⚗️ Clinical Chemistry Review for the MedTech Board Exam

What the Clinical Chemistry course covers

1. Unit 1: Lab Foundations

   Solutions, statistics, automation and getting the specimen right.

   Solutions & concentration · Lab statistics · Automation & LIS · Before & after the test

2. Unit 2: Light & Electrodes

   Spectrophotometry, Beer’s law, optical methods, electrochemistry and osmometry.

   The spectrophotometer · Light & Beer’s law · More optical methods · Electrodes & osmometry

3. Unit 3: Special Methods

   Electrophoresis, immunoassays and chromatography.

   Electrophoresis · Immunoassays · Chromatography

4. Unit 4: Organ Systems

   Kidney, liver, GI tract, pancreas and heart — the physiology behind the tests.

   The kidney · Liver & bilirubin · Jaundice & hepatitis · GI tract, pancreas & heart

5. Unit 5: Proteins

   Amino acids, plasma proteins, protein methods and electrophoresis patterns.

   Amino acids · Plasma proteins & methods · SPE & protein disorders

6. Unit 6: Electrolytes & Acid–Base

   Sodium, potassium, chloride, bicarbonate, the anion gap and blood gases.

   Sodium & potassium · Chloride, bicarbonate & anion gap · Acid–base & blood gases

7. Unit 7: Nitrogen Wastes

   Urea, ammonia, creatinine and uric acid — markers of kidney and liver function.

   Urea & ammonia · Creatinine & uric acid

8. Unit 8: Carbohydrates

   Sugars, glucose control, diabetes and glucose testing.

   Sugars & metabolism · Glucose control & diabetes · Testing glucose

9. Unit 9: Lipids

   Fats, cholesterol, lipoproteins, lipid disorders and lipid testing.

   Lipids & lipoproteins · Lipid disorders & testing

10. Unit 10: Vitamins & Tumor Markers

    Fat- and water-soluble vitamins, and the markers used to follow cancer.

    Vitamins · Tumor markers

11. Unit 11: Porphyrins & Iron

    Heme synthesis, the porphyrias, iron metabolism and iron studies.

    Porphyrins & porphyrias · Iron

12. Unit 12: Heart & Bone Markers

    Troponin, myoglobin and CK-MB in heart attacks; markers of bone formation and loss.

    Cardiac markers · Bone & its markers

13. Unit 13: Enzymes

    How enzymes work, kinetics, and the clinically important enzymes.

    Enzyme basics · Enzyme kinetics · Liver & bone enzymes · CK, LD & other enzymes

14. Unit 14: Endocrinology

    Hormones, the pituitary, adrenal, thyroid, parathyroid and reproductive glands.

    Hormones & the pituitary · Adrenal glands · Thyroid · Parathyroid & calcium · Reproductive hormones

15. Unit 15: Toxicology & Drug Monitoring

    Poisons and antidotes, drugs of abuse, and therapeutic drug monitoring.

    Poisons & antidotes · Alcohols & drugs of abuse · Therapeutic drug monitoring

16. Unit 16: SI Units for International Exams

    Converting conventional units to SI — essential for ASCPi and other international exams such as AIMS (Australia) and CSMLS (Canada).

    Chemistry in SI units · Blood counts in SI units

Sample Clinical Chemistry board exam questions

A few practice questions from the course, with explanations. Thousands more are in the app.

1. 1. How many grams of NaOH (MW 40) are needed to make 500 mL of a 0.2 M solution?

   1. 40 g
   2. 2.0 g
   3. 8.0 g
   4. 4.0 g
   Show answer

   Answer: D. 4.0 g

   moles = 0.2 mol/L × 0.5 L = 0.1 mol; 0.1 mol × 40 g/mol = 4.0 g.

2. 2. A solution transmits 25% of the incident light. Its absorbance is closest to:

   1. 0.398
   2. 0.250
   3. 0.602
   4. 1.398
   Show answer

   Answer: C. 0.602

   A = 2 − log %T = 2 − log 25 = 2 − 1.398 = 0.602.

3. 3. Serum protein electrophoresis shows a narrow, dense band in the γ region with reduced background γ-globulins. This most suggests:

   1. A polyclonal response to chronic infection
   2. Acute inflammation
   3. A monoclonal gammopathy such as multiple myeloma
   4. Nephrotic syndrome
   Show answer

   Answer: C. A monoclonal gammopathy such as multiple myeloma

   A single sharp “M-spike” comes from one clone of plasma cells; normal immunoglobulins are often suppressed.

4. 4. Total bilirubin 8 mg/dL (direct 6 mg/dL), very high ALP, urine bilirubin positive, urine urobilinogen absent and pale stools. The most likely type of jaundice is:

   1. Posthepatic (obstructive)
   2. Gilbert syndrome
   3. Prehepatic (hemolytic)
   4. Early viral hepatitis
   Show answer

   Answer: A. Posthepatic (obstructive)

   Blocked bile flow: conjugated bilirubin backs up into blood and urine, little reaches the gut (no urobilinogen, pale stools), and ALP rises sharply.

5. 5. Albumin measured with bromcresol green (BCG) tends to read slightly high because BCG:

   1. Is affected only by hemolysis
   2. Reacts with bilirubin
   3. Binds lipids in the sample
   4. Also binds some α- and β-globulins
   Show answer

   Answer: D. Also binds some α- and β-globulins

   BCG is less specific than bromcresol purple; it picks up some globulins, especially when albumin is low.

6. 6. pH 7.25, pCO₂ 60 mmHg, HCO₃⁻ 26 mmol/L. Interpretation:

   1. Metabolic acidosis
   2. Metabolic alkalosis
   3. Fully compensated respiratory acidosis
   4. Acute (uncompensated) respiratory acidosis
   Show answer

   Answer: D. Acute (uncompensated) respiratory acidosis

   Low pH with high pCO₂ = respiratory acidosis; a near-normal bicarbonate means the kidneys haven’t compensated yet.

7. 7. BUN 60 mg/dL and creatinine 1.5 mg/dL (ratio 40:1) in a dehydrated patient most suggest:

   1. Acute tubular necrosis
   2. Postrenal obstruction resolved
   3. Prerenal azotemia
   4. Severe liver failure
   Show answer

   Answer: C. Prerenal azotemia

   Poor renal perfusion increases urea reabsorption more than creatinine, raising the BUN:creatinine ratio above ~20:1.

8. 8. A fasting plasma glucose of 115 mg/dL (6.4 mmol/L) on two occasions indicates:

   1. Normal fasting glucose
   2. Fasting hypoglycemia
   3. Diabetes mellitus
   4. Prediabetes (impaired fasting glucose)
   Show answer

   Answer: D. Prediabetes (impaired fasting glucose)

   Fasting 100–125 mg/dL (5.6–6.9 mmol/L) is impaired fasting glucose; ≥ 126 mg/dL (7.0 mmol/L) is diabetes.

Practice more Clinical Chemistry questions

How you review in MedTech Reviewer

• Learning path: short lessons, each followed by questions, with a checkpoint at the end of every unit.
• Spaced repetition: questions you miss come back sooner, so key facts stick for exam day.
• Flashcards and timed quizzes in exam style, with an explanation for every answer.
• Board-readiness score per subject, so you know where to focus.
• Arcade games, PvP battles and Guilds to keep reviewing fun with classmates.

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