SlideShare une entreprise Scribd logo
1  sur  17
Télécharger pour lire hors ligne
CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                               BODY FLUIDS



                                       Clinical & Chemical Pathology MCQs
                          Classified, Reorganized And Updated To Shawual 1425 With Short Notes                                                                                                                             Body fluids
                                                              By Dr Mohammad A. Emam                                                                                    1.       **Doctor sending a sample requesting for lecithin                 1.       (c) Amniotic fluid sample is used to measure
                                                                                                                                                                                 spingomyelin ratio what is the sample?                                     lecithin: sphingomyelin ratio (L/S). L/S > 2:1
                                                                                                                                                                                    a. Blood.                                                               (or 2.5:1) denotes acceptable lung maturity.
                                                  Contents                                                                                                                          b. CSF
              Body fluids ................................................................................. 2                                                                       c. Amniotic fluid.
                                                                                                                                                                                    d. Urine
              Clinical Chemistry .................................................................... 4
                   INSTRUMENTATION ...................................................................................................................4                 2.       ***Cytological examination of pleural effusion in a 60 yrs        2.       (d) Lung cancer: 75% of malignant pulmonary
                   BLOOD GASES, PH AND ELECTROLYTES. .............................................................................5                                              old man revealed the presence of malignant cells. The                      effusions are due to 3 causes; lung cancer
                   GLUCOSE, HEMOGLOBIN, IRON AND BILIRUBIN. ...............................................................7                                                     most likely primary tumor will be:                                         (30%), breast cancer (25%) & lymphoma (20%).
                   CALCULATIONS, QC AND STATISTICS ..................................................................................9                                               a. Lymphoma.                                                           Practically, cytological examination only
                   CREATININE, UA, BUN AND AMMONIA ...............................................................................10                                                 b. Mesothelioma.                                                       establishes the presence of malignant effusion,
                   PROTEINS, ELECTROPHORESIS AND LIPIDS .......................................................................11                                                    c. Cancer colon.                                                       however, in most cases it cannot identify the
                   CLINICAL ENZYMOLOGY........................................................................................................13                                     d. lung cancer.                                                        primary site of the tumor.
                   CLINICAL ENCOCRINOLOGY .................................................................................................14                                                                                                               Regarding mesothelioma, it is a rather a rare
              General ..................................................................................... 17                                                                                                                                              tumor of the pleura.

              Hematology .............................................................................. 19                                                              3.       *****Regarding Albustix:                                          3.       (c) Commercial strips for detecting albumin
                   BASIC HEMATOLOGY CONCEPTS / LABORATORY PROCEDURES ................................19                                                                            a. Useless if infected urine.                                            (Albustix) use the following formula:
                   NORMOCYTIC NORMOCHROMIC ANEMIAS .......................................................................20                                                       b. Gives red color.                                                      Tetrabromophenol blue (yellow at 3.0)
                   HYPOCHROMIC MICROCYTIC ANEMIAS .............................................................................24                                                  c. Not useful if acid is added to urine.                                 shades of green in the presence of protein at the
                   MACROCYTIC NORMOCHROMIC ANEMIA .........................................................................25                                                      d. Depends on acid precipitation of urinary proteins                     same pH.
                   QUALITATIVE / QUANTITATIVE WBC DISOREDERS ........................................................26                                                                                                                                     This reaction is sensitive to 0.03g/L albumin. A
                   LYMPHOPROLIFERATIVE / MYELOPROLIFERATIVE DISORDERS .................................29                                                                                                                                                   false negative result occurs with acidification of
                   COAGULATION AND PLATELETS ..........................................................................................35                                                                                                                   urine. Also, a markedly alkaline urine (pH or
              Immunohematology ................................................................ 40                                                                                                                                                          higher can give false +ve.

              Immunology ............................................................................. 41                                                               4.       ****Which is not a reducing sugar in urine?                       4.       (c) A reducing substance is the one that reduces
                                                                                                                                                                                   a. Glucose.                                                              alkaline cupric sulfate to red coprous oxide.
              Microbiology............................................................................ 43                                                                          b. Galactose.                                                            Most important are glucose, lactose, fructose,
                   ANTIBIOTICS, ANTIMICROBIALS, STERILIZATION AND DISINFECTION .....................43                                                                             c. Sucrose.                                                              galactoses and pentoses (e.g. ribose, xylose and
                   BASIC TECHNIQUES .................................................................................................................44                            d. Fructose.                                                             arabinose) while sucrose will not reduce alkaline
                   BASIC BACTERIOLOGY............................................................................................................46                                                                                                         cupric sulfate.
                   GRAM POSITIVE COCCI ...........................................................................................................47
                   GRAM NEGATIVE COCCI .........................................................................................................49                                                                                                          b. Rifampicin is a well known drug to cause red
                                                                                                                                                                        5.       ***Red urine is due to?                                           5.
                   GRAM POSITIVE BACILLI ........................................................................................................49                                a. INH                                                                   urine.
                   ENTEROBACTERECIAE & PSEUDOMONAS .........................................................................50                                                     b. Rifampicin
                   RICHETTSIAE, CHLAMYDIA AND MYCOPLASMA .............................................................52                                                           c. Pyrizinamide.
                   SPIROCHETES .............................................................................................................................53
                   BORDETELLA & BORRELIA ....................................................................................................53
                                                                                                                                                                        6.       **Urine strips detect all except                                  6.       Fat droplets. Occur with glomerulonephritis and
                   ANEROBIC BACTERIA ..............................................................................................................54
                                                                                                                                                                                                                                                            nephritic syndrome but are not detected by the
                   BRUCELLA ..................................................................................................................................55
                                                                                                                                                                                                                                                            routine urine strips.
                   MYCOBACTERIA .......................................................................................................................55
                   MISCELLANEOUS ......................................................................................................................56
                                                                                                                                                                        7.       **If urine is left for long time which is affected more?          7.       Urea. The most labile constituent of urine is
                   MYCOLOGY ................................................................................................................................57
                                                                                                                                                                                                                                                            urea. Bacterial action decrease urea and increase
                   VIROLOGY ..................................................................................................................................60
                                                                                                                                                                                                                                                            ammonia and pH.
              26th Shawual 1425 .................................................................. 64
                                                                                                                                                                        8.       **Abnormal constituent of urine includes?                         8.       (c) Although also glucose and protein are
                                                                                                                                                                                   a. Urea                                                                  abnormal constituents of urine, yet they
                                                                                                                                                                                   b. Glucose                                                               normally present in trace amounts below the
                                                                                                                                                                                   c. Cholesterol.                                                          detection limit of ordinary methods.
                                                                                                                                                                                   d. Uric acid
                                                                                                                                                                                   e. Protein.
         mohammad_emam@hotmail.com                                                                                                                           1                      mohammad_emam@hotmail.com                                                                                 2




CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                                                                    BODY FLUIDS        CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                              CHEMISTRY



9.    ****Calcium in urine stone is present in all of the                                         9.          (b) In 2ry hyperparathyroidism, hypocalcemia
      following except:
         a. UTI
                                                                                                              due to e.g. chronic renal failure is the cause of
                                                                                                              increased parathormone. Stones due to                                                             Clinical Chemistry
         b. Secondary hyperparathyroidism.                                                                    hyperparathyroidism only occur with the 1ry or
                                                                                                              3ry disease.
                                                                                                              Calcium is precipitated in stones with oxalate (at        INSTRUMENTATION
                                                                                                              acid or neutral pH), or less commonly with urate     1.        ******Difference between ELISA & RIA is ?                        1.        (a) Both techniques apply almost the same
                                                                                                              (at acidic pH) or with phosphate (at normal urine                 a. ELISA technique uses an enzyme.                                      methodology, .ELISA technique uses an enzyme
                                                                                                              pH). Causes of hypercalciurea include:                            b. ELISA is used by bacteriologists while RIA by                        label and RIA uses radioisotopic label.
                                                                                                                 - intestinal calcium absorption ( P level                      virologists
                                                                                                                    vit D     Ca absorption Or in case of
                                                                                                                 hypervitaminosis D.                               2.        The label in ELISA is?                                           2.
                                                                                                                 - Lack of renal tubular reabsorption e.g. with                 a. Enzyme
                                                                                                                 furosamide.                                                    b. Antibody
                                                                                                                 - Loss of Ca from bone (due to mobilization                    c. Antigen.
                                                                                                                 as in 1ry & 3ry hyperparathyroidism, due to
                                                                                                                 bone destruction or due to Cushing's and          3.        ***Which of the following not seen in chemistry lab?             3.        (d) Electron microscope.
                                                                                                                 thyrotoxicosis)                                                a. Analytic balance.
                                                                                                              Otherwise, UTI causes stones at alkaline pH                       b. Centrifuge
                                                                                                              where ammonium is high and mixed stones form                      c. Spectrophotometer
                                                                                                              due to obstructing Ca stone which favors                          d. Electron microscope,
                                                                                                              infection and precipitation of ammonia salts.                     e. Turbidimeter.

10.   If urine is kept for a long time:                                                           10.         See 7.                                               4.        **The washing is must in all heterogenous ELISA                  4.        (b) In ELISA, the first washing is used to
            a. Becomes black.                                                                                 Urine becomes black on standing in cases of                    techniques because?                                                        remove the unbound (free) sample antigen. The
            b. Urea increases.                                                                                alkaptonurea ( homogentesic acid) and                              a. It remove the excess binding                                        second washing removes unreacted free label
            c. Urea decreases.                                                                                methemoglobinurea.                                                 b. Increase the specificity                                            (not excess binding in either of the 2 washings)
            d. Creatinine increases                                                                                                                                              c. Increase the sensitivity.                                           If washing is not complete, this will false high
11.   Myoglobinuria is seen in:                                                                   11.         Muscle injury (also known as rhabdomyolysis)                                                                                                     specificity.
                                                                                                              e.g. in cases of crush injuries and strenuous                                                                                             If the question comes as It avoids excess
                                                                                                              exercise.                                                                                                                                 binding, then this will be the choice.

                                                                                                                                                                   5.        **The enzyme in ELISA is present in the?                         5.        (a) The conjugate is the second antibody
                                                                                                                                                                                a. Conjugate                                                            conjugated with the enzyme.
                                                                                                                                                                                b. Microplate
                                                                                                                                                                                c. Buffer.

                                                                                                                                                                   6.        **A standard microplate in an ELISA has?                         6.        (a) 96 wells are present in the microplate (8
                                                                                                                                                                                a. 96 wells                                                             rows x 12 columns).of these, 1 is used for the
                                                                                                                                                                                b. 98 wells                                                             blank, 2 for the –ve controls, 2 for the +ve
                                                                                                                                                                                c. 92 wells.                                                            controls and 4 for the cutoff control (COC). The
                                                                                                                                                                                                                                                        remaining 85 for tests.

                                                                                                                                                                   7.        Five ml of a colored solution has an absorbance of 0.500.        7.        (b) According to Beer's law, absorbance is
                                                                                                                                                                             The absorbance of 10ml of the same colored solution will                   proportional to the final concentration (whatever
                                                                                                                                                                             be:                                                                        the volume is)
                                                                                                                                                                               a. 1.000
                                                                                                                                                                               b. 0.500
                                                                                                                                                                               c. 0.250

                                                                                                                                                                   8.        a dichromatic analysis is carried to increase:                   8.        (a) Di- (bi) chromatic photometry measures
                                                                                                                                                                                a. Specificity                                                          absorbance of the sample at 2 different
                                                                                                                                                                                b. Linearity                                                            wavelengths. This corrects for interfering
                                                                                                                                                                                c. Sensitivity.                                                         substances increasing specificity of the method.



         mohammad_emam@hotmail.com                                                                                                                           3          mohammad_emam@hotmail.com                                                                                  4
CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                   CHEMISTRY                      CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                         CHEMISTRY



