CLINICAL CHEMISTRY

GLANELA MANALOTO
1. Driving force of bicarbonate buffer system Carbon dioxide

2. Screening tests for Cushing’s syndrome 24-hour urinary free cortisol

Overnight dexamethasone suppression test

Salivary cortisol test

3. Confirmatory tests for Cushing’s syndrome Low-dose dexamethasone suppression test

Midnight plasma cortisol

CRH stimulation test

4. Tissues that secrete hormones Ex. anterior pituitary, thyroid and parathyroid

5. Recently proposed new marker for the early Cystatin C

assessmentof changes to the glomerular
filtration rate
6. Most commonly used as monochromators Diffraction grating (SPECTROPHOTOMETER)

Filter paper (FLUOROMETER)

7. High WBC count = Substantial decreased Leukocytosis can lead to excessive glycolysis
glucose
8. Therapeutic drug Measuring serum or plasma concentrations at indicated times
monitoring (TDM) after administration (PEAK level, TROUGH level or both,
depending on the particular need), useful information can be
generated allowing the clinical staff to adjust dosage and
increase benefit and safety for the patient

9. Metabolite of cocaine Benzylecgonine

10. Pronounced elevation of AST C - Circulatory collapse (shock)

(≥ 5x than normal)
A - Acute pancreatitis

M - Myocardial infarction

A - Acute hepatocellular damage

I –Infectious mononucleosis

11. Decreased anion gap of <10 mmol/L Decrease in the unmeasured anions
(ADIC)
Increase in unmeasured cations

12. Antitussive drug Codeine(cough suppressant)

13. Specimen for drug testing Drug of abuse: urine / TDM: serum, plasma

14. Indication of relative concentration Dilution

15. Ratio of bicarbonate to carbonic acid 20:1

16. Classification of azotemia Pre-renal, renal and post-renal

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 17. Glucose is metabolized at room temp 7 mg/ dL/ hour

18. Glucose is metabolized at 4oC 2 mg/ dL / hour

19. Maintains electric neutrality Chloride

20. Calcium regulation PTH, calcitonin, vitamin D

21. Cholesterol and TAG in hypothyroidism Increased cholesterol and Triglycerides

22. Cholesterol and TAG in hyperthyroidism Decreased cholesterol and Triglycerides

23. Definition of hypoglycemia Defined as blood glucose level <50 mg/dL

24. Blood pressure cuff as tourniquet 60 mmHg

25. Production of alpha-fetoprotein Fetal liver

26. Specimen for newborn screening Blood spot collection

27. Important use of serum protein electrophoresis Detection of monoclonal gammopathies such
as M.myeloma

28. Low CV % High precision

29. 10% contamination with 5% dextrose will By 500 mg/dl

increase glucose in a blood sample
30. Basal state collection Early in the morning

31. Instrument having 2 monochromators Fluorometer

32. Instrument having 2 photodetectors Spectrophotometer- DOUBLE-BEAM IN SPACE

33. Color of flame Sodium - yellow

Potassium - violet

Magnesium - blue

Lithium, Rubidium - red

34. BMI of obese ≥ 30 kg/m2

35. Potentiometry pH and pCO2

36. Amperometry, polarography pO2

37. Most potent estrogen E2 or estradiol

38. Hypersecretion of growth hormone in adults Acromegaly

39. Relationship of T3 and T3 uptake Directly proportional

40. Relationship of T3 uptake test and TBG Indirect or inversely proportional

41. Floating beta lipoprotein β– VLDL

42. Sinking pre beta lipoprotein Lp(a)

43. OGTT Patient should be ambulatory, unrestricted

diet of 150g CHO/ day for 3 days prior to
testing; fasting of 8 to 14 hours

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 44. Normal BUN to creatinine ratio 10 to 20:1

45. Danger of kernicterus level 20 mg/dL

46. Bilirubin level interfering assays for albumin, 430 mmoL/l (25 mg/L)
cholesterol and total protein
47. Beta gamma bridging pattern in electrophoresis Liver Cirrhosis,

Usage of plasma sample (due to

fibrinogen/fibrin that causes pseudo-beta
gamma bridging )

48. Copper reduction method for glucose Nelson-Somogyi (arsenomolybdic acid)

Folin-Wu (phosphomolybdic acid)

Neocuproine, Benedict’s metod

49. Sodium in DM or hyperglycemia Decreased sodium due to polyuria

50. Reference method for measuring ALP Bowers and McComb

51. Conditions involving female reproductive PCOS: polycystic ovary syndrome

hormones
Hirsutism

Infertility

52. Light source for AAS Hallow cathode lamp

53. Comparing patient present result to previous Delta check

results
54. Low temperature storage LD4 and LD5 decrease; ALP increases

55. Patency of biliary ducts, hepatocellular Ratio of direct and total bilirubin
metabolism
56. Overall capacity to transport bile Serum bilirubin level

57. Overall patency of biliary ducts Serum bile acids(salts)

58. Abnormality of bile duct epithelium Serum alkaline phosphatase (ALP)

59. Substrate in Cherry-Crandall (lipase) Olive oil , triolein, or fats

60. Routinely measured electrolytes Sodium, potassium, chloride and bicarbonate

61. Effect of fever to pO2and pCO2 pO2 decreased by 7%

pCO2 increased by 3%

62. Paracetamol/ acetaminophen Hepatotoxic / poison

63. Increased alpha2-globulin Nephrotic syndrome

64. Based on fragmentation and ionization of Massspectrometry

molecules
65. Vancomycin Red man syndrome

66. Aminoglycoside adverse reaction Nephrotoxic and ototoxic

67. Specimen for POCT of DM patients Capillary blood

68. Chemical spills and exposure: when skin contact Best first aid is to flush the area with
occurs large amounts of water FOR AT LEAST 15

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 MINUTES, then seekmedical attention

69. Counterbalance/ counter ion of sodium Chloride

70. Response of any given patient to drug treatment Age, physical condition and genetic make-up
is highly individual and variable
Patients differ response to same medication

71. 135 mEq/L sodium (Na+) 135 mmol/L, conversion factor is 1

72. Antitussive drug Codeine

73. No longer used (obsolete) chemical method for Nelsone somogyi

glucose
74. Fasting hours required for lipid profile Minimum of 12 hours, range 12 to 14 hours

75. The highest protein level in lipoproteins HDL

76. In SPE, what is the farthest protein to the Albumin

anode
77. Method for the assay of creatinine that is non Colorimetric: endpoint
specific
78. Calcium Is regulated/affected by PTH, Calcitonin, and vitamin D

79. Most abundant protein Albumin

80. AFP is produced in Fetal liver and yolk sac

81. Method for drug detection/quantification GC/MS (GOLD STANDARD FOR DRUG TESTING)

82. Creatinine clearance test Index of overall renal function

83. B2 microglobulin Appears in the urine when reabsorption is

incomplete because of proximal tubular
damage, as in acute kidney injury

84. Heparin for most chemistry tests Lithium heparin

85. A progressive and irreversible loss of renal Chronic renal failure

function, results from several disease entities
86. Hypoglycemia Blood glucose level less than 50 mg/dl

87. Gestational diabetes patients develop diabetes Within 5 to10 years

88. Performed routinely to monitor glucose control Glycosylated hemoglobin

89. Lock and Key (Emil fischer) The shape of the key (substrate) must fit
into the lock (enzyme)

90. Hypersecretion of growth hormone in adults Acromegaly

91. Cretinism Hyposecretion of thyroxine in children

92. Air displacement pipet Relies on piston for suction to draw sample
into disposable tip; the piston does not
come in contact with the liquid

93. Lean Six sigma DMAIC (Define, measure analyze, Improve and
control ) methodology

94. Most common abused drug Grain alcohol (Ethanol)

95. Associated with blindness Wood alcohol (Mehtanol)

96. Rubbing alcohol Isopropanol

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 97. Mercury Amalgamate: mix or merge with other
substances

98. Lysergenic acid diethylamide (LSD, lysergide) “Undulating vision ; “bad trip” –panic
depression

99. Assay for Creatinine 1.Simple nonspecific method

Colorimetric : endpoint

2.Rapid and with increased specificity

Colorimetric: Kinetic, Jaffe

3.Measures ammonia colorimetrically or with ion selective

electrode

Enzymatic: UV

100. Assay for Urea Nitrogen 1.Inexpensive but lacks specificity

Colorimetric, diacetyl

2.Greater specificity, more expensive and measure ammonia

formation

Enzymatic

101. Assay for Uric Acid 1.Problems with turbidity

Colorimetric: Phosphotungstic acid method/

caraway method

2.Needs special instrumentation and optical cells

Enyzmatic: UV

3.Prone to interference by reducing substances

Enyzmatic: H2O2

102. Modified Allen’s test Assess collateral circulation before collecting a blood
specimen from the radial artery

103. Lithium Heparin Anticoagulant of choice in clinical chemistry with least

interference in analysis

104. OGTT patient preparation Ingest at least 150g of CHO for 3days

105. Glycosylated Hemoglobin Performed routinely to monitor glucose control

106. 5 to 10 years (10yrs) Patient with Gestational diabetes may develop DM after

107. Minor lipoproteins IDL and Lp(a)

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 108. Major lipoproteins LDL, HDL, VLDL, Chylomicrons

109. Abnormal lipoproteins Beta-VLDL(Floating beta-Lipoprotein), Lipoprotein X

110. Apo A-1 Major structural apolipoprotein in HDL

111. Apo B-100 Major structural apolipoprotein in LDL AND VLDL

112. Apo B-48 Major structural apolipoprotein in CHYLOMICRONS

113. > 60mg/dl HDL Level protective against heart disease

114. <40mg/dl HDL level Major risk for heart disease

115. HDL of 60mg/dl Negative risk factor for coronary heart disease

116. HDL of ≤40mg/dl Positive risk factor for coronary heart disease

117. Lp(a) Sinking pre-Beta-Lipoprotein

118. Increase Effect of growth hormone to blood glucose level

119. Cushing’s disease Increase in cortisol caused by excessive development and

activity of pituitary gland. (Increase both ACTH AND
CORTISOL)

