MLT Chemistry Class 1120

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MLT Chemistry Class 1120 - Quiz

Another certification quiz enjoy its straight from the book edition 5


Questions and Answers
  • 1. 

    Following overnight fasting, hypoglycemia in adults is defined as glucose of:  

    • A.

      A

    • B.

      B

    • C.

      C

    • D.

      D

    Correct Answer
    D. D
    Explanation
    Hypoglycemia in adults is defined as a low blood glucose level. The correct answer, option d, suggests that the glucose level after overnight fasting is below the normal range, indicating hypoglycemia.

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  • 2. 

    The following results are from a 21 yr old patient with a back injury who appears otherwise healthy: whole blood glucose:       77mg/dl (4.2 mmol/L) serum glucose:                88 mg/dl (4.8 mmol/L) CSF glucose:               56 mg/dl (3.1 mmol/L)

    • A.

      The whole blood serum values are expected but the csf values is elevated

    • B.

      The whole blood glucose value should be higher than the serum value

    • C.

      All values are consistent with a normal healthy individual

    • D.

      The serum and whole blood values should be identical

    Correct Answer
    C. All values are consistent with a normal healthy individual
  • 3. 

    The preparation of a patient for standard for glucose tolerance testing should include:

    • A.

      A high carbohydrate diet for 3 days

    • B.

      A low carbohydrate diet for 3 days

    • C.

      Fasting for 48 hours prior to testing

    • D.

      Bed rest for 3 days

    Correct Answer
    A. A high carbohydrate diet for 3 days
    Explanation
    The correct answer is a high carbohydrate diet for 3 days. This is because glucose tolerance testing is used to diagnose diabetes or assess insulin resistance. By consuming a high carbohydrate diet for several days prior to the test, it ensures that the body has a sufficient amount of carbohydrates to measure how well it processes glucose. This helps in obtaining accurate results and ensures that the test is effective in diagnosing or monitoring the patient's condition.

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  • 4. 

    If a fasting glucose was 90 mg/dl, which of the following 2hr postprandial glucose results would most closely represent normal glucose metabalism

    • A.

      55 mg/dl (3.0 mmol/L)

    • B.

      100 mg/dl (5.5 mmol/L)

    • C.

      180 mg/dl (9.9 mmol/L)

    • D.

      260 mg/dl (14.3 mmol/L)

    Correct Answer
    B. 100 mg/dl (5.5 mmol/L)
  • 5. 

    A healthy person with a blood glucose of 80 mg/dl (4.4 mmol/L) would have a simultaneously determined cerebrospinal fluid glucose value of:

    • A.

      25 mg/dl (1.4 mmol/L)

    • B.

      50 mg/dl (2.3 mmol/L)

    • C.

      100 mg/dl (5.5 mmol/L)

    • D.

      150 mg/dl (8.3 mmol/L)

    Correct Answer
    B. 50 mg/dl (2.3 mmol/L)
    Explanation
    The cerebrospinal fluid (CSF) glucose value is typically about two-thirds of the blood glucose value. Therefore, a healthy person with a blood glucose of 80 mg/dl would have a CSF glucose value of approximately 50 mg/dl. This is because glucose is actively transported from the blood into the CSF, but at a slower rate than in other tissues.

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  • 6. 

    A 25 yr old man became nauseated and vomited 90 minutes after receiving a standard 75g carbohydrate dose for an oral glucose tolerance test. the best course of action is to:

    • A.

      Give the patient a glass of orange juice and continue test

    • B.

      Start the test over immediately with a 50 g carbohydrate dose

    • C.

      Draw blood for glucose and discontinue

    • D.

      Place the patient in the dorsal recumbent position

    Correct Answer
    C. Draw blood for glucose and discontinue
    Explanation
    The patient's symptoms of nausea and vomiting after receiving a standard 75g carbohydrate dose for an oral glucose tolerance test suggest that they may be experiencing an adverse reaction or intolerance to the high carbohydrate load. Drawing blood for glucose levels will help determine if the patient is experiencing hyperglycemia, which could be causing their symptoms. Discontinuing the test is the best course of action to ensure the patient's safety and to prevent further discomfort or complications.

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  • 7. 

    Cerebrospinal fluid for glucose assay should be:

    • A.

      Refrigerated

    • B.

      Analyzed immediately

    • C.

      Heated to 56 degrees celsius

    • D.

      Stored at room temperature

    Correct Answer
    B. Analyzed immediately
    Explanation
    Cerebrospinal fluid (CSF) should be analyzed immediately for glucose assay because glucose levels can rapidly change after collection. Delayed analysis may lead to inaccurate results, as glucose can be metabolized by cells in the CSF or may be affected by bacterial or fungal contamination. Therefore, it is crucial to analyze CSF for glucose levels promptly to obtain reliable and meaningful results.

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  • 8. 

    Which of the following 2 hr postprandial glucose values demonstrates unequivocal hyperglycemia diagnostic for biabetes mellitus

    • A.

