Chain-of-custody procedures must be followed for: * 0/1 Blood specimens for alcohol level determination Routine urinalysis for glucose and ketones Therapeutic drug threshold determinations Throat swabs of group A beta streptococcus screening

Calibration is defined as: * 1/1 How close results are to one another How close a test result is to the true value Specimen that is similar to patient’s blood; known concentration of constituent Comparison of an instrument measure or reading to a known physical constant

Standards are defined as: * 1/1 How close a test result is to the true value Specimens that are similar to patient’s blood; known concentration of constituent Comparison of an instrument measure or reading to a known physical constant Highly purified substances of known composition

A control is defined as: * 1/1 How close a test result is to the true value Specimen that is similar to patient’s blood; known concentration of constituent Comparison of an instrument measure or reading to a known physical constant Measurement of a highly purified substance of known composition

The preparation of a patient for standard glucose tolerance testing should include: * 0/1 A high carbohydrate diet for 3 days A low carbohydrate diet for 3 days Fasting for 48 hours prior to testing Bed rest for 3 days

A 25-year-old man became nauseated and vomited 90 minutes after receiving a standard 75 carbohydrate dose for an oral glucose tolerance test. The best course of action is to: * 1/1 Give the patient a glass of orange juice and continue the test Start the test over immediately with a 50 g carbohydrate dose Draw blood for glucose and discontinue test Place the patient in a recumbent position, reassure him and continue the test

The conversion of glucose or other hexoses into lactate or pyruvate is called: * 1/1 Glycogenesis Glycogenolysis Gluconeogenesis Glycolysis

Which of the following values obtained during a glucose tolerance test is diagnostic of diabetes mellitus? 1/1 2-hour specimen = 150 mg/dl (8.3 mmol/L) Fasting plasma glucose = 126 mg/dl (6.9 mmol/L) Fasting plasma glucose = 110 mg/dl (6.1 mmol/L) 2-hour specimen = 180 mg/dl (9.9 mmol/L)

A patient with hemolytic anemia will: * 1/1 Show a decrease in glycated Hb value Show an increase in glycated Hb value Show little or no change in glycated Hb value d demonstrate an elevated HbA1 Demonstrate an elevated HbA1

An increase in serum acetone is indicative of a defect in the metabolism of: * 1/1 Carbohydrates Fat Urea nitrogen Uric acid

One international unit of enzyme activity is the amount of enzyme that will, under specified reaction conditions of substrate concentration, pH and temperature, cause utilization of substrate at the rate of: * 1/1 1 mol/min 1mmol/min 1 μmol/min 1 nmol/min

In spectrophotometric determination, which of the following is the formula for calculating the absorbance of a solution? * 1/1 (absorptivity x light path)/concentration (absorptivity x concentration)/light path absorptivity x light path x concentration (light path x concentration)/absorptivity

High levels of which lipoprotein class are associated with decreased risk of accelerated atherosclerosis? * 1/1 Chylomicrons VLDL LDL HDL

The chemical composition of HDL corresponds to: * 0/1 Trigyceride 60%, cholesterol 15%, protein 10% Trigyceride 10%, cholesterol 45%, protein 25% Triglyceride 5%, cholesterol 15%, protein 50% Trigyceride 85%, cholesterol 5%, protein 2%

A 9-month-old boy from Israel has gradually lost the ability to sit up, and develops seizures. He has an increased amount of a phospholipid called ganglioside in his neurons, and he lacks the enzyme hexosaminidase A in his leukocytes. These findings suggest: * 1/1 Neimann-Pick disease Tay-Sachs disease Phenylketonuria Hurler syndrom

On electrophoresis at alkaline pH, which of the following is the slowest migrating hemoglobin? * 1/1 Hb A Hb S Hb C Hb G

In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates? * 0/1 Gilbert disease Rotor syndrome Dubin-Johnson syndrome Crigler-Najjar syndrome

What substance gives feces its normal color? 1/1 Uroerythrin Urochrome Urobilin Urobilinogen

Which of the following enzymes of heme biosynthesis is inhibited by lead? * 0/1 Delta-aminolevulinate dehydratase Porphobilinogen synthase Uroporphyrinogen synthase Bilirubin synthetase

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are both elevated in which of the following diseases? * 1/1 Muscular dystrophy Viral hepatitis Pulmonary emboli Infectious mononucleosis

Which of the following clinical disorders is associated with the greatest elevation of lactate dehydrogenase isoenzyme 1? * 0/1 Pneumonia Glomerulonephritis Pancreatitis Pernicious anemia

