Following overnight fasting,hypoglycemia is defined as a glucose of:

A.  ≤ 70 mg/dl

B.  ≤ 60 mg/dl

C.  ≤ 55 mg/dl

D.  ≤ 45 mg/dl

A patient is admitted to the ED in a state of metabolic alkalosis. Which of the following  would be consistent with this diagnosis?

A. High TCO₂, increased HCO₃

B. Low TCO₂, increasedHCO₃

C. High TCO₂, decreased H₂CO₃

D. Low TCO₂, decreased H₂CO₃

The serum protein electrophoresis pattern is consistent with:

A. cirrhosis

B. acute inflammation

C. monoclonal gammopathy

D. polyclonal gammopathy(chronic inflammation)

This SPE pattern is consistent with:

A. cirrhosis

B. acute inflammation

C. polyclonal gammopathy(chronic inflamation)

D. alpha-1 antitrypsin deficiency(severe emphysema)

A patient has the following results:

FE 250 (ref 60-150)

TIBC 350 (ref 300-350)

Best conclusion is that this patient has:

A. normal iron status

B. iron deficiency disease

C. chronic disease

D. iron hemochromatosis

In order to prepare 100 mL of 15 mg/dl working standard from a stock solution containing 500 mg/dL of urea nitrogen, the number of mL of stock solution the number of mls of stock solution that should be used is:

A. 3mL

B. 5 mL

C. 33 mL

D. 75 mL

A. 3mL

V1C1 = V2C2

(100)(15) = x (500)

Oligoclonal bands are present on electrophoresis of concentrated CSF and also in concurrently tested serum of the same patient, The interpretation is:

A. diagnostic for primary CBS tumor

B. diagnostic for multiple sclerosis

C. CNS involvement by acute leukemia

D. nondiagnostic for multiple sclerosis

If the total bilirubin is 3.1 mg/dL and the conjugated bili is 2.0 mg/dl, the unconjugated bili is:

A. 0.5

B. 1.1

C. 2.2

D. 5.1

In which of the following disease states is conjugated bilirubin a major serum component ?

A. biliary obstruction

B. hemolysis

C. neonatal jaundice

D. erythroblastosis fetalis

In which of the following conditions does decreased activity of glucuronyl transferase result in increased unconjugated bili and kernicterus in neonates ?

A. Gilbert disease

B. Rotor syndrome

C. Dubin-Johnson syndrome

D. Crigler-Najjar syndrome

The most sensitive enzymatic indicator for liver damage from ethanol intake is:

A. ALT

B. AST

C. GGT

D. Alk Phos

Which of the following diseases results from a familial absence of high density lipprotein ?

A. Krabbe disease

B. Gaucher disease

C. Tangier disease

D. Tay-Sachs disease

A 1 year old girl with a hyperlipidoproteinemia and lipase deficiency has the following lipid profile:

Chol 300 mg/dL, LDL and HDL increased

Trig 200 mg/dL , Chylomicrons present

Serum specimen refrigerated overnight would most likely be:

A. clear

B. cloudy

C. creamy layer over cloudy serum

D. creamy layer over clear serum

Which of the following lipid results would be expected to be falsely elevated on a serum specimen from a nonfasting patient?

A. Cholesterol

B. Triglycerides

C. HDL

D. LDL

The class of phosopholipid surfactants represented by the dotted line on the amniotic fluid analysis shown above is thought to originate in what fetal organ system ?

A. cardivascular

B. pulmonary

C. hepatic

D. placental

Lab A measures maternal serum AFP at 16-18 weeks gestation as a screen for fetal disorders. The 16 week MSAFP median for Lab A is 32 μg/L. A 37 year old woman has a MSAFP level of 34 μg/L at her 16th week. Result is consistent with:

A. A normal MSAFP for 16 week gestation

B. Possible neural tube defect, including spina bifida

C. Possibel multiple births

D. Possible trisomy disorder, including Downs syndrome

A. A normal MSAFP for 16 week gestation

MOM calc = 34/32 = 1.06 or (less than 2.o)

A drug has a half life of 6 hours.If a dose os given ever 6 hours, a steady state drug level would usually be achieved in:

A. 3-5 hours

B. 10-12 hours

C. 24-42 hours

D. 48-50 hours

C. 24-42 hours

(Between 4-7 doses)

Free therapeutic drug levels are usually higher when serum protein concentrations are below normal. In which of the following conditions would this most likely occur?

A. acute inflammation

B. nephrotic syndrome

C. pregnancy

D. multiple myeloma

Serum and urine copper levels are assayed on a hospital patient with the following results:

serum Cu 20  (ref 70-140)

urine Cu  83  (ref < 40)

Most consistent with:

A. normal copper levels

B. Wilms tumor

C. Wilsons disease

D. Addison disease

As part of a hyperlipidemia screening program, the following results were obtained on a 25 year old woman 5 hours post eating:

Triglycerides: 260 mg/dL

Cholesterol: 129 mg/dL

Best interpretation of these results:

A. both results are normal & not affected by recent meal

B. Chol is normal, but trig are elevated,which may be attributed to the recent meal

C. both results are elevated,indicating a metabolic problem in addition to the nonfasting state

D. Both results are below normal despite the recent meal,indicating a metabolic problem

Arterial blood that is collected in a heparinized syringe but exposed to room air would be most consistent with the changes in which of the following specimens?