      160 mg/dl (8.8 mmol/L)

    • B.

      170 mg/dl (9.4 mmol/L)

    • C.

      180 mg/dl (9.9 mmol/L)

    • D.

      200 mg/dl (11. mmol/L)

    Correct Answer
    D. 200 mg/dl (11. mmol/L)
    Explanation
    A 2 hr postprandial glucose value of 200 mg/dl (11. mmol/L) demonstrates unequivocal hyperglycemia diagnostic for diabetes mellitus. This level of blood glucose after a meal indicates that the body is unable to effectively regulate blood sugar levels, which is a characteristic feature of diabetes mellitus.

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  • 9. 

    Serum levels that define hypoglycemia in pre-term or low birth weight infants are:

    • A.

      The same as adults

    • B.

      Lower than adults

    • C.

      The same as a normal full-term infant

    • D.

      Higher than a normal full-term infant

    Correct Answer
    B. Lower than adults
    Explanation
    Pre-term or low birth weight infants have underdeveloped organs, including the liver, which is responsible for regulating blood sugar levels. As a result, their serum levels are lower than those of adults. This is because their bodies are not yet capable of producing and regulating glucose at the same level as fully developed adults. Therefore, their serum levels defining hypoglycemia are lower than adults.

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  • 10. 

    A 45-year old woman has a fasting serum glucose concentration of 95 mg/dL (5.2 mmol/L) and a 2-hour postprandial glucose concentration of 105 mg/dL(5.8 mmol/L). The statement which best describes this patient's fasting serum glucose concentration is:

    • A.

      Normal; reflecting glycogen breakdown by the liver

    • B.

      Normal; reflecting glycogen breakdown by skeletal muscle

    • C.

      Abnormal; indicating diabetes mellitus

    • D.

      Abnormal; indicating hypoglycemia

    Correct Answer
    A. Normal; reflecting glycogen breakdown by the liver
    Explanation
    The fasting serum glucose concentration of 95 mg/dL (5.2 mmol/L) falls within the normal range, indicating that the patient's blood sugar level is not elevated. The statement suggests that this normal fasting glucose concentration is a result of glycogen breakdown by the liver. During fasting, the liver breaks down glycogen to release glucose into the bloodstream to maintain normal blood sugar levels. Therefore, the correct answer is "normal; reflecting glycogen breakdown by the liver."

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  • 11. 

    Pregnant women with symptoms of thirst, frequent urination or unexplained weight loss should have which of the following tests performed?

    • A.

      Tolbutamide test

    • B.

      Lactose tolerance test

    • C.

      Epinephrine glucose tolerance test

    • D.

      Glucose tolerance test

    Correct Answer
    D. Glucose tolerance test
    Explanation
    Pregnant women experiencing symptoms of thirst, frequent urination, or unexplained weight loss should undergo a glucose tolerance test. This test is used to diagnose gestational diabetes, a condition that affects pregnant women and causes high blood sugar levels. By measuring how the body processes glucose, the test can determine if a woman has gestational diabetes and needs treatment to manage her blood sugar levels during pregnancy.

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  • 12. 

    In the fasting state, the arterial blood and the capillary blood glucose concentration varies from venous glucose concentration by approximately  how many mg/dl (mmol/L)

    • A.

      1mg/dl (0.05 mmol/L) higher

    • B.

      5 mg/dl (0.27 mmol/L)higher

    • C.

      10 mg/dl (0.55 mmol/L) lower

    • D.

      15 mg/dl (0.82 mmol/L)

    Correct Answer
    B. 5 mg/dl (0.27 mmol/L)higher
    Explanation
    In the fasting state, the arterial blood and the capillary blood glucose concentration are higher than the venous glucose concentration by approximately 5 mg/dl (0.27 mmol/L). This means that the glucose levels in the arteries and capillaries are slightly elevated compared to the venous blood.

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  • 13. 

    The conversion of glucose or other hexoses into lactate or pyruvate is called:

    • A.

      Glycogenesis

    • B.

      Glycolysis

    • C.

      Gluconeogenesis

    • D.

      Glycogenolysis

    Correct Answer
    B. Glycolysis
    Explanation
    Glycolysis is the correct answer because it refers to the process of breaking down glucose or other hexoses into lactate or pyruvate. This process occurs in the cytoplasm of cells and is the first step in both aerobic and anaerobic respiration. Glycolysis produces ATP, which is used as an energy source for various cellular activities.

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  • 14. 

    Which of the following values obtained during a glucose tolerance test are diagnosticof diabetes mellitus?

    • A.

      2hr specimen= 150 mg/dl (8.3 mmol/L)

    • B.

      Fasting plasma glucose= 126 mg/dl (6.9 mmol/L)

    • C.

      Fasating plasma glucose= 110 mg/dl (6.1 mmol/L)

    • D.

