Which of the following clinical disorders is associated with the greatest elevation of lactate dehydrogenase? a. Pneumonia b. Glomerulonephritis c. Pancreatitis d. Pernicious anemia

The most specific indicator of myocardial infarction: a. Troponin I b. Myoglobin c. AST d. CK-MB

Ca concentration in the serum is regulated by: a. Insulin b. Parathyroid hormone c. Thyroxine d. Vitamin C

Which are considered in pre-analytical quality assurance in relation to specimen management? 1. Correctly separated or centrifuged 2. Tests done within specified timeframes 3. Intact and seal 4. Stored properly a. 1, 2, and 4 b. 1 and 4 c. 2, 3, and 4 d. 1, 2, 3, and 4

The enzyme, which exist chiefly in skeletal muscle, heart, and brain, is grossly elevated in active muscular dystrophy, and rises early in myocardial infarction is: a. Lipase b. Aspartate transaminase c. Lactate dehydrogenase d. Creatine kinase

What protein fraction migrates the farthest towards the anode? a. Albumin b. Alpha globulins c. Beta globulins d. Gamma globulins

Osmolality can be defined as a measure of the concentration of a solution based on: a. The number of particles present b. The number and size of particles present c. The density of particles present d. The isoelectric point of a particle

In which of the following disease states would you see an elevation in total bilirubin and conjugated bilirubin only? a. Biliary obstruction b. Hemolytic anemia c. Neonatal jaundice d. Hepatitis

What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens? a. Cortisol b. Catecholamines c. Progesterone d. Cholesterol

Hepatocellular damage may be best assessed by which of the following parameters? a. Serum AST and ALT b. Serum GGT and ALP c. Bilirubin, GGT, and ALP d. Ammonia and urea

Where does TCA happens? a. Mitochondria b. Deoxyribonucleic acid c. Ribonucleic acid d. Golgi apparatus

Unconjugated bilirubin: (1) Cannot appear in urine (2) Can appear in urine (3) Direct bilirubin (4) Indirect bilirubin a. 1 and 3 b. 1 and 4 c. 2 and 3 d. 2 and 4

If a screening TSH is high, which test is likely to be ordered next? a. Cholesterol b. Free T4 c. Ferritin d. Glucose

Which of the following blood samples would serve best to assay lipoproteins because this anticoagulant preserve lipoproteins? a. EDTA plasma sample b. Heparin plasma sample c. Citrate plasma sample d. Fluoride plasma sample

What is the critical value for hypoglycemia? a. >20 mg/dL b. >30 mg/dL c. >40 mg/dL d. >50 mg/dL

Sample of choice for potassium measurement: a. Whole blood b. Plasma c. Urine d. Serum

The Dubowski method for glucose utilizes: a. Arsenomolybdic acid b. Orthotoluidine c. G6PD d. Mutarotase

Which of the following formula refers to globulin? a. Total protein + albumin b. Total protein – albumin c. Total protein x albumin d. Total protein / albumin

Which test might be used to assess a person who is disoriented or confused? a. Cholesterol b. Ammonia c. CRPs d. Iron

Which of the following sets of values for repeat analyses of a sample (target value of 100) shows the least bias? a. 100, 105, 110 b. 95, 100, 105 c. 90, 95, 100 d. 90, 100, 105

Measurements of bilirubin in chemistry analyzers are based on: a. Nephelometry b. Turbidimetry c. Photometry d. None of the above

Which of the following refers to chylomicrons? a. I b. II c. III d. IV

The recommended initial thyroid function test for either a healthy, asymptomatic patient for a patient with symptoms which may be related to a thyroid disorder is: a. Free thyroxine (free T4) b. Thyroid-stimulating hormone (TSH) c. Total thyroxine (T4) d. Triiodothyronine (T3)

The biologically most active, naturally occurring androgen is: a. Androstenedione b. Cortisol c. Epiandrosterone d. Testosterone

Kinetic enzyme assays are best performed during which phase of an enzymatic reaction? a. Linear phase b. Lag phase c. Plateau phase d. Any phase as long as temp. and pH are constant

