test bank for Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, 8th Edition

Test bank for Tietz Fundamentals of Clinical Chemistry
and Molecular Diagnostics,
8th Edition by Nader Rifai, PhD
Chapters 1 - 49

,Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics 8th Edition Test Bank

Table of contents:
I. Principles Of Laboratory Medicine
Chapter 1. Clinical Chemistry, Molecular Diagnostics, and Laboratory Medicine
Chapter 2. Selection and Analytical Evaluation of Methods — With Statistical Techniques
Chapter 3. Clinical Evaluation of Methods
Chapter 4. Evidence-Based Laboratory Medicine
Chapter 5. Establishment and Use of Reference Values
Chapter 6. Specimen Collection, Processing, and Other Preanalytical Variables
Chapter 7. Quality Management
II. Analytical Techniques And Instrumentation
Chapter 8. Principles of Basic Techniques and Laboratory Safety
Chapter 9. Optical Techniques
Chapter 10. Electrochemistry and Chemical Sensors
Chapter 11. Electrophoresis
Chapter 12. Chromatography
Chapter 13. Mass Spectrometry
Chapter 14. Enzyme and Rate Analyses
Chapter 15. Immunochemical Techniques
Chapter 16 Automation
Chapter 17. Point-of-Care Instrumentation
III. Analytes
Chapter 18. Amino Acids, Peptides, and Proteins
Chapter 19. Serum Enzymes
Chapter 20. Tumor Markers and Cancer Genes
Chapter 21. Kidney Function Tests — Creatinine, GFR, Urea, and Uric Acid
Chapter 22. Carbohydrates
Chapter 23. Lipids, Lipoproteins, Apolipoproteins, and Other Cardiac Risk Factors
Chapter 24. Electrolytes and Blood Gases
Chapter 25. Hormones
Chapter 26. Catecholamines and Serotonin
Chapter 27. Vitamins, Trace Elements, Nutritional Assessment
Chapter 28. Hemoglobin, Iron, and Bilirubin
Chapter 29. Porphyrins and Porphyrias
Chapter 30. Therapeutic Drugs and Their Management
Chapter 31. Clinical Toxicology
Chapter 32. Toxic Metals
IV. Pathophysiology
Chapter 33. Diabetes

,Chapter 34. Cardiovascular Disease
Chapter 35. Kidney Disease
Chapter 36. Physiology and Disorders of Water, Electrolyte, and Acid-Base Metabolism
Chapter 37. Liver Disease
Chapter 38. Gastrointestinal and Pancreatic Diseases
Chapter 39. Disorders of Bone and Mineral Metabolism
Chapter 40. Disorders of the Pituitary Gland
Chapter 41. Disorders of the Adrenal Cortex
Chapter 42. Thyroid Disorders
Chapter 43. Reproduction-Related Disorders
Chapter 44. Pregnancy and Prenatal Testing
Chapter 45. Newborn Screening and Inborn Errors of Metabolism
Chapter 46. Pharmacogenetics
V. Molecular Diagnostics
Chapter 47. Principles of Molecular Biology
Chapter 48. Nucleic Acid Techniques and Applications
Chapter 49. Genomes and Nucleic Acid Alterations

,Chapter 01: Clinical Chemistry, Molecular Diagnostics, and Laboratory Medicine Test
Bank


MULTIPLE CHOICE

1. An individual working in a clinical chemistry laboratory is married to a sales representative
who works for a company that sells chemistry laboratory supplies. When the laboratory
manager requests a list of needed supplies, cost of supplies, and vendors, this individual
onlyrecommends the spouse’s company as the vendor. This is considered to be a(n):
a. accounting issue.
b. possible conflict of interest.
c. maintenance of confidentiality issue.
d. problem with resource allocation.

ANS: B
Concern has been raised over the interrelationships between practitioners in the medical
fieldand commercial suppliers of drugs, devices, equipment, etc., to the medical profession.
Similarly, relationships have been scrutinized between clinical laboratorians and
manufacturers and providers of diagnostic equipment and supplies. These concerns led the
National Institutes of Health (NIH) in 1995 to require official institutional review of financial
disclosure by researchers and management of situations in which disclosure indicates
potentialconflicts of interest.

DIF: 1 REF: Page 4-5 OBJ: 6 | 7

2. A patient visits her physician stating that her prescribed painkiller is not working to
reduce the pain following her recent surgery. A friend of the patient claims that the same
painkiller“worked wonders” to reduce her pain after the same surgery. The physician
states that the difference in the effect of the drug might be caused by , which is studied
in pharmacogenetics.
a. epidemiology
b. an inherited disease
c. a conflict of interest
d. a genetic variation in drug-metabolizing enzymes

ANS: D
Pharmacogenetics is the study of the genetic variation of drug metabolism
betweenindividuals.

