ABPath Chemical Pathology 3 — Questions and Answers
Question 1: A patient with hemolyzed serum will show a falsely increased value for which analyte?
- Potassium (Correct answer)
- Sodium
- Bicarbonate
- Albumin
Correct answer: Potassium
Red cells are rich in potassium, so hemolysis releases it into serum and elevates the measured value.
Question 2: The best screening test for adrenal insufficiency is which of the following?
- ACTH (cosyntropin) stimulation test (Correct answer)
- Random cortisol
- 24-hour urinary free cortisol
- Dexamethasone suppression test
Correct answer: ACTH (cosyntropin) stimulation test
The cosyntropin stimulation test assesses adrenal cortisol reserve and is standard for diagnosing insufficiency.
Question 3: In a patient with suspected multiple myeloma, which test detects a monoclonal protein spike?
- Serum protein electrophoresis (Correct answer)
- Serum ferritin
- C-reactive protein
- Haptoglobin
Correct answer: Serum protein electrophoresis
Serum protein electrophoresis reveals the characteristic monoclonal (M) band of a paraprotein.
Question 4: Which acid-base disorder is expected in a patient with severe prolonged vomiting?
- Metabolic alkalosis (Correct answer)
- Metabolic acidosis
- Respiratory alkalosis
- Respiratory acidosis
Correct answer: Metabolic alkalosis
Loss of gastric hydrochloric acid depletes hydrogen ions and produces metabolic alkalosis.
Question 5: Elevated conjugated (direct) bilirubin with elevated alkaline phosphatase most suggests which process?
- Cholestasis/biliary obstruction (Correct answer)
- Hemolysis
- Gilbert syndrome
- Crigler-Najjar syndrome
Correct answer: Cholestasis/biliary obstruction
Obstruction to bile flow raises conjugated bilirubin and ALP, the hallmark of a cholestatic pattern.
Question 6: Which analyte requires collection on ice and rapid processing to avoid falsely low results?
- Ammonia (Correct answer)
- Cholesterol
- Total protein
- Uric acid
Correct answer: Ammonia
Ammonia rises rapidly at room temperature from deamination, so chilled tubes and quick processing are required.
Question 7: A markedly elevated hCG with a uterine mass and 'snowstorm' ultrasound suggests which condition?
- Hydatidiform mole (Correct answer)
- Ectopic pregnancy
- Normal early pregnancy
- Choriocarcinoma of the lung
Correct answer: Hydatidiform mole
Molar pregnancy produces very high hCG levels with characteristic vesicular sonographic appearance.
ABPath Chemical Pathology 3
A patient with hemolyzed serum will show a falsely increased value for which analyte?