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AMT Chemistry > AMT Chem > Flashcards

AMT Chem Flashcards

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1
Q

Protein soluble in water

A

albumin

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2
Q

What diff proteins from carb/lipid

A

nitrogen

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3
Q

conjugated protein

A

protein plus prosthetic grp

lipo, glyco/muco, nucleo

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4
Q

5 plasma proteins

A

albumin, alpha 1, alpha 2, beta, gamma

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5
Q

Primary protein structure

A

amino acids

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6
Q

Secondary protein structure

A

alpha helix, beta pleated sheets

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7
Q

Tertiary protein structure

A

3D

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8
Q

Quaternary protein structure

A

2+ polypeptide chains

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9
Q

Enzyme deficiency with decreased enzymes leading to buildup of ketoacids

inherited metabolic disorder involving leucine, isoleucine, and valine (a group of branch chain amino acids).

A

maple syrup disease

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10
Q

Aminoacidpathy caused by defiency in the enzyme to metabolize phenylalanine

mousy urine

A

Phenylketonuria, PKU

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11
Q

Aminoacidopathy due to enzyme deficiency due to lack of enzyme to break down tyrosine/phenylalanine leading to buildup of homo-gentistic acid

deficiency of a single enzyme called homogentisate 1,2 dioxygenase

urine turns a dark brownish-black color when exposed to air

A

Alkaptonuria

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12
Q

Cystinuria

Tyrosinemia

A

inherited metabolic,
excessive amount of undissolved cysteine, doesn’t get reabsorbed by kidney, kidney stones

Tyrosine/metabolites excreted in urine

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13
Q

Deficiency in enzyme needed to metabolize methionine

Increased levels of this amino causes stroke, CVD, alzheimers, osteoporesis, nutrional def

A

Homocystinuria

build up of methionine and homo-cysteine (metabolite of methionine)

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14
Q

4 causes of hypoproteinemia

A

Not getting/making enough:
malnutrition
liver disease(doesn’t make protein)

Protein loss:
burns(protein loss thru wound)
nephrotic syndrome(loss thru urine)

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15
Q

3 Causes of hyperproteinemia

A

dehydration
Multiple myeloma, Waldenstroms

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16
Q

5 immunoglobulin

A

G,A,M,E,D

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17
Q

4 measurements of TP…

TP g/dL…

A

Biuret
Dye binding
Kjeldahl
Refractometry

TP 6.4-8.3 g/dL

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18
Q

TP g/dL
albumin g/dL
microalbumin in urine mg/24hr

A

TP 6.4-8.3g/dL
Albumin 3.5-5 g/dL (about 60% of TP) rest is globulins

microalbumin 50-200 mg/24hr

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19
Q

Calculation of A/G ratio

A

Albumin/TP-albumin

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20
Q

Total protein method that reacts with >= 2 peptide bonds in proteins

A

Biuret

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21
Q

Biuret reaction for TP uses…
which forms what color complex

A

copper salts
which forms a purple color

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22
Q

What does a biuret reaction for total protein analysis depend on?

A

Peptide bonds
Under strongly alkaline conditions, Cu2+ ions form multivalent complexes with peptide bonds in proteins. The absorbance attributable to proteins is measured spectrophotometrically at 540 nm, and the biuret reaction reacts equally with all proteins and peptides longer than two amino acids

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23
Q

4 dyes in dye binding for TP

A

Bromophenol Blue
Coomassie brilliant blue

Ponceau S
Amido black

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24
Q

Reference method for TP, not used often

A

Kjeldahl

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25
Q

TP method that measures nitrogen

A

Kjeldahl

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26
Q

This reaction follows Beers law for a reasonable range of protein

Depends on presence of at least two peptide linkages

Is insensitive to low protein in urine…

A

Biuret reaction

Beers law:
concentration of analyte=
Abs unknown/Abs std x con std

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27
Q

3 things that can interfere with Biuret method for TP

A

hemoglobin, hemolysis and lipemia

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28
Q

Two dyes used in dye binding method for albumin

A

BCP less interference
BCG

Bromcresol

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29
Q

BCP/BCG is used in what method…
are used to determine…

A

Dye-binding method

for albumin

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30
Q

Principle of protein strip measurement called

pH

color change from,to…

Most sensitive to…

false pos seen in what pH..

A

protein error of indicators:
-indicatir is nonionized

pH 3.0

yellow to green: due to ion/union changing

Most sensitive to albumin

False pos: alkaline urine

*Not affected by bence Jones

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31
Q

Breakdown of protein turns to… liver converts it to

A

Gut bacteria make ammonia
Liver turns to urea

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32
Q

B2 microgobulin used as a marker for

A

reduced GFR

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33
Q

CSF protein
How many mg, What percent of plasma

A

15-45mg/dL, 1%

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34
Q

3 Methods for Urine/CSF protein, BAD acronym

A

Biuret
Acid: SSA precipitation
Dye: Coomassie brillant blue

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35
Q

Increased CSF protein in these 3

A

meningitis, tramatic tap, MS

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36
Q

Protein in Spina bifida

A

AFP
alpha fetoprotein

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37
Q

CEA stands for, is a

A

carcino-embryonic antigen

oncofetal antigen

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38
Q

CEA nonspecific for

A

colorectal carcinoma/colon cancer

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39
Q

AFP

A

alpha fetoprotein

tumor associated; secreted by fetal liver

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40
Q

Increased AFP 4 conditions

A

liver/heptocellular cancer

neural tube defects
(spina bifida)

ovarian
testicular cancer

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41
Q

Decreased AFP in

A

Down syndrome

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42
Q

HCG
Made by…
Has…

A

human chorionic gonadotropin

made by placenta after implantation by trophoblastic cells

alpha+beta subunits
NONcovalently bound
NONidentical

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43
Q

HCG seen in these two cancers

A

ovarian
testicular

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44
Q

PSA
Made by…
Seen in..

A

prostate specific antigen

made by prostatic epi cells

prostatic cancer

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45
Q

CA-125

A

ovarian cancer

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46
Q

CA19-9

A

pancreatic

GI, adenocarcinoma

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47
Q

CA15-3, 27.29

A

mestatic breast

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48
Q

Two markers in breast cancer

A

CA27-29, CA15-3

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49
Q

Thyroglobulin marker for

A

thyroid

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50
Q

All proteins carry a net…charge due to protein being a higher pH than its isoelectric point

and travel towards

A

net negative, anode

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51
Q

Fastest/smallest protein toward anode

A

albumin

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52
Q

Which globulin migrates to cathode due to electro/endosmosis

Several gels used routinely for protein electrophoresis attract positive ions from the buffer and form a positive ion cloud. This ion cloud moves in the opposite direction to the cathode. This phenomenon is called electroendosmosis or endosmosis.
The tension created by these oppositely moving ion clouds can affect the movement of sample macromolecules. The migration of some proteins can be slowed, some proteins can become immobile, and other proteins are pushed toward the cathode.

A

gamma

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53
Q

pH of electrophoresis

A

8.6

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54
Q

Anode

A

positively charged electrode

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55
Q

Cathode

A

negatively charged electrode

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56
Q

Protein in highest concentration and made in liver

% of plasma protein

A

Albumin
65%

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57
Q

Method of detection for albumin and reagents used

A

dye binding, bromcresol purple
methyl orange

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58
Q

Albumin function

A

transport/binds protein
osmotic pressure

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59
Q

Albumin decreased in these 3 things

A

malnutrition
liver disease

nephrotic syndrome/renal loss/kidney disease

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60
Q

Albumin increased in this

A

dehydration

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61
Q

Another name for prealbumin and used to assess…

A

trans-thy-retin

nutrional status

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62
Q

Liver makes these 4 globulins and RE/plasma cells make this

A

liver: albumin, alpha 1/2, beta

RE/plasma: gamma

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63
Q

two alpha 1 globulins

A

AAT: alpha1 antitrypsin

inhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.

AFP: alpha fetoprotein

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64
Q

AAT
increased in… and ….
decreased causes this…

A

increased in acute phase/prego
(Action of Neutrophils cause AAT to try to keep it from damaging tissue)

decreased in emphysema
(Def means neutrophil byproducts are damaging tissue)

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65
Q

AFP
increased these 4…
decreased in…

A

increased in:
neural tube defects
liver cancer
ovarian/testicular

decreased in Downs

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66
Q

Globulin increased in acute inflamation

A

alpha 2

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67
Q

Large globulin made in liver, inhibits trypsin/pepsin/plasmin

nephrotic/kindey disease
diabetes

lupus
increased in prego

A

alpha 2 macroglobulin

Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when lower molecular weight proteins are lost, but alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.

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68
Q

three alpha 2 globulins

A

alpha 2 macroglobulin
Haptoglobin
ceruplasmin

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69
Q

Alpha 2 globulin made in liver
acute phase reactant that binds hmg

A

Haptoglobin

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70
Q

haptoglobin increased/decreased in these two

A

increased in acute phases, nephrotic syndrome

(Increased α2-macroglobulin is seen in nephrotic syndrome due to increased synthesis and inability to pass through the glomerulus)

decreased in transfusion, hemolysis

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71
Q

Alpha2 globulin transports 65-90% copper, made in liver, acute phase reactant

A

Ceruloplasmin

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72
Q

Disease with decreased serum ceruloplasmin and decreased serum, increased urine copper. Increased storage of copper in organs/cornea

A

wilsons

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73
Q

Disease with decreased ceruloplasmin due to decreased absorption, decreased serum copper

A

Menkes

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74
Q

Ceruplasmin is a …. that transports…
increased in these two…
decreased in these two conditions…

A

glycoprotein that transports copper

increased in acute phase/inflammation, prego

decreased in Wilsons disease and Menkes

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75
Q

Beta globulins examples

A

Beta2 microglobulin
beta lipoprotein/LDL

transferrin
hemoplexin

complement
fibrinogen
CRP

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76
Q

Beta globulin that is a heme scavenger

A

hemopexin

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77
Q

Beta globulin that transports iron

A

transferrin

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78
Q

examples of glycoproteins

A

transferrin
ceruloplasmin

mucins
AFP

immunoglobulins, antibodies

FSH, LH, HCG, TSH

Fibrinogen

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79
Q

A non-glycoprotein that are temp sensitive proteins that precipitate from serum/plasma at temps lower than 37C (4C)

A

Cryoglobulin

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80
Q

Striated muscle/cardiac; increased in heart attack, muscle dystrophy, crush

A

myoglobin

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81
Q

complex of 3 proteins in striated/cardiac; muscle contration, most sensitive for heart attach

3 subunits

A

Troponin

TnI, TnT, TnC

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82
Q

Urine/CSF concentration first

Bence Jones in urine migrate to..
Prealbumin band seen in…

A

BJ to gamma region

Prealbumin in CSF

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83
Q

globulin increased
globulin decreased in viral hepatitis

A

gamma increased
albumin decreased

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84
Q

globulins increased…
globulin decreased…
maligment tumor

A

alpha 1/2 increased

albumin decreased

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85
Q

beta-gamma bridge,
broad gamma seen in

A

active cirrhosis/liver

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86
Q

M spike seen in

A

Monoclonal gammopathy

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87
Q

increased alpha 2/gamma ratio
Decreased albumin seen in

A

nephrotic syndrome

liver makes less albumin

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88
Q

Migration of globulins from anode to cathode and % of each…

A

albumin 65%, alpha1 2%,
alpha2 8%, beta 10%, gamma 15%

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89
Q

Polar hydrophillic and nonpoloar hydrophobic fatty acid chains; cell membranes are made of these

A

phospholipids

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90
Q

Examples of phospholipids

A

lecithin
sphingomyelin
PG(phosphatidyl glycerol)

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91
Q

Long chain polyunsaturated fatty acids that activates inflammation

Stimultes clotting; also stimulates cervix to dialate and contractions

a group of lipids with hormone-like actions that your body makes primarily at sites of tissue damage or infection

A

PG
Prostaglandins

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92
Q

Transports lipids, classified w/ultracentrifugation

Protein part of lipoproteins/structural components…

A

transports lipids: lipoproteins

Protein part: Apoprotein

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93
Q

Order of lipids from heaviest to lighest

A

HDL, LDL, VLDL, Chylo

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94
Q

Alpha lipoprotein is…
Beta lipoprotein is…
Prebeta lipoprotein is…

Migration of liproteins from origin/cathode to anode

Influenced by size and charge/amt protein

A

alpha: HDL most protein, fastest
Beta: LDL
PreBeta: VLDL, bigger than LDL
Chylo: least protein, slowest

