Western Lab Test MidTerm Flashcards by Han La

1) Lab tests can be used for:
a) monitoring treatment or course of disease
b) to establish baselines
c) to determine effective drug dosage
d) all of the above

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2) Which of the following is incorrect? Specificity of a test means that:
a) it has the ability to rule out a suspected disease
b) it has the ability to exclude those who do not have a condition
c) they are best used to confirm a suspected disease
d) a positive result rules in the disease

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3) Which of the following is false?
a) Lab tests never have errors
b) Reference rages are established by testing large numbers of people
c) Critical values may indicate need for prompt clinical intervention
d) Incidence is the number of new cases of a disease in a stated time period.

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4) Which of the following are NOT on a CBC and Differential?
a) Hematocrit
b} Hemoglobin
c) Platelet count
d) Prothrombin time

d
Complete blood count and differential count (CBC and diff)
i. Red blood cell count.
ii. Hemoglobin (HgB)
iii. Hematocrit (Hct)
iv. Red blood cell indices
Mean corpuscular volume (MCV)
Mean corpuscular hemoglobin (MCH)
Mean corpuscular hemoglobin concentration (MCHC)
Red blood cell distribution width (RDW)
v. White blood cell count and differential count
Neutrophils (polys, segs, band cells, stab cells)
Lymphocytes
Eosinophils
Basophils
vi. Blood smear
vii. Platelet count
viii. Mean platelet volume

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5) The percentage of red blood cells (RBCs) in total volume of blood is called:
a) Red blood cell count
b) Hemoglobin
c) Hematocrit
d) White blood cell count

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6) Polycythemia is:
a) increased RBC count
b) decreased RBC count
c) increased WBC count
d) decreased WBC count

Abnormal increase in the RBC count is
called polycythemia.

A 10% or more decrease in RBC count is
called anemia.

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7 The “size” or volume of a single RBC is called:

a) Hematocrit
b) MCHC
c) MCV
d) Hemoglobin

Normal MCV is known as Normocytic anemia (82-100 μm3 or fL)

a. Blood loss
b. Hemolytic anemia

Mean corpuscular volume = volume or size occupied by a single RBC.

Increase in MCV is known as Macrocytic anemia (>100 μm3 or fL)

Decrease in MCV is known as Microcytic anemia (<82 μm3 or fL)

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8) Does the hematocrit ever reach critical values?
a) Yes
b) No

a
A decision for blood transfusion is based on the Hct
or Hgb. Transfusion is considered if Hct is < 24%.
Critical values: < 15% or >60%.

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9) Mean Corpuscular Volume can be __ by folic acid or Vitamin B12 deficiency
a) decrease
b} increased
c) unaffected

Increase in MCV is known as Macrocytic anemia (>100 μm3 or fL)
 Folic acid deficiency
 Vitamin B12 deficiency
 Some COPD patients
Having too little vitamin B12 or folic acid (a type of vitamin) in the body can also cause the MCV level to
increase.

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10) Mean Corpuscular Volume can be __ by iron deficiency or chronic Illness.
a) decrease
b) increased
c) unaffected

10. a
Decrease in MCV is known as Microcytic anemia (<82 μm3 or fL)
 Iron deficiency anemia
 Thalassemia
 Anemia of chronic illness

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11) Anisocytosis is a term for abnormal variation in RBC size, characterized by which:
a) hematocrit
b) hemoglobin
c) RDW
d) MCV

c
Red Cell Size Distribution Width (RDW)
The RDW is an indication of the degree of anisocytosis (abnormal variation in size of RBCs) and is expressed as a percentage. The reference range for CLS is 11-16 %.

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12) True/False: Reticulocyte counts help us identify the cause of anemia (whether blood loss or bone marrow disease)
a) True
b) False

True
Reticulocyte:
a. Immature red blood cells.
b. Called reticulocytes because of a reticular (mesh-like) network
of ribosomal RNA.
c. Develop and mature in the bone marrow.
d. Circulate for about a day in the blood stream.
e. Developing into mature red blood cells
Helpful to identify cause of Anemia:
a. Increase (reticulocytosis) indicates Anemia is due to Blood loss.
b. Decrease may indicate bone marrow disease.

