Clinical Chemistry II MCQS

Final

Section B

Urinalysis

1. preservatives

boric acid, H2SO4, HCl, Na2CO3, NaOH

2. parameters in physical examination

color, SG, volume, odor, turbidity/clarity/appearance

3. how to prepare urine sediment for microscopic test

10~15 mL well-mixed urine in conical centrifuge tube

centrifuge 1500~3000 rpm for 5 min

decant supernatant leave 1 mL

resuspension of sediment

place 1 drop urine on slide by using pipette

apply coverslip

examine under microscope

4. factor in cast formation

increase in protein and concentration

decrease in urine flow rate and pH

5. changes in unpreserved urine

dark color due to oxidation

decrease clarity due to bacterial growth and precipitation

increase odor due to bacterial multiplication or breakdown of urea to ammonia

increase pH due to breakdown of urea to ammonia

decreased glucose due to glycolysis

decreased ketones due to volatilization

decreased bilirubin due to exposure to light

decreased urobilinogen due to oxidation to urobilin

increased nitrite

decreased RBC WBC cast due to disintegration in dilute alkaline urine

6. compare results of urine transparency

clear--no particulate, transparent

hazy--a few particulate, print can be seen

cloudy--many particulate, print blur

turbid--print cannot be seen through urine

milky--may be precipitated or clotted

7. urine creatinine 120 mg/dL, plasma creatinine 1.0 mg/dL, urine volume 1440 mL, GFR?

UV/P

1440/(24*60)=1

(120*1)/1=120

8. types of urine specimen

random for routine, sometimes dilute-false negative

first morning for pregnancy test

24 h for quantitative chemical test

timed collects at specific time

clean-catch ahs lesser contamination, towelettes are used

midstream collects middle portion (20mL)

2 h postprandial for diabetic monitoring

fasting (second morning) for diabetic screening

9. urine examinations

10. types of crystals

normal acid urine

amorphous urate

yellow-brown/colorless granules

uric acid

yellow/red-brown
irregular
square, diamond, wedge, rosettes
gout

calcium oxalate

octahedral
dumbbell
double refractive index
stone

normal alkaline urine

amorphous phosphate

colorless, small granules

calcium phosphate

colorless prisms, rosettes
chronic UTI, urine stasis

triple phosphate

colorless prims with 3~6 sides
coffin-lids
chronic UTI, urine stasis

calcium carbonate

colorless, amorphous
dumbbell, leaf

ammonium biurate

yellow-brown
thorny apples
spheres

calcium blurate

abnormal urine

tyrosine

thin, dark needles
shaves, clumps
colorless, pale yellow-brown
liver ds

leucocine

yellow-brown
spheres
radial striations
liver ds

cystine

clear
hexagonal
cystinuria

sulfa

yellow-brown
sheave, rosette, hexagonal
sulfonamide drugs

cholesterol

colorless, transparent plates
regular or irregular corner notches
UTI, chyluria, nephritic syndrome

creatine

pseudohexagonal plates
positive birefringence
muscle dystrophy, atrophy, myositis

bilirubin

needles, rhombic
red-brown

hippuric acid

star, needles, elongated prisms
colorless, yellow-brown

ampicillin
X ray media

11. clear, red urine

a. would you expect to see RBC? why?

yes, kidneys or urinary tract allows RBC to leak into urine, urinary bleeding

b. 2 pathologic causes of red urine

UTI, kidney stones

c. clear in morning, cloudy in evening, is it possible? why?

yes, it could be because of dehydration or diet

Cancer-tumor marker

1. define tumor marker

a substance found in blood, urine or body tissues that can be elevated in cancer

2. example of tumor marker

enzyme, hormones, tumor antigens

3. uses of tumor marker

screening of ds in asymptomatic patient
diagnosis of ds in symptomatic patient
aid in clinical staging
therapeutic monitoring and selection
measurement of total burden
detection of recurrence of ds
prognostic cancer

4. define cancer cachexia

multifactorial syndrome characterized by weight loss, anorexia, pyrexia, anemia, lethargy, muscle weakness

5. evidence of ectopic hormone production

condition after surgery
hormone level in arterial supply to tumor<in venous
hormone may be extracted from tumor
histochemical demonstration of hormone in tumor

6. important of tumor marker

=uses of tumor marker

7. cancer development

8. characteristics of ideal tumor marker

specificity of cancer
sensitivity of cancer
amount of produced
consistency with ds
half-life short enough
level (initial and serial)
the assay (accurate, precise, easy, inexpensive, rapid)

Metabolism disorder: lipid

1. types and functions of lipoprotein

chylomicrons--main carrier of dietary TAG

VLDL--main carrier of endogenously produced TAG

LDL--main carrier of cholesterol

HDL--protective function, take cholesterol from extrahepatic tissues to the liver for excretion

Intermediate DL--remove sterol from peripheral tissues to liver

2. common causes of secondary hyperlipidemia

DM, alcohol excess, chronic renal failure, drug (non-selective Beta blockers)--increase TAG

hypothyroidism, nephrotic syndrome--increase cholesterol

3. main lipids

CHOL, TAG, fatty acid, phospholipids, lipoproteins

4. drugs increasing blood lipid

thiazides, B-blockers lacking intrinsic sympathomimetic activity (ISA), corticosteroids, progestogens

Section C

Metabolism disorder: carbohydrate

1. factors that cause metabolic disorder

enzyme deficiency

genetic factor
anemia deficiency G6PD, hyperlipoproteinemia

hormone deficiency

genetic/non genetic factor
insulin deficiency in DM

receptor deficiency

DM type II

protein deficiency

Wilson ds
lack of ceruplasmin carrier

substrate/co-enzyme deficiency

lack of V, ds

inhibition of enzyme by some agent

endo/exogenous agent
cytochrome oxidase inhibition by CO and Pb

changes in protein primer structure

sickle cell anemia
changes in 1 amino acid at beta-globin chain in RBC-hemolysis

metabolism disturbance

protein & enzyme synthesis ds

increase of hormone concentration

increase metabolism rate & thyroid hormone concentration (Grave ds)

2. types of DM

Insulin Dependent DM

15% of all diabetics

absolute lack of insulin: autoimmune destruction of insulin-producing beta cells/other factor like viral infection

peak of incidence: 9~14 y

NIDDM

85% of all diabetics

any age

cause: resistance of peripheral tissue to the action of insulin

Gestational diabetes

pregnant women who have never had diabetes before, have a high blood glucose during pregnancy, may precede development of DM type II

3. compare and contrast DM type I and II

DM type I--insulin-dependent, pancreas unable to produce enough insulin, young/any age, cannot be prevented, require insulin therapy, rapid onset, 50% concordance in identical twins, less prevalent, DKA, IDDM

DM type II--insulin resistance, body does not respond to insulin, older age, prevent with lifestyle changes, insidious onset, 90% concordance in identical twins, more prevalent, NIDDM

symptoms: frequent urination, increased thirst and appetite, fatigue, blurry vision, numbness, unexplained weight loss

4. diagnosis and monitoring of DM

Urine testing

Glucose >10 mmol/L
Ketones in urine or plasma

acetone, acetoacetate, and beta-hydroxybutyrate

Blood glucose

Random RBG

should be <8 mmol/L
>11 mmol/L indicates DM

at least 10 h
better than RBG
non DM: <6 mmol/L
borderline: 6~8 mmol/L
DM: >8 mmol/L

OGTT

principle: patient's response to an oral glucose load
methodology

baseline blood sample is taken after an overnight fast
patient is given 75g of glucose orally, and 300mL water to be drunk within 5 min
plasma glucose levels are measured every 30 min for 2 h
patient should be sitting comfortably and has normal diet, not smoking, exercise for at least 3 days

interpretation

DM: increase of 2h glucose level
BG>11 mmol/L

Hb A1c

reflect to the mean of glycemia over 2 months prior to the half life of Hb

Fructosamine

the ketonuria product of non-enzymatic glycation
indication of an extend of Hb glycation can be obtained by measuring fructosamine
complementary to HbA1c

Microalbuminuria

albumin excretion rate intermediate between normality (2.5~25 mg/day) and macroalbuminuria (>250mg/day)
the small increase in urinary albumin stick test needs confirmation by quantitation of 24 h urine
a measure of early, reversible renal damage and nephropathy

5. microvascular and macrovascular complications of DM

microvascular

microangiopathy

abnormalities in the walls of blood vessels
thickening of basement membrane

retinopathy

viterous hemorrhage from proliferating retinal vessels, and maculopathy as a result of exudate from vessel or edema affecting the macula

nephropathy

early stage: kidney hyperfunction, increase GFR and size, microalbuminuria
late stage: increase proteinuria, uremia

neuropathy

diarrhea, postural hypotension, impotence, neurogenic bladder, neuropathic foot ulcer, abnormal glucose metabolism in nerve cells

macrovascular

atherosclerosis
macroangiopathy

multifactorial and still unknown
hyperlipidemia and increase in protein glycation
lead to pre-mature coronary heart disease

6. clinical assessment of DM

7. hormone regulating blood glucose

Decrease the concentration of blood glucose

insulin

Increase the concentration of blood glucose

glucagon, cortisol, GH, epinephrine

Geriatric

1. biochemical changes

Increases

BUN
uric acid
lactate dehydrogenase
FBG
postprandial glucose
glycated Hb
fructosamine
total CHOL and TAG

Decreases

GH
triiodothyronine T3
albumin
total protein
creatinine clearance
Hb
Fe
folate and VB 12

