PRE-BOARD EXAMINATION IN CLINICAL CHEMISTRY (PART3) DONOVANI01

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1. What is the prefix for factor 10 ?
A. Nano B. Atto C. Pico D. Femto
2. Fasting serum glucose has a concentration of 110 mg/dL. In SI, this value is equivalent to:
A. 6.05 mmol/L B. 3.03 mmol/L C. 6.49 mmol/L D. 4.99 mmol/L
3. A normal BUN value was reported at 25mg/dL. What is its equivalent in SI units?
A. 8.93umol/L B. 8.93mmol/L C. 7.14umol/L D. 7.14mmol/L
4. Lactescence occurs when serum triglyceride level exceeds what concentration?
A. 25 mg/L B. 25 mg/dL C. 400 mg/L D. 400 mg/dL
5. Given that a method mean is 25 mg/dL and the standard deviation is 1.2 mg/dL, what would be the coefficient
of variation?
A. 2.1% B. 2.4% C. 4.8% D. 9.6%
6. Considering a normal Gaussian curve distribution, how many values from a population will be within 2 SD?
A. 95.45% B. 75.30% C. 68.27% D. 99.73%
7. A delta check:
A. Relates control difference from mean C. Evaluates statistical drift
B. Reports patient value difference from previous analysis D. Flags abnormal results
8. Which of the following instruments is used in the clinical laboratory to detect beta and gamma emissions?
A. Fluorometer B. Nephelometer C. Scintillation counter D. Spectrophotometer
9. In potentiometry, the following are types of reference electrodes, EXCEPT:
A. Glass electrode C. Saturated calomel electrode
B. Standard hydrogen electrode D. Silver-silver chloride electrode
10. Which of the following substances are introduced in a continuous-flow analyzer to minimize diffusion of
reagents and mixing between samples?
A. Membranes B. Resins C. Air bubbles D. Gel polymers
11. The protein fraction that migrates the fastest toward the anode:
A. Albumin B. Beta-globulin C. Alpha1-globulin D. Gamma-globulin
12. Protein also known as orosomucoid:
A. 1-Acid glycoprotein B. 2- Macroglobulin C. -Lipoprotein D. C-reactive protein
13. Which of the following substances is markedly increased in nephrotic syndrome?
A. Ceruloplasmin B. Alpha-2-macroglobulin C. Alpha-1-antitrypsin D. Albumin
14. The neocuproine method for glucoses is based on:
A. Glucose oxidase reaction C. Condenstaion reaction
B. Copper reduction by glucose D. Hexokinase reaction
15. Select the enzyme most specific for beta D-glucose.
A. Hexokinase C. Phosphohexisomerase
B. Glucose-6phosphate dehydrogenase D. Glucose oxidase
16. All of the following are characteristics of Type II diabetes mellitus except:
A. Insulin levels may or may not be abnormal
B. It is more common than Type I diabetes
C. It requires insulin therapy to control hyperglycemia
D. It is associated with obesity and more common in persons greater than 40 years old
17. Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6.
A. – Chylomicrons  prebeta  beta  alpha +
B. – Beta  prebeta  alpha chylomicrons +
C. – Chylomicrons beta  prebeta  alpha +
D. – Alpha  beta  prebeta  chylomicrons +
18. Select the lipoprotein fraction that carries most of the endogenous triglycerides.
A. VLDL B. LDL C. HDL D. Chylomicrons
19. The lipoprotein that transports the exogenous triglycerides:
A. HDL B. LDL C. VLDL D. Chylomicrons
20. Apolipoprotein A is the primary protein component of:
A. HDL B. LDL C. VLDL D. None of these
21. “Floating beta lipoprotein” refers to:
A. B-VLDL B. HDL C. VLDL D. B-LDL
22. An abnormal LDL lipoprotein, also known as the “sinking pre-B-lipoprotein” associated with a higher risk for
atherosclerosis:
