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CLC621S - CLINICAL CHEMISTRY 2B - 2ND OPP - JANUARY 2024 |
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'nAml BIA UnlVERSITY
OF SCIEnCE AnDTECHnOLOGY
Faculty of Health, Natural
Resources and Applied
Sciences
School of Health Sciences
Department of Clinical
Health Sciences
13Jackson Kaujeua Street
Private Bag 13388
Windhoek
NAMIBIA
T: +264 61 207 2970
F: +264 61207
E: dchs@nust.na
W: www.nust.na
QUALIFICATION : BACHELOR of MEDICAL LABORATORY SCIENCES
QUALIFICATION CODE: 08BMLS
LEVEL: 6
COURSE: CLINICAL CHEMISTRY 2B
COURSE CODE: CLC621S
DATE: JANUARY 2024
SESSION: 1
DURATION: 3 HOURS
MARKS: 100
SECOND OPPORTUNITY/ SUPPLEMENTARY: EXAMINATION QUESTION PAPER
EXAMINER:
MODERATOR:
MRS. CARA MIA DUNAISKI
MRS. EDWIG SH/NGENGE
INSTRUCTIONS:
1. Answer all questions on the separate answer sheet.
2. Please write neatly and legibly.
3. Do not use the left side margin of the exam paper. This must be allowed for the
examiner.
4. No books, notes and other additional aids are allowed.
5. Mark all answers clearly with their respective question numbers.
PERMISSIBLE MATERIALS:
1. Non-Programmable Calculator
ATTACHMENTS:
1. Reference values
This question paper consists of 6 pages including this front page
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SECTIONA: SHORTQUESTIONS
[30 MARKS]
QUESTION 1:
State the principles of the following assays as used in clinical chemistry:
1.1
Electrophoresis
1.2 Ion selective electrodes.
1.3 Biuret test
1.4 Osmometer
1.5 Estimation of Low Density Lipoprotein (LDL) using the Friedewald equation
[10 MARKS]
(2)
(2)
(2)
(2)
(2)
QUESTION2:
[10 MARKS]
A student performed an experiment on a urea samples and obtained the following results
presented in table below:
Sample
Absorbance
Standard (Reference range: 10.0 mmol/L)
0.45
Control (Reference range: 10.0-15.0 mmol/L)
0.52
Patient sample (Reference range: 2.5-8.3 mmol/L)
0.71
2.1
Calculate the urea concentration of the control and patient.
(4)
2.2 Comment on the results of both the control and patient.
(2)
2.3 Identify FOUR clinical uses of serum urea measurements.
(4)
QUESTION 3:
[10 MARKS]
A patient presents to the oncology ward with the following serum measurements and
elevated levels lgM monoclonal antibodies:
Total protein
140 g/L (Reference range: 65-85)
Albumin
29 g/L (Reference range: 35-55)
3.1 Suggest TWO possible causes of such a presentation.
(2)
3.2 Propose further testing you would perform to help in making a diagnosis. Justify your
(2)
choice of test.
3.3 Illustrate the expected presentation of your analysis proposed in (b).
(6)
Clinical Chemistry 2B (CLC621S)
2nd Opportunity- January 2024
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SECTION B: SHORT AND LONG QUESTIONS
[70 MARKS]
QUESTION 4:
A patient's lipogram has the following results:
Total cholesterol
7.1 mmol/L
HDL cholesterol
1.1 mmol/L
Triglyceride
2.63 mmol/L
[10 MARKS]
Enumerate the following (Show all working):
4.1 Calculate LDLusing the Friedewald method (1 decimal place).
(2)
4.2 Describe the FOURmajor classesof Lipoproteins that transport hydrophobic lipid
(8)
molecules in in blood plasma.
QUESTION 5:
5.1 Discussthe significance of measuring serum and urine osmolality.
[10 MARKS]
(10)
QUESTION 6:
[15 MARKS]
6.1 Using relevant examples illustrate how enzymes are used as reagents in the (15)
clinical chemistry laboratory to diagnose various disorders.
