PRE-BOARD EXAMINATION IN CLINICAL CHEMISTRY (PART 1)

1. All of the following are correct match, EXCEPT:

Conversion of Conventional Unit to SI Unit:
Conventional Unit SI Unit
A Cholesterol 150 mg/dL 3.88 mmol/L
B Triglyceride 10 mg/dL 0.11 mmol/L
C Glucose 70 mg/dL 3.9 mmol/L
D BUN 8 mg/dL 0.47 mmol/L
2. A cholesterol quality control chart has the following data for the normal control:
Mean o f the data (X) = 150 mg/dL
2 Standard deviation = 4
X = 1,372 mg/dL
N = 10
Determine the coefficient of variation for this control:
A. 1.33% B. 2.67% C. 15.0 % D. 7.06%
3. The extent to which measurements agree with the true value of the quantity being measured is known as:
A. Acceptable limits B. Accuracy C. Precision D. Reliability
4. The reproducibility of test measurements is referred to as:
A. Accuracy B. Precision C. Quality control D. Reliability
5. In a Gaussian curve distribution, the 2 SD range includes the following percentage of values:
A. 31.6% B. 68.3% C. 95.5% D. 99.7%
6. Which Westgard rule detects random error?
A. 13s B. 41s C. 22s D. 100
7. The component of a spectrophotometer that is responsible for detecting transmitted light and converting light energy
to electrical energy is the:
A. Detector B. Analytical cell C. Monochromator D. Readout device
8. The process by which fluorescence of an analyte is reduced due to the excited molecule losing some of its energy by
interacting with other substances in a solution is known as:
A. Ionization B. Quenching C. Phosphorescence D. Self-absorption
9. In flow cytometry, the side scatter is related to the:
A. DNA content of the cell C. Size of the cell
B. Granularity of the cell D. Number of cells in G0 and G1
10. Which of the following approaches of automated analyzers uses a rotor to mix reagents?
A. Centrifugal analysis C. Discrete analysis
B. Continuous flow D. Dry chemistry slide analysis
11. Which of the following chemistry analyzers uses “slides” to conatin the entire reagent system?
A. Vitros© analyzers C. Paramax© analyzers
B. ACA© analyzers D. None of the above
12. Ceruloplasmin and haptoglobin migrate electrophoretically as:
A. Alpha1 globulins B. Alpha2 globulins C. Beta globulins D. Gamma globulins
13. In cirrhosis, a predominant characteristic observed in electrophoretic serum pattern is a(an):
A. Increase in alpha2 globulin fraction C. Monoclonal band in gamma globulin region
B. Bridging effect between beta and gamma globulin fraction D. Polyclonal band in gamma globulin region
14. A congenital disorder characterized by a split in the albumin band when serum is subjected to electrophoresis is
known as:
A. Analbuminemia C. Bisalbuminemia
B. Anodic albuminemia D. Prealbuminemia
15. Which enzymes are generally quantitated to help diagnose acute pancreatitis?
A. ALT and CK C. Amylase and lipase
B. ALT and LD D. ALP and cholinesterase
16. Serum levels of total CK are elevated after an acute myocardial infarction and in which of the following conditions?
A. Diabetes mellitus C. Duchenne type muscular dystrophy
B. Chronic renal failure D. Early pregnancy
17. The isoenzymes LD-4 and LD-5 are elevated in:
A. Pulmonary embolism C. Renal disease
B. Liver disease D. Myocardial infarction
18. Which of the following liver enzymes is the best to use to evaluate liver function?
A. AST B. GGT C. ALT D. LD
19. In an adult, a normal GGT level with an elevated serum ALP level may be suggestive of:
A. Bone disease C. Liver disease
B. Heart disease D. Skeletal muscle disease
20. A decreased LDH/HBD ratio is significant for:
A. Myocardial infraction C. Both of these
B. Liver disease D. None of these
21. Isoenzyme of ALP that is most heat stable:
A. Placental ALP C. Intestinal ALP
B. Bone ALP D. Liver ALP
22. Which of the following enzymes exhibit a decreased serum level in liver disease?
A. Alanine aminotransferase D. Cholinesterase
B. Gamma glutamyltransferase E. All of the above
C. Lactate dehydrogenase
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23. The relative concentration of LD isoenzymes in normal serum:
A. LD 1>2>3>4>5 C. LD 2>1>4>3>5
B. LD 2>1>3>4>5 D. LD 5>4>3>2>1
24. Substrate exhibiting high specificity for prostatic acid phosphatase:
A. Beta-glycerophosphate (Bodansky)
