CC Flashcards
Microhematocrit:
10,000 g for 5 minutes
Standing plasma test:
creamy layer (chylomicrons); turbid(VLDL)
neuromotor irritability accompanied by muscular twitching and eventual convulsions; generally due to low calcium levels (hypocalcemia)
TETANY
Nanometer is also
millimicron
Most important androgen in terms of potency and amount is
testosteronen (Marshall)
Conn syndrome:
primary aldosteronism
: male-pattern hair growth in women; most common cause is PCOS (polycystic ovary syndrome, Marshall)
Hirsutism
• Decreased testosterone
• Increased LH and FSH
Primary male hypogonadism
Decreased testosterone
Decreased LH and FSH
Secondary male hypogonadism
early morning before the patient has eaten or become physically active. This is a good time to draw blood specimens because the is at rest and food has not been ingested during the night.
BASAL STATE
: substance than can yield a hydrogen ion or hydronium ion when dissolved in water
ACID
substance than can yield hydroxyl ions (OH-)
BASE
properties of osmotic pressure, freezing point, boiling point and vapor pressure
COLLIGATIVE PROPERTIES
. compare accuracy, mean (TAM)
t-test
compare precision, SD (SPF)
f-test
1:2SD, 1:3SD, R:4S (ODD NUMBERS)
Random error
2:2SD, 4:1SD, 10:x (EVEN NUMBERS)
Systematic error
: reaction rate is dependent on enzyme concentration only
ZERO-ORDER KINETICS
thickening or hardening of the walls of arteries
Arteriosclerosis
accumulation of lipid in the veins and arteries
Atherosclerosis
: elevated urea in blood (Turgeon: urea and creatinine)
Azotemia
: deficiency of adrenocortical hormones
Addison’s disease
: aldosterone secreting adrenal adenoma
Conn’s syndrome
: excessive production of glucocorticoids (cortisol)
Cushing’s syndrome
: tumors of the adrenal medulla or symphatetic ganglia that produce and release large quantities of catecholamines
Phaeochromocytoma
: cessation of menstruation
Amenorrhea
Greek work YELLOW; irreversible scarring process by which normal liver architecture is transformed into abnormal nodular architecture
Cirrhosis
hereditary disorder in which there is DECREASED BILIRUBIN TRANSPORT into the hepatocytes.
Gilbert’s syndrome
hereditary DEFICIENCY of the UDPG-TRANSFERASE ENZYME
Crigler-Najjar syndrome:
is associated with increased plasma conjugated bilirubin, inborn error of metabolism
Dubin-Johnson syndrome
possibly of viral origin, where there is also a block in the excretion of conjugated bilirubin but without liver pigmentation
Rotor syndrome
is bilirubin but defect a of copper transport from the liver resulting in overload of copper in liver and brain
Wilson’s disease
is an X-linked recessive disorder in which defective transport of copper from mucosal cells results in copper deficiency
Menkes disease
chronic autoimmune thyroiditis; it is the most common cause of primary hypothyroidism
Hashimoto’s thyroiditis
diffuse toxic goiter
Graves’ disease
: chronic protein deficiency under conditions of adequate non–protein calorie intake, which leads to marked hypoalbuminemia; may result from the net loss of albumin from both the intravascular and extravascular pools
Kwashiorkor
: a deficiency of calories with adequate protein status. In this condition; the serum albumin level remains normal despite considerable loss of body weight
Marasmus
cells of the testicles that produce testosterone
Leydig cells
: basic pipet
GLASS PIPET
for glucose testing and for other assays are used frequently in many health care facilities for bedside testing, or point-ofcare testing (POCT)
CAPILLARY BLOOD SAMPLES
hormone produced by the hypothalamus to regulate water reabsorption in the COLLECTING DUCT
ANTIDIURETIC HORMONE
regulates flow of blood to and within the kidneys by responding to changes in blood pressure and plasma sodium content
RENIN-ANGIOTENSIN ALDOSTERONE SYSTEM
: abrupt change in the mean of a series of results
SHIFT
: gradual change in one direction of the mean of a control substance
TREND
: institutional policy to provide customer satisfaction
TOTAL QUALITY MANAGEMENT (TQM)
program that focuses on satisfaction and expectations institutional customer
CONTINUOUS QUALITY IMPROVEMENT (CQI):
light scattered at an angle of less than 90 degrees, which indicates the SIZE OF A CELL
FORWARD angle light scatter
: light scattered at 90 degrees in a flow cytometer that indicates the GRANULARITY OF A CELL
SIDE ANGLE, right angle light scatter
measures TOTAL IgE
RADIOIMMUNOSORBENT TEST (RIST):
measures ANTIGEN-SPECIFIC IgE
RADIOALLERGOSORBENT TEST (RAST):
DRIVING FORCE of the bicarbonate buffer system is
CARBON DIOXIDE.