Origin to Anode:
Chylo, LDL, VLDL, HDL

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95
Q

Largest lipoprotein, carrier of exo Trig
Apoproteins associated with it

A

Chylomicron
ApoB-48

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96
Q

Exogenous/dietary lipids and it’s liproprotein/carrier

A

Triglycerides
chylomicrons

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97
Q

most artherogenic lipid causing CHD, mostly composed of cholesterol and transported to the heart

Third fastest to anode

A

LDL

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98
Q

Endogenous lipid made of mostly triglycerides

Second fastest to anode

A

VLDL

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99
Q

Lipid transports lipid out of liver, heaviest and smallest

A

HDL

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100
Q

primary form of lipid storage…
transported by these two…

A

triglycerides
exo/dietary: chylomicrons
endo:VLDL

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101
Q

Lipid made monstly in liver, manufacture/repair cell membranes, makes biles salts/vitD, precurosr to steroids….

two kinds:
transports to cells…
transports out of cells…

A

cholesterol

to: LDL
out of: HDL

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102
Q

% of Cholesterol made in liver…
% of Trig made in liver versus diet…

A

Cholesterol 85%
Trig 10% liver, 90 diet

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103
Q

Apoprotein B-100 are part of these two lipids

A

LDL, VLDL

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104
Q

Apoprotein A is part of this lipoprotein

A

HDL

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105
Q

Apoprotein B-48 is part of this lipoprotein

A

Chylo

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106
Q

LDL % carrries lipids

A

LDL % carrries lipids
60-70

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107
Q

HDL % carries lipid

A

HDL % carries lipid
20-35

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108
Q

VLDL % carries lipid

A

VLDL % carries lipid
5-12%

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109
Q

Major protein in HDL

A

Apolipoprotein A

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110
Q

Major protein in LDL/VLDL

A

Apolipoprotein B

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111
Q

Protein versus lipid density

A

protein more dense than lipid

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112
Q

Disease with very low HDL

A

Tangier

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113
Q

Method for cholesterol

purpose of saponification step

A

cholesterol oxidase

convert cholesterol esters to free cholesterol

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114
Q

Liebermann Burchard reaction used to determine

A

cholesterol

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115
Q

2 reagents used for color developemnt in Liebermann Burchard reaction for cholesterol

A

acetic anhydride
sulfuric acid

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116
Q

Lieberman has cholesterol
goes to a.a. and s.a.

A

Lieberman Burchard reaction for cholesterol

Reagents are:
Acetic
Anhydride

and

Sulfuric
Acid

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117
Q

Lipid w/3 fatty acids/glycerol
storage form
90% in diet, 10% liver
lipemia from chylomicrons

A

Trig

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118
Q

Enzyme method for triglycerides…
Hydrolyzes to…

A

Lipase hydrolyzes triglyceride to form glycerol

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119
Q

Fredewald calculation for LDL

A

TC- (TG/5+ HDL)

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120
Q

Friedwald calculation for VLDL

A

TG/5

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121
Q

Cannot used Friedwald calculation for LDL/VLDL if…

A

TG is >400mg/dL

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122
Q

Risk factors for CHD
age by genders
history of
bp, HDL
two conditions

A

> 45men, >55 women
family history of CHD
smoking
bp >120, HDL <40
D.mellitus, metabolic syndrome

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123
Q

Lipid goals
TC
Trig
LDL
HDL

A

TC <200
Trig <150
LDL<100

HDL>35

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124
Q

Condition where blood cholesterol is increased

A

hypothyroidism

Thyroid hormones help your liver process blood. When your thyroid hormone levels are low, your liver processes blood more slowly, which can lead to higher levels of cholesterol in your bloodstream

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125
Q

Examples of ….
lipid deposits in vascular/legs/arms
CAD, AMI, arteries
lipid in brain, stroke

A

atheriosclerosis

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126
Q

Disease with increased TC, LDL and decreased HDL

Calculate coronary risk index using these two parameters

Elevated beta liproprotein is what lipid and leads to which kind of disease

A

CHD

TC, HDL

LDL, cardiovascular

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127
Q

4 non protein nitrogen

A

urea, ammonia
uric acid
creatinine

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128
Q

non protein nitrogen increased in plasma in renal impairment called

A

azotemia

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129
Q

Best way to evaluate renal impairment and what is most common analyte to monitor it

A

GFR

creatinine

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130
Q

Creatinine clearance calc

based off the principle that creatinine passes into the ultrafiltrate

A

U creat/P creat x mL/1440

vol in mL, min/24hr

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131
Q

Correction for clerance by body surface area

A

creat clearx1.73/area

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132
Q

Used with eGFR to stage/monitor CKD

A

urine albumin

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133
Q

Made from creatine in muscle

A

Creatinine

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134
Q

Method for creatinine

reacts with

color formed

A

Jaffe

alkaline picrate

yellow-red

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135
Q

Rises more rapidly than serum creatinine in acute renal failure

A

BUN

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136
Q

BUN increased in these two things

A

renal impairment
high protein

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137
Q

diacetyl monoxime used in determining…by measuring…

can be used in untreated urine because…

A

BUN
urea

method isn’t measuring ammonia

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138
Q

Type of method for BUN that measures urea…
reagent that reacts with urea…

A

Colorimetric method

reacts with diacetyl monoxime

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139
Q

Enzymatic method for BUN uses….
which hydrolyzes…to…

A

urease

which hydrolyzes urea into ammonia

Unlike the colorimetric method using diacetyl monoxime used for BUN/urea

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140
Q

diacetyl monoxime-

urease-

A

diacetyl monoxime-
BUN/urea

urease-
BUN/ammonia

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141
Q

BUN mg/dL
Creatinine mg/dL

BUN/creatinine ratio

elevated creatinine will result in elevated BUN of how much

A

BUN 6-20mg/dL
Creatinine around 1mg/dL

10:1 to 20:1

BUN will be elevated

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142
Q

GFR marker made by nucleated cells

A

cystatin c

NOT c peptide

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143
Q

end product of purine metabolism from nuclei, allantoin

A

uric acid

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144
Q

The colorimetric method for uric acid is an alkaline oxidation where uric acid reduces…to…

A

phospho-tungistic acid to tungsten blue

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145
Q

phosphotungistic acid used in

A

uric acid

*Acid=uric acid

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146
Q

Uric acid NV mg/dL

A

2.6-7.2

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147
Q

Hyperuricemia causes

A

-gout

-leukemia/lymphoma (overproduction of new cells, more breakdown)

-Lesch-Nyhan
(The HGPRT deficiency causes a build-up of uric acid in all body fluids. The combination of increased synthesis and decreased utilization of purines leads to high levels of uric acid production.)

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148
Q

Disease where there is over production of uric acid that arent recycled; mostly males

The HGPRT deficiency causes a build-up of uric acid in all body fluids. The combination of increased synthesis and decreased utilization of purines leads to high levels of uric acid production.)

A

Lesch-Nyhan

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149
Q

Uric acid is measured by… at 290nm before/after treatment with…

A

UV absorption at 290
before/after treatment with uricase

Also use isotope dilution/MS

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150
Q

This is from bacterial action on contents of colon and metabolized by liver

A

ammonia

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151
Q

Analyte that is a prognostic indicator of liver failure

A

ammonia

not eliminated by kidneys

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152
Q

Increased ammonia in these 3 main reasons

A

liver disease
(cirrhosis, viral hep)

impaired renal
(increased urea,ammonia)

Reye’s Syndrome
Reye’s syndrome is a rare condition that happens in children after a viral infection or illness, especially if they took aspirin (salicylate) to treat their symptoms. Reye’s syndrome targets their brain, blood and liver.

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153
Q

Syndrome that leads to increased ammonia, mostly kids, previous virus, salicylate

A

Reyes

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154
Q

Bromphenol blue or GLDH used to measure

A

ammonia

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155
Q

Nessler used to detect

A

used to detect ammonina

potassium iodide plus
mercury iodide/chloride plus
sodium hydroxide in water

dirty brown precipitate

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156
Q

Disaccharide with 2 glucose

A

maltose

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157
Q

Disaccharide with 1 glucose, 1 galactose

A

lactose

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158
Q

disaccharide with 1 glucose, 1 fructose

A

sucrose

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159
Q

monosaccharide with 6 carbons

A

hexose

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160
Q

process that uses glucose for energy, changed to lactic acid for energy

A

glycolysis

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161
Q

process of glucose to glycogen

A

glycogenesis

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162
Q

process of glycogen to glucose

A

glycogenolysis

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163
Q

process of glucose from noncarb sources

A

gluconeogenesis

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164
Q

renal threshold for glucose

CSF glucose % of plasma

best anticoagulant

A

160-180mg/dL

CSF 60-65% of plasma

sodium flouride

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165
Q

Diabetes melliutus

plasma/OGTT
A1C

A

> 200mg/dL
=6.5%

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166
Q

Hypoglycemia mg/dL

A

70mg/dl

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167
Q

Hormones that regulate glucose

which one decreases?
all the rest increase

A

insulin, only one decreases

glucagon: alpha cells
Stomatostain: delta cells

epineph/cortisol
GH, ACTH
T3/T4(Thyroxine)

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168
Q

hormones made in pancreas:
alpha cells/increase or decrease
beta cells/increase or decrease
delta cells/increase or decrease

A

alpha: glucagon, increase
beta: insulin, decrease
delta: stomatostain, increase

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169
Q

peptide hormone made in beta cells and decreases blood glucose/goes into cells

A

insulin

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170
Q

steroid hormone that is a glucocorticoid, made in adrenal cortex, and increases blood glucose

A

cortisol

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171
Q

peptide hormone made in alpha cells, increases blood sugar by making glucose from glycogen

A

glucagon

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172
Q

hormone made in delta cells, inhibits secretion of insulin making more glucose in blood

A

stomatostain

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173
Q

hormone that is adrenaline, neurotransmitter and regulates glucose

A

epinephrine

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174
Q

glycogen storage disease

increased or decreased glucose

A

von Gierkes

decreased

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175
Q

diabetes where glucose is normal

A

insipidus

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176
Q

condition with tumor that results in increased insulin

increased or decreased glucose

A

insulinoma

decreased glucose

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177
Q

two conditions that increase glucose

Thyroid, adrenal cortex

A

hashimotos
(Hypothyroidism, which is caused by Hashimoto’s disease, decreases glucose absorption, leading to an accumulation of sugar. In turn, this accumulation of sugar causes more insulin to be produced to utilize excess glucose, eventually leading to insulin resistance.)

cushings(increased cortisol)

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178
Q

most employed automated method for glucose uses what two enzymes where there’s oxidation that forms a chromagen

contamination can happen with

A

glucose oxidase, peroxidase

contamination with catalase

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179
Q

Gold standard for glucose testing/higher specificity…

Two enzymes used….

Amount of… is proportional to glucose

Is read at…nm

A

Hexokinase method

Hexokinase, G6PD

NADH formed is proportional to glucose

340nm

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180
Q

hexokinase method:

what is reduced and measured?
measured at what nm?

A

NAD coenzyme reduced to NADH

measured at 340nm

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181
Q

Normal fasting blood glucose

A

70-110mg/dL

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182
Q

Test to confirm prenatal borderline blood glucose

A

3 hr GTT

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183
Q

HmgA1C binds to hmg and monitors long term diabetes/largest fraction of HbA

how long of picture of glucose?
Normal?
Diabetic?

A

2-3mth

Normal 4.0-6.0%
Diabetic 6.5%

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184
Q

How is the formation of HbA1c related to plasma glucose concentration?

A

Directly proportional

The rate at which a glucose molecule attaches to hemoglobin to form a ketoamine is directly proportional to the glucose concentration in the plasma.

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185
Q

Juvenille onset, insulin dependent, autoimmune destruction of beta cells
ketoacidosis

A

Type 1

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186
Q

adult onset, non insulin, insulin resistance, no ketoacidosis, obsesity

Which of the following is a non-insulin dependent diabetes, is characterized by insulin resistance and progressive hyperglycemia, and is called “adult-onset diabetes”?

A

Type 2

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187
Q

What is a byproduct of insulin and can differentiate between medication/exo insulin and what the body makes/endogenous insulin?

