Loresca, Kaycee-Clinical Chemistry

CLINICAL CHEMISTRY
Name : Loresca, Kaycee Gretz V.

Yr/Section : O4A
1. Total glycosylated hemoglobin levels in a hemolysate reflect the:
A. Average blood glucose levels of the past 2-3 months

B. Blood glucose level at the time the sample is drawn
C. Average blood glucose levels for the past week
D. Hemoglobin A1c level at the time the sample is drawn
Answer: A. Average blood glucose levels of the past 2-3 months

The rate of formation is directly proportional to the plasma glucose concentrations.
Because the average red blood cell lives approximately 120 days, the glycosylated
hemoglobin level at any one time reflects the average blood glucose level over the previous
2 to 3 months.
Reference: Clinical Chemistry: Principles, Techniques, Correlations 6th Edition, Michael
Bishop pp. 324
2. Blood ammonia levels are usually measured in order to evaluate:
A. Renal failure
B. Hepatic coma
C. Acid – base status
D. Gastrointestinal malabsorption
Answer: B. Hepatic coma
The monitoring of blood ammonia may be used to determine the prognosis, although
correlation between the extent of hepatic encephalopathy and plasma ammonia
concentation is not consistent
Bishop pp. 277
3. The most important buffer pair in plasma in the:

A. Phosphate / biphosphate pair
B. Bicarbonate / carbonic acid pair
C. Hemoglobin / imidazole
D. Sulfate / bisulfate pair
Answer: B. Bicarbonate / carbonic acid pair
HCO3 is the major component of the buffering system in the blood. Carbonic anhydrase in
RBCs converts CO2 and H2O to carbonic acid, which dissociates into H and HCO3
Bishop pp. 368
CLINICAL CHEMISTRY

Yr/Section : O4A
4. Most of the carbon dioxide present in blood is in the form of:

A. Dissolve CO2
B. Bicarbonate ion
C. Carbonate
D. Carbonic acid
Answer: B. Bicarbonate ion
HCO3 diffuses out of the cell in exchange for Cl to maintain ionic charge neutrality within the cell
(chloride shift;. This process converts potentially toxic CO2 in the plasma to an effective buffer:
HCO3. HCO3 buffers excess H_ by combining with acid, then eventually dissociating into H2O and
CO2 in the lungs where the acidic gas CO2 is eliminated.
Reference: Clinical Chemistry: Principles, Techniques, Correlations 6th Edition, Michael Bishop pp.
368
5. Urea concentration is calculated from the blood urea nitrogen (BUN) try multiplying by
the factor of:
A. 0.5
B. 6.45
C. 2.14
D. 14
Answer: 2.14
Urea nitrogen concentration can be converted to urea concentration by multiplying by 2.14,

Bishop pp. 267
6. Serum “anion gap” is increased in patients with:

A. Renal tubular acidosis
B. Diabetic alkalosis
C. Metabolic acidosis due to diarrhea
D. Lactic acidosis
Answer: D. Lactic acidosis

An elevated anion gap may be caused by uremia/renal failure, which leads to PO4 and SO4
2 retention; ketoacidosis, as seen in cases of starvation or diabetes; methanol, ethanol,
ethylene glycol poisoning, or salicylate; lactic acidosis; hypernatremia; and instrument
error.
CLINICAL CHEMISTRY

Yr/Section : O4A

Bishop pp. 381
7. The anion gap is useful for quality control of laboratory results for:
A. Amino acids and proteins

B. Blood gas analyses
C. Sodium, potassium, chloride, and total CO2
D. Calcium, phosphorus and magnesium
Answer: C. Sodium, potassium, chloride, and total CO2
Routine measurement of electrolytes usually involves only Na_, K_, Cl_, and HCO3_ (as total
CO2). These values may be used to approximate the anion gap (AG), which is the difference
between unmeasured anions and unmeasured cations. There is never a “gap” between total
cationic charges and anionic charges. The AG is created by the concentration difference
between commonly measured cations (Na_K) and commonly measured anions (Cl_HCO3)
Reference: Reference: Clinical Chemistry: Principles, Techniques, Correlations 6th Edition,
Michael Bishop pp. 380-381
8. The buffering capacity of blood is maintained by a reversible exchange process between

bicarbonate and:
A. Sodium
B. Calcium
C. Potassium
D.Chloride
Answer: D. Chloride
Chloride is the major extracellular anion that acts to maintain osmotic pressure, keeps the
body hydrated, and maintains electric neutrality via interaction with sodium or carbon
dioxide.
Reference: A Concise Review of Clinical Laboratory Science Second Edition, pp. 18
9. Select the primary reagent used in the Jaffe reaction for creatinine:
A. Alkaline copper (II) sulphate