B. Phenylphosphate (Gutman, King-Armstrong)
C. Thymolphthalein phosphate (Roy)
D. Alpha-naphthylphosphate (Babson and Reed)
25. Time course of CK activity in myocardial infarction:
Onset of Elevation Peak Activity Duration of Elevation
A 1-3 h 5-12 h 18-30 h
B 4-8 h 12 h 3-4 d
C 8-12 h 24 h 5d
D 12-24 h 72 h 10 d
26. Serum enzymes typically elevated due to skeletal muscle disease:
A. Aspartate aminotransferase, Creatine kinase, Lactate dehydrogenase
B. Aspartate aminotransferase, Alanine aminotransferase, Alkaline phosphatase
C. Aldolase, Pseudocholinesterase, Trypsin
D. 5'-Nucleotidase, Alkaline phosphatase, Gamma-glutamyl transferase
27. Most sensitive enzyme index of primary muscle involvement:
A. Aldolase B. AST C. CK D. LD
28. In pesticide poisoning, cholinesterase activity is:
A. Normal B. Decreased C. Increased D. Variable
29. Glucose oxidase oxidizes glucose to gluconic acid and:
A. H2O2 B. CO2 C. HCO3 D. H2O
30. Hexokinase catalyzes the formation of --- from glucose and ATP:
A. Acetyl CoA C. Glucose 6-phosphate
B. Fructose 6-phosphate D. Lactose
31. Select the enzyme that is most specific for -D-glucose:
A. Glucose oxidase C. Hexokinase
B. Glucose-6-phosphate dehydrogenase D. Phophohexoisomerase
32. Select the coupling enzyme used in the hexokinase method for glucose:
A. Glucose dehydrogenase C. Glucose-6-phosphate dehydrogenase
B. Glucose-6-phosphatase D. Peroxidase
33. Which of the following methods provides information about glucose metabolism over a 3 month period?
A. Fructosamine C. Glycosylated hemoglobin
B. Glucose oxidase D. Oral glucose tolerance
34. Measurement of glycosylated albumin, which reflects hyperglycemic state within the previous 2 – 3 weeks is:
A. Glucosamine B. Fructosamine C. Urine glucose D. Galactosamine
35. Type I DM maybe described by all of the following, EXCEPT:
A. Insulin dependent B. Insulinopenia C. Ketosis prone D. Adult-onset type
36. Which of the following methods estimates urine sugar concentration by measuring total reducing substances?
A. Copper sulfate C. Hexokinase
B. Glucose oxidase D. Ferricyanide
37. A patient with severe, uncontrolled case of diabetes mellitus exhibits all of the following conditions EXCEPT:
A. Glycosuria C. Ketosis
B. Hyperglycemia D. Metabolic alkalosis
38. Which NPN fraction constitutes nearly half of the NPN substances in the blood?
A. Urea C. Ammonia
B. Creatine D. Uric acid
39. In the Jaffe reaction, a red-orange chromogen is formed when creatinine reacts with:
A. Picric acid C. Diacetyl monoxime
B. Naphthylethylenediamine D. Nitroferricyanide
40. A BUN of 9 mg/dL is obtained by a technologist. What is the urea concentration?
A. 18.3 mg/dL B. 19.3 mg/dL C. 10.3 mg/dL D. 9.3 mg/dL
41. BUN/creatinine ratio in serum in renal disease:
A. >20:1 B. <10:1 C. 10:1 D. Variable
42. Uric acid is the final breakdown product of:
A. Urea metabolism C. Glucose metabolism
B. Purine metabolism D. Bilirubin metabolism
43. The bilirubin fraction that is covalently attached to albumin and contributes to the conjugated bilirubin value is:
A. Delta B. Direct C. Indirect D. Bound
44. In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated
bilirubin and kernicterus in neonates?
A. Gilbert’s disease C. Dubin-Johnson syndrome
B. Rotor’s syndrome D. Crigler-Najjar syndrome
45. A decrease in which of the following indicates increased intravascular hemolysis?
A. Methemoglobin C. Haptoglobin
B. Methemalbumin D. Hemopexin
46. Major carrier of liver synthesized triglycerides:
A. Chylomicrons B. HDL C. LDL D. VLDL
47. The lipoprotein that transports the exogenous triglycerides:
A. HDL B. LDL C. VLDL D. Chylomicrons
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48. “Floating beta lipoprotein” refers to:
A. B-VLDL B. HDL C. VLDL D. B-LDL
49. An abnormal lipoprotein found in patients with obstructive biliary disease:
A. B-VLDL B. LpX C. Lp(a) D. LDL
50. Which of the following is referred to as the “good cholesterol”?
A. HDL B. LDL C. VLDL D. Free cholesterol
51. Chemical composition of HDL:
Protein (%) Cholesterol (%) Triglyceride (%) Phospholipid (%)
A 1-2 1-3 80-95 3-6
B 6-10 4-8 45-65 15-20
C 18-22 6-8 4-8 18-24
D 45-55 3-5 2-7 26-32
52. Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6.
