LEMAR REVIEW HUB

SESSMENT EXAMINATION IN CLINICAL CHEMISTRY by completions

Or

E h of
a cSelect statements is
the numbered items or incomplete followed by answers or

statement. the one lettered answer or completion that is best in each case.

1. Chemicals should be stored:

properties and classification
A. Alphabetically, for easy accessibility C. According to their chemical when opened
B. Inside a safety cabinet with proper ventilation D. Inside fume hood, if toxic vapors can be released
2. A cholesterol quality control chart has the following data for the normal control:

Mean o f the data (X) = 150 mg/dL LEMAR,

REVIEW HUB
2 Standard deviatior 4
EX 1,372 mg/dL
N 10
Determine the coeficient of variation for this control: Cr
C. 15.0 % D. 7.06%
A. 1.33% B. 2.67%
3. All of the following conversion factors from conventional unit to SI are correct match, except:
A. Urea nitrogen, 0.357 B. Triglycerides, 0.01129 C. Cholesterol, 0.02586 D.Bilirubin88.4
4. The ability of an analytical method to measure only the analyte of interest.
C. Sensitivity D. Specificity
A. Accuracy B. Precision
5. The ability of the test to detect the proportion of individuals with disease who test positively with the test:
A. Reliability B. Practicability O. Diagnostic sensitivity y " D. Diagnostic specificity disease:
without the disease who test negatively for the
6. The ability of the test to detect the proportion of individuals D, Diagnostic specificty
B. Practicability C. Diagnostic sensitivity
Reliability is known as:
7. The middle value of a set of numbers that are arranged according to their magnitude
B. Geometric mean C. Median D. Mode
A.Arithmetic mean
8. t is the most frequent observation. D. Mode
A. Arithmetic méan B. Geometric mean C. Median
9. t is important in maintaining long-tem accuracy of the analytical methods:
A. Quality assurance 8. Chain of evidence C. Intralab QC (Internal QC D. Interlab Qc (External QC)
of analytical methods:
10. It is important for the daily monitoring of accuracy and precision
(Intemal QC) D. Interlab QC (Extemal QC)
A. Quality assurance B. Chain of evidence C.Intralab QC
11. All of the foilowing are possible causes of a random error, EXCEPT:/
Deterioration of reagents D. Temperature fluctuation
A. Pipetting emorss B. Mislabeling ofsamples
EXCEPT:
12. All of the following are possible causes of a systematic error,
Contaminated solutions C. Unstable reagent blanks and
B. Leaky ion-selective electrode (ISE) D. Improper mixinginofeither
sample reagent
to and resuts are s e e n to vary direction, the problem is referred to
13. When data fluctuations are due chance
as C. Expenimental error D. Systematic error
A. Coefficient of variation B. Random error
value and the value. t exists when there is a constant difference
14. It refers to the difference between the target assay
between the comparative method and the test method regardless of the concentration.

A. Random emor B. Constant systematic emor C. Proportional systematic eror D. Clerical error
15. It results in greater deviation from the target value due to higher sample concentration. It exists when the difference
between the test method values are proportional to the analyte concentration.

