ChemAMTdeck_13943569 Flashcards
1
Q
Protein soluble in water
A
albumin
2
Q
What diff proteins from carb/lipid
A
nitrogen
3
Q
conjugated protein
A
protein plus prosthetic grp
lipo, glyco/muco, nucleo
4
Q
5 plasma proteins
A
albumin, alpha 1, alpha 2, beta, gamma
5
Q
Primary protein structure
A
amino acids
6
Q
Secondary protein structure
A
alpha helix, beta pleated sheets
7
Q
Tertiary protein structure
A
3D
8
Q
Quaternary protein structure
A
2+ polypeptide chains
9
Q
Enzyme deficiency with decreased enzymes leading to buildup of ketoacids
inherited metabolic disorder involving leucine, isoleucine, and valine (a group of branch chain amino acids).
A
maple syrup disease
10
Q
Aminoacidpathy caused by defiency in the enzyme to metabolize phenylalanine
mousy urine
A
Phenylketonuria, PKU
11
Q
Aminoacidopathy due to enzyme deficiency due to lack of enzyme to break down tyrosine/phenylalanine leading to buildup of homo-gentistic acid
deficiency of a single enzyme called homogentisate 1,2 dioxygenase
urine turns a dark brownish-black color when exposed to air
A
Alkaptonuria
12
Q
Cystinuria
Tyrosinemia
A
inherited metabolic,
excessive amount of undissolved cysteine, doesn’t get reabsorbed by kidney, kidney stones
Tyrosine/metabolites excreted in urine
13
Q
Deficiency in enzyme needed to metabolize methionine
Increased levels of this amino causes stroke, CVD, alzheimers, osteoporesis, nutrional def
A
Homocystinuria
build up of methionine and homo-cysteine (metabolite of methionine)
14
Q
4 causes of hypoproteinemia
A
Not getting/making enough:
malnutrition
liver disease(doesn’t make protein)
Protein loss:
burns(protein loss thru wound)
nephrotic syndrome(loss thru urine)
15
Q
3 Causes of hyperproteinemia
A
dehydration
Multiple myeloma, Waldenstroms
16
Q
5 immunoglobulin
A
G,A,M,E,D
17
Q
4 measurements of TP…
TP g/dL…
A
Biuret
Dye binding
Kjeldahl
Refractometry
TP 6.4-8.3 g/dL
18
Q
TP g/dL
albumin g/dL
microalbumin in urine mg/24hr
A
TP 6.4-8.3g/dL
Albumin 3.5-5 g/dL (about 60% of TP) rest is globulins
microalbumin 50-200 mg/24hr
19
Q
Calculation of A/G ratio
A
Albumin/TP-albumin
20
Q
Total protein method that reacts with >= 2 peptide bonds in proteins
A
Biuret
21
Q
Biuret reaction for TP uses…
which forms what color complex
A
copper salts
which forms a purple color
22
Q
What does a biuret reaction for total protein analysis depend on?
A
Peptide bonds
Under strongly alkaline conditions, Cu2+ ions form multivalent complexes with peptide bonds in proteins. The absorbance attributable to proteins is measured spectrophotometrically at 540 nm, and the biuret reaction reacts equally with all proteins and peptides longer than two amino acids
23
Q
4 dyes in dye binding for TP
A
Bromophenol Blue
Coomassie brilliant blue
Ponceau S
Amido black
24
Q
Reference method for TP, not used often
A
Kjeldahl
25
TP method that measures nitrogen
Kjeldahl
26
This reaction follows Beers law for a reasonable range of protein
Depends on presence of at least two peptide linkages
Is insensitive to low protein in urine...
Biuret reaction
Beers law:
concentration of analyte=
Abs unknown/Abs std x con std
27
3 things that can interfere with Biuret method for TP
hemoglobin, hemolysis and lipemia
28
Two dyes used in dye binding method for albumin
BCP less interference
BCG
Bromcresol
29
BCP/BCG is used in what method...
are used to determine...
Dye-binding method
for albumin
30
Principle of protein strip measurement called
pH
color change from,to...
