Module 4 Worksheet

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Keck Graduate Institute *

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4

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Chemistry

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Jan 9, 2024

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17

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Answer the following multiple-choice questions. There is no time limit, and you may save and return to your work as many times as you need to before submitting the worksheet. But you may submit this worksheet only once. Flag question: Question 1 Question 1 1 pts What is the major intracellular cation? Group of answer choices Potassium Magnesium Calcium Sodium Flag question: Question 2 Question 2 1 pts What is the major extracellular cation? Group of answer choices Chloride Calcium Magnesium Sodium Flag question: Question 3 Question 3 1 pts Osmolality can be defined as a measure of the concentration of a solution based on the Group of answer choices Number of dissolved particles Density of the dissolved particles Number and size of the dissolved particles Number of ionic particles present
Flag question: Question 4 Question 4 1 pts Hyponatremia may be caused by each of the following EXCEPT Group of answer choices Acute or chronic renal failure Prolonged vomiting or diarrhea Aldosterone deficiency Hypomagnesemia Flag question: Question 5 Question 5 1 pts Hypokalemia may be caused by each of the following EXCEPT Group of answer choices Hyperaldosteronism Hypomagnesemia Acidosis Prolonged vomiting or diarrhea Flag question: Question 6 Question 6 1 pts Hyperkalemia may be caused by each of the following EXCEPT Group of answer choices Hypoaldosteronism Sample hemolysis Alkalosis Acute or chronic renal failure Flag question: Question 7 Question 7 1 pts The main difference between a direct and indirect ISE is Group of answer choices Sample is diluted in the indirect method, not in the direct method Whole blood samples can be measured with the direct method and not with the indirect method Direct ISEs use a reference electrode, whereas indirect ISEs do not The type of membrane that is used Flag question: Question 8
Question 8 1 pts Which method of analysis will provide the most accurate electrolyte results if a grossly lipemic sample is used? Group of answer choices Atomic absorption Indirect ISE Flame emission photometry Direct ISE Flag question: Question 9 Question 9 1 pts The most frequent cause of hypermagnesemia is due to Group of answer choices Renal failure Hypoaldosteronism Acidosis Increased intake of magnesium Flag question: Question 10 Question 10 1 pts A hemolyzed sample will cause falsely increased levels of each of the following EXCEPT Group of answer choices Potassium Magnesium Sodium Phosphate Flag question: Question 11 Question 11 1 pts The largest portion of total body water is found in which tissue? Group of answer choices Intravascular extracellular fluid Extracellular fluid Plasma Interstitial cell fluid Intracellular fluid Flag question: Question 12
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Question 12 1 pts Osmoreceptors in the hypothalamus are key to regulating blood osmolality. Typically, a 1% to 2% shift in osmolality causes a ______ change in circulating concentration of arginine vasopressin (AVP). Group of answer choices Twofold Fourfold Tenfold Eightfold Flag question: Question 13 Question 13 1 pts The quantitative relationship between changes in blood osmolality and the normal expected response by AVP is best described as a(n): Group of answer choices Direct relationship Logarithmic relationship There is no quantitative relationship Indirect relationship Flag question: Question 14 Question 14 1 pts The sample of choice for measuring blood osmolality is: Group of answer choices Whole blood Serum or plasma may both be used Serum Plasma Flag question: Question 15 Question 15 1 pts With increased water loss, burn patients are most likely to also experience: Group of answer choices Hyponatremia Hypoosmolality Hypomagnesemia Hypernatremia Flag question: Question 16 Question 16 1 pts
