lOM oA R c P S D| 22 83 079 2
, lOM oA R c P S D| 22 83 079 2
Chapter 01: Clinical Chemistry, Molecular Diagnostics,
and Laboratory Medicine Test Bank
MULTIPLE
CHOICE
1. An individual working in a clinical chemistry laboratory is married to a sales
representative who works for a company that sells chemistry laboratory
supplies. When the laboratory manager requests a list of needed supplies, cost
of supplies, and vendors, this individual only recommends the spouse’s
company as the vendor. This is considered to be a(n):
a. accounting issue.
b. possible conflict of interest.
c. maintenance of confidentiality issue.
d. problem with resource allocation.
ANS: B
Concern has been raised over the interrelationships between practitioners in the
medical field and commercial suppliers of drugs, devices, equipment, etc., to
the medical profession.
Similarly, relationships have been scrutinized between clinical laboratorians and
manufacturers and providers of diagnostic equipment and supplies. These
concerns led the National Institutes of Health (NIH) in 1995 to require official
institutional review of financial disclosure by researchers and management of
situations in which disclosure indicates potential conflicts of interest.
DIF: 1 REF: Page 4-5 OBJ: 6 | 7
2. A patient visits her physician stating that her prescribed painkiller is not working
to reduce the pain following her recent surgery. A friend of the patient claims that
the same painkiller ―worked wonders‖ to reduce her pain after the same surgery.
The physician states that the difference in the effect of the drug might be caused
by , which is studied in
pharmacogenetics.
a. epidemiology
b. an inherited disease
c. a conflict of interest
d. a genetic variation in drug-metabolizing enzymes
ANS: D
Pharmacogenetics is the study of the genetic variation of drug
metabolism between individuals.
DIF: 1 REF: Page 3 OBJ: 1
3. John works in a molecular diagnostics laboratory and receives a blood sample
that has the name of a close friend printed on the bar-coded label. The genetic
test that is ordered on the friend’s sample would provide diagnostic
information about a disorder that has a poor prognosis, and the test is usually
performed by John. He asks a fellow employee to analyze the sample for him
and not divulge the results. This ethical issue concerns:
a. confidentiality of patient genetic and medical information.
b. a conflict of interest.
, lOM oA R c P S D| 22 83 079 2
c. resource allocation.
d. diagnostic accuracy.
ANS: A
Clinical laboratorians have long been responsible for maintaining the
confidentiality of all laboratory results, a situation made even more critical
with the advent of increasingly powerful genetic testing.
DIF: 1 REF: Page 4 OBJ: 6 | 7
4. Molecular diagnostic testing methods and results can be:
a. qualitative only.
b. quantitative only.
c. either qualitative or quantitative.
ANS: C
Molecular diagnostic methods can be either qualitative or quantitative in nature,
depending on the clinical need.
DIF: 1 REF: Page 3 OBJ: 5
5. Clinical epidemiology, which is the study of the patterns, causes, and effects of
health and disease in certain populations, has provided the clinical laboratory
with methods that evaluate the effects and outcomes of laboratory testing. This
allows for a more effective:
a. process of determining the cost of the testing methods.
b. selection and interpretation of laboratory tests.
c. determination of the boundaries between the components of the clinical lab.
d. conduct assessment.
ANS: A
Clinical epidemiologists have introduced methods to evaluate the effects and
value of laboratory testing in healthcare. These developments are expected to
play an increasing role in the selection and interpretation of laboratory tests.
DIF: 1 REF: Page 3 OBJ: 4
6. Analysis of which one of the following by molecular diagnostic methods
provides a measure of processes that are ongoing at the time of blood
sampling?
a. Genetic variation in an individual’s response to a drug
b. Circulating plasma nucleic acids
c. Malignant lymphomas
d. Histocompatibility
ANS: B
Molecular diagnostics, given its very high sensitivity, has been applied to the
study of plasma nucleic acids (or circulating nucleic acids). Plasma nucleic acids
analysis has been made possible by the discovery that dying cells in the body
release their DNA and RNA into the extracellular compartment and ultimately
into the bloodstream, where they can be detected and analyzed. Given their
short half-life in circulation (less than 24 hours), plasma nucleic acids provide a
measure of processes that are ongoing at the time of blood sampling.
