Baby - CC Flashcards
Bilirubin conversion factor mg/dL to umol/L
17.1
Creatinine conversion factor mg/dL to umol/L
88.4
Sodium, Potassium, Chloride conversion factor mEq/L to mmol/L
1
TP/Albumin/globulin g/dL to mg/L
10
Ig conversion factor from mg/dL to mg/L
10
Ig conversion factor from mg/dL to g/L
0.1
Thryoxine ug/dL to nmol/L
12.9
BUN conversion factor from mg/dL to mmol/L
0.357
BUN to Urea
2.14
Urea to BUN
0.467
Normal BUN: Creatinine ratio
10-20:1
Creatinine clearance
Indirect method used to asses the glomerular filtration functioning capabilities of the kidneys
Creatinine
Index of overall renal function
B2 microglobulin
Appears in the urine when reabsorption is incomplete because of proximal tubular damage, as in acute kidney injury
Assay for urea that is inexpensive but lacks specificity
Colorimetric, diacetyl
Assay for urea that measures ammonia formation
Enzymatic
Simple nonspecific method for creatinine
Colorimetric, endpoint
Assay for creatinine which is rapid and with increased specificity
Colorimetric: kinetic
Assay for creatinine that measures ammonia colorimetrically or with ion-selective
Enzymatic
Assay for uric acid, problems with turbidity
Colorimetric
Asssay for uric that needs special instrumentation and optical cells
Enzymatic: UV
Assay for uric acid, interference by reducing substances
Enzymatic: H2O2
A progressive and irreversible loss of renal function, results from several disease entities
Chronic renal failure; Progressive and irreversible
Least interference with analysis; Natural
Heparin
Heparin for most chemistry tests; common
Lithium heparin
Glucose is metabolized at a room temperature
7 mg/dL/hour
Glucose is metabolized at 4degC
2 mg/dL/hour
Hypoglycemia
Blood glucose level less then 50 mg/dL
OGTT
Patient should be ambulatory; fasting of 8 to 14 hours
Unrestricted diet of 150 grams CHO/day for 3 days prior to testing
Performed routinely to monitor glucose control
Glycosylated hemoglobin
Gestational diabetes patients develop diabetes
Within 5 to 10 years
Sodium concentration in patient with DM
Decreased due to polyuria
Cholesterol [NCEP Guideline for acceptable measurement error]
CV ≤ 3%
Triglycerides [NCEP Guidelines for acceptable measurement error]
CV ≤ 5%
LDLs, HDLc [NCEP Guidelines for acceptable measurement error]
CV ≤4%
Minor lipoproteins
IDL and Lp (a)
Major structural protein in HDL
Apo A1
Major structural protein in VLDL and LDL
Apo B100
Structural protein in chylomicrons
Apo B48
LDL cholesterol may be calculated from measurements of:
TC, TAG and HDL-c
Floating beta-lipoprotein
B-VLDL
Sinking pre-beta lipoprotein
Lp (a)
HDL cholesterol protective against heart disease
≥ 60mg/dL
HDL cholesterol major risk for heart disease
<40 mg/dL
Serum cholesterol: moderate risk>170 mg/dL, high risk >185 mg/dL
2-19 years old
Serum cholesterol: moderate risk>200 mg/dL, high risk >220 mg/dL
20-29
Serum cholesterol: moderate risk>220 mg/dL, high risk >240 mg/dL
30-39 years old
Serum cholesterol: moderate risk>240 mg/dL, high risk >260 mg/dL
40 and over
One-step, direct method for cholesterol
Libermann-Burchardt (L-B) procedure
Current reference method for cholesterol
Abell-Kendall method
PiSO
Potassium: Inside
Sodium: outside
Chloride
Counterion of sodium
Counterbalance of sodium
Routinely measured electrolytes
Sodium, potassium, chloride and bicarbonate
Largest contribution to the osmolality value of serum
Sodium, chloride and bicarbonate
Osmolality of plasma
2 Na + Glucose (mg/dL) / 20 + BUN (mg/dL) / 3
Or
1.86 Na + glucose/18 + BUN/2.8 + 9
Osmolal gap
Difference between the measured osmolality and calculated osmolality
Indirectly indicates the presence of osmotically active substances other than Na+, urea, or glucose, such as ethanol, methanol, ethylene glycol, lactate, or B-hydroxybutyrate
Anion
Na - (Cl + HCO3)
NV: 7-16 mmol/L
Anion gap
Na + K) - (Cl + HCO3
NV: 10-20 mmol/L
Anion gap exceeds 16 mmol/L
Indication of increased concentrations of the unmeasured anions (PO4 3-, SO4 2-, proteins ions
ADIC
Anion Decrease
Increase Cation
Decrease anion gaps of less than 10 mmol/L
The anion gap is also useful as a QUALITY CONTROL measure for electrolyte results
If an increased anion gap is gap is found for electrolytes in a healthy person, one or more of the test results may be erroneous, and the tests should be repeated
Most common cause of hyperkalemia in hospitalized patients
Due to therapeutic K+ administration.
