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Chemistry II- Final Exam
Terms in this set (127)
Mod 1 - Blood Gases, pH, Trace Elements, Porphyrin and Hemoglobin
A metal ion required for optimal enzyme activity is best termed a(an)?
A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would most likely be consistent with this diagnosis?
a. High pCO2, increased HCO3
A common cause of respiratory alkalosis is:
A compound that may be detected by observing its rose-red color in the aqueous layer of the Watsen-Schwartz test is:
A fresh urine sample is received for analysis for "porphyrins" or "porphyris" without furthur information of specifications. Initial analysis shouls include?
c. porphyrin and porphobilogen screen
A genetic disorder causing a deficiency of certain enzymes in the synthetic pathways leading to cortisol and aldosterone production is referred to as:
a .Congenital adrenal hyperplasia
A low-salt diet, low blood pressure, and diuretics would cause the following results:
a. increased renin, increased aldosterone, hypernatremia, hypokalemia
A patient has an elevated serum T3 and free T4 and undetectable TSH. What is the most likely cause of these results?
b. Primary Hyperthyroidism
A patient presents with Addison's disease. Serum sodium and potassium analyses are done. The results would reveal:
c .Low sodium, high potassium levels
A patient is suspected of having Addison's disease. His laboratory tests show low serum sodium and chloride, elevated serum potassium, and elevated urine sodium and chloride levels. The aldosterone cortisol levels are decreased. To make a definitive diagnosis, the physician orders an ACTH stimulation test, and the cortisol level is measured again. If the patient has Addison's disease, the cortisol level would ________. If the patient has hypopituitarism, the levels would _______.
d. Remain the same; increase
A shift of the oxygen dissociation curve to the right, resulting in a decreased affinity of hemoglobin oxygen, may be due to:
a. Low blood pH level
A two-year-old child with a decreased serum T4 is described as being somewhat dwarfed, stocky, and overweight and having coarse features. Of the following, the most informative additional laboratory test would be serum
b. Thyroid-binding globin (TBG)
A urine screening test for porphobilinogen is positive. The MOST likely disease state is:
c. Acute porphyria attack
Acute intermittent porphyria (AIP) patients have a deficiency of:
c. PBG deaminase
All of the following statements about partially compensated respiratory alkalosis are true EXCEPT:
d. Hypoventilation is the causative defect
Aluminum, arsenic, lead, molybdenum and manganese are most often measured using:
An example of ectopic hormone production would be:
Growth hormone production by lung tumors
An increased P50 causes a shift of the oxygen dissociation curve to the left.
Androgen secretion by the testes is stimulated by:
a .Luteinizing hormone (LH)
As a screening test for Cushing's syndrome, the physician wishes to see whether a patient exhibits normal diurnal rhythm of his cortisol secretion. At what time should the specimens be drawn for plasma cortisol determination? (Assume a daytime work schedule for the patient.)
c. 8 AM, 8 PM
At blood pH of 7.40, what is the ratio of bicarbonate to carbonic acid?
Arterialized blood is always an acceptable alternative to arterial blood providing you warm up the puncture site before obtaining the specimen.
Base excess is a blood gas parameter that measures the deviation from the normal buffer base and can be either positive or negative.
Chronic fetal metabolic distress is demonstrated by:
d .Decreased urinary estriol excretion and decreased maternal serum estriol
Extreme copper deficiency is seen in what fatal condition?
b. Menke's disease
For the past 3 weeks, serum estriol levels in a pregnant woman have been steadily increasing. This is consistent with:
a .A normal pregnancy
In a patient who is suspected of having pheochromocytoma, measurement of which of the following urinary compounds would be the most useful?
In a patient suspected of having primary hyperthyroid myxedema, one would expect the following serum results: T4 _______, TSH ________.
d .Increased, decreased
In an enzyme activity assay, the concentration of a coenzyme:
b. Should be in excess of its requirement
In respiratory acidosis, a compensatory mechanism is the increase in?
d. plasms bicarbonate concentration
Individuals taking recurring regimens of androgens or anabolic steroid drugs may exhibit increased TBG levels.
Iron is physiologically active only in the ferrous form in?
Humans do not absorb aluminum:
Hyponatremia (low serum sodium level) may be found in all of the following conditions EXCEPT:
d. Conn's syndrome
Maganese toxicity resembles the following disease?
c. Parkinson's disease
Mass-to-charge ratio is detected in:
Metabolic acidosis is described as a(n):
d. Decrease on HCO3 and pCO2 with a decreased pH
Organic forms of mercury accumulated in the brain can take several years to be eliminated.
