CLINICAL CHEMISTRY

COMPREHENSIVE EXAMINATION (PRE-INTERNSHIP: 2nd SEMESTER- SY 2021-2022

Prepared by: Raymundo Rosales II

1) Sample hemolysis may probably result to 4) Schales and Schales Method will
false elevation of the analytes below, determine what analyte?
EXCEPT: a. Lipase
a. Bicarbonate b. Calcium
b. Potassium c. Chloride/
c. Magnesium d. Potassium
d. Gamma-glutamyl transferase/ e. Bicarbonate
e. Aspartate aminotransferase
5) Cherry-Crandall method determines what
analyte?
1) What electrolyte is a sensitive indicator of a. Lipase/
low oxygen supply to body tissues? b. Calcium
a. pCO2 c. Sodium
b. Phosphate d. Potassium
c. Lactate/ e. Selenium
d. Bicarbonate
e. Chloride 6) The fourth most abundant cation in the
body is generally reabsorbed at what
2) The most abundant monovalent cation anatomic portion of the kidney?
housed within the cells of our body is a. Glomerulus
selectively bound to what membrane in ISE b. Proximal convoluted tubule
analyzers? c. Distal convoluted tuble
a. Ion exchange resin d. Ascending loop of Henle/
b. Glass e. Descending loop of Henle
c. Electrical impedance
d. Valinomycin/ 7) The most abundant anion that is housed
within the cells of our body is:
3) Which is TRUE about kinetic assay for a. Bicarbonate
enzyme measurement? b. Potassium
a. Reaction rate proceeds in a defined c. Magnesium
time d. Chloride
b. Reaction is stopped usually e. Phosphate/
inactivated by weak acids/
c. Multiple measurements are done in 8) Plasma osmolality is evaluated using this
various time intervals test:
d. Less preferred than fixed-time a. Ion-Selective Electrode
assay b. Water deprivation/
c. Lockhead & Purcell
d. Schales & Schales
e. Atomic absorption
spectrophotometry

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CLINICAL CHEMISTRY
COMPREHENSIVE EXAMINATION (PRE-INTERNSHIP: 2nd SEMESTER- SY 2021-2022
Prepared by: Raymundo Rosales II

9) When measuring calcium with a 13) Severe dehydration cause which

complexometric dye, magnesium is kept physiologic regulatory mechanisms? (Group
from interfering by: the numbered choices): 2PTS
a. Using an alkaline pH 1- Increase urine output
b. Adding 8-hydroxyquinoline/ 2- Decrease urine output
c. Measuring at 450 nm 3- Increase water retention
d. Complexing with EDTA (nephron)
4- Decrease water retention
10) Most analyzers using ISE system uses (nephron)
what ion-exchange membrane for the 5- Increase AVP secretion
quantitation of sodium? 6- Decrease AVP production
a. Valinomycin Choices:
b. Plastic a. 1, 3, 6
c. Resin b. 2, 3, 5/
d. Glass/ c. 1, 4, 5
e. Paper d. 2, 4, 6

11) Which among the following statements is 14) Which electrolytes are generally stored in
FALSE about specimen handling for ionized the bones? 2PTS
calcium determination? 1- Lactate
a. No liquid heparin should be used 2- Phosphate
b. Samples must be collected 3- Calcium
anaerobically 4- Magnesium
c. Use of EDTA and oxalate a. 1, 2
anticoagulant may cause b. 2, 3/
interferences c. 3, 4
d. Serum may be used if clotting and d. 1, 4
centrifugation is done beyond 30
minutes/ 15) False elevation of potassium is caused by
the following, EXCEPT:
12) The following electrolytes are important in a. Thrombocytopenia/
maintaining normal cardiac rhythm and b. Thrombocytosis
contraction, EXCEPT: c. In-vitro hemolysis
a. Sodium/ d. Excessive fist clenching
b. Magnesium
c. Calcium 16) The following are macroenzymes,
d. Potassium EXCEPT:
a. ACP
b. ALP
c. AMS
d. CK
e. LDH/

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CLINICAL CHEMISTRY
COMPREHENSIVE EXAMINATION (PRE-INTERNSHIP: 2nd SEMESTER- SY 2021-2022
Prepared by: Raymundo Rosales II

