FREQUENTLY ASKED BOARD EXAM QUESTIONS CLINICAL CHEMISTRY 1QA&QC, Lab Math, Carbohydrates, Protein, NPN, Lipids

1. The electrophoretic pattern of a plasma sample compared with a serum sample shows - fibrinogen peak

2. Biuret reaction depends on the number of - peptide bonds3. Transmittance of a solution maybe converted to %absorbance using the

formula - 2-log%T4. In a spectrophotometer, light of specific wavelength can be isolated from

white light with - diffraction grating5. The following serum constituent is unstable if a blood specimen is left

standing at room temperature for 8hours - glucose6. In electrophoretic analysis, buffers ____ - maintain basic pH7. How many grams of SSA (MW 254) to prepare 1L of 3% w/v solution - 30grams8. Statistical term for the average value is the - mean9. Most frequent value in a collection of data is statistically known as - mode10. In a specimen collected for a plasma glucose analysis, NaF - inhibits glycolysis11. To be analyzed by gas liquid chromatography, a compound must - be volatile or made

volatile12. Which of the following serum protein fraction is most likely to be elevated in

patients with nephritic syndrome - alpha-2 and beta-globulin

13. The substance that is measured to estimate the serum concentration of triglyceride by most method is - glycerol

14.

+ -

The serum protein electrophoretic pattern is consistent with

- monoclonal gammopathy

15. Which of the following statement about fluorometry is or are true - a compound is set to fluoresce when it absorbs light at one wavelength and emits light at a second wavelength

16. Beta- gamma bridge pattern in a protein electrophoresis is consistent with - cirrhosis17. Nanometer is used as a measure of - wavelength of radiant

energy18. What is the molarity of a solution that contains 18.7grams of KCl (MW 74.5) in

500mL of water? - 0.5M19. A colorimetric method calls for use of 0.1mL serum, 5mL of reagent and 4.9mL

of water. What is the dilution of serum? - 1:10020. The conversion of glucose or other hexoses into lactate or pyruvate is called - glycolysis21. Total glycosylated hemoglobin level in a hemolysate reflects the - ave. blood glucose levels

of past 2-3months22. The function of major lipid component of VLDL is to transport - endogenous triglyceride23. The most widely used support medium for electrophoretic separation of

lipoprotein is - agarose gell24. 60-75% of the plasma cholesterol is transported by - LDL25. A mean value of 100 and a Standard deviation of 1.8 mg/dL were obtained

from a set of glucose measure on a control solution. The 95% confidence interval in mg/dL would be: - 96.4-103.6

26. The extent to which the measurements agree with the true glucose values of the quantity being measured is known as - accuracy

27. In the Jaffe reaction, creatinine reacts with - alkaline picrate solution

to yield an orange-red complex

28. In electrophoresis of proteins, when the sample is placed in an electric field connected to the buffer of pH 8.6, all the proteins: - have a neg charge

29. MSUD is characterized by an increase in which of the following urinary amino acids - valine, leucine, isoleucine

30. .A characteristic of the Bence Jones Proteins used to distinguish it from other proteins is its solubility - 100deg C

31. The principal excretory form of Nitrogen is - urea32. A 45yo male of average height and weight was admitted to the hospital for

renal function studies. He has the following lab resultsUrine crea: 120mg/dL Total urine volume in 24hrs: 1500mLSerum crea: 1.5mg/dLCalculate the crea clearance for this patient in mL/min - 100mL/min

33. Spectrophotometers isolate a narrow band by means of - prisms and gratings34. The serum electrophoresis pattern was obtained on cellulose acetate at pH 8.6.