A. Random error B. Constant systematic error (C. Proportional systematic emor D. Clerncal eTor

16. Examples of pre-analytical errors:

Improper patient preparation 3. Incomect order of draw

Wrong specimen container 4. Unavailable ordelayed laboratory results
C. 1,2 and 3 D. 1, 2, 3 and 4
A. 1 and 3 B. 2 and 4
17. It is used to detemine whether there is a significant
statistically differencelbetween the standard deviations of two
groups of data.
C. Variance D. Standard deviation index
A. ftest B. ttest
18. ftis used to detemine whether there is statistically significant difference between the means of two groups of data.
B. ttest C. Varnance D. Standard deviation index
A. f test
19. In a Gaussian curve distribution, the t2 SD range includes the following percentage of values:
A. 31.6% B. 68.3% C 95.5% D. 99.7%
used QC chart in the clinical laboratory. It allows laboratorians to apply mutiple rules without the aid
20. It most widely
of a computer.
A. Gaussian curve (bell-shaped curve) C. Cumulative sum graph (CUSUM)
D. Shewhart Levey-Jennings chart
B. Youden/Twin plot
21. It is used to compare results obtained on high and low control serum from different laboratories.
A. Gaussian curve (bell-shaped curve) C. Cumulative sum graph (CUSUM)
B. Youden/Twin plot D. Shewhart LeveyJennings chart
22. It is formed by control values that either increase or decrease for six consecutive days. The main cause is
deterioration of reagents.
A Trend B. Shift C. Outlier D. Kurtosis
23. It is fomed by control values that distribute themselves on one side or either side of the mean for six consecutive
days. The main cause is improper calibration of instruments.
A. Trend B. Shift C. Outlier D. Kurtosis
24. Which Westgard rule detemines random error?
A 13s B. 41s C. 22s D. 100
25. Two control observations consecutively exceeding the same + 2s or - 2s. Allows high sensitivity to systematic
error.
A. 13s B. 41s C. 2 D. 100
 LEMAR REVIEW HUB Page |2
One
e
control +6394795 60660
A 1a exceeding the+ 2s and anothereexceeding the 2s. Allows detection of
rence bebween twoB.consecutive
1a random eror.
(CRs
measurements
D. 22
28. Point of of the same analytes on the
care B. Delta check same indv
1. testing (POCT C. Physiokogic limit D. Recovery experiment
Near-patient
2 and 4 testing 2. Altemate site testing 3. Decentralized testing 4. Bedside testing
enve reliable estimatesB.of1,3 and 4
reference interval) at
C. 4 only (D. 1,2, 3 and 4
categories. least_individuals should be tested in eacn
dg
A.50
70
, oniy 20 reference individuals need to be sampled forC.100 (D, 120
Snstrument and the test subjecd analysis on the test instrument if the laboratonan determlnes n a
30. The population are similar to those described in the
visible region of the electromagnetic manutactureS packay
A. 200 and 700 nm
B.
spectrum
340 and 850 nm
lies between
J1. A (C 400 and 700 nm D. 500 and 900 nm
Spectrophotometer that uses 2 photodetectors, for
A. Single beam spectrophotometer the sample beam and reference
beam.
B. Simplest
2 . t is the most
absorption spectrometer
(C Double beam in time spectrophotometer
D. Double beam in space spectrophotometer REVIEW HUB LEMAR
commonly used light source in the visible and near-infrared region:
A. Tungsten
JS. A
light bulb B. Deuterium lamp C. Xenon discharge lamp D Mercury lamp
monochromator isolates specific wavelength of light. Which of the following is the most commonly used type of
monochromator?
A. Prismns
34This type of detector has ekcellent Diffraction gratings
C. Filters D. Holographic gratings
sensitivity and has a rapid response; it detects very low levels of light:
A. Barier layer cell (B. Photomultiplier (PM) tube C. Photodiode D. Phototube
35. Which of the following light sources is used in atomic
absorption spectrophotometry?
(AHollow cathode lamp B. Xenon arc lamp C. Tungsten ight ( . Laser
s6. path of the exciting light is at right angle to thé path of the emited light.
orometers
What is the aredesigned so thatthe
purpose of this design?
A. Prevent loss of enitted light C. Focus emitted and excitation light upon the detector
B. Prevent loss of the excitation light D. Prevent excitation ight from reaching the detector
37. A fluorescent substance absorbs light of one wavelength and emits light of
A. Longer wavelength and lower energy C. Longer wavelength and higher energy
B. Shorter wavelength and lower energy O. Shorter wavelength and higher energy
38. The process by which fluorescence of an analyte is reduced due to the excited molecule losing some of its energy
by interacting with other substances in a solution is known as
A. lonization B Quenching C. Phosphorescence D. Self-absorption
39. Which of the following instruments is used in the clinical laboratory or in reference laboratories to detect beta and
gamma emissions? a ndiae
A. Fluorometer B. Nephelometer C. Scintilation counter D. Spectrophotometer
40. When measuring K* with an ion-selective electrode by means of liquid ion-exchange membrane, what antibiotic wil
be incorporated into the membrane? lue crta rgaic-calu'um u
A. Monactin B. Nonactin C. Streptomycin D. Valinomycin
41. It is useful for compounds that are naturally volatile or can be easily converted into a volatile fom.
A. Paper chromatography B. Thin layer chromatography C, Gas chromatography D. HPLC
42. Allof the following are corect match, EXCEPT:
AM A. Polarography: pOz detemination C. Amperometry: pH and pCO2 tests
B. Coulometry: Chlonide tests in CS, serum and sweat D. Voltammetry: lead and iron testing
43. Which of the following approaches of automated analyzers uses arotor to mix reggents
A.Centrifugal analysis B. Continuousflow C. Discrete analysis D . Dry chemistry slide analysis
44. The process used in continuous-flow analysis to separate out protein from the specimen is?
A. Chemical precipitation B. Column chromatography C. lon-exchange chromatography D. Dialysis
45. All samples are loaded at the same time and a single test is conducted on each sample
ABatch testing B. Parallel testing C. Sequential testing D. Random access testing
46. More than one test is analyzed concurrenthy on a given clinical specimen:
A. Batch testing B. Parallel testing C. Sequential testing D. Random access testing
47. in
Any test
can be perfomed on
any sample any sequence:
A. Batch testing B. Paralll testing C. Sequential testing (D Random access testing
48. one after another on a given
Muttiple
tests analyzed specimen:
A. Batch testing B. Parallel testing Sequential testing D. Random access testing
49. Which of the following chemistry analyzers uses "slides" to contain the entire reagent system?
A. Vitros analyzers B. ACAO analyzers C. Paramax© analyzers D. None of the above
50. The pH value at which the serum of the electric charges on a protein equals zero is referred to as the:
A. Balanced point B. Equalization point CAsoelectric point D. Zwitterion point
51. pipet for viscousfluids; it characterized with an etched ring:
Transfer
A. Volumetric pipet BOstyald-Folin C. Serological pipet D. Mohr pipet
52. A graduated or measuring pipetwithoutgraduationstothe tip. It is calibrated between 2 marks and self-draining
pipet.
A. Volumetric pipet B. Ostwald-Folin C. Serological pipet O. Mohr pipet
53. Exercise:
1. Increased lactate
A. 1 andd4
2. Increased ammonia
B. 1,3and 4
3. Increased ALT, AST
C.1, 2 and 3
4.Increased CK
D. 1,2, 3 and 4
 hich
1 o te tolowing will increase
Banana
the
LEMAR EVIEW HUB +63 9479560 6 60 Page j3
urinary excretdon of
A
55. Analytes that
1 and 4 2. Pineapple
B. 1,3 and 4 Tomato
6-hydroxyindoleacetic acid (b
4. Avocado
1. exhibits
Iron diumal variation: (C1,2 end3 D. 1,2, 3 and 4
A. 1 and3 2. Cortisol
56. 3. ACTH Growth homone
Order of draw in evacuatedB.tubes
2 and 3
C. 1.2 and3 (9.1,2,3 and 4
and
Senlelight blue serum syringe:
Slenle-ight blue -serum tube green lavender-gray slopper
tube -lavender
.Sterile- serum tube- light blue- green -green-gray stopper
57. The Stere- serum tube
green
needle is consideredlight
-
lavender gray
-
-

