CARBOHYDRATES

Glucose concentration might be measured using a whole blood sample or a plasma sample
recovered after centrifugation of non-anticoagulated whole blood or a serum sample recovered
after centrifugation of non-anticoagulated whole blood.  FALSE
 

Type 1 diabetes often goes undiagnosed for many years and is associated with a strong genetic
predisposition, with patients at increased risk with an increase in age, obesity, and lack of
physical exercise FALSE
  

In Neocupreine method which follows the copper reduction principle will produces blue to green
complex. FALSE
 
Glycogen storage disease type VI was originally called Hers disease when Henry-Gery Hers first
described it in 1969. Hers reported three children with an enlarged liver, mild hypoglycemia, and
increased glycogen content in the liver.  FALSE
  

Glycogen storage disease type 2, also known as Pompe disease or acid maltase deficiency
disease, is an lifestyle-related metabolic disorder.  FALSE
  

C-peptide Test is measured to tell the difference between insulin the body produces and insulin
that is rejected into the body.  TRUE
 
Glycogen storage disease type 7 (GSD7) is an inherited condition in which the body is unable to
break down glycogen (a complex sugar) in the muscle cells. Because glycogen is an important
source of energy, this can interfere with the normal functioning of muscle cells. TRUE
  
FRUCTOSE-1-6-BIPHOSPHATE DEFICIENCY is a deficiency in fructose 1-6-biphosphate
results in failure of hepatic glucose generation by gluconeogenic precursors such as lactate and
glycerol.  TRUE
 
Fructosamine is used for monitor the glucose control over the previous 2-3 months and 3-6
months when a person is diagnose as diabetes  FALSE
 
Monosaccharides and Disaccharides – are usually white, crystalline solids that contain a single
aldehyde or ketone functional group. TRUE
 
Glycogen storage disease (GSD) is a common condition that changes the way the body uses
and stores glycogen, a form of sugar or glucose. FALSE
  

Hypoglycemia refers to low levels of sugar, or glucose, in the blood. Signs of low blood sugar
include thirsty, motionless, bradycardia, and anhidrosis. FALSE
  

One of the treatment for hypoglycemia is to eat or drink 30 to 20 grams of fast-acting

carbohydrates. These are sugary foods with protein or fat that are easily converted to sugar in
the body.  FALSE
  
Carbohydrates are commonly called as sugars, generally defined as polyhydroxy aldehydes or
polyhydroxy ketones or substances that yield these compounds when hydrolyzed. TRUE
 
The classification of carbohydrate is based on four different properties these are the number of
the base carbon chain, the location of the CO function group, the number of sugar units and the
stereochemistry of the compound.  FALSE
  

Fructose is a ketohexose that occurs in fruit juices, honey and as a constituent of sucrose and
the polysaccharide inulin. TRUE
 
 
Fermentation is the conversion of a carbohydrate food to alcohol or acid brought about by
biological agents like enzymes. This is how alcoholic beverages are made. Common bread yeast
will yield the enzyme zymase to ferment glucose, mannose and fructose producing
alcohol. TRUE
  
Seliwanoff's test is a general test for carbohydrates. It uses alpha – naphthol and concentrated
sulfuric acid as its dehydrating agent. Once furfural derivatives are formed, it reacts with alpha –
naphthol to yield a violet ring. FALSE
  

Glycogenesis is a synthesis of excess glucose molecules into a polymer called glycogen that will
be eventually stored in the liver. This process is regulated by the hormone INSULIN. TRUE
 

 
The solubility of carbohydrates in water is directly proportional to the complexity of their
molecular structure.  FALSE
 

In Nelson Somogyi method, following the copper reduction principle the cupric ions present in
Phosphomolybdate acid will reduce into Phosphomolybdenum BLUE.  FALSE
  

Interstitial glucose measuring device it utilizes electrochemical methods to automatically and

frequently measure glucose levels in the interstitial fluid of dermis or subcutaneous fat tissue and
require repeated calibration to plasma or whole blood glucose levels. TRUE
 
Anderson disease is also known as glycogen storage disease (GSD) type IV. It is caused by
deficient activity of the glycogen-branching enzyme, resulting in accumulation of abnormal
glycogen in the liver, muscle, and/or other tissues.  FALSE
 

Glycolysis – also known as the Embden – Meyerhoff Pathway (EMP). It is the breakdown of
glucose to form pyruvate with the release of ATP molecules as the source of biochemical
energy. TRUE
  
TYPE 2 Diabetes - otherwise known as Insulin-dependent Diabetes Mellitus (IDDM) or Juvenile
onset Diabetes Mellitus - characterized by inappropriate hyperglycemia primarily result of
pancreatic islet of beta cell destruction.  FALSE
 
IDENTIFICATION:

It is formed when the terminal carbonyl or the aldehyde group has been oxidized to a carboxyl
group while the primary alcohol group remains intact.  Aldonic acid

 
It is a synthesis of excess glucose molecules into a polymer called glycogen that will be
eventually stored in the liver. This process is regulated by the hormone insulin. Glycogenesis
 
It is also known as the simple sugars which consist of only one sugar unit that cannot be
hydrolyzed already into simpler forms. They are the building blocks for more complex forms of
carbohydrates.  Monosaccharides
 
Otherwise known as Insulin-dependent Diabetes Mellitus (IDDM) or Juvenile onset Diabetes
Mellitus and characterized by inappropriate hyperglycemia primarily result of pancreatic islet of
beta cell destruction. Type 1
 
In ______, the International Expert Committee on the Diagnosis and Classification of Diabetes
Mellitus was given a task on updating the 1979 classification. 1995
 
It is an inherited disorder caused by the buildup of a complex sugar called glycogen in the body's
cells. The accumulation of glycogen in certain organs and tissues, especially the liver, kidneys,
and small intestines, impairs their ability to function normally.  Glycogen storage disease

A disorder characterized by impaired ability to metabolize carbohydrate usually caused by a

deficiency of insulin, metabolic or hormonal changes, occuring in pregnancy and disappearing
after delivery but in some cases returning year later. Gestational diabetes mellitus
 
This is measured to tell the difference between insulin the body produces and insulin that is
rejected into the body and it is formed during the conversion of pro-insulin to insulin. C-peptide
test

When CSF is increased, what are the condition produced? Diabetes 

 
Defined as two-hour glucose levels of 140 to 199 mg per dL (7.8 to 11.0 mmol) on the 75-g oral
glucose tolerance test, and impaired fasting glucose is defined as glucose levels of 100 to 125
mg per dL (5.6 to 6.9 mmol per L) in fasting patients. Impaired glucose tolerance
 
Also known as glycosylated or glycated albumin, or plasma protein ketoamine. It is used for
monitoring control over the previous 2-3 weeks and it is a reflection of short term glucose
control. Fructosamine
 
It is used for continuous monitoring of glucose levels in people with diabetes. It also utilizes
electrochemical methods to automatically and frequently measure glucose levels in the
interstitial fluid of dermis or subcutaneous fat tissue and require repeated calibration to plasma
or whole blood glucose levels. Interstitial glucose measuring device

It is also known as the Hexose Monophosphate Shunt (HMP) or the Phosphogluconate Oxidative
Pathway that is an alternative pathway where glucose molecules can also be catabolized and
form ATP molecules. Penthose phosphate pathway
 
It is a test that uses a solution of Copper (II) sulfate with Rochelle salt and Sodium hydroxide.
When a reducing sugar is dissolved and boiled with the Fehling’s solution, it reduces the Copper
ion forming Cuprous oxide which is seen as a brick – red precipitate. Fehling’s test

It uses resorcinol and Hydrochloric acid as its dehydrating agent. Here, a red color is developed
rapidly in the presence of a ketose sugar like fructose. Seliwanoff’s test
 
It is produced by the delta cells of the islets of Langerhans of the pancreas and it is primarily
inihibits the action of insulin and glucagon. Somatotastin
 
Also known as animal starch since it is the storage form of carbohydrates in animals. It is also a
glucose polymer mostly stored in the liver and is ready to be hydrolyzed or broken down into
glucose units when needed through a metabolic process called glycogenolysis. Glycogen
 
Also known as malt sugar. It is the most common reducing saccharide found as a constituent of
starch and glycogen in nature. It is hydrolyzed into two molecules of glucose by the enzyme
maltase. Commercially, it is used as a raw material in making beer. Maltose
 
Also known as “double sugar” that has a chemical formula of C12H22O11. They yield two
monosaccharide units, either alike or different, when hydrolyzed. Disaccharides

