Bishop Clinical Chemistry Practice Test

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• Which of the following cardiac markers is the most useful indicator of congestive heart failure?
• Which starting substance is used to initiate the biosynthesis of steroid hormones?
• Which of the following is an oncofetal antigen?
• Which biomarker rises earliest after myocardial infarction?
• All of the following abnormalities might be expected in a severely ill patient EXCEPT
• What term refers to the movement of buffer ions and solvent relative to a fixed support in electrophoresis?
• Which procedure is not currently used for point-of-care testing devices?
• Which condition most commonly leads to prerenal acute kidney injury?
• Which factor is not considered part of the Lean Six Sigma framework (per the source)?
• The most common immunoassays used to measure PSA detect which form of the enzyme?
• Which of the following defects is the most common type of congenital cardiovascular defect encountered?
• What is the major lipid transported by chylomicrons?
• A Gaussian distribution is usually described as which shape?
• Which of the following is a common clinical application for identifying SNPs in patients?
• The measurement of serum cystatin C is useful for which of the following?
• The most common PSA immunoassays detect which form?
• Which light source is used in atomic absorption spectrophotometry?
• Osmolality can be defined as a measure of the concentration of a solution based on which factor?
• The kidney is the primary site for the final activation step of vitamin D to 1,25-dihydroxyvitamin D.
• Teriparatide is best described as which category of osteoporosis therapy?
• A person with a confirmed blood pressure of 125/87 would be classified as
• Analysis of ascites fluid by paracentesis is performed to accomplish which goal?
• All of the following are advantages to automation EXCEPT which?
• Which statement about zero-order kinetics is true?
• In monoclonal antibody production, the specificity of the antibody is determined by the:
• Convert 4 cm to millimeters (mm).
• Which statement best describes the composition of Hb Barts?
• Compared with serum, the protein electrophoretic pattern of plasma commonly shows which feature?
• Which of the following is not commonly used as a CSF biomarker for multiple sclerosis?
• All of the following describe a nucleic acid probe except:
• Which statement is true about the relationship between a chemical's structure and its mass spectrum?
• Which hormone is produced by the pituitary gland and stimulates growth?
• Which test measures the thyroid gland's uptake of radioactive iodine and helps differentiate causes of hyperthyroidism?
• What is the preferred specimen for glucose analysis?
• In laboratory testing, the greatest percentage of errors occurs during which phase?
• Comparison of method studies:
• The d-xylose absorption test is used to assess the absorptive ability of the intestine.
• Examples of typical reference interval data distribution plots include all of the following except
• Which statement best describes synovial fluid?
• Which clinical feature is most associated with neurologic porphyrias such as acute intermittent porphyria?
• Uric acid is the final product of
• Which enzyme is measured in red blood cells as a marker of organophosphate exposure?
• A pattern with decreased albumin, increased α1- and α2-globulins, and normal γ-globulins on protein electrophoresis is most characteristic of which condition?
• What constitutes proper PPE for routine chemistry laboratory testing?
• Amniotic fluid provides a cushion for the fetus.
• Which type of analyzer offers random-access capabilities?
• A patient presents with a very high BUN relative to a modestly elevated creatinine; which condition is most consistent?
• Using the Cockcroft-Gault equation, estimate CrCl for a 40-year-old female weighing 55 kg with serum creatinine 1.4 mg/dL.
• Which scenario is NOT considered a preanalytical error?
• For an orally administered drug, peak concentration is typically reached within which time frame?
• Select the answer that designates three techniques widely used for elemental analysis, identified according to the initials for the techniques.
• ABG interpretation: pH 7.39; pCO2 65; HCO3- 37. Which pattern best fits this result?
• Osmoreceptors in the hypothalamus are key to regulating blood osmolality. They primarily respond to changes in plasma osmolality to adjust the secretion of which hormone?
• Several enzymatic triglyceride methods measure the production or consumption of which substance?
• Monitoring the levels of ketone bodies in the urine via nitroprusside reagents provides a semi-quantitative measure of
• The kidneys compensate for respiratory alkalosis by (excretion, retention) of bicarbonate and (increased, decreased) excretion of NaH2PO4.
• Diagnostic specificity is best described as:
• The hydrogen ion concentration of a solution is 9.37 × 10^-5 M. What is the pH?
• Which hypothalamic factor inhibits prolactin secretion?
• All statements about iodine are true EXCEPT which of the following?
• Cystic fibrosis occurs predominantly in populations of which descent?
• Which analyzer automation approach can use mixing paddles to stir?
• Radionuclide uptake (RAIU) testing is often useful in determining the cause of which condition?
• Iron is physiologically active only in the ferrous form in which protein?
• The major clinical use for CA-125 is monitoring treatment response of which cancer?
• Which of the following is the most appropriate specimen for glucose analysis when glycolysis must be inhibited?
• Glucose oxidase oxidizes glucose to gluconic acid and
• In diabetic management, which patient group should urine ketone testing be emphasized for?
• Which result is most consistent with a high risk of coronary heart disease?
• Which analyte has the highest specificity for cardiac injury?
• Which year marks the introduction of the first commercial centrifugal analyzer?
• The specific feedback effector for follicle-stimulating hormone (FSH) is
• Which CSF protein would be measured when investigating active demyelination in multiple sclerosis?
• Which creatinine measurement method uses the alkaline picrate reaction?
• With increased water loss, burn patients are most likely to also experience:
• In the context of dexamethasone suppression testing, which scenario best describes a possible interpretation when cortisol is not suppressed?
• The primary organs involved in the maintenance of calcium homeostasis are the intestine, _____, and kidney.
• Which hemoglobin is resistant to alkali denaturation in NaOH?
• Automation offers which of the following advantages?
• The reagent p-dimethylaminobenzaldehyde is used to measure which of the following?
• Which statement correctly differentiates tropic hormones from direct effector hormones?
• Teriparatide is the only FDA-approved drug for osteoporosis that directly stimulates bone formation.
• The largest portion of total body water is found in which tissue?
• The biologically most active, naturally occurring androgen is
• The strength of binding between an antigen and antibody is related to the:
• What is the primary product of methanol metabolism by the ADH and ALDH system?