In which of the following conditions would a normal level of creatine kinase be found? * 0/1 Acute myocardial infarct Hepatitis Progressive muscular dystrophy Intramuscular injection

A 10-year-old child is admitted to pediatrics with an initial diagnosis of skeletal muscle disease. The best confirmatory tests would be: * 1/1 Creatine kinase and isocitrate dehydrogenase Gamma-glutamyl transferase and alkaline phosphatase Aldolase and creatine kinase Lactate dehydrogenase and malate dehydrogenase

The most heat labile fraction of alkaline phosphatase is obtained from: * 1/1 Liver Bone Intestine Placenta

Cholinesterase levels are generally assayed to aid in diagnosis of: * 1/1 Pancreatitis Methamphetamine overdose Organophosphate poisoning Hepatobiliary disease

lsoenzyme assays are performed to improve: 1/1 Precision Accuracy Sensitivity Specificity

The main function of serum albumin in the peripheral blood is to: * 1/1 Maintain colloidal osmotic pressure Increase antibody production Increase fibrinogen formation Maintain blood viscosity

The first step in analyzing a 24-hour urine specimen for quantitative urine protein is: 1/1 Subculture the urine for bacteria Add the appropriate preservative Screen for albumin using a dipstick Measure the total volume

A characteristic of the Bence Jones protein that is used to distinguish it from other urinary proteins is its solubility: * 0/1 In ammonium sulfate In sulfuric acid At 40-60°C At 100°C

The identification of Bence Jones protein is best accomplished by: * 0/1 Sulfosalicylic acid test Urine reagent strips Immunofixation electrophoresis Immunoelectrophoresis

A critically ill patient becomes comatose. The physician believes the coma is due to hepatic failure. The assay most helpful in this diagnosis is: * 1/1 Ammonia ALT AST GGT

Creatinine clearance is used to estimate the: 1/1 Tubular secretion of creatinine Glomerular secretion of creatinine Renal glomerular and tubular mass Glomerular filtration rate

Which of the following represents the end product of purine metabolism in humans? * 1/1 AMP and GMP DNA and RNA Allantoin Uric acid

The presence of C-reactive protein in the blood is an indication of: * 1/1 A recent streptococcal infection Recovery from a pneumococcal infection An inflammatory process A state of hypersensitivity

Clinical assays for tumor markers are most important for: * 1/1 Screening for the presence of cancer Monitoring the course of a known cancer Confirming the absence of disease Identifying patients at risk for cancer

Detection of which of the following substances is most useful to monitor the course of a patient with testicular cancer? * 0/1 Alpha-fetoprotein Carcinoembryonic antigen Prolactin Testosterone

In monitoring glomerular function, which of the following tests has the highest sensitivity? * 1/1 Urine sodium BUN/creatinine ratio Creatinine clearance Urea clearance

A double albumin band seen on serum protein electrophoresis indicates: * 1/1 Severe liver disease Bisalbuminemia Acute inflammation Hemolytic anemia

Which term describes a congenital disorder that is characterized by a split in the albumin band when serum is subjected to electrophoresis? * 1/1 Analbuminemia Anodic albuminemia Prealbuminemia Bisalbuminemia

Which of the following serum proteins migrate with the beta-globulins on cellulose acetate at pH 8.6? * 0/1 Ceruloplasmin Hemoglobin Haptoglobin C3 component of complement

The expected blood gas results for a patient in chronic renal failure would match the pattern of: * 1/1 Metabolic acidosis Respiratory acidosis Metabolic alkalosis Respiratory alkalosis

At blood pH 7.40, what is the ratio of bicarbonate to carbonic acid? * 1/1 15:1 20:1 25:1 30:1

The reference range for the pH of arterial blood measured at 37°C is: 1/1 7.28 to 7.34 7.33 to 7.37 7.35 to 7.45 7.45 to 7.50

The most important buffer pair in plasma is the: * 1/1 Phosphate/biphosphate pair Hemoglobin/imidazole pair Bicarbonate/carbonic acid pair Sulfate/bisulfate pair

Select the test which evaluates renal tubular function. * 0/1 IVP Creatinine clearance Osmolality Microscopic urinalysis

Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure? * 1/1 Chloride Calcium Potassium Sodium

The solute that contributes the most to the total serum osmolality is: 0/1 Glucose Sodium Chloride Urea

The osmolality of a urine or serum specimen is measured by a change in the: * 0/1 Freezing point Sedimentation point Midpoint Osmotic pressure

The hormone that triggers ovulation is: * 0/1 Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Thyroid-stimulating hormone (TSH) Human chorionic gonadotropin (HCG)