B. Sodium nitroprusside and phenol
C. Salurated picric acid and sodium hydroxide
D. Phosphotungstic acid
CLINICAL CHEMISTRY

Yr/Section : O4A
Answer: C. Salurated picric acid and sodium hydroxide
In the kinetic Jaffe method, serum is mixed with alkaline picrate and the rate of change in
absorbance is measured
Bishop p 275
10. In respiratory acidosis, a compensatory mechanism is the increase in:
A. Respiration rate
B. Blood PCO2
C. Ammonia formation
D. Plasma bicarbonate concentration
Answer: D. Plasma bicarbonate concentration
As with acidosis, alkalosis can result from nonrespiratory and respiratory causes. Primary
nonrespiratory alkalosis results from a gain in HCO3 _, causing an increase in the
nonrespiratory component and pH.
Bishop p 390
11. A potassium level of 6.8 mEq/L (6.8 mmol/L) is obtained. Before reporting the results,
the first step the technologist should take is to:
A. Check the serum for hemolysis

B. Check the age of the patient
C. Rerun the test
D. Do nothing, simply report out the result
Answer: A. Check the serum for hemolysis

If hemolysis occurs after the blood is drawn, K+ may be falsely elevated—the most
commoncause of artifactual hyperkalemia. Slight hemolysis (~50 mg/dL of hemoglobin)
can cause an increase of approximately 3%, while gross hemolysis (>500 mg/dL of
hemoglobin) can cause an increase of up to 30%.
Bishop p 365
12. The solute that contributes the most to the serum osmolality is:
A. Glucose
B. Chloride
CLINICAL CHEMISTRY

Yr/Section : O4A
C. Sodium
D. Urea
E.
Answer: Sodium
Chloride (Cl_) is the major extracellular anion. Its precise function in the body is not well
understood; however, it is involved in maintaining osmolality, blood volume, and electric
neutrality.
Bishop p 366
13. Calcium concentration in the serum is regulated by:
A. Insulin
B. Thyroxine
C. Parathyroid hormone
D. Vitamin C
Answer: C. Parathyroid hormone
PTH secretion in blood is stimulated by a decrease in ionized Ca2+ and, conversely, PTH
secretion is stopped by an increase in ionized Ca2+.
14. The primary function of serum albumin in the peripheral blood is to:
A. Maintain colloidal osmotic pressure

B. Increase fibrinogen formation
C. Increase antibody production
D. Maintain blood viscosity
Answer: A. Maintain colloidal osmotic pressure
Albumin is responsible for nearly 80% of the colloid osmotic pressure (COP) of the
intravascular fluid, which maintains the appropriate fluid balance in the tissue.
Bishop p 373
15. The biuret reaction for the analysis of serum protein depends on the number of:
A. Free amino groups

B. Peptide bonds
C. Free carboxyl groups
CLINICAL CHEMISTRY

Yr/Section : O4A
D. Tyrosine residues
Answer: B. Peptide bonds
The biuret procedure is the most widely used method and the one recommended by the
International Federation of Clinical Chemistry expert panel for the determination of total
protein. In this reaction, cupric ions (Cu2) complex with the groups involved in the peptide
bond.
Bishop p 253
16. In the creatinine clearance formula, the term 1.73/A is used to:
A. Normalize clearance, making it independent of muscle mass