Identify the serum protein fraction on the far right of the pattern - albumin35. Which of the following is the formula for calculating a %w/v solution? - (g solute / volume

solvent) x 10036. Which of the following is the formula for coefficent of variation? - (SDx100)/mean37. Which of the following is the formula for calculating the molarity of a solution? - #moles solute/L of

solution38. 4mL of water is added to 1mL of serum, this represents which of the following

serum dilution? - 1:539. How many mL of 0.25N NaOH are needed to make 100mL of a 0.05N folution

of NaOH? - 20mL40. Specimens for blood gas determination should be drawn into a syringe

containing - heparin41. The measurement of light scattered by particles in the sample is the principle

of - nephelometry42. The measurement of the amount of electricity passing between two electrodes

in an electrochemical cell is the principle of - coulometry43. Which of the following lipid results would be expected to be falsely electaed in

a serum sample from a non-fasting patient? - triglyceride44. Turbidity in serum suggests elevation of - chylomicron45. Which of the following would be an example of a glucose-specific colorimetric

method? - glucose oxidase46. The relative migration rate of protein on cellulose acetate is based on - ionic charge47. A patient of glomerulonephritis would present the following serum results - BUN increased48. Creatinine clearance is used to estimate the - glomerular filtration rate49. Chemical composition of HDL cholesterol corresponds to - TG: 5%; chole: 15%;

CHON: 50%50. Blood was collected in a serum separator tube from patient who has been

fasting since midnight. The time of collection was 7am. The lab test that should be recollected is - triglyceride

51. A 45yo woman who’s fasting serum glucose concentration of 95mg/dL and a 2-hr post prandial glucose concentration of 105mg/dL. The statement that best describes the patient fasting serum glucose concentration is

- normal, reflecting glycogen breakdown by liver

52. In lipoprotein phenotyping, chylomicrons are present in the plasma of a person with which of the following protein phenotype? - I and V

53. Monitoring long term glucose control in patients with adult onset DM can best be accomplished by measuring - HBA1C

54. In familial hypercholesterolemia, hallmark finding is an elevation of - LDL55. Pregnant women with symptons of thirst, frequent urination or unexplained

weight loss should have which of the following test performed? - GTT

56. Nephelometers measure light - scattered at right angle to light path

57. If the LDL cholesterol is to be calculated by Friedwald formula, what are the 2 measurements that need to be carried out by the same chemical procedure - TC and HDL

58. High levels of which lipoprotein class are associated with decreased risk of accelerated atherosclerosis - HDL

59. Premature atherosclerosis can occur when which of the following become elevated - LDL

60. Following overnight fasting hypoglycemia in adults is defined as a glucose of - < or = 45mg/dL61. Which of the following is within the UV range? - 340nm62. Most chemical methods for determining total protein utilize which of the

following reaction - biuret63. Chromatography is based on the principle of - differential solubility64. In QC, +/-2SD from the mean includes what percent of sample population? - 95%65. The term used to described reproducibility is - precision66. When the exact concentration of the solute of a solution is known and is used

to evaluate the concentration of an unkwon solution, the known solution is - standard67. If a fasting glucose is 95mg/dL, which of the following 2-hr post prandial

glucose results would most closely represent normal glucose metabolism - 10068. Slight hemolysis can cause eroneous lab results in % serum analyte - potassium69. A serum sample demonstrates an elevated result when tested with Jaffe

reaction. This indicates - renal functional impairment

70. Ability of procedure to measure only components it claims to measure is called - specificity71. HBA1C value represents a time average of glucose concentration during the

preceding - 8-12 weeks72. Protein that has the highest dye binding capacity - albumin73. Buffer pH most effective in allowing amphoterin proteins to migrate toward

the anode in an electrophoretic system would be - pH 8.674. An acid cleaning solution for glassware - potassium dichromate in

concentrated sulfuric acid75. The Kjeldahl technique is reference method for determination of serum total

protein method is based on- quantitation of N content of CHON

76. Electrophoresis is a technique used to separate serum protein. A dye that maybe used for staining protein bands following electrophoresis is - Ponceau S