• Connectivity for POCT provides the ability to which of the following?
• Which hormone is released in response to osmolality changes and acts on the kidneys to conserve water?
• 1,25(OH)2D, due to 1-hydroxylase activity in macrophages, may be produced to excess in granulomatous diseases and lymphoid disorders, leading to hypercalcemia.
• Rheumatic heart disease is a result of infection with which organism?
• Which statement best describes prerenal azotemia in relation to BUN and creatinine?
• Which enzyme would best aid in identifying hepatobiliary disease?
• True or False? Laboratory liquid-in-glass thermometers should be calibrated against an NIST-certified thermometer.
• The correlation coefficient:
• Urine albumin measurements over three years show 15, 56, and 156 mg/24 h. What is the likely interpretation?
• Following the 2012 ADA guidelines, the times of measurement for plasma glucose levels during an OGTT in nonpregnant patients are
• EQC per CLIA means which of the following?
• What best describes a tandem mass spectrometer?
• Among pancreatic enzymes, which is more specific for pancreatitis?
• A tumor marker used in the assessment of choriocarcinoma or hydatidiform mole is which?
• Creatinine clearance results are corrected using a patient's body surface area to account for differences in which factor?
• TD50 refers to the dose causing toxic effects in 50% of the population, while LD50 refers to the lethal dose in 50% of the population. Which statement is true?
• A deficiency in estrogen during the follicular phase will result in which outcome?
• Androgen secretion by the testes is stimulated by which hormone?
• Which factor is least likely to affect the purification of genomic DNA for analysis in molecular methods?
• The most effective way to quantitate hemoglobin A2 is by?
• Which apolipoprotein is the major component of HDL?
• In partition chromatography, separation is based primarily on the distribution of analytes between two immiscible liquids. True or False?
• In healthy adults, which compartment contains the largest share of total body water?
• Which component of a chromatography instrument is primarily responsible for the selective separation of a mixture?
• Given the following information, calculate the creatinine clearance using the Cockcroft-Gault formula: Age = 85; weight = 70 kg; sex = male Serum creatinine = 1.0 mg/dL
• Which electrochemical assay measures current at a fixed potential?
• Which newer marker of inflammation circulates in serum bound to LDL and HDL?
• Skin, _____, and kidneys are involved in the production of the active metabolite of vitamin D.
• The metal ion essential for the activity of xanthine oxidase and xanthine dehydrogenase is
• From the following chloride results, which value is the minimum? 106 115 111 83 120 127 119 100 104 83 105 107 106 110 106 110 112 108 108 109 114 102
• Which of the following best describes nonionizing radiation?
• Which enzyme is commonly used as a tumor marker among the following?
• Which statement best describes the relationship between early and late precursors and porphyria types?
• In primary hyperparathyroidism, the defect primarily lies in the parathyroid glands.
• Which of the following is NOT a driving force for more automation?
• Which statement about chromatography is TRUE?
• Monitoring the levels of ketone bodies in the urine is
• A serum PSA is used for all of the following except which?
• _______ is responsible for epinephrine production.
• Which of the following is not a porphyria?
• When a reaction is performed in zero-order kinetics
• High blood ammonia levels result in
• According to the material, which sample is best for measuring catecholamine metabolites?
• Which cells in bone are responsible for bone resorption, and which are responsible for bone formation?
• Which endocrine disorder is commonly associated with hypertension due to aldosterone overproduction?
• Laboratory findings in pancreatitis include all of the following EXCEPT which?
• Immunofixation electrophoresis of serum in the most common type of multiple myeloma typically shows which pattern?
• A peptide bond is
• The most likely cause for serum/plasma to appear 'milky' is the presence of which particles?
• Which bone cell type is primarily responsible for bone resorption?
• When measuring ammonia blood levels, which of the following might cause a false increase in this analyte?
• The most common cause of ascites is due to which condition?
• Growth hormone exerts many of its growth-promoting effects primarily through which mediator produced in the liver?
• Stray light in a spectrophotometer primarily affects which performance aspect?
• Interference studies typically use _____ as an interferent.
• Which compound constitutes nearly half of the NPN substances in the blood?
• Deletion of two alpha-globin genes primarily results in which condition?
• Excluding analytic error, which could explain a low serum cholinesterase with a normal erythrocyte acetylcholinesterase in suspected organophosphate poisoning?
• Which of the following is influenced by growth hormone?
• The main purpose of porphyrins in the body is to
• The d-xylose absorption test helps differentiate malabsorption due to intestinal mucosa from pancreatic insufficiency because:
• What is the hydrogen ion concentration of an acetate buffer having a pH of 4.24?
• What is the proper disposal method for microbiologic waste?
• In reference interval transference studies, which reference limit percentage is described as acceptable?
• Which hemoglobin contains four gamma chains and has an extremely high affinity for oxygen?
• Direct bilirubin is the water-soluble fraction produced after conjugation.
• When arterial blood from a normal patient is exposed to room air, which of the following occurs?
• Pleural exudates are typically characterized by which laboratory pattern?
• What is the most prevalent metabolic bone disease in the United States?
• The anticoagulant of choice for arterial blood gas measurements is ______ in the ______ state.
• Which of the following is an example of a modular integrated chemistry/immunoassay analyzer?
• An urea N result of 9 mg/dL is obtained by a technologist. What is the urea concentration?
• Which statement regarding mass spectrometry is false?
• Which statement best describes the TD50 of a compound?
• Which condition would result in elevations in primarily conjugated bilirubin?
• Osmoreceptors in the hypothalamus regulate blood osmolality. A 1% to 2% shift in osmolality typically causes a ______ change in circulating concentration of ADH.
• Which one of the listed conditions is not associated with elevated plasma uric acid concentration?
• In reversed-phase liquid chromatography, which description best represents the typical stationary/mobile phase relationship?
• The most common cause of hypoparathyroidism.
• Rising serum estriol levels over three weeks in a pregnant patient are most consistent with which condition?
• Hb E is most prevalent in which region?
• Which statement accurately describes insulin-like growth factor (IGF-1) in relation to growth hormone?
• For a data value set that is Gaussian distributed, what is the likelihood (%) that a data point will be within ±1 SD from the mean?
