Clinical Chemistry Questions PDF

# CLINICAL CHEMISTRY ## By Apollon et.al. ## CHAPTER 1 - Chemistry Questions ### Clinical Chemistry Questions 1. A volumetric pipette has an accuracy of : - 1:1000 2. A pipette with a bulb close to the delivery tip is used for viscous fluids and is called a: - Lewis-Dahn pipette 3. The etch...

# CLINICAL CHEMISTRY ## By Apollon et.al. ## CHAPTER 1 - Chemistry Questions ### Clinical Chemistry Questions 1. A volumetric pipette has an accuracy of : - 1:1000 2. A pipette with a bulb close to the delivery tip is used for viscous fluids and is called a: - Lewis-Dahn pipette 3. The etched rings on the top of a pipette means: - The pipette should be allowed to drain and the last drop should remain in the pipette 4. Standard solution from which 99.95% of the chemical can be retrieved are referred to as: - Primary standards 5. When preparing solutions: - A percent solution can be prepared from a volumetric solution 6. A solution in which the molecules of solute in solution are in equilibrium with excess undissolved molecules is referred to as: - Saturated 7. A 1 N solution of hydrochloric acid (HCl) has a pH of: - 0 8. Pure water has a pH of: - 7.0 9. The statistical term that most specifically describes analytical precision is the: - Coefficient of variation 10. Quality control should be used with all procedures to determine: - Precision 12. A procedure has a 2 SD variation from a mean value. How many values from a normal population will the 2 SD include: - 99.73% 13. Material with physical and chemical properties closely resembling the test specimen and containing concentrations of the substances being measured is known as: - Standard 14. Optical density, according to Beer's law, is: - Directly proportional to the concentration 15. The difference between serum and plasma is that serum does not contain: - Fibrinogen 16. Two control sera are desirable for each general chemistry procedure. Which of these combinations would be appropriate? - High normal range and abnormal (high) 17. Sodium fluoride is used in specimen collection to: - Prevent glycolysis 18. The concentration of oxalate recommended to be used as an anticoagulant, in mg/mL blood, is: - 2-4 19. Ethylenediamine tetraacetic acid (EDTA) works as anticoagulant by: - Chelating calcium 20. The venipuncture site for a routine puncture is commonly cleaned with: - 70% alcohol 21. The one precaution to be followed with a specimen for bilirubin determination is to: - Protect from light 22. Which of these substances cannot be preserved by freezing? - Lactic dehydrogenase 23. Serum iron should be drawn at the same time on successive days to avoid: - Diurnal variation 24. Which of the proteins is soluble in water? - Albumin 25. The alpha-amino acids constitute the basic building blocks of proteins. The amino acids are joined together to form a chainlike structure through : - Peptide bonding 26. Which of the four elements in proteins differentiate this class of substances from carbohydrates and lipids? - Nitrogen 27. Which amino acid cannot rotate polarized light? - Glycine 28. Proteins may become denatured when subjected to mechanical agitation, heat, or extreme chemical treatment. Denaturation of proteins refers to an: - Alteration in tertiary structure 29. The hemoglobin measurement technique employed for blood donors is: - Flotation technique of Phillips 30. The ratio of velocities of light in two different media refers to the: - Refractive index 31. The most anodic protein on electrophoresis at pH 8.6 is: - Albumin 32. Proteins are dipolar or zwitterion compounds containing both positive and negative charges. When a protein is at its isoelectric point, the protein will have a: - Net zero charge 33. Svedberg (S) number refer to protein: - Ultracentrifugation 34. The macroglobulins belong to what sedimentation class? - 19.0S 35. As urine is heated, a precipitate appears at 60 C and disappears at 100 C. The substance present is a: - Bence Jones protein 36. The process of separating albumin from globulins using sodium sulfate is known as: - Salting out 37. The conversion of protein nitrogen content to protein content depends on the factor: - 6.25 38. Which of the following is NOT true of the biuret reaction? - It is insensitive to the low protein levels of urine 39. In acute renal failure which nonprotein nitrogen rises the fastest? - Blood urea nitrogen 40. Why is bromcresol purple the preferred indicator for albumin dye binding technics? - There is less interference from pigment 41. Which reagent is employed in the serum protein determination? - Biuret 42. Hemolyzed serum should not be used for total protein because: - Hemoglobin reacts with biuret reagent 43. Turbidity in serum is associated with the presence of: - Chylomicrons 44. Glycoproteins and mucoproteins are usually bound to: - Galactose and mannose 45. All of the following are glycoproteins, except: - Cryoglobulin 46. Which of these statements is not applicable to mucoproteins? - Hormones and coagulation proteins are included in this class 47. How many immunoglobulin classes are currently recognized? - Five 48. When performing an immunoglobulin electrophoresis, there must be present: - Excess antibody and constant trough distance between antibody and antigen 49. A normal serum protein electrophoresis has approximately 60% albumin and 5-10% each of the other 4 fractions. If an electrophoretic pattern shows 30% albumin, 4-10% of other fractions except gamma which is 45%, you would expect what condition to exist in the patient? - Monoclonal gammopathy 50. Which of the following applies to cryoglobulins? - They are temperature-sensitive proteins 51. Which of the following statements is true of albumin? - It is produced in the liver 52. To measure urinary protein you can use: - Bromcresol green 53. An elevated creatinine value is most likely to be accompanied by which of these values? - Elevated blood urea nitrogen, 10x creatinine value 54. The conversion factor for blood urea nitrogen to urea is: - 2.14 55. By the urease method, urea is enzymatically converted to: - Ammonia 56. Untreated urine can be used for the determination of urea by the diacetyl monoxime method because: - The method is not measuring ammonia 57. Urinary creatine may be elevated in which of the following? - Muscle destruction 58. The measurement of creatinine is based on the formation of a yellow-red color with: - Alkaline picrate 59. The classic creatinine reaction is that of: - Jaffe 60. The specificity of the Jaffe reaction can be enhanced by: - Adsorption with Lloyd's reagent 61. A disease state associated with an elevation of serum uric acid is: - Gout 62. The most common reagent employed in uric acid methodology by alkaline oxidation is: - Phosphotungstic acid 63. The uricase method for uric acid assay depends on: - Increase in absorption after uricase treament 64. The most precise method for amino acid determination is: - Isothermal distillation 65. The urea clearance test is an indication of: - Overall kidney function 66. The creatinine clearance is based on the assumption that creatinine: - Is passively reabsorbed by the kidney tubule 67. Which of the clearance tests offers the most accurate measure of glomerular filtration? - Inulin 68. Which of the clearance tests offers the best measure of tubular function? - p-aminohippurate (PAH) 69. A creatinine clearance test is performed. The 24-hour volume of urine is 770 mL; serum creatinine is 2.0 mg/dL and urine creatinine is 240 mg/dL. What is the clearance expressed in mL plasma cleared per minute, assuming average body surface? - 33.4 70. The usual determination of osmolality involves measurement of: - Electrolytes 71. Which of the following is true of blood glucose?; - Once excreted in the glomerular filtrate, glucose must be excreted in the urine 72. Patients with borderline blood glucose levels are further investigated by performing: - Postprandial