77. What is the end product of purine catabolism in man - uric acid78. By the urease method, urea is enzymatically converted to - ammonia79. The specificity of Jaffe reaction can be converted to - adsorption with Lloyd’s

rgt80. A disease state association with an elevation of serum uric acid is - gout81. EDTA - lavender82. Sodium heparin - green83. Sodium polyanethol sulfonate - yellow84. No anticoagulant - plain red85. Sodium citrate - light blue86. Sodium fluoride - gray87. For serum chemistry - plain red88. For glucose testing or glucose tolerance - gray89. Whole blood hematology cell counting - lavender90. Plasma chemistry - green91. Blood culture - yellow92. Coagulation studies - light blue93. The urea nitrogen method using diacetyl monoxime measures - urea nitrogen only

94. What compound normally found in urine maybe used to assess the completeness of a 24hr urine collection - creatinine

95. Post renal kidney malfunction does not include - diarrhea96. What technique is commonly used to differentiate several amino acids - chromatography97. Condition wherein there is increased in the proportion of formed elements in

the blood due to prolong application of torniquet - hemoconcentration98. Fainting due to sudden insufficiency of blood supply to the brain - syncope99. Inflamation of the vein in which thrombus is present - thrombophlebitis

100.The destruction or breakdown of RBC - hemolysis

FREQUENTLY ASKED BOARD EXAM QUESTIONSCLINICAL CHEMISTRY 2Enzyme and Liver Profile

1.The following enzyme determination is used to evaluate liver disorders: Either SGPT or ALP2. Transaminases are tested by the following procedures: Reitman-Frankel3.Aspartic acid and alpha ketoglutaric acid are used as substrates in the determination of

SGOT

4.Reitman Frankel and Karmen are procedures for testing Transaminases5. What is the peak of SGOT in myocardial infarction 18-20 hours6. This CK isoenzyme is increased in brain injury CK BB7. One of the following is a pancreatic enzyme Amylase8. The Somogyi Method of amylase assay is based on the measurement of Reducing Sugar9. Hemolyzed hemoglobin will yield Erroneously high LDH level10. Flipped LD is found in Myocardial infarction11. Enzymes that catalyzes the reaction of ATP + D-glucose to ADP + D-glucose-6PO4 CPK12. Substrate in serum lipase determination using the Cherry-Crandall method Olive oil13. Amylase and lipase values are usually elevated in Acute pancreatitis14. The tetramer composition of LDH5, the most cathodic isoenzyme on electrophoresis is

MMMM

15. The following are used to quantitate phosphatases except Reitman Frankel16. Which of the following are the major tissue sources of ALP Liver, Bone, Pancreas17. The following characterize the assessment of MI except Abnormal serum ALP

isoenzyme pattern18. Give the order list (first to last) of the cardiac enzymes AST, CK, LD that will be elevated in serum when AMI occurs

CK, AST, LD

19. The most useful enzyme assay for diagnosis of metastatic prostatic carcinoma ACP20. The most routinely method to differentiate isoenzymes Electrophoresis21. An enzyme the converts emulsified fats to fatty acids and glycerol is Lipase22. A common cause of pre hepatic jaundice Hemolytic disease23. Detection of neonatal jaundice depends largely on Bilirubin24. One of the following characteristics of serum form a hepatic patient Icteric25. Which is present in the urine of patients with jaundice Direct bilirubin26. In the liver, bilirubin is converted into Bilirubin and glucoronide27. The standard use for Icterus index Potassium dichromate28. Jendrassik and Groff method of Bilirubin uses Caffeine 29. Thus bilirubin is soluble in water Conjugated bilirubin30. Methods for bilirubin determination Eveleyn and Malloy,

Jendrassik and Groff

31. The BSP liver function test assumes the BSP dye is primarily removed from the blood stream by the liver and these exists

