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Clinical Chemistry > CC 1 > Flashcards

CC 1 Flashcards

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1
Q

Standard clinical specimen for glucose

A

Fasting (8-10 hrs) venous plasma

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2
Q

Which specimen has greater glucose

A

Arterial> capillary > venous

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3
Q

Gray fop tubes composition

A 
Sodium fluoride (2 mg) antiglycolytic
Potassium oxalate (2 mg) anticoagulant
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4
Q

What enzyme can fluoride inhibit

A

Enolase (fluoride binds to magnesium)

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5
Q

CSF glucose concentration

A

60-70%

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6
Q

To convert whole blood glucose to serum or plasma (multiply by ____)

A

1.15

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7
Q

Hyperglycemia leads to (sodium)

A

Hyponatremia

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8
Q

Most common glycogen storage disorder and enzyme deficient

A

Von Gierke dss (deficient in glucose-6 phosphatase)

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9
Q

Essential amino acids

A

PVTTIMLL

Phenylalanine
Valine
Threonine
Tryptophan
Isoleucine 
Methionine 
Leucine 
Lysine
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10
Q

pH where proteins have no net charge

A

Isoelectric point

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11
Q

Ion that has two differing charges but the net charge on the molecule is zero

A

Zwitterion

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12
Q

Carbohydrate digestion

A 
Begins in the mouth (salivary amylase -ptyaline) 
Skips stomach (acidic pH prevents digestion)
Continues in the small intestine (pancreatic amylase)
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13
Q

Protein digestion

A

Begins in the stomach and completed in the small intestines

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14
Q

Enzyme responsible for protein digestion in the stomach

A

Pepsin

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15
Q

Another name for prealbumin

A

Transthyretin

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16
Q

2nd most predominant protein in the CSF

- carrier protein for thyroid hormones and vitamin A

A

Prealbumin

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17
Q

Marker for cystic fibrosis

A

Albumin

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18
Q

Majority of alpha-2 globulins

A

Alpha-2-macroglobulin

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19
Q

Carrier for steroid hormones

A

Alpha-1-acid glycoprotein

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20
Q

AFP amount in down syndrome and neural tube defect

A 
Down Syndrome (decrease)
Neural tube defect (elevated)
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21
Q

Another name for transferrin

A

Siderophilin

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22
Q

Soluble storage form of iron

A

Ferritin

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23
Q

How to measure fibrinogen

A

Parfentjev method (ammonium sulfate and sodium chloride) was

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24
Q

Associated with Alzheimer’s disease

A

Alpha-1 antichymotrypsin

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25
Q

Albumin:Globulin ratio

A

1:3

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26
Q

How to measure Bence Jones Protein

A

Immunofixation

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27
Q

Preferred specimen for protein

A

Serum

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28
Q

How to get protein content by nitrogen alone? Mulitply by

A

6.25 (others 6.54)

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29
Q

Reference method for protein determination

A

Kjeldahl method

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30
Q

Most widely used method for protein determination

A

Biuret reaction

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31
Q

Molecule that forms when urea (end product of protein metabolism) is heated at 180 deg C

A

Biuret (2 molecules of urea)

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32
Q

Reagents for biuret rxn

A

RANK

Rochelle’s salt (sodium potassium tartrate) - complex cupric ion and prevent their precipitation
Alk. CuSO4 (major reactant)
NaOH (alkali environment)
KI (stabilizer - keeps copper in cupric form)

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33
Q

Wavelength for Biuret Rxn

A

540 nm (same as bilirubin)

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34
Q

Most sensitive for Protein determination

A

Lowry (Folin-Ciocalteu) Method

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35
Q

Most commonly used dye for proteins determination

A

Bromcresol green

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36
Q

Most sensitive, specific and precise among the dye-binding assays for protein determination

A

Bromcresol purple

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37
Q

Dye for amino acids

A

Ninhydrin

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38
Q

Dye used in urine reagent strip (sensitive to albumin)

A

Tetrabromphenol blue

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39
Q

Electrophoresis protein pattern seen in patients with liver cirrhosis caused by an increase in IgA

A

Beta-gamma bridging effect

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40
Q

Electrophoresis pattern seen in cases of monoclonal gammopathy (multiple myeloma, Waldenstrom’s macroglobulinemia)