blue lavender gray stopper

-

stopper
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g e
A. 19 gauge the standard for most routine adult antecubital
B. 20 gauge
C)21 gauge venipunctures.
8.ASte as 10% contamination with 5% dextrose
will glucose increase
D. 22 gauge
A. 100 mg/dL or more B. 200 in a blood sample by mg/dL or more.
59. Order of draw from mg/dL or more C. 300 mg/dL or more
(Dy500 ma/dL or more
(A. Blood for bloodcatheter
culture lines 3. Blood for anticoagulated tubes
B.A. Discard
1,2, 3 then 4 3to mL(
tube, 5 4. Blood for clot tubes
60. Low . 2,1, 3 then 4 C. 2,1,4then 3 D. 2,3,1then 4
temperaturestorage prior to testing:
ADecreased LD4, LD5 and ALP C. Increased LD4, LD5 and ALP
(B.) Decreased LD4 and LD5, increased ALP
61. 8pecimens that D. Increased LD4 and LD5, decreased ALP
1. Ammonia
require chilling (4"C)*
2. Blood gases
A. 1 and 3 B. 2 and 4 3. Gastrin
C. 1,2 and 3
4. Lactic acid
62. Analyte used to assess the completeness of a 2Ahour collection:
1.2,3 and 4
A.
Glucose 8. Urea
urine
63. Homones that tend to increase CCreatinine D. Chloride
1. Cortisol
glucose concentration:
2. Catecholamines
A. 1 and 3 B. 2 and 4
3 ACTH Insulin
C. 1,2 and 3 1,2, 3 and 4
64. aboratory findings in
A. Increased glucosehyperglycemia
in plasma and uñne 3. Increased urine specific gravity
(8. Presence of ketones in serum and urine 4. Increased blood pH and urine pH
1 and 3
B2and4 bccur at thisC.1,2
65, Observable symptoms ofbypoglycemia and-3
glucose concentration: D.1,2,3 and 4
A. 100 to 120 mg/dL B. 90 to 110 mg/dL C. 70 to 80 mg/dL
66. Type 1 DM: D50to 55 mg/dL
AInsulin-dependent DM Maturity onset DM 3. Ketosis-prone DM 4. Receptor-deficient DM
A. 1 and3 B-2-and C42-end3
67. Decreased or undetectable C-peptide level D4-2-3and 4
(A.Type 1 DM B. Type 2 DM C. Types 1 and 2 DM D. None of these
68. Venous blood is than capillary blood due to tissue metabolism.
A. 4 mg/dL higher B. 4 mg/dL lower C.7 mg/dL higher
69. Alkaline copper reduction method for
D) 7 mg/dL lower
glucose:
A. Folin Wu method 2. Nelson Somogyi method 3. Neocuproine method 4. Hagedom Jensen method
A. 1 and 3 B. 2 and 4 C.1,2 and 3 D. 1,2, 3
4 and
70. Select the coupling enzyme used in the hexokinase method for
glucose: m
A. Glucose dehydrogenase C. Glucose-8-phosphate dehydrogenase duitrn
B. Glucose-6-phosphatase D. Peroxidase
71. Fasting plasma gluctse of 110 mg/dL:
A. Non-diabetic B. Impaired plasma glucose C, Diabetes mellitus D. Hypoglycemia
72. Diagnostic criteria for diabetes melitus:
A. RBS 2 200 mg/dL
2. FBS2 126 mg/dL 32-hour post glucose load 2 200 mg/dL
A. 1 and 2 B.1 and3 C1,2 and 3
73. Glycosylated D. 1, 2, 3 and 4
A. 24.5 %
hemoglobin yalue 2_% on two occasions can be used to diagnose diabetes.
B.25.7 % C. 6 % D 26.5 9%
74. Methods for measurement
1. Electrophoresis
of glycosylated hemoglobin(HbA1c} 3 mols n
2. HPLC 3. Affinity chromatography
A. 1 and 3 B. 2 and 4 C. 1,2 and 3 4.D. Immunoassay
75. Most common glycogen 1, 3 and 4
storage disease (GSD):
A. Pompe B. Andersen
76. Conditions
C. Mc Ardle von Gierke
characterized
by increased cholesterol:
A Biliary cinhosis 2. Nephrotic syndrome 3. Alcoholism
A 1 and3 4. Hyperthyroidism
77.
8.2and 4 C. 1,2 and 3
D.1,2,3 and4
Triglyceride
A. Normal
value of 150mo/dL: 1Dnq /hL 1s-9a 27- y9n/
/ >sVD
B. Borderline high
78. Condition characterized by increased
C. High TAG D. Very high TAG
A. Alcoholism
triglycerides:
2. Nephrotic syndrome 3. Pancreeatitis
A. 1 and3 B. 2 and 4
4 Hypothyroidjsm
79. The largest and least dense of the C.1,2and-3 D. 1,2,3 and 4
A. VLDL
lipoprotein particles:
B. LDL
80. Lew density lipoprotein:
C. HDL
6.Chylomicrons
A.90%TAG+1-2% protein C C. 30% phospholipid, 20% chole ester +45-50% proteit
B. 65% TAG, 16% chole
ester +6-10% protein D. 50% chole ester+ 18% and
protein phospholipid
-VLDL
 e reference method for LEMARREV IEW HUB +63 94 7 95 60 660 Page 14

