Chem Exam 3

Front 1

When a reaction is performed in zero order kenetics

Back 1

The rate of the reaction is independent of the substrate concentration

Front 2

Activation energy is

Back 2

Decreased by enzymes

Front 3

Enzyme reaction rates are imcreased by increasing temperature until they reach the point of denaturation at

Back 3

40-60 degrees C

Optimal temp 37 degrees C

Front 4

An example of using enzymes as reagents in the clinical lab is

Back 4

The hexokinase glucose method

Front 5

Activity of enzymes in serum maybe determined rather than concentration because

Back 5

The amount of enzyme is too low to measure

Front 6

Which CK isoenzyme is elevated in muscle diseases

Back 6

CK-MM

Front 7

Elevation of serum amylase & lipase is commonly seen in

Back 7

Acute pancreatitis

Front 8

The saccharogenic method for amylase determinations measures

Back 8

The amount of product produced

Front 9

Elevation of tissue enzymes in serum may be used to detect

Back 9

Tissue necrosis or damage

Front 10

Which of the foll errors is the most common cause of false increases in serum enzyme measurements

Back 10

The serum was not separated from red blood cells within 1 hr

**hemolysis truly #1

Front 11

Which isoenzyme will be most abundant during a heart attack

Back 11

LD1

Front 12

When differentiating liver from bone disease which enzyme levels will be most useful

Back 12

ALP

Front 13

Back 13

Normal

Front 14

Back 14

Multiple myeloma

-peak in the gamma region

-increased IgG (k or l chains)

Front 15

Back 15

Nephophic syndrome

-kidney disease

-albumin decreased

Front 16

Back 16

Inflammatory condition

-albumin decreased

Increase in:

-A1 antitrypsin

-A2 ceruloplasmin

-Haptoglobin

-burns

-trauma

-infarction

-chronic infection

Front 17

Back 17

Liver disease

-decreased albumin

-beta-Gamma bridging

-hepatitis, alcoholism

Front 18

Back 18

-A1 Antitrypsin deficiency

-decrease in a1 band

Front 19

Back 19

Hyaline cast

Front 20

Back 20

Granular cast

Front 21

Back 21

Red blood cell casts in urine

Front 22

Back 22

WBC cast in urine

Front 23

Renal threshold

Back 23

>180

Front 24

Plasma protein determination in CSF

Back 24

CSF/serum albumin index = CSF albumin (mg/dL)/serum albumin (g/dL)

Front 25

Which of the foll acute-phase reactant proteins decreases during inflammation

Back 25

Transferrin

Front 26

Which refers to the 3D spatial configuration of a single polypeptide chain determined by disulfide linkages, hydrogen bonds, electrostatic attractions & van der Waals forces

Back 26

Tertiary structure

Front 27

Which plasma protein is primary responsible for maintaining in vivo colloidal osmotic pressure

Back 27

Albumin

Front 28

Which best describes a peptide bond

Back 28

An amino group bonded to a carboxyl group of another amino acid

Front 29

Which results would correlate best with malnutrition & a poor protein-caloric status

Back 29

Decreased prealbumin

Front 30

Which conditions would correlate best with a normal level of myoglobin

Back 30

Multiple myeloma

Front 31

An immunofoxation protein electrophoresis is performed on serum from a patient with the most common type of multiple myeloma. The resulting pattern would most likely reveal which of the foll

Back 31

An IgG monoclonal band

Front 32

Which of the foll would indicate a plasma specimen was used for protein electrophoresis instead of serum

Back 32

A small peak between the Beta & gamma globulins

Front 33

Which condition would correlate best with serum protein electrophoresis results below

Back 33

Albumin: decreased

A1-globulins: increased

A2-globulins: increased

B-globulins: normal

Y-globulins: normal

a. Acute inflammation

Front 34

Which condition would correlate best with the presence of distinct oligoclonal bands in the Y-zone on CSF protein electrophoresis

