SOUTHWESTERN UNIVERSITY PHINMA

COLLEGE OF MEDICAL TECHNOLOGY

QUIZ on UA, TAG & TP ASSAYS IN MLS 043 LABORATORY
ANSWER KEY

I. ENZYMATIC REACTIONS. Complete the following enzyme-catalyzed reactions by filling in

the blanks with the correct reactant/cofactor needed or correct product/s as reaction yield :
(20 points)
Urease
A) __urea____ + _HOH___ ____CO2 or HCO3-__ + ___NH3_or NH4-___
(1) (2) (3) (4)

Urease
B) Urea + __HOH__ Ionized products are HCO3- + NH4-
(5) (6) (7)

CIH
C) ___creatinine_________ N-methylhydantoin + ammonia (NH3)
(8) (9) (10)

Uricase
D) Uric acid + oxygen + H2O _ allantoine_ + CO2 + __H2O2____
(11) (12) (13) (14) (15)

Glutamate Dehydrogenase
E) NH3 + ∞-ketoglutarate + NADH glutamate + NAD+ + NH4+
(16) (17) (18) (19) (20)

II. COMPARE & CONTRAST. Fill in the table with the required information about the Uric Acid,
TAG & Total Protein based on their corresponding inserts. ( 150 points)
NOTE: 25 points of differentiation or cells to answer x 2 points each = 50 points; 50
points x 3 substances/columns = 150 points all in all

Points of Uric Acid Mono TAG MONO SL Total Protein

Differentiation SL Plus
Method Enzymatic, Enzymatic, Biuret, endpoint
colorimetric, colorimetric, Trinder,
Trinder, Endpoint Endpoint

Specimens that Serum, Serum, heparinized Serum,

can be used Heparinized plasma heparinized
plasma, Urine plasma
Standard 6 mg/dl (357 200 mg/dl (2.26 6 g/dl; 60 g/l
concentration umol/L) mmol/L)
Indicator enzyme Peroxidase peroxidase none

Path length 1 cm 1 cm
1 cm
Wavelength used 546nm 505 nm 546nm

Linear range 0.5-25 mg/dl (30- 30-1000 mg/dl (0.34- 0.20-12.0 g/dl
1487 umol/L) 1.3 mmol/L) (2.0-120 g/l)

Limit of detection 0.2 mg.dl (12 30 mg/dl (0.34 mmol/l) 0.03 g/dl (0.3 g/l)
umol/L)

Product quinoneimine quinoneimine Protein-copper

 2

measured biuret complexes

Color endpoint Pink to red purple
Pink to red
Chromogen used 4-AAP Biuret reagent
Amino-4-
antipyrine (4-
AAP)
Type of blank Reagent blank Reagent blank
used Reagent blank
Give 5 reagents Pipes buffer – Potassium iodide
used & their Phosphate buffer maintain the pH of 7.0 – keeps divalent
specific uses – maintain pH of copper form
7.0

4-AAP - chromogen Potassium

4-AAP - sodium tartrate –
chromogen stabilizes copper
salt
GPO (glycerol-3- Copper sulfate –
Uricase – convert phosphate oxidase) – provides copper
UA to H2O2 convert glycerol-3- ions
phosphate to H2O2

Peroxidase – NaOH - alkalinity

Peroxidase – produce
produce quinoneimine
quinoneimine product
product

Sodium azide- Sodium azide-

Sodium azide- preservative preservative
preservative

Preservative used 0.5% Sodium 0.1% sodium azide 0.1% sodium

for reagents & azide azide
standard
Incubation 37degC 37degC 37degC
temperature
Interfering Bilirubin, Bilirubin, Bilirubin,
substances hemoglobin, hemoglobin, glucose, hemoglobin,
glucose, ascorbic ascorbic acid, glucose, ascorbic
acid, methyl- methyl-dopa, and acid, dextran,
dopa, calcium triglycerides and triglycerides
dobesilate, and
triglycerides
Conversion factor 0.0113 10
59.48 or 0.059
Normal values in <150 mg/dl Ambulatory pts:
conventional Serum,plasma: 6.4-8.3 g/dl
units males 3.5-7.2
mg/dl Patients at rest:
Females: 2.6-6.0 6.0-7.8 g/dl
mg/dl

Normal values in Males 208-428 <1.69 mmol/L Ambulatory pts:

SI units umol/l 64-83 g/l
 3

Females 155-357
umol/l Patients at rest:
60-78 g/l

Associated Gout, Lesch- Atherosclerosis, Edema,

diseases Nyhan syndrome, hyperlipoproteinemia, dehydration due
leukemia, apo CII deficiency, to vomiting,
psoriasis, renal diabetes, renal and protein
failure, Fanconi endocrine disorders insufficiency,
syndrome, renal and hepatic
Hodgkin’s diseases,
disease multiple myeloma
and infection
among others

III. MEASUREMENT OF NITROGENOUS SUBSTANCES. Calculate the concentration of the

following nitrogenous substances using the given absorbance values and other data. Fill in
the blanks with the correct information that pertains to each substance. (30 points)

A) Serum Albumin Measurement (BCG Method)

Absorbance values: TEST …………………………..…….0.90
STANDARD ………………………1.75
Concentration of Albumin Standard: 5 g/dL

Concentration of Albumin in g/dL: _____2.57_____

Concentration of Albumin in g/L: _____25.7_____
Interpretation of the result below normal or decreased
Cite two (2) diseases associated with this lab result salt retention
syndrome & water
intoxication (dehydration
& vomiting are WRONG)

B) Uric Acid Determination (Enzymatic Method)

Absorbance values: TEST ………………..…….0.60
STANDARD………………………….0.85
Concentration of Uric Acid Standard: 6 mg/dL
Wavelength used in nm: ___500-550 nm_
Conversion factor for Uric Acid from mg/dL to mmol/L: ____0.059_____
Concentration of Uric Acid in mg/dL: ___4.24_______
Concentration of Uric Acid in mmol/L: ___0.25_______
Interpretation of the result ____normal____

C) Creatinine Determination (Jaffe Reaction)

Absorbance values: TEST ………………..…….0.78
STANDARD………………………….0.85
Concentration of Creatinine Standard: 2 mg/dL

Wavelength used in nm: ____492nm____

Conversion factor for Creatinine from mg/dL to µmol/L: _____88.4_____
Concentration of Creatinine in mg/dL: _____1.84_____
 4

Concentration of Creatinine in µmol/L: _____162____

Interpretation of the result ____normal____

GOOD LUCK!
AY 2223 MLS 043 LAB Formative Test 7
on Carbs & PFF
Total points 10/15

Answer the following questions correctly. This is an individual  formative assessment.

Email *

frpe.lopez.swu@phinmaed.com

Compare the normal blood glucose level for newborns and adults. *

According to age-related variations in blood glucose levels, newborn newborns have lower
blood sugar levels than older children and adults. Blood glucose levels in newborn newborns
normally range between 2.5 mmol/l (45 mg/dl) and 7.0 mmol/l (126 mg/dl). Blood glucose
levels in adults without diabetes should be between 90 and 110 mg/dL two hours after
eating.