• At a pH of 7.70, the H+ concentration is equal to
• What is the purpose of the chopper in an atomic absorption spectrophotometer?
• Hypothyroidism is generally associated with all of the following EXCEPT
• Which statement concerning vasopressin secretion is NOT true?
• A patient's arterial blood gas results are as follows: pH 7.37; pco2, 75 mm Hg; HCO3 -, 37 mmol/L. These values are consistent with
• Which hormone rise is associated with the basal body temperature increase during the ovulatory period?
• Which LD isoenzyme pattern is most associated with liver and skeletal muscle tissues?
• A 34-year-old woman presents with goiter, tachycardia, and weight loss. TSH is undetectable and free T4 is high. All of the following tests are useful in diagnosing the cause of the hyperthyroidism EXCEPT
• In mass spectrometry, where would singly charged and doubly charged ions of Ca-40 appear on the spectrum, given that singly charged Ca is listed first?
• Ammonia concentrations are usually measured to evaluate
• What is the percent (w/v) for 100 g NaCl dissolved in 250 mL of solution?
• Convert 5×10^-3 milliliters to microliters.
• Renal clearance is defined as which of the following?
• The first commercial centrifugal analyzer was introduced in which year?
• Which plasma electrolyte has the most narrow reference range and is MOST strictly regulated by the body?
• Which tissue is a known source of steroid hormone production?
• Hyperglycemic factor produced by the pancreas is which hormone?
• The isoenzymes LD-4 and LD-5 are elevated in
• Genetic screening for cystic fibrosis is usually unsuccessful.
• The conjugation of bilirubin occurs in which organ?
• Diagnostic specificity describes the test's ability to correctly identify those without the disease. Which term corresponds to this concept?
• In reference interval transference studies, what is the primary purpose?
• A fibrinogen peak between the β- and γ-globulins on a protein electrophoresis pattern indicates which type of sample?
• Using the Cockcroft-Gault equation, estimate CrCl for a 30-year-old male weighing 80 kg with serum creatinine 2.0 mg/dL.
• A metal ion required for optimal enzyme activity is best termed a(an)
• Which ketone body is primarily detected by the nitroprusside urine test?
• The presence of dyshemoglobins will cause a calculated %SO2 result to be falsely (elevated, decreased) and a pulse oximeter %Spo2 value to be falsely (elevated, decreased).
• Hepatitis E is likely to cause serious consequences in which population group?
• What is the normality for a solution containing 100 g of NaCl made up to 500 mL with distilled water? Assume a gram molecular weight of approximately 58 g/mol.
• Which immunoglobulin class is most commonly produced as the monoclonal protein in the most common type of multiple myeloma?
• Drugs of abuse are typically measured by:
• A 26-year-old man presents with a 3-cm, right lobe, thyroid nodule and a normal TSH. What is the next test that should be performed?
• Which of the following enzymes is commonly used as a tumor marker?
• Aminoglycoside drug levels, such as gentamicin, should be measured
• In nephrotic syndrome, urinary total protein is typically:
• Of the following thyroid hormones, which is considered the most biologically active?
• LD isoenzyme analysis helps distinguish damage to which tissues?
• In automated chemistry, throughput refers to which concept?
• The primary serum test to screen for thyroid disease is:
• Which of the following is a common example of solid support hybridization?
• A serum albumin of less than 2.5 g/dL would be most indicative of which condition?
• The thyroid gland produces all of the following EXCEPT
• Delayed separation of serum from red blood cells can lead to falsely elevated enzyme activities. Which option best represents this preanalytical error?
• Suppose the controller on a GFAAS is defective and the furnace is running cold. What effect will this likely have on the number of photons absorbed in the measurements?
• Select the coupling enzyme used in the hexokinase method for glucose.
• RFLP stands for which term?
• Which statement about von Gierke disease is true?
• ABG interpretation: pH 7.52; pCO2 30; HCO3- 22. Which pattern best fits this result?
• What term describes an antibody that reacts with more than one antigen?
• When hypertension results from an endocrine disorder, what hormonal state is usually found?
• Systematic error can best be described as consisting of
• In which type of cells does the conjugation of bilirubin take place?
• Which pituitary hormone stimulates the thyroid gland?
• Which statement best describes catecholamines?
• A patient on gentamicin for two weeks develops a renal condition with significantly decreased glomerular filtration rate. What dosage adjustment is appropriate?
• Which step in automation generally remains manual in most laboratories?
• The nucleic acid technique in which RNA is converted to cDNA, which is then amplified, is known as:
• For developing an analyte standard curve in an HPLC procedure, which label would be most appropriate for a standard with 100% purity?
• A reference range can be verified by
• For the following series, the true value is 6.0. Series: 5,4,5,6,7,5,3,8,5,9,5,4,5,6. The SDI is:
• Which of the following is NOT a feature of an ideal cardiac marker?
• All of the following are characteristic of von Gierke disease EXCEPT
• Pre-beta-lipoprotein refers to which lipoprotein fraction?
• Which type of bone is most rapidly lost in response to hypogonadism and glucocorticoid therapy?
• Elevation of tissue enzymes in serum may be used to detect
• Which hormone promotes gluconeogenesis?
• Which statement about fluorometry is true?
• The fetus which of the following statements is true?
• Which vitamin D metabolite is most reflective of vitamin D stores in the body?
• An example of using enzymes as reagents in the clinical laboratory is
• Which statement about chylomicrons is FALSE?
• Development of kidney stones is the primary complication of hypercalciuria.
• _______ is the common substrate from which all adrenal steroids are produced.
• In selecting an automated chemistry analyzer, which item is NOT a primary consideration?
• In a grossly lipemic sample, which method yields the most accurate electrolyte results?
• Isoelectric focusing uses a pH gradient to separate molecules by their isoelectric point.
• The collection of a 24-hour urine is used for measuring:
• Real-time PCR development was driven by which property of Taq polymerase?
• Which substance is known to interfere with creatinine measurement by the Jaffe reaction, causing an apparent increase?
• A normal myoglobin concentration 8 hours after the onset of symptoms of a suspected MI will which of the following?