time from ordering a test through analysis in the laboratory to the charting of the report.
TURNAROUND TIME (TAT)
should be labeled with a description of their particular hazard, such as POISONOUS, CORROSIVE OR CARCINOGENIC.
Hazardous chemicals
Information contained in the ________________includes the following: and physical chemical characteristics, fire and explosion potential, reactivity potential, health hazards and methods for safe handling.
Material Safety Data Sheets (MSDS)
In pancreatic adenocarcinoma, 96% of tumors with CA 19-9 levels ________ are considered UNRESECTABLE (cannot be removed completely through surgery)
> 1,000 U/mL
: individual facility COMPARE ITS RESULTS WITH THOSE OF ITS PEERS
BENCHMARKING
_________average value
________most frequently occurring value
_________middle value within range
MEAN
MODE
MEDIAN
CONSTANT systematic error
y - intercept
PROPORTIONAL systematic error -
PRO siya mag SLOPE
SLOPE
Blood should NEVER be drawn from a vein in an arm with a __________ (temporary dialysis access device) or ________ (a permanent surgical fusion of a vein and an artery).
CANNULA; FISTULA
Glassware CLEANING SOLUTION:
ACID DICHROMATE
Lamp used in AAS
HOLLOW CATHODE LAMP
Gaussian (normal) distribution:
Mean = median = mode
Material with physical and chemical properties closely resembling the test specimen and containing preanalyzed concentrations of the substances being measured:
CONTROL
Material of known composition available in a highly purified form:
STANDARD
Sodium FLAME
YELLOW
Lithium produces a flame
Red
Potassium a flame
Violet
Rubidium a flame
Red
Magnesium a flame
blue
Reliable index of intestinal carbohydrate absorption:
D-XYLOSE
Condensation of glucose with aromatic amine in hot glacial acetic acid solution to produce a green-colored product:
O-TOLUIDINE
REFERENCE METHOD for glucose:
HEXOKINASE
Split in the albumin band:
BISALBUMINEMIA
Compound normally found in urine that may be used to assess the completeness of a 24-hour urine collection:
CREATININE
Myocardial infarction:
CK then AST then LD
Specimen of choice for analysis of acid-base disturbances:
ARTERIAL BLOOD
Anticoagulant of choice for blood gas analysis:
HEPARIN
Symptom of HYPOCALCEMIA:
TETANY
Calcium and phosphate metabolism is regulated by the:
PARATHYROID
In the blood, bicarbonate leaves the RBCs and enters the plasma through an exchange mechanism with:
CHLORIDE
Major mineralocorticoid
ALDOSTERONE
Adrenal medulla secretes this hormone in the greatest quantity:
EPINEPHRINE
Hollander insulin test is used to confirm:
VAGOTOMY
Most potent estrogen:
ESTRADIOL
Assay to monitor the fetoplacental unit:
ESTRIOL
Hormone associated with galactorrhea, pituitary adenoma and amenorrhea:
PROLACTIN
Zollinger-Ellison syndrome is characterized by elevation of:
GASTRIN
PRIMARY HYPERALDOSTERONISM caused by adrenal hyperplasia
Conn’s disease:
Pharmacological parameters that determine serum drug concentration:
liberation, absorption, distribution, metabolism and excretion (LADME)
Route associated of drug with administration 100% bioavailability:
INTRAVENOUS
TRINDER REACTION:
SALICYLATE
Acetaminophen (paracetamol) is particularly toxic to the
LIVER3
Increased trough levels of ______________ in the serum are often associated with toxic effects to the KIDNEY
NEPHROTOXIC (toxic to KIDNEYS) and OTOTOXIC (EARS)
AMINOGLYCOSIDES
Specimen appropriate for determining exposure to lead:
WHOLE BLOOD
HEROIN is synthesized from
MORPHINE
is the principal active component of MARIJUANA
TETRAHYDROCANNABINOL (THC)
ODOR OF BITTER ALMONDS:
CYANIDE POISONING
Garlic on breath, metallic taste on mouth. HAS HIGH AFFINITY TO KERATIN. Analysis of urine, hair, and nails, using ion emission spectroscopy, is important for the diagnosis of chronic (Henry).
