ONLINE MTLE REVIEW ASSESSMENT EXAM #1 – CLINICAL CHEMISTRY QUESTIONNAIRE

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MARCH 2021 ONLINE MTLE REVIEW

SECTION A
ASSESSMENT EXAM 1 – CLINICAL CHEMISTRY

1. If a laboratory worker accidentally gets a drop of 0.1N mineral acid in the eye, you should
a. wash the eye immediately with running water and notify a physician
b. use 0.1N base to neutralize the acid and see a physician
c. avoid touching the eye as this is a delicate mechanism, and find a doctor
d. use weak vinegar to wash the eye, for this is always a soothing substance
2. The pipette with a bulb close to the delivery tip is used for viscous fluids and is called a
a. Mohr pipette c. Lewis-Dahn pipette
b. Volumetric pipette d. Ostwald-Folin pipette
3. Standard solutions from which 99.95% of the chemical can be retrieved are referred to as:
a. secondary standards c. lyophilized standards
b. primary standards d. preset standards
4. Pure water has a pH of
a. 6.8 b. 7.0 c. 7.4 d. 9.0
5. Quality control should be used with all procedures to determine
a. Accuracy b. reliability c. precision d. coefficient of variation
6. What does this formula define?

(X – X)2
n-1
a. coefficient of variation c. mean
b. confidence limits d. standard deviation
7. Optical density, according to Beer’s Law, is
a. inversely proportional to the concentration
b. directly proportional to the concentration
c. proportional to the square of the concentration
d. proportional to the square root of the concentration
8. Two control sera are desirable for each general chemistry procedure. Which of these combinations would be appropriate?
a. mean of normal range and abnormal (high)
b. high normal range and abnormal (high)
c. low normal range and abnormal (low)
d. abnormal (low) and abnormal (high)
9. Ethylenediamine tetraacetic acid (EDTA) works as an anticoagulant by
a. chelating calcium
b. preventing conversion of prothrombin to thrombin
c. forming an insoluble complex with calcium
d. binding magnesium

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 ONLINE MTLE REVIEW ASSESSMENT EXAM #1 – CLINICAL CHEMISTRY QUESTIONNAIRE

10. To store a sample for a lipoprotein electrophoresis, one should

a. freeze the sample
b. store at room temperature
c. cap and refrigerate
d. instead perform immediately, as lipids are unstable
11. Which of the proteins is soluble in water?
a. albumin b. beta globulins c. gamma globulins d. histones
12. Which amino acid cannot rotate polarized light?
a. cystine b. glycine c. histidine d. thionine
13. The most anodic protein on electrophoresis at pH 8.6 is:
a. alpha1 globulin b. albumin c. beta globulin d. gamma globulin
14. As urine is heated, a precipitate appears at 60C and disappears at 100C. The substance present is a:
a. macroglobulin b. cryoglobulin c. Bence Jones protein d. protease
15. Which of the following is NOT true of the Biuret reaction?
a. It follows Beer’s law for a reasonable range of protein
b. It depends on the presence of at least two peptide linkages
c. It is relatively free from interference by lipids and hemoglobin
d. It is insensitive to the low protein levels of urine
16. Hemolyzed serum should not be used for total protein because
a. hemoglobin is absorbed at the same wavelength as protein in biuret reagent
b. of elevated protein amounts in red blood cells as compared to serum
c. hemoglobin reacts with biuret reagent
d. the value will be falsely lowered
17. Which of these statements is NOT applicable to mucoproteins?
a. they are proteins complexed with carbohydrates
b. they are related to glycoproteins
c. they contain more than 4% hexosamine
d. hormones and coagulation proteins are included in this class
18. A normal serum protein electrophoresis has approximately 60% albumin and 5-10% each of the other 4 fractions. If an
electrophoretic pattern showed 30% albumin, 4-10% of other fractions except gamma which was 45%, you would expect
what condition to exist in the patient?
a. cirrhosis c. inflammation
b. monoclonal gammopathy d. chronic lymphocytic leukemia
19. Which of the following statements is true of albumin?
a. compared to globulin, it makes up the lesser portion of total protein
b. its size prevents its passage through even a damaged glomerular barrier
c. it is produced in the liver
d. clinical problems are usually related to high serum values
20. The conversion factor for bun to urea is
a. 1.10 b. 2.14 c. 3.14 d. 6.25
21. Untreated urine can be used for the determination of urea by the diacetyl monoxime method because
a. dialysis in an autoanalyzer removes interfering substances
b. the method is not measuring ammonia
c. the increased temperature destroys the ammonia
d. zinc does not interfere

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22. Which of these substances cannot be preserved by freezing?

a. BUN c. LD
b. CK isoenzymes d. prostatic acid phosphatase
23. The classic creatinine reaction is that of
a. Jaffe b. Lloyd c. Kjeldahl d. Nessler
24. A disease state associated with an elevation of serum uric acid is
a. atherosclerosis b. arthritis c. diabetes d. gout
25. The uricase method for uric acid assay depends on
a. ultraviolet absorption peak at 290 nm before and after treatment with uricase
b. collection of evolved gas after uricase treatment
c. increase in absorption after uricase treatment
d. measurement of a blue-violet color
26. The most precise method for amino acid determination is
a. isothermal distillation c. alkaline oxidation
b. gasometric ninhydrin reaction d. color development with Berthelot reagent
27. The usual determination of osmolality involves measurement of
a. pCO2 and pO2 c. electrolytes
b. sodium and potassium d. freezing point depression
28. The test that gives a two to three (2-3) month picture of a diabetic’s glucose levels is
a. hemoglobin A1 c. hemoglobin A1c
b. 2 hour postprandial sugar d. 3 hour glucose tolerance test
29. Contamination of the glucose reagent with catalase is a problem with which glucose method?
a. alkaline cupric ion reduction (neocuproine) c. glucose oxidase
b. alkaline ferric ion reduction (ferricyanide) d. hexokinase
30. Seliwanoff’s test detects
a. dextrose b. glucose c. lactose d. fructose
31. Prehepatic bilirubin has which of the following for a protein carrier?
a. albumin c. beta globulin
b. alpha2 globulin d. gamma globulin
32. Direct-reacting bilirubin is
a. free bilirubin c. bilirubin diglucuronide
b. bilirubin bound to albumin d. bilirubin bound to RBC
33. The “Port Wine” color of some urine can be attributed to
[Link] b. melanin c. red blood cells d. bilirubin
34. Both porphobilinogen and urobilinogen form a red colored compound with Ehrlich’s reagent. Differentiation can be
obtained by:
a. solubility of porphobilinogen in chloroform
b. solubility of urobilinogen in water
c. difference in u-v absorption
d. solubility of urobilinogen in chloroform
35. During enzymatic reactions there can be inhibitors. The following are types of inhibitors EXCEPT:
a. competitive b. non-competitive c. uncompetitive d. irreversible
36. In a zero order reaction, there will be no further increase in velocity because
a. there is no excess substrate c. all enzyme is bound to substrate
b. the temperature is 35C d. there is excess enzyme

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37. A metal ion is sometimes necessary in an enzymatic reaction

a. to act as an activator of the enzyme
b. to permit the colorimetric reaction to occur
c. to regulate the pH
d. to inhibit competing enzymes
38. Which of the following is true of the isoenzyme LD-1?
a. it is the slowest moving of the LD isoenzymes on electrophoresis
b. it is the most positively charged fraction
c. it is a heat-labile fraction
d. it is present in the greatest amount in normal heart tissue
39. Serum creatine kinase is clinically significant in diseases of the
a. pancreas b. liver c. muscle d. gonads
40. In kinetic or rate enzymatic methodologies, optical density decreases as
a. TPN is changed to TPNH c. NADH is changed to NAD
b. NAD is changed to NADH d. ceric ion is changed to cerous
41. During a suspected myocardial infarction, you should perform CPK isoenzymes and LD isoenzymes to demonstrate
a. the MB fraction of CK and LD 5 c. the LD5 and LD3
b. the MB fraction of CK and the LD1-LD2 flip d. the BB fraction of CK and LD1
42. In muscular dystrophy, the clinically significant enzymes are
a. CK, aldolase, AST c. CK, AST, ALT
b. ALT, aldolase, LD d. aldolase, AST, ALT
43. Possibly the most sensitive enzyme indicator of Liver function, particularly in obstructive jaundice, is
a. alkaline phosphatase c. acid phosphatase
b. ALT d. LD
44. The clinical significance of an elevated acid phosphatase is
a. renal disease c. bone disease
b. pancreatic disease d. prostatic disease
45. The substrate for the cherry crandal lipase method is
a. glyceride b. nitrophenyl acetate c. olive oil d. starch
46. The classic Clark-Collip method for calcium is based on the assumption that calcium will be
a. precipitated as calcium carbonate
b. precipitated as an oxalate and converted to an oxide
c. chelated with EDTA
d. precipitated as an oxalate and converted to oxalic acid
47. In the compleximetric titration (EDTA) method for calcium, the pH must be adjusted to prevent
a. Incomplete precipitation of calcium c. a reversible color change
b. interference by magnesium d. co-binding of phosphorus
48. At a pH of 7.4, most of the inorganic phosphate in the plasma is in which form?
a. HPO4-- b. PO4--- c. H2PO4- d. P2O5
49. In the classic schales and schales (mercurimetric titration) method for chloride, what substance reacts with the indicator to
form a violet color?
a. HgCl2 b. HgNO3 c. excess Hg++ d. Br-
50. What is the purpose of caprylic alcohol in the gasometric method for CO2?
a. to prevent foaming c. to absorb CO2
b. to release CO2 d. to maintain the atmospheric pressure at a constant value

