CHEMICAL PATHOLOGY QUESTIONS FOR Diploma

1. Chemical Pathology is a branch of medicine and it aids in:

A. The monitoring of the underlying mechanisms of disease

B. The description of how symptoms and signs can be correlated to
pathophysiology of a disease
C. The provision of specimens for diagnosis of a disease
D. Treatment of diseases
E. The decentralization of laboratory tests for patient management.

2. The MOST frequently used specimen for chemical pathology assay is

A. Urine
B. Blood
C. Serum
D. Saliva
E. Cerebrospinal fluid

3. Which of the following statement is FALSE?

A. Quality control involves all the systematic actions required to provide adequate
confidence for the medical needs for patient care.
B. Accuracy is a measure of the closeness of an estimated value to the true value
C. Precision is the closeness with which the repeat measurements on samples agree
D. Quality control does not focus on individual tests and technical aspects of the
testing process
E. Reproducibility of an analytical method is termed precision

4. Fresh early morning urine is the most suitable specimen for analysis because

A. The specific gravity is usually at its highest

B. Destruction of glucose by bacteria does not occur in such urine
C. It has a sweet odour
D. The colour is usually normal
E. Such urine is not turbid

5. Changes that may occur in blood after collection include which of the following?
A. Diffusion of potassium and some enzyme through the RBC membrane into
plasma
B. increase in plasma [PO4]
C. Increase in pH of blood
D. High levels of CO2
E. increase in volume
6. In the examination of urine
A. Specific gravity cannot be determined at 37°C
B. The presence of glucose always predicts an abnormal glucose concentration
 C. The appearance and colour should not be noted
D. The protein precipitate formed by heating may not dissolve after acidification
E. Appearance of protein in urine may be normal

7. Prolong application of tourniquet can give false negative results of

A. Cortisol
B. Glucose
C. Albumin
D. Calcium
E. Protein

8. Glycosuria is best detected by

A. Clinistix strips
B. Biuret reaction
C. Rothera’s test
D. Folin-Wu reagent
E. Bromocresol reaction

9. Biochemical tests on serum may be affected by all of the following EXCEPT:

A. Exercise
B. Time of day
C. Diet
D. Type of analyzer used
E. Gender

10. Consider these statements

A. Refrigeration of whole blood has no the effect on K+ concentration by reducing
the activity of the ATPase pump
B. Freezing of the blood samples will results in haemolysis and falsely elevate Na+
concentration
C. Blood for glucose estimation should be put into any tube.
D. The concentrations of many substances are the same in erythrocytes and the
surrounding plasma
E. The results generated by plasma and serum are all the same for all clinical
chemistry analytes.

11. Blood sample for blood gases is collected into

A. K2-EDTA tube
B. Fluoride oxalate tube
C. Lithium heparin tube
D. Na-EDTA
E. Plain tube
12. Serum electrolytes are accurately measured by which of the following method
A. Cation selective electrode
B. Anion selective electrode
C. Iron selective electrode
D. Ion selective electrode
E. Flame photometry

13. The general quantitative relationship that governs all absorption processes is
known as
A. Nernst law
B. Faraday’s law
C. Beer-Lambert law
D. Fluorometric law
E. Lambert law

14. Point of care testing:

A. Eliminates the need for training staff who use these instruments
B. Cannot be used to measure bilirubin
C. Is best established independently from the central biochemistry lab
D. Is less costly per unit test than analysis undertaken in the central laboratory
E. Can be monitored for training and quality purposes through linkage to a central
laboratory computer

15. Serum:
A. Comprises the liquid component of unclotted blood
B. Is suitable for measurement of fibrinogen levels
C. Can be used for analysis of most biochemical tests on blood
D. Is obtained by taking blood into an anticoagulant and then comprises the liquid
phase after centrifugation of the cellular elements
E. Just like plasma, is not suitable for detection of a paraprotein on suspected
multiple myeloma

16. Body water compartment

A. Is composed of intracellular and extracellular compartments.

B. The lymph and transcellular fluid are considered as part of the intracellular
compartment.
C. The transcellularfluid consists of all fluids inside the cell.
 D. The intracellular fluid constitutes approximately 63% of total body weight in
infants.
E. The extracellular fluid constitutes approximately 37% of total body weight in
infants.