DIF: 1 REF: Page 3 OBJ: 5
, lOM oA R c P S D| 22 83 079 2
7. A healthy individual with no clinical signs or symptoms of disease visits his
physician for a routine physical examination. Blood samples are collected and
sent to the laboratory. The tests requested on the sample are for general
laboratory analyses, including a complete blood count, a panel of general
chemistry tests (including glucose, protein, cholesterol, and others), and an
analysis of urine. This type of testing in laboratory medicine is directed at:
a. confirming a clinical suspicion of disease.
b. selecting a treatment for disease.
c. ruling in a diagnosis.
d. screening for disease in the absence of clinical signs or symptoms.
ANS: D
Testing in laboratory medicine may be directed at (1) confirming a clinical
suspicion; (2) making, or ruling in, a diagnosis; (3) excluding, or ruling out, a
diagnosis;, (4) assisting in the selection, optimization, and monitoring of
treatment; (5) providing a prognosis; (6) screening for disease in the absence of
clinical signs or symptoms; or (7) establishing and monitoring the severity of a
physiologic disturbance. The field of laboratory medicine includes clinical
chemistry and areas such as microbiology and hematology. The general tests
ordered on this healthy individual are done to screen the physiologic systems
despite the absence of any symptoms.
DIF: 2 REF: Page 2 OBJ: 2
8. The discipline involved in the selection, provision, and interpretation of diagnostic
testing that uses primarily samples from patients is:
a. clinical chemistry.
b. hematology.
c. laboratory medicine.
d. molecular diagnostics.
ANS: C
The term ―laboratory medicine‖ refers to the discipline involved in the (1)
selection, (2) provision, and (3) interpretation of diagnostic testing that
uses primarily samples from patients.
DIF: 1 REF: Page 1 OBJ: 1 | 3
9. A male laboratorian works in the clinical chemistry laboratory of a large hospital.
He is approached by his friend, who is a representative of a drug company, and
asked to analyze some patient samples for drug levels of a specific drug that the
representative’s company sells and that these patients use. The representative
wants to publish a report on the rate of drug absorption and distribution of this
drug and tells his laboratorian friend that he will personally reimburse him for his
time. What ethical issues come into play here?
a. Resource allocation and conflict of interest
b. Maintenance of confidentiality and publishing issues
c. Maintenance of confidentiality, conflict of interest, and publishing issues.
d. Resource allocation, maintenance of confidentiality, conflict of
interest, and publishing issues.
ANS: D
, lOM oA R c P S D| 22 83 079 2
Chapter 01: Clinical Chemistry, Molecular Diagnostics,
and Laboratory Medicine Test Bank
MULTIPLE
CHOICE
1. An individual working in a clinical chemistry laboratory is married to a sales
representative who works for a company that sells chemistry laboratory
supplies. When the laboratory manager requests a list of needed supplies, cost
of supplies, and vendors, this individual only recommends the spouse’s
company as the vendor. This is considered to be a(n):
a. accounting issue.
b. possible conflict of interest.
c. maintenance of confidentiality issue.
d. problem with resource allocation.
ANS: B
Concern has been raised over the interrelationships between practitioners in the
medical field and commercial suppliers of drugs, devices, equipment, etc., to
the medical profession.
Similarly, relationships have been scrutinized between clinical laboratorians and
manufacturers and providers of diagnostic equipment and supplies. These
concerns led the National Institutes of Health (NIH) in 1995 to require official
institutional review of financial disclosure by researchers and management of
situations in which disclosure indicates potential conflicts of interest.
DIF: 1 REF: Page 4-5 OBJ: 6 | 7
2. A patient visits her physician stating that her prescribed painkiller is not working
to reduce the pain following her recent surgery. A friend of the patient claims that
the same painkiller ―worked wonders‖ to reduce her pain after the same surgery.
The physician states that the difference in the effect of the drug might be caused
by , which is studied in
pharmacogenetics.
a. epidemiology
b. an inherited disease
c. a conflict of interest
d. a genetic variation in drug-metabolizing enzymes
ANS: D
Pharmacogenetics is the study of the genetic variation of drug
metabolism between individuals.
DIF: 1 REF: Page 3 OBJ: 1
3. John works in a molecular diagnostics laboratory and receives a blood sample
that has the name of a close friend printed on the bar-coded label. The genetic
test that is ordered on the friend’s sample would provide diagnostic
information about a disorder that has a poor prognosis, and the test is usually
performed by John. He asks a fellow employee to analyze the sample for him
and not divulge the results. This ethical issue concerns:
a. confidentiality of patient genetic and medical information.
b. a conflict of interest.