There is direct proportionality between body wt and ability of the

liver to excrete dye32. Bilirubin is formed during the metabolism of Hemoglobin33. Direct reacting bilirubin diglucoronide is formed in a reaction catalyzed by UDP-glucoronyl transferase34. Direct reacting bilirubin is elevated in Liver disease35. The normal BSP retention is reported as +/- 5% retention in 45 mins36. Cephalin flocculation and thymol turbidity may be indicative of Liver disease37. Urobilinogen is determined by reaction with Ehrlich’s aldehyde reagent38. Urobilinogen is formed in the intestine from Porphobilinogen39. Serum bilirubin is unstable because of Light sensitivity40. The diazo-bilirubin color appearing after the addition of alcohol is Total bilirubin41.When benzoic acid ingested the following substances is excreted Hippuric acid42. Conjugation of bilirubin occurs mostly in Liver43. Kernicterus is caused by Deposits of unconjugated

bilirubin in brain cells44. Pre hepatic jaundice is caused by Hemolytic anemia45. Jaundice usually first becomes visible when serum bilirubin levels are 2.0 mg/dL46. Bilirubin glucoronide Water soluble47. The BSP test measures Liver detoxification ability48. Bilirubin is the breakdown product of Heme49. A severe disease with marked hyperbilirubinemua that results form a genetic deficiency of the UDP glucornyl transferase

Criggler-Najjar Syndrome

50. Accelerator used in the Jendrassik-Groff bilirubin Caffeine – Sodium Benzoate

FREQUENTLY ASKED BOARD EXAM QUESTIONSCLINICAL CHEMISTRY IIElectrolytes and Acid Base Balance

Test I. Multiple Choice

C 1. Importance of osmolalityA. Parameter to which the hypothalamus respondB. For regulation of sodium concentrationC. Both A and BD. Neither

B 2. Specific organs which play important roles in maintaining H+ balanceA. Heart and liver C. Liver and kidneysB. Lungs and kidneys D. Heart and lungs

B 3. Toxic levels of this trace metal is found in Alzheimer’s diseaseA. Nickel C. ZincB. Aluminum D. Chromium

D 4. Functions of potassiumA. For concentration of skeletal and smooth muscleB. For transmission of nerve impulsesC. For regulation of intracellular fluid volumeD. All of the above

A 5. The anion that is lost in great quantities due to vomitting, gastric suction or diureticsA. Chloride C. PotassiumB. Sodium D. Calcium

D 6. TIBC is measured to assess the blood level of:A. Ferritin C. HaptoglobinB. Hemopexin D. Transferrin

C 7. Hydrogen ion concentration is usually measured by:A. Fluorometry C. Potentiometry

B. Coulometry D. All of the aboveA 8. Respiratory alkalosis occurs as a result of a carbonic acid deficit due to:

A. blowing off CO2 C. drop in blood pHB. retention of CO2 D. excess HCO3-

B 9. In which of the following conditions is serum potassium elevated?A. prolonged diarrhea C. prolonged vomittingB. renal failure D. all of the above

D 10. Hyponatremia is found in all of the following conditions except:A. Addison’s disease C. Renal tubular diseaseB. Diabetic acidosis D. Dehydration

B 11. The most important buffer system in the body:A. PhosphateB. Bicarbonate/carbonic acidC. ProteinD. Hemoglobin/oxyhemoglobin

B 12. Hormones produced by the pituitary gland responsible for the promotion of water retention

A. renin C. aldosteroneB. ADH D. calcitonin

A 13. Hormones that causes increase in circulating calciumA. PTH and Vit. D C. Calcitonin and Vit. DB. PTH and Calcitonin D. Calcitonin only

C 14. An iron transport protein in the body:A. Ferritin C. TransferrinB. Haptoglobin D. Hemopexin

C 15. Created by the concentration difference between commonly measured cations and commonly measured anions

A. electrolyte balance C. anion gapB. acid-base balance D. cation gap

D 16. Chloride shift happens:A. When HCO3- concentration increases in the red cells and diffuse into the plasmaB. To maintain electroneutralityC. When Cl- diffuses into the cellD. All of the above

B 17. Secreted by the thyroid gland whose action is to decrease Calcium level in the circulation:A. PTH C. Vit. DB. calcitonin D. phosphorus

