 18 weeks gestation

Basic unit for mass: A. Mole B. Milligram C. Gram D. Kilogram

D. Kilogram

Basic unit for length: A. Second B. Millimeter C. Meter D. Kilometer

C. Meter

The sex steroids are synthesized by all of the following, EXCEPT: A. Hypothalamus B. Ovaries C. Testes D. Adrenal gland

A. Hypothalamus

The mechanism of action for tetracycline is inhibition of: A. RNA synthesis B. Cell wall synthesis C. Protein synthesis D. Membrane function

C. Protein synthesis

What plasma protein functions to bind hemoglobin following intravascular hemolysis? A. Albumin B. Transferrin C. Haptoglobin D. C-reactive protein

C. Haptoglobin

Preanalytical (preexamination) variables in laboratory testing include: A. Result accuracy B. Report delivery to the ordering physician C. Test turnaround time D. Specimen acceptability

D. Specimen acceptability

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease? A. Cathepsin-D B. CA-15-3 C. Retinoblastoma gene D. Estrogen receptor (ER)

B. CA-15-3

Which tumor marker is used to determine the usefulness of TRASTUZUMAB (HERCEPTIN) therapy for breast cancer? A. PR B. CEA C. HER-2/neu D. Myc

C. HER-2/neu

Employees should not work with radioisotopes if they are: A. Wearing contact lenses B. Allergic to iodine C. Sensitive to latex D. Pregnant ## Footnote Stras

D. Pregnant

The first thing to do when a fire is discovered is to: A. Rescue persons in danger B. Activate the alarm system C. Close doors to other areas D. Extinguish the fire if possible ## Footnote Stras

A. Rescue persons in danger

The NPFA classification symbol contains information on all of the following except: A. Fire hazards B. Biohazards C. Reactivity D. Health hazards ## Footnote Stras

B. Biohazards

The testing of sample from an outside agency and the comparison of results with participating laboratories is called: A. External QC B. Electronic QC C. Internal QC D. Proficiency testing ## Footnote Stras

D. Proficiency testing ## Footnote Proficiency Testing (External Quality Assessment) External QA (not External QC) PT or EQA is the testing of unknown samples received from an outside agency, and provides unbiased validation of the quality of patient test results. The laboratory accuracy is evaluated and compared with other laboratories using the same method of analysis.

The classification of a fire that can be extinguished with water is: A. Class A B. Class B C. Class C D. Class D ## Footnote Stras

A. Class A

Employers are required to provide free immunization for: A. HIV B. HTLV-1 C. HBV D. HCV ## Footnote Stras

C. HBV

The primary chemical affected by the renin-angiotensin-aldosterone system is: A. Chloride B. Sodium C. Potassium D. Hydrogen ## Footnote Stras

B. Sodium

A. Lesch-Nyhan syndrome

Seventy (70) percent recirculated to the cabinet work area through HEPA; 30% balance can be exhausted through HEPA back into the room or to outside through a canopy unit: A. BSC Class I B. BSC Class II, A1 C. BSC Class II, B1 D. BSC Class II, B2

B. BSC Class II, A1

Thirty (30) percent recirculated, 70% exhausted. Exhaust cabinet air must pass through a dedicated duct to the outside through a HEPA filter. A. BSC Class I B. BSC Class II, A1 C. BSC Class II, B1 D. BSC Class II, B2

C. BSC Class II, B1

No recirculation; total exhaust to the outside through a HEPA filter. A. BSC Class I B. BSC Class II, A1 C. BSC Class II, B1 D. BSC Class II, B2

D. BSC Class II, B2

In ENTERIC ISOLATION, the technologist is required to wear: A. Gown and gloves B. Gown, mask and gloves C. Gown, mask, gloves and shoe coverings D. Mask

A. Gown and gloves

Reverse isolation may be used for: A. A patient with the measles B. An adult patient with the flu C. A patient with tuberculosis D. A patient with severe burns

D. A patient with severe burns

Which of the following plots is best for detecting all types of QC errors? A. Levy–Jennings B. Tonks–Youden C. Cusum D. Linear regression

A. Levy–Jennings

Which of the following plots is best for comparison of precision and accuracy among laboratories? A. Levy–Jennings B. Tonks–Youden C. Cusum D. Linear regression

B. Tonks–Youden

Which plot will give the earliest indication of a shift or trend? A. Levy–Jennings B. Tonks–Youden C. Cusum D. Histogram

C. Cusum

Which of the following statistical tests is used to compare the means of two methods? A. Student’s t test B. F distribution C. Correlation coefficient D. Linear regression analysis

A. Student’s t test

When the magnitude of error increases with increasing sample concentration, it is called: A. Constant error B. Proportional error C. Random error D. Bias

B. Proportional error

Urea is produced from: A. The catabolism of proteins and amino acids B. Oxidation of purines C. Oxidation of pyrimidines D. The breakdown of complex carbohydrates

A. The catabolism of proteins and amino acids

In the ultraviolet enzymatic method for BUN, the urease reaction is coupled to a second enzymatic reaction using: A. AST B. Glutamate dehydrogenase C. Glutamine synthetase D. Alanine aminotransferase (ALT)

B. Glutamate dehydrogenase

Which product is measured in the coupling step of the urease-UV method for BUN? A. CO2 B. Dinitrophenylhydrazine C. Diphenylcarbazone D. NAD+

D. NAD+

Which of the following conditions is classified as a renal-type aminoaciduria? A. Fanconi syndrome B. Wilson’s disease C. Hepatitis D. Homocystinuria

A. Fanconi syndrome

Which of the following protein methods has the highest analytical sensitivity? A. Refractometry B. Folin–Lowry C. Turbidimetry D. Direct ultraviolet absorption

B. Folin–Lowry

Hyperalbuminemia is caused by: A. Dehydration syndromes B. Liver disease C. Burns D. Gastroenteropathy

A. Dehydration syndromes

Which of the following dyes is the most specific for measurement of albumin? A. Bromcresol green (BCG) B. Bromcresol purple (BCP) C. Tetrabromosulfophthalein D. Tetrabromphenol blue

B. Bromcresol purple (BCP)

At pH 8.6, proteins are ________ charged and migrate toward the ________. A. Negatively, anode B. Positively, cathode C. Positively, anode D. Negatively, cathode

A. Negatively, anode

Which of the following proteins migrates in the beta region at pH 8.6? A. Haptoglobin B. Orosomucoprotein C. Antichymotrypsin D. Transferrin

D. Transferrin

A patient with hemolytic-uremic syndrome associated with septicemia has a haptoglobin level that is normal, although the plasma free hemoglobin is elevated and hemoglobinuria is present. Which test would be more appropriate than haptoglobin to measure this patient’s hemolytic episode? A. Hemopexin B. Alpha-1 antitrypsin C. C-reactive protein D. Transferrin

A. Hemopexin

Which test is the most sensitive in detecting early monoclonal gammopathies? A. High-resolution serum protein electrophoresis B. Urinary electrophoresis for monoclonal light chains C. Capillary electrophoresis of serum and urine D. Serum-free light chain immunoassay