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51. The first step in the serum iron method involves

a. break-up of the iron-protein complex
b. reaction of iron with a chromogen
c. addition of excess iron for protein to absorb
d. measurement of amount of free serum iron
52. The major intracellular cation is
a. chloride b. manganese c. potassium d. sodium
53. In gasometric analysis of CO2, the liberated gas is absorbed with
a. lactic acid b. HCl c. H2SO4 d. NaOH
54. Which of these is the Henderson-Hasselbalch equation?
a. pKa = pH + log dissociated salt
undissociated acid
b. pH = pKa + loga + log undissociated salt
dissociated salt
c. pH = pKa + (A )-

(HA)
d. pH = pKa + log dissociated salt (A-)
undissociated acid (HA)
55. The ratio of bicarbonate: carbonic acid in normal plasma is
a. 1:20 b. 5:1 c. 10:1 d. 20:1
56. What will happen if blood is exposed to air during collection for pH and blood gas studies?
a. CO2 content increases c. pO2 decreases
b. pH decreases d. pCO2 decreases
57. Measurement by flame photometry involves
a. absorption of energy when an element is ionized
b. electrometric titration
c. colorimetric analysis
d. emission of a color when an element is burned
58. What is the light source in atomic absorption instrumentation?
a. cathode lamp b. flame c. grating d. prism
59. The Rf value in chromatography is defined as
a. The ratio of the distance the compound moves to the distance moved by the solvent
b. The distance in cm the compound moves
c. The distance in inches the compound moves
d. The time in minutes required for the compound to move 10 cm
60. T3 uptake is actually a measurement of
a. T3 b. T-4 c. TBG d. free thyroxine
61. Which of the following is true of the steroids?
a. they are excreted as hormones rather than as metabolites
b. there is no differential value for male and female
c. they are lipids
d. they contain the 21 carbon atoms of the cyclopentanoperhydrophenanthrene ring
62. Which of the following is a metabolite of epinephrine?
a. 17-ketosteroids c. vanillyemandelic acid
b. follicle stimulating hormone d. thyroid stimulating hormone

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63. The Kober reaction refers to the pink color resulting from the combination of hot concentrated sulfuric acid and extracted
a. estrogens b. androgens c. corticosteroids d. 17 ketosteroids
64. The Zimmerman determination of 17-ketosteroids is based on reaction with
a. acetic anhydride c. meta-dinitrobenzene
b. Ehrlich’s reagent d. potassium ferricyanide
65. Which of the statements applies to Bloor’s reagent?
a. it provides for color development in the cholesterol methods
b. it is composed of ethanol and ether in a ratio of 3:1
c. it compensates for the otherwise unequal color measurement resulting from free and esterified cholesterol
d. it compensates for possible water contamination of the reagents
66. The purpose of digitonin in cholesterol methodology is the
a. precipitation of free cholesterol c. color developer
b. precipitation of esterified cholesterol d. reagent for extraction
67. When evaluating a coronary risk index for a patient you should know the total cholesterol and
a. total lipid b. triglyceride c. LDL cholesterol d. HDL cholesterol
68. Which of these lipids has the lowest density?
a. alpha lipoprotein c. chylomicrons
b. beta lipoprotein d. pre-beta lipoprotein
69. Diseases of which system are associated with elevated beta lipoprotein values?
a. pulmonary b. cardiovascular c. gastrointestinal d. connective tissue
70. The point of equilibrium between drug dosage intake and drug elimination is referred to as:
a. peak concentration c. steady state
b. trough concentration d. drug half-life
71. A major disadvantage of drug detection by immunoassays is
a. speed of performance
b. stability of reagents
c. technical difficulty of procedure
d. simultaneous assay of multiple drugs in one specimen is not feasible
72. When a kidney stone is tested with sodium cyanide and sodium nitroprusside, the appearance of a magenta color identifies
what substance?
a. carbonate b. cystine c. calcium d. uric acid
73. The sweat chloride test is useful in the diagnosis of
a. dehydration c. hyperkalemia
b. cystic fibrosis d. paroxysmal nocturnal hemoglobinuria
74. The use of the radioisotope 51Cr provides a direct measurement of which of the following?
a. plasma volume c. hematocrit
b. red cell mass d. total blood volume
75. The amount of impurities of a substance is known in all of the following EXCEPT:
a. Technical grade c. Analytical grade e. USP grade
b. Reagent grade d. Spectroquality
76. Glassware is usually calibrated at:
a. 98 F b. 72 F c. 20 C d. 37 C e. Ambient temperature
77. The following equation can be used to convert solutions of one normality to another:
a. 1 x N1 = V2 x N2 c. N1 / V1 = N2 / V2 e. N1 + V1 = N2 + V2
b. N1 x V2 = N2 x V1 d. V1 / N1 = V1 / N2

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78. Strong alkaline solutions should not be stored in glass-stoppered bottles because:
a. Pressure may build up causing an explosion
b. Light will decompose the solution
c. The solution is too heavy and will break the glass
d. The glass conducts heat too readily
e. The alkali reacts with glass an may freeze the stopper shut
79. Which of the following hypodermic needles sizes has a bore with the widest diameter:
a. 18 g b. 19 g c. 20 g d. 21 g e. 22 g
80. If a blood sample is left uncapped but refrigerated, the pH will
a. Increase due to CO2 loss
b. Decrease due to CO2 loss
c. Increase due to metabolism of glucose
d. Decrease due to metabolism of glucose
e. Not be affected
81. Which statement about heparin is not true:
a. Heparin is a physiological anticoagulant
b. Heparin is found normally in the body
c. Heparin prevents clotting by inhibiting thrombin
d. Heparin is a hydrolytic enzyme
e. Heparin is the best anticoagulant for preventing hemolysis
82. As an anticoagulant EDTA acts by:
a. Removal of Ca by chelation
b. Forming a weakly dissociated Ca component
c. Forming a double salt with Ca
d. Combining with Ca to form an insoluble calcium oxalate
e. Inhibiting thrombin
83. In which one of the following blood chemistry determinations is it most necessary to have serum separated from blood
samples within 15-30 minutes?
a. Potassium c. Bilirubin e. Porphyrins
b. Calcium d. Sodium
84. Oxalate prevents blood coagulation by:
a. Removing fibrinogen d. Changing the pH
b. Precipitating calcium e. Inactivating prothrombin
c. Precipitating magnesium
85. What is the concentration of a physiological saline solution?
a. 1% NaCl by weight/volume d. 0.20 M NaCl
b. 0.85% NaCl by weight/volume e. 2.4 M NaCl
c. 1.2% salt
86. What is the molarity of a 5% NaCl solution? (Molecular weight, NaCl = 58.5)
a. 8.55 b. 85.5 c. 5.0 d. 0.85 e. 0.085
87. A patient’s weight is 165 pounds. Express his weight in kilograms.
a. 33 b. 82 c. 75 d. 52 e. 104
88. In a coupled enzymatic method for measuring serum cholesterol, the color change observed during the indicator reaction
is dependent upon the generation of
a. ATP b. NAD c. oxygen d. hydrogen peroxide

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89. A molar solution contains:

a. 1 mole of solute per liter of solution
b. 1 equivalent weight of solute per liter of solution
c. 1 millimole of solute per liter of solution
d. 1 g molecular weight of solute per 100 ml of solution
e. 1 g molecular weight of solute per 1000 ml of solvent
90. A trough blood sample for routine therapeutic drug monitoring is usually obtained
a. just after a does is administered
b. just before the next scheduled dose
c. at the calculated peak time after a dose
d. one half-life after a dose is administered
91. A single tube of cerebrospinal fluid is received in the laboratory and the following tests requested: total protein, albumin,
IgG quantitation, microbial culture, Gram stain, leukocyte count, and differential cell count. The specimen should be sent to
the various laboratories in which order?
a. Chemistry lab, hematology lab, microbiology lab
b. Hematology lab, chemistry lab, microbiology lab
c. Microbiology lab, hematology lab, chemistry lab
d. Hematology lab, microbiology lab, chemistry lab
92. You need to prepare a 1 to 4 (1:4 or ¼) dilution of a serum specimen using saline before analysis. Which of the following
pipetting steps would result in this dilution?
a. Pipet 0.5 mL serum, then add 1.0 mL saline
b. Pipet 1.0 mL serum, then add 2.0 mL saline
c. Pipet 1.5 mL serum, then add 4.5 mL saline
d. Pipet 2.0 mL serum, then add 5.0 mL saline
93. pH 8.6 is used for serum protein electrophoresis so that
a. all serum proteins will have a net negative charge
b. all serum proteins will have a net positive charge
c. electroendosmosis is avoided
d. heat production is minimized
94. Which one of the following protein fractions, when separated in serum by electrophoresis on cellulose acetate, contains a
single protein?
a. Albumin b. Alpha1-globulin c. Alpha2-globulin d. Beta-globulin
95. Turbidimetric assays for serum lipase measure the
a. amount of bile acid produced c. rate of production of NADH
b. amount of titratable acid produced d. rate of degradation of triglyceride micelles
96. Osmolality measurements determine the
a. activity of ions per kilogram of solvent
b. grams of dissolved solutes per kilogram of solvent
c. moles of dissolved solutes per kilogram of solvent
d. equivalents of dissolved solutes per kilogram of solvent
97. When using an automated instrument, the amount of carryover between consecutive samples is not affected by
a. rinsing the probe between samples
b. separating consecutive samples in a tubing by air segments
c. using a separate reaction chamber for each sample
d. using a serum blank