A. – Chylomicrons → prebeta → beta → alpha + C. – Chylomicrons →beta → prebeta → alpha +
B. – Beta → prebeta → alpha→ chylomicrons + D. – Alpha → beta → prebeta → chylomicrons +
53. Which phenotype in the Frederickson classification of hyperlipoproteinemia is characterized by an increase in
cholesterol, an increase in beta lipoproteins, normal triglycerides, and the absence of chylomicrons?
A. I B. II C. III D. IV
54. Apolipoprotein A is the primary protein component of:
A. HDL B. LDL C. VLDL D. None of these
55. Apolipoprotein affected in Tangier’s disease:
A. Apo A1 B. Apo B100 C. Apo B48 D. Apo (a)
56. A fasting serum sample from an asymptomatic 43-year-old woman is examined visually and chemically with the
following results:
Initial appearance of serum: Milky Triglyceride level: 2000 mg/dL Cholesterol level : 550 mg/dL
Appearance of serum after overnight refrigeration: Cream layer over turbid serum
This sample contains predominantly:
A. Chylomicrons alone B. chylomicrons and VLDL C. VLDL and LDL D. HDL
57. In lipoprotein phenotyping, chylomicrons are present in the plasma of persons with which of the following lipoprotein
phenotypes?
A. I and IIa B. I and IIb C. II and III D. I and V
58. Which is the major intracellular cation?
A. Calcium B. Magnesium C. Sodium D. Potassium
59. Which is the major extracellular cation?
A. Chloride B. Sodium C. Magnesium D. Calcium
60. In cystic fibrosis, which sweat electrolytes are elevated?
A. Calcium and chloride C. Sodium and potassium
B. Chloride and sodium D. Potassium and chloride
61. Hyponatremia may be caused by each of the following EXCEPT:
A. Hypomagnesemia C. Prolonged vomiting or diarrhea
B. Aldosterone deficiency D. Acute or chronic renal failure
62. Hypokalemia may be caused by each of the following EXCEPT:
A. Acidosis C. Hypomagnesemia
B. Prolonged vomiting or diarrhea D. Hyperaldosteronism
63. A hemolyzed sample will cause falsely increased levels of each of the following EXCEPT:
A. Potassium C. Phosphate
B. Sodium D. Magnesium
64. Fiske-Subbarow reaction is used in the determination of:
A. Proteins C. Inorganic phosphorus
B. Magnesium D. Calcium
65. When measuring potassium using ion-selective electrode, the membrane is composed of:
A. Glass B. Plastic C. Silver D. Valinomycin
66. The total iron binding capacity (TIBC) test is performed to assess the blood level of:
A. Ferritin B. Hemopexin C. Iron D. Transferrin
67. Which protein is produced in decreased amount in Wilson’s disease?
A. Albumin B. Ceruloplasmin C. Haptoglobin D. Hemopexin
68. Buffer system/s in the body:
1. Bicarbonate/carbonic acid 3. Plasma proteins
2. Hemoglobin 4. Plasma phosphates
A. 1 and 2 B. 1, 2 and 3 C. 1, 3 and 4 D. 1, 2, 3 and 4
69. In health, when the kidneys and lungs are functioning properly, a 20:1 ratio of HCO 3- to H2CO3 will be maintained,
resulting in a pH of:
A. 7.10 B. 7.30 C. 7.40 D. 7.50
70. The normal ratio of carbonic acid to bicarbonate in arterial blood is:
A. 7.4:6.1 B. 1:20 C. 0.003:1.39 D. 20:1
71. When arterial blood from a “normal patient is exposed to room air, the following happens:
A. PCO2 decreases, PO2 increases C. PCO2 decreases, PO2 decreases
B. PCO2 increases, PO2 decreases D. PCO2 increases, PO2 increases
72. Which of the following is the primary mechanism of compensation for metabolic acidosis?
A. Hyperventilation C. Aldosterone release
B. Hypoventilation D. Bicarbonate excretion
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73. Severe diarrhea causes:
A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
74. In the patient’s circulatory system, bicarbonate leaves the red blood cell and enters the plasma through an exchange
mechanism with:
A. Carbonic acid B. Lactate C. Chloride D. Sodium
75. TSH is produced in the:
A. Hypothalamus B. Pituitary gland C. Adrenal cortex D. Thyroid
76. The major carrier protein of T3 and T4 in the circulation is:
A. Albumin B. Thyroglobulin C. TBG D. Thyroxine-binding prealbumin
77. T3 uptake test is used to quantitate the concentration of:
A. Free T3 B. Protein-bound T3 C. Total T3 D. TBG
78. Thyroid function test in primary hypothyroidism:
T3 T4 TSH
A Decreased Decreased Decreased
B Decreased Decreased Increased
