TEST BANK FOR TIETZ FUNDAMENTALS
OFCLINICAL CHEMISTRY AND
MOLECULAR DIAGNOSTICS 7TH
EDITION BYBURTIS
Chapter 01: Clinical Chemistry, Molecular Diagnostics, and
Laboratory Medicine Test Bank
MULTIPLE CHOICE
• 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 onlyrecommends the spouse’s company as the vendor. This is
considered to be a(n):
• accounting issue.
• possible conflict of interest.
• maintenance of confidentiality issue.
• problem with resource allocation.
ANS: B
Concern has been raised over the interrelationships between practitioners in the
medical fieldand 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 potentialconflicts of interest.
DIF: 1 REF: Page 4-5 OBJ: 6 | 7
• A patient visits her physician stating that her prescribed painkiller is not working to
reduce thepain 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.
• epidemiology
• an inherited disease
• a conflict of interest
• a genetic variation in drug-metabolizing enzymes
ANS: D
Pharmacogenetics is the study of the genetic variation of drug metabolism
betweenindividuals.
DIF: 1 REF: Page 3 OBJ: 1
• 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:
• confidentiality of patient genetic and medical information.
• a conflict of interest.
• resource allocation.
• diagnostic accuracy.
ANS: A
Clinical laboratorians have long been responsible for maintaining the
confidentiality of alllaboratory results, a situation made even more critical with the
advent of increasingly powerful genetic testing.
DIF: 1 REF: Page 4 OBJ: 6 | 7
• Molecular diagnostic testing methods and results can be:
• qualitative only.
• quantitative only.
• either qualitative or quantitative.
ANS: C
, Molecular diagnostic methods can be either qualitative or quantitative in nature,
depending onthe clinical need.
DIF: 1 REF: Page 3 OBJ: 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 evaluatethe effects and outcomes of laboratory testing. This allows for a more
effective:
• process of determining the cost of the testing methods.
• selection and interpretation of laboratory tests.
• determination of the boundaries between the components of the clinical lab.
• 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 inthe selection and interpretation of laboratory tests.
DIF: 1 REF: Page 3 OBJ: 4
• Analysis of which one of the following by molecular diagnostic methods provides a
measureof processes that are ongoing at the time of blood sampling?
• Genetic variation in an individual’s response to a drug
• Circulating plasma nucleic acids
• Malignant lymphomas
• Histocompatibility
ANS: B
Molecular diagnostics, given its very high sensitivity, has been applied to the study of
plasmanucleic 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
• 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 testsrequested 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:
• confirming a clinical suspicion of disease.
• selecting a treatment for disease.
, • ruling in a diagnosis.
• 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 theselection, 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
• The discipline involved in the selection, provision, and interpretation of diagnostic
testing that uses primarily samples from patients is:
• clinical chemistry.
• hematology.
• laboratory medicine.
• 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
• 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 sellsand 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 personallyreimburse him for his time. What ethical issues come into
play here?
• Resource allocation and conflict of interest
• Maintenance of confidentiality and publishing issues
• Maintenance of confidentiality, conflict of interest, and publishing issues.
• Resource allocation, maintenance of confidentiality, conflict of
interest, andpublishing issues.
ANS: D
Resource allocation, maintenance of confidentiality, conflict of interest, and publishing
issuesare being compromised by the representative and the laboratorian if the
laboratorian follows through with the request. Using laboratory resources for a study
OFCLINICAL CHEMISTRY AND
MOLECULAR DIAGNOSTICS 7TH
EDITION BYBURTIS
Chapter 01: Clinical Chemistry, Molecular Diagnostics, and
Laboratory Medicine Test Bank
MULTIPLE CHOICE
• 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 onlyrecommends the spouse’s company as the vendor. This is
considered to be a(n):
• accounting issue.
• possible conflict of interest.
• maintenance of confidentiality issue.
• problem with resource allocation.
ANS: B
Concern has been raised over the interrelationships between practitioners in the
medical fieldand 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 potentialconflicts of interest.
DIF: 1 REF: Page 4-5 OBJ: 6 | 7
• A patient visits her physician stating that her prescribed painkiller is not working to
reduce thepain 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.
• epidemiology
• an inherited disease
• a conflict of interest
• a genetic variation in drug-metabolizing enzymes
ANS: D
Pharmacogenetics is the study of the genetic variation of drug metabolism
betweenindividuals.
DIF: 1 REF: Page 3 OBJ: 1
• 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:
• confidentiality of patient genetic and medical information.
• a conflict of interest.
• resource allocation.
• diagnostic accuracy.
ANS: A
Clinical laboratorians have long been responsible for maintaining the
confidentiality of alllaboratory results, a situation made even more critical with the
advent of increasingly powerful genetic testing.
DIF: 1 REF: Page 4 OBJ: 6 | 7
• Molecular diagnostic testing methods and results can be:
• qualitative only.
• quantitative only.
• either qualitative or quantitative.
ANS: C
, Molecular diagnostic methods can be either qualitative or quantitative in nature,
depending onthe clinical need.
DIF: 1 REF: Page 3 OBJ: 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 evaluatethe effects and outcomes of laboratory testing. This allows for a more
effective:
• process of determining the cost of the testing methods.
• selection and interpretation of laboratory tests.
• determination of the boundaries between the components of the clinical lab.
• 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 inthe selection and interpretation of laboratory tests.
DIF: 1 REF: Page 3 OBJ: 4
• Analysis of which one of the following by molecular diagnostic methods provides a
measureof processes that are ongoing at the time of blood sampling?
• Genetic variation in an individual’s response to a drug
• Circulating plasma nucleic acids
• Malignant lymphomas
• Histocompatibility
ANS: B
Molecular diagnostics, given its very high sensitivity, has been applied to the study of
plasmanucleic 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
• 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 testsrequested 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:
• confirming a clinical suspicion of disease.
• selecting a treatment for disease.
, • ruling in a diagnosis.
• 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 theselection, 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
• The discipline involved in the selection, provision, and interpretation of diagnostic
testing that uses primarily samples from patients is:
• clinical chemistry.
• hematology.
• laboratory medicine.
• 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
• 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 sellsand 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 personallyreimburse him for his time. What ethical issues come into
play here?
• Resource allocation and conflict of interest
• Maintenance of confidentiality and publishing issues
• Maintenance of confidentiality, conflict of interest, and publishing issues.
• Resource allocation, maintenance of confidentiality, conflict of
interest, andpublishing issues.
ANS: D
Resource allocation, maintenance of confidentiality, conflict of interest, and publishing
issuesare being compromised by the representative and the laboratorian if the
laboratorian follows through with the request. Using laboratory resources for a study