D. Serum-free light chain immunoassay

Which test is the most useful way to evaluate the response to treatment for multiple myeloma? A. Measure of total immunoglobulin B. Measurement of 24-hour urinary light chain concentration (Bence–Jones protein) C. Capillary electrophoresis of M-protein recurrence D. Measurement of serum-free light chains

D. Measurement of serum-free light chains

In familial β dyslipoproteinemia (formerly type III hyperlipoproteinemia), which lipoprotein accumulates? A. Chylomicrons B. VLDL C. IDL D. VLDL

C. IDL

Which of the following mechanisms accounts for the elevated plasma level of β lipoproteins seen in familial hypercholesterolemia (formerly type II hyperlipoproteinemia)? A. Hyperinsulinemia B. ApoB-100 receptor defect C. ApoC-II activated lipase deficiency D. ApoE3 deficiency

B. ApoB-100 receptor defect

Which enzyme deficiency is most commonly associated with familial hypertriglyceridemia associated with fasting plasma cholomicrons (formerly type I hyperlipoproteinemia)? A. β Glucocerebrosidase deficiency B. Post–heparin-activated lipoprotein lipasedeficiency C. Apo-B deficiency D. Apo-C-III deficiency

B. Post–heparin-activated lipoprotein lipasedeficiency

Which of the following enzymes is considered most tissue specific? A. Creatine kinase (CK) B. Amylase C. Alkaline phosphatase (ALP) D. Alcohol dehydrogenase (ADH)

D. Alcohol dehydrogenase (ADH)

Which of the following enzymes is activated by calcium ions A. CK B. Amylase C. ALP D. LD

B. Amylase

Which substance is used in the CK assay to activate the enzyme? A. Flavin adenine dinucleotide (FAD) B. Imidazole C. N-acetylcysteine D. Pyridoxyl-5 ́-phosphate

C. N-acetylcysteine

Select the coupling enzyme used in the kinetic AST reaction of Henry. A. LD B. Malate dehydrogenase C. Glutamate dehydrogenase D. G-6-PD

B. Malate dehydrogenase

Which isoenzyme of ALP is most heat stable? A. Bone B. Liver C. Intestinal D. Placental

D. Placental

Which substrate is used in the Bowers–McComb method for ALP? A. p-Nitrophenyl phosphate B. β-Glycerophosphate C. Phenylphosphate D. α-Naphthylphosphate

A. p-Nitrophenyl phosphate

Which is normally the most abundant corticosteroid hormone secreted by the adrenal cortex? A. Cortisol B. Dehydroepiandrosterone C. Aldosterone D. Corticosterone

A. Cortisol

Which assay using 24-hour urine is considered the best single screening test for pheochromocytoma? A. Total urinary catecholamines B. VMA C. Homovanillic acid (HVA) D. Metanephrines

D. Metanephrines

Select the most appropriate single screening test for thyroid disease. A. Free thyroxine index B. Total T3 assay C. Total T4 D. TSH assay

D. TSH assay

Which statement about TSH and T4 in early pregnancy is correct? A. TSH and thyroid hormones fall B. TSH falls and thyroid hormones rise C. TSH and thyroid hormones both rise D. TSH rises and thyroid hormones fall

B. TSH falls and thyroid hormones rise

Which route of administration is associated with 100% bioavailability? A. Sublingual B. Intramuscular C. Oral D. Intravenous

D. Intravenous

Which substance has the longest detection time? A. Amphetamines B. Cocaine C. Benzodiazepines D. Marijuana

D. Marijuana

The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity: A. Choramphenicol B. Penicillin C. Sulfonamide D. Vancomycin

D. Vancomycin

Which specimen is the sample of choice for lead screening A. Whole blood B. Hair C. Serum D. Urine

A. Whole blood

Which tumor marker is associated with cancer of the urinary bladder? A. CA-19-9 B. CA-72-4 C. Nuclear matrix protein D. Cathepsin-D

C. Nuclear matrix protein

A blood sample is left on a phlebotomy tray for 4.5 hours before it is delivered to the laboratory. Which group of tests could be performed? A. Glucose, Na, K, Cl, TCO2 B. Uric acid, BUN, creatinine C. Total and direct bilirubin D. CK, ALT, ALP, AST

B. Uric acid, BUN, creatinine

A. Absorbance

Beer-Lambert law (Beer’s law) Mathematically establishes the relationship between concentration and absorbance in many photometric determinations Beer’s law is expressed as A = abc a (small a) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

B. Absorptivity constant

Beer-Lambert law (Beer’s law) Mathematically establishes the relationship between concentration and absorbance in many photometric determinations Beer’s law is expressed as A = abc b (small b) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

D. Length of light path

Beer-Lambert law (Beer’s law) Mathematically establishes the relationship between concentration and absorbance in many photometric determinations Beer’s law is expressed as A = abc c (small c) in Beer's law is: A. Absorbance B. Absorptivity constant C. Concentration D. Length of light path

C. Concentration

Expression of one amount relative to another amount: A. Concentration B. Dilution C. Ratio

C. Ratio

The amount of one substance relative to the amounts of other substances in the solution: A. Concentration B. Dilution C. Ratio

A. Concentration

RELATIVE CONCENTRATIONS of the components of a mixture: A. Concentration B. Dilution C. Ratio

B. Dilution

It is increased in hemolytic anemias: A. B1 B. B2 C. Both fractions D. None of these

A. B1

It is increased in bile duct obstruction: A. B1 B. B2 C. Both fractions D. None of these

B. B2

Increased in hepatitis: A. B1 B. B2 C. Both fractions D. None of these

C. Both fractions

C-peptide is formed during the conversion of pro-insulin to insulin. The amount of circulating C-peptide provides reliable indicators for pancreatic and insulin secretions (β-cell function). It is decreased in: A. Type 1 DM B. Type 2 DM C. Insulinoma D. Ingestion of hypoglycemic drugs

A. Type 1 DM

VERY LOW OR UNDETECTABLE C-peptide: A. Type 1 diabetes B. Type 2 diabetes C. Both of these D. None of these

A. Type 1 diabetes

DETECTABLE C-peptide: A. Type 1 diabetes B. Type 2 diabetes C. Both of these D. None of these

B. Type 2 diabetes

Blood alcohol concentration associated with mental confusion, dizziness, strongly impaired motor skills (staggering, slurred speech): A. 0.09 to 0.25% B. 0.18 to 0.30% C. 0.27 to 0.40% D. 0.35 to 0.50%

B. 0.18 to 0.30%

Blood alcohol concentration associated with vomiting and impaired consciousness. The patient is unable to stand. A. 0.09 to 0.25% B. 0.18 to 0.30% C. 0.27 to 0.40% D. 0.35 to 0.50%

C. 0.27 to 0.40%

Blood alcohol concentration associated with coma and possible death: A. 0.09 to 0.25% B. 0.18 to 0.30% C. 0.27 to 0.40% D. 0.35 to 0.50%

D. 0.35 to 0.50%

A solution used to clean the site before routine venipuncture is: A. 5.25% sodium hypochlorite. B. 70% isopropyl alcohol. C. 70% methanol. D. Povidone–iodine.