Correct answer

The mean blood glucose level for neonates is 35 mg/dL. Glucose is lower in newborns
because of the small glycogen reserve in the liver.
What is the purpose of the D-xylose absorption test? *

The D-xylose absorption test determines the concentration of D-xylose, a form of sugar, in a
blood or urine sample. This test is performed to assist in the diagnosis of disorders that
impede the small intestine from absorbing nutrients from meals.

Correct answer

It differentiates malabsorption of intestinal origin from malabsorption due to pancreatic

insufficiency. D-xylose is a pentose sugar that is absorbed in the small intestines without
the action of pancreatic enzymes. Following oral administration of D-xylose, blood or urine
(collected over a 5 hour period) is obtained. Low levels of xylose a re suggestive of an
absorptive defect in the jejunum.

Full name (Family Name, Given Names, MI) *

Lopez, Francis Clair P.

What are "critical values" for glucose? *

Each laboratory determines its own essential limits, however 40 mg/dL or 4g/L and >600
mg/dL >60g/L are common.

Correct answer

Each laboratory establishes its own critical levels, but <40 mg/dL and >600 mg/dL are
often used. When a critical value is obtained and verified, the physician or other
appropriate healthcare professional must be notified immediately so that therapy can be
initiated.
What is the clinical significance of an elevated glycated hemoglobin (hemoglobin *
A1c)?

Indicates poor glucose control for 6 to 8 weeks.

Correct answer

It indicates poor glucose control overt the past 6-8 weeks. Values >=12% are typical of
poor diabetic control. The therapeutic goal is less than 6.5%.

What is microalbuminuria? *

Microalbuminuria is characterized by a little increase in the quantity of a protein known as

albumin in your urine when compared to normal. It might be an early indicator of renal
disease, which is frequently a consequence of diabetes and other illnesses.

Correct answer

Excretion of urinary albumin at a rate of 20-200 ug/minute or 30-300 mg/24 hours. These
low levels are below the sensitivity of routine urine screening methods. Microalbuminuria
is highly predictive of diabetic nephropathy in type 1 diabetes. Early detection and tight
glycemic control retard progression to nephropathy. Detection is by an immunochemical
measurement of the albumin excretion rate on a 24-hour urine specimen using antibodies
to human albumin.

The protein precipitant uses 2.3N sulfuric acid and a metallic salt are used in:  *0/1
        

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

 Both Folin Wu & Somogyi Nelson

Neither the two methods

Correct answer

Neither the two methods

How do glucose levels differ in venous nd capillary specimens? *

Glucose levels in capillary specimens are somewhat greater than in venous specimens.

Correct answer

Following ingestion of sugar, glucose levels are a little higher in capillary blood. In a
fasting specimen, values are the same.

  The method that ensures the removal of non-glucose reducing substances *0/1
is:                                                                                                                                      

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

Correct answer

Somogyi-Nelson

Which method 
uses whole blood as sample? * 1/1

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

This method uses sodium tungstate, 10% solution.  * 1/1

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

What is the purpose of the lactose tolerance test? *

Lactose tolerance tests show how efficiently your intestines can absorb the sugar lactose.

Correct answer

It aids in the diagnosis of lactase deficiency. Lactase is the enzyme that cleaves lactose
into glucose and galactos. Following ingestion of milk or milk products, affected
individuals experience cramps and diarrhea as lactose in the intestines is metabolized by
bacteria. In the lactose tolerance test, glucose is measured in the blood following oral
administration of lactose. An increase in glucose of less than 20 mg/dL indicates that
lactose was not broken down and absorbed. It has been shown that the most reliable
method of determining lactose absorption is the measurement of the amount of hydrogen
in exhaled breath after the oral administration of lactose. Levels are above normal with
lactase deficiency because hydrogen is one of the by-products of bacterial metabolism of
lactose. The definitive diagnosis of lactase deficiency is made by tissue enzyme assays
on biopsies of the intestinal mucosa.

   In this test, the proteins in the sample are precipitated using metallic salt.        *1/1
                                                                      

Folin-Wu
 Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

The original procedure will produce 15 mL total volume. It is: * ···/1

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

No correct answers

Define glycolysis, glycogenesis, glycogenolysis, and gluconeogenesis. *

Glycolysis: The conversion of a glucose molecule to pyruvate or lactate for energy

production. Glycogenesis: The conversion of glucose to glycogen for storage.
Glycogenolysis: The breakdown of glycogen to glucose for energy production.
Gluconeogenesis: The formation of glucose-6-phosphate from noncarbohydrate sources.

Correct answers

Glycolysis - conversion of glucose to pyruvic acid or lactic acid

Glycogenesis - production of glycogen form glucose

Glycogenolysis - production of glucose from glycogen

Gluconeogenesis - production of glucose from non-carbohydrate sources

Feedback

Glycolysis - conversion of glucose to pyruvic acid or lactic acid

Glycogenesis - production of glycogen form glucose

Glycogenolysis - production of glucose from glycogen

Gluconeogenesis - production of glucose from non-carbohydrate sources

What reagent is used to detect ketones? *

Sodium Nitroprusside

Correct answer

Sodium nitroprusside.

A specimen for a fasting glucose is drawn in a tube without anticoagulant at 5 *

AM in a nursing home. It is placed in a rack for pickup by the courier. The sample
is picked up at 9 AM, delivered to the lab at 10:30 AM, and analyzed at 11:30 AM.
Will the results be adversely affected by the handling of the specimen?

Yes, if the specimen is not received on time, the findings will degrade. To avoid a reduction
in glucose due to glycolysis, serum should be withdrawn from cells within 1 hour of
collection. If the testing is postponed, a preservative such as sodium fluoride or lithium
iodoacetate is utilized.

Correct answer

Yes. Serum should be removed from cells within 1 hour of collection to prevent a
decrease in glucose due to glycolysis. A preservative such as sodium fluoride or lithium
iodoacetate should be used when testing will be delayed. Other options are to centrifuge
the blood and remove the serum or to use serum-separator tubes. With serum-separator
tubes, following centrifugation, the gel forms a barrier between the cells and the serum,
preventing glycolysis.

What is glucosuria? *

It implies that glucose is present in the urine. This situation develops when the glomerulus
filters more glucose than the proximal tubule can absorb.

Correct answer
 Glucose in urine. Glycosuria is a more general term, referring to the presence of any sugar
in the urine.

What should be done when a patient scheduled for an OGTT has a fasting *
glucose of 150 mg/dL?

When a patient is scheduled for an Oral Glucose Tolerance Test (OGTT) and the predicted
result is much higher than the usual range. Normal, impaired, or abnormal results are
possible. The OGTT test should be rescheduled.

