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

Test bank for Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics 8th Edition by Nader Rifai, PhD Chapters 1 - 49 DR ERIC DR ERIC DR ERIC 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 DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC 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 DR ERIC V. Molecular Diagnostics Chapter 47. Principles of Molecular Biology Chapter 48. Nucleic Acid Techniques and Applications Chapter 49. Genomes and Nucleic Acid Alterations DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC TO GET ALL CHAPTERS EMAIL ME AT>>>>> TO GET ALL CHAPTERS EMAIL ME AT>>>>> Chapter 01: Clinical Chemistry, Molecular Diagnostics, and Laboratory Medicine TestBank DR ERIC 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 only recommends 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 field and 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 potential conflicts 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 between individuals. 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 the friend’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 analyze the sample for him and not divulge the results. This ethical issue concerns: DR ERIC DR ERIC DR ERIC a. confidentiality of patient genetic and medical information. DR ERIC DR ERIC DR ERIC b. a conflict of interest. c. resource allocation. d. diagnostic accuracy. DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC ANS: A Clinical laboratorians have long been responsible for maintaining the confidentiality of all laboratory 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 on the 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 evaluate the 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 in the 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 measure of 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 DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC 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 tests requested 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) screening for 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. DIF: 2 REF: Page 2 OBJ: 2 8. The discipline involved in the selection, provision, and interpretation of diagnostic testing that uses 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. DIF: 1 REF: Page 1 OBJ: 1 | 3 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 sells and 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 personally reimburse 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, and publishing issues. ANS: D DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC Resource allocation, maintenance of confidentiality, conflict of interest, and publishing issues are being compromised by the representative and the laboratorian if the laboratorian follows through with the request. Using laboratory resources for a study that has not been approved by the institutional review board is a resource allocation issue, revealing results of laboratory tests is a confidentiality issue, receiving money to run laboratory tests from an individual with a direct interest in the laboratory results is a conflict of interest, and publishing the results of the testing would possibly be considered fraudulent and inappropriate. DIF: 2 TRUE/FALSE REF: Page 4-5 OBJ: 3 | 6 | 7 1. Molecular diagnostics testing is only used by the clinical chemistry laboratory. ANS: F The discipline of molecular diagnostics, which entered the realm of laboratory medicine in multiple forms and in multiple fields, includes but is not limited to the study of hematopoietic malignancies, such as malignant lymphomas and leukemias; the existence of nonhost nucleic acids (microorganisms, graft-donor, fetal nucleic acids during pregnancy); and assessment of solid tumors. DIF: 1 DR ERIC REF: Page 3 OBJ: 1 | 5 . . DR ERIC DR ERIC DR ERIC DR ERIC Chapter 02: Selection and Analytical Evaluation of Methods—With Statistical Techniques DR ERIC MULTIPLE CHOICE 1. A statistic is a: a. constant that describes some particular characteristic of a population. b. value calculated from the observations in a sample to describe a particular characteristic of that sample. c. complete set of all observations that might occur as a result of performing a particular procedure according to specified conditions. d. graphic device for displaying a large set of data. ANS: B A statistic is a descriptive measure of a sample; it is a value calculated from the observations in a sample to describe a particular characteristic of that sample. DIF: 1 REF: Page 10 OBJ: 3 2. A population mean (µ) is calculated by which one of the following formulae? a. xi/N b. (b 1)/SE(b) c. (x2i x1i) d. (x1 ANS: A )2/N The parameter most commonly used to describe the central location of a population of N values is the population mean ( ): DIF: 1 REF: Page 10 OBJ: 3 | 11 3. Which one of the following is the correct formula for calculating the percent coefficient of variation of a set of measurements? a. CV = standard deviation 100% b. CV = standard deviation ÷ 100% c. CV = (standard deviation ÷ mean) 100% d. CV = (mean + standard deviation) ÷ 100% ANS: C The coefficient of variation is the measure of relative imprecision. The value of CV% is determined by calculating the ratio of the SD to the mean multiplied by 100%. DIF: 1 REF: Page 10 OBJ: 11 4. The type of method comparison that compares the average results between two analyses with the differences between varying concentration values of the two analyses is referred to as a(n): a. Deming analysis. DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC DR ERIC b. linear regression plot. c. ordinary least-squares plot. d. Bland-Altman difference plot. ANS: D When comparing values obtained with two different methodologies, the average values of the results are plotted against the differences between the values obtained from the two methods. This examines the differences at varying analyte concentrations to determine whether a problem exists at a certain concentration. DIF: 2 REF: Page 19 OBJ: 1 | 6 5. How is the formula for population standard deviation ( ) stated? a. The positive square root of the mean ÷ sum of squared differences between mean and individual values b. Square root of the mean ÷ (N 1) c. The positive square root of the [(sum of squared differences between mean and individual values) ÷ N] d. The sum of squared differences ÷ the positive square root of the mean ANS: C Standard deviation describes the dispersion (or variance) of values around a central point (typically the mean). Variance is calculated by summing the squared differences between the population mean and each individual sample value and dividing this sum by the population size. This results in a large number, thus SD is the positive square root of this variance. DIF: 1 REF: Page 10 OBJ: 1 | 11 6. Two types of error may be encountered during analysis of a substance. The type of error that occurs with a constant or predictable difference or trend, either positive or negative, and thus is related to bias, is a(n) error. a. systematic b. random c. analytical d. All of the above are correct. ANS: A Systematic error is a component of error, which in the course of a number of analyses of the same measure and/or analyte remains constant or varies in a predictable (proportional) way. This type of error will directly influence the mean value and affects bias. DIF: 2 REF: Page 7 OBJ: 1 | 7 7. A research project examining cholesterol values using a new Cholestcheck assay produces the following cholesterol values from a random sample of 14, 25-year-old women: Mean = 137 mg/dL 2 standard deviations = 6 mg/dL N = 14 1.14%. The coefficient of variation percent for this assay is: a. b. 2.19%