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Term 1 Definition 1

An International unit (IU) of enzyme


activity is the quantity of enzyme that:
 
   
   
Converts 1 μmol of substate to
product per minute
 

Term 2 Definition 2

Which enzyme statement below


describes a nonkinetic enzyme assay
?
 
 
Initial absorbance is measured,
followed by a second reading after 5
minutes

Term 3 Definition 3

Which if the following statements


regarding enzymatic reactions is true
?
 
 
The enzyme increases the rate  of the
reaction

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Term 4 Definition 4

Which statement about enzymes is


true ?
 
 
 
A competetitive inhibitor will alter the
apparent Km (Michaelis-Menten Constant)
of the reaction

Term 5 Definition 5

Which substrate concentration is


needed to achieve zero-order
conditions ?
 
 
> than 99 x K m
 

Term 6 Definition 6

Which statement is true ?


 
 
Apoenzyme + prosthetic group =
holoenzyme
 
 
 

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Term 7 Definition 7

Which of the following statements


about enzymatic reactions is true ?
 
 
 
NADH has absorbance maximum at
340 and 366 nm

Term 8 Definition 8

The increase in the level of serum


enzyme used to detect cholestatic
liver disease is caused mainly by :
 
 
 
Increased production and secretion by
cells

Term 9 Definition 9

Which enzyme below is considered


most tissue specfic ?
 
Alcohol dehydrogenase
(along with ALT-necrotic liver disease)

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Term 10 Definition 10

Which of the following enzymes is


activated by calcium ions?
 
Amylase

Term 11 Definition 11

Which of the following enzymes is a


transferase ?
 
CK
 
(not - Alkp,Amy,LD)

Term 12 Definition 12

Which statement about the methods


for measuring LD is true ?
 
The pyruvate to lactate reaction
proceeds at about twice the rate as the
forward reaction

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Term 13 Definition 13

Which condition produces the highest


elevation of serum lactate
dehydrogenase ?
 
Pernicious Anemia

Term 14 Definition 14

Which condition is the LD most likely


to be within normal limits .?
 
Acute appendicitis
 
(not hepatic ca,pulmonary
infarct,crush injury)

Term 15 Definition 15

Following an acute MI, activity of LD


usually peaks:
 
Three days postinfarction and returns
to normal after 1 week.

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Term 16 Definition 16

The LD pleural fluid:serum ratio for a


transudative fluid is usually :
 
 
1:2 or less

Term 17 Definition 17

Which type of liver disease would you


expect the greatest elevation of LD ?
 
Toxic hepatitis
 
(not etoh hepatitis,cirrhosis,acute viral
hepatitis)

Term 18 Definition 18

Which of the following conditions will


interfere with measurement of LD ?
 
 
Slight hemolyis during sample
collection 
 
(LD is stable 2 days at RT or 1 week in
refer)

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Term 19 Definition 19

In the Oliver-Rosalki method, the


reverse reaction is used to measure
CK activity. The enzyme used in the
coupling reactions are:
 
 
Hezokinase and G6PD

Term 20 Definition 20

In the Oloiver-Rosalki method for CK,


adenosine monophosphate(AMP) is
added to the substrate in order to :
 
 
Inhibit adenylate kinase
 

Term 21 Definition 21

Which substance is used in the CK


assay to activate the enzyme ?
 
 
 
N-acetylcysteine

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Term 22 Definition 22

Specimen for CK performed on an


automated analyzer gives an error flag
indicating substrate depletion. The
sample is diluted x2 and x4. After
correction the results are as follows:
x2=3000       x4=3600    Explanation ?
 
An endogenous competitive inhibitor
is present in the serum

Term 23 Definition 23

2 hour old citrated coag sample, can


we add on a CK?
 
No, citrate will interfere

Term 24 Definition 24

Which of the statements below


regarding total CK is true?
 
Highest levels are seen in Duchenne's
Muscular Dystrophy.

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Term 25 Definition 25

Which of the following statements


regarding the clinical use of CK-MB
(CK-2) is true ?
 