ARSENIC poisoning
Iron conversion factor from conventional to SI (µmol/L):
0.179
Bilirubin conversion factor from conventional to SI (µmol/L):
C —-> SI (x)
17.1
Thyroxine conversion factor to SI
12.9
Thyroxine conversion factor to SI 619. (µg/dl to nmol/L):
12.9
Specimen collection & processing:
Pre-analytical QA
Long-term accuracy of analytical methods:
External QC
One control value exceeds +2s and another exceeds -2s:
R4s
2 consecutive ctrl values exceed the same mean +2s or -2s:
2:2s
Used to determine whether there is statistically significant difference between the SD of 2 groups of data:
f-test
Used to determine whether there is statistically significant difference between the means of 2 groups of data:
t-test
Sample of known quantity with several analytes.:
Control
Anticoagulant for cardiopulmonary bypass:
Heparin
Basal state collection:
Early morning blood collection
Uses 2 monochromators, affected by quenching:
Fluorometry
Uses 2 photodetectors, for the sample beam and reference beam:
Double –beam in space
Obsolete blood glucose methodologies:
Folin-Wu
Nelson Somogyi
Chemical method for glucose, still widely used:
Ortho-toluidine condensation method
Test for chylomicrons, creamy layer on top:
Standing plasma test
Apolipoprotein component of VLDL:
Apo-B100
Transports component of exogenous triglycerides:
Chylomicrons
Highest cholesterol content:
LDL
One step method for cholesterol determination:
“LieberChol” (libre kol) one lang
Liebermann - Burchardt
Used in enzymatic method determinationof cholesterol
Cholesterol esterase:
CV of HDLc (NCEP Guidelines for Acceptable Measurement Error):
≤ 4%
Assay for Uric acid that uses mercury arc vapor lamp:
Enzymatic: UV
Greater specificity and more expensive BUN assay :
Enzymatic: ammonia formation
Simple, Nonspecific test for Creatinine determination :
Colorimetric: end point
Categories of Azotemia:
Pre-renal, Renal, Post-renal
Test used to assess the ability to conjugate bilirubin and secrete bile:
SERUM BILIRUBIN LEVELS
Gamma spike/ Monoclonal gammopathy:
Multiple myeloma
Beta-gamma bridging:
Hepatic cirrhosis
Reaction rate is directly proportional to substrate concentration:
First-order kinetics
Enzyme specific for both pancreas and salivary glands:
Amylase
Clinically significant if decreased:
Cholinesterase
Substrate used in Bowers-McComb method for ALP activity measurement:
p-nitrophenylphosphate
Chief counterion of sodium:
Chloride
Chloride and Bicarbonate relationship:
Reciprocal
Confirmatory test for Acromegaly:
Glucose suppression test
Increased in Hypothyroidism (primary):
TSH
T3 uptake levels in Hypothyroidism :
Decreased
Requires whole blood EDTA sample:
Cyclosporine and Tacrolimus test
Method of choice for measuring antidepressants:
HPLC
Gold standard for drug testing:
GCMS
Inhibits acetylcholinesterase:
Organophosphates & Carbamates
Dissociable substance that yields hydrogen ions:
Acid
Dissociable substance that yields hydroxyl ions:
Base
Dissociable substance that accepts hydrogen ions:
Base
Dissociable substance that accepts hydroxyl ions:
Acid
Comparing patient’s results with previous results:
Delta check
is most often performed by nurses, perfusionists (who operate heartlung machine during open heart surgery), respiratory therapists and physician themselves
POCT
RERENCE METHOD FOR CHOLESTEROL AND TRIGLYCERIDES:
GC-MS
• CHOLESTEROL: Abell-Kendall——–> GC-MS
• TRIGLYCERIDE: Modification of van Handel and Zilversmit——–> GC-MS
used to involve hexane extraction and Liebermann-Burchard color reagent, followed by hydrolysis with alcoholic KOH. Recently, the reference method has shifted to gas chromatography-mass spectrometry (GC–MS), which specifically measures cholesterol without detecting related sterols.