120. acromegaly Hypersecretion of growth hormones in adults

121. Gigantism Hypersecretion of growth hormones in children

122. NCEP GUIDELINES FOR ACCEPTABLE

MEASUREMENT ERROR
Cholesterol CV of ≤3%

Triglycerides CV of ≤5%

HDL and LDL CV of ≤4%

123. Recommended Cut off points for serum

cholesterol
Age (Years) Moderate Risk High Risk

2-19 >170 mg/dl >185 mg/dl

20-29 >200 mg/dl >220 mg/dl

30-39 >220 mg/dl >240 mg/dl

40 and over >240 mg/dl >260 mg/dl

124. Growth
hormone
disorders
test Condition Screening Confirmatory

Acromegaly (GH excess) Somatomedin C or glucose suppression

insulin-like growth test- OGTT (75g
factor 1 (IGF-1) glucose)

Dwarfism (GH deficiency) Physical activity test Insulin Tolerance

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 (exercise test) test-=Gold Standard

Arginine stimulation
test- 2ndconfirmatory
test

125. Cortisol
disorders
test
Condition Screening Confirmatory

Cushing’s syndrome/ -24-hour urinary free -Low-dose dexamethasone

cortisol suppression test

Hypercorticolism
-Overnight dexamethasone -Midnight plasma cortisol
suppression test

-CRH stimulation test

-Salivary cortisol test

Addison’s disease/ -ACTH stimulation test Insulin tolerance test

Hypocorticolism

-Cosyntropin stimulation test

126. Aldosterone
disorders test
Condition Screening confirmatory

Conn’s disease / Plasma -saline suppression

aldosterone/plasma
Hyperaldosteronism renin ratio

-oral sodium loading

-Fludrocortisone
suppression test

-Captopril challenge test

Condition Tests

Hypoaldosteronism Furosemide stimulation test (+) result; low

aldosterone levels

Saline suppression test– (+) result; high

aldosterone levels

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 127. ACTH Test to differentiate Cushing’s syndrome from Cushing’s disease

Cushing’s disease =Increase ACTH and cortisol

Cushing’s syndrome = decrease ACTH ,Increase cortisol

128. Forward reaction for CK Tanzer Gilvarg

129. Reverse reaction for CK Oliver Rosalki

130. Forward reaction for LDH Wacker

131. Reverse reaction for LD Wrobleuski and LaDue

132. Enzyme specificity

High Specificity ACP RBC, prostate

ALT Liver

Amylase Pancreas, salivary gland

Lipase Pancrease

Moderate AST Liver, heart, Skeletal

Specificity muscles

CK Heart, Skeletal muscles,

brain

Low specificity ALP Liver, Bone, kidney

LD All tissues

133. Enzyme classification

Class Function EXAMPLES

Oxidoreductases Catalyze the removal or LDH, MDH, ICD. G6PD

addition of electrons

Ex: ends with

dehydrogenase or
oxidase

Transferases Catalyze the transfer CK, AST, ALT ,OCT

of a chemical group
other than hydrogen
from one substrate to
another Ex: ends with kinase
or transferase

Hydrolases Catalyze hydrolysis or Esterases: ACP,ALP

splitting of a bond by

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 the addition of water Peptidases: Trypsin,
Pepsin, LAP

Glycosidase: AMS,
galactosidases

Lyases Catalyze removal of Glutamate

groups from substrates decarboxylase,
without hydrolysis. The pyruvate
product contains double decarboxylase,
bonds aldolase

Ex: ends with

decarboxylase

Isomerases Catalyze the Glucose phosphate

intramolecular isomerase
arrangement of the
substrate compound

Ligases Catalyze the joining of Glutathione

two substrate synthetase
molecules, coupled with
breaking of the Synthase
pyrophosphate bondind
ATP

134. Isoenzyme Multiple forms of the same enzyme catalyzing the same chemical
reaction

135. GGT Enzyme marker for occult alcoholism

136. Cholinesterase Enzyme that the significant value is decrease

137. Direct/linear Relationship of T3 and T3 uptake test

138. Inverse Relationship of T3 uptake and TBG

139. TSH -Diagnostic test to differentiate Primary and secondary

Hypo/Hyperthyroidism

-Most important thyroid function test

-best method for detecting clinically significant thyroid

dysfunction

140. Thyroid disorders Primary 2ndary Tertiary

hypothyroidism Hypothyroidism Hypothyroidism

(Hashimoto’s
disease)

TSH INCREASE DECREASE DECREASE

T3/T4 DECREASE DECREASE DECREASE

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 T3 uptake DECREASE DECREASE DECREASE

TBG INCREASE INCREASE INCREASE

Primary 2ndary Tertiary

hyperthyroidism Hyperthyroidism Hyperthyroidism

(Grave’s
disease)

TSH DECREASE INCREASE INCREASE

T3/T4 INCREASE INCREASE INCREASE

T3 INCREASE INCREASE INCREASE

uptake

TBG DECREASE DECREASE DECREASE

Condition T3/T4 TSH

Subclinical Normal Increase
hypothyroidism

Subclinical Normal Decrease

hyperthyroidism

141. Stages of
impairment by
ethanol
Blood Alcohol % Signs and symptoms
W/V

1.1- 0.05 No obvious impairment, some changes observable on performance testing

0.03-0.12 Mild euphoria, decreased inhibitions, some impairment of motor skills

0.09-0.25 Decreased inhibitions, loss of critical judgement, some impairment of motor

skills

0.18-0.30 Mental confusion, dizziness, strongly impaired motor skills (staggering,

slurred speech)

0.27-0.40 Unable to stand or walk, vomiting, impaired consciousness

0.35-0.50 Coma and possible death

142. 0.10% (100mg/dl) Presumptive evidence of driving under the influence of

alcohol

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 143. BMI

Nutritional status WHO Criteria Cut-OFF ASIAN CRITERIA Cut-

OFF

Underweight <18.5 <18.5

Normal 18.5 to 24.9 18.5 to 22.9

Overweight 25 to 29.9 23 to 24.9

Pre Obese - 25 to 29.9

Obese ≥30 ≥30

Obese type 1 30 to 40 30 to 40

Obese type 2(Morbid) 40.1 to 50 40.1 to 50

Obese type 3(Super) >50 >50

144. X-axis Horizontal,absicca, independent variables

145. Y-AXIS Vertical, ordinate, Dependent variables

146. T-Test Accuracy, Mean

147. F-test Precision, SD

148. Inverselyproportional Relationship of %CV to precision

149. Point of care testing Alternative site testing, Near-patient test, decentralized testing,
bedside testing, or ancillary testing

150. Osmolality test Test used to investigate pseudohyponatremia

151. Calcium and magnesium Electrolytes involved in coagulation

152. Hyponatremia due to increase

sodium loss
a. Hypoadrenalism
b. Potassium deficiency
c. Diuretic use
d. Ketonuria
e. Salt-losing nephropathy
f. Prolonged vomiting or diarrhea
g. Severe burns
153. Hyponatremia due to increase
water retention
a. Renal failure
b. Nephrotic syndrome
c. Hepatic cirrhosis
d. Congestive heart failure
154. Hyponatremia due to water
imbalance
a. Excess water intake
b. SIADH
c. Pseudohyponatremia

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 155. Hypernatremia due to excess
water loss a. Diabetes insipidus
b. Renal tubular disorder
c. Prolonged diarrhea
d. Profuse sweating
e. Severe burns
156. Hypernatremia due to decrease a. Older persons
water intake b. Infants
c. Mental impairment
157. Hypernatremia due to increase a. Hyperaldosteronism
intake or retention b. Sodium bicarbonate excess
c. Dialysis fluid excess
158. Causes of
Hyperkalemia
Due to decreased renal -Acute or chronic renal failure
excretion
(GFR <20 mL/min)

-Hypoaldosteronism

-Addison’s disease

-Diuretics

Due to Cellular shift -Acidosis

-Muscle/cellular injury

-Chemotherapy

-Leukemia

-Hemolysis

Due to Increased intake -Oral or intravenous potassium

replacement therapy

Artifactual /Psuedo -Sample hemolysis

-Thrombocytosis

-Prolonged tourniquet use or

excessive fist clenching

159. CAUSES OF HYPOKALEMIA Due to gastrointestinal -Vomiting

loss
-Diarrhea

-Gastric suction

-Intestinal tumor

-Malabsorption

-Cancer therapy—chemotherapy,
radiation therapy

-Large doses of laxatives

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 Due to renal loss -Diuretics—thiazides,
mineralocorticoids

-Nephritis

-Renal tubular acidosis

-Hyperaldosteronism

-Cushing’s syndrome

-Hypomagnesemia

-Acute leukemia

Due to cellular shift Alkalosis

Insulin overdose

Due to decreased intake -

160. <135mg/dl Sodium level that indicates Hyponatremia

161. >145mg/dl Sodium level that indicates Hypernatremia

162. Critical values

Hypernatremia 160 mmol/L

Hyponatremia 120 mmol/L

Hyperkalemia 6.5 mmol/L

Hypokalemia 2.5 mmol/L

163. Sodium primary extracellular cation in the human body and is

excreted principally through the kidneys.

164. Potassium main intracellular cation in the body

165. Chloride the principal extracellular anion and is involved in the

maintenance of extracellular fluid balance.