 
Commonly known as the sugars, are generally defined as polyhydroxy aldehydes or polyhydroxy
ketones or substances that yield these compounds when hydrolyzed.  Carbohydrates
 
Macromolecular substance that can be hydrolyzed to yield many monosaccharide units. They
are the most complex form of carbohydrates. Polysaccharides
 
It is formed when both the aldehyde and the primary alcohol groups of the aldoses are oxidized
to carboxyl groups. Saccharic acid
 
It is a general test for carbohydrates. It uses alpha – naphthol and concentrated sulfuric acid as
its dehydrating agent. Once furfural derivatives are formed, it reacts with alpha – naphthol to
yield a violet ring. Molisch’s test
 
It stimulates release of cortisol from the adrenal cortex. It also promotes glycogenolysis and
glucogenesis. Adrenocorticotropic hormone

Sugars that has two to six monosaccharide units linked together. Oligosaccharides

 
It is the most abundant organic substance found in nature. It is an insoluble carbohydrate which
is the chief structural component of plants and wood. In humans, cellulose serves as roughage
in the digestive tract due to its abundant fiber content. Cellulose

It is the primary hormone responsible for the entry of glucose into the cell. It is also synthesized
by the beta cells of the islets of Langerhans in the pancreas and it is normally released when
glucose levels are high and it is stored from sources such as liver, fat and muscles. Insulin
 
Funtions as both an endocrine and exocrine organ in the control of carbohydrate
metabolism. Pancreas
 
it is released from the chromaffin cells of the adrenal cortex. And it inhibits insulin secretion and
promotes glycogenolysis and lipolysis. Cathecholamines
 
It is sometimes called as the amylum, it is the reserved food or the storage form of
carbohydrates in plants. It is a glucosan or a glucose polymer, thus can be hydrolyzed into
several glucose units by dilute inorganic acids or by mixing a solution of diastase. Starch
 
A polysaccharide found in the outer coverings of animals such as insects and crustaceans. It is
rigid, hard and inflexible which gives support and protection to these animals. Chitin
 
Also known as table sugar, saccharose, beet sugar or cane sugar. It is a non – reducing
disaccharide which is the chemical combination of glucose and fructose. It is the common table
sugar used to sweeten our foods and drinks obtained commercially from sugar cane and sugar
beets. Sucrose
 
Upon addition of water, disaccharides and polysaccharides are broken down to monosaccharide
units with the aid of dilute acids or enzymes. Hyrolysis
 
It is formed when the primary alcohol group has been oxidized to a carboxyl group while the
aldehyde group remains intact. Uronic acid

It is the reverse process of glycogenesis. It is the breakdown of glycogen to glucose molecules

that will be utilized for the production of ATP molecules. This process is regulated by the
hormone glucagon. Glycogenolysis
 
It is also known as the Embden – Meyerhoff Pathway. It is the breakdown of glucose to form
pyruvate with the release of ATP molecules as the source of biochemical energy. Glycolysis
 
It measures the amount of glucose in your blood. The test is often called A1c, or sometimes
HbA1c. It is also known as glycated haemoglobin. Glycosylated hemoglobin test
 
It is a form of type 1 diabetes that has no known etiology, is strongly inherited, and does not
have β-cell autoimmunity. Individuals with this form of diabetes have episodic requirements for
insulin replacement. Idiopathic type 1 diabetes

It is an inherited disorder caused by the buildup of a complex sugar called glycogen in the body's
cells. Glycogen storage disease type iii
 
It is congenital deficiency of one of three enzymes involved in galactose
metabolism. Galactosemia

It refers to low levels of sugar, or glucose, in the blood. Signs of low blood sugar include hunger,
trembling, heart racing, nausea, and sweating. In severe cases, it can lead to coma and
death. Hypoglycemia
 
It is a measurement used to determine the concentration of glucose in cerebrospinal fluid. It is
about 40-60% of the plasma glucose level. CSF glucose
 
It is required during insulin shock and hyperglycemic ketonic coma. Random blood sugar

It is the conversion of a carbohydrate food to alcohol or acid brought about by biological agents
like enzymes. This is how alcoholic beverages are made. Common bread yeast will yield the
enzyme zymase to ferment glucose, mannose and fructose producing alcohol. Fermentation

It follows the same principle in the Fehling’s test but uses a solution containing Copper (II)
sulfate, Sodium carbonate and Sodium citrate. The positive result is still the production of a brick
red precipitate. Benedict’s test
 
It promotes glycogenolysis, gluconeogenesis. Thyroid hormones
 
The solubility of carbohydrates in water is _____ to the complexity of their molecular
structure. Inversely proportional
 
It is more accurate than glucose oxidase methods because the coupling reaction using G6PDH
is highly specific; therefore, it has less interference than the coupled glucose oxidase
procedure. Hexokinase method
 
It is a multiple blood sugar test. It is used to determine how well the body metabolizes glucose
over a required period of time, same with 2-HPPBS. Glucose tolerance test
 
The _______ developed a classification and diagnosis scheme for diabetes into two broad
categories: - type 1, insulin dependent diabetes mellitus (IDDM) - type 2, non-insulin dependent
diabetes (NIDDM).  National diabetes group
It detects acetoacetate better than acetone. 
Acetest tablets
Gerhardt’s ferric chloride test
Nitroprusside test
Ketostix
KetoSite Assay

What is the normal values of CSF glucose in adults? 

40-70 mg/dL
54-68 mg/dL
43-70 mg/dL
60-80 mg/dL
20-40 mg/dL

It is characterized by fasting blood glucose concentration between normal and diabetic values.
Fasting plasma glucose is between 100 and 125 mg/dL. 
Impaired glucose tolerance
Impaired fasting glucose
Oral glucose tolerance test
Intravenous glucose tolerance test
Glucose dehydrogenase method  

Carbohydrates play the following roles for the benefit of the living body. Which of the following is
not the roles of the carbohydrates in the benefit to living body? 

They can serve as very effective building materials.

They are important structural components of the living cell.
They are very effective energy – yielding nutrients.
They serve as the backbone or precursor substances of some other important molecules of the living body
like some secretory materials and nucleotides.
They can also increase your risk of diabetes, heart disease and high cholesterol.
 
It is an aldopentose which is an indispensable component of the nucleic acid RNA and other
biologically important molecules needed to carry out biochemical reactions in the body. 
Deoxyribose
Pentose
Ribose
Fructose
Lactose  

_________ are differentiated by their microscopic appearance and also by their melting points. 
Osazone crystals
Enzyme zymase
Urate crystals
Uric acid crystals
Glucose crystals

In the presence of a weak alkali, rearrangement of the atoms in the molecule may take place
with the result that one sugar may change to another. The intermediate product is an ______. 
Enol 
Phenol
Sodium carbonate
Sodium citrate
Oxide

Fasting glucose in whole blood is _____, _____than in serum or plasma. 

15%, lower
20%, greater
30%, lower
25%, greater
25%, lower

What is the normal ratio for the β-hydroxybutyrate and acetoacetic acid? 
2:1
1:1
3:1
1:3
3: 1

It is used to determine how well the body metabolizes glucose over a required period of time,
same with 2-HPPBS and it is a multiple blood sugar test. 
Random blood sugar
Glucose tolerance test
2-hour postprandial blood sugar
Fasting blood sugar
Oral glucose tolerance test

It is a form of hemoglobin that is chemically linked to a sugar where most monosaccharides,

including glucose, galactose and fructose, spontaneously bond with hemoglobin, when present
in the bloodstream of humans. 
Glycated hemoglobin
 Oxyhemoglobin
Methemoglobin
Glycosylated hemoglobin
Deoxyhemoglobin

It is actually a group of metabollic diseases characterized by hyperglycemia resulting from

defects in insulin secretion, insulin action, or both. 
Diabetes insipidus
Diabetes
Diabetes mellitus
Gestational diabetes mellitus
Type 1

It is a genetically linked metabolic disorders that involve the enzymes regulating glycogen
metabolism. Also, it is a rare condition that changes the way the body uses and stores glycogen,
a form of sugar or glucose. 
Glycogen storage disease type 1 a
Glycogen storage disease type v
Glycogen storage disease
Glycogen storage disease type 0
Glycogen storage disease type vii

What are the condition when C-peptide is decreased? 