Which plasma electrolyte has the most narrow reference range and is MOST strictly regulated by the body? Group of answer choices Calcium Chloride Potassium Magnesium Sodium Flag question: Question 17 Question 17 1 pts True or False? RBCs are key for oxygen transport, carbon dioxide transport, and maintaining electroneutrality in the blood. Group of answer choices True False Flag question: Question 18 Question 18 1 pts The presence of dyshemoglobins will cause a calculated % SO 2 result to be falsely (elevated, decreased) and a pulse oximeter % Sp O 2 result to be falsely (elevated, decreased). Group of answer choices Decreased, elevated Elevated, elevated Decreased, decreased Elevated, decreased Flag question: Question 19 Question 19 1 pts The preferred anticoagulant for arterial blood gas measurements is _____ in the _____ state. Group of answer choices Lithium heparin; dry EDTA; dry Sodium citrate; dry Potassium oxalate; liquid Flag question: Question 20 Question 20 1 pts
At a pH of 7.10, the H + concentration is equivalent to Group of answer choices 20 nmol/L 60 nmol/L 80 nmol/L 40 nmol/L Flag question: Question 21 Question 21 1 pts In respiratory alkalosis, the kidneys compensate by (excretion, retention) of bicarbonate and (increased, decreased) excretion of NaH 2 PO 4 . Group of answer choices Retention, increased Excretion, increased Excretion, decreased Retention, decreased Flag question: Question 22 Question 22 1 pts The normal ratio of carbonic acid to bicarbonate in arterial blood is Group of answer choices 1:20 20:1 7.4:6.1 0.003:1.39 Flag question: Question 23 Question 23 1 pts When arterial blood from a normal patient is exposed to room air Group of answer choices p CO 2 decreases; p O 2 increases p CO 2 increases; p O 2 decreases p CO 2 decreases; p O 2 decreases p CO 2 increases; p O 2 increases Flag question: Question 24 Question 24 1 pts
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A patient's arterial blood gas results are as follows: pH 7.37; p CO 2 , 75 mm Hg; HCO 3 -, 37 mmol/L. These values are consistent with Group of answer choices Compensated nonrespiratory acidosis Compensated respiratory acidosis Uncompensated nonrespiratory alkalosis Uncompensated respiratory alkalosis Flag question: Question 25 Question 25 1 pts A patient's arterial blood gas results are as follows: pH 7.48; p CO 2 , 54 mm Hg; HCO 3 -, 38 mmol/L. These values are consistent with Group of answer choices Compensated respiratory alkalosis Uncompensated nonrespiratory alkalosis Compensated nonrespiratory alkalosis Uncompensated respiratory alkalosis Flag question: Question 26 Question 26 1 pts In the circulatory system, bicarbonate leaves the red blood cells and enters the plasma through an exchange mechanism with ________ to maintain electroneutrality. Group of answer choices Sodium Carbonic acid Chloride Lactate Flag question: Question 27 Question 27 1 pts Hypoventilation can compensate for which of the following acid-base disorders: Group of answer choices Mixed acidosis Mixed alkalosis Nonrespiratory acidosis Nonrespiratory alkalosis Flag question: Question 28
Question 28 1 pts Carbonic acid concentration in blood plasma is equivalent to Group of answer choices Bicarbonate concentration divided by the p CO 2 value in mm Hg 0.0307 mmol/L/mm Hg times the p CO 2 value in mm Hg p CO 2 value in mm Hg plus HCO 3 - value in mm Hg Apparent p K a of carbonic acid, 6.1, plus the p CO 2 value in mm Hg Flag question: Question 29 Question 29 1 pts Oxygen content in blood reflects Group of answer choices O 2 dissolved in blood plasma only p O 2 value O 2 Hb only O 2 Hb + pO 2 Flag question: Question 30 Question 30 1 pts Extreme copper deficiency is seen in what fatal condition? Group of answer choices Klinefelter's syndrome Kayser-Fleischer rings Menkes' disease Meese disease Flag question: Question 31 Question 31 1 pts Suppose the controller on a GFAAS is defective and the furnace is running cold. What effect will this likely have on the number of photons absorbed in the measurements? Group of answer choices It will decrease the number of photons absorbed. It will increase the number of photons absorbed. It will have little effect. It is not a relevant question because AAS relies on emission of light from electronically excited atoms.