sugar (PPS) 73. The test that gives a two to three (2-3) month picture of a diabetic's glucose levels is: - Hemoglobin A1c 74. Which of the following precautions is necessary to insure validity of the glucose tolerance test? - All of the above 75. Contamination of the glucose reagent with catalase is a problem with which glucose method? - Glucose oxidase 76. The hexokinase methodology for glucose determination is based on: - Reduced coenzyme read at 340 nm 77. Proteins are precipitated by which of the following reagents in the Folin-Wu method? - Tungstic acid 78. The interfering reducing substances in the Folin-Wu glucose method may be removed by: - Heating 79. In the copper reduction method for glucose, measurable color is developed through the formation of: - Copper-cobalt complex 80. The most frequently employed automated method for glucose uses: - Coupled enzyme system consisting of glucose oxidase and catalase 81. When sugars are separated by chromatography, the application of anisaldehyde/sulfuric acid/ethyl alcohol spray will identify galactose as what color spot? - Blue 82. Seliwanoff's test detects: - Fructose 83. Xylose excretion is helpful in the determination of: - Intestinal malabsorption 84. Prehepatic bilirubin has which of the following for a protein carrier? - Alpha globulin 85. An increase in indirect-reacting bilirubin is suggestive of: - Hemoglobin breakdown 86. Direct-reacting bilirubin is: - Bilirubin diglucuronide 87. Bilirubin is converted in the intestines to which of the following: - Urobilinogen 88. Which of the following will interfere with the Evelyn and Malloy method for bilirubin? - Hemolysis 89. The "port wine" color of some urines can be attributed to: - Porphyrins 90. Para-dimethylaminobenzaldehyde is a constituent of which reagent? - Ehrlich 91. Both porphobilinogen and urobilinogen form a red-colored compound with Ehrlich's reagent. Differentiation can be obtained by: - Solubility of porphobilinogen in chloroform 92. Bilirubin will develop a violet color after which of the following is added: - Methyl alcohol 93. A urine specimen that exhibits yellow foam on being shaken should be suspected of having an increased concentration of: - Ketones 94. An enzyme may be defined as a/an: - Biological catalyst 95. Hemolysis will interfere with all of the following enzyme measurements except: - Aldolase 96. A high alkaline phosphatase level in the presence of other negative liver function tests is indicative of: - Obstructive jaundice 97. A metal ion is sometimes necessary in an enzymatic reaction to: - Regulate pH 98. Which of the following is true of an isoenzyme? - The electrophoretic property is different for each isoenzyme 99. As the temperature is increased from 25 C to 37 C in the aspartate aminotransferase reaction, the activity of the reaction: - Is tripled 100. The Michaelis-Menten constant in the rate of conversion of substrate to product is determined by: - Temperature, pH and substrate concentration 101. In a zero order reaction, there will be no further increase in velocity because: - All enzyme is bound to substrate 102. Lipase catalyzes the hydrolysis of: - Glycerides 103. Which of the following is true of the isoenzyme LD-1. It is: - The slowest moving of the lactate dehydrogenase (LD) isoenzymes electrophoresis 104. Lactate + NAD → Pyruvate + NADH. The catalyst in the reaction is: - Lactate dehydrogenase (LDH) 105. Serum creatine kinase is clinically significant in diseases of the: - Muscle 106. Creatine kinase is frequently elevated in disorders such as acute myocardial infarction (MI) and: - Duchenne muscular dystrophy 107. The kinetic or rate enzymatic methodologies, optical density decreases as: - Nicotinamide adenine dinucleotide (NAD) is changed to nicotinamide adenine dinucleotide - reduced form (NADH) 108. In myocardial infarction, the clinically significant enzymes are: - Creatine kinase, aspartate aminotransferase, alanine aminotransferase 109. During