Type 1 diabetes mellitus
Type 2 diabetes mellitus
Hypoglycemia
Hyperglycemia
Insulinoma

Glucose is reduced to produce a ______ that is measure spectrophotometrically or an electrical

current. 
Chromophore  
Urochrome
Microtome
Centromere
Mutarotase  

It is a test that is measured to tell the difference between insulin the body produces and insulin
that is rejected into the body and it is formed during the conversion of pro-insulin to insulin. 
CSF glucose
C-peptide test
Glucose tolerance test
Impaired glucose tolerance
Gerhardt’s ferric chloride test

 
Also known as the Citric acid cycle or the Tricarboxylic acid cycle. It is the final common pathway
for the breakdown of foodstuff where acetyl coA is utilized to generate this cycle in producing
ATP molecules. 
Glycogenesis
Hydrolysis
Cell lysis
Kreb's cycle
Pentose phosphate pathway

It is the primary hormone responsible for increasing glucose. It is synthesized by the alpha cells
of the islets of Langerhans in the pancreas. In addition, it is released during stress and fasting
states and it enhances catabolic functions during fasting periods: promotes glycogenolysis. 
Insulin
Glucagon
Pancreas
Cortisol
Liver

Complete name of ACTH that stimulates release of cortisol from the adrenal cortex and also
promotes glycogenolysis and glucogenesis. 
Adrenocroticortophic hormone
Adrenalcorticotrophic hormone 
Adrenocorticrotropic hormorne
Adrenocorticotrophic hormone
Adrenolcorticotropic hormone

 
The following are the classification of carbohydrate is based on four different properties except:  
The stereochemistry of the compound.
The location of the CO function group.
The number of sugar units.
The size of the base carbon chain.
The structure of carbohydrate polymers.
 
It is commonly known as the sugars, are generally defined as polyhydroxy aldehydes or
polyhydroxy ketones or substances that yield these compounds when hydrolyzed. 
Lipids
Proteins
Carbohydrates
Iron
Zinc

 
The standard clinical laboratory determination of glucose specimen is the _______ because
plasma and serum glucose concentration are unaffected by the confounding effect of hematocrit,
they are a more accurate measure of circulating glucose than _______. 

Venous plasma glucose; whole blood glucose concentration

Plasma glucose; hemoglobin concentration
Whole blood glucose; serum concentration
Capillary blood glucose; whole blood glucose concentration
Fasting glucose; plasma glucose concentration

It is a defect of fructose-1-6-biphosphate aldolase B activity in the liver, kidney and intestine due
to the inability to convert fructose-1-phosphate and fructose-1-6-biphosphate into
dihydroxyacetone phosphate, glyceraldehyde-3-phosphate and glyceraldehydes. This defect has
a clinical features such as irritability, lethargy, seizures and hepatomegaly. 

Galactosemia
Hereditary fructose tolerance
Fructose 1-6 biphosphate deficiency
Essential fructosuria
Glycogen storage disease

It constitutes the majority of the diabetes cases. Most patients in this type are obese or have an
increased percentage of body fat distribution in the abdominal region. 
Type 1 
Type 2
Gestational diabetes mellitus
Other specific types
Idiopathic type 1 diabetes

For those people without diabetes, what is the fructosamine range. 

175-280 mmol/L  
125-250 mmol/L
225-260 mmol/L
210-42I mmol/L
269-870 mmol/L
NON-PROTEIN NITROGEN

The NPN fraction comprises about 20 compounds are found in the plasma and majority of these
compounds arise from the catabolism of proteins and nucleic acids.
False
The enzyme urease hydrolyzes urea in the sample and the ammonium ion (NH4+) produced in the
reaction is quantified.
True
In the clearance test, plasma concentration and clearance are inversely proportional, as the
clearance substance declines, its concentration in plasma increases.
True
The Cystatin C is a low molecular weight protease inhibitor and produced at a constant rate by all
nucleated cells.
True
The simplest test of renal concentrating ability is osmolality.
False
Most of the urea in the glomerular filtrate is excreted in the urine, although some urea is
reabsorbed.
True
About 35 grams of urea is excreted daily, in stable nitrogen balance.
False
The purposes of BUN measurement are to evaluation of renal function, assess hydration status,
determine nitrogen balance, aid in diagnosis of renal disease and verify adequacy of dialysis.
True
Methods for plasma or serum may require modification for use with urine specimens because of
low urea concentration and the presence of endogenous ammonia.
False
Uric acid is relatively insoluble in serum and, at high concentrations, can be deposited in the joints
and tissue, causing painful inflammation.
False
Purines (adenine and thymine) from the break-down of ingested nucleic acids or from tissue
destruction, are converted into uric acid, primarily in the liver.
False
A patient with baseline of 12 mg/dl whose level increases to 24 mg/dl in a steady state of hydration
and protein intake may well have significant reduction of renal function regardless of the fact that
the level is within the reference range.
True
In Koch-McMackin Method, Sulfuric acid is used instead of phosphoric acid as catalyst. Hydrogen
peroxide is used for stronger concentration.
False
Creatinine is formed from creatine and creatine phosphate in muscle and is excreted into the
plasma at a constant rate related to muscle mass.
True
Creatine phosphate loses phosphoric acid and creatine loses water to form the cyclic compound,
creatinine, which diffuses into the serum and is excreted in the urine.
False
The importance of measurement of creatinine concentration are to determine the sufficiency of
kidney function, to determine the severity kidney damage and to confirm diagnosis and monitor
treatment of gout.
False
The GFR is the volume of plasma filtered (V) times the glomerulus per unit of time (t).
False
Elevated creatinine concentration is associated with normal renal function, especially as it relates
to glomerular function.
False
Free ammonia is toxic and present in the plasma in high concentration.
False
The Reye’s syndrome occurring most commonly in children, is a serious disease that can be fatal.
True
Erythrocytes contain two to three times as much as ammonia as plasma; hemolysis should be
allowed.
False
Toxicity may be partly a result of increased intracellular glutamate concentration and subsequent
depletion of adenosine triphosphate in the brain.
False
Following synthesis in the liver, urea is carried in the blood to the kidney, where it is readily
filtered from the plasma by the glomerulus.
True
The Lesch-Nyhan syndrome a Y-linked genetic disorder seen only in females caused by the
complete deficiency of hypoxanthine guanine phosphoribosyl transferase, an important enzyme
in the biosynthesis of purines.
False
Plasma creatine concentration is elevated in renal disease.
False
A high urea nitrogen/creatinine ratio with an elevated creatinine is usually seen in postrenal
conditions.
True
It compares the weight of a fluid with that of distilled water at a reference temperature,
measurement is affected by solute number and mass.
Specific gravity
It is the removal of the substance from plasma into urine over fixed time. It represents the volume
of plasma that would contribute all the solute excreted.
Clearance test
What is the reference value for female in Inulin test or Reference method?
118 mg/min
It is a low molecular weight protease inhibitor and produced at a constant rate by all nucleated
cells. It is completely reabsorbed and catabolized by the proximal convoluted tubule, hence its
presence in urine denotes damage of that tubule – serum level is an indirect estimate of GFR.
Cystatin C
It is affected only by the number of solutes present, thus more accurate than specific gravity in
assessing renal tubular function.
Osmolality
How many grams of urea is excreted daily in stable nitrogen balance?
25 grams
It is the primary and most cost-effective screening evaluation of kidney function.
Routine urinalysis
An analytical method which is similar and identical with Henry method. The recent method of
Henry returned to the older methods of providing alkalinity due to the disadvantages and hazards
when one is using cyanide.
Caraway method
An elevated level of urea as well as creatine in the blood largely related to decrease glomerular
filtration rate.
Azotemia
It is a test in renal tubular function that measures excretion of dye proportional to renal tubular
mass.
Phenolsufonthalein dye test
This is a non-protein nitrogen compound that is formed in the liver from amino groups and free
ammonia generated during protein catabolism.
Blood urea nitrogen
This is the same as the Folin–Wu method except for the digestion mixture. Hydrogen peroxide is
used instead of phosphoric acid as catalyst. Sulfuric acid is used for stronger concentration
Koch-McMackin method
This consists of breaking down the nitrogenous compound after separating proteins and the
conversion of nitrogen into a common measurable form. This is done by using acid digestion
mixture and heat.
Digestion
These are two purines from the break-down of ingested nucleic acids or from tissue destruction,
are converted into uric acid, primarily in the liver.
Adenine and guanine
It is a non-protein nitrogen compound that is a product of catabolism of the purine nucleic acids.
Uric acid
It is termed as very increase level of plasma urea and creatinine accompanied by renal failure-
eventually fatal, if not treated by dialysis.
Uremia
In this method, a protein free filtrate is made. To the filtrate, an acid digestion mixture is added to
help liberate ammonia. This is heated to decompose nitrogenous substances in the form of
ammonium salts. Nessler’s solution is added to convert ammonium salts to yellow simercuric
ammonia iodide which is measured colorimetrically
Folin Wu method
It is the full meaning of DAM.
Diacetyl monoxime method
The enzyme that hydrolyzes urea in the sample and the ammonium ion produced in the reaction is
quantified.
Urease
How many percent is uric acid present in plasma concentration?
10%
It does not give reliable estimates of the GFR since urea is freely filtered by the glomeruli but
variably reabsorbed by the tubules, in the presence of high urine osmolality and high urea
concentration, the amount reabsorbed in the inner medullary collecting duct in increased.
Urea clearance test
A mixture of concentrate sulfuric acid and 85% phosphoric acid. Concentrated sulfuric acid is used
to convert nitrogen to ammonia and to oxidize other organic compounds while phosphoric acid is
used to raise the boiling point.
Acid digestion mixture
Oxalated blood is diluted and enzyme urease is added to decompose urea and form ammonium
carbonate. Then, the proteins are precipitated. Nessler’s reagent is then added to the filtrate to
convert ammonium carbons to yellow dimercuric ammonium iodide which is measured
photometrically.
Gentzkow Massen method
In what year did Fearon found that reaction of ammonia with diacetyl monoxime followed by
oxidation gives a color.
1939
Urea Nitrogen concentration can be converted to urea concentration by multiplying by _____.
2.14
It is the final breakdown product of purine metabolism.
Uric acid
In the colorimetric method of uric acid, it serves both as protein precipitating agent and color
agent.
Phosphotungstic acid
All of the uric acid in plasma is present as ___________.
Monosodium urate
The disadvantage of this method is that 5% NaCN, which is added to intensify the color is
poisonous.
Benedict’s method
It is a type of colorimetric method of uric acid where a special PFF is made and treated with urea–
cyanide solution and lithium arsenotungstate to form arsenotungstate complex.
Newton method
Aside from EDTA, what is the suitable anti-coagulant for ammonia?
Heparin
The specificity of this method is enhanced by pre–treatment of the serum with sodium hydroxide.
Archibald method
It is one of the problems involved in the colorimetric method of uric acid determination in the final-
colored solution.
Appearance of turbidity
It is an enzyme found in most mammals except man, which catalyzes the complicated
transformation of uric acid into allantoin.
Uricase
It is the result of overproduction of uric acid.
Hyperuricemia
It is the mutations in the first enzyme in the purine synthesis pathway.
Phosphoribosylpyrophosphate synthetase
It is is released into the circulation at a relatively constant rate that has been shown to be
proportional to an individual's muscle mass.
Creatinine
It measures the amount of creatinine eliminated from the blood of the kidneys.
Creatinine clearance
These is the most useful when serum creatinine results are produced in an assay that has been
calibrated to be traceable to an IDMS method.
Modification of diet in renal disease equation
It catalyzes the conversion of creatinine to N-methylhydantoin and ammonia.
Creatinine deaminase
It is consumed by the parenchymal cells of the liver in the production of urea.
Ammonia
These should be obtained without trauma and placed on ice immediately.
Venous blood
Diffusion of NH3 through selective membrane into NH4Cl causes a pH change, which is measure
potentiometrically
Ion-selective electrode
Assay of blood ammonia can be used to monitor hyperalimentation therapy.
Monitor hyperalimentation therapy
It is produced in the catabolism of amino acids and by bacterial metabolism in the lumen of the
intestine.
Ammonia
It is not specific for creatine since there are many substances in the red cells which give the same
reaction as creatinine.
Jaffe reaction
It is used for isolation of creatinine from interfering substances.
Lloyd’s reagent
It is waste product of muscle metabolism synthesized primarily in the liver from arginine, glycine,
and methionine.
Creatine
It is a common feature of toxemia of pregnancy and lactic acidosis.
Hyperuricemia
What is the meaning of HGPRT?
Hypoxanthine guanine phosphoribosyl transferase

