AMT chem/bf quick Flashcards

1
Q

CEA;
PSA:

AFP: 4 related conditions

HCG: 3 related, composed of

A

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

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2
Q

CA15-3
CA 27-29

CA 19-9

CA 125

2 cardiac

A

CA15-3, 27-29 breast

19-9 pancreatic, GI

CA125 ovarian

cardiac: crp, homocysteine

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3
Q

Water soluble vit names, associated conditions
Pee out Bs, Cs

B1
B2
B3
B6
B7
B9
B12
C

A

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

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4
Q

Fat soluble vitamins name, ass disease

A

ADEK

A retinol, night blindless
D calciferol, rickets, hormone
E tocopherol, HA/antioxidant
K phylloquinone, hemmorage/clots

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5
Q

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

A

+Albumin, a1, a2, beta, gamma-

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

*highest is albumin 65%, 2nd highst gamma 15%

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6
Q

globulins % from anode to cathode

A

albumin 65

alpha1 2

alpha2 8
beta 10
gamma 15

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7
Q

Proteins increased/decreased in…
-decrease in nephrotic, malnutrion, liver disease, burns
-increase proteins dehydration, MM/WM

-viral hepatitis:

-active cirrhosis:

-nephrotic syndrome:

-acute inflammation

A

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

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8
Q

Proteins in

monoclonal
versus
hypogamma

A

Mono: sharp increase in gamma

Hypo: no gamma

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9
Q

A/G calc

A

Albumin/TP-albumin

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10
Q

BUN: rises the fastest in acute renal failure,
BUN to creatinine ratio…

2 methods of BUN…
-one not measuring ammonia
-one measures ammonia

A

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

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11
Q

Copper protein carrier…alpha 2 globulin

-Condition where its decreased, excess copper storage

-Condition where its decreased, but decreased serum copper

A

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

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12
Q

Creatinine test name, reagent, color…

Creatinine is used to measure…
calc…

alternate marker of GFR…

A

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

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13
Q

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…

A

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

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14
Q

ammonia seen in…
-heparin on ice

tested using 4 diff…

A

liver disease, reyes, encephalopathy

ISE, pH

spectro=blue dye

Enzyme=GLDH, NAD

Nessler

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15
Q

Disaccharides composed of…

-maltose:

-lactose:

-sucrose:

Monosaccharide
-hexose:

A

Sugars composed of…

-maltose: glucose, glucose

-lactose: glucose, galactose
lac=galac

-sucrose: glucose, fructose
su=fru

-hexose: monosaccharide with 6 Cs

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16
Q

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:

A

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

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17
Q

oral GTT

prego grams:
standard grams:

if after 1hr >140, give….g

compare fasting 1,2,3 hrs

A

prego grams: 50
standard grams: 75

if after 1hr >140, give….100g

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18
Q

Cystatin versus Cpeptide

A

Cystatin: gfr, in nucleated cells

Cpeptide: endogenous production of insulin

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19
Q

What cells make in regards to glucose regulation

alpha:
beta:
delta:

Specimen for glucose test…

A

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

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20
Q

Glucose increased or decreased…

-VonGierke:

-insulinoma

-diabetes insipidus:

-diabetes mellitus:

-Hashimoto:

-Cushings:

A

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

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21
Q

2 tests for glucose, use fluorinated plasma…
both have coupled enzyme…

A

Glucose oxidase
-oxidase, perioxidase
-oxidize chromagen, colorimetric
*contamination with catalase

Hexokinase:
-hexokinase, G6PD
-NAD reduced to NADH, read at 340nm

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22
Q

Storage lipids being used a primary source of energy will cause urinary…

Reagent…

A

ketones

Sodium nitroprusside

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23
Q

Reagent and name used in urobilinogen testing…

What is used to distinguish urobilinogen from porphobilinogen since they’re both red w/Erlichs reagent…

A

pDMAB
p-di-methyl-amino-benzaldehyde
Erlich

Chloroform: urobilinogen is soluble in chloroform but porphobilinogen isn’t and is in lower phase

