Competency In Biochemistry And Immunochemistry

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  • 1/46 Questions

    When a clot is detected in Beckman LX 20 pro, the system will do one retry to aspirate the sample. If the retry is successful, testing will continue and the missed test will be rescheduled. If the retry is unsuccessful, no sampling will occur from the sample.

    • True
    • False
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About This Quiz

You are given 30 mins to complete the questions. The passing score is 50%.

Competency In Biochemistry And Immunochemistry - Quiz

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  • 2. 

    In a hemolytic crisis, bilirubin levels are________________.

    • Normal

    • Increased

    • Decreased

    Correct Answer
    A. Increased
    Explanation
    In a hemolytic crisis, bilirubin levels are increased. This is because hemolysis, the breakdown of red blood cells, releases large amounts of bilirubin into the bloodstream. Bilirubin is a yellow pigment that is produced when red blood cells are broken down, and it is normally processed by the liver and excreted in the bile. However, in a hemolytic crisis, the liver may not be able to keep up with the increased bilirubin production, leading to elevated levels in the blood.

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  • 3. 

    Serum bilirubin measurement using Leica bilirubinometer should ideally be performed on neonates less than 4 weeks old or have not consumed any solid food.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The explanation for the given correct answer is that the measurement of serum bilirubin using Leica bilirubinometer is most accurate and reliable in neonates who are less than 4 weeks old or have not consumed any solid food. This is because bilirubin levels can vary in infants who are older or have started solid food, making the measurement less accurate. Therefore, to obtain the most reliable results, this test should ideally be performed on neonates within the specified age range or feeding status.

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  • 4. 
    What is the crystal shown in the picture above? - ProProfs

    What is the crystal shown in the picture above?

    • Calcium oxalate

    • Uric acid

    • Triple phosphate

    • Tyrosine

    Correct Answer
    A. Calcium oxalate
    Explanation
    The crystal shown in the picture above is most likely calcium oxalate. This conclusion can be made based on the appearance of the crystal, which appears as a cluster of needle-like structures. Calcium oxalate crystals are commonly found in urine and can indicate the presence of certain medical conditions, such as kidney stones or urinary tract infections.

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  • 5. 

    G6PD deficiency is transmitted in a X-linked recessive trait.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    G6PD deficiency is indeed transmitted in an X-linked recessive trait. This means that the gene responsible for G6PD deficiency is located on the X chromosome. Since males have only one X chromosome, they are more likely to be affected by the condition if they inherit the defective gene. Females, on the other hand, have two X chromosomes, so they can be carriers of the gene without showing symptoms. This pattern of inheritance is characteristic of X-linked recessive disorders.

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  • 6. 

    The vendor's minimum clotting time recommendation for gel separation tube is 30 minutes.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The vendor recommends a minimum clotting time of 30 minutes for gel separation tubes. This means that the blood sample should be allowed to clot for at least 30 minutes before further processing or analysis.

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  • 7. 

    What type of sample can be used to test for protein?

    • CSF

    • Urine

    • Serum / Plasma

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    All of the above samples can be used to test for protein. CSF (cerebrospinal fluid) is a clear fluid that surrounds the brain and spinal cord, and it can be tested for protein levels. Urine can also be used to test for protein, as the presence of protein in urine can indicate various health conditions. Serum or plasma, which are components of blood, can also be tested for protein levels. Therefore, all three samples - CSF, urine, and serum/plasma - can be used to test for protein.

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  • 8. 
    Identify the structure indicated above. Biochemical test result: pH: 6.5 RBC: 3+ Leukocyte esterase: Neg Glucose: Neg Protein: Trace Bilirubin: Neg Nitrite: Neg - ProProfs

    Identify the structure indicated above. Biochemical test result: pH: 6.5 RBC: 3+ Leukocyte esterase: Neg Glucose: Neg Protein: Trace Bilirubin: Neg Nitrite: Neg

    • RBCs

    • WBCs

    • Yeasts

    • Hyphae

    Correct Answer
    A. Yeasts
    Explanation
    The given biochemical test results indicate a pH of 6.5, negative leukocyte esterase, negative glucose, trace protein, negative bilirubin, and negative nitrite. These results are consistent with a urinary tract infection caused by yeasts. Yeasts are fungi that can cause infections in the urinary tract, especially in individuals with compromised immune systems or those who have been on antibiotics. The presence of yeasts in the urine can be confirmed by microscopic examination, which may show budding yeast cells. Therefore, the structure indicated above is yeasts.