      BLOOD GASES, PH AND ELECTROLYTES.                                                                                            19.     H+ homeostasis is altered by;                                     19.   In actively contracting muscle, 8% of the pyruvate
                                                                                                                                   New     a. Excessive change of pyruvate to lactate.                       New   is utilised by the citric acid cycle and the
9.      ******PO2 (or gases) is measure in which unit?              9.     © mEq/L (mmol in SI) is used for electrolytes                                                                                           remaining molecules are reduced to latctate. This
           a. Mmol                                                         e.g. BE, bicarbonate and H+. While mmHg (or                                                                                             lactate is oxidized by the liver to pyruvate which
           b. umol                                                         kpa in SI) is used for gases e.g. pCO2 and pO2.                                                                                         ,through gluconeogenesis, becomes glucose. If
           c. mmHg                                                                                                                                                                                                 lactate is not efficiently reutilized in such a way, it
                                                                                                                                                                                                                   accumulates in the blood causing lactic acidosis.
11.     Acidemia is associated with                                 11.    Acid in urine and increased HCO2-.                      20,     ***Main extracellular ions?                                       20,   b. Na is the major ECF cation, Cl is the major ECF
                                                                           Increased hydrogen ion in the blood is termed           21,       a. Na & K                                                       21,   anion, K is the major ICF cation and proteins
                                                                           academia. If the cause is metabolic, there will be      22,       b. Na & Cl                                                      22,   followed by phosphates are the major anions.
                                                                           compensatory hyperventilation         H+ back to        24,     **Main electrolyte in blood is?                                   24,
                                                                           normal while HCO3- drops. Furthermore, if renal         25,     ***Electrolytes in ECF                                            25,
                                                                           function is normal, H+ will be excreted.                26.         a. Na is a major cation                                       26.
                                                                           If the cause is respiratory, renal compensation                     b. Cl is a major cation
                                                                           will cause H+ excretion and HCO3- retention and                     d. HCO3 is a major anion.
                                                                           generation lowering H+ back to normal.                          ***Main intracellular cation is;
                                                                                                                                           **In serum:
12.     ***To correct acidosis, the kidneys:                        12.    (c). See 11.                                                        a. Sodium is the main cation.
            a. secrete more H+ in urine.                                                                                                       b. Bicarbonate.
            b. Synthesis bicarbonate to ECF                                                                                                ***Intracellular fluid contains:
            c. Both a and b                                                                                                                    a. More potassium less sodium than extracellular fluid..
                                                                                                                                               b. Sodium and potassium in equal amount.
13.     **A buffer is made of ?                                     13.    (c) A buffer system is made of a weak acid and
           a. Strong acid & strong salt                                    its salt with a strong base of a weak base and its      23.     **All causes renal damage except                                  23.   Hypocalcaemia.
           b. Strong acid & weak salt                                      salt with a strong acid.                                                                                                                Causes of renal damage include; hypovolemia
           c. Weak acid & strong salt                                                                                                                                                                              (hemorrhage or dehydration), myoglobulinurea,
           d. Weak acid & weak salt.                                                                                                                                                                               hypercalciurea, uricosuria, and drugs e.g.
                                                                                                                                                                                                                   aminoglycosides and ACE inhibitors.
14.     ****pH means:                                               14.    Negative log H+ concentration                           27.     Renal tubular injury occurs in                                    27.   See 23.

15.     ***What is the base: acid ratio at pH 7 for acid of pK6?    15.    (d) According to Henderson Hasselbalch's                28.     Hypernatremia occurs with                                         28.   (d) Hypernatremia occurs with:
          a. 0.01                                                          equation, pH = pK + Log base/acid. By                            a. Cushing disease                                                        * body Na : due to extrarenal water loss or
          b. 0.1                                                           compensation, Log (base / acid)= 1, thus base:                   b. Dehydration                                                            renal diuresis.
          c. 1.0                                                           acid = 10:1.1                                                    c. hypothalamic injury                                                    * Normal body Na: due to extrarenal loss e.g.
          d. 10                                                                                                                             d. All of the above                                                       hyperthermia or renal loss e.g. DI.
          e. 100                                                                                                                                                                                                      * Na retention e.g. steroids or Na intake.

16.     ***Which is more serious?                                   16.    (c) Critical K+ values are <2.5 or > 6.5 mEq/L          28.     Regarding concentration of urine;                                 28.   a. Approximately 80% of the water and NaCl
           a. Glucose 15mmol/l                                                 Critical glucose <40mg or >450mg (2.2 &             New     a. Proximal tubules return 75% of filtered water.                 New   contenet together with glucose, phosphate, and
           b. pH 7.25 acidosis.                                            25mmol respectively),                                   1       b. Distal convoluted tubules deliver 40-60L of fluid to           1     amino acids are reabsorbed in the proximal tubule.
           c. Potassium 1.5 mmol/l                                             critical pH <7.2 or >2.6                                    collecting tubules / day.                                               About 20% of the tubular fluid enters the loop of
           d. Sodium 150 mmol/l                                                critical Na+ <120 or > 160mEq/L                             c. Osmotic pressure in renal cortex is higher than in medulla.          Henle where water is passively aborbed; 6ml per
                                                                                                                                           d. ADH acts on all parts of nephrone.                                   minute of concentrated tubular fluid now enters
17.     ******Metabolic acidosis can result from:                   17.    (a) Ingestion of certain medicines or chemicals                 e. Aldosterone increase Na excretion.                                   the distal tubule, where there is an active
                                                                           e.g. metformin.(glucophage).                                                                                                            reabsorption of sodium. The fluid leaves the distal
                                                                           Metformin causes lactic acidosis.                                                                                                       tubule at a rate of approximately 1ml per minute
                                                                           Generally, metabolic acidosis is due to either                                                                                          passing into the collecting ducts in the form of
                                                                           addition of H+ ( AG),      excretion of H+ or                                                                                           urine. Aldosteron is relased due to ineffective
                                                                           loss of HCO3-                                                                                                                           arterial pressure in the kidney. It causes sodium
                                                                                                                                                                                                                   reabsorption which raises plasma osmolality. ADH
18.     pH of the blood.                                            18.                                                                                                                                            increases permeability of distal and collecting
                                                                                                                                                                                                                   tubules to water urine concentration.
19      Acid base balance.                                          19




      mohammad_emam@hotmail.com                                                                       5                                  mohammad_emam@hotmail.com                                                                             6




      CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                   CHEMISTRY                      CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                         CHEMISTRY



28.     Regarding excretion of Na+                                   28.   b. Na+ excretion is influenced by                       33.     *****HBA1c (Glycosylated hemoglobin) is?                         33.    (b) GlycHb (RR 4-6%) is formed by non
New     a. Not dependent on aldosterone.                             New   mineralocorticoids (mainly aldosterone):                           a. Not present in healthy normal individuals.                        enzymatic attachment of glucose to N-terminal
2       b. Major share of GF osmolarity with associated ions.        2                                                                                                                                             valine of B-chain of Hb. Three types occur, HbA1a,
                                                                           reabsorption. The GF is isoosmolar with plasma                     b.   in prolonged sustained hyperglycemia
        c. It passively diffuses in proximal tubules.                      i.e. Na is the major electrolyte. 90% of Na is                                                                                          HbA1b, HbA1c, Both total and HbA1a are used.
        d. In distal tubules it is exchanged for K+                        actively (not passively) reabsorbed in the PCT. K                                                                                       Time averaged blood glucose = GlycHbx33.3-86
        e. Coupled with K+                                                 is excreted from DCT in exchange with Na (not                                                                                           (mg/dL)
                                                                           the reverse and not coupled with it).                                                                                                   GlycHb reflects 8-12 weeks of blood glucose
                                                                                                                                                                                                                   while fructosamine reflects 2-4 weeks.

28.     Regarding buffer systems;                                    28.   b. Acids are substances that tare capable of            34.     ***Glycogen differs from starch in:                              34.    It is a highly branched structure
New     b. An acid is a substance that releases H+                   New   donating protons. When a strong acid is added to a
3                                                                    3                                                             35.     **Cellulose is not metabolized in humans because of              35.    Glucose units in cellulose are combined by
        c. Buffering involves change of strong acid to base.               buffer, the salt reacts with the acid forming weak
                                                                           acid, and its salt (not base).                                  absence of which enzyme?                                                cellobiose bridges. These are hydrolyzed by
                                                                                                                                                                                                                   cellobiase which is lacking in animal and human
                                                                                                                                                                                                                   gut.
      GLUCOSE, HEMOGLOBIN, IRON AND BILIRUBIN.                                                                                     36.     **Xylose test is done to detect the function of:                 36.    c. Xylose is absorbed from proximal small
10.     Factors affecting glucose level in blood include:           10.    Adrenaline, T4. These together with cortisol, GH                   a. Stomach.                                                          intestine independent on pancreas..
                                                                           and glucagons are the hyperglycemic hormones                       b. Pancreas.
                                                                           causing 2ry diabetes in case of excessive secretion.               c. Upper small intestine.
                                                                                                                                              d. Lower small intestine.
29.     **Glucose level to diagnose hypoglycemia in newborn is.     29.    - 25-30 g/dl                                                       e. Large intestine
                                                                           In newborn babies, glucose tends to be lower than
                                                                           in adults. Critical low level in newborn is 30mg/dL     37.     ****Von Gerke's disease is caused by deficiency of:              37.    (a) See 32.
                                                                                                                                              a. Glucose 6 phosphatase
30.     ***About GTT, which is correct according to WHO             30.    (c) WHO recommendations for GTT include:                           b. Glucose 6 phosphate dehydrogenase
        recommendations?
            a. Should not be done in pregnant women,                                                                               38.     What happens if sucrose is given parentrally:                    38.    It will be secreted unchanged or metabolized
            b. Should not be done after giving heavy carbohydrate
            diet for 3 days.                                                                                                       39.     ***Which of these is not a ketone body?                          39.    (c) Ketone bodies are formed by condensation of 2
            c. Should be done after 4-6 hrs fasting.                                                                                          a. Acetone.                                                          acetyl Co A     Acetoacetic acid which gives B
                                                                                                                                              b. Acetoacetic acid.                                                 hydroxyl butyric acid by reduction or acetone by
31.     **With age renal threshold for glucose?                     31.    (b) With age, the renal ability to reabsorb filtered               c. Butyric acid.                                                     decarboxylation.
           a. Increased                                                    glucose is decreased leading to appearance of                      d. B-hydroxy butyric acid.                                           Butyric acid is a fatty acid
           b. Decreased                                                    glucose in the urine at lower plasma levels.                       e. None of the above.
           c. Not changed
                                                                                                                                   40.     ***In Gaucher's disease;                                         40.    (b) Gaucher's is a glucosylceramide lipidosis
32.     **All are inborn error of glycogen metabolism except?       32.    (b) Essential fructosuria is due to aldolase B defect           a. Glycoprotein is accumulated.                                         (lysosomal storage disease). It is caused by
           a. Essential fructosuria                                        leading to accumulation of fructose-1-P                         b. Glucocerebrosidase is deficient.                                     glucocerebrosidase enzyme leading to
           b. Phenyl ketonuria                                             Galactosemia (serious) is due to decreased                                                                                              accumulation of glucosylceramide        HSM and
           c. Galactosemia                                                 Galactose-6-P uridyl transferase leading to                                                                                             pigmentation of exposed parts.
           d. Glycogen storage disease                                     decreased glycogen synthesis.
                                                                           Types of glycogen storage diseases (GSD) include:       41.     Bile duct obstruction can be diagnosed by:                       41.    (c) Cholestatic hyperbilirubinemia is characterized
                                                                             Type I (VonGierke's):      G6P                                  a. AST                                                                by conjugated hyperbilirubinemia and
                                                                                                                                             b. T. Bilirubin                                                       hyperbilirubinuria (only the conjugated fraction
                                                                             Type II (Pompe's):     lysosomal maltase
                                                                                                                                             c. Bilirubin in urine                                                 appears in urine).
                                                                             Type III (Cori's) : debranching enzyme.                         d. Ester bilirubin
                                                                             Type IV (Anderson's): Absent debranching
                                                                             enzyme                                                42.     *** Increased jaundice is diagnosis by                           42.    (a) Estimation of jaundice depends on serum
                                                                             Type V (McArdle's):       muscles                               a. T. bilirubin                                                       bilirubin, other mentioned tests help to identify the
                                                                             phosphorylation.                                                b. AST                                                                cause of jaundice.
                                                                                                                                             c. ALT
                                                                                                                                             d. ALP




      mohammad_emam@hotmail.com                                                                       7                                  mohammad_emam@hotmail.com                                                                             8
CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                  CHEMISTRY                  CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                        CHEMISTRY