      2hr specimen = 180 mg/dl (9.9 mmol/L)

    Correct Answer
    B. Fasting plasma glucose= 126 mg/dl (6.9 mmol/L)
    Explanation
    A fasting plasma glucose level of 126 mg/dl (6.9 mmol/L) is diagnostic of diabetes mellitus according to the criteria set by the American Diabetes Association. A fasting plasma glucose level of 110 mg/dl (6.1 mmol/L) is within the normal range, and a 2-hour specimen glucose level of 150 mg/dl (8.3 mmol/L) and 180 mg/dl (9.9 mmol/L) are elevated but not diagnostic of diabetes.

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  • 15. 

    The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding:

    • A.

      1-3 weeks

    • B.

      4-5 weeks

    • C.

      6-8 weeks

    • D.

      16-20 weeks

    Correct Answer
    C. 6-8 weeks
    Explanation
    Glycated hemoglobin (HbA1c) is a measure of the average blood glucose levels over a period of time. It reflects the amount of glucose that has attached to hemoglobin molecules in red blood cells. As red blood cells have a lifespan of around 120 days, HbA1c provides an indication of blood glucose control over the previous 2-3 months. Therefore, the correct answer is 6-8 weeks, as this timeframe aligns with the lifespan of red blood cells and provides an accurate representation of long-term glucose levels.

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  • 16. 

    Monitoring long-term glucose control in patients with adult onset diabetes mellitus can best be accomplished by measuring:

    • A.

      Weekly fasting 7am serum glucose

    • B.

      Glucose tolerance testing

    • C.

      2hr postprandial serum glucose

    • D.

      Hemoglobin A1c

    Correct Answer
    D. Hemoglobin A1c
    Explanation
    Hemoglobin A1c is the best measure for monitoring long-term glucose control in patients with adult onset diabetes mellitus. This is because hemoglobin A1c reflects the average blood glucose levels over the past 2-3 months, providing a more comprehensive picture of glucose control compared to the other options. Weekly fasting 7am serum glucose, glucose tolerance testing, and 2hr postprandial serum glucose are all measures of short-term glucose control and may not accurately represent long-term control. Hemoglobin A1c is a reliable indicator of overall glucose control and is commonly used in clinical practice to assess diabetes management.

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  • 17. 

    A patient with type 1 insulin-dependent diabetes mellitus has the following results: test                                                                          patient                                                            referance range fasting blood glucose                  150 mg/dl (8.3 mmol/L)                                      70-110 mg/dl (3.9-6.1 mmol/L) hemoglobin A1c                                    8.5%                                                                                4.0%-6.0% fructosamine                                     2.5 mmol/L                                                                  2.0- 2.9 mmol/L

    • A.

      "steady state" of metabolic control

    • B.

      State of flux, progressively worsening metabolic control

    • C.

      Improving state of metabolic control as indicated by fructosamine

    • D.

      State of flux as indicted by the fasting glucose lvl

    Correct Answer
    C. Improving state of metabolic control as indicated by fructosamine
    Explanation
    The patient's fasting blood glucose level is higher than the reference range, indicating a state of flux and progressively worsening metabolic control. However, the patient's fructosamine level is within the reference range, indicating an improving state of metabolic control. Therefore, the correct answer is that the patient is in an improving state of metabolic control as indicated by fructosamine.

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  • 18. 

    The glycosylated hemoglobin levels in a hemolysate reflect the:

    • A.

      Average blood glucose levels of the past 2-3 months

    • B.

      Average blood glucose levels for the past week

    • C.

      Blood glucose level at the time the sample drawn

    • D.

      Hemoglobin a1c level at the time the sample is drawn

    Correct Answer
    A. Average blood glucose levels of the past 2-3 months
    Explanation
    The correct answer is that glycosylated hemoglobin levels in a hemolysate reflect the average blood glucose levels of the past 2-3 months. This is because glycosylated hemoglobin, also known as Hemoglobin A1c, is formed when glucose attaches to hemoglobin in red blood cells. The level of glycosylated hemoglobin in the blood is directly proportional to the average blood glucose levels over a period of 2-3 months. Therefore, measuring the level of glycosylated hemoglobin provides an indication of long-term blood glucose control.

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  • 19. 

    Which of the following hemoglobins has a glucose-6-phosphate on the amino-terminal valine of the beta chain:

    • A.

      S

    • B.

      C

    • C.

      A2

    • D.

      A1c

    Correct Answer
    D. A1c
    Explanation
    The correct answer is A1c. Hemoglobin A1c is a form of hemoglobin that is formed when glucose binds to the amino-terminal valine of the beta chain. This process, known as glycation, occurs in individuals with high blood sugar levels over a prolonged period of time. Measurement of hemoglobin A1c levels is commonly used to assess long-term blood sugar control in individuals with diabetes.

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  • 20. 

    A person with hemolytic anemia will:

    • A.

      Show a decrease in glycated hgb value

    • B.