A. Utracentrifugation quantification of
B. Electrophoresislipoproteins:
2. Migration of
lipoproteins from the origin to the anode:C. Chemical precipitation D. Immunoassays

6ChykomioronsLDL- VLDL-HDL
Chylomicrons-VLDL-LDL-HDL C.HDL-VLDL - LDL- chylomicrons
83. A D. HDL -LDL - VLDL- chylomicrons
rare autosomal recessive disorder
A Bassen-Komzweig syndrorme characterized by complete absence of HD
B.Tangier's disease C. Niemann-Pick disease
84. D. Anderson's disease
An abnomat lipoprotein fodnd in patients with
A. B-VLDL obstructive biliary disease:
. LpX C. Lp(a)
0.Ais patient's total cholesterol is 300 mg/dL, his HDL cholesterol is 60 mg/dL, andD.hisLDL
triglyceride is 200 mg/dL. wnat
this patient's
A. 200 calculatedDL?
8.
8 210 C. 290 D. 350
Standard reference method for total protein detemination based on the measurement of nitrogen coment
A. Biuret method B Kjeldahl method C. colloidal
Folin-Cocalteu D. UV absorption method
87. The plasma protein mainly responsible for maintaining osmotic pressure in vivo is:
A. Hemoglobin B. Fibrinogen D. Albumin
C. Alpha2-macroglobulin
88.
Inwhat condition would an increased serum albumin be expected?
A.)Malnutrition B. Acute infammation
89. Poor protein-caloric nutrition status is associated
C. Dehydration D. Renal disease

A. A low level of with:

gamma-globulins
B. An elevated haptoglobin
C. A decreased level of prealbumin
concentratio D An increased level of alpha1-fetoprotein
90. Deficiency is associated with emphysematous pulmonary disease and juvenile hepatic cirhosis:

.
AAlpha1-antitrypsin B. Orosomucoud C. Prealbumin D. Hemopexin
This protein appears in the urine when reabsorption is incomplete because of proximal tubular damage as in acute
kidney injury:
A. Ceruloplasmin B. Alpha2-macroglobulin C. Siderophilin D. Beta2-microglobulin
92. Serum electrophoretic patterm associated with alpha2 globulin band spike:
A. Multiple myeloma B. Hepatic cirthosis CNephrotic syndrome
D. Juvenile cirhosis
93. Bence Jones proteinuria is a condition characterized by the urinary excretion of what type of light chain?
A. Kappa light chains CBoth kappa and lambda light chains
B. Lambda light chains D. Either kappa or lambda ight chains
94. Ceruloplasmin and haptoglobin migrate electrophoretically as:
A. Alpha1 globulins BAlpha2 globulins C. Beta globulins D. Gamma globulins
95. Which of the proteins listed migrates in the beta region at pH 8.6?
A. Haptoglobin B. Orosomucoprotein C. Ceruloplasmin Transferin
96. Acute phase reactants:
CRP a1 antitrypsin 3. a1-acid glycoprotein
A, 1 and 2 B. 2 and3 C. 1 and3 D. 1.2 and 3
97. Thé following pattern of serum protein electrophoresis is obtained:
Albumin: decreased or normal
Alphal and alpha2 globulins: incxeased
Beta and gama globulins: normal
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This pattem is characteristiç of which of the following conditions:
A. Cihosis B.Acute inflammation C. Nephrotic syndrome D. Gammopathy
98. A congenital disorder characterized by a split in the albumin band when serum is subjected to eectrophoresis is
known a
A. Analbuminemia B. Anodic albuminemia
99. Conditions associated with increased total protein concentration:
CBlsalbuminemia D. Prealbuminemia

