QUESTIONS (BISHOP): AMINO ACIDS, PROTEINS, AND NPNs

1. Which of the following acute-phase reactant proteins decreases during inflammation?

a. Transferrin
b. A1-antitrypsin
c. Haptoglobin
d. Fibrinogen
2. Which of the following refers to 3-dimensional spatial configuration of a single polypeptide
chain determined by disulfide linkages, hydrogen bonds, electrostatic attractions, and van
der Waals forces?
a. Primary
b. Secondary
c. Tertiary
d. Quaternary
3. Which of the following plasma protein is primarily responsible for maintaining in vivo
colloidal osmotic pressure?
a. Albumin
b. Hemoglobin
c. Fibrinogen
d. A2-macroglobulin
4. Which of the following best describes a peptide bond?
a. An amino group and carboxyl group bonded to an alpha-carbon
b. A double carbon bond between the alpha-carbons of two amino acids
c. An amino group bonded to a carboxyl group of another amino acid
d. Two carboxyl groups bonded to the alpha-carbon of an amino acid
5. Which of the following results would correlate best with malnutrition and a poor protein-
caloric status?
a. Decreased prealbumin
b. Decreased gamma globulins
c. Elevated ceruloplasmin
d. Elevated a1-fetoprotein
6. Which of the following conditions would correlate best with a normal level of myoglobin?
a. Multiple myeloma
b. Acute myocardial infarction
c. Acute renal failure
d. Skeletal muscle injury
7. An immunofixation protein electrophoresis is performed on serum from a patient with the
most common type of multiple myeloma. The resulting pattern would most likely rveal the
following?
a. An IgG monoclonal band
b. Oligoclonal bands
c. Significant β–γ bridging
d. An IgM monoclonal band
8. Which of the following would indicate a plasma specimen was used for protein
electrophoresis instead of serum?
a. A small peak between the β- and γ-globulins
b. A broad increase in γ-globulin fraction
c. A bridge between the α1- and α2-globulins
 d. A significantly decreased albumin peak
9. Which of the following conditions would correlate best with the serum protein
electrophoresis results below? albumin: decreased
α1-globulins: increased
α2-globulins: increased
β-globulins: normal
γ-globulins: normal

A. Acute inflammation
B. Chronic liver cirrhosis
C. Nephrotic syndrome
D. Monoclonal gammopathy
10. Which of the following conditions would correlate best with the presence of distinct
oligoclonal bands in the γ-zone on CSF protein electrophoresis?
a. Multiple sclerosis
b. Multiple myeloma
c. Bacterial meningitis
d. Myoglobinemia
11. When a protein is dissolved in a buffer solution that is more alkaline than its pI and an
electric current is passed through the solution, the protein will act as:
a. An anion and migrate to the anode
b. A cation and migrate to the cathode
c. An anion and migrate to the cathode
d. An uncharged particle will not move
12. Which of the following conditions would correlate best with an elevated serum total protein
with high levels of both albumin and globulins?
a. Dehydration
b. Myocardial infarction
c. Glomerulonephritis
d. Liver cirrhosis
13. Which of the following urine total protein results would correlate best with a patient with
nephrotic syndrome?
a. Normal
b. Lower than normal
c. Higher than normal
d. Similar to levels in CSF total protein levels
14. Isoelectric focusing is used to phenotype α1-antitrypsin deficiencies. When protein is
electrophoresed, it migrates to which of the following?
a. The site there the pH is the same as its pI
b. The site whe the mass of the protein correlates with the pI
c. The site where the protein’s net charge exceeds the pI
d. The site where the protein’s net charge is less than the pI
15. A CSF-serum albumin ratio of 9.8 was reported. How is this best interpreted?
a. The ratio is in the normal range for the patient
b. The blood-brain barrier may be compromised
c. It is biologically impossible to achieve this value
d. This is diagnostic of fungal meningitis
16. Which of the following CSF proteins would be measured when investigating active
demyelination in multiple sclerosis?
a. CSF-serum albumin ratio
b. A1-antitrypsin
c. Myelin basic protein
d. Immunoglobulin G