17) All of the following statements describes 22) Following an acute MI, activity of LD
enzymatic reactions, EXCEPT: usually peaks:
a. The enzyme is not consumed in the a. Within 1 day post-infarction and
reaction returns to normal after 3 days
b. The equilibrium of the reaction b. 24 to 36 hours post-infarction and
shifts to the right/ returns to normal after 3 days
c. The rate of the reaction is increased c. 48-hours post-infarction and returns
d. The activation of energy is lower to normal after 4 days
d. 3 days post-infarction and returns
18) Which enzyme requires a specific divalent to normal after one week/
cation for activation?
a. Creatine kinase 24. The most abundant form of LDH isoenzyme in
b. Amylase the serum concentration is:
c. Alkaline phosphatise a. LDH-1
d. None of the above b. LDH-2/
e. All of the above/ c. LDH-3
d. LDH-4
19) Which of the following enzymes is a e. LDH-5
transferase?
a. LDH 23) In acute pancreatitis, which amylase
b. CK/ isoenzyme is typically increased?
c. ALP a. P1
d. ALD b. P2
e. AMS c. P3/
d. S1
20) Which of the following enzymes is a e. S2
hydrolase?
a. LDH 24) 26. Which among the following analytes
b. ACP/ stays longer in the serum after the onset of
c. GGT acute pancreatitis?
d. AST a. Salivary Amylase
e. PK b. Pancreatic Amylase
c. Lipase/
21) A 50-year-old male was diagnosed to have d. LDH
obstructive jaundice, which among the e. CK
following is the LEAST useful analyte to aide
in the differentiation of obstructive jaundice?
a. LDH/
b. GGT
c. ALT
d. 5-Nucleotidase
e. Alcohol dehydrogenase

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CLINICAL CHEMISTRY
COMPREHENSIVE EXAMINATION (PRE-INTERNSHIP: 2nd SEMESTER- SY 2021-2022
Prepared by: Raymundo Rosales II

27. In hepatitis, the rise in the serum conjugated 32. Lead which is absorbed in our body is excreted in
bilirubin levels can be caused by: greater amount in what specimen?
a. Secondary renal insufficiency a. Urine/
b. Failure of the enterohepatic b. Blood
circulation/ c. Feces
c. Enzyme conversion of urobilinogen to d. Hair
bilirubin e. Sweat
d. Extrahepatic conjugation
33. Mercury attacks which system of the human
28. Which reagent is used in the body?
Jendrassik-Grof method to solubilise a. Gastrointestinal
unconjugated bilirubin? b. Urinary
a. 50% methanol c. Cardiovascular
b. N-butanol d. Central Nervous/
c. Caffeine/ e. Respiratory
d. Acetic acid
34. This element is used in electrical switches, and
29. Which among the following instrumentation for incorporated in dental amalgams:
detecting trace elements is least likely used due to a. Lead
difficulty of operation? b. Mercury/
a. Flame AAS c. Copper
b. Flameless GFAAS/ d. Chromium
c. ICP-AES e. Arsenic
d. ICP-MS
35. The following are toxic effects of Chromium
30. Increase total arsenic concentration in the urine is exposure, EXCEPT:
caused by what main arsenic species in seafood? a. Blindness/
a. Arsenocholine b. Severe dermatitis
b. Arsenobetaine/ c. Skin ulcers
c. Arsenovaline d. Airway obstruction
d. Arsenoadenine e. Lung cancer

31. What must be done to avoid contamination of 36. This element is responsible for making rubies red
samples for Cadmium quantification? and emeralds green.
a. Store in room temp a. Cadmium
b. Tightly seal the container b. Chromium/
c. Anaerobic environment must be c. Selenium
maintained d. Copper
d. Never use yellow-colored plastic e. Mercury
container/

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CLINICAL CHEMISTRY
COMPREHENSIVE EXAMINATION (PRE-INTERNSHIP: 2nd SEMESTER- SY 2021-2022
Prepared by: Raymundo Rosales II

37. The following are toxic effects of Chromium 41. It is considered as the fourth most abundant
exposure, EXCEPT: element in the earth’s crust.
a. Blindness/ a. Chromium
b. Severe dermatitis b. Copper
c. Skin ulcers c. Nickel
d. Airway obstruction d. Zinc
e. Lung cancer e. Iron/