2. kidney function (renal)

major renal function: glomerular filtration, fluid and electrolyte homeostasis, acid-base homeostasis, BP regulation, Ca and P metabolism, erythropoiesis

organ size decrease, glomerular sclerosis increases, renal tubular changes occur and renal blood flow is altered

between age 30 and 80, renal mass declines by 20~25%

reduction in GFR

number of functioning glomeruli is reduced and renal blood is diminished

after age 40, GFR rate declines by 1% per year

serum creatinine remain between 0.8 to 1 mg/dL

BUN increase

reduction in protein intake may offset any increase due to diminished glomerular filtration

reduction in renal responsiveness to ADH

less able to cope with dehydration or water load

high BP may occur due to atherosclerotic changes, decreased vascular elasticity, inappropriate sodium intake and/or retention and progressive loss of nephrons

total K declines due to loss of muscle mass, excessive renal loss of K

K is a major IC cation, involved in energy metabolism, membrane transport

increased risk of drug toxicity

drugs accumulate in tissue at levels excess of therapeutic dose

therapeutic monitoring is essential to guide dose adjustment

3. glucose homeostasis

glucose tolerance declines

FBG increase from 1 to 2 mg/dL per decade over the age 30

in 1 or 2 h postprandial specimens, average glucose increases of 4 mg/dL per decade after age 40

oral glucose tolerance test OGTT

phase 1 (after 1 h): similar

phase 2 (after 2.5 h): peak values are not reached in elderly

rising glucose and insulin levels do not trigger peripheral uptake due to tissue insensitivity to the hormone

postprandial serum insulin levels increase

hyperinsulinemia may contribute to atherosclerosis, hypertension, increased risk for coronary heart disease

reduced number of peripheral cell receptors for insulin as adipose tissue replace muscle, impaired binding of hormone by cell membrane receptors and increasing occurrence of IC defects increase tissue resistance to insulin

4. list the tests which show decreased values when tested to normal elderly

Decreases

GH
triiodothyronine T3
albumin
total protein
creatinine clearance
Hb
Fe
folate and VB 12

Metabolism disorder: amino acid

1. phenylketonuria and screening test in newborn

absence of phenylalanine hydroxylase which prevents conversion of phenylalanine to tyrosine

tyrosine is required for production of thyroxine and adrenaline, and synthesis of melanin

phenylalanine accumulate in blood and excreted in urine

mousy or musty odor in urine

causes significant brain damage

symptoms: child have smaller than normal head, epilepsy, mental retardation, seizures, eczema, behavioral problems

decreased production of serotonin, epinephrine, norepinephrine, dopamine and GABA

treatment: control low protein diet

2, Guthrie's test procedure

bacterial inhibition assay (Bacillus subtilis)

capillary blood (ideally 48~72 h after protein feeds) from heel stick is absorbed into filter paper circles

circles completely saturated with a single layer of blood

blood impregnated discs place on culture media streaked with B. subtilis

if increased phenylalanine level, it will counteract action of beta-2-phenylalanine (inhibitor of B. subtilis)

observe growth

April 2019

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)0

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. Which of the following can estimate the concentration of normal urine specimen?

(A) odor

(B) foam

(D) clarity

2. A person exhibiting oliguria would have a daily urine volume of

(A) 200-400 ml*

(B) 600-1000 ml

(D) over 1500 ml--polyuria >2L

anuria--less than 100 ml

normal--1000~2000 ml

3. The formation of casts in the urine is an implication of

(A) blood

(B) nitrite

(D) bilirubin

4. Failure to mix a specimen prior to inserting the reagent strip will primarily affect the

(A) pH reading

(B) blood reading*--leukocytes reading

(D) glucose reading

5. Rickets is a disease caused by the deficiency of

(A) vitamin A

(B) vitamin B

(D) vitamin D*

6. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) diabetes insipidus

7. Which of the following is a trace element?

(A) cobalt--ultra trace

(B) silicon--ultra trace

(D) chromium--ultra trace--molybdenum, Ni, Tin, Vanadium

8. Which of the following statement is associated with Human Chorionic Gonadotrophin hormone?

(A) It is synthesized by ovary.--placenta

(B) It is decreased in ectopic pregnancies.*--and spontaneous abortions (miscarriage)

(D) Its concentration is highest in the 2nd trimester of pregnancy.--first

9. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria--proteinuria

10. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*--maternal serum screening, alpha fetoprotein

(D) fetal skin biopsy

chronic vilus sampling

11. Which of the following statements is TRUE for aging process?

(A) Hypertrophy of tissues and organs--atrophy

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.--decreased

progressive decline in physiologic responsiveness

12. Identify the CORRECT biochemical change in geriatric.

(A) uric acid - decrease--increase

(B) albumin - decrease*

(D) lactate dehydrogenase - decrease--increase

Increase--BUN, FBG, postprandial glucose, fructosamine, total CHOL and TAG, glycated hemoglobin

Decrease--GH, triiodothyronine T3, total protein, creatinine clearance, Fe, folate and V B12

13. Which of the following statements is TRUE regarding glucose homeostasis in elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.*

(D) Glucose levels in postprandial specimen will increase.--1~2h

14. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

15. Mutated gene that cause cancer is called a/an

(A) mutagen--factor brings mutation

(B) oncogene*

(D) carcinogen--agent cause cancer

16. “It interferes with neighbouring cells and block blood vessels, the gut, glands, and lungs”. This statement BEST describes

(A) benign tumors--do not spread but crowd out (squash) surrounding cells

(B) carcinogenesis

(C) tumor markers--substance in blood, urine or body tissues that can be elevated in cancer (hormones, enzyme, tumor antigens)

(D) malignant tumor*

17. Which of the following organs secrete hormones?

(A) lung

(B) brain

(D) kidneys*

18. The condition most likely to be associated with low levels of thyroid in the blood is

(A) hypothyroidism*

(B) Cushing’s disease--excess ACTH

(D) Hashimoto's thyroiditis

19. Which of the following is a steroid hormone?

(A) insulin--protein

(B) gastrin

(D) glucagon--protein

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin--inadequate

(B) low level of blood glucose--high

(D) normally occur in diabetes mellitus Type 2--Type 1

21. Which of the following terminology is associated with microvascular complication in diabetes mellitus?

(A) alkalosis

(B) retinopathy*--microangiopathy, nephropathy, neuropathy

(D) macroangiopathy--macrovascular, atherosclerosis

22. Which of the following statements is CORRECT for lipid?

(A) It is soluble in water--insoluble

(B) An example of lipids is amino acid

(D) It is high density lipoprotein is often called good cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*--acute pancreatitis, failure to thrive and weakness, cataracts

25. Which of the following specimens are NOT accepted in drug analysis?

(A) skin*

(B) sweat

26. Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) electrophoresis

(B) atomic absorption

(D) enzyme-linked immunosorbent assay (ELISA)

27. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

28. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

29. What is the disease that causes a musty odour in baby’s urine?

(A) Phenylketonuria*

(B) Isoveleric acidemia

(D) Hypermethioninemia

30. Which of the following statement is NOT the cause of dehydration in a newborn?

(A) increased reabsorption of glucose*

(B) reduced reabsorption of bicarbonate.

(D) the ability of kidneys to concentrate urine is poor

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. List FOUR (4) types of preservative that are used in urine sampling. (4 Marks)

b. Briefly explain THREE (3) parameters that are measured in the physical examination of urine. (6 Marks)

2. a. Define tumor marker and give TWO (2) examples of tumor markers. (3 Marks)

b. Briefly explain the uses of tumor markers. (7 Marks)

3. a. State the classification of hormones with examples. (2 Marks)

b. Briefly explain the pituitary disorders. (8 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Elaborate phenylketonuria and its screening test in newborn. (20 Marks)

Question 2

Discuss factors that cause metabolic disorder. (20 Marks)

Question 3

Explain the geriatric biochemical changes in clinical chemistry laboratory test. (20 Marks)

September 2018

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. A person exhibiting anuria would have a daily urine volume of

(A) 0 - 200 ml*

(B) 200 - 400 ml

(D) over 1500 ml

2. Which of the following can estimate the concentration of normal urine specimen?

(A) odor

(B) foam

(D) clarity

3. Failure to mix a specimen prior to inserting the reagent strip will primarily affect the

(A) pH reading

(B) blood reading*

(D) glucose reading

4. The formation of casts in the urine is an implication of

(A) blood

(B) nitrite

(D) bilirubin

5. Rickets is a disease caused by the deficiency of

(A) vitamin A

(B) vitamin B

(D) vitamin D*

6. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) diabetes insipidus

7. Which of the following is a trace element?

(A) cobalt

(B) silicon

(D) chromium

8. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

9. Which of the following statement is associated with Human Chorionic Gonadotrophin hormone?

(A) It is synthesized by ovary.

(B) It is decreased in ectopic pregnancies.*

(D) Its concentration is highest in the 2nd trimester of pregnancy.

10. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*

(D) fetal skin biopsy

11. Which of the following statements is TRUE for aging process?

(A) Hypertrophy of tissues and organs.

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

12. Identify the CORRECT biochemical change in geriatric.

(A) albumin - decrease*

(B) uric acid - decrease

(D) lactate dehydrogenase - decrease

13. Which of the following statements is TRUE regarding biochemistry elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.

(D) Glucose levels in postprandial specimen will increase.

14. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It may cause metastasis

(D) Endometrial polyps is an example

15. Mutated gene that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

16. “It interferes with neighbouring cells and block blood vessels, the gut, glands, and lungs”. This statement BEST describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

17. Which of the following organ secretes hormones?

(A) lung

(B) brain

(D) kidneys*

18. The condition most likely to be associated with low levels of thyroid in the blood is

(A) Hypothyroidism*

(B) Cushing’s disease

(D) Hashimoto's thyroiditis

19. Which of the following is a steroid hormone?

(A) insulin

(B) gastrin

(D) glucagon

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in diabetes mellitus Type 2

21. Which of the following terminology is associated with microvascular complication in diabetes mellitus?

(A) alkalosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statement is CORRECT for lipid?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is high density lipoprotein is often called good cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following specimen is NOT accepted in drug analysis?

(A) skin*

(B) sweat

26. Which of the following technique is used in qualitative and quantitative assessment of drugs?

(A) electrophoresis

(B) atomic absorption

(D) enzyme-linked immunosorbent assay (ELISA)

27. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

28. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

29. Which of the following statement is NOT the cause of dehydration in a newborn?

(A) increased reabsorption of glucose*

(B) reduced reabsorption of bicarbonate.

