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1
Q

Aldosterone secreting ADRENAL ADENOMA

A

Cohns syndrome

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2
Q

Hereditary - dec. bilirubin transport

A

Gilberts syndrome

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3
Q

Hereditary - Deficiency w/ UDPT

A

Crigler najar (uridine diphosphate glucorynyl transferase)

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4
Q

Acromegaly

Screening
Confirmatory

A

Screening: Somatomedin C/IGF-1 (insulin glucose factor)
Confirmatory: 2hr-OGTT

N: 350mg/dl
> - Type 1 (severe)
< - Type 2 (less)

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5
Q

Treatment for Crigler najar 2

A

Phenobartital

Type 1
1. Transplant
2. Phototherapy

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6
Q

Condition: IBIL - >20mg/dl

A

Kernicterus (brain dmge)

<20mg/dl - Ictericia = yellow skin, serum
Total bili - 2-3mg/dl (34.2-51.3 umol/l) = Jaundice

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7
Q

Gel electrophoresis buffer
1. Negative
2. Positive

A
  1. Barbital buffer (alk)
  2. Citric accid (acd)
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8
Q

GE:
1. Large DNA
2. Small DNA

A
  1. Agarose (gellidium red algae)
  2. Polyacryl amide
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9
Q
  1. Protein malnutrition suffered mostly by displaced child
  2. Protein and carbohydrate deficiency
A
  1. Kwashiokor
  2. Marasmus

Treatment for Marasmus
* Refeeding syndrome - liquid to solid food (death if solid first)

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10
Q

Driving force of HCO3 buffer sys

A
  1. CO2
  2. Carbonic anhydrase
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11
Q

Only dec in DM

A
  1. HCO3
  2. Blood pH
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12
Q

Important in electrolyte, volume, homeostasis regulates thur inc. NA2+ excretion

A

Atrial natriuretic factor (ANF)

3 neurohormones
* atrial natriuretic
* b type natriuretic peptide -brain
* c type natriuretic peptide -long bones

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13
Q

Electrolyte for
1. Prod. and use of atp from glucose
2. Replication DNA and translate mRNA
3. ATPase ion pump

A

Mg2+

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14
Q

Source of T4 and Caticholamines

A

Tyrosine

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15
Q

Troponin
1. C
2. I
3. T

A
  1. Calcium binding
  2. Inhibitory protein
  3. Tropomyocin binding protein
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16
Q

Long stress hormones that may lead to cushing syndrome

A

Cortisol

Inc. during stress and morning

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17
Q

Circardian variation (24hrs cycle) it involves:

A

Liver enzymes: AST, ALT, GGT, AAP (Acetaminophen)

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18
Q

Extra pts

PAMET HYMM
1. Music
2. Script

A
  1. Francis jerota pefanco
  2. Hector gentapanan gayares, jr.
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19
Q

Type of glass used in PYREX, KIMAX

A

Borosilicate

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20
Q

Type of glass used in COREX

A

Aluminosilicate

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21
Q
  • tolerates heat but clouds and scartch with alkali
A

borosilicate

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22
Q

6x stronger with borosilicate thus, R with scatching in alkali

A

aluminosilicate

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23
Q

a boron free glass - used with strong acids and alkali only

A

soft glass

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24
Q

a soda lime glass - cheapest, for disposable and cause error due to alkali

A

flint glass

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25
Q

amber glass thus reduces light transmission

A

low actinic glass

BOALS type F

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26
Q

Excellent temperature and chemical resistance - glass

A

Teflon
Polytetrafluoroethylene

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26
Q

R to chemicals and used for tips and tubes

A

Polypropylene

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26
Q

R to chemicals but not to concentrated acids. for disposable transfer pipets

A

polyethylene

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27
Q

Stonger than polypropylene but not for chemical use and it has better temperature tolerance

A

polycarbonate

ppt = can autoclaved

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27
Q

rigid and clear for test tubes and graduated

A

polystyrene

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28
Q

soft and flexible but porous and is used for tubing

A

polyvinyl cl

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29
Q
  • transfer pipets
  • self drain
  • single mark
  • for nonviscous
A

volumetric (most accurate)