1. Malignancy 2. Waldenstrom's macrogobulinemia 3. Multiple myeloma 4. Glomerulonephritis

A. 1 and3 B. 2 and 4 C. 1,2 and 3 D. 1. 2.3 and 4
100. First metabolite to elevate in kidney diseases:
A BUN B. Creatinine C. Cystatinc D. Unc acid
101. Index of overall renal function:
A. BUN B. Creatinine C. Cystatin D. Uric acid
102. Conditions with increased BUN:
Chronic renal disease 2. Poor nutrition 3.C. High protein diet 4. Hepatic disease
A. 1 and 3 B. 2 and 4 1,2 and 3 D. 1,2, 3 and 4
103. Conditions with increased creatinine clearance:
A. Impaired kidney function 2. Shock, dehydration 3. Hemorhage 4. High cardiac output
A 1 and 3 B. 2 and4 C. Only 4 D. 1,2. 3 and 4
104. Azotemia is characterized by elevated levels of: Rodriguez
A. Urea B. Creatinine CUrea and creatinine D. None of these
106. is
ItA. of
usually the result urinary
Pre-renal azotemia
tract obstruction:
B. Renal azotemia CPost-renal azotemia D. Pre-renal and renal azotemia
106. acidC.determination:
Simplest and the most specific method for uric
Isotope dilution mass spectrometry D. None of these
A. Chemical method(B Enzymatic method
107. During chemotherapyfor leukemic, which of the following analytes woukd most likely be elevated in the blood?
A.) Unc acid B. Urea C. Creatinine D. Ammonia
108. Calculate the creatinine clearance based on thefollowing infomation: urine concentration= 120 mg/dL; plasma
concentration 1.5 mg/dL; urine volume for 24 hours 1520 mL; body surface = 150 m.
A. 78 mL/min B. 82 mL/min C. 84 mLUmin D. 91 mlmin
109. Tests for measuring the hepatic synthetic (syrnthesis) ability: 144
A. Serum albumin 2. Ammonia 3. Coagulation factors 4. Bilirubin
A. 1 and 3 B. 2 and 4 C. 1,2 and3 D. 1, 2,3 and 42
 639 479S60660 Page
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soen as scleral icterue when the patient has total serum bilirubin concemtratione above
mg/d. Henry initially
m/dtoen
A. 0.5 mg/dL
111. Which of the B. 1 mo/dL C. 1.5 mo/dL D. 2 m/dL
foliowing statements refer to
Conjugated bilirubin 2, Indirect reacing B1. 3. Water soluble 4. Unconjugated bilirubin
A and 3
4
@ 2 and 4 C. Only 4 D. 1,2,3 and 4
112. Gliberts syndrome:

113.
A.Conjugstion deficit (8. Billinubin trensport defit C. Bilirubin excretion defict D Conjugated hyperblirubinermia
BIllary obstructon (oalf tones) is characternzed
A. Increased B1 b C Increased B1 and B2 D. Decreesed B1 and B2
B. Increased B2
T7 ne following resuts are obtained, what is the most likely condition of the patiemr
High AST, ALT, LD, billinubin; but normal total protein, albumin, ammonia
A. Hepatitis D. Hemoytic anemia
6.
lw t Cinhosis C. Billary obstruction
he following resuts are obtained, what is the mostNomal:
Low: Total protein, albumin
lkely condton of the patent?
AST, ALT and LD
High: Bilirubin, ammonla Nomal to slightly high: ALP
A. Hepatitis B. Cirthosis C. Bliary obstruction D. Hemohytic anemia
116. The following resuks are obtained, what is the most likely conditon of the patient?
High: ALP, bilirubin Nomal: Total protein, albumin Nomal: AST, ALT, LD
A. Hepattis B. Cirrhosis C. Billary obstruction D. Hemolyic anemia
117. 8erum and other body fluids for ammonia determination: D. Chilled within 12 hours
A Chilled, fresh specimen B. Chilled within 4 hours C. Chiled within 8 hours
118. Blood ammonia levels are usually measured in order to evaluate:
A. Renal failure B. Acid-base status CHepatic coma D. Gastrointestinal malabsorption
119. Which of the following enzymes does not belong tothe class of enzymes known asthehydrolases?
A. Alkaline phosphatase B. Aldolase C. Amylase D. Lipase
120. To what class of enzymes does lactate dehydrogenase belong?
A. Isomerases B. Ligases COxidoreductases D. transferases
121. Transferases:
1 ALT AST CK 4. LD
A. 1 and 3 B. 2 and 4 (C) 1,2 and 3 D. 1,2, 3 and 4
122. Order of ALP heat stability: from most heat stable to most heat labile.
A. Bone, intestinal, Iiver and placental C. Placental, intestinal, liver and bone
B. Bone, liver, intestinal and placental D. Intestinal, liver, placental and bone
123. Major LD isoenzyme in the sera of healthy persons:
A. LD 1 B. LD 2 C. LD 3 D. LD 5
124. LD is elevated in all patients with:
A. Aplastic anemia B. Iron deficiency anemia C. Megaloblastic anemia D. All of these
125. Serum levels of total CK are elevated after an acute myocardial infarction and in which of the following
conditions?
A. Diabetes mellitus C. Duchenne type muscular dystrophy
B. Chronic renal failure D. Early pregnancy
126. The isoenzymes LD-4 and LD-5 are elevated in:
A. Pulmonary embolism (B) Liver disease C. Renal disease D. Myocardial infarction
127. Highest level of ALP:
A. Hepatitis B. Hepatobiliary disease C. Obstructive disease D Paget dise ase
128, In an adult, a normal GGT level with an elevated serum ALP level may be suggestive of:
A) Bone disease B. Heart disease C. Lver disease D. Skeletal muscle disease
129. Which of the following enzymes exhibit a decreased serum level in liver dise ?
A. Alanine aminotransferase C. Cholinesterase
B. Gamma glutamytransferase D. Lactate dehydrogenase
130. The relative concentration of LD isoenzymes in nomal serum:
A. LD 1>2>3>4>5 B.LD 2>1>3>4>55 C. LD 2>1>4>3>5 D. LD 5>4»21
131. A substrate exhibiting high specificity for prostatic acid phosphatase:
A. Beta-ghycerophosphate (Bodansky) C. Phenylphosphate (Gutman, King-Amstrong)
B. Thymolphthalein phosphate (Ro D. Alpha-naphthylphosphate (Babso Reed)
132. Time course of CK activity ONSET
in myocardial infarction:
OF ELEVATION PEAK ACTIVITY
DURATION OF ELEVATION
1-3 h 5-12 18-30 h
4-8 h 12 h 3-4d
8-12 h 24 h 5d
12-24 h 72 h 10 d
133.
Serum enzymestypically elevated due to skeletalmugcle disease:
ASpartate aminotránsferase, creatine kinase, lactatedehydrogenase
Aspartate aminotransferase, alanine aminotransterase, alkaline phosphatase
Aldolase, pseudocholinesterase, trypsin
LEMAR
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D. 5-Nucleotidase, alkaline phosphatase, gamma-glutamyl transferase
134. Most sensitive enzyme index of primary muscle
inyivement:
A Aldolase B. AST
136. In pesticide poisoning. pholinesterase activity is:
C CK D. LD