Mass unit assays are more sensitive
than electrophoretic methods

Term 26 Definition 26

Isoforms of CK are:
 
 
 
Formed in the circulation by
hydrolysis of lysine from CK-MM and
CK-MB

Term 27 Definition 27

A patient's CK-MB is reported at 18


and the total CK as 560. What is the
CK relative index?
 
3.2%
 
CKI =    CK-MB     x 100
Total CK

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Term 28 Definition 28

In a nonmyocardial as opposed toa


myocardial cause of an increased
serum or plasm CK-MB, which would
be expected?
 
 
An increase in CK-MB that is
persistent.

Term 29 Definition 29

Which statement best describes the


clinical utility of plasma or serum
myoglobin ?
 
Levels below 100 on admission and 2-
4 hours postadmission help to
exclude a diagnosis of acute MI.

Term 30 Definition 30

What is the typical time course for


plasma myoglobin following an acute
MI ?
 
Abnormal with in 3 hours, peaks
within 12 hours, returns to normal in
36  hours.

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Term 31 Definition 31

What is the typical time course for


plasma TnI or TnT following an acute
MI ?
 
Abnormal within 4 hours, peaks within
24 hours, returns to normal in 1 week

Term 32 Definition 32

Which of the following is the most


effective serial sampling tiem for
ruling out acute MI using both
myoglobin and a cardiac spedific
marker in an emergency department
environment ?
 
Admission, 3 hrs, 6 hrs and a final
sample within 12 hrs

Term 33 Definition 33

Whic of the cardiac markers is


consistently increased in persons who
exhibit unstable angina ?
 
Troponin T

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Term 34 Definition 34

Patient has a myoclobin level of 10 at


admission. three hours later the
myoglobin is 14 and the Tropponin I is
0.04 (ref 0.0-0.4) Results are
consistent with what condition ?
 
No evidence of myocardial or skeletal
condition .

Term 35 Definition 35

A patient has a plasma CK-MB of 14 at


admission and a totla CK of 170.
Myoglobin is 130 and TnI is 1.6. Three
hours later the cK-MB is 24. What best
descrives this situation ?
 
This patient has had an acute MI and
further testing is unnecessary.

Term 36 Definition 36

EDTA sample for TnI assay gives


result of 0.7(ref0.0-0.4). The test is
repeated three hours later and is 0.6,
six hours later is 0.7. Most likely
explanation ??
 
The patient has suffered cardiac
injury, probably less severe than an
MI.

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Term 37 Definition 37

Which of the following lab tests is a


marker for ischemic heard disease ?
 
Albumin cobalt binding.

Term 38 Definition 38

Which test provides the earliest


warning of increased risk of coronary
artery disease ?
 
High sensitivity CRP

Term 39 Definition 39

Which statement best describes the


clinical utilitity of B-type natriuretic
peptide (BNP) ?
 
A normal test result helps rule out
congestive heart failure in persons
with symptoms associated with
coronary insufficiency.

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Term 40 Definition 40

Which best describes the clinical


utility of plasma homocysteine ?
 
High plasma levels are assiciated with
atherosclerosis and increased risk of
thrombosis.
 

Term 41 Definition 41

Which of the following statements


about the aminotransferases  (ALT &
AST) is true ?
 
Both transfer an amino group to α-
ketoglutarate

Term 42 Definition 42

Select the products formed from the


forward reaction of AST ?
 
 
 
Oxaloacetate and glutamate

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Term 43 Definition 43

Select the products formed form the


forward reaction of ALT ?
 
 
Pyruvate and glutamate

Term 44 Definition 44

Which of he statements below


regarding the methods of Henry for
AST and ALT is correct ?
 
Hemolysis causes positive
interference in both AST and ALT
assays

Term 45 Definition 45

Select the coupling enzyme used in


the kinetic reaction of Henry ?
 
 
Malate dehydrogenase

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Term 46 Definition 46

What is the purpose of LD in the


kinetic method of Henry for AST ?
 