166. Calcium the second-most predominant intracellular cation, is the

most important inorganic messenger in the cell

167. Potassium Electrolyte that serves as an integral part of the

transmission of nerve impulses

168. Sodium Electrolyte that has in relation of regulation of water

level in the body , and osmotic pressure

169. Chloride Electrolyte that serve as an enzyme activator for amylase

170. bicarbonate the second most abundant anion in the Extra Cellular Fluid

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 171. chloride Electrolyte that maintains electroneutrality through the
chloride shift

172. chloride shift Bicarbonate diffuses out of the cell in exchange for
chlorideto maintain ionic charge neutrality within the
cell

173. GI tract, Kidney, Bone Organ systems that regulates Calcium and phosphorous metabolism

174. Increase Effect of high bilirubin and Hemoglobin level in ACP measurement

175. bicarbonate major component of the buffering system in the blood

176. Components of the Bicarbonate, Carbon dioxide, Carbonic acid, Water, and protons
buffering system

177. Major Functions of

electrolytes
Volume and osmotic regulation Na, Cl, K

Regulation of ATPase ion pumps Mg

Myocardial rhythm and contraction K,Mg, Ca

Cofactors of enzyme activation Mg, Ca, Zn

Blood coagulation Mg, Ca

Acid-Base balance K, Cl, HCO3

Production and used of ATP from Phosphorus/Phosphate,

glucose Mg

Neuromuscular excitability Mg, K, Ca

178. Anion gap Serve as a quality control in measurements of

electrolytes

179. Increase ANION GAP (MUDPHILES)

M- methanol poisoning

U-Uremia

D-Diabetic Ketoacidosis

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 P- Phosphate/paracetamol/paraformaldehyde

H-Hypernatremia

I-Instrument error / Iron / Isoniazid/ Inborn error of

metabolism

L-Lactic acidosis

E-Ethanol /ethylene glycol poisoning

S-salicylate poisoning

180. Decrease anion gap Decrease unmeasured anion, Increased Unmeasured cation

(HHM)

H- Hypoalbuminemia

H-Hypercalcemia

M-Multiple myeloma

181. albumin -major/general transporter

-most anodic protein

-negative acute phase reactants

-maintains osmotic pressure

-marker of malnutrition

-most predominant protein

182. Troponin I Most specific AND REFERENCE cardiac marker for ACUTE
MYOCARDIAL INFARCTION

183. myoglobin 1st cardiac marker to increase in A.M.I

184. Na, K, Cl, and Bicarbonate Routinely measured electrolytes , component of

electrolyte profile

185. Ethosuximide (1st answer) The drug of choice for treating PETIT-MAL(absence
186. Valproic acid (2nd answer if seizures)
wala yung ethosuximide)
187. Capillary puncture/capillary Sample used for glucose monitoring done or performed by
blood patients

188. Dilution Indicative of relative concentration

189. percentage Refers to parts per 100

190. Triglycerides, Total LDL-C may be computed/calculated from the measurements of

cholesterol, and HDL

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 *Note = VLDL NOT included in the
computation

191. QC errors

Random Errors Systematic errors

a. Mislabeling a sample a. Improper calibration

b. Pipetting errors b. Deterioration of
c. Improper mixing of sample reagents
and reagent c. Sample instability
d. Voltage fluctuations not d. Instrument drift
compensated for by e. Changes in standard
instrument circuitry, and materials
e. Temperature
fluctuations/variations
f. Instrument instability
g. Reagent variation
h. Handling techniques, and
operator variables

192. Appearance of plasma in association

with TAG level
Clear TAG <200mg/dl

Hazy or Turbid TAG >300mgd/dl

Opaque or Milky TAG >600mg/dl

193. STANDING PLASMA TEST

2. Chylomicrons = accumulate as a floating creamy

layer
3. VLDL = Plasma sample remains turbid after standing
overnight
194. MONITOR HBA1C and Fructosamine values are used to ___ glucose levels

195. below 400mg/dL or (4.52 mmo/L) The fridewald formula is valid only if the TAG level
is

196. >600mg/dl TAG level greater than ____hinders the usage of LDL-C
methods(inaacurate)

197. Liquid nitrogen Most widely used cryogenic fluid in laboratory

198. Hazards associated with Liquid 1. Fire or explosion

nitrogen or cryogenic materials 2. Asphyxiation
3. Pressure buildup
4. Embrittlement of materials
5. Tissue damage similar to thermal burns
199. standard Material of known composition available in a highly
purified form / known analyte with same concentration

200. control Material with physical and chemical properties

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 closely resembling the test specimen and containing
pre-analyzed concentrations of the substances being
measured

201. Transaminases(ALT and AST) Test that conveys information on hepatocellular

damage and necrosis

202. Analytes affected by Hemolysis PAPAALAM Ca Iwan Ko?

Potassium, ammonia, phosphorus ,AST, ALT,LD, ACP,

Magnesium,catecholamines, iron, CK

203. Effect of marked hemolysis in Decrease sodium level due to dilutional effect
Sodium
204. Quadruple test for down syndrome

Test Significant level in DS

AFP Decrease

Estriol(E3) Decrease

Inhibin A Increase

HcG Increase

205. Analytes that shows circardian or

diurnal variation
CAPAI GAPI:D


Cortisol, ACTH, Plasma renin activity,
Aldosterone, insulin, growth hormone,
ACP,Prolaction, and Iron
206. Cardiac troponins Gold standard in the diagnosis of Acute coronary syndrome

207. Immunochemical and Two basic techniques involved in measuring drugs, whether
Chromatographic methods drug of abuse or therapeutic drugs

208. Marijuana Oldest and most widely used mind altering drug

209. Enzyme: First order Reaction rate is directly proportional to the substrate
kinetics concentration

210. Enzyme: Zero order kinetics Reaction rate is directly proportional to enzyme
concentration

211. Transporters

Transporter protein Substance transported

Orosomucoid/A1- acid glycoprotein Progesterone

A1-antichymotrypsin PSA(Prostate specific Ag)G

Gc-Globulin Vitamin D /cholecalciferol

haptoglobin Free hemoglobin

hemopexin Free heme

ceruloplasmin copper

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 Transferrin/siderophilin Iron (ferric iron)

TBG(Thyroid binding globulin T3 and T4

Prealbumin/Transthyretin Retinol (vitamin A),T3 , and

T4

212. Analytes with its

active metabolite
Analyte Metabolite

Amitriptyline Nortriptyline

Cocaine Benzylecgonine

Dopamine HVA(homovanillic acid)

Epinephrine VMA(Vanillylmandelic acid)

Heroin Morphine

marijuana tetrahydrocannabinol

norepinephrine VMA(Vanillylmandelic acid)

Primidone Phenobarbital

Procainamide NAPA(N-acetly procainamide)

Serotonin 5-HIAA(Hydroxy indole acetic

acid)

213. FORMULAS/EQUATIONS

ANION GAP (Na + K) – (HCO3 + Cl) or Na –(HCO3+Cl)

osmolality 2(Sodium) + (glucose/20) + (BUN/3) or

1.86(Sodium) + (Glucose/18) + (BUN/2.8)+ 9

FRIDEWALD LDL-C = Total cholesterol- HDL –(TAG/2.175 mmol/L)

FROMULA OF
LDL-C LDL-C = Total cholesterol – HDL –(TAG/5 mg/dl)

DeLong LDL-C = Total cholesterol- HDL –(TAG/2.825 mmol/L)

FORMULA OF

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 LDL LDL-C = Total cholesterol – HDL –(TAG/6.5 mg/dl)

Handerson- Ph = pKa + log (Bicarbonate/carbonic acid)

hasselbach
*note!!! pKa value is 6.1

214. ORDER OF NPN SUBSTANCES ACCORDING TO ITS Uh! Ah ! Uh! Ca! Ca! AH!
CONCENTRATION (Highest to lowest)

Urea, Amino acid, Uric acid, Creatinine,

creatine, Ammonia

215. Urea Non protein nitrogenous substance that

constitutes almost half of the total NPN

216. Anticoagulant of choice for blood gas Lithium Heparin

analysis

217. ACID BASE

BALANCE
ACID BASE DISODER COMPENSATION CAUSE

RESPIRATORY ACIDOSIS RETENTION OF Hypoventilation

BICARBONATE

RESPIRATORY ALKALOSIS SECRETION OF Hyperventilation

BICARBONATE

METABOLIC ACIDOSIS HYPERVENTILATION Excess H+ production

METABOLIC ALKALOSIS HYPERVENTILATION Excess H+ loss, Excess

alkali intake

218. Hyperventilation 1. Causes respiratory alkalosis

2. Compensation for Metabolic acidosis
3. Carbon dioxide is exhaled faster
219. MEASURES OF CENTER

Mean Commonly called the average, most commonly used measure

of center

Median Middle point of the data and is often used with skewed
data

Mode Most frequently occurring value in a dataset. Although

it is seldom used to describe data, it is referred to
when in reference to the shape of data, a bomodal
distribution, for example

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 220. Associated with LOW OR 1. Nephrotic syndrome
INVERTED Albumin/Globulin 2. Multiple myeloma
ratio 3. Liver cirrhosis
221. List of some analytes
and its respective
Reference method ANALYTE REFERENCE METHOD

HBa1c HPLC

PROTEIN KJELDAHL

GLUCOSE HEXOKINASE

LIPOPROTEINS ULTRACENTRIFUGATION

CHOLESTEROL ABELL KENDALL

TRIGLYCERIDE MODIFIED VAN HANDEL

GLOMERULAR FILTRATION RATE INULIN CLEARANCE TEST

NPN SUBSTANCES (BUN, URIC ACID, ISOTOPE DILUTION MASS

CREATININE) SPECTROMETRY (IDMS)

DRUG TESTING GAS CHROMATOGRAPHY/MASS

SPECTROMETRY (GC/MS)

NEW BORN SCREENING TANDEM MS/MS

ALP BOWERS AND MCCOMB

CALCIUM , MAGNESIUM and AAS(ATOMIC ABSORTION

ELECTROLYTES SPECTROSCOPY)