17. The normal distribution of water in adults

A. 20 – 30% of a healthy adult’s body is composed of water.

B. The total volume of water in a 70 kg human adult is about 36 litres.
C. About 2/3 of this water is within body cells.
D. 25 to 30 litres of body water is found in the intracellular compartment.
E. Solids constitute 20-30% of the body weight.

18. Variations in water levels in humans could be due to all the following EXCEPT

A. Age.
B. Environment.
C. Gender.
D. Tissue type.
E. Water intake.

19. Electrolytes in the body includes all of the following EXCEPT

A. Sodium.
B. Zinc.
C. Chloride.
D. Potassium.
E. Phophorus.

20. The functions of the kidney include all of the following EXCEPT

A. Regulation of electrolytes.
B. Maintenance of acid-base balance.
C. Regulation of blood pressure.
D. Natural filtration of blood.
E. Production of insulin.

21. Initial investigations of renal function includes all the following EXCEPT

A. Urea.
B. Creatinine.
C. Routine urine examinations.
D. Serum albumin.
E. Serum electrolytes.

22. The plasma creatinine depends on

 A. Site of production.
B. Rate of excretion.
C. Creatine concentration.
D. Urea concentration.
E. Glucose concentration.

23. The units used for GFR is

A. µmol/min
B. mmol/sec
C. ml/min
D. mg/min
E. g/min

24. Creatinine is synthesized mainly in the

A. Skeletal muscle
B. Pancreas
C. Liver
D. Spleen
E. Heart

25. Cystatin C is

A. A protease enhancer.
B. Not freely filtered by the kidneys.
C. Produced constantly by nucleated cells.
D. Influenced by sex and diet.
E. Reabsorbed and degraded by the convoluted tubules.

26. Which of the following urine colouration is well matched to its cause?

A. Black urine- porphyria.

B. Milky white urine- BancroftianFilariasis.
C. Greenish urine- Melanuria
D. Red urine- Haemolysis
E. Yellow-orange- schistosomiasis.

27. A student is nervous for a big exam and is breathing rapidly.Which of the
followingislikely to occur?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
 D. Respiratory Alkalosis
E. lactic acidosis

28. Causes of lactic acidosis include all of the following EXCEPT

A. Acute Myocardial infarction
B. Hypoxia
C. Circulatory failure
D. Infections
E. diabetic ketoacidosis

29. Carbonic anhydrase is present in all the following EXCEPT

A. Gastric parietal cells
B. Red blood cells
C. Renal tubular cells
D. kidney cells
E. Plasma

30. Factors to consider in selecting a plasma enzyme for diagnosis include all of
thefollowing EXCEPT

A. Sensitivity
B. Specificity
C. Half life of the enzyme
D. Molecular weight of the enzyme
E. Rate of release of the enzyme

31. The activity of plasma enzymes can be affected through all of the following EXCEPT

A. Rate of release from the target organs

B. Distribution of the enzyme in the extracellular fluid
C. Size of the plasma enzyme
D. Rate of elimination of the plasma enzyme
E. Route of inactivation of the plasma enzyme

32. Albumin acts as the major carriers of :

A. Hormones such as thyroxine and cortisol
B. Drugs such as salicylates and penicillins
C. Excretory product such as bilirubin
D. Haemoglobin
E. Calcium
33. The Liver
A. Weighs about 5.1-6.0kg.
B. Located beneath the stomach.
C. Is not the only organ that can regenerate.
D. Receives blood from the portal vein.
E. Have the left lobe being smaller than the right lobe.

34. The functions of the liver includes all of the following EXCEPT
A. Playing essential role in protein and carbohydrate metabolism.
B. Detoxification of drugs.
C. Synthesis of immunoglobulins and complements.
D. Synthesis of primary bile.
E. Synthesis of albumin.

35. Unconjugated bilirubin

A. Is water soluble
B. Gives direct Jendrassik-Grof reaction
C. Is not bound to proteins in plasma
D. Is decreased in haemolytic anaemia
E. Is increased in post hepatic jaundice.

