Top One Review Masters

Pre Board Examination

Clinical Chemistry

1. Which of the following is an appropriate sample for blood ammonia determination?

a. Arterial blood immediately chilled for 12 hours
b. Arterial blood immediately chilled for 8 hours
c. Arterial blood immediately chilled for 4 hours
d. Freshly drawn blood
2. All emergency (STAT) laboratory analyses should be reported to the ordering physician within:
a. 30 mins to 1 hour c. 1 to 2 hours
b. 10 to 20 minutes d. 3 hours
3. Which of the following are caused by a random error?
1. R:4s3. 1:2s 5. 10:x
2. 4:1s 4. 1:3s 6. 2:2s
a. 1, 2, 3 and 6 c. 1, 3 and 4
b. 1, 4 and 6 d. 2, 3 and 5
4. Which Westgard multirule applies to a situation where one control point exceeds the mean by +2SD and a
second control point exceeds the mean by -2SD?
a. 1:2s b. 2:2s c. 4:1s d. R:4s
5. Which of the following assays for uric acid requires mercury arc vapour lamps?
a. Colorimetric: Endpoint c. Enzymatic: UV
b. Colorimetric: Kinetic d. Enzymatic: H2O2
6. A condition in which the metabolism of uric acid, but not of other nitrogenous urinary constituents, is
impaired:
a. Uremia b. Azotemia C. Gout d. Nephritis
7. Urea concentration is calculated from the blood urea nitrogen (BUN) by multipying by the factor of:
a. 0.5 b. 2.14 c. 6.45 d. 14
8. Which of the following is classified as a mucopolysaccharide storage disease?
a. Pompes disease c. Andersens disease
b. von Gierkes disease d. Hurlers syndrome
9. According to WHO, what is the standard glucose load for OGTT procedure?
a. 75g b. 150g c. 50g d.100g
10. To produce reliable results, at which time should blood specimens for lipid studies be drawn ?
a. 2-4 hour fasting c. 8-10 hour fasting
b. 6-9 hour fasting d. 12-16 hour fasting
11. During serum electrophoresis, which of the following proteins migrate in the alpha-2 region?
1. Alpha-feto protein 3. Haptoglobin 5. Transferrin
2. Hemopexin 4. Ceruloplasmin 6. Complement
a. 1, 2, 5 and 6 c. 3 and 4
b. 1, 3, 4, and 6 d. 2 and 3
12. Which of the following match(es) is (are) correct?
1. CK = Tanzer-Gilbarg and Oliver-Rosalki method
2. LD = Wacker and Wrobleuski La Due method
3. LPS = Cherry Crandal method
4. AST & ALT = Karmen & Reitman-Frankel method
a. 1, 2 and 3 b. 2, 3 and 4 c. 1, 3 and 4 d. 1, 2, 3 and 4
13. Acetaminophen is particularly toxic to what organ?
a. Heart b. Kidney c. Spleen d. Liver
14. What is the major urinary metabolite of cocaine?
a. Morphine c. NAPA
b. Benzoylecgonine d. Primidone
15. For each degree of fever in a patient, pO2 values will decrease by ___% and pCO2 values will increase by
___%
a. 7; 3 b. 3; 7 c. 3; 3 d. 7; 7
16. Flammable liquids may be store:
a. In an ordinary refrigerator with a flammable storage label affixed
b. In any refrigerator within the laboratory department
c. In an explosion-proof refrigerator
d. Only in an explosion-proof refrigerator in a remote area
17. This class of fire is usually allowed to burn out and nearby materials protected
a. Type A (ordinary Combustibles) c. Type D (Flammable Metals)
b. Type B (Flammable Liquids) d. Type E (Arsenal Fire)
