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2026 Statistics

Key Facts: Examen Integrado Bioquímica Exam

100

Exam Questions

MSAL / CoReBio 2026 Blueprint

4 hours

Examination Duration

Resolución MSAL 555/2026

Free ($0 ARS)

Registration Fee

Ministerio de Salud de la Nación

5 Domains

Blueprint Content Areas

CoReBio Content Guidelines

SISA

Digital Platform

Sistema de Información Sanitaria Argentino

No penalty

Incorrect Answers

Resolución MSAL 555/2026

The Argentina Examen Integrado de Residencias de Bioquímica is a 100-question multiple-choice exam (3 hours, free of charge) administered nationwide by MSAL and CoReBio under Resolución 555/2026 to rank biochemistry graduates for hospital residency positions across Clinical Chemistry (25%), Hematology (25%), Microbiology (25%), Immunology/Endocrinology (15%), and Quality/Biosafety (10%).

Sample Examen Integrado Bioquímica Practice Questions

Try these sample questions to test your Examen Integrado Bioquímica exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to the American Diabetes Association (ADA) and Sociedad Argentina de Diabetes (SAD) criteria, which laboratory finding confirms the diagnosis of Diabetes Mellitus in an asymptomatic adult patient when confirmed on repeat testing?

A.Fasting plasma glucose ≥ 126 mg/dL (7.0 mmol/L) after an overnight fast of at least 8 hours

B.Two-hour plasma glucose ≥ 140 mg/dL during a 75-g oral glucose tolerance test (OGTT)

C.Glycated hemoglobin (HbA1c) ≥ 5.7% measured by an NGSP-certified assay

D.Random plasma glucose ≥ 160 mg/dL in the absence of classic hyperglycemic symptoms

Explanation: The ADA and SAD criteria define diabetes mellitus as a fasting plasma glucose ≥ 126 mg/dL (7.0 mmol/L), a 2-hour OGTT glucose ≥ 200 mg/dL (11.1 mmol/L), or an HbA1c ≥ 6.5% (48 mmol/mol). In an asymptomatic patient, the diagnosis requires confirmation by a second test performed on a subsequent day. Fasting plasma glucose measures basal hepatic glucose output after an overnight fast.

2Which standardized pre-analytical and analytical protocol is REQUIRED when performing an Oral Glucose Tolerance Test (OGTT / PTOG) for non-pregnant adult diagnostic evaluation?

A.Administering 75 g of anhydrous glucose in 300–375 mL of water consumed within 5 minutes, following 3 days of unrestricted carbohydrate intake (>150 g/day) and an 8–12 hour fast

B.Administering 100 g of glucose after 24 hours of strict carbohydrate restriction and vigorous physical exercise

C.Administering 50 g of glucose orally without prior fasting, measuring capillary blood glucose at 60 minutes only

D.Administering 75 g of glucose following a 4-hour fast, with mandatory serial venous blood sampling every 15 minutes for 4 hours

Explanation: Standardized OGTT (PTOG) protocol requires that the patient maintain an unrestricted diet containing at least 150 g of carbohydrates daily and normal physical activity for at least 3 days prior to the test. After an 8–12 hour overnight fast, a baseline fasting blood sample is drawn, followed by ingestion of 75 g of anhydrous glucose (or 82.5 g monohydrate) dissolved in 300–375 mL of water within 5 minutes, with a second blood sample obtained exactly at 120 minutes.

3In which clinical condition will glycated hemoglobin (HbA1c) be FALSELY DECREASED relative to mean ambient glycemic levels?

A.Chronic autoimmune hemolytic anemia with shortened red blood cell survival

B.Severe iron deficiency anemia with prolonged erythrocyte circulation lifespan

C.Severe untreated vitamin B12 megaloblastic deficiency

D.Aplastic anemia with profound marrow reticulocytopenia

Explanation: HbA1c reflects non-enzymatic glycation of hemoglobin over the average erythrocyte lifespan of ~120 days. Any condition that shortens red blood cell survival (e.g., hemolytic anemia, acute blood loss, hemodialysis, splenomegaly, or erythropoietin therapy) reduces the exposure time of hemoglobin to circulating glucose, leading to falsely low HbA1c values. In such patients, alternative markers like fructosamine or continuous glucose monitoring must be used.

