CC 1 Flashcards
Standard clinical specimen for glucose
Fasting (8-10 hrs) venous plasma
Which specimen has greater glucose
Arterial> capillary > venous
Gray fop tubes composition
Sodium fluoride (2 mg) antiglycolytic Potassium oxalate (2 mg) anticoagulant
What enzyme can fluoride inhibit
Enolase (fluoride binds to magnesium)
CSF glucose concentration
60-70%
To convert whole blood glucose to serum or plasma (multiply by ____)
1.15
Hyperglycemia leads to (sodium)
Hyponatremia
Most common glycogen storage disorder and enzyme deficient
Von Gierke dss (deficient in glucose-6 phosphatase)
Essential amino acids
PVTTIMLL
Phenylalanine Valine Threonine Tryptophan Isoleucine Methionine Leucine Lysine
pH where proteins have no net charge
Isoelectric point
Ion that has two differing charges but the net charge on the molecule is zero
Zwitterion
Carbohydrate digestion
Begins in the mouth (salivary amylase -ptyaline) Skips stomach (acidic pH prevents digestion) Continues in the small intestine (pancreatic amylase)
Protein digestion
Begins in the stomach and completed in the small intestines
Enzyme responsible for protein digestion in the stomach
Pepsin
Another name for prealbumin
Transthyretin
2nd most predominant protein in the CSF
- carrier protein for thyroid hormones and vitamin A
Prealbumin
Marker for cystic fibrosis
Albumin
Majority of alpha-2 globulins
Alpha-2-macroglobulin
Carrier for steroid hormones
Alpha-1-acid glycoprotein
AFP amount in down syndrome and neural tube defect
Down Syndrome (decrease) Neural tube defect (elevated)
Another name for transferrin
Siderophilin
Soluble storage form of iron
Ferritin
How to measure fibrinogen
Parfentjev method (ammonium sulfate and sodium chloride) was
Associated with Alzheimer’s disease
Alpha-1 antichymotrypsin
Albumin:Globulin ratio
1:3
How to measure Bence Jones Protein
Immunofixation
Preferred specimen for protein
Serum
How to get protein content by nitrogen alone? Mulitply by
6.25 (others 6.54)
Reference method for protein determination
Kjeldahl method
Most widely used method for protein determination
Biuret reaction
Molecule that forms when urea (end product of protein metabolism) is heated at 180 deg C
Biuret (2 molecules of urea)
Reagents for biuret rxn
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)
Wavelength for Biuret Rxn
540 nm (same as bilirubin)
Most sensitive for Protein determination
Lowry (Folin-Ciocalteu) Method
Most commonly used dye for proteins determination
Bromcresol green
Most sensitive, specific and precise among the dye-binding assays for protein determination
Bromcresol purple
Dye for amino acids
Ninhydrin
Dye used in urine reagent strip (sensitive to albumin)
Tetrabromphenol blue
Electrophoresis protein pattern seen in patients with liver cirrhosis caused by an increase in IgA
Beta-gamma bridging effect
Electrophoresis pattern seen in cases of monoclonal gammopathy (multiple myeloma, Waldenstrom’s macroglobulinemia)
Gamma spike
Electrophoresis pattern seen in patients with nephrotic syndrome
Alpha 2 macroglobulin elevation with albumin decrease
Electrophoresis pattern seen in patients with emphysema
Alpha-1 antitrypsin deficiency
Use of plasma instead of serum during electrophoresis
Increased beta region
Electrophoresis pattern seen in acute inflammations
Low albumin
High alpha-1 and alpha-2 region
Reference range for protein and albumin
Protein 6.5-8.3 g/dL
Albumin 3.5-5.5g/dL
Conversion factor for protein g/dL to g/L
10
NPNs according to concentration
Urea (45%) > amino acids (25%)> uric acid (10%) > creatinine (5%) > creatine (1-2%) > ammonia (0.2%)
Conversion factor BUN to Urea
2.14
Urea concentration to BUN conversion factor
0.4673
Occurs when monosodium urate precipitates from supersaturated body fluids
Gout
Deposits of uric acid crystals as sodium urates in great toe, ear lobe, elbow and in other tissues
Tophi
Reference value for BUA
3.5 - 7.2 mg/dL
Conversion factor BUA mg/dl to umol /L
0.0595
What amino acids are synthesized to form creatine
MGA
Methionine
Glycine
Arginine
Primary site of ammonia production
Small intestine
Specimen for ammonium determination and considerations
EDTA plasma or heparinized plasma (placed immediately on ice bath and analyzed immediately)
Another name for triglycerides (2)
Triacylglycerol
