AMT chem/bf quick Flashcards
CEA;
PSA:
AFP: 4 related conditions
HCG: 3 related, composed of
CEA: oncofetal/fetal colon, corectal
PSA: prostate
AFP:
-fetal liver
-ovarian, testicular
-neural tube defects: decreased Downs, increased neural tube/cancer
HCG: composed of 2 noncovalently subunits alpha and beta
-pregnacy
-ovarian, testicular
CA15-3
CA 27-29
CA 19-9
CA 125
2 cardiac
CA15-3, 27-29 breast
19-9 pancreatic, GI
CA125 ovarian
cardiac: crp, homocysteine
Water soluble vit names, associated conditions
Pee out Bs, Cs
B1
B2
B3
B6
B7
B9
B12
C
Water soluble vits, associated conditions Bs,
C
*B1 thiamin, Beriberi
B2 Riboflavin
*B3 Niacin, Pellegra
B6 Pyridoxal
B7 Biotin
*B9 folate megaloblastic
*B12 cobalamin, PA/IF
*C scurvy
Fat soluble vitamins name, ass disease
ADEK
A retinol, night blindless
D calciferol, rickets, hormone
E tocopherol, HA/antioxidant
K phylloquinone, hemmorage/clots
Migration of protein from most anododic/anode to least/cathode…
%…
Albumin: most anodic at pH8.6
-BCP less interference
-water soluble and carries things/osmotic pressure
-mostly decreased do to liver not making/not eating/kidney loss
-only increase is dehydration
Prealbuin/transthytin will have faint band, nutrutional status
+Albumin, a1, a2, beta, gamma-
albumin 65
alpha1 2%
alpha2 8%
beta 10%
gamma 15%
*highest is albumin 65%, 2nd highst gamma 15%
globulins % from anode to cathode
albumin 65
alpha1 2
alpha2 8
beta 10
gamma 15
Proteins increased/decreased in…
-decrease in nephrotic, malnutrion, liver disease, burns
-increase proteins dehydration, MM/WM
-viral hepatitis:
-active cirrhosis:
-nephrotic syndrome:
-acute inflammation
Proteins increased/decreased in…
-viral hepatitis:
increased gamma, decreased albumin
-active cirrhosis: beta-gamma bridge
increased gamma, decreased albumin
-nephrotic syndrome:
increased alpha2, decreased albumin
decreased gamma
-acute inflammation:
increase in alpha 2
Proteins in
monoclonal
versus
hypogamma
Mono: sharp increase in gamma
Hypo: no gamma
A/G calc
Albumin/TP-albumin
BUN: rises the fastest in acute renal failure,
BUN to creatinine ratio…
2 methods of BUN…
-one not measuring ammonia
-one measures ammonia
BUN: rises the fastest in acute renal failure,
BUN to creatinine ratio…10:1
-BUN is 1/2 of NPNs
-urea made from protein, governed by renal fnc
2 methods of BUN…
-one not measuring ammonia:
urea is measured w/diacetyl monoxime
-one measures ammonia: urease
ammonia is measured with urease
Copper protein carrier…alpha 2 globulin
-Condition where its decreased, excess copper storage
-Condition where its decreased, but decreased serum copper
Ceruplasmin:
-Copper protein carrier
-alpha 2 globulin
-acute phase, increased in inflammation
Wilsons:
-decreased ceruplasmin, increased serum copper
-Kayser Fleisher in cornea
Menkes:
-decreased ceruplasmin, decreased serum copper
-males, kinky blond hair
Creatinine test name, reagent, color…
Creatinine is used to measure…
calc…
alternate marker of GFR…
Creatinine:
Jaffe, alkaline picrate, yellow red
Creatinine used to measure GFR, clearance test
-creatine to creatinine
-little is reabsorbed, most excreted at a constant rate and passes into ultrafiltrate
Ucr x vol/Serum cr x 1440
mL/min
alternate GFR marker is Cystatin C, made by all nucleated cells
Uric acid causes…seen in also…
most uric acid is…
Alkaline oxidation uses what reagent…
Turns into…
Uricase method uses …. at…nm …&….treatment with uricase…
Uric acid is breakdown of purine from nuclei, seen in gout, also leukemia/lesch nyhan
monosodium urate
Colorimetric method with an Alkaline oxidation reaction uses phosphotungistic acid which turns to tungten blue
uricase uses UV adsorption at 290nm b4/after uricase
ammonia seen in…
-heparin on ice
tested using 4 diff…
liver disease, reyes, encephalopathy
ISE, pH
spectro=blue dye
Enzyme=GLDH, NAD
Nessler
Disaccharides composed of…
-maltose:
-lactose:
-sucrose:
Monosaccharide
-hexose:
Sugars composed of…
-maltose: glucose, glucose
-lactose: glucose, galactose
lac=galac
-sucrose: glucose, fructose
su=fru
-hexose: monosaccharide with 6 Cs
Renal thresold for glucose…
normal fasting glucose…
Diabetes:
-fasting:
-non/2hr:
-A1C:
