Download Chemistry ASCP Exam ACCURATE QUESTIONS AND DETAILED ANSWERS | GUARANTEED PASS | GRADED A and more Exams Chemistry in PDF only on Docsity! Chemistry ASCP | ACCURATE QUESTIONS AND DETAILED ANSWERS | GUARANTEED PASS | GRADED A | LATEST UPDATE 2024-2025 WITH 150 QUESTIONS What conclusion can be made if a person has a cardiovascular risk that is abnormal? - CORRECT ANSWER-The person has an increased probability of developing cardiovascular disease Which of the following is used primarily for the treatment of manic- depression? - CORRECT ANSWER-Lithium Deviation from Beer law are caused by: - CORRECT ANSWER-Stray light based on the that absorbance is directly proportional to the concentration of a solution. Troponin I is used frequently to assess acute myocardial infarction. If patient has experienced on AMI, at what point will the troponin I begin to increase and how long will it stay increased? - CORRECT ANSWER-3-12 hours and elevated until 7-14 days Which of the following would be considered a normal cerebrospinal fluid glucose level if the serum glucose is 70 mg/dL? - CORRECT ANSWER-About 45 mg/dL Which of the following would most likely occur as the result of hemodilution: - CORRECT ANSWER-Low serum electrolyte values The lecithin to sphingomyelin ratio (L/S) is used to assess: - CORRECT ANSWER-Fetal lung maturity Which analyze measurement is used to detect early nephropathy in a diabetic patient - CORRECT ANSWER-Albumin When iontophoresis is used to collect sweat for chloride analysis, pilocarpine is used to: - CORRECT ANSWER-Induce the sweat secretion Which of the following is the most specific biochemical marker of myocardial infarction? - CORRECT ANSWER-Troponin Which of the following is true concerning atherosclerosis ? - CORRECT ANSWER-Atherosclerosis is the deposition of plague containing cholesterol and lipids on the innermost layer of walls of large and medium sized arteries Zinc deficiency in the elderly is often caused by: - CORRECT ANSWER-Decreased intake and absorption Which of the following forms of calcium is biologically active? - CORRECT ANSWER-Free ionized calcium A lipid panel is composed of which of the following test? - CORRECT ANSWER-Cholesterol, lipoprotein, high density cholesterol, triglycerides Iontophoresis is a technique used in the diagnosis of? - CORRECT ANSWER-Cystic fibrosis- since it is ionizable through intact skin by the administration of continuous - CORRECT ANSWER-Increase - long term used alcohol abuse cause accumulation of lipid in hepatocytes. Cholesterol is used by the body for which of the following function? - CORRECT ANSWER-Processor of hormone synthesis Chylomicrons carry dietary triglycerides to the cells and bicarbonate helps to maintain acid-base balance The production of neutral 17-Ketosteroids is a measure of which of the following? - CORRECT ANSWER-Androgen production- male steroid hormones Elevation in conjugated bilirubin is most likely to be found in which of the following condition? - CORRECT ANSWER-Biliary obstruction Unconjugated bilirubin included: Crigler-Najjar syndrome Erythroblastosis fetalis Transfusion reaction In the condition kernitcterus, the abnormal accumulation of bilirubin occurs in what tissue? - CORRECT ANSWER-Brain- This process will cause a build up of unconjugated bilirubin in the bloodstream from the breakdown of red blood cells Respiratory acidosis is associated with - CORRECT ANSWER-Increased pCO2 Recently the ADA recommended reporting which of these values to correlate with hemoglobin A1 as a further indicator of glycemic control? - CORRECT ANSWER-Estimate average glucose Creatinine excretion correlates best with which of the following parameter? - CORRECT ANSWER-Muscle mass A patient has the following test: Increase serum phosphorus level Decreased serum calcium level Decreased serum parathyroid hormone - CORRECT ANSWER-Hypoparathyroidism Increase in PTH - CORRECT ANSWER-Hyperparathyrodism Increase calcium level - CORRECT ANSWER-Hypercalcemia Decrease potassium level - CORRECT ANSWER-Hypokalemia Which of the following statements about diagnosing gestational diabetes is true? - CORRECT ANSWER-All non-diabetic pregnant women should be screened at 24 to 28 weeks gestation Which of the following will give the best overall picture of a patient's iron stores? - CORRECT ANSWER-Ferritin The other form is hemosiderin What additional fraction would be seen if plasma rather than serum was subjected to electrophoresis? - CORRECT