      CALCULATIONS, QC AND STATISTICS                                                                                         50.     Sensitivity and specificity are                                  50.   (b) Sensitivity & specificity can be adjusted
                                                                                                                                        a. Directly related.                                                 according to cutoff level. Sensitivity can be
43.     **Most of the concentration are calculated using factor,   43.   (b) For methods obeying Beer's law, slope of the               b. Inversely related.                                                increased by choosing a higher cutoff to include
        this factor is?                                                  calibration curve (Cs/As) provides a constant to               c. They mean the same.                                               more TP, this meanwhile will include more FP
             a. Std absorbance / std value                               calculate the unknown concentration. Also                                                                                           thus specificity. However, this is not always
             b. Std value / std absorbance                               depending on the formula:
                                                                                                                                                                                                             the case as highly specific highly sensitive tests
             c. Std value x std absorbance                               At x Cs = As x Ct, thus, Ct=(Cs/As)x As
                                                                                                                                                                                                             as well as poorly specific poorly sensitive exist.
44.     **Ten microliters are?                                     44.   (d) μL = 10-6L    10 μL = 10-5L = 0.00001L           51.     A carryover in chemistry analyzer means a disturbance in         51.   (b) Carryover is due to contamination by a
           a. 0.01 L
                                                                                                                                      readings because:                                                      previous sample. It is calculated by measuring a
           b., 0.001 L
                                                                                                                                        a. The analyzer was carried and placed at a different place.         high standard and a low standard each 3 times
           c. 0.0001 L
                                                                                                                                        b. The previously measured solution was still in the cuvette         then applying the following formula:
           d. 0.00001 L
                                                                                                                                        c. The current solution is overflowing in the cuvette.               Carry over = (contaminated low – actual low) /
           e. non of these.
                                                                                                                                                                                                             contaminated high – actual high)
45.     **How much water should be added to 500ml of a solution    45.   (c) Using the formula:
                                                                                                                              52.     STAT test means:                                                 52.   (c) Stat refers to immediate or as initial dose.
        of 10% NaOH to bring it to 75%?                                      C1 x V1 = C2 x V2
                                                                                                                                        a. Start at.
             a. 666ml                                                        10 x 500 = 7.5 x V2
                                                                                                                                        b. Standardize and test.
             b. 125ml                                                        V2 = 666mL
                                                                                                                                        c. Short turn around time
             c. 166ml                                                        Thus, 166 mL of DW should be added.
             d. 250ml
             e. 375ml
                                                                                                                                    CREATININE, UA, BUN AND AMMONIA
46.     When calculated osmolarity can not be accounted as a       46.   Calculated osmolarity = 2 X Na + Glu + Urea          53.     ***Which of the following result shows renal impairment?         53.   (e) A urine osmolarity less than 800 after 12 hrs
        measurement for osmolarity?                                      (All in mmol/L)                                                a. urea 9 mmol                                                       of water deprivation denotes renal impairment.
         a. per 100gm/l                                                  When calculated osmolarity is less than                        b. creatinine 10 mmol/l                                              Urea 9mmol is high normal (n: 2.9-8.2) and is
         b. Urea 20 mm/l                                                 measurement for osmolarity, this denotes                       c. urates                                                            not a very sensitive measure of GFR.
                                                                         increased osmolar gap (OG). This occurs with:                  d. cholesterol                                                       Creatinine, although a sensitive measure of GF,
                                                                           -     Factitious hyponatremia (due to                        e. urine osmolarity less than 800 after 12 hrs of water              10umol is normal (n: 53-106)
                                                                                decreased water)                                        deprivation.                                                         Cholesterol and urates are useless in this regard.
                                                                           -     Unmeasured osmotically active
                                                                                compounds e.g. alcohols, sugars, and          54.     **Low GFR occurs in all except:                                  54.   (b) low GFR occurs with:
                                                                                ketones.                                                 a. Congestive heart failure.                                            - Hemorrhage.
                                                                                                                                         b. Urethral obstruction.                                                - Dehydration.
47.     **Calibrator sera are?                                     47.   (b) Secondary std?                                                                                                                      - Renal loss of fluids e.g. diuretics.
           a. Primary std                                                A primary Std is a reference standard.                                                                                                  - Ineffective blood volume, e.g. CO,
           b. Secondary std                                              Secondary Std is standardized depending on the                                                                                          systemic VD, renal vasoconstriction.
           c. Tertiary std                                               primary standard.
           d. Internal std.                                                                                                   55.     Diagnosis of RF                                                  55.   GFR is an index and a monitor of increased or
                                                                                                                                                                                                             decreased renal functions. It is practically
48.     **External QC program means?                               48.   (b) In EQC, participants receive QC material to                                                                                     estimated from serum creatinine and creatinine
           a. An external person come & does the QC test                 be tested inside their labs. Results are sent to                                                                                    clearance.
           b. A QC person goes to another lab & does the test..          supplier to be compared to other labs' results.
                                                                         EQC will be most practically implemented             56.     ****Nephrotic syndrome is characterized by all except:           56.   (a) Nephrotic syndrome consists of:
                                                                         during the regular visit of the lab coordinator.                a. Hypocholesterolemia.                                                - Heavy proteinuria.
                                                                         This will give opportunity for errors to be                     b. Hypoalbuminemia.                                                    - Hypoalbuminemia.
                                                                         investigated on site and corrected rapidly                      c. Albuminuria.                                                        - Oedema.
                                                                         (Monica)                                                        d. Hypertriglyceridemia.                                               - Hypercholesterolemia (Almost always
49.     **We select 2SD value to plot LJ curves because?           49.   (c) QC results follow a Gaussian distribution,                  e. None of the above                                                   present).
           a. They are easy to calculate,                                thus 95% of these results normally fall within                                                                                         Hypertriglyceridemia is present in 50% of
           b. They cover 97.5% of normal population,                     ±5% of the mean. Therefore, 2.5 out of 100                                                                                             cases.
           c. Patient value rarely go beyond these limits.               (1:40) are acceptable to be above +2s and 2.5
                                                                         our of 100 are acceptable below -2s.




      mohammad_emam@hotmail.com                                                                     9                               mohammad_emam@hotmail.com                                                                           10




      CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                  CHEMISTRY                  CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                        CHEMISTRY



57.     ****Ureate excretion by the kidney is inhibited by:        57.   (b) Thiazide diuretics cause relatively urate        65.     **Lipoprotein related to hypertension?                           65.   . LDL
           a. Probenecid.                                                retention, glucose intolerance and hypokalemia
           b. Thiazide diuretics.                                        and interfere with water excretion and may           66.     *****Which is important for atherosclerosis?                     66.   (b)
                                                                         cause hyponatremia.                                             a. HDL
                                                                         Probenecid is a uricosuric agent like allopurinol.              b. LDL
                                                                                                                                         c. Chylomicrons.
58.     Chronic glomerulonephritis is diagnosed by:                58.   (d) In chronic glomerulonephritis, there is
         a. Blood urea.                                                  persistent deterioration of renal functions ending   67.     ***In plasma protein electrophoresis, the protein that will      67.   Albumin.
         b. Creatinine.                                                  with renal failure.                                          go first is (moves furthest from application)?
         c. Proteinuria
         d. All of the above                                                                                                                                                                                 On electrophoresis;
                                                                                                                              68.     ***Based on behavior of lipoproteins in                          68.
                                                                                                                                      ultracentrifugation pre-B lipoprotein is?                               Chylomicrons and its remnants stay at the
                                                                                                                                         a. HDL                                                               origin.
      PROTEINS, ELECTROPHORESIS AND LIPIDS                                                                                               b. LDL.                                                              VLDL at preβ (=α2 globulin region)
59.     **The protein having molecular wt less then albumin is?    59.   (b) B2-microglobulin has a MW 11,800.                           c. VLDL                                                              IDL at broad β
           a. Beta protein                                               Betalipoprotein is 380,000.                                     d. Chylomicron                                                       LDL at β (= β globulin region)
           b. B2-microglobulin.                                          BJ protein is the light chains of                                                                                                    HDL at α (= α1 globulin region)/
           c. Lysozyme.                                                  immunoglobulins. It's MW is variable from
           d. Benze Jones protein.                                       11,000 for monomers, 22,0000 for dimmers or          69.     **All of the following are lipoproteins except?                  69.   (d) Although phospholipids are not lipoproteins,
                                                                         tetramers.                                                      a. Phospholipid                                                     they are ingredients of lipoproteins, conferring
                                                                         Lysozyme is 14,000. It is used to differentiate                 b. VLDL                                                             the hydrophilic properties.
                                                                         AML M4 and M5 and appears as a far cathodal                     d. Sphingomylin
                                                                         band on serum or urine EP.                                      e. LDL
                                                                                                                                         f. HDL
60.     ******In cystic fibrosis, which is deficient?              60.   (d) Alpha 1 antitrypsin
           a. Beta globulin                                                                                                   70.     What is the proposition of pulmonary surfactant?                 70.   (b) Dipalmityl lecithin (a lecithin phospholipid
           b. Macroglobulin                                                                                                             a. Phospholipid acid                                                 with 2 palmetic acid residues) is the chemical
           c. Albumin                                                                                                                   b. Dipalmityl lecithin                                               composition of pulmonary surfactant.
           d. Alpha 1 antitrypsin                                                                                                       c. Phosphatidyl choline,
           e. Alpha 2 antitrypsin.
                                                                                                                              71.     **HDL is good cholesterol because?                               71.   (a) HDL is composed of 20% cholesterol, 30%
61.     ***Diet rich in phenylalanine should be restricted in?     61.   (a) In phenylketonuria, there is    phenylalanine               a. It has more protein & phospholipids in it                        phospholipids and 50% proteins.
           a. Phenyl ketonuria                                                                                                           b. It has no cholesterol in it,.
                                                                         hydroxylase leading to accumulation of
           b. Tyrosinemia                                                                                                                c. It has less TG in it.
                                                                         phenylpuruvate and its derivatives and their
           c. Maple syrup disease                                        excretion in urine. Diet rich in phenylalanine
                                                                         should be restricted to prevent brain damage.        72.     ***Which lipoprotein has highest concentration of                72.   (b) VLDL are the TG rich lipoproteins
                                                                                                                                      cholesterol?                                                           HDL has 20% cholesterol.
                                                                                                                                          a. VLDL                                                            IDL has cholesterol and TG in equal amounts.
62.     ***In phenylketonuria, diet should be low in:              62.   (a) Phenylalanine (see 61)
                                                                                                                                          b. LDL                                                             LDL is the richest lipoprotein in cholesterol
           a. Phenylalanine.
                                                                                                                                          c. IDL                                                             esters.
           b. Carbohydrate.
                                                                                                                                          d. HDL
           c. Lipids.
                                                                                                                              74.     ****Which is not associated with abetalipoproteinemia:           74.   (b) Hereditary spherocytosis is due to spectrin
62.     Hypoalbuminemia is associated with all except?             62.   (a) Tetanus is clostridial infection caused be C.
                                                                                                                                         a. Acanthocytes in the peripheral blood.                            deficiency.
           a. Tetanus                                                    tetani has nothing to do with albumin.
                                                                                                                                         b. Hereditary spherocytosis.                                        Abetalipoproteinemia is a lipoprotein
           b. hypocalcaemia
                                                                                                                                         c. Malabsorption and fatty stools                                   abnormality of absent LDL due to autosomal
           c. oedema
                                                                                                                                                                                                             recessive abnormality in the synthesis of apoB +
           d. toxic effect of sulfonamide
                                                                                                                                                                                                             failure of chylomicron formation leading to
                                                                                                                                                                                                             malabsorption of fats + fat soluble vitamins +
64.     **Gluconic amino acids include:                            64.   (a) Ketogenic amino acids are: Leucine and
                                                                                                                                                                                                             adrenal dysfunction. 50-70% of RBCs have
           a. Alanine.                                                   lysine,
                                                                                                                                                                                                             spinal projections (acanthocytes)
           b. Methionine.                                                Mixed amino acids are: Isoleucine,
           c. Valine.                                                    phenylalanine, threonine, tryptophan and
                                                                                                                              75.     Chylomicrons:                                                    75.   (a) Chylomicrons don't confer an excess
           d. Glutamic acid.                                             tyrosine.
                                                                                                                                         a. Can cause thrombosis.                                            cardiovascular risk, however, in LpL deficiency
           e. All of the above.                                          Gluconic amino acids are all the other amino
                                                                                                                                         b. Cannot cause thrombosis.                                         and apoC II deficiency, the patient presents with
                                                                         acids.
                                                                                                                                                                                                             lipemia retinalis and retinal vein thrombosis.

      mohammad_emam@hotmail.com                                                                     11                              mohammad_emam@hotmail.com                                                                           12
CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                        CHEMISTRY                     CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                            CHEMISTRY