B. Correct clearance for creatinine that is secreted by the renal tubules
C. Normalize clearance, making it independent of filtrate flow
D. Adjust clearance so that it is equal to inulin clearance
Answer: A. Normalize clearance, making it independent of muscle mass
Results are normalized to a standard body surface area (1.73 m2). The equation is valid for
adults older than 18 years and younger than 70 years of age.
Bishop p 275
17. In electrophoresis of proteins, when the sample is placed in an electric field connected to
a buffer of Ph 8.6, all of the proteins:
A. Have a positive charge

B. Are electrically neutral
C. Have a negative charge
D.Migrate toward the cathode
Answer: C. Have a negative charge
In the standard method for serum protein electrophoresis (SPE), serum samples are applied
close to the cathode end of a support medium that is saturated with an alkaline buffer (pH
8.6). The support medium is connected to two electrodes and a current is passed through
the medium to separate the proteins. All major serum proteins carry a net negative charge
at pH 8.6 and migrate toward the anode.
CLINICAL CHEMISTRY

Yr/Section : O4A
Bishop p 256
18. The relative migration rate of proteins on cellulose acetate is based on:
A. Molecular weight
B. Ionic charge
C. Concentration
D. Particle size
Answer: B. Ionic charge
Electrophoresis separates proteins on the basis of their electric charge densities. Protein,
when placed in an electric current, will move according to their charge density, which is
determined by the pH of a surrounding buffer. At a pH greater than the pI, the protein is
negatively charged (AA_COO_) and vice versa (AA_NH3 ). The direction of movement
depends on whether the charge is positive or negative; cations (positive net charge) migrate
to the cathode (negative terminal), whereas anions (negative net charge) migrate to the
anode (positive terminal).
Bishop p 254
19. The cellulose acetate electrophoresis at Ph 8.6 of serum proteins will show an order of
migration beginning with the fastest migration as follows:
A. Albumin, alpha- 1 globulin, alpha-2 globulin, beta globulin, gamma globulin

B. Alpha- 1 globulin, alpha- 2 globulin, beta globulin, gamma globulin, albumin
C. Albumin, alpha- 2 globulin, alpha-1 globulin, gamma globulin
D. Gamma globulin, beta globulin, alpha-2 globulin, alpha-1 globulin, albumin
Answer: A. Albumin, alpha- 1 globulin, alpha-2 globulin, beta globulin, gamma globulin
Using standard SPE methods, serum proteins appear in five bands: albumin travels farthest
to the anode, followed by alpha 1-globulins, alpha 2-globulins, beta-globulins, and gamma-
globulins, in that order.
Bishop p 256
20. Bilirubin is transported from reticuloendothelial cells to the liver by:
A. Albumin
B. Bilirubin binding globulin
C. Haptoglobin
CLINICAL CHEMISTRY

Yr/Section : O4A
D. Transferrin
Answer: A. Albumin
The globin is degraded to its constituent amino acids, which are reused by the body. The
heme portion of hemoglobin is converted to bilirubin in 2–3 hours. Bilirubin is bound by
albumin and transported to the liver
Bishop p 518
21. A critically ill patient becomes comatose. The physician believes the coma is due to
hepatic failure. The assay most helpful in this diagnosis is:
A. Ammonia
B. AST
C. ALT
D. GGT
Answer: A. ammonia
Clinical conditions in which blood ammonia concentration provides useful information are
hepatic failure, Reye’s syndrome, and inherited deficiencies of urea cycle enzymes. Severe
liver disease is the most common cause of disturbed ammonia metabolism. The monitoring
of blood ammonia may be used to determine prognosis, although correlation between the
extent of hepatic encephalopathy and plasma ammonia concentration is not always
consistent.
Bishop p 277
22. A characteristic of the Bence Jones protein that is used to distinguish it from other urinary
proteins is its solubility:
A. In ammonium sulfate
B. At 40° - 60°C
C. In sulfuric acid
D.At 100°C
Answer: D. at 100 C
23. Analysis of CSF for oligoclonal bands is used to screen for which of the following disease
states?
A. Multiple myeloma
B. Myasthenia gravis
CLINICAL CHEMISTRY