a suspected myocardial infarction, you should perform creatine phosphokinase isoenzyme and lactate dehydrogenase isoenzymes to demonstrate the: - MB fraction of creatine kinase and the LD 1-2 flip 110. In muscular dystrophy, the clinically significant enzymes are: - Creatine kinase, aldolase, aspartate aminotransferase 111. Ceruloplasmin is an alpha, globulin that binds: - Copper 112. Possibly the most sensitive enzyme indicator of liver function, particularly in obstructive jaundice, is: - Alkaline phosphatase 113. In acute viral hepatitis, which of the following would NOT be suspected? - Lactate dehydrogenase -5 increase 114. What is the optimum pH for acid phosphatase? - 5.0 115. The clinical significance of an elevated acid phosphatase is: - Prostatic disease 116. If an acid phosphatase test cannot be performed immediately after collection, how should the serum be treated? - Either acidify or freeze 117. Tests for acid phosphatase detect levels of the enzyme from tissues such as: - Liver, spleen, prostate, and platelets 118. The substrate for the Cherry - Crandall lipase method is: - Nitrophenyl acetate 119. Because ionized calcium can be changed without affecting the total calcium level, what other parameter/s must be known to properly evaluate calcium? - Phosphorus 120. The classic Clark - Collip method for calcium is based on the assumption that calcium will be: - Precipitated as an oxalate and converted to an oxide 121. In the titration of calcium oxalate with potassium permanganate, the temperature must be maintained at: - 60-80 C 122. A low parathyroid hormone level will cause a: - Low serum calcium 123. In the compleximetric titration (EDTA) method for calcium, the pH must be adjusted to prevent: - Interference by magnesium 124. What is the purpose of lanthanium in the atomic absorption determination of calcium? Lanthanium: - Will bind phosphate 125. All of the following can cause low chloride levels, EXCEPT: - Prolonged vomiting 126. Inorganic phosphate can be determined from a combination of trichloroacetic acid filtrate and: - Molybdate 127. At a pH of 7.4, most of the inorganic phosphate in the plasma is in which form? - HPO4 128. A phosphorus value of 2.5 mEq/L would be how many mg/dL? (At.W. P=31)? - 8.5 129. The colorimetric method for magnesium employs which reagent? - 8-hydroxy-5-quinoline 130. The first step in the serum iron method involves: - Break up of the iron - protein complex 131. The major extracellular cation is: - Sodium 132. The major intracellular cation is: - Potassium 133. Which of these potassium values would be termed hypokalemic? - 3.0 mmol/L 134. What is the internal standard when sodium and potassium are measured by flame photometry? - Lithium 135. In the classic Schales and Schales (mercurimetric titration) method for chloride, what substance reacts with the indicator to form a violet color? - HgCl2 136. In the coulometric - amperometric method for chloride, the amount of chloride is measured by: - AgCl produced 137. What is the purpose of caprylic alcohol in the gasometric method for CO₂? To: - Maintain the atmospheric pressure at a constant value 138. In gasometric analysis of CO2, the liberated gas is absorbed with: - Sodium hydroxide 139. The normal pH of blood is: - 7.35-7.45 140. Which of the following is the Henderson - Hasselbalch equation? - pH = pKa + log undissociated salt(HA) dissociated salt(A-) 141. The ratio of bicarbonate: carbonic acid in normal plasma is: - 20:1 142. Most of the CO2 in the blood is present in which form? - Bicarbonate ion 143. What will happen if blood is exposed to air during collection for pH and blood gas studies? - PO2 decreases 144. If the glass electrode of the pH instrument is coated with protein, the pH value will be: - Too low 145. Which of the following is true of the pCO2 electrode? - Both charged and uncharged particles can cross the membrane 146. The wavelength at which oxyhemoglobin and reduced hemoglobin have the same