C Normal Increased Decreased
D Normal Normal Normal
79. A patient’s T4 is 10 mg/dL. The THBR is 24% (normal=30%). What is the FT4I?
A. 8 B. 6 C. 4 D. 2
80. All of the following are correct match, EXCEPT:
Hormone classification by structure:
A. Peptide: Insulin, TSH, FSH C. Amino acids: Nor/Epinephrine,
B. Steroid: T4, T3 D. Fatty acids: Prostaglandins
81. All of the following are correct match, EXCEPT:
Tissues and the Hormones they produce:
A. Pancreas: Insulin, Glucagon C. Adrenal medulla: Epinephrine
B. Adrenal cortex: Cortisol D. Thyroid: TSH
82. The principal estrogen produced during pregnancy is:
A. Progesterone B. Estradiol C. Estrone D. Estriol
83. The Kober reaction is used in the assay of:
A. Urinary estrogen B. Glucocorticoids C. Testosterone D. Epinephrine
84. In which of the following would gastrin levels be increased:
A. Peptic ulceration C. Achlorhydria
B. Zollinger-Ellison syndrome D. Amyloidosis
85. Which of the following may be classified as an end product of catecholamine metabolism?
A. Dopamine C. Metanephrine
B. Normetanephrine D. Vanillylmandelic acid
86. Which of the following polypeptide hormones may be described as having alpha chains that are biochemically
identical but beta chains that as biochemically unique?
A. FSH, TSH, ACTH, TRH C. TSH, LH, TRH, HCG
B. LH, ACTH, HCG, TRH D. HCG, FSH, TSH, LH
87. 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 C. Porter-Silber Reaction
B. Zimmerman Reaction D. Pisano Method
88. A marked increase in 5-HIAA excretion occurs in patients with:
A. Argentaffinoma C. Diabetes insipidus
B. Pheochromocytoma D. Diabetes mellitus
89. Which of the following drugs would be correctly classified as antiepileptic?
A. Digoxin D. Phenytoin
B. Disopyramide E. Tacrolimus
C. Chloramphenicol
90. Digoxin, procainamide, and quinidine are drugs that may be classified as:
A. Aminoglycosides C. Antideppresants
B. Anticonvulsants D. Cardioactive
91. The medication of choice for treatment of manic-depression is:
A. Carbamazepine C. Phenobarbital
B. Lithium carbonate D. Phenytoin
92. Which of the following drugs may be quantitated colorimetrically using Trinder’s reagent (mercuric chloride, ferric
nitrate and hydrochloric acid)?
A. Acetaminophen B. Phenobarbital C. Salicylate D. Theophylline
93. Cocaine is metabolized to:
A. Carbamazepine B. Codeine C. Hydrocodone D. Benzoylecgonine
94. Four children are admitted with malaise, anorexia, and abdominal pain. Further evaluations reveal mild anemia,
erythrocyte basophilic stippling, and profound pica habits. Poisoning by which heavy metal is most likely responsible?
A. Arsenic B. Iron C. Mercury D. Lead
95. Caffeine is an important metabolite of this drug:
A. Acetaminophen B. Digoxin C. Theophylline D. Phenobarbital
96. Odor of bitter almond:
A. Cyanide poisoning B. Ethanol poisoning C. Arsenic poisoning D. CO poisoning
97. The system of choice for drug analysis because of its specificity and sensitivity is:
A. HPLC B. TLC C. GC/mass spectrometry D. None of these
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98. 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
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. Condition characterized by an increased gastrin levels:
A. Peptic ulcer disease C. Achlorhydria
B. Zollinger-Ellison syndrome D. Amyloidosis
101. All of the following are correct match, EXCEPT:
A. Vitamin A: Retinol C. Vitamin C: Ascorbic acid
B. Vitamin B2: Cyanocobalamin D. Vitamin K: Menaquinone
102. Which type of extinguisher should put out a fire caused by electrical equipment?
Type of Extinguisher
A Pressurized water/Dry chemical
B Dry chemical/Carbon dioxide
C Carbon dioxide/Halon/Dry chemical
D Metal X/Special dry chemical
103. Specifications set by CAP define three grades of water. Type 1 reagent water is used for:
1. Preparation of standard solutions 3. Tissue or cell culture methods
2. Ultramicrochemical analyses 4. Washing glasswares
A. 1 and 3 B. 2 and 4 C. 1, 2 and 3 D. 1, 2, 3 and 4
104. Calculate the dilution if 5 mL of serum is diluted with 15 mL of saline solution.
A. 1:2 B. 1:3 C. 1:4 D. 1:5
105. How much 20% alcohol is required to make 1 liter of 10% alcohol?
A. 0.4 L B. 0.5 L C. 0.8 L D. 1.0 L