Amylase Saccharogenic method

Lipase Cherry crandal method

ACP Roy and Hillman

Alcohol testing Chromatography

Electrode in Ph Calomel and silver-silver

electrode

222. 10 to 15% Whole blood glucose is ____ lower than serum glucose

223. PARTS OF POSITIVE DISPLACEMENT Piston, piston seal,Capillary,shaft, hypodermic needle

PIPET
224. Liver Most sensitive organ associated with ethanol abused

225. Organs sensitive to ethanol abuse LIVER, stomach, GI tract, CNS (brain), Pancreas

226. Sodium and Chloride Electrolytes that provides that largest contribution of serum
osmolality

227. Most potent estrogen Estradiol (E2)

228. Posterior pituitary gland Endocrine gland that secretes that ADH and Oxytocin

229. Albumin In electrophoresis, the protein that migrates closest to the

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 anode(positive charge)

230. Gamma In electrophoresis, the protein that migrates closest to the

globulins/antibodies cathode(negative charge)

231. Example of CNS -Barbitrurates (phenobarbital)

depressants
-Benzodiazepines (valium/diazepam)

-Methaqualone

232. SYSTEMATIC ERROR It is an error that influences observations consistently in one

direction (constant difference)

233. Normal Gaussian curve MEAN=MEDIAN=MODE

234. pseudohyponatremia Hyperlipidemia and Hyperproteinemia will cause

235. The hormones that assist in controlling thyroxine, growth hormone, insulin, and
protein synthesis testosterone.

236. The hormones that assist in controlling glucagon and cortisol

protein catabolism
237. Condition associated with increased patients receiving steroids, in alcoholism, and
Prealbumin/Transthyretin in chronic renal failure

238. B-Natriuretic PePtide marker for congestive heart failure.

239. Fibronectin A glycoprotein composed of two nearly identical subunits. Although

fibronectin is the product of a single gene, the resulting protein
can exist in multiple forms due to splicing of a single pre-mRNA.
The variants demonstrate a wide variety of cellular interactions,
including roles in cell adhesion, tissue differentiation, growth,
and wound healing. Fetal fibronectin (fFN) is a glycoprotein used
to help predict the short-term risk of premature delivery. Plasma
fibronectin has been used as a nutritional marker.

240. Adiponectin is a 247–amino acid fat hormone composed of an N-terminal

collagen-like domain and a C-terminalglobular domain produced by
adipocytes. Recent studies have shown an inverse correlation
between body mass index (BMI) and adiponectin values. Lower levels
of adiponectin correlate with an increased risk of heart disease,
type 2 diabetes, and metabolic syndrome, and obesity

241. Beta-Trace Protein Recently, it was verified that BTP was established as an accurate
marker of CSF leakage.

Reported recently as a potential lmarker in detecting impaired

renal function, although no more sensitive than cystatin C.

Apromising marker in the diagnosis of perilymphatic fluid

fistulas.

242. Cross-linked C- Cross-linked C-telopeptides (CTXs) are proteolytic fragments of

telopeptides collagen I formed during bone resorption (turnover). CTX is a
biochemical marker of bone resorption that can be detected in
serum and urine

243. Cystatin C Cystatin C, a low-molecular-mass protein with 120 amino acids, is

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 a cysteine proteinase inhibitor. It is produced and destroyed at a
constant rate, making it a recently proposed new marker for the
early assessment of changes to the glomerular filtration rate.

Cystatin C levels are not affected by muscle mass, gender, age, or

race unlike creatinine, nor are they generally affected by most
drugs, infections, diet, or inflammation.

244. Amyloids Amyloids are insoluble fibrous protein aggregates formed due to an
alteration in their secondary structure known as Beta-pleated
sheets. Amyloid characteristically stains with Congo red. It can
be used as supplemental tests to help differentiate a diagnosis of
Alzheimer disease from other forms of dementia. (Increase in
Alzheimer Disease)

245. High-sensitity CRP High-sensitivity CRP (hsCRP) is the same protein but is named for
the newer, monoclonal antibody–based test methodologies that can
detect CRP at levels below 1 mg/L. The hsCRP test determines risk
of CARDIOVASCULAR DISEASES. High levels of hsCRP consistently
predict recurrent coronary events in patients with unstable angina
and AMI.

246. Negative acute phase -decreases during inflammation

reactants
Transferrin, Albumin, Pre-Albumin

247. At least 20mg/dl bilirubin Danger level of kernicterus

248. Blood pH

Normal 7.35 to 7.45

Alkalemia Above 7.45

acidemia Below 7.35

average 7.40

Arterial blood 7.45

Venous blood 7.35

249. Peak Highest concentration of drug in blood obtained in the dosing

interval

*blood should be collected 30 minutes before the next dose

250. Through Lowest concentration of drug in blood obtained in the dosing interval

*blood should be collected an hour after the dose of drug

251. Microalbuminuria Earliest indication of Diabetic nepropathy

252. RENIN

Increased in RESPONSE TO Low plasma sodium level, hypotension(low

blood pressure), and low blood volume

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 Effect Will lead to hypertension(Increase BP)

253. Liver disease The most common cause of abnormal ammonia metabolism

254. Male hypogonadism

Primary hypogonadism Secondary

Hypogonadism

Testosterone Decrease Decrease

LH and FSH Increase Decrease

255. Acid Substance that can yield a hydrogen ion or hydronium ion when
dissolved in water

-Hydrogen Donator

256. Base Substance that can yield hydroxide ion (OH)when dissolved in water

-Hydrogen acceptor

257. Colligative properties Freezing point , vapor pressure, osmotic pressure, boiling point

 For every 1 molecule added in a solution

Increases osmotic pressure, boiling point

Decreases Freezing point, vapor pressure

 Increase osmolality will lead to -

Decrease Freezing point and vapor pressure

258. vapor pressure the pressure at which the liquid solventis in equilibrium with the
water vapor

259. Freezing point the temperature at which the vapor pressures of the solid and
liquid phases are the same

260. boiling point temperature at which the vapor pressure of the solvent reaches one
atmosphere

261. osmotic pressure the pressure that opposes osmosis when a solvent flows through a
semipermeable membrane to establish equilibrium between
compartments of differing concentration

262. errors

Random errors(ODD numbers) Systematic errors (EVEN

numbers)

12s , 13s , R4s 22s , 41s, 10x

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 263. wavelength of non-
ionizing radiation
Wavelength – is the distance between two successive peaks and it
is expressed in terms of nanometer(nm)

Radiation Wavelength Light source examples

UV (Ultra violet <400nm Deuterium lamp, mercury arc,

spectrum) xenon lamp, hydrogen lamp

Visible spectrum 400-700nm Tungsten lamp, xenon lamp,

mercury arc

Infrared region >700nm Merst glower and Globar

(silicone carbide)

264. VERY SHORT WAVELENGTH OF UV LIGHTS

265. CIRRHOSIS Irreversible scarring, fibrosis , and destruction of the normal

liver architecture

From normal liver architecture to abnormal nodular architecture

Note!
80% of the liver should be damaged to abolish its function

266. Neonatal jaundice A neonate bilirubin above 28 should be reported immediately

Newborns appear jaundiced when bilirubin level is >7mg/dl (Manual

of Neonatal care by John Cloherty)

267. Spectrophotometers Instrument that uses monochromatic light diffraction gratings

268. photometers Uses glass filters and interference filters

269. spectrophotometers Uses diffraction gratings and prisms

270. measures of dispersion Range, SD, and CV

271. Indicates the extent of variation of the Range, SD, and CV

observations
272. Criteria for Fasting Plasma Glucose Non diabetic = <100mg/dl
Impaired Plasma Glucose = 100-125 mg/dl
Diabetes Mellitus = ≥126 mg/dl

273. Criteria for Oral Glucose tolerance Test Normal/Non diabetic = 2hr plasma glucose <140mg/dl
Impaired GTT = 2hr plasma glucose 140-199mg/dl
Diabetes Mellitus = 2hr plasma glucose ≥200mg/dl

274. Criteria for DM RBS = ≥200 mg/dl

FBS = ≥126mg/dl
2hrPost Glucose load = ≥200mg/dl
HBA1C = ≥6.5%

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 275. ANTI-ASTHMATIC DRUGS/BRONCHODILATORS Theophylline and Theobromine

276. BASAL STATE COLLECTION Blood collection early in the morning before the patient has eaten or
become physically active. This is a good time to draw blood sample because
the body is at rest and food has not been ingested during the night

277. TAM T test = accuracy = Mean

278. SPF F test= precision = SD

279. Leydig cells Testicular cells that produces testosterone

280. Kwashiorkor Acute protein calories malnutrition

281. Marasmus Caused by caloric insufficiency without protein insufficiency so that the serum albumin
level remains normal; there is considerable loss of body weight

282. Disorders related to BILIRUBIN

METABOLISM
Gilbert’s syndrome  Bilirubin transport deficit
 Characterized by impaired cellular uptake of
bilirubin
 Elevated B1

Crigley Najjar Syndrome  Conjugation Deficit

 Increase levels of B1
 Type 1 Crigle najjar = lacks UDPGT , (+)
KERNICTERUS
 Type 2 Crigler Najjar = partial deficiency of UDPGT

Dubin Johnson Syndrome and 

Bilirubin Excretion Deficit
Rotor syndrome 
Elevated B2

There is an intense dark pigmentation of the liver
(black liver) due to accumulation of lipofuscin
pigment (dubin Johnson)
Lucey Driscoll syndrome  A familial form of uncojugated hyperbilirubinemia
caused by a circulating inhibitor of bilirubin
conjugation
 Elevated B1
283. Kernicterus seen in criggler –Najjar syndrome, is the deposition of unconjugated
bilirubin in the brain, particularly affecting the basal ganglia,
mainly the lenticular nucleus, causing severe motor dysfunction and
retardation

284. Glass pipet It is a BASIC PIPET

285. At 20 degree celcius Calibration of glass pipet

286. 9 grams dissolved in 1L How will you prepare 1 liter of NSS using pure Sodium chloride
of water crystals?