absorbance is referred to as the: - Isoelectric point 147. Which of these statements is appropriate for the plotting of a concentration curve? On: - Linear graph paper, plot absorbance on y axis and standard concentration on x axis 148. When performing spectrophotometer quality control checks, the holmium oxide glass filter is used to assess: - Wavelength accuracy 149. For the ultraviolet range, which of these must be employed in the spectrophotometer? - Quartz cuvette 150. Measurement by flame photometry involves: - Emission of a color when an element is burned 151. Atomic absorption spectroscopy is based on the measurement of: - Light absorbed at wavelength of resonance line by unexcited atoms 152. What is the light source in atomic absorption instrumentation? - Cathode lamp 153. Quenching is a disadvantage encountered in: - Flame photometry 154. To achieve the best levels of sensitivity and specificity, a type of detector system that a gas chromatograph may be coupled to is a/an: - Mass spectrophotometer 155. Automated chemistry systems, whether discrete or continuous flow, must include: - Standards, mixing, incubation, calculation, and reporting of results 156. If an isotope has a half-life of 12 hours and an activity of 24 millicuries (mCi), what will be its activity in 38 hours? - 3 mCi 157. Concentrated sulfuric acid has a normality of: - 36 158. Match the following types of instruments with the description: - a. Atomic absorption, b. Discrete processing system, c. Flame photometry, d. Continuous flow analysis, e. Chromatography 159. The major binding protein for T-4 is: - Thyroid-binding globulin (TBG) 160. What purpose does iodine serve in the protein-bound iodine (PBI) methodology?: - Keeps organic iodine in the protein-bound state 161. A T-4 measured as iodine is 1.8 mcg/dL. To what thyroxine value is it equivalent? - 5.40 162. In T-4 by radioimmunoassay (RIA), the more thyroxine present in the patient's serum: - The more the amount of radioactive-labeled thyroxine bound to antibody 163. T-3 uptake is actually a measurement of: - TBG 164. The following tests are good indications of hypothyroidism, except: - Free T-4 by radioimmunoassay (RIA) 165. Which of the steroids is identified as an 18-carbon compound that possesses a phenolic "A' ring? - Estrogens 166. The estrogen with the greatest concentration in urine is: - Estriol 167. The standard for 17-ketosteroid determinations is: - Dehydroepiandrosterone 168. Which of the following is true regarding pregnanediol? It is: - The excretion product of progesterone 169. Which of the following is true of steroids? - They are lipids 170. What is the hormone that controls the reabsorption of sodium in the kidney? - Aldosterone 171. The Kober reaction refers to the pink color resulting from the combination of hot concentrated sulfuric acid and extracted: - Estrogens 172. The Ittrich extraction for estrogens involves the reagent: - m-dinitrobenzene 173. The Porter-Silber reaction employs phenylhydrazine to detect: - Corticosteroids 174. The Zimmerman determination of 17-ketosteroids is based on reaction with: - Sodium bismuthate 175. For the measurement of 17-ketogenic steroids (17-hydroxycorticosteroids), prior treatment with what reagent is required? - Hot sufuric acid 176. Catecholamines are secreted by the: - Adrenal medulla 177. Which of the following is a metabolite of epinephrine?: - Vanillylmandelic acid 178. A two-hour pregnancy test can measure: - Chorionic gonadotropins, beta subunit 179. Which of these statements is true of an immunological test for pregnancy?: - Drugs do not present a problem with interference 180. Which subunit of human chorionic gonadotropin (hCG) will give a very specific radioimmunoassay test for the measurement of hCG? - Beta 181. Which of the following specimens is/are used for pregnancy tests? - Urine 182. An ectopic pregnancy is one that occurs in the: - Fallopian tubes 183. Human chorionic gonadotropin (hCG) is