Clinical Chemistry : Carbohydrates
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Note that since a lot of recalls exist, many of the objective questions here are nice-to-knows.
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- 1.
This is the simplest carbohydrate.
- A.
Formaldehyde
- B.
Glutaraldehyde
- C.
Glycol Aldehyde
- D.
Glucose
Correct Answer
C. Glycol AldehydeExplanation
Glycol aldehyde is the simplest carbohydrate because it is the smallest molecule that can be classified as a carbohydrate. It consists of a carbon chain with a carbonyl group (aldehyde) and two hydroxyl groups (alcohol). This structure meets the criteria for a carbohydrate, which is a compound composed of carbon, hydrogen, and oxygen in a ratio of 1:2:1. Formaldehyde and glutaraldehyde are not carbohydrates as they do not have the required carbon, hydrogen, and oxygen ratio. Glucose is a more complex carbohydrate compared to glycol aldehyde.Rate this question:
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- 2.
The first enzyme that degrades polymers of glucose to dextrins and disaccharides:
- A.
Dextran
- B.
Disaccharidases
- C.
Amylopsin
- D.
Ptyalin
Correct Answer
D. PtyalinExplanation
Dextran is an endogenous polysaccharide used to treat post-surgical hypovolemia. // Disaccharidases (e.g. Maltase, Sucrase, and Lactase) exist in the brush border of the small intestines and, as the term denotes, degrades disaccharides (e.g. Maltose, Sucrose, and Lactose, respectively), into glucose. // Amylopsin is also known as Pancreatic Amylase, which degrades remaining polymers of glucose not degenerated by Salivary Amylase.Rate this question:
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- 3.
Choose the incorrect metabolic process : description pair.
- A.
Glycolysis : metabolism of glucose to lactose for energy production
- B.
Gluconeogenesis : formation of glucose-6-phosphate from noncarbohydrate sources
- C.
Glycogenolysis : breakdown of glycogen to glucose for energy use
- D.
Lipogenesis : conversion of carbohydrates to fatty acids (calories)
Correct Answer
A. Glycolysis : metabolism of glucose to lactose for energy productionExplanation
The product of glycolysis is LACTATE and pyruvate, not lactose.Rate this question:
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- 4.
Choose the incorrect glucose metabolic regulator : function pair.
- A.
Glucagon : primary hyperglycemic hormone
- B.
Adrenocorticotropic Hormone : secondary glycogenolytic hormone
- C.
Cortisol : primary lipolytic hormone
- D.
Thyroxine : primary gluconeogenetic hormone
Correct Answer
D. Thyroxine : primary gluconeogenetic hormoneExplanation
The primary gluconeogenetic hormone is GLUCAGON, not Thyroxine.Rate this question:
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- 5.
What is secreted by the F cells of the Pancreatic Islets of Langerhans?
- A.
Pancreatic Amylase
- B.
Somatostatin
- C.
Pancreatic Polypeptide
- D.
Insulin
Correct Answer
C. Pancreatic PolypeptideExplanation
Pancreatic Amylase is secreted by the Acinar Cells of the Pancreas. // Somatostatin, also known as the Growth Hormone Inhibiting Hormone, and Insulin, the primary AND ONLY hypoglycemic hormone, are secreted by the Pancreatic Islets of Langerhans (specifically and respectively the Delta and Beta Cells).Rate this question:
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- 6.
This body system accounts for 60% of glucose utilization in the resting state.
- A.
Cardiopulmonary
- B.
Nervous
- C.
Muscular
- D.
Digestive
Correct Answer
B. NervousExplanation
Specifically the brain, the central nervous system unfortunately lacks fuel stores, thus constantly needing glucose for its efficiency. Lack of glucose may lead to decreased cognitive function, and studies have shown that it is a factor for triggering Alzheimer's Disease.Rate this question:
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- 7.
A component of dietary fiber, this is an/these are indigestible polymer/s of glucose found in food.
- A.
Inulin
- B.
Lignin
- C.
Dextrin
- D.
All of the Above
Correct Answer
D. All of the AboveExplanation
All of the options mentioned - inulin, lignin, and dextrin - are components of dietary fiber that are indigestible polymers of glucose found in food. Inulin is a type of soluble fiber found in many plants, lignin is a complex polymer found in the cell walls of plants, and dextrin is a type of soluble fiber produced from starch. Therefore, all of these options are correct as they are examples of indigestible glucose polymers found in food.Rate this question:
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- 8.
The critical hyperglycemic level is:
- A.
≥ 200 mg/dL
- B.