Unconjugated bilirubin: (1) Cannot appear in urine (2) Can appear in urine (3) Direct bilirubin (4) Indirect bilirubin a. 1 and 3 b. 1 and 4 c. 2 and 3 d. 2 and 4

What is the most common cause of pseudohyperkalemia? a. In vitro phenomenon b. Diarrhea c. Starvation d. Blood transfusion

A fasting blood sugar result of equal or greater than ____ is diagnostic for diabetes mellitus. a. 90 mg/dL b. 126 mg/dL c. 110 mg/dL d. None of the above

Which is a sign of primary adrenal insufficiency? a. Acidosis b. Hypertension c. Hypokalemia d. Hypercortisolism

During pregnancy, the form of estrogen measured in urine is mostly: a. Estradiol b. Estriol c. Estrone d. Pregnanediol

What is the sample of choice for measuring blood osmolality? a. Serum b. Plasma c. Whole blood d. Urine

Which of the following does not contain alcohol? a. Soju b. Wine c. Brandy d. Root beer

Which test might be ordered on a patient with abdominal pain to test for possible pancreatitis? a. Amylase and lipase b. Sodium and potassium c. Cholesterol and triglyceride d. C3 and C4

Type 1 Diabetes mellitus: (I) Detectable C-peptide level (II) Undetectable C-peptide level (III) Most common in childhood/teens (IV) Most common in advancing age a. I and III b. I and IV c. II and III d. II and IV

Most common method for electrolyte testing involves: a. Turbidimetry b. Nephelometry c. Potentiometry d. Fluorometry

How is tolbutamide administered in tolbutamide tolerance test? a. Intramuscularly b. Intravenously c. Subcutaneously d. Percutaneously

Which of the following would be most adversely affected by a nonfasting sample? a. HDL b. LDL c. Cholesterol d. Triglycerides

Neurotoxic product of amino acid deamination: a. Ammonia b. Urea c. Uric acid d. Creatinine

Which type of lipids are steroids derived from? a. Glyceride b. Nonglyceride c. Fatty acid d. Complex

Plasma cortisol determinations were collected at 7 AM, after waking the patient, and at 10 PM that evening. The cortisol level of the morning sample was higher than the evening sample. This is consistent with: A. A normal finding b. Cushing syndrome c. Addison disease d. Hypopituitarism

Which of the following buffers is used in the IFCC recommended method for ALP? a. Acetic acid b. Tris-EDTA c. 2-Amino-2-methyl-1-propanol d. Bicarbonate

At what serum glucose concentration would glucose begin to appear in the urine (renal threshold)? a. 50 mg/dL b. 75 mg/dL c. 100 mg/dL d. 170 mg/dL

Which of the following methods is used as the primary reference method in the determination of HBA1c? a. HPLC b. Affinity chromatography c. Ion-exchange chromatography d. Immunoassay

Which of the following refers to a warning rule?

Albumin level in ascites: a. No effect b. Variable c. Increased d. Decreased

Creatinine is formed in the: a. Liver b. Muscles c. Brain d. Kidney

Which of the following is secreted by the placenta and used for the early detection of pregnancy? a. Follicle-stimulating hormone (FSH) b. Human chorionic gonadotropin (HCG) c. Luteinizing hormone d. Progesterone

The center of thyroid hormone production: a. Follicle b. Parafollicle c. Anterior pituitary gland d. Posterior pituitary gland

Which set of results is consistent with uncompensated metabolic acidosis? a. pH 7.25, HCO3 15 mmol/L, PCO2 37 mmHg b. pH 7.30, HCO3 16 mmol/L, PCO2 30 mmHg c. pH 7.45, HCO3 22 mmol/L, pCO2 40 mmHg d. pH 7.40, HCO3 25 mmol/L, pCO2 40 mmHg

The chart demonstrated trend, starting at: a. Day 7 b. Day 8 c. Day 10 d. Day 11

A farmer that is working in the field accidentally had a pesticide poisoning. Cholinesterase activity is tested, which of the following is the expected result? a. Increased b. Decreased c. Variable result d. Normal

Chief plasma cation whose main function is maintaining osmotic pressure a. Chloride b. Calcium c. Sodium d. Potassium

The following target shows a set of result that show a high degree of: a. Accuracy b. Precision c. Sensitivity d. Specificity