secreted by the: - Placenta 184. The highest level of human chorionic gonadotropin (hCG) occurs in which trimester of pregnancy?: - First trimester 185. A glycoprotein consisting of two nonidentical noncovalently bound subunits is: - NC TA 186. Some commercial kits now available for pregnancy tests incorporate which of the following? - Monoclonal antibodies 187. To produce reliable results, at which time should blood specimens for lipid studies be drawn? - 8-10 hour fasting 188. The reagent for color development in the Liebermann-Burchard reaction for cholesterol is: - Acetic anhydride/sulfuric acid 189. Which of the statements applies to Bloor's reagent? It: - Compensates for possible water contamination of the reagents 190. The purpose of the saponification step in some cholesterol methods is to: - Convert esters to free cholesterol so that all measured cholesterol is of the same type 191. The purpose of the digitonin in cholesterol methodology is the: - Precipitation of esterified cholesterol 192. In which of these clinical conditions may blood cholesterol be increased? - Hypothyroidism 193. Which of the following is the Friedewald formula by which low density lipoprotein (LDL) cholesterol can be estimated? (TC = total cholesterol, TG = triglycerides, PL = phospholipids) - LDL cholesterol = TC - (TG/5 + HDL cholesterol) 194. When evaluating a coronary risk index for a patient you should know the total cholesterol and: - Low-density lipoprotein cholesterol 195. Most triglyceride procedures involve measurement of: - Glycerol 196. Which of these lipids has the lowest density? - Chylomicrons 197. The more current kinetic methods for the quantitation of serum triglycerides employ enzymatic hydrolysis. The enzymatic hydrolysis of triglycerides may be accomplished by what enzyme? - Lipase 198. The migration sequence, from the origin, of lipoproteins is: - Chylomicrons, pre-beta, beta, alpha 199. Diseases of which system are associated with elevated beta lipoprotein values? - Cardiovascular 200. Which statement is true for the oral route of drug administration? - Patient compliance is not always reliable 201. Which of the following therapeutic drugs is not an anticonvulsant? - Digoxin 202. The point of equilibrium between drug dosage intake and drug elimination is referred to as: - Steady state 203. A major disadvantage of drug detection by immunoassays is: - Technical difficulty of procedure 204. Lithium is measured by: - Flame photometry 205. Tricyclic antidepressants include: - Doxepin 206. When a kidney stone is tested with sodium cyanide and sodium nitroprusside, the appearance of a magenta color identifies what substance?: - Cystine 207. The sweat chloride test is useful in the diagnosis of: - Cystic fibrosis 208. The use of the radioisotope 51Cr provides a direct measurement of which of the following? - Red cell mass 209. The average blood volume for human beings, expressed in ml/kg body weight, is: - 70 ## Math Questions 259. The mean for a series of laboratory results is 10.0, the 95% confidence limits are 9.8 to 10.2. What is the standard deviation? - 0.1 SD 260. If 0.5 ml packed red blood cells are diluted to a volume of 10 ml with normal saline, what dilution is achieved? - 1:20 261. 5 ml filtrate are required for a procedure. The final colored solution proves to be too high to read accurately on the spectrophotometer. 1 ml filtrate and 4 ml distilled water are substituted for the original filtrate and the procedure is run as. before. The graph reading is 46 mg/dl. What is the actual amount of substance in the patient's serum? - 11.5 mg/dl 262. 1.0 ml serum is diluted with 4 ml 25% benzoic acid, how much serum is represented in 2.0 ml of the solution?: - 0.20 ml 263. 90 ml distilled water is added to 10 ml of a 3% solution. What is the strength of the resulting solution? - 0.27% 264. 