Rapidly exhausts endogenous
pyruvate in the lag phase

Term 47 Definition 47

Which statement regarding the


naming of transaminases is true ?
 
SGPT is the old abbreviation for ALT

Term 48 Definition 48

Which statement accurately describes


serum transaminase levels in AMI ?
 
AST peaks 24-48 hours after an acute
MI and returns to normal with 4-6 days

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Term 49 Definition 49

Which condition gives rise to the


highest serum level of transaminases
?
 
Acute hepatitis

Term 50 Definition 50

In which liver disease is the DeRitis


ratio (ALT:AST) usually greater than
1.o ?
 
Acute hepatitis
 
(ALT prevails over AST in acute
hepatitis, but AST is higher than ALT
in chronic hepatitis, carcinoma and
cirrhisis of the liver)

Term 51 Definition 51

Which of the following liver diseases


produces the highest levels of
transaminases ?
 
 
Chronic hepatitis

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Term 52 Definition 52

Which of the following statements


regarding transaminames is true ?
 
ALT is far more spedific for liver
diseases than is AST

Term 53 Definition 53

Select the most sensitive marker for


alcoholic lever disease ?
 

GGT

Term 54 Definition 54

Which enzyme is least useful in


differentating necrotic from
obstructive jaundice ?
 
 
LD

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Term 55 Definition 55

Which of the statements below about


the phosphatases is true ?
 
They are divided into two classes
based upon pH needed for activity
(alkaline or acid)

Term 56 Definition 56

Which of the following statements


regarding ALP is true ?
 
 
Pregnant women have a higher lever
of serum ALP than other adults

Term 57 Definition 57

Which isoenzyme of ALP are inhibited


by L-phenylalanine ?
 
 
Intestional and placental

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Term 58 Definition 58

Which isoenzyme of ALP is most heat-


stable ?
 
 
Placental
 
 

Term 59 Definition 59

Which isoenzyme of ALP migrates


farthers toward the anode (+) when
electrophoresed at pH 8.6 ?
 
 
Liver

Term 60 Definition 60

Which isoenzyme of ALP is inhibited


by urea ?
 
Bone

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Term 61 Definition 61

Which of the following statements


regarding ALP is true ?
 
 Elevated serum ALP seen with
elevated GGT suggests a hepatic
source

Term 62 Definition 62

In which condition would an elevated


serum alkaline phosphatase be likely
to occur ?
 
Squamous cell carcinoma

Term 63 Definition 63

Which condition is least likely to be


associated with increased serum ALP
concentrations ?
 
 
Osteoporosis

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Term 64 Definition 64

Which substrate is used in the


Bowers-McComb method for ALP ?
 
p-Nitrophenylphosphate

Term 65 Definition 65

Term 66 Definition 66

Which of the following buffers is used


in the IFCC recommended method for
ALP ?
 
 
2-amino-2-methyl-1-propanol

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Term 67 Definition 67

Serum form a 50 year old collected


following digital exam. Prostatic acid
phos 6.o (upper ref 3.0)
PSA 2.0 (upper ref 4.0) Most likely
explanation ?
 
 
Acid phos is falsely elevated by
prostatic irritation

Term 68 Definition 68

Which definition best describes the


catalytic activity of amylase  ?
 
Hydrolyzes second a-1-4-glycosidic
linkages of starch,glycogen and other
polyglucans 

Term 69 Definition 69

Which of the following anylase


methods is typically based upon a rate
reaction ?
 
 
Turbidimetric

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Term 70 Definition 70

How soon following acute abdominal


pain due to pancreatitis is the serum
anylase level expected to rise ?
 
 
 
2-12 hours

Term 71 Definition 71

Which of the statements below


regarding the diagnosis of pancreatitis
is correct ?
 
 
 
Diagnostic sensitivity is increased by
assaying both amylase and lipase

Term 72 Definition 72

Which of the following conditions is


associated with a high level of S-type
anylase ?
 
Mumps
 
S-salivary

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Term 73 Definition 73

Which of the statements regarding


amylase methods is true ?
 
Amyloclastic methods measure the
production of glucose.