A

C-peptide

not cystatin(kidney)

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188
Q

Diabetes caused by placental lactogen inhibiting insulin

A

GDM
gestational diabetes mellitus

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189
Q

Measurement of light intensity, chemical rxn forms color and is absorbed at specific wavelenth

visible light 400-700, frequency inverse to wavelength, uses quartz cuvette for UV range

tungsten or deuterium

A

spectrophotometry

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190
Q

Filter used for QC of spectrophotometer and what it tests

A

holmium oxide
glass filter

wavelength accuracy

*Glass filter for spectrometry

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191
Q

Meaasurement of emission of color when element is burned

A

flame photometry

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192
Q

Measurement of light abosorption of electromagnetic radiation

A

atomic absorption spectrophotometry

Atomic=radiation
Absorption
Spectrometry=light

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193
Q

Atomic absorption measures using what light source

also uses monochormator, flame sample cell, PM tube

A

hollow cathod lamp

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194
Q

term that decreases fluorescent intensity of a substance

is a disadvantage of…

A

quenching
fluorometry

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195
Q

Measurement using electrode, ref electrode, liquid, potential diff between the two equals concentration

A

ISE

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196
Q

Measurement of light scattered by particles in a solution and measured at an angle, seen in ag-ab rxn…

Measurement of reduction in light transmission by particles in suspension ie proteins

A

scattered: nephelometry

reduced transmisson: turbidimetry

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197
Q

In immunoelectrophoresis there must be excess…
and a constant…. ……

A

excess antibody

constant trough distance

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198
Q

Used to separate volatile or able to volatile and to confirm toxicology
Is a reference for alcohol…

This is used to enhance sensitivity and specificity…

A

gas chromatography

MS(mass spectro)

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199
Q

Technique w/sorbent coated and solvent screens for drugs/urine
Uses Rf value

Rf value is…

A

TLC Thin layer chromatography

Rf= drug distance/solvent distance

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200
Q

Osmometry based off

measures

m-Osmol/kg

A

freezing point depression

measure osmolality of urine/serum
(dissolved particle in sln)

Tubular fnc

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201
Q

Hmg-Verdo-hmg

Plasma/store: biliverdin-iron-globin
Liver: bilirubin-albumin
Conjugataed: Bili diglucuronide

A

…

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202
Q

Ehrlich, p-DMAB reagent measures

A

Urobilinogen

Increased in liver damage, hemolytic disease

Negative in bile duct obstruction

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203
Q

p-DMAB stands for, used in the
…method for…

A

p-Di-Methyl-Amino-
Benzaldehyde

Ehrlich method for urobilnogen

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204
Q

Color produced with Erlichs reagent w/porphobilinogen and urobilinogen

reagent used to distinguish the two

A

red/pink color

chloroform,
urobilinogen will be soluble

porphobilinogen will be insoluble and stay in aqueous phase

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205
Q

Protein that carries unconjugated bilirubin..
Where is bilirubin conjugated…
Name of conjugated/direct bili…

A

albumin carries unconjugated
conjugated in liver
conjugated is bilirubin diglucuronide

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206
Q

Jendrassik-Grof measures

uses
turns into

A

bilirubin

uses diazo-tized sulfanilic

turns into purple, measures green azobilirubin

Alkaline tartrate eliminates interference

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207
Q

Bilirubin that is seen is not solube, thus not secreted in urine, cause of hemolytic trans rxn, prehaptic jaundice

A

indirect bili/unconjugated bili

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208
Q

Bilirubin that is formed/converted in intestine

A

urobilinogen

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209
Q

bilirubin that is oxidized/green in RE system

A

biliverdin

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210
Q

oxidized form of urobilinogen excreted in
urine…
stool…

A

urobilin: urobilinogen goes to kidney; yellow
stercobilin: urobilinogen oxidized, brown stool

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211
Q

Evelyn Malloy method used for…
Interference..

A

bilirubin
hemolysis

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212
Q

Jaundice with increasd unconjugated and increased urine urinobilinogen

A

Prehepatic jaundice

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213
Q

Disease where all bili is increased, bili/uro in urine

A

hepatic

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214
Q

condition where unconjugated is normal, decreased uro, but increased conjugated bilirubin in urine

A

Posthepatic obstruction

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215
Q

Have diff/mobility rates due to different aminos/structure

Different Electrophoretic property

Different rxns

Same substrate

A

Isoenzyme

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216
Q

Metals ions in enzymatic reactions act as

A

activators

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217
Q

This contant determines rate of conversion of substrate to product by differing

substrate concentrations

and

rate of dissociation of complex
(Enzyme acting on substrate making product)

A

Michaelis-Menten

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218
Q

Order rxn where large excess substrate allows for amt of enzyme activity to be limiting factor when all enzyme is bound to substrate

substrate: A reactant in a chemical reaction is called a substrate when acted upon by an enzyme.

A

zero order

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219
Q

LD catalyzes lactate +NAD to… And…

A

pyruvate + NADH

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220
Q

LD isoenzyme that migrates the fastest to anode and highest in heart/rbc (Most negatively charged)

A

LD1 HHHH

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221
Q

LD isoenzyme in healthy, HHHM

A

LD2

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222
Q

LD isoezyme that migrates the slowest (most positively charged)

A

LD5

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223
Q

Increased in LD1,2,3

A

PA
pernicious anemia

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224
Q

Enzyme greatly affected by hemolysis because its in all cells

A

LD

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225
Q

CK increased in these 3: stress to muscles

A

heart attack
muscular dystrophy
exercise

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226
Q

3 CK isoenzymes are dimers
Fastest to slowest

Brain faster than muscle

A

CKBB, CKMB, CKMM

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227
Q

CK isoenzyme slowest, in skeletal muscle

A

CKMM

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228
Q

CKMB sensitive for AMI

rises w/in…down in…

A

2-4hrs
2-4 days

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229
Q

Most sensitive for AMI and two most used…
rise/fall…

A

Troponin
TnT,TnI
4-8hrs, 10 days

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230
Q

LD rises, days last

A

rises 8-12hrs, 10-14 days

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231
Q

Myoglobin rises, normal

A

30min, 24hrs

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232
Q

condition can’t pump, fluids in lungs, cause CAD, BNP to diagnose

A

CHF

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233
Q

Condition were lack of oxygen, ischemia, leads to CHF/angina/heart attack

Narrowing of the small blood vessels that supply blood and oxygen to the heart.

A

CHD

Coronary heart disease (CHD) is also called coronary artery disease

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234
Q

3 conditions elevated AST

1 not elevated

A

acute heart
liver disease
muscular

not elevated in acute pancreatitis

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235
Q

2 Liver enzymes not affected by hemolysis

A

ALT, GGT

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236
Q

Increased ALP in 3 things in liver

A

obstruction of biliary tract/jaundice
acute viral hep
biliary cirosis

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237
Q

ALP increased in these 3 bone disorders

increased in 1 random

A

Pagets:
overgrowth

osteomalacia:
soft bones, decreased D/Ca

Rickets: Vit d def

prego (increased in mom and baby’s bones)

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238
Q

High ALP but no other liver increased

A

bone

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239
Q

pH for ACP

increased in

A

5.0
acid

prostatic disease

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240
Q

Enzyme in alcoholics, heptobiliary, obstructive jaundice, cirrhosis

A

GGT

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241
Q

Enzyme in mumps and acute pancreatitits

enzyme most specific for pancreatittis

A

mumps: amylase
pancreatitis: lipase

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242
Q

Cherry Crandall used to determine…

substrate…

A

lipase

olive oil

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243
Q

Disease with highest level of aldolase

A

muscular dystrophy

Aldolase is necessary for glycolysis in muscle as a “rapid response” pathway for production of adenosine triphosphate, independent of tissue oxygen.

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244
Q

Zollinger-Ellison is a… increased…

A

gastrinoma
gastrin HCl

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245
Q

diacetyl monoxime used to determine

A

BUN

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246
Q

phospho-tungistic acid to tungsten blue used to determine

A

Uric acid

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247
Q

most uric acid in plasma is what form…

increased in…

A

monosodium urate

gout

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248
Q

Kayser-Fleischer

A

Cooper deposits in cornea

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249
Q

To evaluate ionized calcium you need to know these two things and why

A

pH and protein

ionized calcium is pH dependent;
ph will increase if CO2 is lost

Ca will increase with increased protein

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250
Q

things that regulate calcium
2 increase/1 decrease

A

VitD/PTH: increase Ca

-VitD increases GI absorption of Ca
-low Ca will stimulate PTH production

Calcitonin: decrease Ca
-inhibits bone reabsorption

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251
Q

Hypocalcemia causes

A

Tetany (decreased Ca,Mg)
VitD def, hypoPTH

hypo mag, albumin

Normally, the parathyroid glands release a hormone that increases blood calcium levels when they are low. Magnesium is required for the production and release of parathyroid hormone, so when magnesium is too low, insufficient parathyroid hormone is produced and blood calcium levels are also reduced (hypocalcemia).

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252
Q

hypercalcemia

A

Vit excess, hyperPTH

Malignancy

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253
Q

8-hydroxy-quinoline removes…

In determination of…

A

Mg

Ca

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254
Q

In the complexometric titration for Ca, the pH is adjusted to prevent…

Complexometric titrations are used mainly to determine metal ions by use of complex-forming reactions.

A

complexometric titration:
pH is adjusted to prevent
interference from Mg
with 8-hydroxy-quinoline removes Mg

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255
Q

Method for Ca where its precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate

A

Clark-Collip

precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate

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256
Q

Clark-Collip measures…
it will be precipitated as…

A

Calcium
oxalate

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257
Q

In determining calcium, lanthanum is used to

A

lanthanum binds phosphate

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258
Q

Most phosphorus is in… at pH

A

bone 7.4

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259
Q

Phosphorus is controlled by this and how does it affect it, opposite of Ca

A

PTH:
decreases Pho
increases Ca

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260
Q

Affect on Phos
PTH
Calcitonin, Vit D

A

PTH decreased Pho

Calcitonin, Vit D increases phosphate

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261
Q

Reagent used for phosphate

A

molybdate
molybdeum blue

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262
Q

Hyperparathyroidism= increased PTH,
Phosphorus is

A

decreased

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263
Q

Hypoparathyroidism= decreased PTH
Phosphorus…

A

increased

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264
Q

Magnesium is controlled by kidney thru tubular reabsorption, what is renal threshold

A

1.5-2.1mg/dL

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265
Q

Treatment for preeclampsia/contractions will result in what lab result to be increased

A

magnesium
hypermagnesemia

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266
Q

Condition decreased iron/ferritin/% sat, increased transferrin/TIBC

A

IDA

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267
Q

Reagent for magnesium

A

titan yellow

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268
Q

2 Conditions with increased iron/ferritin/%sat and decreased transferrin/TIBC

A

sideroblastic and hemocromatosis

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269
Q

trace metal involved in melanin, inorganic cofactor, bound to albumin, transported/bound mostly by ceruloplasmin

A

copper

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270
Q

Fat soluble vitamins

A

A,D,E,K

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271
Q

Water soluble vitamins

A

All B, C

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272
Q

Fat soluble Retinol, cause of night blindness

A

A

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273
Q

Fat soluble calciferol, hormone precursor, Rickets

A

D

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274
Q

Fat soluble Tocopherol, antioxidant/immunity
Hemolytic anemia

A

E

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275
Q

Fat soluble phylloquinine, for clots
hemmorage

A

K

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276
Q

Water soluble B1
condition

A

thiamin
Beriberi

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277
Q

water soluble riboflavin

A

B2

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278
Q

water soluble B3, condition

A

niacin
pellegra

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279
Q

water soluble pyridoxal

A

B6

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280
Q

water soluble B7

A

Biotin

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281
Q

water soluble B9, condition

A

folate

megaloblastic

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282
Q

water soluble cobalamin, condition

A

B12
PA/IF

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283
Q

cause of Scurvy

A

C

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284
Q

Major extracellular cation…
NV…

A

Sodium 135-145

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285
Q

Hormone that increases Na reabsorption and acts on distal convoluted tube

Released by adrenals

A

Aldosterone

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286
Q

Hypoaldosterone Na

Hyperaldosterone Na

A

Hypo: decreased Na
Hyper: increased Na

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287
Q

Normal values
Na
Cl

K

A

Na 135-145
Major extracellular cation

Cl 98-106
Major extracellular anion

K 3.5-5.0
Major intracellular cation

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288
Q

BUN

Creatinine

A

BUN 6-20
Creatinine 0.7-1.5

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289
Q

CO2/Bicarb

A

23-29

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290
Q

Na 165
Cl 125
K 3.5

A

Saline contamination

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291
Q

Diabetes mellitus
Fasting…
Nonfasting…
Glucose

A

126, 200

292
Q

Increased K causes

Phleb issues…
Tube additive…
Condition…

A

Hemolysis, tourniquet, squeezing

EDTA

Diabetic ketoacidosis

(Insulin promotes potassium entry into cells. When circulating insulin is lacking, as in diabetic ketoacidosis, potassium moves out of cells, thus raising plasma potassium levels even in the presence of total body potassium deficiency )

293
Q

Used to enhance sensitivity of ISE electrode for K

A

Valino-mycin

294
Q

Hypokalemia is less than

Hyperkalcemia greater than

A

Potassium

<3.5

> 5

295
Q

Chloride shift

A

Cl is inverse HCO3, when one leaves the other goes in

High Cl, low HCO3=metabolic acidosis

296
Q

Causes of increased Cl

A

IV
Dehydration

Metabolic/diabetic acidosis
(lose HCO3, chloride shift)

297
Q

Low Cl
4 things

A

Diarrhea, vomiting

Renal failure: not reabsorbed

metabolic alkalosis: excess bicarb, less CO2

298
Q

Chloride measured with titration methods such as
C.A. and S.S.

