Term
Glucose is (higher/lower) in newborns that adults |
|
Definition
|
|
Term
Why is the A1C test invalid in a patient with hemoglobin S or C? |
|
Definition
because of the shortened life span of the RBCs |
|
|
Term
Describe the solubility properties of lipids in the blood. |
|
Definition
In the blood, liids are soluble due to their combination with protein (lipoprotein |
|
|
Term
What is the main storage form of lipid storage in the body? |
|
Definition
Triglycerides in adipose tissue |
|
|
Term
What is the major site of cholesterol synthesis |
|
Definition
|
|
Term
What is the most common method for cholesterol determination? |
|
Definition
enzymatic using cholesterol esterase and cholesterol oxidase |
|
|
Term
How is LDL cholesterol determined |
|
Definition
Friedwald formula (Total cholester - HDL cholesterol)- (triglycerides/5)
This formula is not valid if triglycerides > 500 mg/dL |
|
|
Term
What is the main storage form of lipid storage in the body? |
|
Definition
Triglycerides in adipose tissue |
|
|
Term
What is the major site of cholesterol synthesis |
|
Definition
|
|
Term
What is the most common method for cholesterol determination? |
|
Definition
enzymatic using cholesterol esterase and cholesterol oxidase |
|
|
Term
How is LDL cholesterol determined |
|
Definition
Friedwald formula (Total cholester - HDL cholesterol)- (triglycerides/5)
This formula is not valid if triglycerides > 500 mg/dL |
|
|
Term
|
Definition
Largest and least dense of lipoproteins. They transport EXOgenous triglycerides and account for the turbidity of serum following a meal |
|
|
Term
What is the major waste product of protein catabolism? |
|
Definition
|
|
Term
Which element if found in protein but not in carbohydrates or lipids |
|
Definition
|
|
Term
What is the most common method for measuring serum total protein? |
|
Definition
biuret method Cuprous ions react with peptide bonds at al alkaline pH to produce a colored complex |
|
|
Term
Why is biuret method of protein analysis not used for urine or CSF |
|
Definition
It is not sensitive enough Trichloracetic acid can be used to precipitate protein in urine and CSF |
|
|
Term
How does hemolysis affect serum total protein |
|
Definition
|
|
Term
How is the concentration of globulins determined in a chemistry profile? |
|
Definition
Total protein minus albumin |
|
|
Term
In the body, what charge do most proteins carry |
|
Definition
at pH 7.4 proteins are negatively charged |
|
|
Term
What is electroendosmosis |
|
Definition
The flow of bufferr toward the cathode due to the negative surface charge present in the support medium. On cellulose acetate, this results in gamma globulins being swept toward the cathode |
|
|
Term
What stains are used in serum protein electrophoresis |
|
Definition
Coomassie brilliant blue (CBB), amido black, Ponceau S, and bromphenol blue. CBB is more widely used because it is more sensitive |
|
|
Term
What is the name of the instrument used to quantitate rotein fractions following serum protein electrophoresis |
|
Definition
|
|
Term
What causes increased albumin concentrations |
|
Definition
|
|
Term
What causes decreased alpha-1 globulin |
|
Definition
alpha 1 antitrypsin deficiency. this is seen in emphysema |
|
|
Term
What causes a decreased gamma globulin fraction |
|
Definition
|
|
Term
Describe the acute phase reactant or inflammatory pattern |
|
Definition
Albumin is decreased alpha 1, alpha 2, and BETA globulins are increased |
|
|
Term
Describe the chronic response pattern |
|
Definition
Albumin is decreased alpha 1, alpha 2, and GAMMA globulins are increased |
|
|
Term
What is the name of the instrument used to quantitate rotein fractions following serum protein electrophoresis |
|
Definition
|
|
Term
What causes increased albumin concentrations |
|
Definition
|
|
Term
What causes decreased alpha-1 globulin |
|
Definition
alpha 1 antitrypsin deficiency. this is seen in emphysema |
|
|
Term
