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[MT 6317] Clinical Chemistry Laboratory > [2S] UNIT 7 HbA1c & Nyco Card > Flashcards

[2S] UNIT 7 HbA1c & Nyco Card Flashcards

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1
Q

Percentage of HbA

A

97%

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2
Q

Percentage of HbA2

A

2.5%

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2
Q

Percentage of HbAF

A

0.5%

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3
Q

A protein in its quaternary structure - larger unit that is made up of tertiary units - made up of 4 polypeptide chains (2a & 2b)

A

HbA

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4
Q

T/F: Glycogen is always found in the extracellular fluid

A

F; Glucose

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5
Q

T/F: Glucose finds a way to the valine terminal molecules

A

T

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6
Q

Formation of a hgb compound produced when glucose reacts with the amino group of hemoglobin

A

Glycosylated Hemoglobin

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7
Q

GLYCOSYLATED HEMOGLOBIN

The glucose molecule attaches non enzymatically to the hgb molecule to form a _______

A

ketoamine

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8
Q

The rate of formation is directly proportional to the plasma glucose concentration

A

Glycosylated Hemoglobin

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9
Q

Reflects the average blood glucose level over the previous 2 to 3 months

A

Glycosylated Hemoglobin

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10
Q

Forms the major fraction of adult hemoglobin

A

HbA1

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10
Q

T/F: Glycosylated Hemoglobin is tested to measure short-term glucose metabolism

A

F; Long-term

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11
Q

More reliable method of monitoring long-term diabetes control than random plasma glucose

A

HbA1c

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12
Q

T/F: Current ADA guidelines recommend that an HbA1c test be performed at least 2 times a year with patients who are meeting treatment goals and who have stable glycemic control

A

T

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13
Q

T/F: For patients whose therapy has changed or who are not meeting glycemic goals, a quarterly HbA1c test is recommended

A

T

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14
Q

T/F: HbA1c testing does not require fasting and is a long term diabetes control

A

T

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15
Q

T/F: Glycated hemoglobin is not an antigen

A

F; it is an antigen

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15
Q

Most to least antigenic molecule

A
  1. Proteins
  2. Polysaccharides
  3. Lipids / Nucleic Acid
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16
Q

Any type of molecules that invoke an immune response

A

Antigen

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17
Q

METHODS BASED ON STRUCTURAL DIFFERENCES

Polyclonal or monoclonal antibodies toward the glycated N-terminal group of the b-chain of hemoglobin

A

Immunoassays

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18
Q

METHODS BASED ON STRUCTURAL DIFFERENCES

Not affected by other hemoglobins

A

Affinity Chromatography

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19
Q

METHODS BASED ON STRUCTURAL DIFFERENCES

Separates based on chemical structure using borate to bind glycosylated proteins

A

Affinity Chromatography

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19
Q

Nobel prize winners: antibodies method

Start with B lymphocyte of the mouse and vaccine it with foreign protein to gather antibodies and be utilized as reagent for assays

A

Milstein & Kohler

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19
Q

METHODS BASED ON STRUCTURAL DIFFERENCES

Not temperature
dependent

A

Affinity Chromatography

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19
Q

Plasma cell
Nucleus: ______
Chromatin: _______
__________ Halo

A
  1. Eccentric
  2. Cart-wheel
  3. Perinuclear Halo
  4. Elongated
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20
Q

Gathered and utilized as reagent of immunoassays and labeled with radioactive dye or enzymes

A

Antibodies

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21
Q

Principle of Nyco Card

A

Reflectometry / Reflectance Photometry

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22
Q

BASED ON CHARGE DIFFERENCES

Positive-charge resin bed

A

Ion-exchange chromatography

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22
Q

BASED ON CHARGE DIFFERENCES

Highly temperature dependent

Affected by hemoglobinopathies

A

Ion-exchange chromatography

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23
Q

BASED ON CHARGE DIFFERENCES

Separation is based on differences in charge & MW

A

Electrophoresis

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23
Q

BASED ON CHARGE DIFFERENCES

Type of electrophoresis using isoelectric point to separate

A

Isoelectric Focusing

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23
Q

BASED ON CHARGE DIFFERENCES

Hemoglobin F values > 7% interfere

A

Electrophoresis

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24
Q

BASED ON CHARGE DIFFERENCES

pre-HbA1c interferes

A

Isoelectric Focusing

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25
Q

BASED ON CHARGE DIFFERENCES

A form of ion-exchange chromatography - gold standard for identifying glycated hemoglobin

A

High-pressure liquid chromatography

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26
Q

BASED ON CHARGE DIFFERENCES

Separates of all forms of glyco-Hb: A1a , A1b , A1c

A

High-pressure liquid chromatography

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27
Q

Specimen requirement for HbA1c

A

EDTA Whole Blood Sample

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28
Q

Whole blood may be stored at?