DIF: 1 REF: Page 3 OBJ: 1

3. John works in a molecular diagnostics laboratory and receives a blood sample that has
the name of a close friend printed on the bar-coded label. The genetic test that is ordered
on thefriend’s sample would provide diagnostic information about a disorder that has a
poor prognosis, and the test is usually performed by John. He asks a fellow employee to
analyzethe sample for him and not divulge the results. This ethical issue concerns:
a. confidentiality of patient genetic and medical information.
b. a conflict of interest.
c. resource allocation.
d. diagnostic accuracy.

, ANS: A
Clinical laboratorians have long been responsible for maintaining the confidentiality of
alllaboratory results, a situation made even more critical with the advent of increasingly
powerful genetic testing.

DIF: 1 REF: Page 4 OBJ: 6 | 7

4. Molecular diagnostic testing methods and results can be:
a. qualitative only.
b. quantitative only.
c. either qualitative or quantitative.
ANS: C
Molecular diagnostic methods can be either qualitative or quantitative in nature, depending
onthe clinical need.

DIF: 1 REF: Page 3 OBJ: 5

5. Clinical epidemiology, which is the study of the patterns, causes, and effects of health and
disease in certain populations, has provided the clinical laboratory with methods that
evaluatethe effects and outcomes of laboratory testing. This allows for a more effective:
a. process of determining the cost of the testing methods.
b. selection and interpretation of laboratory tests.
c. determination of the boundaries between the components of the clinical lab.
d. conduct assessment.

ANS: A
Clinical epidemiologists have introduced methods to evaluate the effects and value of
laboratory testing in healthcare. These developments are expected to play an increasing role
inthe selection and interpretation of laboratory tests.

DIF: 1 REF: Page 3 OBJ: 4

6. Analysis of which one of the following by molecular diagnostic methods provides a
measureof processes that are ongoing at the time of blood sampling?
a. Genetic variation in an individual’s response to a drug
b. Circulating plasma nucleic acids
c. Malignant lymphomas
d. Histocompatibility

ANS: B
Molecular diagnostics, given its very high sensitivity, has been applied to the study of plasma
nucleic acids (or circulating nucleic acids). Plasma nucleic acids analysis has been made
possible by the discovery that dying cells in the body release their DNA and RNA into the
extracellular compartment and ultimately into the bloodstream, where they can be
detected and analyzed. Given their short half-life in circulation (less than 24 hours), plasma
nucleic acids provide a measure of processes that are ongoing at the time of blood sampling.

DIF: 1 REF: Page 3 OBJ: 5

, 7. A healthy individual with no clinical signs or symptoms of disease visits his physician for a
routine physical examination. Blood samples are collected and sent to the laboratory. The
testsrequested on the sample are for general laboratory analyses, including a complete
blood count,a panel of general chemistry tests (including glucose, protein, cholesterol, and
others), and an analysis of urine. This type of testing in laboratory medicine is directed at:
a. confirming a clinical suspicion of disease.
b. selecting a treatment for disease.
c. ruling in a diagnosis.
d. screening for disease in the absence of clinical signs or symptoms.

ANS: D
Testing in laboratory medicine may be directed at (1) confirming a clinical suspicion; (2)
making, or ruling in, a diagnosis; (3) excluding, or ruling out, a diagnosis;, (4) assisting in the
selection, optimization, and monitoring of treatment; (5) providing a prognosis; (6)
screeningfor disease in the absence of clinical signs or symptoms; or (7) establishing and
monitoring the severity of a physiologic disturbance. The field of laboratory medicine
includes clinical chemistry and areas such as microbiology and hematology. The general
tests ordered on this healthy individual are done to screen the physiologic systems despite
the absence of any symptoms.

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8. The discipline involved in the selection, provision, and interpretation of diagnostic testing
thatuses primarily samples from patients is:
a. clinical chemistry.
b. hematology.
c. laboratory medicine.
d. molecular diagnostics.

ANS: C
The term “laboratory medicine” refers to the discipline involved in the (1) selection,
(2)provision, and (3) interpretation of diagnostic testing that uses primarily samples
from patients.

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9. A male laboratorian works in the clinical chemistry laboratory of a large hospital. He is
approached by his friend, who is a representative of a drug company, and asked to analyze
some patient samples for drug levels of a specific drug that the representative’s company
sellsand that these patients use. The representative wants to publish a report on the rate of
drug absorption and distribution of this drug and tells his laboratorian friend that he will
personallyreimburse him for his time. What ethical issues come into play here?
a. Resource allocation and conflict of interest
b. Maintenance of confidentiality and publishing issues
c. Maintenance of confidentiality, conflict of interest, and publishing issues.
d. Resource allocation, maintenance of confidentiality, conflict of interest,
andpublishing issues.
ANS: D