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What does a raised erythrocyte sedimentation rate (ESR) show?

1. AInflammation somewhere in the body, without showing where
2. BDamage to heart muscle within the past few hours
3. CA specific infection of the urinary tract by bacteria
4. DA low level of iron stored in the bone marrow

Why is prealbumin (transthyretin) sometimes used to follow a patient's nutritional status instead of albumin?

1. AIt has a long half-life, so it changes over months
2. BIt is not affected by inflammation or liver disease
3. CIt is measured in urine, so no blood test is needed
4. DIt has a short half-life, so it changes within days

Which statement about HDL cholesterol is correct?

1. AHigher levels are the main cause of plaque in the arteries
2. BIt should ideally be kept below 40 mg/dL (1.0 mmol/L)
3. CIt is the same as the fasting triglyceride level
4. DHigher levels are linked to a lower risk of heart disease

When several samples are drawn at the same venipuncture, which tubes or bottles are filled first?

1. AEDTA (complete blood count) tubes
2. BFluoride (glucose) tubes
3. CCoagulation (citrate) tubes
4. DBlood culture bottles

A young adult with new diabetes has a very low C-peptide level. What does this suggest?

1. AThe pancreas is making very little insulin, as in type 1 diabetes
2. BThe patient is injecting too much insulin and needs a lower dose
3. CThe kidneys are excreting all of the patient's insulin in urine
4. DThe patient has high insulin resistance, as in type 2 diabetes

A patient takes high-dose biotin supplements for hair and nails. Why should the nurse report this before blood tests?

1. ABiotin can distort some immunoassays, such as troponin or TSH
2. BBiotin makes the blood clot in the tube before testing
3. CBiotin lowers the hemoglobin by destroying the red cells
4. DBiotin causes a true rise in blood glucose in all patients

A patient has painless jaundice, itching, dark urine and pale stools. ALP is markedly raised, conjugated (direct) bilirubin is high and ALT is only mildly raised. What is the most likely cause?

1. AGilbert syndrome, a harmless inherited bilirubin disorder
2. BAcute viral hepatitis with widespread liver cell damage
3. CBlockage of bile flow, for example by a tumor in the bile duct
4. DIncreased breakdown of red blood cells (hemolytic anemia)

Four results arrive at the same time. Which patient should the nurse see first?

1. AHemoglobin 10.4 g/dL (104 g/L) in a patient with stable chronic kidney disease
2. BWhite cell count 12.0 × 10³/µL on the first day after surgery
3. CGlucose 48 mg/dL (2.7 mmol/L) in a patient who had insulin an hour ago
4. DINR 2.6 in a patient on warfarin for atrial fibrillation