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24
Q

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

A

Glucose

automated: glucose oxidase
-oxidase, peroxidase, oxidize chromagen

Coenzyme at 340, hexokinase
-hexokinase, G6PD
-NAD reduced to NADH at 340

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25
Q

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

A

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

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26
Q

Jaundice type:

-increased unconjugated, increased urine urobilinogen

-everything increased, billi/urobili in urine

-unconjugated normal, conjugated increased, urobilinogen decreased

A

Jaundice type:

Preheptatic: hemolytic
-increased unconjugated, increased urine urobilinogen

Hepatic
-everything increased, billi/urobili in urine

Post hepatic, obstruction:
-unconjugated normal, urobilinogen decreased

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27
Q

3 disorders of bilirubin related to reduced enzyme or bili transport issues…

which one involved in kernicterus…

which one with increased porphyrin/transport issue

A

Gilbert: reduced enzyme activity

Crigler Najjar: lack,lowered enzyme
1: absense, kernicterus
2: decreased

Dublin Johnson: bili transport issue, dark pigment/porphyrin

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28
Q

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….

A

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

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29
Q

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

A

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

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30
Q

CK in muscles,

When start to rise, when normal…
conditions…

isoenzymes: fastest to slowest, location

A

CK rises 2-4hrs, normal 2-4 days

Seen in heart attach, muscular dystrophy, exercise

CKBB fastest, brain
CKMB 2nd, AMI
CKMM slowest, muscle

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31
Q

First protein to rise in heart attack, rise/normal…

2nd to rise, normal…

3rd to rise, normal…

A

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

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32
Q

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…

A

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

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33
Q

AST elevated in these 3

aldolase highest in..

A

muscle (dystrophy, heart)
liver

aldolase highest in muscular dystrophy

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34
Q

enzyme in mumps…
enzyme specific for acute pancreatitis…

4 pancreatic conditions…

A

mumps/pancretaitis: amylase
-in acute rise in hours, normal 3 days

pancreatitis: lipase

-cystic fibrosis: mucous dysfuction
-cancer 19-9
-insulin resistance
-gastrinoma, ZollingerEllison

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35
Q

lipase:

name of test..uses what for substrate…
lipase catalyzes the hydrolysis of….into…

A

Cherry-Crandall, olive oil

lipase hydrolyzes triglycerides in olive oil into glycerol

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36
Q

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….

A

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

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37
Q

In the complexometric titration for Ca, 8 HYDROXY QUINOLINE REMOVES…from interering

A

MG

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38
Q

Clark Collip method for…that precipitates it as…oxalate

A

Ca, calcium oxalate

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39
Q

Lanthanum in Ca used to bind

A

phosphorus

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40
Q

Calcium is affected by..and…
collect in…
increased by these two, decreased by one..

A

ph, protein

collect in heparanized plasma, green top

increased by PTH, Vit D
decreased calcitonin

45%bound to protein, 45 ionized/active, 10 complexed

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41
Q

Decreased Ca…
hypo PTH, vit D def
hypo mag, hypo albumin
tetany

A

Increased Ca…
hyper PTH, vit D excess
Malig

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42
Q

Phosphorus at pH7.4 most in…

reagent used in inorganic phosphate colorimetric method…

what two things increase Phosphorus
what decreases it

A

bone

molybdate, molybedum blue

PTH decreases phosphorus, opposite of Ca
Cacitonin increased PTH, opposite of Ca
Vit D increases phosphate(and Ca)

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43
Q

Decreased Phosphate…
hyper PTH, antacids, dextrose

A

Increased Phosphate…
hypo PTH, renal failure

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44
Q

Major extracellular cation…

Major extracellular anion…

Major intracellular cation…

Major intracellular anion…

A

Major extracellular cation…Na
Major extracellular anion…Cl

Major intracellular cation…K
Major intracellular anion…Phos

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45
Q

NV

Na:
K:
CO2:
Cl:

BUN:
Creatitinine:

Glucose:

sign of saline contamination:

A

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

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46
Q

Things that cause low chloride…

Things that cause high chloirde…

A

low cl:
-vomit, diarrhea, sweat, kidney loss
-metabolic alkalosis(increase HCO3)

high cl:
-Iv contamination
-metabolic acidosis(decrease HCO3)

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47
Q

Coulometry used to measure

A

Cl, sweat Cl

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48
Q

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

A

Coulometric amperometric/titration:
-Silver, Cl

Schales Schales mercurimetric:
-excess Hg react to form violet

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49
Q

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

A
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50
Q

Magnesium…

reagent called..
interference with calcium method…use…to prevent…

A

Magnesium…

reagent called..titan yellow, dye lake

interference with calcium method, adjust pH to prevent interference in calcium by using 8hydroxyquinoline

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51
Q

Electrodes:
PH:
pCO2:
pO2:

Henderson-Hasselbach equation for pH…
Normal ph..
acidosis..
alkalosis..
bicarb:acid ratio…

A

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

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52
Q

Spectrophotometer QC of wavelength uses….
To get UV range use…

atomic adsorption spectrophotometry uses this as light source….

A

Wavelengh QC uses holomium glass filter
UV range uses quartz cuvette

atomic adsorption spectrophotometry uses cathode lamp for light

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53
Q

Potentiametry: free ions, electrical potential
Amperometry: single potential, current
Coulometry: coulombs
Polarography: current, applied voltage

immunoelectrophoresis: must be excess antibody and constant trough distance

A

Immunoassays:
-radio: tracer/tag/label, counter
-enzyme: horshradish, alp, g6pd
-fluoresncent: fluorescein isothiocynate
-chemiluminescent: chemical, light

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54
Q

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…

A

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

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55
Q

Porter Silber uses Phenyl-hydrazine to detect…

Metabolite of androgens, Zimmerman detects…

A

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

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56
Q

3 catecholamines adrenal medulla make:

which ones have VMA, which one HVA

A

epi, norepi=VMA

dopamine=HVA

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57
Q

methods for confirmation of drugs that are pos screens

A

gas chromatography and M/S

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58
Q

Quinidine
Procainamide
Digoxin all are

A

antiarrthymics,cardiactives

Digoxin requires tdm, glycoside, congestive heart failure

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59
Q

Immunosuppresives…

A

cyclo, tacro, siro

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60
Q

bronchodilator

A

theophylline

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61
Q

aminoglycoside all end in…

inhibit protein synthesis gp

A

cin

vancomy-cin/glycopeptide
gentamy-cin
tobramy-cin
kanamy-cin

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62
Q

psychoactive=ine

A

lithium

imipram-ine
despiram-ine
amitri/nortriptyl-ine

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63
Q

anti epileptic

A

phenobarbitol
phenytoin/dilantin

valproic acid

carbamazepine
ethosuximide

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64
Q

antitumor,neoplastic

A

methothrexate

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65
Q

liproproteins from lighest to heavist:

lipoprotein electrophoresis names

HDL:
VLDL:
LDL:

migration from origin..

A

lighests chylo, vldl, ldl, hdl

lipoprotein electrophoresis names
HDL: alpha
VLDL: prebeta
LDL: beta

migration from origin/cathod(-)
chylo, beta, prebeta, alpha

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66
Q

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

A

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

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67
Q

2 methods for fat:

cholesterol: 90% liver, steroids
name, reagents, what does saponification step do

triglyceride: 90% diet
-enzyme, what is liberated

A

Liebermann Burchard:
cholesterol
-a.a., s.a.
-saponification frees esters (chol-ester-ol)

triglyceride:
-lipase catlyzes hydrolysis of triglyceride into glycerol (tri-glycer-ide)

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68
Q

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

A

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

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69
Q

Urine PH 4.5-8

Urine left at RT: alkaline

increased

decreased

A

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

70
Q

smokey/red brown..

dark red…

dark yellow..

dark yellow/orange/amber…

brown black on standing…

cloudy in freshly voided…

A

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

71
Q

3 methods for sg: tests for concentration and dilution function of kidney tubules