ANSWER-Fibrinogen Which of the following conditions would make a sample unsuitable for lactic acid testing? - CORRECT ANSWER-Movement of hand or arm during specimen collection Estriol levels in conjunction with hCG, inhibin A and alpha fetoprotein (AFP) can be obtained during pregnancy to - CORRECT ANSWER-Assess the risk of Down's syndrome The accuracy of an immunoassy is it ability to discriminate between result that are true positive and result that are true negative. Two parameter of test accuracy are specificity and sensitivity. Which of these statement apply to an immunoassay with low sensitivity - CORRECT ANSWER- Has many false negative result decrease T4 Increase TSH Increase TRH stimulation - CORRECT ANSWER-Hashimoto thyroiditis Acute phase protein generally fall into which category? - CORRECT ANSWER-Glycoproteins An increase in CEA levels is most closely associated with which of the following organs? - CORRECT ANSWER-Colon Increased concentration of alpha fetoprotein (AFP) in adults are most characteristically associated with? - CORRECT ANSWER-hepatocellular carcinoma A physician needs to prescribe a drug to a patient but the drug has a narrow therapeutic window. he is concerned about possible toxic effects. To assess upper concentration of such a triglycerides bicarbonate ALP albumin AST - ANSWER these will be increased in serum fluorometry - ANSWER atoms absorb light of specific wavelength and emit light of longer wavelength. 90 degrees, more sensitive than colormetry. used to measure drugs and hormones chemiluminescence - ANSWER chemical rxn produces light,extremely sensitive and is used in immunoassys turbidity - ANSWER used to measure proteins in urine and in CSF nephelometry - ANSWER similar to turbidity but light is measured at an angle G6PD on the amino-terminal valine of the beta chain - ANSWER A1c is used to measure what? boiling point - ANSWER the elution orders of volatiles is based upon what? 70-99 - ANSWER fasting glucose range >60 - ANSWER HDL range <100 - ANSWER LDL range <150 - ANSWER triglyceride range 6.4-8.3 - ANSWER total protein range 3.5-5 - ANSWER albumin range osteoporosis - ANSWER high urine and serum n-telopeptide type 1 collagen albumin > alpha-1 globulin >alpha-2 > beta > gamma - ANSWER order of protein electrophoresis gamma region - ANSWER Bence-jones proteins migrate to which region in electrophoresis? Pheylkentonuria (PKU) - ANSWER deficiency of an enzyme that converts phenylaline to tyrosine. Causes retardation and mousy odor urine. Use Guthrie bacterial inhibition assay to confirm. all newborns are screened Tyrosinemia - ANSWER disorder of tyrosine catabolism. Causes liver and kidney disease. diagnosed by MS Alkaptonuria - ANSWER deficiency of the enzymes needed in the metabolism of tyrosine and phenylaline. Build up of homogentisic acid. Black urine and darkening of tissues. Hip and back pain. diagnosed by gc/ms maple syrup urine disease - ANSWER Enzyme deficiency leading to the build up of leucine, isoleucine, and valine. Burnt sugar urine and breath. Failure to thrive. Mental retardation, acidosis, seizures, coma and death. Diagnosed by modified Guthrie and MS Homocystinuria - ANSWER deficiency in the enzyme needed to metabolize methionine. Buildup of methionine and homocystine. Causes osteoporosis, dislocated lenses, mental retardation, and thrombolic events. Diagnosed by modified Guthrie and MS cystinuria - ANSWER increased excretion of cystine due to a defect in renal absorption. Recurring kidney stones. Test urine w/ cyanide nitro-prusside 1st order kinetics - ANSWER enzyme > substrate 2nd order kinetics - ANSWER substrate > enzyme cTn - ANSWER definitive marker for AMI ck-mb - ANSWER DX of AMI; increased w/ physical activity; used to be the gold standard for AMI ALT - ANSWER increased in liver disease and viral hep; more specific than AST cCRP - ANSWER BEST single biomarker for predicting cardiovascular events UDP-glucuronyl transferase - ANSWER Converts unconjugated bilirubin in the liver to conjugated Rayleigh's Law - ANSWER when incident wavelengths are much longer than the particle diameter there is max backscatter and min right-angle scatter glutamate dehydrogenase - ANSWER The urease reaction in the UV enzymatic method for BUN is coupled w/ what second enzyme? Hexokinase & G6PD - ANSWER What enzymes are used in the oliver-rosalki method for the measurement of creatine kinase activity? Urobilinogen - ANSWER Elrlich-aldehyde reaction detects... Hexokinase - ANSWER What