(D) the ability of kidneys to concentrate urine is poor

30. What is the disease that causes a musty odour in baby’s urine?

(A) Phenylketonuria*

(B) Isoveleric acidemia

(D) Hypermethioninemia

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. How to prepare urine sediment for microscopic test? (6 Marks)

b. Briefly explain the factor that involved in cast formation. (4 Marks)

2. a. Define cancer cachexia. (2 Marks)

b. Briefly explain the evidence of ectopic hormone production in a cancer patient. (8 Marks)

3. a. State FOUR (4) hormones involved in regulating blood glucose level. (2 Marks)

b. Briefly discuss the types of diabetes mellitus. (8 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss the changes seen in unpreserved urine. (20 Marks)

Question 2

Elaborate the kidney functions in geriatric. (20 Marks)

Question 3

Describe the pituitary function test. (20 Marks)

February 2018

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. Which of the following can estimate the concentration of normal urine specimen?

(A) odor

(B) foam

(D) clarity

2. A person exhibiting oliguria would have a daily urine volume of

(A) 200-400 ml*

(B) 600-1000 ml

(D) over 1500 ml

3. The formation of casts in the urine is an implication of

(A) blood

(B) nitrite

(D) bilirubin

4. Failure to mix a specimen prior to inserting the reagent strip will primarily affect the

(A) pH reading

(B) blood reading*

(D) glucose reading

5. Rickets is a disease caused by the deficiency of

(A) vitamin A

(B) vitamin B

(D) vitamin D*

6. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) diabetes insipidus

7. Which of the following is a trace element?

(A) cobalt

(B) silicon

(D) chromium

8. Which of the following statement is associated with Human Chorionic Gonadotrophin hormone?

(A) It is synthesized by ovary.

(B) It is decreased in ectopic pregnancies.*

(D) Its concentration is highest in the 2nd trimester of pregnancy.

9. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

10. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*

(D) fetal skin biopsy

11. Which of the following statements is TRUE for aging process?

(A) Hypertrophy of tissues and organs

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

12. Identify the CORRECT biochemical change in geriatric.

(A) uric acid - decrease

(B) albumin - decrease*

(D) lactate dehydrogenase - decrease

13. Which of the following statements is TRUE regarding glucose homeostasis in elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.

(D) Glucose levels in postprandial specimen will increase.

14. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

15. Mutated gene that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

16. “It interferes with neighbouring cells and block blood vessels, the gut, glands, and lungs”. This statement BEST describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

17. Which of the following organs secrete hormones?

(A) lung

(B) brain

(D) kidneys*

18. The condition most likely to be associated with low levels of thyroid in the blood is

(A) hypothyroidism*

(B) Cushing’s disease

(D) Hashimoto's thyroiditis

19. Which of the following is a steroid hormone?

(A) insulin

(B) gastrin

(D) glucagon

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in diabetes mellitus Type 2

21. Which of the following terminology is associated with microvascular complication in diabetes mellitus?

(A) alkalosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statements is CORRECT for lipid?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is high density lipoprotein is often called good cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following specimens are NOT accepted in drug analysis?

(A) skin*

(B) sweat

26. Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) electrophoresis

(B) atomic absorption

(D) enzyme-linked immunosorbent assay (ELISA)

27. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

28. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

29. What is the disease that causes a musty odour in baby’s urine?

(A) Phenylketonuria*

(B) Isoveleric acidemia

(D) Hypermethioninemia

30. Which of the following statement is NOT the cause of dehydration in a newborn?

(A) increased reabsorption of glucose*

(B) reduced reabsorption of bicarbonate.

(D) the ability of kidneys to concentrate urine is poor

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Briefly compare the result of urine transparency test. (6 Marks)

b. Using urine creatinine of 120mg/dl, plasma creatinine of 1.0 mg/dl and urine volume of 1440 ml obtained from 24 –hour specimen. Calculate the GFR. (4 Marks)

1440/(24*60)=1

(120*1)/1=120

2. a. Define tumor marker and give TWO (2) examples of tumor markers. (3 Marks)

b. Briefly explain the important of tumor markers. (7 Marks)

3. Briefly discuss the types and functions of lipoprotein. (10 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss the diagnosis and monitoring of diabetes mellitus. (20 Marks)

Question 2

Explain the geriatric biochemical changes in clinical chemistry laboratory test. (20 Marks)

Question 3

Elaborate phenylketonuria and its screening test in a newborn. (20 Marks)

September 2017

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. The primary chemical constituents of normal urine are

(A) urea, water, and protein

(B) urea, chloride, and water*

(D) urea, bilirubin, and glucose

2. A person exhibiting oliguria would have a daily urine volume of

(A) 0-200 mL

(B) 200-400 mL*

(D) over 1500 mL

3. What is the specimen of choice for routine urinalysis?

(A) fasting specimen

(B) random specimen*

(D) first morning specimen

4. The CORRECT method for labeling a urine specimen container is to

(A) attach the label to the lid

(B) use a wax pencil for labeling

(D) use a permanent pen for labeling

5. Beri-beri is a disease caused by the deficiency of

(A) vitamin A

(B) vitamin B*--B1

(D) vitamin D

6. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) diabetes insipidus

7. Which of the following is an ultra trace element?

(A) iron

(B) cobalt*--molybdenum, chromium, nikel, sillicon, tin, vanadium

(D) selenium

8. Human chorionic gonadotrophin hormone

(A) is synthesized by ovary

(B) is decreased in ectopic pregnancies*

(D) concentration is highest in the 2nd trimester of pregnancy

9. Which of the following is a maternal physiological change?

(A) decreased prolactin

(B) decreased fibrinolysis*

(D) increased osmotic threshold--decreased

10. An invasive technique for prenatal diagnosis is

(A) urine test

(B) ultrasound

(D) abdominal palpation

11. Which of the following statement is associated with renal function in geriatric?

(A) renal mass will increase--decline

(B) renal blood flow is diminished*

(D) renal responsiveness to anti diuretic hormone will increase--reduce

12. Common cause of acid base disturbance in elderly is

(A) hepatitis

(B) pneumonia*--TB, pulmonary emboli, congestive heart failure

(D) pituitary hypofunction

13. Identify the CORRECT biochemical change in geriatric.

(A) hemoglobin - decrease*

(B) total protein - increase*

(D) creatinine clearance - increase--decrease

14. Tumours are classified by

(A) their weight

(B) their ability to spread*

(D) the abnormal function of organ

15. Which of the following statement is a characteristic of cancer cell?

(A) may metastasize

(B) slow growth rate--rapid

(D) decrease blood supply

16. The systemic effects of tumour growth is

(A) obstruction

(B) tissue destruction

(D) ectopic hormones*

17. Which of the following is seen in Cushing’s Syndrome?

(A) excessive production of cortisol*--ACTH

(B) decreased production of thyroxine

(D) excessive production of vasopressin

18. Too much growth hormone in an adult results in

(A) gigantism--childhood

(B) acromegaly*

(D) Hashimoto's thyroiditis

19. Which of the following is a protein hormone?

(A) cortisol

(B) estrogen

(D) aldosterone

20. The cause of diabetes insipidus is

(A) hyposecretion of insulin

(B) hypersecretion of insulin

(D) hypersecretion of anti diuretic hormone

21. Diabetes ketoacidosis is associated with

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in diabetes mellitus Type 2

22. The function of a low density lipoprotein is

(A) as the main carrier of cholesterol*

(B) as the main carrier of dietary triglyceride--chylomicrons

(D) to take cholesterol from extra hepatic tissue to the liver for excretion--HDL, protective function

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following specimen is NOT accepted in drug analysis?

(A) skin*

(B) sweat

26. In drug disposition, biotransformation is

(A) the pharmacokinetic process or metabolism of drugs*

(B) the process whereby a drug is eliminated from the body--excretion

(D) the pharmacokinetic process whereby a drug is translocated to its site of action--distribution

27. Which of the following is a parenteral drug administration technique?

(A) oral

(B) sublingual

(D) intramuscular*--intravenous, intradermal, intrathecal, subcutaneous

28. What is the disease that causes a cabbage odour in baby’s urine?

(A) phenylketonuria

(B) isoveleric acidemia--sweety feet or cheese

(D) hypermethioninemia*

trimethylaminuria--fish

29. Which of the following statement is associated with phenylketonuria?

(A) decrease phenylalanine in blood

(B) due to the deficiency of phenylalanine hydroxylase*

(D) glucose test is use for phenylketonuria screening test

30. Alkaptonuria is a disorder of

(A) fatty acid metabolism

(B) amino acid metabolism*

(D) carbohydrate metabolism

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. List FOUR (4) types of preservative that are used in urine sampling. (4 Marks)

b. Briefly explain THREE (3) parameters that are measured in the physical examination of urine. (6 Marks)

2. a. Define tumor marker and give TWO (2) examples of tumor markers. (3 Marks)

b. Briefly explain the important of tumor markers. (7 Marks)

3. a. State FOUR (4) hormones involved in regulating blood glucose level. (2 Marks)

b. Briefly discuss the types of diabetes mellitus. (8 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Explain the types of urine specimen. (20 Marks)

Question 2

Discuss the pituitary function test. (20 Marks)

Question 3

Elaborate on the nutritional assessment. (20 Marks)

January 2017

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1 Analysis of hair sample is carried out to detect

(A) the presence of opiods in the bloodstream.

(B) the presence of alcohol in the bloodstream.*

(D) the presence of acetaminophen in the bloodstream.

2. A person exhibiting oliguria would have a daily urine volume of

(A) 200-400 ml*

(B) 600-1000 ml

(D) Over 1500 ml

3. The formation of casts in urine is an implication of

(A) nitrite

(B) blood

(D) bilirubin

4. Failure to mix a specimen prior to inserting the reagent strip will primarily affect the

(A) pH reading

(B) blood reading*

(D) glucose reading

5. Rickets is a disease caused by the deficiency of

(A) vitamin A

(B) vitamin B

(D) vitamin D*

6. Which of the following is a disease associated with malnutrition?

(A) hepatitis

(B) marasmus*

(D) diabetes insipidus

7. Which of the following is a trace element?

(A) cobalt

(B) silicon

(D) chromium

8. Which of the following statement is associated with Human Chronic Gonadothropin hormone?

(A) it is synthesized by ovary.

