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Test Bank for Tietz Fundamentals of Clinical Chemistry and
th
Molecular Diagnostics, 7 Edition by Carl A. Burtis

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
ST
Chapter 9. Optical Techniques
Chapter 10. Electrochemistry and Chemical Sensors
Chapter 11. Electrophoresis
Chapter 12. Chromatography
Chapter 13. Mass Spectrometry
O
Chapter 14. Enzyme and Rate Analyses
Chapter 15. Immunochemical Techniques
IC
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
ST
V. Molecular Diagnostics
Chapter 47. Principles of Molecular Biology
Chapter 48. Nucleic Acid Techniques and Applications
Chapter 49. Genomes and Nucleic Acid Alterations
O
IC

,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 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.
ST
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
O
difference in the effect of the drug might be caused by , which is studied in
pharmacogenetics.
a. epidemiology
IC
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:
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 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.
ST
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
O
laboratory testing in healthcare. These developments are expected to play an increasing role in
the selection and interpretation of laboratory tests.
IC
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

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