      Show an increase in glycated hgb value

    • C.

      Show lil or no change in glycated hgb value

    • D.

      Demonstrate an elevated hgb A1

    Correct Answer
    A. Show a decrease in glycated hgb value
    Explanation
    A person with hemolytic anemia will show a decrease in glycated hgb value because hemolytic anemia is a condition where red blood cells are destroyed faster than they can be produced. Glycated hemoglobin (hgb) is a measure of the average blood sugar levels over the past 2-3 months. In hemolytic anemia, the lifespan of red blood cells is shortened, leading to a decrease in the amount of time available for glucose to bind to hemoglobin. As a result, there will be a decrease in the glycated hgb value.

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  • 21. 

    In using ion-exchange chromotographic methods, falsely increased levels of hgb A1c might be demonstrated in the presence of:

    • A.

      Iron defiency anemia

    • B.

      Pernicious anemia

    • C.

      Thalassemias

    • D.

      Hgb S

    Correct Answer
    D. Hgb S
    Explanation
    In ion-exchange chromatographic methods, falsely increased levels of Hgb A1c can be demonstrated in the presence of Hgb S. This is because Hgb S has a different charge compared to Hgb A1c, which can lead to interference in the chromatographic separation. Therefore, when analyzing Hgb A1c levels using this method, the presence of Hgb S can result in inaccurate measurements, leading to falsely increased levels.

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  • 22. 

    An increase in serum acetone is indicative of a defect in the metabolism of:

    • A.

      Carbohydrates

    • B.

      Fat

    • C.

      Urea nitrogen

    • D.

      Uric acid

    Correct Answer
    A. Carbohydrates
    Explanation
    An increase in serum acetone is indicative of a defect in the metabolism of carbohydrates. This is because acetone is produced when the body breaks down fats for energy in the absence of sufficient carbohydrates. When carbohydrates are not properly metabolized, the body starts using fats as an alternative energy source, leading to the production of acetone. Therefore, an increase in serum acetone suggests that there is a problem with the metabolism of carbohydrates.

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  • 23. 

    An infant with diarrhea is being evaluated for a carbohydrate intolerance. his stool yields a positive copper reduction test and a ph of 5.0. it should be concluded that

    • A.

      Further test are indicated

    • B.

      Results are inconsistent-repeat both tests

    • C.

      The diarrhea is not due to carbohydrate intolerance

    • D.

      The tests provided nno useful information

    Correct Answer
    A. Further test are indicated
    Explanation
    The positive copper reduction test and low pH in the stool suggest a possible carbohydrate intolerance. However, these results alone are not conclusive enough to make a definitive diagnosis. Further tests are needed to confirm the presence of carbohydrate intolerance and to determine the specific cause of the diarrhea.

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  • 24. 

    Blood samples were collected at the beginning of an excercise class and afer thirty minutes of aerobic activity. which of the following would be most consistent with the post exercise sample?

    • A.

      Normal lactic acid, low pyruvate

    • B.

      Low lactic acid, elevated pyruvate

    • C.

      Elevated lactic acid, low pyruvate

    • D.

      Elevated lactic acid, elevated pyruvate

    Correct Answer
    D. Elevated lactic acid, elevated pyruvate
    Explanation
    After thirty minutes of aerobic activity, the body goes through a process called glycolysis, in which glucose is broken down to produce energy. This process produces lactic acid as a byproduct. Therefore, the post-exercise sample would have elevated levels of lactic acid. Additionally, pyruvate is an intermediate product of glycolysis, so it would also be expected to be elevated in the post-exercise sample. Therefore, the answer "elevated lactic acid, elevated pyruvate" is the most consistent with the post-exercise sample.

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  • 25. 

    What is the best method to diagnose lactase deficiency?

    • A.

      H2 breath test

    • B.

      Plasma adolase lvl

    • C.

      LDH level

    • D.

      D-xylose test

    Correct Answer
    A. H2 breath test
    Explanation
    The best method to diagnose lactase deficiency is the h2 breath test. This test measures the levels of hydrogen in the breath after consuming a lactose-rich beverage. Lactase deficiency leads to the undigested lactose being fermented by bacteria in the colon, producing hydrogen gas that is absorbed into the bloodstream and exhaled through the breath. Elevated levels of hydrogen indicate lactose malabsorption, confirming the diagnosis of lactase deficiency. The h2 breath test is a non-invasive and reliable method for diagnosing lactase deficiency.

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  • 26. 

    The expected blood gas results for a patient in chronic renal failure would match the pattern of:

    • A.

      Metabolic acidosis

    • B.

      Respiratory acidosis

    • C.

      Metabolic alkalosis

    • D.

      Respiratory alkalosis

    Correct Answer
    A. Metabolic acidosis
    Explanation
    In chronic renal failure, the kidneys are unable to effectively remove metabolic waste products, such as acids, from the body. This leads to an accumulation of acid in the blood, resulting in metabolic acidosis. The expected blood gas results for a patient in chronic renal failure would show decreased pH, decreased bicarbonate levels, and possibly decreased pCO2 levels. This pattern is consistent with metabolic acidosis.