END OF THE EXAM

PRE-BOARD EXAMINATION IN CLINICAL CHEMISTRY (PART 2)

1. The extent to which measurements agree with the true value of the quantity being measured is known as:
A. Acceptable limits B. Accuracy C. Precision D. Reliability
2. The reproducibility of test measurements is referred to as:
A. Accuracy B. Precision C. Quality control D. Reliability
3. In a Gaussian curve distribution, the 2 SD range includes the following percentage of values:
A. 31.6% B. 68.3% C. 95.5% D. 99.7%
4. Given the following data, calculate the coefficient of variation for glucose.
Analyte Mean Standard deviation
Glucose 76 mg/dL 2.3
A. 3.0% B. 4.6 % C. 7.6% D. 33.0%
5. A cholesterol QC chart has the following data for the normal control:
x = mean of data
x = 137 mg/dL x = 1,918 mg/dL
2 SD = 6 mg/dL N = 14
The coefficient of variation for this control is:
A. 1.14% B. 2.19% C. 4.38% D. 9.49%
6. Which Westgard rule detects random error?
A. 13s B. 41s C. 22s D. 100
7. In addition to the number of true negative (TN), which of the following measurements is needed to calculate
specificity?
A. True positives B. Prevalence C. False negatives D. False positives
8. The component of a spectrophotometer that is responsible for detecting transmitted light and converting light energy
to electrical energy is the:
A. Detector B. Analytical cell C. Monochromator D. Readout device
9. Nephelometry is based on the measurement of light that is:
A. Absorbed by particles in suspension C. Produced by fluorescence
B. Scatterd by particles in suspension D. Produced by excitation of ground-state atoms
10. Which of the following instruments is used in the clinical laboratory or in reference laboratories to detect beta and
gamma emissions?
A. Fluorometer B. Nephelometer C. Spectrophotometer D. Scintillation counter
11. In flow cytometry, the side scatter is related to the:
A. DNA content of the cell C. Size of the cell
B. Granularity of the cell D. Number of cells in G0 and G1
12. The cellulose acetate electrophoresis at pH 8.6 of serum proteins will show an order of migration beginning with the
fastest migration as follows:
A. Albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, gamma globulin
B. Alpha-1 globulin, alpha-2 globulin, beta globulin, gamma globulin, albumin
C. Albumin, alpha-2 globulin, alpha-1 globulin, beta globulin, gamma globulin
D. Gamma globulin, beta globulin, alpha-2 globulin, alpha-1 globulin, albumin
13. Ceruloplasmin and haptoglobin migrate electrophoretically as:
A. Alpha1 globulins B. Alpha2 globulins C. Beta globulins D. Gamma globulins
14. Which of the following serum protein fractions is most likely to be elevated in patients with nephrotic syndrome?
A. Alpha-1 globulin B. Albumin C. Alpha-2 globulin D. Beta globulin and gamma globulin
15. In cirrhosis, a predominant characteristic observed in electrophoretic serum pattern is a(an):
A. Increase in alpha2 globulin fraction C. Monoclonal band in gamma globulin region
B. Bridging effect between beta and gamma globulin fraction D. Polyclonal band in gamma globulin region
16. Which hemoglobin may be differentiated from other hemoglobins on the basis of its resistance to denature in alkaline
solution?
A. A1 B. A2 C. C D. F
17. Which of the following ezymes does not belong to the class of enzymes known as hydrolases?
A. Aldolase B. Amylase C. Lipase D. Alkaline phosphatase
18. Which of the following enzymes is a transferase?
A. ALP B. CK C. Amylase D. LD
19. When myocardial infarction occurs, in what order (list from first to last) will the enzymes aspartate aminotransferase
(AST), creatine kinase (CK), and lactate dehydrogenase (LD) become elevated in the serum?
A. AST, LD, CK B. CK, LD, AST C. CK, AST, LD D. LD, CK, AST
20. Time course of CK activity in myocardial infarction:
Onset of Elevation Peak Activity Duration of Elevation
A 1-3 h 5-12 h 18-30 h
B 4-8 h 12 h 3-4 d
C 8-12 h 24 h 5d
D 12-24 h 72 h 10 d
21. An electrophoretic separation of lactate dehydrogenase isoenzymes that demonstrates an elevation in LD-1 and LD-2
in a “flipped” pattern is consistent with:
A. Myocardial infarction B. Viral hepatitis C. Pancreatitis D. Renal failure
22. Which of the following enzymes exhibit a decreased serum level in liver disease?
A. Alanine aminotransferase D. Cholinesterase
B. Gamma glutamyltransferase E. All of the above
C. Lactate dehydrogenase
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23. Which enzymes are generally quantified to help diagnose acute pancreatitis?
A. ALT and CK B. ALT and LD C. Amylase and lipase D. ALP and cholinesterase
