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Reconstruction exam 31.10.23

Clinical Chemistry II
31.10.2023

SC = single choice (only 1 answer is correct)
MPC = multiple choice (multiple answers are correct)

A paper about liver failure upon hepatitis E infection had been distributed one week before the exam. Questions 1 and 2 were mostly referring to this article.

1. Statements about HepB (SC):
a)
b) HepB prevalence in Switzerland is low.
c) HepB infection in Switzerland mostly via meat.
d)

2. Statements about HepB (MPC)
a) HepB is usually self-limiting in immunocompetent people.
b)
c) Immediate treatment monitoring via AP.
d) Conjugated bilirubin is elevated during HepB infection.

3. Hypertension follow up (MPC)
a) Cortisol should be measured in all hypertension patients.
b) Most hypertension cases can be treated by one drug.
c) Lifestyle changes are recommended even in treatment with drugs.
d)

4. Hepatitis status (SC)
- HbsAg pos.
- anti-Hbc IgM/IgG pos.
- anti-Hbc IgM pos.
- anti-Hbs neg.

a)
b) chronic infection
c) acute infection
d) vaccinated

5. Vitamin D (MPC)
a) Vitamin D needs to be metabolised to be active.
b) Main source of VitD is food, e.g. fish and meat.
c) In the population of Zurich similar endogenic Vit D levels can be measured the whole year.
d) Only 40% of German 10 y old boys have suffient VitD levels.

6. Kidney stones: values that indicate a high risk (MPC)
a) Calcium: elevated
b) Citrate: elevated
c) Parathyroidhormone: elevated
d) Urea: elevated
e) Calcium: reduced

7. Fetal Occult Blood Test (FOBT) (MPC)
a) Detects most colorectal cancers.
b) Aspirin leads to false negative result.
c) Upon a negative test, one can be sure there' no colorectal cancer present.
d) Can be done in a pharmacy.
e) FOBT is recommended once for 50-69 y old people.

8. Calculate the risk prognosis (SC): 50 y old male hypertension (145/95) patient, smoker, family history of cardiovascular disease
a)
b) low risk
c) moderate
d) high risk
e) very high risk

9. HIV laboratory parameter for monitoring (MPC)
a) plasma viral load
b) anti-HIV antibody
c) ALT
d) CD4 levels
e) leukocyte levels

10. Clinical laboratory in pharmacy being reimbursed by health insurance (MPC)
a) Does require external quality control.
b) Does not require external quality control.
c) Does require internal quality control.
d) Does not require internal quality control.

11. Competitive Immunoassay (MPC)
a) Used for therapeutic drug monitoring.
b) 2 antibodies are used.
c) Shows an increasing readout upon increasing analyte concentration.
d) The concdntrstion of the labelled antibody is known.
e) Used for protein analysis.

12. Which measured parameter is used for which disease?
Parameter: Normetanephrin, Deoxypyridinoline, Thyreoglobulin, ALT, Cystin
Diseases: kidney stone, pheochromocytoma, osteoporosis, acute hepatitis, thyroid cancer