How should a laboratory verify the reference range it uses for a particular test? a. Call another laboratory b. Use the numbers form a textbook c. Test samples from healthy people d. Look on a medical internet site

The pituitary gland is located in a small cavity in the ________ of the skull called Sella turcica or Turkish saddle. a. Lacrimal bone b. Ethmoid bone c. Sphenoid bone d. External acoustic meatus

Creatinine is expressed in: a. umol/L b. mL/s c. mmol/L d. mL/min

The majority of thyroxine (T4) is converted into the more biologically active hormone: a. Thyroglobulin b. Thyroid-stimulating hormone c. Triiodothyronine (T3) d. Thyrotropin-releasing hormone

Cocaine is metabolized to: a. Carbamazepine b. Codeine c. Hydrocodone d. Benzoylecgonine

What form of sugar in the liver is converted to glucose? a. Starch b. Cellulose c. Glycogen d. Amylopectin

Which of the following is a rare autosomal recessive disorder characterized by the absence of VLDL, LDL, and chylomicrons? a. Bassen-Kornzweig syndrome b. Tangier disease c. Anderson’s disease d. Sitosterolemia

An electrophoretic separation of lactate dehydrogenase isoenzymes that demonstrates an elevation in LD-1 and LD-2 in a flipped pattern is consistent with: a. Myocardial infarction b. Viral hepatitis c. Pancreatitis d. Renal failure

Which of the following statements best describes the predominant feedback system associated with endocrinology? a. Decreased levels of circulating hormones directly result in the production of hormone from the target organ b. Increased circulating levels of hormones directly result in the production of releasing factor from the hypothalamus c. Increased circulating levels of hormones directly result in the production of inhibiting factor from the hypothalamus d. Normal levels of circulating hormones directly result in the production of hormone from the target organ

A patient sample is assayed for fasting triglycerides and a triglyceride value of 1036 mg/dL. This value is of immediate concern because of its association with which of the following conditions? a. Coronary heart disease b. Diabetes c. Pancreatitis d. Gout

What is the main reason that causes the following blood gas values: pH= 7.25 pCO2= 36 mmHg HCO3= 19 mEq/L a. Hypoventilation b. Bicarbonate retention c. Hyperventilation d. Bicarbonate loss

Which of the following apoproteins is inversely related to risk for coronary heart disease and is a surrogate marker for HDL? a. Apo A-I b. Apo B48 c. Apo B100 d. Apo E

How is ethanol formed? a. Fermentation of sugars b. Oxidation of fats c. Breakdown of purines d. None of the above

Which of the following enzymes is the best indicator of pancreatic function? a. AST b. ALT c. Amylase d. Lipase

Conjugated bilirubin: (1) Cannot appear in urine (2) Can appear in urine (3) Direct bilirubin (4) Indirect bilirubin a. 1 and 3 b. 1 and 4 c. 2 and 3 d. 2 and 4

Type II Diabetes mellitus: (I) Detectable C-peptide level (II) Undetectable C-peptide level (III) Most common in childhood/teens (IV) Most common in advancing age a. I and III b. I and IV c. II and III d. II and IV

Starting at day number 7, the control values demonstrated: a. Trend b. Shift c. Outliers d. None of the above

A Gaussian distribution is usually: a. Bell-shaped b. Rectangular c. Bimodal d. Skewe

Which of the following apoproteins is responsible for receptor binding for IDL and the chylomicron remnant produced in fat transport? a. Apo A1 b. Apo C c. Apo E d. Apo B

Trophic hormones are produced by the ______, and releasing factors are produced by the ______. a. Hypothalamus; pituitary b. Pituitary; hypothalamus c. Specific endocrine glands; hypothalamus d. Pituitary; target gland

In the direct Jaffe method for creatinine, a _____ tautomer of creatinine picrate is formed when creatinine is mixed with alkaline picrate reagent. a. Yellow-green b. Blue-green c. Mauve lavender d. Red-orange

Which of the following enzymes catalyzes the conversion of p-nitrophenyl phosphate to a colored pnitrophenol product? a. AST b. ALT c. ALP d. GGT