B. 70% isopropyl alcohol.

This antiseptic has been traditionally used to obtain the high degree of skin antisepsis required when BLOOD CULTURES are being collected: A. 70% Ethyl alcohol B. 70% Isopropanol C. Hydrogen peroxide D. Povidone–iodine

D. Povidone–iodine

When drawing a blood alcohol specimen, it is acceptable to clean the arm with: A. Benzalkonium chloride B. Isopropyl alcohol C. Methanol prep D. Tincture of iodine

A. Benzalkonium chloride

It is used for procedures that require maximum water purity for accuracy and precision: A. Type I reagent water B. Type II reagent water C. Type III reagent water D. Any of these

A. Type I reagent water

Which of the following is a proper way to clean up a small blood spill that has dried on a countertop? A. Moisten it with a disinfectant and carefully absorb it with a paper towel B. Rub it with an alcohol pad, then wipe the area with a clean alcohol pad C. Scrape it into a biohazard bag and wash the surface with soap and water D. Use a disinfectant wipe and scrub it in ever increasing concentric circles

A. Moisten it with a disinfectant and carefully absorb it with a paper towel

One international unit of enzyme activity is the amount of enzyme that will, under specified reaction conditions of substrate concentration, pH and temperature, cause utilization of substrate at the rate of: A. 1 mol/min B. 1 mmol/min C. 1 μmol/min D. 1 nmol/min

C. 1 μmol/min

In familial hypercholesterolemia, the hallmark finding is an elevation of: A. Low-density lipoproteins B. Chylomicrons C. High-density lipoproteins D. Apolipoprotein A1

A. Low-density lipoproteins

What substance gives feces its normal color? A. Uroerythrin B. Urochrome C. Urobilin D. Urobilinogen

C. Urobilin

The most heat labile fraction of alkaline phosphatase is obtained from: A. Liver B. Bone C. Intestine D. Placenta

B. Bone

Cholinesterase levels are generally assayed to aid in diagnosis of: A. Pancreatitis B. Methamphetamine overdose C. Organophosphate poisoning D. Hepatobiliary disease

C. Organophosphate poisoning

A characteristic of the Bence Jones protein that is used to distinguish it from other urinary proteins is its solubility: A. In ammonium sulfate B. In sulfuric acid C. At 40 to 60 °C D. At 100 °C

D. At 100 °C

A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is: A. Ammonia B. ALT C. AST D. GGT

A. Ammonia

An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

A. Respiratory acidosis

RENAL TUBULAR FUNCTION Select the test which evaluates renal tubular function. A. IVP B. Creatinine clearance C. Osmolality D. Microscopic urinalysis

C. Osmolality

Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure? A. Chloride B. Calcium C. Potassium D. Sodium

D. Sodium

The solute that contributes the most to the total serum osmolality is: A. Glucose B. Sodium C. Chloride D. Urea

B. Sodium

A delta check is a method that: A. Determines the mean and variance of an instrument B. Monitors the testing system for precision C. Monitors patient samples day to day D. Is determined by each laboratory facility

C. Monitors patient samples day to day

Which of these attributes is the advantage for adding point-of-care testing? A. Higher test accuracy B. Lower costs C. Faster TAT D. More skilled test personnel

C. Faster TAT

The primary advantage of point-of-care testing (POCT), also known as bedside testing or near patient testing is: A. POCT can be performed by nonlaboratorians at a lower cost B. The turn-around time for test results is faster C. POCT bypasses costly regulatory requirements that apply to testing in a central lab D. Testing is easier to perform, which reduces the cost of training

B. The turn-around time for test results is faster

Which of the following is considered as ENVIRONMENTAL POLLUTANTS? A. Elemental mercury B. Mercurous mercury C. Mercuric mercury D. Alkyl mercury

D. Alkyl mercury

D. Cyanide

The odor of garlic may be on the breath, and a metallic taste in the patient’s mouth: A. Arsenic B. Cyanide C. Iron D. Mercury

A. Arsenic

This toxin has high affinity to keratin, can be identified from hair and nails: A. Lead B. Cyanide C. Mercury D. Arsenic

D. Arsenic

Kayser-Fleischer ring in the cornea: A. Cretinism B. Hemochromatosis C. Minamata disease D. Wilson's disease

D. Wilson's disease

Establishing a reference interval: A new reference interval is established when there is no existing analyte or methodology in the clinical or reference laboratory with which to conduct comparative studies. It is a costly and labor-intensive study that will involve laboratory resources at all levels and may require from ____ to as many as ≈700 study individuals. A. 20 study individuals B. 50 study individuals C. 100 study individuals D. 120 study individuals

D. 120 study individuals

# **** Verifying a reference interval (transference): This is done to confirm the validity of an existing reference interval for an analyte using the same (identical) type of analytic system (method and/or instrument). These are the most common reference interval studies performed in the clinical laboratory and can require as few as ____ study individuals. A. 20 study individuals B. 50 study individuals C. 100 study individuals D. 120 study individuals

A. 20 study individuals

Gross hemolysis and extremely elevated bilirubin may cause ____ in HEXOKINASE results. (Bishop) A. False increase B. False decrease C. No effect D. Variable

B. False decrease

Typically, a full Six Sigma improvement project takes ____ to complete. A. 1 to 2 weeks B. 3 to 4 months C. 6 to 8 months D. 1 to 2 years

C. 6 to 8 months

Smaller scale improvement projects typically headed by ____ belts use the same Lean Six Sigma principles condensed over 1 week to improve more focused and limited processes. A. White belts B. Yellow belts C. Purple belts D. Black belts

C. Purple belts

The sample of choice for measuring blood osmolality is: A. Serum B. Plasma C. Whole blood D. Serum or plasma may be used

A. Serum

Glassware is usually calibrated at: A. 98F B. 72F C. 20C D. 37C

C. 20C

Acid cleaning solution contains: A. 10% HCl B. Potassium dichromate in concentrated H2SO4 C. Potassium chlorate in concentrated H2SO4 D. Dilute solution of any acid

B. Potassium dichromate in concentrated H2SO4

If a blood gas specimen is left exposed to the air for an extended period, which of the following changes will occur? A. pO2 increases, pH and pCO2 decrease B. pO2 decreases, pH and pCO2 increase C. pO2 and pH increase, pCO2 decreases D. pO2 and pH decrease, pCO2 increases

C. pO2 and pH increase, pCO2 decreases

The first step to take when attempting to repair electronic equipment is to: A. Check all electronic connections B. Turn instrument off and unplug it C. Reset all the printed circuit boards D. Review instrument manual

B. Turn instrument off and unplug it

Which of the following light sources is used in atomic absorption spectrophotometry? A. Hollow-cathode lamp B. Xenon arc lamp C. Tungsten light D. Deuterium lamp E. Laser

A. Hollow-cathode lamp

What test is best to assess kidney glomerular filtration? A. Urea nitrogen B. Creatinine clearance C. PSP D. Urine protein E. Serum protein electrophoresis

B. Creatinine clearance

The chloride shift in blood takes place between chloride and: A. Sodium B. Potassium C. Bicarbonate D. Calcium E. Oxygen

C. Bicarbonate

Physiologically active calcium is: A. Protein bound B. Complexed to oxalate C. Complexed to citrate D. Total calcium E. Ionized calcium

E. Ionized calcium

Symptom of hypocalcemia: A. Stupor B. Tetany C. Vomiting D. Dehydration E. Tremors