C.A. is…
S.S. is…

A

Coulometric amperometric

Schales-Schales

299
Q

Coulometric amperometric method uses a… Method
It’s is the…

Analyte measured…

A

Titration
Time needed to get to end pt

Chloride

300
Q

Schales-Schales is what kind of method…
For…
Violet color formed from reaction with…

A

Mercurimetric titration
Chloride
Excess Hg++

301
Q

C-A and S-S are both these kind of reactions…for…

A

Titration
Chloride

302
Q

Most CO2 in blood is

A

Bicarb

303
Q

Specimen Least ordered, not used for CO2

A

Urine

304
Q

Anion Gap, NV

A

Na+K-(Cl+HCO3)
10-20

305
Q

Increased anion Gap

A

Diabetic ketoacidosis
Lactic acidosis

Salicylate
Methanol
Ethanol
Poly glycol

Unmeasured

306
Q

Decreased anion Gap used as, due to

A

Analytical QC
Analyzer error

307
Q

Glass, Ag/AgCl, measures H for measurement of

A

pH

308
Q

Platinum+Ag/AgCl, amperometric measures

A

pO2

309
Q

Henderson Hasselbalch

A

pH= pKa + log [salt]|[acid]

[A base]|[HA acid]

pH=log HCO3/pCO2
pH=log kidney/lungs
pH=log metabolic/respiratory

310
Q

Bicarb: carbonic acid ratio in plasma

A

20:1

311
Q

Acidosis
Normal
Alkalosis

A

<7.38

7.35-7.45, around 7.4

> 7.42

312
Q

Metabolic acidosis: pH, HCO3 levels compensation

A

Decreased pH, HCO3
Lung: Hyperventilating releases CO2

313
Q

Metabolic alkalosis 2 parameters influenced, compensation

A

Increased pH, HCO3
Lung: Hypoventilation increases CO2

314
Q

Respiratory acidosis 2 parameters, compensation

A

Decreased pH,
Increased CO2
Kidneys: increase bicarb

315
Q

Respiratory alkalosis 2 parameters, compensation

A

Increased pH,
decreased pCO2
Kidneys compensate

316
Q

Beer-Lambert law

A

The Beer-Lambert law relates the concentration of a sample to the amount of light the sample absorbs as it passes through the sample.

317
Q

Synovial: joints, hyaluronic acid makes viscous, obtain by arthrocentesis

2 Synovial crystals/conditions

A

Uric acid: gout

Pyro-phosphate: pseudogout

318
Q

Amniotic fluid:
access neural tube defects/AFP

4 Fetal lung tests…

A

L/S: >2
PG
FLM 2
Lamellar

319
Q

Sweat:
Analyte
Condition, death cause

A

Cl
Cystic fibrosis, pneumonia

320
Q

Sperm:
mL, live%, motility %, #/mL

A

2-5mL
>75% alive
>50% motility
# 20-250 million/mL

321
Q

Decreased CSF glucose seen in

Increased CSF glucose seen in

A

Decreased CSF glucose:
Bacterial meningitis

Increased CSF glucose:
Diabetes

322
Q

CSF tube order/department

A

1 chem
2 micro
3 heme

323
Q

CSF protein mg/dL

A

15-45

324
Q

CSF glucose

A

60-70% plasma

325
Q

CSF diff

A

70% lymph
30% mono

326
Q

4 causes of increased CSF Protein

A

Meningitis
Intracranial hemorrhage
Traumatic tap
MS

327
Q

Decreased CSF TP seen in

A

Leak, tear

328
Q

Increased CSF IgG index and oligoclonal banding seen in…

A

MS
Multiple scelerosis

Oligoclonal bands are proteins called immunoglobulins. The presence of these proteins indicates inflammation of the central nervous system. The presence of oligoclonal bands may point to a diagnosis of multiple sclerosis.

329
Q

Urine ph normal…
If left at rt becomes..

A

normal 6.0 (4.5-8)
alkaline at RT

330
Q

Normal urine volume:

poly>
olig <
noc
anuria

A

1200-1500

poly >2500
olig<500
noc: more at night
anuria: none

331
Q

left at RT, what
decreases…
increases…

False pos…

A

decreases:
glucose/ketones
bili/uro
cells/casts

increases:
nitrites/bacteria
turbidity(bacteria)
pH(amm)

False pos: protein

332
Q

3 things kidneys make

2 hormones that influence kidney

A

renin, erythropoeitin, PG

aldosterone, ADH

333
Q

Urine is made of 7 things

A

95% water

urea, uric acid, creatinine

Cl/Na/K

334
Q

Urine RBCs color

A

smoky, red/brown urine

335
Q

Urine bili/pyridum color

A

dark yellow/amber/orange

Phenazopyridine (Pyridium) is a dye that’s a red-orange color

336
Q

Met/Hmg and homogentistic acid urine color

A

brown black upon standing

337
Q

Reabsorbs H2O only…

Rebabsorbs solutes only…

A

H2O only Descening Loop

solutes only ascending loop

338
Q

Specific gravity NV…

increased in these 3
decreased in this

A

1.003-1.030

increased in:
-renal damage(isotheniuria 1.010)
-diabetes mellitus
-xray

decreased in diabetes insipidus

339
Q

3 methods to determine sg

A

refractometer
reagent strip

harmonic oscillation:
densitometry; current helps measure sg

340
Q

Urine strip protein method name…
ph…and can leach to the pH strip and …the pH
what protein it binds to…
color…
confirm with…

A

protein error of indicators

3.0 and can leach to the pH strip and lower the pH

albumin

sulf. acid precipitation

341
Q

How many neprons per kidney….
filtration ml/min

A

1 million
90-120mL/min

342
Q

Protein of indicators on dipstick description…

has nothing to do with…
not affected by…

What will cause false pos…

A

Most of the indicator is non-ionized.
The protein will combine with the non-ionized form and will change the ratio of ionized and nonionized

Has nothing to do with pH and not affected by bence jones

False pos due to alkaline/buffered urine

343
Q

Renal threshold for glucose
dipstick measures only glucose

two enzymes in rxn

A

160-180mg/dL

glucose oxidase, perioxidase

344
Q

Clinitest/Benedicts is a… …method for…
Can screen for…
but reacts with…

False neg with these two…

A

copper reduction method for glucose

screen for galctosemia
reacts with all reducing substances

false neg with Vit C and pass thru

345
Q

Occult blood on urine dipstick depends on

A

perioxidase activity of rbc/hmg

346
Q

Nitrite:
bacteria type…
2 names for rxn:

A

GNR (E.coli)

Diazo, Griess rxn

347
Q

RBC dipstick:
false neg with one vitamin and mistaken with 3 things…

false pos…

A

false neg: vitC
yeast, oil,
calcium oxalate crystals

false pos: oxidizing like bleach

348
Q

UTI, renal calculi, acute glomerulonephritis you’ll see these cells

A

RBCs

349
Q

reagent for LE, color

A

diazo reagent, purple

350
Q

Cell related to glitter cell, UTI/pyelonephritis…

type seen in UTI…

A

white

neutrophils

351
Q

Seen in diabetes mellitus, breakdown of lipids…
reagent…
color…

confirm with…

A

ketones

sodium nitroprusside
purple

Acetest (Acetoacetic/diacetic acid, acetone)

352
Q

Sodium nitroprusside used in determination of…on dipstick

A

ketones

353
Q

Acetest is used to confirm…
detects these two..

A

confirm ketones
diacetic acid, acetone

False pos: highly pigmented, levadopa

354
Q

Ictotest, Diazo rxn used for

A

Bilirubin

VitC false neg

Bike duct obstructions, liver, ciirhosis

355
Q

Reagent used in Erlich

A

p-DMAB

356
Q

Erlich, p-DMAB used in

A

Urobili

357
Q

Leukocyte in DILUTE HYPOTONIC urine where granules appear to move/Brownian Mvt

A

glitter cell

358
Q

Large epithelial seen in catherterization, renal pelvis, ureter, bladder

A

transitional

359
Q

Cell seen in tubular necrosis, renal tubles, oval fat bodies are made from

A

renal tubular

360
Q

glycoprotein made from TRE that makes up casts (two names)

A

Tamm horsfall mucoprotein

Uromodulin

361
Q

Cast are formed in what part of tubules

A

distal convoluted tubule

362
Q

Casts seen in chronic renal disease, urinary stasis

A

waxy

363
Q

cast seen in stress/exercise, normal

A

hyaline

364
Q

cast seen in nephron/acute glomerulonephritis

A

RBC

365
Q

Cast from dialated collecting ducts

A

broad

366
Q

cast seen in acute glomerulonephritis and is decomposition of cellular

A

granular

367
Q

cast from break down of epi casts/oval fat bodies, nephrotic syndrome

A

fatty

368
Q

cell in pyleonephritis

A

wbc

369
Q

4 urine parasites

A

T.vag
E.vermiculares (bread loaf ova)
strongy
S.haematobium

370
Q

5 abnormal crystals

A

Cysteine: 6 sides

Leucine: concentric circles
Tyrosine: needles

Bili: yellow/brown needles
Cholesterol: notched plates

371
Q

3 normal crystals in acidic urine

A

Uric acid: rhomboid/pleomorphic
amorphouse urates: pink sediment

Calcium oxalate: envelope/oval/dumbell,
*monohydrate form in antifreeze

372
Q

4 normal crystals in alkaline urine

A

amorphous phosphates
triople phosphate: coffin lid

calcium carbonate: dumbell
amm. biurate: thorny apple

373
Q

NV for… 50-200 mg/24hr

A

microalbumin

374
Q

AAT globulin

A

Alpha-1-antitrypsin
Alpha1 globulin

inhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.

375
Q

Tangier low in

A

HDL

376
Q

Colorimetric method for BUN measures…uses…

Enzymatic method for BUN measures…uses…

Which one can be used for untreated urine, why

A

Colorimetric measures urea and uses diacetyl monoxime, can be used with untreated urine since it’s not measuring ammonia

Enzymatic measures ammonia and uses urease

377
Q

Hexokinase
Glucose method reduces this coenzyme…
To…
At…nm

A

NAD coenzyme is reduced to NADH and measured at 340nm

378
Q

diazo rxn/Jendrassik-Grof

A

Bilirubin

379
Q

Jendrassik-Grof and
Evelyn Malloy
measure

A

Bilirubin

380
Q

Jendrassik-Grof=
Bilirubin+Diazo (caffeine)=azobili

A

Jendrassik-Grof=
Bilirubin+Diazo (caffeine)=azobili

381
Q

Evelyn Malloy method uses…as an accelerator

Jendrassik-Grof uses…as an accelerator

Measures…

A

Evelyn Malloy method uses methanol as an accelerator

Jendrassik-Grof uses caffeine benzoate acetate as an accelerator

bilirubin

382
Q

LD1 HHHH
Fastest, marker for these two

A

heart/rbc

383
Q

sideroblastic and hemocromatosis

Iron,ferritin,%sat, transferrin/tibc high or low

A

increased iron/ferritin/%sat
decreased transferrin/TIBC

Sideroblastic anemia is a type of anemia that results from abnormal utilization of iron during erythropoiesis.