Term 74 Definition 74

Which of the following statements


regarding amylase methods is true ?
 
Synthetic substrates can be
conjugated to p-nitrophenol (PNP) for
a kinetic assay ?
 

Term 75 Definition 75

The reference method for lipase uses


olive oil as the substrate because ?
 
Other esterases can hydrolyze
triglyceride and synthetic diglycerides

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Term 76 Definition 76

Which statement about the clinical


utility of plasma or serum lipase is
true ?
 
Lipase is not incresed in mumps,
malignancy or ectopic pregnancy

Term 77 Definition 77

The reference method for serum lipase


is based upon :
 
Titration of fatty acids with dilute
NaOH following controlled incubation
of serum with olive oil

Term 78 Definition 78

The most commonly employed


method of assay for plasma or serum
lipase is based upon:
 
Peroxidase coupling
 

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Term 79 Definition 79

Which of the following enzymes is


usually depressed in liver disease ?
 
 
Pseudocholinesterase

Term 80 Definition 80

A serum ALP lever greater than twice


the elevation of GGT suggests:
 
 
Bone disease or malignancy

Term 81 Definition 81

How many of the substances below


would be neede to enable an early
diagnosis of stroke ?
 
D-Dimer, vonWillebrand's factor,
matric metalloproteinase-9, S100B,
BNP, vascular cell adhesion molecule .
 
 
All six

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Term 82 Definition 82

Which of the following  hormones is


often decreased by approx 25% in the
serum of pregnamt women who have a
fetus with Down's Syndrome ?
 
EStriol (E3)

Term 83 Definition 83

The syndrome of anapprioate


antidieuretic hormone secretion
(SIADH) causes:
 
 
Urine osmolality to be lower than that
of plasma osmo

Term 84 Definition 84

Select the hormone that is associated


with galactorehea, pituitary adenoma,
and amehorrhea ?
 
 
Prolactin

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Term 85 Definition 85

Zollinger-Ellison(Z-E) syndrome is
characterized by great (20 fold)
elevation of :
 
 
Gastrin
 

Term 86 Definition 86

Which statement about multiple


endocrine neoplasia (MEN) is true ?
 
 
It is associated with hyperplasia or
neoplasia of at least two endocrine
organs
 

Term 87 Definition 87

Select the main estrogen produced by


the ovaries and used to evaluate
ovarian function ?
 
 
Estradiol (E2)
 
 
E2 is the major estrogen produced by
the ovaries

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Term 88 Definition 88

When pituitary adenoma is the cause


of decreased estrogen production, an
increase of which hormone os most
frequently responsible ?
 
Prolactin

Term 89 Definition 89

Which of the following statements is


correct in aaesing GH deficiency ?
 
 
Pituitary failure may involve one,
several, or all adenohyphophyseal
hormones, but GH deficiency is
usually found.

Term 90 Definition 90

Which statement best describes the


level of GH in patients with pituitary
adenoma associated with acromegaly
?
 
 
Some patients require a glucose
suppression test to establish a
diagnosis

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Term 91 Definition 91

Hyperparathyroidism is most
consistently associated with ?
 
 
Hypophosphatemia
 
(Inc serum Ca , dec serum phos)

Term 92 Definition 92

Which statement reagarding the use of


PTH is true ?
 
 
 
PTH levels differentiate primary and
secondary cause of hypocalcemia

Term 93 Definition 93

The best method of analysis for serum


PTH involves using antibodies that
detect ?
 
 
 
Both the amino-terminal fragment and
intact PTH

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Term 94 Definition 94

Which of the following is most often


elevated in hypocalcemia associated
with malignancy ?
 
 
 
Parathyroid hormone related protein
(PTHRP)

Term 95 Definition 95

Steroids with a dihydroxyacetone


group at C17 are sclassified as :
 
 
17-hydroxycorticosteroids
 

Term 96 Definition 96

Which statement below regarding


adrenal cortical dysfunction ?
 
 
 
Cushing's syndrome is associated
with glucose intolerance

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Term 97 Definition 97

Which of the following statements


about cortisol in Cushing's syndrome
is true ?
 