18-21. Matching Type

A. HCO3- decrease, PCO2 decrease, pH increaseB. HCO3- decrease, PCO2 decrease, pH decreaseC. HCO3- decrease, PCO2 increase, pH decreaseD. HCO3- increase, PCO2 increase, pH decreaseE. HCO3- increase, PCO2 increase, pH increase

A 18. Respiratory AlkalosisE 19. Metabolic AlkalosisD 20. Respiratory AcidosisB 21. Metabolic Acidosis

B 22. Physiologically active form of calciumA. Complexed C. Lipid boundB. Ionized D. Protein bound

B 23. Blood specimen required from blood gas measurementA. Capillary C. Venous blood

B. Arterial D. All of the aboveA 24. Indicator used in mercurimetric titration of chloride which gives a violet blue end color

A. diphenyl carbazone C. phenolthaleinB. cresol red D. formazen dye

C 25. A trace metal considered part of vitamin B 12 for red cell synthesisA. Zinc C. CobaltB. Aluminum D. Copper

Test II. Matching Type

B 26. Hyperventilation A. Respiratory AcidosisC 27. Deficit of bicarbonate B. Respiratory AlkalosisA 28. Accumulation of carbonic acid with retention of CO2 C. Metabolic AcidosisC 29. Diabetic ketoacidosis D. Metabolic AlkalosisD 30. Excess bicarbonateB 31. Reduction of carbonic acid with excess elimination of CO2B 32. AsthmaB 33. Anxiety and hysteriaC 34. Renal diseaseC 35. Excessive loss of electrolytes

D 36. Titan yellow A. CalciumF 37. Fiske Subbarow B. ChlorideE 38. Valinomycin electrode C. IronA 39. Chelation with OCP D. MagnesiumB 40. Schales and Schales E. PotassiumF 41. Gomori Modification F. PhosphorusE 42. Flame photometryD 43. CalmagiteA 44. Arsenzo dye IIIC 45. TIBC

Test III. Write A, B, or C

A 46. Chloride in Cushing’s syndrome A. increasedC 47. Phosphorus in acute pancreatitis B. decreasedB 48. Ceruloplasmin in Wilson’s disease C. unaffectedA 49. Magnesium in dehydrationA 50. Iron in hemolytic anemiaB 51. Calcium in hypoparathyroidismB 52. Potassium in diarrheaB 53. Calcium in tetanyA 54. Chloride in eclampsiaA 55. Sodium in hyperadrenalism

Test IV.

On the first blank, write the LETTER of unrelated item found in COLUMN I. On the SECOND blank, write the NUMBER of the item found in COLUMN II that is related to the four items in Column I.

COLUMN I COLUMN IIC 3 56. A. major extracellular anion 1. Potassium

B. precipitates with mercury 2. SodiumC. major intracellular cation 3. ChlorideD. Decreased in prolonged vomitting 4. PhosphorusE. determined by coulometric titration

B 3 57. A. chemical sponge 1. pHB. represents free H+ in a solution 2. HCO3-C. weak acid in combination with the salt 3. buffer

of that acid 4. pCO2D. prevents flunctuation of pHE. helps in the maintenance of acid-base

Equilibrium

D 1 58. A. greatest single constituent of the body 1. waterB. obtained from the combustion of 2. electrolytes

foodstuffs 3. acidC. 70% of total body weight of an average 4. base

adultD. serves as co-factor of enzymesE. medium in which all cellular reactions

take place

D 4 59. A. base gaining 1. respiratory acidosisB. acid losing 2. respiratory alkalosisC. hypokalemia 3. metabolic acidosisD. high pCO2 4. metabolic alkalosisE. high bicarbonate

A 2 60. A. no anticoagulant 1. IronB. drawn anaerobically 2. Blood gassesC. arterial blood sample 3. PhosphateD. heparinized needle and syringe 4. MagnesiumE. whole blood