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13) Neutrophilia (elevated neutrophils) is associated with;
a) acute infection
b) allergies
c) parasitic infection
d) collagen vascular disease

b. Leukopenia
 Abnormally low leukocyte level
 Commonly caused by certain drugs, bone marrow failure and hypersplenism.

Neutrophils: Phagocytes that accumulate at site of infection

a
Abnormal leukocyte levels
a. Leukocytosis
I. Above 11 10E9/L (E=exponent which means the number of tens you multiply a number by)
 ii. Generally indicates an infection. Other causes include trauma, stress, and hemorrhage.
iii. Marked leukocytosis is usually due to neutrophils or lymphocytes.
iv. If the neutrophils are causing the leukocytosis, compare the neutrophil % to total WBC.
v. The percentage of neutrophils indicates the severity of the infection; the total WBC reflects the quality of the immune system.

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14) Which WBC is associated with antibody production?
a) neutrophils
b) lymphocytes
c) monocytes
d) eosinophils

b
Neutrophils: Phagocytes that accumulate at site of
infection
Lymphocytes: Make antibodies
Monocytes: Phagocytes that ingest debris and bacteria
Eosinophils: Phagocytes for allergens
Basophils: Heparin and histamine producers

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15) Which WBC is associated with allergic and parasitic conditions?
a) neutrophils
b) lymphocytes
c) monocytes
d) eosinophils

15. d
Neutrophils: Phagocytes that accumulate at site of
infection
Lymphocytes:  Make antibodies
Monocytes:  Phagocytes that ingest debris and bacteria
Eosinophils:  Phagocytes for allergens
Basophils: Heparin and histamine producers

Eosinophils:
     1-4 % of total white blood cell count.
 Highest Levels in am
 Allergic Diseases
 Parasitic Infections
 Leukemias
 Familial
 Addison Disease
 Drugs: Aspirin

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16) Thrombocytopenia is:
a) too many platelets
b) too few platelets
c) too many lymphocytes
d) too few lymphocytes

Thrombocytosis:
 Malignant disorder like leukemia, lymphomas.
 Polycythemia vera
 Postsplenectomy syndrome.
 Iron-deficiency anemia.
 Trauma

b
Hemostasis process: a. Vasoconstriction, b. Platelet aggregation, c. clot formation
Thrombocytopenia
 Hypersplenism: An enlarged spleen extracts both
aged and new platelets and platelet count diminishes.
 Hemorrhage: Platelets are lost in the process of
bleeding.
 Immune thrombocytopenia: Idiopathic, posttransfusion,
or drug-induced.
 Leukemia: The bone marrow is replaced by neoplastic tissue.
 Cancer chemotherapy: Cytotoxic drugs cause bone
marrow depression.
 Infection: Bacterial, viral, and other infections can
cause thrombocytopenia, especially when the patient
is immunocompromised e.g. in AIDS.

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17) The test that measures the clotting ability of prothrombin and fibrinogen and other coagulation factors is called:
a) PT or INR
b) blood typing
c) ferritin
d) ESR

17. a
Prothrombin Time (PT, Pro-Time, International Normalized Ratio (INR)

The test measures the clotting ability of prothrombin (factor II) and fibrinogen (factor I) as well as other coagulation factors (V, VII and X) as shown in the accompanying diagram. When these factors are deficient PT is prolonged. Many drugs and diseases can cause it.
 a. Hepatocellular diseases like cirrhosis, hepatitis, and neoplastic invasion can cause decreased production of factor I, II, V, VII, X, as they are all made in liver.
 b. PT is increased in vitamin K deficiency. Vitamin K dependent clotting factors are not made adequately.
c. PT is also increased with anticoagulants like warfarin (Coumadin) which is given orally.
d. DIC (disseminated intravascular coagulation) where clotting factors are consumed and PT increases.
 e. Massive blood transfusions. Anticoagulants in banked blood can raise PT.
f. Aspirin intoxication.

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18) An indirect measure of the degree of inflammation in the body is:
a) PT or INR
b) blood typing
c) ferritin
d) ESR

18. d
Peripheral Blood Smear
1. Normal Smear
2. ESR
3. Iron Metabolism
4. Blood Typing
5. Cross-Matching
ESR is an indirect measure of the degree of inflammation present in the body. It actually measures the rate of fall (sedimentation) of erythrocytes (red blood cells) in a tall, thin tube of blood. Results are reported as how many millimeters of clear plasma are present at the top of the column after one hour. Normally, red cells fall slowly, leaving little clear plasma. Increased blood levels of certain proteins (such as fibrinogen or immunoglobulins, which are increased in inflammation) cause the red blood cells to fall more rapidly, increasing the ESR.

