This document contains a 51-question pre-board examination in clinical chemistry. The questions cover topics such as:
- Units of measurement for glucose, BUN, and triglycerides
- Coefficient of variation calculation
- Characteristics of normal distribution and standard deviation
- Instruments used to detect beta and gamma emissions
- Reference electrodes in potentiometry
- Protein fractions in electrophoresis and associated conditions
- Lipoprotein classes and characteristics
- Constituents of plasma and urine and their measurement methods
- Electrolyte imbalances in certain conditions
This document contains a 51-question pre-board examination in clinical chemistry. The questions cover topics such as:
- Units of measurement for glucose, BUN, and triglycerides
- Coefficient of variation calculation
- Characteristics of normal distribution and standard deviation
- Instruments used to detect beta and gamma emissions
- Reference electrodes in potentiometry
- Protein fractions in electrophoresis and associated conditions
- Lipoprotein classes and characteristics
- Constituents of plasma and urine and their measurement methods
- Electrolyte imbalances in certain conditions
This document contains a 51-question pre-board examination in clinical chemistry. The questions cover topics such as:
- Units of measurement for glucose, BUN, and triglycerides
- Coefficient of variation calculation
- Characteristics of normal distribution and standard deviation
- Instruments used to detect beta and gamma emissions
- Reference electrodes in potentiometry
- Protein fractions in electrophoresis and associated conditions
- Lipoprotein classes and characteristics
- Constituents of plasma and urine and their measurement methods
- Electrolyte imbalances in certain conditions
PRE-BOARD EXAMINATION IN CLINICAL CHEMISTRY (PART3)
1. What is the prefix for factor 10-15?
A. Nano B. Atto C. Pico D. Femto 2. Fasting serum glucose has a concentration of 110 mg/dL. In SI, this value is equivalent to: A. 6.05 mmol/L B. 3.03 mmol/L C. 6.49 mmol/L D. 4.99 mmol/L 3. A normal BUN value was reported at 25mg/dL. What is its equivalent in SI units? A. 8.93umol/L B. 8.93mmol/L C. 7.14umol/L D. 7.14mmol/L 4. Lactescence occurs when serum triglyceride level exceeds what concentration? A. 25 mg/L B. 25 mg/dL C. 400 mg/L D. 400 mg/dL 5. Given that a method mean is 25 mg/dL and the standard deviation is 1.2 mg/dL, what would be the coefficient of variation? A. 2.1% B. 2.4% C. 4.8% D. 9.6% 6. Considering a normal Gaussian curve distribution, how many values from a population will be within 2 SD? A. 95.45% B. 75.30% C. 68.27% D. 99.73% 7. A delta check: A. Relates control difference from mean C. Evaluates statistical drift B. Reports patient value difference from previous analysis D. Flags abnormal results 8. Which of the following instruments is used in the clinical laboratory to detect beta and gamma emissions? A. Fluorometer B. Nephelometer C. Scintillation counter D. Spectrophotometer 9. In potentiometry, the following are types of reference electrodes, EXCEPT: A. Glass electrode C. Saturated calomel electrode B. Standard hydrogen electrode D. Silver-silver chloride electrode 10. Which of the following substances are introduced in a continuous-flow analyzer to minimize diffusion of reagents and mixing between samples? A. Membranes B. Resins C. Air bubbles D. Gel polymers 11. The protein fraction that migrates the fastest toward the anode: A. Albumin B. Beta-globulin C. Alpha1-globulin D. Gamma-globulin 12. Protein also known as orosomucoid: A. 1-Acid glycoprotein B. 2- Macroglobulin C. -Lipoprotein D. C-reactive protein 13. Which of the following substances is markedly increased in nephrotic syndrome? A. Ceruloplasmin B. Alpha-2-macroglobulin C. Alpha-1-antitrypsin D. Albumin 14. The neocuproine method for glucoses is based on: A. Glucose oxidase reaction C. Condenstaion reaction B. Copper reduction by glucose D. Hexokinase reaction 15. Select the enzyme most specific for beta D-glucose. A. Hexokinase C. Phosphohexisomerase B. Glucose-6phosphate dehydrogenase D. Glucose oxidase 16. All of the following are characteristics of Type II diabetes mellitus except: A. Insulin levels may or may not be abnormal B. It is more common than Type I diabetes C. It requires insulin therapy to control hyperglycemia D. It is associated with obesity and more common in persons greater than 40 years old 17. Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6. A. – Chylomicrons prebeta beta alpha + B. – Beta prebeta alpha chylomicrons + C. – Chylomicrons beta prebeta alpha + D. – Alpha beta prebeta chylomicrons + 18. Select the lipoprotein fraction that carries most of the endogenous triglycerides. A. VLDL B. LDL C. HDL D. Chylomicrons 19. The lipoprotein that transports the exogenous triglycerides: A. HDL B. LDL C. VLDL D. Chylomicrons 20. Apolipoprotein A is the primary protein component of: A. HDL B. LDL C. VLDL D. None of these 21. “Floating beta lipoprotein” refers to: A. B-VLDL B. HDL C. VLDL D. B-LDL 22. An abnormal LDL lipoprotein, also known as the “sinking pre-B-lipoprotein” associated with a higher risk for atherosclerosis: A. B-VLDL B. LpX C. Lp(a) D. LDL 23. An abnormal lipoprotein found in patients with obstructive biliary disease: A. B-VLDL B. LpX C. Lp(a) D. LDL 24. Which of the following is referred to as the “good cholesterol”? A. HDL B. LDL C. VLDL D. Free cholesterol 25. A type IIA hyperlipoproteinemia phenotype is associated with an increased level of: A. Chylomicrons B. HDL C. VLDL D. LDL 26. The bilirubin fraction that is covalently attached to the albumin is: A. Direct B. Indirect C. Delta D. Bound 27. What is the second largest constituent of the plasma non-protein nitrogen? A. Urea B. Uric acid C. Ammonia D. Amino acids 28. Which of the following is the most abundant amino acid in plasma? A. Lysine B. Glutamine C. Ornithine D. Cysteine 2
29. In the diacetyl monoxime method, diacetyl reacts directly with:
A. Urea B. Uric acid C. Ammonia D. Ammonium ion 30. It absorbs light at 293 nm in the uricase method: A. Uric acid B. Uricase C. Allantoin D. None of these 31. The Wacker method uses what reaction? A. Pyruvate (LD) Lactate C. Creatine phosphate (CK) creatine B. Lactate (LD) Pyruvate D. Creatine (CK) Creatine phosphate 32. Which LDH isoenzyme migrates the farthest from the origin on electrophoresis? A. LD1 B. LD2 C. LD4 D. LD5 33. The presence of a flipped LD1/LD2 pattern in the presence of CK-MB is suggestive of: A. Hepatitis B. Cirrhosis C. MI D. Bone disease 34. The isoenzymes LD-4 and LD-5 are elevated in: A. Acute pancreatitis C. Hepatic injury or inflammation B. Hemolyzed specimen D. Myocardial infarct 35. Which of the following methods applies to the principle below? Creatine + ATP (CK) Creatine phosphate + ADP A. Szaz B. Wroblewski C. Tanzer-Gilvarg D. Oliver-Rosalki 36. Which isoenzyme of creatine kinase (CK) has the fastest electrophoretic mobility at pH 8.6? A. MM B. MB C. BB D. Macro-CK 37. Which of the isoenzymes of ALP is most anodal? A. Placental ALP B. Bone ALP C. Intestinal ALP D. Liver ALP 38. Which enzyme is a useful indicator of possible insecticide poisoning? A. 5’nucleotidase B. ACP C. Cholinesterase D. LDH 39. Which of the isoenzymes of ALP is most heat stable? A. Placental ALP B. Bone ALP C. Intestinal ALP D. Liver ALP 40. There are several alkaline phosphatase isoenzymes that are characteristic of cancer. Electrophoretic mobility of these fractions is similar to what ALP isoenzyme: A. Placental ALP B. Bone ALP C. Liver ALP D. Intestinal ALP 41. The Szasz assay determines the activity of: A. CK B. ALP C. GGT D. LDH 42. Formula for serum osmolality: A. (2Na+) + (Glucose/20) + (BUN/3) C. Na+ + 3Glucose + 2BUN + B. (Na /3) + (2Glucose) + (BUN/20) D. Na+ - ( Cl- + total CO2) 43. Later models of flame photometer uses_____ as an internal standard that allows the operator to measure sodium, potassium and lithium directly. A. Lithium B. Cesium C. Magnesium D. Calcium 44. When measuring potassium using an ion selective electrode, the membrane is composed of: A. Glass B. Plastic C. Silver D. Valinomycin 45. Which electrolytes are elevated in cystic fibrosis? A. Calcium and chloride C. Sodium and potassium B. Chloride and sodium D. Potassium and chloride 46. In the blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with: A. Sodium B. Potassium C. Chloride D. Phosphate 47. It is an essential component of the glucose tolerance factor, thought to play a role in maintaining normal insulin response to glucose load by affecting membrane response to