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  • 9. 
    The pH of the urine specimen was 8.0. What is the likely crystal seen above? - ProProfs

    The pH of the urine specimen was 8.0. What is the likely crystal seen above?

    • Amorphous phosphate

    • Uric acid

    • Triple phosphate

    • Tyrosine

    Correct Answer
    A. Triple phosphate
    Explanation
    The pH of the urine specimen is 8.0, which is alkaline. Triple phosphate crystals are commonly found in alkaline urine. Therefore, the likely crystal seen above is triple phosphate.

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  • 10. 

    Potassium level is higher outside the cell than inside.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The correct answer is False. The normal concentration of potassium is higher inside the cell than outside. This is because potassium ions are actively pumped into the cell by the sodium-potassium pump, which maintains the concentration gradient. This higher concentration of potassium inside the cell is important for various cellular processes such as maintaining membrane potential and regulating cell volume.

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  • 11. 

    What three changes will affect the results of the microscopic examination of urine if it is not tested within 2 hours?

    • Decreased bacteria, decreased RBCs, decreased casts

    • Increased bacteria, increased RBCs, increased casts

    • Increased bacteria, decreased RBCs, decreased casts

    • Decreased bacteria, increased RBCs, increased casts

    • None of the above

    Correct Answer
    A. Increased bacteria, decreased RBCs, decreased casts
    Explanation
    If urine is not tested within 2 hours, the bacteria present in the urine can multiply, leading to increased bacteria. On the other hand, red blood cells (RBCs) and casts are fragile and can deteriorate over time, resulting in decreased RBCs and decreased casts. Therefore, the correct answer is increased bacteria, decreased RBCs, decreased casts.

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  • 12. 

    Serum pH is a measure of the relative acidity or alkalinity of blood and is a reflection of the concentration of Hydrogen ions in blood. A high concentration gives a low pH (acid), while a low concentration gives a high pH (alkaline). What is the normal range for arterial pH?

    • 7.00 to 7.50

    • 7.40 to 7.50

    • 7.35 to 7.45

    • 7.30 to 7.50

    • None of the above

    Correct Answer
    A. 7.35 to 7.45
    Explanation
    The normal range for arterial pH is 7.35 to 7.45. This range indicates a slightly alkaline pH, which is necessary for proper functioning of the body's systems. Any deviation from this range can indicate an imbalance in the body's acid-base balance and may require medical intervention.

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  • 13. 

    Which of the following cause a white layer on the surface of serum/plasma when it is left to stand overnight?

    • Chylomicrons

    • VLDL

    • LDL

    • HDL

    Correct Answer
    A. Chylomicrons
    Explanation
    When serum/plasma is left to stand overnight, chylomicrons can cause a white layer to form on the surface. Chylomicrons are a type of lipoprotein that transport dietary fats from the intestines to various tissues in the body. They are composed of triglycerides, cholesterol, and proteins. When chylomicrons are present in high levels, they can separate and rise to the top of the serum/plasma, forming a white layer. This phenomenon is known as lipemia and is often seen in individuals with conditions such as hyperlipidemia or pancreatitis.

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  • 14. 

    Sedentary persons who consume rich diets sometimes suffer gout, a condition which may cause toes to swell and joints to become painful due to an accumulation of:

    • Glucose

    • Glycogen

    • Fatty tissue

    • Acetylcholine

    • Uric acid

    Correct Answer
    A. Uric acid
    Explanation
    Gout is a condition caused by the accumulation of uric acid in the joints. Uric acid is a waste product that is normally excreted by the kidneys. However, sedentary individuals who consume rich diets, particularly those high in purines (found in foods like red meat, seafood, and alcohol), may produce excessive amounts of uric acid and have difficulty excreting it. This can lead to the formation of urate crystals in the joints, resulting in inflammation, swelling, and pain. Therefore, uric acid is the correct answer in this context.