1.002-1.035

SG directly proportional to color

A

reagent strip (colorimetric)
refractometer
harmonic oscillation
-densitometry, current

72
Q

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

A
73
Q

Casts: tammhorsfall, distal convoluted tubule

A

Collecting duct: last part, final concentration

74
Q

CSF protein NV, what % plasma glucose
normal lymph versus mono

A

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

75
Q

Sperm
ml, live, motile, #

A

2-5ml, 75 alive, 50 motile, 20-250million

76
Q

Main reason for false negatives in urine

A

vit C

-glucose, blood, bili, nitrite

77
Q

Bleach and pigment will usuall cause false

A

pos

glucose, ketones, blood, bili, uro, leuko

78
Q

4 protein methods for serum protein

A

Biuret: 2+ peptide bonds

Dye binding: albumin,
-bromthymol/coomassie blue
-Ponceau, amido

Kjeldahl: nitrogen

refractometry: refractive index

79
Q

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

A
80
Q

two alpha 2 proteins that are acute phase proteins…
one binds hmg the other copper

large alpha 2 protein seen in nephrotic syndrome

A

haptoglobin, ceruplasmin

alpha1macroglobin

81
Q

Most iron is in…

storage form..

transport iron…

in muscles…

A

Most iron is in…hmg

storage form..ferritin

transport iron…transferrin

in muscles…myoglobin

82
Q

IDA:
-decreased seru/storage
-increased TIBC/transferrin

Sideroblastic/Hemochromatosis:
-decreased transferin/TIBC
-increased iron, ferrtin

A
83
Q

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…

A

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

84
Q

Catecholamines: metabolites, tumors

A

Epi/norepi: VMA
-Pheo

Dopamine: HVA
-Neuro

85
Q

Name of

T3, T4, TBG, what binds to T4,measured by

3 best indicatiors for hypothyroidism

A

T3 triodothyronine

T4 thyroxine

Thyroid binding globulin-binds to T4,
Measured by T3uptake

best to use s-TSH, TT4,FT4

86
Q

Hormone in bone/calcium metabolism..

Hormone that stimulates renal to make VitD….

A

Hormone in bone/calcium metabolism…
calcitonin

Hormone that stimulates renal to make VitD….PTH

87
Q

Mineralocoricoids (aldosterone)
Glucorticoids(cortisol)
androgens
released by

A

adrenal cortex

88
Q

Aldosterone… reabsorb Na, decrease K
-distal tubes/collecting duct
-renin to angio 1/2, cortex increase aldosterone

increassed in Conns, decreased addision

A
89
Q

Disease with increased aldosterone/Na…

Disease with decreased aldosterone/Na…

A

Disease with increased aldosterone/Na…
Conns

Disease with decreased aldosterone/Na…
Addisons

90
Q

Cortisol…
Increased, decreased

A

Increased Cushing’s, increased glucose/sodium

Decreased Addison, decreased aldosterone/Na

91
Q

2 GI hormones

Zollinger Ellison…

5HIAA…

A

Increased gastrin

Serotonin metabolite

92
Q

PTH stimulates renal production of and bone reabsorption of

A

PTH stimulates renal production of vitD and bone reabsorption of Ca

93
Q

Liebermann Burchard has
cholesterol and goes to a.a., s.a.

A

94
Q

B2
B7

A

B2 riboflavin
B7 bioton

95
Q

Protein% AND MIGRATION ANODE TO CATHODE

A

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

96
Q

Proteins origin to anode

A

Chylo, beta, pre beta, alpha

97
Q

Ag, Hg Cl… Time needed to reach end point both titration for chloride

A
98
Q

Metabolite and disorder for dopamine

Metabolite and disorder for epi/norep

A

Metabolite and disorder for dopamine
HVA, Neuroblastoma

Metabolite and disorder for epi/norep
VMA, Pheochromocytoma

99
Q

Vancomycin is an antibiotic that is a…
inhibits cell wall of…

A

glycoprotein
gp

100
Q

Creatinine clearnace

A

U creat/Plasma creatinine x
volume ml/1440

101
Q

LD 1 HHHH highest in these two…
LD2 HHHM highest in the…

Flipped LD1/2 indicates

A

LD1 heart, rbc
LD2 in healthy

heart attack

102
Q

Slowest versus fastest LD isoenzyme

A

slowest is LD5(pos charged)
fastest is LD1(neg charged)