The following are the functions of the kidneys, except:

Elimination of waste products
Endocrine function
Maintenance of electrolyte balance
Maintenance of acid-base balance
Excretion of bilirubin, cholesterol, hormones and drugs

Which of the following is not a disadvantage of colorimetric method?

Color develops rapidly and fades rapidly
Color is photosensitive
Color does not follow Beer’s law
Unpleasant odor and irritant fumes of the reagent
The reaction is completely specific

Buffered urease is added to serum or plasma to decompose urea and form ammonia. The mixture is incubated to
enhance the reaction. Phenol color reagent and alkali hypocholorite reagent are added which is measured
colorimetrically.
Karr method
Van Slyke Cullen method
Gentzkow Massen method
Folin-Svedberg method
Berthelot color reaction

Which of the following is not a purpose of determining uric acid?

Prevent uric acid nephropathy during chemotherapeutic treatment
Assess inherit disorders of purine metabolism
Detect kidney function
Assist in the diagnosis of renal calculi
Determine nitrogen balance

The following are tests for measuring tubular function, except:

Para-amino Hippurate test
Phenolsulfonthalein dye test
Deproteinization
Osmolality
Specific gravity

In Folin-Wu method, it is a reagent used to prevent cloudiness.

Acid digestion mixture
Nessler’s reagent
Glass beads
Gum ghatti
Yellow

In Folin-Wu method, it is a reagent used to prevent bumping of the solution.

Acid digestion mixture
Nessler’s reagent
Glass beads
Gum ghatti
Yellow

A buffer solution is added to oxalated blood to control the pH. Enzyme urease is added to decompose urea and form
ammonium carbonate. Potassium carbonate is added to liberate ammonia which is collected in boric acid solution.
This is then titrated with a standard acid solution and urea nitrogen is determined by calculation.
Karr method
Van Slyke Cullen method
Gentzkow Massen method
Folin-Svedberg method
Berthelot color reaction

Which of the following is not a pathophysiology when there is a decrease in serum creatinine?
Decreased muscle mass
Advanced and severe liver disease
Congestive heart failure
Pregnancy
Inadequate dietary protein

It is produced in the catabolism of amino acids and by bacterial metabolism in the lumen of the intestine.
Blood urea nitrogen
Uric Acid
Creatinine
Creatine
Ammonia

The following are the variables involved in Jaffe reaction, except:

Picric acid
Turbidity
Temperature
Protein precipitation
pH

In a series of reactions catalyzed by the enzymes creatininase, creatine kinase, pyruvate kinase, and lactate
dehydrogenase, NAD+ is produced and measured as a decrease in absorbance and lacks sensitivity; not used widely.
Creatininase
Creatinase
Creatininase-CK
Creatininase-H2O2
Creatinine deaminase

It is an increased urate concentrations may be found following ingestion of a diet rich in purines or as a result of
increased tissue catabolism due to inadequate dietary intake.
Gout
Toxemia
Drugs and poisons
Hemolytic anemia
Purine rich diet

An enzyme found in most mammals except man, which catalyzes the complicated transformation of uric acid into
allantoin.
Uricase
Urease
Creatinase
Creatininase
Creatinine deaminase

It is a variable involved in Jaffe reaction that commercial preparations must be purified.

Picric acid
Turbidity
Temperature
Protein precipitation
pH

It is considered the best overall indicator of the level of the kidney function. About 150 liters of glomerular filtrate is
produced daily.
Glomerular filtration rate
Clearance test
Inulin test
Creatinine test
Urea clearance test

The following are measurement of ammonia, except:

Distillation
Nesslerization
Gasometrically
Color reaction
Karr method

It is the final breakdown product of purine metabolism.

Blood urea nitrogen
Uric Acid
Creatinine
Creatine
Ammonia

A PFF is treated with urea cyanide and phosphotungstic acid to form a phosphotungstate complex. This is reduced by
the uric acid present to form blue phosphotungstite complex. This then measured colorimetrically with a standard.
Benedict’s method
Folin method
Brown method
Newton method
Caraway method

Total NPN in the plasma is __mg/dl.

200-500 mg/dl
300-350 mg/dl
250-400 mg/dl
150-300 mg/dl
300-500 mg/dl

What is the reference value for phenolsulfonthalein dye test?

1100 ml/min
1150 ml/min
1200 ml/min
1250 ml/min
1300 ml/min

The reference value for female in creatine test is.