B. Tetany

In lipoprotein electrophoresis, the dense band that doesn't migrate from the origin is: A. Chylomicrons B. LDL C. Beta lipoproteins D. Cholesterol E. Phospholipids

A. Chylomicrons

TSH is produced by the: A. Hypothalamus B. Pituitary gland C. Adrenal cortex D. Thyroid

B. Pituitary gland

During pregnancy, the form of estrogen that predominates and may be useful in prenatal screening is: A. Estradiol B. Estriol C. Estrone D. Pregnanediol

B. Estriol

A carbonate salt used to control manic-depressive disorders is: A. Digoxin B. Acetaminophen C. Lithium D. Phenytoin

C. Lithium

The reason carbon monoxide is so toxic is because it: A. Is a protoplasmic poison B. Combines with cytochrome oxidase C. Has 200 times the affinity of oxygen for hemoglobin binding sites D. Sensitizes the myocardium

C. Has 200 times the affinity of oxygen for hemoglobin binding sites

A 3-year-old child is evaluated for abdominal pain and anorexia by a physician. A CBC reveals a hemoglobin of 9.8 g/dl (98 g/L) and basophilic stippling of the RBCs. The doctor should order further tests to check for poisoning from: A. Arsenic B. Iron C. Mercury D. Lead

D. Lead

Hepatocellular damage may be best assessed by which of the following parameters? A. Serum AST and ALT levels B. GGT and ALP C. Bilirubin, GGT, and ALP D. Ammonia and urea

A. Serum AST and ALT levels

Which of the following analytes is the best indicator of hepatobiliary damage? A. AST B. ALT C. ALP D. Bilirubin

C. ALP

Given the following results: ALP: marked increased AST: slight increased ALT: slight increased GGT: marked increased This is most consistent with: A. Acute hepatitis B. Osteitis fibrosa C. Chronic hepatitis D. Obstructive jaundice

D. Obstructive jaundice

A physician orders several laboratory tests on a 55-year-old male patient who is complaining of pain, stiffness, fatigue and headaches. Based on the following serum test results, what is the most likely diagnosis? ALP: significantly increased GGT: normal A. Biliary obstruction B. Cirrhosis C. Hepatitis D. Osteitis deformans (Paget disease)

D. Osteitis deformans (Paget disease)

A 42-year-old male presents with anorexia, nausea, fever, and icterus of the skin and mucous membranes. He noticed that his urine had appeared dark for the past several days. The physician orders a series of biochemical tests. Based on the following test results, what is the most likely diagnosis? ALP: slightly elevated ALT: markedly elevated AST: markedly elevated GGT: slightly elevated Serum total bilirubin: moderately elevated Urine bilirubin: positive Fecal urobilinogen: decreased A. Acute hepatitis B. Alcoholic cirrhosis C. Metastatic carcinoma of the pancreas D. Obstructive jaundice

A. Acute hepatitis

Given the following results: ALP: slight increased AST: slight increased ALT: slight increased GGT: slight increased This is most consistent with: A. Acute hepatitis B. Chronic hepatitis C. Obstructive jaundice D. Liver hemangioma

B. Chronic hepatitis

Which of the following is a marker for bone resorption? A. β-trace protein B. Adiponectin C. Fibronectin D. Crosslinked C-telopeptide

D. Crosslinked C-telopeptide

A. Osteocalcin

Which test is used as an indicator of congestive heart failure? A. CRP B. BNP C. Cholesterol D. Troponin E. Haptoglobin

B. BNP

As a cardiac biomarker, ________ has been used in conjunction with troponin to help diagnose or rule out a heart attack. A. BNP B. Myoglobin C. Troponin D. Adiponectin

B. Myoglobin

The “gold standard” in the diagnosis of acute coronary syndrome (ACS): A. Fibronectin B. Cystatin C C. Troponin D. β-Trace Protein

C. Troponin

Which of the following can cause cardiac arrest in the absence of warning symptoms or signs? A. Hypernatremia B. Hyponatremia C. Hyperkalemia D. Hypokalemia

C. Hyperkalemia

Recently, it was established as an accurate marker of CSF leakage: A. Fibronectin B. Cystatin C C. Troponin D. β-Trace Protein

D. β-Trace Protein

Variants demonstrate a wide variety of cellular interactions, including roles in cell adhesion, tissue differentiation, growth, and wound healing: A. Adiponectin B. Fibronectin C. Crosslinked C-telopeptide D β-trace protein

B. Fibronectin

The protein present in vaginal secretions that can identify patients who are at risk for preterm delivery is: A. Human chorionic gonadotropin B. Estrogen C. PAMG-1 D. Fetal fibronectin

D. Fetal fibronectin

B. Progesterone

D. HPLC

PREFERRED METHOD of measuring HbA1c: A. Immunoassay B. Electrophoresis C. Affinity chromatography D. HPLC

C. Affinity chromatography

Copper reduction method for glucose that uses arsenomolybdic acid: A. Folin-Wu B. Nelson-Somogyi C. Neocuproine D. All of these

B. Nelson-Somogyi

B. Folin-Wu

Glucose measurements can be ____ mg/dL erroneously higher by reducing methods than by more accurate enzymatic methods. A. 1 to 5 mg/dL B. 5 to 15 mg/dL C. 20 to 25 mg/dL D. 30 to 35 mg/dL

B. 5 to 15 mg/dL

B. 50%

Reversal (low) albumin and globulin (A/G) ratio: A. Liver cirrhosis B. Liver cirrhosis and nephrotic syndrome C. Liver cirrhosis, nephrotic syndrome and multiple myeloma D. Nephrotic syndrome and multiple myeloma

C. Liver cirrhosis, nephrotic syndrome and multiple myeloma

In ketoacidosis, the anion gap would most likely to be affected in what way? A. Unchanged from normal B. Increased C. Decreased D. Balanced

B. Increased

Which of the following conditions will cause an increased anion gap? A. Diarrhea B. Hypoaldosteronism C. Hyperkalemia D. Renal failure

D. Renal failure

Which of the following blood gas disorders is most commonly associated with an abnormal anion gap? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

A. Metabolic acidosis

In the Henderson-Hasselbalch equation, the numerator denotes ____ functions. A. Brain B. Pituitary C. Lung D. Kidney

D. Kidney

In the Henderson-Hasselbalch equation, the denominator denotes _____ functions. A. Brain B. Pituitary C. Lung D. Kidney

C. Lung

The most common light source for fluorometry is: A. Hydrogen lamp B. Mercury lamp C. Tungsten lamp D. Xenon lamp

D. Xenon lamp

D. Valinomycin

To calibrate the pH electrode in a pH/ blood gas analyzer, it is necessary that: A. The barometric pressure be known and used for adjustments B. Calibrating gases of known high and low concentrations be used C. The calibration be performed at room temperature D. Two buffer solutions of known pH be used

D. Two buffer solutions of known pH be used

Which of the following reagents can be used to measure protein in cerebrospinal fluid? A. Biuret B. Coomassie brilliant blue C. Ponceau S D. Bromcresol green

B. Coomassie brilliant blue

Which term describes a congenital disorder that is characterized by a split in the albumin band when serum is subjected to electrophoresis? A. Analbuminemia B. Anodic albuminemia C. Prealbuminemia D. Bisalbuminemia