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98. Which of the following formulas is an accurate rearrangement of Beer’s law, when using a calibration constant (K)?
a. c = A/K b. b = A • K c. A = c/K d. K = a • c / A
99. A patient with biliary obstruction has a serum bilirubin assay performed. The bilirubin results determined using the
Jendrassik-Grof method are as follows:
Total bilirubin: 0.8 mg/dL
Conjugated bilirubin: 1.0 mg/dL
The clinical laboratory technician does not report the results. The results obtained are most consistent with
a. a technical error occurring during analysis
b. insufficient accelerator added to the total bilirubin reaction
c. a reduced reaction time for the conjugated bilirubin reaction
d. excess diazo reagent added to the conjugated bilirubin reaction
100. In an adult, a blood glucose level of 35 mg/dL is
a. normal c. dangerously high
b. dangerously low d. physiologically impossible
101. Measurements of urinary human chorionic gonadotropin (HCG) in men can be used to
a. diagnose hypogonadism c. assess pituitary function
b. detect testicular tumors d. detect excessive estrogen secretion
102. Xanthochromic cerebrospinal fluid is an indicator of
a. bacterial meningitis
b. increased pressure of cerebrospinal fluid
c. increased protein concentration in cerebrospinal fluid
d. cerebral hemorrhage
103. A creatinine clearance result below the normal reference range most likely indicates a decrease in
a. hepatic blood flow c. renal blood flow
b. hepatic creatinine synthesis d. renal glomerular filtration
104. A physician suspects that a patient has Cushing’s syndrome. Based on this information, which of the following tests
would assist in this diagnosis?
a. Cortisol level c. Thyroid-stimulating hormone level
b. Vanillylmandelic acid level d. 24-hour creatinine clearance
105. The amniotic fluid from a 40-year-old female is tested and the following results obtained:
Test Result Reference Interval
L/S ratio: 1.6 > 2.0
Alpha-fetoprotein: normal normal
Based on these results, if the fetus were delivered today it could have
a. Down’s syndrome c. respiratory distress syndrome
b. an open neural tube defect d. an increased risk of renal failure
106. Which of the following analytes can deteriorate if a blood specimen is exposed to light?
a. Bilirubin b. Calcium c. Cholesterol d. Glucose
107. Which of the following collection tubes is the specimen of choice for the determination of glycated hemoglobin?
a. Citrate tube c. Red/marble top tube
b. EDTA tube d. Ammonium heparin tube
108. A centrifuge is loaded with patient samples and turned on. It begins to vibrate and dance across the table top. Which of
the following statements best accounts for this observation?
a. The brake was left “ON” c. The rate of acceleration was too high
b. The brushes need to be replaced d. The tubes are not balanced in the carriers

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109. A clinical laboratory scientist (CLS) is summoned to the emergency room to draw blood on Jane Doe. At the same time,
numerous injury victims begin to arrive by ambulances from a multiple car accident. The CLS does not want to disturb the
now busy ER staff. According to the room board, Jane Doe is in Ward D. The CLS goes to Ward D and collects blood from the
only woman present. She is unable to verify that it is actually Jane Doe because the patient does not speak English and does
not have an identification bracelet. However, the woman nods approvingly when asked if her name is Jane Doe. The CLS
labels the blood specimen as “Jane Doe” and returns to the laboratory. What should be done next?
a. Proceed with testing: woman positively identified herself
b. Specimen should not be used; positive identification of patient was never made
c. Specimen should not be used until an ER staff member comes to the laboratory to sign a waiver verifying patient’s
identity
d. Proceed with testing: “Jane” is a female name and she was the only female present in Ward D, so it must be her
110. Which of the following devices is used in a spectrophotometer to determine the wavelengths of light that pass through
the sample cuvette?
a. Detector b. Light source c. Monochromator d. Photomultiplier
111. When performing a thin layer chromatography procedure, the solvent front moved 10.0 centimeters. The substance of
interest moved 2.5 centimeters. What is the Rf for the substance of interest?
a. 0.25 b. 0.40 c. 2.5 d. 4.0
112. Which of the following enzymes catalyzes the conversion of glucose to hydrogen peroxide and gluconic acid?
a. Peroxidase c. Glucose oxidase
b. Hexokinase d. Glucose-6-phosphate dehydrogenase
113. Which of the following constituents has the greatest effect on serum osmolality?
a. Glucose b. Protein c. Sodium d. Urea
114. When measuring serum bilirubin, the purpose of adding caffeine-sodium benzoate or dyphylline to the reaction mixture
is to
a. accelerate the reaction with unconjugated bilirubin
b. stop the reaction by destroying excess diazo reagent
c. enable azobilirubin formation with conjugated bilirubin
d. shift the wavelength absorbed by azobilirubin for increased sensitivity
115. When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to
a. clean the skin area c. complete the circuit
b. complex with chloride d. induce sweat secretion
116. When using atomic absorption spectrophotometry for calcium quantitation, lanthanum or strontium is routinely added
to each sample to
a. minimize matrix interferences
b. prevent ionization of calcium atoms
c. avoid interference from phosphate in the sample
d. reduce fluctuations from the hollow-cathode lamp
117. Which of the following methods is not used to quantitate serum albumin?
a. Nephelometry
b. Electrophoresis at pH 8.6
c. Sulfosalicylic acid (SSA) precipitation test
d. Dye-binding method using bromcresol green
118. Sodium fluoride may be used because:
a. it dissolves rapidly c. it is expensive
b. it acts as a preservative and anticoagulant d. it is easily prepared in-house

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119. If a moderately hemolyzed serum specimen is used for protein electrophoresis, which of the following protein fractions
will be elevated?
a. Albumin c. Beta-globulin
b. Alpha1-globulin d. Gamma-globulin
120. LDL cholesterol can be estimated using the Friedewald formula:
LDL = Total cholesterol – HDL – triglyceride/5
This calculation should not be used when the
a. HDL cholesterol is greater than 40 mg/dL
b. triglyceride level is greater than 400 mg/dL
c. plasma shows no visible evidence of lipemia
d. total cholesterol is elevated based on the age and sex of he patient
121. Using the following data, calculate the corrected creatinine clearance.
Serum creatinine: 1.8 mg/dL
Urine creatinine: 2.7 mg/mL
Urine volume: 640 mL/24h
Body surface area: 1.25 m2
a. 41 mL/min b. 67 mL/min c. 92 mL/min d. 132 mL/min
122. The normal ratio of bicarbonate ion to carbonic acid in arterial blood is
a. 0.03:1 b. 1:1.8 c. 20:1 d. 6.1:7.4
123. Increase serum uric acid is found in each of the following conditions except
a. gout b. hypothyroidism c. Lesch-Nyhan syndrome d. renal failure
124. A patient with intermittent hypertension has an elevated value for urinary catecholamine metabolites (e.g.,
vanillylmandelic acid [VMA]). This result may indicate
a. hyperaldosteronism c. idiopathic hypertension
b. hypercortisolism d. pheochromocytoma
125. The following results are obtained from a patient whose admission diagnosis is biliary obstruction:
Test Result
Serum: Conjugated bilirubin Increased
Togal bilirubin Increased
Urine: Bilirubin Positive
Urobilinogen Increased
Which of the results obtained is inconsistent with the admission diagnosis?
a. Serum conjugated bilirubin c. Urinary bilirubin
b. Serum total bilirubin d. Urinary urobilinogen
126. Blood and cerebrospinal fluid (CSF) samples were collected from a patient within 30 minutes of each other. Which set
of glucose results indicates possible bacterial meningitis?
Blood CSF
a. 60 mg/dL 40 mg/dL
b. 100 mg/dL 60 mg/dL
c. 200 mg/dL 30 mg/dL
d. 200 mg/dL 120 mg/dL
127.5 ml of 0.1 N KCl were required to neutralize 15 ml of a base. The normality of the base is:
a. 30 b. 3 c. 0.033 d. 0.3
[Link], colorimetric, fluorometric are methods for testing:
a. triglycerides b. chloride c. sodium d. potassium

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[Link] is caused in:

a. increased blood pressure c. Diabetes mellitus
b. low blood sugar levels d. elevated potassium
[Link] cause serum to be:
a. hemolyzed b. jaundiced c. unchanged d. lipemic
[Link] occurs when:
a. serum is jaundiced c. serum is not separated within 30 min
b. blood is spun too quickly d. serum is hemolyzed
[Link] function excretes which waste product:
a. uric acid b. sodium c. creatinine d. urea
[Link] and total bilirubin are markedly increased in the serum in:
a. biliary obstruction c. Diabetes mellitus
b. renal disorders d. Infectious hepatitis
[Link] post hepatic/obstructive jaundice which test(s) would most likely be elevated:
1. bilirubin, conjugated (direct) 5. fecal urobilinogen
2. bilirubin, total 8.9 mg/dL 6. AST
3. urine bilirubin 7. ALP
4. urine urobilinogen 8. GGT
a. 1 and 2 only b. 6,7, and 8 only c. 1,2,3,6,7, and 8 d. 8 only
[Link], carbon, and oxygen make up:
a. proteins b. glucose c. lipids d. carbohydrates
[Link] glucose concentration at which active reabsorption by tubules ceases is:
a. renal reabsorption c. the renal threshold
b. 20% d. renal concentration
[Link], hormones, chromosomes are made up of:
a. Na ions b. aminoglycosides c. proteins d. carbohydrates
138.L-Tartrate is used in one method for testing:
a. uric acid b. urea c. PSA d. prostatic acid phosphatase
[Link] has a metabolite called:
a. hydroxy-ketosteroids c. vanillylmandelic acid
b. long-chain beta carotene d. SLE
140.7.35 – 7.45 is the normal pH range of:
a. arterial blood b. capillary blood c. venous blood d. none of these
[Link] blood is always used in testing for which determination:
a. glucose b. BUN c. blood gas d. electrolytes
[Link] range is kept within the normal range by:
a. urea b. electrolytes c. kidneys d. heart
[Link] and this analyte have close values in the blood:
a. urea b. calcium c. chloride d. magnesium
[Link], cholesterol and triglycerides make up the:
a. hypokalemia profile c. carbohydrates
b. protein triad d. total plasma lipids
[Link] formula for calculating the coefficient of variation is:
a. mean/ standard deviation = CV c. standard deviation/mean x 100 = CV
b. CV = 100/mean d. CV = standard deviation/mean x 10