Yr/Section : O4A
C. Multiple sclerosis
D. Von willebrand disease
Answer: C. Multiple sclerosis
The identification of discrete bands in the _ region that are present in the CSF but not in the
serum is consistent with production of IgG in the CSF. These bands cannot be seen on routine
cellulose acetate electrophoresis but require a high-resolution technique in which agarose
is usually used. More than 90% of patients with multiple sclerosis have oligoclonal bands,
although the bands also have been found in inflammatory conditions and infectious
neurologic diseases such as Guillain- Barre syndrome, bacterial meningitis, viral
encephalitis, subacute sclerosing panencephalitis (SSPE), and neurosyphilus.
Bishop p 263
24. Total iron-binding capacity measures the serum iron transporting capacity of:
A. Hemoglobin
B. Transferrin
C. Ceruloplasmin
D. Ferritin
Answer: B. Transferrin
The major functions of transferrin are the transport of iron and the prevention of loss of iron
through the kidney. Its binding of iron prevents iron deposition in the tissue during
temporary increases in absorbed iron or free iron. Transferrin transports iron to its storage
sites, where it is incorporated into apoferritin, another protein, to form ferritin. Transferrin
also carries iron to cells, such as bone marrow, that synthesize hemoglobin and other iron-
containing compounds.
Bishop p 243
25. The principle excretory form of nitrogen is:
A. Amino acids
B. Creatinine
C. Urea
D. Uric acid
Answer: C. urea
CLINICAL CHEMISTRY

Yr/Section : O4A
Urea is the major excretory product of protein metabolism.4 It is formed in the liver from
amino groups (-NH2) and free ammonia generated during protein catabolism.5 Since
historic assays for urea were based on measurement of nitrogen, the term blood urea
nitrogen (BUN) has been used torefer to urea determination. Urea nitrogen (urea N) is a
more appropriate term.
Bishop pp267
26. In the Jaffe reaction, creatinine reacts with:
A. Alkaline sulfasalazine solution to produce an orange-yellow complex

B. Potassium iodide to form a reddish- purple complex
C. Sodium nitroferricyanide to yield an orange-red complex
D. Alkaline picrate solution to yield an orange- red complex
Answer: D. Alkaline picrate solution to yield an orange- red complex
The methods most frequently used to measure creatinine are based on the Jaffe reaction first
described in 1886.In this reaction, creatinine reacts with picric acid in alkaline solution to
form a red- orange chromogen.
Bishop pp 274
27. Creatinine clearance is used to estimate the:
A. Tubular secretion of creatinine

B. Renal glomerular and tubular mass
C. Glomerular secretion of creatinine
D. Glomerular filtration rate
Answer: D. glomerular filtration rate
Creatinine clearance overestimates GFR because a small amount of creatinine is reabsorbed

by the renal tubules and up to 10% of urine creatinine is secreted by the tubules. However,
CrCl provides a reasonable approximation of GFR.
Bishop pp 274
CLINICAL CHEMISTRY

Yr/Section : O4A
28. The troponin complex consists of:
A. Troponin T, calcium and tropomyosin

B. Renal glomerular and tabular mass
C. Glomerular secretion of creatinine
D. Glomerular filtration rate
Answer: A. Troponin T, calcium and tropomyosin
TnT and TnI are found in cardiac and skeletal muscle with a different gene encoding for the
forms found in the two muscle types. TnC is less specific than the others, because the same
amino acid sequence makes up this protein subunit in both skeletal and cardiac muscle
tissue.
29. 90% of the copper present in the blood is bound to:
A. Transferrin
B. Albumin
C. Ceruloplasmin
D. Cryoglobin
Answer: C. Ceruloplasmin
Ceruloplasmin is a copper containing, 2-glycoprotein enzyme that is synthesized in the liver.