76.     Nature of apoproteins.                                        76.   5 major classes of proteins A to E                         85.     ***In MI, which is the last enzyme to be raised and lasts          85.     (d)
                                                                                                                                               long?                                                                                    Onset (h)    Peak (h)     Duration
                                                                                                Saturated          Unsaturated                     a. CK                                                                                                          (d)
77.     Saturated vs unsaturated fats (nutritional value)             77.
                                                                             e.g.               Oleic a (50% of    Linoleic a                                                                                              CK           6-12         20-30        2-6
                                                                                                                                                   b. CK-MB.                                                               CK-MB        3-10         12-24        1.5-3
                                                                                                body fat)          Linolenic a
                                                                                                Palmitic a (25%    (both are
                                                                                                                                                   c. AST.                                                                 AST          6-12         20-30        2-6
                                                                                                of body fat)       Essential)                      d. LDH                                                                  LDH          6-12         24-72        7-14
                                                                                                Stearic a (5% of   Arachidonic a.
                                                                                                body fat)                              86.     **Isoenzymes:                                                      86.     © Isoenzymes have the same catalytic activities
                                                                                                Acetic a.
                                                                                                Butyric a.                                          a. Are physical types of one enzyme.                                  and differ in physicochemical properties.
                                                                             Presence           Adipose            Vegitable oils.                  b. Have different electrophoretic mobility.
                                                                             Suffix             Anoic              Enoic                            c. All of the above
                                                                             Significance                          Arachidonic
                                                                                                                   acid is precursor
                                                                                                                   of Pgs.
                                                                                                                                       87.     **MI is diagnosed by:                                              87.     (a) CK-MB is specific for cardiac muscle, CK-
                                                                                                                   Although not                  a. CKMB                                                                  BB for brain and CK-MM for skeletal muscle.
                                                                                                                   essential, it                 b. CKBB
                                                                                                                   depends on                    c. CKMM
                                                                                                                   essential FA
                                                                                                                                                 d. LDH
                                                                             Chemistry          No double          Double bonds
                                                                                                bonds
78.     Which is best for parentral alimentation?                     78.   (b) Parentral nutrition is composed essentially            88.     **Elevation of LDH is caused by:                                   88.     (d) LDH is present in the cells of the heart, liver,
           a. FFA.                                                    79.   of:                                                                  a. Myocardial disease                                                    muscles, blood and malignancies.
           b. AA                                                            a) Nitrogen source: synthetic valuable amino                         b. Liver disease
           c. lipoproteins                                                  acids (9-17g/L N2)                                                   c. Prostatic disease
                                                                            b) Energy source: Glucose (mainly) and fat                           d. many organ disease because it has many distribution
                                                                            emulsion (additional source to avoid EFA
                                                                            deficiency).                                               89.     ****Myoglobin      in injury of:                                   89.     (a) muscle whether cardiac or skeletal is the
                                                                            c) Electrolytes and trace elements.                                   a. muscle.                                                              source of myoglobin.
79.     Protocol for IV nutrition?                                                                                                                b. Liver

80.     **Regarding lipoprotein metabolism:                           80.   Although cholesterol can be synthesized by all
                                                                            nucleated cells, however, cholesterol in VLDL,                   CLINICAL ENCOCRINOLOGY
                                                                            IDL and LDL is of hepatic origin

82.     Treatment of familial hypercholesterolemia.                   82.   These include general management of                        90.     *****ADH is?                                                       90.     (b) ADH is produced by the hypothalamus and
                                                                            hypercholesterolemia + cholesterol lowering                          a. Produced by posterior pituitary                                       stored and secreted from the posterior pituitary.
                                                                            drugs + oestrogen replacement in                                     b. Produced in the hypothalamus.
                                                                            postmenopausal women.                                      91.     **The method used to estimating insulin is?                        91.     (d) Immunoassay (multiple labels) is used for
                                                                                                                                                  a. Electrophoresis                                                      the measurement of insulin.
                                                                                                                                                  b. Kinetic estimation.
                                                                                                                                                  c. Spectrophotometer.
      CLINICAL ENZYMOLOGY                                                                                                                         d. Radioimmuno assay.
83.     ***The better for diagnosis of acute pancreatitis is?         83.   (b) Lipase elevation is of a greater magnitude (2-
          a. Amylase                                                        10 xN) and duration than amylase in acute                  92.     *****After the insulin dose, the patient soon comatozed            92.     (b) Hypoglycemia (glucose <3mmol/l)
          b. Lipase                                                         pancreatitis. When lipase method is optimized,                     due to
          c. ALP                                                            the test is more sensitive and specific than                           a. Hyperglycemia
          d. ACP                                                            amylase for detection of acute pancreatitis.                           b. Hypoglycemia (glucose <3mmol/l)
                                                                                                                                                   c. ketonuria
84.     **Activities of some enzyme increased in some disease         84.   (b) That’s why enzymes are measured for the                            c. Ketoacidosis is the cause of coma
        conditions because they are?                                        most part by their activity rather than                                d. Lactic acidosis,
           a. Non functional enzymes                                        concentration.
           b. Functional enzymes
           c. Neither




      mohammad_emam@hotmail.com                                                                           13                                 mohammad_emam@hotmail.com                                                                               14




      CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                        CHEMISTRY                     CLINICAL & CHEMICAL PATHOLOGY MCQ                                                                            CHEMISTRY



93.     **While using the pregnancy test we are measuring?            93.   (b) α subunit of HCG is very similar to α                  98.     Carcinoid tumors secrete                                           98.     5HIAA.
           a. B-HCG                                                         subunit of TSH and FSH and identical to LH.                New                                                                        New     Carcinoid tumors originate from the
           b. Total HCG                                                     Although β subunits of HCG and LH are very                                                                                                    enterocromaffin cells (APUD cells) of the
           c. B-HCG & LH                                                    similar, antibodies can be made to the β subunit                                                                                              intestine and most commonly occurs in the
           d. B-HCG & FSH.                                                  of HCG that do not cross react with LH or other                                                                                               appendix, terminal ilium and rectum.
                                                                            pituitary hormones. Most EIA use 2 monoclonal                                                                                                 Presentation may be asymptomatic until
                                                                            antibodies against different sites of HCG                                                                                                     metastasis (most cases), appendicitis (10%) or
                                                                            molecule one for carboxyl terminal of β chain                                                                                                 carcinoid syndrome (in5% when there is liver
                                                                            and the other to the α chain, i.e. react with intact                                                                                          metastasis) as spontaneous flushing on the face
                                                                            HCG.                                                                                                                                          and neck, abdominal pain and water diarrhea,
                                                                                                                                                                                                                          cardiac abnormalities and hepatomegally. The
94.     ****Water deprivation test is used in the diagnosis of:       94.   (b) Water intake is restricted the patient loses 3-                                                                                           tumor secretes a wide variety of amines an
           a. Anterior pituitary disease.                                   5% of body weight or until 3 consecutive hourly                                                                                               peptides including serotonin (5-
           b. Posterior pituitary disease.                                  determination of urine osmolarity are within                                                                                                  hydroxytryptamine (5-HT) with its major
           c. Hypothyroidism.                                               10% of each other. Measure urine osmolality,                                                                                                  metabolite 5-hydroxyindoleacetic acid (5-
                                                                            plasma vasopressin and increased urine                                                                                                        HIAA)), bradykinin, histamine and tachykinins
                                                                            osmolality with exogenous vasopressin.                                                                                                        and prostaglandins.
                                                                                            Urine         Pl. VP        After VP
                                                                                            osmol
                                                                             Normal         >800          >2
                                                                             DI             <300          Undetectab
                                                                                                                                                    Neeman Peck disease is due to deficiency of sphengomylinase
                                                                                                          le                                        Cholesterol: In LDL, cell membrane, precursor of bile salts and steroid hormones.
                                                                             Nephrogeni     <300          >5            No change
                                                                             c DI



95.     ****24 hours urine for VMA is used for diagnosis of           95.   (b) Catecholamines are oxidized to VMA and
        diseases of:                                                        metanephrins. 24hour urinary metanephrins is
            a. Adrenal cortex.                                              the best single test for pheochromocytoma.
            b. Adrenal medulla                                              Specificity and sensitivity approach 100% when
                                                                            both VMA and metanephrines are measured.

96.     ***Hypertension is found in all of the following endocrinal   96.   (d) Hypertension secondary to endocrinal causes
        diseases except:                                                    occurs in:
            a. Cushing's syndrome.                                            - Pheochromocytoma.
            b. Pheochromocytoma.                                              - Crohn's syndrome
            c. Adrenal medulla hyperplasia.                                   - Cushing's syndrome.
            d. Addisson's disease.                                            Addison is associated with hypos
                                                                              (hypotension, hypokalemia, hyponatremia and
                                                                              hypocortisol)

97.     Diabetic coma presents with:                                  97.   All.
         a. Ketone bodies in urine                                          In diabetes, 2 types of coma may occur, DKA
         b. Blood glucose may be 1000mg or more                             and nonDKA. Glucose levels in nonDKA are
         c. osmotic diuresis present                                        typically <800 mg/dL. Once hyperglycemia is
                                                                            established, ketonurea & pH should be looked
                                                                            for to differentiate.

98.     **While anti-PSA is coated on to the well in total PSA        98.   (a) different antibodies.
        estimation, the antibodies coated in free PSA is?
            a. The same antibodies that is coated for total PSA
            b. Same antibodies in large amount
            c. Same antibodies in very low amount
            d. Different antibodies.




      mohammad_emam@hotmail.com                                                                           15                                 mohammad_emam@hotmail.com                                                                               16
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1
هام  Clinical & chemical pathology mc qs-1

Contenu connexe

Tendances

486 qualitative disorders of wbc
486 qualitative disorders of wbc486 qualitative disorders of wbc
486 qualitative disorders of wbcNabin Chaudhary
 
Body fluids, cervical pap
Body fluids, cervical papBody fluids, cervical pap
Body fluids, cervical papAayra
 
Leukemia
LeukemiaLeukemia
LeukemiaBadheeb
 
MCQ for Lab Technician
MCQ for Lab TechnicianMCQ for Lab Technician
MCQ for Lab TechnicianPradip Hamal
 
Pathology Slides For Exam (Kiev Medical University)
Pathology Slides For Exam (Kiev Medical University)Pathology Slides For Exam (Kiev Medical University)
Pathology Slides For Exam (Kiev Medical University)VIKRAM SINGH PANIHARIYA
 
MCQs respiratory system
MCQs respiratory systemMCQs respiratory system
MCQs respiratory systemDOCTOR WHO
 
Reticulocyte count
Reticulocyte countReticulocyte count
Reticulocyte countPrbn Shah
 
Quality control in clinical biochemistry
Quality control in clinical biochemistryQuality control in clinical biochemistry
Quality control in clinical biochemistryAshok Katta
 
Reticulocyte count
Reticulocyte countReticulocyte count
Reticulocyte countShabab Ali
 
MCQ for Medical Lab Technician
MCQ for Medical Lab TechnicianMCQ for Medical Lab Technician
MCQ for Medical Lab TechnicianPradip Hamal
 
Haematological Malignancies
Haematological MalignanciesHaematological Malignancies
Haematological Malignanciesmeducationdotnet
 
cytology of body fluid
 cytology of body fluid cytology of body fluid
cytology of body fluidMusa Khan
 
packed cell volume and blood indices
packed cell volume and blood indicespacked cell volume and blood indices
packed cell volume and blood indicesmardeen farooq
 
Demonstration of le cells
Demonstration of le cellsDemonstration of le cells
Demonstration of le cellsSHRUTHI VASAN
 
Cytologic assessment of bronchopulmonary lesions
Cytologic assessment of bronchopulmonary lesionsCytologic assessment of bronchopulmonary lesions
Cytologic assessment of bronchopulmonary lesionsAseem Jain
 
Gastrointestinal mcq
Gastrointestinal mcqGastrointestinal mcq
Gastrointestinal mcqRashed Hassen
 

Tendances (20)

486 qualitative disorders of wbc
486 qualitative disorders of wbc486 qualitative disorders of wbc
486 qualitative disorders of wbc
 
Body fluids, cervical pap
Body fluids, cervical papBody fluids, cervical pap
Body fluids, cervical pap
 
Leukemia
LeukemiaLeukemia
Leukemia
 
MCQ for Lab Technician
MCQ for Lab TechnicianMCQ for Lab Technician
MCQ for Lab Technician
 
Pathology Slides For Exam (Kiev Medical University)
Pathology Slides For Exam (Kiev Medical University)Pathology Slides For Exam (Kiev Medical University)
Pathology Slides For Exam (Kiev Medical University)
 
Wound Swab PowerPoint
Wound Swab PowerPointWound Swab PowerPoint
Wound Swab PowerPoint
 
CSF BIOCHEMICAL EXAMINATION
CSF BIOCHEMICAL EXAMINATIONCSF BIOCHEMICAL EXAMINATION
CSF BIOCHEMICAL EXAMINATION
 
MCQs respiratory system
MCQs respiratory systemMCQs respiratory system
MCQs respiratory system
 
Reticulocyte count
Reticulocyte countReticulocyte count
Reticulocyte count
 
Quality control in clinical biochemistry
Quality control in clinical biochemistryQuality control in clinical biochemistry
Quality control in clinical biochemistry
 
Reticulocyte count
Reticulocyte countReticulocyte count
Reticulocyte count
 
MCQ for Medical Lab Technician
MCQ for Medical Lab TechnicianMCQ for Medical Lab Technician
MCQ for Medical Lab Technician
 
Haematological Malignancies
Haematological MalignanciesHaematological Malignancies
Haematological Malignancies
 
cytology of body fluid
 cytology of body fluid cytology of body fluid
cytology of body fluid
 
packed cell volume and blood indices
packed cell volume and blood indicespacked cell volume and blood indices
packed cell volume and blood indices
 
introduction of cytopathology
introduction of cytopathologyintroduction of cytopathology
introduction of cytopathology
 
Demonstration of le cells
Demonstration of le cellsDemonstration of le cells
Demonstration of le cells
 
Cytologic assessment of bronchopulmonary lesions
Cytologic assessment of bronchopulmonary lesionsCytologic assessment of bronchopulmonary lesions
Cytologic assessment of bronchopulmonary lesions
 