 
24 hour urinary free cortisol is a more
sensitive test than plasma total
cortisol

Term 98 Definition 98

Which of the following diseases is


characterized by primary
hyperaldosteronism caused by
adrenal adenoma, carcinoma, or
hypoplasia ?
 
 
Conn's disease

Term 99 Definition 99

Which of the following is the most


common cause of Cushing's
syndrome ?
 
 
 
Overuse of Corticosteroids

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Term 100 Definition 100

Which of the following is the


mechanism causing Cushing's
disease ?
 
 
Excess secretion of pituitary ACTH

Term 101 Definition 101

In which situation is the plasma or 24-


hour urinary cortisol not consisent
with the clinical picture ?
 
 
Evaluation of congenital adrenal
hyperplasia
 
 

Term 102 Definition 102

Which test is used to distinguish


Cushing's disease (pituitary
Cushing's) from Cushing's syndrome
?
 
 
Serum ACTH
 
 

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Term 103 Definition 103

Whic is the most widely used


screening test for Cushing's
syndrome ?
 
 
Overnight dexamethasone
suppression test

Term 104 Definition 104

Which test is the most specific for the


establising a diagnosis of Cushing's
disease (pituitary Cushing's) ?
 
 
Petrosal sinus sampling following
corticotropin-releaseing hormone
stimulation

Term 105 Definition 105

Which of the statements below


regarding the catecholamines is true ?
 
 
Plasma levels show both diurnal and
pulsed variation

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Term 106 Definition 106

Which assay using 24 hour urine is


considered the best single screening
test for pheochromocytoma ?
 
 
Metanephrines
 

Term 107 Definition 107

Which metabolite is most often


increased in carcinoid tumors of the
intestines ?
 
 
5-hydroxyindolacetic acid (5-HIAA)

Term 108 Definition 108

Which statement regarding the


measure ment of urinary
catecholamines is true ?
 
 
24 hour urinary catecholamine assay
avoids pulse variations associated
with measurement of plasma
catecholamines

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Term 109 Definition 109

Which method used to measure


catecholamines is the least specific ?
 
 
 
Measurement of fluorescence
following oxidation by potassium
ferrocyanide

Term 110 Definition 110

Which statement about sample


collection for catecholamines and
metabolites is true ?
 
 
24 hour urine creatinine should be
measured with vanillymandelic acid,
homovanillic acid, or metanephrines

Term 111 Definition 111

Which statement below applies to both


measurement of VMA and
metanephrines in the urine ?
 
 
Both can be measured by specific
HPLC and GC-MS asays

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Term 112 Definition 112

Thyroid hormones are derived from


the amino acid ?
 
 
Tyrosine
 

Term 113 Definition 113

Which statement regarding thyroid


hormones is true ?
 
 
T3 is about tenfold more active than T4

Term 114 Definition 114

Which of teh statements below


regarding thyroid hormones is true ?
 
 
 
Total T3 and T4 are influenced by the
level of thyroixine-binding globulin

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Term 115 Definition 115

Which of the following conditions


increase total T4 by increaseing
thyroxine binding globulin (TBG) ?
 
 
Pregnancy or estrogens

Term 116 Definition 116

Select the most appropriate single


screening test for thyroid disease ?
 
 
TSH assay

Term 117 Definition 117

The serum TSH level is decreased in :


 
 
Primary hyperthyroidism

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Term 118 Definition 118

Which assay is the most specific and


sensitive test for diagnosing thyroid
disease ?
 
 
 
Thyrotropin releaseing hormone (TRH)

Term 119 Definition 119

Which of the following statements is


true regarding reverse T3 (rT3)  ?
 
 
 
Formed in the blood by degradation of
T4

Term 120 Definition 120

A patient has an elevated serum T3,


and Free T4 and a very low serum
TSH. What is the most likely cause of
these results ?
 
 
Primary hyperthyroidism

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Term 121 Definition 121

A serum thyroid panel reveals an


increase in Total T4, normal TSH , and
normal Free T4. What is the most likely
cause of these results ?
 