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30
Q
  • transfer pipets
  • blow out
  • single mark
  • for viscous
A

ostwald folin

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31
Q
  • graduated pipets
  • to tip
  • serial dilution
A

serologic

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32
Q
  • graduated pipets
  • between 2 marks
  • serial dilution
A

mohr

BO - has etched rings

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33
Q
  • air cushion between piston
  • air displaced = vol of liquid
  • for aqueous
A

air displacement pipettes

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34
Q
  • direct contact w/ samples
  • aspiration force constant
  • for viscous/high density
A

positive displacement pipettes

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35
Q
  • for body fluid cell ct/csf
  • 200-2k rpm
A

cytocentrifuge

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36
Q
  • std prep
  • high degree of accuracy and precision
  • 2/more purification: distiliiation, deionization, reverse osmosis, filtration
A

type 1 water

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37
Q
  • rgt prep
  • gen. lab test
A

type 2 water

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38
Q

```

  • for quali tests
  • washing glassware
A

type 3 water

final wash with type 1 or 2

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38
Q
  1. decontamination of body fluids
  2. contact time
  3. inactivation of hbv
  4. inactivation of hiv
A
  1. 5.25% or 10%sodium hypochlorite
  2. 20 mins
  3. 10mins
  4. 2mins
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38
Q

best indicator of precision - inverse rs

A

CV

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39
Q

nrl for cc

A

lung center of the ph

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39
Q

aka reproducibility

A

precision

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40
Q

2 controls every 24hrs for 20 days

A

internal/intralab qc

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41
Q

loss of precision due to deviating control values by random and systematic error

A

outliers

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42
Q
  1. simplest approach in lab quality mgmt
  2. to conitnually improve practices
  3. to reduce test errors or defects
  4. reduce waste to improve tat
A
  1. pdca/deming cycle
  2. cqi
  3. six sigma
  4. lean
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42
Q

inhibits urease and uricase - false dec in bun and uric lvls

A

sodium fluoride

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42
Q

length for lancet

A

1.75mm

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43
Q

tube/preservative that is affected by light also it prevent plt activation

A

dipyridamole in ctad

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44
Q

Measurement of the amount of light from a specific wavelength of the electromagnetic wavelength

A

spectrophotometry

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45
Q
  1. 2 cuvets are struck by light at the same time; 2 photodetectors
  2. 1 photodetector; light is alternately passed
    through the sample and the reference cuvet by using a chopper
A
  1. Double-beam-in-space
  2. Double-beam-in-time
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46
Q
  1. gamma counter; ligands labelled with iodine 125 or iodine 131
  2. beta counter; ligands labelled with hydrogen 3 of carbon 14
A
  1. crystal scintillation
  2. liquid scintillation
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47
Q

used in therapeutic drug monitoring (specially for immunosuppressants)

A
  1. Microparticle capture enzyme immunoassay (MEIA)
  2. Fluorescence polarization immunoassay (FPIA)
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47
Q

measurement of immune
complexes (antigen-antibody
complexes)

A

turbidometry and nephelometry

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47
Q
  1. Gold standard for drug analysis
  2. IEM detection
  3. non-protein nitrogenous compounds
  4. biomolecules e.g. peptides and
    protein signatures, also used for microbial or bacterial identification
A
  1. gc-ms
  2. tandem im
  3. idms
  4. maldo tof ms
48
Q

 Symptoms of hypoglycemia
 Low plasma glucose level
 Relief of symptoms following correction

A

Whipple’s triad