is the ref method for measuring serum glucose? Glucose oxidase - ANSWER Most specific enzyme that reacts w/ beta-D-glucose septic meningitis, cancer, and MS - ANSWER levels of glucose in CSF below 40 are indicative of ? hurler's syndrome - ANSWER autosomal recessive disease resulting from a deficiency of iduronidase. mucopolysaccarides accumulate in the lysomes. multiple organ failure, resulting in early mortality. G-6-PD - ANSWER what is the enzyme that is deficient in von Gierke's disease? D-xylose absorption test - ANSWER used for the differential diagnosis between pancreatic insufficiency from malabsorption Bilirubin - ANSWER what does albumin transport? free Hgb - ANSWER what does haptoglobin transport? ferric iron - ANSWER what does transferrin transport? alpha = unconjugated beta = monoglucuronide gamma = diglucuronide delta = irreversibly albumin - ANSWER HPLC seperates bilirubin into these 4 sections... direct bilirubin assay - ANSWER reacts w/ diazo reagent along w/ conjugated bilirubin Dubin-Johnson syndrome - ANSWER produces mild jaundice from accumulation of conjugated bilirubin that is not secreted into the bile canaliculi ACTH - ANSWER stimulates production of adrenocortical hormones by adrenal cortex. increased in cushing's disease. Highest levels are in the early AM TSH - ANSWER stimulates production of T3 and T4 by thyroid. increased in hypothyroidism (primary). decreased in hyperthyroidism ADH - ANSWER Stimulates reabsorption of water in renal distal tubules. Release is stimulated by an increase in osmolality. decreased in diabetes T4 & T3 - ANSWER increased in hyperthyroidism decreased in hypothyroidism calcitonin - ANSWER inhibition of Ca2+. important for the diagnosis of thyroid cancer PTH - ANSWER regulation of Ca2+ and phosphate increased in primary hyperthyroidism decreased in hypothyroidism primary hypothyroidism (thyroid insufficiency) - ANSWER TSH = increase T4 = increase T3 = decrease secondary hypothyroidism (pituitary insufficiency) - ANSWER TSH = decrease T4 = decrease T3 = decrease Hyperthyroidism - ANSWER TSH = decrease T4 = increase T3 = increase Crigler-Najjar Type 1 - ANSWER Causes total deficiency of UDP-glycuronyl transferase. Life expectancy <1 year Crigler-Najjar Type 2 - ANSWER lesser jaundice. absence of kernicterus. levels can be controlled w/ phenobarbital Lucey-Driscoll syndrome - ANSWER rare form of jaundice. caused by an inhibitor of UDP- glycuronyl transferase in the maternal plasma that crosses the placenta. Usually severe enough to require treatment. Jendrassik-Grof - ANSWER measures the total bilirubin based upon diazo reaction that may be suppressed by HgB. Uses caffeine to solubilize unconjugated bilirubin. Fehling's reagent is added after the diazo reagent to reduce optical interference by HgB. Creatinine Clearance - ANSWER (Urine/Plasma X Vol. of Urine) X 1.73/Pt surface Area Jaffe reaction - ANSWER To detect creatinine. Uses saturated picric acid and NaOH for detection. Its non-specific. Pyruvate, protein, and ascorbate will cause interference. This is reduced by a timed reaction (20-80 sec). Test is less specific than the peroxidase coupled enzymatic assay glomeruli - ANSWER Urea is completely filtered by ? Urease-UV method - ANSWER Measures BUN. Urease reation is coupled with glutamate dehydrogenase reaction generating NAD+ - F to A to S to C + - ANSWER Hgb migration at pH 6.2 Immunofixation electrophoresis (IFE) - ANSWER Used to identify monoclonal bands in serum or urine. Must both be tested when looking for a monoclonal gammopathy. CSF concentrated to 50 to 100X before performing Serum-free light chain immunoassy (immunoephelometric) - ANSWER Most sensitive when detecting monoclonal gammopathies MGUS - ANSWER most common cause of monoclonal gammopathy. 5% of US pop over 70 - Chylomicros to Beta 1 to Pre Beta & VLDL to alpha + - ANSWER lipoprotein migration at 8.6 50% protein 30% phospholipid 20% cholesterol - ANSWER HDL weight IDL - ANSWER This accumulates in familial Beta dyslipoproteinemia... Tangier disease - ANSWER Deficiency of apo A-1, heterozygotes have about half of the normal level of HDL and homozygotes have almost no detectable HDl. Caused by a mutation in the ATP- binding cassette gene ldl = 7 hdl = 10 - ANSWER subfractions of LDL and HDL Niemann-Pick disease - ANSWER Deficiency of sphingomyelinase Glycerol kinase - ANSWER Common enzyme in all enzymatic methods for tryglyceride measurement Abell-kendall method - ANSWER ref method for