Test where glucose attaches to protein, 2-3 weeks
test best for prenatal with borderline blood glucose…
hypo:
Renal thresold for glucose…160-180mg/dL
normal fasting 70-110
Diabetes:
-fasting: 126
-non/2hr: 200
-A1C: 6.5
N terminus valine, 2-3mth picture
Test where glucose attaches to protein, 2-3 weeks: fructosamine
prenatal 3hr gtt
hypo: <70, clinical <54
oral GTT
prego grams:
standard grams:
if after 1hr >140, give….g
compare fasting 1,2,3 hrs
prego grams: 50
standard grams: 75
if after 1hr >140, give….100g
Cystatin versus Cpeptide
Cystatin: gfr, in nucleated cells
Cpeptide: endogenous production of insulin
What cells make in regards to glucose regulation
alpha:
beta:
delta:
Specimen for glucose test…
What cells make in regards to glucose regulation
alpha: glucagon: opposes insulin, increase blood glucose back down glycogen by liver
beta: insulin (decreases)
delta: stomatostatin
fluorinated plasma(grey top)
-inhibits glycolysis
Glucose increased or decreased…
-VonGierke:
-insulinoma
-diabetes insipidus:
-diabetes mellitus:
-Hashimoto:
-Cushings:
Glucose increased or decreased…
-VonGierke: decreased
glycogen storage disorder
-insulinoma: decreased
tumor makes too much insulin
-diabetes insipidus: normal
not enough ADH
-diabetes mellitus: increased
insulin issue
-Hashimoto: increased
decreased metabolism
-Cushings: increased
due to increased cortisol
2 tests for glucose, use fluorinated plasma…
both have coupled enzyme…
Glucose oxidase
-oxidase, perioxidase
-oxidize chromagen, colorimetric
*contamination with catalase
Hexokinase:
-hexokinase, G6PD
-NAD reduced to NADH, read at 340nm
Storage lipids being used a primary source of energy will cause urinary…
Reagent…
ketones
Sodium nitroprusside
Reagent and name used in urobilinogen testing…
What is used to distinguish urobilinogen from porphobilinogen since they’re both red w/Erlichs reagent…
pDMAB
p-di-methyl-amino-benzaldehyde
Erlich
Chloroform: urobilinogen is soluble in chloroform but porphobilinogen isn’t and is in lower phase
2 methods for glucose: both use coupled enzymes
-Which one most frequent automated…
what are the two enzymes
-Which one uses reduced coenzyme at 340…
what are two enzymes
Glucose
automated: glucose oxidase
-oxidase, peroxidase, oxidize chromagen
Coenzyme at 340, hexokinase
-hexokinase, G6PD
-NAD reduced to NADH at 340
Protein that transport bilirubin to liver…
-bili is breakdown of hmg
-protect from light
indirect bili…direct bili…
form thats in intestine…
Two bilirubin test names:
-diazotized, caffeine
-uses methonal, affected by hemolysis
Protein that transport bilirubin to liver…albumin
indirect bili…unconjuated
direct bili…conjugated, diglucuronide
-increased with hmg breakdown
form thats in intestine…urobilinogen
Two bilirubin test names:
-diazotized, caffeine: Jendrassik Grof
-uses methonal, affected by hemolysis: Evelyn Malloy
-biliverdin: oxidized billi, green in RE system
-urobilin: oxidized from urobilinogen excreted in stool/stercobilin; also makes yellow color to kidney for urine
Jaundice type:
-increased unconjugated, increased urine urobilinogen
-everything increased, billi/urobili in urine
-unconjugated normal, conjugated increased, urobilinogen decreased
Jaundice type:
Preheptatic: hemolytic
-increased unconjugated, increased urine urobilinogen
Hepatic
-everything increased, billi/urobili in urine
Post hepatic, obstruction:
-unconjugated normal, urobilinogen decreased
3 disorders of bilirubin related to reduced enzyme or bili transport issues…
which one involved in kernicterus…
which one with increased porphyrin/transport issue
Gilbert: reduced enzyme activity
Crigler Najjar: lack,lowered enzyme
1: absense, kernicterus
2: decreased
Dublin Johnson: bili transport issue, dark pigment/porphyrin
Enzymes: biological catalysts, measured in…
Isoenzymes:
Each isoenzyme…
-have different electrophoretic properties/diff mobility rates
-have different structures
-have different rate of rxns
-have different rxns to chemical inhibitors
-BUT, have the same substrate
Metal ions act as…in enzymatic rxns…
Rate of conversion of substrate to product is determined by substrate concen and rate of dissociation of complex…
Zero order rxn is….