Hemochromatosis, or iron overload, is a condition in which your body stores too much iron. It’s often genetic.

384
Q

Pyrophosphate seen in

A

pseudogout

385
Q

Porter-Silber reaction uses phenylhydrazine to detect…

Zimmerman reaction detects…

A

PS=phenylhydrazine=
corticosteroids

Zimm=
17-KS/17-ketosteroids

386
Q

Phenlyhydrazine used to detect corticosteroids in what reaction

A

PS=Porter-Silber

387
Q

17-ketosteroids/17-KS is detected in what reaction…

Is a metabolite of…

A

Zimmerman

Zimmerman is a man that takes 17-KS/steroids

metabolite of androgens

388
Q

Porter and Zimmerman take steroids

A

…

389
Q

Hypothalmus makes releasing/inhibiting hormones that act on the pituitary

Pituitary then makes hormones that have their effects on organs that make the end product/action

A

…

390
Q

Primary caussed by…
secondary caused by…
tertiary caused by…

A

Primary…end organ
Secondary:pituitary
Tertiary: Hypothalamus

391
Q

Increased GH causes these two things
kids versus adults

Decreased GH causes

A

kids: giantism
adults: acromegaly

dwarfism

392
Q

Hormone that solely initiates and maintains lactation

A

prolactin

393
Q

increased prolactin cause of these two

A

Hypogonadism:
In hyperprolactinemia, which induces hypogonadism, the excess prolactin interferes with secretion of gonadotropin-releasing hormone, resulting in decreased testosterone and erectile dysfunction.

and

prolactinoma
(pituitary tumor)

394
Q

menstral disorder and inadequate lactation due to

A

decreased prolactin

395
Q

Vasopression is also called

A

antidiuretic hormone

396
Q

ADH acts on…to increase…

decreased in…

A

acts on renal tubles to increase water reabsorption

diabetes insipidus

397
Q

Hormone that stimulates urterine contraction/myoepithelial cells in breast thus ejecting milk

A

oxytocin

398
Q

Hormone that forms male sex characteristics, spermatogensis, facial hair, deep voice, sex drive

A

testosterone

399
Q

Testosterone is made from…

A

cholesterol (as is a lot of steriods)

400
Q

hormones that stimulate sex organ development, linear growth, epiphyseal fusion

A

androgens

401
Q

infertility men/women

polycystic ovarian due to

adrenal hyperplasia:
A group of genetic conditions limiting hormone production in the adrenal glands.

A

hypertestosteronemia

402
Q

hypogonadism due to

A

hypotestosteronemia

403
Q

TRH, GRH, CRH GHRH
PIF, GHIH released by

A

hypothalamus

404
Q

GH, PRL, TSH, LH, FSH, ACTH released by the … …

A

anterior pituitary

405
Q

ADH, oxytocin released by

A

posterior pituitary

406
Q

Hormone that induces ovulation, prmotes ovary secretion of estrogens/progesterone for possible pregnancy and stimulates testes to produce testosterone

A

Luteinizing hormone

407
Q

GnRH,
gonadotropin-releasing hormone

stimulates this organ to produceb these 2 hormones… which affects these two organs

A

GnRH stimulates pituitary to make LH and FSH to affect ovaries or testes

408
Q

GHIH is also called

A

Somatostatin

409
Q

GHIH/Somatostatin

GHRH: growth hormone-releasing hormone

A

Somatostatin from the hypothalamus inhibits the pituitary gland’s secretion of growth hormone and thyroid stimulating hormone.

GHRH: growth hormone-releasing hormone

410
Q

Somatostatin inhibits the pituitary gland’s secretion of…and…

A

Somatostatin from the hypothalamus inhibits the pituitary gland’s secretion of GH and TSH

411
Q

FSH stimulates, secretion of
females:
males:

A

females: egg development, estrogen
males: sperm, testosterone

412
Q

hypothalmus makes CRH, Corticotrophin-releasing hormone

that act on pituitary to make ACTH,
Adrenocorticotropic hormone

this stimulates the adrenal cortex to make steroid hormones made from cholesterol

3 steroids made in adrenal cortex…

A

mineralcoritcoids(aldosterone)
glucocorticoids(cortisol)

sex hormones (androgens, estrogens)

413
Q

What converts angiotensinogen to angiotensin I which converts to II and stimulates cortex to make aldosterone

A

Renin

414
Q

hormone that induces secretion of glucorticoids(cortisol) of adrenal cortex

A

ACTH
adreno-cortiotropic hormone

415
Q

CRH stimulates the…to make… which causes… to release cortisol, aldoseterone, estrogens and testosterone

A

CRH stimulates the pituitary to make ACTH

causing the adrenal cortex to make cortisol, aldosterone, estrogens/testosterone

416
Q

Mineralocorticoids, glucorticoids, and androgens released by

A

adrenal cortex

417
Q

aldosterone is an example of a…

maintains…and…
by retaining…and…
and excreting…

A

mineralocorticoid

maintains H2O and electrolytes by retaining water and Na and excreting K

418
Q

Cortisol is a type of

A

glucocorticoid

419
Q

Hyperadolsoterone, increased Na, decreased K, hypertension

A

Conns Disease

420
Q

Conns Disease has increased…and thus increased…
decreased…
leading to….due to increased…

A

has increased aldosterone and thus increased Na
Decreased K
leading to hypertenstion due to increased fluid retention

421
Q

Hypoaldosterone, decreased Na/Cl, decreased cortisol

everything down

A

Addisons Disease

422
Q

Increased cortisol, increased glucose, increased Na

buffalo hump

A

Cushings
everything up

423
Q

Testosterone is a type of

A

androgen

male sex hormone

424
Q

metabolite of androgen…
reaction used to detect…

A

17-ketosteroid, 17-KS

Zimmerman reaction

425
Q

3 types of catecholamines

purpose

A

epineph
norepi
dopamine

These hormones are released into the body in response to physical or emotionalstress.

426
Q

Two GI hormones

A

Gastrin
serotonin

427
Q

Hormone increased in Zollinger Ellison syndrome

A

gastrin

428
Q

Hormone made in GI, vascoconstricter of PLTs/brain/tissue

A

serotonin

429
Q

5HIAA is a urinary metabolite of…

increased in chromaffin cell tumors of GI, drugs, bananas, pineapples etc

A

serotonin

430
Q

Catecholamines produced in…by…

A

adrenal medulla

by chromaffin cells

431
Q

Metabolites of epineph

A

metanephrine, VMA

432
Q

Metabolites of norepineph

A

normetaneph,VMA

433
Q

Metabolites of dopamine

A

HVA

434
Q

Pheochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headache

with increased…

A

VMA

435
Q

Pheochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of…and…

metabolite is…

A

epinephrine and norepinephrine

VMA

436
Q

Neuroblastoma is a childhood cancer that starts in immature nerve cells (neuroblasts)

with increased…

A

HVA

437
Q

Most of the releasing and inhibiting hormones (except for ACTH) are producted by the…

A

hypothalamus

438
Q

Thyroid hormones: stimulate metabolic processes

In tissues…is coverted to….

99.97% of…is bound to mosntly TBG, some TB-PA, albumin

99.5% of….is also bound

A

In tissues T4 is converted to T3

99.97% of T4 is bound to TBG

99.5% of T3 is bound

439
Q

TSH stimulates the … to make these two

A

thyroid, T3/T4

440
Q

3 things hormones made by thyroid

A

thyroxine/T4, triiodothyronine/T3

calcitonin

441
Q

Thyroxine/T4 and Triiodothyronine/T3 increases…

Calcitonin increases…

A

Thyroxine, Triiodothyronine: metabolism
Calcitonin: Ca reabsorbtion

442
Q

3 calcitropic hormones

A

PTH, VitD, calcitonin

443
Q

Low PTH lowers these two…
increases this…

A

Lowers serum Ca, D
Increases Phos

444
Q

TRH stimulates pituitary to release… which acts on…

A

TSH, acts on thyroid

445
Q

TSH stimulates thyroid to make…

A

T3,T4

446
Q

Free… stimulate negative feedback loop and inhibit secretion of…

A

Free T3/4 inhibit TSH

447
Q

primary Hyperparathyroidism also called…
symptoms

A

Graves

weight loss, heat, hair loss, anxious

448
Q

Graves is hyper or hypo…
T3/T4 levels…
TSH levels…

thyroid overproduces… due to… …

A

hyper: T3/T4
decreased TSH to stop production of T3/T4

Primary means thyroid overproduces T3/T4 due to TSH antibodies

449
Q

Primary Hypothyroidism is called…
symptoms

A

Hashimotos

weight gain, tired, cold

450
Q

Hashimotos is hyper or hypo…
T3/T4 levels…
TSH levels…

due to… …

A

hypo: T3/T4
increased TSH to decreased T3/T4 levels

Thyroid autoab

451
Q

Major binding protein for thyroxine/T4

How is it measured

A

TBG
thyroid binding globulin

By measuring T3 uptake (amount of TBG bound to thyroid hormones)

452
Q

3 good indicators for hypothyroidism

1 not good indicator

A

FT4, TT4, s-TSH (singles best)
Most is T4 not T3

not good T3 uptake (indirect, not used)

453
Q

Ovaries productes these two hormones

A

estrogen, estadiol

454
Q

hormone female sex charac, hyper=amenorrhea, hypo=menopause

A

Estrogen

455
Q

hormone that’s active form of estrogen, evaluates fetoplacental function

A

estadiol

456
Q

Progesterone made by the… … … and then by the…in pregnancy

A

ovarian corpus luteum and then placenta in pregnancy

Progesterone is also secreted by the ovarian corpus luteum during the first ten weeks of pregnancy, followed by the placenta in the later phase of pregnancy.

corpus luteum: yellowish mass of progesterone-secreting endocrine tissue that forms immediately after ovulation

457
Q

prepares uterus for prego, maintains endometrium lining, inhibits uterine contractions, prepares breasts for lactation

A

progesterone

458
Q

progesterone levels
perimenopause
postmenopause

A

peri: increased progesterone

post:decreased progesterone

459
Q

What hormone maintains progesterone in early pregnancy

A

HCG

460
Q

HCG increased/decreased…

A

increased: prego, mutiple pregos, tumors

decreased: spontaneous abortion

461
Q

HCG subunits are…

A

alpha, beta subunits

NON-covalently bound subunits
NONidentical

462
Q

subunit that cross reacts with LH,FSH,TSh

A

alpha

463
Q

subunit that has analytical specificity

A

beta

464
Q

Trimester with highest level of HCG…
When does it show up, how long does it last…

A

first

seen in days, peaks 2-3mths

465
Q

Toxicology, best specimen for screening/qualitative, best for quantitative

A

Urine-QL
Blood-QNT

466
Q

Creatitinine, pH, or oxidizing activity, dilute/substituted/adultered as a measure of

A

validity

467
Q

Major disadvantage of immunoassay drug detection…

best 2 ways to confirm for drugs that have positive screens…

A

Immunoassays can’t simultaneously assay multiple drugs in one specimen

gas chromatography/MS

468
Q

Aminoglycosides and Glycoprotein are two kinds of

A

antibiotics

469
Q

Kind of Glycoprotein/antibiotic
that inhibits.. ..synthesis of gram…

A

Vancomycin

inhibit cell wall synthesis, treat gp

470
Q

gentami/tobramy/amika/kana-cin are all…

they inhibit… … of gram…

A

aminoglycosides

inhibit protein synthesis, treat gn

471
Q

Monitor toxic range of antibiotics to prevent damage to…and…

A

hearing/ototoxic
kidneys/nephrotoxic

472
Q

Phenobarbital, phenytoin/dilantin
Valproic acid, Carbamazepine
ethosuximide are all

A

anti-epileptic/anti-convulsants

473
Q

Bronchodialator

asthma, IV/oral, 10-20ug/mL, toxic >20ug

A

Theophylline

active metabolite in neotates is caffeine, also caffeine given as a brochodilator