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  • 27. 

    Severe diarrhea causes

    • A.

      Metabolic acidosis

    • B.

      Repiratory acidosis

    • C.

      Metabolic alkalosis

    • D.

      Respiratory alkalosis

    Correct Answer
    A. Metabolic acidosis
    Explanation
    Severe diarrhea causes metabolic acidosis because the loss of fluids and electrolytes through diarrhea leads to an imbalance in the body's acid-base levels. The excessive loss of bicarbonate ions in the stool causes a decrease in the body's buffering capacity, resulting in an accumulation of acid and a decrease in pH. This leads to metabolic acidosis, characterized by symptoms such as increased breathing rate, confusion, and fatigue.

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  • 28. 

    The following blood gas results were obtained:  pH:                        7.18 PO2:                     86 mm Hg PCO2:                  60 mm Hg O2 saturation:     92% HCO3:                  7921 mEq/L (21 mmol/L) TCO2:                   23 mEq/L   (23mmol/L) base excess:      -8.0 mEq/L (-8.0 mmol/L) The patients results are compatible with which of the following?

    • A.

      Fever

    • B.

      Uremia

    • C.

      Emphysema

    • D.

      Dehydration

    Correct Answer
    C. Emphysema
    Explanation
    The given blood gas results show a low pH (7.18) and a high PCO2 (60 mm Hg), which indicates respiratory acidosis. This is commonly seen in patients with emphysema, a lung condition characterized by damage to the air sacs in the lungs. Emphysema leads to impaired gas exchange, causing an increase in carbon dioxide levels and a decrease in oxygen levels. The low pH and high PCO2 in this patient's blood gas results are consistent with the respiratory acidosis seen in emphysema.

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  • 29. 

    Factors that contribute to a PCO2 electrode requiring 60-120 seconds to reach equilibrium include the:

    • A.

      Diffusion characteristics of the membrane

    • B.

      Actual blood pO2

    • C.

      Type of calibrating standard (ie, liquid or humidified gas)

    • D.

      Potential of the polarizing mercury cell

    Correct Answer
    A. Diffusion characteristics of the membrane
    Explanation
    The diffusion characteristics of the membrane play a significant role in the time it takes for a PCO2 electrode to reach equilibrium. The membrane acts as a barrier between the sample and the electrode, allowing the diffusion of CO2 molecules. If the membrane has low permeability or thickness, it can impede the diffusion process, resulting in a longer time for the electrode to reach equilibrium. On the other hand, a membrane with high permeability or thinness allows for faster diffusion, reducing the time required for equilibrium to be reached. Therefore, the diffusion characteristics of the membrane directly affect the time it takes for the PCO2 electrode to reach equilibrium.

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  • 30. 

    An emphysema patient suffering from fluid accumulation in the alveolar spaces is the likely to be in what metabolic state?

    • A.

      Respiratory acidosis

    • B.

      Respiratoy alkalosis

    • C.

      Metabolic acidosis

    • D.

      Metabolic alkalosis

    Correct Answer
    A. Respiratory acidosis
    Explanation
    An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in a state of respiratory acidosis. Emphysema is a chronic lung disease that causes damage to the alveoli, leading to impaired gas exchange. Fluid accumulation in the alveolar spaces further impairs the exchange of oxygen and carbon dioxide. This results in a buildup of carbon dioxide in the blood, leading to respiratory acidosis, which is characterized by low blood pH and high levels of carbon dioxide.

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  • 31. 

    At blood ph  7.40, what is the ratio of bicarbonate to carbonic acid?

    • A.

      15:1

    • B.

      20:1

    • C.

      25:1

    • D.

      30:1

    Correct Answer
    B. 20:1
    Explanation
    The ratio of bicarbonate to carbonic acid at a blood pH of 7.40 is 20:1. This means that there are 20 times more bicarbonate ions (HCO3-) than carbonic acid (H2CO3) present in the blood at this pH level. This ratio is important for maintaining the acid-base balance in the body, as bicarbonate acts as a buffer to regulate pH levels and prevent excessive acidity.

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  • 32. 

    The referance range for the pH of arterial blood measured at 37 degree celsius is:

    • A.

      7.28-7.34

    • B.

      7.33-7.37

    • C.

      7.35-7.45

    • D.

      7.45-7.50

    Correct Answer
    C. 7.35-7.45
    Explanation
    The correct answer is 7.35-7.45. This range represents the normal pH level of arterial blood when measured at 37 degrees Celsius. The pH of arterial blood is tightly regulated within this range to maintain normal physiological functions. Values below 7.35 indicate acidosis, while values above 7.45 indicate alkalosis. Therefore, the pH range of 7.35-7.45 is considered the normal reference range for arterial blood pH.