85-125 ml/min
100-125 ml/min
75-112 ml/min
85-112 ml/min
65-100 ml/min

In what year did Ormsby applied colorimetric determination its reaction with diacetyl monoxime of urea.
1939
1940
1941
1942
1943

Oxalated blood is diluted and enzyme urease is added to decompose urea and form ammonium carbonate. Then, the
proteins are precipitated. Nessler’s reagent is then added to the filtrate to convert ammonium carbons to yellow
dimercuric ammonium iodide which is measured photometrically
Karr method
Van Slyke Cullen method
Gentzkow Massen method
Folin-Svedberg method
Berthelot color reaction

Acute metabolic disorder of the liver, and autopsy findings show severe fatty infiltration of that organ. Survival
reaches 100% if plasma NH3 concentration remains below five times normal.
Reye’s syndrome
Liver disease
Hepatic failure
Iron deficiency
Chronic nephritis

PROTEINS

A negative acute phase reactant protein like albumin is a protein that increases its content to reduce the
inflammation present in the patient
FALSE
Proteins contributes 12 to 20% of the cell’s dry weight and 50% to 70% of the total daily body energy requirement1
FALSE
Proteins' functions include maintaining the osmotic pressure in the blood, acting as a reserve of protein for tissue,
repair and growth. It also act as pH buffers and provide factors and necessary enzymes for normal blood coagulation.
FALSE
Albumin, a major plasma protein, exceeds the total intravascular amount by 80%.
FALSE
Glucogenic amino acids are degraded to pyruvate, α-ketoglutarate, succinyl CoA, fumarate, or oxaloacetate and
because these intermediates are not gluconeogenesis substrates, they can result in net glycogen synthesis in the
liver and muscle.
FALSE
Haptoglobin phenotype is a dependent risk factor for cardiovascular disease in individuals with Diabetes Mellitus
type 2.
FALSE
Alpha-1 antitrypsin’s most important function is the stimulation of the protease neutrophil elastase
FALSE
Albumin is a special group of proteins characterized by being essentially insoluble in some common reagents in
contrast with albuminoids, which are proteins that are insoluble in water, soluble in weak neutral salt solutions but
insoluble in concentrated salt solutions.
FALSE
The modification, known as High Resolution Electrophoresis, uses a higher voltage coupled with a cooling system in
the electrophoretic apparatus and this is the collection of techniques in which the separation of molecules takes
place in silica capillaries.
FALSE
 Alpha 1 fetoprotein is an acute phase reactant associated with the pathogenesis of Alzheimer's disease.
FALSE
An inflammatory pattern indicating an inflammatory condition is seen when there is an increase in albumin and an
decrease in the α1-globulins (AAG and α1-antitrypsin), α2-globulins (ceruloplasmin and haptoglobin), and β-globulin
band (CRP).
FALSE
In serum electrophoresis, albumin travels the farthest towards the cathode and is about 53% to 54% of the total
protein concentration, however when the separation is good, pre albumin moves closer to the cathode than the
albumin.
FALSE
The specimen most often used to determine the total protein is plasma because it contains a clotting factor, which is
the fibrinogen.
FALSE
Maple syrup disease is characterized by the presence of phenylpyruvic acid (prime metabolite) in both blood and
urine in elevated concentration. Clinical features includes: failure to thrive, muscular rigidity, mental retardation,
hypoglycemia.
TRUE
Macroalbuminuria is an early indicator of glomerular dysfunction and precedes nephropathy associated with type 1
and 2 diabetes mellitus.
FALSE
Cerebrospinal fluid is an ultrafiltrate of serum formed in the choroids plexus of the ventricles of the brain. It
normally contains very little protein because the proteins in the blood do not cross easily in the blood brain barrier.
FALSE
Labile protein is important for optimal structure and function in some important organs like liver, intestines and
kidneys.
TRUE
A condition known as aminoacidopathies exist in either the activity of a specific enzyme in the metabolic pathway or
in the membrane transport system for amino acids
TRUE
The most widely used method, biuret procedure is one recommended by the International Federation of Clinical
Chemistry expert panel for the determination of total protein.
TRUE
In 1940, Kingsley introduced the use of ether as a means of separating the precipitated globulin from the soluble
albumin without resorting to the slow tedious filtration.
TRUE
The electrophoretic pattern can give information about the relative increases and decreases within the protein
population, as well as information about the homogeneity of a fraction. The most significant finding from an
electrophoretic pattern is the human monoclonal immunoglobulin
TRUE
Cystatin C may be useful especially in those cases where creatinine measurement is not appropriate, such as in liver
disease, obesity or those with muscular disease
TRUE
This process occurs in the body wherein proteins are degraded and resynthesized to be distributed in other parts of
the body, this process is known as protein turnover.
TRUE
In electrophoresis, 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).
TRUE
The most widely studied and tested storage protein is ferritin, which stores iron to be later used in the manufacture
of hemoglobin.
TRUE
Symptomatic patients with Covid-19 are considered recovered if they are no longer symptomatic at least five days
prior to discharge and have completed at least 14 days of isolation without the need for further testing provided that
a licensed nurse clears the patient.
FALSE
 Close contacts refer to person/s who have experienced a face-to-face contact with a probably or confirmed patient
within 1 meter for at least 15 minutes during 2 days before and 14 days after the onset of symptoms of a probable or
confirmed case.
TRUE
The Department of Health (DOH) continuously re-calibrates its strategies targeted to address the overall objective of
the COVID-19 response and among its top priority is to decrease the capacity of the health system to identify those
infected and determine the appropriate level of care and facilities that cater to them.
FALSE

This is one of the characteristic of protein that means that the molecule can bear positive and negative charges.
AMPHOTERIC
It is an alternate dye used for albumin determinations, binding specifically to albumin and is also precise and exhibits
excellent correlation with immunodiffusion reference methods.
BROMOCRESOL PURPLE
This measures all chemically bound nitrogen in the sample. The analysis of total nitrogen level is useful in assessing
nitrogen balance. This method can be applied to various biologic samples such as plasma and urine
Total nitrogen determination
Proteins are very effective antigens due to their molecular mass, specificity and this particular content.
Tyrosine
An acid that is secreted by parietal cells is used to kill bacteria, also to denature proteins; this makes them more
susceptible to subsequent hydrolysis by proteases.
Hydrochloric acid
An analogous reaction takes place between the cupric ions and the organic compound, biuret and therefore the
reaction is called
BIURET REACTION
Some proteins function in the distribution of water throughout the compartments of the body.
Osmotic pressure
Of the 20 amino acids, only leucine and _______ are unable to furnish carbon for net glucose synthesis.
Lysine
In alkaptonuria, the error of metabolism at birth is due to the absence of this enzyme in the tyrosine pathway.
Homogentisate oxidase
It is the bluish black discoloration of certain tissues, such as the ear cartilage and the ocular tissue, seen with
alkaptonuria.
OCHRONOSIS
Approximately 90% of patients with this condition exhibit oligocional bands in the gamma region of the protein
electrophoresis.
Multiple sclerosis

Modified Guthrie test is used to screen this metabolic disorder. Physical defects, thrombosis, osteoporosis, eye lens
abnormality, mental retardation are the clinical features of this condition

HOMOCYSTINURIA
Presence of microalbuminuria is also associated with an increased risk of this disease.
CARDIOVASCULAR DISEASE
It is the difference between nitrogen intake and nitrogen excretion
NITROGEN BALANCE
These proteins are combined with nucleic acids, DNA or RNA.
NUCLEOPROTEINS
This condition is characterized by sparse, kinky hair; failure to gain weight and grow at the expected rate
Menkes syndrome
This is characterized by markedly reduced or absence of α -ketoacid decarboxylase.
MAPLE SYRUP URINE DISEASE
In acute myocardial infarction, the level of this cardiac troponin begins to rise 3-6 hours, peak in 12-18 hours, return
to normal in 5-10 days.
Troponin I
This increases in response to peptide (BNP) ventricular systolic and diastolic dysfunction and is diagnostic of
congestive heart failure.
B-type natriuretic peptide
Overload proteinuria includes, myoglobinuria, hemoglobinuria and _____.
Bence-Jones proteinuria

This is used as a landmark to confirm that the specimen is really CSF.

