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PRE-BOARD EXAMINATION IN CLINICAL CHEMISTRY (PART 2) The extent to which measurements agree with the true value of the quantity being measured is known as: A. Acceptable limits B. Accuracy C. Precision D. Reliability The reproducibility of test measurements is referred to as: A. Accuracy B. Precisio...

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PRE-BOARD EXAMINATION IN CLINICAL CHEMISTRY (PART 2) 1. The extent to which measurements agree with the true value of the quantity being measured is known as: A. Acceptable limits B. Accuracy C. Precision D. Reliability 2. The reproducibility of test measurements is referred to as: A. Accuracy B. Precision C. Quality control D. Reliability 3. In a Gaussian curve distribution, the 2 SD range includes the following percentage of values: A. 31.6% B. 68.3% C. 95.5% D. 99.7% 4. Given the following data, calculate the coefficient of variation for glucose. Analyte Mean Standard deviation Glucose 76 mg/dL 2.3 A. 3.0% B. 4.6 % C. 7.6% D. 33.0% 5. A cholesterol QC chart has the following data for the normal control: x = mean of data x = 137 mg/dL x = 1,918 mg/dL 2 SD = 6 mg/dL N = 14 The coefficient of variation for this control is: A. 1.14% B. 2.19% C. 4.38% D. 9.49% 6. Which Westgard rule detects random error? A. 13s B. 41s C. 22s D. 100 7. In addition to the number of true negative (TN), which of the following measurements is needed to calculate specificity? A. True positives B. Prevalence C. False negatives D. False positives 8. The component of a spectrophotometer that is responsible for detecting transmitted light and converting light energy to electrical energy is the: A. Detector B. Analytical cell C. Monochromator D. Readout device 9. Nephelometry is based on the measurement of light that is: A. Absorbed by particles in suspension C. Produced by fluorescence B. Scatterd by particles in suspension D. Produced by excitation of ground-state atoms 10. Which of the following instruments is used in the clinical laboratory or in reference laboratories to detect beta and gamma emissions? A. Fluorometer B. Nephelometer C. Spectrophotometer D. Scintillation counter 11. In flow cytometry, the side scatter is related to the: A. DNA content of the cell C. Size of the cell B. Granularity of the cell D. Number of cells in G0 and G1 12. 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, beta globulin, gamma globulin D. Gamma globulin, beta globulin, alpha-2 globulin, alpha-1 globulin, albumin 13. Ceruloplasmin and haptoglobin migrate electrophoretically as: A. Alpha1 globulins B. Alpha2 globulins C. Beta globulins D. Gamma globulins 14. Which of the following serum protein fractions is most likely to be elevated in patients with nephrotic syndrome? A. Alpha-1 globulin B. Albumin C. Alpha-2 globulin D. Beta globulin and gamma globulin 15. In cirrhosis, a predominant characteristic observed in electrophoretic serum pattern is a(an):

A.I n c r e a s ei na l p h a l o b u l i nf r a c t i o n C.Mo n o c l o n a l b a n di ng a mmag l o b u l i nr e g i o n 2g B.Br i d g i n ge ff e c t b e t we e nb e t aa n dg a mmag l o b u l i nf r a c t i o n D.Po l y c l o n a l b a n di ng a mmag l o b u l i nr e g i o n 16. Which hemoglobin may be differentiated from other hemoglobins on the basis of its resistance to denature in alkaline solution? A. A1 B. A2 C. C D. F 17. Which of the following ezymes does not belong to the class of enzymes known as hydrolases? A. Aldolase B. Amylase C. Lipase D. Alkaline phosphatase 18. Which of the following enzymes is a transferase? A. ALP B. CK C. Amylase D. LD 19. When myocardial infarction occurs, in what order (list from first to last) will the enzymes aspartate aminotransferase (AST), creatine kinase (CK), and lactate dehydrogenase (LD) become elevated in the serum? A. AST, LD, CK B. CK, LD, AST C. CK, AST, LD D. LD, CK, AST 20. Time course of CK activity in myocardial infarction: Onset of Elevation Peak Activity Duration of Elevation A 1-3 h 5-12 h 18-30 h B 4-8 h 12 h 3-4 d C 8-12 h 24 h 5d D 12-24 h 72 h 10 d 21. 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 22. Which of the following enzymes exhibit a decreased serum level in liver disease? A. Alanine aminotransferase D. Cholinesterase