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  • 33. 

    A 68 year-old man arrives in the emergency room with a glucose level of 722 mg/dl (39.7 mmol/L) and serum acetone of 4+ undiluted. an arterial blood gas from this patient is likely to be

    • A.

      Low ph

    • B.

      High ph

    • C.

      Low PO2

    • D.

      High PO2

    Correct Answer
    A. Low ph
    Explanation
    A glucose level of 722 mg/dl (39.7 mmol/L) and serum acetone of 4+ undiluted indicate that the patient is most likely experiencing diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes characterized by high blood glucose levels, ketones in the blood, and metabolic acidosis. Metabolic acidosis is associated with a low pH level in the arterial blood gas. Therefore, the arterial blood gas from this patient is likely to show a low pH.

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  • 34. 

    A patient is admitted to the emergency room in a state of metaboolic alkalosis. which of the following would be consistent with diagnosis?

    • A.

      High TCO2, increased HCO3

    • B.

      Low TCO2, increased HCO3

    • C.

      High TCO2, decreased H2CO3

    • D.

      Low TCO2, decreased H2CO3

    Correct Answer
    A. High TCO2, increased HCO3
    Explanation
    A patient with metabolic alkalosis would have an increased bicarbonate (HCO3) level and a high total carbon dioxide (TCO2) level. This is because metabolic alkalosis is characterized by an excess of bicarbonate in the blood, which leads to an increase in TCO2. The increased HCO3 and TCO2 levels indicate an imbalance in the body's acid-base balance, resulting in alkalosis.

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  • 35. 

    A person suspected of having metabolic alkalosis would have which of the following laboratory findings?

    • A.

      CO2 content and PCO2 elevated, ph decreased

    • B.

      CO2 content decreased and Ph elevated

    • C.

      CO2 content, PCO2 and ph decreased

    • D.

      CO2 content and pH elevated

    Correct Answer
    D. CO2 content and pH elevated
    Explanation
    A person suspected of having metabolic alkalosis would have elevated CO2 content and pH. This is because metabolic alkalosis is a condition characterized by an increase in bicarbonate (HCO3-) levels in the blood, which leads to an increase in CO2 content. This increase in CO2 content causes a shift in the pH towards the alkaline side, resulting in an elevated pH. Therefore, the laboratory findings of elevated CO2 content and pH support the diagnosis of metabolic alkalosis.

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  • 36. 

    Metabolic acidosis is described as a (n):

    • A.

      Increase in CO2 content and PCO2 with a decreased pH

    • B.

      Decrease in CO2 content with an increased pH

    • C.

      Increase in CO2 with an increased pH

    • D.

      Decrease in CO2 content and PCO2 with a decreased pH

    Correct Answer
    A. Increase in CO2 content and PCO2 with a decreased pH
    Explanation
    Metabolic acidosis is characterized by an increase in CO2 content and PCO2 with a decreased pH. This means that there is an accumulation of carbon dioxide in the body, leading to an increase in its content and partial pressure. This results in a decrease in pH, making the blood more acidic.

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  • 37. 

    Respiratory acidosis is described as a (n):

    • A.

      Increase in CO2 content and PCO2 with a decreased pH

    • B.

      Decrease in CO2 content an increased pH

    • C.

      Increase in CO2 content with an increased pH

    • D.

      Decrease in CO2 content and PCO2 with a decreased pH

    Correct Answer
    A. Increase in CO2 content and PCO2 with a decreased pH
    Explanation
    Respiratory acidosis is a condition characterized by an increase in carbon dioxide (CO2) content and partial pressure of carbon dioxide (PCO2) in the blood, which leads to a decrease in pH. This occurs when the lungs are unable to effectively remove CO2 from the body, causing it to accumulate in the bloodstream. The increased CO2 levels result in the formation of carbonic acid, leading to a decrease in pH and an acidic environment.

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  • 38. 

    A common cause of respiratory alkalosis is:

    • A.

      Vomiting

    • B.

      Starvation

    • C.

      Asthma

    • D.

      Hyperventilation

    Correct Answer
    D. Hyperventilation
    Explanation
    Hyperventilation is a common cause of respiratory alkalosis. When a person hyperventilates, they breathe rapidly and shallowly, leading to an excessive elimination of carbon dioxide from the body. This decrease in carbon dioxide levels causes a shift in the body's acid-base balance towards alkalinity, resulting in respiratory alkalosis. Vomiting, starvation, and asthma may cause other respiratory or metabolic imbalances, but they are not directly associated with respiratory alkalosis.

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  • 39. 

    Acidosis and alkalosis are best defined as fluctuations in blood pH and CO2 content due to changes in:

    • A.

      Bohr effect

    • B.

      O2 content

    • C.

      Bicarbonate buffer

    • D.