0.1 ml serum is added to 0.4 ml saline in the first tube of a serial dilution. Half (0.25) of the contents of the first tube are transferred to the second tube, which already contains 0.25 ml saline. What is the serum dilution in the second tube? - 1:50 265. In a thrombocytopenia, twice the usual amount of blood is drawn into the red cell diluting pipet (blood to the 1.0 mark), which is then filled with Rees-Ecker diluent to the line at the top of the bulb. All nine squares of the hemacytometer are employed to increase the accuracy of the count. In these nine squares, 27 platelets are counted. In cells/cu mm, what is the platelet count for this patient? - 3000 266. Dilution of a spinal fluid is accomplished in a white cell diluting pipet, using diluent to the 1.0 mark and spinal fluid to the 11 mark.. All nine squares of a hemacytometer are counted, with a tally of 45 white cells. In cells/cu mm, what is the spinal fluid cell count? - 500 267. A 10% (W/V) solution of sodium chloride is needed. Of what does it consist? - 10 g NaCl/100 ml 268. A solution of calcium chloride contains 3 grams per 100 ml. What percent is this solution? - 3.0 269. How much sodium citrate is required to make 500 ml of a 3.2% solution for coagulation studies? (M.W. of sodium citrate = 258) - 16.0 g 270. A concentrated acid has a specific gravity of 1.5. What is the weight of 30 ml of this acid? - 45.0 g 271. Concentrated sulfuric acid has a specific gravity of 1.84 and a percent purity of 98%. How many grams of sulfuric acid are there in 200 ml of concentrated acid? - 368 272. 150 ml urine weighs 154 grams. What is the specific gravity of the urine? - 1.027 273. How much NaOH is needed to make 4 liters of a 1N solution?. (M.W. Na = 23; O = 16; H = 1) - 160 g 274. How many milligrams of CaCl2 are needed to prepare 100 ml of a 1 x 10^-3 M solution? - 111.0 275. How much Na2SO4 is there in 400 ml of a 4M solution? (M.W. Na = 23; S = 32; O = 16) - 227 g 276. What is the normality of isotonic saline (0.85%)? (M.W. Na = 23; CI = 35.5) - 0.140N 277. What is the normality of 4M NaOH? (M.W. Na = 23; O = 16; H = 1): - 4.0 N 278. A solution of HCl contains 84 grams per liter. What is its normality? (M.W. H = 1; Cl = 35.5) - 2.30 N 279. What is the normality of a 3.6M sulfuric acid solution? (M.W. H = 1; S = 32; O = 16) - 7.2 N 280. HNO3 has a percent purity (assay) of 70 and a specific gravity of 1.42. How many ml of concentrated acid are needed to make 500 ml of 0.22N acid? - 7.0 ml 281. What percent solution is 0.4N HCI? (At. W. H. = 1; Cl = 35.5) - 14.60% 282. What amount of 10N NaOH must be used to prepare 1 liter of 1N NaOH? - 100 ml 283. A serum calcium level of 10 mg/dl would be expressed as how many mEq/L? (At.W. Ca = 40) - 2.5 284. The microgram can be expressed as which of the following? - 1/1000 mg ## Answer Key | Question # | Answer | Question # | Answer | Question # | Answer | Question # | Answer | Question # | Answer | Question # | Answer | | ----------- | ----------- | ----------- | ----------- | ----------- | ----------- | ----------- | ----------- | ----------- | ----------- | ----------- | ----------- | | 1 | D | 51 | C | 101 | C | 151 | B | 196 | C | 241 | A | | 2 | D | 52 | B | 102 | C | 152 | A | 197 | B | 242 | A | | 3 | B | 53 | D | 103 | D | 153 | A | 198 | A | 243 | C | | 4 | B | 54 | B | 104 | C | 154 | D | 199 | B | 244 | D | | 5 | A | 55 | A | 105 | C | 155 | A | 200 | D | 245 | B | | 6 | C | 56 | B | 106 | A | 156 | A | 201 | A | 246 | D | | 7 | B | 57 | C | 107 | C | 157 | D | 202 | C | 247 | B | | 8 | C | 58 | A | 108 | B | 158 | E | 203 | D | 248 | C | | 9 | D | 59 | A | 109 | B | 159 | B | 204 | B | 249 | A | | 10 | B | 60 | A | 110 | A | 160 | B | 205 | D | 250 | A | | 11 | D | 61 | D | 111 | A | 161 | B | 206 | B | 251 | B | | 12 | C | 62 | B | 112 | A | 162 | B | 207 | B | 252 | B | | 13 | A | 63 | A | 113 | A | 163 | C | 208 | B | 253 | B | | 14 | B | 64 |B | 114 | B | 164 | A | 209 | C | 254 | D | | 15 | C | 65 | A | 115 | D | 165 | C | 255 | D | 256 | C | | 16 | A | 66 |A | 116 | D | 166 | A | 257 | A | 258 | B | | 17 | A