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  • 15. 

    Hyperkalemia can cause all of the following EXCEPT.

    • Neuromuscular symptoms

    • Muscle weakness

    • Decreased Vitamin D absorption

    • Heart arrhythmias

    Correct Answer
    A. Decreased Vitamin D absorption
    Explanation
    Hyperkalemia is a condition characterized by high levels of potassium in the blood. It can cause various symptoms and complications, including neuromuscular symptoms such as muscle weakness and heart arrhythmias. However, it does not directly affect the absorption of Vitamin D. Therefore, the correct answer is decreased Vitamin D absorption.

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  • 16. 

    Bilirubin is photosensitive to

    • Direct sunlight

    • Artificial light

    • Direct sunlight and artificial light

    • None of the above

    Correct Answer
    A. Direct sunlight and artificial light
    Explanation
    Bilirubin is photosensitive to both direct sunlight and artificial light. This means that exposure to these types of light can cause a reaction or degradation of bilirubin. It is important to protect bilirubin from direct sunlight and artificial light in order to prevent any negative effects on its stability or function.

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  • 17. 

    Which of the following enzymes is most specific for diagnosis of a Myocardial Infarction?

    • CK

    • CK-MB

    • Troponin

    • CRP

    Correct Answer
    A. Troponin
    Explanation
    Troponin is the most specific enzyme for the diagnosis of a Myocardial Infarction. Troponin is a protein found in cardiac muscle cells, and its levels in the blood increase after damage to the heart muscle, such as during a heart attack. Elevated troponin levels indicate myocardial injury, making it a reliable marker for diagnosing a myocardial infarction. CK (creatine kinase), CK-MB (creatine kinase-MB), and CRP (C-reactive protein) are also used in the diagnosis of heart conditions, but troponin is considered the most specific enzyme for detecting myocardial infarction.

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  • 18. 

    Which of the following statement is true?

    • Osmolality is a measure of the amount of solvent in solution.

    • The osmolality of serum increases with dehydration and decreases with overhydration.

    • The osmolality of serum decreases with dehydration as well as with overhydration.

    • The osmolality of serum decreases with dehydration but increase with overhydration.

    Correct Answer
    A. The osmolality of serum increases with dehydration and decreases with overhydration.
    Explanation
    Osmolality is a measure of the concentration of solutes in a solution. When someone is dehydrated, there is a decrease in the amount of water in the body, causing the concentration of solutes to increase. This leads to an increase in osmolality. On the other hand, when someone is overhydrated, there is an excess of water in the body, causing the concentration of solutes to decrease. This leads to a decrease in osmolality. Therefore, the correct statement is that the osmolality of serum increases with dehydration and decreases with overhydration.

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  • 19. 
    What is shown in picture above? - ProProfs

    What is shown in picture above?

    • Hyaline cast

    • Waxy cast

    • Granular cast

    • Epithelial cell

    Correct Answer
    A. Waxy cast
    Explanation
    The picture above shows a waxy cast. Waxy casts are cylindrical structures that are smooth, have a homogeneous appearance, and have a waxy texture. They are formed when there is stasis or slowing down of urine flow in the kidney tubules. Waxy casts are often associated with chronic kidney disease and indicate severe damage to the renal tubules. They can be seen in the urine under a microscope and are an important diagnostic finding in assessing kidney function.

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  • 20. 
    What is shown in the picture below? - ProProfs

    What is shown in the picture below?

    • RBC

    • WBC

    • Starch

    • Fat

    • None of the above

    Correct Answer
    A. Starch
  • 21. 

    Detection of CA 125 in peritoneal fluid is indicative of:

    • Colon cancer

    • Ovarian cancer

    • Gastric malignancy

    • Prostrate cancer

    • None of the above

    Correct Answer
    A. Ovarian cancer
    Explanation
    Detection of CA 125 in peritoneal fluid is indicative of ovarian cancer. CA 125 is a tumor marker that is often elevated in women with ovarian cancer. It is used to monitor the response to treatment and detect recurrence of the disease. Therefore, the presence of CA 125 in peritoneal fluid suggests the presence of ovarian cancer.