A. B-VLDL B. LpX C. Lp(a) D. LDL
23. An abnormal lipoprotein found in patients with obstructive biliary disease:
A. B-VLDL B. LpX C. Lp(a) D. LDL
24. Which of the following is referred to as the “good cholesterol”?
A. HDL B. LDL C. VLDL D. Free cholesterol
25. A type IIA hyperlipoproteinemia phenotype is associated with an increased level of:
A. Chylomicrons B. HDL C. VLDL D. LDL
26. The bilirubin fraction that is covalently attached to the albumin is:
A. Direct B. Indirect C. Delta D. Bound
27. What is the second largest constituent of the plasma non-protein nitrogen?
A. Urea B. Uric acid C. Ammonia D. Amino acids
28. Which of the following is the most abundant amino acid in plasma?
A. Lysine B. Glutamine C. Ornithine D. Cysteine
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29. In the diacetyl monoxime method, diacetyl reacts directly with:

A. Urea B. Uric acid C. Ammonia D. Ammonium ion
30. It absorbs light at 293 nm in the uricase method:
A. Uric acid B. Uricase C. Allantoin D. None of these
31. The Wacker method uses what reaction?
A. Pyruvate  (LD) Lactate C. Creatine phosphate  (CK) creatine
B. Lactate  (LD) Pyruvate D. Creatine  (CK) Creatine phosphate
32. Which LDH isoenzyme migrates the farthest from the origin on electrophoresis?
A. LD1 B. LD2 C. LD4 D. LD5
33. The presence of a flipped LD1/LD2 pattern in the presence of CK-MB is suggestive of:
A. Hepatitis B. Cirrhosis C. MI D. Bone disease
34. The isoenzymes LD-4 and LD-5 are elevated in:
A. Acute pancreatitis C. Hepatic injury or inflammation
B. Hemolyzed specimen D. Myocardial infarct
35. Which of the following methods applies to the principle below?
Creatine + ATP  (CK) Creatine phosphate + ADP
A. Szaz B. Wroblewski C. Tanzer-Gilvarg D. Oliver-Rosalki
36. Which isoenzyme of creatine kinase (CK) has the fastest electrophoretic mobility at pH 8.6?
A. MM B. MB C. BB D. Macro-CK
37. Which of the isoenzymes of ALP is most anodal?
A. Placental ALP B. Bone ALP C. Intestinal ALP D. Liver ALP
38. Which enzyme is a useful indicator of possible insecticide poisoning?
A. 5’nucleotidase B. ACP C. Cholinesterase D. LDH
39. Which of the isoenzymes of ALP is most heat stable?
A. Placental ALP B. Bone ALP C. Intestinal ALP D. Liver ALP
40. There are several alkaline phosphatase isoenzymes that are characteristic of cancer.
Electrophoretic mobility of these fractions is similar to what ALP isoenzyme:
A. Placental ALP B. Bone ALP C. Liver ALP D. Intestinal ALP
41. The Szasz assay determines the activity of:
A. CK B. ALP C. GGT D. LDH
42. Formula for serum osmolality:
+ +
A. (2Na ) + (Glucose/20) + (BUN/3) C. Na + 3Glucose + 2BUN
+ + -
B. (Na /3) + (2Glucose) + (BUN/20) D. Na - ( Cl + total CO2)
43. Later models of flame photometer uses_____ as an internal standard that allows the operator to measure
sodium, potassium and lithium directly.
A. Lithium B. Cesium C. Magnesium D. Calcium
44. When measuring potassium using an ion selective electrode, the membrane is composed of:
A. Glass B. Plastic C. Silver D. Valinomycin
45. Which electrolytes are elevated in cystic fibrosis?
A. Calcium and chloride C. Sodium and potassium
B. Chloride and sodium D. Potassium and chloride
46. In the blood, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism
with:
A. Sodium B. Potassium C. Chloride D. Phosphate
47. It is an essential component of the glucose tolerance factor, thought to play a role in maintaining normal insulin
response to glucose load by affecting membrane response to insulin:
A. Chromium B. Zinc C. Nickel D. Molybdenum
48. Increased chloride levels as determined by colorimetric and ion-selective electrode methods may be caused by
the presence in the solution of:
A. Bromide B. Calcium C. Hydrogen D. Chylomicrons
49. Which of the following is the primary mechanism causing respiratory alkalosis?
A. Hyperventilation C. Deficient pulmonary perfusion
B. Hypoventilation D. Parasympathetic inhibition
50. If a blood gas specimen is left exposed to the air for an extended period of time, which of the following changes
will occur?