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[Link] Laboratory Safety manual should provide the instructions for:

1. alarm activation and evaluation
2. equipment shutdown procedure
3. procedures for extinguishing clothing fires
a. 1 only b. 2 only c. 2 and 3 only d. 1,2, and 3
147.A monoclonal peak in the gamma globulin fraction is seen in the disease when testing for:
a. Bright’s disease b. Liver disease c. Diabetes d. Multiple Myeloma
[Link] develops when:
a. the renal threshold is reached when the blood glucose is sufficiently elevated
b. too many sweets are consumed
c. the blood glucose drops suddenly
d. the BUN is elevated
[Link] the decrease in substrate, measuring the amount of product formed, and following the utilization of substrate
are methods of determining:
a. enzyme activity c. substrate strength
b. protein breakdown d. carbohydrate conversion
[Link] is a method for separation of serum:
a. proteins c. gamma globulins
b. beta-globulins d. electromagnetic particles
[Link] migration pattern of the albumins and globulins is:
a. alpha-1, beta, alpha-2, gamma c. alpha-1, alpha-2, albumin, beta, gamma
b. albumin, beta, gamma, alpha-1, alpha-2 d. gamma, beta, alpha-2, alpha-1, albumin
[Link] many grams of NaOH would be required to prepare 500 ml of a 0.4 N solution of NaOH (atomic weight = Na=23, O-
16, H=1):
a. 6 b. 4 c. 8 d. 12
[Link] metabolism produces the by-product of:
a. creatinine b. calcium oxalate c. uric acid d. allopurinal
[Link] sensitivity is a factor with the measurement of this in the serum:
a. glucose b. alanine transaminase c. electrolytes d. bilirubin
[Link] is:
a. the shortest wavelength in the visible range
b. the invisible light wavelength
c. the longest wavelength in the visible range
d. the longest wavelength not detected without UV filter
[Link] gram equivalent weight of solute per liter of solution is:
a. the normality of a solution c. a 1% dilution
b. the alkalinity of a solution d. 1 1:1000 dilution
[Link] with quality control material means:
a. precision b. consistency c. accuracy d. insured quality
[Link] and alkaline picrate produce the:
a. wrong reaction c. Jaffe reaction
b. Rosalki reaction d. intense color blue
[Link] of the bone and liver may cause elevated:
a. lactic dehydrogenase c. alkaline phosphatase
b. pyruvic transaminase d. calcium

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160.A normal distribution curve is:

a. plotted as a U-shaped
b. control values remain consistently on the mean
c. control values are close to the mean value, but deviate a small amount on either side of the mean
d. control values vary with the age of the QC material
[Link] amount of light emitted by the chemical element is proportionate to the concentration in this instrument:
a. chloride meter c. glucose analyzer
b. ion-selective electrode d. flame photometer
[Link] glucose returns to normal in a glucose tolerance curve at:
a. 30 mins b. 1 hour c. 120 minutes d. 4 hours
[Link] point depression of the solution is one method for determining:
a. pH b. osmolality c. alkalosis d. cryoprecipitates
[Link] proteins with a solution of copper sulphate cause the:
a. formation of sulfur gases c. Lowenstein – Jensen reaction
b. Jaffe reaction d. Biuret reaction
165.A protein catalyst is:
a. a gamma globulin c. an immunoglobulin
b. the IgE complex d. an enzyme
166.L-tartrate is utilized in this test method:
a. prostatic specific antigen c. LDH electrophoresis
b. prostatic alkaline phosphatase d. prostatic and phosphatase
[Link] is:
a. another name for T3 c. the iodothyronine referred to as T4
b. bound by T4 d. a synthetic thyroid enhancer
[Link] chloride:
a. hyperkalemia b. hypochloridemia c. hyperchloremia d. hypochloremia
[Link] (Na) is the:
a. minor extracellular cation c. major extracellular anion
b. major intracellular cation d. major extracellular cation
[Link] is:
a. an organic serum carbon c. not measurable in arterial blood
b. not necessary d. principal inorganic blood buffer
[Link] values are closely related to these values:
a. calcium b. globulin c. sodium d. iron
[Link] quality control, a trend is:
a. 2 or more values outside 2 SD
b. 10 control values below the mean
c. control values continue to increase over 6 days
d. control values go from –2SD to +2SD immediately
[Link] are the by-products of:
a. urea breakdown c. enzymatic destruction
b. oxygen usage d. fat metabolism
[Link] term for increased potassium in serum is:
a. hyperkalemia c. hypokalemia
b. hyperpotassiumnemia d. hypercalcemia

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175.T3, T4, and T3 by RIA are all tests for:

a. thyroid function c. pancreatic dysfunction
b. Burns disease d. glandular tumors
176. 500 lambda or microliter is equal to:
a. a. 0.5 ml b. 0.5 L c. 0.05 L d. 0.05 ml e. 5.0 µL
177. Prepare 250 ml of a 4N solution of a compound having a GMW of 25 and a valence of 2.
a. 13 gm of compound and water to 250 ml d. 52 gm of compound and water to 250 ml
b. 25 gm of compound and water to 250 ml e. 13 gm of compound and 237 ml water
c. 25 gm of compound and 224 ml of water
178. Turbidity produced when trichloroacetic acid is added to cerebrospinal fluid is a measure of:
a. chloride b. glucose c. protein d. urea e. WBC
179. Liberated glycerol is measured in procedure for:
a. cholesterol esters c. free fatty acids e. total cholesterol
b. lipase d. triglycerides
180. The best way to evaluate several methodologies for the same constituent is by looking at the:
a. standard deviation d. controls for one month
b. coefficient of variation e. cost of the reagent
c. reference limits
181. The lipoprotein composed of the largest amount of lipid and smallest amount of protein is:
a. chylomicrons b. alpha protein c. LDL d. VLDL e. HDL
182. An increased excretion of urobilinogen in the urine and feces is characteristic of which of the following?
a. post-hepatic jaundice d. prehepatic-hemolytic jaundice
b. Dublin-Johnson syndrome e. Crigler-Najjar syndrome
c. Hepatocellular jaundice
183.A plasma HCO3 level of 10 meg/L is characteristic of:
a. metabolic acidosis d. respiratory alkalosis
b. metabolic alkalosis e. compensated respiratory acidosis
c. respiratory acidosis
[Link] enzyme found almost exclusively in the liver is:
a. AST b. ALP c. CEA d. OCT e. PHI
[Link] is often associated with:
a. acute hemorrhagic pancreatitis d. cirrhosis
b. mumps in the adult male e. obstructive types of jaundice
c. prostatic carcinoma
186.A loss of bicarbonate ions from the blood will probably cause:
a. an increase pH d. an increase in Na
b. no changes in Cl or Na e. an increase in Cl
c. a drop in Cl and decrease in Na
[Link] diabetes mellitus, abnormal carbohydrate metabolism eventually results in:
a. a decreased urinary output c. osmotic diuresis, dehydration, and acidosis
b. decrease in blood lipids d. increased glycogenesis
[Link] the chemical procedure for the measurement of creatinine, the picrate must be at what pH?
a. acidic b. alkaline c. neutral d. pH unrelated
[Link] catalyzes the conversion of uric acid to:
a. ammonium carbonate b. oxaloacetate c. allantoin d. gluconic acid

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[Link] analyzers incorporate a reagent blank reading while measuring certain analytes in order to:
a. correct for endogenous sample color
b. allow time for temperature equilibration
c. allow time for mixing
d. detect sample with high initial absorbance readings
e. correct for color imparted by the reagent
[Link] humans, the condition known as diabetes insipidus is caused by:
a. deficiency of insulin c. excessive secretion of ADH
b. excessive secretion of cortisol d. deficiency of ADH
[Link] disease would be most likely to be detected by:
a. an increased BUN c. an elevated creatine
b. an elevated glucose d. an increased uric acid
[Link] hemolytic jaundice, the elevated bilirubin is one that:
a. reacts immediately with diazo reagent c. is water soluble
b. is unconjugated d. is not light sensitive
[Link] of the binding of Cu++ to amide groups in the Biuret reaction, all of the following will falsely elevate results
EXCEPT:
a. elevated lipids c. marked hemolysis
b. hyperbilirubinemia d. high blood-ammonia levels
195.A severe loss of albumin could bring about:
a. a reduction of osmotic pressure resulting edema
b. an increase in osmotic pressure resulting in an abnormal loss of water
c. a decrease in serum globulins
d. the formation of Bence-Jones protein
[Link] organ important in cholesterol metabolism is the:
a. liver b. pancreas c. thyroid d. spleen e. kidney
197.A hypercholesterolemia usually occurs in the following conditions EXCEPT:
a. obstructive jaundice c. diabetes
b. hypothyroidism d. hyperthyroidism
[Link] should serum for a phosphorus test be separated from the clot immediately after the specimen has been collected?
a. to prevent hemolysis from occurring
b. to prevent enzymes in the cells from splitting H3PO4 from organic phosphatase
c. to prevent glycolysis
d. the inorganic phosphates shift to the cells
[Link] AST of 1000 mU/mL and a LDH of 650 mU/mL may be indicative of:
a. viral hepatitis c. obstructive jaundice
b. myocardial infarction d. megaloblastic anemia
[Link] of the following anticoagulants may be used for enzyme determinations EXCEPT:
a. heparin b. oxalate c. EDTA d. citrate e. fluoride

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ACTS REVIEW CENTER

Rm. 509 J&T Bldg.
3894 R. Magsaysay Blvd. Sta. Mesa, Manila
02.716.7683/ 02.714.3405

MARCH 2021 ONLINE MTLE REVIEW

SECTION A
ASSESSMENT EXAM 1 – CLINICAL CHEMISTRY

1. If a laboratory worker accidentally gets a drop of 0.1N mineral acid in the eye, you should
a. wash the eye immediately with running water and notify a physician
b. use 0.1N base to neutralize the acid and see a physician
c. avoid touching the eye as this is a delicate mechanism, and find a doctor
d. use weak vinegar to wash the eye, for this is always a soothing substance
2. The pipette with a bulb close to the delivery tip is used for viscous fluids and is called a
a. Mohr pipette c. Lewis-Dahn pipette
b. Volumetric pipette d. Ostwald-Folin pipette
3. Standard solutions from which 99.95% of the chemical can be retrieved are referred to as:
a. secondary standards c. lyophilized standards
b. primary standards d. preset standards
4. Pure water has a pH of
a. 6.8 b. 7.0 c. 7.4 d. 9.0
5. Quality control should be used with all procedures to determine
a. Accuracy b. reliability c. precision d. coefficient of variation
6. What does this formula define?