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  • 22. 

    Which of the following Westgard Rules primarily detect systematic error?

    • 1-2s

    • 2-2s

    • 1-3s

    • All of the above

    • None of the above

    Correct Answer
    A. 2-2s
    Explanation
    The Westgard Rules are a set of quality control rules used in laboratory testing to detect errors and ensure the accuracy of test results. The rule 2-2s is used to detect systematic errors, which are consistent errors that occur in a predictable manner. This rule flags results that are more than 2 standard deviations away from the mean in the same direction in two consecutive control measurements. By identifying systematic errors, laboratories can investigate and correct any issues that may be affecting the accuracy of their test results.

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  • 23. 

    ALP is elevated in the following disorder?

    • Addison's disease

    • Paget's disease

    • Scleroderma

    • Diabetes insipidus

    Correct Answer
    A. Paget's disease
    Explanation
    Paget's disease is a condition characterized by abnormal bone remodeling, leading to weak and brittle bones. ALP (alkaline phosphatase) is an enzyme that is involved in bone formation and is typically elevated in Paget's disease due to increased bone turnover. Addison's disease is a hormonal disorder affecting the adrenal glands, Scleroderma is a connective tissue disorder, and Diabetes insipidus is a condition characterized by excessive thirst and urination, none of which are typically associated with elevated ALP levels.

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  • 24. 

    The ability of an assay to reproducibly hit a target concentration is referred to as:

    • Sensitivity

    • Specificity

    • Precision

    • Accuracy

    • None of the above

    Correct Answer
    A. Precision
    Explanation
    Precision refers to the ability of an assay to consistently and reproducibly hit a target concentration. It measures the degree of agreement between repeated measurements or tests. A high precision means that the assay produces consistent and reliable results, even if they are not necessarily accurate. In other words, precision indicates the reliability or consistency of the assay in hitting the desired target concentration.

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  • 25. 

    Calibrators are samples from individuals known to be in the normal range that are used to check instrumentation set-up.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Calibrators are samples of known concentration used to set analyzer or instrumentation parameters.

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  • 26. 

    The principle of the urine reagent strip test for bilirubin is:

    • Diazo reaction

    • Ehrlich reaction

    • Greiss reaction

    • Peroxidase reaction

    • None of the above

    Correct Answer
    A. Diazo reaction
    Explanation
    The correct answer is diazo reaction. The diazo reaction is a chemical reaction that is used to detect the presence of bilirubin in urine. In this reaction, the reagent strip contains a diazonium salt, which reacts with bilirubin to produce a purple color. This color change indicates the presence of bilirubin in the urine sample. The diazo reaction is a specific and sensitive test for detecting bilirubin and is commonly used in medical laboratories for diagnosing liver and gallbladder diseases.

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  • 27. 

    Alcohol induces which of the following enzymes

    • Cholinesterase

    • AST

    • ALP

    • GGT

    Correct Answer
    A. GGT
    Explanation
    Alcohol induces the enzyme GGT (gamma-glutamyl transferase). GGT is primarily found in the liver and is involved in the metabolism of glutathione, a molecule that helps protect cells from oxidative damage. Increased levels of GGT in the blood are often seen in individuals who consume alcohol excessively, indicating liver damage or disease. Therefore, alcohol can stimulate the production of GGT, leading to higher levels of this enzyme in the body.

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  • 28. 
    Which analyte will be falsely elevated due to hemolysis? - ProProfs

    Which analyte will be falsely elevated due to hemolysis?

    • Glucose

    • LDL

    • Calcium

    • LDH

    Correct Answer
    A. LDH
    Explanation
    LDH (lactate dehydrogenase) is an enzyme found in red blood cells. When hemolysis occurs, the red blood cells break open and release LDH into the bloodstream, leading to falsely elevated levels of LDH. Glucose, LDL (low-density lipoprotein), and calcium are not directly affected by hemolysis.

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  • 29. 

    When comparing an instrument to its peer group, which statistic provides the most useful description of overall imprecision.