QUESTION 7:
[10 MARKS)
7.1 Compare and contrast the HbAlC enzymatic method with the HbAlC High (10)
Performance Liquid Chromatography (HPLC)method used to monitor diabetes.
QUESTION 8:
[10 MARKS]
8.1 Compare and contrast the HbAlC enzymatic method with the HbAlC High
(10)
Performance Liquid Chromatography (HPLC)method used to monitor diabetes.
Clinical Chemistry 28 (CLC621S)
2nd Opportunity- January 2024
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QUESTION 9:
(15 MARKS]
9.1 A patient presents at her Physician with general body malaise, spells of dizziness over (15)
a long period and pronounced parlour. The Physician notices that the patient
generally looks unwell and collects blood samples for analysis by the Laboratory. He
strongly feels the patient has anaemia of chronic disease. Identify the tests, which
are likely to be performed in the clinical chemistry laboratory. State the expected
results that may support the Physician's provisional diagnosis. Justify the choice of
your tests and expected results. Only give relevant tests.
END OF QUESTION PAPER
Clinical Chemistry 2B (CLC621S)
2nd Opportunity- January 2024
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CLINICAL LABORATORY TESTS - REFERENCEVALUES
This table lists reference ranges (expressed in both SI units and traditional units) for the most common laboratory tests and is intended for interpretation of
the results as they are provided in the examinations. Most of the values apply to adults and where they differ for children it will be indicated. Many
important laboratory reference values are not listed here. because of the less frequent use of these tests. Such values are inserted parenthetically following
the result recorded in the examination question.
Tests
I'
'
Activated partial thromboplastin time (aPTT)
Albumin (serum)
Amylase (serum)
Bicarbonate (HCO,) (serum)
Bilirubin (serum)* Neonates (conjugated)
(total)
Adults (conjugated)
(total)
Bleeding time (lvv)
Calcium (serum)**
Total
Ionized
Calcium (urine)
Carcinoembryonic antigen (CEA) (serum)
CO, (total)**
Chloride (serum)
Chloride (urine) Infant
Child
Adults
Cholesterol (serum)**
Cortisol (plasma) SAM
4PM
Creatinine (serum)
Creatinine (urine) Males
Females
Creatine kinase (CK. CPK) - Males (race dependent)
Females (race deoendent)
Ervthrocvtes (RBCs) - Children**
Males
Females
Ferritin (serum)
Follicle-stimulating hormone (FSH) (plasma)
Males
Females. premenopausal
Females. postmenopausal
Glucose (fasting) (plasma or serum)
Growth hormone (hGH) (serum. adult) fasting
Hematocrit - Newborn