≥ 300 mg/dL
- C.
≥ 400 mg/dL
- D.
≥ 450 mg/dL
Correct Answer
C. ≥ 400 mg/dLExplanation
≥ 200 mg/dL ( ≥ 11.1 mmol/L ) in Random Blood Sugar and 2-Hour OGTT is a diagnostic criterion for Diabetes Mellitus.Rate this question:
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- 9.
The Micral Test determines microalbuminuria, a diagnostic marker of early Diabetic Nephropathy. What is the level nadir for microalbuminuria?
- A.
30-300 µg/mg of creatinine
- B.
30 µg/mg of creatinine
- C.
300 µg/mg of creatinine
- D.
None of the Above
Correct Answer
B. 30 µg/mg of creatinineExplanation
In clinical terminology, "level nadir" is the lowest level in any numerical range. 30-300 µg/mg of creatinine denotes microalbuminuria, and in that range, 30 is defined as the level nadir for microalbuminuria. There is no medical term for the highest level, but in ordinary linguistics, the opposite of nadir is zenith.Rate this question:
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- 10.
What is the meaning of % as the unit for HBA1c?
- A.
Fraction of Hemoglobin A1c
- B.
Fraction of Hemoglobin A1
- C.
Fraction of Hemoglobin A
- D.
Fraction of Hemoglobin
Correct Answer
D. Fraction of HemoglobinExplanation
Basically, if the HBA1c level of an individual is, say, 6.5%, it means that HBA1c comprises 6.5% of total hemoglobin levels in the blood. This level (and above) is a diagnostic marker of Diabetes Mellitus.Rate this question:
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- 11.
What are the antibodies associated with Type I Diabetes Mellitus?
- A.
Islet Cell Autoantibodies
- B.
Glutamic Acid Decarboxylase Autoantibodies
- C.
Tyrosine Phosphatase Autoantibodies
- D.
All of the Above
Correct Answer
D. All of the AboveExplanation
An addition to the list is Insulin Autoantibodies. All of these directly destroy the Beta Cells of the Pancreatic Islets of Langerhans, thus a complete deficiency of Insulin, which is the case with Type I Diabetes Mellitus.Rate this question:
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- 12.
A medical technologist, Dan, received chemistry samples, including one from a patient, coded 556969, at basal state at 8AM for FBS testing. Unfortunately, Dan had to troubleshoot the chemistry analyzer, thus having to delay all chemistry tests for the AM shift. As a preventive measure, he refrigerated all the samples and endorsed them to the PM shifter, Ces. Ces managed to measure the glucose level of patient 556969 at 3PM, which was 120 mg/dL. If you were Ces, will you release the result as 120 mg/dL?
- A.
Yes, because the FBS level of patient 556969 is really 120 mg/dL.
- B.
No, because the actual FBS level of patient 556969 is 169 mg/dL.
- C.
No, because the actual FBS level of patient 556969 is 127 mg/dL.
- D.
No, because the actual FBS level of patient 556969 is 134 mg/dL.
Correct Answer
D. No, because the actual FBS level of patient 556969 is 134 mg/dL.Explanation
The actual FBS level of patient 556969 is 169 mg/dL IF the specimen was unpreserved. Note that any delay of glucose will lead to a decrease of 7 mg/dL per hour if unpreserved.
It is noted, however, that the specimen in question, among others, was refrigerated by Dan. Therefore, the decrease in glucose per hour is only 2 mg/dL. When the glucose level was finally determined, 7 hours have passed since its collection time. Therefore, the net reduction of glucose level is 14 mg/dL, hence the 120 mg/dL result in the analyzer.Rate this question:
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- 13.
If a specimen for glucose measurement from a patient said to be showing signs and symptoms of diabetic ketoacidosis was collected in a tube containing Sodium Fluoride at 8AM today, the medical technologist can delay the measurement until:
- A.
8AM tomorrow
- B.
8AM the day after tomorrow
- C.
8AM in another time zone
- D.
He/She cannot delay it
Correct Answer
D. He/She cannot delay itExplanation
The preservation capacity of Sodium Fluoride for glucose is indeed 48 hours or 2 days. HOWEVER, a case of suspected diabetic ketoacidosis is considered an emergency, thus requiring STAT measurements that must be released in less than an hour.Rate this question:
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- 14.
A group of friends who were happy because they can finally go to internship had a beer drinking session last Monday. Unfortunately, nearly all of them were hangover throughout Tuesday, so only one of them, Jizan, went for the annual check-up in the afternoon. What will he expect?
- A.
His Gamma-Glutamyl Transferase levels will be increased.