(B) it is decreased in ectopic pregnancy.*

(D) the highest concentration is the 2nd trimester of pregnancy.

9. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

10. What is the first step for urine drug screening?

(A) immunoassay--initial screen

(B) thin layer chromatography--mass screening

(D) gas chromatography-mass spectrometry--confirm

11. Which of the following statement is related to aging process?

(A) hypertrophy of tissues and organs

(B) susceptibility to most malignancies is increased*

(D) the capacity to adequately oxygenate tissues is increased

12. Too much growth hormone in an adult results in

(A) gigantism

(B) acromegaly*

(D) Hashimoto's thyroiditis

13. Which of the following statement is TRUE for glucose homeostasis in elderly?

(A) serum insulin will increase

(B) glucose tolerance will decrease

(D) glucose levels in postprandial specimen will increase

14. Which of the following statement is TRUE for malignancy?

(A) it rarely causes death

(B) it may cause metastasis

(D) endometrial polyps is an example

15. Which of the following statement refers to maternal physiological change?

(A) decreased prolactin

(B) decreased fibrinolysis*

(D) increased osmotic threshold

16. Which of the following tumor marker increases in ovarian cancer of epithelial origin?

(A) CA-125*

(B) placenta ALP--lung, seminoma

(D) Bence Jones protein--multiple myeloma, macroglobuli

17. Which of the following organ secretes hormones?

(A) lung

(B) bone

(D) kidneys*

18. Which of the following is TRUE for malnutrition?

(A) osteoporosis is more common in men--women after menopause

(B) osteoporosis occurs due to lack of vitamin D--ricket

(D) ricket is a disease of bone that leads to an increased risk of fracture--osteoporosis

19. Which of the following is a steroid hormone?

(A) insulin

(B) cortisol*

(D) glucagon

20. Which of the following statement is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in Diabetes Mellitus Type 2

21. Which of the following condition is associated with microvascular complication of Diabetes mellitus?

(A) alkalosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statement is associated with lipids?

(A) it is soluble in water

(B) amino acid is the basic unit of lipid

(D) high density lipoprotein (HDL) is often called as good cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following specimen is NOT for drug analysis?

(A) skin*

(B) sweat

26. Which of the following technique is used in both qualitative and quantitative assessments of drugs?

(A) ELISA

(B) Electrophoresis

(D) thin layer chromatography*

27. Which of the following is a parenteral drug administration route?

(A) inhalation

(B) sublingual

(D) percutaneous

28. Which of the following is FALSE for respiratory distress syndrome?

(A) it is due to increase plasma glucose in diabetic mother*

(B) it may be treated with surfactant administered exogenously

(D) it is caused by the absence of surfactant, hence the alveoli fail to expand

29. What is the disease that causes a musty odour in baby’s urine?

(A) phenylketonuria*

(B) isoveleric acidemia

(D) hypermethioninamea

30. Which of the following statement is NOT the cause of dehydration in a newborn?

(A) increased reabsorption of glucose*

(B) reduced reabsorption of bicarbonate.

(D) the ability of kidneys to concentrate urine is poor

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Differentiate THREE (3) types of Diabetes mellitus . (3 Marks)

b. Briefly discuss the diagnosis and monitoring of diabetes mellitus. (7 Marks)

2. a. Define inborn error metabolism. (2 Marks)

b. State FIVE (5) inherited metabolic diseases. (5 Marks)

c. Recall THREE (3) diagnostic techniques in inherited metabolic diseases detection. (3 Marks)

3. a. State THREE (3) tests to detect pregnancy. (3 Marks)

b. Discuss the importance of prenatal diagnosis . (4 Marks)

c. Name THREE (3) prenatal diagnosis. (3 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss thoroughly on urine examinations. (20 Marks)

Question 2

Explain the analysis of geriatric biochemical changes in clinical chemistry laboratory. (20 Marks)

Question 3

Evaluate the nutritional assessment. (20 Marks)

August 2016

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. Hormone that may affect the kidney function is

(A) calcitonin*--aldosterone, parathyroid hormone, ADH, atrial natriuretic peptide

(B) magnesonin

(D) leukopoietin

2. A reduced volume in urea can be called as

(A) anuria--absence

(B) oliguria*

(D) glycosuria

3. A cloudy urine indicates

(A) a clean normal urine--clear

(B) a few particulates in the urine--hazy

(D) many precipitation or to be clotted--milky

4. Which of the following procoagulant factors increased during pregnancy?

(A) I*--VII, VIII, IX, X

(B) II

(D) IV

5. Which of the following samples can be used with the pregnancy kit?

(A) urine*--blood

(B) saliva

(D) cerebrospinal fluid

6. Which of the following hormone can be measured to monitor the fetus?

(A) estriol*--low unconjugated estriol=Down syndrome, Edward's syndrome; +HCG, human chorionic somatomammotropin/placenta lactogen

(B) oxytocin

(D) erythropoietin

7. Which of the following increased in obstetric cholestatis (maternal itch, absence of rash)?

(A) protein

(B) glucose

(D) uric acid

places baby at risk of intrauterine death which occurs after 36 w

8. Which of the following is FALSE regarding alpha fetoprotein?

(A) detection through amniotic fluid

(B) used to assess the chromosomal disorders

(D) increased value suggested anecephaly or spina bifida

9. Which of the following is the physical nutritional assessment?

(A) fecal test

(B) blood test

(D) skin fold thickness*--BMI, arm circumference

10. Which of the following is an ultratrace elements?

(A) iron

(B) nickel*

(D) manganese

11. Which of the following is a disease caused by the lack of vitamin B1 (thiamin)?

(A) rickets

(B) beri-beri*

(D) osteoporosis

12. Tumor marker for ovarian cancer is

(A) CA-12

(B) CA-19

(D) CA-195

13. Which of the following is FALSE about ideal tumor markers?

(A) specific

(B) sensitive

(D) consistent with diseases

level, assay, amount of produced

14. Which of the following is healthily increased when people get older?

(A) iron

(B) uric acids*--BUN, lactate dehydrogenase, FBG, postprandial glucose, glycated Hb, fructosamine, total CHOL & TAG

(D) hemoglobin

15. Which of the following is healthily decreased when people get older?

(A) protein*--GH, T3, albumin, creatinine, Hb, Fe, folate and V B12

(B) glucose

(D) triglycerides

16. Which of the following analytes is critically increased in geriatric chemistry?

(A) albumin

(B) creatine kinase

(D) alkaline phosphatase*--AST

17. Which of the following describes hypothyroidism in elderly?

(A) Common in women

(B) Experience weight gain*

(D) Decrease serum thyroid stimulating hormone (TSH)--increase

18. Cushing’s disease is caused by a pituitary tumor that produces excess

(A) antidiuretic hormone

(B) adrenocorticotropic hormone*

(D) corticotropin releasing hormone

19. Kallman’s syndrome is presented by a/an

(A) early puberty--delay or absent

(B) occurrence among men*

(D) increase luteinizing hormone (LH) level--lack of LH, FSH

20. What is the effect of thyroxine?

(A) increase heart rate*--basal, metabolic rate, sympathetic activity (catecholamines), potentiates brain development, thickens endometrium

(B) increased cardiac rest

(D) decrease ventilation rate--increase

21. Which of the following is involves in anabolism?

(A) glycolysis

(B) proteolysis

(D) ketogenesis

22. Which of the following is NOT a reactive hypoglycemia?

(A) fasting*

(B) alcoholic

(D) drug induced

23. An elevated CKBB *(brain) is associated with which of the following organ system?

(A) liver

(B) heart

24. Which of the following is the enzyme involves in lipid metabolism?

(A) lipase*

(B) protease

(D) Phosphatase

25. Which of the following is the smell of urine for phenylketonuric patients?

(A) fishy

(B) musty*

(D) cheesy

26. Which of the following are the routes of administration for drugs?

I. oral

II. vein

III. skin

IV. muscles

(A) I, II and III

(B) I, II and IV

(D) I, II, III and IV*

27. Which of the following are samples used for drug abuse analysis?

I. hair

II. sweat

III. blood

IV. saliva

(A) I, II and III

(B) I, II and IV*

(D) I, II, III and IV

28. Which of the following are drugs that can increase blood lipid?

I. thiazides

II. B-blockers

III. progestogens

IV. corticosteroids

(A) I, II and III

(B) I , II and IV

(D) I, II, III and IV*

29. Which of the following are the microvascular complications of diabetes mellitus?

I. neuropathy

II. retinopathy

III. nephropathy

IV. microangiopathy

(A) I, II and III

(B) I, II and IV

(D) I, II, III and IV*

30. Which of the following describes Type 1 lactic acidosis?

I. hypoxic

II. excess lactate

III. extreme acidosis--Type II

IV. high level of ketones--low or absent

(A) I, II and III*

(B) I, II and IV

(D) I, II, III and IV

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. Explain the drugs disposition in the body. (10 Marks)

2. Describe the diagnostic techniques to screen the inherited metabolic diseases in inborn. (10 Marks)

3. Describe types and functions of lipoproteins. (10 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question1

Summarize diabetes mellitus. (20 Marks)

Question2

Explain the development of cancer. (20 Marks)

Question 3

Describe types of crystals found in urine. (20 Marks)

January 2016

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. The primary chemical constituents of normal urine are