• Which set of laboratory results most accurately reflects severe renal disease?
• Which immunoglobulin is provided to a newborn by the mother?
• Hearing loss is common among the elderly and may cause embarrassment. What should be done to facilitate the specimen collection process?
• Which analytic method is most commonly used as the confirmatory test for identification of drugs of abuse?
• Prerenal azotemia is caused by
• PTH and 1,25(OH)2D are the principal hormones involved in the normal physiologic regulation of calcium homeostasis.
• What does quality control lockout prevent?
• Digene's Hybrid Capture 2 is an example of which type of assay?
• To evaluate a moderately complex laboratory test, all of the following must be done except:
• Silent carriers of alpha-thalassemia are missing how many alpha genes?
• Poor protein-caloric nutritional status is associated with which of the following changes in serum proteins?
• When selecting quality control reagents for measuring an analyte in urine, which choice is correct?
• Which pattern best describes the presence of predominantly conjugated bilirubin elevation?
• In the hexokinase–based glucose assay, which enzyme acts as the coupling step to allow NADPH-based detection?
• Extremely high levels of ALA and PBG in the urine with normal porphyrin levels in the feces and blood most likely indicate which porphyria?
• Renin release by the kidney is stimulated by which condition?
• Of the following statements concerning procainamide, which is TRUE?
• Convert 0.02 mL to microliters (μL).
• How long does it typically take for an infant to double its birth weight?
• At a pH of 7.10, the H+ concentration is equal to
• Tumor marker tests are used for which of the following purposes?
• The parent substance in the biosynthesis of androgens and estrogens is
• Which unlabeled immune precipitation method in gel is used to quantitate a serum protein?
• Which statement is true regarding osmolality sample usage for measurement?
• How much blood should be drawn at any one time from a 7-lb baby?
• Which specimen is typically used for a waived point-of-care test?
• Using the Henderson-Hasselbalch equation, give the ratio of salt to weak acid for a Veronal buffer with apH of 8.6 and apKa of 7.43.
• A patient serum CK measurement is out of range and a dilution is required. Which water would be appropriate to prepare the dilution?
• Which technique has the highest potential sensitivity?
• Which patient reached a PSA value above 100 ng/mL at any time?
• Which test is commonly used to assess fetal lung maturity by evaluating surfactant composition?
• ABG interpretation: pH 7.50; pCO2 60; HCO3- 40. Which pattern best fits this result?
• Which of the following statements best reflects HAV serology indicating immunity rather than active infection?
• Which statement about competency for non-waived testing is true?
• Leucovorin rescue in methotrexate therapy serves to which of the following?
• Which of the following is the preferred biomarker for the assessment of myocardial necrosis?
• When evaluating whether therapeutic drug monitoring is needed for a new orally administered drug, which factors should be considered?
• Bidirectional communication between the chemistry analyzer and the laboratory information system has had the greatest impact on which phase of clinical testing?
• Fetal pulmonary maturity is characterized by which change in lipid indicators?
• What metal may be used as a treatment for Wilson's disease?
• ABG interpretation: pH 7.51; pCO2 40; HCO3- 38. Which pattern best fits this result?
• Elevations of both serum amylase and lipase are most commonly seen in which condition?
• Which of the following is not an objective of proteomics research?
• Increased intravascular hemolysis is indicated by a decrease in which of the following?
• Tandem mass spectrometry can be used to detect
• Which of the following is the precursor for estradiol formation in the placenta?
• What is the presumed defect in most cases of familial type IIa hyperlipoproteinemia?
• Given a drug with a half-life of 2 days and a noon concentration today of 10 μg/mL, what is the expected concentration at noon tomorrow?
• Which porphyrin is excreted primarily in urine?
• Increased levels of apo A-I are associated with increased risk of CAD. True or False?
• Which test is commonly used to screen for cystic fibrosis by measuring a specific electrolyte in sweat?
• Salicylate binds albumin; what effect would prehepatic jaundice have on salicylate?
• Allowable analytical error is:
• Which symptom is commonly associated with hypothyroidism?
• A deficiency in vasopressin can lead to which of the following?
• Which amino acid is needed for the biosynthesis of norepinephrine and epinephrine?
• Which substance is a placental precursor for estradiol formation?
• Pleural fluid exudates are characterized by which features?
• In method comparison studies, why should primary QC material and standards span the reportable range?
• Which lipoprotein class is the major carrier of cholesterol away from tissues?
• Which of the following enzyme patterns is MOST diagnostic of Duchenne-type muscular dystrophy?
• The preferred screening test for diabetes in nonpregnant adults is measurement of
• The relationship between precursors in the heme synthesis pathway and the type of porphyria resulting from excess buildup is:
• Which container is calibrated to hold only one exact volume of liquid?
• Which liver enzyme is most useful in identifying hepatobiliary disease due to its elevation in bile duct obstruction?
• Besides chelating agents, which metal is used to reduce copper absorption in Wilson's disease?
• Manganese toxicity resembles which disease?
• Which option is NOT used to identify analytes in mass spectrometry?
• A technologist obtains a urea N value of 61 mg/dL and a serum creatinine value of 2.5 mg/dL on a patient. These results indicate
• Which statement best describes direct ISE measurement of electrolytes in blood?
• Secondary porphyrias not due to an inherited biochemical defect in heme synthesis can be distinguished from true porphyrias by measuring levels of
• What percentage of women will develop invasive cancer at some point in their lifetime?
• Cod liver oil is a source of vitamin D.
• Which is the correct sequence of electrophoretic migration of hemoglobins from slowest to fastest on cellulose acetate at an alkaline pH?
• Which of the following specimens is NOT used for a waived POC test?
• Which placental hormone is used for early detection of pregnancy?
• Which of the following describes a function of the proximal tubule?
• Why are enzyme activities in serum often measured rather than enzyme concentrations?
• PTHrP is produced by some cancers and often leads to cancer-associated hypercalcemia.
• The following are treatment options for hyperthyroidism associated with Graves' disease EXCEPT
• Distinct oligoclonal bands in the γ region on CSF protein electrophoresis are diagnostic of which disease?