 
Euthyroid with increased thyroxine-
binding protein

Term 122 Definition 122

Which statement about TSH and T4 in


early pregnancy is correct ?
 
 
TSH falls and thyroid hormone levels
rise

Term 123 Definition 123

In which case might a very low plasma


TSH result not correlate with thyroid
status ?
 
 
After high dose corticosteroid
treatment

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Term 124 Definition 124

In which case below is qualitative


analysis of the drug usually adequate
?
 
 
 
To determine whether the patient has
been taking amphetamines

Term 125 Definition 125

The term pharmokinetics refers to the


:
 
 
Relationship between drug dose and
the drug blood level

Term 126 Definition 126

The term pharmacodynamics is an


expression of the relationship
between:
 
 
 
Drug concentration at target sites and
physiological effect

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Term 127 Definition 127

The study of pharmacogenomics


involves which type of testing ?
 
 
Testing for single nucleotide
polymorphisms known to affect drug
metabolism
 

Term 128 Definition 128

Select the five pharmacological


parameters that determine serum drug
concentrations:
 
 
Liberation,absorbtion, distribution,
metabolism, excretion
 

Term 129 Definition 129

Which route of administration is


associated with 100% bioavailbility ?
 
 
Intravenous

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Term 130 Definition 130

The phrase first- pass hepatic


metabolism means that :
 
 
Some drug is matabolized from the
portal circulation, reducing
bioavailability
 

Term 131 Definition 131

Which formula can be used to


estimate dosage needed to give a
desired steady state blood level ?
 
 
Dose per hour = clearance (milligrams
per hour) x average concentration at
steady state / f
 
 

Term 132 Definition 132

Which statement is true regarding the


Vd of a drug ?
 
 
Vd is the theoretical volume in liters
into which the drug is distributes

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Term 133 Definition 133

For drugs with first order elimination,


which statement about drug clearance
is true ?
 
 
Clearance = elimination rate/serum
level

Term 134 Definition 134

Which statement about steady state


drug levels is true ?
 
 
Oral dosing intervals result in peaks
and troughs in the dose response
curve
 
 

Term 135 Definition 135

If too small a peak trough difference is


seen for a drug given orally then :
 
 
Dose interval should be increased
 

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Term 136 Definition 136

If the peak level is appropiate but the


trough level os too low at steady state,
then the dose interval should:
 
 
 
Be shortened, but the dose per day
not changed

Term 137 Definition 137

If the steady state drug level is too


high, the best course of action is to:
 
 
Decrease the dose

Term 138 Definition 138

When should blood samples for


trough drug levels be collected ?
 
 
 
Immediately before the next dose is
given
 

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Term 139 Definition 139

Blood sample collection time for peak


drug levels :
 
 
Varies with the drug, depending on its
rate of absorbtion

Term 140 Definition 140

Which could account for drug toxicity


following a normally prescribed dose
?
 
Decreased renal clearance caused by
kidney disease
Discontinuance of another drug
Altered serum protein binding caused
by disease
All above:
 
 

Term 141 Definition 141

Select the elimination model that best


describes most oral drugs ?
 
 
One compartment, linear first order
elimination
 

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Term 142 Definition 142

Drugs rapidly infused intravenously


usually follow which elimination
model ?
 
Biphasic or two compartment with
serum level rapidly falling in the first
phase
 

Term 143 Definition 143

Which fact must be considered when


evaluating a patient who displays
signs of drug toxicity ?
 
 
Drug natabolites (eg-N-
acetylprocanimide) may need to be
measured as well as the parent drug
toxicity

Term 144 Definition 144

When a therapeutic drug is suspected


of causing toxicityl, which specimen is
the most appropriate for an initial
investigation ?
 
Peak blood sample

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Term 145 Definition 145

For a drug that follows first order


pharmacokinetics, adjusting of
dosage to ahcive the desired blood
level can be made using which
formula ?
 