(A) urea, water, and protein

(B) urea, chloride, and water*

(D) urea, bilirubin, and glucose

2. A person exhibiting anuria would have a daily urine volume of

(A) 0-200 mL*

(B) 200-400 mL

(D) over 1500 mL

3. What is the specimen choice for routine urinalysis?

(A) fasting specimen

(B) random specimen*

(D) first morning specimen

4. The CORRECT method for labeling a urine specimen container is to

(A) attach the label to the lid

(B) use a wax pencil for labeling

(D) use a permanent pen for labeling

5. Beri-beri is a disease caused by the deficiency of

(A) vitamin A

(B) vitamin B*

(D) vitamin D

6. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) diabetes insipidus

7. Which of the following is an ultra trace element?

(A) iron

(B) cobalt*

(D) selenium

8. Human chorionic gonadotrophin hormone

(A) synthesized by ovary

(B) decrease in ectopic pregnancies*

(D) concentration is highest in the 2nd trimester of pregnancy

9. Which of the following is a maternal physiological change?

(A) decreased prolactin

(B) decreased fibrinolysis*

(D) increased osmotic threshold

10. An invasive technique for prenatal diagnosis is

(A) urine test

(B) ultrasound

(D) abdominal palpation

11. Which of the following statement is associated with renal function in geriatric?

(A) renal mass will increase

(B) renal blood flow is diminished*

(D) number of functioning glomerulus will increase

12. Common cause of acid base disturbance in elderly is

(A) hepatitis

(B) pneumonia*

(D) pituitary hypofunction

13. Identify the CORRECT biochemical change in geriatric.

(A) hemoglobin - decrease*

(B) total protein - increase

(D) creatinine clearance - increase

14. Tumours are classified by

(A) their weight

(B) their ability to spread*

(D) the abnormal function of organ

15. Which of the following statements is characteristic of cancer cell?

(A) may metastasize*

(B) slow growth rate

(D) decrease blood supply

16. The systemic effects of tumour growth is

(A) obstruction

(B) tissue destruction

(D) ectopic hormones*

17. Which of the following is seen in Cushing’s Syndrome?

(A) excessive production of cortisol*

(B) decreased production of thyroxine

(D) excessive production of vasopressin

18. Too much growth hormone in an adult results in

(A) gigantism

(B) acromegaly*

(D) Hashimoto's thyroiditis

19. Which of the following is a protein hormone?

(A) cortisol

(B) estrogen

(D) aldosterone

20. The cause of diabetes insipidus is

(A) hyposecretion of insulin

(B) hypersecretion of insulin

(D) hypersecretion of anti diuretic hormone

21. Diabetes ketoacidosis is associated with

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in diabetes mellitus Type 2

22. The function of a low density lipoprotein is

(A) as the main carrier of cholesterol*

(B) as the main carrier of dietary triglyceride

(D) to take cholesterol from extra hepatic tissue to the liver for excretion

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following specimens are NOT accepted in drug analysis?

(A) skin*

(B) sweat

26. In drug disposition, biotransformation is

(A) the pharmacokinetic process or metabolism of drugs*

(B) the process whereby a drug is eliminated from the body

(D) the pharmacokinetic process whereby a drug is translocated to its site of action

27. Which of the following is a parenteral drug administration technique?

(A) oral

(B) sublingual

(D) percutaneous

28. What is the disease that causes a cabbage odour in baby’s urine?

(A) phenylketonuria

(B) isoveleric acidemia

(D) hypermethioninemia*

29. Which of the following statement is associated with phenylketonuria?

(A) decrease phenylalanine in blood

(B) due to the deficiency of phenylalanine hydroxylase*

(D) glucose test is use for phenylketonuria screening test

30. Alkaptonuria is disorder of

(A) fatty acid metabolism

(B) amino acid metabolism*

(D) carbohydrate metabolism

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. List FOUR (4) types of preservative that are used in urine sampling. (4 Marks)

b. Briefly explain THREE (3) parameters that are measured in the physical examination of urine. (6 Marks)

2. a. State FOUR (4) hormones involved in regulating blood glucose level. (2 Marks)

b. Briefly discuss the types of diabetes mellitus. (8 Marks)

3. a. Define cancer cachexia. (2 Marks)

b. Briefly explain the evidence of ectopic hormone production in a cancer patient. (8 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Explain the types of urine specimen. (20 Marks)

Question 2

Discuss the pituitary function test. (20 Marks)

Question 3

Elaborate on the nutritional assessment. (20 Marks)

August 2015

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. Which of the following can be estimate the concentration of normal urine specimen?

(A) odor

(B) foam

(D) clarity

2. A person exhibiting oliguria would have a daily urine volume of

(A) 200-400 ml*

(B) 600-1000 ml

(D) over 1500 ml

3. The formation of casts in the urine is an implication of

(A) blood

(B) nitrite

(D) bilirubin

4. Failure to mix a specimen prior to inserting the reagent strip will primarily affect the

(A) pH reading

(B) blood reading*

(D) glucose reading

5. Rickets is a disease caused by the deficiency of

(A) vitamin A

(B) vitamin B

(D) vitamin D*

6. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) diabetes insipidus

7. Which of the following is a trace element?

(A) cobalt

(B) silicon

(D) chromium

8. Which of the following statement is associated with Human Chorionic Gonadotrophin hormone?

(A) It is synthesized by ovary.

(B) It is decreased in ectopic pregnancies.*

(D) Its concentration is highest in the 2nd trimester of pregnancy.

9. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

10. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*

(D) fetal skin biopsy

11. Which of the following statements is TRUE regarding with aging process?

(A) Hypertrophy of tissues and organs

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

12. Identify the CORRECT biochemical change in geriatric.

(A) uric acid - decrease

(B) albumin - decrease*

(D) lactate dehydrogenase - decrease

13. Which of the following statements is TRUE regarding glucose homeostasis in elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.

(D) Glucose levels in postprandial specimen will increase.

14. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

15. Mutated genes that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

16. It interferes with neighbouring cells and block blood vessels, the gut, glands, and lungs. This statement best describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

17. Which of the following organs secrete hormones?

(A) lung

(B) brain

(D) kidneys*

18. The condition most likely to be associated with low levels of thyroid in the blood is

(A) hypothyroidism*

(B) Cushing’s disease

(D) Hashimoto's thyroiditis

19. Which of the following is a steroid hormone?

(A) insulin

(B) gastrin

(D) glucagon

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in diabetes mellitus Type 2

21. Which of the following terminologies is associated with microvascular complication in diabetes mellitus?

(A) alkalosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statements is CORRECT about lipids?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is high density lipoprotein is often called good cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following specimens are NOT accepted in drug analysis?

(A) skin*

(B) sweat

26. Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) electrophoresis

(B) atomic absorption

(D) enzyme-linked immunosorbent assay (ELISA)

27. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

28. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

29. What is the disease that causes a musty odour in baby’s urine?

(A) Phenylketonuria*

(B) Isoveleric acidemia

(D) Hypermethioninemia

30. Which of the following statements is NOT the cause of dehydration in a newborn?

(A) increased reabsorption of glucose*

(B) reduced reabsorption of bicarbonate.

(D) the ability of kidneys to concentrate urine is poor

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. A concerned male athlete brings a clear, red urine specimen to the clinic.

a. Would you expect to see red blood cell (RBC) in the microscopic examination? Why? (2 Marks)

b. Name two pathologic causes of clear, red urine. (2 Marks)

c. The patient reported that the urine appeared cloudy when he collected it the previous evening, but it was clear in the morning. Is this possible? Why? (3 Marks)

d. Compare the results of hazy, cloudy and turbid appearances of the transparency test. (3 Marks)

2. a. Define tumor marker and give TWO (2) examples of tumor markers. (3 Marks)

b. Briefly explain the important of tumor markers. (7 Marks)

3. Briefly discuss the diagnosis and monitoring of diabetes mellitus. (10 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss the changes seen in unpreserved urine. (20 Marks)

Question 2

Explain the geriatric biochemical changes in clinical chemistry laboratory test. (20 Marks)

Question 3

Elaborate phenylketonuria and its screening test in a newborn. (20 Marks)

January 2015

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. The correct method for labeling urine specimen containers is to

(A) attach the label to the lid

(B) attach the label to the container*

(D) only use a yellow sticker for labeling

2. The primary chemical constituents of normal urine are

(A) water, urea and protein

(B) urea, chloride, and water*

(D) urea, bilirubin, and urobilinogen

3. The formation of casts in the urine is an implication of

(A) blood

(B) glucose

(D) bilirubin

4. Patient presenting with polyuria, polydipsia and high urine specific gravity is exhibiting symptoms of

(A) uremia

(B) diabetes mellitus

(D) urinary tract infection

5. Which of the following statement associated with Human Chronic Gonadothropin hormone?

(A) It’s synthesized by placenta.*

(B) It’s increase in ectopic pregnancies.

(D) It concentrations highest in the 2nd trimester of pregnancy.

6. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) ultrasound*

(B) amniocentesis

(D) chronic vilus sampling

7. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

8. Beri-beri is a disease caused by the deficiency of

(A) vitamin C

(B) vitamin D

(D) vitamin B2

9. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) myocardial infarction

10. Which of the following is a ultratrace element?

(A) iron

(B) zinc

(D) selenium

11. Which of the following statements is associated with malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

12. It interferes with neighbouring cells and block blood vessels, the gut, glands, and lungs. This statement describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

13. Mutated genes that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

14. Which of the following statements is TRUE regarding with aging process?

(A) Hypertrophy of tissues and organs

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

15. Identify the CORRECT biochemical change in geriatric.

(A) Uric acid - Decrease

(B) Albumin - Decrease*

(D) Lactate dehydrogenase - Decrease

16. Which of the following statements is TRUE regarding renal function in elderly?

(A) Decreased risk of drug toxicity.--increased

(B) Glomerulus filtration rate maintain normal--reduce

(D) Reduction in renal responsiveness to antidiuretic hormone (ADH)*

17. Which of the following organs secrete hormones?

(A) lung

(B) brain

(D) pancreas*

18. The condition that most likely to be associated with high levels of thyroid antibodies in the blood is

(A) Hypothyroidism

(B) Cushing’s disease

(D) Hashimoto's Thyroiditis*

19. Which of the following is a protein hormone?

(A) insulin*

(B) cortisol

(D) progesterone

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in Diabetes Mellitus Type 2

21. Which of the following statements is CORRECT about lipids?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is low density lipoprotein is often called bad cholesterol*

22. Which of the following hormones that involved in decreased concentration of blood glucose?

(A) insulin*

(B) cortisol

(D) epinephrine

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following statements is NOT the cause of dehydration in a newborn?