A. Normal
Decreased C.
136. t is considered as the most common electrolyte disorder
Increased D. Variable
A. Hypermatremia B. Hyponatremia C. Hyperkalemia D. Hypokaiemia
 LE MAR REVIEW HUJB +6 3 94 795 60 6 60 Page j6
Functions of potassium:
A.
Heart contraction M
1and 3 Neuromuscular
B. 2 and4
excitability 3. ICF volume regulation 4. Enzyme activator
138.
Hyperkalemia is almost aways due to: C. 1,2 and 3 D. 1, 2, 3 and 4
A. Impaired renal excretion B. Rodriguez
139.
Most common cause of Acidosis C. Muscle injury D. Oral or IV infusion
hyperkalemia
B. Severe dehydration hospitalized patients
A. Renal failure among
140. Most C. Vigorous exercise D Therapeutic K administration
common cause of
A. Renal lass of hypokalemia:
141.
Which of the potassium B. Diahea C. Alkalosis D. Intestinal tumor
A. Vitamin D following affects serum calcium
142. Which 8. Parathyroid homonelevels?
C. Calcitonin DAll of these
protein produced in decreased amount in Wilson's
is
A. Albumin disease?
(B)Cenuloplasmin C. Haptoglobin D. Hemopexin
Menkes' syndrome is caused by accumulation of the following metal in the intestinal mucosal cell and associated
low plasma concentrations:
A. Iron
144. Buffer
system/s in the
B. Zinc C Copper D. Manganese
1.
body:
Bicarbonate/carbonic acid B. Hemoglobin 3. Plasma proteins 4. Plasma phosphates
A. 1 and 2 B. 1,2 and 3 1,3 and 4 D. 1,2,3 and 4
n h a t h ,whenthe kidneys and lungs are functioning property, a 20:1 ratio ofHCO to H,cOs will be maintained,
resulting in a pH of:
A. 7.10
146. The nomal ratio of
A. 7.4:6.1
B. 7.30 C. 7.40
carbonic acid to bicarbonate in arterial blood is:
B) 1:20 C. 0.003:1.39
D. 7.50