287. Calibration the comparison of an instrument measure or reading to a known physical

constant.

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 288. control represents a specimen with a known value that is similar in
composition, for example, to the patient’s blood. Controls are the best
measurements of precision and may represent normal or abnormal test
values.

289. Standard are highly purified substances of a known composition. A standard may
differ from a control in its overall composition and in the way it is
handled in the test. Standards are the best way to measure accuracy.
Standards are used to establish reference points in the construction of
graphs (such as the manual hemoglobin curve) or to calculate a test
result.

290. Quality control a process that monitors the accuracy and reproducibility of results through the use of
control specimens

291. Trend A gradual change in the mean

292. Shift An abrupt change in the mean

continuous quality improvement The ongoing process of making certain the correct laboratory result is reported for the
right patient in a timely manner and at the correct cost is known as
293. (CQI)
294. Total Quality is a systematic problem-solving approach using visual tools to
Management (TQM) identify the steps in the process for meeting customer
satisfaction of quality care in a timely manner at reduced costs

295. Benchmarking Individual facility COMPARE ITS RESULTS WITH THOSE OF ITS PEERS

296. UNRESECTABLE In pancreatic adenocarcinoma, 96% of tumors with CA 19-9 levels

>1000 U/ml are considered as UNRESECTABLE (cannot be removed
completely through surgery)

297. Calcium and albumin Significantly affected by a change in posture from supine to a
sitting or standing position

298. Deterioration of Main cause of TREND in Quality control

reagent
299. Improper calibration of Main cause of SHIFT in QC
the instrument
300. Unit of measurements

Measure Unit

Meter (m) Length

Kilogram (kg) Mass

Seconds (s) Time

Mole (mol) Quantity of substance

Ampere (A) Electric current

Kelvin (k) Thermodynamic temperature

Candela (cd) Luminous intensity

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 301. Absorbance Abc = 2 – log%T

302. Ortho toluidine, and condensation CHEMICAL method for glucose that is still widely
method used

303. Inversely proportional / reciprocal Relationship of Bicarbonate and Chloride

304. Base Dissociable Substance that can accepts Hydrogen ions

305. Acid Dissociable Substance that can accepts Hydroxyl ions

306. Tangier’s disease Disorder characterized by abnormal and decrease HDL

307. >100 mg/dl Blood alcohol level that is considered as legally intoxicated

308. Pituitary gland Master gland

309. Hypothalamus It synthesizes or produces ADH and oxytocin

310. Posterior pituitary gland It stores and secretes ADH and oxytocin

311. Hyposecretion of gonadotrophins results in SEXUAL UNDERVELOPMENT and INFERTILITY

(e.g FSH and LH)
312. Hypersecretion of gonadotrophins Results in SEXUAL PRECOCITY and is usually a result
(e.g FSH and LH) of a brain tumors in the region of hypothalamus

313. Euthyroidism Refers to a normal functioning thyroid gland in the

presence of an abnormal concentration of TBG

314. Arterial blood gas monitoring is the standard for assessing a patient’s
oxygenation, ventilation, and acid-base status.  Although ABG monitoring
has been largely replaced by non-invasive monitoring, it is still useful
in the confirmation and calibration of non-invasive monitoring
techniques. 

315. Serum
protein
electrophoresis Increase alpha-2-macroglobulin with Nephrotic syndrome
patterns decrease albumin

Sharp increase in a single immunoglobulin Monoclonal gammopathy

(M spike) , all other fractions are
decrease

Diffuse increase in gamma region Polyclonal gammopathy

Beta gamma bridging( primarily due to Liver Cirrhosis

increase IgA)

Extra band between beta and gamma region Usage of plasma (due to
(pseudo beta gamma bridging) fibrinogen)

Increase beta or unusual band between Hemolyzed specimen

alpha2 and beta

Increase alpha-1 and alpha-2 Acute inflammation

Increase alpha-1, alpha-2 and gamma Chronic inflammation

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 Decrease alpha-1region Associated with alpha-
1antitrypsin deficiency
(causes emphysema and juvenile
cirrhosis)

316. Detection of monoclonal Single most important and clinical application of serum
gammopathies (E.g Multiple protein electrophoresis
myeloma)
317. Characteristic of liver Presence of fibrosis, scarring and destruction of normal
cirrhosis liver architecture

318. 80% __ of the liver should be damaged in cirrhosis to abolish its

function

319. Critical or panic values -Test results that indicate a potentially life-threatening
situation. Patient care personnel must be notified
immediately

- Critical/Panic values are defined as values that are

outside the normal range to a degree that may constitute an
immediate health risk to the individual or require immediate
action on the part of the ordering physician

examples : glucose, Sodium, potassium, total Co2, CALCIUM,

MAGNESIUM,phosphorus, total bilirubin, and blood gases

320. Critical value list

321. Read back policy Person receving critical values must record and read back
patient’s name and critical values. Laboratory must document
person who received information and time of notification.

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 322. Classification
of azotemia
Pre-renal  Due to diminished glomerular filtration with normal renal function
 Caused by reduce blood flow, poor perfusion of the kidnesy

E.g : dehydration, shock and congestive heart failure

Renal  Characterized by damaged within the kidneys (decrease GFR)

 Produced by renal failure, damage to filtering structures of the
kidney

e.g : Acute/chronic renal disease, glomerulonephritis, tubular necrosis

Post-renal  Usually the result of urinary tract obstruction (decrease GFR)

 Urea level is higher than creatinine due to back diffusion of urea
into the circulation; increased urea and creatinine in blood

e.g : renal stones, cancer or tumors of urinary tract

323. Uremia or uremic syndrome Toxic condition of very high plasma urea concentration
accompanied with renal failure

324. Food rich in HMMA (OH- Banana, vanilla,tea, coffee

3methoxymandelic acid
325. Ratio Refers to the amount of something in proportion to the amount
of something else

326. Concentration Refers to amount of solute in a given volume of solution

327. Molarity Refers to gram molecular mass or weight of a compound per liter of solution

328. Fluorescence Emmits light in a longer wavelenght and lower energy

329. dispersion Refers to the increase frequency of outliers

330. Age,Sex, and What are the factors that affect TDM?
renal function

1. -Patient demographics (age, sex, body weight)

2. -Patient Compliance
3. -Individuals capacity to distribute/metabolize/excrete the drug (liver
and renal function)
4. -Genetic factors
5. -Concomitant disease, Tropical disease and nutritional deficiencies
6. -Alternative system of medicine
7. -Ethnic differences and extrapolation of the normal range
8. -Alcohol & Tobacco use
9. -Quality of medication and generic formulation
10. -Control of drug assay
11. -Medication or sampling errors
12. -Laboratory errors
13. -cost effectiveness
331.

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 332.

Serum Bilirubin level Overall capacity to transport bile

Ratio of direct and total bilirubin Patency of biliary ducts; hepatocellular metabolism of bilirubin

Serum bile acids (salts) Overall patency of biliary duct

Fecal color and fat content Patency of biliary ducts

Fecal urobilinogen Patency of biliary ducts; quantity bilirubin processed

Urine urobilinogen Patency of biliary ducts; quantity of bilirubin processed; hepatocellular excretory
capacity

Serum ALP and other obstructive Abnormality of bile duct epithelium

enzymes

Excretion of BSP Hepatocellular function and patency of the bile ducts

Urine bilirubin Patency of biliary ducts, hepatocellular bilirubin metabolism

I.K. Aytona Page 30

 333. Horizontal or swinging  Allow the tubes to attain a horizonal position in the
bucket centrifuge centrifuge when spinning and a vertical position whe the
head is not moving
334. Fixed angle or angle  For the fixed angle–head centrifuge, the cups are held in a
head centrifuge rigid position at a fixed angle. This position makes the
process of centrifuging more rapid than with the
horizontal-head centrifuge. There is also less chance that
the sediment will be disturbed when the centrifuge stops.
 Fixed angle–head centrifuges are used when rapid
centrifugation of solutions containing small particles is
needed; an example is the microhematocrit centrifuge
335. cytocentrifuge  A cytocentrifuge uses a very high-torque and low-inertia
motor to spread monolayers of cells rapidly across a
special slide for critical morphologic studies
 An advantage of this technology is that only a small amount
of sample is used, producing evenly distributed cells that
can then be stained for microscopic study.
 It is the slowest centrifuge
 The speed of cytocentrifuge should be checked monthly
(Strasinger)
336. ultracentrifuge  high speed centrifuges used to separate layers of different
specific gravities. They are commonly used to separate
lipoproteins. The chamber is usually refrigerated to
counter heat produced friction
 it is the fastest centrifuge
337. refrigerated centrifuge  available with internal refrigeration temperatures ranging
from -15 °C to -25 °C during centrifugation.
 The temperature of refrigerated centrifuge should be
checked regularly, and the thermometers should be checked
periodically for accuracy
338. Liebermann-Burchardt One step direct method for measuring cholesterol

339. Errors

VARIATIONS / ERRORS

Random error  Present in all measurements ; it is due to chance

 A type of error that varies from sample to sample
 Errors of variation of techniques
Systemic error  It is an error that influences observations consistently in one direction
(constant difference)
a.Constant error /Y-intercept

 refers to a difference between the target value and the assayed value
 it is independent of sample concentration
 it exists when there is a continual difference between the comparative
method and the test method regardless of the concentration
b.Proportional / Slope/ Percent error

 it results in greater deviation from the target value due to higher

sample concentration

Clerical error  it is the highest frequency of clerical errors occurs with the use of
handwritten labels and requests form

340. Jaundice Physical sign characterized by a yellow appearance of the skin, mucuous
membrane, and sclera cause by bilirubin deposition. It is usually apparent