Most sensitive to...
false pos seen in what pH..
protein error of indicators:
-indicatir is nonionized
pH 3.0
yellow to green: due to ion/union changing
Most sensitive to albumin
False pos: alkaline urine
*Not affected by bence Jones
31
Breakdown of protein turns to... liver converts it to
Gut bacteria make ammonia
Liver turns to urea
32
B2 microgobulin used as a marker for
reduced GFR
33
CSF protein
How many mg, What percent of plasma
15-45mg/dL, 1%
34
3 Methods for Urine/CSF protein, BAD acronym
Biuret
Acid: SSA precipitation
Dye: Coomassie brillant blue
35
Increased CSF protein in these 3
meningitis, tramatic tap, MS
36
Protein in Spina bifida
AFP
alpha fetoprotein
37
CEA stands for, is a
carcino-embryonic antigen
oncofetal antigen
38
CEA nonspecific for
colorectal carcinoma/colon cancer
39
AFP
alpha fetoprotein
tumor associated; secreted by fetal liver
40
Increased AFP 4 conditions
liver/heptocellular cancer
neural tube defects
(spina bifida)
ovarian
testicular cancer
41
Decreased AFP in
Down syndrome
42
HCG
Made by...
Has...
human chorionic gonadotropin
made by placenta after implantation by trophoblastic cells
alpha+beta subunits
NONcovalently bound
NONidentical
43
HCG seen in these two cancers
ovarian
testicular
44
PSA
Made by...
Seen in..
prostate specific antigen
made by prostatic epi cells
prostatic cancer
45
CA-125
ovarian cancer
46
CA19-9
pancreatic
GI, adenocarcinoma
47
CA15-3, 27.29
mestatic breast
48
Two markers in breast cancer
CA27-29, CA15-3
49
Thyroglobulin marker for
thyroid
50
All proteins carry a net...charge due to protein being a higher pH than its isoelectric point
and travel towards
net negative, anode
51
Fastest/smallest protein toward anode
albumin
52
Which globulin migrates to cathode due to electro/endosmosis
Several gels used routinely for protein electrophoresis attract positive ions from the buffer and form a positive ion cloud. This ion cloud moves in the opposite direction to the cathode. This phenomenon is called electroendosmosis or endosmosis.
The tension created by these oppositely moving ion clouds can affect the movement of sample macromolecules. The migration of some proteins can be slowed, some proteins can become immobile, and other proteins are pushed toward the cathode.
gamma
53
pH of electrophoresis
8.6
54
Anode
positively charged electrode
55
Cathode
negatively charged electrode
56
Protein in highest concentration and made in liver
% of plasma protein
Albumin
65%
57
Method of detection for albumin and reagents used
dye binding, bromcresol purple
methyl orange
58
Albumin function
transport/binds protein
osmotic pressure
59
Albumin decreased in these 3 things
malnutrition
liver disease
nephrotic syndrome/renal loss/kidney disease
60
Albumin increased in this
dehydration
61
Another name for prealbumin and used to assess...
trans-thy-retin
nutrional status
62
Liver makes these 4 globulins and RE/plasma cells make this
liver: albumin, alpha 1/2, beta
RE/plasma: gamma
63
two alpha 1 globulins
AAT: alpha1 antitrypsin
inhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.
AFP: alpha fetoprotein
64
AAT
increased in... and ....
decreased causes this...
increased in acute phase/prego
(Action of Neutrophils cause AAT to try to keep it from damaging tissue)
decreased in emphysema
(Def means neutrophil byproducts are damaging tissue)
65
AFP
increased these 4...
decreased in...
increased in:
neural tube defects
liver cancer
ovarian/testicular
decreased in Downs
66
Globulin increased in acute inflamation
alpha 2
67
Large globulin made in liver, inhibits trypsin/pepsin/plasmin
nephrotic/kindey disease
diabetes
lupus
increased in prego
alpha 2 macroglobulin
Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when lower molecular weight proteins are lost, but alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.