D. 20:1
LEMAR
REVIEW HUB
147. Which of the following is
the primary mechanism causing respiratory alkalosis?
A. Hyperventiation C. Deficient alveolar diffusion
B. Deficient pulmonary perfusion D. Parasympathetic inhibition
148. hich of the following is the primary mechanism of compensation for metabolic acidosis?
AJ Hyperventlation
149. Conditions associated with
B. Hypoventilation C. Aldosterone release D. Bicarbonate excretion
respiratory.acidosis: Uv
1. Chronic obstructive pulmonary
2. Myasthenia gravis
disease (COPD)3. Pneumonia
4 nxie
A. 1 and3 B.-2 and4 C.42an
150. Conditions associated with metabolic acidosis: ptt
D12,3and4
1. Diabetic ketoacidosis 2. Lactic acidosis (alcoholism) 3. Renal failure, diarhea 4. Vomiting
A. 1 and 3 B. 2 and4 C. 1,2 and 3 D. 1, 2,3 and 4
151. Electrodes for pCO2 PO2 and pH:
A. Glass electrode, Ciarke, Severinghaus electrode C. Severinghaus, Clarke, glass electrode
B Clarke.glasselectrode, Severinghause electrode D. Clarke electrode, Severinghaus, glass electrode
152. Which element is reduced at the cathode of a Clark polarographic electrode?
A. Silver B. Oxygen C. Chloridde D. Potassium
153. Inthepatient's circulatory system, bicarbonate leaves the red blood cell and enters the plasma through an
exchange mechanism with:
A. Carbonic acid B. Lactate C.)Chloride D. Sodium
154. All of the following are correct match, EXCEPT: HORMONE CLASSIFICATION BY STRUCTURE
A. Peptide: Insulin, TSH, FSH C. Amino acids: Nor/Epinephrine,
B. Steroid: T4, T3 D. Fatty acids: Prostaglandins
155. All ofthe following arecorect match, EXCEPT: TISSUES AND THE HORMONES THEY PRODUCE
A. Pancreas: Insulin, Glucagon C Adrenal medulla: Epinephrine
B. Adrenal cortex Cortisol
156. Tissues/organs capable of producing
DThyroid: TSH
A. Thyroid gland
homones
A. 1 and 3
2. Adrenal gland AAnterior pituitary gland 4. Posterior pituitary gland
B. 2 and 4 C1,2 and 3 D. 1,2,3 and 4
157. The major carier protein of T3 and T4 in the circulation is:
A. Aibumin
158.
B. Thyroglobulin (C)TBG D. Thyroxine-binding prealbumin
T3 uptake
A. Free T3
test is used to quantify the concentration of:
B. Protein-bound T3 C. Total T3 TBG
159. Thyroid function test in primary hypothyroidism:
4
T S
Decreased Decreased Decreaseed
Decreased Decreased Increased
Nomal Increased Decreased
160. Plummer's disease:
Normal Nomal Nomal
A. Low TSH, nomal FT4, increased FT3 C. Increased TSH, nomal FT4, increased FT3
B Low TSH, nomal FT4 and FT3 D.Increased TSH, increased FT4 and FT3
161. TSH level is low, nomal FT3 and FT4:
A. Primary hypothyroidism Subclinical hypothyroidism
B. Secondary hypothyroidismm D. Subclinical hyperthyroidism
162. Themostimportant thyroid function test and the best screening test for thyroid disorders
A. TRH stimulation test B. TSH test C.Radioactive iodine uptake D. Thyroglobulin assay
 LEMAR REVIEW HUB
6 3 94795 606 60 Page 17
zona reticuleris,
retCularis. w
What is SSsite
of 3layers from outemost to innermost: zona glomerulosa, zona fasciculata ana
A Zone glomerulosa the of aldosterone
164.
Sceening tests for Cushing's Zona fasciculataproduction?
B. C. Zona reticularis D. All of thes
1. 24 hour urinary free syndrome:
Salvary cortisol test cortisol test
A. 1 and3 XOvemight dexamethasone suppression test
165. B. 2 and 4 sMidnight plasma cortisol test
Confimatory
1. Lwdose
tests for
Cushing's syndrome
C. .2 and 3 D.1,2, 3 and 4
dexamethasone suppression test
2.Midnighplaana.cortisotiest
A. 1 and33
Conn's disease: B2and4
3. CRH stimulation test
4. Urinary free cortisol test
C. 1,2 and 3 D. 1,2,3 and 4
A. Primary hypoaldosteronism
167.
B. Secondary hypoaldosteronism CPrimay hyperaidosteronism
The adrenal medulla secretes which the following inD.the
secondary hyperaldosteronism
1
A. Metanephrine
B. norepinephrine greatest quantity?
C. Epinephrine 9
. D. Dopamine
Diabetes insipidus
A. Prolactin
is associated with depressed secretion of which of the following hormones? o -|
169. The B ADH C.growth homone D. oxytocin
7
principal estrogen produced during -1-3
A. Progesterone B. Estrone pregnancyC.is: Estradiol to- 3g
170. The Kober reaction is used in the assay of: (D) Estriol
-7-4s
A. Uinary estrogen B. Glucocorticoids
171. C. Testosterone D. Epinephrine TS
Confimatory test for acromegaly:
AGlucose suppression test-OGTT C. Dexamethasone suppression test 13
B.
Midnight plasma cortisol D. 24 hour urinary free cortisol test 38
172. Primary mae
hypogonadism: TESTICULAR INFERTILITY
A, Decreased testosterone, increased FSH and LH C. Decreased testosterone, decreased FSH and LH
B. Decreased
estrogen, increased FSH and LH D. Decreased estrogen, decreased FSH and LH
173. Secondary male hypogonadism: DUE TO
A. Decreased testosterone, increased FSH HYPOTHALAMIC
OR PITUITARY LESIONS
and LH CDecreased testosterone,
decreased FSH and LH
B. Decreased estrogen, increased FSH and
LH D.
174. A process in which secondary male characteristic are Decreased estrogen, decreased FSH and LH
dysfunction or homonal medication: acquired by a female usually as a result of adrenal
AAmenorrhea B. Gynecomastia
CVirilization D. Hirsutism
175.Excesshegrowth
A. Amenohea
of hair with a male distribution patem in females; most
common endocrine disorder in female:
B. Gynecomastia C. Virilization
176. In which of the
followingwould gastrin levels be increased: DHirsutism
A. Peptic ulceration
BZollinger-Elison syndrome
177. Homovanillic acid is the principal metabolite of: T
C. Achlorhydria D. Amyloidosis
A. Dopamine B, Epinephrine C. Metanephrine D. Vanillylmandelic acid
178. The process of chemicat modification of the
A. Liberation
drug by the cells:
B. Absorption C. Distribution
179.Acardiac glycoside for treating congestive heart failure: D Metabolism E. Excretion
Aminoglycosdie B. Theophyline
C. Digoxin D. Valproic acid
180. A beta-receptor blocking drug used in the treatment
disease: of angina pectoris, hypertension and coronoary artery
A. Acetaminophen B. Theophyline
181. Red
A.
man syndrome, nephrotoxicity and ototoxicity are
Chloramphenicol Vancomycin
C. Ethosuximide D. Propanolol
associated with which drug?
C. Phenobarbital
LEMAR
REVIEW HUB
182. The drug of choice D. Phenytoin
A. Acetaminophen
for controlling petit mal:
183. Immunosuppressive drugs: B. Theophyiline C. Ethosuximide
Propanolol
1. Cyclosporine 2. Tacrolimus 3. Rapamycin 4. Theophylline
A. 1 andd3 B. 2 and 4
184. Uses of C.1,2 and 3 D. 1,2,3 and 4
salicylates/aspirin (acetylsalicylic acid):
Analgesic 2. Anti-pyretic 3. Anti-inflammatory 4. Anti-neoplastic
1 and 3 B. 2 and 4
185. Caffeine is an C. 1,2 and 3 D. 1,2,3 and 4
important metabolite of this drug:
A. Acetaminophen B. Digaxin
186. Acetaminophen is
particularly toxic to what Theophyline
organ?
D. Phenobarbital
A. Heart
187. Which of the Kidney C. Spleen D. Liver
following drugs may be quantitated colorimetrically using Trinder's
ferric nitrate and hydrochloric
acid)? reagent (mercuric chloride,
A. Acetaminophen B. Phenobarbital
188. Specimen of choice C. Salicylate D. Theophyline
for THERAPEUTIC DRUG
A. Urine
B. Saliva MONITORING (TDM
C. Whole blood
189. Best specimen for
aLOHOL DETERMINATION: ( Serum or plasma
A. Urine
B. Saliva Whole blood D. Serum or
190. Analysis for the plasma
presence of ABUSED
choice. The SUBSTANCES
has
focused
specimen represents the net load of the drug over primanly on the use of as the test
A. Urine a long
period. sample of
B. Saliva C. Whole blood D. Serum or
plasma
 Four children LEMAR REVIBW HUB
erythrocyte are admitted
basophilic
withmalaise, anorexia, and abdominal
stippling, and profound pica
+63 94 795 60 660 P age |8
pain. Further evaluations inemia,
responsible?
A. Arsenic habits. Poisoning by which heavy metalrevea is most
et likely
likely
192. Odor of garlic on B. Iron
A.
Cyanide breath, and a metallic taste in the C. Mercury (D Lead
193. The system of poisoning B. Ethanol poisoning patient's mouth:
A. HPLC
choice for drug
analysis because ofTArsenic poisoning D. cO poisoning
its specificity and sensitivy S
B. TLC
194. The formation
of this
crystal in urine, although (CGCmass specirometry D. None of these
glycol poisoning: nota constant finding is an important diagnostic clue or
A. Uric acid
B. Ammonium biurate
ey
195. Blood alcohol C. Dihydrate CaoOx D. Monohydrate CaOx
concentration of 50 mg/dL:
A Legally intoxicated
B. Not C. Cannot be detemined
legally intoicated
196. Biood alcohol D. Varies
concentration of 0.27 to 0.40%
A.Decreased inhibitions, loss of critical judgement, memory impaiment, diminished reaction time
BMental confusion, dizziness, strongly impaired motor skills, staggering slurred speecn
Unable to stand or walk, vomitüng, impaired consciousness
D. Coma and
197. All of the
possible death
following are correct match, EXCEPT:
A. Vitamin A: Retinol C. Vitamin C: Ascorbic acid
B. Vitamin B2: Cyanocobalamin D, Vitamin K: Menaquinone
9 8 h e tem "lipid" encompasses a wide variety of compounds characterized as being insoluble in water but soluble
n
nonpolar solvents. Which of the following vitamins is NOT classiffed as fat soluble?
A. Vitamin A B. Vitamin C C. Vitamnin D D. Vitamin E DEK
199 A deficiency in which of the following leads to increased clotting time and may result in hemorhagic disease of
infancy?
A. Riboflavin B. Pyridoxine C. Tocopherols OMenaquinone
200. Which type of extinguisher should put out a fire caused by electrical equipment?
E X T I NGU ISHE R
TY PE O F
A Pressurized water/Dry chemical
Dry chemical/Carbon dioxide
Carbon dioxide/Halon/Dry chemical
Metal X/Special dry chemical
LEMAR
REVIEW HUB