What causes a decreased gamma globulin fraction |
|
Definition
|
|
Term
Describe the acute phase reactant or inflammatory pattern |
|
Definition
Albumin is decreased alpha 1, alpha 2, and BETA globulins are increased |
|
|
Term
Describe the chronic response pattern |
|
Definition
Albumin is decreased alpha 1, alpha 2, and GAMMA globulins are increased |
|
|
Term
When is beta-gamma bridging seen |
|
Definition
|
|
Term
Describe pattern for monoclonal gammopathy |
|
Definition
Sharp peak in the gamma region |
|
|
Term
When is beta-gamma bridging seen |
|
Definition
|
|
Term
Describe pattern for monoclonal gammopathy |
|
Definition
Sharp peak in the gamma region |
|
|
Term
What causes the hyperproteinemia seen in multiple myeloma |
|
Definition
An increase in one of the immunoglobulins or free light chains |
|
|
Term
Which immunoglobulin is increased in waldenstroms macroglobulinemia |
|
Definition
|
|
Term
A patient has a monoclonal gammopathy on serum protein electrophoresis. What test can be done to determine which immunoglobulin is increased |
|
Definition
|
|
Term
What is the substrate for starch |
|
Definition
|
|
Term
Why shouldn't EDTA plasma be used for an amylase determination? |
|
Definition
Ca++ is needed for the reaction and EDTA chelates Ca++ |
|
|
Term
Which enzyme is most specific for acute pancreatitis |
|
Definition
|
|
Term
In which disease does the highest elevations of alkaline phospatase (ALP) occur? |
|
Definition
Paget's disease (bone disease characterized by excessive bone destruction and unorganized bone repair |
|
|
Term
What is the clinical significance of ACP (acid phosphatase) |
|
Definition
Highest levels of ACP are seen in the prostate. It is most significant use is in rape cases |
|
|
Term
In which condition is the highest levels of CK seen |
|
Definition
|
|
Term
Which cardiac enzyme is most specific |
|
Definition
CKMB is the most specific cardiac enzyme but not the most specific cardiac biomarker. Cardiac troponins are more specific for AMI |
|
|
Term
How is cardiac troponin measured |
|
Definition
immunoassays using monoclonal antibodies |
|
|
Term
Which cardiac marker is most likely to be elevated 4 days after a suspect myocardial infarction? |
|
Definition
Cardiac troponins. CK-MB would have returned to normal |
|
|
Term
What is the clinical significance of B-type natriuretic peptide |
|
Definition
It is a cardiac hormone produced by the heart ventricles in response to ventricular volume expansion. It is a predictor of congestive heart failure. The test is an immunoassay tha can be performed at point of care |
|
|
Term
What is significance of highly sensitive C-reactive protein (hs-CRP) |
|
Definition
CRP is a marker of inflammation and appears to be assoicated with increased risk for coronary heart disease, sudden death, and peripheral artery disease |
|
|
Term
Which enzymes are most useful for assessment of liver function |
|
Definition
ALT AST ALP GGT and LD
Other liver tests include total protein, albumin, and total and conjugated bilirubin |
|
|
Term
Which enzyme is most sensitive for all types of liver disease |
|
Definition
GGT
Levels are highest with biliary obstruction |
|
|
Term
Which disease has the highest elevation of AST and ALT |
|
Definition
|
|
Term
|
Definition
In all cells of body. In liver disease, LD does not increase as much as AST and ALT |
|
|
Term
What effect does hemolysis have on LD |
|
Definition
Increasedd LD is 100 to 150 times more concentrated i the RBCs |
|
|
Term
How should specimens for LD be stored |
|
Definition
25C and analyzed with in 48 hours They should not be refrigerated because LD decreases more rapidly at 4C |
|
|
Term
What clinical condition results in the highest level of LD |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
CK, AST, LD, and aldolase |
|
|
Term
What is clinical significance of low pseudocholinesterase levels |
|
Definition
Low levels are seen following exposure to insecticides and nerve gases |