(X – X)2
n-1
a. coefficient of variation c. mean
b. confidence limits d. standard deviation
7. Optical density, according to Beer’s Law, is
a. inversely proportional to the concentration
b. directly proportional to the concentration
c. proportional to the square of the concentration
d. proportional to the square root of the concentration
8. Two control sera are desirable for each general chemistry procedure. Which of these combinations would be appropriate?
a. mean of normal range and abnormal (high)
b. high normal range and abnormal (high)
c. low normal range and abnormal (low)
d. abnormal (low) and abnormal (high)
9. Ethylenediamine tetraacetic acid (EDTA) works as an anticoagulant by
a. chelating calcium
b. preventing conversion of prothrombin to thrombin
c. forming an insoluble complex with calcium
d. binding magnesium

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10. To store a sample for a lipoprotein electrophoresis, one should

a. freeze the sample
b. store at room temperature
c. cap and refrigerate
d. instead perform immediately, as lipids are unstable
11. Which of the proteins is soluble in water?
a. albumin b. beta globulins c. gamma globulins d. histones
12. Which amino acid cannot rotate polarized light?
a. cystine b. glycine c. histidine d. thionine
13. The most anodic protein on electrophoresis at pH 8.6 is:
a. alpha1 globulin b. albumin c. beta globulin d. gamma globulin
14. As urine is heated, a precipitate appears at 60C and disappears at 100C. The substance present is a:
a. macroglobulin b. cryoglobulin c. Bence Jones protein d. protease
15. Which of the following is NOT true of the Biuret reaction?
a. It follows Beer’s law for a reasonable range of protein
b. It depends on the presence of at least two peptide linkages
c. It is relatively free from interference by lipids and hemoglobin
d. It is insensitive to the low protein levels of urine
16. Hemolyzed serum should not be used for total protein because
a. hemoglobin is absorbed at the same wavelength as protein in biuret reagent
b. of elevated protein amounts in red blood cells as compared to serum
c. hemoglobin reacts with biuret reagent
d. the value will be falsely lowered
17. Which of these statements is NOT applicable to mucoproteins?
a. they are proteins complexed with carbohydrates
b. they are related to glycoproteins
c. they contain more than 4% hexosamine
d. hormones and coagulation proteins are included in this class
18. A normal serum protein electrophoresis has approximately 60% albumin and 5-10% each of the other 4 fractions. If an
electrophoretic pattern showed 30% albumin, 4-10% of other fractions except gamma which was 45%, you would expect
what condition to exist in the patient?
a. cirrhosis c. inflammation
b. monoclonal gammopathy d. chronic lymphocytic leukemia
19. Which of the following statements is true of albumin?
a. compared to globulin, it makes up the lesser portion of total protein
b. its size prevents its passage through even a damaged glomerular barrier
c. it is produced in the liver
d. clinical problems are usually related to high serum values
20. The conversion factor for bun to urea is
a. 1.10 b. 2.14 c. 3.14 d. 6.25
21. Untreated urine can be used for the determination of urea by the diacetyl monoxime method because
a. dialysis in an autoanalyzer removes interfering substances
b. the method is not measuring ammonia
c. the increased temperature destroys the ammonia
d. zinc does not interfere

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22. Which of these substances cannot be preserved by freezing?

a. BUN c. LD
b. CK isoenzymes d. prostatic acid phosphatase
23. The classic creatinine reaction is that of
a. Jaffe b. Lloyd c. Kjeldahl d. Nessler
24. A disease state associated with an elevation of serum uric acid is
a. atherosclerosis b. arthritis c. diabetes d. gout
25. The uricase method for uric acid assay depends on
a. ultraviolet absorption peak at 290 nm before and after treatment with uricase
b. collection of evolved gas after uricase treatment
c. increase in absorption after uricase treatment
d. measurement of a blue-violet color
26. The most precise method for amino acid determination is
a. isothermal distillation c. alkaline oxidation
b. gasometric ninhydrin reaction d. color development with Berthelot reagent
27. The usual determination of osmolality involves measurement of
a. pCO2 and pO2 c. electrolytes
b. sodium and potassium d. freezing point depression
28. The test that gives a two to three (2-3) month picture of a diabetic’s glucose levels is
a. hemoglobin A1 c. hemoglobin A1c
b. 2 hour postprandial sugar d. 3 hour glucose tolerance test
29. Contamination of the glucose reagent with catalase is a problem with which glucose method?
a. alkaline cupric ion reduction (neocuproine) c. glucose oxidase
b. alkaline ferric ion reduction (ferricyanide) d. hexokinase
30. Seliwanoff’s test detects
a. dextrose b. glucose c. lactose d. fructose
31. Prehepatic bilirubin has which of the following for a protein carrier?
a. albumin c. beta globulin
b. alpha2 globulin d. gamma globulin
32. Direct-reacting bilirubin is
a. free bilirubin c. bilirubin diglucuronide
b. bilirubin bound to albumin d. bilirubin bound to RBC
33. The “Port Wine” color of some urine can be attributed to
[Link] b. melanin c. red blood cells d. bilirubin
34. Both porphobilinogen and urobilinogen form a red colored compound with Ehrlich’s reagent. Differentiation can be
obtained by:
a. solubility of porphobilinogen in chloroform
b. solubility of urobilinogen in water
c. difference in u-v absorption
d. solubility of urobilinogen in chloroform
35. During enzymatic reactions there can be inhibitors. The following are types of inhibitors EXCEPT:
a. competitive b. non-competitive c. uncompetitive d. irreversible
36. In a zero order reaction, there will be no further increase in velocity because
a. there is no excess substrate c. all enzyme is bound to substrate
b. the temperature is 35C d. there is excess enzyme

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37. A metal ion is sometimes necessary in an enzymatic reaction

a. to act as an activator of the enzyme
b. to permit the colorimetric reaction to occur
c. to regulate the pH
d. to inhibit competing enzymes
38. Which of the following is true of the isoenzyme LD-1?
a. it is the slowest moving of the LD isoenzymes on electrophoresis
b. it is the most positively charged fraction
c. it is a heat-labile fraction
d. it is present in the greatest amount in normal heart tissue
39. Serum creatine kinase is clinically significant in diseases of the
a. pancreas b. liver c. muscle d. gonads
40. In kinetic or rate enzymatic methodologies, optical density decreases as
a. TPN is changed to TPNH c. NADH is changed to NAD
b. NAD is changed to NADH d. ceric ion is changed to cerous
41. During a suspected myocardial infarction, you should perform CPK isoenzymes and LD isoenzymes to demonstrate
a. the MB fraction of CK and LD 5 c. the LD5 and LD3
b. the MB fraction of CK and the LD1-LD2 flip d. the BB fraction of CK and LD1
42. In muscular dystrophy, the clinically significant enzymes are
a. CK, aldolase, AST c. CK, AST, ALT
b. ALT, aldolase, LD d. aldolase, AST, ALT
43. Possibly the most sensitive enzyme indicator of Liver function, particularly in obstructive jaundice, is
a. alkaline phosphatase c. acid phosphatase
b. ALT d. LD
44. The clinical significance of an elevated acid phosphatase is
a. renal disease c. bone disease
b. pancreatic disease d. prostatic disease
45. The substrate for the cherry crandal lipase method is
a. glyceride b. nitrophenyl acetate c. olive oil d. starch
46. The classic Clark-Collip method for calcium is based on the assumption that calcium will be
a. precipitated as calcium carbonate
b. precipitated as an oxalate and converted to an oxide
c. chelated with EDTA
d. precipitated as an oxalate and converted to oxalic acid
47. In the compleximetric titration (EDTA) method for calcium, the pH must be adjusted to prevent
a. Incomplete precipitation of calcium c. a reversible color change
b. interference by magnesium d. co-binding of phosphorus
48. At a pH of 7.4, most of the inorganic phosphate in the plasma is in which form?
a. HPO4-- b. PO4--- c. H2PO4- d. P2O5
49. In the classic schales and schales (mercurimetric titration) method for chloride, what substance reacts with the indicator to
form a violet color?
a. HgCl2 b. HgNO3 c. excess Hg++ d. Br-
50. What is the purpose of caprylic alcohol in the gasometric method for CO2?
a. to prevent foaming c. to absorb CO2
b. to release CO2 d. to maintain the atmospheric pressure at a constant value

