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Here is a comprehensive bank of 120+ Clinical Chemistry questions with clear answers, designed for
medical laboratory science students and covering:

Liver Function Tests (LFT)

Renal Function Tests (RFT)

Lipid profile (Lipogram)

Glucose & HbA1c

Electrolytes & Acid–Base

Biomarkers & Cardiac markers

Pancreatic Function Tests (PFT)

Proteins & Enzymes

These are theory + practical oriented, suitable for exams, OSPE, and ward rotations.

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🧪 A. LIVER FUNCTION TESTS (LFT) – Questions 1–30

1. What is the primary function of the liver assessed by LFTs?

Answer: Metabolism, detoxification, and protein synthesis

2. Which enzyme is most specific for hepatocellular injury?

Answer: Alanine aminotransferase (ALT)

3. Which enzyme is found in liver and muscle?

Answer: Aspartate aminotransferase (AST)

4. What AST/ALT ratio >2 suggests?

Answer: Alcoholic liver disease

5. Which enzyme is elevated in cholestasis?

Answer: Alkaline phosphatase (ALP)

6. Which enzyme helps differentiate liver vs bone ALP?

Answer: Gamma-glutamyl transferase (GGT)

7. What is the normal function of bilirubin conjugation?

Answer: Make bilirubin water-soluble for excretion

8. Which bilirubin is elevated in hemolytic jaundice?

Answer: Unconjugated bilirubin

9. Which bilirubin is elevated in obstructive jaundice?

Answer: Conjugated bilirubin

10. What does elevated GGT indicate?

Answer: Alcohol use or biliary obstruction

11. What protein reflects liver synthetic function?

Answer: Albumin

12. What does low serum albumin suggest?

Answer: Chronic liver disease or malnutrition

13. Which clotting factor test assesses liver function?

Answer: Prothrombin time (PT)

14. Which condition causes markedly high ALT and AST?

Answer: Acute viral hepatitis

15. Which enzyme is elevated in fatty liver disease?

Answer: ALT

16. What is the normal color of urine in obstructive jaundice?

Answer: Dark urine

17. Which bile pigment gives stool its color?

Answer: Stercobilin

18. Which test assesses liver excretory function?

Answer: Serum bilirubin

19. What condition shows raised ALP but normal ALT?

Answer: Bone disease

20. Which enzyme increases earliest in biliary obstruction?

Answer: ALP

21. What does elevated ammonia indicate?

Answer: Hepatic encephalopathy

22. Which LFT parameter is decreased in cirrhosis?

Answer: Albumin

23. What sample is used for LFTs?

Answer: Serum

24. Which test distinguishes hepatocellular from cholestatic injury?

Answer: Enzyme pattern (ALT vs ALP)

25. What is Dubin-Johnson syndrome associated with?

Answer: Conjugated hyperbilirubinemia

26. Which enzyme is induced by alcohol?

Answer: GGT

27. What is the main transport protein of bilirubin in blood?

Answer: Albumin

28. What does pale stool indicate?

Answer: Obstructive jaundice

29. Which test monitors chronic liver disease progression?

Answer: Albumin and PT

30. What condition causes isolated AST elevation?

Answer: Muscle injury

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🚽 B. RENAL FUNCTION TESTS (RFT) – Questions 31–55

31. What is the primary function assessed by RFTs?

Answer: Glomerular filtration

32. Which waste product reflects kidney function?

Answer: Creatinine

33. Why is creatinine preferred over urea?

Answer: Less affected by diet

34. What does elevated urea indicate?

Answer: Renal impairment or dehydration

35. Which test best estimates GFR?

Answer: Serum creatinine with eGFR

36. What is BUN?

Answer: Blood urea nitrogen

37. What is prerenal azotemia associated with?

Answer: Dehydration

38. What does low creatinine indicate?

Answer: Reduced muscle mass

39. Which electrolyte is regulated by kidneys?

Answer: Potassium

40. What does proteinuria indicate?

Answer: Glomerular damage

41. Which urine test detects microalbuminuria?

Answer: Albumin-creatinine ratio (ACR)

42. What condition causes high creatinine with normal urea?

Answer: Muscle breakdown

43. What is renal clearance?

Answer: Volume of plasma cleared per unit time

44. Which test assesses tubular function?

Answer: Urine osmolality

45. What does high potassium indicate?

Answer: Renal failure

46. What is the normal pH of urine?

Answer: 4.5–8.0

47. What condition leads to decreased GFR?

Answer: Chronic kidney disease

48. Which marker rises earliest in kidney injury?

Answer: Creatinine
49. What test is used in dialysis monitoring?

Answer: Urea

50. What sample is used for RFTs?

Answer: Serum

51. What does hyponatremia indicate?

Answer: Excess water or renal dysfunction

52. Which hormone regulates calcium via kidneys?

Answer: Parathyroid hormone

53. What is post-renal azotemia caused by?

Answer: Urinary obstruction

54. Which condition causes metabolic acidosis?

Answer: Renal failure

55. What does elevated phosphate indicate?

Answer: Renal impairment

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🩸 C. LIPID PROFILE (LIPOGRAM) – Questions 56–75

56. What parameters are measured in a lipid profile?

Answer: TC, HDL, LDL, triglycerides

57. Which lipid is protective?

Answer: HDL cholesterol

58. What does high LDL indicate?

Answer: Cardiovascular risk

59. Which lipid is elevated after meals?

Answer: Triglycerides
60. Why is fasting required for lipid profile?