- B.
His glucose levels will be decreased.
- C.
His triglyceride levels will not be falsely altered.
- D.
All of the Above
Correct Answer
B. His glucose levels will be decreased.Explanation
Jizan is experiencing alcohol-induced hypoglycemia, usually seen in the setting of a history of drinking alcohol of 50-300 grams without food intake for the preceding 6 to 36 hours.
Gamma-Glutamyl Transferase levels are increased ONLY in CHRONIC active alcoholism.
Alcoholism was also shown to cause an increase triglyceride levels, particularly beer.Rate this question:
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- 15.
What is the hypersensitivity type of Type I Diabetes Mellitus?
- A.
I
- B.
II
- C.
III
- D.
IV
Correct Answer
D. IVExplanation
Type I DM is a T-Cell Mediated autoimmune disease.Rate this question:
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- 16.
This is the enzymatic test specific for β-D-Glucose.
- A.
Glucose Oxidase
- B.
Glucose Dehydrogenase
- C.
Glucose Isomerase
- D.
Hexokinase
Correct Answer
A. Glucose OxidaseExplanation
Glucose oxidase is the correct answer because it is an enzyme that specifically acts on β-D-glucose. It catalyzes the oxidation of glucose to produce gluconic acid and hydrogen peroxide. This enzymatic test is commonly used to measure glucose levels in various biological samples. Glucose dehydrogenase, glucose isomerase, and hexokinase are not specific for β-D-glucose and have different functions in glucose metabolism.Rate this question:
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- 17.
This is the most specific non-enzymatic method for glucose.
- A.
Dubowski Method
- B.
Salkowski Method
- C.
Nelson-Somogyi Method
- D.
Neocuproine Method
Correct Answer
A. Dubowski MethodExplanation
Also known as the Ortho-Toluidine Method, the Dubowski Method has this reaction:Rate this question:
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- 18.
Which of these is a method with the principle of Ferric Reduction?
- A.
Hagedorn-Jensen
- B.
Folin-Wu
- C.
Nelson-Somogyi
- D.
B and C
Correct Answer
A. Hagedorn-JensenExplanation
Folin-Wu and Nelson-Somogyi rely on Ferrous Reduction.Rate this question:
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- 19.
Statement 1: The screening test for Gestational Diabetes Mellitus is the 2-hour OGTT. Statement 2: The diagnostic test for Gestational Diabetes Mellitus is the 3-hour OGTT.
- A.
Statement 1 is correct; Statement 2 is wrong.
- B.
Statement 1 is wrong; Statement 2 is correct.
- C.
Both statements are correct.
- D.
Both statements are wrong.
Correct Answer
B. Statement 1 is wrong; Statement 2 is correct.Explanation
The screening test for Gestational Diabetes Mellitus is the 1-hour OGTT.Rate this question:
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- 20.
In Hexokinase Method for glucose, the metabolite being directly measured depends on the source of G6PD. If ____________ is the source, NADH production is measured. If __________ is the source, NADPH production is measured.
- A.
Yeast ; a bacterium, Leuconostoc acetavulum
- B.
Yeast ; a bacterium, Leuconostoc mesenteroides
- C.
A bacterium, Leuconostoc mesenteroides ; yeast
- D.
A bacterium, Leuconostoc acetavulum ; yeast
Correct Answer
C. A bacterium, Leuconostoc mesenteroides ; yeastExplanation
In the Hexokinase Method for glucose, the metabolite being directly measured depends on the source of G6PD. If a bacterium, Leuconostoc mesenteroides, is the source, NADPH production is measured. If yeast is the source, NADH production is measured.Rate this question:
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- 21.
The Tolbutamide Tolerance Test is used in the investigation of fasting hypoglycemia. How is it taken by the patient?
- A.
Orally
- B.
Anally
- C.
Intravenously
- D.
Sublingually
Correct Answer
C. IntravenouslyExplanation
Normal patients react to Tolbutamide by a decrease of glucose (50% of FBS) in 30 minutes, then a return to the same amount as FBS in 120 minutes. Patients with fasting hypoglycemia exhibit a lower glucose nadir, with hypoglycemia persisting up to 2 hours.Rate this question:
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- 22.
Only patients with _______________ exhibit exaggerated plasma insulin concentrations.
- A.
Insulinomas
- B.
Insulinemias
- C.
All of the Above
- D.
None of the Above
Correct Answer
A. InsulinomasExplanation
Insulinemia is a general term for increased plasma concentrations of insulin. Insulinoma is a tumor of the Beta Cells of the Pancreatic Islets of Langerhans.Rate this question:
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- 23.