insulin: A. Chromium B. Zinc C. Nickel D. Molybdenum 48. Increased chloride levels as determined by colorimetric and ion-selective electrode methods may be caused by the presence in the solution of: A. Bromide B. Calcium C. Hydrogen D. Chylomicrons 49. Which of the following is the primary mechanism causing respiratory alkalosis? A. Hyperventilation C. Deficient pulmonary perfusion B. Hypoventilation D. Parasympathetic inhibition 50. If a blood gas specimen is left exposed to the air for an extended period of time, which of the following changes will occur? A. PO2 and pH increase; PCO2 decreases C. PO2 increases; pH and PCO2 decrease B. PO2 and pH decrease; PCO2 increases D. PO2 decreases; pH and PCO2 increase 51. Sealed heparinized arterial blood was left at room temperature for 2 hours. The most likely changes in PO 2 (mmHg), PCO2(mm Hg), and pH, respectively, are: A. Increase, increase and increase C. Decrease, increase, and decrease B. Decrease, decrease, and decrease D. Decrease, decrease, and increase 52. The adrenal medulla secretes which of the following in the greatest quantity? A. Metanephrine B. Noradrenaline C. Epinephrine D. Dopamine 53. Homovanillic acid is the principal urine metabolite of: A. Norepinephrine B. Epinephrine C. Adrenaline D. Dopamine 54. Diurnal variation is important to consider when collecting blood for the assay of: A. Catecholamines B. Creatinine C. Cortisol D. Thyroid hormones 55. T-3 uptake is actually a measurement of: A. T-3 B. T-4 C. TBG D. Free thyroxine 3
56. Active hormonal form of T3 an T4:
A. Those bound to TBG C. Those bound to transthyretin B. Those bound to albumin D. Those in free from 57. The principle is based on the reaction of urinary estrogen with a mixture of phenol and sulfuric acid to produce pink color. This refers to: A. Kober reaction B. Trinder reaction C. Zimmermann reaction D. Porter-Silber reaction 58. The Kober reaction is used in the assay of: A. Urinary estrogen B. Glucocorticoids C. Testosterone D. Epinephrine 59. In the Porter-Silber assay, the dihydroxyacetone side chain of the steroid hormone reacts with: A. Sulfuric acid-hydroquinone and forms reddish-brown color B. m-dinitrobenzene and forms purple color C. Ceric and arsenite compound and forms a yellow product D. 2, 4 –dinitrophenylhydrazizne and forms a yellow derivative 60. The assay employed for 17-ketosteroids, in which steroids react with m-dinitrobenzene in alcoholic KOH solution resulting to the formation of a purple color: A. Kober Reaction B. Zimmerman reaction C. Porter-Silber ReactionD. Pisano Method 61. Zollinger-Ellison syndrome is characterized by elevated blood levels of: A. Cholecystokinin B. Trypsin C. Pepsin D. Gastrin 62. Tumor marker most useful in the detection of familial medullary carcinoma of the thyroid: A. Calcitonin B. CA 125 C. CEA D. CA 19-9 63. What metal toxin in urine is detected by the Reinsch test? A. Lead B. Mercury C. Bromide D. Zinc 64. Trinder’s reagent (mercuric chloride, HCl, and ferric nitrate) is used in the colometric assay for: A. Acetaminophen B. Salicylate C. Theophylline D. Ethanol 65. Caffeine is an important metabolite of this drug, which is assayed in newborns and young children to monitor its therapeutic level. What is this? A. Acetaminophen B. Digoxin C. Theophylline D. Phenobarbital 66. Odor of bitter almond gives a clue of: A. Cyanide poisoning B. Ethanol poisoning C. Arsenic poisoning D. Carbon monoxide poisoning 67. Benzoylecgonine is the major metabolite of: A. Heroin B. Marijuana C. Cocaine D. Phencyclidine 68. The formation of this crystal in urine, although not a constant finding is an important diagnostic clue of ethylene glycol poisoning: A. Uric acid B. Ammonium biurate C. Triple phosphate D. Calcium oxalate 69. What is the major carrier of drugs in the circulation? A. Albumin B. Globulin C. Transferrin D. Hemoglobin 70. Fire extinguishers designated as Class A are used for: A. Paper and wood B. Electrical equipment fire C. Flammable liquids and gases D. All of the above 71. It is a specialized colorimeter designed to scan and quantitate electrophoresis patterns: A. Densitometer B. Detector C. Atomizer D. Monochromator 72. The element that distinguishes proteins from carbohydrate and lipid compounds is: A. Carbon B. Oxygen