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19) The major iron-storage protein is:
a) iron
b) transferrin
c) ferritin
d) TIBC

c
Lab tests for iron metabolism
Ferritin (major iron-storage protein) F=13-375 mcg/L; M=30-400 mcg/L
Increased: Hemochromatosis, Hemolytic anemias, Hepatocellular disease, Inflammatory disease, Advanced cancers
Decreased: Iron-deficiency anemia, Hemodialysis which reduces iron stores.

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20) If we have tested and found PT abnormal, which test may we use to diagnose a suspected bleeding
disorder?
a) transferrin
b) ESR
c) fibrinogen
d) CBC &amp; diff

c
Plasma Fibrinogen
a. Indication: Diagnosis of suspected bleeding disorder. Fibrinogen is essential to blood clotting mechanism.
b. Normal Findings: 1.6-4.1 g/L
c. Critical Values: <1.0 g/L. It is associated with spontaneous bleeding.

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21) Are Natriuretic Peptides correlated with extent of heart failure?
a) Yes
b) No
The NPs are released in small quantities in circulation. However, body produces more of them in conditions
characterized by fluid overload or cardiac wall stretch e.g. congestive heart failure, renal failure, and liver diseases.
B-type natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP) are substances that are produced in the heart and released when the heart is stretched and working hard to pump blood. Tests for BNP and NT-proBNP measure their levels in the blood in order to detect and evaluate heart failure. In general the blood levels of BNP and NT-proBNP correlate with both the severity of the symptoms (higher with worsening class) and patient prognosis (higher with worse prognosis).

The assay chosen for use in Calgary is NT-proBNP.

21.
Natriuresis is the process of excretion of abnormally large amounts of salt in the urine. It is similar to diuresis, the excretion of an unusually large quantity of urine, except that in natriuresis the urine is exceptionally salty. There are 3 naturally occurring protein hormones in the body:
1. ANP is made in the cardiac atrial muscle. It causes natriuresis and vasodilation.
2. BNP is made in the cardiac ventricle. It causes natriuresis and vasodilation
3. CNP is made by the vascular endothelial cells. It causes only vasodilation

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22) The most specific and sensitive test in heart tissue damage, such as sustained in a myocardial infarction is:
a) CK
b) LOH
c) Troponin
d) ANP

Cardiac troponin T (cTnT) and I (cTnI) are contractile proteins unique to cardiomyocytes (cardiac muscle cells) that are released into blood upon myocardial damage.

22. c
CARDIAC MARKERS (MYOCARDIAL DAMAGE)
1. Troponins
2. Enzymes
1. Lactic dehydrogenase (LDH)
2. Creatine phosphokinase (CPK), Creatine kinase (CK)
3. C-Reactive protein (CRP)

Cardiac troponins increase approximately 3-4 hours after acute myocardial infarction (AMI) and may persist up to 2 weeks (cTnT) thereafter as shown in the accompanying graph.

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23) The test described above is highest:
a) 1 hour after
b) 12 hours after
c) 12 days after
d) 12 months after

Cardiac troponins increase approximately 3-4 hours after acute myocardial infarction (AMI) and may persist up to 2 weeks (cTnT) thereafter as shown in the accompanying graph.

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24) Which of the following is considered “good cholesterol”?
a) LDL
b) VLDL
c) triglycerides
d) HDL

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25) Cholesterol ratio, used to calculate heart disease risk, is calculated by dividing your: a) HDL into your total cholesterol b) LDL into VLDL c) VLDL Into t riglycerides d) triglycerides into LDL

25. a Cholesterol ratio is calculated by dividing your high-density lipoprotein (HDL, or "good") cholesterol into your total cholesterol. For example, if your total cholesterol is 5.2 mmol/L and your HDL cholesterol is 1.3 mmol/L, your cholesterol ratio is 4-to-1.There are no units as it is a ratio.

26) The best tests for acute pancreatitis include: a) cholesterol levels b) red blood cell indices c) serum amylase and lipase d) serum pancreatase and gall bladderase The two most important causes of acute pancreatitis, alcohol and gall stones, were ruled out by: a. patient denied alcohol intake, b. ultrasound of the GB was normal.

