First Midterm Examination - Sample Questions
-For each of the following questions, pick the most appropriate answer of those provided:
(1) The preferred blood vessel for drawing a venous blood sample is:
a) The median vein
b) The medial cubital vein
c) The basilic vein
d) The cephalic vein
(2) The anticoagulant of choice for blood glucose measurement is:
a) Sodium citrate
b) EDTA
c) Sodium fluoride
d) Lithium heparin
(3) Which of the following stopper colors are listed in the proper order?
a) Green, red, gray, lavender
b) Gray, green, lavender, red
c) Lavender, gray, red, green
d) Red, green, lavender, gray
(4) A reference range can be verified by:
a) Literature and vendor material review (articles and researches)
b) Using samples from previously tested hospital patients
c) Using combined results of QC and true patient samples
d) Testing as few as 40 normal donor specimens
e) All of these methods can be applied for establishment of a RR
(5) A sudden variation in QC results above the mean is termed a:
a) Random error
b) Systematic error
c) Shift
d) Trend
(6) Single out the correct statement regarding the Westgard rule:
a) It means that 1 QC result is outside the range by ten folds
b) It can detect both shifts and trends
c) It’s considered the most sensitive check for systematic error
d) a & c
(7) In photometric techniques, the amount of light absorbed is dependent upon:
a) The intensity of the original light
b) The concentration of the solution
c) The thickness of the cuvette
d) all of the above
e) b & c
(8) HPLC and GC-MS are similar in that they both:
a) Depend on pressure to move the mobile phase
b) Apply spectrophotometry to quantify separated compounds
c) Rely on retention time to identify compounds
d) None of the above
(9) Applications of GC-MS include:
a) Detection of trace elements (e.g., iron)
b) Quantification of hemoglobin fractions (e.g., HbA1c)
c) Measurement of salicylate (main ingredient of aspirin)
d) All of the above
(10) The form of electrophoresis that depends least on the charge of the protein molecule is:
a) SDS-PAGE
b) Gel electrophoresis
c) Free zone capillary electrophoresis
d) None of the above
(11) All of the following statements regarding glucose homeostasis are true EXCEPT:
a) Glucose is regulated by insulin in the fed state and glucagon in the fasting state
b) Glucose is maintained at normal levels by suppressing hepatic production in fasting state
c) Insulin antagonist hormones act to increase glucose levels in response to hypoglycemia
d) Glucose utilization is stimulated by insulin in the fed state
(12) Ketoacidosis in untreated diabetes may develop due to:
a) Excessive fat metabolism
b) Excessive fluid loss (dehydration)
c) Metabolic acidosis
d) All of the above
e) a & b
(13) Testing urine for ketone bodies is most useful for:
a) Establishing a diagnosis of diabetes mellitus
b) Monitoring and managing known cases of diabetes mellitus
c) Confirmation of Fanconi's syndrome
d) All of the above
e) a & b
(14) A 30-year old diabetic patient came to the clinic for her annual checkup. Her initial blood work showed mild hyperglycemia but was normal for lipids and electrolytes. Also, her 1st morning urinary albumin was within normal levels. What mistake did the physician make?
a) He ordered an albumin level to check for possible renal complications
b) He didn’t order a HbA1c test
c) He ruled out possible ketoacidosis by measuring serum electrolyte levels
d) Nothing. He monitored glucose and checked for common findings like hyperlipidemia
(15) Galactosemia is caused by a deficiency of:
a) Glucose-6-phosphatase
b) Gal-1-P-uridyltransferase
c) Glycogen phosphorylase
d) Any of the above
-Indicate whether you agree (T) or disagree (F) with the following sentences:
1. Silica particles and thrombin may be used as clot activators.
2. Thixotropic gel tubes are ideal for drug testing.
3. Heparin enjoys more interference in blood chemistry than does EDTA.
4. Diseases detected by screening programs are well managed compared to those identified discretionarily.
5. Transport of a semen specimen under direct sunlight is an analytical error
6. A narrow reference range allows for better analytical sensitivity
7. A disinfectant for blood and body fluid decontamination is isopropyl alcohol
8. All specimens must be discarded in biohazardous waste containers
9. Inconstancy in the rate of light absorbance indicates high activity of enzyme
10. Spectrofluorometry is most accurate at very low concentrations of analyte
11. At pH values more acidic than the pI of a given molecule, the molecule would move toward the – ve pole
12. Coomassie brilliant blue is a nonspecific stain for proteins
13. HbA1c is a sensitive screening test for DM
14. A green-top blood collection tube delivered on ice is ideal for lactate testing
15. Whipple’s triad, when present, is diagnostic of reactive hypoglycemia
16. Neurodegenerative symptoms in galactosemia may be prevented by diet restriction
17. All GSD forms are characterized by extra accumulation of glycogen in the liver except glycogen synthase deficiency
18. A fluorescence in Beutler test indicates GALT deficiency
19. The amount of bound labeled Ag is inversely proportional to patient Ag in competitive, homogenous immunoassays.
20. Chemiluminescent-labeled immunoassay applies a type IV reaction
What does it mean that an immunoassay test for TSH has a sensitivity of 0.09 mU/L? Is this a diagnostic or an analytical sensitivity index?
Compare and contrast nephelometry to turbidimetry.
Discuss the operational principles and clinical applications of Ion-exchange Chromatography (IEC).