A

Gamma spike

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41
Q

Electrophoresis pattern seen in patients with nephrotic syndrome

A

Alpha 2 macroglobulin elevation with albumin decrease

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42
Q

Electrophoresis pattern seen in patients with emphysema

A

Alpha-1 antitrypsin deficiency

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43
Q

Use of plasma instead of serum during electrophoresis

A

Increased beta region

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44
Q

Electrophoresis pattern seen in acute inflammations

A

Low albumin

High alpha-1 and alpha-2 region

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45
Q

Reference range for protein and albumin

A

Protein 6.5-8.3 g/dL

Albumin 3.5-5.5g/dL

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46
Q

Conversion factor for protein g/dL to g/L

A

10

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47
Q

NPNs according to concentration

A

Urea (45%) > amino acids (25%)> uric acid (10%) > creatinine (5%) > creatine (1-2%) > ammonia (0.2%)

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48
Q

Conversion factor BUN to Urea

A

2.14

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49
Q

Urea concentration to BUN conversion factor

A

0.4673

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50
Q

Occurs when monosodium urate precipitates from supersaturated body fluids

A

Gout

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51
Q

Deposits of uric acid crystals as sodium urates in great toe, ear lobe, elbow and in other tissues

A

Tophi

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52
Q

Reference value for BUA

A

3.5 - 7.2 mg/dL

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53
Q

Conversion factor BUA mg/dl to umol /L

A

0.0595

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54
Q

What amino acids are synthesized to form creatine

A

MGA

Methionine
Glycine
Arginine

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55
Q

Primary site of ammonia production

A

Small intestine

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56
Q

Specimen for ammonium determination and considerations

A

EDTA plasma or heparinized plasma (placed immediately on ice bath and analyzed immediately)

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57
Q

Another name for triglycerides (2)

A

Triacylglycerol

Neutral fats/lipids

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58
Q

Unlike other lipids, it is not readily catabolized by most cells and therefore does not serve as source of fuel

A

Cholesterol

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59
Q

Composed of cholesterol ring and a fatty acid (hydrophobic)

- 60-70% of cholesterols

A

Cholesterol esters

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60
Q

Cholesterol ring only, no fatty acids attached (30-40%) - hydrophilic

A

Free cholesterol

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61
Q

Unsaturated fatty acids are usually in what form

A

Cis form

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62
Q

What apolipoprotein activates LCAT

A

Apo A-I and

Apo -D

63
Q

Homologous to plasminogen (may be prothrombotic)

A

Apo (a) - Lp (a)

64
Q

Also known as the sinking prebeta lipoprotein

A

Lp(a)

65
Q

Found in the LDL density (ultracentrifugation) but

Moves in the pre-beta region during electrophoresis

A

Lp(a)

66
Q

Also know as the floating Beta lipoprotein - VLDL that is richer in cholesterol than triglycerides

  • seen in patients with type III -hyperlipoproteinemia
A

Beta-VLDL (apo E-III deficiency)

67
Q

Found in the VLDL density range but migrates electrophoretically with or near LDL

A

Beta-VLDL

68
Q

Abnormal lipoprotein rich in lipids, primarily unesterified cholesterol and phospholipids

  • found patients with obstructive biliary disease
  • migrates towards the cathode during electrophoresis
A

Lpx

69
Q

Reference method for lipoprotein analysis

And the unit of sedimentation rate

A

Ultracentrifugation

Unit: Svedberg Unit

70
Q

General term for the thickening and hardening of arteries

A

Arteriosclerosis

71
Q

Type of arteriosclerosis due to the hardening of arteries caused by plaque (made up of cholesterol, fatty substances, cellular waste products, calcium and fibrin)

A

Artherosclerosis

72
Q

Also known as Tangier’s disease (HDL deficiency) due to the mutation of ABCA1 gene

A

Analphalipoproteinemia

73
Q

Another name for abetalipoproteinemia (deficiency of B48 and B100) and presence of acanthocytes in peripheral blood smear

A

Bassen-Kornzweig Syndrome

74
Q

HDL deficiency or the fish eye disease

A

LCAT deficiency

75
Q

Defective hepatic uptake of bilirubin

A

Gilbert Syndrome

76
Q

Defective conjugation of bilirubin due to deficiency of enzyme UDPGT

A

Crigler-Najjar Syndrome

Type 1 - total UDPGT def
Type 2 - Partial UDPGT def

77
Q

Defective hepatic excretion of bilirubin (dark pigmentation of the liver) with associated abnormal gall bladder function

