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PathMD Quizes, Clinical

Clinical Chemistry – 01

October 29, 2017 peferguson

Author: Joshua Bornhorst, Ph.D.

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1. Which forms of the elements Arsenic (As) and Mercury (Hg) are considered to be the most toxic?

Organic Arsenic compounds such as arsenobetaine and arsenocholine, and organic Mercury compounds such as methyl Mercury (CH3Hg+)

Inorganic Arsenic species and organic Mercury compounds

All Arsenic and Mercury compounds are highly toxic

Organic Arsenic compounds and inorganic Mercury species

Inorganic Arsenic species such as As(III) and As(V), and inorganic Mercury species such as elemental mercury (Hg)

2. What is the most appropriate sample type for diagnosing suspected acute arsenic exposure in the previous 3 days.

Serum

Hair samples

Whole Blood

EDTA Plasma

Urine

3. Which of the following are often associated with Wilson’s disease?

I. Elevated ceruloplasm levels.
II. The Presence of Kayser-Fleisher rings
III. The Presence of Mees’ Lines
IV. Increased Free Serum Copper
V. Low Urine Serum copper

IV and V

All of the above

II and IV

I and V

I, III and V

4. Suppose a study was performed using a third assay for factor X on a group of 1500 individuals with elevated liver enzymes. The prevalence of HCC was 10% in this population. Of the patients with confirmed HCC, 120 were identified as positive by this assay. Unfortunately 150 patients who did not have HCC were also classified as positive by factor X testing. What is the specificity (%) of the test?

89%

90%

10%

11%

80%

5. Suppose a hypothetical serum marker “factor X” was discovered to be elevated in cases hepatocellular carcinoma (HCC). Two different plate-based ELISA tests for factor X were developed, test A and test B. Examine the ROC curve of the factor X concentration cutoffs (factor X concentration above which a sample is called positive), and determine the most effective test for the detection of HCC and the best “factor X” cutoff concentration. (See Image below)

85 mg/L using Test A

100 mg/L using Test A

85 mg/L using Test B

100 mg/L using Test B

6. Which of the following elements are found predominately in erythrocytes while in circulation?

Cadmium and Lead

Copper

Lead

Organic Mercury compound

Cadmium

7. If the same test were performed on an apparently healthy population with a HCC prevalence of 1.0% which of the following values would you expect to change.

Specificity

There would be no change in expected specificity, sensitivity and positive predictive values.

Positive predictive value

The specificity, sensitivity, and positive predicative value would all change.

Sensitivity

8. Which set of elements are all considered to be essential trace elements?

Mercury, Cadmium, Lead, Cobalt

Selenium, Cobalt, Lead, Cadmium, Zinc, Iron, Nickel

Molybdenum, Selenium, Zinc, Nickel

Mercury, Selenium, Zinc, Iron

Arsenic, Mercury, Iron, Nickle, Manganese

9. Suppose a study was performed using a third assay for factor X on a group of 1500 individuals with elevated liver enzymes. The prevalence of HCC was 10% in this population. Of the patients with confirmed HCC, 120 were identified as positive by this assay. Unfortunately 150 patients who did not have HCC were also classified as positive by factor X testing. What is the sensitivity (%) of this test?

80%

11%

10%

89%

90%

10. Suppose a study was performed using a third assay for factor X on a group of 1500 individuals with elevated liver enzymes. The prevalence of HCC was 10% in this population. Of the patients with confirmed HCC, 120 were identified as positive by this assay. Unfortunately 150 patients who did not have HCC were also classified as positive by factor X testing. What is the positive predictive value (%) of the test?

40%

85%

15%

44%

56%

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