474
Q

Cyclosporine, Tacrolimus, Sirolimus,MPA
all are

A

immunosuppressive

475
Q

Methotrexate are all

A

antineoplastics/antitumor

476
Q

Cyanide, arsenic, mercury all are

A

heavy metals

477
Q

Substances/acute poisoning

A

acetaminophen-liver damage
salicylates
alcohols-ethanol,isopro,glycol

cyanide

carbon monoxide(carboxyhmg 200x infinity)

organophosphates/pesticide:
-CNS, decrease cholinesterase

478
Q

Must wait until…to TDM

how many half lives to reach…
how many half lives to clear…

metabolized by liver, excreted in urine

A

steady state

5.5

479
Q

Specimen drawn imme before next dose is called…

Peaks drawn…hrs

A

Trough

1-2hrs after oral dose

480
Q

AID:
Amtriphtyline, Imipramine, Doxepin

Lithium are all

A

pyschotropics

481
Q

Amtriphtyline, Imipramine, Doxepin are all

A

tricyclics

482
Q

Digoxin, Quinidine, Procainamide,
Disopyramide, Lidocaine all are

A

Antiarrythmics/cardiactive

483
Q

Increased alpha 2 in these two

A

Acute inflammation
nephrotic syndrome

484
Q

Tetany decreased in these two

A

Ca,Mg

485
Q

LD 4,5 related to

A

Liver disease

486
Q

Elevation in LD1/LD2 in a flipped pattern is related to

A

Myocardial infarction

487
Q

Increased total serum LD 4,5 related to

A

Acute viral hepatitis

488
Q

Increased LD 1,2 related to

A

Hemolytic anemia

489
Q

Gilbert, Crigler-Najjar and Dubin-Johnson syndromes all are issues with what analyte

A

Billirubin

490
Q

Syndrome that’s genetic liver disease, reduced glucuronyl transferase, thus increased bili

A

Gilbert syndrome

491
Q

Name of syndrome where there’s two types,

the type and name where there’s compete absence of glucuronyl transferase, severe unconjugated bili and kernicterus…

Type work decreased glucuronyl transferase, chronic increased bili

A

Crigler-Najjar Syndrome

Complete:Type 1

Decreased: Type 2

492
Q

Syndrome that’s genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion

A

Dubin-Johnson syndrome

493
Q

Dubin-Johnson syndrome

A

Syndrome that’s genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion

494
Q

2 Hepatitis fecal, oral

A

A, E

495
Q

3 Recent Hep B infection markers

A

HBsAg,HBeAg
Anti-HBc IgM

496
Q

DNA hep, with a core and envelope
BF, sex, IV drug

A

Hep B

B=body fluids

497
Q

RNA, blood-to-blood contact:
blood transfusion, needles, no vaccine
Development of cirrhosis

A

Hep c

C=cirrosis

498
Q

Hep that needs HBV, coinfection

A

Hep D

499
Q

Tetany caused by these two

A

(decreased Ca,Mg)

500
Q

2 Sex hormones…
Type of…
Made in…

A

Androgen: testestosterone
Estrogen: estradiol

Steroid
Made in adrenal cortex

501
Q

Electrode w/silver chloride anode, platinum wire cathode

suspended in KCl w/a permeable membrane measures

A

PO2

502
Q

H+ concentration (pH) has what kind of electrode

A

glass

503
Q

An electrochemical tecnique used to measure the amount of electricity passing between 2 electrodes in and electrochemical cell.

Quantity of amount of electricity directly proportional to the chemical reaction at the electrode.

A

Coulometry

504
Q

Coulometry is an automated method that generates silver ions and often is used to measure..in…

A

chloride in sweat

C=chloride, Coulometry

505
Q

Application of coulometry is titration of…with silver ions generated by electrolysis from a silver wire at the anode

A

titration of chloride

506
Q

glass electrode
reference electrode
specimen put in a capillary tube surrounded by buffer solution
the tube is made of … sensitive glass across which a potential difference is generated, which is proportional to the…

A

pH

507
Q

PO2 electrode is uses this principle where theres measurement of a electrical current at a constant voltage or potential

A

amperometry

508
Q

Clark electrode or polargraphic electrode
….molecules diffuse across a plastic membrane to small platinum or gold 2nm diameter wire cathode in a glass rod immersed in a phosphate buffer with KCl

…is reduced and this creates current flow between the cathode and silver/silver chloride anode.
increasing the voltage increases the current up to a plateau determined by the rate of supply of …molecules & proportional to the concentration.

A

PO2 measurement

509
Q

A self contained potentiometric electrode measures….

…gas from the sample diffuses thru the selective membrane and dissolves in the internal electrolyte layer.

Carbonic acid is formed and dissociates, shifting ph

A

PCO2

CO2 gas

510
Q

modified glass electrode
comprises of a glass pH electrode that is permeable to…

…diffuses from the specimen into the …solution where it dissociates with a change in pH which is measured by the electrode potential difference is proportional to concentration

A

PCO2

HCO3

511
Q

Glucose method that is glucoses specific colorimetric method

A

glucose oxidase

512
Q

In the hexokinase method for glucose, what is the end product measured

A

NADH from the reduction of NAD

513
Q

Procedure for calcium that uses lanthanum chloride to eliminate interfering substance…

what substance does it bind to…

A

…atomic absorption spectrophometry
…Binds to phosphate

AAS measures calcium by detecting its atomic absorption by electromagnetic radiation.

Atomic absorption spectrometry (AAS) detects elements in either liquid or solid samples through the application of characteristic wavelengths of electromagnetic radiation from a light source. Individual elements will absorb wavelengths differently, and these absorbances are measured against standards.

…
Phosphates present can complex with calcium. Addition of lanthanum chloride competes for the phosphate and prevents interference with calcium

514
Q

Both Malloy Evelyn and Jendrassik-Grof measure… which determines…

A

measures azobilirubin
determines bilirubin

515
Q

Coenzyme and reduced used in LD reaction

A

NAD/NADH

516
Q

Increased LD4,5 in these two

A

liver and skeletal musdscle

517
Q

increased LD3 in

A

pulmonary edema

518
Q

Steady state theurapeutic drug achieved between… and…doses

A

4-7

519
Q

Benzoylecgonine is a metabolite of what drug

A

cocaine

520
Q

Pheytoin is also called…
is what kind of drug…

A

Dilantin

anticonvulsant

521
Q

IU is amt of enzyme that would convert…of substrate per min

1 IU=

A

1micro mol

1IU=micro mol/min

522
Q

Fraction increased in biliary cirrhosis

A

gamma

elevated gamma w/beta gamma bridging due to increased IgA

523
Q

Fraction increased due to nephrotic syndrome

A

Alpha2 globulin

loss of albumin, increased alpha 2 is compensatory

524
Q

Lack of alpha1 globulin due to these two

A

alpha1 AT def

servere emphysema

Emphysema is caused by the protease-antiprotease imbalance when smoking-induced release of neutrophil elastase in the lung is inadequately inhibited by the deficient levels of AAT, the major inhibitor of neutrophil elastase.

525
Q

Electrophoretic pattern of plasma will show a

A

sharp fibrinogen peak

526
Q

Slight increase in alpha 2 and decrease albumin due to

A

acute inflammation, acute phase reactants

527
Q

Broad increase in gamma electrophoresis due to…

A

polyclonal gammopathy/chronic inflammation

528
Q

Condition with decreased activity of glucuronyl transferase leading to increased unconjugated bili/kernicterus in neonates

A

Crigler
Najjar

Syndrome

529
Q

Immunosuppressants
T, C, S, M

A

Tacro, Cyclo, Siro, Myco

530
Q

Tricyclics
AID

A

Amt, Imi,Dox

531
Q

Antiarrhythmic

Digoxin
-dine, -amide, -caine

A

…

532
Q

High alpha 2 only

A

Acute inflammation

533
Q

High alpha 2/gamma ratio

A

Nephrotic syndrome

534
Q

High alpha 1&2 with low albumin

A

Malignant tumor

535
Q

High gamma with low albumin

A

Viral hepatitis

536
Q

Beta game bridge, broad gamma

A

Active cirrosis/liver

537
Q

From anode, migration of serum proteins…
Percentages…

A

Albumin, alpha1, alpha2, beta, gamma

65, 2, 8, 10, 15

538
Q

Alpha1 globulins

A

Alpha1 antitrypsin, AAT
Alpha1 glycoprotein
Alpha liprotein

AFP

539
Q

Alpha 2 globulins

A

Alpha2 macroglobulin

Haptoglobin
Ceruplasmin

540
Q

Beta globulins

A

Beta2 microglobulin
Beta lipoprotein

Transferrin
Hemoplexin

Complement
Fibrinogen
CRP

541
Q

Acute phase reactant, binds hmg…
Increased in…
Decreased in these 3…

A

Haptoglobin

Increased in inflammation

Decreased in HA
hemolytic transfusion reaction
Hemolytic disease of newborn
(Lots of loose hmg needs to be picked up)

542
Q

2 alpha2 globulins that are acute phase reactants, increase with inflammation

A

Haptoglobin
Ceruplasmin

543
Q

Ceruplasmin will be… When there’s excess storage of copper

Seen in…

A

Decreased

Wilson’s

544
Q

Ceruplasmin will be… When there’s decreased absorption of copper…

Seen in…

A

Decreased…
Menkes

545
Q

GLDH, coupled enzyme rxn for…

A

Urea, BUN

546
Q

In GLDH for urea, what is formed at end

A

NAD

547
Q

Conductimetric uses gold electrode to measure…

A

Urea

548
Q

What is measured in conductimetric method for urea…

A

NH4 conductivity

549
Q

Ref method for creatinine and uric acid

A

Isotope dilution M/S

550
Q

-ISE, pH
-Spectro/blue dye
-enzyme: GLDH

Used for

A

Ammonia

551
Q

Most common ammonia method used

A

GLDH
Enzymatic

552
Q

Fluorescein isothiocyanate
and
Phycoeryrhrin are…

A

Two fluorochromes in fluorescent immunoassay

553
Q

Method where there’s absorption of one wavelength and emission of a longer, lower one

A

Fluorometry

554
Q

Luminol and acridinium esters are used in this method

A

Chemiluminescent

555
Q

Method where light is made from chemical reaction;
Rapid increase in intensity of emitted light followed by gradual decayb to ground state with emission of photons

A

Chemiluminescent

556
Q

Labeled antigen is called a…in radio immunoassays

A

Tracer

The basic principle of radioimmunoassay is competitive binding, where a radioactive antigen (“tracer”) competes with a non-radioactive antigen for a fixed number of antibody or receptor binding sites.

557
Q

Cintillation counter and gamma counter are used in

A

Radio immunoassays

558
Q

Isotopes used in radio immunoassays

A

3^H, 125^I

559
Q

Enzymes used in immunoassays increase…

A

Analytical specificity

560
Q

The pCO2 electrode is a…electrode but… doesn’t affect sample.

Electrode measures… …

A

pH electrode measures dissolved CO2

561
Q

Method that measures light adsorption of electromagnetic radiation by atoms

A

Atomic adsorption spectrometry

562
Q

Hollow cathode lamp is light source for

A

AAS
Atomic adsorption spectrometry

563
Q

Measures coulombs needed for a reaction

Analytical technique that measures the amount of electricity (in coulombs) required to fully react with a sample.

A

Coulometry

564
Q

Measures current at a single potential

Detection of ions in a solution based on electric current or changes in electric current.

A

Amperometry

A=alone

565
Q

Measures current flow of solution as a function of an applied voltage

an electromechanical technique of analyzing solutions that measures the current flowing between two electrodes in the solution as well as the gradually increasing applied voltage to determine respectively the concentration of a solute and its nature

A

Polarography

566
Q

Chromatography that uses Rf value to id drugs of abuse

A

Thin layer chromatography, TLC

567
Q

Rf in TLC is the … Of the… Over the …of the…

A

Distance of drug over
Distance of solvent

568
Q

Chromatography that consists of a stationary phase in LC (liquid) of small diameter particles

A

High performance liquid chromatography

569
Q

Chromatography that’s a ref method for alcohol, drugs of abuse

A

Gas chromatography

570
Q

What enzyme increased at RT

A

ALP

571
Q

3 enzymes not affected by hemolysis

A

ALT, GGT
Amylase

572
Q

Peptide used to diagnose CHF…
Common causes of CHF…

A

BNP, Btype natriuretic peptide
CAD

573
Q

Hyperparathyroidism, antacids, dextrose sln all… phosphorus

A

Decrease

574
Q

Hypoparathyroidism and renal failure can… phosphorus

A

Increase

575
Q

Final site urine concentration

A

Collecting duct

576
Q

Sg seen in severe renal damage

A

1.010
Isothenuria

577
Q

Oval fat bodies: highly refractile RTE w/fat

Form…
Seen in…

A

Maltese cross
Nephrotic syndrome

578
Q

Crystal seen in renal calculi and ethylene glycol poisoning

A

Calcium oxalate

579
Q

… Protein is a form of transferrin present in csf

A

Tau protein

580
Q

Lipoprotein
Origin/cathode to anode:

A

Chylo, beta, pre beta, alpha

581
Q

5’NT
Nucleotidase is in.. But not…

A

In liver but not bone

582
Q

Decreased cholinesterase seen in

A

Organophosphate/pestiside poisoning

583
Q

Major anion of extra cellular

A

Cl

584
Q

HCO3 NV versus pCO2 NV

A

HCO3 22-26
pCO2 35-45

585
Q

pO2 NV

A

85-105

586
Q

Alkaline urine gives… … With protein

A

Falsely positive

587
Q

Water soluble…
Fat soluble…

A

Water: B, C
-pee out

Fat: ADEK
-risk of toxicity

588
Q

Homocystinuria
maple syrup disease
Phenylketonuria, PKU
Alkaptonuria

All are amino acid…

Two that aren’t are…

A

Deficiencies

Two that aren’t are are Cystinuria, Tyrosinemia

589
Q

LDL % carrries most of the lipids
60-70

HDL % carries lipid
20-35

VLDL % carries the least lipid
5-12%

A

…

590
Q

Glu-glu: mal

Glu-galac: lac

Glu-fruc: sucr

A

…

591
Q

Holmium oxide glass filter…

Hollow cathod lamp….

