Chem 40005 - Clinical Chemistry » Summer 2021 » Module 7 Quiz

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Question #1
The role of the clinical laboratory in diagnosis of diabetes mellitus involves initial diagnostic criteria. For many years, the only diagnostic criterion required was demonstration of hyperglycemia in two or more fasting plasma glucose tests. What other laboratory analysis is now considered to be useful as a diagnostic criterion?
A.   Presence of ketones in urine on more than one occasion
B.   Demonstration of elevated hemoglobin A1c
C.   Demonstration of impaired glucose tolerance in the OGTT
D.   Consistent hyperglycemia after a 72-hour fast
Question #2
A pregnant woman at 27 weeks gestation is screened for gestational diabetes mellitus. Plasma venous glucose was measured at 1 hour following a 50 g oral glucose load. What value must this glucose be above or equal to for a glucose tolerance test to be performed?
A.   The value must be ≥500 mg/dL glucose.
B.   The value must be ≥200 mg/dL glucose.
C.   The value must be ≥140 mg/dL glucose.
D.   The value must remain within healthy glucose reference interval.
Question #3
An individual with a severe, uncontrolled case of type 1 diabetes mellitus will exhibit all of the following laboratory results except
A.   decreased blood pH with increased ketone bodies.
B.   hyperinsulinemia.
C.   hyperglycemia.
D.   hyperlipidemia.
Question #4
Type 2 diabetes mellitus
A.   is also referred to as gestational diabetes.
B.   is associated with resistance to the action of insulin.
C.   is often initially observed in an individual with ketoacidosis.
D.   occurs less frequently than type 1 diabetes.
Question #5
Factors identified as associated with (and possibly causing) type 1 diabetes mellitus include all of the following except
A.   autoimmune reaction.
B.   genetic factors.
C.   absolute deficiency of insulin.
D.   insulin resistance.
Question #6
High albuminuria is defined as
A.   increased urinary albumin excretion between the range of 20–200 µg/min that is measured by the laboratory in the chronic management of diabetes mellitus.
B.   an albumin molecule that is larger and less functional because of the effects of hyperglycemia that is measured by the laboratory in the clinical diagnosis of diabetes.
C.   a large albumin molecule that is present only in urine and that is measured by the lab in preclinical screening for diabetes.
D.   a long-lived glycated albumin molecule found in the urine of a type 2 diabetic and measured by the laboratory in the acute management of a diabetic.
Question #7
Determining urinary albumin excretion (UAE) is critical in type 1 and type 2 diabetics because
A.   increased UAE is highly predictive of and is thought to precede diabetic nephropathy and end-stage renal disease.
B.   UAE increase indicates increased glycation of serum albumin that forms fructosamine and leads to ketoacidosis.
C.   it assesses the long-term blood glucose concentration in a diabetic to monitor glucose control over an 8- to 12-week period.
D.   this indicates increased attachment of glucose to proteins, lipids, and nucleic acids that contribute to the microvascular complications of diabetes.
Question #8
In the process of atherosclerotic plaque formation, what is the typical precipitating event?
A.   Cellular involvement and clot formation
B.   Release of tissue factor leading to coagulability
C.   Increased concentration of circulating coagulation factors
D.   Damage to the endothelium of cardiac blood vessels
Question #9
Which one of the following troponins appears as uncomplexed or free following myocardial injury?
A.   Cardiac troponin C
B.   Cardiac troponin I
C.   Cardiac troponin T
D.   Ternary complex of T-I-C
Question #10
Chest pain that is associated with a decrease in oxygen supply to the heart muscle but that exhibits no cellular necrosis based on cardiac troponin value and is considered a less severe event is referred to as
A.   thrombolysis.
B.   congestive heart failure.
C.   angina.
D.   acute myocardial infarction.
Question #11
Which one of the following cardiac markers is elevated for the longest period of time after a myocardial infarction?
A.   Troponins
B.   CK-2 (CK-MB)
C.   Myoglobin
D.   hs-CRP
Question #12
Which one of the following cardiac biomarkers is elevated about 50 times the upper limit of normal at 24 hours after onset of an acute myocardial infarction?
A.   Troponin
B.   CK-2 (CKMB)
C.   Myoglobin
D.   Total CK
Question #13
The most common laboratory method used to assess brain natriuretic peptides is
A.   serum electrophoresis.
B.   HPLC.
C.   nephelometry.
D.   immunoassay.
Question #14
Regarding assessment of congestive heart failure, NT-proBNP can be measured. This protein is
A.   the N-terminal fragment of proBNP.
B.   an isoenzyme that migrates separately from BNP on an electrophoresis.
C.   degraded by circulating proteases to form the final form of BNP.
D.   the C-terminal portion of the prepro-hormone natriuretic peptide (BNP).
Question #15
You have been asked what laboratory tests should be requested to assess the electrolyte balance regulatory function of an individual’s kidneys. Which of the following is your reply?
A.   Serum sodium and potassium, and arterial blood pH
B.   Serum and urine protein
C.   Serum creatinine, serum urea, serum uric acid, and creatinine clearance
D.   Serum renin and erythropoietin
Question #16
Secretion of renin and aldosterone is induced by low blood pressure and volume. Renin is synthesized in the _____ and aldosterone is made in the _____.
A.   adrenal gland; kidney
B.   kidney; adrenal gland
C.   adrenal gland; brain
D.   kidney; brain
Question #17
In an individual with chronic kidney disease, what might be the predominant cause of the low hemoglobin value and anemia?
A.   Bone loss from decreased 1,25(OH2) vitamin D3 synthesis
B.   Decreased iron absorption
C.   Folate deficiency
D.   Decreased erythropoietin synthesis
Question #18
The functional unit of the kidney is the
A.   lobule.
B.   bladder.
C.   glomerulus.
D.   nephron.
Question #19
If a physician requests a creatinine clearance on an individual, what is the physician attempting to determine?
A.   Urine creatinine level
B.   Random urine output volume
C.   Glomerular filtration rate (GFR)
D.   Serum creatinine level
Question #20
Secretion of renin and aldosterone is induced by low blood pressure and volume. What other hormone would be released in the event of low blood pressure and volume?
A.   Erythropoietin
B.   Growth hormone
C.   1,25(OH2) Vitamin D3
D.   Antidiuretic hormone

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