prealbumin

This protein has this property of showing elevations in concentrations in response to stressful or inflammatory states
that occur with infection, injury, surgery, trauma, or other tissue necrosis.
Acute phase reactant proteins
It is a useful marker for monitoring the success or failure of reperfusion.
myoglobin
This is a classic method for quantitation of total protein, which determines nitrogen.
Kjeldahl method
The serum proteins are precipitated to this organic acid
Tungstic acid
This method employs Folin and Ciocalteau reagent (lithium salts) of phosphotungstic– phosphomolybdic acid in an
alkaline solution
Phenol method
This is the worldwide organization that recommended biuret procedure for the determination of total protein.
International Federation of Clinical Chemistry
This is the major component of beta fraction. Increase content of this protein can be seen in hemochromatosis, and
iron deficiency anemia.
Transferrin
One of the largest proteins in the blood and the most abundant of the coagulation factor. This protein is not seen in
serum.
Fibrinogen
Refers to the removal of the carboxyl group of the amino acid for the formation of a physiologic active amine by the
aid of a decarboxylase enzyme.
Decarboxylase
This indicates that the body uses more protein than it consumes, resulting in protein loss.
Negative nitrogen balance
Proteins that consist of a protein and a non-protein (prosthetic) group such as lipid, carbohydrate, porphyrins,
metals, and others.
Conjugated proteins
It is an independent risk factor for cardiovascular disease (CVD) in individuals with DM type 2.
Haptoglobin phenotype

It is the largest non immunoglobulin protein in plasma. found principally in intravascular. Also this protein forms a
complex with prostate-specific antigen.
Alpha-2 macroglobulin

The most abundant form in serum. It is also important in pathogenesis of age-related macular degeneration.
Complement C3
It is an autosomal recessive trait characterized by the deficiency of the enzyme phenylalanine hydrolase
(PAH)/phenylalanine-4-mono-oxygenase, which catalyzes the conversion of phenylalanine to tyrosine.
Phenylketonuria
This is the most significant finding from an electrophoretic pattern.
Monoclonal immunoglobulin
In this condition, there is an increased concentration of lipoproteins, which is an indicator of its biliary origin.
Obstructive jaundice
The other term used to describe the major plasma glycoprotein and is negatively charged even in acid solutions.
orosomucoid
It binds to the C-polysaccharide of the pneumococcus, and is increased in tissue necrosis, rheumatic fever, infections,
myocardial infarction, rheumatoid arthritis and gout.
C-reactive protein
Glycoproteins which consist of two identical heavy chains and two identical light chains linked by two disulfide
bonds.
Immunoglobulins
It results to elevated levels of homocysteine and methionine in blood and urine. Clinical features include physical
defects, thrombosis, osteoporosis, eye lens abnormality, mental retardation.
homocystinuria
This protein transports cholesterol ,TAG, and phospholipids. It also binds with proteins and lipids forming LDL, HDL,
VLDL, chylomicrons.
lipoproteins
Most proteins are negatively charged cathode which means they will migrate towards______.
Positively charged anode
With this condition, the patient loses serum albumin and low-molecular-weight proteins in the urine. Some IgG is
also lost. At the same time, an increase occurs in α2-macroglobulin, β-lipoprotein, complement and haptoglobin.
Nephrotic syndrome
Grabar and Burtin published methods for examining serum proteins using electrophoresis coupled with
immunochemical reactions in agarose. In what year did the publication occur?
1964
In this method, monospecific antiserum is added to the liquefied agarose; then the agarose is poured into a plate
and cooled.
Radial immunodiffusion
This antibody protects the body against parasitic worms. Responsible for allergic reactions.
Immunoglobulin E
The support medium most commonly used in High- resolution protein electrophoresis.
Agarose gel
All plasma proteins are synthesized in the liver except the ________.
Immunoglobulins
In this case definition of Covid-19, it refers to a probable or confirmed case of COVID-19 with impending or ongoing
respiratory failure , in need of mechanical ventilation or with evidence of end-organ damage.
Critical case, Critical cases, Critical
It is the restriction of movement, or separation from the rest of the population, of healthy persons who may have
been exposed to the virus.
Quarantine
It is the separation of ill or infected persons from others to prevent the spread of infection or contamination.
Isolation
It is the meaning of "R" in the PDITR strategy where the LGUs are expected to institutionalize social assistance and
social safety nets mechanism.
Reintegrate
Part 3 - MULTIPLE CHOICE

Siderophilin is used to determine the cause of anemia and prevents iron loss through the kidneys. This is the
reference value of this protein in females.
250-380 g/dl

CRP is a cardiac and inflammatory marker and a general scavenger molecule. It is the reference value of this protein.
Less than 1.0mg/dl
Fibrinogen is increased in pregnancy, inflammatory disorders, and use of birth control pills. It is the reference value
of this protein.
200-400 mg/dl

Beta-2 microglobulin is freely filtered at the glomerulus. Reabsorbed and metabolized completely by the proximal
convoluted tubule. It is the reference value of this protein.
0.2-2.8ug/dl

CSF proteins are decreased in intracranial hypertension, hyperthyroidism, leakage of CSF due to trauma. It is the
reference value of this protein.
15-45 mg/dl
Alpha-2 macroglobulin increases 10 times during nephrosis. It is the reference value of this protein.
150-420 mg/dl
Transferrin is increased in hemochromatosis, and iron deficiency anemia. It is the reference value of this protein in
males.
215-365 mg/dl

It is an inborn error of metabolism characterized by the absence of the homogentive oxidase in the tyrosine
pathway.

alkaptonuria

It is characterized by impaired activity of cystathionine beta-synthetase, results to elevated levels of homocysteine

and methionine in blood and urine.
homocystinuria
Globulin consists of α1, α2, β and γ fractions. Each fraction consists of a number of different proteins with different
functions. It is reference value of this plasma protein.
2.3-3.5 g/dl
Haptoglobin is elevated in the following inflammatory diseases EXCEPT
Intravascular hemolysis
Clinical features of Wilson’s disease includes the deposition of copper in the following ECEPT:
Thyroid
Protein is precipitated by a protein precipitant and the precipitated is washed, dried and weighed. This method
requires large amounts of serum and its time consuming.
Gravimetric method
A classic method for quantitation of total protein, which determines nitrogen.
Kjeldahl method
Which of the following is not a composition of biuret reagent?
Sodium chloride
Diluted serum is treated with sulfosalicylic acid resulting in the precipitation of protein. The resultant precipitate of
protein is read photometrically as a turbidity.
Turbidimetric method
Albumin/Globulin ratio: Albumin ÷
Globulin: Total protein-albumin
Αlpha 1-Globulin: 2.5% to 5%
Alpha 2-Globulin:7% to 13%
This condition shows a beta-gamma bridging effect in serum protein electrophoresis.
Liver cirrhosis
This alpha 2 globin binds to 90% of copper and is decreased in Wilson’s disease.
Ceruloplasmin
This is sensitive but not specific for protein for kidney damage.
proteinuria
Which of the following statements is incorrect?
Electrophoresis separates proteins on the basis of their electric charge densities
Proteins that migrate in the alpha 2 globulin band in serum protein electrophoresis EXCEPT:
Transferrin
Which dye is used for nonspecific for albumin; β-lipoproteins and some alpha 1- and alpha 2-globulins?
Methyl orange
IEF uses constant power and polyacrylamide or agarose gel mediums, which contain a pH gradient. The pH gradient
range from:
3.5-10
In this case definition of Covid-19, patients experience difficulty in breathing, altered mental status, considered high-
risk or in need of hospital care.
Moderate case
Asymptomatic patients can be released from quarantine after how many days (?) as long as the patient remains
asymptomatic for the entire duration of the quarantine, even without testing or test result.
14 days
This exposure risk level states that a person has NO direct contact with a Covid-positive individual during the
infectious period and wears at least a face covering.
Low risk exposure