103
Q

LD 1,2,3 indicates

A

Pernicious anemia

104
Q

increased LD3

A

pulmonary edema

105
Q

LD 4,5 indicates these two

A

liver disease, viral hepatitis
skeletal

106
Q

relates to the concentration of sample to amount of light sample absorbs as it passes thru the sample

A

Beer, Lambert Law

107
Q

Disease due to TSH receptor antibodies…

Disease due to thyroid autoantibodies…

A

Disease due to TSH receptor antibodies…
Graves

Disease due to thyroid autoantibodies…
Hashimotos

108
Q

Apoprotein A is…

Apoprotein B-48 is…

Apoprotien B-100 are these two…

A

Apoprotein A is…HDL

Apoprotein B-48 is…Chylo

Apoprotien B-100 are these two…LDL, VLDL

109
Q

Estrogen, estadiol made by…

hyper estrogen…
hypo estrogen…

active form of estrogen, fetoplacental fnc…

A

Estrogen, estadiol made by…ovaries

hyper estrogen…amenorrhea
hypo estrogen…menopause

active form of estrogen, fetoplacental fnc…
estadiol

110
Q

Progesterone made by…and….
helps…

perimenopause…
postmenopause…

hormone that maintains progesterone in early prego…

A

Progesterone made by corpeus lutum and placenta

perimenopause…increased
postmenopause…decreased

hormone that maintains progesterone in early prego…hcg

111
Q

Best sample for toxicology screen…
best to quantify…

A

screen urine
quantify blood

112
Q

drug that causes liver damage…

steady state in…

A

liver is acetaminophen(tylenol)

steady state in 5-7 doses

113
Q

Benzoglyegonine metabolite of

A

cocaine

114
Q

codeine and morphine are

A

opiates

115
Q

Bicarb NV
CO2 NV

A

Bicarb 22-26
CO2 35-45

116
Q

additive for blood gas…

glycolysis affect on ph, CO2…

directly measured….
calculated…

A

additive for blood gas…heparin

glycolysis affect on ph, CO2…CO2 increase, ph fall

directly measured….CO2,O2
calculated…bicarb, oxy sat

117
Q

Glucose, blood, WBC false positive with

A

bleach

118
Q

Alkaline urine…
false pos in…
false neg in…

A

Alkaline urine…
false pos in…protein
false neg in…SG

119
Q

Ketones, nitrite
urobili,bili
false pos with

A

pigment, med color

120
Q

Glucose, blood
bili, nitrite flase neg

A

Vit C

121
Q

Sternheimer Malbin is a supravital stain in microscopic exam

A

122
Q

HER2/neu marker for breast, ovarian, cervical cancer

All woman issues

A

123
Q

Cells that make 70% of CSF…

CSF obtained between…or…

A

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

124
Q

AChe
AcetylCholinEsterase

found in these 3

A

cns
rbc
fetal serum

125
Q

4 bands in CSF…
which one confirms CSF…

A

Prealbumin/transthyretin
albumin
Transferin
T Transferrin (confirms CSF)

126
Q

Rous tests for

A

hemosiderin

127
Q

which test diff urobili from porphobili

which tests for porphobili, inverse erlich

A

WatsonSchwartz: diff between urobilinogen and porphobiloinogen

Hoesch: only porphobiloinogen, inverse Erlich

128
Q

Spectrophotometry
Absorb light at wavelength, std Sln, color; light is radiant energy, travels thru in form of waves

A

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

129
Q

Vit D can be made in the…

and also from the….

