Clinical Chemistry
Midterm Exam
Course Introduction
Clinical Chemistry is a branch of laboratory medicine that focuses on the analysis of bodily fluids, primarily blood and urine, to diagnose, monitor, and treat diseases. This course covers the principles and techniques involved in chemical analysis of metabolic substances, enzymes, hormones, electrolytes, and drugs, emphasizing the correlation between laboratory results and clinical conditions. Students will gain hands-on experience in various analytical methods, understand quality control processes, and explore the interpretation of laboratory data in the context of patient health, ultimately preparing them to play a crucial role in modern diagnostic and therapeutic practices.
Recommended Textbook
Linne Ringsruds Clinical Laboratory Science 7th Edition by Mary Louise Turgeon
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17 Chapters
529 Verified Questions
529 Flashcards
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Chapter 1: Fundamentals of the Clinical Laboratory
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Sample Questions
Q1) The role of the CEO of a health care organization is to:
A) implement policy and daily activities.
B) set policy and guide the organization.
C) manage financial affairs of the organization.
D) manage the hospital information system.
Answer: B
Q2) ASCP
A)American Society for Clinical Laboratory Science
B)National Accrediting Agency for Clinical Laboratory Sciences
C)American Society of Clinical Pathologists
Answer: C
Q3) The fastest growing segment of laboratory testing is:
A) dry reagent chemistry.
B) lab on a chip technology.
C) molecular diagnostics.
D) automation of blood cell counting.
Answer: C
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Chapter 2: Safety in the Clinical Laboratory
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Sample Questions
Q1) Contact lenses can be manipulated with gloved hands.
A)True
B)False
Answer: False
Q2) Treatment for alkali or acid burns of the skin is to:
A) rinse thoroughly with large amounts of running tap water.
B) apply ice.
C) wash thoroughly with soap and water.
D) apply direct pressure.
Answer: A
Q3) Preemployment health profiles of students and laboratory staff should include immune status evaluation for ____ at a minimum.
A) hepatitis B
B) rubella
C) measles
D) all of the above
Answer: D
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Chapter 3: Quality Assessment and Quality Control in the Clinical Laboratory
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Sample Questions
Q1) Accuracy describes:
A) how close a test result is to the true value.
B) comparison of an instrument measure or reading to a known physical constant.
C) how close the test results are to one another when repeated analyses of the same material are performed.
D) the purity of a substance.
Answer: A
Q2) One way to determine a control range for a particular analysis is to:
A) assay an aliquot of the control serum with the regular batch of assays for 15 to 25 days.
B) treat a control sample exactly like an unknown specimen.
C) estimate the most reasonable value.
D) do both a and b.
Answer: B
Q3) chronic shortage of qualified laboratory staff
A)active error
B)latent error
Answer: B
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Chapter 4: Phlebotomy: Collecting and Processing Blood
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Sample Questions
Q1) Major errors in the identification of patients can include:
A) absent wristband.
B) erroneous information on the wristband.
C) partially missing information on the wristband.
D) all of the above.
Q2) The most common cause of an abnormal appearance of a collected blood specimen is:
A) hemolysis.
B) icterus (jaundice).
C) lipemia.
D) excess anticoagulant.
Q3) The pale,straw-colored fluid visible in clotted blood in a test tube is:
A) plasma.
B) serum.
C) fibrinogen.
D) fibrin.
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Chapter 5: The Microscope
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Sample Questions
Q1) The numerical aperture (NA)is:
A) an index of the resolving power of a lens.
B) the distance from an object being viewed to the lens.
C) inscribed on each objective lens.
D) both a and b.
Q2) The definition of Köhler illumination is the:
A) strength of the transmitted light.
B) light path through the microscope.
C) light path passing through the condenser of the microscope.
D) light path passing through the diaphragm of the microscope.
Q3) Total magnification is the product of the magnification of the objective ____ the magnification of the ocular.
A) added to
B) multiplied by
C) divided by
D) subtracted from
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Chapter 6: Systems of Measurement, laboratory
Equipment, and Reagents
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Sample Questions
Q1) Distilled water is defined as water from which:
A) iron, magnesium, calcium, and other minerals have been removed by heating and cooling the vapor.