The risk is greatest with IV K+ replacement.
Hypernatremia
Increased intake or retention
Conn’s disease
Hyperaldosteronism
Most abundant cation in the ECF
Sodium
Hyponatremia
Increased water retention
Renal failure
Major intracellular cation in the body, Integral part of the transmission of nerve impulses
Potassium
Nonspecific but sensitive for renal disease
Urea
BUN to Crea in renal disease
Maintained or NORMAL
Test for overall renal function; Tubular injury:
Crea, B2-Microglobulin
Test that requires mercury lamp:
Enzymatic UV
Short term glucose testing:
Fructosamine “glycosylated albumin” (2-3 wks)
Not needed for the measurement of LDLc
VLDLc - computed value
Hormones that regulate calcium
PTH, Calcitonin, Vit. D
Hyperkalemia
Decreased renal excretion
Acute or chronic renal failure
Increased intake
Hypokalemia
Gastrointestinal loss
Major extracellular anion
Chloride
Inversely related with Chloride
Bicarbonate
Calcium distribution in blood
50% ionized
Respiratory acidosis
Increase pCO2
Respiratory alkalosis
Excess CO2 loss
Metabolic acidosis
Excess H+ production
Metabolic alkalosis
Excess H+ loss
Fever will decrease pO2 by:
7%
Fever will increase pCO2 by:
3%
Potentiometry
pH, pCO2
Amperometry
pO2, Polarography
89 to 90% of all the CO2 in serum
Form of Bicarbonate (HCO3-)
Driving force of the Bicarbonate buffer system
Carbon dioxide
Lock-and-Key (EMIL FISCHER)
The shape of the key (substrate) must fit into the lock (enzyme)
Induced-Fit (Daniel Koshland)
Substrate binding to the active site of the enzyme
Fixed-time
Reactants are combined; reaction proceeds for a designated time; reaction is stopped and measurement is made
Continuous monitoring/kinetic
Multiple measurements of absorbance are made during the reaction; more advantageous
Forward reaction for CK
Tanzer-Gilvarg
Reverse reaction for CK
Oliver-Rosalki
Forward reaction for LD
Wacker
Reverse reaction for LD
Wroblewski LaDue
High specificity for erythrocyte, prostate
Acid phosphatase
High specificity for the liver
Alanine aminotransferase
High specificity for the pancreas
Lipase
High specific for the pancreas, salivary gland
Amylase
Moderate specificity for liver, heart, skeletal muscles
Aspartate aminostranferase
Moderate specificity for heart, skeletal muscles, brain
Creatinine kinase
Low specificity for liver, bone and kidney
Alkaline phosphatase
Most potent of the estrogens
Estradiol
Hypersecretion of growth hormone in adult
Acromegaly
Confirmatory test for acromegaly
Glucose suppression test - OGTT
Effect of growth hormone to blood glucose
Increased
Cushing’s disease description
Increase in cortisol caused by excessive development and activity of pituitary gland
Cretinism
Hyposecretion of thyroxine in children
T3 and T3 uptake test in hypothyroidism
Both decreased
Computed from Henderson-Hasselbach equation
HCO3- (Bicarbonate)
T3 and T3 uptake test in hyperthydoidism
Both increased
Relationship of T3 uptake and T3 test
Direct
Relationship of T3 uptake test and TBG
Inverse
Cholesterol and triglycerides in hypothyroidism
Increased
ACTH is from
Anterior pituitary gland
Conn’s Syndrome
Aldosterone-secreting adrenal adenoma