24. Select the most sensitive marker for alcoholic liver disease.
A. AST B. ALT C. GGT D. None of these
25. In an adult, a normal GGT level with an elevated serum ALP level may be suggestive of:
A. Bone disease B. Heart disease C. Liver disease D. Skeletal muscle disease
26. The relative concentration of LD isoenzymes in normal serum:
A. LD 1>2>3>4>5 B. LD 2>1>4>3>5 C. LD 2>1>3>4>5 D. LD 5>4>3>2>1
27. A decreased LDH/HBD ratio is significant for:
A. Myocardial infarction B. Liver disease C. Both of these D. None of these
28. Isoenzyme of ALP that is most heat stable:
A. Placental ALP B. Bone ALP C. Intestinal ALP D. Liver ALP
29. Which of the following hormones does not promote an increase in blood glucose levels?
A. Growth hormone B. Cortisol C. Glucagon D. Insulin
30. Of the following blood glucose levels, which would you expect to result in glucose in the urine?
A. 60 mg/dL B. 120 mg/dL C. 150 mg/dL D. 225 mg/dL
31. An individual has a plasma glucose level of 110 mg/dL. What would be the approximate glucose concentration in the
patient’s cerebrospinal fluid?
A. 33 mg/dL B. 55 mg/dL C. 66 mg/dL D. 110 mg/dL
32. Select the enzyme that is most specific for -D-glucose:
A. Glucose oxidase C. Hexokinase
B. Glucose-6-phosphate dehydrogenase D. Phophohexoisomerase
33. Select the coupling enzyme used in the hexokinase method for glucose:
A. Glucose dehydrogenase C. Glucose-6-phosphate dehydrogenase
B. Glucose-6-phosphatase D. Peroxidase
34. Which of the following methods provides information about glucose metabolism over a 3 month period?
A. Fructosamine C. Glycosylated hemoglobin
B. Glucose oxidase D. Oral glucose tolerance
35. Measurement of glycosylated albumin, which reflects hyperglycemic state within the previous 2 – 3 weeks is:
A. Glucosamine B. Fructosamine C. Urine glucose D. Galactosamine
36. Type I DM maybe described by all of the following, EXCEPT:
A. Insulin dependent B. Insulinopenia C. Ketosis prone D. Adult-onset type
37. What is the compound that comprises the majority of the nonprotein-nitrogen fractions in serum?
A. Uric acid B. Creatinine C. Ammonia D. Urea
38. What analyte is measured using the Jaffe reaction?
A. Urea B. Uric acid C. Ammonia D. Creatinine
39. The creatinine clearance test is routinely used to assess the glomerular filtration rate. Given the following information
for an average-size adult, calculate the creatinine clearance.
Urine creatinine - 120 mg/dL
Plasma creatinine - 1.2 mg/dL
Urine volume for 24 hours - 1520 mL
A. 11 mL/min B. 63 mL/min C. 95 mL/min D. 106 mL/min
40. Given the following data, calculate the creatinine clearance, Serum creatinine = 1.2mg/dL; urine creatinine =- 120
mg/dL; urine volume = 1.75 L/day; surface area = 1.80 m2.
A. 16 mL/min B. 117 mL/min C. 126 mL/min D. 168 mL/min
41. During chemotherapy for leukemia, which of the following analytes would most likely be elevated in the blood?
A. Uric acid B. Urea C. Creatinine D. Ammonia
42. A BUN of 9 mg/dL is obtained by a technologist. What is the urea concentration?
A. 18.3 mg/dL B. 19.3 mg/dL C. 10.3 mg/dL D. 9.3 mg/dL
43. Blood ammonia levels are usually measured in order to evaluate:
A. Renal failure B. Acid-base status C. Hepatic coma D. Malabsorption
44. Indirect-reacting bilirubin may be quantified by reacting it initially in which reagent?
A. Dilute hydrochloric acid C. Caffeine-sodium benzoate
B. Dilute sulfuric acid D. Sodium hydroxide
45. The bilirubin fraction that is covalently attached to albumin and contributes to the conjugated bilirubin value is:
A. Delta B. Direct C. Indirect D. Bound
46. In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated
bilirubin and kernicterus in neonates?
A. Gilbert’s disease B. Dubin-Johnson syndrome C. Rotor’s syndrome D. Crigler-Najjar syndrome
47. A decrease in which of the following indicates increased intravascular hemolysis?
A. Methemoglobin B. Methemalbumin C. Haptoglobin D. Hemopexin
48. Select the order of mobility of lipoproteins electrophoresed on cellulose acetate or agarose at pH 8.6.
A. – Chylomicrons → prebeta → beta → alpha + C. – Chylomicrons →beta → prebeta → alpha +
B. – Beta → prebeta → alpha→ chylomicrons + D. – Alpha → beta → prebeta → chylomicrons +
49. Chemical composition of HDL:
Protein (%) Cholesterol (%) Triglyceride (%) Phospholipid (%)
A 1-2 1-3 80-95 3-6
B 6-10 4-8 45-65 15-20
C 18-22 6-8 4-8 18-24
D 45-55 3-5 2-7 26-32
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50. Which phenotype in the Frederickson classification of hyperlipoproteinemia is characterized by an increase in