D. Bisalbuminemia

Bisalbuminemia: A. Acquired disorder B. Congenital disorder

B. Congenital disorder

Which of the following proteins is normally produced by the fetus but is found in increased amounts in the amniotic fluid in cases of spina bifida? A. Alpha1-antitrypsin B. Alpha1-acid glycoprotein C. Alpha1-fetoprotein D. Alpha2-macroglobulin

C. Alpha1-fetoprotein

Which of the following disorders is NOT associated with an elevated blood ammonia level? A. Reye syndrome B. Renal failure C. Chronic liver failure D. Diabetes mellitus

D. Diabetes mellitus

Which of the following enzyme activities can be determined by using a dilute olive oil emulsion substrate, whose hydrolyzed product is monitored as a decrease in turbidity or light scatter? A. Alkaline phosphatase B. Amylase C. Lipase D. Trypsin

C. Lipase

Of the total serum osmolality, sodium, chloride, and bicarbonate ions normally contribute approximatelywhat percent? A. 8 B. 45 C. 75 D. 92

D. 92

C. Low sodium, high potassium levels

What percentage of serum calcium is in the ionized form? A. 30% B. 50% C. 60% D. 80%

B. 50%

Organs that affect calcium levels: A. Heart, lungs and liver B. Heart, lungs and kidney C. Bone, intestines and heart D. Bone, intestines and kidney

D. Bone, intestines and kidney

Which of the following is NOT a colligative property of solutions? A. pH B. Freezing point C. Osmotic pressure D. Vapor pressure

A. pH

If a blood gas specimen is left exposed to air, which of the following changes will occur? A. pO2 and pH increase; pCO2 decreases B. pO2 and pH decrease; pCO2 increases C. pO2 increases; pH and pCO2 decrease D. pO2 decreases; pH and pCO2 increase

A. pO2 and pH increase; pCO2 decreases

How would blood gas parameters change if a sealed specimen is left at room temperature for 2 or more hours? A. pO2 increases, pCO2 increases, pH increases B. pO2 decreases, pCO2 decreases, pH decreases C. pO2 decreases, pCO2 increases, pH decreases D. pO2 increases, pCO2 increases, pH decreases

C. pO2 decreases, pCO2 increases, pH decreases

ELECTRIC NEUTRALITY In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what electrolyte? A. Sodium B. Potassium C. Chloride D. Phosphate

C. Chloride

You receive a blood gas sample on a patient who is in the emergency room for assessment of unexplained vomiting for the past 4 days and abnormal respirations. Which of the following interpretations best describes the patient’s blood gas results? pH: 7.50 pO2: 85 mm Hg pCO2: 55 mm Hg HCO3-: 35 mmol/L A. Partially compensated metabolic acidosis B. Partially compensated metabolic alkalosis C. Compensated metabolic alkalosis D. Compensated metabolic acidosis

B. Partially compensated metabolic alkalosis

In salicylate overdose, what is the first acid-base disturbance present? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

D. Respiratory alkalosis

B. Proper hand washing

The appropriate dilution of bleach to be used in laboratory disinfection is: A. 1:2 B. 1:5 C. 1:10 D. 1:100

C. 1:10

Where should alcohol and other flammable chemicals be stored? A. In an approved safety can or storage cabinet away from heat sources B. Under a hood and arranged alphabetically for ease of identification in an emergency C. In a refrigerator at 28C to 88C to reduce volatilization D. On a low shelf in an area protected from light

A. In an approved safety can or storage cabinet away from heat sources

Slope = proportional SE = 1 (perfect correlation) Y-intercept = constant SE = 0 (perfect correlation) You validate a new assay using linear regression to compare assay calibrator results with the distributor’s published calibrator results. The slope is 0.99 and the y-intercept is +10%. What type of error is present? A. No error B. Random error C. Constant systematic error D. Proportional systematic error

C. Constant systematic error

Which is a statistical test comparing means? A. Bland-Altman B. Student’s t-test C. ANOVA D. Pearson

B. Student’s t-test

What is the primary goal of TQM? A. Precise test results B. Increased laboratory productivity C. Improved patient outcomes D. Reproducible test results

C. Improved patient outcomes

Acanthocytes are found in association with: A. Abetalipoproteinemia B. G6PD deficiency C. Rh deficiency syndrome D. Vitamin B12 deficiency

A. Abetalipoproteinemia

2 hour serum glucose: a. 130 mg/dL b. 135 mg/dL c. 150 mg/dL d. 250 mg/dL

c. 150 mg/dL

Buffer used in the IFCC recommended method for ALP

2-Amino-2-methyl-1-propanol

The follicles are sites of thyroid hormone synthesis and storage. The thyroid gland also contains parafollicular cells, or C cells, which are responsible for the synthesis and secretion of calcitonin, a hormone important in

calcium metabolism

Major systems in a flow cytometer include all of the following except: A. Fluidics B. Optics C. Computerized electronics D. Gating

D. Gating

In flow cytometry, the term “gating” refers to: A. Selection of a subpopulation of cells to count B. Determining the fluorescent emission spectrumof cells of interest C. Interference caused by binding of more than asingle antibody D. Selecting the appropriate counting aperture

A. Selection of a subpopulation of cells to count

The purest type of reagent water is: A. Type I B. Type II C. Type III D. All are equal

A. Type I

How would 6.32 be rounded off to one less decimal place? A. 6.32 B. 6.4 C. 7.0 D. 6.3

D. 6.3

How would 15.57 be rounded off to one less decimal place? A. 15.6 B. 15.5 C. 16.0 D. 15.0

A. 15.6

Laser is an acronym for: A. Light amplification by stimulated emission of radiation B. Light augmentation by stimulated emission of radiation C. Light amplification of stimulated energy radiation D. Large-angle stimulated emission of radiation

A. Light amplification by stimulated emission of radiation

Using serum electrophoresis, protein can be separated into how many fractions? A. Three B. Four C. Five D. Six

C. Five

The concentration of human chorionic gonadotropin (hCG) is generally at a particular level in serum about 2 to 3 days after implantation. This is the concentration at which most sensitive laboratory assays can give a positive serum hCG result. What is the lowest level of hormone for which most current serum hCG tests can give a positive result? A. 25 mIU/mL B. 50 mIU/mL C. 100 mIU/mL D. 100,000 mIU/mL

A. 25 mIU/mL

A patient being treated for metastatic carcinoma was found to have a white cell count of 5×10^9/L with 5 metarubricytes (nucleated red cells) per 100 white WBCs. What is the corrected white cell count for this patient? A. 2.1 × 10^9/L B. 2.4 × 10^9/L C. 4.8 × 10^9/L D. 5.2 × 10^9/L

C. 4.8 × 10^9/L

A white blood cell (WBC) count and WBC differential are performed. WBC count: 7.0 × 10^9/L; of 100 WBCs classified: 70% neutrophils 20% lymphocytes 7% monocytes 2% eosinophils 1% basophil The absolute neutrophil cell count is: A. 2.10×10^9/L B. 3.55×10^9/L C. 3.99×10^9/L D. 4.9×10^9/L