B) ions have been removed by charcoal filters.
C) microbiological organisms have been removed.
D) All of the above are correct.
Q2) Flammable solvents should be stored in:
A) a refrigerator.
B) a freezer.
C) special safety cans.
D) a draft-free location.
Q3) Convert 20° C to ° F.
A) 32
B) 46
C) 68
D) 100
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Chapter 7: Laboratory Mathematics and Solution Preparation
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Sample Questions
Q1) A significant figure should contain only the digits in a number needed to express the precision of the measurement.
A)True
B)False
Q2) The term dilution refers to:
A) the volume or number of parts of the substance to be diluted in the total volume.
B) the volume or number of parts of the substance to be diluted in the parts of the final solution.
C) an expression of concentration that indicates the relative amount of substance in solution.
D) all of the above.
Q3) Laboratory results should only contain the digits necessary for the precision of the determination.
A)True
B)False
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Chapter 8: Basic and New Techniques in the Clinical Laboratory
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Sample Questions
Q1) 500-580
A)not visible (infrared light)
B)red
C)orange
D)yellow
E)green
F)blue
G)violet
H)not visible (ultraviolet light)
Q2) Coulometry measures the:
A) amount of current passing between two electrodes in an electrochemical cell.
B) color generated in a chemical reaction.
C) heat generated in a chemical reaction.
D) relative speed of current passing between two electrodes in an electrochemical cell.
Q3) Various enzymes are used in enzyme immunoassay.In order to be used,an enzyme must fulfill certain criteria,including multiple antigen specificity.
A)True
B)False
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Chapter 9: Delivery of Laboratory Testing From Point of
Care to Total Automation
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Sample Questions
Q1) Computer interfaces are important to the laboratory for all of the following reasons except:
A) transmission of tests results is faster.
B) accuracy of analytical testing is improved.
C) transposition of numbers errors are eliminated.
D) charting of patient results can be direct.
Q2) Leukocytes can be differentiated by:
A) automated three-part differential.
B) automated five-cell differential.
C) digital imaging.
D) all of the above.
Q3) False-positive fecal occult blood results can be caused by ingestion of:
A) red meat.
B) horseradish.
C) apples and oranges.
D) both a and b.
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Chapter 10: Introduction to Clinical Chemistry
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Sample Questions
Q1) CEA
A)suggests early recurrence of breast cancer
B)secreted in endodermal sinus tumors
C)detected in choriocarcinoma
D)found in 20% of smokers
Q2) Estimation of the blood glucose level over the previous 4 to 6 weeks is determined with which test?
A) HbA<sub>1c</sub>
B) Ketones
C) Clinitest
D) Microalbumin
Q3) The term chloride shift refers to the:
A) exchange of chloride with sodium to maintain electrical neutrality.
B) exchange of chloride with bicarbonate between red blood cells and plasma.
C) contribution of chloride to serum osmolality.
D) kidney's excretion of chloride by the renal tubules.
Q4) Free T is ____ and thyroid stimulating hormone is ____ in hypothyroidism.
A) increased; decreased
B) decreased; increased
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Chapter 11: Principles and Practice of Clinical Hematology
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Sample Questions
Q1) The RBC distribution width is:
A) measurement of the degree of anisocytosis present.
B) measurement of the degree of RBC size variability.
C) abbreviated as RDW.
D) all of the above.
Q2) Reticulocytes represent RBCs that:
A) have lost their nuclei but not their cytoplasmic RNA.
B) are immature, nucleated RBCs.
C) are increased in untreated pernicious anemia.
D) have abnormal staining characteristics.
Q3) When insufficient amounts of oxygen are present in the circulating blood,a patient's skin will appear:
A) bright cherry red.
B) pale pink.
C) blue.
D) white.
Q4) Platelets maintain the structure or integrity of the endothelium by plugging any gaps in the lining.
A)True
B)False
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Chapter 12: Introduction to Hemostasis
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Sample Questions
Q1) The appropriate anticoagulant for prothrombin time assay is:
A) EDTA.
B) 3.2% sodium citrate.
C) 3.8% sodium citrate.
D) heparin.
Q2) D-dimer assay is important in detecting:
A) factor VIII deficiency.