, lOM oA R c P S D| 22 83 079 2
c. resource allocation.
d. diagnostic accuracy.
ANS: A
Clinical laboratorians have long been responsible for maintaining the
confidentiality of all laboratory results, a situation made even more critical
with the advent of increasingly powerful genetic testing.
DIF: 1 REF: Page 4 OBJ: 6 | 7
4. Molecular diagnostic testing methods and results can be:
a. qualitative only.
b. quantitative only.
c. either qualitative or quantitative.
ANS: C
Molecular diagnostic methods can be either qualitative or quantitative in nature,
depending on the clinical need.
DIF: 1 REF: Page 3 OBJ: 5
5. Clinical epidemiology, which is the study of the patterns, causes, and effects of
health and disease in certain populations, has provided the clinical laboratory
with methods that evaluate the effects and outcomes of laboratory testing. This
allows for a more effective:
a. process of determining the cost of the testing methods.
b. selection and interpretation of laboratory tests.
c. determination of the boundaries between the components of the clinical lab.
d. conduct assessment.
ANS: A
Clinical epidemiologists have introduced methods to evaluate the effects and
value of laboratory testing in healthcare. These developments are expected to
play an increasing role in the selection and interpretation of laboratory tests.
DIF: 1 REF: Page 3 OBJ: 4
6. Analysis of which one of the following by molecular diagnostic methods
provides a measure of processes that are ongoing at the time of blood
sampling?
a. Genetic variation in an individual’s response to a drug
b. Circulating plasma nucleic acids
c. Malignant lymphomas
d. Histocompatibility
ANS: B
Molecular diagnostics, given its very high sensitivity, has been applied to the
study of plasma nucleic acids (or circulating nucleic acids). Plasma nucleic acids
analysis has been made possible by the discovery that dying cells in the body
release their DNA and RNA into the extracellular compartment and ultimately
into the bloodstream, where they can be detected and analyzed. Given their
short half-life in circulation (less than 24 hours), plasma nucleic acids provide a
measure of processes that are ongoing at the time of blood sampling.
DIF: 1 REF: Page 3 OBJ: 5
, lOM oA R c P S D| 22 83 079 2
7. A healthy individual with no clinical signs or symptoms of disease visits his
physician for a routine physical examination. Blood samples are collected and
sent to the laboratory. The tests requested on the sample are for general
laboratory analyses, including a complete blood count, a panel of general
chemistry tests (including glucose, protein, cholesterol, and others), and an
analysis of urine. This type of testing in laboratory medicine is directed at:
a. confirming a clinical suspicion of disease.
b. selecting a treatment for disease.
c. ruling in a diagnosis.
d. screening for disease in the absence of clinical signs or symptoms.
ANS: D
Testing in laboratory medicine may be directed at (1) confirming a clinical
suspicion; (2) making, or ruling in, a diagnosis; (3) excluding, or ruling out, a
diagnosis;, (4) assisting in the selection, optimization, and monitoring of
treatment; (5) providing a prognosis; (6) screening for disease in the absence of
clinical signs or symptoms; or (7) establishing and monitoring the severity of a
physiologic disturbance. The field of laboratory medicine includes clinical
chemistry and areas such as microbiology and hematology. The general tests
ordered on this healthy individual are done to screen the physiologic systems
despite the absence of any symptoms.
DIF: 2 REF: Page 2 OBJ: 2
8. The discipline involved in the selection, provision, and interpretation of diagnostic
testing that uses primarily samples from patients is:
a. clinical chemistry.
b. hematology.
c. laboratory medicine.
d. molecular diagnostics.
ANS: C
The term ―laboratory medicine‖ refers to the discipline involved in the (1)
selection, (2) provision, and (3) interpretation of diagnostic testing that
uses primarily samples from patients.
DIF: 1 REF: Page 1 OBJ: 1 | 3
9. A male laboratorian works in the clinical chemistry laboratory of a large hospital.
He is approached by his friend, who is a representative of a drug company, and
asked to analyze some patient samples for drug levels of a specific drug that the
representative’s company sells and that these patients use. The representative
wants to publish a report on the rate of drug absorption and distribution of this
drug and tells his laboratorian friend that he will personally reimburse him for his
time. What ethical issues come into play here?
a. Resource allocation and conflict of interest
b. Maintenance of confidentiality and publishing issues
c. Maintenance of confidentiality, conflict of interest, and publishing issues.
d. Resource allocation, maintenance of confidentiality, conflict of
interest, and publishing issues.
ANS: D
