Clinical Chemistry mcqs for Medical Lab Technologist,

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Q1. Which of the following tissues is important in vitamin D metabolism? 

A. Skin 

B. Spleen 

C. Pancreas 

D. Thyroid

Ans- A

 The designation "vitamin D" applies to a family of essential fat-soluble sterols that includes vitamin D3 or cholecalciferol. This compound can either be absorbed directly or synthesized in the skin from 7-dehydrocholesterol with the help of ultraviolet irradiation. For physiological functioning, vitamin D3 must be metabolized first by the liver to 25-hydroxyvitamin D3 and then by the kidney to the final hormonal product, 1,25- dihydroxy vitamin D3 (calcitriol). The kidney also synthesizes 24,25-dihydroxyvitamin D3 by an alternate pathway. This compound does not have the hormonal activity of calcitriol, but because of its similar structure and relatively high concentration in the serum, it has complicated the determination of serum calcitriol.

Q2. Which of the following is another name for vitamin B12? 

A. Retinol 

B. Pyridoxine 

C. Cyanocobalamin 

D. Riboflavin 


Vitamin B12 (cyanocobalamin) is a cobalt containing vitamin that is necessary for normal erythropoiesis. Intrinsic factor is a gastric protein that specifically binds vitamin B12 and carries it to the ileurn for absorption. The transcobalamins are a group of plasma proteins, some of which bind vitamin B12 and some of which bind both vitamin B12 and cobalamin analogs. The cobalophilins (R proteins) are those transcobalamins that can also bind the cobalamin analogs.

Q3. Which of the following is not associated with vitamin B12? 

A. Insoluble in water

 B. Intrinsic factor 

C. Schilling test 

D. Pernicious anemia


Vitamin B12 is a water-soluble vitamin. It is absorbed in the gastrointestinal tract by way of a substance called intrinsic factor. Deficiency of vitamin B12 produces a megaloblastic anemia. Anemia caused by a deficiency of vitamin B12 because of a lack of intrinsic factor (IF) is called pernicious anemia. The Schilling test (with and without IF) is used to diagnose pernicious anemia. It is helpful in distinguishing pernicious anemia from other malabsorption syndromes. A positive Schilling test indicates low absorption of B12 without IF and normal absorption with IF.

Q4- Which vitamin is a constituent of two redox coenzymes? 

A. Vitamin A 

B. Vitamin B2 

C. Vitamin B6 

D. Vitamin C


Riboflavin (vitamin B2) is a constituent of two redox coenzymes, flavin mononucleotide (FMN) and flavin-adenine dinucleotide (FAD). These coenzymes, in combination with appropriate proteins, form the flavoprotein enzymes, which participate in tissue respiration as components of the electron-transport system. The property that enables them to participate in electron-transport is their ability to exist in the half-reduced form (FADH) and in the fully reduced form (FADH2)

Q5- Measuring which of the following compounds is useful in the diagnosis of steatorrhea?

 A. Vitamin B12

 B. Vitamin C 

C. Carotenoids 

D. Folic acid



Q-6.  Bile acids that are synthesized in the liver are derived from what substance? 

A. Bilirubin 

B. Fatty acid 

C. Cholesterol 

D. Triglyceride


Q7= . The turbid, or milky, appearance of serum after fat ingestion is termed postprandial lipemia, which is caused by the presence of what substance? 

A. Bilirubin 

B. Cholesterol 

C. Chylomicron 

D. Phospholipid 


Q8=  Cholesterol ester is formed through the esterification of the alcohol cholesterol with what substance? 

A. Protein 

B. Triglyceride 

C. Fatty acid 

D. Digitonin 


Q9=. Which of the following tests would most likely be included in a routine lipid profile? 

A. Total cholesterol, triglyceride, fatty acid, chylomicron 

B. Total cholesterol, triglyceride, HDL cholesterol, phospholipid 

C. Triglyceride, HDL cholesterol, LDL cholesterol, chylomicron 

D. Total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol 


Q10. To produce reliable results, when should blood specimens for lipid studies be drawn? 

A. Immediately after eating 

B. Anytime during the day 

C. In the fasting state, approximately 2 to 4 hours after eating 

D. In the fasting state, approximately 9 to 12 hours after eating 


Q11. Which of the following lipid tests is least affected by the fasting status of the patient?