      Carbonic anhydrase

    Correct Answer
    C. Bicarbonate buffer
    Explanation
    Acidosis and alkalosis refer to imbalances in blood pH and CO2 content. The bicarbonate buffer system plays a crucial role in maintaining the acid-base balance in the body. It consists of a weak acid (carbonic acid) and its conjugate base (bicarbonate ions). When there is an excess of acid in the blood, the bicarbonate ions act as a buffer, binding with the excess acid to maintain a stable pH. Conversely, when there is an excess of base in the blood, carbonic acid is produced to neutralize it. Therefore, fluctuations in blood pH and CO2 content are best defined by changes in the bicarbonate buffer system.

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  • 40. 

    A blood gas sample was sent to the lab on ice and a bubble was present in the syringe. the blood  had been exposed to room air for at least 30 minutes. The following change in blood gases will occur

    • A.

      CO2 content increased/PCO2 decreased

    • B.

      CO2 content and PO2 increased/pH increased

    • C.

      CO2 content and PCO2 decreased/pH decreased

    • D.

      PO2 increased/HCO3 decreased

    Correct Answer
    D. PO2 increased/HCO3 decreased
    Explanation
    When a blood gas sample is exposed to room air for an extended period of time, the oxygen (O2) content in the blood will increase (PO2 increased) due to the oxygen in the air diffusing into the sample. Additionally, the bicarbonate (HCO3) levels in the blood will decrease (HCO3 decreased) as the exposure to room air causes a shift towards the formation of carbonic acid, leading to a decrease in bicarbonate levels. Therefore, the correct answer is PO2 increased/HCO3 decreased.

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  • 41. 

    The following laboratory results were obtained:         Serum electrolytes         sodium:                   136 mEq/L(136mmol/L)         potassium:              4.4 mEq/L(4.4mmol/L)         chloride:                   92 mEq/L(92mmol/L)         bicarbonate:            40 mEq/L(40mmol/L)        Arterial blood        pH:                             7.32        PCO2:                       79 mm Hg These results are most compatible with:

    • A.

      Respiratory alkalosis

    • B.

      Respiratory acidosis

    • C.

      Metabolic alkalosis

    • D.

      Metabolic acidosis

    Correct Answer
    B. Respiratory acidosis
    Explanation
    The laboratory results show a low pH (7.32) and a high PCO2 (79 mm Hg), indicating respiratory acidosis. In respiratory acidosis, there is an accumulation of carbon dioxide in the blood due to inadequate ventilation, leading to an increase in PCO2 and a decrease in pH. The other options (respiratory alkalosis, metabolic alkalosis, and metabolic acidosis) do not match the laboratory findings in this case.

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  • 42. 

    Select the test which evaluates renal tubular function:

    • A.

      IVP

    • B.

      Creatinine clearance

    • C.

      Osmolarity

    • D.

      Microscopic urinalysis

    Correct Answer
    C. Osmolarity
    Explanation
    Osmolarity is a measure of the concentration of solutes in a solution. In the context of evaluating renal tubular function, osmolarity can provide information about the ability of the kidneys to regulate water and electrolyte balance. It can help determine if the kidneys are properly concentrating or diluting the urine. By measuring the osmolarity of urine, healthcare professionals can assess the functioning of the renal tubules and identify any abnormalities or disorders affecting the kidneys' ability to regulate fluid and electrolyte balance. Therefore, osmolarity is a suitable test for evaluating renal tubular function.

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  • 43. 

    A patient has the following serum results:          Na:              140 mEq/L (140 mmol/L)     K:                 4.0 mEq/L  (4.0 mmol/L)     glucose:     95 mg/dL   (5.2 mmol/L)     BUN:           10 mg/dL   (3.57 mmol/L) Which osmolaity is consistent with these results? 

    • A.

      188

    • B.

      204

    • C.

      270

    • D.

      390

    Correct Answer
    C. 270
  • 44. 

    The degree to which the kidney concentrates the glomerular filtrate can be determined by:

    • A.

      Urine creatine

    • B.

      Serum creatine

    • C.

      Cratinine clearance

    • D.

      Urine to serum osmolality ratio

    Correct Answer
    D. Urine to serum osmolality ratio
    Explanation
    The urine to serum osmolality ratio is a measure of the concentration of solutes in the urine compared to the concentration in the blood. This ratio indicates how well the kidney is able to concentrate the glomerular filtrate. If the ratio is high, it means that the kidney is effectively reabsorbing water and concentrating the urine. On the other hand, if the ratio is low, it suggests that the kidney is not able to concentrate the urine properly. Therefore, the urine to serum osmolality ratio is a useful indicator of the kidney's ability to concentrate the glomerular filtrate.

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  • 45. 

    Osmolal gap is aa difference between:

    • A.

      The ideal and real osmolality values

    • B.

      Calculated and measured osmolality values

    • C.

      Plasma and water osmolality values

    • D.