    • Mean

    • Standard Deviation

    • CVR

    • SDI

    • None of the above

    Correct Answer
    A. CVR
    Explanation
    CVR, which stands for Coefficient of Variation Ratio, provides the most useful description of overall imprecision when comparing an instrument to its peer group. CVR is a statistical measure that compares the standard deviation to the mean. It is used to assess the relative variability of a dataset, taking into account the scale of the data. A higher CVR indicates greater imprecision, while a lower CVR indicates greater precision. Therefore, CVR is a valuable statistic for evaluating the overall imprecision of an instrument in comparison to its peers.

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  • 30. 

    What is the read time for this QuickVue urine HCG kit?

    • 3 mins

    • 5 mins

    • 10 mins

    • 20 mins

    • None of the above

    Correct Answer
    A. 3 mins
    Explanation
    The correct answer is 3 mins. The QuickVue urine HCG kit has a read time of 3 minutes, which means that after adding the urine sample to the kit, the results can be read and interpreted after 3 minutes.

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  • 31. 

    What is the detection level of the QuickVue urine HCG test?

    • 50mIU/L

    • 25mIU/L

    • 20mIU/L

    • 10mIU/L

    • None of the above

    Correct Answer
    A. 25mIU/L
    Explanation
    The detection level of the QuickVue urine HCG test is 25mIU/L.

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  • 32. 

    What is produced in the reaction of G6PD test which fluoresce under long wave UV-light?

    • NAD

    • Gluconate 6-P

    • NADPH

    • NADP+

    Correct Answer
    A. NADPH
    Explanation
    NADPH is produced in the reaction of G6PD test which fluoresces under long wave UV-light.

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  • 33. 
    What is shown in the picture below? - ProProfs

    What is shown in the picture below?

    • Calcium carbonate

    • Ammonium biurate

    • Leucine

    • Tyrosine

    • None of the above

    Correct Answer
    A. Leucine
  • 34. 

    Faeces gets its brown pigmentation from _________________.

    • Stecobilirubin

    • Stercobilin

    • Stecobilin

    • Stercobilinogen

    Correct Answer
    A. Stercobilin
    Explanation
    Faeces gets its brown pigmentation from stercobilin. Stercobilin is a breakdown product of bilirubin, which is a yellow pigment produced from the breakdown of red blood cells in the liver. As bilirubin is further metabolized and excreted in the intestines, it undergoes a chemical reaction that results in the formation of stercobilin. This pigment gives feces its characteristic brown color.

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  • 35. 

    A strong odour of ammonia in a urine specimen could indicate: 

    • Ketones

    • Normal

    • Phenylketonuria

    • Urinary tract infection

    • None of the above

    Correct Answer
    A. Urinary tract infection
    Explanation
    A strong odor of ammonia in a urine specimen could indicate a urinary tract infection. Ammonia is a byproduct of bacterial metabolism, and a strong odor could suggest the presence of bacteria in the urinary tract. Urinary tract infections are typically caused by bacteria entering the urethra and multiplying in the urinary tract, leading to symptoms such as frequent urination, pain or burning during urination, and cloudy or strong-smelling urine. Therefore, a strong odor of ammonia in a urine specimen is a potential indicator of a urinary tract infection.

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  • 36. 

    HAMA antibodies occur as a result of:

    • Contamination of the sample with mouse proteins

    • Patient exposure to mice or mouse proteins

    • Immunization

    • Food allergies

    • None of the above

    Correct Answer
    A. Patient exposure to mice or mouse proteins
    Explanation
    HAMA antibodies occur as a result of patient exposure to mice or mouse proteins. This means that the patient has been exposed to mice or products derived from mice, which has triggered an immune response and the production of HAMA antibodies. These antibodies can interfere with diagnostic tests and lead to false-positive results. It is important to consider this possibility when interpreting test results and to take precautions to minimize the risk of contamination with mouse proteins in laboratory settings.

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  • 37. 

    Maple syrup urine disease results from an inborn error of metabolism of certain types of amino acids. Which ones?