Enzymes: biological catalysts, measured in…IU/L or micromol/L
Isoenzymes:
Each isoenzyme…
-have different electrophoretic properties/diff mobility rates
-have different structures
-have different rate of rxns
-have different rxns to chemical inhibitors
-BUT, have the same substrate
Metal ions act as activators of enzymes in enzymatic rxns
Rate of conversion of substrate to product is determined by substrate concen and rate of dissociation of complex…Michaelis Menten
Zero order rxn is….all enzyme bound to substrate
-large excess substrate leads to enzyme being only rate limiting
LD: catalyzes lactate+NAD to pyruvate+NADH
most greatly affected by hemolysis
Order from fastest to slowest…
-LD that is highest in heart:
-heart attach LD patterm:
-Pernicious anemia LDs:
-Liver LD
LD1 fastest, L2,L3,L4, L5 slowest
LD1: highest in heart, heat stabile, fastest/most neg charged
LD1/2 flipped is heart attack
LD1,2,3 is pernicious anemia
LD4,5 Liver, skeletal
LD5:slowest, most positively charged
CK in muscles,
When start to rise, when normal…
conditions…
isoenzymes: fastest to slowest, location
CK rises 2-4hrs, normal 2-4 days
Seen in heart attach, muscular dystrophy, exercise
CKBB fastest, brain
CKMB 2nd, AMI
CKMM slowest, muscle
First protein to rise in heart attack, rise/normal…
2nd to rise, normal…
3rd to rise, normal…
Myoglobin: 30min, 24hrs
-striated skeletal muscle/cardia
CK: 2-4hrs, 2-4days
Troponin: 4-8hrs, 10 days
-complex of TnT,TnI (also C)
-striated/cardiac
LD similar to Troponin
Aldolase stays the longest
Enzyme related to CHF…
Enzyme specific to liver…
3 enzymes related to muscular dystrophy…
3 enzymes in biliary obstruction…
1most sensitive to obstructive jaundice…
bone enzyme
prostatic disease…
alcoholics…
CHF: BNP
Liver specific: ALT
-nonspecific: ast,alp,ggt,ld
Muscular dystrophy: aldolase, AST, CKMM
biliary obstruction: alp, ggt, 5nt
1most sensitive to obstructive jaundice…ALP
bone alp
-pagets, osteomalacia, rickets , prego
prostatic:
acid phosphatase,
*best for carcinoma is total PSA
ph5.0
alcoholics. GGT
AST elevated in these 3
aldolase highest in..
muscle (dystrophy, heart)
liver
aldolase highest in muscular dystrophy
enzyme in mumps…
enzyme specific for acute pancreatitis…
4 pancreatic conditions…
mumps/pancretaitis: amylase
-in acute rise in hours, normal 3 days
pancreatitis: lipase
-cystic fibrosis: mucous dysfuction
-cancer 19-9
-insulin resistance
-gastrinoma, ZollingerEllison
lipase:
name of test..uses what for substrate…
lipase catalyzes the hydrolysis of….into…
Cherry-Crandall, olive oil
lipase hydrolyzes triglycerides in olive oil into glycerol
3 methods for calcium:
use heparanized plasma (green top)
One is named…and calcium precipitated as…
One is complexometric EDTA, and this is adjusted to prevent interference from magnesium
One uses atomic adsportion and uses lanthanum to bind….
3 methods for calcium:
One is named…and calcium precipitated as…Clark Collip
C=Clark, C=Collip
One is complexometric EDTA, and this is adjusted to prevent interference from magnesium…ph adjusted with 8hydroxy-quinoline
One uses atomic adsportion and uses lanthanum to bind….phosphate
*magnesium and phosphate can interfere with calcium, so pH and lanthanum are to help
In the complexometric titration for Ca, 8 HYDROXY QUINOLINE REMOVES…from interering
MG
Clark Collip method for…that precipitates it as…oxalate
Ca, calcium oxalate
Lanthanum in Ca used to bind
phosphorus
Calcium is affected by..and…
collect in…
increased by these two, decreased by one..