      Molality and molarity at 4 degres celsius

    Correct Answer
    B. Calculated and measured osmolality values
    Explanation
    The osmolal gap is a difference between the calculated and measured osmolality values. Osmolality is a measure of the concentration of solutes in a solution, specifically in this case, in the blood plasma. The calculated osmolality is determined using a formula based on the concentrations of various solutes, while the measured osmolality is determined through laboratory tests. The osmolal gap represents any unaccounted for solutes or errors in the measurement process.

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  • 46. 

    The most important buffer pair in plasma is the

    • A.

      Phosphate/biphosphate pair

    • B.

      Hemoglobin/imidazole pair

    • C.

      Bicarbonate/carbonic acid pair

    • D.

      Sulfate/bisulfate pair

    Correct Answer
    C. Bicarbonate/carbonic acid pair
    Explanation
    The bicarbonate/carbonic acid pair is the most important buffer pair in plasma because it helps maintain the pH balance in the body. When there is an increase in acidity, carbonic acid dissociates into bicarbonate ions, which helps to neutralize the excess hydrogen ions and maintain a stable pH. On the other hand, when there is an increase in alkalinity, bicarbonate ions can combine with hydrogen ions to form carbonic acid, thus reducing the pH. This buffer system plays a crucial role in regulating the acid-base balance in the body and ensuring the proper functioning of various physiological processes.

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  • 47. 

    Quantitation of Na+ and K+ by ion-selective electrode is the standard method because:

    • A.

      Dilution is required for flame photometry

    • B.

      There is no lipoprotein interference

    • C.

      Of advances in electrochemistry

    • D.

      Of the abscence of an internal standard

    Correct Answer
    C. Of advances in electrochemistry
    Explanation
    The correct answer is "of advances in electrochemistry". This is because advances in electrochemistry have allowed for the development of ion-selective electrodes, which can accurately and selectively measure the concentration of Na+ and K+ ions in a sample. This method does not require dilution like flame photometry, and it also does not suffer from lipoprotein interference. Additionally, the ion-selective electrode method does not require an internal standard, making it a more convenient and efficient technique for quantitating Na+ and K+ ions.

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  • 48. 

    What battery of tests is most useful in evaluating an anion gap of 22 mEq/L (22 mmol/L) ?

    • A.

      Ca, Mg, PO^-4, and pH

    • B.

      BUN, creatinine, salicylate and methanol

    • C.

      AST, ALT, LD and amylase

    • D.

      Glucose, CK, myoglobin and cryoglobulin

    Correct Answer
    B. BUN, creatinine, salicylate and methanol
    Explanation
    The correct answer is BUN, creatinine, salicylate, and methanol. An anion gap of 22 mEq/L suggests an imbalance of electrolytes in the body. BUN and creatinine are markers of kidney function and can help determine if there is a renal cause for the anion gap. Salicylate and methanol are toxic substances that can cause an increased anion gap. Therefore, testing for these substances can help identify potential causes for the abnormal anion gap. The other options listed do not directly relate to the evaluation of an anion gap.

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  • 49. 

    A patient with myeloproliferative disorder has the following values: Hgb:            10 g/dL ( 130 mmol/L) Hct:              38% WBC:           30 x 10^3/uL (30 x 10^9/L) platelets:     1000 x 10^/uL (1000 x 10^9/L) serum Na:   140 mEq/L (140 mmol/L) serum K:      7 mEq/L (7 mmol/L) The serum K should be confirmed by:

    • A.

      Repeat testing of the original serum

    • B.

      Testing freshly drawn serum

    • C.

      Testing heparinized plasma

    • D.

      Atomic absorption spectrometry

    Correct Answer
    C. Testing heparinized plasma
    Explanation
    The correct answer is testing heparinized plasma. Heparinized plasma should be used to confirm the serum potassium (K) level in patients with myeloproliferative disorder. This is because platelet counts can be extremely high in these patients, which can lead to in vitro release of potassium from platelets during serum collection. Heparinized plasma prevents this release of potassium, providing a more accurate measurement of the patient's true serum potassium level. Repeat testing of the original serum or testing freshly drawn serum may still be affected by platelet release of potassium, while atomic absorption spectrometry is not necessary for confirming the serum K level in this case.

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  • 50. 

    Most of the carbon dioxide present in blood in the form of:

    • A.

      Dissolved CO^2

    • B.

      Carbonate

    • C.

      Bicarbonate ion

    • D.

      Carbonic acid

    Correct Answer
    C. Bicarbonate ion
    Explanation
    In the blood, carbon dioxide is mostly present in the form of bicarbonate ions. When carbon dioxide enters the bloodstream, it combines with water to form carbonic acid. This carbonic acid then dissociates into bicarbonate ions and hydrogen ions. The bicarbonate ions are important for maintaining the pH balance of the blood and are transported to the lungs where they are converted back into carbon dioxide to be exhaled. Therefore, the majority of carbon dioxide in the blood exists as bicarbonate ions.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 27, 2011
    Quiz Created by
    Red_Ghost

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