Increased serum B2

A

Dubin-Johnson Syndrome

78
Q

Defective hepatic excretion of bilirubin, no liver pigmentation, normal gallbladder function

A

Rotor Syndrome

79
Q

Presence of circulating antibody against UDPGT

A

Lucey-Driscoll Syndrome

80
Q

Bicarbonate-carbonic acid ratio

A

20:1

81
Q

Low oxygen levels in the blood

A

Hypoxemia

82
Q

Low oxygen levels in tissues

A

Hypoxia

83
Q

What is the coenzyme for creatine kinase reaction

What is the activator

A

Coenzyme-cysteine

Cofactor - magnesium (metallic)

84
Q

Coenzyme for dehydrogenase reactions

A

NADP/NADPH, NAD/NADH

85
Q

Coenzyme for transaminase reaction

A

Pyridoxal (vit B6) phosphate

86
Q

Activator for amylase (metallic and nonmetallic)

A

Calcium (metallic)

Chloride (nonmetallic)

87
Q

Metallic cofactor for lactate dehydrogenase

A

Zinc

88
Q

Rate depends on substrate concentration

A

First order reaction

89
Q

Rate does not depend on substrate concentration, rate depends only on enzyme concentration

A

Zero Order Kinetics

90
Q

Inhibitor binds to the active site (substrate and inhibitor compete for the same binding site)

Reversible by addition or more substrate

A

Competitive inhibition

91
Q

Inhibitor binds to enzyme other than the active site (allosteric site)

May be reversible or irreversible

Addition of subject has no effect (cannot reverse)

A

Noncompetitive Inhibition

92
Q

Inhibitor binds to the enzyme substrate complex

More ES complex increases inhibition

A

Uncompetitive inhibition

93
Q

Micromole of substrate per minute, also known as U/L

A

International unit (MMM)

94
Q

Mole of substrate per second

A

Katal Unit (MSS)

95
Q

Reaction is measured and stopped at a specific time (assumed to be linear)

A

Fixed time (static or two point) assay

96
Q

Multiple measurements usually of absorbance change (substrate product per minute)

-preffered, more accurate to measure deviations

A

Multipoint Continuous Monitoring (Kinetic Assays)

97
Q

Method to measure enzyme activity which requires a large amount of substrate and longer incubation time

A

Spectrophotometric (colorimetric)

98
Q

Measures pressure of gases and vapor (evolution of gas or disappearance of gas as the reaction proceeds)

A

Manometry

99
Q

Concentration of Lactate dehydrogenase isoenzymes (highest to lowest)

A

LD 2>1>3>4>5

100
Q

Electrophoresis if LDH isoenzymes

A

Origin LD 5,4,3,2,1 (Anode)

101
Q

Lactate dehydrogenase isoenzyme that are cold labile fractions

A

LD4 and LD5

102
Q

LD flip (LD1>LD2) is oftentimes associated with

A

AMI

103
Q

Highest elevation of LDH seen in

A

Megaloblastic anemia

104
Q

Electrophoresis of ALP isoenzymes

A

Electrophoresis (origin towards the anode) - IPBL

INTESTINAL - PLACENTAL - BONE - LIVER

105
Q

Heat denaturation of ALP isoenzymes

A

PLACENTAL - INTESTINAL - LIVER - BONE

PILB

106
Q

Most heat stable of all the NORMAL ALP isoenzymes

A

Placental ALP

107
Q

Most heat stable among all the types of ALP

A

Regan ALP

108
Q

inhibits liver and bone isoenzymes for ALP

A

Levamisol

L-homoarginine

109
Q

Inhibits bone isoenzyme of ALP

A

2M urea

110
Q

Inhibits Nagao isoenzyme of ALP

A

L-leucine

111
Q

Denatures liver ALP rapidly than bone

A

20% ethanol

112
Q

Denatures liver ALP rapidly than bone

A

20% ethanol

113
Q

Inhibits placental, intestinal, Regan and Nagao

A

L-phenylalanine

114
Q

Inhibited by 2% formaldehyde solution of 1 mM curpric sulfate solution
Nonspecific acid phosphatase