26. c Serum Amylase And Lipase Normal findings (CLS): • amylase: 30 - 110 U/L • Lipase: 1 day - 16 years: 0 - 60 U/L 16 years - 150 years: 0 - 80 U/L • Critical values: More than three times the upper limit of normal. INCREASED LEVELS: • Acute pancreatitis. • Chronic relapsing pancreatitis. • Inflammation of the parotid gland (mumps). • Renal failure. These enzymes are cleared by kidneys. Renal disease will reduce excretion. • GI diseases like peptic ulcer and acute cholecystitis.

27) Which liver function test (LFT) is most elevated by viral causes of hepatocellular damage a) ALT b) AST c) ALP d) bilirubin

27. a (ALT) because AST/ALT should be less than 1. Other causes of moderate increases in ALT include obstruction of bile ducts, cirrhosis (usually the result of chronic hepatitis or bile duct obstruction), heart damage, alcohol abuse, and with tumors in the liver. ALT is often performed together with a test for AST or as part of a liver panel. AST/ALT <1 I. Acute hepatitis II. Viral hepatitis III. Infectious mononucleosis

28) Jaundice is caused by abnormally high levels of_ in blood. a) ALT b) AST c) ALP d) bilirubin

28. d Jaundice is the yellowish discoloration of body tissues caused by abnormally high levels of bilirubin in blood.

29) In malnutrition, you would expect albumin levels to: a) increase b) decrease c) stay the same ``` Liver functions: • Synthesizes glycogen from glucose • Makes plasma proteins (albumin, lipoproteins, coagulation proteins) • Forms cholesterol and degrades it into bile acids, which emulsifies fats for absorption • Stores iron, glycogen, vitamins and other substances • Destroys old blood cells and recycles components of hemoglobin ```

29. b Liver Function Tests (LFTs) a. Alanine aminotransferase (ALT) b. Aspartate aminotransferase (AST) c. Alkaline phosphatase d. Serum bilirubin (Total) i. Serum bilirubin (direct) ii. Serum bilirubin (Indirect) e. Blood proteins (protein electrophoresis) i. Albumin ii. Globulin iii. Total protein A number of health and lifestyle factors influence albumin levels. Malnutrition, especially protein malnutrition, liver and kidney disease, smoking, a decreased muscle mass, a loss of strength, and low levels of physical activity are all associated with lower albumin levels.

30) True/False: A patient that shows HAV-Ab/lgG may have been exposed to Hepatitis B in the years. a) True b) False

30. False Hepatitis A Virus (HAV) and Antibodies to HAV: • HAV-Ab/IgM: These antibodies appear 4-6 weeks after infection and lasts for 3-4 months. These antibodies indicate acute infection. • HAV-Ab/IgG: These antibodies appear 8-12 weeks after infection and may remain detectable for almost 10 years. These antibodies indicate previous exposure/immunity.

31) True/False: FOBT is a useful screening tool for uterine cancer a) True b) False

31. False To find out whether endometrial hyperplasia or endometrial cancer is present, the doctor must remove some tissue so that it can be looked at with a microscope. Endometrial tissue can be obtained by endometrial biopsy or by dilation and curettage (D&C) with or without a hysteroscopy.

32) Diarrhea and fever may be investigated most likely with which test? a) amylase b) lipase c) FOBT d) AST A lipase test measures the amount of this enzyme in a blood sample. High amounts of lipase may be found in the blood when the pancreas is damaged or when the tube leading from the pancreas (pancreatic duct) to the beginning of the small intestine is blocked. Fecal occult blood test and fecal immunochemical test (FOBT, FIT): Detects digestive tract bleeding that may indicate colon cancer

32. An amylase test measures the amount of this enzyme in a sample of blood taken from a vein or in a sample of urine. Normally, only low levels of amylase are found in the blood or urine. But if the pancreas or salivary glands become damaged or blocked, more amylase is usually released into the blood and urine. The fecal occult blood test (FOBT) is a lab test used to check stool samples for hidden (occult) blood. Occult blood in the stool may indicate colon cancer or polyps in the colon or rectum — though not all cancers or polyps bleed. The blood test for aspartate aminotransferase (AST) is usually used to detect liver damage. It is often ordered in conjunction with another liver enzyme, alanine aminotransferase (ALT), or as part of a liver panel to screen for and/or help diagnose liver disorders.