68
three alpha 2 globulins
alpha 2 macroglobulin
Haptoglobin
ceruplasmin
69
Alpha 2 globulin made in liver
acute phase reactant that binds hmg
Haptoglobin
70
haptoglobin increased/decreased in these two
increased in acute phases, nephrotic syndrome
(Increased α2-macroglobulin is seen in nephrotic syndrome due to increased synthesis and inability to pass through the glomerulus)
decreased in transfusion, hemolysis
71
Alpha2 globulin transports 65-90% copper, made in liver, acute phase reactant
Ceruloplasmin
72
Disease with decreased serum ceruloplasmin and decreased serum, increased urine copper. Increased storage of copper in organs/cornea
wilsons
73
Disease with decreased ceruloplasmin due to decreased absorption, decreased serum copper
Menkes
74
Ceruplasmin is a .... that transports...
increased in these two...
decreased in these two conditions...
glycoprotein that transports copper
increased in acute phase/inflammation, prego
decreased in Wilsons disease and Menkes
75
Beta globulins examples
Beta2 microglobulin
beta lipoprotein/LDL
transferrin
hemoplexin
complement
fibrinogen
CRP
76
Beta globulin that is a heme scavenger
hemopexin
77
Beta globulin that transports iron
transferrin
78
examples of glycoproteins
transferrin
ceruloplasmin
mucins
AFP
immunoglobulins, antibodies
FSH, LH, HCG, TSH
Fibrinogen
79
A non-glycoprotein that are temp sensitive proteins that precipitate from serum/plasma at temps lower than 37C (4C)
Cryoglobulin
80
Striated muscle/cardiac; increased in heart attack, muscle dystrophy, crush
myoglobin
81
complex of 3 proteins in striated/cardiac; muscle contration, most sensitive for heart attach
3 subunits
Troponin
TnI, TnT, TnC
82
Urine/CSF concentration first
Bence Jones in urine migrate to..
Prealbumin band seen in...
BJ to gamma region
Prealbumin in CSF
83
globulin increased
globulin decreased in viral hepatitis
gamma increased
albumin decreased
84
globulins increased...
globulin decreased...
maligment tumor
alpha 1/2 increased
albumin decreased
85
beta-gamma bridge,
broad gamma seen in
active cirrhosis/liver
86
M spike seen in
Monoclonal gammopathy
87
increased alpha 2/gamma ratio
Decreased albumin seen in
nephrotic syndrome
liver makes less albumin
88
Migration of globulins from anode to cathode and % of each...
albumin 65%, alpha1 2%,
alpha2 8%, beta 10%, gamma 15%
89
Polar hydrophillic and nonpoloar hydrophobic fatty acid chains; cell membranes are made of these
phospholipids
90
Examples of phospholipids
lecithin
sphingomyelin
PG(phosphatidyl glycerol)
91
Long chain polyunsaturated fatty acids that activates inflammation
Stimultes clotting; also stimulates cervix to dialate and contractions
a group of lipids with hormone-like actions that your body makes primarily at sites of tissue damage or infection
PG
Prostaglandins
92
Transports lipids, classified w/ultracentrifugation
Protein part of lipoproteins/structural components...
transports lipids: lipoproteins
Protein part: Apoprotein
93
Order of lipids from heaviest to lighest
HDL, LDL, VLDL, Chylo
94
Alpha lipoprotein is...
Beta lipoprotein is...
Prebeta lipoprotein is...
Migration of liproteins from origin/cathode to anode
Influenced by size and charge/amt protein
alpha: HDL most protein, fastest
Beta: LDL
PreBeta: VLDL, bigger than LDL
Chylo: least protein, slowest
Origin to Anode:
Chylo, LDL, VLDL, HDL
95
Largest lipoprotein, carrier of exo Trig
Apoproteins associated with it
Chylomicron
ApoB-48
96
Exogenous/dietary lipids and it's liproprotein/carrier
Triglycerides
chylomicrons
97
most artherogenic lipid causing CHD, mostly composed of cholesterol and transported to the heart
Third fastest to anode
LDL
98
Endogenous lipid made of mostly triglycerides
Second fastest to anode
VLDL
99
Lipid transports lipid out of liver, heaviest and smallest
HDL
100
primary form of lipid storage...
transported by these two...
triglycerides
exo/dietary: chylomicrons
endo:VLDL
101
Lipid made monstly in liver, manufacture/repair cell membranes, makes biles salts/vitD, precurosr to steroids....
two kinds:
transports to cells...
transports out of cells...
cholesterol
to: LDL
out of: HDL
102
% of Cholesterol made in liver...