Correct answer

The physician or pathologist should be consulted. Since the patient's glucose is already
elevated, he/she should not be given a glucose load. If confirmed on another occasion, a
fasting glucose of 150 mg/dL is sufficient for a diagnosis of diabetes mellitus. An oral
glucose tolerance test is not required.

What is the most common method for glycated hemoglobin (hemoglobin A1c) in *
the U.S.?

Affinity Chromatography

Correct answer

Affinity chromatography. Glycated hemoglobin binds to the column; nonglycated

hemoglobin does not. The absorbances of the bound and unbound fractions are
measured at 415 nm. HPLC is the reference method for glycated hemoglobin.

This test is  applicable for anticoagulated blood.     * 1/1

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

What is the reference range for a fasting glucose in an adult? *

Normal fasting blood glucose concentrations are estimated to be between 70 mg/dL (3.9
mmol/L) and 100 mg/dL (5.6 mmol/L).

Correct answer

70-110 mg/dL

What are the criteria of the American Diabetes Association for the diagnosis of *
diabetes mellitus?

Any of the following on two occasions: a random plasma glucose more than or equal to
200mg/dl, a fasting plasma glucose greater than or equal to 126 mg/dl, or one oral glucose
tolerance test (OGTT) greater than or equal to 200mg/dl.

Correct answer

Any of the following on two (2) occasions: a random plasma glucose of >=200mg/dL, a
fasting plasma glucose of >=126 mg/dL, or one oral glucose tolerance test (OGTT) value
of >=200 mg/dL. The values were recently lowered so that diagnosis could be made
earlier. It is thought that earlier treatment will reduce the risk of diabetic complications.

Why is the 5 hour oral glucose tolerance test no longer recommended for the *
diagnosis of hypoglycemia?

The oral glucose tolerance test has been utilized in a variety of clinical settings. In this
procedure, your blood is drawn at a fasting baseline and you are given a measured amount
of glucose to consume. Following that, blood samples will be taken at regular intervals for
the following 5 hours. As a result, the test should never be used to identify whether or not
someone has hypoglycemia.

Correct answer

Because at least 10% of healthy individuals have glucose levels below 50 mg/dL during
 Because at least 10% of healthy individuals have glucose levels below 50 mg/dL during
this procedure. Hypoglycemia is recognized by the presence of Whipple's triad: plasma
glucose less than 40 mg/dL, symptoms of hypoglycemia (nervousness, anxiety,
neurologic abnormalities), and relief of symptoms by administration of glucose.

What is glycated hemoglobin? *

When glucose attaches to hemoglobin, compounds known as glycohemoglobin are

generated. And arise in proportion to serum glucose levels.

Correct answer

Hemoglobin A with glucose attached to the beta chains (hemoglobin A1). It is comprised
of hemoglobin A1a, A1b, and A1c. Hemoglobin A1c is the largest fraction. Some
procedures to measure total glycated hemoglobin while others measure only hemoglobin
A1c. Other names used are glycohemoglobin, glycosylated hemoglobin, and fast
hemoglobin. Glycated hemoglobin is a useful indicator of long-term glucose control.

What are the most common causes of hypoglycemia? *

Alcohol consumption, increasing physical activity without eating enough, using too much
insulin or diabetes medicine, not eating enough, postponing or skipping a meal or snack

Correct answer

Inappropriate insulin production, insulin injection, or ingestion of oral hypoglycemic

agents.

What is the end product of anaerobic glycolysis? *

Lactic acid or lactate

Correct answer

Lactic acid
  The precipitation of hemoglobin requires vigorous shaking of the blood- *1/1
reagent mixture in this test:                                                                             

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

How does the oral glucose tolerance test differ for a pregnant woman? *

A 100g glucose load is used, and fasting, 1 hour, 2 hour, and 3 hour specimens are obtained.

Correct answer

The glucose load is 100 grams and a fasting, 1-hour, 2-hour, and 3-hour specimen are
drawn. Gestational diabetes is diagnosed by two or more of the following venous plasma
glucose values: fasting >=105 mg/dL, 1-hour >=190 mg/dL, 2-hour >=165 mg/dL, and 3-
hour >=145 mg/dL.

The better method for PFF is _________ because the 0.3N alkali used adsorbs *1/1
interfering substances.                                                                                           

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

Neither the two

Name two (2) enzymatic methods for glucose determinations. *

Glucose Oxidase (GOD) Coupled Reaction, Polarographic GOD Method

Correct answer

Glucose oxidase and hexokinase. Glucose oxidase catalyzes the conversion of glucose to
hydrogen peroxide and gluconic acid. The second step of the reaction is a peroxidase
reaction, which is much less specific than the glucose oxidase reaction. Hexokinase
catalyzes the phosphorylation of glucose to glucose-6-phosphate, which is the oxidized by
G-6-PD in the presence of NADP. The hexokinase method is more specific than the
glucose oxidase reaction.

The total volume produced is such that the volume of sample is 10% of the *1/1
total  volume in:                                              

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

What is hyperglycemia? *

High blood glucose levels are referred to as hyperglycemia (blood sugar). High blood sugar
occurs when the body has insufficient insulin or when the body is unable to effectively
utilise insulin.

Correct answer

High blood sugar. It is most often due to diabetes mellitus.

Why is the glycated hemoglobin test invalid in a patient with hemoglobin S or C? *

Hemoglobin C is an oxygen-carrying protein found in red blood cells. Meanwhile,

Hemoglobin S results in stiff and irregularly shaped Red Blood Cells. Moderate quantities
suggest sickle cell trait, whereas excessive amounts imply sickle cell illness. Low levels
suggest hemoglobin C trait, whereas high levels indicate hemoglobin C illness. Because red
blood cells have a shorter life lifetime, both would render the glycated hemoglobin test
invalid.

Correct answer

Because of the shortened life span of the RBCs.

A patient has a FBS of 110 mg/dL and a glycated hemoglobin (hemoglobin A1c) *
of 12%. What do these results indicate?

According to the results, the patient has great short-term glucose control but poor long-term
glucose control

Correct answer

Good short-term control, but poor long-term control.

  This method requires the use of a serum sample.                           * 1/1

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

What happens when glucose levels drop below 20-30 mg/dL? *

If your glucose levels go below 20-30 mg/dL, you may lose consciousness and have
seizures. If you are experiencing symptoms of low glucose levels, you should seek medical
assistance right once.

Correct answer

Central nervous system dysfunction.

What is the clinical significance of fructosamine levels? *

Fructosamine levels are used to monitor short term glucose control (2-3 weeks).

Correct answer

Fructosamine is a glycated protein that can be used to determine glycemic control over
the past 2-3 weeks. The assay can be automated and is more precise and less expensive
than glycated hemoglobin but there is currently no consensus on its clinical value.

   The procedure removes serum proteins via alkaline adsorbing agent, the *1/1
barium hydroxide.      