    • Phenylalanine and tyrosine

    • Leucine, isoleucine, and valine

    • Serine and threonine

    • Any acidic amino acids

    • Cysteine and methionine

    Correct Answer
    A. Leucine, isoleucine, and valine
    Explanation
    Maple syrup urine disease is caused by a deficiency of the enzyme complex that breaks down the amino acids leucine, isoleucine, and valine. This leads to a buildup of these amino acids in the body, which can cause a sweet-smelling urine, neurological symptoms, and other health problems. Phenylalanine and tyrosine are not involved in this condition. Serine and threonine, any acidic amino acids, and cysteine and methionine are also not related to maple syrup urine disease.

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  • 38. 

    The principle of analysis for D10 analyser uses

    • Fractionating chromatography

    • High pressure anion exchange chromatography

    • High pressure cation exchange chromatography

    • Enzyme linked immunoassay

    Correct Answer
    A. High pressure cation exchange chromatography
    Explanation
    The D10 analyzer uses the principle of high pressure cation exchange chromatography for analysis. This technique involves separating charged molecules based on their interactions with a cation exchange resin. The sample is loaded onto the resin column, and the cations in the sample are exchanged with the cations on the resin. The analytes of interest are then eluted from the column by changing the pH or ionic strength of the eluent. This technique is commonly used for the separation and analysis of charged molecules in various fields including pharmaceuticals, environmental analysis, and biochemistry.

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  • 39. 

    Small changes in the body pH can be life threatening and these changes are regulated by buffers. Carbonic acid (H2CO3) and base bicarbonate (NaHCO3) are paired buffers that work to maintain homeostasis of body pH. What body systems control these buffers?

    • H2CO3 Metabolic | NaHCO3 Respiratory

    • H2CO3 Cardiac | NaHCO3 Respiratory

    • H2CO3 Respiratory | NaHCO3 Renal

    • H2CO3 Renal | NaHCO3 Respiratory

    • None of the above

    Correct Answer
    A. H2CO3 Respiratory | NaHCO3 Renal
    Explanation
    The correct answer is H2CO3 Respiratory | NaHCO3 Renal. The respiratory system controls the levels of carbonic acid (H2CO3) by regulating the rate of breathing, which affects the amount of carbon dioxide (CO2) in the body. The renal system controls the levels of bicarbonate (NaHCO3) by reabsorbing or excreting it in the urine. Together, these two systems work to maintain the balance of carbonic acid and bicarbonate in the body, ensuring proper pH regulation.

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  • 40. 

    Given the following arterial blood gas values: pH: 7.56 PCO2: 31 mm Hg HCO3: 27 mEq/l PO2: 56 mm Hg What is(are) the most likely acid-base state(s) in the patient?

    • Acute respiratory alkalosis

    • Chronic respiratory alkalosis

    • Respiratory alkalosis and metabolic alkalosis

    • Respiratory acidosis and metabolic acidosis

    • Respiratory alkalosis and metabolic acidosis

    Correct Answer
    A. Respiratory alkalosis and metabolic alkalosis
    Explanation
    Based on the given values, the patient has a high pH (7.56) and a low PCO2 (31 mm Hg), indicating respiratory alkalosis. Additionally, the HCO3 level (27 mEq/l) is higher than normal, suggesting metabolic alkalosis. Therefore, the most likely acid-base state(s) in the patient are respiratory alkalosis and metabolic alkalosis.

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  • 41. 

    Which of the following Westgard Rules primarily detect random error?

    • R-4s

    • 2-2s

    • 1-3s

    • A & c

    • Non of the above

    Correct Answer
    A. A & c
    Explanation
    The Westgard Rules are a set of quality control rules used in laboratory testing to detect errors and ensure the accuracy of test results. The R-4s rule primarily detects random error, which refers to unpredictable variations in test results that can occur due to factors such as instrument malfunction or operator error. Similarly, the 1-3s rule also detects random error by flagging test results that deviate significantly from the mean. Therefore, both options "a & c" are correct as they both primarily detect random error.

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  • 42. 

    When comparing an instrument to its peer group, which statistic provides the most useful information regarding its accuracy?

    • Mean

    • Standard deviation

    • CVR

    • SDI

    Correct Answer
    A. Mean
    Explanation
    The mean provides the most useful information regarding accuracy when comparing an instrument to its peer group. The mean represents the average value of a set of data, which can give an indication of the instrument's overall performance. By comparing the mean of one instrument to the mean of its peer group, one can determine how accurate the instrument is relative to its peers.