49
Q

type 2 dm panic value for hyperglycemia

A

> 500mg/dl

50
Q

glycemic control over the past 2-3 weeks in cases when HbA1c is unreliable

A

fructosamine - glycosylated albumin

  • unreliable - <3gdl
  • ref. values - 205-285 umol/l
50
Q

Pre-prandial: 70-130 mg/dL
Post-prandial: < 180 mg/dL

A

wb glucose

Capillary blood glucose is higher than venous blood glucose by 2-5mg/dL

50
Q

Effect of dextrose contamination

A

10% contan, 5% dextrose, inc. pg by 500mg/dl

inc.
* 7 mg/dL/hour at room temperature
* 2 mg/dL/hour at 4oC (refrigerator temperature)

51
Q
  • hagedorn-jensen mtd
  • reverse colorimetry
A

ferric reduction

51
Q
  • folin wu
  • nelson somogyi
  • neocuprione
A

copper reduction

52
Q

what rxn in condensation is when intensity is proportional to glu conc

A

dubowski rxn

glucose with aromatic amines (ortho-toluidine)

53
Q
  • body’s major cholesterol carrier
  • transports a large amount of endogenous cholesterol
  • “bad cholesterol,”
  • increased risk for
    atherosclerosis (atherogenic).
A

LDL

normal: brings cholesterol to peripheral cells for membrane synthesis and formation of adrenal and reproductive hormones
abnormal: deposited in tissues

53
Q
  • formed in the intestines
  • apoproteins B-48, mainly
  • Transports dietary or exogenous TGs
A

chylomicrons

53
Q

cholestero esters (70%)

attachment of fatty acid to non-esterified cholesterol - catalyzed by

A

Lecithin cholesterol acyltransferase (lcat)

transfer of excess cellular cholesterol from peripheral tissues to the liver for excretion

53
Q

Highest conc in blood fromed in liver by co2 and ammonia. Major excretory product of metabolism of proteins and nitrogen containing chemicals

A

Urea

53
Q

screening test for galactosemia

A

clinitest

Newborn screen - inborn error of carbs metabolism

53
Q
  • synthesized in the intestine and liver cells
  • Reverse cholesterol transport
  • antiatherogenic effect
  • mainly apo a-1,2
A

hdl

54
Q
  • synthesized in the liver
  • apolipoproteins B-100, mainly
  • endogenous TGs
  • secreted into the blood by the liver for metabolism in peripheral tissues
A

vldl

IDLs carry endogenous triglycerides and cholesterol esters

54
Q

most common gsd; due to glucose6-phosphatase deficiency

A

von Gierke disease (GSD Type Ia)

under hepatic glycogenosis

54
Q

2 major isomers in plasma

A
  • b-d-glucose (65%)
  • a-d-glucose (35%)
54
Q

under glucose peroxidase

  • measures degree of O2 consumption using a pO2 (Clark) electrode
  • oxygen detected is inversely proportional to glucose
A

polarographic -amperometric

prevent reformation of
hydrogen from hydrogen peroxide (cime)
* catalase
* iodide
* molybdate
* ethanol

54
Q

An atherogenic because a significant part is transported to tissues and may be deposited there in excess amounts; bad cholesterol

A

LDL

remove by hdl

54
Q

reference method for protein analysis

A

ultracentrifugation

54
Q
  • cardiovascular disorders such as stroke, MI, CHD
  • Sinking pre-beta lipoprotein (apo a + b100)
  • Competes with plasminogen or plasmin core binding sites
A

lp(a)

54
Q
  • obstructive biliary disease and LCAT deficiency
  • Consists mostly of phospholipids and non-esterified cholesterol
A

lpx

54
Q
  • type 3 hyperlipoproteinemia
  • Floating beta-lipoprotein
A

b-vldl

54
Q
  • Absolute absence of Apo B-
  • mutated MTTP gene (chrom 4) with absolute nonexistent of apo B-48 and apo B-100
A

abetalipoproteinemia (bassen kornzweig syndrome)

54
Q
  • nonsense or missense mutation in the Apo-B gene
A

hypobetalipoproteinemia

55
Q

creatinine

  1. ref. values
  2. chemical mtd w/ rgt
  3. enzymatic mtd w/ rgt
A
  1. jaffe = 0.9-1.3mg/dl (m); 0.6-1.1mg/dl (f) ; enzymatic = 0.6-1.1mgdl (m); 0.5-0.8mg/dl (f)
  2. jaffe mtd - alkaline picrate (red orange tautomer)
  3. creatininase pod coupled (sarcosine oxidase), creatininase ck coupled (creatine phosphate)
55
Q
  • autosomal recessive
  • mutated abca1 gene
  • absence of hdl, apo a1,2
A

tangier dse

56
Q

urea

  1. ref value
  2. ref. mtd
  3. chem mtd w/ rgt
  4. enzyme mtd w/ rgt
A
  1. 6-20mg/dl
  2. idms
  3. fearon - diazine (yellow)
  4. Colorimetric = nesslerization - dimercuric ammonium iodide (yellow orange), berthelot - na nitropusside (blue)
    * gldh enzyme
    * conductimetric - inc. due to nh4+ and co32-
57
Q

absorbent used for jaffe mtd.

A