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

This test will, after addition of barium hydroxide, produces a brown mixture.      *···/1
                                                                

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

No correct answers

How is gestational diabetes diagnosed? *

When the symptoms of insulin resistance are clinically apparent, gestational diabetes is
generally diagnosed between the 24th and 28th week of pregnancy. The diagnostic test is a
3-hour OGTT with a 100g glucose load, which requires an overnight fast. GDM is diagnosed
when plasma glucose levels are at or above the threshold value (140 mg/dl) in two or more
samples.

Correct answer

The screening test is the O'Sullivan test. The woman is given a 50-gram load of glucose. A
1-hour plasma glucose >=140 mg/dL is abnormal and carries a risk of fetal death or
neonatal complications - macrosomia, hypolycemia, hypocalcemia, polycythemia, and
hyperbilirubinemia. Some women with gestational diabetes develop type 2 diabetes years
later.
Name five (5) hormones that regulate glucose levels and tell whether each raises *
or lowers the level.

Glucagon – Increases blood glucose level Insulin – Lowers blood glucose level Growth
Hormone – Increases blood glucose level Cortisol – Increases blood glucose level
Epinephrine – Increases blood glucose level

Correct answers

Insulin - lowers glucose

Glucagon, cortisol, epinephrine, and growth hormone all increase it, with glucagon having
the greatest effect

Which sugar accounts for nearly all blood sugar and is the body's major source of *
cellular energy?

Blood sugar is the most common kind of sugar present in the body. It is the body's primary
source of energy and is obtained from the food we consume. Furthermore, a steady
concentration of blood sugar in blood plasma of 60 to 100 mg/dL is essential to maintain
the body functioning correctly

Correct answer

Glucose

 The total volume produced is 20 milliliters in:                             * 1/1

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

 gy

Section, Group No. & Group name *

3A1 - GROUP 5 - Medical Rangers

A 60-year-old diabetic has a blood glucose of 210 mg/dL. His urine glucose is *
negative. Assuming there are no substances in his urine to inhibit the glucose
reaction, what might account for the apparent discrepancy in these test results?

As the urine glucose test cannot differentiate between the two. A negative urine glucose
test can indicate either normal blood glucose levels or dangerously low blood glucose
levels.

Correct answer

Diabetics may develop elevated renal thresholds. That is why urine testing is not a good
screening test for diabetes mellitus.

What patient preparation is required for an oral glucose tolerance test (OGTT)? *

To obtain an accurate result, the patient must ingest 150 grams of carbohydrates per day for
three days prior to the OGTT, and they must refrain from eating or drinking anything other
than water after 10 p.m. the night before.

Correct answer

An overnight fast. A fasting specimen is drawn and the patient is given a glucose load (75
grams for an adult, 1.75 grams/kg body weight for a child, and 100 grams for a pregnant
woman). The 3-hour OGTT is falling out of favor because of its poor reproducibility and
the inconvenience to the patient. New guidelines from the American Diabetes Association
recommend a baseline and 2-hour specimen only except during pregnancy.
Email address *

frpe.lopez.swu@phinmaed.com

Define renal threshold. *

The renal threshold is the concentration of a drug dissolved in blood that causes the kidneys
to begin removing it into the urine.

Correct answer

The blood concentration of a substance that can be reabsorbed by the renal tubules. For
glucose, the average renal threshold is 160-180 mg/dL. When the blood level exceeds this
amount, glucose is excreted in the urine.

What specimen is required for glycated hemoglobin (hemoglobin A1c)? *

EDTA Whole blood sample

Correct answer

Whole blood. Fasting is not required.

When are ketones present in the blood? *

When there is defective carbohydrate metabolism with fatty acid breakdown, such as
uncontrolled diabetes, hunger, vomiting, or a low carbohydrate diet.

Correct answer

Whenever there is impaired carbohydrate metabolism with breakdown of fatty acids, such
as uncontrolled diabetes mellitus, starvation, vomiting, or low carbohydrate diet. The
ketones are acetone, acetoacetic acid (diacetic acid), and beta-hydroxybutyric acid. High
levels lead to metabolic acidosis (ketoacidosis).
Compare & Contrast regarding the two methods of PFF preparation (14 points) *
FOLIN-WU METHOD & SOMOGYI-NELSON METHOD according to the following:  
 1) Protein Precipitants used (NOTE: Write the correct concentration and name of
the chemicals); 2) Sample required (NOTE: Write the type of specimen and
volume used); and 3) Color of the Residue formed.

METHOD OF FOLIN-WU

1. Protein precipitants included 10% sodium tungstate and 2/3N sulfuric acid.

2. 1 mL of whole blood is required as a sample.

3. The generated residue is a phosphomolybdenum blue complex.

METHOD OF SOMOGYI-NELSON

1. Protein precipitants included 5% zinc sulfate and 0.3N barium hydroxide.

2. 1 mL of serum is required as a sample.

3. The color of the generated residue is arsenomolybdenum blue.

Feedback

FOLIN-WU protein precipitants are sodium tungstate and sulfuric acid, 1ml whole blood
sample is required and brown residue while SOMOGYI-NELSON protein pptants include
zinc sulfate and barium hydroxide, 1ml serum sample is used and white residue is formed.

Which test is recommended by the American Diabetes Association for screening *

for diabetes, except during pregnancy?

Fasting plasma glucose is the American Diabetes Association recommends for screen of
diabetes. In addition, repeat testing on the following day is recommended to confirm the
results.

Correct answer

A fasting plasma glucose.

A diabetic patient who performs home monitoring of his glucose is ordered by his *
physician to be tested by the local hospital laboratory. The patient is suspicious
of the quality of care he receives from his HMO, so immediately before going to
the lab to have his blood drawn, he tests it himself. His result is 128 mg/dL. The
laboratory result is 150 mg/dL. Assuming that both testes were performed
correctly and that controls were within the acceptable range, what might account
for the discrepancy in values?

The specimen used determines the difference in values depending on the kind of test done.
Capillary blood is used in home testing, whereas venous blood is used in laboratory testing.
The glucose concentrations in random and fasting samples differ as well, with venous
plasma being higher than capillary blood.

Correct answer

Home testing uses capillary whole blood; laboratory methods use venous plasma or
serum. Whole blood glucose is 10-15% lower than plasma glucose. In additiion, different
methodologies are used.

Compare type 1 and type 2 diabetes mellitus. *

Type 1 diabetes most commonly affects children and adolescents, although it can also
affect adults. The immune system destroys pancreatic beta cells, causing them to stop
producing insulin. Type 1 diabetes cannot be prevented, and it is typically inherited. While
Type 2 diabetes is more likely to occur as individuals get older, many youngsters are
increasingly developing it. The pancreas makes insulin, but the body is unable to utilise it
efficiently. It appears that lifestyle variables have a role in its development.