Back 34

Multiple sclerosis

Front 35

When a protein is dissolved in a buffer solution that is more alkaline than its pI & an electric current is passed through the solution, the protein will act as

Back 35

An anion & migrate to the anode

Front 36

Which conditions would correlate best with an elevated serum total protein with high levels of both albumin & globulins

Back 36

Dehydration

Front 37

Which urine total protein results would correlate best with a patient with nephrotic syndrome

Back 37

Higher than normal

Front 38

Isoelectric focusing is used to phenotype a1-antitrypsin deficiencies. When protein is electrophoresed, it migrates to which of the foll

Back 38

The site where the pH is the same as its pI

Front 39

A CSF-serum albumin ratio of 9.8 was reported. How is this best interpreted

Back 39

The blood-brain barrier may be compromised

Front 40

Which of the foll CSF proteins would be measured when investigating active demyelination in multiple sclerosis

Back 40

Myelin basic protein

Front 41

Which of the foll is not an NPN substance

Back 41

Allatoin

Front 42

Which compound constitutes nearly half of the NPN substances in the blood

Back 42

Urea

Front 43

A technologist reports blood urea N of 9 mg/dL. What is the urea concentration for this sample

Back 43

19.3 mg/dL

9 × 2.14

Front 44

Which blood collection tube additive can be used to collect a specimen for measurement of urea

Back 44

Lithium heparin

Front 45

In the clinical lab, urea N is measured most often using

Back 45

Enzymatic reactions

Front 46

Elevated blood urea concentration is termed

Back 46

Azotemia

Front 47

Prerenal azotemia is caused by

Back 47

Congestive heart failure

Front 48

A technologist obtains blood urea N value of 18 mg/dL & a serum creatinine value of 2.5 mg/dL (normal 0.9-1.3) on a patient. These results indicate

Back 48

Urinary tract obstruction

BUN range 6-20

Front 49

Uric acid is the final product of

Back 49

Purine metabolism

Front 50

Sources of error in measurement of uric acid include

Back 50

Assay interference

Front 51

Which condition is not associated with elevated plasma uric acid concentration

Back 51

Allopurinol overtreatment (gout meds)

Front 52

Complete deficiency of hypoxanthine-guanine phosphoribosyltransferase results in which of the foll

Back 52

Lesch-Nyhan syndrome

Front 53

Uric acid nephrolithiasis refers to

Back 53

Precipitation of urates in the urinary tract

Front 54

45 year old male

Intense joint pain

Inflammation & redness

Serum uric acid conc done

Which result is consistent?

Back 54

Uric acid 9.1 mg/dL; gout

Front 55

Which statement describes creatinine biosythesis

Back 55

Creatine phosphate undergoes spontaneous cyclization to form creatin ine

Front 56

Substances known to increase results when measuring creatinine by the Jaffe reaction include all except

Back 56

Bilirubin

Front 57

In the Jaffe reaction, a red-orange chromogen is formed when creatinine reacts with

Back 57

Picric acid

Front 58

Creatinine excretion typically

Back 58

Is highest for adult men aged 18-50 years (muscle mass)

Front 59

Use of serum creatinine to calculate GFR

Back 59

Is encouraged as a means to identify kidney disease & improve patient care

Front 60

Which factor must be considered for calculation of creatinine clearance using the MDRD equation

Back 60

Identification of ethnicity

Front 61

Which situation would be expected to falsely increase measured blood ammonia concentration

Back 61

The patient smoked 2 cigarettes 15 mins prior to phlebotomy

Front 62

Although arterial blood is the recommended specimen for determination of this analyte, its is seldom used

Back 62

Ammonia

Front 63

Toxic effects of elevated blood amonia concentration include

Back 63

Mental status changes & coma

Front 64

Ammonia concentrations are measured to evaluate

Back 64

Hepatic encephalopathy

Front 65

Ammonia concentration correlates with disease severity & prognosis for

Back 65

Reyes syndrome