A

Holmium oxide glass filter…
Spectrometer wavelength accuracy

Hollow cathod lamp….
Atomic adsorption

592
Q

Both measure…

Jendrassik-Grof uses, turns into…

Evelyn Malloy method affected by…

A

Bilirubin

Jendrassik-Grof measures:
uses diazo-tized sulfanilic
turns into purple azobilirubin

Evelyn Malloy method affected by hemolysis

593
Q

Calcium: titration

complexometric: titration interference from Mg,
8-hydroxy-quinoline removes Mg

Clark-Collip:
precipitated as CALCIUM OXALATE and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate

lanthanum:
binds PHOSPHATE so it doesn’t interfere with calcium

A
594
Q

Cl NV…
CO2/bicarb…

A

Cl 98-106
Major extracellular anion

CO2/bicarb 23-29

595
Q

Lose Cl thru Diarrhea, vomiting and loss thru Renal failure, not reabsorbed

Increased in metabolic acidosis

A

…

596
Q

Lipid carried:

LDL carries %…
HDL carries %…
VLDL carries %…

A

LDL carries %… 60-70
-carries the most lipids

HDL carries %… 20-35
VLDL carries %… 5-12

597
Q

Method for cholesterol:

cholesterol oxidase
-purpose of saponification step is to convert cholesterol esters to free cholesterol

Liebermann Burchard reaction:
-2 reagents used for color developemnt: acetic anhydride
sulfuric acid

Lieberman has cholesterol and goes to a.a. and s.a.

A

…

598
Q

Uric acid: 2.6-7.2 mg/dL

The colorimetric method:
-is an alkaline oxidation where
uric acid reduces phospho-tungistic acid to tungsten blue

Uricase/enzymatic:
-UV absorption at 290
before/after treatment with uricase

A
599
Q

Ammonia:

Bromphenol blue or GLDH used to measure

Nessler

A

…

600
Q

Bilirubin:

Jendrassik-Grof:
uses diazo-tized sulfanilic,
turns into purple azobilirubin

Evelyn Malloy:
Watch for hemolysis

A
601
Q

Calcium:
Titrant is added until the reaction is complete. To be suitable for determination, the end of the titration reaction must be easily observable

complexometric titration:
*pH is adjusted to prevent
interference from *Mg
with 8-hydroxy-quinoline removes Mg

Clark-Collip:
-precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate

*lanthanum binds *phosphate

A

calcium:

pH, Mg

CC, oxalate

Lanthanum, phosphate

602
Q

Chloride measured with titration methods such as
C.A. and S.S.

Titrant is added until the reaction is complete. To be suitable for determination, the end of the titration reaction must be easily observable

Coulometric amperometric: time
-Titration
-Time needed to get to end pt

Schales-Schales: excess Hg
-Mercurimetric titration
-Violet color formed from reaction with excess Hg++

A

…

603
Q

Migration of lipoproteins from cathode(-) to anode (+)…

A

Chylo, beta, pre beta, alpha

Named in order from anode to cathode…
+Alpha, pre beta, beta, chylo

-Chylo slowest, HDL fastest
-Pre beta before beta

604
Q

Bicarb NV

A

HCO3 22-26

605
Q

Which of the following determinations is used to assess the total body lead poisoning burden?

A

Whole blood lead

Whole blood lead levels are the most commonly used biomarker of human lead exposure. In lead poisoning, impaired iron delivery or utilization within the mitochondrion has the similar effect of increasing erythrocyte zinc protoporphyrin.

606
Q

Which analyte rises first in response to inflammation?

Associated with this disease…

A

C-reactive protein, or CRP, is one of the first acute-phase proteins to increase as a result of inflammation.

Increase in serum of CRP concentrations is associated with a risk of future CHD events.

607
Q

Which of the following instruments ionizes the target molecule then separates and measures the mass-to-charge ratio?

A

Mass spectrometer

Mass spectrometer instruments measure mass-to-charge ratios rather than molecular mass but are referred to as mass spectroscopy.

608
Q

In a developing embryo, which type of deficiency can lead to death or severe neurological birth defects?

A

Folate

A folate deficiency in a developing embryo can lead to death or severe neurological birth defects. Folate and single-carbon metabolism are imperative to both cell growth and division.

609
Q

What are the two most common aminotransferases measured in the clinical laboratory?

A

AST,ALT

610
Q

SSA stands for…
used for…

A

Sulfosalicylic acid

Proteins are precipitated by 5-sulphosalicylic acid. Any resulting turbidity will give an estimation of the amount of protein present in the urine which can be subjectively quantitated visually or more precisely quantitated using photometry. Cells and casts in the urine must be removed by centrifuging before carrying out the test. The test can detect albumin, hemoglobin, myoglobin, and Bence Jones proteins.

611
Q

A refractometer is an instrument that measures how light bends as it passes through a sample. The degree to which a sample bends light is correlated to the number and size of solute particles. When a refractometer tests a urine sample, it measures the specific gravity of the urine.

The urine’s specific gravity indicates the kidneys’ ability to balance water content and excrete waste. Typical values range between 1.005 to 1.030. A low specific gravity suggests an inability to concentrate urine, excessive hydration, or diabetes insipidus. A high specific gravity could indicate dehydration or diabetes mellitus.

A

pass thru refractometer

612
Q

A screening test for diagnosing intermittent porphyria, although it might also become positive in porphyria cutanea tarda (a skin form of porphyria). In this method, porphobilinogen is detected by a color reaction with Ehrlich reagent and confirming that the color is not removed by chloroform. As the test is just a screening test, it usually is confirmed by a more specific test such as a Hoesch test.

A

Watson-Schwartz differentiation test

613
Q

Test that is a colorimetric screening for porphobiloinogen in urine. More sensitive and specific. Color directly relates to amount.
Inverse Erlich reaction: volume of urine to reagent reversed, acidity prevents urobilinogen from reacting. Positive is pink at interface

A

Hoesch test

614
Q

PH urine

A

4.5-8.0

615
Q

Amount of urine..

normal:
anuria:
oliguria:
polyuria:

A

normal: 1200-1500ml
anuria: none
oliguria: <400
polyuria: >2500

616
Q

3 urine substances false positive with bleach

A

Glucose, blood, WBC

617
Q

Alkaline urine:
False pos in, false neg in

A

False pos protein
False neg SG

618
Q

Highly pigmented/Medication color false pos is urine 4 substances

A

Ketones, nitrite

urobilinogen, Bilirubin

619
Q

4 urine substances false neg with vitC

A

Glucose, blood
bilirubin, nitrite

620
Q

What tubule reabsorbs 80% of the fluid, electrolytes…

A

Proximal

Water, NaCl,K, aminos etc

621
Q

Loop of Henley:

Which one reabsorbs water only

Which one reabsorbs solutes only

A

Descending: water only
Ascending: solutes only

622
Q

Casts formed in…

Final concentration in…

A

Casts formed in… Distal

Final concentration in… Collecting

623
Q

Most frequently used supravital stain in microscopic exam trying
Urine

A

Sternheimer Malbin

The Sternheimer-Malbin (SM) stain is a commonly used supravital stain containing crystal-violet and safranin. WBC’s, epithelial cells, and casts stain well with SM stain. Sedi-Strain (Clay Adams, Sparks, MD) and Kova stain (ICL Scientific) are among those commercially available. Nuclei and cytoplasm of various cells can be stained with a 0.5% solution of toluidine blue.

624
Q

Name of and 3 colors of CSF supernatant due to hemoglobin, hemorrhage

A

Xanthochromia

Pink, orange, yellow

625
Q

abnormally high urea nitrogen in the blood is called…

A significant increase in
the plasma concentrations of urea and creatinine, in
kidney insufficiency, is known as…

Once instance urea levels are lower…

A

high urea nitrogen: uremia

increase in plasma concentration of urea and creatinine is azotemia.

During pregnancy, lower-than normal urea levels are often seen.

Azotemia can result
from prerenal, renal, or postrenal causes:
* Prerenal azotemia is the result of poor perfusion of the kidneys and therefore diminished
glomerular filtration. The kidneys are otherwise normal in their functioning capabilities.
Poor perfusion can result from dehydration,
shock, diminished blood volume, or congestive heart failure. Another cause of prerenal
azotemia is increased protein breakdown, as
in fever, stress, or severe burns.
* Renal azotemia is caused primarily by diminished glomerular filtration as a consequence
of acute or chronic renal disease. Such diseases include acute glomerulonephritis,
chronic glomerulonephritis, polycystic kidney disease, and nephrosclerosis.
* Postrenal azotemia is usually the result
of any type of obstruction in which urea is
reabsorbed into the circulation. Obstruction
can be caused by stones, an enlarged prostate
gland, or tumors

626
Q

HER2/neu a marker for
Breast, Ovarian, and Cervical Cancer
Markers

A

oncogene
HER2/neu as a prognostic indicator and a marker
related to the choice of therapy. This is particularly useful since the introduction of Herceptin as
a chemotherapeutic agent that targets the HER2/
neu receptor. Breast cancer patients who express
HER2/neu in their cancers have a poor prognosis

627
Q

example of aminoglycoside antibiotic…

example of glycopeptide antibiotic…

A

Aminoglycoside antibiotics such as gentamicin

Glycopeptide antibiotics such as vancomycin

628
Q

carbamazepine, phenytoin, ethosuximide,
phenobarbitone, valproic acid are all examples of

A

Anticonvulsant (antiepileptic) drugs

629
Q

digoxin is a

A

cardioactive

630
Q

amitriptyline, clomipramine, desipramine, dothiepin,
imipramine, nortriptyline

(AID)

A

Tricyclic antidepressants

631
Q

HOW LONG CAN URINE SIT OUT AT RT

A

A fresh urine specimen is particularly important
for reliable results. If the urine cannot be examined
within 2 hours, it should be refrigerated as soon as
possible after collection. Specimens left at room
temperature for more than 2 hours are not acceptable.

632
Q

AChE
Acetylcholinesterase

A

enzyme in cns,rbc, fetal serum

confirm pos afp

open neural tube defect

633
Q

% of CSF made by chroidal cells in choroid plexus

% of CSF made by ependymal cells

A

70% of CSF made by chroidal cells

30% of CSF made by ependymal cells

634
Q

CSF found in…

obtained between these two or these two

A

subarachnoid space

3/4th or 4/5th

635
Q

CSF storage

chemical…
micro…
cell…

A

CSF storage

chemical…frozen
micro…RT
cell…fridge

636
Q

Albumin not normal in CNS

CSF/serum albumin index of… is normal

A

<9

637
Q

4 bands in CSF protein electrophoresis

A

Prealbumin/transthyretin
albumin
Tranferrin (Beta1)
T Transferrin(Beta 2)

638
Q

What CSF protein confirms presence of CSF

A

T tranferrin(beta 2)

639
Q

3 most common bacteria in bacterial meningitis in CSF

A

N.meningiitis
H.influenzae
S.pneumo

640
Q

transudates wbcs
exudates wbcs

A

transudates <1000 wbc
exudates >1000 wbc

641
Q

Caused by increase purine metabolism, uric acid, Monosodium urate crystals

A

gout

642
Q

knee, Ca pyrophosphate dihydate crystalsj

A

pseudogout

643
Q

Sperm
get to lab within…
liquefy within…
ml…
ct….
pH…

A

witin1 hr to lab
30min to liquify, by 60 min
2-5mL
20-250million
ph 7.2-7.8

644
Q

Reagent strip protein sensitive to…

SSA sensitive to…

A

reagent to albumin

SSA to all protein

645
Q

Micro-Bumintest (Bayer) tests for

A

microalbuminuria

646
Q

Rous test for

A

Hemosiderin

647
Q

Test that diff urobilinogen from porphobilinogen

A

Watson-Schwart

648
Q

EM Quant (Merkoquant)

A

Vit C when interference

649
Q

Test for porphobilinogoen and inverse Erlich

A

Hoesch

650
Q

Which of the following determinations is used to assess the total body lead poisoning burden?