D. 4.9×10^9/L

Whih is not included in spectrometry? a. FEP b. EMITT c. AAS d. Fluorometry

b. EMITT ## Footnote EMITT - Immunoassay

A non-invasiive techniquw which has a limited use in some laboratory tests a. Mass Spectrometry b. Nuclear Magnetic Resonance Spectroscopy c. Chemiluminescent Immunoassay d. Enzyme multiplied immunoassay technique (EMIT)

b. Nuclear Magnetic Resonance Spectroscopy

Light source most commonly used for visible to near infrared a. Deutrerium lamp b. Hollow Cathode lamp c. Mercury lamp d. Tungsten light bulb

d. Tungsten light bulb

Which of the following is in the analytical phase of testing a. Diabetes monitoring b. Blood culture contamination c. TAT d. Adequancy of specimen information

a. Diabetes monitoring ## Footnote b. Blood culture contamination - preana c. TAT - post ana d. Adequancy of specimen information - preana

Used in monitoring and diagnosing a disease I. Diagnostic sensitivity II. Diagnostic specificity III. Accuracy IV. Precision a. I, III b. I, II c. III, IV d. all

b. I, II

Procedure with minimal complexity, instrumentation amd personnel requirements so that the results can be quickly determined a. Presumptive test b. Screening test c. Definitive test d. Confirmatory test

a. Presumptive test

Highly sensitive and specific test in which resuolts can be used as a legal evidence a. Presumptive test b. Screening test c. Definitive test d. Confirmatory test

c. Definitive test

Preferred for individual assays of anti-convulsant/ anti-epilectic drug: a. GC b. HPLC c. Immunoassay d. None of these

c. Immunoassay

In pharmacokinetics, the concentration ____ as the rate of elimination and distribution exceeds absorption. a. Rises b. Spuriously rises c. declines d. Spuriously declines

c. declines ## Footnote Absorption > distribution and elimination: rise concentration Absorption< distribuition and elimination: decline concentration

BUN, glucose, electrolytes and osmolality determination have been performed on a patient suspected of ingesting ethanol. WHat can be done to diagnose thsi condition without requestig additional laboratory test? a. Determine glycosylated hemoglobin b. Determine anion gap c. Determine osmolality d. Determine the osmolal gap, which is the difference between the measured osmolality and the calculated osmolality

d. Determine the osmolal gap, which is the difference between the measured osmolality and the calculated osmolality

In a tst for albumin, all the albumin reacts very rapildy with an excess of the dye Bromcresol purple (BCP) to produce a colored complex. The detector is set to measure the product complex. What method is most suitable for this determination of albumin? a. Endpoint (end-up) b. Endpoint (end-down) c. Rate (rate-up) d. Rate (rate-down)

a. Endpoint (end-up)

The conversion factor 17.1 converts mg/dL of bilirubin into: a. umol/L b. mg/L c. mmol/L d. nmol/L

a. umol/L

Convert 1 ug/dL of thyroxine to SI unit a. 12.9 mmol/L b. 12.9 nmol/L c. 12.9 g/L d. 12.9 mg/dL

b. 12.9 nmol/L ## Footnote Conversion factor = 12.9

Convert 10 g/dL of albumin to g/L a. 10 g/L b. 100 g/L c. 1000 g/L

b. 100 g/L ## Footnote Conversion factor = 10

Which problem can be encountered in phlebotomy? Neurological Dermatological Anemia All of these

All of these

Most affected from supine to standing or just by prolonged standing? Iron Calcium Cortisol Aldosterone

Calcium Calcium and aldosterone are both affected (increase), hut it will take more time for aldosterone to increase while calcium will immediately increase due to sympathetic nervous system activating the arterioles to constrict

Most affected by diurnal variation? Iron ACTH Aldosterone Growth hormone

ACTH Iron - dec 30% in evening ACTH is directly proportional to Cortisol = dec 50%-80% in the evening

A serum/plasma appeared milky and opaque. What is the value of triglycerides? 200 mg/dL 300 mg/dL 400 mg/dL 600 mg/dL

600 mg/dL

Type 1 DM 1. Usually affects age of onset before 20 years old 2. Usually leads to deficiency or absence of insulin 3. Prone to ketosis 4. Destruction of B cells a. 1,2 b. 1,3 c. 1234 d. 134

c. 1234

Need emergency treatment or response: 1. Glycosuria 2. Ketoacidosis 3. Hyperkalemia a. 12 b. 13 c. 23 d. 123

c. 23

Reagent of Folin Wu Phosphomolybdic acid Arsenomolybdic acid O-toluidine Ferric chloride

Phosphomolybdic acid

Metabolism of glucose molecule to pyruvate Glycogenolysis Gluconeogenesis Glycogenesis Glycolysis

Glycolysis

Screening test for non-pregnant women 75 OGTT FBS RBS HBA1c

FBS

Indicator or malnutrition Transthyretin Albumin B trace protein Transferrin

Transthyretin Transthyretin = pre albumin (TRANSport protein for THYroxine and RETINol binding protein) Albumin = nutritional status B trace protein = indicator of CSF leakage Transferrin = B protein that transports iron in ferric state

Used to correct for the absorbance of the reagent. It is composed of the reagents without the analyte Blanking technique Patient blank Reagent blank Water blank

Reagent blank

Class A fire Carbon dioxide Water Dry chemicals Halon Metal X

Water

Not included durung inflammation a. increase capillary permeability b. migration of lymphocytes c. release of haptoglobin d. CRP release

b. migration of lymphocytes

Non-invasive procedure usig vaginal secretions to detect threatened abortion: a. AFP b. Fetal fibronectin c. B-HCG

c. B-HCG ## Footnote decreases during threatened abortion increases during pregnancy Threatened abortion: intact placenta but partially detached from uterus causing vaginal bleeding but baby is still alive

Used as a marker for nutrition a. Cystatin C b. Cross-linked C telopeptides c. Fibronectin d. Adiponectin

c. Fibronectin

Urea is reabsorbed in the circulation due to obstruction a. Pre renal azotemia b. Renal azotemia c. Post renal azotemia d. None of the above

c. Post renal azotemia

Which of the following is used as an early biomarker in the diagnosis of acute kidney injury? a. NGAL b. Cystatin C c. Creatinine d. Urine volume

a. NGAL ## Footnote Cystatin C - marker of kidney function

Not belong to liver function test Bilirubin Enzymes Factor assay Prothrombin

Factor assay

Involved in Excretory and Synthetic function of the liver Prothrombin time Bilirubin Albumin Transaminases

Bilirubin

Involved in hepatocellular damage and necrosis Prothrombin time Bilirubin Transaminase Albumin

Transaminase

Important part in enzyme function Cofactor Conezyme Activator

Activator

True of enzymes 1. catalyzes the transfer of chemical or functional group from one substance to another 2. catalyzes intramolecular rearrangemetn of the substrate compound 3. increased activity intracellularly when red cells are damaged

1. catalyzes the transfer of chemical or functional group from one substance to another 2. catalyzes intramolecular rearrangemetn of the substrate compound ## Footnote 1. function of transferase 2. function of isomerase 3. should be extracellularly

Structural change Isomerase Ligase Transferase Oxidoreductase

Isomerase

Moderate specificity to heart, liver and skeletal muscle LDH CK ALT AST

AST ## Footnote LDH - least specific CK - heart, skeletal, muscle and brain ALT - high specific