ph, protein
collect in heparanized plasma, green top
increased by PTH, Vit D
decreased calcitonin
45%bound to protein, 45 ionized/active, 10 complexed
Decreased Ca…
hypo PTH, vit D def
hypo mag, hypo albumin
tetany
Increased Ca…
hyper PTH, vit D excess
Malig
Phosphorus at pH7.4 most in…
reagent used in inorganic phosphate colorimetric method…
what two things increase Phosphorus
what decreases it
bone
molybdate, molybedum blue
PTH decreases phosphorus, opposite of Ca
Cacitonin increased PTH, opposite of Ca
Vit D increases phosphate(and Ca)
Decreased Phosphate…
hyper PTH, antacids, dextrose
Increased Phosphate…
hypo PTH, renal failure
Major extracellular cation…
Major extracellular anion…
Major intracellular cation…
Major intracellular anion…
Major extracellular cation…Na
Major extracellular anion…Cl
Major intracellular cation…K
Major intracellular anion…Phos
NV
Na:
K:
CO2:
Cl:
BUN:
Creatitinine:
Glucose:
sign of saline contamination:
NV
Na: 135-145 major extracellular cation
K: 3.5-4.5 major intra-cellular cation
-valinomycin
CO2: 23-29 (not urine)
Cl: 98-106 major extra-cellular anion
BUN: 6-20
Creatitinine: 0.7-1.5
Glucose: 70-110
sign of saline contamination:
increased Na/Cl, decreased K
Things that cause low chloride…
Things that cause high chloirde…
low cl:
-vomit, diarrhea, sweat, kidney loss
-metabolic alkalosis(increase HCO3)
high cl:
-Iv contamination
-metabolic acidosis(decrease HCO3)
Coulometry used to measure
Cl, sweat Cl
Cl NV
Two titration methods,
-Cl measured by time needed to reach titration end point
-which method measures excess Hg which reacts to form violet
Coulometric amperometric/titration:
-Silver, Cl
Schales Schales mercurimetric:
-excess Hg react to form violet
Anion Gap: cations-anions, can be done w/out K
Na+K - (Cl+HCO3)=10-20
increased GAP:
-diabetic ketoacidosis, lactic acid
-salicylate/ethanol/glycol
-dehydration
decreased: error
Magnesium…
reagent called..
interference with calcium method…use…to prevent…
Magnesium…
reagent called..titan yellow, dye lake
interference with calcium method, adjust pH to prevent interference in calcium by using 8hydroxyquinoline
Electrodes:
PH:
pCO2:
pO2:
Henderson-Hasselbach equation for pH…
Normal ph..
acidosis..
alkalosis..
bicarb:acid ratio…
Electrodes:
PH: glass, H+
pCO2: ph electrode w/membrane, not H+ but dissolved CO2
pO2: platinum w/silver/Cl, amperometric
Henderson-Hasselbach equation for pH…
-pH=pka+log(salt/acid) or (A)+(HA)
bicarb/CO2=kidney/lungs
Normal ph..7.35-7.45
acidosis..<7.35
alkalosis..>7.45
ratio bicarb:acid 20:1
Spectrophotometer QC of wavelength uses….
To get UV range use…
atomic adsorption spectrophotometry uses this as light source….
Wavelengh QC uses holomium glass filter
UV range uses quartz cuvette
atomic adsorption spectrophotometry uses cathode lamp for light
Potentiametry: free ions, electrical potential
Amperometry: single potential, current
Coulometry: coulombs
Polarography: current, applied voltage
immunoelectrophoresis: must be excess antibody and constant trough distance
Immunoassays:
-radio: tracer/tag/label, counter
-enzyme: horshradish, alp, g6pd
-fluoresncent: fluorescein isothiocynate
-chemiluminescent: chemical, light
Name of stationary phase, gas/liquid, height measured…
Name of absorbant coated/solvent, screen for drugs/urine, has Rf(drug/solvent distance)…
what adds sensitivity and specificity…
Name of stationary phase, gas/liquid, height measured…HPLC high performance liquid chromatography
Name of absorbant coated/solvent, screen for drugs/urine, has Rf(drug/solvent distance)…TLC thin layer chromatography
what adds sensitivity and specificity…M/S for gas
Porter Silber uses Phenyl-hydrazine to detect…
Metabolite of androgens, Zimmerman detects…
Porter Silber uses Phenyl-hydrazine to detect…corticosterids
*Porter=P=Phenyl=corti
Metabolite of androgens, Zimmerman detects…17KS
*Zimmerman does 17KS
Porter and Zimmerman do cortico-keto steroids
3 catecholamines adrenal medulla make:
which ones have VMA, which one HVA
epi, norepi=VMA
dopamine=HVA
methods for confirmation of drugs that are pos screens
gas chromatography and M/S
Quinidine
Procainamide
Digoxin all are
antiarrthymics,cardiactives
Digoxin requires tdm, glycoside, congestive heart failure
Immunosuppresives…
cyclo, tacro, siro
bronchodilator
theophylline
aminoglycoside all end in…
inhibit protein synthesis gp
cin
vancomy-cin/glycopeptide
gentamy-cin
tobramy-cin
kanamy-cin
psychoactive=ine
lithium
imipram-ine
despiram-ine
amitri/nortriptyl-ine
anti epileptic
phenobarbitol
phenytoin/dilantin
valproic acid
carbamazepine
ethosuximide
antitumor,neoplastic
methothrexate
liproproteins from lighest to heavist:
lipoprotein electrophoresis names
HDL:
VLDL:
LDL:
migration from origin..
lighests chylo, vldl, ldl, hdl
lipoprotein electrophoresis names
HDL: alpha
VLDL: prebeta
LDL: beta
migration from origin/cathod(-)
chylo, beta, prebeta, alpha
Friedewald formula for LDL…
elevated LDL/beta leads too…
calculation of coronary risk index needs these two…
Goals:
TC:
LDL:
Trig:
HDL:
Apolipoproteins
HDL
LDL/VLDL
Chylo
fast 12-16hrs
Friedewald formula for LDL…
LDL=TC-(TG/5+HDL)
elevated LDL/beta leads too…
cardiovascular disease
calculation of coronary risk index needs these two…TC, HDL
Goals:
TC: <200
LDL: <100
Trig: <150
HDL: >35/60
Apolipoproteins:
HDL=A
LDL/VLDL=B100
chylo=B48, lightest, smaller number
2 methods for fat:
cholesterol: 90% liver, steroids
name, reagents, what does saponification step do
triglyceride: 90% diet
-enzyme, what is liberated
Liebermann Burchard:
cholesterol
-a.a., s.a.