cholesterol, an increase in beta lipoproteins, normal triglycerides, and the absence of chylomicrons?
A. I B. II C. III D. IV
51. Apolipoprotein A is the primary protein component of:
A. HDL B. LDL C. VLDL D. None of these
52. The lipoprotein that transports the exogenous triglycerides:
A. HDL B. LDL C. VLDL D. Chylomicrons
53. “Floating beta lipoprotein” refers to:
A. B-VLDL B. HDL C. VLDL D. B-LDL
54. Which of the following is referred to as the “good cholesterol”?
A. HDL B. LDL C. VLDL D. Free cholesterol
55. Which of the following diseases results from a familial absence of high density lipoprotein?
A. Krabbe disease B. Gaucher disease C. Tangier disease D. Tay-Sachs disease
56. The chemical composition of HDL cholesterol corresponds to:
A. Triglyceride 60% Cholesterol 15% Protein10% C. Triglyceride 5% Cholesterol 15% Protein 50%
B. Triglyceride 10% Cholesterol 45% Protein 25% D. Triglyceride 85% Cholesterol 5% Protein 2%
57. A fasting serum sample from an asymptomatic 43-year-old woman is examined visually and chemically with the
following results:
Initial appearance of serum: Milky Triglyceride level : 2000 mg/dL Cholesterol level : 550 mg/dL
Appearance of serum after overnight refrigeration: Cream layer over turbid serum
This sample contains predominantly:
A. Chylomicrons alone B. chylomicrons and VLDL C. VLDL and LDL D. HDL
58. In lipoprotein phenotyping, chylomicrons are present in the plasma of persons with which of the following lipoprotein
phenotypes?
A. I and IIa B. I and IIb C. II and III D. I and V
59. A patient’s total cholesterol is 300 mg/dL, his HDL cholesterol is 50 mg/dL, and his triglyceride is 200 mg/dL. What is
this patient’s calculated LDL cholesterol?
A. 200 B. 210 C. 290 D. 350
60. Which is the major intracellular cation?
A. Calcium B. Magnesium C. Sodium D. Potassium
61. Which is the major extracellular cation?
A. Chloride B. Sodium C. Magnesium D. Calcium
62. In cystic fibrosis, which sweat electrolytes are elevated?
A. Calcium and chloride C. Sodium and potassium
B. Chloride and sodium D. Potassium and chloride
63. A hemolyzed sample will cause falsely increased levels of each of the following EXCEPT:
A. Potassium B. Sodium C. Phosphate D. Magnesium
64. When measuring potassium using ion-selective electrode, the membrane is composed of:
A. Glass B. Plastic C. Silver D. Valinomycin
65. The total iron binding capacity (TIBC) test is performed to assess the blood level of:
A. Ferritin B. Hemopexin C. Iron D. Transferrin
66. Which protein is produced in decreased amount in Wilson’s disease?
A. Albumin B. Ceruloplasmin C. Haptoglobin D. Hemopexin
67. At blood pH 7.40, what is the ratio of bicarbonate to carbonic acid?
A. 15:1 B. 20:1 C. 25:1 D. 30:1
68. The reference range for blood pH is:
A. 7.28 – 7.34 B. 7.33 – 7.37 C. 7.35 – 7.45 D. 7.45 – 7.50
69. The most important buffer pair in plasma is the:
A. Phosphate / biphosphate pair C. Bicarbonate / carbonic acid pair
B. Hemoglobin / imidazole pair D. Sulfate / bisulfate pair
70. When arterial blood from a “normal patient is exposed to room air, the following happens:
A. PCO2 decreases, PO2 increases C. PCO2 decreases, PO2 decreases
B. PCO2 increases, PO2 decreases D. PCO2 increases, PO2 increases
71. A common cause of respiratory alkalosis is:
A. Vomiting B. Starvation C. Asthma D. Hyperventilation
72. Which of the following is the primary mechanism of compensation for metabolic acidosis?
A. Hyperventilation B. Hypoventilation C. Aldosterone release D. Bicarbonate excretion
73. Severe diarrhea causes:
A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
74. TSH is produced in the:
A. Hypothalamus B. Pituitary gland C. Adrenal cortex D. Thyroid
75. Thyroid function test in primary hypothyroidism:
T3 T4 TSH
A Decreased Decreased Decreased
B Decreased Decreased Increased
C Normal Increased Decreased
D Normal Normal Normal
76. The major carrier protein of T3 and T4 in the circulation is:
A. Albumin B. Thyroglobulin C. TBG D. Thyroxine-binding prealbumin
77. T3 uptake test is used to quantitate the concentration of:
A. Free T3 B. Protein-bound T3 C. Total T3 D. TBG
 4