LIPIDS & LIPOPROTEINS

1. It is the breakdown or hydrolysis of the substance such as triglycerides into fatty acids and glycerol
occurs through the action of the lipase.
Answer: Lipolysis
2. These are commonly referred to as fats, composed mostly of carbon-hydrogen bonds.
Answer: Lipids
3. These are linear chains of carbon-hydrogen bonds that terminate with a carboxyl group.
Answer: Fatty acids
4. Fatty acids are mostly found as constituents of phospholipids and _.
Answer: Triglycerides
5. Reference value for fatty acids.
Answer: 9-15 mg/dL
6. In fatty acids, the __ and cis-monosaturated fatty acids are not associated with elevated serum LDL
cholesterol.
Answer: Polyunsaturated
7. What do you call the process for conversion of a substance to glucose?
Answer: Gluconeogenesis
8. They released TAG to adipose tissue as they circulate.
Answer: Chylomicrons
9. In this pathway, the production of TAG from FA by the liver take place, with synthesis of VLDL particles
containing apo B100 and apo E.
Answer: Endogenous pathway
10. Where does Cholesterol ester transfer protein produced?
Answer: Liver
11. It is a lypolytic enzyme wherein it catalyzes the esterification of cholesterol from HDL; enables HDL to
accumulate cholesterol as cholesterol ester.
Answer: Lecithin cholesterol acyl transferase
12. It is a lypolytic enzyme that hydrolyzes TAG and phospholipids from HDL; hydrolyzes lipids on VLDL
and IDL.
Answer: Hepatic lipase
13. In the principle of total fatty acids, it is extracted by refluxing with alcohol–ether and the extract is
saponified with KOH. The fatty acids are precipitated, separated and titrated with standard KOH.
Answer: Serum
14. Also known as free fatty acids.
Answer: Non–esterified fatty acid
15. Lipolytic mobilization is promoted by Growth hormone, Glucagon, Adrenocorticosteroid and ___.
Answer: Pituitary hormone
16. It contains 3 molecules of fatty acid and one molecule of glycerol by ester bonds.
Answer: Triglycerides
17. An average person ingests, absorbs, resynthesizes, and transports about 60g-__ of fat daily in the
body, mostly in the form of triglycerides.
Answer: 130g
18. Very high triglyceride has a reference value of __.
Answer: >500
19. An enzymatic method in triglyceride that involves hydrolysis of triglycerides to free fatty acids and
glycerol, followed by the phosphorylation of glycerol to glycerophosphate.
Answer: Glycerol kinase method
20. It can be used during the extraction step to remove interfering substances.
Answer: Adsorbents
21. It is an amphipathic lipd, which means it contains polar hydrophilic (water-loving) head groups and non-
polar (water-fearing) fatty acid chains - the saturated fatty acid content of plasma phospholipids is is
reported to be an independent risk factor for atherosclerosis.
Answer: Phospholipid
22. It is a form of phospholipid attached to a choline particle.
Answer: Lecithin or Phosphatidyl choline
23. A form of phospholipid that has an abundant sphingolipid in cellular membranes: its hydrolysis releases
ceramide and phosphocholine and several stimuli are known to activate sphingomyelin hydrolysis.
Answer: Sphingomyelin
24. Each mole of phosphorus contributes about __ to the total Phospholipid mass; thus, phospholipid mass
can be determined by multiplying the phospholipid phosphorus concentration expressed in mg/dL) by 25.
Answer: 4%
25. It is estimated from the evaluation of pulmonary surfactant in amniotic fluid - the lecithin/spingomyelin
ratio (L/S) and phosphatidyl glycerol (PG) by chromatography or the microviscosity by fluorescence
polarization are used.
Answer: Status of fetal lung maturation
26. It is found on the surface of lipid layers and synthesized in the liver.
Answer: Cholesterol
27. It is a polar nonesterified alcohol.
Answer: Free cholesterol
28. Cholesterol increases with age, with women having lower values than men before the age of what?
Answer: 45
29. The presence of this and hydroxyl group in the sterol’s structure makes it possible for cholesterol to
carry out a colorimetric assay.
Answer: Double bonds
30. It is the end product of Salkowski Reaction in the chemical methods of cholesterol.
Answer: Cholestadienyl disulfonic acid
31. The Saponification + Extracton + Colorimetry + Precipitation is under on what step method?
Answer: Four-step method
32. These are large macromolecular complexes of lipids with specialized proteins known as
apolipoproteins.
Answer: Lipoproteins
33. Cholesterol and triglycerides travel in plasma not as free-floating molecules, but as part of wter-soluble
complexes called __.
Answer: Lipoproteins
34. It aids in the solubilization of the lipids and also in their transfer from the gastrointestinal tract to the
liver, which contains specific receptors for apolipoproteins.
Answer: Apolipoprotein
35. Apolipoprotein contains a structural motif called __.
Answer: Amphipatic helix
36. These are protein units found in lipoproteins but not yet incorporated into their respective lipoprotein
particles.
Answer: Apoproteins
37. It is a type of apoprotein that functions in the activation of lipoprotein lipase (LPL), leading to the
breakdown of triglycerides at the cellular level, with subsequent release of fatty acids to the cells for
metabolism and storage.
Answer: Apoprotein C
38. It is a major lipoprotein and the largest and least dense of the lipoprotein particles.
Answer: Chylomicrons
39. It is an abnormal lipoprotein found in obstructive jaundice & LCAT deficiency.
Answer: Lipoprotein X
40. It is the smallest lipoproteins but the most dense.
Answer: High Density Lipoprotein/Alpha Lipoprotein (HDL)
41. It is a test for lipid that used to detect derangement of lipid metabolism and for assessing susceptibility
to atherosclerosis and coronary heart disease.
Answer: Fat tolerance test
42. It is present when elevated plasma lipoproteins have been clinically important in the genesis of
atherosclerosis and pancreatitis
Answer: Hyperlipoproteinemia
43. Abetalipoproteinemia is also known as __.
 Answer: Bassen–Kornzweig syndrome
44. This disorder is inherited as an autosomal dominant trait. The defect appears to be an inability to
synthesize ApoB–100 and ApoB–48.
Answer: Hypobetalipoproteinemia
45. It is also known as density gradient and is the reference method for quantitation of lipoproteins (LPPs).
Answer: Ultracentrifugation
46. It uses antibodies specific to epitopes on the apolipoproteins.
Answer: Immunochemical methods
47. It is referred to as diseases associated with abnormal lipid concentrations.
Answer: Dyslipidemias
48. It is one of the complications in arteriosclerosis wherein if a bulge in the wall of an artery bursts, it can
cause a slow leak or life-threatening internal bleeding.
Answer: Aneurysms
49. It is a rare autosomal recessive disorder characterized by complete absence of HDL due to a mutation
in the ABCA1 gene on chromosome 9.
Answer: Tangier disease
50. It is a recessive disorder wherein plant sterols are absorbed and accumulate in plasma and peripheral
tissues.
Answer: Sitosterolemia

II. TRUE or False.

1. One of the functions of lipids is to participate in cellular metabolism and blood coagulation.
Answer: False
2. The uptake into tissue cells and subsequent oxidation into acetyl Co–A which can be further, oxidized to
carbon dioxide and water via the Kreb’s or monocarboxylic acid cycle take place.
Answer: False
3. Phospholipids are linear chains of carbon-hydrogen bonds that terminate with a carboxyl group.
Answer: False
4. Large amount of fatty acids is present in plasma (free unsterified form), less is bound to albumin.
Answer: False
5. The polyunsaturated and cis-monosaturated fatty acids are associated with elevated serum LDL
cholesterol.
Answer: False
6. In fatty acids, the classification As to Chain is a saturated (without double bonds) fatty acids or
unsaturated (with double bonds) fatty acids.
Answer: False
7. Lipogenesis provide the substance for conversion to glucose.
Answer: False
8. The most hydrophobic lipids, such as fatty acids and phospholipids, are located in the core of the
lipoprotein particle.
Answer: False
9. CETP connects the forward and reverse triglyceride transport pathways.
Answer: False
10. Esterified fatty acids –5%; Free fatty acids –95%
Answer: False
11. Since only 3–5% of the fatty acids in serum are unesterified, this procedure to determine the esterified
fatty acids is often satisfactory as measure of the total fatty acids of serum.
Answer: True
12. Free Fatty Acids are determined by titrating with alkali after direct extraction with a non–polar solvent.
Answer: True
13. When triglycerides (TAGs) are metabolized , their fatty acids are released to the cells and converted
into energy – provide excellent insulation.
Answer: True
14. TAG and cholesterol are the most important lipids in the management of coronary artery disease
(CHD).
Answer: True
15. Phospholipid is the most abundant lipid derived from phosphatidic acid
Answer: True
16. In diagnostic significance of cholesterol, there is a direct relationship between elevated serum
cholesterol and myocardial infarction.
Answer: True
17. Excess cholesterol is re-esterified by the microsomal enzyme acyl : cholesterol acyl transferase (ACAT)
and is stored until it is needed.
Answer: True
18. The four major lipoproteins classes can be identified based on Particle size, Chemical composition,
Flotation characteristics, physicochemical properties and Electrophoretic mobility
Answer: True
19. When apoproteins complexed into lipoprotein particles, they are referred to as apolipoproteins.
Answer: True
20. Apo AI in combination with Apo AII and Apo CI is responsible for the removal of free cholesterol from
extrahepatic tissues.
Answer: True
21. Intermediate Density Lipoprotein (IDL) is a product of VLDL catabolism – “VLDL remnant”.
Answer: True
22. Stool with normal and 1+ amounts of fatty acids may show as many as 100 tiny globules per HPO with
diameters between 1–4 micra. If the amount is 5+ there is clinical steatorrhea.
Answer: False
23. Familial Lipoprotein Lipase Deficiency is also known as Familial Chylomicronemia.
Answer: True
24. LDL-Z is currently considered the most important value in assessing cardiac risk and directing therapy.
Answer: False
25. Chromatographic methods utilizes either Gel Chromatography of Affinity Chromatography.
Answer: True

III. MULTIPLE CHOICE.

1. These are commonly referred to as fats, composed mostly of carbon-hydrogen bonds. These are primary
sources of fuel, they provide stability to cell membrane and allow for transmembrane transport.