-saponification frees esters (chol-ester-ol)
triglyceride:
-lipase catlyzes hydrolysis of triglyceride into glycerol (tri-glycer-ide)
Polar hydrophiilic and nonpolar hydrophobic fatty acid chains, make up cell membraines
-lecithin, sphingomyelin, phosphatidyl glycerol
Long chain unsaturated fatty acids, activates/inactivates inflammation; stimulates clotting, cervix dilation/contractions
Phospholipids:
Polar hydrophiilic and nonpolar hydrophobic fatty acid chains, make up cell membraines
-lecithin, sphingomyelin, phosphatidyl glycerol
Prostaglandins: PG
Long chain unsaturated fatty acids, activates/inactivates inflammation; stimulates clotting, cervix dilation/contractions
Urine PH 4.5-8
Urine left at RT: alkaline
increased
decreased
Urine RT:
increased
-nitrite/bacteria, turbidity
-pH=ammonia normal is 4.5-6
-false pos protein (increased pH)
decreased
-glucose(bacteria)
-ketones, bili, urobilinogen
-cells/casts lyse
smokey/red brown..
dark red…
dark yellow..
dark yellow/orange/amber…
brown black on standing…
cloudy in freshly voided…
smokey/red brown..rbc, myoglobin,hmg
dark red…poryrin, port wine
dark yellow..urobilinogen
dark yellow/orange/amber…bili, pyridum
Yellow green biliverdin
Green blue old, pseudomonas
Blue indican
brown black…homogentistic acid, melanin, alkaptonuria
cloudy freshly voided…wbcs
3 methods for sg: tests for concentration and dilution function of kidney tubules
1.002-1.035
SG directly proportional to color
reagent strip (colorimetric)
refractometer
harmonic oscillation
-densitometry, current
Protein strip: protein error of indicators
-indicates renal disease
-most senstive to albumin
-no interference from bence jones
-highly alkaline urine will cause false pos
-most indicator is nonionized
-protein will combine with nonionized in indicator
-color due to change in ratio of ionized to non
Casts: tammhorsfall, distal convoluted tubule
Collecting duct: last part, final concentration
CSF protein NV, what % plasma glucose
normal lymph versus mono
15-45 protein, 60% glucose
70 lymph, 30 mono
Meningitis:
-viral has normal glucose and lactate, lymphs
-bacterial and fungal decreased glucose, increased lactate
-bacterial: neu, fungal: lymph/mono
Sperm
ml, live, motile, #
2-5ml, 75 alive, 50 motile, 20-250million
Main reason for false negatives in urine
vit C
-glucose, blood, bili, nitrite
Bleach and pigment will usuall cause false
pos
glucose, ketones, blood, bili, uro, leuko
4 protein methods for serum protein
Biuret: 2+ peptide bonds
Dye binding: albumin,
-bromthymol/coomassie blue
-Ponceau, amido
Kjeldahl: nitrogen
refractometry: refractive index
Biuret:
TP 6-8g,
albumin 3-5g: highest concentration, smallest in liver; BCP less interference, water soluble
-Interference from hmg/lipids: cant use hemolyzed because hmg is absorbed at same wavelenght as protein in the reagent
-follows beer law=concen=abs
-needs at least 2+pepetides
-insensitive to low protein levels in urine, microalbumin
two alpha 2 proteins that are acute phase proteins…
one binds hmg the other copper
large alpha 2 protein seen in nephrotic syndrome
haptoglobin, ceruplasmin
alpha1macroglobin
Most iron is in…
storage form..
transport iron…
in muscles…
Most iron is in…hmg
storage form..ferritin
transport iron…transferrin
in muscles…myoglobin
IDA:
-decreased seru/storage
-increased TIBC/transferrin
Sideroblastic/Hemochromatosis:
-decreased transferin/TIBC
-increased iron, ferrtin
renin…
LH…
FSH….
HCG secreted by…
-2 NON-indentical, NON-convalently bound subunits(alpha, beta)
-highest in first trimester, seen w/in days
Corpus luteum makes this to maintain HCG and prepare uterus…
renin contorls BP and converts angiotension 1 to 2 which stimultes
cortex to make aldosterone
LH induces ovulation
FSH deal with egg/sperm, secretion of estrogen and testosterone
HCG placenta
Progesterone maintains HCG, uterus
Catecholamines: metabolites, tumors
Epi/norepi: VMA
-Pheo
Dopamine: HVA
-Neuro
Name of
T3, T4, TBG, what binds to T4,measured by
3 best indicatiors for hypothyroidism
T3 triodothyronine
T4 thyroxine
Thyroid binding globulin-binds to T4,
Measured by T3uptake
best to use s-TSH, TT4,FT4
Hormone in bone/calcium metabolism..