Neutral fats/lipids
Unlike other lipids, it is not readily catabolized by most cells and therefore does not serve as source of fuel
Cholesterol
Composed of cholesterol ring and a fatty acid (hydrophobic)
- 60-70% of cholesterols
Cholesterol esters
Cholesterol ring only, no fatty acids attached (30-40%) - hydrophilic
Free cholesterol
Unsaturated fatty acids are usually in what form
Cis form
What apolipoprotein activates LCAT
Apo A-I and
Apo -D
Homologous to plasminogen (may be prothrombotic)
Apo (a) - Lp (a)
Also known as the sinking prebeta lipoprotein
Lp(a)
Found in the LDL density (ultracentrifugation) but
Moves in the pre-beta region during electrophoresis
Lp(a)
Also know as the floating Beta lipoprotein - VLDL that is richer in cholesterol than triglycerides
- seen in patients with type III -hyperlipoproteinemia
Beta-VLDL (apo E-III deficiency)
Found in the VLDL density range but migrates electrophoretically with or near LDL
Beta-VLDL
Abnormal lipoprotein rich in lipids, primarily unesterified cholesterol and phospholipids
- found patients with obstructive biliary disease
- migrates towards the cathode during electrophoresis
Lpx
Reference method for lipoprotein analysis
And the unit of sedimentation rate
Ultracentrifugation
Unit: Svedberg Unit
General term for the thickening and hardening of arteries
Arteriosclerosis
Type of arteriosclerosis due to the hardening of arteries caused by plaque (made up of cholesterol, fatty substances, cellular waste products, calcium and fibrin)
Artherosclerosis
Also known as Tangier’s disease (HDL deficiency) due to the mutation of ABCA1 gene
Analphalipoproteinemia
Another name for abetalipoproteinemia (deficiency of B48 and B100) and presence of acanthocytes in peripheral blood smear
Bassen-Kornzweig Syndrome
HDL deficiency or the fish eye disease
LCAT deficiency
Defective hepatic uptake of bilirubin
Gilbert Syndrome
Defective conjugation of bilirubin due to deficiency of enzyme UDPGT
Crigler-Najjar Syndrome
Type 1 - total UDPGT def
Type 2 - Partial UDPGT def
Defective hepatic excretion of bilirubin (dark pigmentation of the liver) with associated abnormal gall bladder function
Increased serum B2
Dubin-Johnson Syndrome
Defective hepatic excretion of bilirubin, no liver pigmentation, normal gallbladder function
Rotor Syndrome
Presence of circulating antibody against UDPGT
Lucey-Driscoll Syndrome
Bicarbonate-carbonic acid ratio
20:1
Low oxygen levels in the blood
Hypoxemia
Low oxygen levels in tissues
Hypoxia
What is the coenzyme for creatine kinase reaction
What is the activator
Coenzyme-cysteine
Cofactor - magnesium (metallic)
Coenzyme for dehydrogenase reactions
NADP/NADPH, NAD/NADH
Coenzyme for transaminase reaction
Pyridoxal (vit B6) phosphate
Activator for amylase (metallic and nonmetallic)
Calcium (metallic)
Chloride (nonmetallic)
Metallic cofactor for lactate dehydrogenase
Zinc
Rate depends on substrate concentration
First order reaction
Rate does not depend on substrate concentration, rate depends only on enzyme concentration
Zero Order Kinetics
Inhibitor binds to the active site (substrate and inhibitor compete for the same binding site)
Reversible by addition or more substrate
Competitive inhibition
Inhibitor binds to enzyme other than the active site (allosteric site)
May be reversible or irreversible
Addition of subject has no effect (cannot reverse)
Noncompetitive Inhibition
Inhibitor binds to the enzyme substrate complex
More ES complex increases inhibition
Uncompetitive inhibition
Micromole of substrate per minute, also known as U/L
International unit (MMM)
Mole of substrate per second
Katal Unit (MSS)
Reaction is measured and stopped at a specific time (assumed to be linear)
Fixed time (static or two point) assay
Multiple measurements usually of absorbance change (substrate product per minute)
-preffered, more accurate to measure deviations
Multipoint Continuous Monitoring (Kinetic Assays)
Method to measure enzyme activity which requires a large amount of substrate and longer incubation time
Spectrophotometric (colorimetric)
Measures pressure of gases and vapor (evolution of gas or disappearance of gas as the reaction proceeds)
Manometry
Concentration of Lactate dehydrogenase isoenzymes (highest to lowest)
LD 2>1>3>4>5
Electrophoresis if LDH isoenzymes