18. Which of the following types of centrifuge will allow rapid separation of plasma or serum from cells?
a. Horizontal head centrifuge c. Cytocentrifuge
b. Angle-head centrifuge d. All of the above
19. All are false for horizontal centrifuge EXCEPT:
a. Speed of 9000 x g
b. Vertical position when not in use
c. Remixing is not possible
d. Faster than an angle head centrifuge
20. What are the approaches to automation?
a. Continous flow & discrete c. Continous flow & centrifugal
b. Discrete & centrifugal d. Continous flow, discrete & centrifugal
21. What is the HDL value of a person with a high risk for cardiovascular disease?
a. <40 mg/dL b. 40-60 mg/dL c. 50 mg/dL d. >60 mg/dL
22. Which of the following is (are) not acute-phase reactant (s)?
1. alpha1 acid glycoprotein 3. C-reactive protein
2. alpha1 anti-trypsin 4. Alpha-fetoprotein
a. 1 and 3 b. 2 and 3 c. 1, 2 and 3 d. 4 only
23. What is the formula for the Michaelis-Menten equation?
a. UV/P x 1.73/A c. Vmax x [S] / Km + [S]
b. A = abc dN=MxV
24. Which hormones play a significant role in calcium metabolism?
a. Aldosterone and calcitonin c. Thyroid hormone and calcitonin
b. Calcitonin and PTH d. Aldosterone and PTH
25. Blood alcohol level of 0.27-0.40 (% w/v):
a. No obvious impairement c. Impaired consciousness
b. Coma and possible death d. Mild euphoria
26. Convert 0.5 mg/dL of bilirubin to umol/L:
a. 6.45 b. 8.6 c. 0.1785 d. 0.0295
27. BMI of an obese individual in kg/m2:
a. 25 b. 30 c. 18.5 d. 29.9
28. If blood pressure cuff is used as tourniquet, it should be inflated at:
a. 20 mmHg b. 30 mmHg c. 60 mmHg d. 100 mmHg
29. Reduction method of glucose that uses arsenomolybdate reagent:
a. Folin-Wu c. Hagedorn-Jensen
b. Nelson-Somogyi d. Glucose oxidase
30. Normal ratio of BUN to Creatinine:
a. 10:1 b. 20:1 c. 10-20:1 d. None of the above
31. Which of the following is the simplest method for creatinine determination?
a. Enzymatic: H2O2 c. Colorimetric: Endpoint
b. Enzymatic: Colorimetric d. Colorimetric: Kinetic
32. Which of the following best describes Zero order kinetics?
 a. Substrate in excess, rate of reaction depends on enzyme concentration
b. Enzyme in excess, rate of reaction depends on coenzyme concentration
c. Substrate in excess, rate of reaction is directly proportional to substrate concentration
d. Enzyme in excess, rate of reaction is directly proportional to substrate concentration