33) As carbon dioxide accumulates in the blood, the pH of the blood ___, signalling ____ a) decreases, increasing acidity b) decreases, decreasing acidity c) increases, increasing acidity d) increases, decreasing acidity Carbon dioxide has the chemical formula CO2. This means that for every one molecule of carbon, there are two molecules of oxygen. When dissolved in water, carbon dioxide forms carbonic acid, H2CO3. Carbon acid can lose two hydrogen atoms, or protons. The loss of protons in a solution is what makes that solution acidic. pH is a measurement of acidity. The lower the pH, the more acidic a solution is.

33. a Conversely, a decrease in carbon dioxide provokes an increase in pH, which results in hemoglobin picking up more oxygen. Since carbon dioxide reacts with water to form carbonic acid, an increase in CO2 results in a decrease in blood pH. Humans breathe in oxygen and breathe out carbon dioxide. This process sounds simple, but the details are actually quite complex. During the process of breathing, humans convert sugar into energy. Carbon dioxide is a waste product of this process. Carbon dioxide is released into the blood, travels to the lungs and is exhaled. Because carbon dioxide is a weak acid, the more carbon dioxide in the blood, the more acidic the blood becomes.

34) In the previous question, this condition is called ___. a) respiratory alkalosis b) metabolic alkalosis c) respiratory acidosis d) metabolic acidosis

34. c Respiratory acidosis, also called respiratory failure or ventilatory failure, is a condition that occurs when the lungs can't remove enough of the carbon dioxide (CO2) produced by the body. Excess CO2 causes the pH of blood and other bodily fluids to decrease, making them too acidic.

35) Which of the following is elevated in metabolic alkalosis? a) C02 b) HCO3 c) pO2 d) O2 saturation

35. b Metabolic alkalosis is bicarbonate HCO3− accumulation due to I. Acid loss II. Alkali administration III. Intracellular shift of hydrogen ion (H+—as occurs in hypokalemia) IV. HCO3−retention Regardless of initial cause, persistence of metabolic alkalosis indicates that the kidneys have increased their HCO3− reabsorption, because HCO3− is normally freely filtered by the kidneys and hence excreted. Volume depletion and hypokalemia are the most common stimuli for increased HCO3− reabsorption, but any condition that elevates aldosterone or mineralocorticoids (which enhance sodium [Na] reabsorption and potassium [K] and H+ excretion) can elevate HCO3−. Thus, hypokalemia is both a cause and a frequent consequence of metabolic alkalosis. Causes are listed; the most common are volume depletion (particularly when involving loss of gastric acid and chloride [Cl] due to recurrent vomiting or nasogastric suction) and diuretic use

36) True/False: a near 100% oxygen saturation means that the body tissues are getting adequate oxygen. a) True b) False

36. True Oxygen saturation measures how much oxygen the blood is carrying compared with its full capacity. An SpO2 of greater than 95% is generally considered to be normal. An SpO2 of 92% or less (at sea level) suggests hypoxemia.

37) True/False: A patient with tuberculosis will have a large skin reaction (>5mm diameter) to the Mantoux test a) True b) False

37. True Classification of the Tuberculin Skin Test Reaction An induration of 5 or more millimeters is considered positive in -HIV-infected persons -A recent contact of a person with TB disease -Persons with fibrotic changes on chest radiograph consistent with prior TB -Patients with organ transplants -Persons who are immunosuppressed for other reasons (e.g., taking the equivalent of >15 mg/day of prednisone for 1 month or longer, taking TNF-a antagonists)

38) A Pap Smear is used to detect neoplastic cells and is most accurate for detecting carcinoma of the: a) labia b) uterus; c) bladder d) cervix

38. d. A Pap smear (also called a Pap test) is a screening procedure for cervical cancer.