Bishop pp 243
30. Absorption of vitamin B12 requires the presence of:
A. Intrinsic factor
B. Secretin
C. Gastrin
D. Folic acid
Answer: A. intrinsic Factor
Metabolism occurs in the small intestine. Dietary B12 is released from digestion of animal
proteins in meats and is bound by gastric intrinsic factor (IF).
CLINICAL CHEMISTRY

Yr/Section : O4A
31. The procedure used to determine the presence of neural tube defects is:
A. Lecithin / sphingomyelin ratio

B. Measurement of absorbance at 450 nm
C. Amniotic fluid creatinine
D. Alpha-fetoprotein
Answer: D. alpha- fetoprotein
Conditions associated with an elevated AFP level include spina bifida, neural tube defects,
abdominal wall defects, anencephaly (absence of the major portion of the brain), and general
fetal distress.
Bishop pp 241
32. A breakdown product of hemoglobin is:
A. Lipoprotein
B. Hematoxylin
C. Bilirubin
D. Bence jones protein
Answer: C. bilirubin
One of the most important functions of the liver is the processing and excretion of endogenous and
exogenous substances into the bile or urine such as the major heme waste product, bilirubin.
Bishop pp 518
33. The hemoglobin that is resistant to alkali (KOH) denaturation is:
A. A
B. C
C. A2
D. F
Answer: D. F
Fetal hemoglobin may be quantitated based on the principle that it is resistant to alkali
denaturation in 1.25 mol/L NaOH for 2 minutes.
Bishop pp 439
CLINICAL CHEMISTRY

Yr/Section : O4A
34. In the liver, bilirubin is converted to:
A. Urobilinogen
B. Bilirubin-albumin complex
C. Urobilin
D. Bilirubin diglucuronide
Answer: D. bilirubin diglucuronide
The conjugation (esterification) of bilirubin occurs in the presence of the enzyme

uridyldiphosphate glucuronyl transferase (UDPGT), which transfers a glucuronic acid
molecule to each of the two proprionic acid side chains of bilirubin to form bilirubin
diglucuronide, also known as conjugated bilirubin
Bishop pp 518
35. Kemicterus is an abnormal accumulation of bilirubin in:
A. Heart tissue
B. Liver tissue
C. Brain tissue
D. Kidney tissue
Answer: C. Brain tissue
When this type of bilirubin builds up in the neonate, it cannot be processed and it is
deposited in the nuclei of brain and nerve cells, causing kernicterus. Kernicterus often
results in cell damage and death in the newborn, and this condition will continue until
glucuronyl transferase is produced.
Bishop pp 522
36. The most specific enzyme test for acute pancreatitis is:
A. Acid phosphatase
B. Amylase
C. Trypsin
D. Lipase
Answer: D. Lipase
Clinical assays of serum LPS measurements are confined almost exclusively to the diagnosis
of acute pancreatitis. Itvis similar in this respect to AMS measurements but is considered more
specific for pancreatic disorders than AMS measurement.
CLINICAL CHEMISTRY

Yr/Section : O4A

Bishop pp 303
37. Which of the following clinical disorders is associated with the greatest elevation of lactate
dehydrogenase isoenzyme 1?
A. Pneumonia
B. Pancreatitis
C. Glomerulonephritis
D.Pemicious anemia
Answer: D. Pernicious anemia
Elevated serum levels of LD up to 50 times the upper limit of normal are seen with pernicious
anemia. The ineffective erythropoiesis results in the release of large quantities of LD1 and
LD2. Increased levels of LD1 and LD2 may be seen in renal disease, but the increase is not as
great as for the pernicious anemia. Slight increases of LD3 are seen in pulmonary conditions
and pancreatitis.
Bishop pp 294
38. The enzyme presents in almost all tissues that may be separated by electrophoresis into
5 components is:
A. Lipase
B. Creatinine kinase
C. Transaminase
D.Lactate dehydrogenase
Answer: D. Lactate dehydrogenase
LDH is widely distributed in the body. High activities are found in the heart, liver, skeletal
muscle, kidney, and erythrocytes; lesser amounts are found in the lung, smooth muscle, and
brain.
Bishop pp 294
39. When myocardial infarction occurs, the first enzyme to become elevated is:
A. CK
B. AST
C. LD
D. ALT
CLINICAL CHEMISTRY