(A) increased reabsorption of glucose*

(B) reduced reabsorption of bicarbonate

(D) the ability of kidneys to concentrate urine is poor

26. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

27. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

28. What is the disease that cause a cabbage odour in baby’s urine?

(A) Phenulketonuria

(B) Isoveleric acidemia

(D) Hypermethioninamea*

29. Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) ELISA

(B) Electrophoresis

(D) thin layer chromatography*

30. Which of the following specimens are NOT accepted in drug analysis?

(A) skin*

(B) sweat

(D) seminal fluid

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. What is the cancer cachexia? (2 Marks)

b. Briefly explain the evidence for ectopic hormones production in cancer patient. (8 Marks)

2. Briefly discuss the microvascular complication of Diabetes Mellitus. (10 Marks)

3. Explain the type and function of lipoproteins. (10 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss the physical examination of urine. (20 Marks)

Question 2

Elaborate the glucose homeostasis in geriatric. (20 Marks)

Question 3

Describe the pituitary function test. (20 Marks)

August 2014

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. The primary chemical constituents of normal urine are

(A) urea, water, and protein

(B) urea, chloride, and water*

(D) urea, bilirubin, and glucose

2. The correct method for labeling urine specimen containers is to

(A) attach the label to the lid

(B) attach the label to the container*

(D) only use a white sticker for labeling

3. The formation of casts in the urine is an implication of

(A) nitrite

(B) blood

(D) bilirubin

4. Patient presenting with polyuria, polydipsia and high urine specific gravity is exhibiting symptoms of

(A) uremia

(B) diabetes mellitus

(D) urinary tract infection

5. Which of the following statement associated with Human Chronic Gonadothropin hormone?

(A) It’s synthesized by ovary.

(B) It’s decreased in ectopic pregnancies.*

(D) It concentrations highest in the 2nd trimester of pregnancy.

6. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

7. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*

(D) fetal skin biopsy

8. Rickets is a disease caused by the deficiency of

(A) vitamin C

(B) vitamin D*

(D) vitamin B2

9. Which of the following is a trace element?

(A) cobalt

(B) silicon

(D) chromium

10. Which of the following is a disease caused by malnutrition?

(A) hepatitis

(B) marasmus*

(D) myocardial infarction

11. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

12. Mutated genes that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

13. It interferes with neighbouring cells and block blood vessels, the gut, glands, and lungs. This statement BEST describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

14. Which of the following statements is TRUE regarding with aging process?

(A) Hypertrophy of tissues and organs

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

15. Identify the CORRECT biochemical change in geriatric.

(A) Uric acid - Decrease

(B) Albumin - Decrease*

(D) Lactate dehydrogenase - Decrease

16. Which of the following statements is TRUE regarding glucose homeostasis in elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.

(D) Glucose levels in postprandial specimen will increase.

17. Which of the following organs secrete hormones?

(A) lung

(B) heart

(D) kidneys*

18. The condition t most likely to be associated with high levels of thyroid antibodies in the blood is

(A) Hypothyroidism

(B) Cushing’s disease

(D) Hashimoto's Thyroiditis*

19. Which of the following is a protein hormone?

(A) insulin*

(B) cortisol

(D) progesterone

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in Diabetes Mellitus Type 2

21. Which of the following terminologies is associated with microvascular complication in Diabetes Mellitus?

(A) acidosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statements is CORRECT about lipids?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is low density lipoprotein is often called bad cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following is associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

26. What is the disease that cause a cabbage odour in baby’s urine?

(A) Phenulketonuria

(B) Isoveleric acidemia

(D) Hypermethioninamea*

27. Which of the following statements is NOT the cause of dehydration in a newborn?

(A) Increased reabsorption of glucose*

(B) Reduced reabsorption of bicarbonate

(D) The ability of kidneys to concentrate urine is poor

28 Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

29. Which of the following specimens are NOT accepted in drug analysis?

(A) skin*

(B) sweat

(D) seminal fluid

30 Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) ELISA

(B) Electrophoresis

(D) thin layer chromatography*

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. Briefly explain TWO (2) types of pituitary functions test. (10 Marks)

2. Discuss Guthrie’s test procedure. (10 Marks)

3. a. Define tumor marker and give TWO (2) examples of tumor markers. (3 Marks)

b. Briefly explain the important of tumor markers. (7 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss the changes seen in unpreserved urine. (20 Marks)

Question 2

Discuss the causes of metabolic disorder (20 Marks)

Question 3

Discuss the diagnosis and monitoring of diabetes mellitus. (20 Marks)

January 2014

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. Which of the following hormones affect kidney function?

(A) renin--produced by kidney

(B) cortisol

(D) erythropoietin--produced by kidney

2. Which of the following is a quantitative urine test?

(A) 24 hours urine specimen*

(B) Random urine specimen

(D) Early morning urine specimen

3. The formation of casts in the urine is an implication of

(A) nitrite

(B) blood

(D) bilirubin

4. A urine specimen with a strong ammonia odour is most often associated with

(A) diabetes mellitus--fruity, sweet

(B) urinary tract infection*--bacterial decomposition

(D) ingestion of certain foodstuffs

5. The principle of a pregnancy test kit used in early detection of pregnancy is based on the presence of

(A) estradiol hormone

(B) progesterone hormone

(D) human chorionic gonadothrophin hormone*

6. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

7. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*

(D) fetal skin biopsy

8. Beri-beri is a disease caused by the deficiency of

(A) vitamin B1*

(B) vitamin B2

(D) vitamin B4

9. Which of the following is an ultratrace element?

(A) copper

(B) selenium

(D) manganese

10. Which of the following is a disease caused by malnutrition?

(A) rickets*

(B) hepatitis

(D) myocardial infarction

11. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

12. Mutated genes that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

13. They interfere with neighbouring cells and block blood vessels, the gut, glands, and lungs. This statement BEST describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

14. Which of the following statements is TRUE regarding with aging process?

(A) Hypertrophy of tissues and organs

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

15. Identify the CORRECT biochemical change in geriatric.

(A) Uric acid - Increase*

(B) Albumin - Increase

(D) Lactate dehydrogenase - Decrease

16. Which of the following statements is TRUE regarding glucose homeostasis in elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.

(D) Glucose levels in postprandial specimen will increase.

17. Thyrotropin-releasing hormone secreted by

(A) thyroid

(B) adrenal

(D) hypothalamus*--GnRH, GHRH, CRH, somatostatin, dopamine

18. A condition most likely to be associated with high levels of thyroid antibodies in the blood is

(A) hypothyroidism

(B) Cushing’s disease

(D) Hashimoto's Thyroiditis*

19. Which of the following is a steroid hormone?

(A) insulin

(B) cortisol*

(D) anti diuretic hormone (ADH)

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in Diabetes Mellitus Type 2

21. Which of the following terminologies is associated with microvascular complication in Diabetes Mellitus?

(A) acidosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statements is CORRECT about lipids?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is low density lipoprotein is often called bad cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following are associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following statement regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with antibiotic administered exogenously.

(D) It is caused by the absence of surfactant making the broncus fail to expand.

26. What is the disease that causes a cabbage odour in baby’s urine?

(A) Phenulketonuria

(B) Isoveleric acidemia

(D) Hypermethioninamea*

27. Which of the following statements is NOT the cause of dehydration in a newborn?

(A) Increased reabsorption of glucose*--reduced

(B) Reduced reabsorption of bicarbonate

(D) The ability of kidneys to concentrate urine is poor

28. Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) ELISA

(B) electrophoresis

(D) thin layer chromatography*

29. Which of the following specimens CANNOT be accepted in drug analysis?

(A) skin*

(B) sweat

(D) seminal fluid

30. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

SECTION B SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

1. Briefly explain the pituitary function test. (10 Marks)

2 A concerned male athlete brings a clear, red urine specimen to the clinic.

a. Would you expect to see red blood cell (RBC) in the microscopic examination? Why? (2 Marks)

b. Name two pathologic causes of clear, red urine. (2 Marks)

c. The patient reported that the urine appear cloudy when he collected it the previous evening, but it was clear in the morning. Is this possible? Why? (3 Marks)

d. Compare the results of hazy, cloudy and turbid appearances of the transparency test. (3 Marks)

3 Discuss homeostasis of glucose in geriatric. (10 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions ONLY.

Question 1

Discuss the causes of metabolic disorder. (20 Marks)

Question 2

Discuss the diagnosis and monitoring of diabetes mellitus. (20 Marks)

Question 3

Elaborate phenylketonuria and its screening test in a newborn. (20 Marks)

August 2013

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. Which of the following hormones affect kidney function?

(A) renin

(B) cortisol

(D) erythropoietin

2. Which of the following is a quantitative urine test?

(A) 24 hours urine specimen*

(B) Random urine specimen

(D) Early morning urine specimen

3. The formation of casts in the urine is an implication of

(A) nitrite

(B) blood

(D) bilirubin

4. A urine specimen with a strong ammonia odour is most often associated with

(A) diabetes mellitus

(B) urinary tract infection*

(D) ingestion of certain foodstuffs

5. The principle of a pregnancy test kit used in early detection of pregnancy is based on the presence of

(A) estradiol hormone

(B) progesterone hormone

(D) human chorionic gonadothrophin hormone*

6. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

7. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*

(D) fetal skin biopsy

8. Beri-beri is a disease caused by the deficiency of

(A) vitamin B1*

(B) vitamin B2

(D) vitamin B4

9. Which of the following is an ultratrace element?

(A) copper

(B) selenium

(D) manganese

10. Which of the following is a disease caused by malnutrition?

(A) rickets*

(B) hepatitis

(D) myocardial infarction

11. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

12. Mutated genes that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

13. They interfere with neighbouring cells and block blood vessels, the gut, glands, and lungs. This statement BEST describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

14. Which of the following statements is TRUE regarding with aging process?

(A) Hypertrophy of tissues and organs

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

15. Identify the CORRECT biochemical change in geriatric.

(A) Uric acid - Increase*

(B) Albumin - Increase

(D) Lactate dehydrogenase - Decrease

16. Which of the following statements is TRUE regarding glucose homeostasis in elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.

(D) Glucose levels in postprandial specimen will increase.