Correct answers

Type 1 DM: Formerly known as Juvenile onset diabetes or Insulin dependent diabetes
mellitus (IDDM). CAUSES: Pancreatic beta cell destruction, absence of insulin,
autoimmune antibodies to insulin and islet cells, genetic predisposition (HLA DR 3/4).
CHARACTERISTICS: Onset usually below age 40, dependency on injected insulin, prone to
ketoacidosis and diabetic complications.
 Type 2 DM: Formerly known as Adult onset diabetes or Non-insulin dependent diabetes
mellitus (NIDDM). CAUSES: Underproduction of insulin or insulin resistance, associated
with obesity. CHARACTERISTICS: Most common type, onset usually after age 40, not
dependent on exogenous insulin, not prone to ketoacidosis.

This method requires freezing after proteins have been removed when testing *0/1
is delayed.   

Folin-Wu

Somogyi-Nelson

Both Folin-Wu & Somogyi-Nelson

Correct answer

Both Folin-Wu & Somogyi-Nelson

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 Clinical Chemistry Review - Lipids Upgrade
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Clinical Chemistry Review - Lipids

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Term
Definition 1 / 28

Triglyceride is made of one molecule of

Discuss the structure of triglycerides.
glycerol and 3 molecules of fatty acid.

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Terms in this set (28)
Clinical Chemistry Review - Lipids Study

Lipids are insoluble in water and soluble in organic

Desribe the solubility
solvents. In blood, lipids are soluble due to their
properties of lipids.
combination with protein (lipoproteins).

What is the main form of lipid Triglycerides in adipose tissue.

storage in the body?

Name two substances that play Lipase and bile salts.

a role in the digestion of lipids.

Why is it recommended that a Values are higher when standing.

patient be seated for 5 min
prior to drawing blood for
cholesterol?

What is the major site of The liver.

cholesterol synthesis?

Which lipoprotein transports Low density lipoprotein (LDL).

most cholesterol?

What is the National Less than 200 mg/dL. Higher levels are a risk factor
Cholesterol Education Project's for coronary heart disease (CHD). Borderline high is
(NCEP) recommended 200-239 mg/dL and above.
desirable leve
level for total
cholesterol for adults?
Clinical Chemistry Review Serum
- Lipids
or EDTA plasma. When EDTA is used, plasma
Study
should be cooled 2-4 immediately. Cholesterol
measurements made on EDTA plasma require
What specimen is required for correction by the factor of 1.03. Samples do not
total cholesterol? have to be fasting unless triglycerides or LDL
cholesterol will also be measured on the same
specimen.

What is the mosts common Enzymatic using cholesterol esterase and

method for cholesterol? cholesterol oxidase.

What is the relationship Inverse-the higher the HDL cholesterol, the lower
between HDL cholesterol the risk of coronary artery disease. HDL-C less than
(HDL-C) and risk of coronary 40mg/dL is a major risk factor for CHD. Values of
artery disease? 60mg/dL are protective

LDL and VLDL are precipitated chemically and the

cholesterol remaining in the superanatant is
How is HDL cholesterol
measured. Direct methods that do not require
measured?
precipitation are also available and are expected to
replace the older precipitation methods.

What is the desirable leve

level for greater than or equal to 40mg/dL
HDL cholesterol?

Elevated LDL-C is recognized as a major cause of

CHD. The Adult treatment Panel III (ATPIII), issued in
What is the desirable leve
level for 2001, identifies the optimal level of LDL-C as less
LDL cholesterol? than 100 mg/dL. It further identifies borderline high
as 130-159 mg/dL, high as 160-189 mg/dL, and very
high as 190 mg/dL or above.
Clinical Chemistry Review It- can
Lipids
be calculated by the Friedeald formula:Study
How is LDL cholesterol
determined?
Calculate the LDL cholesterol
and assess the patient's risk for
coronary artery disease if the
total cholesterol is 240 mg/dL,
the HDL cholesterol is 64
mg/dL, and the triglycerides
are 310 mg/dL.
Discuss the structure of
triglycerides.
What are exogenous
triglycerides?
What is usually measured in
triglyceride assays?
LDL
cholesterol = Total Cholesterol - HDL cholesterol -
(Triglycerides/5). Triglycerides divided by 5 is an
estimate of VLDL cholesterol. The formula is not
valid if triglycerides are greater than 400 mg/dL.
The disadvantage to the calculated LDL cholesterol
is that it is dependent on the accuracy of two other
determinations. Several methods for direct
measurements of LDL cholesterol are now available
and are recommended for improved precision and
accuracy.
114 mg/dL.
Both the total cholesterol and the LDL cholesterol
are above the desirable limit but the HDL
cholesterol is in the desirable leve
level. Other risk
factors such as age, sex, family history, high blood
pressure, diabetes mellitus, and smoking should be
taken into account to assess teh patient's overall
risk. It would also be important to ascertain if the
specimen was fasting. The elevated triglycerides
could be due to a recent meal.
Triglyceride is made of one molecule of glycerol
and 3 molecules of fatty acid.
Triglycerides from the diet. They are carried by the
chylomicrons. Endogenous triglycerides are
synthesized in the body.
Glycerol, following cleavage of fatty acids by
lipases and proteases.
Clinical Chemistry Review Triglycerides
- Lipids are now recognized as an
What is the desirable leve
level of
triglycerides?
What are chylomicrons?
What tests should be included
in a lipoprotein panel?
Name the four classes of
lipoproteins and the major lipid
carried by each.
What specimen is required for
a lipid profile?
Discuss patient preparation for
a lipoprotein profile.
Study
independent risk factor for CHD. ATPIII classifies
serum triglycerides as follows:
N - less than 150mg/dL
Borderline high 150-199 mg/dL
High 200-499 mg/dL
Very High 500 mg/dL
The largest of the lipoproteins. They transport
exogenous triglycerides and account for the
turbidity of serum following a meal.
Total cholesterol, LDL cholesterol, HDL cholesterol,
and triglycerides. All adults over 20 years of age
should be tested every 5 years.
By utltracentrifugation - Major lipid
Chylomicron - triglycerides (exogenous)
VLDL - triglycerides (endogenous)
LDL - cholesterol
HDL - Phospholipids
Serum collected after a 10-12 hr fast.
The patient should be in metabolic steady state and
should maintain usual diet and weight for 2 weeks
prior to blood collection. The patient should not
exercise vigorously for 24h before the blood is
drawn. The patient should be fasting and should
remain seated for 5 minutes being drawn.
Clinical
What causesChemistry
a cream-layer onReview High
- Lipids
levels of triglycerides or chylomicrons. Study
top of plasma after overnight
refrigeration?

What might lead you to Lipemia or a chylomicron band on lipoprotein

suspect the specimen was non- electrophoresis.
fasting?

A specimen for a lipid profile A non-fasting specimen. Recent ingestion of fast

had elevated triglycerides but will elevate triglycerides but no total cholesterol.
normal total cholesterol. What The tests should be repeated on a fasting specimen.
is the most likely cause?