Yr/Section : O4A
Answer: A. CK
Because of the high concentrations of CK in muscle tissue, CK levels are frequently elevated
in disorders of cardiac and skeletal muscle. The CK level is considered a sensitive indicator
of acute myocardial infarction (AMI) and muscular dystrophy, particularly the Duchenne
type. Striking elevations of CK occur in Duchenne-type muscular dystrophy, with values
reaching 50 to 100 times the upper limit of normal (ULN).
Bishop pp 298
40. Regan isoenzyme has the same properties as alkaline phosphates that originates in the:
A. Skeleton
B. Intestine
C. Kidney
D. Placenta
Answer: D. Placenta
The Regan isoenzyme has been characterized as an example of an ectopic production of an

enzyme by malignant tissue. It has been detected in various carcinomas, such as lung, breast,
ovarian, and colon, with the highest incidences in ovarian and gynecologic cancers.
Bishop pp 298
41. High levels of which lipoprotein class are associated with decreased risk of accelerated
atherosclerosis?
A. Chylomicrons
B. LDL
C. VLDL
D.HDL
Answer: D. HDL
Because lipid deposits in the vessel walls are frequently associated with increased serum
concentrations of LDL cholesterol or decreased HDL cholesterol, lowering LDL is an
important step in preventing and treating CHD.
Bishop pp 340
42. The majority of thyroxine (T4) is converted into the more biologically active hormone:
A. Thyroglobulin
CLINICAL CHEMISTRY

Yr/Section : O4A
B. Triiodothyronine (T3)
C. Thyroid-stimulating hormone (TSH)
D. Thyrotropin-releasing hormone
Answer: B. Triiodothyronine (T3)
The hormones are either stored within the follicle or released into the bloodstream. In the
blood, most T4 eventually gives up an iodine molecule and forms T3. There is much more
circulating T3 than T4.
Reference: A Concise Review of Clinical Laboratory Science Second Edition, pp.41
43. TSH is produced by the:
A. Hypothalamus
B. Adrenal cortex
C. Pituitary gland
D. Thyroid
Answer: Pituitary gland
Thyroid-releasing hormone (TRH) is released by the brain and stimulates the release of TSH
(thyrotropin) from the pituitary gland.
44. Which of the following is secreted by the placenta and used for early detection of
pregnancy?
A. Follicle- stimulating hormone (FSH)

B. Luteinizing hormone (LH)
C. Human chorionic gonadotropin (HCG)
D. Progesterone
Answer: C. Human chorionic gonadotropin
hCG is a dimeric hormone normally secreted by trophoblasts in the placenta to maintain the
corpus luteum during pregnancy. hCG is elevated in trophoblastic tumors, choriocarcinoma,
and germ cell tumors of the ovary and testis.
Bishop pp 647
45. Which of the following is the characteristics of type 1 diabetes mellitus?

CLINICAL CHEMISTRY

Yr/Section : O4A
A. Low blood insulin levels

B. High frequency of autoantibodies to islet cells
C. Ketosis often accompanies hyperglycemia
D. All of the above
Answer: D. all of the above
Characteristics of type 1 diabetes include abrupt onset, insulin dependence, and ketosis
tendency. This diabetic type is genetically related.
Bishop pp 316
46. During pregnancy the form of estrogen measured in urine is mostly:
A. Estradiol
B. Estrone
C. Estriol
D. Prenanediol
Answer: C. estriol
Estriol, is produced in the placenta. Therefore, little is present in nonpregnant women.

47. Which of the following steroids is an adrenal cortical hormone?
A. Angiotensinogen
B. Epinephrine
C. Aldosterone
D. Growth hormone
Answer: C. Aldosterone
Aldosterone is the primary mineralocorticoid produced and secreted by the adrenal cortex. Its
functions include:
(a)Stimulating sodium resorption in the distal convoluted tubules in exchange for potassium or
hydrogen
(b) Increasing blood volume (via renin/angiotensin system) and pressure
(c) Regulating extracellular fluid volume
CLINICAL CHEMISTRY

Yr/Section : O4A
48. What common substrate is used in the biosynthesis of adrenal steroids, including
androgens and estrogens?
A. Cortisol
B. Progesterone
C. Catecholamines
D. Cholesterol
Answer: D. cholesterol
All adrenal steroids are derived by sequential enzymatic conversion of a common substrate,
cholesterol.
Bishop pp 459
49. Night blindness is associated with deficiency of which of the following vitamins?
A. A
B. Niacin
C. C
D. Thiamine
Answer: A
The best understood physiology of vitamin A is in the visual system; a lack of vitamin A
leads to night blindness.
50. Pellagra is associated with deficiency of which of the following vitamins?