 A. Cholesterol 

B. Triglyceride 

C. Fatty acid 

D. Lipoprotein


Q12=  Exogenous triglycerides are transported in the plasma in what form? 

A. Phospholipids 

B. Cholesteryl esters 

C. Chylomicrons 

D. Free fatty acids


Q13=  Ketone bodies are formed because of an excessive breakdown of fatty acids. Of the following metabolites, which may be classified as a ketone body? 

A. Pyruvic acid 

B. (β -Hydroxybutyric acid 

C. Lactic acid 

D. Oxaloacetic acid


Q14= . What substance is the precursor to all steroid hormones?

 A. Fatty acid 

B. Cholesterol 

C. Triglyceride 

D. Phospholipid


 The 27-carbon, ringed structure of cholesterol is the backbone of steroid hormones. The nucleus is called the cyclopentanoperhydrophenanthrene ring. The steroid hormones having this ring include estrogens (18 carbons), androgens (19 carbons), glucocorticoids (21 carbons), and mineralocorticoids (21 carbons).

Q15= . The VLDL fraction primarily transports what substance?

 A. Cholesterol 

B. Chylomicron 

C. Triglyceride 

D. Phospholipid


The VLDL fraction is primarily composed of triglycerides and lesser amounts of cholesterol and phospholipids. Protein components of VLDL are mostly apolipoprotein B-100 and apolipoprotein C. VLDL migrates electrophoretically in the prebeta region. 

Q16= Which of the following techniques can be used to quantify apolipoproteins? 

A. Spectrophotometric endpoint 

B. Ion-selective electrode 

C. Immunonephelometric assay 

D. Refractometry


A number of immunochemical assays can be used to quantify the apolipoproteins. Some of the techniques that can be used include immunonephelometric assay, enzyme-linked immunosorbent assay (ELISA), and immunoturbidimetric assay. Commercial kits are available for the quantification of Apo A-I and Apo B-100. Measuring the apolipoproteins can be of use in assessing increased risk for coronary heart disease.

  Q17= To what class of enzymes does lactate dehydrogenase belong? 

A. Isomerases 

B. Ligases 

C. Oxidoreductases 

D. Transferases


Q18=What abbreviation has been used in the past to designate alanine aminotransferase? 


B. A AT 




Alanine aminotransferase (ALT), formerly known as glutamate pyruvate transaminase (GPT), and aspartate aminotransferase (AST), formerly known as glutamate oxaloacetate transaminase (GOT), are categorized as transferase enzymes. These older designations are still seen in conjunction with the current terminology on reagent packaging, on physician test request forms, and on laboratory test result forms. Through the transfer of amino groups, ALT and AST catalyze the interconversion of amino acids and keto acids. ALT catalyzes the interconversion of alanine and oxoglutarate to pyruvate and glutamate. The reaction is reversible. In viral hepatitis, both ALT and AST are elevated. In acute myocardial infarction, AST is elevated and ALT is normal or slightly increased. 

L-Alanine +α-oxoglutarate =ALT P-5'-P  = pyruvate + L-glutamate 

>Q19= Which test, if elevated, would provide information about risk for developing coronary artery disease? 

A. Troponin 


C. hs-CRP 

D. Myoglobin


. C-reactive protein is an acute-phase reactant that is increased in the presence of inflammation. High-sensitivity C-reactive protein (hs-CRP) refers to a sensitive method that is able to measure low levels of CRP in serum. One theory is that elevated levels of CRP contribute to the damage of arterial walls that precedes plaque formation. hs-CRP is considered a good predictor test for assessing cardiovascular risk. How ever, it is also elevated in other conditions, including infection, stress, and trauma. CK-MB,troponin, and myoglobin are tests used to assess if a myocardial infarction has occurred.

Q20= Which of the following disorders is not characterized by an elevated serum myoglobin? 

A. Renal failure 

B. Vigorous exercise 

C. Acute myocardial infarction 

D. Hepatitis


Q21= Which of the following functions as a transport protein for bilirubin in the blood? 

