Chemistry BOC set 1

  1. Followong overnight fasting, hypoglycemia in adults is defined as a glucose of:

    • D. ≤45mg/dL (≤2.5mmol/L)
    • Diagnosis of hypoglycemia in adults.
  2. The following results are from a 21-year-old patient with a back injury who appears otherwise healthy:

    whole blood glucose: 77mg/dL (4.2mmol/L)
    serum glucose: 88mg/dL (4.8mmol/L)
    CSF glucose: 56mg/dL (3.1mmol/L)

    The best interpretation of these results is that:

    • B. all values are consistent with a normal healthy individual
    • Body fluid glucose reference ranges.
  3. The preparation of a patient for standard glucose tolerance testing should include:

    • B. a high carbohydrate diet for 3 days
    • GTT diet preparation
  4. 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
  5. 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.
  6. 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
  7. Cerebrospinal fluid for glucose assay should be:

    • C. analyzed immediately
    • Effect of glycolysis on glucose
  8. 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
  9. Serum levels that define hypoglycemia in pre-term or low birth weight infants are:

    • C. lower than adults
    • Age effect on glucose
  10. 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
  11. Pregnant women with symptoms of thirst, frequent urination or unexplained weight loss should have which of the following tests performed?

    B. glucose tolerance test

    Gestational diabetes
  12. 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
  13. The conversation of glucose or other hexoses into lactate or pyruvate is called:

    D. glycolysis

    Definition of glycolysis
  14. 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
  15. The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding:

    D. 6-8 weeks

    definition of glycated hemoglobin
  16. 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
  17. A patient with Type I, insulin-dependent diabetes mellitus has the following results:

    Test               Patient                                    Reference 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
  18. Total glycosylated hemoglobin levels in a hemosylate reflect the:

    D. average blood glucose levels of the past 2-3 months

    Interpretation of glycated hemoglobin
  19. Which of the following hemoglobins has glucose-6-phosphate on the amino-terminal valine of the beta chain?

    B. A1c

    Hgb A1c structure
  20. A patient with hemolytic anemia will:

    • D. show a decrease in glycated Hgb value
    • Glycated hemoglobin directly related to life of RBC
  21. 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
  22. An increase in serum acetone is indicative of a defect in the metabolism of:

    • D. carbohydrates
    • Acetone in carbohydrate metabolism
  23. 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
  24. 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
  25. What is the best method to diagnose lactase deficiency?

    • B. H2 breath test
    • Diagnose of lactase deficiency
  26. The expected blood gas results for a patient in chronic renal failure would match the pattern of:

    • B. metabolic acidosis
    • Reduced excretion of acids
  27. Severe diarrhea causes:

    • A. metabolic acidosis
    • Excessive loss of bicarbonate
  28. The following blood gas results were obtained:

    pH: 7.18
    PO2: 86mmHg
    PCO2: 60mmHg
    O2 sat: 92%
    HCO3: 7921 mEq/L (21mmol/L)
    TCO2: 23 mEq/L (23mmol/L)
    base excess: -8.0 mEq/L (-8.0mmol/L)

    The patient's results are compatible with which of the following?

    • A. emphysema
    • Diseases causing respiratory acidosis
  29. Factors that contribute to a PCO2 electrode requiring 60-120 seconds to reach equilibrium include the:

    • A. diffusion characteristics of the membrane
    • Blood gas instrumentation
  30. An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state?

    • A. respiratory acidosis
    • Diseases causing respiratory acidosis
  31. At blood pH 7.40, what is the ratio of bicarbonate to carbonic acid?

    • C. 20:1
    • Normal ratio bicrbonate/carbonic acid
  32. The reference range for the pH of arterial blood measured at 37oC is:

    • B. 7.35-7.45
    • Arterial pH reference range
  33. A 68-year-old man arrives in the emergency room with a glucose level of 722mg/dL (39.7mmol/L) and serum acetone of 4+ undiluted. An arterial blood gas from this patient is likely to be:

    • D. low pH
    • Interpretation of metabolic acidosis
  34. A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would be consistent with this diagnosis?

    • C. high TCO2, increased HCO3
    • HCO3 and TCO2 in metabolic acidosis
  35. A person suspected of having metabolic alkalosis would have which of the following laboratory findings?