39) A pregnancy (hCG) test can be elevated by all of the following except: a) pregnancy b) ectopic pregnancy c) tumours of testes d) tumours of liver A low hCG level can indicate: 1. Miscalculation of pregnancy dating 2. Possible miscarriage or blighted ovum 3. Ectopic pregnancy

39. b An HCG test may be done to: 1. confirm a pregnancy 2. help diagnose and monitor a person’s response to treatment for certain cancers i. testicular cancer ii. gestational trophoblastic disease (cancer that develops from an abnormally fertilized egg) iii. germ cell tumours of the ovary screen high-risk women for a rare type uterine cancer called choriocarcinoma

40) PSA (Prostate Specific Antigen) can be elevated by all of the following except: a) prostate cancer b) bladder cancer c) prostatitis d) benign prostatic hyperplasia (BPH)

40. c Thirteen per cent of men over 55 have a PSA level of ≥ 4 ng/ml but this does not automatically mean you have cancer. An elevated level can also be due to other conditions, such as benign enlargement of the prostate (BPH), a urinary tract infection or a prostate infection

41. A patient with acute rheumatic fever (ARF) might be expected to have which of the following in recent history? a. high cholesterol with known arteriosclerosis b. elevated blood calcium and oxidative damage c. recent streptococcal infection and antibodies against streptolysin O d. hospitalization for diabetes and abnormal HbAlC

41. c Autoimmune Response

42. What lab values should be monitored In a patient with thrombophlebitfs (inflammation and clot formation in a vein) who is undergoing anticoagulant therapy with warfarin (Coumadin)? a. PTI b. PT/INR c. platelet count d. hemoglobin (Hgb) e. hematocrit (Hct)

42. b

43. The percentage of blood consisting of red blood cells is seen on a CBC as: a. Mean corpuscular volume b. hematocrit c. hemoglobin d. red cell distribution width

43. b

44. ____ cells are lacking in hemoglobin, which can be measured on a CBC. a. Hyper-chromic b. Hypochromic c. Normocytic d. Megaloblastic

44. b

45. Lack of vitamin 812 causes: a. Iron deficiency anemia b. Pernicious anemia c. Thalassemia d. Spherocytosis

``` 45. b Pernicious anemia: severe hyperchromic anemia char by 1. increase in size 2. increased in hemoglobin contents 3. decreased in absorption of B12 4. decreased in numbers ```

46. Leukocytosis is a term meaning increase in the total number of white blood cells (>10,000 leukocytes/mm3 of blood). It generally indicates: a. Infection b. Stress c. Hemorrhage d. Trauma e. All of the above

46. e

47. An abnormal variation in the size of red blood cells is described as: a. Poikilocytosis b. Anisocytosis c. Macrocytosi d. Microcytosis

47. b Anisocytosis

48. CBC report will index the above abnormal variation as: a. RDW b. MCHC c. MCV d. MCH

48. a

49. A diagnosis of pancreatitis is certain in light of which lab tests? a. Serum lipase b. Serum amylase c. Urine amylase d. All of the above

49. d

50. A patient on admission has yellow eyes and pain in the right upper quadrant of abdomen. His direct(conjugated) bilirubin was 50.Sμmol/L (Normal: 0-7 μmol/L. It is indicative of: a. Hepatic jaundice b. Posthepatic jaundice c. Pre hepatic jaundice d. Any of the above

50. b. PostHepatic Jaundice

51. ABG reveals pH 7.3, Pco2 46 mm of Hg, Po2 55 mm of Hg, HC03 24 mEq/L. What is the likely acid-base disturbance? a. Primary respiratory acidosis b. Primary respiratory alkalosis c. Primary metabolic acidosis d. Primary metabolic atkalosis Normal Readings pH: 7.35·7.45 (<7.25. >7 .55 is cnt1cal) w Pco2: 35-45 mm of Hg ( <20, >60 1s critical) Hco3,·: 21-28mEq/L (<15, >40 1s critical; Po2: 80-100 mm of Hg (<40 in arterial blood is critical); 02 saturation: 95· 100% (75% or lower is critical)

51. a

52. Measurement of arterial blood gas shows pH 7.2, P02 100 mm Hg, PCO2 25 mm Hg, and HC03 10 mEq/L. What is your assessment? a. Primary respiratory acidosis b. Primary respiratory alkalosis c. Primary metabolic acidosis d. Primary metabolic alkalosis

52. c

53. Is body trying to compensate in the situation given in question #52? (Primary metabolic acidosis) Support your answer from the lab findings given in Q52. (2 marks)

53. Breathing heavily, body is lacking oxygen

54. Western Blot is considered a gold standard for the confirmation of HIV infection because: a. It is a rapid and sensitive test. b. It detects both antigen and antibodies against HIV. c. It detects antibodies against human immunodeficiency virus (HIV). d. None of the above.

54. c

55. Bence-Jones protein is present in cases of: a. Hodgkin lymphoma b. Chronic myeloid leukemia c. multiple myeloma d. acute myeloid leukemia

55. c

56. Parasitic diseases are associated with: a. increase in neutrophils b. increase in monocytes c. increase in lymphocytes d. increase in eosinophils

56. d.

57. Infectious mononucleosis (kissing disease) is caused by a. echo virus b. cytomegalo virus c. coxsaki virus d. Epstein-Barr virus (EBV)

57. d

58. Which cells are responsible for production of antibodies (immunoglobulins)? a. monocytes b. B lymphocytes c. T lymphocytes d. neutrophils Immunoglobulins, also known as antibodies, are glycoprotein molecules produced by plasma cells (white blood cells). They act as a critical part of the immune response by specifically recognizing and binding to particular antigens, such as bacteria or viruses and aiding in their destruction.

58. b (B lymphocytes) The B lymphocytes produces antibodies which attack antigens. The T lymphocytes directly attack the foreign antigens.

59. The peripheral blood smear gives the physician information concerning: a. morphology (shape and size) of red blood cells, white blood cells and platelets b. presence of immature blood cells c. presence of abnormal inclusions d. all of the above

59. d

60. All of the following are transfusion transmitted diseases EXCEPT: a. hepatitis A b. hepatitis B c. hepatitis C d. AIDS

60. a

61. A blood test which is considered specific marker of rheumatoid arthritis: a. rheumatoid factor b. ESR (erythrocyte sedimentation rate) c. C reactive protein d. Complement levels

61. a

62. Over what period does an HbAlc measurement reflect the glucose control? a. The previous 24 hours b. The previous 7 days c. The previous 30 days d. The previous 10-12 weeks

62. d

63. When should post-prandial blood glucose measurements be made in pregnancy· a. 1 hour after a meat b. 2 hours after a meal c. 4 hours after a meal d. They are unreliable and should not be checked

63. a

64. All are seen in Cushing syndrome (increased cortisol) EXCEPT: a. hypertension b. trunci obesity c. rounded or moon shaped face d. hypoglycemia

64. d