Medicine BCQs (Renal System)
Medicine BCQs (Renal System)Medicine BCQs (Renal System)
Medicine BCQs (Renal System)
 
Gastrointestinal mcq
Gastrointestinal mcqGastrointestinal mcq
Gastrointestinal mcq
 

En vedette

Mcq 1060 questions
Mcq 1060 questionsMcq 1060 questions
Mcq 1060 questionsadrioz
 
Microbiology MCQs
Microbiology MCQsMicrobiology MCQs
Microbiology MCQsPankaj Jha
 
500 single best answers in medicine
500 single best answers in medicine500 single best answers in medicine
500 single best answers in medicinehamadadodo
 
Liver Disease Case Study
Liver Disease Case StudyLiver Disease Case Study
Liver Disease Case StudySonja Silva
 
Chem+path+intro
Chem+path+introChem+path+intro
Chem+path+introPacman28
 
Pathology Practice Examination
Pathology Practice ExaminationPathology Practice Examination
Pathology Practice ExaminationDJ CrissCross
 
Internal Medicine Board Review - Rheumatology Flashcards - by Knowmedge
Internal Medicine Board Review - Rheumatology Flashcards -  by KnowmedgeInternal Medicine Board Review - Rheumatology Flashcards -  by Knowmedge
Internal Medicine Board Review - Rheumatology Flashcards - by KnowmedgeKnowmedge
 
Parsitology mcq with answers
Parsitology mcq with answersParsitology mcq with answers
Parsitology mcq with answersCristi Francis
 
Pathology of the Musculoskeletal Muscles (Elaborate)
Pathology of the Musculoskeletal Muscles (Elaborate)Pathology of the Musculoskeletal Muscles (Elaborate)
Pathology of the Musculoskeletal Muscles (Elaborate)MBBS Help
 
Cns stimulant by yogesh sangle
Cns stimulant by yogesh sangleCns stimulant by yogesh sangle
Cns stimulant by yogesh sangleAshish Agrawal
 
Administration & Calculation Of Drugs, Iv Fluids
Administration & Calculation Of Drugs, Iv FluidsAdministration & Calculation Of Drugs, Iv Fluids
Administration & Calculation Of Drugs, Iv Fluidsmohammed indanan
 
Iv therapy by Aakash M. Gupta
Iv therapy  by Aakash M. GuptaIv therapy  by Aakash M. Gupta
Iv therapy by Aakash M. GuptaAakash Gupta
 
Cns stimulants & cognition enhancers
Cns stimulants & cognition enhancersCns stimulants & cognition enhancers
Cns stimulants & cognition enhancersRudhra Prabhakar
 
intravenous infusion therapy
intravenous infusion therapyintravenous infusion therapy
intravenous infusion therapyrahand95
 
Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...
Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...
Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...Ronald Magbitang
 
Hvgpress presentation
Hvgpress presentationHvgpress presentation
Hvgpress presentationHvg Press
 

En vedette (20)

Mcq 1060 questions
Mcq 1060 questionsMcq 1060 questions
Mcq 1060 questions
 
Microbiology MCQs
Microbiology MCQsMicrobiology MCQs
Microbiology MCQs
 
500 single best answers in medicine
500 single best answers in medicine500 single best answers in medicine
500 single best answers in medicine
 
Liver Disease Case Study
Liver Disease Case StudyLiver Disease Case Study
Liver Disease Case Study
 
Chem+path+intro
Chem+path+introChem+path+intro
Chem+path+intro
 
Pathology Practice Examination
Pathology Practice ExaminationPathology Practice Examination
Pathology Practice Examination
 
Internal Medicine Board Review - Rheumatology Flashcards - by Knowmedge
Internal Medicine Board Review - Rheumatology Flashcards -  by KnowmedgeInternal Medicine Board Review - Rheumatology Flashcards -  by Knowmedge
Internal Medicine Board Review - Rheumatology Flashcards - by Knowmedge
 
Parsitology mcq with answers
Parsitology mcq with answersParsitology mcq with answers
Parsitology mcq with answers
 
Pathology of the Musculoskeletal Muscles (Elaborate)
Pathology of the Musculoskeletal Muscles (Elaborate)Pathology of the Musculoskeletal Muscles (Elaborate)
Pathology of the Musculoskeletal Muscles (Elaborate)
 
speech
speechspeech
speech
 
Drugs Used In Disorders of the Reproductive System
Drugs Used In Disorders of the Reproductive SystemDrugs Used In Disorders of the Reproductive System
Drugs Used In Disorders of the Reproductive System
 
Cns stimulant by yogesh sangle
Cns stimulant by yogesh sangleCns stimulant by yogesh sangle
Cns stimulant by yogesh sangle
 
Renal pathology
Renal pathologyRenal pathology
Renal pathology
 
Administration & Calculation Of Drugs, Iv Fluids
Administration & Calculation Of Drugs, Iv FluidsAdministration & Calculation Of Drugs, Iv Fluids
Administration & Calculation Of Drugs, Iv Fluids
 
Iv therapy by Aakash M. Gupta
Iv therapy  by Aakash M. GuptaIv therapy  by Aakash M. Gupta
Iv therapy by Aakash M. Gupta
 
Cns stimulants & cognition enhancers
Cns stimulants & cognition enhancersCns stimulants & cognition enhancers
Cns stimulants & cognition enhancers
 
Iv fluids
Iv   fluidsIv   fluids
Iv fluids
 
intravenous infusion therapy
intravenous infusion therapyintravenous infusion therapy
intravenous infusion therapy
 
Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...
Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...
Basic Intravenous Therapy 2: Pharmacology, Rational Therapy, Pharmacodynamics...
 
Hvgpress presentation
Hvgpress presentationHvgpress presentation
Hvgpress presentation
 

Similaire à هام Clinical & chemical pathology mc qs-1

Apoptosis manual roche
Apoptosis manual rocheApoptosis manual roche
Apoptosis manual rocheMaha Lakshmi
 
Atlas of salivary gland pathology
Atlas of salivary gland pathologyAtlas of salivary gland pathology
Atlas of salivary gland pathologymostafa hegazy
 
Poin of care testing
Poin of care testingPoin of care testing
Poin of care testingLAB IDEA
 
Integrin Signalling And Cancer Front Pgs
Integrin Signalling And Cancer   Front PgsIntegrin Signalling And Cancer   Front Pgs
Integrin Signalling And Cancer Front Pgsefreiter
 
TECO_Katalog_Diabetes_GB_0113_F
TECO_Katalog_Diabetes_GB_0113_FTECO_Katalog_Diabetes_GB_0113_F
TECO_Katalog_Diabetes_GB_0113_FPeter Haima, Ph.D.
 
Human cytogenetic وراثة عملي
Human cytogenetic وراثة عملي Human cytogenetic وراثة عملي
Human cytogenetic وراثة عملي في رحاب الله
 
Second or third additional chemotherapy drug for non-small cell lung cancer i...
Second or third additional chemotherapy drug for non-small cell lung cancer i...Second or third additional chemotherapy drug for non-small cell lung cancer i...
Second or third additional chemotherapy drug for non-small cell lung cancer i...James Hilbert
 
An overview of the toxic effect of potential human carcinogen Microcystin-LR ...
An overview of the toxic effect of potential human carcinogen Microcystin-LR ...An overview of the toxic effect of potential human carcinogen Microcystin-LR ...
An overview of the toxic effect of potential human carcinogen Microcystin-LR ...rkkoiri
 
Glicolisis y el cancer
Glicolisis y el cancerGlicolisis y el cancer
Glicolisis y el cancerGean Arroyo
 
2013 - The impact of coffee on health.pdf
2013 - The impact of coffee on health.pdf2013 - The impact of coffee on health.pdf
2013 - The impact of coffee on health.pdfJonh85
 
Pbpk models for the prediction of in vivo performance of oral dosage forms
Pbpk models for the prediction of in vivo performance of oral dosage formsPbpk models for the prediction of in vivo performance of oral dosage forms
Pbpk models for the prediction of in vivo performance of oral dosage formsAlberto Palomino Huarhua
 
Scoping insight final publication (1)
Scoping insight final publication (1)Scoping insight final publication (1)
Scoping insight final publication (1)Ahmed Ali
 
Absolute Obstetric Anesthesia Review.pdf
Absolute Obstetric Anesthesia Review.pdfAbsolute Obstetric Anesthesia Review.pdf
Absolute Obstetric Anesthesia Review.pdf0r0ym1rra
 
Fat embolism syndrome state of-the-art review focused on
Fat embolism syndrome state of-the-art review focused onFat embolism syndrome state of-the-art review focused on
Fat embolism syndrome state of-the-art review focused oncadoc
 

Similaire à هام Clinical & chemical pathology mc qs-1 (20)

Apoptosis manual roche
Apoptosis manual rocheApoptosis manual roche
Apoptosis manual roche
 
Atlas of salivary gland pathology
Atlas of salivary gland pathologyAtlas of salivary gland pathology
Atlas of salivary gland pathology
 
Poin of care testing
Poin of care testingPoin of care testing
Poin of care testing
 
Integrin Signalling And Cancer Front Pgs
Integrin Signalling And Cancer   Front PgsIntegrin Signalling And Cancer   Front Pgs
Integrin Signalling And Cancer Front Pgs
 
TECO_Katalog_Diabetes_GB_0113_F
TECO_Katalog_Diabetes_GB_0113_FTECO_Katalog_Diabetes_GB_0113_F
TECO_Katalog_Diabetes_GB_0113_F
 
Human cytogenetic وراثة عملي
Human cytogenetic وراثة عملي Human cytogenetic وراثة عملي
Human cytogenetic وراثة عملي
 
Second or third additional chemotherapy drug for non-small cell lung cancer i...
Second or third additional chemotherapy drug for non-small cell lung cancer i...Second or third additional chemotherapy drug for non-small cell lung cancer i...
Second or third additional chemotherapy drug for non-small cell lung cancer i...
 
An overview of the toxic effect of potential human carcinogen Microcystin-LR ...
An overview of the toxic effect of potential human carcinogen Microcystin-LR ...An overview of the toxic effect of potential human carcinogen Microcystin-LR ...
An overview of the toxic effect of potential human carcinogen Microcystin-LR ...
 
Glicolisis y el cancer
Glicolisis y el cancerGlicolisis y el cancer
Glicolisis y el cancer
 
At
AtAt
At
 
2013 - The impact of coffee on health.pdf
2013 - The impact of coffee on health.pdf2013 - The impact of coffee on health.pdf
2013 - The impact of coffee on health.pdf
 
Who blood products
Who blood productsWho blood products
Who blood products
 
Pbpk models for the prediction of in vivo performance of oral dosage forms
Pbpk models for the prediction of in vivo performance of oral dosage formsPbpk models for the prediction of in vivo performance of oral dosage forms
Pbpk models for the prediction of in vivo performance of oral dosage forms
 
Scoping insight final publication (1)
Scoping insight final publication (1)Scoping insight final publication (1)
Scoping insight final publication (1)
 
Absolute Obstetric Anesthesia Review.pdf
Absolute Obstetric Anesthesia Review.pdfAbsolute Obstetric Anesthesia Review.pdf
Absolute Obstetric Anesthesia Review.pdf
 
Wiley et al PRER
Wiley et al PRERWiley et al PRER
Wiley et al PRER
 
Fat embolism syndrome state of-the-art review focused on
Fat embolism syndrome state of-the-art review focused onFat embolism syndrome state of-the-art review focused on
Fat embolism syndrome state of-the-art review focused on
 
What is food test
What is food testWhat is food test
What is food test
 
Atb en dialisis[1]
Atb en dialisis[1]Atb en dialisis[1]
Atb en dialisis[1]
 
THE DIABETES CONTROL LOOP
THE DIABETES CONTROL LOOPTHE DIABETES CONTROL LOOP
THE DIABETES CONTROL LOOP
 

Plus de dream10f

Drehab cv 2022
Drehab cv 2022Drehab cv 2022
Drehab cv 2022dream10f
 
Drehab cv 2022
Drehab cv 2022Drehab cv 2022
Drehab cv 2022dream10f
 
The new saudi labor law
The new saudi labor lawThe new saudi labor law
The new saudi labor lawdream10f
 
Regulations for employing non saudis in universities
Regulations for employing non saudis in universitiesRegulations for employing non saudis in universities
Regulations for employing non saudis in universitiesdream10f
 
Professional registration classification_manual_vr.5
Professional registration classification_manual_vr.5Professional registration classification_manual_vr.5
Professional registration classification_manual_vr.5dream10f
 
Labeled assays
Labeled assays Labeled assays
Labeled assays dream10f
 
Week 9 radioimmunoassay
Week 9 radioimmunoassayWeek 9 radioimmunoassay
Week 9 radioimmunoassaydream10f
 