• The Lean Six Sigma quality improvement framework will include all of the following factors EXCEPT:
• True or False? Serum creatinine levels may be falsely elevated when a patient is taking cephalosporin.
• Exudative pleural effusions are typically due to disease involving which structure?
• Which two factors are primary drivers for automation in clinical chemistry?
• When assessing the lipid profile for fetal lung maturity, which centrifugation approach is recommended?
• The pKa for acetic acid is 4.76. If the concentration of salt is 5 mmol/L and that of acetic acid is 10 mmol/L, what is the expected pH?
• Which statement about ion-exchange chromatography is true?
• Convert 5×10^-2 L to milliliters (mL).
• Using the same chloride data set, what is the median?
• If serum levels of estradiol do not increase after injection of hCG, the patient has
• If two methods agree perfectly in a method comparison study, the slope equals _____ and the y-intercept equals _____.
• RFLP analysis detects genetic variation based on differences in which factor?
• From the following chloride results, which value is the maximum? 106 115 111 83 120 127 119 100 104 83 105 107 106 110 106 110 112 108 108 109 114 102
• Which autoimmune antibody is commonly associated with Hashimoto's thyroiditis?
• The two main classes of porphyrias, according to symptoms, are?
• Which of the following fractions of bilirubin is water soluble and reacts with a diazo reagent without the addition of an accelerator?
• For laboratories with a provider-performed microscopy procedure CLIA certificate, which of the following would NOT be approved?
• A CSF albumin to serum albumin ratio suggests what about the blood-brain barrier?
• What component selects specific wavelengths in a spectrophotometer?
• Which CK isoenzyme is elevated in muscle diseases?
• Which statement about PSA velocity interpretation is most accurate?
• Point-of-care testing is helpful when
• Which statement about lithium is TRUE?
• What is Beer's law as used in spectrophotometry?
• Which one of the following is not an NPN substance?
• Which test is commonly used to diagnose cystic fibrosis?
• Which test is most useful to confirm Graves' disease?
• What volume of 14 N H2SO4 is required to prepare 250 mL of 3.2 M H2SO4 (MW 98.08 g/mol)?
• Predict GFR in a 50-year-old woman who weighs 60 kg using the Cockcroft-Gault equation. Her serum creatinine level is 2.5 mg/dL.
• What is the grams per liter in a 3.45 M NaCl solution? (MW ≈ 58 g/mol)
• Based on PSA velocity over 18 weeks, which statement best describes the data?
• CSF glucose measurement is most useful for assessing which condition?
• Beer's law states that absorbance is related to which factors?
• When sequencing DNA, what stops DNA synthesis in sequencing reactions?
• Which of the following is NOT an advantage of capillary electrophoresis (CE)?
• A primary hyperaldosteronemic state is characterized by which of the following?
• The primary excretion route for protoporphyrin (PROTO), uroporphyrin (URO), and coproporphyrin (COPRO) are
• Which item is essential for routine laboratory testing PPE?
• Hypercalcemia in granulomatous diseases can be mediated by extrarenal production of 1,25(OH)2D.
• The first step in the event of a spill of a strong base is to
• Which lipoprotein is the major carrier of cholesterol to peripheral tissue?
• Deletion of all four alpha-globin genes is associated with which fetal condition?
• Which hormone is responsible for the rise in basal body temperature at the time of ovulation?
• DNA content analysis on a sample of breast tissue for suspected malignancy using flow cytometry and results DI = 2.5 and % cells in S phase = 29%. Based on these results you can conclude:
• Which statement about transmittance (%) is correct?
• Dwell time in automated analysis refers to which concept?
• What is the most appropriate time to evaluate a peak digoxin level after oral administration?
• Which measurement is commonly used to estimate glomerular filtration rate (GFR) in clinical practice?
• TRH stimulates the secretion of
• Which condition is least likely to be associated with increased alkaline phosphatase levels?
• Which practice is recommended for safe chemical storage?
• A patient has an abnormal hemoglobin band that migrates with Hb S on cellulose acetate (pH 8.4) hemoglobin electrophoresis. The solubility test is negative. What test should be performed next?
• True or false: Major warning signs of adrenal disease include abnormal blood pressure, abnormal electrolytes, and unexplained weight change.
• Which of the following is a capability of POCT connectivity?
• Quality control lockout, which statement best describes its effect on QC documentation?
• Cystic fibrosis is caused by mutations on which chromosome?
• Which equation is commonly used to estimate LDL-C when triglycerides are available?
• Which statement best describes fluorescence?
• Which method of analysis will provide the most accurate electrolyte results if a grossly lipemic sample is used?
• For a buffer with a pKa of 4.76, if the pH equals the pKa, what is the ratio of salt to weak acid?
• Hypokalemia may be caused by each of the following EXCEPT
• When calculating creatinine clearance using the MDRD equation, which of the following factors are considered?
• Which statement best describes when to consider therapeutic drug monitoring for a new drug with unpredictable pharmacokinetics?
• Porphobilinogen is most commonly quantitated in the urine by which method?
• A monoclonal spike in the gamma region on serum protein electrophoresis is most suggestive of which condition category?
• What are the major contributing factors to repetitive strain injuries?
• What are the primary purposes of the torch in ICP-MS?
• Between which weeks did Patient B's PSA increase the most?
• Select the enzyme that is most specific for beta-D-glucose.
• During standard lipoprotein electrophoresis, which lipoprotein is typically seen remaining at the origin due to its large size?
• If a patient has reduced albumin levels, what is the expected effect on the free fraction of a highly protein-bound drug?
• The acute-phase reactant proteins include all of the following EXCEPT
• Which statement about fetal thyroid development is true?
• Which factor is applied to the Cockcroft-Gault equation to adjust for female sex?
• Estrogen influences the secretion of which of the following hormones?
• What is the purpose for determining serum concentrations of the antineoplastic drug methotrexate?
• ABG interpretation: pH 7.42; pCO2 50 mm Hg; HCO3- 34 mmol/L. Which pattern best fits this result?
• Which anterior pituitary hormone lacks a stimulatory hypophysiotropic hormone?
• Of the following, which will MOST likely interfere with quantitation of thyroglobulin?
• Cystatin C is produced by which type of cells?