Their ratio is used to assess fetal lung maturity. A

What is the significance of the mature fetus greater than 2.0. The L/S ratio is
L/S ratio in amniotic fluid? determined by thin layer chromatography. Lecithin
and sphingomyelin are phospholipids.
 Clinical Chemistry Review - Proteins Upgrade
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Clinical Chemistry Review - Proteins

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Definition
Term 1 / 50

Protein. The reference rage is 6-8g/dL. Most

What is the most concentrated solute of the
other chemistry analytes are measured in
blood?
mg/dL.

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Terms in this set (50)
Clinical Chemistry Review - Proteins Study

What is the most concentrated Protein. The reference rage is 6-8g/dL. Most other
solute of the blood? chemistry analytes are measured in mg/dL.

Which element is found in Nitrogen. The protein molecule is 16% nitrogen.

proteins but not in
carbohydrates or lipids.

Where are most proteins In the liver.

synthesized?

What is the waste product of Urea. It is excreted in the urine.

protein catabolism?

Heat, pH, enzymes,, and UV light all can disrupt the

What causes denaturation of
molecular structure of protein, resulting in loss of
protein?
function.

Why should repeated freezing Repeated freezing and thawing may cause proteins
and thawing of a specimen be to deteriorate.
avoided?

What is the most common The biuret method. Cuprous ions react with peptide
method for measuring serum bonds at an alkaline pH to produce a colored
total protein? complex

Why is the biuret method of It is not sensitive enough for the small amount of
protein analysis not suitable for protein in the urine. Trichloracetic acid can be used
urine or CSF protein? to precipitate protein in urine and CSF.

How would hemolysis affect Hemoglobin in the serum would increase the
the serum total protein level? protein level.
Clinical Chemistry
What does low total protein Review Edema.
- Proteins
cause in the patient?
What is the main physiological
function of albumin?
What are the most common
dyes for the direct analysis of
albumin?
What happens to total protein
and albumin levels in the
nephrotic syndrome?
How is the concentration of
globulins determined in a
chemistry profile?
What is the normal A:G ratio?
Calculate the A:G ratio for
patient whose total protein is
9.2 g/dL and whose albumin is
4.2 g/dL.
Water leaves the blood vessels and goes
Study
into the tissues.
It maintains the osmotic pressure and the
distribution of water in the body. When albumin is
low, edema results. Albumin also has an important
role in binding and transporting various substances
in the blood such as bilirubin and some drugs.
Bromcresol green (BCG) and bromcresol purple
(BCP).
They decrease due to loss through the urine.
By subtracting albumin from total protein
1-1.8 a reversed A:G ratio is seen with monoclonal
gammopathies and other increases in globulin
fraction.
0.84 - Globulins are determined by subtracting the
albumin from the total protein (9.2-4.2 = 5.0) A:G
ratio is determined by dividing albumin by globulin
(4.2/5.0 = 0.84) The normal ratio is 1.0-1.8 This patient
has a reversed ratio, indicating increased globulins,
possibly due to gammopathy.
Clinical Chemistry Review The
- Proteins
property of proteins to assume a positive Study
and
negative or neutral charge, depending on the pH of
What is amphoterism? the medium. With serum protein electrophoresis at
pH 8.6, proteins carry a negative charge.

In the body, what charge do At pH 7.4 proteins are negatively charged (anions)
most proteins carry?

When an electric current is applied to a medium

containing charged particles, the particles will
migrate to the pole of the opposite charge.
Negatively charged particles (anions) will migrate
toward the positively charged pole (anode) and
Explain the principle of serum
positively charged particles (cations) will migrate
protein electrophoresis (SPE).
toward the negatively charged pole (cathode). The
rate of migration depends on the net charge of the
particle, the size and shape of the molecule the
strength of the electric field, the properties of the
support medium, and the temperature.

Cellulose acetate or agarose are used to separate

What support media are used
proteins on the basis of molecular charge. Starch
for serum protein
and polyacrylamide gel can be used to separate
electrophoresis?
proteins based on both size and charge.

The flow of buffer toward the cathode due to the

negative surface charge present on the medium. On
What is electroendosmosis?
cellulose acetate, this results in gamma globulins
being swept toward the cathode.
Clinical Chemistry Review At
Describe a normal serum
- Proteins
pH 8.6, proteins are negatively charged andStudy
migrate toward the anode in the following order:
protein electrophoretic pattern
albumin, alpha-1 globulin, alpha-2 globulin, beta
on cellulose acetate at pH 8.6.
globulin, and gamma globulin.

Albumin 53-65%

What are the normal Alpha-1 globulin 2.5-5%

percentages of the five protein Alpha-2 globulin 7-13%

fractions? Beta globulin 8-14%

Gamma globulin 12-22%

What is the significance of a It means that the specimen was plasma, not serum.
sixth band migrating between The extra band is due to fibrinogen.
beta and gamma on serum
protein electrophoresis?

Amido black and Ponceau S were popular in the

What stains are used in serum
past. Coomassie brilliant blue (CBB) is more widely
protein electrophoresis?
used today because it is more sensitive.

What is the name of the A densitometer.

instrument used to quantitate
protein fractions following
serum protein electrophoresis?

Which protein fraction Albumin

normally accounts for over half
of the serum total protein?

In electrophoresis serum at pH Albumin

8.6, which fraction is the fastest
moving?
Clinical
What causesChemistry
increased Review Dehydration
- Proteins Study
Albumin?

What causes decreased alpha- Alpha-1 antitrypsin deficiency. This is seen in

1 globulin? emphysema.

What causes a decreased Hypogammaglobulinemia

gamma globulin fraction?

Describe the acute phase Alpha-1 and alpha-2 globulins are increased.
reactant or inflammatory
pattern.

Describe the chronic response Albumin is decreased and alpha-1, alpha-2, and
pattern. gamma globulins are increased.

There is no valley between the beta and gamma

Describe beta-gamma
globulin regions on SPE because of increased IgA.
bridging.
Beta-gamma bridging is seen in cirrhosis.

Describe polyclonal A diffuse increase in the gamma region.

gammopathy.

Describe the electrophoretic Albumin is decreased an alpha-2 is increased.

pattern seen in the nephrotic
syndrome.
Clinical Chemistry Review A- sharp
Proteins
peak in the gamma region due to an Study
increase in one immunoglobulin. It is known as an M
spike. Because of its association with malignancy,
What is a monoclonal
such as multiple myeloma and Waldenstrom's
gammopathy?
macroglobulinemia. THe name should not be
misinterpreted to mean that the increased
immunoglobulin is IgM.

What causes the An increase in one of the immunoglobulins, most

hyperproteinnemia seen in often IgG.
multiple myeloma?

Which immunoglobulin is IgM.

increased in Waldenstrom's
macroglobulinemia?