Serological tests
Serological testsSerological tests
Serological testsdream10f
 
Radioimmunoassay
RadioimmunoassayRadioimmunoassay
Radioimmunoassaydream10f
 
Principles of immunodetection
Principles of immunodetectionPrinciples of immunodetection
Principles of immunodetectiondream10f
 
Peptide radioimmunoassay (ria)
Peptide radioimmunoassay (ria)Peptide radioimmunoassay (ria)
Peptide radioimmunoassay (ria)dream10f
 
Lecture5(6)
Lecture5(6)Lecture5(6)
Lecture5(6)dream10f
 
Diagnosis of-aids
Diagnosis of-aidsDiagnosis of-aids
Diagnosis of-aidsdream10f
 
2 collinspres
2 collinspres2 collinspres
2 collinspresdream10f
 
1 elisa technique
1 elisa technique1 elisa technique
1 elisa techniquedream10f
 
Chronic leukemia
Chronic leukemiaChronic leukemia
Chronic leukemiadream10f
 
Immune diseases
Immune diseasesImmune diseases
Immune diseasesdream10f
 

Plus de dream10f (20)

Drehab cv 2022
Drehab cv 2022Drehab cv 2022
Drehab cv 2022
 
Drehab cv 2022
Drehab cv 2022Drehab cv 2022
Drehab cv 2022
 
The new saudi labor law
The new saudi labor lawThe new saudi labor law
The new saudi labor law
 
Regulations for employing non saudis in universities
Regulations for employing non saudis in universitiesRegulations for employing non saudis in universities
Regulations for employing non saudis in universities
 
Professional registration classification_manual_vr.5
Professional registration classification_manual_vr.5Professional registration classification_manual_vr.5
Professional registration classification_manual_vr.5
 
Hiv
HivHiv
Hiv
 
Labeled assays
Labeled assays Labeled assays
Labeled assays
 
Fluor
FluorFluor
Fluor
 
Week 9 radioimmunoassay
Week 9 radioimmunoassayWeek 9 radioimmunoassay
Week 9 radioimmunoassay
 
Serological tests
Serological testsSerological tests
Serological tests
 
Radioimmunoassay
RadioimmunoassayRadioimmunoassay
Radioimmunoassay
 
Principles of immunodetection
Principles of immunodetectionPrinciples of immunodetection
Principles of immunodetection
 
Peptide radioimmunoassay (ria)
Peptide radioimmunoassay (ria)Peptide radioimmunoassay (ria)
Peptide radioimmunoassay (ria)
 
Lecture5(6)
Lecture5(6)Lecture5(6)
Lecture5(6)
 