Constituents of a number of common foods, including bananas, vanilla, tea and coffee
May react in the test for HMMA (VMA)
Enzyme produced by the kidney which acts on angiotensin from angiotensin II
Renin
Corrects renal blood flow by causing vasodilation of the afferent arterioles and constriction of the efferent arterioles, stimulating reabsorption of sodium and water in the proximal convoluted tubules, and triggering the release of the sodium-retaining hormone aldosterone by the adrenal cortex and antidiuretic hormone by the hypothalamus
Angiotensin II
Increased antidiuretic hormone
Fluid retention, low serum Na+
Decreased antidiuretic hormone
Fluid loss
Increased aldosterone
Hypertension, low serum K+
Decreased aldosterone
Low serum Na+, high serum K+
Increased renin
Hypertension
“Confused teenager; 27 Pregnant; 50 dead”
- 18%-0.30% - Mental confusion, impaired motor skills
- 27%-0.40% - unable to walk, vomiting, impaired consciousness
- 35%-0.50% - coma and possible death
Presumptive evidence of driving under the influence of alcohol
0.10%
>100 mg/dL
Metabolite of cocaine
Bezoylecgonine
BMI of obese
≥30kg/m²
Blood pressure cuff as tourniquet
60 mmHg
40 mmHg during WBLD collection
Air displacement pipet
Relies on piston for suction to draw sample into disposable tip; the piston does not come in contact with the liquid
Positive displacement pipet
Operates by moving the piston in the pipet tip or barrel, much like a hypodermic syringe; it does not require a different tip for each use
Horizontal centrifuge/swinging bucket
Horizontal position in the centrifuge when spinning and a vertical position when the head is not moving
Most basic pipet
Glass pipet
“DpOMA”
Drop in pO2 = metabolic acidosis
Cushing’s disease
Hypersecretion of ACTH
Cushing’s syndrome
Increased cortisol
Fastest centrifuge
Ultra centrifuge
Monolayer centrifuge
Cyto centrifuge
“SPiCY”
Slope = Prop. Sys. Error
Y intercept = Constant sys. Error
“HAXI”
X-Axis Horizontal, Abscissa, Independent Variables
“VDOY”
Y-Axis, Vertical, Ordinate, Dependent Variables
Reliability
Ability of an analytical method to maintain accuracy and precision over an extended period of time during which equipment, reagent, and personel may change
“SPF”
F-Test = Precision, S.D.
“TAM”
T-Test = Accuracy, mean
Control that continue to either increase or decrease over a period of 6 consecutive days
Trend
Six or more consecutive daily values that distribute themselves on one side or either side of mean
Shift
The smaller the CV
Greater is the precision
Point-of-care testing (POCT)
Alternate site testing, near-patient testing, decentralized testing, bedside testing, or ancillary testing
Fahey RID
d = log Ag. Conc.
Measurement of the diameters of all circles at a set time after initiation of the diffusion process, measurements are made 24 hours (or 18 hours) after addition of samples to the plate, preferable since results are available much sooner
Mancini RID technique
d² = Ag. Conc.
Measurements of the diameters after diffusion has ceased, often requires 2 to 3 days before results are available; provide a more reliable estimation of low levels of antigen.
Increased sensitivity