Answer: Reduce postprandial triglycerides

61. What does low HDL indicate?

Answer: Increased cardiovascular risk

62. Which formula calculates LDL?

Answer: Friedewald formula

63. When is Friedewald formula invalid?

Answer: Triglycerides >400 mg/dL

64. What is dyslipidemia?

Answer: Abnormal lipid levels

65. Which lipid causes pancreatitis when very high?

Answer: Triglycerides

66. What condition shows high cholesterol?

Answer: Hypothyroidism

67. Which lipid profile change is seen in diabetes?

Answer: High TG, low HDL

68. What is non-HDL cholesterol?

Answer: Total cholesterol minus HDL

69. What enzyme method measures cholesterol?

Answer: CHOD-PAP

70. What lipoprotein is atherogenic?

Answer: LDL

71. What is VLDL rich in?

Answer: Triglycerides

72. What sample is used for lipogram?

Answer: Fasting serum

73. What lifestyle change improves HDL?

Answer: Exercise

74. Which drug lowers cholesterol?

Answer: Statins

75. What lipid abnormality causes xanthomas?

Answer: Hypercholesterolemia

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🍬 D. GLUCOSE & HbA1c – Questions 76–95

76. What is the normal fasting blood glucose?

Answer: 70–99 mg/dL

77. What test diagnoses diabetes mellitus?

Answer: Fasting glucose / HbA1c

78. What does HbA1c reflect?

Answer: Average glucose over 2–3 months

79. What HbA1c value indicates diabetes?

Answer: ≥6.5%

80. Which method measures glucose?

Answer: Glucose oxidase

81. What causes false low glucose?

Answer: Delayed sample processing

82. Which anticoagulant preserves glucose?

Answer: Sodium fluoride

83. What condition causes hypoglycemia?

Answer: Insulin overdose

84. What is postprandial glucose measured after?

Answer: 2 hours

85. What does high HbA1c indicate?

Answer: Poor glycemic control

86. Which test monitors diabetes long-term?

Answer: HbA1c

87. What condition affects HbA1c accuracy?

Answer: Hemolytic anemia

88. What is gestational diabetes screened with?

Answer: OGTT

89. What sample is used for HbA1c?

Answer: Whole blood (EDTA)

90. What is the renal threshold for glucose?

Answer: ~180 mg/dL

91. What causes glycosuria?

Answer: Hyperglycemia

92. What hormone lowers blood glucose?

Answer: Insulin

93. What hormone raises blood glucose?

Answer: Glucagon

94. Which condition causes high fasting glucose?

Answer: Diabetes mellitus

95. What complication is linked to high HbA1c?

Answer: Microvascular damage

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⚡ E. ELECTROLYTES & BIOMARKERS & PFT – Questions 96–125

96. Which electrolyte maintains osmotic balance?

Answer: Sodium

97. What causes hyperkalemia?

Answer: Renal failure

98. Which electrolyte is vital for muscle contraction?

Answer: Calcium

99. What does low calcium cause?

Answer: Tetany

100. What biomarker is specific for myocardial infarction?

Answer: Troponin I/T

101. Which enzyme rises early in MI?

Answer: CK-MB

102. What does BNP indicate?

Answer: Heart failure

103. Which biomarker indicates inflammation?

Answer: CRP

104. What electrolyte imbalance causes arrhythmia?

Answer: Potassium imbalance

105. What test assesses pancreatic function?

Answer: Serum amylase

106. Which enzyme is more specific for pancreatitis?

Answer: Lipase
107. What does elevated amylase indicate?

Answer: Acute pancreatitis

108. Which sample is used for electrolyte analysis?

Answer: Serum or plasma

109. What is metabolic acidosis?

Answer: Low blood pH with low bicarbonate

110. What electrolyte imbalance occurs in vomiting?

Answer: Hypokalemia

111. What biomarker predicts cardiovascular risk?

Answer: hs-CRP

112. What does raised phosphate indicate?

Answer: Renal failure

113. Which electrolyte is regulated by aldosterone?

Answer: Sodium

114. What test monitors chronic pancreatitis?

Answer: Fecal elastase

115. What electrolyte abnormality occurs in diarrhea?

Answer: Hypokalemia

116. Which biomarker indicates tissue hypoxia?

Answer: Lactate

117. What does low magnesium cause?

Answer: Neuromuscular irritability

118. Which analyzer measures electrolytes?

Answer: Ion-selective electrode

119. What does elevated LDH indicate?

Answer: Tissue damage

120. What electrolyte abnormality causes seizures?

Answer: Hyponatremia

121. What test assesses acid-base status?

Answer: Blood gas analysis

122. What is the main buffer in blood?

Answer: Bicarbonate

123. What condition elevates lipase chronically?

Answer: Pancreatic cancer

124. What electrolyte imbalance occurs in SIADH?

Answer: Hyponatremia

125. What is the role of clinical chemistry?

Answer: Diagnosis, monitoring, and prognosis of disease

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