B) disseminated intravascular coagulation (DIC).
C) fibrinogen deficiency.
D) defective platelet aggregation.
Q3) Most patients on warfarin therapy should maintain an international normalized ratio (INR)of approximately ____ times of a normal value.
A) 0.5-1.5
B) 1-2
C) 2-3
D) 3-4
Q4) A function or activity of platelets is to help activate and be a participant in plasma coagulation.
A)True
B)False
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Chapter 13: Renal Physiology and Urinalysis
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Sample Questions
Q1) nocturia
A)any increase in urine volume, even if the increase is only temporary
B)complete absence of urine formation
C)abnormally small amount of urine, less than 500 mL/24 hours
D)excretion of more 400 mL urine at night
E)consistent elimination of an abnormally large volume of urine (more than 2000 mL/24 hours)
Q2) medications (e.g.,azo-containing compounds or dyes that color urine red or that turn red in an acidic medium when testing for nitrite for the detection of bacteria in urine)
A)false positive
B)false negative
Q3) The first part of the routine urinalysis is the ____ examination.
A) physical
B) chemical
C) microscopic
D) either b or c
Q4) Urine specimens must be fresh and centrifuged for reagent strip testing.
A)True
B)False
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Chapter 14: Examination of Body Fluids and Miscellaneous Specimens
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Sample Questions
Q1) If CSF has a xanthochromic appearance,it can indicate bleeding:
A) within 30 minutes to 1 hour.
B) within 1 to 2 hours.
C) between 12 hours and 2 to 4 weeks.
D) within the past month.
Q2) Serous fluids:
A) have a composition that is unlike serum.
B) are contained within the closed cavities of the body.
C) are ultrafiltrates of plasma.
D) Both a and b are correct.
Q3) The type of specimen that is most critical to deliver immediately to the laboratory for examination is ____ fluid.
A) cerebrospinal
B) synovial
C) pericardial
D) peritoneal
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Chapter 15: Introduction to Microbiology
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Sample Questions
Q1) Which of the following is the appearance of a positive catalase test?
A) Fibrin clot
B) Bubbles of oxygen
C) Visible clumping
D) Blue-green color
Q2) The Gram stain is used to differentiate bacteria that have similar morphologic features.The Gram stain method uses different reagents,including:
A) Gram iodine.
B) decolorization.
C) a counterstain.
D) all of the above.
Q3) Interpret the following Gram stain of urethral discharge from a male: Many polymorphonuclear leukocytes (PMNs)
Few gram-negative intracellular diplococci
Q4) Which of the following is the "cold" method for staining acid-fast bacteria?
A) Ziehl-Neelsen
B) Kinyoun
C) Fluorochrome
D) All of the above
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Chapter 16: Immunology and Serology
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Sample Questions
Q1) Rheumatoid factors are autoantibodies.
A)True
B)False
Q2) plateau
A)no detectable antibody
B)antibody titer stabilizes
C)antibody is catabolized
D)antibody titer increases
Q3) lag
A)no detectable antibody
B)antibody titer stabilizes
C)antibody is catabolized
D)antibody titer increases
Q4) Indirect immunofluorescent assay (IFA)
A)A conjugated antibody is used to detect antigen-antibody reactions.
B)Antibodies can act as antigens and react with antiimmunoglobulins.
Q5) Factors that influence an individual's defense against disease include status of general health.
A)True
B)False
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Chapter 17: Immunohematology and Transfusion Medicine
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Sample Questions
Q1) Whole blood
A)Best used when oxygen-carrying capacity is needed
B)Rarely used but can meet a patient's need for volume replacement, oxygen-carrying capacity, and heat-labile coagulation factors
C)Used to treat multiple coagulation deficiencies
D)Used to treat hemophilia
Q2) Transfusion reactions that are the most life threatening are:
A) hemolytic.
B) febrile.
C) nonimmune.
D) iron-overload.
Q3) Fresh frozen plasma
A)Best used when oxygen-carrying capacity is needed
B)Rarely used but can meet a patient's need for volume replacement, oxygen-carrying capacity, and heat-labile coagulation factors
C)Used to treat multiple coagulation deficiencies
D)Used to treat hemophilia
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