• In nephelometry, the antigen-antibody complex formation is enhanced in the presence of:
• Which form of hepatitis is caused by a DNA virus?
• CA-125 is primarily used to monitor treatment response in which cancer?
• The most biologically active androgen in this list is:
• Tumor markers may be defined as which of the following?
• Open-loop negative feedback refers to the phenomenon of
• The percentage of cells in S phase in a tissue sample analyzed by flow cytometry mainly reflects:
• Which trace element should be monitored weekly during TPN therapy?
• Modifications in microsampling and reagent dispensing improve which phase of clinical testing?
• Which electrophoresis method is commonly used to separate proteins by size using a gel matrix?
• In newborn physiology, which statement describes bilirubin elimination?
• Which of the following target tissues is incapable of producing steroidal hormones?
• Hormone replacement does not inhibit bone resorption in osteoporotic patients.
• An IgG index of 0.8 is most indicative of which phenomenon?
• Monoclonal bands of IgM on serum immunofixation are most strongly associated with which disease?
• A patient in coma has negative immunoassay screens for multiple drugs and no ethanol detected. Can drug overdose be ruled out?
• Which of the following preanalytical errors most commonly causes false increases in serum enzyme measurements?
• During a low dose (1 mg) dexamethasone suppression test, total cortisol level at 8:35 am is 2.8 μg/dL. How is this interpreted?
• Which statement accurately describes Zollinger-Ellison syndrome?
• An ROC includes all of the following except:
• Acute kidney injury is classified into prerenal, intrinsic (renal), and postrenal categories. Which of the following is an example of postrenal AKI?
• Chronic fetal metabolic distress is demonstrated by which pattern of estriol levels?
• What is the dilution factor for a solution containing 100 g of NaCl made up to 500 mL with distilled water?
• Hexokinase catalyzes the formation of what compound from glucose and ATP?
• Hypoventilation can compensate for
• In creatinine clearance calculation using the standard urine collection method, the result is expressed in which units?
• Lipoprotein phenotyping shows triglyceride 340 mg/dL, total cholesterol 180 mg/dL, pre-beta-lipoprotein fraction increased, beta-lipoprotein normal, no chylomicrons, turbid serum. Which hyperlipoproteinemia is most suggested?
• In a child with microcytic, hypochromic anemia and high zinc protoporphyrin with a positive urinary porphyrin screen and basophilic stippling, which laboratory test would be best to confirm lead exposure?
• Which of the following abnormal hemoglobins, found frequently in individuals from Southeast Asia, migrates with hemoglobin A2 on cellulose acetate electrophoresis?
• The plasma protein mainly responsible for maintaining colloidal osmotic pressure in vivo is
• Enzyme reaction rates are increased by increasing temperatures until they reach the point of denaturation at
• Why would a clinical chemist develop an arsenic method that combines liquid chromatography with ICP-MS?
• Which value occurs most frequently (the mode) in the provided dataset? 106 115 111 83 120 127 119 100 104 83 105 107 106 110 106 110 112 108 108 109 114 102
• Excess porphyrins tend to accumulate in which organ systems?
• To obtain the spectrum of a compound from 190 to 500 nm, which item is not necessary?
• In HPTLC, how is each band typically quantified?
• Lamellar body counts reflect
• Which statement best describes the role of LH in the male reproductive system?
• Glucose intolerance, abnormal cholesterol level, high blood pressure, and upper body obesity are characteristics of
• In the colorimetric determination of cholesterol using the enzyme cholesterol oxidase, which agent oxidizes the colorless organic compound 4-aminoantipyrine to a pink complex?
• Which describes the correct source, function, and deficient state of the vitamin listed?
• Which class of porphyrias is typically associated with photosensitivity?
• Serous fluids are best described as...
• The thyroid gland depends on which enzyme to permit iodination of tyrosyl residues to make MIT and DIT?
• Hyponatremia may be caused by each of the following EXCEPT
• Besides average plasma glucose, which factor can affect HbA1c level?
• In flow cytometry, the side scatter is related to the:
• A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?
• The following chloride (mmol/L) results were obtained using a new analyzer: 106 115 111 83 120 127 119 100 104 83 105 107 106 110 106 110 112 108 108 109 114 102. What is the mean?
• Which binding protein modulates the bioavailability of IGF-I?
• Serum or plasma myoglobin levels are used as?
• The two main sites in the body for accumulation of excess porphyrins are
• Which item in the clinical laboratory does not require calibration?
• In chromatography, the stationary phase is always a solid matrix. True or False?
• Inherited disorders in which a genetic defect causes abnormalities in rate and quantity of synthesis of structurally normal polypeptide chains of the hemoglobin molecule are called?
• Using the Cockcroft-Gault equation, estimate CrCl for a 65-year-old man weighing 72 kg with serum creatinine 1.8 mg/dL.
• Hyperkalemia may be caused by each of the following EXCEPT
• Given the lipid results Total cholesterol 400 mg/dL; triglycerides 300 mg/dL; HDL-C 100 mg/dL, what is the LDL-C?
• What is the major extracellular cation?
• Metabolic syndrome assessment: which item is NOT needed to assess the syndrome?
• Amniotic fluid is sampled by amniocentesis.
• Which combination of laboratory findings would be most consistent with acute high-level exposure to inorganic mercury (Hg2+)?
• A CLIA waived test requires that operators
• Which chemistry analyzer uses slides to contain the entire reagent system?
• Which statement about ion-selective electrodes (ISEs) is most accurate?
• Which is the most sensitive detector for spectrophotometry?
• In nephelometry, which solution would not enhance antigen-antibody complex formation?
• High serum total protein with elevated levels of both albumin and globulins is most commonly seen in which state?
• Salicylic acid in a patient with gastric achlorhydria is given a standard dose. Which is the predicted serum concentration relative to normal?
• Which statement best describes the discrete analysis approach in analyzer automation?
• Which test differentiates Hb S trait from other variants when solubility results are inconclusive?
• Hyperchylomicronemia (type I) in childhood has been associated with which of the following?
• After an initial immunoassay screen for drugs of abuse yields a positive result, which method is most commonly used to confirm the identity of the specific drug?
• Competency for non-waived testing
• Which laboratory condition is commonly associated with hyperkalemia?
• In isoelectric focusing, where does a protein migrate relative to its pI?
• In immunofixation electrophoresis, two discrete bands appear at the same electrophoretic location, one reacted with antihuman IgA (α chain specific) reagent and the other reacted with antihuman λ reagent. This is best described as:
• Which statement about point-of-care testing devices is true?
• What is the percent (w/v) for a solution containing 100 g of NaCl made up to 500 mL with distilled water?
• The quantitative relationship between changes in blood osmolality and the normal expected response by ADH is best described as a(n):
• Convert 4×10^4 mg to grams.
• Which antigen is considered an oncofetal antigen?
• Which laboratory test would be most appropriate to assess carbon monoxide exposure?
• A 1:200 dilution of a urine specimen yields a creatinine result of 0.8 mg/dL; the serum value is 1.2 mg/dL. What is the final creatinine value in mg/dL in the undiluted urine sample?
• A patient in coma with negative results on standard immunoassay screens could still have an overdose due to substances not included in the screens. Which statement is true?
• TDM is most valuable for drugs with which characteristics?
• Which of the following represents the most active androgen among the listed options in typical physiology contexts?
• The three-dimensional spatial configuration of a single polypeptide chain as determined by disulfide linkages, hydrogen bonds, electrostatic attractions, and van der Waals forces is referred to as the
• Calculate the Sigma value for a method with total allowable error 8%, bias 0.9%, and CV 2%.
• In the circulatory system, bicarbonate leaves the red blood cells and enters the plasma through an exchange mechanism with ______ to maintain electroneutrality.
• Which statement best describes a key advantage of PCR/ESI-TOF in pathogen identification?
• Which enzyme is essential for iodination in thyroid hormone synthesis?
• In hypothyroidism, which lipid abnormality is commonly observed?
• Which finding on urinalysis would most strongly support biliary obstruction when bilirubin metabolism is considered?
• Which lipoprotein electrophoresis method depends on both charge and molecular size?
• In Type IV hyperlipoproteinemia, which lipoprotein fraction is increased?
• Which enzyme is responsible for the conjugation of bilirubin?
• A fire caused by a flammable liquid should be extinguished using which type of extinguisher?
• A 24-hour urine has a total volume of 1,200 mL. A 1:200 dilution yields a creatinine result of 0.8 mg/dL. The serum value is 1.2 mg/dL. What is the creatinine excretion in grams per 24 hours?
• Which of the following is the best test to differentiate beta-thalassemia minor from iron deficiency anemia?
• Mass spectrometry identifies analytes based on:
• Which assay is an example of a homogeneous immunoassay?
• What is the molarity of a solution containing 100 g of NaCl made up to 500 mL with distilled water? Assume a gram molecular weight of approximately 58 g/mol.
• A patient's arterial blood gas results are as follows: pH 7.48; pco2, 54 mm Hg; HCO3 -, 38 mmol/L. These values are consistent with
• Which vitamin deficiency is correctly matched with its nutrient source and disease?
• Which hormone acts as an LH analog to stimulate ovulation?
• Laboratory testing for the assessment of fetal lung maturity includes all of the following tests except
• Twenty milligrams of a drug is injected IV. One hour later the concentration is 0.4 mg/L. What is the volume of distribution for this drug?
• Reflectance spectrometry uses which of the following?
• When choosing a chemistry analyzer for a pediatric laboratory, it is necessary to
• Chemical storage should be organized according to
• The main difference between a direct and indirect ISE is
• Which hormone's secretion is primarily regulated by plasma osmolality?
• With increased water loss, which electrolyte level is most likely elevated in serum?
• Analysis of amniotic fluid lipid profile for fetal lung maturity relies on which ratio?
• True or False? Pre-beta (VLDL) lipoproteins migrate further toward the anode on polyacrylamide gel than they do on cellulose acetate or agarose.
• What is the value in mg/dL for a solution containing 10 mg of CaCl2 made with 100 mL of distilled water?
• Which phenomenon can cause falsely low results in immunoassays when analyte concentration is very high?
• Which could account for drug toxicity following a normally prescribed dose?
• A patient of Southeast Asian heritage presents with mild microcytic anemia and target cells. Hemoglobin electrophoresis on cellulose acetate at pH 8.4 shows a major band that migrates with Hb A2 and no Hb A, and citrate agar electrophoresis shows the band in the position of Hb A. Which abnormal hemoglobin is most probable?
• Which of the following are examples of nonionizing radiation?
• Which trace metal is contained in glucose tolerance factor?
• Given LD50 values of 5 mg/kg for compound A and 50 mg/kg for compound B, which statement describes their relative acute oral toxicity?
• For method development studies, which analytical performance test should be done first?
• If a protein is placed in a buffer with pH higher than its pI and an electric field is applied, where will the protein migrate?
• Quantitative fecal fat analysis is used to assess which aspect of pancreatic function?
• Automation typically affects labor in what way?
• True or false: When produced, free catecholamines (NE and EPI) are short-lived. They are best measured in the urine, though catecholamine metabolites are best measured in the serum.
• Which detector is typically used to measure emitted light in sensitive fluorescence measurements?
• Which statement best indicates disruption of the blood-brain barrier?
• Convert 1.3×10^2 mL to deciliters (dL).
• A 65-year-old woman presents with fatigue, hypothermia, pericardial effusions, and hair loss. Her thyroid function tests show a significantly elevated TSH and a low free T4. All of the following laboratory test abnormalities may be associated with her underlying condition EXCEPT
• Which statement about the relationship between troponin T testing and CK-MB is supported by these materials?
• Which protein transports iron in the bloodstream?
• Activation energy is
• A hemolyzed sample will cause falsely increased levels of each of the following EXCEPT
• In the provided dataset, the mean equals the median.
• In immunofixation electrophoresis, if a band reacts with anti IgA reagent and the heavy chain is present, which immunoglobulin heavy chain is indicated?
• In the Jaffe reaction, a red-orange chromogen is formed when creatinine reacts with
• Which homogeneous immunoassay relies on inhibiting the activity of the enzyme label when bound to antibody reagent to eliminate separating freelabeled from bound-labeled reagent?