Origin LD 5,4,3,2,1 (Anode)
Lactate dehydrogenase isoenzyme that are cold labile fractions
LD4 and LD5
LD flip (LD1>LD2) is oftentimes associated with
AMI
Highest elevation of LDH seen in
Megaloblastic anemia
Electrophoresis of ALP isoenzymes
Electrophoresis (origin towards the anode) - IPBL
INTESTINAL - PLACENTAL - BONE - LIVER
Heat denaturation of ALP isoenzymes
PLACENTAL - INTESTINAL - LIVER - BONE
PILB
Most heat stable of all the NORMAL ALP isoenzymes
Placental ALP
Most heat stable among all the types of ALP
Regan ALP
inhibits liver and bone isoenzymes for ALP
Levamisol
L-homoarginine
Inhibits bone isoenzyme of ALP
2M urea
Inhibits Nagao isoenzyme of ALP
L-leucine
Denatures liver ALP rapidly than bone
20% ethanol
Denatures liver ALP rapidly than bone
20% ethanol
Inhibits placental, intestinal, Regan and Nagao
L-phenylalanine
Inhibited by 2% formaldehyde solution of 1 mM curpric sulfate solution
Nonspecific acid phosphatase
Erythrocytic Acid phosphatase
Inhibited by L-tartrate
Specific acid phosphatase
Prostatic Acid Phosphatase
Specimen Considerations for G6PD
Red cell hemolysate - enzyme deficiency
Serum - enzyme elevation
Another name for ACE (angiotensin converting enzyme)
Kininase II and peptidyl-dipeptidase (conversion occurs in the lungs)
Main tissue sources of Angiotensin-Converting Enzyme
Macrophages and epithelioid cells
Clinical diseases associated with elevated ACE (4)
Sarcoidosis
Disorders involving macrophage (Gaucher’s disease)
Leprosy
Indicator of Alzheimer’s
Specimen considerations for ACE
Serum samples should be frozen for transport
Type of cholinesterase present in plasma and liver
Pseudocholinesterase
Type of cholinesterase present in nerve endings and erythrocytes
-detected in amniotic fluid for assessment of neural tube defects (spina bifida and anencephaly)
True cholinesterase (Acetylcholinesterase)
Another name for amylase
Diastase
Salivary amylase (migrates fastest to the anode)
Ptyalin
Pancreatic amylase (migrates slowest to the anode - cathodal)
Amylopsin
Anticoagulant of choice for electrolyte analysis
Heparin
Another name for Hyperaldosteronism
Conn’a disease
Sodium ion-selective electrode
Glass aluminum silicate
Flame emission photometry internal standard for Na and K
Lithium or Cesium (Cesium is presently used)
Flame Emission Photometry wavelength for Na and color
590 nm (yellow)
Flame Emission Photometry wavelength for K and color
768 nm (violet)
Ion selective electrode for K
Valinomycin membrane
Ion selective electrode for K
Silver Wire Coated with AgCl
Principle of Amperometric-Coulometric Titration for Cl
Cotlove chloridometer
Principle for Mercuric titration of Cl
Schales and Schales Method
Another for Colorimetric method for Cl
Method of Skeggs (autoanalyzer)
Second most abundant intracellular cation after Potassium
And fourth most abundant cation
Magnesium
As the osmolality increases
What decreases and increases
Increase (boiling point and osmotic pressure)
Decrease (freezing point and vapor pressure)
Insoluble storage form of iron
Hemosiderin
Steps in Iron measurement
ARC
Acidification
Reduction
Colorimetry
Extreme form of copper deficiency characterized by kinky or steely hair, and invariably fatal, progressive brain disease.
Menke’s disease
Another name for Vit. E and associated deficiency
Tocopherol
def = mild hemolytic anemia
Another name for Vitamin B1
And def
Thiamine
Def = beriberi and Wenicke-Koreakoff Syndrome
Another name for Vitamin B2
Riboflavin
Another name for Vitamin B3
And deficiency
Niacin or nicotinic Acid
Def: Pellagra
Another name for Vitamin B5
Pantothenic acid
Another name for Vitamin B6
Pyridoxine
Another name for Vitamin B7
Vitamin H or Biotin
Another name for Vitamin B9
Folic acid / Pterylglutamic acid
Calibration of centrifuges is done every
Disinfection ?
3 months or quarterly
Disinfection is done every week
Measure of central tendency -
Measure of scatter /dispersion -
Measure of central tendency - mean, median (skewed), mode (two centers or bimodal)
Measure of scatter /dispersion -
SD, CV, variance
Range for ultraviolet light -
Range for infrared light ー
Range for visible light -
Range for ultraviolet light - 4-400
Range for infrared light ー700-0.3cm
Range for visible light - 400 -700
Type of conjugated bilirubin bound to albumin
Delta bilirubin