A. PO2 and pH increase; PCO2 decreases C. PO2 increases; pH and PCO2 decrease
B. PO2 and pH decrease; PCO2 increases D. PO2 decreases; pH and PCO2 increase
51. Sealed heparinized arterial blood was left at room temperature for 2 hours. The most likely changes in PO 2
(mmHg), PCO2(mm Hg), and pH, respectively, are:
A. Increase, increase and increase C. Decrease, increase, and decrease
B. Decrease, decrease, and decrease D. Decrease, decrease, and increase
52. The adrenal medulla secretes which of the following in the greatest quantity?
A. Metanephrine B. Noradrenaline C. Epinephrine D. Dopamine
53. Homovanillic acid is the principal urine metabolite of:
A. Norepinephrine B. Epinephrine C. Adrenaline D. Dopamine
54. Diurnal variation is important to consider when collecting blood for the assay of:
A. Catecholamines B. Creatinine C. Cortisol D. Thyroid hormones
55. T-3 uptake is actually a measurement of:
A. T-3 B. T-4 C. TBG D. Free thyroxine
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56. Active hormonal form of T3 an T4:

A. Those bound to TBG C. Those bound to transthyretin
B. Those bound to albumin D. Those in free from
57. The principle is based on the reaction of urinary estrogen with a mixture of phenol and sulfuric acid to produce
pink color. This refers to:
A. Kober reaction B. Trinder reaction C. Zimmermann reaction D. Porter-Silber reaction
58. The Kober reaction is used in the assay of:
A. Urinary estrogen B. Glucocorticoids C. Testosterone D. Epinephrine
59. In the Porter-Silber assay, the dihydroxyacetone side chain of the steroid hormone reacts with:
A. Sulfuric acid-hydroquinone and forms reddish-brown color
B. m-dinitrobenzene and forms purple color
C. Ceric and arsenite compound and forms a yellow product
D. 2, 4 –dinitrophenylhydrazizne and forms a yellow derivative
60. The assay employed for 17-ketosteroids, in which steroids react with m-dinitrobenzene in alcoholic KOH
solution resulting to the formation of a purple color:
A. Kober Reaction B. Zimmerman reaction C. Porter-Silber Reaction D. Pisano Method
61. Zollinger-Ellison syndrome is characterized by elevated blood levels of:
A. Cholecystokinin B. Trypsin C. Pepsin D. Gastrin
62. Tumor marker most useful in the detection of familial medullary carcinoma of the thyroid:
A. Calcitonin B. CA 125 C. CEA D. CA 19-9
63. What metal toxin in urine is detected by the Reinsch test?
A. Lead B. Mercury C. Bromide D. Zinc
64. Trinder’s reagent (mercuric chloride, HCl, and ferric nitrate) is used in the colometric assay for:
A. Acetaminophen B. Salicylate C. Theophylline D. Ethanol
65. Caffeine is an important metabolite of this drug, which is assayed in newborns and young children to monitor its
therapeutic level. What is this?
A. Acetaminophen B. Digoxin C. Theophylline D. Phenobarbital
66. Odor of bitter almond gives a clue of:
A. Cyanide poisoning B. Ethanol poisoning C. Arsenic poisoning D. Carbon monoxide poisoning
67. Benzoylecgonine is the major metabolite of:
A. Heroin B. Marijuana C. Cocaine D. Phencyclidine
68. The formation of this crystal in urine, although not a constant finding is an important diagnostic clue of ethylene
glycol poisoning:
A. Uric acid B. Ammonium biurate C. Triple phosphate D. Calcium oxalate
69. What is the major carrier of drugs in the circulation?
A. Albumin B. Globulin C. Transferrin D. Hemoglobin
70. Fire extinguishers designated as Class A are used for:
A. Paper and wood B. Electrical equipment fire C. Flammable liquids and gases D. All of the above
71. It is a specialized colorimeter designed to scan and quantitate electrophoresis patterns:
A. Densitometer B. Detector C. Atomizer D. Monochromator
72. The element that distinguishes proteins from carbohydrate and lipid compounds is:
A. Carbon B. Oxygen C. Nitrogen D. Phosphorus
73. Parfentjev’s method is for the determination of:
A. Fibrinogen B. Albumin C. Globulin D. Amylase
74. Apolipoprotein A is the primary protein component of:
A. HDL B. IDL C. LDL D. VLDL
75. It is biologically important, as it serves as the starting point in many metabolic pathways including Vitamin D
synthesis, steroid hormone synthesis, and bile acid metabolism.