38. The following metals are solid in room 42. Hypernatremia due to decreased water intake
temperature, EXCEPT: most likely occurs among what patients?
a. Gold a. Geriatric/
b. Silver b. Adult
c. Iron c. Teens
d. Mercury/ d. Pediatric
e. None of the above
43. Who among the following is prone to physiologic
39. A 5-month-old male was rushed in the emergency iron loss?
room due to seizures. He was born prematurely at 32 a. Adult male
weeks of life. He shows stunted growth; cannot b. Adult female/
respond to external stimuli like sound and is very c. Pediatric patients
malnourished to his age. He has peculiar hair growing d. Menopausal women
all over his body. He is most likely to have what
disease? 2pts 44. The following are enzyme tumor markers,
a. Z-E disease EXCEPT:
b. Keshan disease a. PSA
c. Rotor Syndrome b. LDH
d. Menkes disease/ c. ALP
e. Kayser-Fleischer disease d. ADH/

40. The above condition has depleted levels of what 45. The following electrolytes are important in the
trace element: normal neuromuscular excitability, EXCEPT:
a. Chromium a. Calcium
b. Copper/ b. Bicarbonate/
c. Nickel c. Magnesium
d. Zinc d. Potassium
e. Asbestos

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CLINICAL CHEMISTRY
COMPREHENSIVE EXAMINATION (PRE-INTERNSHIP: 2nd SEMESTER- SY 2021-2022
Prepared by: Raymundo Rosales II

46. All of the following conditions will interfere with the 51. Which of the following best represents the
measurements of LDH, EXCEPT: reference range for arterial pH?
a. Use of serum that was stored at a. 7.35 – 7.45/
room temperature for 24 hours/ b. 7.42 – 7.52
b. Serum the was frozen at -20C for 30 c. 7.38 – 7.68
days d. 6.85 – 7.56
c. Slight hemolysis during sample
collection 52. What is the electrolyte that balances the
d. Use of plasma from blood collected in movement of bicarbonate outside the red blood
EDTA cell?
a. Zinc
47. Which electrolyte measurement is LEAST affected b. Chloride/
by hemolysis? c. Sodium
a. Potassium d. Potassium
b. Calcium/ e. Phosphorus
c. Inorganic phosphorus
d. Magnesium 53. Select the anticoagulant of choice for blood gas
studies.
48. Which electrolyte is least likely elevated in renal a. EDTA
failure? b. Sodium citrate
a. Potassium c. Lithium heparin/
b. Magnesium d. Ammonium oxalate
c. Inorganic phosphorus e. No anticoagulant is recommended
d. Sodium/
54. The most ideal collection device for arterial blood
49. Which isoenzyme of ALP is inhibited by L- sampling is:
phenylalanine? a. At least 5 mL disposable syringe
a. Intestinal and placental/ b. 1 to 3 mL disposable syringe/
b. Bone and intestinal c. Heparinized Capillary tube
c. Liver and placental d. Heparinized Evacuated tube system
d. Renal and liver
55. In-vitro and in-vivo hemolysis may ______ serum
50. One of the laboratory parameter to be considered potassium level.
in the diagnosis of Cushing’s syndrome is: a. Decrease
a. PTH and GH b. Elevate/
b. Cortisol/ c. No affect
c. Calcitonin d. None of the above
d. C- Peptide
e. ACTH

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CLINICAL CHEMISTRY
COMPREHENSIVE EXAMINATION (PRE-INTERNSHIP: 2nd SEMESTER- SY 2021-2022
Prepared by: Raymundo Rosales II

56. The products formed from the forward reaction of

AST:
a. Alanine and alpha ketoglutarate 60. Increase plasma osmolality causes which
b. Oxaloacetate and glutamate/ physiologic regulatory mechanisms?2pts
c. Aspartate and glutamine 1- Increase AVP
d. Glutamate and NADH production
2- Decrease AVP
57. The reference method for determining the second production
most abundant intracellular cation is: 3- Increase thirst
a. Ion-selective electrode (ISE) sensation
b. Atomic absorption 4- Decrease thirst
spectrophotometry/ sensation
c. Nephelometry and turbidimetry 5- Increase renal water
d. Electrical impedance excretion
6- Decrease renal water
58. How is the specimen for lactate assay ideally excretion
stored? 7- Increase aldosterone
a. On ice/ production
b. At refrigerator temperature 8- Decrease aldosterone
c. At room temperature production
d. At body temperature Choices:
e. Not applicable a. 1, 3, 5, 8
b. 2, 3, 5, 7
59. Increased renal excretion of magnesium occurs c. 1, 3, 6, 8/
in: d. 2, 4, 6, 7
a. Hyponatremia and
hypoparathyroidism
b. Hypercalcemia and hyponatremia
c. Hypernatremia and
hypercalcemia/
d. Hypoaldosteronism and
hypoparathyroidism

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