A. A
B. Thiamine
C. B1
D. Niacin
Answer: D. Niacin
Vitamin A and related retinoic acids are a group of compounds essential for vision,
cellular differentiation, growth, reproduction, and immune system function.
Reference: Clinical Chemistry Techniques, Principles and Correlations Pg. 1648 8th Ed
CLINICAL CHEMISTRY

Yr/Section : O4A
Thiamine
The clinical condition associated with chronic thiamine deficiency is beriberi.
Reference: Clinical Chemistry Techniques, Principles and Correlations Pg. 1655 8th Ed
D. Niacin
Pellagra, the clinical syndrome resulting from niacin deficiency, is associated with
diarrhea, dementia, dermatitis, and death. Niacin deficiency may result from alcoholism
Bishop pp 656

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CLINICAL CHEMISTRY

Name : Loresca, Kaycee Gretz V.

1. Total glycosylated hemoglobin levels in a hemolysate reflect the:

A. Average blood glucose levels of the past 2-3 months

Answer: A. Average blood glucose levels of the past 2-3 months

2. Blood ammonia levels are usually measured in order to evaluate:

Answer: B. Hepatic coma

3. The most important buffer pair in plasma in the:

Answer: B. Bicarbonate / carbonic acid pair

Name : Loresca, Kaycee Gretz V.

4. Most of the carbon dioxide present in blood is in the form of:

Answer: B. Bicarbonate ion

Urea nitrogen concentration can be converted to urea concentration by multiplying by 2.14,

6. Serum “anion gap” is increased in patients with:

Answer: D. Lactic acidosis

Name : Loresca, Kaycee Gretz V.

Reference: Clinical Chemistry: Principles, Techniques, Correlations 6th Edition, Michael

A. Amino acids and proteins

Answer: C. Sodium, potassium, chloride, and total CO2

8. The buffering capacity of blood is maintained by a reversible exchange process between

A. Alkaline copper (II) sulphate

Name : Loresca, Kaycee Gretz V.

Answer: C. Salurated picric acid and sodium hydroxide

10. In respiratory acidosis, a compensatory mechanism is the increase in:

Answer: D. Plasma bicarbonate concentration

A. Check the serum for hemolysis

Answer: A. Check the serum for hemolysis

Name : Loresca, Kaycee Gretz V.

13. Calcium concentration in the serum is regulated by:

Answer: C. Parathyroid hormone

A. Maintain colloidal osmotic pressure

Answer: A. Maintain colloidal osmotic pressure

A. Free amino groups

Name : Loresca, Kaycee Gretz V.

Answer: B. Peptide bonds

A. Normalize clearance, making it independent of muscle mass

Answer: A. Normalize clearance, making it independent of muscle mass

A. Have a positive charge

Answer: C. Have a negative charge

Name : Loresca, Kaycee Gretz V.

Answer: B. Ionic charge

A. Albumin, alpha- 1 globulin, alpha-2 globulin, beta globulin, gamma globulin

20. Bilirubin is transported from reticuloendothelial cells to the liver by:

Name : Loresca, Kaycee Gretz V.

Name : Loresca, Kaycee Gretz V.

Answer: C. Multiple sclerosis

25. The principle excretory form of nitrogen is:

Name : Loresca, Kaycee Gretz V.

26. In the Jaffe reaction, creatinine reacts with:

A. Alkaline sulfasalazine solution to produce an orange-yellow complex

Answer: D. Alkaline picrate solution to yield an orange- red complex

27. Creatinine clearance is used to estimate the:

A. Tubular secretion of creatinine

Answer: D. glomerular filtration rate

Creatinine clearance overestimates GFR because a small amount of creatinine is reabsorbed

Name : Loresca, Kaycee Gretz V.

28. The troponin complex consists of:

A. Troponin T, calcium and tropomyosin

Answer: A. Troponin T, calcium and tropomyosin

29. 90% of the copper present in the blood is bound to: