B. all values are consistent with a normal healthy individual
Body fluid glucose reference ranges.
The preparation of a patient for standard glucose tolerance testing should include:
B. a high carbohydrate diet for 3 days
GTT diet preparation
If a fasting glucose was 90mg/dL, which of the following 2-hour postprandial glucose results would most closely represent normal glucose metabolsim?
D. 100mg/dL (5.5mmol/L)
Normal 2-hour postprandial value
A healthy person with a blood glucose of 80mg/dL (4.4mmol/L) would have a simultaneously determined cerebrospinal fluid glucose value of:
B. 50mg/dL (2.3mmol/L)
Ratio of CSF glucose to blood glucose.
A 25-year-old man became nauseated and vomited 90 minutes after receiving a standard 75g carbohydrate dose for an oral glucose tolerance test. The best course of action is to:
C. draw blood for glucose and discontinue test
Use of partial GTT information
Cerebrospinal fluid for glucose assay should be:
C. analyzed immediately
Effect of glycolysis on glucose
Which of the following 2 hour postprandial glucose values demonstrates unequivocal hyperglycemia diagnostic from diabetes mellitus?
D. 200mg/dL (11.0mmol/L)
Unequivocal diagnosis of diabetes mellitus
Serum levels that define hypoglycemia in pre-term or low birth weight infants are:
C. lower than adults
Age effect on glucose
A 45-year old woman has a fasting serum glucose concentration of 95mg/dL (5.2mmol/L) and a 2-hour postprandial glucose concentration of 105mg/dL (5.8mmol/L). The statement which best describes this patient's fasting serum glucose concentration is:
A. normal; reflecting glycogen breakdown by the liver
Factors contributing to FBS
Pregnant women with symptoms of thirst, frequent urination or unexplained weight loss should have which of the following tests performed?
B. glucose tolerance test
In the fasting state, the arterial and capillary blood glucose concentration varies from the venous glucose concentration by approximately how many mg/dL (mmol/L)?
A. 5mg/dL (0.27mmol/L) higher
Arterial vs venous glucose values
The conversation of glucose or other hexoses into lactate or pyruvate is called:
Definition of glycolysis
Which of the following values obtained during a glucose tolerance test are diagnostic of diabetes mellitus?
C. fasting plasma glucose = 126mg/dL (6.9mmol/L)
Diagnosis of diabetes mellitus
The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding:
D. 6-8 weeks
definition of glycated hemoglobin
Monitoring long-term glucose control in patients with adult onset diabetes mellitus can best be accomplished by measuring:
D. hemoglobin A1c
Average glucose over time is the best predictor
A patient with Type I, insulin-dependent diabetes mellitus has the following results:
TestPatientReference Range fast bld glu: 150mg/dL (8.3mmol/L) 70-110 (3.9-6.1)
hgb A1c: 8.5% 4.0-6.0
fructosamine: 2.5mmol/L 2.0-2.9
After reviewing these test results, the technologist concluded that the patient is in a:
B. improving state of metabolic control as indicated by fructosamine
Role of fructosamine
Total glycosylated hemoglobin levels in a hemosylate reflect the:
D. average blood glucose levels of the past 2-3 months
Interpretation of glycated hemoglobin
Which of the following hemoglobins has glucose-6-phosphate on the amino-terminal valine of the beta chain?
Hgb A1c structure
A patient with hemolytic anemia will:
D. show a decrease in glycated Hgb value
Glycated hemoglobin directly related to life of RBC
In using ion-exchange chromatographic methods, falsely increased levels of Hgb A1c might be demonstrated in the presence of:
C. Hgb S
Interference Hgb A1c
An increase in serum acetone is indicative of a defect in the metabolism of:
Acetone in carbohydrate metabolism
An infant with diarrhea is being evaluated for a carbohydrate intolerance. His stool yields a positive copper reduction test and a pH of 5.0. It should be concluded that:
B. further tests are indicated
Copper reduction reaction detects many reducing substances
Blood samples are collected at the beginning of an exercise class and after thirty minutes of aerobic activity. Which of the following would be most consistent with the post-exercise sample?
B. elevated lactic acid, elevated pyruvate
Products of glycolysis
What is the best method to diagnose lactase deficiency?
B. H2 breath test
Diagnose of lactase deficiency
The expected blood gas results for a patient in chronic renal failure would match the pattern of:
Electrolyte/blood gas values in respiratory acidosis
Select the test which evaluates renal tubular function.
D. creatine clearance
Best test for renal tubular function
A patient had the following serum results: Na+: 140 mEq/L (140 mmol/L) K+: 4.0 mEq/L (4.0 mmol/L) glucose: 95 mg/dL (5.2 mmol/L) BUN: 10 mg/dL (3.57 mmol/L)
Which osmolality is consistent with these results?
Osmolality empirical calculation
The degree to which the kidney concentrates the glomerular filtrate can be determined by:
C. urine to serum osmolality ratio
Kidney concentration determination
Osmolal gap is the difference between:
A. calculated and measured osmolality values
Definition of osmolal gap
The most important buffer pair in plasma is the:
B. bicarbonate/carbonic acid pair
Quantitation of NA+ and K+ by ion-selective electrode is the standard method because:
D. of advances in electrochemistry
What battery of tests is most helpful in evaluating an anion gap of 22 mEq/L (22 mmol/L)?
C. BUN, creatinine, salicylate and methanol
A patient with myeloproliferative disorder has the following values:
Hgb: 13g/dL (130 mmol/L)
WBC: 30 x 103/uL (30 x 109/L)
platelets: 1000 x 103/uL (1000 x 109/L)
serum NA+: 140 mEq/L (140 mmol/L)
serum K+: 7 mEq/L (7 mmol/L)
The serum K+ should be confirmed by:
B. testing heparinized plasma
Most of the carbon dioxide present in blood is in the form of:
A. bicarbonate ion
Serum "anion gap" is increased in patients with:
A. lactic acidosis
The anion gap is useful for quality control of laboratory results for:
A. sodium, potassium, chloride, and total CO2
The buffering capacity of blood maintained by a reversible exchange process between bicarbonate and:
In respiratory acidosis, a compensatory mechanism is the increase in:
B. plasma bicarbonate concentration
Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?
A potassium level of 6.8 mEq/L (6.8 mmol/L) is obtained. Before reporting the results, the first step the technologist should take is to:
D. check the serum for hemolysis
The solute that contributes the most to the total serum osmolality is:
A sweat chloride result of 55 mEq/L (55 mmol/L) and sweat sodium of 52 mEq/L (52 mmol/L) were obtained on a patient who has a history of respiratory problems. The best interpretation of these results is:
A. borderline results, the test should be repeated
Which of the following is true about direct ion selective electrodes for electrolytes?
C. whole blood specimens are acceptable
Sodium determination by indirect ion selective electrode is falsely decreased by:
A. elevated lipid levels
A physician requested that electrolytes on a multiple myeloma patient specimen be run by direct ISE and not indirect ISE because:
B. Na is falsely decreased by indirect ISE
Which percentage of total serum calcium is nondiffusible protein bound?
Calcium concentration in the serum is regulated by:
D. parathyroid hormone
The regulation of calcium and phosphorous metabolism is accomplished by which of the following glands?