- Lipids
- Carbohydrates
- Proteins
- Amino Acids
- Electrolytes
Answer: Lipids
2. All are functions of Lipids, except:

- As regulatory substances.
- As transport form of metabolic fuel.
- As an important constituent in the assembly of cell membranes and bile acids.
- As membrane structural components.
- As intracellular storage depots of metabolic fuel.
Answer: As an important constituent in the assembly of cell membranes and bile acids.
3. These are linear chains of carbon-hydrogen bonds that terminate with a carboxyl group.

- Phospholipids
- Triglycerides
- Fatty Acids
- Proteins
- Cholesterol
Answer: Fatty Acids
4. Normal Reference value for Triglyceride:

- 9-15mg/dL
- 150-199mg/dL
- 200-499mg/dL
 - >500mg/dL
- <150mg/dL
Answer: <150mg/dL
5. Hydrolyzes TAG and cholesterol esters in lipoproteins; hydrolyzes TAG releasing fatty acid and glycerol;
it is present on the surface of capillary endothelial cells in adipose tissues, cardiac and skeletal muscles.

- Lipoprotein lipase
- Hepatic lipase
- Lecithin Cholesterol Acyl Transferase
- Endothelial lipase
- ATP-binding casette protein A1
Answer: Lipoprotein lipase
6. Is an abundant sphingolipid in cellular membranes: its hydrolysis
releases ceramide and phosphocholine and several stimuli are known to activate sphingomyelin hydrolysis.

- Cephalin
- Lecithin
- Phosphatidyl/choline
- Sphingomyelin
- Lysolecithin
Answer: Sphingomyelin
7. It is an unsaturated steroid alcohol containing four rings, and it has a single C-H side chain tail similar to
fatty acid.

- Phospholipids
- Triglycerides
- Amino Acids
- Proteins
- Cholesterol
Answer: Cholesterol
8. Cholesterol is the precursor of five major classes of steroids, except:

- Progestins
- Glucocorticoids
- Mineralocorticoids
- Estrogens
- Glycogen
Answer: Glycogen

9. Functions primarily as a marker for hepatic receptors. Synthesized in the liver, this is incorporated into
HDL. HDL then transfers ApoE molecules VLDL and chylomicrons. As these particles are subsequently
degraded to IDL and chylomicrons remnants. It has four polymorphic forms.

- Apoprotein A
- Apoprotein B
- Apoprotein C
- Apoprotein D
- Apoprotein E
Answer: Apoprotein E
10. It is the largest and least dense of the lipoprotein particles. It is produced in the intestine from dietary
fat; completely cleared within 6-9 hours post-prandial. It transports exogenous/dietary TAG to liver, muscles
and fat depot.

- Chylomicron
- Very Low Density Lipoprotein
 - High Density Lipoprotein
- Low Density Lipoprotein
- Intermediate Density Lipoprotein
Answer: Chylomicron
11. Blood is drawn from the finger tip of a fasting patient. Specimens are centrifuged and the serum is
placed on a glass slide. It is examined under dark field technique and the number of the particles of visible
fat is counted in a single plane of the oil immersion field.

- Fat tolerance test

- Examination of stool for fat
- Chylomicron count
- Estimation of serum lipid phosphorus
- Status of fetal lung maturation - Lecithin/ Spingomyelin (L/S) Ratio
Answer: Chylomicron count
12. Common disorder of lipid metabolism characterized by increased levels of plasma triglycerides and
VLDL without any other specific clinical or biochemical features.

- Type I: Familial Chylomicronemia
- Type II: Familial Hypercholesterolenemia
- Type III: Familial Dysbetalipoproteinemia
- Type IV: Familial Hypertriglyceridemia
- Type V: Familial Combined Hyperlipidemia
Answer: Type IV: Familial Hypertriglyceridemia
13. It uses antibodies specific to epitopes on the apolipoproteins.

- Ultracentrifugation
- Electrophoresis
- Chemical Precipitation
- Immunochemical methods
- Immunoassay
Answer: Immunochemical methods

14. Type of Niemann-Pick that occurs mainly in infants, who show severe, progressive brain disease. There
is no cure, so most children do not live beyond their first few years.

- Type A
- Type B
- Type A and B
- Type C
- Type D
Answer: Type A
15. It is an inherited neurodegenerative disorder of lipid metabolism characterized by a deficiency of the
enzyme hexosaminidase A, which results in the accumulation of spinogolipids in the brain.

- Sitosterolemia
- Anderson’s Disease
- Tangier Disease
- Bassen-Kornzweig Syndrome
- Tay-Sachs Disease
Answer: Tay-Sachs Disease
16. It is a rare, autosomal recessive disorder that presents in childhood with abdominal pain and
pancreatitis.
 - Lipoprotein Lipase (LPL) Deficiency
- Lecithin Cholesterol Acyl Transferase (LCAT) Deficiency
- Sitosterolemia
- Niemann-Pick disease (Lipid storage disease)
- Abetalipoproteinemia (Bassen-Kornzweig Syndrome)
Answer: Lipoprotein Lipase (LPL) Deficiency

17. It is one of the complications of arteriosclerosis wherein the arteries are narrowed in the arms or legs
may cause circulation problems that make it difficult to feel heat and cold, and cause gangrene that can
lead to limb amputation.

- Coronary Arteriosclerosis (Coronary artery disease)

- Carotid artery disease

- Peripheral artery disease

- Aneurysms
- Chronic kidney disease
Answer: Peripheral artery disease

18. It is the main distribution of apolipoprotein B-100.

- HDL, CM, and free in plasma

- HDL, LDL, VLDL
- HDL, CM, LDL, VLDL
- CM, VLDL, IDL, and remnants
- VLDL, LDL
Answer: VLDL, LDL

19. It is a recessive disorder wherein plant sterols are absorbed and accumulate in plasma and peripheral
tissues.

- Tangier Disease
- Sitosterolemia
- Arteriosclerosis
- Hypobetalipoproteinemia
- Lipoprotein Lipase (LPL) Deficiency
Answer: Sitosterolemia

20. This apolipoprotein is not recognized by LDL receptor.

- Apolipoprotein B-48
- Apolipoprotein C-I
- Apolipoprotein E
- Apolipoprotein J
 - Apolipoprotein L
Answer: Apolipoprotein B-48

21. LDL-C can be measured directly but is usually calculated using what formula?

- De Long Formula
- Friedwold Formula
- De Short Formula
- Friedewald Formula
- Quadratic Formula
Answer: Friedewald Formula

22. How many amino acids does apolipoprotein A-II have?

- 299
- 169
- 4536
- 396
- 154
Answer: 154

23. All are functions of Phospholipids, except;

- Phospholipids alter fluid surface tension (surfactant) - it decreases surface tension within the
alveolar space, thus allowing effective gas exchange, and prevents alveolar collapse during
expiration.
- It participates in cellular metabolism and blood coagulation.
- They are also important substrates for a number of lipoprotein metabolizing enzymes (e.g., LCAT,
LPL, HL); therefore changes in the composition could adversely affect the function of these
enzymes.
- Deficiency of surfactant leads to neonatal respiratory distress syndrome (RDS)
- It is an important constituent in the assembly of cell membranes and bile acids.
Answer: It is an important constituent in the assembly of cell membranes and bile acids.

24. Increased values in total cholesterol may due to, which of the following;

- Hyperthyroidism    
- Epilepsy
- Multiple Sclerosis
- Xanthomatosis  
- Pernicious anemia
Answer: Xanthomatosis  

25. Four major lipoproteins classes can be identified based on:

 - Particle size
- Chemical composition
- Flotation characteristics
- All of the above
- None of the above
Answer: All of the above