A

Erythrocytic Acid phosphatase

115
Q

Inhibited by L-tartrate

Specific acid phosphatase

A

Prostatic Acid Phosphatase

116
Q

Specimen Considerations for G6PD

A

Red cell hemolysate - enzyme deficiency

Serum - enzyme elevation

117
Q

Another name for ACE (angiotensin converting enzyme)

A

Kininase II and peptidyl-dipeptidase (conversion occurs in the lungs)

118
Q

Main tissue sources of Angiotensin-Converting Enzyme

A

Macrophages and epithelioid cells

119
Q

Clinical diseases associated with elevated ACE (4)

A

Sarcoidosis
Disorders involving macrophage (Gaucher’s disease)
Leprosy
Indicator of Alzheimer’s

120
Q

Specimen considerations for ACE

A

Serum samples should be frozen for transport

121
Q

Type of cholinesterase present in plasma and liver

A

Pseudocholinesterase

122
Q

Type of cholinesterase present in nerve endings and erythrocytes

-detected in amniotic fluid for assessment of neural tube defects (spina bifida and anencephaly)

A

True cholinesterase (Acetylcholinesterase)

123
Q

Another name for amylase

A

Diastase

124
Q

Salivary amylase (migrates fastest to the anode)

A

Ptyalin

125
Q

Pancreatic amylase (migrates slowest to the anode - cathodal)

A

Amylopsin

126
Q

Anticoagulant of choice for electrolyte analysis

A

Heparin

127
Q

Another name for Hyperaldosteronism

A

Conn’a disease

128
Q

Sodium ion-selective electrode

A

Glass aluminum silicate

129
Q

Flame emission photometry internal standard for Na and K

A

Lithium or Cesium (Cesium is presently used)

130
Q

Flame Emission Photometry wavelength for Na and color

A

590 nm (yellow)

131
Q

Flame Emission Photometry wavelength for K and color

A

768 nm (violet)

132
Q

Ion selective electrode for K

A

Valinomycin membrane

133
Q

Ion selective electrode for K

A

Silver Wire Coated with AgCl

134
Q

Principle of Amperometric-Coulometric Titration for Cl

A

Cotlove chloridometer

135
Q

Principle for Mercuric titration of Cl

A

Schales and Schales Method

136
Q

Another for Colorimetric method for Cl

A

Method of Skeggs (autoanalyzer)

137
Q

Second most abundant intracellular cation after Potassium

And fourth most abundant cation

A

Magnesium

138
Q

As the osmolality increases

What decreases and increases

A

Increase (boiling point and osmotic pressure)

Decrease (freezing point and vapor pressure)

139
Q

Insoluble storage form of iron

A

Hemosiderin

140
Q

Steps in Iron measurement

A

ARC

Acidification
Reduction
Colorimetry

141
Q

Extreme form of copper deficiency characterized by kinky or steely hair, and invariably fatal, progressive brain disease.

A

Menke’s disease

142
Q

Another name for Vit. E and associated deficiency

A

Tocopherol

def = mild hemolytic anemia

143
Q

Another name for Vitamin B1

And def

A

Thiamine

Def = beriberi and Wenicke-Koreakoff Syndrome

144
Q

Another name for Vitamin B2

A

Riboflavin

145
Q

Another name for Vitamin B3

And deficiency

A

Niacin or nicotinic Acid

Def: Pellagra

146
Q

Another name for Vitamin B5

A

Pantothenic acid

147
Q

Another name for Vitamin B6

A

Pyridoxine

148
Q

Another name for Vitamin B7

A

Vitamin H or Biotin

149
Q

Another name for Vitamin B9

A

Folic acid / Pterylglutamic acid

150
Q

Calibration of centrifuges is done every

Disinfection ?

A

3 months or quarterly

Disinfection is done every week

151
Q

Measure of central tendency -

Measure of scatter /dispersion -

A

Measure of central tendency - mean, median (skewed), mode (two centers or bimodal)
Measure of scatter /dispersion -
SD, CV, variance

152
Q

Range for ultraviolet light -
Range for infrared light ー
Range for visible light -

A

Range for ultraviolet light - 4-400
Range for infrared light ー700-0.3cm
Range for visible light - 400 -700

153
Q

Type of conjugated bilirubin bound to albumin

A

Delta bilirubin

Clinical Chemistry (2 decks)

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