78. A patient’s T4 is 10 mg/dL. The THBR is 24% (normal=30%). What is the FT4I?
A. 8 B. 6 C. 4 D. 2
79. The principal estrogen produced during pregnancy is:
A. Estrone B. Estradiol C. Estriol D. Corticosterone

80. The Kober reaction is used in the assay of:

A. Urinary estrogen B. Glucocorticoids C. Testosterone D. Epinephrine
81. In which of the following would gastrin levels be increased:
A. Peptic ulceration C. Achlorhydria
B. Zollinger-Ellison syndrome D. Amyloidosis
82. Which of the following polypeptide hormones may be described as having alpha chains that are biochemically
identical but beta chains that as biochemically unique?
A. FSH, TSH, ACTH, TRH C. TSH, LH, TRH, HCG
B. LH, ACTH, HCG, TRH D. HCG, FSH, TSH, LH
83. 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. Porter-Silber Reaction C. Zimmerman Reaction D. Pisano Method
84. A marked increase in 5-HIAA excretion occurs in patients with:
A. Argentaffinoma B. Diabetes insipidus C. Pheochromocytoma D. Diabetes mellitus
85. Which vitamin would be affected if a patient was diagnosed with a disorder involving fat absorption?
A. Vitamin B12 B. Ascorbic acid C. Thiamine D. Vitamin K
86. Which of the following drugs would be correctly classified as antiepileptic?
A. Digoxin B. Chloramphenicol C. Phenytoin D. Disopyramide
87. Digoxin, procainamide, and quinidine are drugs that may be classified as:
A. Aminoglycosides B. Anticonvulsants C. Antideppresants D. Cardioactive
88. The medication of choice for treatment of manic-depression is:
A. Carbamazepine B. Lithium carbonate C. Phenobarbital D. Phenytoin
89. A drug that relaxes the smooth muscles of the bronchial passages is:
A. Acetaminophen B. Lithium C. Phenytoin D. Theophylline
90. Which of the following drugs may be quantified colorimetrically using Trinder’s reagent (mercuric chloride, ferric nitrate
and hydrochloric acid)?
A. Acetaminophen B. Phenobarbital C. Salicylate D. Theophylline
91. Cocaine is metabolized to:
A. Carbamazepine B. Codeine C. Hydrocodone D. Benzoylecgonine
92. Four children are admitted with malaise, anorexia, and abdominal pain. Further evaluations reveal mild anemia,
erythrocyte basophilic stippling, and profound pica habits. Poisoning by which heavy metal is most likely responsible?
A. Arsenic B. Iron C. Mercury D. Lead
93. Caffeine is an important metabolite of this drug:
A. Acetaminophen B. Digoxin C. Theophylline D. Phenobarbital
94. Odor of bitter almond:
A. Cyanide poisoning B. Ethanol poisoning C. Arsenic poisoning D. CO poisoning
95. 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
96. 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
97. Which type of extinguisher should put out a fire caused by electrical equipment?
Type of Extinguisher
A Pressurized water/Dry chemical
B Dry chemical/Carbon dioxide
C Carbon dioxide/Halon/Dry chemical
D Metal X/Special dry chemical
98. 4 mL of water is added to 1 mL of serum. This represents which of the following serum dilutions?
A. 1:3 B. 1:4 C. 1:5 D. 1:6
99. What is the molarity of a solution that contains 18.7 g of KCl (MW =74.5) in 500 mL of water?
A. 0.1 B. 0.5 C. 1.0 D. 5.0
100. All of the following are correct match, EXCEPT:
Conversion of Conventional Unit to SI Unit:
Conventional Unit SI Unit
A Cholesterol 150 mg/dL 3.88 mmol/L
B Triglyceride 10 mg/dL 0.11 mmol/L
C Glucose 70 mg/dL 3.9 mmol/L
D BUN 8 mg/dL 0.47 mmol/L

END OF THE EXAM

PRE-BOARD EXAMINATION IN CLINICAL CHEMISTRY (PART3)

1. What is the prefix for factor 10-15?

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?
 2

A. Lysine B. Glutamine C. Ornithine D. Cysteine

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
 3

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?
 4

A. EDTA B. Heparin C. Oxalate D. Citrate

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