L1 CC Flashcards
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
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
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%
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%
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
Green belts
A. Project sponsors or champions
B. Project coaches or leaders
C. Project team members
D. Not traditionally used
C. Project team members
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
Black pleural fluid:
A. Hemothorax
B. Chylous material from thoracic duct leakage
C. Rupture of amoebic liver abscess
D. Aspergillus infection
D. Aspergillus infection
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
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
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 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
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
The major toxicities of this antibiotic are RED MAN SYNDROME, nephrotoxicity, and ototoxicity:
A. Choramphenicol
B. Penicillin
C. Sulfonamide
D. Vancomycin
D. Vancomycin
Easy to define but DIFFICULT TO ESTABLISH AND MAINTAIN:
A. Accuracy
B. Precision
C. Sensitivity
D. Specificity
A. Accuracy
Relatively EASY TO MEASURE AND MAINTAIN:
A. Accuracy
B. Precision
C. Sensitivity
D. Specificity
B. Precision
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
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
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
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
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
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
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
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