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 clinically when plasma bilirubin level reaches 2 to 3mg/dl(34 to 51umol/L)

341. Enzymes 1. No truly specific enzyme ; all enzymes are found in more than one
tissue
2. Enzyme data cannot be interpreted by itself. We must look at other
lab results and other pertinent clinical information before a
diagnosis can be made
3. Negative or normal results are useful
4. Serial measurements provide most useful data; a single measurement
can be misleading
342. decreased Level of chloride in hyponatremia

343. NPN
substances
urea Major end product of protein metabolism

creatinine Major end product of muscle metabolism; directly

proportional to muscle mass

Uric acid Major end product of PURINE and/or nucleic acid

metabolism

Ammonia Major end product of AMINO ACID DEAMINATION /METABOLISM

344. ORDER /GRADES

OF REAGENT
PURITY (PUREST 1. Analytical reagent
TO LEAST ) 2. Ultrapure
3. Chemically pure
4. United state pharmacopeia and national formulary
5. Technical or commercial grade
345. Wilson’s Also known as hepatolenticular degeneration
disease
- Autosomal recessive disease that results from impaired biliary copper
excretion.
-Increase copper - Due to deficiency or absence of CERULOPLASMIN (copper transport
-Decrease protein
ceruloplasmin - Symptoms include neurologic, cirrhosis of liver, and Kayser-Fleischer
rings caused by deposition of copper in cornea

346. Types TAG CHOL LDL VLDL CM FEATURE

FREDRICKSON
CLASSIFICATIO Type 1 Hyperchylomicronemia High N N N HIGH Low cardiac risk, eruptive
N
xanthoma, recurrent pancreatitis
-Familial LPL deficiency

Type 2a N High High N N High cardiac risk, xanthelasma,

tendon xanthoma, corneal arcus,
-Familial hypercholesterolemia hypothyroidism and nephritic
syndrome

Type 2b – mixed effect High High High High N High Cardiac Risk

-Familial combined
Hyperlipidemia

Type 3 High High N High N Eruptive and palmar xanthomas

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 Familial
Dysbetolipoproteinemia

Type 4 High N N High N Low cardiac risk

Familial Hyperglycedemia

Type 5 High High N High High Low cardiac risk; eruptive

xanthoma, may be associated with
pancreatitis.

347. Incorrect regarding to arterial Usage of ETS or vacutainer

blood collection / blood gas analysis
348. Triglycerides and Protein percentage It is used to differentiate VLDL and CHYLOMICRONS from HDL AND LDL

349. Pronounced (≥5X) elevation of LDH MEGALOBASLTIC ANEMIA, systemic shock and hypoxia, Hepatitis, Renal
infarction

350. Pronounced (≥5X) elevation of CK DUCHENNE’S SYNDROME, polymyositis, Dematomyositis, Myocardial

infarction

351. Pronounced (≥5X) elevation of AST Acute hepatitis, Myocardial infarction, Circulatory collapse, Acute
pancreatitis, Infectious mononucleosis

352. Pronounced (≥5X) elevation of ALP Bile duct obstruction(intra and extra hepatic) , Biliary cirrhosis, Osteitis
deformans (Paget’s disease) , Osteogenic sarcoma, Hyperparathyroidism

353. Flipped LD pattern (LD1>2) Associated with MYOCARDIAL INFARCTION, RENAL INFARCTION, AND
HEMOLYTIC ANEMIA/HEMOLSYS (E.g Pernicious anemia)

354. 70-75% = Thyroxine binding Major transport protein of Thyroid hormones

globulin(TBG)
355. Epinephrine (80%) PRIMARY HORMONE PRODUCED IN ADRENAL MEDULLA

Note: norepinephrine (20%)

356. WHOLE BLOOD Specimen of choice for Therapeutic drug monitoring of

TACROLIMUS AND CYCLOSPORINE

357. Infectious aerosol / airborne Majority of cases of laboratory related infection is

due to

358. Errors

Pre- analytical incorrect patient identification, improper patient preparation, incorrect specimen
collection ,mislabeled specimen, incorrect order of draw, incorrect used of tubes for blood
collection, incorrect anticoagulant to blood ratio, improper mixing of blood and anticoagulant,
incorrect specimen preservation, mishandled specimen

Analytical errors incorrect sample and reagent volume, incorrect incubation of solution, equipment/instrument
malfunction, improper calibration of equipment

Post analytical unavailable or delayed laboratory results, long turnaround time, incomplete laboratory
results, wrong transcription of the patient’s data and lab results, missing laboratory results

359. Tetrahydrocannabinol (THC) Psychoactive substance of marijuana

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 360. MOLARITY -is the number of moles of solute per liter of solution

M = ___Grams of solute_____

GMW x Vol of sol. (L)

Gram molecular weight – obtained by adding the atomic

weights of the components

NORMALITY -is the number of equivalent weight of solute per liter

of solution

N =____Grams of solute____

EW x Volume (L)

Equivalent weight (EW) = MW / Valence

MOLALITY -is the amount of solute per 1 kilogram of solvent

m = __Grams of solute____

MW x Kg of solvent

Dilution -indicative of relative concentration

Dilution = ___________solute___________

Volume of solution (Total volume)

Temperature
conversions
Centigrade to Kelvin = 273 + ‘C

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 Centigrade to Farenheit = (‘C x1.8 ) +32

Farenheit to Centigrade = (‘F -32 ) x 0.556

361. Firs order kinetics Reaction rate is directly proportional to substrate

concentration

362. Zero order kinetics Reaction rate depends only on enzyme concentration

363. Beers law States that the concentration of a substance is directly

proportional to the amount of radiant energy absorbed

364. Example of Mechanical Glasswares, Sharp instrument, Compressed gases, Equipements

hazards such as Centrifuge ,autoclaves, and homogenizers

365. Ethylene glycol Known as anti-freeze agent

366. cyanide Odor of bitter almonds

367. arsenic Odor of garlic, metallic taste

-strong affinity to keratin

368. 5 to 15mg/dl GLUCOSE MEASUREMENT BY REDUCING METHODS (COPPER REDUCTION

METHODS) ARE ______ erroneously HIGHER than ENZYMATIC Method

369. Von Gierke disease Most common congenital form of glycogen storage disease ;
associated with hyperlipidemia

370.

screening Detection of subclinical disease

diagnosis Confirmation or rejection of clinical disease

monitoring Monitoring progression or response to treatment

prognosis Information regarding the likely outcome of disease

371. SYMPTOMS Subjective evidence of a disease

372. SIGN Objective evidence of a disease

373. SULFURIC ACID-Dichromate mixture Used for cleaning of glasswares

374. Monochromators 1. Glass filters and interference filters are used in photometers
2. Diffraction gratings and prisms are used in spectrophotometers
375. Used to calibrate 1. HOLMIUM OXIDE = for narrow spectral bandwidth instrument
wavelength 2. DIDYNIUM FILTER = for broader bandpass instrument
376. Hallow-cathode lamp Light source used in Atomic absorption spectrophotometer (AAS)

377. Quenching of Excited state of the molecule loses some of its energy by
fluorescence interaction with another component of the reaction

- Major disadvantage in methods based of fluorescence

378. Effect of the
following to
fluorescence 1. Temperature = inversely proportional (Increase temp = decrease
fluorescence )

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 2. Light exposure
379. Fasting Blood Very rough indication of glycogen storage and capacity to
Gluocse (FBS) synthesize glucose

380. Fresh, and chilled Specimen for determination of ammonia level in the body

381. catalytic mechanism E + S = ES = E + P

382. Michaelis-Menten V = V max(S) / Km + S

Hypothesis
383. LD4 & LD5 = Decrease Effects of low temperature storage to LD4/LD5 and ALP
ALP = Increase
384. Tetany Associated with decrease calcium / hypocalcemia

385. <3:1 Desirable LDL:HDL ratio

386. Lipid transport

Transport dietary or exogenous Chylomicrons

Triglycerides

Transport endogenous TAG VLDL

Transport mainly Cholesterol LDL

Reverse transport of cholesterol HLD

387. Urea First metabolite to increase in kidney diseases

*urea is only a rough estimate of renal function and will not show
any significant level of increased concentration until GFR is
decreased by at least 50%

388. Biochemical changes INCREASED =Urea, creatinine, electrolytes (K,Phosphate, Magnesium &
in acute kidney disease H+
and End stage renal
disease

DECREASE = Sodium, calcium and bicarbonate

389. Intravenous Route of drug administration that is associated with

100%bioavailability

390. Five pharmacological

parameters that determine
serum drug conc. Liberation It is the release of drug

absorption is the transport of drug from the site of

administration to the blood.

Distribution refers to the delivery of the drug to the

tissues.

Metabolism is the process of chemical modification of the

drug by cells

Excretion is the process by which the drug and its

metabolites are excreted from the body.

391. Fasting No food or drink except for water for 8 to 12 hours

392. NPO NON-per-orem / Nothing by mount

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 no food or drink allowed (including water)

393. Immunoassay technique Method of choice for individual assay assays of anticonvulsants

394. GC or HPLC Method for multiple drug assays. anticonvulsants

395. Biological
safety cabinet
Class I Allows room (unsterilized) air to pass into the cabinet and around the area and material
within, sterilizing only the air to be exhausted; they have negative pressure, are
ventilated to the outside, and are usually operated with an open front

Class II Sterilizes air that flows over the infectious material, as well as air to be exhausted.