|
|
Term
Name 3 substances that are elevated in renal disesase |
|
Definition
BUN, creatinine, and uric acid |
|
|
Term
|
Definition
End product of protein metabolism |
|
|
Term
Where is 98% of the body's creatinine located? |
|
Definition
|
|
Term
Where is 98% of the body's creatinine located? |
|
Definition
|
|
Term
|
Definition
end product of purine metabolism The purines are adenosine and guanine. Uric acid is increased with gout and renal disease |
|
|
Term
|
Definition
end product of purine metabolism The purines are adenosine and guanine. Uric acid is increased with gout and renal disease |
|
|
Term
What reagent is commonly used to mearure uric acid |
|
Definition
|
|
Term
|
Definition
mainly in the intestines from deamination of amino acids. it is converted to urea by the liver |
|
|
Term
|
Definition
with Reye's syndrome and hepatic failure |
|
|
Term
Which protein transports bilirubin |
|
Definition
|
|
Term
Name the 3 type of bilirubin |
|
Definition
unconjugated, conjugated, and delta |
|
|
Term
Which type of bilirubin is bound to albumin |
|
Definition
delta bilirubin
It is ONLY present with hepatic obstruction |
|
|
Term
What is the significance of clay colored stools |
|
Definition
obstruction of the bile duct
Urobilin is not being produced because bilirubin is not reaching the intestines |
|
|
Term
Which form of bilirubin can only be excreted in teh urine |
|
Definition
|
|
Term
Which form of bilirubin can only be excreted in teh urine |
|
Definition
|
|
Term
Which methods are used to determine bilirubin levels |
|
Definition
jendrassik grof and malloy-evelyn
Both use a diazo reagent to react with bilirubin and produce a colored azobilirubin. Malloy-Evelyn is carried out at an acid pH. Jendrassik Grof at an alkaline pH. |
|
|
Term
Name the accelators for the two methods of bilirubins |
|
Definition
Malloy-Evelyn - methanol Jendrassik-Grof - caffeine |
|
|
Term
What is the precursor in the iosynthesis of all steroid hormones |
|
Definition
|
|
Term
What is main action of FSH (follicle stimulating hormone) |
|
Definition
stimulates production of egg and sperm produced in anterior pituitary |
|
|
Term
What is function of growth hormone |
|
Definition
Stimulates protein and cell growth and division produced in anterior pituitary |
|
|
Term
|
Definition
anterior pituitary. stimulates thyroid to produce t3 and t4 |
|
|
Term
What is main action of ADH (anti diuretic hormone) |
|
Definition
Produced in hypothalamus and stored in posterior pituitary Regulates reabsorptio of water from teh distal convoluted tubules. Increased in diabetes insipidus |
|
|
Term
|
Definition
adrenal insufficiency decreased cortisol and increased ACTH The adrenal gland is unable to respond appropriatey to ACTH |
|
|
Term
|
Definition
ELevated levels of cortisol. May be due to tumors |
|
|
Term
|
Definition
It increases the retention of Na and excretions of K and H+ |
|
|
Term
|
Definition
It increases the retention of Na and excretions of K and H+ |
|
|
Term
What is main action of parathyroid hormone (PTH) |
|
Definition
increases calcium and decreases phosphorus |
|
|
Term
What is major intracellular ANION |
|
Definition
|
|
Term
What is major intracellular ANION |
|
Definition
|
|
Term
What is major extracellular ANION |
|
Definition
|
|
Term
What is major extracellular ANION |
|
Definition
|
|
Term
Which hormone regulates the concentration of sodium |
|
Definition
|
|
Term
What is the approximate ration of potassium between RBCs and serum |
|
Definition
|
|
Term
Wht clinical condition results from potassium that is very high or very low |
|
Definition
|
|
Term
What is chloride's role in the body |
|
Definition
maitains hydration, osmotic pressure, and electrolyte balance |
|
|
Term
What happens to lactate in the blood following collection |
|
Definition
it increases due to glycolysis |
|
|
Term
Which substance contributes most to serum osmolality |
|
Definition
|
|
Term
|
Definition
|
|