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🧪 CLINICAL CHEMISTRY – What should know as Technologist before take exit exam

1. A patient with severe diarrhea becomes weak and confused. Lab shows low sodium. What is the best first lab action?
A. Repeat test immediately
B. Check sample hemolysis
C. Report result urgently
D. Ignore and wait
👉 Answer: C
💡 Critical value → must report immediately
2. A potassium result is very high, but sample is hemolyzed. What should you do?
A. Report as hyperkalemia
B. Reject sample
C. Repeat with new sample
D. Ignore
👉 Answer: C
💡 Hemolysis falsely ↑ K⁺
3. A patient is on IV fluids. Sodium result is unexpectedly low. What is likely error?
A. Machine failure
B. Dilution from IV line
C. Calibration error
D. QC failure
👉 Answer: B

4. A patient has high urea but normal creatinine. What should you consider first?
A. Kidney failure
B. Dehydration or high protein intake
C. Liver failure
D. Infection
👉 Answer: B
5. A patient with chronic kidney disease is monitored. Which test is best for follow-up?
A. Urea
B. Creatinine
C. Glucose
D. ALT
👉 Answer: B
6. A lab reports very high creatinine suddenly. What is the first step?
A. Report immediately
B. Check previous result
C. Repeat test
D. Call doctor
👉 Answer: C

7. A patient has jaundice and dark urine. Which test confirms liver involvement?
A. Creatinine
B. ALT
C. Glucose
D. Sodium
👉 Answer: B
8. A lab technician observes AST much higher than ALT. What should be suspected?
A. Viral hepatitis
B. Alcoholic liver disease
C. Kidney disease
D. Diabetes
👉 Answer: B
9. Bilirubin sample exposed to light before analysis. What happens?
A. Increase value
B. Decrease value
C. No change
D. Hemolysis
👉 Answer: B
💡 Bilirubin is light-sensitive

10. A patient has normal FBS but high HbA1c. Interpretation?
A. No diabetes
B. Chronic hyperglycemia
C. Lab error
D. Kidney disease
👉 Answer: B
11. A patient sample for glucose is delayed without fluoride tube. What happens?
A. Glucose increases
B. Glucose decreases
C. No change
D. Hemolysis
👉 Answer: B
💡 Glycolysis ↓ glucose
12. Which test reflects 3-month glucose control?
A. FBS
B. RBS
C. HbA1c
D. OGTT
👉 Answer: C

13. A patient has high LDL and low HDL. What is your interpretation?
A. Low risk
B. High cardiovascular risk
C. Liver disease
D. Kidney disease
👉 Answer: B
14. Patient was not fasting before lipid test. What is affected most?
A. HDL
B. LDL
C. Triglycerides
D. Cholesterol
👉 Answer: C

15. A patient has edema and low albumin. What is likely cause?
A. Heart disease
B. Liver disease
C. Infection
D. Diabetes
👉 Answer: B
16. Total protein high in dehydrated patient. Why?
A. Dilution
B. Concentration
C. Liver failure
D. Infection
👉 Answer: B

17. A patient with chest pain has normal troponin initially. What should be done?
A. Discharge
B. Repeat after few hours
C. Ignore
D. Diagnose MI
👉 Answer: B
18. Which marker is most specific for myocardial infarction?
A. CK
B. AST
C. Troponin
D. ALT
👉 Answer: C

19. COBAS e601 uses which detection method?
A. Color change
B. Light emission
C. Weight measurement
D. Heat
👉 Answer: B

20. If QC fails on COBAS e601, what is correct action?
A. Continue testing
B. Stop and troubleshoot
C. Report results
D. Ignore
👉 Answer: B
21. Which sample is preferred for COBAS e601?
A. Whole blood
B. Serum
C. Urine
D. Saliva
👉 Answer: B

22. Wrong patient labeling leads to:
A. Analytical error
B. Pre-analytical error
C. Post-analytical error
D. No error
👉 Answer: B
23. Hemolyzed sample affects which test most?
A. Sodium
B. Potassium
C. Glucose
D. Cholesterol
👉 Answer: B

24. QC within range means:
A. Reject results
B. Accept results
C. Repeat test
D. Ignore
👉 Answer: B
25. Calibration ensures:
A. Speed
B. Accuracy
C. Volume
D. Color
👉 Answer: B

26. Patient with diabetes + high creatinine → interpretation?
A. Liver disease
B. Diabetic nephropathy
C. Infection
D. Anemia
👉 Answer: B
27. High ALT + high bilirubin → diagnosis?
A. Hepatitis
B. MI
C. Kidney disease
D. Diabetes
👉 Answer: A
28. Low sodium + confusion → urgent step?

A. Repeat later
B. Report immediately
C. Ignore
D. Store sample
👉 Answer: B
29. Lab result inconsistent with patient condition. What is first step?
A. Report
B. Repeat test
C. Ignore
D. Diagnose
👉 Answer: B
30. Machine gives repeated error codes. What should you do?
A. Continue
B. Restart + troubleshoot
C. Ignore
D. Report result
👉B


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