Also known as vertical laminar flow type

IIA Self-contained, and70% of the air is recirculated

IIB Exhaust air cabinets is discharged outside the building; selected if radioisotopes, toxic
chemicals, or carcinogens will be used

Class III Completely enclosed and have negative pressure, afford the most protection to the
worker; air coming into and going out of the cabinet is filter sterilized, and the infectious
material within is handled with rubber gloves that are attached and sealed to the
cabinet

396. 25mg/dl(430 umol/L) Icteric serum sample is apparent when bilirubin level approaches by

397. >400mg/dl Lactescent serum is apparent when TAG levels exceeds by

398. LABORATORY RESULTS

RELATED TO LIVER
DISORDER Hepatitis High : AST, ALT, LD, ALP, Bilirubin

Normal : total protein, albumin, ammonia

CIRRHOSIS High: Bilirubin, ammonia

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 Low: TOTAL Protein

Normal : AST, ALT, LD

Slightly high : ALP

Biliary High: ALP,Bilirubin

obstruction
Normal: Total protein, AST, ALT, LD

Alcoholic High : GGT,AST, Bilirubin, Ketone, TAG, Lipoproteins

liver dis.
Low: Glucose, albumin, transferrin

399. Chronic cholestasis Highest value of GGT (>10x) , may be found in __ due to primary
biliary cirrhosis or sclerosing cholangitis

400. Phenolphthalein Indicator used in assays for Carbon dioxide

*assay as carbon dioxide measure carbon dioxide with ISE and

diffuse carbon dioxide into solution containing Phenolphthalein
indicator

RECALLS

1. Which does NOT apply to discrete analyzers?

a. Multiple tests can be performed on a single sample
b. Liquid reagents are pumped through a continuous system of tubing
c. Samples and reagents are hosed in separate chambers
d. One test can be selected to perform on multiple samples
2. Which are causes of elevated anion gap?
(1) Uremia/renal failure
(2) Hypoalbuminemia
(3) Hypernatremia
(4) Methanol poisoning
a. 1 and 2
b. 1, 2 and 3
c. 3 and 4
d. 1, 3 and 4
3. Which measurement helps assess the acid-base and oxygenation status of the patient?
a. Arterial blood gases
b. Blood pH testing
c. Osmolality
d. Electrolyte panel
4. The change in serum parameter of these enzymes is caused by myocardial infarction. Which hepatic enzymes are referred to?
a. LDH and ALP
b. AST and LDH
c. ALT and AST
d. ALT and ALP
5. Which are causes of hyponatremia due to water imbalance?
(1) Severe burns

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 (2) Excess water intake
(3) SIADH
(4) Pseudohyponatremia
a. 2, 3 and 4
b. 2 and 4
c. 1 and 3
d. 1, 2 and 3
6. The run showed that the result falls under the R4s rule. What decision should be taken regarding the run?
a. Reject
b. Accept
c. Hold results
d. May accept with caution
7. Which refers to potassium?
a. Found in the extracellular fluid
b. All of the items
c. Major extracellular cation
d. Positively charged
8. Which of the following refers to R4S?
(1) Range between two observation in the same run exceeds 4 SD
(2) Detects imprecision
(3) Detects bias
(4) Observations for two QC samples in the same run exceed 2 SD from the target value in the same direction
a. 1 and 2
b. 1 and 3
c. 2 and 4
d. 3 and 4
9. Which is a cause of hypoproteinemia?
a. Renal disease
b. All of the items
c. Severe burns
d. Blood loss
10. Which is a pathologic cause of pronounced elevation of ALP, usually with more than 5 times the upper limit of normal?
a. Cirrhosis
b. Hepatitis
c. Bone tumor
d. Pregnancy
11. Which is the chief counter-ion of sodium?
a. Potassium
b. Magnesium
c. Chloride
d. Bicarbonate
12. The elimination of a substance, as related to its removal from the blood plasma by the kidneys, is ___.
a. Prompted voiding
b. Clearance
c. Urination
d. Excretion
13. Which are measures of enzyme activity?
a. Decrease in coenzyme concentration and increase in concentration of altered coenzyme
b. Increase in product concentration and decrease in coenzyme concentration
c. Increase in concentration of altered coenzyme, increase in product concentration and decrease in coenzyme
concentration
d. Increase in concentration of altered coenzyme and increase in product concentration
14. When performing venipuncture, one enters the vein at an angle of approximately ___ degrees to the arm.
a. 45
b. 15
c. 30
d. 20
15. For 40 years old and above, there is moderate risk of developing coronary heart disease when cholesterol is greater than ___
mg/dL.
a. 240
b. 200
c. 280

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 d. 260
16. Greatly increased ALP activity is characteristic of ____.
a. Hepatocellular damage
b. Both intra and extrahepatic biliary obstruction
c. Intrahepatic biliary obstruction
d. Extrahepatic biliary obstruction
17. Which does require TDM?
(1) Salicylates
(2) Acetaminophen
(3) Ibuprofen
a. 1 and 3
b. 1 and 2
c. 2 and 3
d. 1, 2 and 3
18. A numeric rating of 2 indicates ____ hazard.
a. Moderate
b. Extreme
c. Slight
d. Severe
19. When using a blood pressure cuff to help locate a vein, the cuff should NOT be inflated higher than ____ mmHg.
a. 25
b. 30
c. 25
d. 40
20. Which is a better marker to serum creatinine for GFR assessment?
a. Cystatin
b. BUN
c. Uric Acid
d. None of the items
21. Which is example of beta-globulin>
a. Transferrin
b. None of the items
c. Haptoglobin
d. Alpha1-antitrypsin
22. Which are possible sources of error in creatinine clearance as a rough estimate of glomerular filtration rate?
(1) Increased tubular reabsorption of creatinine
(2) Reduced creatinine generation from muscle tissue
(3) Dietary changes in nitrogenous compounds
a. 1, 2 and 3
b. 2 and 3
c. 1 and 2
d. 1 and 3
23. Which are COMMON support media used for electrophoresis?
(1) Cellulose acetate
(2) Agarose
(3) Polyacrylamide gels
a. 2 and 3
b. 1 and 2
c. 1, 2 and 3
d. 1 and 3

24. Which can cause hypoglycemia in an IDDM patient?

(1) Over-zealous treatment
(2) Missed meal
(3) Increased in physical activity
a. 1, 2 and 3
b. 2 and 3
c. 1 and 3
d. 1 and 2

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Occasional hypoglycaemic episodes are common in patients with type 1 DM, and there may be obvious reasons for them, for example a missed meal or an increase in
physical activity. Recurrent hypoglycaemia can be due to overzealous treatment, but a decrease in insulin requirements suggests a change in the activity of counter-
regulatory hormones. (Marshall, 7th edition)

25. Which centrifuge has swinging buckets?

a. Horizontal-head
b. Cytocentrifuge
c. Fixed-angle head
d. None of the items
26. Which proteins are quantified by standard protein electrophoresis?
a. Transferrin and Fibrinogen
b. C3 and Fibrinogen
c. Transferrin and C3
d. Transferrin, C3 and Fibrinogen
27. An abrupt change from the established mean indicated by the occurrence of all control values on one side of the mean is a ___.
a. Concentration
b. Trend
c. Shift
d. Dispersion
28. Which are included in the operational process chart?
(1) Total allowable error
(2) Systemic error
(3) Random error
a. 1 and 2
b. 2 and 3
c. 1, 2 and 3
d. 1 and 3
29. In glomerulonephritis, which does NOT describe the laboratory picture?
a. Red cells and casts in urine
b. Increased in serum creatinine and BUN
c. Elevated urine protein
d. None of the items
30. Which fire extinguishers are used for Class A fires?
(1) Pressurized water
(2) Dry chemical
(3) Carbon dioxide
(4) Halon
a. 1 and 2
b. 3 and 4
c. 2, 3 and 4
d. 1, 2 and 3
31. What is the color of the chemical reagent label for fire hazard?
a. Fluorescent orange
b. Yellow
c. Blue
d. Red
32. Which is the stereotypic blood gas pattern in myocardial infarction?
(1) PCO2 usually normal or low
(2) With metabolic acidosis
(3) PO2 is significantly reduced
a. 2 and 3
b. 1 and 2
c. 1 and 3
d. 1, 2 and 3
33. Which is NOT part of liver function tests?
a. Bilirubin
b. Enzymes
c. Factor assay
d. Prothrombin time
34. The airflow pattern is 30% recirculated, with 70% exhausted. Exhaust cabinet air passes through a dedicated duct to the outside
through a HEPA filter. Which biological safety cabinet is referred to?
a. II, B1

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 b. I
c. I, B2
d. II, A1
35. What are components of positive displacement pipet?
a. Piston and capillary
b. Piston, capillary and piston seal
c. Capillary and shaft
d. Shaft and piston seal
36. Which electrolytes are cofactors in enzyme activation?
(1) Calcium
(2) Sodium
(3) Zinc
(4) Magnesium
a. 2, 3 and 4
b. 3 and 4
c. 1 and 2
d. 1, 3 and 4
37. What are critical values for bicarbonate in mmol/L that requires immediate communication to the physician?
(1) Less than 5
(2) Less than 10
(3) Greater than 40
(4) Greater than 60
a. 1 and 4
b. 2 and 4
c. 1 and 3
d. 2 and 3
38. Which is an assayed sample that is provided as an unknown to laboratories participating in proficiency testing programs?
a. External control
b. Internal control
c. Reference sample
d. Blind sample
39. Which is NOT a CNS depressant?
a. Barbiturates
b. Methaqualone
c. Cannabinoids
d. Benzodiazipines
40. Under normal conditions, blood glucose returns to normal levels within ____ hours.
a. 3-4
b. 2-3
c. 2-4
d. 1-2
41. To which do the following apply?
(a) The reaction rate is directly proportional to the substance concentration
(b) With enzyme excess, the reaction rate steadily increases as more substrate is added until the substrate saturates all
available enzyme.
a. End-point
b. First-order kinetics
c. Kinetic
d. Zero-order kinetics
42. Which refers to end-point Jaffe reaction?
a. Enzymatic : ISE
b. Colorimetric : end point
c. Colorimetric : kinetic
d. Enzymatic: colorimetric
43. Which refers to Type 1 diabetes?
a. Results from B-cell destruction
b. Usually diagnosed in children
c. Usual leads to absolute insulin deficiency
d. All of the items
44. Ultraviolet (UV) light has ____ wave lengths.
a. Slightly long
b. Very short

