This section contains 65 multiple-choice questions (MCQs) covering various aspects of clinical enzymology. These questions are designed to test your understanding of enzyme function, clinical applications, and diagnostic techniques. Each question is carefully crafted to assess your knowledge and critical thinking skills in this important field of medical science.

Clinical Enzymology MCQ’s
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Serial 46 – 65
  • 46. These reagents can be added to the LD assay mixture as a selective inhibitor of the LD isoenzymes containing M sub-units so that only LD-1, which is composed of four H units, is measured.
    • A. Nitroanilide
    • B. 1,6 hexanediol
    • C. Ro-0683
    • D. Sodium perchlorate
    • A. only 1 and 3 are correct
    • B. only 2 and 4 are correct ✅
    • C. only 1,2, and 3 are correct
    • D. 1,2,3 and 4 are correct

  • 47. Which LD isoenzyme has the highest migration rate?
    • A. LD1 ✅
    • B. LD2
    • C. LD4
    • D. LD5

  • 48. In agarose gel, this LD isoenzyme migrates to the cathode:
    • A. LD1 ✅
    • B. LD2
    • C. LD4
    • D. LD5

  • 49. In cellulose acetate electrophoresis the LD isoenzyme fractions are made visible by coupling the enzymatically formed pyruvate with:
    • A. NAD
    • B. NADH
    • C. tetrazolium salt ✅
    • D. Sodium perchlorate

  • 50. This ratio is used to differentiate between prehepatic jaundice caused by hemolysis or dyserythropoiesis from hepatic jaundice.
    • A. ALT/AST ratio
    • B. LD/AST ratio ✅
    • C. LD/CK ratio
    • D. CK/AST ratio

  • 51. Anodic LD isoenzyme pattern is associated with:
    • 1. Muscular dystrophy
    • 2. Germ cell tumor
    • 3. Renal infarction
    • 4. Cardiac muscle damage
    • A. only 1 and 3 are correct
    • B. only 2 and 4 are correct ✅
    • C. only 1,2, and 3 are correct
    • D. 1,2,3 and 4 are correct

  • 52. Which anticoagulant should not be used in LD assay?
    • A. Oxalate
    • B. Flouride
    • C. both ✅
    • D. neither

  • 53. Which of the following conditions can falsely increase LD measurement?
    • A. Blood sample collection after exercise
    • B. Use of capillary serum
    • C. Use of hemolyzed samples
    • D. All of these ✅

  • 54. At a mean activity of 165U/L, hemolysis of 0.8g hb/L leads to an LD increase of:
    • A. 36%
    • B. 58% ✅
    • C. 360%
    • D. 12%

  • 55. Which of the following LD isoenzymes is not seen mainly in Duchenne muscular dystrophy?
    • A. LD1
    • B. LD2
    • C. LD3
    • D. LD5 ✅

  • 56. The most reliable method for lipase determination is the kinetic, automatic titration of oleic acid released from an emulsion of triolein or pure olive oil by enzymatic hydrolysis with sodium hydroxide at what pH?
    • A. 8.6
    • B. 6.5
    • C. 9.0 ✅
    • D. 8.4

  • 57. As ACP is released from erythrocytes, a hemoglobin concentration of 3.4g/L in serum may increase ACP by:
    • A. 50%
    • B. 40% ✅
    • C. 30%
    • D. 20%

  • 58. ACP is unstable at pH above 7.0 and the pH of plasma or serum is adjusted to 4-5 by the addition of:
    • A. 10% acetic acid(20uL/mL) ✅
    • B. Sodium bisulfate 5mg/mL serum
    • C. both
    • D. neither

  • 59. Which of the following diseases are associated with elevations of ACP in serum?
    • 1. Prostatic carcinoma
    • 2. Multiple myeloma
    • 3. Paget’s disease
    • 4. Gaucher’s disease
    • A. only 1 and 3 are correct
    • B. only 2 and 4 are correct
    • C. only 1,2, and 3 are correct ✅
    • D. 1,2,3 and 4 are correct

  • 60. Without acidification, ACP activity is decreased up to:
    • A. 20% in 3h ✅
    • B. 20% in 2h
    • C. 50% in 2h
    • D. 5% in 2h

  • 61. This protein participates in the uptake and the intracellular transport of the long-chain fatty acids in the cardiomyocytes.
    • A. Cardiac troponin (cTnT)
    • B. Heart fatty acid binding protein(H-FABP) ✅
    • C. myoglobin
    • D. natriuretic peptide

  • 62. This myofibrillar protein of the heart muscle is released from the myocardium following injury and is used in the late diagnosis and monitoring of the course of acute myocardial infarction.
    • A. Cardiac troponin (cTnT) ✅
    • B. Heart fatty acid binding protein(H-FABP)
    • C. myoglobin
    • D. natriuretic peptide

  • 63. This is a specific cardiospecific marker used to assess chronic or subacute graft rejection after heart transplantation.
    • A. Cardiac troponin (cTnT)
    • B. cardiac troponin I (cTnI) ✅
    • C. Heart fatty acid binding protein(H-FABP)
    • D. glycoprotein phosphorylase isoenzyme BB (GPBB)

  • 64. This is highly sensitive to ischemia of cardiomyocytes so that the clinical sensitivity of its measurement for diagnosing an acute coronary syndrome is higher than that of other cardiac markers.
    • A. Cardiac troponin (cTnT) ✅
    • B. cardiac troponin I (cTnI)
    • C. Heart fatty acid binding protein(H-FABP)
    • D. glycoprotein phosphorylase isoenzyme BB (GPBB)

  • 65. This is the most important natriuretic peptide of the ventricles and it is a more sensitive and more specific indicator of ventricular overload.
    • A. Atrial natriuretic peptide
    • B. Cyclic guanosine monophosphate
    • C. brain natriuretic peptide ✅
    • D. CNP

    • Pages: 1 2 3
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