4A fasting lipid panel reveals: Total Cholesterol = 240 mg/dL, HDL-C = 45 mg/dL, and Triglycerides = 200 mg/dL. What is the estimated LDL-C using the Friedewald equation, and in which scenario is this formula INVALID?

A.LDL-C = 155 mg/dL; the formula is invalid when serum triglycerides exceed 400 mg/dL or chylomicrons are present

B.LDL-C = 195 mg/dL; the formula is invalid when total cholesterol exceeds 200 mg/dL

C.LDL-C = 135 mg/dL; the formula is invalid when HDL-C is below 50 mg/dL

D.LDL-C = 165 mg/dL; the formula is invalid only when the patient has not fasted for at least 24 hours

Explanation: The Friedewald formula calculates LDL-C as: LDL-C = Total Cholesterol - HDL-C - (Triglycerides / 5) in mg/dL (where TG/5 estimates VLDL-C). Here, LDL-C = 240 - 45 - (200 / 5) = 240 - 45 - 40 = 155 mg/dL. The formula assumes a constant 5:1 ratio of TG to cholesterol in VLDL and becomes invalid when triglycerides > 400 mg/dL (4.52 mmol/L), in the presence of chylomicrons, or in Type III hyperlipoproteinemia (dysbetalipoproteinemia).

5Which equation is RECOMMENDED by international consensus (KDIGO) and Argentine nephrology guidelines for estimating glomerular filtration rate (eGFR) in adults based on serum creatinine?

A.CKD-EPI 2021 (Chronic Kidney Disease Epidemiology Collaboration) equation without race variable

B.Cockcroft-Gault equation without body surface area adjustment

C.MDRD-4 (Modification of Diet in Renal Disease) equation with race adjustment

D.Schwartz bedside formula utilizing serum urea and urine volume

Explanation: The CKD-EPI 2021 creatinine equation is the currently recommended standard for estimating GFR in adults. It demonstrates superior accuracy compared to MDRD, particularly at GFR values > 60 mL/min/1.73 m², and eliminates the race coefficient to avoid racial disparities in kidney disease staging. Cockcroft-Gault estimates creatinine clearance rather than GFR and is primarily used for drug dosing adjustments.

6What is the clinical definition and diagnostic range for Moderately Increased Albuminuria (formerly microalbuminuria) measured by the urinary Albumin-to-Creatinine Ratio (ACR) on a spot urine sample?

A.30 to 300 mg albumin / g creatinine (3 to 30 mg/mmol)

B.< 30 mg albumin / g creatinine (< 3 mg/mmol)

C.> 300 mg albumin / g creatinine (> 30 mg/mmol)

D.> 3500 mg albumin / g creatinine (> 350 mg/mmol)

Explanation: Moderately increased albuminuria (A2 category, formerly microalbuminuria) is defined as an ACR of 30–300 mg/g creatinine on a random spot urine specimen. It reflects early glomerular endothelial dysfunction and increased vascular permeability in diabetic and hypertensive nephropathy. Normal to mildly increased albuminuria (A1) is < 30 mg/g, and severely increased albuminuria (A3 / overt proteinuria) is > 300 mg/g.

7During microscopic examination of centrifuged urinary sediment by phase-contrast microscopy, what finding specifically indicates GLOMERULAR origin of hematuria?

A.Presence of > 5% acanthocytes (G1 cells) with doughnut-like morphology and blebs/protrusions

B.Presence of 100% isomorphic, biconcave erythrocytes with regular smooth membranes

C.Abundant calcium oxalate dihydrate crystals in envelope shapes

D.Presence of superficial squamous epithelial cells loaded with glycogen

Explanation: Acanthocytes (G1 cells) are ring-shaped erythrocytes with one or more vesicle-like protrusions or blebs caused by mechanical trauma and osmotic pressure shifts as red blood cells traverse damaged glomerular basement membranes and tubular segments. The presence of > 5% acanthocytes or > 40–50% total dysmorphic erythrocytes in the sediment is highly specific for glomerular hematuria (e.g., glomerulonephritis).