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 c. Very long
d. Slightly short
45. Alkalemia is blood pH greater than ____.
a. 7.45
b. 7.25
c. 7.55
d. 7.35
46. There is NO recirculation. Total exhaust to the outside is through a HEPA filter. Which biological safety cabinet is referred to?
a. II, B2
b. I
c. II, A1
d. II, B1
47. Under which condition is anion gap less than 10 mmol/Lseen?
a. Severe hypercalcemia
b. Hypernatremia
c. Ketoacidosis
d. Uremia
48. Which refers to error always in one direction?
a. Proportional
b. Systematic
c. Random
d. Constant
49. In electrophoresis, which lies closest to the negative electrode?
a. Alpha 2
b. Gamma
c. Albumin
d. Alpha 1
50. Which are the components that make up the chain of infection?
a. Source, Modes of transmission and Susceptible host
b. Source and Mode of transmission
c. Source and Susceptible host
d. Modes of transmission and Susceptible host
51. To which class of fire do energized electrical equipment belong to?
a. D
b. B
c. C
d. A
52. Which is NOT sensitive organ to ethanol abuse?
a. Liver
b. Pancreas
c. Kidney
d. Stomach
53. Which principles apply to enzymes data interpretation?
(1) Enzyme data must be integrated with other information
(2) Negative (normal) results are useful
(3) There is No truly “organ-specific” enzyme.
a. 2 and 3
b. 1 and 2
c. 1, 2 and 3
d. 1 and 3
54. Which analyte is affected by diurnal variation?
a. Thyroxine
b. Iron
c. Calcium
d. Cholesterol
55. Which accumulate as a creamy layer when left undisturbed for several hours?
a. VLDL
b. LDL
c. IDL
d. Chylomicrons
56. Which cause analytical errors?
a. Specimen collected from the wrong patient and miscalibrated analyzer

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 b. Specimen collected in the wrong tube and at the wrong time
c. Blood specimen collected in the wrong order and incorrect labeling of specimen
d. Expired reagents and miscalibrated analyzer
57. Which is NOT part of the major lipoproteins
a. HDL
b. VLDL
c. LpX
d. LDL
58. Which is the major NPN constituent?
a. Uric acid
b. Amino acids
c. Urea
d. Creatinine
59. Which are multiple forms of the same enzyme?
a. Isoenzymes
b. Isomerases
c. Isoenzymes and Cofactors
d. Activators and Isomerases
60. Which are components of quality system program?
(1) Personnel qualifications, training, and competency
(2) Quality assessment
(3) Proficiency testing
a. 1 and 3
b. 1, 2 and 3
c. 1 and 2
d. 2 and 3
61. A numeric rating of 4 indicates ___ hazard.
a. Moderate
b. Extreme
c. Slight
d. Severe
62. To which class of fire do ordinary combustible solid materials, such as paper, wood, plastic and fabric belong to?
a. D
b. C
c. B
d. A
63. Which hyponatremia is NOT caused by water imbalance?
a. Excess water intake
b. Congestive heart failure
c. SIADH
d. Pseudo-hyponatremia
64. Which are used for interlaboratory quality control?
a. Proficiency testing (PT) survey and regional quality control programs
b. Cumulative Sum Technique (CUSUM) and average normal
c. Proficiency testing (PT) survey and data check
d. Delta check and Westgard’s multi-rule technique
65. Which HDL cholesterol expressed in mg/dL, indicates positive risk factor for CHD?
a. Lower than 35
b. Lower than 60
c. Greater than 60
d. Greater than 90
66. Which define the shelf life of an evacuated tube?
a. Amount of gas residing in the tube
b. Stability of the additive and vacuum retention
c. Environmental factors
d. Humidity and ambient temperature
67. The concept of treating all blood and body fluids as capable of transmitting infectious disease is ____.
a. Infection control
b. Safe practice standards
c. Universal precautions
d. Safety protocol

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68. In liver damage, a clinically significant change in its level is seen as a decrease, rather than increase in activity. Which hepatic
enzyme is referred to?
a. Alkaline phosphatase
b. Cholinesterase
c. LDH
d. Aminotransferase
69. Enzymes are ____.
a. Catabolites
b. Proteins
c. Lipids
d. Carbohydrates
70. What is the effect of very high white cell counts on glucose level if blood collected in a red tube is allowed to stand for some time
at room temperature?
a. Minimal reduction
b. Substantial reduction
c. Minimal increase
d. Substantial increase
71. Which endocrine gland secretes the antidiuretic hormone (ADH)?
a. Thyroid
b. Pineal
c. Thymus
d. Pituitary
72. To which class of fire do ordinary combustible solid materials, such as paper, wood, plastic and fabric belong to?
a. A
b. D
c. B
d. C
73. If no inhibitor of glycolysis has been added to whole blood specimen, how much glucose is metabolized at 4 degrees centigrade,
expressed as mg/dL/h?
a. 10
b. 2
c. 7
d. 5
74. Which regulate calcium?
(1) Parathyroid hormone
(2) Vitamins D
(3) Calcitonin
a. 1 and 3
b. 1 an 2
c. 2 and 3
d. 1, 2 and 3
75. Which are hazards associated with the use of any cryogenic material?
(1) Asphyxiation
(2) Pressure buildup
(3) Embrittlement of materials
(4) Tissue damage similar to that of thermal burns
a. 1, 2 and 4
b. 1 and 2
c. 1, 2, 3 and 4
d. 3 and 4
76. Which is a major protein constituent of LDL?
a. ApoC
b. ApoD
c. ApoA
d. ApoB
77. Which is NOT present in blood as a gas?
a. Carbon dioxide
b. Bicarbonate
c. Hydrogen
d. Oxygen
78. The run showed that the result falls under the 81S rule. What decision should be taken regarding the run?
a. Accept

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 b. May accept with caution
c. Reject
d. Hold results
79. Which is endogenous triglyceride?
a. LDL
b. HDL
c. Chylomicron
d. VLDL
80. Which protein transports iron?
a. Haptoglobin
b. Prealbumin
c. Transferrin
d. Alphal-antitrypsin
81. Which does NOT have isoenzymes?
a. ALP
b. CPK
c. ACP
d. ALT
82. To which do the following apply? E + S = ES = E + P
a. Michaelis-Menten hypothesis
b. Catalytic mechanism
c. Lineweaver-Burk plot
d. International unit of enzyme activity
83. Which measurement of urea nitrogen has greater specificity but may be more expensive?
a. Enzymatic : ISE
b. Enzymatic : colorimetric
c. Colorimetric : kinetic
d. Colorimetric : end point
84. Which electrolytes provide the largest contribution to the osmolality value of serum?
(1) Sodium
(2) Chloride
(3) Bicarbonate
(4) Potassium
a. 1, 2 and 3
b. 3 and 4
c. 1, and 2
d. 2, 3 and 4
-Sodium, chloride and bicarbonate contribution to osmolality is approximately 92%. Other serum electrolytes, serum proteins, glucose,
and urea contribute to the remaining 8%

85. The information on capacity to synthesize protein is conveyed by which test?

a. Alphal-antitrypsin
b. Ceruplasmin
c. Globulin
d. Albumin
86. Which apply to radial immune diffusion using the Mancini technique?
(1) Measuring the diameters after diffusion has ceased
(2) Measurements require 2 – 3 days
(3) Provides more reliable estimation of low levels of antigen compared with the Fahey technique
a. 1 and 3
b. 1, 2 and 3
c. 2 and 3
d. 1and 2
87. Which are minor lipoproteins?
a. VLDL and IDL
b. LDL and VLDL
c. VLDL and Lp (a)
d. IDL and Lp (a)
88. Which is NOT part of the major lipoptoteins?
a. Chylomicrons
b. HDL
c. B-VLDL

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 d. LDL
89. What is the factor used to convert glucose result expressed in mg/dL to mmol/L?
a. 0.04826
b. 0.05948
c. 0.05551
d. 0.03254
90. Which is the standard needle gauge and length (inch) used for blood collection in adults?
a. 20 x 1
b. 21 x 1.5
c. 20 x 1.5
d. 21 x 1
91. What is the value of 8 g/dL total protein in g/L?
a. 75
b. 80
c. 100
d. 60
92. Which is used by diabetic patients to regularly monitor their glucose levels?
(1) Arterial blood
(2) Capillary blood
(3) Venous blood
a. 1 and 3
b. 2 and 3
c. 2 only
d. 3 only
93. Which is/are used to monitor liver transplant patients?
a. Bilirubin fractions
b. All of the items
c. Coagulation studies
d. Hepatic enzymes
94. Azotemia results to which blood urea level?
a. Variable, but generally decreased
b. Variable
c. Increased
d. Decreased

SITUATIONAL

Situation 1 – the intensity of fluorescence is theoretically linear with the concentration of the fluorescing molecule.

95. What is the effect on fluorescence when temperature is increased?

a. Decreased
b. Erratic
c. Increased
d. Indeterminate
96. The length of time of light exposure is increased. What is the effect?
a. Decreased
b. Indeterminate
c. Erratic
d. Increased
97. There are many absorbing molecules present in solution. What’s the effect?
a. Indeterminate
b. Increased
c. Erratic
d. Decreased

Situation 2 – 2 mL of serum was added to 8 mL of saline.

98. What is the dilution?

a. 2/8
b. 10/2
c. 8/2
d. 2/10

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99. What is the ratio of serum to saline?
a. 2:8
b. 8:2
c. 2:10
d. 10:2
100. What is the ratio of total volume to serum?
a. 2:10
b. 8:2
c. 10:2
d. 2:8

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