Flag question: Question 32 Question 32 1 pts Why would a clinical chemist develop an arsenic method that combines liquid chromatography with ICP-MS? Group of answer choices To eliminate interference by sodium from the analysis To separate and quantitate several different arsenic-containing species in the same sample To shorten the run time of the measurement To lower the coefficient of variation for total arsenic measurements Flag question: Question 33 Question 33 1 pts Select the answer that designates three techniques widely used for elemental analysis, identified according to the initials for the techniques. Group of answer choices GC-MS, ICP-MS, AES HPLC-ICP-MS, AAS, FTIR NMR, ICP-MS, AES AAS, ICP-MS, AES Flag question: Question 34 Question 34 1 pts What primary purposes does the torch serve in ICP-MS? Group of answer choices Vaporization, atomization, and ionization Vaporization, atomization, and electronic excitation Droplet transport, vaporization, and ion detection Nebulization, atomization, and photon absorption Flag question: Question 35 Question 35 1 pts Manganese toxicity resembles the following disease: Group of answer choices Wilson's disease Alzheimer's disease Parkinson's disease Menkes' disease Flag question: Question 36
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Question 36 1 pts Iron is physiologically active only in the ferrous form in Group of answer choices Ferritin Cytochromes Transferrin Hemoglobin Flag question: Question 37 Question 37 1 pts A metal ion required for optimal enzyme activity is best termed a(n) Group of answer choices Accelerator Cofactor Coenzyme Catalyst Flag question: Question 38 Question 38 1 pts Which trace metal is contained in glucose tolerance factor? Group of answer choices Selenium Zinc Chromium Copper Flag question: Question 39 Question 39 1 pts What metal may be used as a treatment for Wilson's disease? Group of answer choices Fluorine Molybdenum Copper Zinc Flag question: Question 40 Question 40 1 pts
The metal ion essential for the activity of xanthine oxidase and xanthine dehydrogenase is Group of answer choices Molybdenum Manganese Iron Zinc Flag question: Question 41 Question 41 1 pts The primary purpose of porphyrins in the human body is to Group of answer choices Transport CO 2 back to the lungs Contribute to the synthesis of heme Transport ferrous iron Transport oxygen to tissues Flag question: Question 42 Question 42 1 pts The chemical structure of porphyrin is described as a(n) Group of answer choices Oxygen-binding prosthetic group Heterocyclic pyrrole Linear tetrapyrrole Cyclic tetrapyrrole Flag question: Question 43 Question 43 1 pts Which statement correctly describes a porphyrin property? Group of answer choices Porphyrins absorb light in the visible region of the spectrum and fluoresce. Porphyrins produced spontaneously are functional compounds. Porphyrins are not soluble in aqueous solution. Porphyrins are oxidized to porphyrinogens when exposed to air. Flag question: Question 44 Question 44 1 pts
The porphyrias can be classified according to disease symptoms as Group of answer choices Hematologic or muscular Erythropoietic or hepatic Congenital or acquired Neurologic or cutaneous Flag question: Question 45 Question 45 1 pts Elevated urinary PBG concentration with negative fecal porphyrin results indicates Group of answer choices Erythropoietic protoporphyria (EPP) Porphyria cutanea tarda (PCT) Hereditary coproporphyria (HCP) Acute intermittent porphyria (AIP) Flag question: Question 46 Question 46 1 pts Porphyria cutanea tarda (PCT) is identified by Group of answer choices Scanning fluorescence of plasma Screening for PBG in a random urine specimen Separation of fecal porphyrins in a 24-h specimen Chromatographic analysis of a 24-h urine collection Flag question: Question 47 Question 47 1 pts Screening for porphobilinogen in urine is done using Group of answer choices The Watson-Schwartz method Electrophoresis Chromatography Spectrophotometry Flag question: Question 48 Question 48 1 pts