33. Increased ALP is associated with what condition (s)?
a. Intrahepatic biliary obstruction
b. Extrahepatic biliary obstruction
c. Osteitis deformans
d. All of these
34. LDH moderately elevates up to 3-5x the normal value in which of the following condition (s)?
a. Renal and myocardial infarction
b. Myocardial infarction
c. Myocardial and pulmonary infarction
d. Renal infarction
35. The medication of choice for treatment of manic-depression is:
a. Carbamazepine c. Phenobarbital
b. Lithium carbonate d. Phenytoin
36. Which of the following best describes the Jendrassik-Grof method for bilirubin determination?
a. Caffeine-sodium benzoate c. Works at an alkaline pH
b. Van den Berg reaction d. All of the above
37. Which of the following are the best early markers for AMI?
a. Myoglobin and CK-MB c. CK-MB and AST
b. Myoglobin and AST d. CK-MB and LDH
38. What time will CK-MB begin to rise after AMI?
a. 4-6 hrs b. 24 hrs c. 6-8 hrs d. 49-72 hrs
39. Lipase activity will begin to rise ___ hours after the onset of acute pancreatitis:
a. 1 b. 3 c. 6 d. 12
40. Reasons for specimen rejection:
1. Wrong anticoagulant selected 3. Icteric specimen
2. Soecimen contaminated with IV fluid 4. Hemolyzed specimen
a. 1, 2 and 3 b. 1, 2 and 4 c. 1, 3 and 4 d. 1, 2, 3 and 4
41. All of the following are considered as emergency situations, EXCEPT:
a. Diabetic ketoacidosis c. Marked hyperkalemia
b. Diabetic coma d. Glycosuria
42. The difference between serum and plasma is that serum does not contain:
a. Thrombin b. Fibrin c. Fibrinogen d. Calcium
43. Turbidity in serumn is associated with the presence of:
a. Chylomicrons c. Free fatty acids
b. Cholesterol d. Total lipids
44. Which of the following can vbe used as a specimen for catecholamine measurements?
a. Plasma b. 24-hr urine c. Either d. Neither
45. When performing spectrophotometer QC checks, the holmium oxide glass filter is used to assess:
a. Stray light c. Absorbance accuracy
b. Linearity d. Wavelength accuracy
46. Basal state collection is done:
a. After dinner c. After lunch
b. In the early morning d. Anytime of the day
47. Measurement by flame photometry involves:
a. Absorption of energy when an element is ionized
b. Electrometric titration
c. Colorimetric analysis
d. Emission of a color when an element is burned
48. In statistical analysis of data, this refers to the middle or midpoint of a distribution:
 a. Mean b. Median c. Mode d. All are correct
49. It is an analytical method in which mixtures can be separated into individual compounds to be measured
on the basis of differences in their physical characteristics
a. Chromatography c. Isoelectric focussing
b. Capillary electrophoresis d. Electrophoresis
50. What is the molarity of a solutuion that contains 18.7 g of KCl (MW = 74.5) in 500 mL of water?
a. 0.1 b. 0.5 c. 1.0 d. 5.0
51. Borderline range for total cholesterol in mg/dL:
a. 110-159 mg/dL c. 200-239 mg/dL
b. 160-199 mg/dL d. 240-250 mg/dL
52. A solution of calcium chloride contains 3 grams per 100 mL. What percent is this solution?
a. 1.5% b. 3.0% c. 6.0% d. 12.0%
53. Which of the following is the formula for calculating absorbance given the percent transmittance (%T) of a
solution?
a. 1 log %T b. Log %T/2 c. 2 x log %T d. 2 log %T
54. If the total bilirubin is 5.1 mg/dL and the conjugated bilirubin is 2.1 mg/dL, the unconjugated bilirubin is:
a. 1.0 mg/dL b. 2.0 mg/dL c. 3.0 mg/dL d. 4.0 mg/dL
55. To convert the concentration of thyroxine from g/dL to nmol/L, the factor to be used is:
a. 12.9 b. 88.4 c. 0.059 d. 0.323
56. Which of the following set of glands produces hromones?
a. Thyroid and parathyroid
b. Anterior and posterior pituitary
c. Thyroid, parathyroid, anterior and posterior pituitary
d. None of these
57. A westgard rule wherein two (2) consecutive control measurements exceeds +2SD or the same mean -2SD
control limit:
a. 1:2s b. 2:2s c. R: 4s d. 10:x
58. Within a run one control is above +2SD and the other below -2SD units from the mean. What do these
results indicate?
a. Poor precision is resultingf from random error
b. A systematic error is present
c. Proportional error is present
d. QC material is contaminated
59. When 6 or more consecutive daily values distribute themselves on one side of the mean but maintain a
constant level, it is known as:
a. Normal distribution curve c. Shift
b. Trend d. Mean deviation curve
60. When plotting daily QC values on a graph and the control value continues to increase or decrease over a
period of 5 or 6 consecutive days, it is a:
a. Shift b. Trend c. Normal curve d. Reliable curve
61. In normal CSF, the glucose concentration is approximately ___ of the plasma glucose level.
a. 30-45% b. 60-70% c. 40-70% d. Equal to that
62. Which element is reduced at the cathode of a Clark polarographic electrode?
a. Sliver b. Choloride c. Potassium d. Oxygen
63. The visible light region ranges from:
a. 400 to 600 nm c. 400 to 700 nm
b. 300 to 700 nm d. 350 to 750 nm
64. Which of the following is a centrifugal analyzer?
a. Beckman-Coulter c. DuPont ACA
b. Technicon SMA 12 d. RotoChem
65. A 10% contamination with 5% dextrose will increase glucose in blood sample by how much?
a. 50 mg/dL b. 500 mg/dL c. 30 mg/dL d. 300 mg/dL
66. Detection of light energy scattered towards a detector refers to what principle of instrumentation?
a. Turbidimetry b. Nephelometry c. Fluorometry d. Chromatography
67. Glycogenesis is:
a. Conversion of glucose to glycogen
b. Breakdown of glycogen to form glucose
c. Formation of glucose from non-carbohydrates
d. Formation of fat from carbohydrates
68. Vitamin D is necessary in the absorption of:
a. Phosphorus b. Protein c. Calcium d. Sodium and potassium
69. The electrolyte that greatly affects cardiac muscle activity is:
a. Sodium b. Potassium c. Chloride d. Magnesium
70. Sodium is filtered by the glomerulus of the kidney and 80-85% is reabsorbed by the proximal tubule.
Reabsorption is controlled by a hormone known as:
a. Testosterone b. Aldosterone c. Insulind. Adrenaline
71. Due to intracellular and extracellular concentration differences of this electrolyte, a hemolyzed serum
specimen causes a false increase in:
a. Chloride b. Iron c. Potassium d. Sodium
72. In cystic fibrosis, which sweat electrolytres are elevated?
a. Calcium and chloride c. Potassium and chloride
b. Sodium and potassium d. Chloride and sodium
73. Which electrolytre plays a major role in the regulation of water balance in the body?
a. Chloride b. Phosphorus c. Potassium d. Sodium
74. When measuring potassium using an ion-selective electrode, the membrane is composed of:
a. Glass b. Valinomycin c. Silver d. Plastic
75. Which of the following matches is (are) correct?
1. Chloride Whitehorn titration
2. Calcium o-cresolphthalein complexone
3. Potassium Lockhead and Purcell
4. Magnesium Fiske-Subbarow
a. 1, 2 and 3 b. 2, 3 and 4 c. 1, 3 and 4 d. 1, 2, 3 and 4
76. The use of a cation exchange resin, an elution step, and reaction of the analyte with phenol-hypochlorite
describes the method to quantitate:
a. Ammonia b. Creatinine c. Urea d. Uric acid
77. An endogenous substance that is commonly quantitated in clearance tests since it is filtered by the
glomeruli, not reabsorbed, and only minimally secreted by the tubules is:
a. Inulin b. Urea c. Creatinine d. Uric acid
78. In the uric acid ultraviolet procedure, the reaction between uric acid an uricase causes:
1. Destruction of uric acid
2. Formation of allantoin
3. Decrease in absorbance proportional to uric acid concentration
4. Formation of hydrogen peroxide
a. 1, 2 and 3 b. 2, 3 and 4 c. 1, 3 and 4 d. 1, 2, 3 and 4
79. A compound which reacts with phosphotungstic acid causing the reduction of the latter to a tungsten blue
complex is:
a. Urea b. Uric acid c. Creatinine d. Ammonia
80. Calculate the creatrinine clearance based on the following information:
Urine creatinine = 120 mg/dL Urine volume for 24 hrs = 1520 mL
Plasma creatinine = 1.5 mg/dL Body surface = 1.60 m2
a. 78 mL/min b. 82 mL/min c. 84 mL/min d. 91 mL/min
81. Which of the following NPN compounds is present in highest concentration in the blood?
a. Amino acids b. Uric acid c. Urea d. Ammonia
82. What is the correct order of non-protein nitrogen componds from the least to most concentrated in the
blood?