Which enzymme is not a macroenzyme? ACP ALP G6PD Transferase

G6PD ## Footnote eg. ACP, ALP, Amylase, AST, CK, GGT, LDH, Lipase

Pathologic increase of AMS Duodenal perforation Acute pancreatitis Cirrhosis Hepatitis

Acute pancreatitis ## Footnote Duodenal perforation Acute pancreatitis AMS increase in both but AMS is earliest marker for Acute pancreatitis

Bilirubin values decrease by ___ per hour of exposure to light 10-20% 20-40% 30-50%

30-50%

Earliest biomarkers of AKI a. NGAL b. Cystatin C c. LFABP d. A and C e. A and B

d. A and C

Which of the following conditions will increase total T4 by increasing TBG? a. Acute illness b. Anabolic steroid use c. Nephrotic syndrome d. Pregnancy or estrogen

d. Pregnancy or estrogen

Which statement about TSH and T4 in early pregnancy is correct? a. TSH and thyroid hormones fall b. TSH falls and thyroid hormones rise c. TSH and thyroid hormones both rise d. TSH rises and thyroid hormones fall

b. TSH falls and thyroid hormones rise

B. Uric acid, BUN, creatinine

Which type of cancer is associated with the highest level of AFP? A. Hepatoma B. Ovarian cancer C. Testicular cancer D. Breast cancer

A. Hepatoma

B. TSH falls and thyroid hormones rise

A patient has an elevated serum T3 and free T4 and undetectable TSH. What is the most likely cause of these results? A. Primary hyperthyroidism B. Secondary hyperthyroidism C. Euthyroid with increased thyroxine-binding proteins D. Euthyroid sick syndrome

A. Primary hyperthyroidism

Select the most appropriate single screening test for thyroid disease. A. Free thyroxine index B. Total T3 assay C. Total T4 D. TSH assay

D. TSH assay

Thyroid hormones are derived from the amino acid: A. Phenylalanine B. Methionine C. Tyrosine D. Histidine

C. Tyrosine

Which assay using 24-hour urine is considered the best single screening test for pheochromocytoma? A. Total urinary catecholamines B. VMA C. Homovanillic acid (HVA) D. Metanephrines

D. Metanephrines

Most laboratories use which type of fire extinguisher? A. Type A B. Type B C. Type C D. Combination ABC

D. Combination ABC

Creatinine concentration in the blood is affected by: A. Muscle mass B. Age and gender C. Dietary protein intake D. A and B

D. A and B

C. Fibronectin

Thyroid status is best assessed by measurement of: A. TRH and TSH B. Plasma TSH and T3 C. Plasma TSH and free T4 D. T3 and T4

C. Plasma TSH and free T4

It is defined as parts per hundred parts: A. Percent B. Ratio C. Molarity D. Normality

A. Percent

Which of the following fluids is not an ultrafiltrate of plasma? A. Cerebrospinal fluid (CSF) B. Peritoneal fluid C. Pleural fluid D. Synovial fluid

A. Cerebrospinal fluid (CSF)

In patients with developing subclinical hypothyroidism, TSH levels will likely be ______, and fT4 will likely be ______. A. Decreased, increased B. Increased, decreased C. Decreased, normal D. Increased, normal

D. Increased, normal

Hazards associated with LIQUID NITROGEN (CRYOGENIC MATERIAL) EXCEPT: A. Fire or explosion B. Asphyxiation C. Pressure build-up and embrittlement of materials D. Tissue damage similar to thermal burns E. Shock

E. Shock

Determines whether there is a significant difference between the standard deviations of two groups of data. A. Mean B. Median C. f-test D. t-test

C. f-test

Acute-phase reactants: A. CRP B. CRP, haptoglobin C. CRP, haptoglobin and α1-antitrypsin D. CRP, haptoglobin, α1-antitrypsin and orosomucoid

D. CRP, haptoglobin, α1-antitrypsin and orosomucoid

In patients with developing subclinical hyperthyroidism, TSH levels will likely be ______, and fT4 will likely be ______. A. Decreased, increased B. Increased, decreased C. Decreased, normal D. Increased, normal

C. Decreased, normal

D. Increased, normal

Which of the following types of analyzers offers RANDOM-ACCESS CAPABILITIES? A. Discrete analyzers B. Continuous-flow analyzers C. Centrifugal analyzers D. None of these

A. Discrete analyzers

Best indication of OVERALL GLUCOSE HOMEOSTASIS: A. Fasting blood glucose B. Oral glucose tolerance test C. Glycosylated hemoglobin D. Fructosamine

A. Fasting blood glucose

D. 120 minutes

Transferrin (siderophilin) is the major component of the ___ fraction. A. Alpha1 globulin B. Alpha2 globulin C. Beta globulin D. Gamma globulin

C. Beta globulin

Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6. A. – Chylomicrons, prebeta, beta, alpha + B. – Chylomicrons, beta, prebeta, alpha + C. – Beta, prebeta, alpha, chylomicrons + D. – Alpha, beta, prebeta, chylomicrons +

B. – Chylomicrons, beta, prebeta, alpha +

Which of the following laboratory values is considered a POSITIVE RISK FACTOR for the occurrence of coronary heart disease? A. HDL cholesterol > 60 mg/dL B. HDL cholesterol < 35 mg/dL C. LDL cholesterol < 130 mg/dL D. Total cholesterol < 200 mg/dL

B. HDL cholesterol < 35 mg/dL

Which of the following is a true statement? A. Tissue-specific enzymes, data can be interpreted by itself B. Tissue-specific enzymes, data cannot be interpreted by itself C. No truly tissue-specific enzymes, data can be interpreted by itself D. No truly tissue-specific enzymes, data cannot be interpreted by itself, correlate with other laboratory results

D. No truly tissue-specific enzymes, data cannot be interpreted by itself, correlate with other laboratory results

Prolactin is produced by the: A. Anterior pituitary gland B. Thyroid C. Parathyroid D. Ovary

A. Anterior pituitary gland

If serum is allowed to remain on the clot for a prolonged period, which of the following effects will be noted? A. Elevated level of serum potassium B. Decreased level of serum potassium C. Elevated level of glucose D. None of these

A. Elevated level of serum potassium

Overall effect of parathyroid hormone is to: A. Raise serum ionized calcium and phosphorus B. Lower serum ionized calcium and phosphorus C. Raise serum ionized calcium level and lower serum phosphorus level D. Lower serum ionized calcium levels and lower phosphorus level

C. Raise serum ionized calcium level and lower serum phosphorus level

These red cell granules are composed of PRECIPITATED RIBOSOMAL PROTEIN and RNA: A. Basophilic stipplings B. Cabot rings C. Heinz bodies D. Howell-Jolly bodies

A. Basophilic stipplings

Physical hazards except: A. Ergonomic issues B. Noise levels C. UV light exposure D. Infections agents/aerosols

D. Infections agents/aerosols

Negative predictive value: Proportion without a disease who have a negative test result compared with all individuals who ____ a negative test result a. may have b. will have c. have d. could have

c. have

Determine the sensitivity, specificity and predictive values in a new assay to detect influenza infection. It was developed and tested on 500 people; 200 people tested positive for the flue. Of these 200 positives, 185 were confirmed as being infected using the reference method. Of the remaining 300 people who tested negative, 6 were later shown to be infected with influenza.