A. Cholesterol B. Phospholipid C. Triglycerides D. Free fatty acids
76. What is the current reference method for cholesterol analysis?
A. Abell-Kendall method B. Bloor’s method C. Salkowski method D. Lieberman-Burchardt
77. A mild condition that appears to result from a genetic defect in transport of bilirubin from sinusoidal blood into
the hepatocyte:
A. Gilbert Syndrome B. Crigler-Najjar Syndrome C. Dubin-Johnson D. Rotor Syndrome
78. What reagent is used in the Evelyn-Malloy method to dissociate the unconjugated bilirubin from protein?
A. Methanol B. Ethanol C. Caffeine D. Acetic acid
79. The Jaffe reaction is employed for the quantitation of:
A. Urea B. Creatinine C. Protein D. Uric acid
80. Lloyd’s reagent improves the specificity of what colorimetric method of determination?
A. Jaffe B. Caraway C. Lieberman-Burchardt D. Biuret
81. What is the major end product of protein and amino acid catabolism?
A. Urea B. Uric acid C. Creatine D. Creatinine
82. Uric acid when oxidized by the enzyme uricase is transformed to:
A. Allantoin B. Monosodium urate C. Xanthine D. Ammonia
83. The sweat chloride test is useful in the diagnosis of:
A. Dehydration B. Cystic fibrosis C. Azotemia D. Diabetes
84. Which trace metal accumulates in Wilson’s disease?
A. Cobalt B. Copper C. Nickel D. Zinc
85. What is the anticoagulant of choice for blood gas analysis?
A. EDTA B. Heparin C. Oxalate D. Citrate
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86. The pH of blood is critically maintained at what level:

A. 7.00-7.50 B. 7.50-7.70 C. 7.15-7.35 D. 7.35-7.45
87. In which of the following are the thyroid hormones classified:
A. Amino acid derivatives B. Steroid hormones C. Fatty acid derivatives D. Peptide hormones
88. Which of the following polypeptide hormones may be described as having alpha chains that are biochemically
identical but beta chains that are biochemically unique?
A. FSH, TSH, ACTH, LH B. TSH, LH, TRH, HCG C. LH, ACTH, HCG, TRH D. HCG, FSH, TSH, LH
89. The thyroid gland produces all of the following hormones EXCEPT:
A. TSH B. Calcitonin C. Thyroxine D. Triidothyronine
90. In hypothyroidism, one would expect the total T4 level to be _____, and the T3 uptake to be ____.
A. Increased, increased B. Decreased, decreased C. Decreased, increased D. Increased, decreased
91. How can primary hypothyroidism be differentiated from secondary hypothyroidism?
A. T3 B. T4 C. TSH D. Both A and B
92. 5-Hydroxyindoleacetic acid is the primary metabolite of:
A. Epinephrine B. Prolactin C. Norepinephrine D. Serotonin
93. A marked increase in 5-HIAA excretion occurs in patients with:
A. Argentaffinoma B. Pheochromocytoma C. Diabetes insipidus D. Diabetes mellitus
94. Digoxin, procainamide and quinidine are drugs that may be classified as:
A. Aminoglycosides B. Anticonvulsants C. Antidepressant D. Cardioactive
95. Lithium therapy is widely used in the treatment of:
A. Hypertension B. Hyperactivity C. Aggression D. Manic-depression
96. A drug that relaxes the smooth muscles of the bronchial passages is:
A. Acetaminophen B. Lithium C. Phenytoin D. Theophylline
97. Which of the following statements pertains to the effect of ethanol?
1. Ethanol functions as a depressant of the central nervous system
2. Initial effect is an increase in heart rate and blood pressure
3. Long-term abuse can impair most organs of the body; primary tissue affected is the liver
4. Blood alcohol content of 0.35 to 0.50 % is associated with coma and possible death
A. 1 and 3 B. 2 and 4 C. 1, 2 and 3 D. 1, 2, 3 and 4
98. This toxin has high affinity to keratin, can be identified from hair and nails:
A. Lead B. Cyanide C. Mercury D. Arsenic
99. This common substance of abuse is derived from Cannabis sativa leaves and stems. Which of the following is
it?
A. Heroine B. Cocaine C. Marijuana D. Amphetamines
100. All of the following vitamins are lipid in nature and classified as fat-soluble, EXCEPT:
A. Vit. A B. Vit. C C. Vit. D D. Vit. K

END OF THE EXAM