``` 65. Hypothyroidism is suspected in a patient on clinical grounds. Serum T4 and TSH are ordered. You can expect: a T4 reduced, TSH reduced. b T4 elevated, TSH reduced. c. T4 normal, TSH reduced. d. T4 reduce, TSH elevated. ```

65. d

66. Select the most specific lab test to diagnose acute gout: a. 24-hour urine collection for uric acid. b. presence of uric acid crystals in the synovial fluid of affected joint c. radiograph of the affected joint d. rheumatoid factor

66. b

67. Which statement is most applicable to vitamin D? a. produced in skin exposed to sunlight b. Its major site of action is kidneys. c. It stimulates the release of parathyroid hormone.

67. a

68. H. pylori: a. Splits urea into C02 and NH3 b. Is a gram positive spiral shaped bacterium c. Lives inside gastric epithelial cells d. Is usually symptomatic e. Maybe transmitted by blood products

68. a

69. A urine sample which tests negative for leukocyte esterase is considered normal. T/F

69. T

70. The serum level of liver enzymes (ALP, AST, ALT), just like cardiac enzymes, decline with the healing process. T/F

70. T

71. HIV is the bacterium that causes AIDS ___ . T/F

71. F

72. Glucagon is secreted by pancreatic alpha cells. T/F

72. T

73. Insulin is a pancreatic hormone which helps cells take in sugar. T/F

73. T

74. A good control of DM is indicated by HbAlc of less than 7%. T/F

74. T

75. The symptoms of polyuria (increased urination), polyphagia (increased eating), and polydipsia (increased thirst) are only observed in DM type 1 and not type 2. T/F

75. F

76. UA (urinalysis) of an undiagnosed diabetic may show glucose and ketones. T/F

76. T

77. Graves' disease results from over activity of adrenal glands. T/F

77. F

78. A normal level of NPs (natriuretic peptides) in the blood rules out congestive heart failure. T/F

78. T

Western Lab Test MidTerm Flashcards

(78 cards)