During a normal pregnancy, quantitative human chorionic gonadotropin (HCG) levels peak how many weeks after the last menstrual period? * 1/1 2 to 4 8 to 10 14 to 16 18 to 20

24-hour homovanillic acid (HVA) is usually ordered to help in diagnosis of: * 0/1 Cushing disease Malignant neuroblastoma Conn disease Graves disease

An antiepileptic (or anticonvulsant) used to control seizure disorders is: * 0/1 Digoxin Acetaminophen Lithium Phenytoin

The typical specimen collected for forensic toxicity of drugs of abuse is: * 1/1 Random urine Whole blood Serum Hair follicle

Preanalytical (preexamination) variables in laboratory testing include: 1/1 Result accuracy Report delivery to the ordering physician Test turnaround time Specimen acceptability

Preanalytical (preexamination) variables in laboratory testing include: 1/1 Result accuracy Report delivery to the ordering physician Test turnaround time Specimen acceptability

A preanalytical error can be introduced by: * 1/1 Drawing a coagulation tube before an EDTA tube Mixing an EDTA tube 8-10 times Transporting the specimen in a biohazard bag Vigorously shaking of blood tube to prevent clotting

Which of the following is not a potential source of postanalytical (postexamination) errors? * 0/1 Excessive delay in reporting or retrieving a test result Interpretation of result Verbal notification of test result Labeling the specimen at the nurses' station

The most important diagnosis and therapeutic management decision tool used to interpret test results is: * 1/1 Statistical analysis Reference intervals Specimen acceptability The age of a patient

A delta check is a method that: 1/1 Determines the mean and variance of an instrument Monitors the testing system for precision Monitors patient samples day to day Is determined by each laboratory facility

A laboratory procedure manual should be available to personnel at the workbench and must include the following elements: * 1/1 Clinical significance, frequency of test performance, quality control processes, calculations, and test interpretation Step-by-step performance instructions, reference intervals, reagent storage location, specimen collection requirements Limitation of test performance (interfering substances), corrective action if QC fails, critical values, and reagent preparation Test principle, criteria for specimen rejection, list of individuals authorized to perform, and calibration procedures

Which of these attributes is the advantage for adding point-of-care testing? * 0/1 Higher test accuracy Lower costs Faster TAT More skilled test personnel

A technologist splashed a corrosive chemical in his/her eyes. To prevent permanent injury, the first action should be to * 1/1 Bandage the eyes and seek immediate emergency medical assistance Flush eyes with a chemical of opposite pH to neutralize the injury Use the eyewash station to flush eyes with water for 15 minutes Seek immediate emergency medical assistance

The acceptable limit of error in the chemistry laboratory is 2 standard deviations. If you run the normal control 100 times, how many of the values would be out of the control range due to random error? * 0/1 1 5 10 20

The target in the figure illustrates a set of results that show a high degree of: Accuracy Precision Sensitivity Specificity

Which of the following wavelengths is within the ultraviolet range? * 0/1 340 nm 450 nm 540 nm 690 nm

In spectrophotometric analysis, what is the purpose of the reagent blank? * 1/1 Correct for interfering chromogens Correct for lipemia Correct for protein Correct for color contribution of the reagents

To calibrate the pH electrode in a pH/ blood gas analyzer, it is necessary that: * 0/1 The barometric pressure be known and used for adjustments Calibrating gases of known high andl ow concentrations be used The calibration be performed at room temperature Two buffer solutions of known pH be used

Checking instrument calibration, temperature accuracy, and electronic parameters are part of * 0/1 Preventive maintenance Quality control Function verification Precision verification

To what class of enzymes does lactate dehydrogenase belong? * 0/1 Isomerases Ligases Oxidoreductases Transferases

Which of the following enzymes does not belong to the class of enzymes known as the hydrolases? * 1/1 Alkaline phosphatase Aldolase Amylase Lipase

If elevated, which laboratory test would support a diagnosis of congestive heart failure? 1/1 Homocysteine Troponin Albumin cobalt binding D. B-typenatriureticpeptide B-type natriuretic peptide

Which of the following enzyme activities can be determined by using a dilute olive oil emulsion substrate, whose hydrolyzed product is monitored as a decrease in turbidity or light scatter? * 0/1 Alkaline phosphatase Amylase Lipase Trypsin

In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what electrolyte? * 1/1 Sodium Potassium Chloride Phosphate

Which of the following organs uses glucose from digested carbohydrates and stores it as glycogen for later use as a source of immediate energy by the muscles? * 0/1 Kidneys Liver Pancreas Thyroid