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51. The first step in the serum iron method involves

a. break-up of the iron-protein complex
b. reaction of iron with a chromogen
c. addition of excess iron for protein to absorb
d. measurement of amount of free serum iron
52. The major intracellular cation is
a. chloride b. manganese c. potassium d. sodium
53. In gasometric analysis of CO2, the liberated gas is absorbed with
a. lactic acid b. HCl c. H2SO4 d. NaOH
54. Which of these is the Henderson-Hasselbalch equation?
a. pKa = pH + log dissociated salt
undissociated acid
b. pH = pKa + loga + log undissociated salt
dissociated salt
c. pH = pKa + (A )-

(HA)
d. pH = pKa + log dissociated salt (A-)
undissociated acid (HA)
55. The ratio of bicarbonate: carbonic acid in normal plasma is
a. 1:20 b. 5:1 c. 10:1 d. 20:1
56. What will happen if blood is exposed to air during collection for pH and blood gas studies?
a. CO2 content increases c. pO2 decreases
b. pH decreases d. pCO2 decreases
57. Measurement by flame photometry involves
a. absorption of energy when an element is ionized
b. electrometric titration
c. colorimetric analysis
d. emission of a color when an element is burned
58. What is the light source in atomic absorption instrumentation?
a. cathode lamp b. flame c. grating d. prism
59. The Rf value in chromatography is defined as
a. The ratio of the distance the compound moves to the distance moved by the solvent
b. The distance in cm the compound moves
c. The distance in inches the compound moves
d. The time in minutes required for the compound to move 10 cm
60. T3 uptake is actually a measurement of
a. T3 b. T-4 c. TBG d. free thyroxine
61. Which of the following is true of the steroids?
a. they are excreted as hormones rather than as metabolites
b. there is no differential value for male and female
c. they are lipids
d. they contain the 21 carbon atoms of the cyclopentanoperhydrophenanthrene ring
62. Which of the following is a metabolite of epinephrine?
a. 17-ketosteroids c. vanillyemandelic acid
b. follicle stimulating hormone d. thyroid stimulating hormone

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63. The Kober reaction refers to the pink color resulting from the combination of hot concentrated sulfuric acid and extracted
a. estrogens b. androgens c. corticosteroids d. 17 ketosteroids
64. The Zimmerman determination of 17-ketosteroids is based on reaction with
a. acetic anhydride c. meta-dinitrobenzene
b. Ehrlich’s reagent d. potassium ferricyanide
65. Which of the statements applies to Bloor’s reagent?
a. it provides for color development in the cholesterol methods
b. it is composed of ethanol and ether in a ratio of 3:1
c. it compensates for the otherwise unequal color measurement resulting from free and esterified cholesterol
d. it compensates for possible water contamination of the reagents
66. The purpose of digitonin in cholesterol methodology is the
a. precipitation of free cholesterol c. color developer
b. precipitation of esterified cholesterol d. reagent for extraction
67. When evaluating a coronary risk index for a patient you should know the total cholesterol and
a. total lipid b. triglyceride c. LDL cholesterol d. HDL cholesterol
68. Which of these lipids has the lowest density?
a. alpha lipoprotein c. chylomicrons
b. beta lipoprotein d. pre-beta lipoprotein
69. Diseases of which system are associated with elevated beta lipoprotein values?
a. pulmonary b. cardiovascular c. gastrointestinal d. connective tissue
70. The point of equilibrium between drug dosage intake and drug elimination is referred to as:
a. peak concentration c. steady state
b. trough concentration d. drug half-life
71. A major disadvantage of drug detection by immunoassays is
a. speed of performance
b. stability of reagents
c. technical difficulty of procedure
d. simultaneous assay of multiple drugs in one specimen is not feasible
72. When a kidney stone is tested with sodium cyanide and sodium nitroprusside, the appearance of a magenta color identifies
what substance?
a. carbonate b. cystine c. calcium d. uric acid
73. The sweat chloride test is useful in the diagnosis of
a. dehydration c. hyperkalemia
b. cystic fibrosis d. paroxysmal nocturnal hemoglobinuria
74. The use of the radioisotope 51Cr provides a direct measurement of which of the following?
a. plasma volume c. hematocrit
b. red cell mass d. total blood volume
75. The amount of impurities of a substance is known in all of the following EXCEPT:
a. Technical grade c. Analytical grade e. USP grade
b. Reagent grade d. Spectroquality
76. Glassware is usually calibrated at:
a. 98 F b. 72 F c. 20 C d. 37 C e. Ambient temperature
77. The following equation can be used to convert solutions of one normality to another:
a. 1 x N1 = V2 x N2 c. N1 / V1 = N2 / V2 e. N1 + V1 = N2 + V2
b. N1 x V2 = N2 x V1 d. V1 / N1 = V1 / N2

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78. Strong alkaline solutions should not be stored in glass-stoppered bottles because:
a. Pressure may build up causing an explosion
b. Light will decompose the solution
c. The solution is too heavy and will break the glass
d. The glass conducts heat too readily
e. The alkali reacts with glass an may freeze the stopper shut
79. Which of the following hypodermic needles sizes has a bore with the widest diameter:
a. 18 g b. 19 g c. 20 g d. 21 g e. 22 g
80. If a blood sample is left uncapped but refrigerated, the pH will
a. Increase due to CO2 loss
b. Decrease due to CO2 loss
c. Increase due to metabolism of glucose
d. Decrease due to metabolism of glucose
e. Not be affected
81. Which statement about heparin is not true:
a. Heparin is a physiological anticoagulant
b. Heparin is found normally in the body
c. Heparin prevents clotting by inhibiting thrombin
d. Heparin is a hydrolytic enzyme
e. Heparin is the best anticoagulant for preventing hemolysis
82. As an anticoagulant EDTA acts by:
a. Removal of Ca by chelation
b. Forming a weakly dissociated Ca component
c. Forming a double salt with Ca
d. Combining with Ca to form an insoluble calcium oxalate
e. Inhibiting thrombin
83. In which one of the following blood chemistry determinations is it most necessary to have serum separated from blood
samples within 15-30 minutes?
a. Potassium c. Bilirubin e. Porphyrins
b. Calcium d. Sodium
84. Oxalate prevents blood coagulation by:
a. Removing fibrinogen d. Changing the pH
b. Precipitating calcium e. Inactivating prothrombin
c. Precipitating magnesium
85. What is the concentration of a physiological saline solution?
a. 1% NaCl by weight/volume d. 0.20 M NaCl
b. 0.85% NaCl by weight/volume e. 2.4 M NaCl
c. 1.2% salt
86. What is the molarity of a 5% NaCl solution? (Molecular weight, NaCl = 58.5)
a. 8.55 b. 85.5 c. 5.0 d. 0.85 e. 0.085
87. A patient’s weight is 165 pounds. Express his weight in kilograms.
a. 33 b. 82 c. 75 d. 52 e. 104
88. In a coupled enzymatic method for measuring serum cholesterol, the color change observed during the indicator reaction
is dependent upon the generation of
a. ATP b. NAD c. oxygen d. hydrogen peroxide

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89. A molar solution contains:

a. 1 mole of solute per liter of solution
b. 1 equivalent weight of solute per liter of solution
c. 1 millimole of solute per liter of solution
d. 1 g molecular weight of solute per 100 ml of solution
e. 1 g molecular weight of solute per 1000 ml of solvent
90. A trough blood sample for routine therapeutic drug monitoring is usually obtained
a. just after a does is administered
b. just before the next scheduled dose
c. at the calculated peak time after a dose
d. one half-life after a dose is administered
91. A single tube of cerebrospinal fluid is received in the laboratory and the following tests requested: total protein, albumin,
IgG quantitation, microbial culture, Gram stain, leukocyte count, and differential cell count. The specimen should be sent to
the various laboratories in which order?
a. Chemistry lab, hematology lab, microbiology lab
b. Hematology lab, chemistry lab, microbiology lab
c. Microbiology lab, hematology lab, chemistry lab
d. Hematology lab, microbiology lab, chemistry lab
92. You need to prepare a 1 to 4 (1:4 or ¼) dilution of a serum specimen using saline before analysis. Which of the following
pipetting steps would result in this dilution?
a. Pipet 0.5 mL serum, then add 1.0 mL saline
b. Pipet 1.0 mL serum, then add 2.0 mL saline
c. Pipet 1.5 mL serum, then add 4.5 mL saline
d. Pipet 2.0 mL serum, then add 5.0 mL saline
93. pH 8.6 is used for serum protein electrophoresis so that
a. all serum proteins will have a net negative charge
b. all serum proteins will have a net positive charge
c. electroendosmosis is avoided
d. heat production is minimized
94. Which one of the following protein fractions, when separated in serum by electrophoresis on cellulose acetate, contains a
single protein?
a. Albumin b. Alpha1-globulin c. Alpha2-globulin d. Beta-globulin
95. Turbidimetric assays for serum lipase measure the
a. amount of bile acid produced c. rate of production of NADH
b. amount of titratable acid produced d. rate of degradation of triglyceride micelles
96. Osmolality measurements determine the
a. activity of ions per kilogram of solvent
b. grams of dissolved solutes per kilogram of solvent
c. moles of dissolved solutes per kilogram of solvent
d. equivalents of dissolved solutes per kilogram of solvent
97. When using an automated instrument, the amount of carryover between consecutive samples is not affected by
a. rinsing the probe between samples
b. separating consecutive samples in a tubing by air segments
c. using a separate reaction chamber for each sample
d. using a serum blank