B. Gamma glutamyltransferase C. Lactate dehydrogenase

E. All of the above

2 23. Which enzymes are generally quantified to help diagnose acute pancreatitis? A. ALT and CK B. ALT and LD C. Amylase and lipase D. ALP and cholinesterase 24. Select the most sensitive marker for alcoholic liver disease. A. AST B. ALT C. GGT D. None of these 25. In an adult, a normal GGT level with an elevated serum ALP level may be suggestive of: A. Bone disease B. Heart disease C. Liver disease D. Skeletal muscle disease 26. The relative concentration of LD isoenzymes in normal serum: A. LD 1>2>3>4>5 B. LD 2>1>4>3>5 C. LD 2>1>3>4>5 D. LD 5>4>3>2>1 27. A decreased LDH/HBD ratio is significant for: A. Myocardial infarction B. Liver disease C. Both of these D. None of these 28. Isoenzyme of ALP that is most heat stable: A. Placental ALP B. Bone ALP C. Intestinal ALP D. Liver ALP 29. Which of the following hormones does not promote an increase in blood glucose levels? A. Growth hormone B. Cortisol C. Glucagon D. Insulin 30. Of the following blood glucose levels, which would you expect to result in glucose in the urine? A. 60 mg/dL B. 120 mg/dL C. 150 mg/dL D. 225 mg/dL 31. An individual has a plasma glucose level of 110 mg/dL. What would be the approximate glucose concentration in the patient’s cerebrospinal fluid? A. 33 mg/dL B. 55 mg/dL C. 66 mg/dL D. 110 mg/dL 32. Select the enzyme that is most specific for -D-glucose: A. Glucose oxidase C. Hexokinase B. Glucose-6-phosphate dehydrogenase D. Phophohexoisomerase 33. Select the coupling enzyme used in the hexokinase method for glucose: A. Glucose dehydrogenase C. Glucose-6-phosphate dehydrogenase B. Glucose-6-phosphatase D. Peroxidase 34. Which of the following methods provides information about glucose metabolism over a 3 month period? A. Fructosamine C. Glycosylated hemoglobin B. Glucose oxidase D. Oral glucose tolerance 35. Measurement of glycosylated albumin, which reflects hyperglycemic state within the previous 2 – 3 weeks is: A. Glucosamine B. Fructosamine C. Urine glucose D. Galactosamine 36. Type I DM maybe described by all of the following, EXCEPT: A. Insulin dependent B. Insulinopenia C. Ketosis prone D. Adult-onset type 37. What is the compound that comprises the majority of the nonprotein-nitrogen fractions in serum? A. Uric acid B. Creatinine C. Ammonia D. Urea 38. What analyte is measured using the Jaffe reaction? A. Urea B. Uric acid C. Ammonia D. Creatinine 39. The creatinine clearance test is routinely used to assess the glomerular filtration rate. Given the following information for an average-size adult, calculate the creatinine clearance. Urine creatinine - 120 mg/dL Plasma creatinine - 1.2 mg/dL Urine volume for 24 hours - 1520 mL A. 11 mL/min B. 63 mL/min C. 95 mL/min D. 106 mL/min 40. Given the following data, calculate the creatinine clearance, Serum creatinine = 1.2mg/dL; urine creatinine =- 120 mg/dL; urine volume = 1.75 L/day; surface area = 1.80 m2. A. 16 mL/min B. 117 mL/min C. 126 mL/min D. 168 mL/min 41. During chemotherapy for leukemia, which of the following analytes would most likely be elevated in the blood? A. Uric acid B. Urea C. Creatinine D. Ammonia 42. A BUN of 9 mg/dL is obtained by a technologist. What is the urea concentration? A. 18.3 mg/dL B. 19.3 mg/dL C. 10.3 mg/dL D. 9.3 mg/dL 43. Blood ammonia levels are usullay measured in order to evaluate: A. Renal failure B. Acid-base status C. Hepatic coma D. Malabsorption 44. Indirect-reacting bilirubin may be quantified by reacting it initially in which reagent? A. Dilute hydrochloric acid C. Caffeine-sodium benzoate B. Dilute sulfuric acid D. Sodium hydroxide 45. The bilirubin fraction that is covalently attached to albumin and contributes to the conjugated bilirubin value is: A. Delta B. Direct C. Indirect D. Bound 46. In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates? A. Gilbert’s disease B. Dubin-Johnson syndrome C. Rotor’s syndrome D. Crigler-Najjar syndrome 47. A decrease in which of the following indicates increased intravascular hemolysis? A. Methemoglobin B. Methemalbumin C. Haptoglobin D. Hemopexin 48. Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6. A. – Chylomicrons  prebeta  beta  alpha + C. – Chylomicrons beta  prebeta  alpha + B. – Beta  prebeta  alpha chylomicrons + D. – Alpha  beta  prebeta  chylomicrons + 49. Chemical composition of HDL: Protein (%) Cholesterol (%) Triglyceride (%) Phospholipid (%) A 1-2 1-3 80-95 3-6 B 6-10 4-8 45-65 15-20 C 18-22 6-8 4-8 18-24 D 45-55 3-5 2-7 26-32...