cholesterol assay. Saponification is performed to hydrolyze the fatty acid esters of cholesterol, forming free cholesterol. (uses cholesterol esterase) Lipoprotein a - ANSWER Independent risk factor for atherosclerosis. Significant when elevated in serum International Unit (IU) - ANSWER the quantity of enzyme that coverts 1 umol of substrate to product per min Pernicious anemia - ANSWER Produces the highest serum LD Oliver-Rosalki - ANSWER Method for CK based upon the formation of ATP from creatine phosphate Muscular dystrophy - ANSWER Highest levels of CK are seen in? abnormal within 2 hours peaks within 12 back to normal at 36 hours - ANSWER Myoglobin levels in AMI abnormal within 4 hours peaks within 24 normal in 1 week - ANSWER Tn1 or TnT levels in AMI High sensitivity C-reactive protein (hs-CRP) - ANSWER Becomes abnormal in the earliest stage of coronary syndrome Actherosclerosis and increased risk of thrombosis - ANSWER High levels of homocysteine are associated with what? ALP - ANSWER Primary diagnostic utility to help differentiate necrotic jaundice (increase in ALT) from obstructive jaundice Bowers-McComb - ANSWER method for detection of ALP uses the substrate p-nitrophenyl phosphate Mumps - ANSWER This is associated with high-level of S-Type amylase Pseudocholinestrase - ANSWER Usually depressed in liver disease Aldolase - ANSWER Usually increased in the plasma of a person suffering from a muscle wasting disorder Whole blood - ANSWER G-6-PD is measured using? Pyruvate and glutamate - ANSWER Products formed from ALT reaction LD - ANSWER Increased in necrotic jaundice more than obstructive Estiol (E3) - ANSWER This is decreased by 25% in pregnant women who have a fetus with down syndrome ionic charge of proteins - ANSWER the migration of proteins of cellulose acetate is primarily based on? 10% - ANSWER recommended bleach disinfectant for the lab Blood lactate levels - ANSWER This will increase if circulation and tissue oxygenation are impaired Specificity - ANSWER TN/TN+FP Sensitivity - ANSWER TP/TP+FN Single nucleotide polymorphism (SNP) - ANSWER Evaluated by a melting curve analysis proximal convoluted tubule - ANSWER Approx 80% of all water and salts are reabsorbed by the... Increases in MB fraction of CK is associated with: A. Liver disease B. Bone disease C. Kidney Failure D. Myocardial infarction - CORRECT ANSWER-D When evaluating a 2 hour glucose tolerance test report performed on a pregnant woman, which of the following results is considered normal? - CORRECT ANSWER-A 2 hours glucose level less than 140 mg/dl A urine specimen which was collected in a dark container, stored in the dark, has a pH of 7.5 and whose sample aliquot is wrapped in foil, is most likely being send for? - CORRECT ANSWER- Porphyrins- needed to limited the exposed of light Which of the following statements about the test for C-reactive protein CRP is true? - CORRECT ANSWER-It is an indicator of an inflammatory condition CPR is one of the first acute raised produced by the liver Which statement below regarding the diagnosis of pancreatitis is correct? - CORRECT ANSWER- Diagnostic sensitivity for acute pancreatitis is increased by assaying both amylase and lipase Which of the following methods may be employed to definitively identify Bence-Jones protein? - CORRECT ANSWER-Immunoelectrophoresis Associated with multiple myeloma dipstick (negative) --> Sulfosalicylic acid (positive) --> precipitate between 40-60C TIBC (Total iron binding capacity) is an indirect measurement of which of the following? - CORRECT ANSWER-Transferrin - is a glycoprotein that reversible binds iron. Serum transferrin = 0.7 X TIBC What are the acute phase protein? - CORRECT ANSWER-Alpha 1 antitrypsin C Reactive protein Fibrinogen Patients who develop severe sepsis or septic shock commonly have ___ plasma lactate value - CORRECT ANSWER-Increase Thin layer chromatography is particular useful as a tool in the identification of: - CORRECT ANSWER-Drug A patient suffering from Celiac disease and Crohn disease (both inflammatory conditions of GI tract( is given a new or medication that has a narrow therapeutic window. Which of the following would be true? - CORRECT ANSWER-Therapeutic drug monitor TDM would be helpful to see how much drug has been absorbed A patient has optimal LDL and HDL cholesterol values but a hsCRP test shows a value of 12 mg.L . Which of the following situation is most likely? - CORRECT ANSWER-The patient has an underlying acute inflammation process