• Which cells are primarily responsible for extrarenal production of 1,25(OH)2D in granulomatous disease?
• A midcycle LH surge will stimulate which series of events?
• When considering an endocrine cause for a patient's hypertension, which gland is the usual suspect?
• Which statement about proteomics objectives is correct?
• The definitive suppression test to prove autonomous production of growth hormone is
• Worldwide, most primary malignant tumors of the liver are related to which condition?
• What does ROC stand for?
• What is the major intracellular cation?
• What is the range of the chloride dataset? 106 115 111 83 120 127 119 100 104 83 105 107 106 110 106 110 112 108 108 109 114 102
• Which test directly determines the exocrine secretory capacity of the pancreas?
• If a patient had a luteal phase defect, which hormone would most likely be deficient?
• Based on the same lipid results (TC 400, TG 300, HDL 100), how would this LDL-C be categorized?
• Which change is a normal physiological event after birth regarding the heart's circulation?
• In mass spectrometry coupled with chromatography, which statement is true?
• You must make 1 L of 0.2 M acetic acid(CH3COOH). All you have available is concentrated glacial acetic acid (assay value, 98%; specific gravity, 1.05 g/mL). It will take ______ milliliters of acetic acid to make this solution. Assume a gram molecular weight of 60.05 grams.
• True or False? Red blood cells are key for oxygen transport, carbon dioxide transport, and maintaining electroneutrality in the blood.
• ABG interpretation: pH 7.46; pCO2 50; HCO3- 32. Which pattern best fits this result?
• Which lipoprotein is produced in the intestinal mucosa?
• A patient with an acute bleed is most accurately described as having which type of acute kidney injury?
• Which porphyrin is excreted primarily in feces?
• In a diabetic patient, the threshold for microalbuminuria is best described as?
• Control of the rate of heme synthesis in liver cells is achieved largely through regulation of which enzyme?
• Cyanide toxicity best described by which mechanism?
• Extreme copper deficiency is seen in what fatal condition?
• Which plasma protein maintains oncotic pressure in vivo?
• Polarographic methods of glucose assay are based on which principle?
• A serum TnT concentration is of most value to the patient with an MI when which condition is true?
• In measuring tumor markers, which has been reported to contribute 30% to 70% of the total measurement error?
• Direct effector hormones exert primary action on which tissue?
• The MDRD equation for estimating GFR requires serum creatinine alongside which demographic factors?
• Which serum protein electrophoresis pattern is characteristic of cirrhosis?
• Which enzyme is most useful in establishing hepatic origin of an elevated serum alkaline phosphatase?
• Elevation of serum amylase and lipase is commonly seen in
• Which standard requires that SDSs be accessible to all employees who handle hazardous chemicals?
• Which ranking correctly orders electromagnetic radiation from low energy to high energy?
• In which condition would a normal level of myoglobin be expected?
• What are the major limitations of tumor markers?
• Which sample-related issue can cause a falsely elevated potassium measurement?
• Which CSF measure best assesses blood-brain barrier integrity?
• A patient presents with elevated levels of IgG anti-HAV while IgM anti-HAV is nondetectable. This patient is likely to:
• Which statement describes what occurs in an infant immediately after birth?
• Elevated sweat chloride levels are a hallmark of which condition?
• Which type of alpha-thalassemia results from deletion of three genes and produces a moderate hemolytic anemia?
• In Beer's law, which term represents the molar absorptivity?
• Which statement correctly describes disposal of microbiologic waste before disposal?
• The lipoprotein contains the greatest amount of protein is called?
• Which statement about tropic hormones is true?
• Measuring serum ammonia levels has potential preanalytical errors. Which option is incorrect?
• 1,25(OH)2D is the best blood test for determining adequacy of vitamin D stores in the body.
• Which of the following actions helps prevent preanalytical errors related to patient identification in phlebotomy?
• The saccharogenic method for amylase determinations measures
• What is the molarity of a solution containing 100 g NaCl dissolved in 1 liter of solution? (MW ≈ 58 g/mol)
• Chromium is associated with which metabolic concept?
• The sample of choice for measuring blood osmolality is:
• A weakly acidic toxin with pKa = 4.0 is ingested. At gastric pH 3.0, where is it most likely to be absorbed passively?
• In the context of OGTT timing, which combination of measurements is described by the 2012 ADA guidelines?
• In situ hybridization is best described as a technique used to localize nucleic acids within which context?
• A urinalysis shows positive reducing sugars while the glucose dipstick is negative. What is the most likely interpretation?
• Calculate creatinine clearance, given the following information: serum creatinine 1.2 mg/dL; urine creatinine 120 mg/dL; urine volume 1750 mL/24 h; body surface area 1.80 m2.
• The most frequent cause of hypermagnesemia is due to
• What is the molarity of a solution containing 10 mg of CaCl2 made with 100 mL of distilled water? Assume a gram molecular weight from the periodic table of approximately 111 g/mol.
• All of the following represent normal physiology of the newborn except
• Which CK isoenzyme is most specific for myocardial infarction?
• What is the molarity of a solution containing 50 g NaCl in 1 L of solution? (MW ≈ 58 g/mol)
• Which statement best describes tumor markers?
• A urinalysis dipstick test indicated that urobilinogen was absent. Which condition does this support?
• What is the purpose of adding RNase to a patient sample during genomic DNA isolation?
• The development of real-time PCR was driven by which factor?
• Which organ dysfunction predominantly drives secondary hyperparathyroidism?
• A xanthochromic CSF indicates
• Substances known to increase results when measuring creatinine by the Jaffe reaction include all of the following EXCEPT
• In the MDRD equation for estimating GFR, which factor is not typically included?
• Xanthine oxidase and xanthine dehydrogenase require which metal as a cofactor?
• What are the long-term sequelae of untreated or partially treated acromegaly?
• What is the proper time period for the collection of a fecal fat specimen?
• The two main sites of production of heme are
• Which statement best describes molecular arrays?
• Cystic fibrosis (CF) is characterized by which combination?
• In fluorometry, where is the detector typically placed relative to the excitation beam?