    • A. CO2 content and pH elevated
    • Levels of CO2 and pH in metabolic alkalosis
  36. Metabolic acidosis is described as a(n):

    • A. decrease in CO2 content and PCO2 with a decreased pH
    • Component levels in metabolic acidosis
  37. Respiratory acidosis is described as a(n):

    • A. increase in CO2 content and PCO2 with a decreased pH
    • Definition of respiratory acidosis
  38. A common cause of respiratory alkalosis is:

    • D. hyperventilation
    • Respiratory alkalosis caused by hyperventilation
  39. Acidosis and alkalosis are best defined as fluctuations in blood pH and CO2 contnet due to changes in:

    • C. bicarbonate buffer
    • Chemical cause of alkalosis and acidosis
  40. A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood had been exposed to room air for at least 30 minutes. The following change in blood gases will occur:

    • A. PO2 increased/HCO3 decreased
    • Blood gas sample conditions
  41. The following laboratory results were obtained:
    Serum electrolytes
    sodium: 136 mEq/L (136 mmol/L)
    potassium: 4.4 mEq/L (4.4 mmol/L)
    chloride: 92 mEq/L (92 mmol/L)
    bicarbonate: 40 mEq/L (40 mmol/L)
    Arterial Blood
    ph: 7.32
    PCO2: 79mmHg

    These results are most compatible with:

    • C. respiratory acidosis
    • Electrolyte/blood gas values in respiratory acidosis
  42. Select the test which evaluates renal tubular function.

    • D. creatine clearance
    • Best test for renal tubular function
  43. 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?

    • D. 270
    • Osmolality empirical calculation
  44. The degree to which the kidney concentrates the glomerular filtrate can be determined by:

    • C. urine to serum osmolality ratio
    • Kidney concentration determination
  45. Osmolal gap is the difference between:

    • A. calculated and measured osmolality values
    • Definition of osmolal gap
  46. The most important buffer pair in plasma is the:

    B. bicarbonate/carbonic acid pair
  47. Quantitation of NA+ and K+ by ion-selective electrode is the standard method because:

    D. of advances in electrochemistry
  48. 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
  49. A patient with myeloproliferative disorder has the following values:

    Hgb: 13g/dL (130 mmol/L)
    Hct: 38%
    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
  50. Most of the carbon dioxide present in blood is in the form of:

    A. bicarbonate ion
  51. Serum "anion gap" is increased in patients with:

    A. lactic acidosis
  52. The anion gap is useful for quality control of laboratory results for:

    A. sodium, potassium, chloride, and total CO2
  53. The buffering capacity of blood maintained by a reversible exchange process between bicarbonate and:

    C. chloride
  54. In respiratory acidosis, a compensatory mechanism is the increase in:

    B. plasma bicarbonate concentration
  55. Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?

    A. sodium
  56. 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
  57. The solute that contributes the most to the total serum osmolality is:

    C. sodium
  58. 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
  59. Which of the following is true about direct ion selective electrodes for electrolytes?

    C. whole blood specimens are acceptable
  60. Sodium determination by indirect ion selective electrode is falsely decreased by:

    A. elevated lipid levels
  61. 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
  62. Which percentage of total serum calcium is nondiffusible protein bound?

    B. 40%-50%
  63. Calcium concentration in the serum is regulated by:

    D. parathyroid hormone
  64. The regulation of calcium and phosphorous metabolism is accomplished by which of the following glands?

    D. parathyroid
  65. A patient has the following test results:

    increased serum calcium levels
    decreased serum phosphate levels
    increased levels of parathyroid hormone

    This patient most likely has:

    A. hyperparathyroidism
  66. A hospitalized patient is experiencing increased neuromuscular irritability (tetany). Which of the following tests should be ordered immediately?

    B. calcium
  67. Which of the following is most likely to be ordered in addition to serum calcium to determine the cause of tetany?

    B. magnesium
  68. A reciprocal relationship exists between:

    B. calcium and phosphate
  69. Fasting serum phosphate concentration is controlled primarily by the:

    A. parathyroid glands
  70. A low concentration of serum phosphorous is commonly found in:

    C. patients who are receiving carbohydrate
  71. The following laboratory results were obtained:

                                    Alkaline          Alkaline
                 Calcium      Phosphate    Phosphatase
    serum:  increased     decreased     normal or increased
    urine:    increased     increased

    These results are most compatible with:

    B. primary hyperparathyroidism
Card Set
Chemistry BOC set 1
Chemistry BOC: 1-25 Carbohydrates, 26-45 Acid-Base, 46-71 Electrolytes.