A

most commonly used biomarker of human lead exposureWhole blood lead

In lead poisoning, impaired iron delivery or utilization within the mitochondrion has the similar effect of increasing erythrocyte zinc protoporphyrin.

651
Q

triglycerides
Normal, borderline, high, very high

A

Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L)

Borderline high — 150 to 199 mg/dL

High — 200 to 499 mg/dL

Very high — 500 mg/dL or above

652
Q

Which drug is used in treatment of congestive heart failure, requires TDM, and is part of the cardiac glycosides class of medications?

A

Digoxin, with the proprietary name Lanoxin, is one of a group of cardiac glycosides obtained from digitalis plants. Digoxin also acts to restore the force of cardiac contraction in congestive heart failure.

653
Q

The degree of wavelength isolation is a function of the monochromator type and

A

width of entrance and exit slits.

The degree of wavelength isolation is dependent on both the type of monochromator used and the width of the entrance and exit slits.

654
Q

What additional information is typically required to measure enzymatic activity in a 24-hour urine test?

A

Weight, height, and total volume of 24-hour collection

The volume of urine excreted indicates the balance between fluid ingestion and water lost from the lungs, sweat, and intestine.

655
Q

The measurement of the decrease in intensity of an incident light beam as it passes through a solution of particles defines which of the following methods?

A

Turbidimetry

While both turbidimetry and nephelometry measure scattered light. Turbidimetry is a method to measure the decrease in intensity of an incident light beam as it passes through a solution of particles.

656
Q

The kidneys are the site of the active form of which vitamin?

A

Vitamin D

The kidneys convert vitamin D from supplements/ the sun to the active form of vitamin D. With chronic kidney disease, low vitamin D levels can be found.

657
Q

In a urine reagent strip, methyl red is used to indicate what pH change?

A

Methyl red is used to indicate a pH change from 4.4 to 6.2 with a color change from red to yellow.

658
Q

The speed at which light travels through air divided by the speed at which it travels through a substance is the

A

refractive index.

The speed at which light travels through air divided by the speed at which it travels through a substance is the refractive index. This value varies directly with the number of dissolved particles in the solution. Although not identical to specific gravity, refractive index varies and corresponds with specific gravity.

659
Q

Which two chemicals are used during a pH reagent strip test with a double indicator system?

A

Bromothymol blue and methyl red

The reagent strip test for pH uses methyl red and bromothymol blue double indicator system that measures the urine pH from 5 to 9.

660
Q

What can cause turbidity in a room temperature, fresh random specimen?

A

Crystalized chemicals

Normal but concentrated urine typically crystalizes certain chemicals out of solution at room or refrigerator temperature.

661
Q

What is the identification of oval fat bodies confirmed with?

A

Sudan III

Sudan III and Oil Red O are stains used to identify fat in substances. With these stains, lobules of triglyceride or neutral fat appear orange or red.

662
Q

Which of the following crystals should be accompanied by a positive test for urine bilirubin?

A

Tyrosine crystals are also seen with leucine crystals. Both are associated with severe liver disease.

663
Q

Modern HPLC systems can work at pressures up to _________ psi.

A

5000 to 6000

Modern HPLC systems can work at pressures up to 5000 to 6000 psi.

664
Q

Which of the following are the two methods used to characterize monoclonal proteins?

A

Immunoelectrophoresis and Immunofixation Electrophoresis

Immunoelectrophoresis (IEP) and immunofixation electrophoresis (IFE) are used to characterize monoclonal urine and serum proteins. In clinical labs, IFE, however, has essentially replaced IEP.

665
Q

What is a simple sugar, or monosaccharide, derived from the breakdown of dietary carbohydrates?

A

Glucose

Intestinal absorption of carbohydrates occurs in the small intestine, where monosaccharides, the single- sugar units of carbohydrates, are absorbed.

666
Q

Whole blood % versus plasma glucose

A

WB 10-15% less

667
Q

Prep for GTT

A

High carb 3 days

668
Q

In fasting, arterial/capillary glucose is… Higher than venous

A

2-5mg

669
Q

Diagnostic for diabetes…
fasting plasma (8hrs)…
random plasma…
2hr plasma…

OGTT…

A1C….

A

fasting plasma (8hrs)…126
random plasma…200
2hr plasma…

OGTT…fasting 92

A1C….6.5

670
Q

Electrolyte panel 4 items

A

Na, K, Cl, CO2

671
Q

BMP 8 things

4 electrolytes, 3 renal related, 1 mineral

A

Na, Cl, K, CO2
glucose, creatinine, BUN
Ca

672
Q

CMP
4 electrolytes, 3 renal related, 1 mineral
plus 5 liver

A

Na, Cl, K, CO2
glucose, creatinine, BUN
Ca
albumin, TP, ALP, AST, bilirubin

673
Q

Liver function panel 6 things

A

albumin, TP, ALT, AST, ALP, bili

674
Q

renal panel 9 things…
Electrolytes, renal, mineral

A

Na, K, CO2
glucose, creatinine, BUN, albumin, phoshate
Ca

675
Q

5 analytes that increase glucose, 1 that doesnt

A

Keeps glucose in blood:
glucagon: break down glycogen, keep glucose up
cortisol, epinephrine: energy from other sources
GH
Thyroxine: glucose in GI absorbed

Takes glucoses out of blood:
insulin

676
Q

onset 1-3hrs
peak 6-10hrs
normal 1-2days

A

Myoglobin: onset, peak, returns normal fastest

677
Q

H2 breath test where bacteria acts on unabsorbed disaccharides used to diagnose

A

Lactase deficiency

678
Q

Biliary obstruction has this increased in serum

A

Conjugated bilirubin

679
Q

Which method for bilirubin uses alcohol that causes issues with turbidity from precipitated proteins

A

Evelyn Malloy

680
Q

Which method for bilirubin uses a serum blank, thus not being affected by turbidity from precipitated proteins

A

Jendrassik Grof

681
Q

In acute pancreatitis, amylase and lipase rise within
Amylase returns to normal in

A

In acute pancreatitis, amylase and lipase rise within a few hours
Amylase returns to normal in 3 days

682
Q

LD 1 and 2 seen in these two

A

Heart, HA

683
Q

Pulmonary LD

Liver LD

A

Pulmonary LD 3

Liver LD 4,5

684
Q

Best in carcinoma of prostate marker

A

Total prostatic specific antigen

685
Q

Hyperlipidemia

1: Exogenous triglyceride; young; cant remove chylo/VLDL
2: increaed LDL
3: dysbetalipo
4: endogenous
5: mixed exo/endo

A
686
Q

Oral GGT test

Prego grams:
Standard grams:
if 1hr >140, give…
and compare fasting, 1,2,3hrs

A

Oral GGT test

Prego grams: 50
Standard grams: 75
if 1hr >140, give…100
and compare fasting, 1,2,3hrs

687
Q

Hypoglycemia…
Clinical sig hypo…

A

hypo <70 mg/dl
clinical <54 mg/dl

688
Q

A1C
glucose attaches to….of Hmg A

A

N-terminus valine

689
Q

Test for diabetes where glucose attaches to proteins, average over 2-3 weeks, intermediate control

A

Fructosamine, total glycated protein

690
Q

5NT
5-nucleotidase
see in…but not…

A

seen in liver but not bone

691
Q

Destroys acetylcholine, decreased levels indicate organophosphate poisoning

A

cholineesterase

692
Q

CRP and homocsysteine can be markers to access for risk of

A

cardiac risk

693
Q

Procalcitonin/PCT is made in the thyroid and helps rule out…

A

sepsis

694
Q

Equation of logarithmic expression of ionization constant equation of a weak acid

A

Henderson-Hasselbalch

695
Q

Henderson equation

A

pH-pKa + log (HCO3/H2CO3) salt/acid

kidney/lungs
metabolic/respiratory

696
Q

In acidbase disorder,

it will be respiratory issue if CO2 is going ….. to pH

it will be metabolic disorder if HCO3 is going…as ph

A

it will be respiratory issue if CO2 is going opposite to pH

it will be metabolic disorder if HCO3 is going same direction as ph

697
Q

pH 7.35-7.45

HCO3 22-26
CO2 35-55

O2 85-105

A
698
Q

pH…

HCO3…
CO2…

A

pH 7.35-7.45

HCO3 22-26
CO2 35-55

699
Q

Cocaine compound tested

A

benzoylecgonine

700
Q

2 opiates

A

codeine, morphine

701
Q

2 general classes of antibiotics

A

aminoglycosides: cin
-gentamicin, tobramycin, amikacin

glycoprotein:
-vancomycin

702
Q

Quinidine
Procainamide
Disopyradmide
Lidocaine all

A

antiarrhymmic/cardioactive

703
Q

Phenytoin/Dilantin
Phenobartitol
Valproic acid all

A

anticonvulsant

704
Q

Amitriptyline
Imipramine
Doxepin all

lithium

A

psychotrpoics

705
Q

Cyclosporine
Tacroliumus
Sirolimus
Mycophenolic acid all

A

immunsuppressants

706
Q

Hyper/Hypo

Primary is…
Secondary is…
Tertiary is…

A

Hyper/Hypo

Primary is…end organ
Secondary is…pituitary
Tertiary is…hypothalamus

707
Q

Tissue T4, bound to TBG
T3 is tissue T4 converted, active

A
708
Q

Graves T4/3 are…. with antibodies to

A

increased, antibodies to TSH receptors

709
Q

Hashimotoes T4/T3 are..with antibodies to

A

decreased T4/T3, antibodies to TRab, TPO
thryoid autoab

710
Q

Metabolic acidosis or alkalosis can compensate quicker, may have compensated CO2.

A

Metabolic alkalosis
high pH, HCO3
high TCO2

Metabolic acidosis
low ph, HCO3
low CO2

711
Q

Additive for blood gas…
glycolsis affect on ph and CO2…
parameters measured directly in automated…
calculated…

A

Additive for blood gas…heparin
glycolsis affect on ph and CO2…rise in CO2, fall ph
parameters measured directly in automated…ph, CO2,O2
-HCO3 and oxg sat are calculatedbn

712
Q

which best for renal tubular function…

A

osmolality over creatinine clearance

best in diabetes

713
Q

if Na, K, glucose, BUN are normal osmal gap is

A

275-295

714
Q

degree kidney concentrates filtrate determined by…

A

urine to serum osmolality ratio

serum >300, urine <300 is diabetes insipidis
not concentrating urine

715
Q

Coulometry is an automated method to measure….using silver ions

A

chloride

716
Q

Lanthanun Chloride eliminates interence in atomic absorption spectrophotometry to measure…

A

calcium

717
Q

Assays for….measure hormone not bound to TBG/TBPA, or albumin

A

free T4

718
Q

Congential hypothyroidism screen with

A

Free T4 blood spot

719
Q

Predominating estrogen useful for prenatal screen

A

estriol

720
Q

Hormone triggers ovulation

A

LH

LH-ovulation-follicle-corpus leteum

721
Q

Normal pregnancy,
hcG peaks at…
and after….weeks of last period…

A

peaks 2-3months
peaks 2-2.5mths after period
8-10weeks

722
Q

this increases vasoconstriction and thus stimulationg formation of aldosterone

A

angiogensin II

723
Q

half life is how many doses…
If half life is 6hrs, given every 6 hrs, when is stead state…

A

5-7

24-42 hrs (6x5-6x7)=24-42

724
Q

Salicylate is called

A

aspirin

725
Q

Best sample for forensic toxicity of drugs of abuse

A

random urine

AMT Chemistry (1 decks)

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