36. Marked elevations of Alanine Aminotransferase (ALT) can be observed in:

A. Viral hepatitis
B. Circulatory failure with shock and hypoxia
C. Cholestatic jaundice
D. Toxic liver necrosis
E. Myocardial infarction

37. Which of the following statement is TRUE?

A. Haemolysed samples have no adverse effect on the results of enzymes estimation
B. Raised levels of gamma glutamyltransferase (GGT) are found in patients on
barbiturates
C. In children, the level of alkaline phosphatase is the same as adults
D. The level of AST is very low in necrosis

38. Management of type 2 diabetes mellitus include all of the following EXCEPT

A. Insulin replacement therapy.

B. Lifestyle changes.
 C. Dietary management.
D. Regular exercise.
E. Regular monitoring of glucose.

39. The oral glucose tolerance test:

A. is used to determine glucosuria without hyperglycaemia
B. to determine the efficiency of the body to metabolize glucose
C. is not used to diagnose prenatal mortality
D. Cannot be used differentiate between glucose intolerance and metabolically
healthy individuals
E. Can be determined at any time of the day

40. Which of the following is the number one complication of diabetes?

A. Diabetic ketoacidosis
B. Obesity
C. Hypertension
D. Cardiovascular disease
E. Glycosuria

41. What are the three COMMON symptoms of diabetes?

A. Headache, vomiting and constant illness

B. Intolerable thirst, constant urination and weight loss
C. Double vision, infections and constant urination
D. Tingling of the feet, slow wound healing wounds and weight loss
E. Intolerable thirst, vomiting and heart burns

42. Causes of secondary dyslipidaemia include

A. Diabetes
B. Hypothyroidism
C. Obstructive liver disease
D. Obesity
E. All of the above

CASE STUDY

A 23 year old female had her fasting plasma lipid checked by her family doctor because
her father had been admitted at the hospital and diagnosed of myocardial infarction,
aged 44years. Her lipid profile results are as follows:
Analyte Results Reference ranges
Cholesterol 9.40 mmol/l 3.50-5.0 mmol/l
HDL-cholesterol 1.2 mmol/l 1.0-1.8 mmol/l
Triglycerides - 0.5-.0.75 mmol/l

The biomedical scientist had the optical density of her triglycerides as 0.09, mean
standard absorbance 0.20 and standard concentration of 2.28mmol/l.

43. What is the triglycerides concentration from the above case study?
A. 5.03 mmol/L
B. 4.03 mmol/L
C. 1.03 mmol/L
D. 3.03 mmol/L
E. 4.50 mmol/L

44. Calculate the [LDL] of the above patient

A. 7.93mmol/L
B. 8.20 mmol/L
C. 8.79mmol/L
D. 7.73 mmol/l
E. 7.03 mmol/L

45. Very low density lipoprotein (VLDL) concentration of the patient is

A. 1.67 mmol/L
B. 1.03 mmol/L
C. 1.20 mmol/L
D. 0.47 mmol/L
E. 0.84 mmol/L

46. The following pituitary hormones have a hypothalamic - stimulating factor EXCEPT
A. TSH
B. GH
C. LH
D. FSH
E. Prolactin

47. The adrenal cortex synthesizes the following hormones

A. Aldosterone
B. Catecholamines
C. FSH
 D. DHEA
E. Prolactin

48. Causes of secondary hyperlipidaemia include

A. Hyperthyroidism
B. Addison’s disease
C. Hepatitis
D. Cushing sydrome
E. Alcohol

49. The following proteins increase in serum during the acute - phase response EXCEPT
A. Albumin
B. C Reactive Protein
C. Ceruloplasmin
D. Anti - protease inhibitors
E. Fibrinogen

50. Which of the following statement is TRUE about CSF?

A. CSF glucose ranges from 2.1-3.3 mmol/l
B. The entire volume of CSF is replaced within 4-6 hours
C. A lumber puncture for CSF glucose analysis should only be obtained after the
patient has fasted.
D. CSF glucose ranges from 100-200mmol/l
E. CSF glucose may be low in patients with acute meningitis

1 B
2 B
3 D
4 A
5 A
6 A
7 D
8 A
9 D
10 A
11 C
12 D
13 C
14 A
15 C
16 A
17 C
18 E
19 B
20 E
21 D
22 B
23 C
24 A
25 C
26 B
27 D
28 D
29 E
30 D
31 C
32 C
33 D
34 C
35 B
36 D
37 B
38 A
39 B
40 D
41 B
42 E
43 C
44 D
45 D
46 E
47 A
48 E
49 A
50 A