C. Nitrogen D. Phosphorus 73. Parfentjev’s method is for the determination of: A. Fibrinogen B. Albumin C. Globulin D. Amylase 74. Apolipoprotein A is the primary protein component of: A. HDL B. IDL C. LDL D. VLDL 75. It is biologically important, as it serves as the starting point in many metabolic pathways including Vitamin D synthesis, steroid hormone synthesis, and bile acid metabolism. A. Cholesterol B. Phospholipid C. Triglycerides D. Free fatty acids 76. What is the current reference method for cholesterol analysis? A. Abell-Kendall method B. Bloor’s method C. Salkowski method D. Lieberman-Burchardt 77. A mild condition that appears to result from a genetic defect in transport of bilirubin from sinusoidal blood into the hepatocyte: A. Gilbert Syndrome B. Crigler-Najjar SyndromeC. Dubin-Johnson D. Rotor Syndrome 78. What reagent is used in the Evelyn-Malloy method to dissociate the unconjugated bilirubin from protein? A. Methanol B. Ethanol C. Caffeine D. Acetic acid 79. The Jaffe reaction is employed for the quantitation of: A. Urea B. Creatinine C. Protein D. Uric acid 80. Lloyd’s reagent improves the specificity of what colorimetric method of determination? A. Jaffe B. Caraway C. Lieberman-Burchardt D. Biuret 81. What is the major end product of protein and amino acid catabolism? A. Urea B. Uric acid C. Creatine D. Creatinine 82. Uric acid when oxidized by the enzyme uricase is transformed to: A. Allantoin B. Monosodium urate C. Xanthine D. Ammonia 83. The sweat chloride test is useful in the diagnosis of: A. Dehydration B. Cystic fibrosis C. Azotemia D. Diabetes 84. Which trace metal accumulates in Wilson’s disease? A. Cobalt B. Copper C. Nickel D. Zinc 85. What is the anticoagulant of choice for blood gas analysis? A. EDTA B. Heparin C. Oxalate D. Citrate 4
86. The pH of blood is critically maintained at what level:
A. 7.00-7.50 B. 7.50-7.70 C. 7.15-7.35 D. 7.35-7.45 87. In which of the following are the thyroid hormones classified: A. Amino acid derivatives B. Steroid hormones C. Fatty acid derivatives D. Peptide hormones 88. Which of the following polypeptide hormones may be described as having alpha chains that are biochemically identical but beta chains that are biochemically unique? A. FSH, TSH, ACTH, LH B. TSH, LH, TRH, HCG C. LH, ACTH, HCG, TRH D. HCG, FSH, TSH, LH 89. The thyroid gland produces all of the following hormones EXCEPT: A. TSH B. Calcitonin C. Thyroxine D. Triidothyronine 90. In hypothyroidism, one would expect the total T4 level to be _____, and the T3 uptake to be ____. A. Increased, increased B. Decreased, decreased C. Decreased, increased D. Increased, decreased 91. How can primary hypothyroidism be differentiated from secondary hypothyroidism? A. T3 B. T4 C. TSH D. Both A and B 92. 5-Hydroxyindoleacetic acid is the primary metabolite of: A. Epinephrine B. Prolactin C. Norepinephrine D. Serotonin 93. A marked increase in 5-HIAA excretion occurs in patients with: A. Argentaffinoma B. Pheochromocytoma C. Diabetes insipidus D. Diabetes mellitus 94. Digoxin, procainamide and quinidine are drugs that may be classified as: A. Aminoglycosides B. Anticonvulsants C. Antidepressant D. Cardioactive 95. Lithium therapy is widely used in the treatment of: A. Hypertension B. Hyperactivity C. Aggression D. Manic-depression 96. A drug that relaxes the smooth muscles of the bronchial passages is: A. Acetaminophen B. Lithium C. Phenytoin D. Theophylline 97. Which of the following statements pertains to the effect of ethanol? 1. Ethanol functions as a depressant of the central nervous system 2. Initial effect is an increase in heart rate and blood pressure 3. Long-term abuse can impair most organs of the body; primary tissue affected is the liver 4. Blood alcohol content of 0.35 to 0.50 % is associated with coma and possible death A. 1 and 3 B. 2 and 4 C. 1, 2 and 3 D. 1, 2, 3 and 4 98. This toxin has high affinity to keratin, can be identified from hair and nails: A. Lead B. Cyanide C. Mercury D. Arsenic 99. This common substance of abuse is derived from Cannabis sativa leaves and stems. Which of the following is it? A. Heroine B. Cocaine C. Marijuana D. Amphetamines 100. All of the following vitamins are lipid in nature and classified as fat-soluble, EXCEPT: A. Vit. A B. Vit. C C. Vit. D D. Vit. K