Hormone that stimulates renal to make VitD….
Hormone in bone/calcium metabolism…
calcitonin
Hormone that stimulates renal to make VitD….PTH
Mineralocoricoids (aldosterone)
Glucorticoids(cortisol)
androgens
released by
adrenal cortex
Aldosterone… reabsorb Na, decrease K
-distal tubes/collecting duct
-renin to angio 1/2, cortex increase aldosterone
increassed in Conns, decreased addision
Disease with increased aldosterone/Na…
Disease with decreased aldosterone/Na…
Disease with increased aldosterone/Na…
Conns
Disease with decreased aldosterone/Na…
Addisons
Cortisol…
Increased, decreased
Increased Cushing’s, increased glucose/sodium
Decreased Addison, decreased aldosterone/Na
2 GI hormones
Zollinger Ellison…
5HIAA…
Increased gastrin
Serotonin metabolite
PTH stimulates renal production of and bone reabsorption of
PTH stimulates renal production of vitD and bone reabsorption of Ca
Liebermann Burchard has
cholesterol and goes to a.a., s.a.
…
B2
B7
B2 riboflavin
B7 bioton
Protein% AND MIGRATION ANODE TO CATHODE
albumin 65
alpha1 2%
alpha2 8%
beta 10%
gamma 15%
Proteins origin to anode
Chylo, beta, pre beta, alpha
Ag, Hg Cl… Time needed to reach end point both titration for chloride
Metabolite and disorder for dopamine
Metabolite and disorder for epi/norep
Metabolite and disorder for dopamine
HVA, Neuroblastoma
Metabolite and disorder for epi/norep
VMA, Pheochromocytoma
Vancomycin is an antibiotic that is a…
inhibits cell wall of…
glycoprotein
gp
Creatinine clearnace
U creat/Plasma creatinine x
volume ml/1440
LD 1 HHHH highest in these two…
LD2 HHHM highest in the…
Flipped LD1/2 indicates
LD1 heart, rbc
LD2 in healthy
heart attack
Slowest versus fastest LD isoenzyme
slowest is LD5(pos charged)
fastest is LD1(neg charged)
LD 1,2,3 indicates
Pernicious anemia
increased LD3
pulmonary edema
LD 4,5 indicates these two
liver disease, viral hepatitis
skeletal
relates to the concentration of sample to amount of light sample absorbs as it passes thru the sample
Beer, Lambert Law
Disease due to TSH receptor antibodies…
Disease due to thyroid autoantibodies…
Disease due to TSH receptor antibodies…
Graves
Disease due to thyroid autoantibodies…
Hashimotos
Apoprotein A is…
Apoprotein B-48 is…
Apoprotien B-100 are these two…
Apoprotein A is…HDL
Apoprotein B-48 is…Chylo
Apoprotien B-100 are these two…LDL, VLDL
Estrogen, estadiol made by…
hyper estrogen…
hypo estrogen…
active form of estrogen, fetoplacental fnc…
Estrogen, estadiol made by…ovaries
hyper estrogen…amenorrhea
hypo estrogen…menopause
active form of estrogen, fetoplacental fnc…
estadiol
Progesterone made by…and….
helps…
perimenopause…
postmenopause…
hormone that maintains progesterone in early prego…
Progesterone made by corpeus lutum and placenta
perimenopause…increased
postmenopause…decreased
hormone that maintains progesterone in early prego…hcg
Best sample for toxicology screen…
best to quantify…
screen urine
quantify blood
drug that causes liver damage…
steady state in…
liver is acetaminophen(tylenol)
steady state in 5-7 doses
Benzoglyegonine metabolite of
cocaine
codeine and morphine are
opiates
Bicarb NV
CO2 NV
Bicarb 22-26
CO2 35-45
additive for blood gas…
glycolysis affect on ph, CO2…
directly measured….