A patient has a monoclonal Immunofixation has replace immunoelectrophoresis

gammopathy on serum protein as the method for identifying immunoglobulins.
electrophoresis. What test can
be done to determine which
immunoglobulin is increased?

Specimens are placed on separate tracks in an

agarose gel or on cellulose acetate strips. The
proteins are separated by electrophoresis. One
track is treated with a fixative that fixes all proteins,
Explain the imm
immunofixation creating a reference pattern. The other tracks are
procedure. treated with monospecific antisera to IgG, IgM, IgA,
and kappa and lambda. Unprecipitated proteins are
washed away and the remaining proteins are
stained. The locations of the stained proteins are
compared to the reference pattern.
Clinical Chemistry Review IgG,
- Proteins
IgA, and IgM are quantitated by nephelometry
Study
and turbidimetry. These methods are preferred to

How are immunoglobulins RID and RIA because of their ease, speed, and

quantitated? precision. EIA or RIA is required for the quantitation

of IgD and IgE because of their lower
concentrations.

What must be done to the Urine and CSF must be concentrated because of
specimen prior to performing their low protein content.
CSF, or urine electrophoresis?

Albumin. It is the smallest protein. A small amount

Which band is normal in urine
croses the glomerular membrane and is excreted in
electrophoresis?
the urine.

A spike is observed in the Bence Jones proteins. Bence Jones proteins are free
gamma region on urine immunoglobulin light chains (kappa or lambda)
electrophoresis. What is which are present in serum and/or urine of patients
present? with multiple myeloma.

High resolution electrophoresis. This technique

What is the name of the test
allows separation of additional proteins not usually
that detects oligoclonal CSF
detectable by serum protein electrophoresis. With
bands associated with multiple
polyacrylamide as the support, over 100 serum
sclerosis?
protein bands may be seen.

Name band that is seen in Prealbumin. It migrates ahead of albumin and

normal CSF electrophoresis accounts for approximately 4% of protein in the
but not in normal serum CSF.
electrophoresis.
Clinical Chemistry Review It- isProteins
an indicator of nutritional status and can be
What is the clinical significance
of prealbumin?
What are cryoglobulins and
when are they present?
What is ceruloplasmin?
Study
used to assess the adequacy of a nutritional feeding
plan. Low levels are seen with protein malnutrition.
This protein was originally named prealbumin
because it migrates ahead of albumin on high
resolution electrophoresis. It has been renamed
transthyretin.
Gamma globulins that precipitate in the cold. They
may be present with multiple myeloma.
Waldenstrom's macroglobulinemia, leukemia,
systemic lupus erythematosus, rheumatoid arthritis,
and polyceythemia vera.
The primary copper-containing protein in plasma.
Levels are usually decreased in Wilson's disease, an
inherited disorder of copper metabolism in which
copper is deposited in the skin, corneas, liver, and
brain. Levels increase in inflammation and
malignancy because ceruloplasmin is an acute-
phase reactant.
AY 2223 MLS 043 LAB Formative Quiz 10
on Renal Function Tests
Total points 51/51

Answer the following questions correctly.

Email *

anca.tul-id.swu@phinmaed.com

Chromatography is based on the principle of: * 1/1

differential solubility

vapor pressure difference

temperature

refractive index

The differential absorption test for uric acid is based on: * 1/1

UV absorption of allantoin at 292nm

coupling hydrogen peroxide with the chromogen

 UV absorption of uric acid at 292nm

reaction of allantoin with a chromogen

A serum sample demonstrates an elevated result when tested with the Jaffe *1/1
reaction.  This indicates:

prolonged hypothermia

pregnancy

renal function impairment

arrhythmia

In the performance of enzymatic methods for NPNs in plasma, one should not *1/1
use:

red top

blue top

green top

gray top

lavender top
Which of the following tests is NOT able to directly assess renal defects? * 1/1

CBC

Isoelectric focusing of amino acids

Total Protein

Electrolyte testing

Ammonia

Enzyme assays

The conversion factor to use to convert urate in mg% to micromoles/L is: * 1/1

0.357

17.1

59.48

88.4

A blood creatinine value of 5.0 mg/dL is most likely to be found with which of *1/1
the following blood values?

osmolality of 292 mOsm/kg

 uric acid level of 8 mg/dl

BUN of 80 mg/dl

ammonia value of 80 ug/dl

Which uric acid method is associated with negative bias caused by reducing *1/1
agents?

uricase coupled to Trinder reaction

UV uricase coupled to catalase & alcohol dehydrogenase

measurement of a negative rate at 290nm after uricase addition

phosphotungtic acid using PFF

To ensure an accurate ammonia level result, the specimen should be: * 1/1

incubated at 37 degrees Centigrade water bath prior to testing

spun and separated immediately and tested as routine

spun, separated, iced, and tested immediately

stored at room temperature until tested

The ratio of serum urea nitrogen to serum creatinine is elevated by: * 1/1

decreased flow of renal tubular filtrate

decreased renal tubular reabsorption

increased blood pressure

 increased hepatic blood flow

Tungsten blue is the measured product in the Caraway method for the *1/1
measurement of:

creatinine

urea

uric acid

ammonia

amino acids

Which one is highly dependent of the nature and number of dissolved solutes? *1/1
 

osmolality

specific gravity

refractive index

osmosis

In the UV enzymatic method for measuring BUN levels, the urease reaction is *1/1
coupled to a second enzymatic reaction using:

AST
 Glutamine synthase

Glutamate dehydrogenase

ALT

Which NPN forms a yellow product with diacetylmonoxime (DAM)? * 1/1

ammonia

BUN

BUA

creatinine

The most abundant normal serum NPN is: * 1/1

BUA

creatine

creatinine

amino acids

urea

ammonia

The main value of serum uric acid determination is in the diagnosis of: * 1/1

Fanconi syndrome

Rheumatoid arthritis
 Gouty arthritis

Chronic renal disease

All of the following statements about BUN are TRUE, EXCEPT: * 1/1

levels are not dependent of the dietary intake

when the filtrate is slow, up to 40% of the urea is reabsorbed

low BUN levels result from necrotic liver disease

BUN is elevated in prerenal and renal failure

In the Jaffe reaction, creatinine reacts with: * 1/1

Alkaline sulfasalazine solution to produce an orange- yellow complex

Potassium iodide to form a reddish –purple complex

Sodium nitroferricyanide to yield a reddish brown color

Alkaline picrate solution to yield an orange –red complex

 Urea can be measured by incubation with urease followed by all, EXCEPT: * 1/1

formation of a colored product with diacetyl monoxime

measurement of increased conductivity

ISE measurement of the ammonia gas produced

NADH consumption in a reaction catalyzed by glutamate dehydrogenase

 NADH consumption in a reaction catalyzed by glutamate dehydrogenase

The normal serum osmolality expressed in mOsm/kg of HOH is approximately *1/1

within:

350-370

280-310

180-250

300-320

A patient’s BUN reading is 60 mg/dL and serum creatinine level is 5.0 mg/dL. *1/1
 These results suggest:

lab error in BUN measurement

renal failure

pre-renal failure

nonfasting patient

Erroneous ammonia levels can be eliminated by all of the following EXCEPT: * 1/1

ensuring water and reagent are ammonia-free

separating plasma from cells and performing test analysis as soon as possible
 drawing the specimen in a prechilled tube and immersing the tube in ice

storing the specimen protected from light until the analysis is done

Full Name (Family name, Given names, MI) *

TUL-ID, JANE CASEY, C.