A

4 °C for up to 1 week

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29
Q

T/F: The ideal specimen for HbA1c is fresh specimen

A

T

30
Q

T/F: Whole blood sample is slightly lower in glucose than plasma or serum. Nevertheless, it does not affect the results of HbA1c

A

T

30
Q

Measures light reflected from the coloured surface of the NycoCard tests in three parts of the visible spectrum and calculates the test concentration

A

The NycoCard™ READER II

31
Q

The NycoCard™ READER II is a _________

A

reflectometer

32
Q

Reflected light from the test sample is measured relative to a white sample

A

The NycoCard™ READER II

33
Q

T/F: NycoCard™ HbA1c Key Features

10 minutes test time

A

F; 3 mins

34
Q

T/F: NycoCard™ HbA1c Key Features

5 µL sample volume (capillary blood)

A

T

35
Q

T/F: NycoCard™ HbA1c Key Features

4%–15% HbA1c measuring range / linearity

A

T

36
Q

T/F: NycoCard™ HbA1c Key Features

Boronic acid affinity test principle
– No interference from common Hb variant

A

T

37
Q

T/F: NycoCard™ HbA1c Key Features

Boronic acid is the working principle not the labelling mechanism

A

F; BA is the labelling mechanism

38
Q

T/F: NycoCard™ HbA1c Key Features

Traceable to the IFCC reference method

A

T

38
Q

T/F: NycoCard™ HbA1c Key Features

NGSP and IFCC certified

A

T

39
Q

T/F: NycoCard™ HbA1c Key Features

Perfect for running (small) test series

A

T

39
Q

How does nyco card differentiate non-glycosylated hemoglobin to glycosylated hemoglobin?

A

Boronic acid affinity test principle

40
Q

2 reagents in 24 prefilled tubes

A

Lysing solution & Boronic acid

41
Q

Washes away non-reacting analytes

A

1 vial of washing soln

42
Q

TEST RESULT TIME

Liquid on the membrane

A

0 minute

42
Q

T/F: Results in nyco card reader should be read within 5 minutes

A

T

42
Q

TEST RESULT TIME

Too dry / crumpled membrane

A

> 5 minutes

42
Q

TEST RESULT TIME

Stable hemoglobin precipitate on the membrane (most ideal)

A

10 seconds - 5 minutes

43
Q

TEST RESULT TIME

False elevated HbA1c readings

A

0 minute

43
Q
  • Binds selectively to OH groups
  • Selective affinity for cis-diol configuration
A

Boronic Acid

44
Q

The affinity of boronic acid to the cis-diol configuration of glycated hemoglobin

A

NycoCard™ HbA1c Test Principle

45
Q

2 functional groups are adjacent towards one another across the cyclic ring

A

cis

45
Q

NycoCard HbA1c is based on a

A

boronic acid affinity test
principle

46
Q

Color of glycoslated hemoglobin stained by boronic acid

A

Blue

46
Q

2 OH groups located adjacent to one another

A

cis-diol

47
Q

T/F: The LCD display presents the results in percentage

A

T

47
Q

The vertical optic system of the nycocard to differentiate HbA1c to hemoglobin that are not glycosylated

A

Nycocard Reader Pen

48
Q

Where you place samples

A

Lid

49
Q

Measures the color intensity of reflected light

A

NycoCard Reader

49
Q

T/F: Red color intensity is directly proportional to Total hemoglobin

A

T

49
Q

2 lights needed for NycoCard

A

2 Light-emitting diode
Light detector

50
Q

T/F: The ratio between the blue and red reflected light will tell us how much exactly in that made up of glycosylated Hgb

A

T

51
Q

T/F: Blue color intensity is directly proportional to Total glycated hemoglobin

A

T

52
Q

T/F: For every 1% increase in the HbA1c result, there is always a 35 mg/dL in blood glucose

A

T

53
Q

Interpret:

HbA1c = 5.7% - 6.4%

A

Borderline High

53
Q

Interpret:

HbA1c = beyond 6.4%

A

Diabetes Mellitus

53
Q

Interpret:

HbA1c = 6% - 7%

A

Retinopathy

54
Q

The incidence of ________ increases in patients with a HbA1c level between 6.0 to 7.0%

A

retinopathy

55
Q

T/F: Fewer chances for retinopathy when the HbA1c level is <6.5%

A

T

55
Q

T/F: HbA1c level in diabetic patients recommended <7.0%

A

T

55
Q

T/F: This is suggested that HbA1c level above 6.5% favor diabetes mellitus

A

T

55
Q

T/F: HbA1c should be checked at least once a year

A

F; twice

56
Q

T/F: In interpreting HbA1c, if it prolongs the life span of RBC, it increases HbA1c

A

T

57
Q

Old RBCs = ↑ contact between hemoglobin & glucose

A

↑ HbA1c readings

58
Q

T/F: Caution should be used when interpreting the HbA1c results from patients with conditions such as Hemolytic anemia or other hemolytic diseases, Homozygous sickle cell trait, and pregnancy

A

T

59
Q

T/F: HbF can cause false increase in HbA1c

A

T

59
Q

T/F: Caution should be used when interpreting the HbA1c results from patients with conditions such as Blood loss, Polycythemia, and Iron deficiency

A

T

60
Q

Hemolytic disease = _ HbA1c

A

↓

60
Q

What are the Hgb variants & vitamins that causes false decrease in HbA1c?

A

HbC
HbS
Vit C
Vit F

61
Q

LIMITATIONS OF THE TEST

T/F: Coagulated or hemolyzed samples cannot be used

A

T

61
Q

LIMITATIONS OF THE TEST

T/F: Diluted samples can be used

A

F; cannot

62
Q

LIMITATIONS OF THE TEST

T/F: If the sample has a hemoglobin value below 6.0 g/dL or above 20.0 g/dL

A

T

63
Q

Interpret

Hemoglobin value = >20.0 g/dL

A

Polycythemia

63
Q

Interpret

Hemoglobin value = <6.0 g/dL

A

Anemia

[MT 6317] Clinical Chemistry Laboratory (10 decks)

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