calculated…
additive for blood gas…heparin
glycolysis affect on ph, CO2…CO2 increase, ph fall
directly measured….CO2,O2
calculated…bicarb, oxy sat
Glucose, blood, WBC false positive with
bleach
Alkaline urine…
false pos in…
false neg in…
Alkaline urine…
false pos in…protein
false neg in…SG
Ketones, nitrite
urobili,bili
false pos with
pigment, med color
Glucose, blood
bili, nitrite flase neg
Vit C
Sternheimer Malbin is a supravital stain in microscopic exam
…
HER2/neu marker for breast, ovarian, cervical cancer
All woman issues
…
Cells that make 70% of CSF…
CSF obtained between…or…
Cells that make 70% of CSF…choridal cells
CSF obtained between 3/4 or 4/5 subarchnoid space
Can also have ependymal cells, less distinct borders
AChe
AcetylCholinEsterase
found in these 3
cns
rbc
fetal serum
4 bands in CSF…
which one confirms CSF…
Prealbumin/transthyretin
albumin
Transferin
T Transferrin (confirms CSF)
Rous tests for
hemosiderin
which test diff urobili from porphobili
which tests for porphobili, inverse erlich
WatsonSchwartz: diff between urobilinogen and porphobiloinogen
Hoesch: only porphobiloinogen, inverse Erlich
Spectrophotometry
Absorb light at wavelength, std Sln, color; light is radiant energy, travels thru in form of waves
degree of wavelength isolation depends on monochromator type
and WIDTH of entrance and exit slits
Light goes thru diffraction grating which selects incident wavelength and is moved behind plate with slot. Light going thru Sln in glass cuvette is read by photoelectric cell in electrons recorded by galvanometer
Vit D can be made in the…
and also from the….
low in…
kidney, sun
chronic kidney disease
methyl red indicates ph change of…to…
from red to yellow
4.4-6.2
Two chemicals for ph strip double indicator
methyl red
bromthymol blue
ph 5-9
HPLC systems pressures of …to…
5000-6000
two method for monoclonoal proteins
Immuno
electrophoresis
immunofixation
electrophoresis
WB is what % less than plasma
Fasting glucose;
arterial/capillary is …mg higher than venous…
WB 10-15% less than plasma
Fasting glucose in arterial/capillary is 2-5mg higher than veins
Test where bacteria acts on unabsorbed disaccharides to diagnose lactase def
H2 Breath
method for bili that uses alcohol and has issues with turbidity from precipitated proteins
method for bili that uses a serum blank and not affected by turbidity
affected by turbidity Evelyn Malloy
not affected by turbidity Jendrassik Grof
Hyperlipedemia:
- Exogenous, young, unable to remove chylo,vldl
- LDL
- dysbetalip
- endogenous
- mixed exo,endo
hormone rules out sepsis
procalcitonin
PCT
osmal gap NV
calculated with
275-295
Na,K
glucose, BUN
Used to access total body lead poisoning burden
Whole blood lead
Instrument ionizes target molecule then separates and measures mass to charge ratio
Mass spectrometer
Def leads to death and severe neurology defects
Folate
Two enzymes most measured
Ast, alt
Borderline trig 150-199mg dl
Fast 12-16hr
90% diet
Glycerol, lipase
Dye update by sample after electrophoresis and staining is
Directly proportional to concentration
Needed for measuring enzymatic activity in 24hr urine
Weight
Height
Total volume
Measurement of decrease in intensity of incident light been as it passes thru solution of particles
Turbidimetry
Gland that stimulates other glands to make hormones add needed
Pituitary, master gland
Hypothalamus sends releasing hormones to pituitary
Pituitary stimulates end organ
Mathematical modeling of drug concentration in circulation to help establish dosage
Pharmakinetics
Which of the following results for an analysis of synovial fluid would you expect to find for inflammatory joint disease?
Question 201Answer
a.
Clear, viscous fluid with a WBC count less than 2000 cells/uL, glucose and protein values are close to normal
b.
Cloudy yellow fluid, low viscosity, moderately high WBC count, neutrophils > 50%, normal glucose and high protein
c.
Cloudy with low viscosity, yellow, green or milky, WBC count is very high with more than 90% neutrophils
d.
Yellow or turbid fluid with a high but variable WBC count, crystals of monosodium urate or calcium pyrophosphate are visible
Cloudy yellow fluid, low viscosity, moderately high WBC count, neutrophils > 50%, normal glucose and high protein
Inflammatory effusions are associated with immunologic diseases, such as RA and lupus arthritis.
In a urine reagent strip, methyl red is used to indicate what pH change?
4.4 to 6.2
Methyl red is used to indicate a pH change from 4.4 to 6.2 with a color change from red to yellow.
The speed at which light travels through air divided by the speed at which it travels through a substance is the
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.
Refractive Index Measurement or Refractometry is the method of measuring substances refractive index and assess their composition or purity. Refractometry is a technique that measures how light is refracted when it passes through a given substance
Which two chemicals are used during a pH reagent strip test with a double indicator system?
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.
What can cause turbidity in a room temperature, fresh random specimen?
Crystalized chemicals
Normal but concentrated urine typically crystalizes certain chemicals out of solution at room or refrigerator temperature.
Absorbance can be calculated easily from percent transmission using which calculation?
2 – log10 %T
Absorbance can be calculated easily from percent transmission using 2 – log10 %T. If all the light passes through a solution without any absorption, absorbance is zero and the %T is 100%. If all the light is absorbed, %T is zero, and absorption is infinite.
How must a laboratory operate to handle TB sputum and TM materials?