% of Trig made in liver versus diet...
Cholesterol 85%
Trig 10% liver, 90 diet
103
Apoprotein B-100 are part of these two lipids
LDL, VLDL
104
Apoprotein A is part of this lipoprotein
HDL
105
Apoprotein B-48 is part of this lipoprotein
Chylo
106
LDL % carrries lipids
LDL % carrries lipids
60-70
107
HDL % carries lipid
HDL % carries lipid
20-35
108
VLDL % carries lipid
VLDL % carries lipid
5-12%
109
Major protein in HDL
Apolipoprotein A
110
Major protein in LDL/VLDL
Apolipoprotein B
111
Protein versus lipid density
protein more dense than lipid
112
Disease with very low HDL
Tangier
113
Method for cholesterol
purpose of saponification step
cholesterol oxidase
convert cholesterol esters to free cholesterol
114
Liebermann Burchard reaction used to determine
cholesterol
115
2 reagents used for color developemnt in Liebermann Burchard reaction for cholesterol
acetic anhydride
sulfuric acid
116
Lieberman has cholesterol
goes to a.a. and s.a.
Lieberman Burchard reaction for cholesterol
Reagents are:
Acetic
Anhydride
and
Sulfuric
Acid
117
Lipid w/3 fatty acids/glycerol
storage form
90% in diet, 10% liver
lipemia from chylomicrons
Trig
118
Enzyme method for triglycerides...
Hydrolyzes to...
Lipase hydrolyzes triglyceride to form glycerol
119
Fredewald calculation for LDL
TC- (TG/5+ HDL)
120
Friedwald calculation for VLDL
TG/5
121
Cannot used Friedwald calculation for LDL/VLDL if...
TG is >400mg/dL
122
Risk factors for CHD
age by genders
history of
bp, HDL
two conditions
>45men, >55 women
family history of CHD
smoking
bp >120, HDL <40
D.mellitus, metabolic syndrome
123
Lipid goals
TC
Trig
LDL
HDL
TC <200
Trig <150
LDL<100
HDL>35
124
Condition where blood cholesterol is increased
hypothyroidism
Thyroid hormones help your liver process blood. When your thyroid hormone levels are low, your liver processes blood more slowly, which can lead to higher levels of cholesterol in your bloodstream
125
Examples of ....
lipid deposits in vascular/legs/arms
CAD, AMI, arteries
lipid in brain, stroke
atheriosclerosis
126
Disease with increased TC, LDL and decreased HDL
Calculate coronary risk index using these two parameters
Elevated beta liproprotein is what lipid and leads to which kind of disease
CHD
TC, HDL
LDL, cardiovascular
127
4 non protein nitrogen
urea, ammonia
uric acid
creatinine
128
non protein nitrogen increased in plasma in renal impairment called
azotemia
129
Best way to evaluate renal impairment and what is most common analyte to monitor it
GFR
creatinine
130
Creatinine clearance calc
based off the principle that creatinine passes into the ultrafiltrate
U creat/P creat x mL/1440
vol in mL, min/24hr
131
Correction for clerance by body surface area
creat clearx1.73/area
132
Used with eGFR to stage/monitor CKD
urine albumin
133
Made from creatine in muscle
Creatinine
134
Method for creatinine
reacts with
color formed
Jaffe
alkaline picrate
yellow-red
135
Rises more rapidly than serum creatinine in acute renal failure
BUN
136
BUN increased in these two things
renal impairment
high protein
137
diacetyl monoxime used in determining...by measuring...
can be used in untreated urine because...
BUN
urea
method isn't measuring ammonia
138
Type of method for BUN that measures urea...
reagent that reacts with urea...