DIagnostic Sensitivity = 96.86% Diagnostic Specificity = 95.15% PPV = 92.5% NPV = 98% ## Footnote TP 185 TN 294 FP 15 FN 6

Acceptable limits of a control value must fall: A. Within ±1 standard deviation of the mean B. Between 1 and 2 standard deviations of the mean C. Within ±2 standard deviations of the mean D. Within ±3 standard deviations of the mean

C. Within ±2 standard deviations of the mean

Loop-mediated isothermal amplification (LAMP) uses _____ primers and proceeds using a constant temperature coupled to a strand displacement reaction. A. 2 primers B. 3 primers C. 4 primers D. 5 primers

C. 4 primers

Which of the following hormones involved in calcium regulation acts by decreasing both calcium and phosphorous? A. PTH B. Calcitonin C. Vitamin D D. Cortisol

B. Calcitonin

It is used when rapid centrifugation of solutions containing small particles is needed: A. Cytocentrifuge B. Horizontal-head centrifuge C. Fixed angle-head centrifuge D. None of these

C. Fixed angle-head centrifuge

A procedure with minimal complexity, instrumentation, and personnel requirements so that the results can be quickly determined: A. Waived test B. Nonwaived test C. Definitive test D. Presumptive test

D. Presumptive test

The term PHARMACOKINETICS refers to the: A. Relationship between drug dose and the drug blood level B. Concentration of drug at its sites of action C. Relationship between blood concentration and therapeutic response D. The relationship between blood and tissue drug levels

A. Relationship between drug dose and the drug blood level

The term PHARMACODYNAMICS is an expression of the relationship between: A. Dose and physiological effect B. Drug concentration at target sites and physiological effect C. Time and serum drug concentration D. Blood and tissue drug levels

B. Drug concentration at target sites and physiological effect

At pH 8.6, proteins are _________ charged and migrate toward the _________. A. Negatively, anode B. Positively, cathode C. Positively, anode D. Negatively, cathode

A. Negatively, anode

For individuals over 40 years old, there is MODERATE risk of developing coronary heart disease when cholesterol is greater than ____mg/dL. A. 200 mg/dL B. 220 mg/dL C. 240 mg/dL D. 260 mg/dL

C. 240 mg/dL

A lab measures total bilirubin by the Jendrassik–Grof bilirubin method with sample blanking. What would be the effect of moderate hemolysis on the test result? A. Falsely increased due to optical interference B. Falsely increased due to release of bilirubin from RBCs C. Falsely low due to inhibition of the diazo reaction by hemoglobin D. No effect due to correction of positive interference by sample blanking

C. Falsely low due to inhibition of the diazo reaction by hemoglobin

A nonprotein molecule necessary for enzyme activity: A. Activator B. Coenzyme C. Cofactor D. Isoenzyme

C. Cofactor

Electrolytes for acid-base balance: 1. Bicarbonate 2. Chloride 3. Potassium 4. Sodium A. 1 and 2 B. 1 and 3 C. 1, 2 and 3 D. 1, 2, 3 and 4

C. 1, 2 and 3

Electrolytes for blood coagulation: A. Potassium and magnesium B. Calcium and chloride C. Calcium and magnesium D. Calcium and potassium

C. Calcium and magnesium

Which of the following values is the threshold critical value (alert or action level) for low plasma potassium? A. 1.5 mmol/L B. 2.0 mmol/L C. 2.5 mmol/L D. 3.5 mmol/L

C. 2.5 mmol/L

A biologically active form of ____ found in brewer’s yeast, known as glucose tolerance factor (GTF). A. Chromium B. Cobalt C. Copper D. Manganese

A. Chromium

he role of the lungs and kidneys in maintaining pH is depicted with the Henderson-Hasselbalch equation. The numerator denotes _____ functions. A. Heart B. Kidney C. Liver D. Lung

B. Kidney

The role of the lungs and kidneys in maintaining pH is depicted with the Henderson-Hasselbalch equation. The denominator denotes _____ function. A. Heart B. Kidney C. Liver D. Lung

D. Lung

In an institution, a comprehensive program in which all areas of operation are monitored to ensure quality with the aim of providing the highest quality patient care: A. Quality assessment B. Quality assurance C. Quality control D. Quality systems

D. Quality systems

A system that verifies the reliability of analytical test results through the use of standards, controls, and statistical analysis A. Quality assessment B. Quality assurance C. Quality control D. Quality systems

C. Quality control

In the laboratory, a program that monitors the total testing process with the aim of providing the highest quality patient care: A. Quality assessment B. Quality control C. Quality systems D. All of these

A. Quality assessment

Immunoassay method for thyroxine similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone: A. Chemiluminescence B. Fluorescent polarization immunoassay (FPIA) C. Fluorescent substrate-labeled inhibition immunoassay D. Microparticle enzyme immunoassay (MEIA)

D. Microparticle enzyme immunoassay (MEIA)

Immunoassay method for thyroxine: addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time. A. Chemiluminescence B. Fluorescent polarization immunoassay (FPIA) C. Fluorescent substrate-labeled inhibition immunoassay D. Microparticle enzyme immunoassay (MEIA)

A. Chemiluminescence

Immunoassay method for thyroxine: antibody-bound labeled thyroxine rotates slowly, emitting lower energy light. A. Chemiluminescence B. Fluorescent polarization immunoassay (FPIA) C. Fluorescent substrate-labeled inhibition immunoassay D. Microparticle enzyme immunoassay (MEIA)

B. Fluorescent polarization immunoassay (FPIA)

Immunoassay method for thyroxine: fluorogenic substrate–labeled thyroxine competing with patient T4 for antibody in a homogeneous assay; only unbound, leftover labeled T4 reacts with enzyme to form fluorescent product. A. Chemiluminescence B. Fluorescent polarization immunoassay (FPIA) C. Fluorescent substrate-labeled inhibition immunoassay D. Microparticle enzyme immunoassay (MEIA)

C. Fluorescent substrate-labeled inhibition immunoassay

In the calculation of the mean, what does “n” represent? A. The sum of the values B. The number of values in the set C. The average of the values D. The middle number of the set

B. The number of values in the set

How many micrograms are in 10 mg? A. 100 B. 1000 C. 10000 D. 100000

C. 10000

How many grams are in 0.85 kg? A. 8.5 B. 85 C. 850 D. 8500

C. 850

Which of the following pairs of concepts are correctly matched A. Sensitivity: prevent false negatives; specificity:prevent false positives B. Sensitivity: prevent false positives; specificity:prevent false negatives C. Sensitivity: precision; specificity: accuracy D. Sensitivity: coefficient of variation; specificity: standard deviation

A. Sensitivity: prevent false negatives; specificity:prevent false positives

Which of the following Westgard rules is indicative of random error? A. 1:3S B. 2:2s C. 4:1s D. 10:x

A. 1:3S

A procedure with minimal complexity, instrumentation, and personnel requirements so that the results can be quickly determined: A. Waived test B. Nonwaived test C. Definitive test D. Presumptive test

D. Presumptive test

L1 CC Flashcards

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