Children**
Males
Females
Hemoglobin (Hb) - Newborn
Children**
Males
Females
High densitv lipoproteins (HDL) (recommended range)
JNR
Iron (serum) - Males
Females
Iron binding capacity (serum) (TIBC)
Lactate dehvdrogenase (LDH) (serum) - Adult
Child
> 60 years old
SI Units
25-40 sec
35-50 l!/L
25-125 IU/L
23-29 mmol/L
0-10 umol/L
1.7-180 umol/L
0-5 µmol/L
3-22 umol/L
<5 min
2.10-2.50 mmol/L
1.15-1.35 mmol/L
<6.2 mmol/d
< 3.0 11/!IL
22-29 mmol/L
96-106 mmol/L
2-10 mmol/d
14-50 mmol/d
110-250 mmol/d
< 5.2 mmol/L
170-635 nmol/L
82-413 nmol/L
50-110 µmol/L
8.8-17.6 mmol/d
7 .0-15.8 mmol/d
20-215 IU/L
20-160 IU/L
4.5-5.1 X 10 12/L
4.6-6.2 x 101-1L
4.2-5.4 x 101-rL
20-200 µg/L
1-I0IU/L
20-50 IU/L
40-250 IU/L
3.9-6.1 mmol/L
0-10 µg/L
0.49-0.54
0.35-0.49
0.40-0.54
0.37-0.47
l65-195g/L
112-165 1)/L
140-180 g/L
120-160 g/L
> 0.91 mmol/L
0.9-1.1
13-31 umol/L
5-29 µmol/L
45- 73 umol/L
45-90 IU/L
60-170 IU/L
55-100 IU/L
Traditional Units
25-40 sec
3.5-5.0 p-/dL
25-125 U/L
23-29 mEq/L
0-0.6 mg/dL
1.0-10.5 mg/dL
0-0.3 mp-/dL
0.2-1.3 mg/dL
<5 min
8.4-10.6 ml!/dL
4.6-5.1 mg/dL
< 250 mg/24h
< 3.0 nl!/mL
22-29 mEq/L
96- I06 mEq/L
2-10 mEq/24h
14-50 mEa/24h
110-250 mEq/24h
< 200 mg/dL
6-23 µg/dL
3-15 µg/dL
0.6-1.2 mg/dL
1.0-2.0 g/24h
0.8-1.8 p-/24h
20-215 U/L
20-160 U/L
4.5-5.1 million/mmj
4.6-6.2 million/mm 3
4.2-5.4 million/mmj
20-200 ng/mL
1-10 mU/mL
20-50 mU/mL
40-250 mU/mL
70-110 mg/dL
0-10 nl!/mL
49-54%
35-49%
40-54%
37-47%
16.5-19.5 g/dL
I 1.2-16.5 gfdL
14.0-18.0 l!/dL
12.0-16.0 p-/dL
> 35 mg/dL
0.9-1.1
75-175 u!!ldL
28-162 u!!ldL
250-410 ul!/dL
45-90 U/L
60-170 U/L
55-100 U/L
*Test values are method dependent
**Test values vary with age
***Test values are diet dependent
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Tests
I,
Leukocytes - Total
Sl Units
3.5-12.0 x 10'/L
Traditional Units
'
3500- I2.000/mm'
Differential: Neutrophils
3000-5800 x 10°/L
3000-5800/mm"
Lvmphocvtes
1500-3000 x I0°/L
1500-3000/mm'
Monocvtes
300-500 x I0°/L
300-500/mm'
Eosinophils
50-250 x I 0°/L
50-250/mm'
BasoPhils
15-50 x I 0°/L
15-50/mm'
Low densitv lipoproteins (LDL) (recommended range)
< 3.4 mmol/L
< 130 mg/dL
Luteinizing hormone (LH) (serum) - Males
1-9 IU/L
1-9 IU/L
Females (follicular)
2-10 IU/L
2-10 IU/L
(mid-cvcle)
15-65 IU/L
15-65 IU/L
(luteal)
1-12 IU/L
1-12 IU/L
(postmenopausal)
12-65 IU/L
12-65 IU/L
Magnesium {serum)
0.65-1.05 mmoVL
1.3-2.1 mg/dL
Magnesium (urine)
3.0-4.3 mmol/d
6.0-8.5 mEq/24h
Mean corouscular volume (MCV)
76-IOOtL
76-100 µm'
Osmolality (serum)
285-295 mmol/kg
285-295 mOsm/kg
Osmolalitv (urine)