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  • 43. 

    The presence of xanthochromia in CSF specimen can be caused by all of the following EXCEPT

    • Immature liver function

    • RBC degradation

    • A recent hemorrhage

    • Elevated CSF protein

    Correct Answer
    A. A recent hemorrhage
    Explanation
    Xanthochromia in a CSF specimen refers to the presence of yellowish discoloration, indicating the breakdown of red blood cells. This can occur due to RBC degradation or a recent hemorrhage. Elevated CSF protein levels can also contribute to xanthochromia. However, immature liver function is not related to the presence of xanthochromia in CSF. Therefore, the correct answer is "A recent hemorrhage."

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  • 44. 

    A 42-year-old man is admitted to the hospital with dehydration and hypotension. Electrolytes show:   Na+ 165 mEq/L K+ 4.0 mEq/L CO2 32 mEq/L Cl- 112 mEq/L No arterial blood gas is obtained. Which statement best applies about this patient's acid-base status?

    • Electrolytes indicate the presence of metabolic acidosis.

    • Electrolytes indicate the presence of metabolic alkalosis.

    • Need serum albumin to make any clinically useful assessment of his metabolic acid-base disorders.

    • Electrolytes indicate the presence of both metabolic acidosis and metabolic alkalosis.

    • Need serum lactate to make any clinically useful assessment of his metabolic acid-base disorders.

    Correct Answer
    A. Electrolytes indicate the presence of both metabolic acidosis and metabolic alkalosis.
    Explanation
    His anion gap is Na - (CO2 + Cl) = 165 - (32+112) = 21, indicating a metabolic acidosis. His bicarbonate gap is (Na - Cl - 39) = 165 - 112 - 39 = 14, which indicates a metabolic alkalosis. Note that it is not necessary to actually calculate a bicarbonate gap, since the elevated serum CO2 (32 mEq/L) in the presence of anion gap acidosis is enough to signify concomitant metabolic alkalosis. Of course without blood gas measurements you don't know which process is predominant, but it is clear from the electrolytes that both metabolic disorders are present. You don't need to measure albumin nor lactate to make this determination.

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  • 45. 

    All the following Beckman reagent require a reagent transfer of Compartment "C" reagent into Compartment "A" EXCEPT

    • ALT

    • AST

    • CK

    • ALP

    • TG

    Correct Answer
    A. ALP
    Explanation
    The reagent transfer of Compartment "C" reagent into Compartment "A" is required for all the following Beckman reagents: ALT, AST, CK, and TG. The only exception is ALP, which does not require this reagent transfer.

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  • 46. 

    One or more of the following statements (A, B, C) about PO2 may be correct. Choose the single letter answer (a - e) that reflects which statement(s) is(are) correct. A) If the lungs and heart are normal, then PO2 is affected only by factors that affect alveolar PO2. B) In a person with normal heart and lungs, anemia should not affect PO2. C) The reason PO2 falls with increasing altitude is because barometric pressure falls.

    • Only A) is correct.

    • A) and B) are correct.

    • A) and C) are correct.

    • B) and C) are correct

    • A), B) and C) are correct.

    Correct Answer
    A. A), B) and C) are correct.
    Explanation
    The correct answer is A), B) and C) are correct.


    A) If the lungs and heart are normal, then PO2 is affected only by factors that affect alveolar PO2. This statement is correct because in a person with normal lung and heart function, the partial pressure of oxygen (PO2) in the blood is primarily determined by the oxygen levels in the alveoli of the lungs.

    B) In a person with normal heart and lungs, anemia should not affect PO2. This statement is correct because anemia, which is a decrease in the number of red blood cells or a decrease in their ability to carry oxygen, does not directly affect the partial pressure of oxygen in the blood.

    C) The reason PO2 falls with increasing altitude is because barometric pressure falls. This statement is correct because at higher altitudes, the atmospheric pressure decreases, leading to a decrease in the partial pressure of oxygen in the air. This decrease in oxygen pressure can affect the PO2 in the blood.

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  • Apr 08, 2010
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