New dose=     current    x conc at steady
state
desired conc

Term 146 Definition 146

For whcih drug group are both peak


and trough measurement usually
required ?
 
 
Aminoglycoside antibiotics

Term 147 Definition 147

Which is the following statements


about TLC for drug screening is true ?
 
 
 
A drug is identified by comparing the
Rf value and staining to standards

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Term 148 Definition 148

The EMIT for drugs of abuse uses an :


 
 
Enzyme conjugated to a drug
 

Term 149 Definition 149

Which statement about EMIT is true ?


 
 
 
Formation of NADH is monitored at
340 nm

Term 150 Definition 150

Which statement below regarding


FPIA is true ?
 
 
Separation of free and bound labeled
antigen is not required
 

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Term 151 Definition 151

Quantitation of a drug by gas


chromotography-mass spectroscopy
(GC-MS) is usually performed in which
mode ?
 
 
Selective ion monitoring
 

Term 152 Definition 152

A urine sample is received in the


laboratory with the appropriate
custody control form and a request for
drug of abuse screening. Which test
result would be a cause for rejection
of the sample ?
 
 
Creatinine level of 5 mg/dl
 

Term 153 Definition 153

Which statement about the


measurement of carboxyhemoglobin
is true ?
 
 
 
Bichromatic analysis is required in
order to eliminate interference by
oxyhemoglobin
 

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Term 154 Definition 154

Which is the following statements


about blood alcohol measurement is
correct ?
 
 
Symptoms of intoxication usually
begin when the level exceeds 0.05 %
w/v

Term 155 Definition 155

Which drug can be detected with ferric


chloride in perchloric-nitric acids ?
 
 
Phenothiazines
 

Term 156 Definition 156

Which specimen is the sample of


choice for lead screening ?
 
 
Whole blood

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Term 157 Definition 157

Which of the following enzymes can


be used to measure plasma or serum
salicylates ?
 
 
Salicylate hydroxylase

Term 158 Definition 158

Which of the following tests is least


essential to the operation of a ER ?
 
 
Lead
 

Term 159 Definition 159

Which of the following tumor markers


is classified as a tumor suppressor
gene ?
 
 
 
BRCA-1
 

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Term 160 Definition 160

In general , in which of the following


situations is the analysis of a tumor
marker most useful ?
 
 
Testing for recurrence 

Term 161 Definition 161

Which of the following enzymes is


increased in persons with prostate
and small cell lung cancer ?
 
 
 
Creatine kinase-1 (CK-1 / CK-BB)
 
often present w/maligancies

Term 162 Definition 162

Which of the following is the best


analyte to monitor the recurrence of
ovarian cancer ?
 
 
CA-125
 

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Term 163 Definition 163

Which tumor marker is associated ith


cancer of the urinary bladder ?
 
 
 
Nuclear matrix protein
 

Term 164 Definition 164

A person presents with a Cushingoid


appearance and an elevated 24-nr
uring cortisol level. Plasma
adrenocotropic hormone(ACTH) is
very elevated and the clinicial
suspects the cause is ectopic ACTH
production. Which test would be most
useful in substantiating this diagnosis
?
 
Alkaline phosphatase isoenzymes

Term 165 Definition 165

Which of the following statements


regarding the Philadelphia
chromosome is true ?
 
 
It results from a translocation of the
long arm of chromosomes 9 and 22

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Term 166 Definition 166

What is the primary clinical utility of


measuring CEA ?
 
 
 
Monitoring for recurrence of cancer
 

Term 167 Definition 167

Which tumor marker is used to


determine the ussefulness of
trastuzumab(Herceptin) therapy for
breast cancer ?
 
 
 
HER-2/neu
 
 

Term 168 Definition 168

A person is suspected of having


testicular cancer. Which type of hCG
test would be most useful ?
 
 
Plasma immunoassay for intact hCG
and the β-hCG subunit

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Term 169 Definition 169


A patinet is treated for a germ cell
tumor has a total and free bhcg assay
performed one week prior to surgery.
The result is 40,000 and one week
following surgery the result is 5000.
Chemo is started and one week later
the result is 10,000. What does this
indicate ?
 