17. Which of the following organs does NOT secrete hormones?

(A) spleen*

(B) ovaries

(D) pancreas

18. A condition is most likely to be associated with high levels of thyroid antibodies in the blood is

(A) Hypothyroidism

(B) Cushing’s disease

(D) Hashimoto's Thyroiditis*

19. Which of the following is a steroid hormone?

(A) insulin

(B) cortisol*

(D) anti diuretic hormone (ADH)

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in Diabetes Mellitus Type 2

21. Which of the following terminologies is associated with microvascular complication in Diabetes Mellitus?

(A) acidosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statements is CORRECT about lipids?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is low density lipoprotein is often called bad cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following are associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

26. What is the disease that causes a cabbage odour in baby’s urine?

(A) Phenulketonuria

(B) Isoveleric acidemia

(D) Hypermethioninamea*

27. Which of the following statements is NOT the cause of dehydration in a newborn?

(A) Increased reabsorption of glucose*

(B) Reduced reabsorption of bicarbonate

(D) The ability of kidneys to concentrate urine is poor

28. Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) ELISA

(B) electrophoresis

(D) thin layer chromatography*

29. Which of the following specimens CANNOT be accepted in drug analysis?

(A) skin*

(B) sweat

(D) seminal fluid

30. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

SECTION B SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

1. a. Define tumor marker and give TWO (2) examples of tumor marker. (3 Marks)

b. Briefly explain the importance of tumor markers. (7 Marks)

2. a. State the classification of hormones (3 Marks)

b. Briefly explain the effects of thyroxine (7 Marks)

3 Describe the common causes of secondary hyperlipidemia.(10 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions ONLY.

Question 1

Discuss the changes seen in unpreserved urine. (20 Marks)

Question 2

Discuss the diagnosis and monitoring of diabetes mellitus. (20 Marks)

Question 3

Explain the geriatric biochemical changes in clinical chemistry laboratory test. (20 Marks)

January 2013

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. Which of the following hormones affect kidney function?

(A) renin

(B) cortisol

(D) erythropoietin

2. Which of the following is a quantitative urine test?

(A) 24 hours urine specimen*

(B) Random urine specimen

(D) Early morning urine specimen

3. The formation of casts in the urine is an implication of

(A) nitrite

(B) blood

(D) bilirubin

4. A urine specimen with a strong ammonia odour is most often associated with

(A) diabetes mellitus

(B) urinary tract infection*

(D) ingestion of certain foodstuffs

5. The principle of a pregnancy test kit used in early detection of pregnancy is based on the presence of

(A) estradiol hormone

(B) progesterone hormone

(D) human chorionic gonadothrophin hormone*

6. Which of the following is a characteristic of eclampsia?

(A) cerebral hemorrhage*

(B) elevation of serum bile acids

(D) impaired renal function resulting in glycosuria

7. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) fetoscopy

(B) ultrasound*

(D) fetal skin biopsy

8. Beri-beri is a disease caused by the deficiency of

(A) vitamin B1*

(B) vitamin B2

(D) vitamin B4

9. Which of the following is an ultratrace element?

(A) copper

(B) selenium

(D) manganese

10. Which of the following is a disease caused by malnutrition?

(A) rickets*

(B) hepatitis

(D) myocardial infarction

11. Which of the following statements is TRUE for malignancy?

(A) It rarely causes death

(B) It has a slow growth rate

(D) Endometrial polyps is an example

12. Mutated genes that cause cancer is called a/an

(A) mutagen

(B) oncogene*

(D) carcinogen

13. They interfere with neighbouring cells and block blood vessels, the gut, glands, and lungs. This statement BEST describes

(A) benign tumors

(B) carcinogenesis

(D) malignant tumor*

14. Which of the following statements is TRUE regarding with aging process?

(A) Hypertrophy of tissues and organs

(B) Susceptibility to most malignancies is increased.*

(D) The capacity to adequately oxygenate tissues is increased.

15. Identify the CORRECT biochemical change in geriatric.

(A) Uric acid - Increase*

(B) Albumin - Increase

(D) Lactate dehydrogenase - Decrease

16. Which of the following statements is TRUE regarding glucose homeostasis in elderly?

(A) Serum insulin will increase.

(B) Glucose tolerance will decrease.

(D) Glucose levels in postprandial specimen will increase.

17. Which of the following organs does NOT secrete hormones?

(A) spleen*

(B) ovaries

(D) pancreas

18. A condition is most likely to be associated with high levels of thyroid antibodies in the blood is

(A) Hypothyroidism

(B) Cushing’s disease

(D) Hashimoto's Thyroiditis*

19. Which of the following is a steroid hormone?

(A) insulin

(B) cortisol*

(D) anti diuretic hormone (ADH)

20. Which of the following statements is associated with diabetes ketoacidosis?

(A) over production of insulin

(B) low level of blood glucose

(D) normally occur in Diabetes Mellitus Type 2

21. Which of the following terminologies is associated with microvascular complication in Diabetes Mellitus?

(A) acidosis

(B) retinopathy*

(D) macroangiopathy

22. Which of the following statements is CORRECT about lipids?

(A) It is soluble in water

(B) An example of lipids is amino acid

(D) It is low density lipoprotein is often called bad cholesterol*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma fatty acid*

(B) plasma total cholesterol

(D) plasma high density lipoprotein (HDL)-cholesterol

24. Which of the following are associated with lipoprotein disorders?

(A) hepatitis

(B) pyelonephritis

(D) coronary heart disease*

25. Which of the following is FALSE regarding respiratory distress syndrome?

(A) It is caused by increased plasma glucose in diabetic mother.*

(B) It may be treated with surfactant administered exogenously.

(D) It is caused by the absence of surfactant making the alveoli fail to expand.

26. What is the disease that causes a cabbage odour in baby’s urine?

(A) Phenulketonuria

(B) Isoveleric acidemia

(D) Hypermethioninamea*

27. Which of the following statements is NOT the cause of dehydration in a newborn?

(A) Increased reabsorption of glucose*

(B) Reduced reabsorption of bicarbonate

(D) The ability of kidneys to concentrate urine is poor

28. Which of the following techniques is used in qualitative and quantitative assessment of drugs?

(A) ELISA

(B) electrophoresis

(D) thin layer chromatography*

29. Which of the following specimens CANNOT be accepted in drug analysis?

(A) skin*

(B) sweat

(D) seminal fluid

30. Which of the following is a parenteral drug administration technique?

(A) inhalation

(B) sublingual

(D) percutaneous

SECTION B SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

1. What are the common causes of secondary hyperlipidemia. (10 Marks)

2 A concerned male athlete brings a clear, red urine specimen to the clinic.

a. Would you expect to see red blood cell (RBC) in the microscopic examination? Why? (2 Marks)

b. Name two pathologic causes of clear, red urine. (2 Marks)

c. The patient reported that the urine appear cloudy when he collected it the previous evening, but it was clear in the morning. Is this possible? Why? (3 Marks)

d. Compare the results of hazy, cloudy and turbid appearances of the transparency test. (3 Marks)

3 Discuss homeostasis of glucose in geriatric. (10 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions ONLY.

Question 1

Discuss the causes of metabolic disorder. (20 Marks)

Question 2

Discuss the diagnosis and monitoring of diabetes mellitus. (20 Marks)

Question 3

Elaborate phenylketonuria and its screening test in a newborn. (20 Marks)

1/2011/2012

PART A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. Which of the following urine constituents might give a false-negative reaction if only supernatant urine is tested, rather than a well-mixed urine specimen?

(A) Glucose

(B) Red blood cells

(D) Protein

2. Which of the following hormones affect kidney function?

(A) Renin

(B) Cortisol.

(D) Erythropoietin.

3. A urine specimen with a strong ammonia odour is most often associated with

(A) diabetes mellitus.

(B) improper handling and storage.

(D) urinary tract infection.*

4. Reagent strip test for urinary leukocyte esterase is most useful when result is evaluated together with the results of the reagent strip for

(A) nitrite.*

(B) blood.

(D) bilirubin.

5. Which of the following statement is FALSE regarding maternal physiological changes?

(A) Decreased level of progesterone.*

(B) Increased in respiratory rate.

(D) Increased total body water increased.

6. Which of the following statement is TRUE regarding human chorionic gonadotrophin (hCG)?

(A) The hormone is synthesized by embryonic fluid.

(B) hCG concentration is highest in the first and third trimester.

(D) hCG is decreased in multiple fetus.

7. Which of the following is a noninvasive technique for prenatal diagnosis?

(A) Fetoscopy

(B) Ultrasound*

(D) Fetal skin biopsy

8. Scurvy is caused by the deficiency of

(A) zinc.

(B) iodin.

(D) ascorbic acid.*

9. The following are examples of trace element in nutrition EXCEPT

(A) selenium

(B) copper

(D) carotene.*

10. Which of the following is a disease caused by malnutrition?

(A) Rickets.*

(B) Hepatitis.

(D) Diabetes Mellitus.

11. The following agent may cause cancer EXCEPT

(A) virus

(B) chemicals--cigarettes (tar)

(D) bacteria*

hereditary predisposition

12. A mutated gene that cause cancer is called

(A) mutagens.

(B) mutagenic.

(D) carcinogens.

13. They interfere with neighbouring cells and block blood vessels, the gut, glands, and lungs. This statement best describe

(A) benign tumors.

(B) tumor markers.

(D) carcinogenesis.

14. Which of the following statement below is TRUE regarding the aging process?

(A) The capacity to adequately oxygenate tissues is increased.

(B) Susceptibility to most malignancies is increased.*

(D) Hypertrophy of tissues and organs.

15. Identify the CORRECT biochemical change in geriatric.

(A) Uric acid - Increase*

(B) Albumin - Increase

(D) Lactate dehydrogenase - Decrease

16. The following statements are TRUE regarding glucose homeostasis in elderly.

(A) Glucose tolerance will decrease.

(B) Serum insulin will increase.

(D) Glucose levels in postprandial specimen will increase.

17. Which of the following organ does NOT secrete hormones?

(A) Ovaries

(B) Kidneys

(D) Spleen*

18. A condition most likely to be associated with high levels of thyroid antibodies in the blood is

(A) Cushing’s disease.

(B) Hashimoto's Thyroiditis.*

(D) Addison’s disease

19. Which of the following is NOT a steroid hormone?

(A) Cortisol.*

(B) Androgen.