Biosafety level of 2+ or 3
BSL-3 builds upon the requirements of BSL-2. Organisms that can cause serious or potentially lethal disease through respiratory transmission are typically worked with in a BSL-3 laboratory. Example: Mycobacterium tuberculosis.
What process helps monitor the accuracy and reproducibility of results using controlled specimens?
Quality control
Quality control is a process that monitors the accuracy and reproducibility of results through the use of control specimens. Usually, normal, and abnormal (low and/or high) control samples are analyzed while patient specimens are analyzed.
A 200-mg/dL solution was diluted 1:10. This diluted solution was then additionally diluted 1:5. What is the concentration of the final solution?
4 mg/dL
200 mg/dL x 1/10 x1/5 = 200/50 = 4 mg/dL
Which substance is employed to produce a chemical reaction?
A reagent is defined as any substance employed to produce a chemical reaction. In highly automated clinical laboratories, very few reagents are prepared by laboratory staff. In many cases, only water or buffer needs to be added to a prepackaged reagent.
Which of the following levels do parathyroid glands either increase or decrease PTH secretion in response to changes?
Calcium-sensing receptors in the parathyroid glands respond to changes in calcium levels.
How is the formation of HbA1c related to plasma glucose concentration?
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.
What methodology has been incorporated into many automated chemistry analyzers and utilizes both direct and indirect measurements for electrolyte testing?
Ion-selective electrode (ISE) potentiometry
ISE methods measure the activity of an ion in the water volume fraction in which it is dissolved.
Modern HPLC systems can work at pressures up to _________ psi.
5000 to 6000
Modern HPLC systems can work at pressures up to 5000 to 6000 psi.
Which of the following are the two methods used to characterize monoclonal proteins?
Question 53Answer
a.
Demensional immunofixation and immunofixation eletrophoresis
b.
Demensional immunofixation and radial immunodiffusion
c.
Immunoelectrophoresis and immunofixation electrophoresis
d.
Immunoelectrophoresis and radial immunodiffusion
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.
What is a simple sugar, or monosaccharide, derived from the breakdown of dietary carbohydrates?
Question 65Answer
a.
Fructose
b.
Galactose
c.
Glucose
d.
Maltose
Glucose
Intestinal absorption of carbohydrates occurs in the small intestine, where monosaccharides, the single- sugar units of carbohydrates, are absorbed.
Which of the following is one of the most common clinical applications of GC-MS analysis?
Question 71Answer
a.
Antiretroviral testing
b.
Confirmation of inborn errors of metabolism
c.
Drug testing
d.
Screening for genetic disorders
Correct Answer: Drug testing
Drug testing
Screening for and confirmation of genetic disorders and analysis of antiretroviral drugs is performed by HPLC-MS/MS and HPLC-MS, respectively.
chromatography is a laboratory technique for the separation of a mixture into its components. The mixture is dissolved in a fluid solvent (gas or liquid) called the mobile phase, which carries it through a system (a column, a capillary tube, a plate, or a sheet) on which a material called the stationary phase is fixed
Densitometry:
Quantitative measure optical density in light sensitive materials after electrophoresis, stained gel passed thru optical system of densitometry making viral l visible diagram bands, measures light thru solid.
chromatography is a laboratory technique for the separation of a mixture into its components. The mixture is dissolved in a fluid solvent (gas or liquid) called the mobile phase, which carries it through a system (a column, a capillary tube, a plate, or a sheet) on which a material called the stationary phase is fixed
Densitometry:
Quantitative measure optical density in light sensitive materials after electrophoresis, stained gel passed thru optical system of densitometry making viral l visible diagram bands, measures light thru solid.
Mass spectrometry (MS) is an analytical technique that is used to measure the mass-to-charge ratio of ions.
In a typical MS procedure, a sample, which may be solid, liquid, or gaseous, is ionized, for example by bombarding it with a beam of electrons
The ions are detected by a mechanism capable of detecting charged particles, such as an electron multiplier. Results are displayed as spectra of the signal intensity of detected ions as a function of the mass-to-charge ratio.
radiant energy, energy that is transferred by electromagnetic radiation, such as light, X-rays, gamma rays, and thermal radiation, which may be described in terms of either discrete packets of energy, called photons, or continuous electromagnetic waves
Visual spectrum/wavelength: radiant energy, 380-750
Joint disorders
Non-inflammatory: clear, yellow, good viscosity, less than 1000wbc
Inflammatory:
-Immunologic cloudy, yellow, poor viscosity, WBc 7500, decreased glucose
-Crystal: cloudy or milky, low viscosity, WBc 100,000 decreased glucose
Septic: cloudy, green yellow, pos gram
Hemorrhage: cloudy red, normal glucose
….
Nephron functional unit of kidney
Made it glomerulus (capillary vessels) and tubules
…
HCG
Glycoprotein, alpha beta subunits secreted by placenta
Early as a week, peak 2 months
B2 microglobulin: renal tube function, increased in reduced GFR
Cystain C: changes in GFR