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In the clinical laboratory, testing to identify specific porphyrins is performed using Group of answer choices Chemical derivatization and spectrophotometry Turbidimetry Liquid chromatography with fluorescent detection Thin layer chromatography Flag question: Question 49 Question 49 1 pts Specimens collected for evaluation of porphyria should be Group of answer choices Diluted to less than 25 mg/dL creatinine Exposed to light and air to oxidize the analytes Allowed to clot at room temperature for an hour Protected from light and stored cold Flag question: Question 50 Question 50 1 pts Inherited disorders in which a genetic defect causes abnormalities in rate and quantity of synthesis of structurally normal polypeptide chains of the hemoglobin molecule are called Group of answer choices Thalassemias Hemoglobinopathies Porphyrias Molecular dyscrasias Flag question: Question 51 Question 51 1 pts Molecular diagnostic techniques that can help diagnose hemoglobin disorders such as hemoglobinopathies and thalassemias include Group of answer choices Biochemical separation, identification, and quantification of mixture components The use of specific monoclonal antibodies DNA amplification, hybridization, and nucleotide sequencing Separation of macromolecules and their fragments, based on their size and charge
Flag question: Question 52 Question 52 1 pts Which of the following abnormal hemoglobins, found frequently in individuals from Southeast Asia, migrates with hemoglobin A 2 on cellulose acetate electrophoresis? Group of answer choices Hemoglobin E Hemoglobin C Hemoglobin D Hemoglobin Lepore Flag question: Question 53 Question 53 1 pts Which type of alpha-thalassemia results from deletion of three genes and produces a moderate hemolytic anemia? Group of answer choices Thalassemia trait Hydrops fetalis Hemoglobin H disease Hemoglobin Bart's Flag question: Question 54 Question 54 1 pts The most effective way to quantitate hemoglobin A 2 is by Group of answer choices Alkali denaturation test Citrate agar electrophoresis Densitometry Column chromatography Flag question: Question 55 Question 55 1 pts Serum or plasma myoglobin concentrations are used as Group of answer choices An early marker of acute myocardial infarction An indicator of congestive heart failure Lead poisoning indicator Liver function tests
Flag question: Question 56 Question 56 1 pts Which of the following is the best test to differentiate beta-thalassemia minor from iron deficiency anemia? Group of answer choices Hemoglobin A2 quantitation Complete blood count Hemoglobin electrophoresis (cellulose acetate, alkaline pH) Solubility test Flag question: Question 57 Question 57 1 pts Which is the correct sequence of electrophoretic migration of hemoglobins from slowest to fastest on cellulose acetate at an alkaline pH? Group of answer choices C, A, S, F C, S, A, F A, F, S, C C, S, F, A Flag question: Question 58 Question 58 1 pts The two main sites of production of heme are Group of answer choices Liver and spleen Heart and lung Liver and bone marrow Muscle and blood Flag question: Question 59 Question 59 1 pts Which hemoglobin is resistant to alkali denaturation in NaOH? Group of answer choices Hb F Hb S Hb A Hb C Flag question: Question 60
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Question 60 1 pts A patient has an abnormal hemoglobin band that migrates with Hb S on cellulose acetate (pH 8.4) hemoglobin electrophoresis. The solubility test is negative. Which test should be performed next? Group of answer choices Acid elution stain Blood film evaluation HbA 2 quantitation Citrate agar (pH 6.2) electrophoresis Flag question: Question 61 Question 61 1 pts Silent carriers of alpha-thalassemia are missing how many alpha genes? Group of answer choices 4 2 1 3 Flag question: Question 62 Question 62 1 pts Which hemoglobin contains four gamma chains and has an extremely high affinity for oxygen? Group of answer choices Hb Gower I Hb Portland I Hb F Hb Bart's Flag question: Question 63 Question 63 1 pts
A patient with Southeast Asian heritage is found to have a mild microcytic anemia and a few target cells. Hemoglobin electrophoresis on cellulose acetate at pH 8.4 reveals a major band that migrates with Hb A 2 and no Hb A. On citrate agar electrophoresis, the band travels in the position of Hb A. What is the most probable abnormal hemoglobin present? Group of answer choices Hb E Hb A Hb C Hb D