The conversion of glucose to lactate and vice versa is also known as the:
- A.
Cori-Forbes Cycle
- B.
Cori Cycle
- C.
Forbes Cycle
- D.
All of the Above
Correct Answer
B. Cori CycleExplanation
The conversion of glucose to lactate and vice versa is known as the Cori Cycle. This cycle occurs in the liver and muscles during anaerobic conditions when there is a lack of oxygen. Glucose is converted to lactate in the muscles, which is then transported to the liver. In the liver, lactate is converted back to glucose through a series of reactions. This cycle allows for the regeneration of glucose and the removal of lactate, maintaining energy production during anaerobic conditions.Rate this question:
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- 24.
NADH formed in Pyruvate to Lactate Reactions is measured at:
- A.
360 nm
- B.
350 nm
- C.
340 nm
- D.
330 nm
Correct Answer
C. 340 nmExplanation
The measurement of NADH formed in Pyruvate to Lactate Reactions is done at 340 nm. This is because NADH has a characteristic absorbance peak at this wavelength, allowing for its quantification. By measuring the absorbance at 340 nm, the concentration of NADH can be determined, providing insight into the activity of the Pyruvate to Lactate Reactions.Rate this question:
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- 25.
The Lactate-to-Pyruvate Ratio is an indicator of redox status and also a sensitive test to determine overdose from what antiretroviral medication?
- A.
Vancomycin
- B.
Resorcinol
- C.
Theophylline
- D.
Zidovudine
Correct Answer
D. ZidovudineExplanation
Vancomycin is an antibiotic for serious staphylococcal infections when the penicillins and cephalosporins cannot be used.
In Seliwanoff's Test for Fructose Determination, Resorcinol is the reagent added to hydroxymethyl furfural, the product from fructose and hydrochloric acid. After such addition, a red compound is produced.
Theophylline is a methylxanthine drug used in therapy for respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma.Rate this question:
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- 26.
Primary source of Galactose in human diet:
- A.
Fruits
- B.
Meat
- C.
Milk
- D.
Cheese
Correct Answer
C. MilkExplanation
Fruits are the primary source of fructose.
Meat is not a good source for any carbohydrate.
Dairy products, such as milk and cheese, are good sources of galactose.Rate this question:
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- 27.
A deficiency of Fructose-1-Diphosphate Aldolase B causes:
- A.
Essential Fructosuria
- B.
Hereditary F16D Deficiency
- C.
Fructose Intolerance
- D.
All of the Above
Correct Answer
C. Fructose IntoleranceExplanation
Essential Fructosuria is caused by a deficiency of the enzyme Fructokinase.
F16D in Option #2 is Fructose-1,6-Diphosphatase.Rate this question:
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- 28.
Bial's Test is for:
- A.
Glucose Measurement
- B.
Sucrose Measurement
- C.
Maltose Measurement
- D.
Pentose Measurement
Correct Answer
D. Pentose MeasurementExplanation
Maltose and other reducing sugars can be determined by the Clinitest. However, Clinitest cannot detect Sucrose, a non-reducing sugar.Rate this question:
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- 29.
What is the major regulatory enzyme in gluconeogenesis?
- A.
Pyruvate Kinase
- B.
Pyruvate Decarboxylase
- C.
Pyruvate Convertase
- D.
Pyruvate Carboxylase
Correct Answer
D. Pyruvate CarboxylaseExplanation
Pyruvate Kinase is an enzyme that catalyzes the final step of glycolysis.
Pyruvate Carboxylase is the enzyme that shunts excess pyruvate from glycolysis (Embden-Meyerhoff) to gluconeogenesis. Pyruvate is converted into oxaloacetate, which is then converted to glucose. A deficiency of this enzyme can cause lactic acidosis, because the excess pyruvate will be converted into lactate instead.Rate this question:
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- 30.
This is a Glycogen Storage Disease that is distinguished from other GSDs by the manifestation of rickets in affected patients:
- A.
Type I / Von Gierke Disease
- B.
Type IV / Andersen's Disease
- C.
Type VI / Hers Disease
- D.
Type XI / Fanconi-Bickel Disease
Correct Answer
D. Type XI / Fanconi-Bickel DiseaseExplanation
Type I GSD is characterized by hypoglycemic seizures.
Type IV GSD is characterized by findings of amylopectin-like material in tissues, thus its other name, Amylopectinosis.
Type VI GSD is the only GSD with a specific genetic marker: the PYGL gene, detected by sequence analysis.
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