Transient hCG increased by
chemotherapy.
 
 
Term 170 Definition 170
Which set of results for ER and PR is
associated with the highest likelhood
of a favorable response to treatment
with estrogen suppression therapy
(tamoxifen)?
 
 
ER positive, PR positive
 
 
(receptor assays performed on breast
tissue bx to determine the potential
response to tamoxifen)
Term 171 Definition 171

Which type of cancer is associated


with the highest level of AFP ?
 
 
Hepatoma

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Term 172 Definition 172

Which of the following assays is


recommended as a screening test for
colorectal cancer in persons over 50
years old ?
 
 
Occult blood
 
 

Term 173 Definition 173

Which of the following substances is


used to determine the rick of
developing cancer ?
 
 
 
p53 gene

Term 174 Definition 174


A person has an elevated 24 hour
urinary homovanillylic acid (HVA) and
vanillymandelic acid (VMA). Urinary
metanephrines, chromogranin A, and
neuron-specific enolase are also
elevated but 5-hydroxyindoleacetic
acid is within the reference range.
What is the most likely diagnosis ?
 
Neuroblastoma
 
 
 

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Term 175 Definition 175

In which of the following conditions is


the PSA least likely to be increased ?
 
 
Post-digital rectal examination

Term 176 Definition 176

Which if the following statements


regarding PSA is true ?
 
 
Free PSA below 25% is associated
with malignant disease
 
 

Term 177 Definition 177

A 55 year old male with early stage


prostate cancer diagnosed by biopsy
had his prostate gland removed. His
PSA prior ro surgery was 10.0 . If the
surgery was successful in completely
removing the tumor cells, what would
the PSA result be 1 month after
surgery ??
 
 
Undectectable

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Term 178 Definition 178


Which of the procedures below can be
used to evaluate a new glucose
mehtod for proportional error ?
 
 
 
Add 5.0 mg of glucose to a 1.0 mL of a
serum of knwon concentration and
measure
(proportional error is percentage
deviation from the expected result and
affects the slope of the calibration
curve. It causes a greater absolute
error as concentration increases?
Term 179 Definition 179

Which of the two instruments can be


assumed to have a narrower bandpass
?  Assume that wavelength is
accurately calibrated.
 
The instrument giving the highest
absorbance for a solution of 0.1
mmol/L NADH at 340 nm.

Term 180 Definition 180

A patient wha has a positive urinalysis


for glucose and ketones has a
glycoslylated Hgb of 4.0 % A fasting
glucose performed the previous day
was 180 mg/dL. Assuming QC was ok,
what would you do ?
 
 
Request a new sample and repeat the
glycosylated Hgb

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Term 181 Definition 181


Laboratory results on a patient from
the ED are :
Glucose = 1100 mg/dL
Na = 155 mmol/L
K = 1.2 mmol/L
Cl = 115 mmol/L
TCO2 = 3.0 mmol/L
Explanation for these results ?
 
Sample is drawn above the
intravenous catheter
 
 
Term 182 Definition 182
A quantitative urine glucose level was
determined to be 160 mg/dL by the
Trinder glucose oxidase method. The
sample was refrigerated overnight and
the glucose the next day was 240
mg/dL with the polarographic method.
What is the most likely cause of the
discrepancy ?
 
 
High levels of reducing substances
interfering with the Trinder reaction
 
Term 183 Definition 183

A tech is asked to use the serum from


a clot tube left over from a chemistry
profile run at 8 am for a stat ionized
calcium. The tech should ?
 
 
Request a new sample
( ionized ca is pH dependant and
heparin is preferred)

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Term 184 Definition 184


A quantitative sandwich enzyme
immunoassay for intact serum hCG
was performed on week 4 and the
result was 40,000 mIU/ml(ref 10,000-
80,00) A clinician suspects a molar
pregnancy and requested that the lab
repeat the test checking for the hook
effect. What process would identify
this problem ?
 
 
Perform a serial dilution of the sample
and repeat the test
Term 185 Definition 185

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