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CLC621S - CLINICAL CHEMISTRY 2B - 1ST OPP - NOV 2022 |
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nAmI BIA un IVERSITY
OF SCIEn CE Ano TECH n OLOGY
FACULTYOF HEALTH,APPLIEDSCIENCESAND NATURALRESOURCES
DEPARTMENTOF HEALTHSCIENCES
QUALIFICATION:BACHELOROF MEDICAL LABORATORYSCIENCES
QUALIFICATIONCODE: 08BMLS
LEVEL: 6
COURSECODE: CLC621S
COURSENAME: CLINICALCHEMISTRY2B
SESSION:
NOVEMBER 2022
DURATION: 3 HOURS
PAPER:
MARKS:
THEORY
100
FIRSTOPPORTUNITYEXAMINATION QUESTION PAPER
EXAMINER(S) MR NOEL RUKANDA
MODERATOR: DR MAURICE NYAMBUYA
INSTRUCTIONS
1. Answer ALL the questions.
2. Write clearly and neatly.
3. Number the answers clearly.
PERMISSIBLEMATERIALS
1. NON PROGRAMMABLECALCULATOR
THIS QUESTIONPAPERCONSISTSOF SEVENPAGES(Including this front page)
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SECTION A [20 MARKS]
Question 1
[10]
1. Judge the following statements whether they are TRUEor FALSEand only write the question
number and the corresponding response.
1.1 Calcium is reabsorbed under the influence of
a. ADH
1
b. PTH
1
c. Aldosterone
1
d. Phosphate
1
e. Glucagon
1
1.2 The following substances are osmotically active and are reflected in the osmolal gap
a. Sodium
1
b. Urea
1
c. Glucose
1
d. Ethanol
1
e. Lactate
1
Question 2
[10]
2. Evaluate the following statements and select the most appropriate/correct or the phrase to
best describe the statement given. Write only the number of the question and the letter of
the statement/word. Each correct answer earns 1 mark.
2.1 The sweat test for chloride is used as screening test for:
a. Parkinson's disease
b. Reyes Syndrome
c. Hyper -or hypochloremia
d. Cystic fibrosis
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2.2 Which of the following tissues is important in Vitamin D metabolism:
a. Spleen
b. Pancreas
c. Thyroid
d. Skin
e. Adrenal Cortex
2.3 Organophosphate poisoning will inhibit the function of the following enzyme:
a. Hexokinase
b. CK
c. Amylase_
d. PCHE
e. G-6-PD
2.4 Conversion of glucose to glycogen for storage is called:
a. Glycolysis
b. Glucogenolysis
C. Gluconeogeneis
d. Glycogenesis
e. All of the above
2.5 Bile acids that are synthesized in the liver are derived from what substance:
a. Bilirubin
b. Fatty acids
C. Triglycerides
d. Cholesterol
e. Uric acid
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2.6 Common clinical laboratory methods for measurement of serum albumin are based
on the properties of albumin an:
a. Enzyme
b. Antibody
C. Glycoprotein
d. Homogenous protein
e. Binding protein
2.7 A urine screening test for porphobilinogen is positive. The MOST likely disease state
is:
a. Lead poisoning
b. Porphyria cutanea farad
c. Acute porphyria
d. Erythrocytic protoporphyria
e. All of the above
2.8 A patient is admitted to the emergency room in a state of metabolic alkalosis. Which
of the following would most likely be consistent with this diagnosis:
a. High pCO2;1ncreased HCO3
b. Low pCO2; increased HCO3
C. High pCO2; decreased HCO3
d. Low pCO2; decreased HCO3
e. None of the above
2.9 One cause of DECREASEDanion gap is:
a. A decrease in albumin
b. A decrease in calcium
c. An increase in organic acids
d. An increase in phosphate
e. An increase in uric acid
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2.10 Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) are both
elevated in which of the following disease:
a. Muscular dystrophy
b. Viral hepatitis
c. Myocardial infarction
d. Obstructive liver disease
e. Renal failure
SECTIONB [50 MARKS]
Question 3
[30]
Review the following Laboratory results and answer the questions below.
Analyte
Result
Reference range
Sodium
134
136-146mmol/l
Potassium
7.1
3.0-5.0mmol/l
Chloride
99
90-ll0mmol/l
CO2
22.0
20.25mmol/l
Urea
18.3
2.5-8.3mmol/l
Creatinine
323
60-120 µmol/I
Total Calcium
1.97
2.05-2.20mmol/l
Magnesium
0.80
1.0-1.l0mmol/l
Total protein
66
70-85g/l
Albumin
31
35-45g/l
Total iron
9.0
10.7-26.9 µmol/I
Ferritin
22.0
30-400µg/l
Transferrin
2.2
2.0-3.6g/l
Urine creatinine
3.0mmo/I
Collection time-24hours
Volume-980ml
Body surface area-2.2
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3.1 Enumerate the following
3.1.1 Anion gap
2
3.1.2 Albumin globulin ratio
4
3.1.3 Corrected calcium
2
3.1.4 Total iron binding capacity
2
3.1.5 % transferrin saturation
2
3.1.6 Corrected Creatinine clearance
4
3.2 Explain the potential causes of the following abnormal parameters in this patient.
3.2.1 Sodium
2
3.2.2 Potassium
2
3.2.3 Creatinine
2
3.2.4 Calcium
2
3.2.5 Magnesium
2
3.2.6 Total protein
2
3.2.7 Albumin
2
Question 4
[20]
4.0 Analyse the following blood gas measurements for EACH patient A and B and answer the
questions that follow.
A
B
ANALYTE RESULT
RESULT
Reference range
pH
7.30
7.56
7.35 - 7.45
HCO3 26
38
35 - 45mmol/L
PCO2 71
56
22-26mmHg
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4.1 Determine the acid base disorder for EACHpatient.
10
4.2 Predict the compensation status of EACHpatient and provide reasons for your answer. 10
SECTIONC [30 MARKS]
Question 5
Explain how each of the following conditions leads to decreased serum protein levels:
5.1 Burns
5.2 Malnutrition
5.3 Liver disease
5.4 Renal disease
5.5 Malabsorption.
[10]
2
2
2
2
2
Question 6
[10]
Discussthe following statement:" Decreased blood volume triggers the RAA system".
Question 7
[10]
With aid of a diagram, illustrate how hemoglobin buffers pH.
END OF EXAMINATION
Total marks 100
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