(D) Aldosterone.

20. Which of the following statement is associated with Diabetes Ketoacidosis?

(A) Over production of insulin.

(B) Low level of blood glucose.

(D) Normally occur in Diabetes Mellitus Type 2.

21. The following terminologies are associated with microvascular complication in Diabetes Mellitus EXCEPT

(A) retinopathy.

(B) macroangiopathy.*

(D) neuropathy.

22. Which of the following statement is CORRECT about lipids?

(A) Soluble in water.

(B) An example of lipids is amino acid.

(D) Low density lipoprotein is often called bad cholesterol.*

23. The following are routine tests for a patient suspected to be at risk of ischaemic heart disease or lipid disorder EXCEPT

(A) plasma total cholesterol.

(B) plasma fasting triglycerides.

(D) plasma fatty acid.*

24. The following are associated with lipoprotein disorders EXCEPT

(A) coronary heart disease.*

(B) cataracts.

(D) acute pancreatitis

25. The following are TRUE regarding respiratory distress syndrome EXCEPT

(A) it is caused by increased plasma glucose in diabetic mother.*

(B) it may be treated with surfactant administered exogenously.

(D) the assessment of lung maturity done by lecithin/sphingomyelin ratio.

26. What is the disease that causes a cabbage odour of baby’s urine?

(A) Isoveleric acidemia.

(B) Maple syrup disease.

(D) Hypermethioninamea.*

27. Which of the following is NOT the cause of dehydration in a newborn?

(A) Renal tubular function is not fully matured.

(B) Reabsorption of bicarbonate is reduced.

(D) Reabsorption of glucose is increased.*

28. The following techniques are used in qualitative and quantitative assessment of drugs EXCEPT

(A) thin layer chromatography.*

(B) immunoassay.

(D) electrophoresis.

29. Which of the following specimens CANNOT be accepted in drug analysis?

(A) Skin.*

(B) Seminal fluid.

(D) Saliva.

30. Below is the parenteral drug administration techniques EXCEPT

(A) Intravenous.

(B) Sublingual.*

(D) Intradermal.

PART B

SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

Question 1

a. Define tumor marker and give TWO (2) examples of tumor markers. (3 Marks)

b. Briefly explain the uses of tumor markers. (7 Marks)

Question 2

Discuss homeostasis of glucose in geriatric. (10 Marks)

Question 3

Briefly explain FIVE (5) types of lipoprotein and their functions. (10 Marks)

PART C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions ONLY.

Question 1

Discuss factors that cause metabolic disorder. (20 Marks)

Question 2

Define endocrinology and explain the Pituitary Function Test. (20 Marks)

Question 3

Elaborate phenylketonuria and its screening test in newborn. (20 Marks)

2/2009/2010

PART A : OBJECTIVE QUESTION (30 Marks)

Choose the best option to answer the questions.

1. The most suitable terminology for absence of urine is

A. polyuria.

B. anuria.*

C. glycosuria.

D. oliguria.

2. Sulphosalicylic acid test is the chemical examination of _________ in the urine specimen.

A. protein*

B. ketone

C. glucose

D. nitrite

3. The following are abnormal crystal found in the urine specimen EXCEPT

A. cystine.

B. bilirubin.

C. urates.*--calcium oxalate, phosphate

D. tyrosine.

4. Which of the following is a quantitative urine test?

A. 24 hours urine specimen.*

B. Random urine specimen.

C. Early morning urine specimen.

D. Mid-stream urine specimen.

5. Small glycoprotein synthesized by yolk and fetal liver is referred to as

A. bilirubin.

B. alfa fetoprotein.*

C. prolactin.

D. estriol.

6. A pregnancy test kit is used to in early detection of pregnancy is based on the presence of

A. progesterone hormone.

B. estradiol hormone.

C. human placental lactogen.

D. human chronic gonathrophin hormone.*

7. The following are common pregnancy associated disorder EXCEPT

A. myocardial infarction.*

B. obstestric cholestasis.

C. diabetis mellitus.

D. hypertension.

8. A factor which causes a mutation is called

A. carcinogenic.

B. metastasis.

C. mutagen.*

D. oncogenes.

9. The following are uses of tumor markers EXCEPT

A. diagnosis of disease is symptomatic patient.

B. aid in prevention of disease.*

C. therapeutic monitoring and selection.

D. detection of recurrence of disease.

10. “They interfere with neighbouring cells and can block blood vessels, the gut, glands, lungs”. This statement best describe

A. benign tumors.

B. mutagenic.

C. malignant tumors.*

D. carcinogenic.

11. The following are generally increased among healthy elderly EXCEPT

A. growth hormone.*

B. fasting blood glucose.

C. uric acid.

D. glycated hemoglobin.

12. The following are pre analytical variables which may affects laboratory assessment in elderly EXCEPT

A. patient moves from lying down to a standing position.--10% increase in total protein

B. patient do vigorous exercise shortly before blood collection.--6% increase in total CHOL

C. patient who is regularly practicing hobby like gardening.*

D. patient who is an heavy smoker.--total body water decrease, loss FFM

13. The following are major endocrine glands EXCEPT

A. pineal gland.

B. testis.

C. pancreas.

D. liver.*

14. A syndrome with deficiency in the release of GnRH which leads to lack of follicle stimulating hormone production is refer to as

A. Nelson’s Syndrome.

B. Kallman’s Syndrome.*

C. Down’ Syndrome.

D. Turner’s Syndrome.

15. The following are vital tasks of cortisol EXCEPT

A. help regulating the excretion of body waste.*

B. help the body respond to stress.

C. helps slow the immune system's inflammatory response.

D. helps maintain proper arousal and sense of well-being.

16. A condition associated with a high level of thyroid antibodies in the blood is referred to as

A. Cushing’ disease.

B. Hashimoto's Thyroiditis.*

C. Hyperthyrodism.

D. Addison’ disease.

17. The following are example of catabolism EXCEPT

A. glycolysis.--catabolism

B. lipogenesis.

C. glycogen synthesis.

D. gluconeogenesis.

18. Which hormone decreased the concentration of blood glucose?

A. Glucagon.

B. Cortisol.

C. Insulin.*

D. Epinephrine.

19. The following may occur as a result of metabolic disturbance of diabetes mellitus EXCEPT

A. diabetic ketoacidosis.

B. lactic acidosis.

C. non-ketotic hyperglycemia.

D. hypothyroidism.*

20. Which of the following is NOT complication of diabetis mellitus?

A. Retinopathy.

B. Neuropathy.

C. Gastropathy.*

D. Microangiopathy.

21. A state of inadequate insulin levels resulting in high blood sugar and accumulation of organic acids and ketones in the blood is refer to as

A. diabetic ketoacidosis.*

B. lactic acidosis.

C. hypoglycemia.

D. diabetis insipidus.

22. Which of the following enzymes is useful in the clinical investigation of myocardial infarction?

A. Acid phosphatase.

B. Creatinine kinase.*

C. Amylase.

D. Lipase.

23. The following techniques are used in qualitative and quantitative asssessment of drugs EXCEPT

A. thin layer chromatography.*

B. immunoassay.

C. gas chromatography.

D. electrophoresis.

24. The following are referred to as the parenteral administration of drugs EXCEPT

A. intravenous.

B. subcutaneous.

C. respiratory.*

D. intrathecal.

25. One type of lipids that always called as bad cholesterol is

A. low density lipoprotein (LDL).*

B. triglycerides.

C. high density lipoprotein (HDL).

D. Chylomicrons.

26. Which of the following drugs may caused increased blood lipid?

A. Amphetamines.

B. Marijuana.

C. Cocaine.

D. Corticosteroids.*--thiazide, ISA, progestogens

27. The following disease are commonly associated with newborns EXCEPT

A. congenital hypothyrodism.

B. myocardial infarction.*

C. jaundice.

D. phenylketonuria.

28. What disease associated with the presence of a musty odour of urine in paediatric?

A. Jaundice.

B. Phenylketonuria.*

C. Maple syrup disease.

D. Hypoglycemia.

29. The following are true about respiratory distress syndrome EXCEPT

A. caused by increased glucose in diabetic mother.*

B. correction action done by supplied surfactant exogenously.

C. caused by no surfactant make failure of alveoli to expand.

D. assessment of lung maturity done by lechitin/sphingomyelin ratio.

30. Accumulation of unconjugated bilirubin occurred due to immature infants’ liver may caused _____________ in the brain.

A. anencephaly.

B. phenylketonuria.

C. kernicterus.*

D. meningitis.

PART B : SHORT ANSWER QUESTION (40 Marks)

Answer ALL questions.

1. Determine each following statement either it is true or false. Mark “T” for the true statement and “F” for the false statement.

a. Glycosuria is an offensive proteins in the urine.

b. Midstream urine is usually required when urine is to be cultured for microorganism.

c. Most of the procoagulant factors increased during pregnancy.

d. High serum urate is useful indicator for eclampsia.

e. Half-life long enough is a characteristic of ideal tumor markers.

f. Postprandial serum insulin levels are decreased in older adults.

g. Sweet gland is an example of endocine organ.

h. Cortrosyn stimulation test is an example of pituitary function test.

i. Calcitonin is one of the pituitary hormones.

j. Chylomicrons is the main carrier of dietary triglycerides.

(10 marks)

2. Define the following terms.

a. Hypothyrodism

b. Hyperglycemia

c. Enzymes

d. Polyuria

e. Marasmus

(10 marks)

3. List the characteristics of ideal tumor markers. (5 marks)

4. List the tests which show decreased values when tested to normal elderly. (5 marks)

5. List the factors that causes metabolism disorders. (5 marks)

6. Write short notes on clinical laboratory assessment for nutritional status. (5 marks)

PART C : ESSAY QUESTION (30 Marks)

Answer only THREE (3) questions.

1. Write an essay on the physical examination of urine specimen. (10 marks)

2. Write an essay on the clinical chemistry assessment during pregnancy. (10 marks)

3. Write an essay on the development of cancer. (10 marks)

4. Write an essay on the clinical chemistry assessment for diabetes mellitus. (10 marks)

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