Diagnosis of-aids
Diagnosis of-aidsDiagnosis of-aids
Diagnosis of-aids
 
2 collinspres
2 collinspres2 collinspres
2 collinspres
 
1 elisa technique
1 elisa technique1 elisa technique
1 elisa technique
 
3 elisa
3 elisa3 elisa
3 elisa
 
Chronic leukemia
Chronic leukemiaChronic leukemia
Chronic leukemia
 
Immune diseases
Immune diseasesImmune diseases
Immune diseases
 

هام Clinical & chemical pathology mc qs-1

  • 1. CLINICAL & CHEMICAL PATHOLOGY MCQ BODY FLUIDS Clinical & Chemical Pathology MCQs Classified, Reorganized And Updated To Shawual 1425 With Short Notes Body fluids By Dr Mohammad A. Emam 1. **Doctor sending a sample requesting for lecithin 1. (c) Amniotic fluid sample is used to measure spingomyelin ratio what is the sample? lecithin: sphingomyelin ratio (L/S). L/S > 2:1 a. Blood. (or 2.5:1) denotes acceptable lung maturity. Contents b. CSF Body fluids ................................................................................. 2 c. Amniotic fluid. d. Urine Clinical Chemistry .................................................................... 4 INSTRUMENTATION ...................................................................................................................4 2. ***Cytological examination of pleural effusion in a 60 yrs 2. (d) Lung cancer: 75% of malignant pulmonary BLOOD GASES, PH AND ELECTROLYTES. .............................................................................5 old man revealed the presence of malignant cells. The effusions are due to 3 causes; lung cancer GLUCOSE, HEMOGLOBIN, IRON AND BILIRUBIN. ...............................................................7 most likely primary tumor will be: (30%), breast cancer (25%) & lymphoma (20%). CALCULATIONS, QC AND STATISTICS ..................................................................................9 a. Lymphoma. Practically, cytological examination only CREATININE, UA, BUN AND AMMONIA ...............................................................................10 b. Mesothelioma. establishes the presence of malignant effusion, PROTEINS, ELECTROPHORESIS AND LIPIDS .......................................................................11 c. Cancer colon. however, in most cases it cannot identify the CLINICAL ENZYMOLOGY........................................................................................................13 d. lung cancer. primary site of the tumor. CLINICAL ENCOCRINOLOGY .................................................................................................14 Regarding mesothelioma, it is a rather a rare General ..................................................................................... 17 tumor of the pleura. Hematology .............................................................................. 19 3. *****Regarding Albustix: 3. (c) Commercial strips for detecting albumin BASIC HEMATOLOGY CONCEPTS / LABORATORY PROCEDURES ................................19 a. Useless if infected urine. (Albustix) use the following formula: NORMOCYTIC NORMOCHROMIC ANEMIAS .......................................................................20 b. Gives red color. Tetrabromophenol blue (yellow at 3.0) HYPOCHROMIC MICROCYTIC ANEMIAS .............................................................................24 c. Not useful if acid is added to urine. shades of green in the presence of protein at the MACROCYTIC NORMOCHROMIC ANEMIA .........................................................................25 d. Depends on acid precipitation of urinary proteins same pH. QUALITATIVE / QUANTITATIVE WBC DISOREDERS ........................................................26 This reaction is sensitive to 0.03g/L albumin. A LYMPHOPROLIFERATIVE / MYELOPROLIFERATIVE DISORDERS .................................29 false negative result occurs with acidification of COAGULATION AND PLATELETS ..........................................................................................35 urine. Also, a markedly alkaline urine (pH or Immunohematology ................................................................ 40 higher can give false +ve. Immunology ............................................................................. 41 4. ****Which is not a reducing sugar in urine? 4. (c) A reducing substance is the one that reduces a. Glucose. alkaline cupric sulfate to red coprous oxide. Microbiology............................................................................ 43 b. Galactose. Most important are glucose, lactose, fructose, ANTIBIOTICS, ANTIMICROBIALS, STERILIZATION AND DISINFECTION .....................43 c. Sucrose. galactoses and pentoses (e.g. ribose, xylose and BASIC TECHNIQUES .................................................................................................................44 d. Fructose. arabinose) while sucrose will not reduce alkaline BASIC BACTERIOLOGY............................................................................................................46 cupric sulfate. GRAM POSITIVE COCCI ...........................................................................................................47 GRAM NEGATIVE COCCI .........................................................................................................49 b. Rifampicin is a well known drug to cause red 5. ***Red urine is due to? 5. GRAM POSITIVE BACILLI ........................................................................................................49 a. INH urine. ENTEROBACTERECIAE & PSEUDOMONAS .........................................................................50 b. Rifampicin RICHETTSIAE, CHLAMYDIA AND MYCOPLASMA .............................................................52 c. Pyrizinamide. SPIROCHETES .............................................................................................................................53 BORDETELLA & BORRELIA ....................................................................................................53 6. **Urine strips detect all except 6. Fat droplets. Occur with glomerulonephritis and ANEROBIC BACTERIA ..............................................................................................................54 nephritic syndrome but are not detected by the BRUCELLA ..................................................................................................................................55 routine urine strips. MYCOBACTERIA .......................................................................................................................55 MISCELLANEOUS ......................................................................................................................56 7. **If urine is left for long time which is affected more? 7. Urea. The most labile constituent of urine is MYCOLOGY ................................................................................................................................57 urea. Bacterial action decrease urea and increase VIROLOGY ..................................................................................................................................60 ammonia and pH. 26th Shawual 1425 .................................................................. 64 8. **Abnormal constituent of urine includes? 8. (c) Although also glucose and protein are a. Urea abnormal constituents of urine, yet they b. Glucose normally present in trace amounts below the c. Cholesterol. detection limit of ordinary methods. d. Uric acid e. Protein. mohammad_emam@hotmail.com 1 mohammad_emam@hotmail.com 2 CLINICAL & CHEMICAL PATHOLOGY MCQ BODY FLUIDS CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY 9. ****Calcium in urine stone is present in all of the 9. (b) In 2ry hyperparathyroidism, hypocalcemia following except: a. UTI due to e.g. chronic renal failure is the cause of increased parathormone. Stones due to Clinical Chemistry b. Secondary hyperparathyroidism. hyperparathyroidism only occur with the 1ry or 3ry disease. Calcium is precipitated in stones with oxalate (at INSTRUMENTATION acid or neutral pH), or less commonly with urate 1. ******Difference between ELISA & RIA is ? 1. (a) Both techniques apply almost the same (at acidic pH) or with phosphate (at normal urine a. ELISA technique uses an enzyme. methodology, .ELISA technique uses an enzyme pH). Causes of hypercalciurea include: b. ELISA is used by bacteriologists while RIA by label and RIA uses radioisotopic label. - intestinal calcium absorption ( P level virologists vit D Ca absorption Or in case of hypervitaminosis D. 2. The label in ELISA is? 2. - Lack of renal tubular reabsorption e.g. with a. Enzyme furosamide. b. Antibody - Loss of Ca from bone (due to mobilization c. Antigen. as in 1ry & 3ry hyperparathyroidism, due to bone destruction or due to Cushing's and 3. ***Which of the following not seen in chemistry lab? 3. (d) Electron microscope. thyrotoxicosis) a. Analytic balance. Otherwise, UTI causes stones at alkaline pH b. Centrifuge where ammonium is high and mixed stones form c. Spectrophotometer due to obstructing Ca stone which favors d. Electron microscope, infection and precipitation of ammonia salts. e. Turbidimeter. 10. If urine is kept for a long time: 10. See 7. 4. **The washing is must in all heterogenous ELISA 4. (b) In ELISA, the first washing is used to a. Becomes black. Urine becomes black on standing in cases of techniques because? remove the unbound (free) sample antigen. The b. Urea increases. alkaptonurea ( homogentesic acid) and a. It remove the excess binding second washing removes unreacted free label c. Urea decreases. methemoglobinurea. b. Increase the specificity (not excess binding in either of the 2 washings) d. Creatinine increases c. Increase the sensitivity. If washing is not complete, this will false high 11. Myoglobinuria is seen in: 11. Muscle injury (also known as rhabdomyolysis) specificity. e.g. in cases of crush injuries and strenuous If the question comes as It avoids excess exercise. binding, then this will be the choice. 5. **The enzyme in ELISA is present in the? 5. (a) The conjugate is the second antibody a. Conjugate conjugated with the enzyme. b. Microplate c. Buffer. 6. **A standard microplate in an ELISA has? 6. (a) 96 wells are present in the microplate (8 a. 96 wells rows x 12 columns).of these, 1 is used for the b. 98 wells blank, 2 for the –ve controls, 2 for the +ve c. 92 wells. controls and 4 for the cutoff control (COC). The remaining 85 for tests. 7. Five ml of a colored solution has an absorbance of 0.500. 7. (b) According to Beer's law, absorbance is The absorbance of 10ml of the same colored solution will proportional to the final concentration (whatever be: the volume is) a. 1.000 b. 0.500 c. 0.250 8. a dichromatic analysis is carried to increase: 8. (a) Di- (bi) chromatic photometry measures a. Specificity absorbance of the sample at 2 different b. Linearity wavelengths. This corrects for interfering c. Sensitivity. substances increasing specificity of the method. mohammad_emam@hotmail.com 3 mohammad_emam@hotmail.com 4
  • 2. CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY BLOOD GASES, PH AND ELECTROLYTES. 19. H+ homeostasis is altered by; 19. In actively contracting muscle, 8% of the pyruvate New a. Excessive change of pyruvate to lactate. New is utilised by the citric acid cycle and the 9. ******PO2 (or gases) is measure in which unit? 9. © mEq/L (mmol in SI) is used for electrolytes remaining molecules are reduced to latctate. This a. Mmol e.g. BE, bicarbonate and H+. While mmHg (or lactate is oxidized by the liver to pyruvate which b. umol kpa in SI) is used for gases e.g. pCO2 and pO2. ,through gluconeogenesis, becomes glucose. If c. mmHg lactate is not efficiently reutilized in such a way, it accumulates in the blood causing lactic acidosis. 11. Acidemia is associated with 11. Acid in urine and increased HCO2-. 20, ***Main extracellular ions? 20, b. Na is the major ECF cation, Cl is the major ECF Increased hydrogen ion in the blood is termed 21, a. Na & K 21, anion, K is the major ICF cation and proteins academia. If the cause is metabolic, there will be 22, b. Na & Cl 22, followed by phosphates are the major anions. compensatory hyperventilation H+ back to 24, **Main electrolyte in blood is? 24, normal while HCO3- drops. Furthermore, if renal 25, ***Electrolytes in ECF 25, function is normal, H+ will be excreted. 26. a. Na is a major cation 26. If the cause is respiratory, renal compensation b. Cl is a major cation will cause H+ excretion and HCO3- retention and d. HCO3 is a major anion. generation lowering H+ back to normal. ***Main intracellular cation is; **In serum: 12. ***To correct acidosis, the kidneys: 12. (c). See 11. a. Sodium is the main cation. a. secrete more H+ in urine. b. Bicarbonate. b. Synthesis bicarbonate to ECF ***Intracellular fluid contains: c. Both a and b a. More potassium less sodium than extracellular fluid.. b. Sodium and potassium in equal amount. 13. **A buffer is made of ? 13. (c) A buffer system is made of a weak acid and a. Strong acid & strong salt its salt with a strong base of a weak base and its 23. **All causes renal damage except 23. Hypocalcaemia. b. Strong acid & weak salt salt with a strong acid. Causes of renal damage include; hypovolemia c. Weak acid & strong salt (hemorrhage or dehydration), myoglobulinurea, d. Weak acid & weak salt. hypercalciurea, uricosuria, and drugs e.g. aminoglycosides and ACE inhibitors. 14. ****pH means: 14. Negative log H+ concentration 27. Renal tubular injury occurs in 27. See 23. 15. ***What is the base: acid ratio at pH 7 for acid of pK6? 15. (d) According to Henderson Hasselbalch's 28. Hypernatremia occurs with 28. (d) Hypernatremia occurs with: a. 0.01 equation, pH = pK + Log base/acid. By a. Cushing disease * body Na : due to extrarenal water loss or b. 0.1 compensation, Log (base / acid)= 1, thus base: b. Dehydration renal diuresis. c. 1.0 acid = 10:1.1 c. hypothalamic injury * Normal body Na: due to extrarenal loss e.g. d. 10 d. All of the above hyperthermia or renal loss e.g. DI. e. 100 * Na retention e.g. steroids or Na intake. 16. ***Which is more serious? 16. (c) Critical K+ values are <2.5 or > 6.5 mEq/L 28. Regarding concentration of urine; 28. a. Approximately 80% of the water and NaCl a. Glucose 15mmol/l Critical glucose <40mg or >450mg (2.2 & New a. Proximal tubules return 75% of filtered water. New contenet together with glucose, phosphate, and b. pH 7.25 acidosis. 25mmol respectively), 1 b. Distal convoluted tubules deliver 40-60L of fluid to 1 amino acids are reabsorbed in the proximal tubule. c. Potassium 1.5 mmol/l critical pH <7.2 or >2.6 collecting tubules / day. About 20% of the tubular fluid enters the loop of d. Sodium 150 mmol/l critical Na+ <120 or > 160mEq/L c. Osmotic pressure in renal cortex is higher than in medulla. Henle where water is passively aborbed; 6ml per d. ADH acts on all parts of nephrone. minute of concentrated tubular fluid now enters 17. ******Metabolic acidosis can result from: 17. (a) Ingestion of certain medicines or chemicals e. Aldosterone increase Na excretion. the distal tubule, where there is an active e.g. metformin.(glucophage). reabsorption of sodium. The fluid leaves the distal Metformin causes lactic acidosis. tubule at a rate of approximately 1ml per minute Generally, metabolic acidosis is due to either passing into the collecting ducts in the form of addition of H+ ( AG), excretion of H+ or urine. Aldosteron is relased due to ineffective loss of HCO3- arterial pressure in the kidney. It causes sodium reabsorption which raises plasma osmolality. ADH 18. pH of the blood. 18. increases permeability of distal and collecting tubules to water urine concentration. 19 Acid base balance. 19 mohammad_emam@hotmail.com 5 mohammad_emam@hotmail.com 6 CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY 28. Regarding excretion of Na+ 28. b. Na+ excretion is influenced by 33. *****HBA1c (Glycosylated hemoglobin) is? 33. (b) GlycHb (RR 4-6%) is formed by non New a. Not dependent on aldosterone. New mineralocorticoids (mainly aldosterone): a. Not present in healthy normal individuals. enzymatic attachment of glucose to N-terminal 2 b. Major share of GF osmolarity with associated ions. 2 valine of B-chain of Hb. Three types occur, HbA1a, reabsorption. The GF is isoosmolar with plasma b. in prolonged sustained hyperglycemia c. It passively diffuses in proximal tubules. i.e. Na is the major electrolyte. 90% of Na is HbA1b, HbA1c, Both total and HbA1a are used. d. In distal tubules it is exchanged for K+ actively (not passively) reabsorbed in the PCT. K Time averaged blood glucose = GlycHbx33.3-86 e. Coupled with K+ is excreted from DCT in exchange with Na (not (mg/dL) the reverse and not coupled with it). GlycHb reflects 8-12 weeks of blood glucose while fructosamine reflects 2-4 weeks. 28. Regarding buffer systems; 28. b. Acids are substances that tare capable of 34. ***Glycogen differs from starch in: 34. It is a highly branched structure New b. An acid is a substance that releases H+ New donating protons. When a strong acid is added to a 3 3 35. **Cellulose is not metabolized in humans because of 35. Glucose units in cellulose are combined by c. Buffering involves change of strong acid to base. buffer, the salt reacts with the acid forming weak acid, and its salt (not base). absence of which enzyme? cellobiose bridges. These are hydrolyzed by cellobiase which is lacking in animal and human gut. GLUCOSE, HEMOGLOBIN, IRON AND BILIRUBIN. 36. **Xylose test is done to detect the function of: 36. c. Xylose is absorbed from proximal small 10. Factors affecting glucose level in blood include: 10. Adrenaline, T4. These together with cortisol, GH a. Stomach. intestine independent on pancreas.. and glucagons are the hyperglycemic hormones b. Pancreas. causing 2ry diabetes in case of excessive secretion. c. Upper small intestine. d. Lower small intestine. 29. **Glucose level to diagnose hypoglycemia in newborn is. 29. - 25-30 g/dl e. Large intestine In newborn babies, glucose tends to be lower than in adults. Critical low level in newborn is 30mg/dL 37. ****Von Gerke's disease is caused by deficiency of: 37. (a) See 32. a. Glucose 6 phosphatase 30. ***About GTT, which is correct according to WHO 30. (c) WHO recommendations for GTT include: b. Glucose 6 phosphate dehydrogenase recommendations? a. Should not be done in pregnant women, 38. What happens if sucrose is given parentrally: 38. It will be secreted unchanged or metabolized b. Should not be done after giving heavy carbohydrate diet for 3 days. 39. ***Which of these is not a ketone body? 39. (c) Ketone bodies are formed by condensation of 2 c. Should be done after 4-6 hrs fasting. a. Acetone. acetyl Co A Acetoacetic acid which gives B b. Acetoacetic acid. hydroxyl butyric acid by reduction or acetone by 31. **With age renal threshold for glucose? 31. (b) With age, the renal ability to reabsorb filtered c. Butyric acid. decarboxylation. a. Increased glucose is decreased leading to appearance of d. B-hydroxy butyric acid. Butyric acid is a fatty acid b. Decreased glucose in the urine at lower plasma levels. e. None of the above. c. Not changed 40. ***In Gaucher's disease; 40. (b) Gaucher's is a glucosylceramide lipidosis 32. **All are inborn error of glycogen metabolism except? 32. (b) Essential fructosuria is due to aldolase B defect a. Glycoprotein is accumulated. (lysosomal storage disease). It is caused by a. Essential fructosuria leading to accumulation of fructose-1-P b. Glucocerebrosidase is deficient. glucocerebrosidase enzyme leading to b. Phenyl ketonuria Galactosemia (serious) is due to decreased accumulation of glucosylceramide HSM and c. Galactosemia Galactose-6-P uridyl transferase leading to pigmentation of exposed parts. d. Glycogen storage disease decreased glycogen synthesis. Types of glycogen storage diseases (GSD) include: 41. Bile duct obstruction can be diagnosed by: 41. (c) Cholestatic hyperbilirubinemia is characterized Type I (VonGierke's): G6P a. AST by conjugated hyperbilirubinemia and b. T. Bilirubin hyperbilirubinuria (only the conjugated fraction Type II (Pompe's): lysosomal maltase c. Bilirubin in urine appears in urine). Type III (Cori's) : debranching enzyme. d. Ester bilirubin Type IV (Anderson's): Absent debranching enzyme 42. *** Increased jaundice is diagnosis by 42. (a) Estimation of jaundice depends on serum Type V (McArdle's): muscles a. T. bilirubin bilirubin, other mentioned tests help to identify the phosphorylation. b. AST cause of jaundice. c. ALT d. ALP mohammad_emam@hotmail.com 7 mohammad_emam@hotmail.com 8