Pituitary secretion of adrenocorticotropic hormone (ACTH) is inhibited by elevated levels of:
Porphobilinogen may be differentiated from urobilinogen in urine by:
a. Difference in chloroform solubility of Ehrlich's aldehyde derivatives
Porphyria cutanea tarda is identified by?
b. Chromatographic analysis of a 24 hour urine collection
d. Parallels activity of the corpus luteum by rapidly increasing following ovulation and then abruptly falling to initial low concentrations prior to the onset of menstruation
Porphobilinogen often is measured in the urine using?
d. The Watson-Schwartz method
Screening and quantitative tests for porphyrins in urine, blood, and feces are based on the principle of enhanced fluorescence of these compounds in:
b. pH-acidic solutions
Secretion of hormones by the anterior pituitary is controlled by circulating levels of hormones from the target gland and hormones secreted by the:
Specimens for blood gas determination should be drawn into a syringe containing:
Pituitary adenomas that secrete _______ are by far the most common form of hyperpituitarism.
The basic porphyrin structure is composed of four pyrrole rings linked by methene bridges. The compounds that originally condense to form the pyrrole structure porphobilinogen are:
e. Succinyl-coenzyme A and glycine
The biologically most active, naturally occurring androgen is:
The definitive diagnosis of primary adrenal insufficiency requires demonstration of:
c. Impaired response to ACTH stimulation
The FINAL metabolite of epinephrine that is measured in urine is:
d. Vanillylmandelic acid
The formation of estriol in a pregnant woman is dependent on:
b. Fetal and placental function
The following laboratory results were obtained:Serum ElectrolytesArterial BloodSodium 136 mEq/LpH 7.3Potassium 4.4 mEq/LpCO2 55mm HgChloride 92 mEq/LBicarbonate 40 mEq/L
b. Respiratory acidosis
The majority of absorbed lead is take up by _____________ and inhibits heme synthesis:
a. Red blood cells
The major fraction of organic iodine circulating in the blood is:
The majority of the iron in whole blood is:
a. Bound to hemoglobin
The most potent estrogen, and the substance considered to be the true ovarian hormone, is:
The most common hemoglobinopathy in the United States is due to a defect in
a. Hgb S
The number of pyrrole rings found in the structure of all porphyrins is:
The old T3 resin uptake test has been replaced by a direct assay for:
b .Bound T3
The parent substance in the biosynthesis of androgens and estrogens is:
The parent substance of all steroid hormones is:
The primary purpose of porphyrins in the human body is to?
d. Chelate free hemoglobin
The primary serum test to screen for thyroid disease is?
The placenta secretes numerous hormones, both protein and steroid. Which of the following hormones is not secreted by the placenta?
e .Luteinizing hormone (LH)
The porphyrias can be classified according to disease symptoms as?
c. Erthropoietic or hepatic
The thyroid produces all the following EXCEPT
The TRH (thyrotropin releasing hormone) stimulation test is useful in differentiating hypothalamic hypothyroidism from:
c. Pituitary hypothyroidism
The solubility coefficient of carbon dioxide in plasma is:
Trace element testing requires special measures to avoid contamination because:
a. Trace elements are ubiquitous in the environment
Thyriod hormones are derived from the amino acid:
What hormone is responsiable for epinephrine production?
What hormone inhibits TRH in the presence of increased levels of T3 and T4?
What metal may be used as a treatment for Wilson's disease?
When taken by a euthyroid individual, oral contraceptives will have an increasing effect on thyroxine binding globulin.
Which amino acid is needed for the biosynthsis of noreinephrine and epinephrine?
Which formula provides the best estimate of serum transferrin?
b. TIBC (μg/dL) × 0.70 = transferrin in mg/dL
Which of the following is secreted by the placenta and used for the early detection of pregnancy?
b. Human chorionic gonadotropin (HCG)
Which of the following hormones is secreted by the posterior pituitary gland?
Which of the following proteins binds ferric iron and is increased in iron-deficiency anemia?
Which one of the following statements about T3 is FALSE?
c .It is not bound to serum proteins.
Which of the interpretations is correct for the following blood gas results:
pCO2 = 32
HCO3 = 18
d. Respiratory acidosis, not compensated
Which of the following forms of the Henderson-Hasselbalch equation is (are) correct?
b. pH = 6.1 + log HCO3/H2CO3 and pH = pKa + log HCO3/H2CO3
Which is the most widely used screening test for Cushings syndrome?
d. Overnight low-dose dexamethasone suppression test
Which of the following statements about the disgnosis of addisons disease is true?
c. Primary and secondary addisons disease can often be differentiated by plasma ACTH
Which of the interpretations of the following blood gases is correct:
pH = 7.35
pCO2 = 48
HCO3 = 31
c. Respiratory acidosis, fully compensated
Which of the following steps is NOT necessary in methods for iron determination?
b. Protein precipitation
Which hormone most directly stimulates testosterone secreation?
