A 30 year old pregnant woman has a 50 gram, 1 hr GTT screening test performed at 26 weeks of gestation. Her serum glucose level is 150 mg/dL at one hour. What should occur next?
B) This is suspicious of diabetes, a 2houroral glucose tolerance test should be performed
All of the following are characteristic of severe hyperglycemia EXCEPT:
C) High osmolal gap
Hemoglobin A1c provides an estimate of blood glucose control over the previous
B) 2-3 months
All of the following hormones promote an increase in blood glucose level EXCEPT:
A) insulin
Which common glucose method uses two coupled reactions and measures glucose using the increase in absorbance of NADPH at 340 nm?
C) Hexokinase
Women with gestational diabetes commonly may develop [select] diabetes following delivery.
A) type 2
Which of the following methods is the LEAST appropriate for analyzing hemoglobin A1c?
C) Isoelectric focusing
A test used for early detection of diabetic nephropathy is
B) urine microalbumin
Diabetes can be diagnosed when HbA1c levels exceed
E) 6.5%
(T/F) Urine microalbumin can be measured with a urine dipstick protein tab.
False
Clinical assays for tumor markers are most effective for :
A) monitoring the course of a known cancer
Congenital alpha1antitrypsin deficiency may be associated with
A) pulmonary emphysema
Which of the following techniques is preferred to identify the immunoglobulin class that is elevated in the monoclonal gammopathies?
D) immunofixation electrophoresis
A disorder characterized by decreased ceruloplasmin and serum copper, increased urine and tissue copper known as:
A) Wilson's disease
The preferred means of assessing intravascular hemolysis is to measure
B) serum haptoglobin
The purpose of ascorbate in the iron reagent is to
A) reduce ferric iron to ferrous iron.
The amount of plasma iron that circulates free in normally is about:
C) 0%
The primary iron transporter in plasma is
C) transferrin
A method of assessing vitamin B12 status besides direct measurement of vitamin B12 might be to measure
D) methylmalonic acid.
The best single analyte to test for diagnosis of iron deficiency is :
D) Ferritin
Blood is collected in a tube containing no anticoagulant and sent uncentrifuged to the laboratory from an outpatient clinic. Time at room temperature including transport, accessioning, and sample preparation equal approximately 2 hours. If a serum glucose level is requested for this tube of blood, how might the results be affected by the timing?
D) The glucose value would be decreased by approximately 15%.
A known type 1 diabetic is brought to the ED in obvious distress. He is breathing very rapidly and his breath smells fruity. For each of the following tests, predict what result would most likely be seen if the patient has a single disease process that is behaving typically.
The preferred blood marker in evaluating diabetic ketoacidosis is
A) betahydroxybutyrate
In isoelectric focusing (IEF), the buffer pH in the gel is:
D) varies within the gel
A patient presents to his MD with a long history of greasy, foulsmellingstool. Which vitamin deficiency migh the be more likely to have?
B) B12
As a patient develops irondeficiencyanemia, place the following events in their likely sequence (1 = first to occur, etc.)
+Decreased iron and TIBC
+Decreased iron and elevated TIBC
+Microcytic, hypochromic rbc
+Decreased ferritin
-1
-2
-3
-not likely to occur
Decreased iron and TIBC: not likely to occur
Decreased ferritin
Decreased iron and elevated TIBC
Microcytic, hypochromic rbc
The TWO tests that both measure the same breast cancer marker are:
a) CA125
b) CA 153
c) CA 27.29
d) CA 724
b and c
How would you sign out the following serum protein electrophoresis?
C) decreased albumin with polyclonal increase in gamma globulins
Nephrotic syndrome would most likely affect the serum protein electrophoresis pattern in what significant way?
+albumin
+alpha-2
+beta
+total protein
-increase
-no change
-decrease
-cannot tell
albumin: decrease
alpha-2: increase
beta: no change
total protein: decrease
(T/F) Pernicious anemia results in a macrocytic anemia due to deficiency of vitamin B12 resulting from antibodies to intrinsic factor .
True
The characteristic that defines a "cirrhotic" SPEP pattern is:
B) beta gamma bridging with decreased albumin
The primary role of complement component quantitation is to
B) look for decreases indicating activation of the complement system in injury or infection
+A porphyria presenting with acute abdominal pain
+A porphyria presenting with photosensitivity
+A lab test appropriate for initial evaluation of porphyria
+The end product of the porphyin synthetic pathway
Differentiation of Type 1 and Type 2 diabetes is best determined by :
B) antiGAD65 antibodies
The gamma globulins migrate toward the cathode in SPEP because
A) the buffer solvent flows toward the cathode.
Serum proteins or protein complexes that precipitate at temperatures lower than normal core body temperature and that, if precipitated in tissues, may result in vasculitis and ischemic injury to peripheral tissues are referred to as:
D) cryoglobulins
A malignant neoplasm that is composed of plasma cells that exhibit monoclonality and are diffusely present in the bone marrow is referred to as:
D) multiple myeloma
A tumor of plasmacytoid cells that is diagnosed as Waldenström macroglobulinemia produces a paraprotein that is an:
A) IgM
The inactive protein fragment arising from insulin synthesis is
C) C-peptide
Use of PSA as a prostate cancer screen has been discouraged. Strategies that may improve the specificity of PSA as a prostate cancer marker might include all of the following EXCEPT:
E) all may improve PSA performance
For each of the following proteins, select the SPEP fraction where that protein would migrate.