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98. Which of the following formulas is an accurate rearrangement of Beer’s law, when using a calibration constant (K)?
a. c = A/K b. b = A • K c. A = c/K d. K = a • c / A
99. A patient with biliary obstruction has a serum bilirubin assay performed. The bilirubin results determined using the
Jendrassik-Grof method are as follows:
Total bilirubin: 0.8 mg/dL
Conjugated bilirubin: 1.0 mg/dL
The clinical laboratory technician does not report the results. The results obtained are most consistent with
a. a technical error occurring during analysis
b. insufficient accelerator added to the total bilirubin reaction
c. a reduced reaction time for the conjugated bilirubin reaction
d. excess diazo reagent added to the conjugated bilirubin reaction
100. In an adult, a blood glucose level of 35 mg/dL is
a. normal c. dangerously high
b. dangerously low d. physiologically impossible
101. Measurements of urinary human chorionic gonadotropin (HCG) in men can be used to
a. diagnose hypogonadism c. assess pituitary function
b. detect testicular tumors d. detect excessive estrogen secretion
102. Xanthochromic cerebrospinal fluid is an indicator of
a. bacterial meningitis
b. increased pressure of cerebrospinal fluid
c. increased protein concentration in cerebrospinal fluid
d. cerebral hemorrhage
103. A creatinine clearance result below the normal reference range most likely indicates a decrease in
a. hepatic blood flow c. renal blood flow
b. hepatic creatinine synthesis d. renal glomerular filtration
104. A physician suspects that a patient has Cushing’s syndrome. Based on this information, which of the following tests
would assist in this diagnosis?
a. Cortisol level c. Thyroid-stimulating hormone level
b. Vanillylmandelic acid level d. 24-hour creatinine clearance
105. The amniotic fluid from a 40-year-old female is tested and the following results obtained:
Test Result Reference Interval
L/S ratio: 1.6 > 2.0
Alpha-fetoprotein: normal normal
Based on these results, if the fetus were delivered today it could have
a. Down’s syndrome c. respiratory distress syndrome
b. an open neural tube defect d. an increased risk of renal failure
106. Which of the following analytes can deteriorate if a blood specimen is exposed to light?
a. Bilirubin b. Calcium c. Cholesterol d. Glucose
107. Which of the following collection tubes is the specimen of choice for the determination of glycated hemoglobin?
a. Citrate tube c. Red/marble top tube
b. EDTA tube d. Ammonium heparin tube
108. A centrifuge is loaded with patient samples and turned on. It begins to vibrate and dance across the table top. Which of
the following statements best accounts for this observation?
a. The brake was left “ON” c. The rate of acceleration was too high
b. The brushes need to be replaced d. The tubes are not balanced in the carriers

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109. A clinical laboratory scientist (CLS) is summoned to the emergency room to draw blood on Jane Doe. At the same time,
numerous injury victims begin to arrive by ambulances from a multiple car accident. The CLS does not want to disturb the
now busy ER staff. According to the room board, Jane Doe is in Ward D. The CLS goes to Ward D and collects blood from the
only woman present. She is unable to verify that it is actually Jane Doe because the patient does not speak English and does
not have an identification bracelet. However, the woman nods approvingly when asked if her name is Jane Doe. The CLS
labels the blood specimen as “Jane Doe” and returns to the laboratory. What should be done next?
a. Proceed with testing: woman positively identified herself
b. Specimen should not be used; positive identification of patient was never made
c. Specimen should not be used until an ER staff member comes to the laboratory to sign a waiver verifying patient’s
identity
d. Proceed with testing: “Jane” is a female name and she was the only female present in Ward D, so it must be her
110. Which of the following devices is used in a spectrophotometer to determine the wavelengths of light that pass through
the sample cuvette?
a. Detector b. Light source c. Monochromator d. Photomultiplier
111. When performing a thin layer chromatography procedure, the solvent front moved 10.0 centimeters. The substance of
interest moved 2.5 centimeters. What is the Rf for the substance of interest?
a. 0.25 b. 0.40 c. 2.5 d. 4.0
112. Which of the following enzymes catalyzes the conversion of glucose to hydrogen peroxide and gluconic acid?
a. Peroxidase c. Glucose oxidase
b. Hexokinase d. Glucose-6-phosphate dehydrogenase
113. Which of the following constituents has the greatest effect on serum osmolality?
a. Glucose b. Protein c. Sodium d. Urea
114. When measuring serum bilirubin, the purpose of adding caffeine-sodium benzoate or dyphylline to the reaction mixture
is to
a. accelerate the reaction with unconjugated bilirubin
b. stop the reaction by destroying excess diazo reagent
c. enable azobilirubin formation with conjugated bilirubin
d. shift the wavelength absorbed by azobilirubin for increased sensitivity
115. When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to
a. clean the skin area c. complete the circuit
b. complex with chloride d. induce sweat secretion
116. When using atomic absorption spectrophotometry for calcium quantitation, lanthanum or strontium is routinely added
to each sample to
a. minimize matrix interferences
b. prevent ionization of calcium atoms
c. avoid interference from phosphate in the sample
d. reduce fluctuations from the hollow-cathode lamp
117. Which of the following methods is not used to quantitate serum albumin?
a. Nephelometry
b. Electrophoresis at pH 8.6
c. Sulfosalicylic acid (SSA) precipitation test
d. Dye-binding method using bromcresol green
118. Sodium fluoride may be used because:
a. it dissolves rapidly c. it is expensive
b. it acts as a preservative and anticoagulant d. it is easily prepared in-house

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119. If a moderately hemolyzed serum specimen is used for protein electrophoresis, which of the following protein fractions
will be elevated?
a. Albumin c. Beta-globulin
b. Alpha1-globulin d. Gamma-globulin
120. LDL cholesterol can be estimated using the Friedewald formula:
LDL = Total cholesterol – HDL – triglyceride/5
This calculation should not be used when the
a. HDL cholesterol is greater than 40 mg/dL
b. triglyceride level is greater than 400 mg/dL
c. plasma shows no visible evidence of lipemia
d. total cholesterol is elevated based on the age and sex of he patient
121. Using the following data, calculate the corrected creatinine clearance.
Serum creatinine: 1.8 mg/dL
Urine creatinine: 2.7 mg/mL
Urine volume: 640 mL/24h
Body surface area: 1.25 m2
a. 41 mL/min b. 67 mL/min c. 92 mL/min d. 132 mL/min
122. The normal ratio of bicarbonate ion to carbonic acid in arterial blood is
a. 0.03:1 b. 1:1.8 c. 20:1 d. 6.1:7.4
123. Increase serum uric acid is found in each of the following conditions except
a. gout b. hypothyroidism c. Lesch-Nyhan syndrome d. renal failure
124. A patient with intermittent hypertension has an elevated value for urinary catecholamine metabolites (e.g.,
vanillylmandelic acid [VMA]). This result may indicate
a. hyperaldosteronism c. idiopathic hypertension
b. hypercortisolism d. pheochromocytoma
125. The following results are obtained from a patient whose admission diagnosis is biliary obstruction:
Test Result
Serum: Conjugated bilirubin Increased
Togal bilirubin Increased
Urine: Bilirubin Positive
Urobilinogen Increased
Which of the results obtained is inconsistent with the admission diagnosis?
a. Serum conjugated bilirubin c. Urinary bilirubin
b. Serum total bilirubin d. Urinary urobilinogen
126. Blood and cerebrospinal fluid (CSF) samples were collected from a patient within 30 minutes of each other. Which set
of glucose results indicates possible bacterial meningitis?
Blood CSF
a. 60 mg/dL 40 mg/dL
b. 100 mg/dL 60 mg/dL
c. 200 mg/dL 30 mg/dL
d. 200 mg/dL 120 mg/dL
127.5 ml of 0.1 N KCl were required to neutralize 15 ml of a base. The normality of the base is:
a. 30 b. 3 c. 0.033 d. 0.3
[Link], colorimetric, fluorometric are methods for testing:
a. triglycerides b. chloride c. sodium d. potassium

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[Link] is caused in:

a. increased blood pressure c. Diabetes mellitus
b. low blood sugar levels d. elevated potassium
[Link] cause serum to be:
a. hemolyzed b. jaundiced c. unchanged d. lipemic
[Link] occurs when:
a. serum is jaundiced c. serum is not separated within 30 min
b. blood is spun too quickly d. serum is hemolyzed
[Link] function excretes which waste product:
a. uric acid b. sodium c. creatinine d. urea
[Link] and total bilirubin are markedly increased in the serum in:
a. biliary obstruction c. Diabetes mellitus
b. renal disorders d. Infectious hepatitis
[Link] post hepatic/obstructive jaundice which test(s) would most likely be elevated:
1. bilirubin, conjugated (direct) 5. fecal urobilinogen
2. bilirubin, total 8.9 mg/dL 6. AST
3. urine bilirubin 7. ALP
4. urine urobilinogen 8. GGT
a. 1 and 2 only b. 6,7, and 8 only c. 1,2,3,6,7, and 8 d. 8 only
[Link], carbon, and oxygen make up:
a. proteins b. glucose c. lipids d. carbohydrates
[Link] glucose concentration at which active reabsorption by tubules ceases is:
a. renal reabsorption c. the renal threshold
b. 20% d. renal concentration
[Link], hormones, chromosomes are made up of:
a. Na ions b. aminoglycosides c. proteins d. carbohydrates
138.L-Tartrate is used in one method for testing:
a. uric acid b. urea c. PSA d. prostatic acid phosphatase
[Link] has a metabolite called:
a. hydroxy-ketosteroids c. vanillylmandelic acid
b. long-chain beta carotene d. SLE
140.7.35 – 7.45 is the normal pH range of:
a. arterial blood b. capillary blood c. venous blood d. none of these
[Link] blood is always used in testing for which determination:
a. glucose b. BUN c. blood gas d. electrolytes
[Link] range is kept within the normal range by:
a. urea b. electrolytes c. kidneys d. heart
[Link] and this analyte have close values in the blood:
a. urea b. calcium c. chloride d. magnesium
[Link], cholesterol and triglycerides make up the:
a. hypokalemia profile c. carbohydrates
b. protein triad d. total plasma lipids
[Link] formula for calculating the coefficient of variation is:
a. mean/ standard deviation = CV c. standard deviation/mean x 100 = CV
b. CV = 100/mean d. CV = standard deviation/mean x 10