38-1400 mmol/kg
38-1400 mOsm/kg
Oxv!.!en(arterial saturation)
94-99%
94-99%
Parathvroid hormone (PTH)
1.4-6.8 pmol/L
13.2-64.1 pg/mL
Partial thromboplastin time (PTT)
See aPTT
See aPTT
pC02 (arterial)
35-45 mm Hg
35-45 mm Hg
oH (arterial)
7.35-7.45
7.35-7.45
Phosphatase. alkaline (serum)
40-160 IU/L
40-160 U/L
Phosphate - Adults
1.0-1.5 mmol/L
3.0-4.5 mg/dL
Children
I .3-2.3 mmoVL
4.0-7.0 mg/dL
Platelet count
oO, (arterial)
150-400 x 10'/L
80-100 mm Hg
150.000-400.000/mm'
80-100 mm Hg
Potassium (serum) - Newborn
3.7-5.9 mmol/L
3.7-5.9 mEq/L
Infant
4.1-5.3 mmol/L
4.1-5.3 mEq/L
Child
3.4-4.7 mmol/L
3.4-4.7 mEq/L
Adult
3.5-5.1 mmol/L
3.5-5.1 mEq/L
Potassium (urine)**"
25-125 mmol/d
25-125 mEq/24h
Progesterone {serum) (adult) - Males
0.0-1.3 nmol/L
0.0-0.4 ng/mL
Females (follicular)
0.3-4.8 nmol/L
0.1-1.5 ng/mL
(luteal)
8.0-89.0 nmoVL
2.5-28.0 ng/mL
Prolactin (serum) - Males
1-20 u!.!IL
1-20 ng/mL
Females
1-25 ug/L
1-25 ng/mL
Prostate specific antigen (PSA)
0-4.0 µg/L
0-4.0 ng/mL
Protein (serum) - Total
60-80 g/L
6.0-8.0 g/dL
Albumin
35-55 g/L
3.5-5.5 g/dL
Protein (urine)
Prothrombin time (PT)
10-150 mg/d
9-12 sec
I 0-150 mg/24h
9-12 sec
Reticu locvtes
Sedimentation rate (ES R)
Sodium (serum or plasma)
Sodium (urine)***
Specific gravitv
25-75 x IO'/L
0-15 mm/h
135-145 mmol/L
40-220 mmol/d
1.003-1.030
25.000-75.000/mm'
0-15 mm/h
135-145 mEq/L
40-220 mEq/24h
1.003-1.030
Spenn count
20-150 x 10°/mL
20.000-150.000/mm'
Testosterone - Males
9.5-30 nmol/L
275-875 ng/dL
Females
0.8-2.6 nmol/L
23-75 ng/dL
Pregnant females
1.3-6.6 nmol/L
38-190 ng/dL
Thrombin time (plasma)
< 17 sec
< 17 sec
1lwroid-stimulating hormone (TSH) (serum) - Adults
0.4-4.8 mIU/L
0.4-4.8 mIU/L
-Term infants: (0-1 day)
1-39 mlU/L
1-39 mIU/L
(1-4 davs)
1-17 mlU/L
1-17 mIU/L
(2-20 weeks)
1.7-9.1 m!U/L
1.7-9.1 mIU/L
Thvroxine. total (T4) (serum)**
Thvroxine. free (FL) {serum)**
(21 weeks to 20 years)
0.7-6.4 mIU/L
66-155 nmol/L
13-27 pmoVL
0.7-6.4 rnlU/L
5-12 µg/dL
1.0-2.1 ng/dL
Transaminase (serum) -- AST (SGOT)
7-40 IU/L
7-40 mU/mL
ALT(SGPD
5-35 IU/L
5-35 mU/mL
Triiodothvroninc. total (T1) (serum)
1.1-2.9 nmol/L
70-190 ng/dL
Triiodothyronine. free (FT1) (serum)
3.5-6.5 pmol/L
2.4-5.0 o!!lmL
Triglycerides
0.45-1.71 mmoVL
40-150 mg/dL
Urea (plasma or serum)
2.9-8.2 mmol/L
see Urea nitrogen
Urea nitro.i;:en(BUN) {olasma or serum)
see Urea
8-23 mg/dL
.. .... Uric acid (serum) (enzymatic)
Test values are method dependent
120-420 r1moVL
2.0-7.0 mg/dL
Test values vary with age ***Test values are diet dependent
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