Which hormone is not secreated form the anterior pituitary?
Upon receiving an arterial specimen for blood gases in the laboratory, you observe that it was not maintained under strict anaerobic conditions. You refuse to analyze the specimen. You base your decision on the premise that the following parameters have been altered:
a. pH increased, pCO2 decreased, pO2 increased
Urinary aminolevulinic acid (ALA) levels are increased in all of the following disorders, except:
You have determined the following blood gas parameters on a patient with emphysema. Calculate the total carbon dioxide content in mEq/L.pH = 7.20HCO3 = 20 mEq/LpO2 = 60 mmHgpCO2 = 100 mmHgBE = +4
Your supervisor asks you to recalibrate the blood gas analyzer. Given the data below, what partial pressures of carbon dioxide and oxygen should be used to standardize the instrument?
Barometric Pressure = 767 mm Hg
Carbon dioxide tank = 10%
CO2Oxygen tank = 20% O2
b. CO2 = 72 mm Hg; O2 = 144 mm Hg
Zinc protoporphyrin or free erythrocyte protoporphyrin measurements are useful to assess blood concentration of:
Mod- 2- Hypothalamic and Pituitary function, adrenal function, gonadal function and Thyroid function.
Caffeine is used in bilirubin assays to:
Accelerate indirect bilirubin reaction
Calcium concentration in the serum is regulated endogenously by:
b .Parathyroid hormone
Each of the following factors influences the serum calcium concentration EXCEPT:
Protein hormones exhibit all of the following characteristics EXCEPT:
b. Long half-life
The test for adrenal cortical hyperfunction that has the greatest diagnostic sensitivity is measurement of:
a. Urinary free cortisol
The three levels of dysfunction that may be evaluated in a patient with an endocrine problem are primary, secondary, and tertiary. The possible defective sites that correspond to these primary, secondary, and tertiary levels of dysfunction are, respectively:
d. Target gland, pituitary, hypothalamus
Which of the following compounds is (are) not considered protein hormones:
e. Aldosterone only
Which of the following is a tropic (stimulating) hormone?
d. Growth hormone
Mod - 3 - Calcium Homeostasis and Hormonal Regulation
A hemolyzed specimen is recieved in the laboratory for enzyme anaysis. The assay for which the following enzyme values would be affected by hemolysis?
c. Creatine kinase
A person witha confirmed blood presure of 125/87 would be classified as?
Bilirubin is reduced to _____ in the small intestine.
In a nonmyocardial, as opposed to a myocardial, cause of an increased serum or plasma CK-MB, which would be expected?
a. An increase in CK-MB that is persistent
In which of the following types of cells does the conjucation of bilirubin take place?
In which of the following types of cells does the conjugation of bilirubin take place?
The overall effect of parathyroid hormone (PTH) release is to:
b. Increase bone resorption of calcium
The following laboratory serum results were obtained: increased calcium, borderline low phosphate, normal alkaline phosphatase, and decreased PTH. These results are most compatible with:
The most widely used method for bilirubin analysis uses two reagents, ____________ and ___________, in the diazo reaction
a.Sulfanilic acid; sodium nitrite
The three hormones that regulate serum calcium are:
b .PTH, vitamin D, and calcitonin
The most widely used method for bilirubin analysis uses two reagents, ____________ and ___________, in the diazo reaction.
a. Sulfanilic acid; sodium nitrite
True or False? skin, liver, and kidneys are involves in the production of the active ,etabolite of vitamin D.
What cells are responsiable for bone formation?
What are the primary organs involved in the maintenance of clacium homeostasis?
b. Bone, Intestine, and Kidney
What reagent is used in the bilirubin method to shift the color reaction to a wavelength with less interference?
a. Alkaline tartrate
When measuring serum ammonia levels, which which of the fillowing preanayltical steps would be incorrect?
d. The blood should be collected in a red clot tube without anticoagulant
Which of the following is NOT a feature of an ideal cardiac marker?
a. Ability topredict future occurance of cardiac disease
Which of the following analytes has the highest specificity for cardic injury?
Which cardiac marker is elevated for the longest period after myocardial infarction (MI)?
d .Troponin T
Which of the following analytes has the highest specificity for cardiac injury?
Which isoenzyme of creatine kinase (CK) is primarily found in cardiac muscle?
Unconjugated bilirubin circulated in the bloodstream is bound to:
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