low in…

A

kidney, sun

chronic kidney disease

130
Q

methyl red indicates ph change of…to…

from red to yellow

A

4.4-6.2

131
Q

Two chemicals for ph strip double indicator

A

methyl red
bromthymol blue

ph 5-9

132
Q

HPLC systems pressures of …to…

A

5000-6000

133
Q

two method for monoclonoal proteins

A

Immuno
electrophoresis

immunofixation
electrophoresis

134
Q

WB is what % less than plasma

Fasting glucose;
arterial/capillary is …mg higher than venous…

A

WB 10-15% less than plasma

Fasting glucose in arterial/capillary is 2-5mg higher than veins

135
Q

Test where bacteria acts on unabsorbed disaccharides to diagnose lactase def

A

H2 Breath

136
Q

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

A

affected by turbidity Evelyn Malloy

not affected by turbidity Jendrassik Grof

137
Q

Hyperlipedemia:

  1. Exogenous, young, unable to remove chylo,vldl
  2. LDL
  3. dysbetalip
  4. endogenous
  5. mixed exo,endo
A
138
Q

hormone rules out sepsis

A

procalcitonin
PCT

139
Q

osmal gap NV

calculated with

A

275-295

Na,K
glucose, BUN

140
Q

Used to access total body lead poisoning burden

A

Whole blood lead

141
Q

Instrument ionizes target molecule then separates and measures mass to charge ratio

A

Mass spectrometer

142
Q

Def leads to death and severe neurology defects

A

Folate

143
Q

Two enzymes most measured

A

Ast, alt

144
Q

Borderline trig 150-199mg dl

A

Fast 12-16hr

90% diet

Glycerol, lipase

145
Q

Dye update by sample after electrophoresis and staining is

A

Directly proportional to concentration

146
Q

Needed for measuring enzymatic activity in 24hr urine

A

Weight
Height
Total volume

147
Q

Measurement of decrease in intensity of incident light been as it passes thru solution of particles

A

Turbidimetry

148
Q

Gland that stimulates other glands to make hormones add needed

A

Pituitary, master gland

Hypothalamus sends releasing hormones to pituitary

Pituitary stimulates end organ

149
Q

Mathematical modeling of drug concentration in circulation to help establish dosage

A

Pharmakinetics

150
Q

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

A

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.

151
Q

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

A

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.

152
Q

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

A

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

153
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.

154
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.

155
Q

Absorbance can be calculated easily from percent transmission using which calculation?

A

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.

156
Q

How must a laboratory operate to handle TB sputum and TM materials?

A

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.

157
Q

What process helps monitor the accuracy and reproducibility of results using controlled specimens?

A

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.

158
Q

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?

A

4 mg/dL

200 mg/dL x 1/10 x1/5 = 200/50 = 4 mg/dL

159
Q

Which substance is employed to produce a chemical reaction?

A

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.

160
Q

Which of the following levels do parathyroid glands either increase or decrease PTH secretion in response to changes?

A

Calcium-sensing receptors in the parathyroid glands respond to changes in calcium levels.

161
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.

162
Q

What methodology has been incorporated into many automated chemistry analyzers and utilizes both direct and indirect measurements for electrolyte testing?

A

Ion-selective electrode (ISE) potentiometry

ISE methods measure the activity of an ion in the water volume fraction in which it is dissolved.

163
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.

164
Q

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

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.

165
Q

What is a simple sugar, or monosaccharide, derived from the breakdown of dietary carbohydrates?
Question 65Answer

a.
Fructose

b.
Galactose

c.
Glucose

d.
Maltose

A

Glucose

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

166
Q

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

A

Drug testing

Screening for and confirmation of genetic disorders and analysis of antiretroviral drugs is performed by HPLC-MS/MS and HPLC-MS, respectively.

167
Q

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

A

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.

168
Q

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

A

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.

169
Q

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.

A

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

170
Q

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

A

….

171
Q

Nephron functional unit of kidney

Made it glomerulus (capillary vessels) and tubules

A

172
Q

HCG

Glycoprotein, alpha beta subunits secreted by placenta

Early as a week, peak 2 months

A

B2 microglobulin: renal tube function, increased in reduced GFR

Cystain C: changes in GFR