Convert: 20 °C = ___ °F 25 53 68 86

Convert: 75 °F = ___°C 5.5 21.0 23.8 32.6

An etched ring on a to-deliver (TD) pipette indicates: * 1/1 A small amount of fluid will remain in tip of pipette, and it is left to remain in the tip The drop remaining in the tip must be blown out Either No significance

The purest type of reagent water is: * 1/1 Type I Type II Type III All are equal

How would 6.32 be rounded off to one less decimal place? * 1/1 6.32 6.4 7.0 6.3

How would 15.57 be rounded off to one less decimal place? * 1/1 15.6 15.5 16.0 15.0

Dilution is: * 1/1 The amount of one substance relative to the amounts of other substances in the solution Relative concentrations of the components of a mixture The gram-molecular mass (or weight) of a com- pound per liter of solution Expression of one amount relative to another amount

Three grams (3 g) of solute in 100mL of solvent equals _____% (w/v). 0/1 0.3 3 30 300

Twenty grams (20 g) of solute dissolved in 1L of solvent equals _____% (w/v). * 0/1 0.2 2 20 200

How many grams of NaCl would be used to prepare 1000 mL of a 5% (w/v) solution of NaCl? * 0/1 0.5 g 5 g 50 g 500 g

What volume of 25% alcohol is needed to prepare 500 mL of 15% alcohol? * 1/1 30 mL 300 mL 350 mL 375 mL

A ratio is: * 1/1 The amount of one substance relative to the amounts of other substances in the solution Relative concentrations of the components of a mixture The gram-molecular mass (or weight) of a compound per liter of solution Expression of one amount relative to another amount

Concentration is: * 0/1 The amount of one substance relative to the amounts of other substances in the solution Relative concentrations of the components of a mixture The gram-molecular mass (or weight) of a compound per liter of solution Expression of one amount relative to another amount

Nephelometry measures the light scatter of: * 1/1 Ions Macromolecules complexes Antibodies Soluble antigens

Which of the following is the most common application of immunoelectrophoresis (IEP)? * 1/1 Identification of the absence of a normal serum protein Structural abnormalities of proteins Screening for circulating immune complexes Diagnosis of monoclonal gammopathies

The most important application of IEP of urine is: * 1/1 Diagnosis of monoclonal gammopathy Diagnosis of polyclonal gammopathy Diagnosis of autoimmune hemolysis Demonstration of Bence Jones (BJ) protein

Which monochromator specification is required in order to measure the true absorbance of a compound having a natural absorption bandwidth of 30 nm? * 0/1 50-nm bandpass 25-nm bandpass 15-nm bandpass 5-nm bandpass

Which of the following conditions is associated with hypernatremia? * 0/1 Diabetes insipidus Hypoaldosteronism Burns Diarrhea

Which formula is most accurate in predicting plasma osmolality? * 0/1 Na + 2(Cl) + BUN + glucose 2(Na) + 2(Cl) + glucose + urea 2(Na) + (glucose ÷ 18) + (BUN ÷ 2.8) Na + Cl + K + HCO3

Identify the enzyme deficiency responsible for type 1 glycogen storage disease (von Gierke’s disease). * 0/1 Glucose-6-phosphatase Glycogen phosphorylase Glycogen synthetase β-Glucosidase

Which of the following abnormal laboratory results is found in von Gierke’s disease? * 0/1 Hyperglycemia Increased glucose response to epinephrine administration Metabolic alkalosis Hyperlipidemia

Which test is the most sensitive in detecting early monoclonal gammopathies? * 1/1 High-resolution serum protein electrophoresis Urinary electrophoresis for monoclonal light chains Capillary electrophoresis of serum and urine Serum-free light chain immunoassay

Which test is the most useful way to evaluate the response to treatment for multiple myeloma? * 0/1 Measure of total immunoglobulin Measurement of 24-hour urinary light chain concentration (Bence–Jones protein) Capillary electrophoresis of M-protein recurrence Measurement of serum-free light chains

Which of the following mechanisms accounts for the elevated plasma level of β lipoproteins seen in familial hypercholesterolemia (formerly type II hyperlipoproteinemia)? * 1/1 Hyperinsulinemia ApoB-100 receptor defect ApoC-II activated lipase deficiency ApoE3 deficiency

Which enzyme deficiency is most commonly associated with familial hypertriglyceridemia associated with fasting plasma cholomicrons (formerly type I hyperlipoproteinemia)? 0/1 β Glucocerebrosidase deficiency Post–heparin-activated lipoprotein lipase deficiency Apo-B deficiency Apo-C-III deficiency

Which of the following enzymes is considered most tissue specific? 0/1 Creatine kinase (CK) Amylase Alkaline phosphatase (ALP) Alcohol dehydrogenase (ADH)