The original alkaline picrate used in Jaffe reaction has this ratio of NaOH to *1/1
picric acid to be:

1:2

1:3

1:4

1:5

1:6

The end-product of purine catabolism in man is: * 1/1

amino acid

ammonia

urea

urate

creatinine
Solve for the creatinine clearance given the following results:Urine creatinine *1/1
concentration = 84 mg/dl; Serum creatinine concentration = 1.4 mg/dl;     24-
hour urine volume = 1440 ml; and Body surface area = 1.60 sq. m.

6.0 ml/min

65 ml/min

22 ml/min

60 ml/min

In the formula for creatinine clearance, the term A refers to the patient’s body *1/1
surface area measured in:

squared cm

squared mm

squared m

squared dm
The following results were obtained: Urine creatinine = 90 mg/100 mL; *1/1
Serum creatinine = 0.90 mg/100 mL; Patient’s total body surface =1.73
m2 (average = 1.73 m2); Total urine volume in 24 hours = 1500 mL Given
the above data, calculate the patient’s creatinine clearance in mL/min.

104

144

124

150

Which uric acid method is associated with positive bias caused by reducing *1/1
agents?

uricase coupled to Trinder reaction

UV uricase coupled to catalase & alcohol dehydrogenase

measurement of a negative rate at 290nm after uricase addition

phosphotungtic acid using PFF

Group No. & Group Name *

GROUP 4 HOTSHOTS
A 45-year-old male of average height and weight was admitted to the hospital *1/1
for renal function studies. He had the following lab results: Urine creatinine
= 120 mg/dl; Serum creatinine = 1.5 mg/dl; and Total urine volume in 24
hours = 1800/l. Calculate the creatinine clearance for this patient in mL/min.

100

156

144

225

The best index of renal disease is the measurement of serum: * 1/1

creatine

BUN

BUA

ammonia

creatinine

amino acids
Falsely elevated urea values as determined by the Berthelot reaction *1/1
commonly occurs when the reaction mixture is contaminated by:

NaF

ammonia

proteins

bacteria

A patient is admitted with nephrotic syndrome.  If a serum protein *1/1

electrophoresis is performed, which of the following globulin fractions will be
most elevated?

Albumin

Alpha-1globulin

Alpha-2 globulin

Beta globulin

Gamma globulin

The conversion factor to use to convert creatinine in mg% to micromoles/L is: *

0.357
 17.1

59.48

88.4

The protein associated with the: "glomerular pattern" proteinuria: * 1/1

urinary light chains

haptoglobin

albumin

a2-macroglobulin

Tamm-Horsfall protein

Early stages of glomerular dysfunction is indicated by: * 1/1

urinary light chains

ketonuria

microalbuminuria

hematuria

The formula for calculating serum osmolality that incorporates a correction for *1/1
the water content of       plasma is:

2 Na x (Glucose/20) x (BUN/3)

2 Na + Glucose/20 + (BUN/3)
 Na + [(2xGlucose)/20] x (BUN/3)

2 Na + Glucose/3 + (BUN/20)

Which of the following statements can be associated with the enzymatic assay of *
ammonia?

increase in absorbance monitored at 340 nm

NAD required as a cofactor

ammonium ion isolated from specimen before the enzymatic step

reaction catalyzed by glutamate dehydrogenase

Creatinine clearance assesses the rate of: * 1/1

glomerular filtration

renal blood flow

renal tubular secretion

renal tubular reabsorption

When collecting a 24-hour urine sample, the patient should be instructed to do *1/1
the following, EXCEPT:

discard the first morning urine

include the 1st morning urine collected

empty the bladder for 24 hours into a preservative-containing bottle

 empty the bladder for 24 hours into a preservative containing bottle

refrigerate the urine every after collection

The creatinine clearance (mL/min) is equal to: * 1/1

Urinary creatinine (mg/L)[volume of urine (mL/min) x plasma creatinine (mg/L)]

[Urinary creatinine (mg/L) x volume (mL/min)]/plasma creatinine (mg/L)

Urinary creatinine (mg/L)/[volume of urine (mL/hour) x plasma creatinine (mg/L)]

[Urinary creatinine (mg/L) x volume (mL/hour)]/plasma creatinine (mg/L)

During the chemotherapy for leukemia, this NPN is most likely elevated in *1/1
blood :

urea

creatinine

urate

creatine

ammonia

Elevated serum levels of urea, creatinine and uric acid   would be suggestive of *1/1
what disorder?

gout

cirrhosis
 chronic renal disease

malnutrition

The most sensitive chemical method in assessing renal function is the *1/1
clearance test using the indicator substance:

urea

amylase

creatine

creatinine

ammonia

uric acid

The NPN with the least molecular weight is: * 1/1

ammonia

amino acid

creatine

urea

BUN

uric acid
This metabolite when measured tends to underestimate the glomerular *2/2
filtration rate:

ammonia

creatinine

amylase

urea

ammonia & creatinine

urea & creatinine

amylase and ammonia

creatinine and amylase

urea & amylase

The most widely used methods for creatinine measurement are those based *1/1
on the :

8-hydroxyquinoline method

Jendrassik-Grof method

Schales & Schales method

Janovsky complex method

The phosphotungstic acid (PTA) method for uric acid determination forms the *1/1
reduction product:

Tungsten blue

Janovsky complex

Biuret

Allantoin

Phosphotungsten complex

In monitoring glomerular functions, which of the following tests has the *1/1
highest sensitivity?

urine sodium

creatinine clearance

BUN/creatinine ratio

urea clearance
The urea nitrogen concentration of a serum sample was measured as 15 *1/1
mg/dL (atomic weights: carbon = 12, oxygen = 16, nitrogen = 14, hydrogen =
1). The urea concentration of the same sample, in mg/dL, is:

15

32

24

40

With a serum osmolality of 345 mOsm/L and a normal BUN and glucose, you *1/1
would expect:

hypernatremia

hyperglycemia

hyponatremia

hypoproteinemia

The NPN causing the renal-induced coma in a patient is: * 1/1

urea

creatinine
 urate

creatine

ammonia

 Which of the following substances can potentially interfere with creatinine *1/1
determination by Jaffe reaction?  1.  Ketoacids 3.  Ascorbic acid2.  Glucose
4.  Cholesterol

1 & 3 only

1, 2 & 3 only

2 & 4 only

1, 2, 3, & 4

only 4

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