  1. lloyd’s rgt (na aluminum silicate)
  2. fuller’s earthy

Note: needs kinetic and the use of absorbent to inc. measurements of absroption. Absorbents will only bind to crea

58
Q
  1. bun crea ratio
  2. pre renal azotemia ratio
  3. renal/post renal azotemia ratio
  4. ratio for repeated dialysis, liver dse, low protein diet
A
  1. 10-20:1
  2. > 20:1 w/ normal creatinine
  3. <20:1 w/ elevated crea
  4. <10:1
59
Q
  1. catabolism of purines in nucleic acid or nucleoprotiens
  2. deposited in joints at what concentrations
A
  1. uric acid
  2. > 6.8 mg/dl
60
Q

uric acid

  1. chemical mtd
  2. enzymatic mtd
  3. ref. values
A
  1. phosphotungstic acid mtd - caraway, archibald, henry (blue)
  2. uricase mtd - (293nm)
  3. 3.5-7.2mg/dl(m); 2.6-6.0mg/dl (f)
61
Q
  1. catabolism of amino acids
  2. toxic compound metabolized in liver via
A
  1. ammonia
  2. krebs kenseleit or urea cycle
62
Q

ammonia

  1. chemical mtd
  2. enzymatic mtd
  3. ref. values
A
  1. potentiometric - ph measurements; colorimetric - nezzlerization, berthelot - bromphenol blue
  2. gldh mtd -glutamate
  3. 19-60ug/dl
63
Q

hyperammonia can be found in:

A
  1. reye syndrome
  2. hepato encephalopathy
64
Q

protein electrophoresis

  1. support media - pace
  2. stains used - c pal
  3. colorimeted designed to scan, quantitate the pattern
A
  1. polyacrylamide gel, agarose, cellulose acetate
  2. coomasie b. blue, ponceau s, amido black, lissamine green
  3. densitometer
65
Q
  1. pre albumin aka as
    2.better indicator of what condition
    3.binds and transprt what hormone and vit
    4.knowns as the 2nd most abundant protein in
A
  1. transthyretin/thyroxine binding pre albumin (tbpa)
  2. malnutrition
  3. t4, vit.a w/ retinol binding protien
  4. csf
66
Q
  1. major contributor to osmotic pressure also a general transport protein. Also most abundant plasma protein
  2. dec albumin - dec. osmotic pressure leads to
  3. Inc is only ass w/ what condition
A
  1. albumin
  2. edema and transudative effusion
  3. dehydration
67
Q
  1. from yolk sac and liver of fetus inc at 13 wks and declines at 34 wks
  2. measured at and reported as
A
  1. a-fetoprotein
  2. 15-20 wks ; multiples of median (mom)

Note:
* only inc in pregnant and in adult due to hepatocellular carcinoma and gonadal tumors

68
Q
  1. most abundant protein in alpha 1 band
  2. serves as inhibitor
  3. inhibited enzymes
A
  1. a1-antitrypsin
  2. proteolytic inhibitor
  3. plasmin, elastase, thrombin, collagenase, chymotrypsin (pet c2)

Note
* seen in repiratory tract, closed spaces (ph maintained) thus, deficieny in a1-antitrypsin is dec in pulmo dse, juvenile hepatic dsorders (cirrhosis)
* not effective in stomach and intestines
* deciency of a1-antitrypsin is asstd w/ serpina 1

69
Q
  1. it binds to progesterone and some drugs
  2. it has high carbohydrate content
  3. only dec in what condition
  4. what its unique characteristic
A
  1. a1-acid glycoprotein
  2. orosmucoid
  3. nephrotic syndrome
  4. neg charge even in acid pH

Notes
* inc in rheumatoid arthritis, pneumonia w/ cell proliferation conditions

70
Q
  1. also a protease inhibitor but a mild apr
  2. bind with what antigen
A
  1. a1-antichymotrypsin
  2. prostate specific antigen
71
Q
  • vit. d binding protein and has a role in calcium homeostasis
A

gc-globulin (dbp)

72
Q
  1. also a protease inhibitor but it is a largest non immunoglobulin protein
  2. in ten fold in what condition
  3. dec markedly in what condition
A
  1. a2-macroglobulin
  2. nephrotic syndrome and protein lose conditions
  3. acute pancreatitis

Note
* inc in pills

73
Q
  1. binds free hgb to preserve iron
  2. dec in wat condition due to formation of complex for removal by the liver
A
  1. haptoglobin
  2. intravascular hemolysis
74
Q
  1. copper binding protein
  2. dec in what condition due to copper accumulation in tissues such as cornea
A
  1. ceruloplasmin
  2. wilson’s dse

Note
* inc in pills
* alpha 2 - CHAM

75
Q

transports ferric form of iron. Also seen as inc. in presudoparaprotein, ida, and pregnancy

A

transferrin

76
Q
  • most abundant complement component
  • for immune response - classical and alternative pathways
A

c3 complement

77
Q

binds heme and conserve iron although hgb is broken down

A

hemopexin

78
Q
  • component of mhc/hla found on nucleated cells (lymphocytes)