Specimen             PO₂            PCO₂         pH

A                         elevated      decreased     elevated

  B                        decreased       elevated      decreased

    C                unchanged         elevated        unchanged

D                decreased       decreassed     decreased

A         PO2    elevated  

            PCO2    decreased    

         pH     elevated

Ur creat 90 mg/dl   Serum creat 0.90 mg/dl

total body surface 1.73   24 hr urine vol 1500 mls

What is the patients creat clearance in mL/min

A. 104

B. 124

C. 144

D. 150

A. 104

CC= ur creat x ur volume  x  1.73

                serum creat                body surface

Which of the following is the formula for calculating absorbance given the percent transmission (%T) of a solution ?

A. 1-log(%T)

B. log(%T) /2

C. 2 x log(%T)

D. 2 - log(%T)

The urea nitrogen concentration of a sample was measured to be 15 mg/dL. What is the urea in mg/dL

A. 15

B. 24

C. 32

D. 40

C. 32

15 x 2.14 = 32

Stray light can be detected in a spectrophotometerby utilizing a:

A. mercury vapor lamp

B. holmium oxide glass

C. potassium dichromate solution

D. sharp cutoff filter

The most specific method for assay of glucose utilizes:

A. hexokinase

B. glucose oxidase

C. glucose-6-oxidase

D. glucose dehydrogenase

Which of the following would be an example of a glucose specific colormetric assay ?

A. alkaline ferrocyanide

B. glucose oxidase

C. hexokinase

D. o-toludine

This illustration represents the change in absorbance at 340 nm over a period of 8 minutes in an assay for lastate dehydrogenase. True statements include:

A. the reaction follows zero order kinetics between 5 and 8 minutes

B. the reaction is proceeding from lactate to pyruvate

C. nonlinearity after 6 minutes due to substrate exhaustion

D. the change in absorbance is due to reduction of NAD to NADH

Refer to the following illustration. The figure shows the reciprocal of the measured velocity of an enzyme reaction plotted against the reciprocal of the substate concentration. True statements:

A. the intercept of the line on the ordinate(y-axis) can be used to calculate the v max

In the anti-double stranded DNA procedure, the antigen most commonly utilized is:

A. rat stomach tissue

B. mouse kidney tissue

C. Crithidia lucilae

D. Toxoplasma gondii

Systemic lupus erythematous patients often have which of the following test results?

A. high titers of DNA antibody

B. decreased serum immunoglobulin levels

C. high titers of anti-smooth muscle antibodies

D. high titers of antimitochondrial antibody

Systemic lupus erythematous patients with active disease often have which of the following test results?

A. high titers of antimicrosomal antibodies

B. high titers of anti-smooth muscle antibodies

C. marked decrease in CH₅₀

D. decreased serum immunoglobulin levels

Which of the following is decreased in serum during the active stages of SLE ?

A. anti-nuclear antibody

B. immune complexes

C. complement (C3)

D. anti-DNA

A positive ANA with the pattern of anticentromere antibodies is most frequently seen in patients with:

A. rheumatoid arthritis

B. SLE

C. CREST syndrome

D. Sjogren syndrome

Rheumatoid factors are immunoglobulins with specificity for allotypic determinations located on the:

A. Fc fragment of IgG 

B. Fab fragment of IgG

C. J chain of IgM

D. secretory component of IgA

The following pattern of agglutination was observed in an antibody titration:

       1  2   3    4    5     6     7    8    9   10   11

     1+ 2+ 4+ 4+ 3+  3+   2+ 1+ 1+   0   0  

Set of reactions most likely represent:

A. faulty pipetting technique

B. postzoning

C. prozoning

D. presence of a high titer,low avidity antibody

A patients serum is being analyzed in a samdwich assay. This patient has received mouse monoclonal antibody therapy, and shows a false positive reaction in the sandwich assay, which is due to:

A. the mouse antibody in the patients serum reacting to the antigen

B. the presence of human anti-mouse antibody reactivity

C. antibody to a mouse virus

D. production of a monoclonal gammopathy of unknown significance after the antibody

Hereditary deficiency of early complement components (C1, C4 and C2) is associated with:

A. pneumoccal septicemia

C. small bowel obstruction

C. lupus erythrematous like syndrome

D. gonoccemia

In laser flow cytometry, applying voltage potential to sample droplets as they stream past the light beam and using charged deflector plates results in:

A. an emission of red fluorescence from cells labeld with fluorescein isothiocyanate

B. an emission of green fluorescence from cells labelded with rhodamine

C. a 90 ° light scater related to cell size

D. the separation of cells into subpopulations based on their charge

Anti-glomular basement membrane antibody is most often associated with this condition:

A. SLE

B. celiac disease

C. chronic active hepatitis

D. Goodpastures disease

A 9 month old boy from Israel gradually lost the ability to sit up, and develops seizures.He has an increased amount of a phospholipid called GM₂-ganglioside in his neurons, and he lacks the enzyme hexosaminidase A in his leuckocytes. These findings suggest ?

A. Neimann-Pick disease

B. Tay-Sachs disease

C. phenylketonuria

D. Hurler syndrome

B. Tay-Sachs disease

Before unconjugated bilirubin can react with Ehrlich diazo reagent, which of the following must be added ?

A. acetone

B. ether

C. distilled water

D. caffeine

D. caffeine