8Which type of urinary cast is characterized by a broad, highly refractive matrix, sharp blunt borders with ground-glass appearance, and transverse fissures/notches, indicating severe tubular stasis and advanced chronic kidney disease?

A.Waxy cast (cilindro céreo)

B.Hyaline cast (cilindro hialino)

C.Bacterial cast (cilindro bacteriano)

D.Urate crystal cast (pseudocilindro de uratos)

Explanation: Waxy casts (cilindros céreos) represent the final evolutionary stage of cellular and granular cast degeneration. They have a homogeneous, highly refractive waxy matrix, distinct blunt ends, and characteristic cracks or lateral notches. Their presence indicates prolonged localized oliguria and severe tubular stasis, serving as a classic marker of advanced chronic renal failure (renal failure casts).

9The identification of Red Blood Cell casts (cilindros hemáticos / eritrocitarios) in fresh urine sediment is PATHOGNOMONIC for which clinical entity?

A.Acute proliferative glomerulonephritis (nephritic syndrome)

B.Acute bacterial cystitis

C.Renal lithiasis lodged in the lower ureter

D.Benign prostatic hyperplasia

Explanation: Red blood cell casts form when erythrocytes that leak through disrupted glomerular capillary walls become trapped and embedded within the Tamm-Horsfall mucoprotein matrix in the distal convoluted tubules. Their presence is pathognomonic for active glomerular bleeding, most commonly seen in acute post-infectious glomerulonephritis, lupus nephritis, and ANCA-associated vasculitis.

10A 48-year-old patient presents with jaundice, hepatomegaly, and ascites. Laboratory results show: AST (GOT) = 280 IU/L, ALT (GPT) = 110 IU/L (De Ritis ratio AST/ALT = 2.5), and GGT = 650 IU/L. This pattern is MOST SUGGESTIVE of:

A.Alcoholic hepatitis (hepatopatía alcohólica)

B.Acute viral hepatitis B in the early icteric phase

C.Acute paracetamol (acetaminophen) toxicity

D.Biliary colic secondary to uncomplicated cholelithiasis

Explanation: An AST/ALT (De Ritis) ratio > 2.0, particularly when total transaminase levels are moderately elevated (< 300–500 IU/L) and accompanied by marked GGT elevation, is highly characteristic of alcoholic liver disease. Alcohol induces mitochondrial toxicity releasing mitochondrial AST, while alcohol-related pyridoxal-5'-phosphate (vitamin B6) deficiency selectively suppresses hepatic ALT synthesis.

About the Examen Integrado Bioquímica Exam

The Examen Integrado de Residencias de la Salud — Bioquímica in Argentina is the official, nationwide competitive selection examination governed by the Ministerio de Salud de la Nación (MSAL) under Resolución 555/2026, in technical coordination with the Comisión de Residencias de Bioquímica (CoReBio) and the Comité Técnico de Residencias de Salud (CAEI). It serves as the unified entry evaluation for graduates in Biochemistry seeking admission into post-graduate hospital residency training programs (Residencias del Equipo de Salud) across national, provincial, and municipal public health institutions throughout the Argentine Republic. The examination comprises 100 multiple-choice questions administered digitally in a single 3-hour session. Candidates are evaluated across five core domains: Clinical Chemistry and Enzymology (25%), Hematology and Immunohematology (25%), Clinical Microbiology and Parasitology (25%), Immunology and Endocrinology (15%), and Quality Assurance, Biosafety, and Bioethics (10%). Questions are rigorously grounded in national health legislation (such as Ley 24.051 on hazardous bio-waste and Ley 26.529 on patient rights), official diagnostic algorithms from the Argentine Ministry of Health (including Chagas disease, HIV, and viral hepatitis protocols), and international laboratory consensus standards (IFCC, ADA, CLSI, EUCAST). Final selection and post allocation follow a strict merit ranking (orden de mérito) combining the written examination score and undergraduate academic grade point average. Language note: the Examen Integrado is set and sat entirely in Spanish, against the official MSAL temario for Bioquímica. These practice questions are an English-language multiple-choice study adaptation built from that official scope — they are not an official translation, not published or endorsed by the Ministerio de Salud de la Nación, and not a simulation of the exam's Spanish-language testing environment. Official exam names, Argentine statute numbers and local clinical terms are kept in Spanish so you can match them to the real bibliography.