  • measure gfr but unreliable if there’s inflammation/autoimmune dsrs
A

b2-microglobulin

notes
* inc. in sle

79
Q
  1. most sensitive positive acute phase reactant and most nonspecific marker of inflammation (inc. 1000x). it also enhances pahogocytosis and a gamma migrating beta globulin
  2. Refers to sensitivity of assay to determine low levels in serum
  3. Predictor for what condition including values
A
  1. c reactive protein
  2. high sensitivity crp (hs-crp)
  3. CV risk (low <1.0mg/l ; >3mg/l)

notes
* 0.3-8.6mg/l (m)
* 0.2-9.1mg/l (f)
* serum amyloid a - inc in inflam but later na, transport cholesterol

80
Q
  1. plasma proteins produced
  2. immoglobulins produced
A
  1. liver
  2. b cells (plasma cells)
81
Q
  1. extra band in beta and gamma region is due to
  2. extra band in beta/alpha 2 and beta region
A
  1. fibrinogen (plasma only)
  2. hemoglobin (due to hemolyzed serum)
82
Q

increase in what conditions

  1. igG
  2. igA
  3. igM
  4. igE
  5. igD
A
  1. collagen dse
  2. autoimune dse
  3. waldenstrom macroglobulinemia (bacterial, viral, fungal)
  4. allergies (asthma, hay, parasitic)
  5. connective tissue dsrdr

notes
* igG,igA,igD - inc in liver dsrdr, inxn

83
Q

conditions under hyperproteinemia

A
  1. monoclonal gammopathy - inc in total protein conc. inappropriate production of gamma globulins (igG.igM)
  2. MM - inc. igG
  3. waldenstrom macroglobulinemia - inc. igM (tall gamma, low albumin)
  4. dehydration
84
Q

urinary proteins

  1. Glomerular dysfunction can be detected in its early stages by measuring
  2. test mtd (Cbb BTS)
  3. ref val for urine total protein
  4. ref val for urine albumin
A
  1. microalbumin
  2. coomasie brilliant blue, nezethonium chloride, trichloroacetic acid, sulfosalicylic acid
  3. 1-14mg/dl ; <100mg/dl
  4. <30mg/day
85
Q
  1. ultrafiltrate of plasma formed in ventricles of brain
  2. ref value
A
  1. csf
  2. 15-45mg/dl

same test performed w/ urinary proteins

86
Q
  • found in skeletal and cardiac muscles
  • primary oxygen carrying protein - it contains heme
  • nonspecific marker for MI -next to trop (rule out mi)
  • a negative predictor for first 2-4 hrs after chest pain

MISCELLANEOUS PROTEINS:

MC and NC are BF ACla NAH

A

myoglobin

87
Q

myoglobin is released in AMI
1. rising
2. peaking
3. normal

A
  1. 1-3hrs
  2. 5-12hrs
  3. 18-30hrs

ref value
* 30-90mg/dl (m)
* <50mg/dl (f)

88
Q
  1. gold std for acute coronary syndrome/mi
  2. used as an ami indicator
  3. what complex binds to filaments of skeletal and cardiac muscles to regulate muscle contraction
A
  1. cardiac troponins
  2. trop I, trop T
  3. trop I,T,C

  • T inc first and has an early peak but I returns to normal first and also it has greater cardiac specificity
  • ref values varies
89
Q
  1. synthesized in and secreted from
    myocardial ventricles in response to ventricular volume expansion and
    pressure overload
  2. specimen needed
  3. ref value
  4. assay that measures N terminal proBNP (NT-proBNP)
A
  1. b type natriuretic peptide
  2. heparinized plasma
  3. <100pg/ml
  4. proBNP - electrochemiluminescence principle (no interference from nesiritide (human recombinant bnp) - treat congestive heart failure (cnf))
90
Q
  • endogenous marker of gfr
  • for px not amendable to urinate for 24hr collection
A

cystatin c

91
Q
  • potentional gfr marker
  • correlates w/ cystatin c and urine microproteins (b2 microglobulin)
A

b trace protein

92
Q
  1. marker for nutritional status
  2. predict the risk of premature delivery because it is a normal constituent in placenta and amniotic fluid
A
  1. fibronectin (fn)
  2. fetal fn
93
Q
  • biochemical marker of bone resorption in serum and urine
  • proteolytic fragments of collagen I
A

cross linked c telopeptides

94
Q

biomarker for alzheimer’s dse

A

neural thread protein

95
Q
  1. insoluble protein aggregates due to altered b-pleated sheets. Deposited in tissue
  2. tests that aids in differential diagnosis of alzhaimer’s dse from other dementia
A
  1. amyloid
  2. amyloid b42, tau protein
96
Q
  • inc cause damage to arterial walls that precedes formation of plaques
  • indicator of arterial inflammation
A

homocyteine

97
Q
  1. ref mtd for nitrogen
  2. ave nitrogen content of protein
  3. rgt for digestion process that coverted nitrogen to ammonium ion
A
  1. kjeldhal mtd
  2. 16%
  3. sulfuric acid
97
Q