a. Urea, amino acid, uric acid, creatinine, creatine, ammonia
b. Ammonia, creatinine, creatine, uric acid, amino acid, urea
c. Urea, amino acid, uric acid, creatine, creatinine, ammonia
d. Ammonia, creatine, creatinine, uric acid, amino acid, urea
83. Which among the methods for urea nitrogen determination lacks specificity and is relatively inexpensive?
a. Colorimetric diacetyl c. Enzymatic: NH3 formation
b. Colorimetric allantoin d. Enzymatic: UV at 340 nm
84. The chain of infection includes:
1. Portal of entry 3. Susceptible host 5. Handwashing
2. Reservoir 4. Infectious agent 6. Mode of transmission
a. All of these c. 2, 3 and 6
b. All except 2 and 5 d. 1, 2, 3, 4 and 6
85. The most important practice in preventing the spread of disease is:
a. Wearing masks during patient contact
b. Proper handwashing
c. Wearing disponsable laboratory coats
d. Identifying specimens from known or suspected HIV- and HBV- infected patients with a red label
86. Radioactive wastes should be disposed into a ___-colored waste container:
a. Yellow with a black band c. Red
b. Green d. Orange
87. True about Type 1 diabetes mellitus:
a. High frequency in children c. Beta cell destruction
b. Absolute insulin deficiency d. All are true
88. Which of the following methods provides a reflection of short term glucose control of about 2-3 weeks?
a. Fructosamine c. Glycosylated hemoglobin
b. Glucose oxidase d. Oral glucose tolerance
89. Identify the enzyme deficiency responsible for Type III glycogen storage disease (Cori Forbes disease):
a. Debrancher enzyme c. Alpha-1, 4-glucosidase
b. Brancher enzyme d. Muscle phosphorylase
90. The lipoprotein class involved in the transport of triglycerides from the small intestine through the
circulation to various tissues is:
a. Chylomicrons b. VLDL c. LDL d. HDL
91. Which of the following apolipoproteins is composed of 45-65% triglycerides?
a. Chylomicrons c. LDL
b. VLDL d. HDL
92. Thyroid disease that manifests hypocholesterolemia:
a. Cushings syndrome c. Addisons disease
b. Hyperthyroidism d. Hypothyroidism
93. According to the NCEP Guidelines for Acceptable Measurement Error, coefficient of variation for total
cholesterol determinations should be on what range?
a. 2% b. 3% c. 4% d. 5%
94. Which phenotype in the Frederickson classification of hyperlipoproteinemias is classified by an increase in
cholesterol in the beta-lipoproteins (LDL), normal triglycerides and the absence of chylomicrons?
a. I b. IIa c. IIb d. III
95. Apolipoprotein A is the primary protein component of:
a. LDL b. VLDL c. IDL d. HDL
96. Which age group has a moderate risk cut off value of >220 mg/dL and high risk cut off value of >240
mg/dL for total cholesterol?
a. 2-19 y.o. b. 20-29 y.o. c. 30-39 y.o. d. >40 y.o.
97. The reagent blank corrects for absorbance caused by:
 a. Sample turbidity c. Bilirubin and hemolysis
b. The color of reagents d. All of the above
98. Labels that must be affixed to reagents or materials prepared by the laboratory include all of the following
EXCEPT:
a. Hazards and precautions c. Amount of reagent used in a procedure
b. Concentratiuon of reagents d. Recommended storage
99. The blue-colored diamond in the National Fire Protection Association hazard warning emblem represents
what type of hazard?
a. Reactivity b. Health c. Flammability d. Specific hazards
100.Which of the following colorimetric method may be used to quantitate total protein in CSF?
a. Bromcresol green c. Sulfosalicylic acid
b. Coomassie brilliant blue d. All of these