Assessment

A 100-question digital multiple-choice examination (3 hours) evaluating Clinical Chemistry & Enzymology (25%), Hematology & Immunohematology (25%), Clinical Microbiology & Parasitology (25%), Immunology & Endocrinology (15%), and Quality Assurance, Biosafety & Bioethics (10%).

Time Limit

3 hours (180 minutes)

Passing Score

Ranked merit list (orden de mérito) calculated from examination score (up to 100 points) and accredited undergraduate grade point average (promedio con aplazos).

Exam Fee

Free ($0 ARS) (Ministerio de Salud de la Nación (MSAL) / Comisión de Residencias de Bioquímica (CoReBio) / CAEI)

Examen Integrado Bioquímica Exam Content Outline

25%

Clinical Chemistry and Enzymology

Carbohydrate metabolism, diabetic ketoacidosis, lipid profile and Friedewald equation, renal clearance and GFR formulas (CKD-EPI), full urinalysis and sediment microscopy, hepatic enzymes, bilirubin metabolism, cardiac biomarkers (hs-cTn, NT-proBNP), blood gas analysis and acid-base disorders (anion gap), and electrolyte/mineral balance.

25%

Hematology and Immunohematology

Automated CBC parameters and erythrocyte indices (MCV, MCH, MCHC, RDW), differential diagnosis of microcytic, macrocytic, and hemolytic anemias, acute and chronic leukemias (AML, ALL, CML, CLL), myeloproliferative neoplasms, peripheral blood cytology, hemostasis testing (PT/INR, aPTT, mixing studies, fibrinogen, D-dimer), coagulopathies and thrombophilias, ABO/Rh typing, Coombs testing, and transfusion compatibility.

25%

Clinical Microbiology and Parasitology

Bacterial staining (Gram, Ziehl-Neelsen), sample quality criteria, culture media, identification of Gram-positive and Gram-negative pathogens, antimicrobial susceptibility testing (Kirby-Bauer, MIC, EUCAST/CLSI), resistance mechanisms (ESBL, AmpC, carbapenemases, MRSA, iMLSb), blood cultures, viral hepatitis, HIV algorithm, Dengue serology/PCR, diagnostic parasitology (Telemann, Graham, Chagas algorithm), and clinical mycology.

15%

Immunology and Endocrinology

Autoimmune serology (ANA/FAN patterns on HEp-2 cells, anti-dsDNA, ENA panel, anti-CCP, celiac disease panel), infectious disease serology (VDRL, treponemal tests, Toxoplasmosis IgG/IgM and avidity), thyroid axis evaluation (TSH, free T4, anti-TPO, TRAb), adrenal axis (cortisol, ACTH, dexamethasone suppression tests), prolactin and PEG precipitation, and reproductive hormones (FSH, LH, beta-hCG).

10%

Quality Assurance, Biosafety, and Bioethics

Pre-analytical variables (order of draw, hemolysis, lipemia, tourniquet time, anticoagulants), internal quality control (Westgard multirules, Levey-Jennings charts, CV%), external quality assessment (PEEC, Z-scores), laboratory biosafety levels (BSL-1 to BSL-4), hazardous bio-waste management (Ley 24.051), post-exposure prophylaxis (PEP), and Argentine patient rights legislation (Ley 26.529).

