clinical chem final part 2
Terms in this set (63)
Calcium concentration in the serum is regulated endogenously by:
Each of the following factors influences the serum calcium concentration EXCEPT
Secondary hyperparathyroidism is often the result of:
high serum phosphate
In rickets patients, typical findings include all of the following EXCEPT
Sulfanilic acid; sodium nitrite
The most widely used method for bilirubin analysis uses two reagents, ____________ and ___________, in the diazo reaction.
Production of bilirubin occurs in the __________, and conjugation of bilirubin to glucuronide occurs in the _____________.
Unconjugated bilirubin circulated in the bloodstream is bound to:
Serum bilirubin is unstable because of:
The enzyme that conjugates bilirubin in the hepatocyte is:
Bilirubin is reduced to __________ in the small intestine.
What reagent is used in the Jendrassik-Grof method as an accelerator?
A 21-year-old man with nausea, vomiting, and jaundice has the following laboratory findings:
Total serum bilirubin
8.5 mg/dL (normal 0-1.0 mg/dL)
Direct serum bilirubin
6.1 mg/dL (normal 0-0.5 mg/dL)
200 U/L (normal 0-50 μ/L)
160 U/L (normal 0-150 μ/L)
What disease state are these findings consistent with?
When elevated amounts of bilirubin are presented to the liver with elevated serum unconjugated bilirubin, what type of jaundice occurs?
Which cardiac marker is elevated for the longest period after myocardial infarction (MI)?
A hemolyzed specimen is received in the laboratory for enzyme analysis. The assay for which of the following enzyme values would be affected by hemolysis?
Which isoenzyme of creatine kinase (CK) is primarily found in cardiac muscle?
Myocardial infarction can produce a CK isoenzyme profile that is similar to:
Which of the following cardiac markers is the first to increase after an acute myocardial infarction?
The following serum results—ALP, marked increase; AST, slight increase; ALT, slight increase; GGT, marked increase; conjugated bilirubin, marked increase—are most consistent with:
LD 1 > LD 2
An LD flip, in assessing a possible myocardial infarction, refers to:
Which MI marker is the most specific and sensitive and remains elevated for 14 days or more?
A creatinine clearance is done on a patient with the following results: serum creatinine, 0.6 mg/dL; urine creatinine, 102 mg/dL; urine volume, 1650 mL/24 hours; body surface area, 1.93 m2. This patient's creatinine clearance, corrected for body surface area, is:
A creatinine clearance is done on a patient with the following results: serum creatinine, 0.6 mg/dL; urine creatinine, 102 mg/dL; urine volume, 1650 mL/24 hours; body surface area, 1.93 m2. Based on the information from calculations above, which of the following is the best interpretation of this patient's creatinine clearance results?
BONUS: A creatinine clearance is done on a patient with the following results: serum creatinine, 0.6 mg/dL; urine creatinine, 102 mg/dL; urine volume, 1650 mL/24 hours; body surface area, 1.93 m2. What is the patient's 24 hour creatinine excretion in grams/day. Show your work on scratch paper and turn it in to receive possible partial credit
Hematuria, proteinuria (>3.5 g/dL), RBC casts, and oliguria are the principal features of:
defective proximal tubules
Fanconi syndrome is a disease of:
What is the first feature of nephrotic syndrome that results in manifestation of the other four classic signs?
chronic renal failure
Anemia, hyperphosphatemia, hypocalcemia, and ongoing azotemia are most indicative of
sodium bicarbonate and blood ph
A physician calls the laboratory and asks what lab tests should be requested to assess the acid-base balance function of a patient's renal system. You reply:
serum amylase and lipase activity
Tests of pancreatic exocrine function include:
An autosomal recessive genetic disorder that leads to lung disease but begins in the pancreas with decreased pancreatic enzyme secretion is:
How soon following acute abdominal pain due to pancreatitis is the serum amylase level expected to rise?
In addition to pancreatitis, an increase in serum lipase activity may be observed in:
Which of the following is NOT produced by the islets of Langerhans of the pancreas?
Which of the following normally does NOT pass through the blood-brain barrier?
During a lumbar puncture, the first collection tube of CSF removed should be used for:
the lability of the immunoglobulins
Which of the following is NOT an analytical concern when testing of the CSF is delayed?
increased numbers of leukocytes
All of the following can cause xanthochromia in CSF EXCEPT:
An uneven distribution of blood in the CSF collection tubes
In CSF, which of the following indicates a traumatic puncture?
Which of the following cell types predominates in CSF with bacterial meningitis?
Increased CSF glucose values are diagnostically significant
Which of the following statements about CSF glucose is false?
Urea, glucose, creatinine, and protein
Analysis for which of the following substances can aid in the differentiation of amniotic fluid from urine?
An L/S ratio of less than 2.0 with PG absent
Which of the following test results would best indicate fetal lung immaturity?
Maternal immunization by fetal antigens
Which of the following causes erythroblastosis fetalis?
Its total protein ratio and lactate dehydrogenase ratio
Which of the following parameters best identifies a fluid as a transudate or an exudate?
It is viscous.
Which of the following is a characteristic of normal synovial fluid?
Crystals may have precipitated or dissolved
A synovial specimen is received in the laboratory 2 hours following its collection. Which of the following changes to the fluid will most likely have taken place?
Which of the following anticoagulants should be used with a synovial fluid specimen when needed?
Monosodium urate monohydrate crystals (uric acid)
Which of the following crystals is characteristically seen in patients with gout?
Staphylococcal bacteria identified by Gram stain
Which of the following provides a definitive diagnosis of a specific joint condition?
A carbonate salt of which drug is used to control manic-depressive disorders?
When therapeutic failure of aminoglycoside levels is suspected, one should draw a _________ serum drug level for measurement.
Immediately before drug administration
A blood sample for determination of the trough level of a drug is appropriately drawn:
Which of the following classes of compounds has a sedative effect and as such is used to treat anxiety?
The "gold standard" confirmation method for positive drug screens is:
BRCA-1 and -2
Which of the following genetic markers is associated with breast cancer?
The oncofetal antigen associated with liver cancer is:
Elevation in serum calcitonin is associated with cancer of the:
AFP and CEA are examples of which type of tumor marker?
The carcinoma-associated tumor antigen most useful for following patients with ovarian cancer is:
CEA is most commonly associated with:
Monitoring the course of a known cance
Clinical assays for tumor markers are most important for:
Chronic deficiency of protein intake
Serum albumin levels are a good indicator of:
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