```

measurement based on velocity of light - bended light direct proportional to solute (protein) in water (serum)

A

refractometry

97
Q
  • for csf protein analysis

buffed used
1. csf
2. urine
3. automated mtd

A

turbidimetry

  1. trichlotoacetic acid
  2. sulfosalicylic acid
  3. benzalkonium chloride
97
Q

Wat condition is pre hepatic. Hemolytic dsrds is seen and inc in urobilinogen due to failure of transport

A

unconju hyperbilirunemia (inc unconju, n conju)

98
Q
  1. combine copper sulfate, potassium iodide in sodium hydroxide, and potassium sodium tartrate
  2. detect peptide bonds form violet - direct prop
A
  1. biuret rgt
  2. biuret mtd
99
Q

more sensitive than biuret; oxidizes phenolic compounds in proteins via phosphotungstomolybdic acid form blue

A

FOLIN-CIOCALTEAU (LOWRY) METHOD

100
Q

mtd that forms violet when amino and peptides are present

A

ninhydrin mtd

100
Q
  1. dye for total protein (CAP)
  2. dye for albumin - routinely performed (BB 2M)
A
  1. coomassie b. blue (sensitive), amido black, ponceau s
  2. bromocresol purple (sensitive), bromocresol green (common), 2,4haba (less), methyl orange (non)
100
Q

Notes

  • a/g ratio = alb / tp - alb
  • low a/g = either dec. alb or inc. glob
  • monoclonal gammopathy - dec. a/g, inc. glob, inc tp
  • ns, ple, liver dse - dec a/g, dec alb, dec tp
  • mm - inc ap, low a/g
A
101
Q

Note
* B1 is related to kernicerus because it is a unconjugated bili which means toxic and if inc it may cross to BBB. Produced from senescent of erythrocytes
* B2 is post hepatic, conjugated, soluble, direct (indirect need solubilizer to react w/ diazo) and is excreted in urine

A
101
Q
  1. conjugated bilirubin aka
  2. enzyme converts unconjugated bilirubin in smooth endoplasmic reticulum of the liver
A
  1. bilirubin diglucoronide
  2. udpgt - urine diphosphate glucuronyl transferase
102
Q

isoenzyme under amylase

A
  • pancreatic amylase
  • salivary amylase - wheat germ lectin (inhibited)
102
Q
A
102
Q
A
102
Q
A
102
Q
A
102
Q
A

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