How to Pass the Examen Integrado Bioquímica Exam

What You Need to Know

Passing score: Ranked merit list (orden de mérito) calculated from examination score (up to 100 points) and accredited undergraduate grade point average (promedio con aplazos).
Assessment: A 100-question digital multiple-choice examination (3 hours) evaluating Clinical Chemistry & Enzymology (25%), Hematology & Immunohematology (25%), Clinical Microbiology & Parasitology (25%), Immunology & Endocrinology (15%), and Quality Assurance, Biosafety & Bioethics (10%).
Time limit: 3 hours (180 minutes)
Exam fee: Free ($0 ARS)

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Examen Integrado Bioquímica Study Tips from Top Performers

1Master acid-base calculations: practice calculating the serum Anion Gap, Henderson-Hasselbalch equations, Winters formula for respiratory compensation in metabolic acidosis, and delta-delta ratios.

2Understand automated hematology flags and peripheral blood smear cytology: correlate red blood cell indices (MCV, MCH, MCHC, RDW) with microcytic and megaloblastic blood smears, blast morphology, and smudge cells in CLL.

3Review antimicrobial resistance mechanisms in depth: differentiate phenotypic and molecular detection of ESBLs, AmpC beta-lactamases, carbapenemases (KPC vs MBL vs OXA-48), MRSA (mecA/cefoxitin disk), and the D-test for inducible clindamycin resistance.

4Memorize Argentine diagnostic algorithms: study the national two-test concordant serology standard for chronic Chagas disease (Ley 26.281), the 4th-generation HIV testing algorithm, and the celiac disease screening consensus (anti-tTG-IgA plus total IgA).

5Learn Westgard multi-rules and quality statistics: differentiate random errors (1-3s, R-4s) from systematic errors (2-2s, 4-1s, 10-x), and understand CV% and Z-score calculations for internal and external quality control (PEEC/FABA).

6Familiarize yourself with essential Argentine sanitary legislation: Ley 24.051 (Residuos Peligrosos / Patogénicos), Ley 26.529 (Derechos del Paciente), and Ley 25.326 (Protección de Datos Personales).

Frequently Asked Questions

What is the Examen Integrado de Residencias de Bioquímica in Argentina?

It is the unified, nationwide competitive examination administered by the Argentine Ministry of Health (MSAL) under Resolución 555/2026, in technical coordination with the Comisión de Residencias de Bioquímica (CoReBio) and CAEI. It selects and ranks biochemistry graduates for postgraduate residency posts in public and affiliated hospitals across Argentina.

What is the structure, timing, and scoring system of the exam?

The examination consists of 100 multiple-choice questions with four answer options each, administered digitally in a single 4-hour (180 minutes) testing session. Each correct response is awarded 1 point, with zero points for unanswered or incorrect questions (no negative marking). The total exam score (out of 100) is combined with the candidate's university grade point average (promedio con aplazos) to determine the final merit ranking.

What subject areas are tested on the Biochemistry Integrated Residency Exam?

The exam blueprint consists of five major areas: 1) Clinical Chemistry and Enzymology (25%), 2) Hematology and Immunohematology (25%), 3) Clinical Microbiology and Parasitology (25%), 4) Immunology and Endocrinology (15%), and 5) Quality Assurance, Biosafety, and Bioethics (10%).

Is there any registration or examination fee for candidates?

No. Registration, examination administration, and residency post allocation are 100% free of charge ($0 ARS), fully financed by the Argentine State under the national health residency regulatory framework.

How are residency positions assigned after the examination?

Following the publication of the final merit list (orden de mérito definitivo) on the SISA platform, candidates are called in order of ranking to select available residency vacancies in clinical biochemistry, hospital biochemistry, toxicology, or microbiology across participating national, provincial, and municipal healthcare institutions.

Is this practice bank in Spanish like the real exam?

No. The Examen Integrado is administered in Spanish only. This bank is an English-language multiple-choice study adaptation derived from the official MSAL temario and bibliography, intended for candidates who prefer to revise the underlying clinical knowledge in English. It is not an official translation and does not reproduce official exam items; Argentine law numbers, programme names and clinical terminology are retained in Spanish so they map onto the real exam.