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[Link] Laboratory Safety manual should provide the instructions for:

1. alarm activation and evaluation
2. equipment shutdown procedure
3. procedures for extinguishing clothing fires
a. 1 only b. 2 only c. 2 and 3 only d. 1,2, and 3
147.A monoclonal peak in the gamma globulin fraction is seen in the disease when testing for:
a. Bright’s disease b. Liver disease c. Diabetes d. Multiple Myeloma
[Link] develops when:
a. the renal threshold is reached when the blood glucose is sufficiently elevated
b. too many sweets are consumed
c. the blood glucose drops suddenly
d. the BUN is elevated
[Link] the decrease in substrate, measuring the amount of product formed, and following the utilization of substrate
are methods of determining:
a. enzyme activity c. substrate strength
b. protein breakdown d. carbohydrate conversion
[Link] is a method for separation of serum:
a. proteins c. gamma globulins
b. beta-globulins d. electromagnetic particles
[Link] migration pattern of the albumins and globulins is:
a. alpha-1, beta, alpha-2, gamma c. alpha-1, alpha-2, albumin, beta, gamma
b. albumin, beta, gamma, alpha-1, alpha-2 d. gamma, beta, alpha-2, alpha-1, albumin
[Link] many grams of NaOH would be required to prepare 500 ml of a 0.4 N solution of NaOH (atomic weight = Na=23, O-
16, H=1):
a. 6 b. 4 c. 8 d. 12
[Link] metabolism produces the by-product of:
a. creatinine b. calcium oxalate c. uric acid d. allopurinal
[Link] sensitivity is a factor with the measurement of this in the serum:
a. glucose b. alanine transaminase c. electrolytes d. bilirubin
[Link] is:
a. the shortest wavelength in the visible range
b. the invisible light wavelength
c. the longest wavelength in the visible range
d. the longest wavelength not detected without UV filter
[Link] gram equivalent weight of solute per liter of solution is:
a. the normality of a solution c. a 1% dilution
b. the alkalinity of a solution d. 1 1:1000 dilution
[Link] with quality control material means:
a. precision b. consistency c. accuracy d. insured quality
[Link] and alkaline picrate produce the:
a. wrong reaction c. Jaffe reaction
b. Rosalki reaction d. intense color blue
[Link] of the bone and liver may cause elevated:
a. lactic dehydrogenase c. alkaline phosphatase
b. pyruvic transaminase d. calcium

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160.A normal distribution curve is:

a. plotted as a U-shaped
b. control values remain consistently on the mean
c. control values are close to the mean value, but deviate a small amount on either side of the mean
d. control values vary with the age of the QC material
[Link] amount of light emitted by the chemical element is proportionate to the concentration in this instrument:
a. chloride meter c. glucose analyzer
b. ion-selective electrode d. flame photometer
[Link] glucose returns to normal in a glucose tolerance curve at:
a. 30 mins b. 1 hour c. 120 minutes d. 4 hours
[Link] point depression of the solution is one method for determining:
a. pH b. osmolality c. alkalosis d. cryoprecipitates
[Link] proteins with a solution of copper sulphate cause the:
a. formation of sulfur gases c. Lowenstein – Jensen reaction
b. Jaffe reaction d. Biuret reaction
165.A protein catalyst is:
a. a gamma globulin c. an immunoglobulin
b. the IgE complex d. an enzyme
166.L-tartrate is utilized in this test method:
a. prostatic specific antigen c. LDH electrophoresis
b. prostatic alkaline phosphatase d. prostatic and phosphatase
[Link] is:
a. another name for T3 c. the iodothyronine referred to as T4
b. bound by T4 d. a synthetic thyroid enhancer
[Link] chloride:
a. hyperkalemia b. hypochloridemia c. hyperchloremia d. hypochloremia
[Link] (Na) is the:
a. minor extracellular cation c. major extracellular anion
b. major intracellular cation d. major extracellular cation
[Link] is:
a. an organic serum carbon c. not measurable in arterial blood
b. not necessary d. principal inorganic blood buffer
[Link] values are closely related to these values:
a. calcium b. globulin c. sodium d. iron
[Link] quality control, a trend is:
a. 2 or more values outside 2 SD
b. 10 control values below the mean
c. control values continue to increase over 6 days
d. control values go from –2SD to +2SD immediately
[Link] are the by-products of:
a. urea breakdown c. enzymatic destruction
b. oxygen usage d. fat metabolism
[Link] term for increased potassium in serum is:
a. hyperkalemia c. hypokalemia
b. hyperpotassiumnemia d. hypercalcemia

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175.T3, T4, and T3 by RIA are all tests for:

a. thyroid function c. pancreatic dysfunction
b. Burns disease d. glandular tumors
176. 500 lambda or microliter is equal to:
a. a. 0.5 ml b. 0.5 L c. 0.05 L d. 0.05 ml e. 5.0 µL
177. Prepare 250 ml of a 4N solution of a compound having a GMW of 25 and a valence of 2.
a. 13 gm of compound and water to 250 ml d. 52 gm of compound and water to 250 ml
b. 25 gm of compound and water to 250 ml e. 13 gm of compound and 237 ml water
c. 25 gm of compound and 224 ml of water
178. Turbidity produced when trichloroacetic acid is added to cerebrospinal fluid is a measure of:
a. chloride b. glucose c. protein d. urea e. WBC
179. Liberated glycerol is measured in procedure for:
a. cholesterol esters c. free fatty acids e. total cholesterol
b. lipase d. triglycerides
180. The best way to evaluate several methodologies for the same constituent is by looking at the:
a. standard deviation d. controls for one month
b. coefficient of variation e. cost of the reagent
c. reference limits
181. The lipoprotein composed of the largest amount of lipid and smallest amount of protein is:
a. chylomicrons b. alpha protein c. LDL d. VLDL e. HDL
182. An increased excretion of urobilinogen in the urine and feces is characteristic of which of the following?
a. post-hepatic jaundice d. prehepatic-hemolytic jaundice
b. Dublin-Johnson syndrome e. Crigler-Najjar syndrome
c. Hepatocellular jaundice
183.A plasma HCO3 level of 10 meg/L is characteristic of:
a. metabolic acidosis d. respiratory alkalosis
b. metabolic alkalosis e. compensated respiratory acidosis
c. respiratory acidosis
[Link] enzyme found almost exclusively in the liver is:
a. AST b. ALP c. CEA d. OCT e. PHI
[Link] is often associated with:
a. acute hemorrhagic pancreatitis d. cirrhosis
b. mumps in the adult male e. obstructive types of jaundice
c. prostatic carcinoma
186.A loss of bicarbonate ions from the blood will probably cause:
a. an increase pH d. an increase in Na
b. no changes in Cl or Na e. an increase in Cl
c. a drop in Cl and decrease in Na
[Link] diabetes mellitus, abnormal carbohydrate metabolism eventually results in:
a. a decreased urinary output c. osmotic diuresis, dehydration, and acidosis
b. decrease in blood lipids d. increased glycogenesis
[Link] the chemical procedure for the measurement of creatinine, the picrate must be at what pH?
a. acidic b. alkaline c. neutral d. pH unrelated
[Link] catalyzes the conversion of uric acid to:
a. ammonium carbonate b. oxaloacetate c. allantoin d. gluconic acid

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[Link] analyzers incorporate a reagent blank reading while measuring certain analytes in order to:
a. correct for endogenous sample color
b. allow time for temperature equilibration
c. allow time for mixing
d. detect sample with high initial absorbance readings
e. correct for color imparted by the reagent
[Link] humans, the condition known as diabetes insipidus is caused by:
a. deficiency of insulin c. excessive secretion of ADH
b. excessive secretion of cortisol d. deficiency of ADH
[Link] disease would be most likely to be detected by:
a. an increased BUN c. an elevated creatine
b. an elevated glucose d. an increased uric acid
[Link] hemolytic jaundice, the elevated bilirubin is one that:
a. reacts immediately with diazo reagent c. is water soluble
b. is unconjugated d. is not light sensitive
[Link] of the binding of Cu++ to amide groups in the Biuret reaction, all of the following will falsely elevate results
EXCEPT:
a. elevated lipids c. marked hemolysis
b. hyperbilirubinemia d. high blood-ammonia levels
195.A severe loss of albumin could bring about:
a. a reduction of osmotic pressure resulting edema
b. an increase in osmotic pressure resulting in an abnormal loss of water
c. a decrease in serum globulins
d. the formation of Bence-Jones protein
[Link] organ important in cholesterol metabolism is the:
a. liver b. pancreas c. thyroid d. spleen e. kidney
197.A hypercholesterolemia usually occurs in the following conditions EXCEPT:
a. obstructive jaundice c. diabetes
b. hypothyroidism d. hyperthyroidism
[Link] should serum for a phosphorus test be separated from the clot immediately after the specimen has been collected?
a. to prevent hemolysis from occurring
b. to prevent enzymes in the cells from splitting H3PO4 from organic phosphatase
c. to prevent glycolysis
d. the inorganic phosphates shift to the cells
[Link] AST of 1000 mU/mL and a LDH of 650 mU/mL may be indicative of:
a. viral hepatitis c. obstructive jaundice
b. myocardial infarction d. megaloblastic anemia
[Link] of the following anticoagulants may be used for enzyme determinations EXCEPT:
a. heparin b. oxalate c. EDTA d. citrate e. fluoride

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