A. Albumin 

B. Alpha-globulin 

C. Beta-globulin

D. Gamma-globulin


Q22= Which bilirubin fraction is unconjugated and covalently bound to albumin? 

A. Alpha

 B. Beta 

C. Delta 

D. Gamma



Q23= . What does hydrolysis of sucrose yield? 

A. Glucose only 

B. Galactose and glucose 

C. Maltose and glucose 

D. Fructose and glucose 


Q24. In what form is glucose stored in muscle and liver? 

A. Glycogen

 B. Maltose 

C. Lactose 

D. Starch 


Q25= Which of the following carbohydrates is a polysaccharide? 

A. Starch 

B. Sucrose 

C. Lactose 

D. Glucose


Q26=  Which of the following is not characteristic of severe hyperglycemia?

 A. Polyuria 

B. Ketonuria

 C. Glycosuria 

D. Hypoglucagonemia


Q27= Which of the following glucose methods should not be used during the administration of an oral xylose absorption test? 

A. Glucose oxidase—colorimetric 

B. Glucose oxidase—polarographic 

C. Glucose dehydrogenase 

D. Hexokinase 


Enzymes and Cardiac Assessment

 Q28. What does an increase in the serum enzyme levels indicate? 

A. Decreased enzyme catabolism 

B. Accelerated enzyme production 

C. Tissue damage and necrosis 

D. Increased glomerular filtration rat 


Q29= . To what class of enzymes does lactate dehydrogenase belong? 

A. Isomerases 

B. Ligases 

C. Oxidoreductases 

D. Transferase


Liver Function and Porphyrin Formation 

Q30. Which compounds originally condense to form aminolevulinic acid? 

A. Oxoglutarate and aspartate 

B. Isocitrate and coenzyme II 

C. Oxalacetate and malate 

D. Succinyl coenzyme A and glycine


Q31= . What breakdown product of bilirubin metabolism is produced in the colon from the oxidation of urobilinogen by microorganisms? 

A. Porphobilinogen 

B. Urobilin 

C. Stercobilinogen 

D. Protoporphyrin


Q32= Which of the following functions as a transport protein for bilirubin in the blood? 

A. Albumin 

B. Alpha-globulin 

C. Beta-globulin 

D. Gamma-globulin 


Q33= . What term is used to describe the accumulation of bilirubin in the skin? 

A. Jaundice 

B. Hemolysis 

C. Cholestasis 

D. Kernicterus 2


Q34= In the condition kernicterus, the abnormal accumulation of bilirubin occurs in what tissue? 

A. Brain 

B. Liver 

C. Kidney 

D. Blood  


Q35=  Which of the following factors will not adversely affect the accurate quantification of bilirubin in serum? 

A. Lipemia 

B. Hemolysis 

C. Exposure to light 

D. Specimen refrigeration 


Q36. Which bilirubin fraction is unconjugated and covalently bound to albumin? 

A. Alpha 

B. Beta 

C. Delta 

D. Gamma 


NOTE- . Four bilirubin fractions represented by Greek letters have been identified: unconjugated (alpha), monoconjugated (beta), diconjugated (gamma), and unconjugated bilirubin covalently bound to albumin (delta). Delta-bilirubin is normally present in low concentration in the blood, and it is known to react directly with diazotized sulfanilic acid. Increased serum levels of delta-bilirubin are associated with liver-biliary disease.

Q37= . As the red blood cells disintegrate, hemoglobin is released and converted to the pigment bilirubin. Which organ is primarily responsible for this function? 

A. Spleen 

B. Kidneys 

C. Intestines 

D. Liver 



Q 38. Which of the following methods is not used for the quantification of serum bilirubin? 

A. Bilirubinometer 

B. Jendrassik and Grof 

C. Zimmerman 

D. Bilirubin oxidase 


Q39. Which of the following does not accurately describe direct bilirubin? 

A. Insoluble in water 

B. Conjugated in the liver 

C. Conjugated with glucuronic acid 

D. Excreted in the urine of jaundiced patients 


Q40= Which of the following reagent systems contains the components sulfanilic acid, hydrochloric acid, and sodium nitrite? 

A. Jaffe 

B. Zimmerman 

C. Diazo 

D. Lowry




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