Which of the following is the most specific enzymatic method for glucose determination (employing G6PD as a second coupling step)? a. Glucose oxidase b. Glucose dehydrogenase c. Hexokinase d. Pyruvate kinase

To maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with which of the following? a. TCO2 b. Sodium c. Chloride d. Phosphate

Of the following, which will most likely interfere with quantification of thyroglobulin? a. Antithyrogolobulin autoantibodies b. Thyroid-stimulating antibodies c. TSH receptor antibodies d. Thyroid peroxidase antibodies

End color of phosphotungstic acid (Caraway method) for uric acid? a. Red b. Orange c. Blue d. Yellow

It is the main storage lipid in humans (found in adipose tissue); constitutes 95% of stored fat: a. Cholesterol b. Phospholipid c. Fatty acids d. Triglycerides

Which of the following is the correct collection and handling for the analysis of blood gases? a. Plastic syringe, dry heparin, store on ice, assay within 1 hour b. Glass syringe, liquid heparin, store on ice, assay within 15 minutes c. Glass syringe, no additive, store on ice, assay within 15 minutes d. Plastic syringe, dry heparin, store at room temperature, assay within 15 minutes

Which specimen is the sample of choice for lead screening? a. Whole blood b. Hair c. Serum d. Urine

Which of the following sets of values for repeat analyses of a QC sample (target value of 50) reflects the best precision? a. 50, 51, 52 b. 50, 52, 56 c. 48, 50, 52 d. 44, 50, 53

What is the least sensitive marker for the diagnosis of pheochromocytoma? a. Plasma metanephrine b. Plasma catecholamines c. Urine metanephrine d. Vanillylmandelic acid

Lead toxicity is acquired via: (1) Skin contact (2) Animal bites (3) Inhalation (4) Ingestion a. 1, 2, 3, and 4 b. 1, 2, and 3 c. 2, 3, and 4 d. 1, 3, and 4

Which are considered in post-analytical quality assurance in relation to timeliness? a. Turnaround times recorded and analyzed b. Including laboratory care in patient surveys c. Specimen collection explained to the patient d. Results are accurately transcribed into the system

Which of these drug levels would be considered toxic? a. Alcohol at 80 mg/dL b. Valproic acid at 50 ug/dL c. Digoxin at 2 ng/mL d. Acetaminophen at 250 ug/mL e. Salicylate at 27 mg/dL

First step in preanalytical phase? a. Test order b. Patient preparation c. Specimen collection d. Specimen handling

The last step in the enzymatic measurement for cholesterol involves which reaction? a. Trinder reaction b. Caraway reaction c. Diazo reaction d. Fearow’s reaction

Abnormality of the hypoxanthine guanine phosphoribosyl transferase indicate problems with ____ metabolism: a. Purine b. Pyrimidine c. Muscle d. Amino acid

Used to calibrate pH electrode: a. Distilled water b. Tap water c. Buffers d. None of the above

Which of the following tests is a good marker of nutritional status? a. Immunoglobulin M b. Prealbumin c. Ceruloplasmin d. Lp(a)

Of the following, which will most likely interfere with quantification of thyroglobulin? a. Antithyrogolobulin autoantibodies b. Thyroid-stimulating antibodies c. TSH receptor antibodies d. Thyroid peroxidase antibodies

Which of the following anticoagulants is generally suitable for most drug analyses (TDM)? a. Heparin b. EDTA c. Citrate d. Oxalate

True about CRP: (I) Elevated in bacterial infection (II) It may be used as a cardiac marker (III) It is an acute inflammatory marker (III) It is a chronic inflammatory marker a. I and III b. I, II, and III c. I, II, and IV d. I, II, III, and IV

Which of the following lipoproteins is considered as the smallest of all lipoproteins and is composed of 50% proteins? a. HDL b. Chylomicrons c. Triglycerides d. LDL

Thyroid hormones are derived from which of the following? a. Histidine b. Cholesterol c. Tyrosine d. Phenylalanine

What is both an enzyme and a hormone? a. Acetylcholinesterase b. Renin c. Cortisol d. None of the above

What is the critical value for hyperglycemia? a. >200 mg/dL b. >300 mg/dL c. >400 mg/dL d. >500 mg/dL