  • 3. CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY CALCULATIONS, QC AND STATISTICS 50. Sensitivity and specificity are 50. (b) Sensitivity & specificity can be adjusted a. Directly related. according to cutoff level. Sensitivity can be 43. **Most of the concentration are calculated using factor, 43. (b) For methods obeying Beer's law, slope of the b. Inversely related. increased by choosing a higher cutoff to include this factor is? calibration curve (Cs/As) provides a constant to c. They mean the same. more TP, this meanwhile will include more FP a. Std absorbance / std value calculate the unknown concentration. Also thus specificity. However, this is not always b. Std value / std absorbance depending on the formula: the case as highly specific highly sensitive tests c. Std value x std absorbance At x Cs = As x Ct, thus, Ct=(Cs/As)x As as well as poorly specific poorly sensitive exist. 44. **Ten microliters are? 44. (d) μL = 10-6L 10 μL = 10-5L = 0.00001L 51. A carryover in chemistry analyzer means a disturbance in 51. (b) Carryover is due to contamination by a a. 0.01 L readings because: previous sample. It is calculated by measuring a b., 0.001 L a. The analyzer was carried and placed at a different place. high standard and a low standard each 3 times c. 0.0001 L b. The previously measured solution was still in the cuvette then applying the following formula: d. 0.00001 L c. The current solution is overflowing in the cuvette. Carry over = (contaminated low – actual low) / e. non of these. contaminated high – actual high) 45. **How much water should be added to 500ml of a solution 45. (c) Using the formula: 52. STAT test means: 52. (c) Stat refers to immediate or as initial dose. of 10% NaOH to bring it to 75%? C1 x V1 = C2 x V2 a. Start at. a. 666ml 10 x 500 = 7.5 x V2 b. Standardize and test. b. 125ml V2 = 666mL c. Short turn around time c. 166ml Thus, 166 mL of DW should be added. d. 250ml e. 375ml CREATININE, UA, BUN AND AMMONIA 46. When calculated osmolarity can not be accounted as a 46. Calculated osmolarity = 2 X Na + Glu + Urea 53. ***Which of the following result shows renal impairment? 53. (e) A urine osmolarity less than 800 after 12 hrs measurement for osmolarity? (All in mmol/L) a. urea 9 mmol of water deprivation denotes renal impairment. a. per 100gm/l When calculated osmolarity is less than b. creatinine 10 mmol/l Urea 9mmol is high normal (n: 2.9-8.2) and is b. Urea 20 mm/l measurement for osmolarity, this denotes c. urates not a very sensitive measure of GFR. increased osmolar gap (OG). This occurs with: d. cholesterol Creatinine, although a sensitive measure of GF, - Factitious hyponatremia (due to e. urine osmolarity less than 800 after 12 hrs of water 10umol is normal (n: 53-106) decreased water) deprivation. Cholesterol and urates are useless in this regard. - Unmeasured osmotically active compounds e.g. alcohols, sugars, and 54. **Low GFR occurs in all except: 54. (b) low GFR occurs with: ketones. a. Congestive heart failure. - Hemorrhage. b. Urethral obstruction. - Dehydration. 47. **Calibrator sera are? 47. (b) Secondary std? - Renal loss of fluids e.g. diuretics. a. Primary std A primary Std is a reference standard. - Ineffective blood volume, e.g. CO, b. Secondary std Secondary Std is standardized depending on the systemic VD, renal vasoconstriction. c. Tertiary std primary standard. d. Internal std. 55. Diagnosis of RF 55. GFR is an index and a monitor of increased or decreased renal functions. It is practically 48. **External QC program means? 48. (b) In EQC, participants receive QC material to estimated from serum creatinine and creatinine a. An external person come & does the QC test be tested inside their labs. Results are sent to clearance. b. A QC person goes to another lab & does the test.. supplier to be compared to other labs' results. EQC will be most practically implemented 56. ****Nephrotic syndrome is characterized by all except: 56. (a) Nephrotic syndrome consists of: during the regular visit of the lab coordinator. a. Hypocholesterolemia. - Heavy proteinuria. This will give opportunity for errors to be b. Hypoalbuminemia. - Hypoalbuminemia. investigated on site and corrected rapidly c. Albuminuria. - Oedema. (Monica) d. Hypertriglyceridemia. - Hypercholesterolemia (Almost always 49. **We select 2SD value to plot LJ curves because? 49. (c) QC results follow a Gaussian distribution, e. None of the above present). a. They are easy to calculate, thus 95% of these results normally fall within Hypertriglyceridemia is present in 50% of b. They cover 97.5% of normal population, ±5% of the mean. Therefore, 2.5 out of 100 cases. c. Patient value rarely go beyond these limits. (1:40) are acceptable to be above +2s and 2.5 our of 100 are acceptable below -2s. mohammad_emam@hotmail.com 9 mohammad_emam@hotmail.com 10 CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY 57. ****Ureate excretion by the kidney is inhibited by: 57. (b) Thiazide diuretics cause relatively urate 65. **Lipoprotein related to hypertension? 65. . LDL a. Probenecid. retention, glucose intolerance and hypokalemia b. Thiazide diuretics. and interfere with water excretion and may 66. *****Which is important for atherosclerosis? 66. (b) cause hyponatremia. a. HDL Probenecid is a uricosuric agent like allopurinol. b. LDL c. Chylomicrons. 58. Chronic glomerulonephritis is diagnosed by: 58. (d) In chronic glomerulonephritis, there is a. Blood urea. persistent deterioration of renal functions ending 67. ***In plasma protein electrophoresis, the protein that will 67. Albumin. b. Creatinine. with renal failure. go first is (moves furthest from application)? c. Proteinuria d. All of the above On electrophoresis; 68. ***Based on behavior of lipoproteins in 68. ultracentrifugation pre-B lipoprotein is? Chylomicrons and its remnants stay at the a. HDL origin. PROTEINS, ELECTROPHORESIS AND LIPIDS b. LDL. VLDL at preβ (=α2 globulin region) 59. **The protein having molecular wt less then albumin is? 59. (b) B2-microglobulin has a MW 11,800. c. VLDL IDL at broad β a. Beta protein Betalipoprotein is 380,000. d. Chylomicron LDL at β (= β globulin region) b. B2-microglobulin. BJ protein is the light chains of HDL at α (= α1 globulin region)/ c. Lysozyme. immunoglobulins. It's MW is variable from d. Benze Jones protein. 11,000 for monomers, 22,0000 for dimmers or 69. **All of the following are lipoproteins except? 69. (d) Although phospholipids are not lipoproteins, tetramers. a. Phospholipid they are ingredients of lipoproteins, conferring Lysozyme is 14,000. It is used to differentiate b. VLDL the hydrophilic properties. AML M4 and M5 and appears as a far cathodal d. Sphingomylin band on serum or urine EP. e. LDL f. HDL 60. ******In cystic fibrosis, which is deficient? 60. (d) Alpha 1 antitrypsin a. Beta globulin 70. What is the proposition of pulmonary surfactant? 70. (b) Dipalmityl lecithin (a lecithin phospholipid b. Macroglobulin a. Phospholipid acid with 2 palmetic acid residues) is the chemical c. Albumin b. Dipalmityl lecithin composition of pulmonary surfactant. d. Alpha 1 antitrypsin c. Phosphatidyl choline, e. Alpha 2 antitrypsin. 71. **HDL is good cholesterol because? 71. (a) HDL is composed of 20% cholesterol, 30% 61. ***Diet rich in phenylalanine should be restricted in? 61. (a) In phenylketonuria, there is phenylalanine a. It has more protein & phospholipids in it phospholipids and 50% proteins. a. Phenyl ketonuria b. It has no cholesterol in it,. hydroxylase leading to accumulation of b. Tyrosinemia c. It has less TG in it. phenylpuruvate and its derivatives and their c. Maple syrup disease excretion in urine. Diet rich in phenylalanine should be restricted to prevent brain damage. 72. ***Which lipoprotein has highest concentration of 72. (b) VLDL are the TG rich lipoproteins cholesterol? HDL has 20% cholesterol. a. VLDL IDL has cholesterol and TG in equal amounts. 62. ***In phenylketonuria, diet should be low in: 62. (a) Phenylalanine (see 61) b. LDL LDL is the richest lipoprotein in cholesterol a. Phenylalanine. c. IDL esters. b. Carbohydrate. d. HDL c. Lipids. 74. ****Which is not associated with abetalipoproteinemia: 74. (b) Hereditary spherocytosis is due to spectrin 62. Hypoalbuminemia is associated with all except? 62. (a) Tetanus is clostridial infection caused be C. a. Acanthocytes in the peripheral blood. deficiency. a. Tetanus tetani has nothing to do with albumin. b. Hereditary spherocytosis. Abetalipoproteinemia is a lipoprotein b. hypocalcaemia c. Malabsorption and fatty stools abnormality of absent LDL due to autosomal c. oedema recessive abnormality in the synthesis of apoB + d. toxic effect of sulfonamide failure of chylomicron formation leading to malabsorption of fats + fat soluble vitamins + 64. **Gluconic amino acids include: 64. (a) Ketogenic amino acids are: Leucine and adrenal dysfunction. 50-70% of RBCs have a. Alanine. lysine, spinal projections (acanthocytes) b. Methionine. Mixed amino acids are: Isoleucine, c. Valine. phenylalanine, threonine, tryptophan and 75. Chylomicrons: 75. (a) Chylomicrons don't confer an excess d. Glutamic acid. tyrosine. a. Can cause thrombosis. cardiovascular risk, however, in LpL deficiency e. All of the above. Gluconic amino acids are all the other amino b. Cannot cause thrombosis. and apoC II deficiency, the patient presents with acids. lipemia retinalis and retinal vein thrombosis. mohammad_emam@hotmail.com 11 mohammad_emam@hotmail.com 12
  • 4. CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY 76. Nature of apoproteins. 76. 5 major classes of proteins A to E 85. ***In MI, which is the last enzyme to be raised and lasts 85. (d) long? Onset (h) Peak (h) Duration Saturated Unsaturated a. CK (d) 77. Saturated vs unsaturated fats (nutritional value) 77. e.g. Oleic a (50% of Linoleic a CK 6-12 20-30 2-6 b. CK-MB. CK-MB 3-10 12-24 1.5-3 body fat) Linolenic a Palmitic a (25% (both are c. AST. AST 6-12 20-30 2-6 of body fat) Essential) d. LDH LDH 6-12 24-72 7-14 Stearic a (5% of Arachidonic a. body fat) 86. **Isoenzymes: 86. © Isoenzymes have the same catalytic activities Acetic a. Butyric a. a. Are physical types of one enzyme. and differ in physicochemical properties. Presence Adipose Vegitable oils. b. Have different electrophoretic mobility. Suffix Anoic Enoic c. All of the above Significance Arachidonic acid is precursor of Pgs. 87. **MI is diagnosed by: 87. (a) CK-MB is specific for cardiac muscle, CK- Although not a. CKMB BB for brain and CK-MM for skeletal muscle. essential, it b. CKBB depends on c. CKMM essential FA d. LDH Chemistry No double Double bonds bonds 78. Which is best for parentral alimentation? 78. (b) Parentral nutrition is composed essentially 88. **Elevation of LDH is caused by: 88. (d) LDH is present in the cells of the heart, liver, a. FFA. 79. of: a. Myocardial disease muscles, blood and malignancies. b. AA a) Nitrogen source: synthetic valuable amino b. Liver disease c. lipoproteins acids (9-17g/L N2) c. Prostatic disease b) Energy source: Glucose (mainly) and fat d. many organ disease because it has many distribution emulsion (additional source to avoid EFA deficiency). 89. ****Myoglobin in injury of: 89. (a) muscle whether cardiac or skeletal is the c) Electrolytes and trace elements. a. muscle. source of myoglobin. 79. Protocol for IV nutrition? b. Liver 80. **Regarding lipoprotein metabolism: 80. Although cholesterol can be synthesized by all nucleated cells, however, cholesterol in VLDL, CLINICAL ENCOCRINOLOGY IDL and LDL is of hepatic origin 82. Treatment of familial hypercholesterolemia. 82. These include general management of 90. *****ADH is? 90. (b) ADH is produced by the hypothalamus and hypercholesterolemia + cholesterol lowering a. Produced by posterior pituitary stored and secreted from the posterior pituitary. drugs + oestrogen replacement in b. Produced in the hypothalamus. postmenopausal women. 91. **The method used to estimating insulin is? 91. (d) Immunoassay (multiple labels) is used for a. Electrophoresis the measurement of insulin. b. Kinetic estimation. c. Spectrophotometer. CLINICAL ENZYMOLOGY d. Radioimmuno assay. 83. ***The better for diagnosis of acute pancreatitis is? 83. (b) Lipase elevation is of a greater magnitude (2- a. Amylase 10 xN) and duration than amylase in acute 92. *****After the insulin dose, the patient soon comatozed 92. (b) Hypoglycemia (glucose <3mmol/l) b. Lipase pancreatitis. When lipase method is optimized, due to c. ALP the test is more sensitive and specific than a. Hyperglycemia d. ACP amylase for detection of acute pancreatitis. b. Hypoglycemia (glucose <3mmol/l) c. ketonuria 84. **Activities of some enzyme increased in some disease 84. (b) That’s why enzymes are measured for the c. Ketoacidosis is the cause of coma conditions because they are? most part by their activity rather than d. Lactic acidosis, a. Non functional enzymes concentration. b. Functional enzymes c. Neither mohammad_emam@hotmail.com 13 mohammad_emam@hotmail.com 14 CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY CLINICAL & CHEMICAL PATHOLOGY MCQ CHEMISTRY 93. **While using the pregnancy test we are measuring? 93. (b) α subunit of HCG is very similar to α 98. Carcinoid tumors secrete 98. 5HIAA. a. B-HCG subunit of TSH and FSH and identical to LH. New New Carcinoid tumors originate from the b. Total HCG Although β subunits of HCG and LH are very enterocromaffin cells (APUD cells) of the c. B-HCG & LH similar, antibodies can be made to the β subunit intestine and most commonly occurs in the d. B-HCG & FSH. of HCG that do not cross react with LH or other appendix, terminal ilium and rectum. pituitary hormones. Most EIA use 2 monoclonal Presentation may be asymptomatic until antibodies against different sites of HCG metastasis (most cases), appendicitis (10%) or molecule one for carboxyl terminal of β chain carcinoid syndrome (in5% when there is liver and the other to the α chain, i.e. react with intact metastasis) as spontaneous flushing on the face HCG. and neck, abdominal pain and water diarrhea, cardiac abnormalities and hepatomegally. The 94. ****Water deprivation test is used in the diagnosis of: 94. (b) Water intake is restricted the patient loses 3- tumor secretes a wide variety of amines an a. Anterior pituitary disease. 5% of body weight or until 3 consecutive hourly peptides including serotonin (5- b. Posterior pituitary disease. determination of urine osmolarity are within hydroxytryptamine (5-HT) with its major c. Hypothyroidism. 10% of each other. Measure urine osmolality, metabolite 5-hydroxyindoleacetic acid (5- plasma vasopressin and increased urine HIAA)), bradykinin, histamine and tachykinins osmolality with exogenous vasopressin. and prostaglandins. Urine Pl. VP After VP osmol Normal >800 >2 DI <300 Undetectab Neeman Peck disease is due to deficiency of sphengomylinase le Cholesterol: In LDL, cell membrane, precursor of bile salts and steroid hormones. Nephrogeni <300 >5 No change c DI 95. ****24 hours urine for VMA is used for diagnosis of 95. (b) Catecholamines are oxidized to VMA and diseases of: metanephrins. 24hour urinary metanephrins is a. Adrenal cortex. the best single test for pheochromocytoma. b. Adrenal medulla Specificity and sensitivity approach 100% when both VMA and metanephrines are measured. 96. ***Hypertension is found in all of the following endocrinal 96. (d) Hypertension secondary to endocrinal causes diseases except: occurs in: a. Cushing's syndrome. - Pheochromocytoma. b. Pheochromocytoma. - Crohn's syndrome c. Adrenal medulla hyperplasia. - Cushing's syndrome. d. Addisson's disease. Addison is associated with hypos (hypotension, hypokalemia, hyponatremia and hypocortisol) 97. Diabetic coma presents with: 97. All. a. Ketone bodies in urine In diabetes, 2 types of coma may occur, DKA b. Blood glucose may be 1000mg or more and nonDKA. Glucose levels in nonDKA are c. osmotic diuresis present typically <800 mg/dL. Once hyperglycemia is established, ketonurea & pH should be looked for to differentiate. 98. **While anti-PSA is coated on to the well in total PSA 98. (a) different antibodies. estimation, the antibodies coated in free PSA is? a. The same antibodies that is coated for total PSA b. Same antibodies in large amount c. Same antibodies in very low amount d. Different antibodies. mohammad_emam@hotmail.com 15 mohammad_emam@hotmail.com 16