Cholesterol measurement
the CDC has recently switched to a GC–MS method that involves the hydrolysis of fatty acids on triglycerides and the measurement of glycerol.
TRIGLYCERIDE MEASUREMENT
Anaerobic and require ICE slurry (immediate cooling):
Lactic acid: Increases due to ongoing metabolism.
Ammonia: Levels rise due to cellular breakdown.
Blood gas: pH and pO₂ decrease.
Ionized calcium (iCa²⁺): Levels drop in heparinized whole blood.
evaluates hypoglycemia and continuous assessment of beta cell function
C-Peptide test
When the body makes insulin, it also makes C-peptide in equal amounts. By measuring both insulin and C-peptide, doctors can tell if the insulin is coming from the body or from an outside source (like insulin injections). If insulin is high and C-peptide is low, it means the insulin is likely from an injection. If both insulin and C-peptide are low, it means the body isn’t making enough insulin.
Insulinoma, type 2 DM, ingestion of hypoglycemic drugs
Increased C-peptide
Decreased C-peptide:
Type 1 DM
Colorimetric method for Triglycerides
“ang TRIc ni VAN kay ZILVER”
van Handel and Zilversmith
CDC reference method for TAG:
Modified van Handle and Zilversmith ——–> GC-MS
Fluorometric method for Triglycerides:
“TriFluorHan”
Hantzch condensation
Largest and least dense:
CHYLOMICRONS
Smallest but the most dense:
HDL
Found in obstructive jaundice and LCAT deficiency:
Lipoprotein X
Floating beta lipoprotein:
β-VLDL
Sinking pre-beta lipoprotein:
Lp (a)
Triglycerides, LDLc: FASTING
12 to 14 hours
Formula for LDLc:
Total cholesterol – HDL – VLDL
Friedewald VLDLc (mmol/L):
Triglycerides/2.175
De Long VLDLc (mmol/L):
Triglycerides/2.825
Friedewald (mg/dL):
Triglycerides/5
De Long (mg/dL):
Triglycerides/6.5
ONE-STEP direct method for cholesterol:
Liebre kol
LIEBERMANN-BURCHARDT (L-B)
One-step method for cholesterol: Colorimetry
Pearson, Stern and MacGavack)
Two-step method for cholesterol:
C + Extraction (Bloors)
Three-step method for cholesterol:
C+ E + Saponification (AbellKendall)
Four-step method for cholesterol:
C + E + S + Precipitation (Schoenheimer, Sperry, Parekh and Jung)
HDL is abnormal and significantly reduced
TANGIER’S DISEASE
A blood alcohol level in the range of _______ has been established as the statutory limit for operation of a motor vehicle in the United States.
80 mg/dL
: measurement of pH and pCO2
Potentiometry
: measurement of pO2
Amperometry
High affinity to keratin:
ARSENIC
Visible region:
400 to 700 nm
UV region
<400 nm
Infrared region
> 700 nm
Cholesterol, acceptable CV
Chol3
≤ 3%
Triglyceride, acceptable CV
≤ 5%
HDLc, LDLc acceptable CV
≤ 4%
OBESE BMI [ASIAPACIFIC 25]
≥ 30 kg/sq.m.
BMI 25 to 29.9 kg/sq.m.
Overweight
BMI < 18.5 kg/sq.m.
Underweight
STAT for the Latin word statim meaning immediately. Tests that fall into this category include:
Glucose in diabetic ketoacidosis
Some drug levels such as theophylline
Amylase in suspected pancreatitis
CK in suspected MI
Hematocrit
Blood gases
Potassium
: list of analytes that truly do have the potential to be lethal if unchecked for a short period.
CRITICAL VALUES or PANIC VALUES
is the specimen of choice for the determination of circulating concentrations of most drugs. THERAPEUTIC DRUGS
SERUM or PLASMA