AD D I T IO N A LrN-OT E S
. An analyic techniquethat measures the decreased amount of light transmitted througha Turbidimetry
solution as a result of light scatter by particles. Measurements are made at 180 degrees to
the incident beam (unscattered light)._
Analytic techniqueto measurethe light absorbed by a solution. A spectrophotometer is spectrophotometry
2.
used to measure the light transmitted by a solution in order to detemine the concentration
of thelight-absorbing substance in the solution.
5. Analytical technique that measures the amount oflight
scattered by particles (immune Nephelometry
complexes) in asolution.Measurements are made at 5-90° incident to the beam.
Analytic technique used to measurefiuorescence (light emitted as a result of energy Fluorometry
absorbed). d mowdhniu Plame photometry
5. Analyic techniquethat measures the wavelength and intensity oflightemittedfroma
bumingsolution (patient specimen). wuebe: Man
6. Analytic techniquethat measures concentrationbf analyte by detedting absorption of Atomic absorption
electromagnetic radiation by atoms rather than by molecules. Instrument is atomic

absorption spectrophotometer.Kallm/_thsde
Analytic technique that uses the force generated by centrifugation to transfer and then Centrifugal
Contain liquids in separate cuvets for measurement at the perimeter ofa spinning rotor analysis
An approach to automated analysis in which liquids (reagents, diluents and samples) are Continuous flow
8.
pumped through a system ofcontinuous tubing?Samples are introdu d in sequential
manner, following each other through the same network. A series of bubbles at regular
intervals serve as separating and cleaning media.
An approach to automated analysis in which each sample and accompanying reagents is in Discrete analysis
S.
tests one sample at a
separate container. Analyzers have the capability of running multiple
time or multipleofsamples
The capability onetest
an automated at a time.
analyzer to process samples independentily of other Random access
| 10.
be programmed to run individual
samples on the analyzer. Random access analyzers may
tests or panel of tests without operatorwhere
intervention. labeled Heterogenous
|11. A
technique (eg, radioimmunoassay) it is necessary to physically separate
remains free in assay
labeled antigen or hapten that
antigen or hapten bound to antibody from a

thesolution. bound and free Homogenous assay

12. Atechnique (eg, EMIT that does not require the physical separation of the
labeledantigen.