Colorimetric method
reacts with diacetyl monoxime
139
Enzymatic method for BUN uses....
which hydrolyzes...to...
urease
which hydrolyzes urea into ammonia
Unlike the colorimetric method using diacetyl monoxime used for BUN/urea
140
diacetyl monoxime-
urease-
diacetyl monoxime-
BUN/urea
urease-
BUN/ammonia
141
BUN mg/dL
Creatinine mg/dL
BUN/creatinine ratio
elevated creatinine will result in elevated BUN of how much
BUN 6-20mg/dL
Creatinine around 1mg/dL
10:1 to 20:1
BUN will be elevated
142
GFR marker made by nucleated cells
cystatin c
NOT c peptide
143
end product of purine metabolism from nuclei, allantoin
uric acid
144
The colorimetric method for uric acid is an alkaline oxidation where uric acid reduces...to...
phospho-tungistic acid to tungsten blue
145
phosphotungistic acid used in
uric acid
*Acid=uric acid
146
Uric acid NV mg/dL
2.6-7.2
147
Hyperuricemia causes
-gout
-leukemia/lymphoma (overproduction of new cells, more breakdown)
-Lesch-Nyhan
(The HGPRT deficiency causes a build-up of uric acid in all body fluids. The combination of increased synthesis and decreased utilization of purines leads to high levels of uric acid production.)
148
Disease where there is over production of uric acid that arent recycled; mostly males
The HGPRT deficiency causes a build-up of uric acid in all body fluids. The combination of increased synthesis and decreased utilization of purines leads to high levels of uric acid production.)
Lesch-Nyhan
149
Uric acid is measured by... at 290nm before/after treatment with...
UV absorption at 290
before/after treatment with uricase
Also use isotope dilution/MS
150
This is from bacterial action on contents of colon and metabolized by liver
ammonia
151
Analyte that is a prognostic indicator of liver failure
ammonia
not eliminated by kidneys
152
Increased ammonia in these 3 main reasons
liver disease
(cirrhosis, viral hep)
impaired renal
(increased urea,ammonia)
Reye's Syndrome
Reye’s syndrome is a rare condition that happens in children after a viral infection or illness, especially if they took aspirin (salicylate) to treat their symptoms. Reye’s syndrome targets their brain, blood and liver.
153
Syndrome that leads to increased ammonia, mostly kids, previous virus, salicylate
Reyes
154
Bromphenol blue or GLDH used to measure
ammonia
155
Nessler used to detect
used to detect ammonina
potassium iodide plus
mercury iodide/chloride plus
sodium hydroxide in water
dirty brown precipitate
156
Disaccharide with 2 glucose
maltose
157
Disaccharide with 1 glucose, 1 galactose
lactose
158
disaccharide with 1 glucose, 1 fructose
sucrose
159
monosaccharide with 6 carbons
hexose
160
process that uses glucose for energy, changed to lactic acid for energy
glycolysis
161
process of glucose to glycogen
glycogenesis
162
process of glycogen to glucose
glycogenolysis
163
process of glucose from noncarb sources
gluconeogenesis
164
renal threshold for glucose
CSF glucose % of plasma
best anticoagulant
160-180mg/dL
CSF 60-65% of plasma
sodium flouride
165
Diabetes melliutus
plasma/OGTT
A1C
>200mg/dL
>=6.5%
166
Hypoglycemia mg/dL
70mg/dl
167
Hormones that regulate glucose
which one decreases?
all the rest increase
insulin, only one decreases
glucagon: alpha cells
Stomatostain: delta cells
epineph/cortisol
GH, ACTH
T3/T4(Thyroxine)
168
hormones made in pancreas:
alpha cells/increase or decrease
beta cells/increase or decrease
delta cells/increase or decrease
alpha: glucagon, increase
beta: insulin, decrease
delta: stomatostain, increase
169
peptide hormone made in beta cells and decreases blood glucose/goes into cells
insulin
170
steroid hormone that is a glucocorticoid, made in adrenal cortex, and increases blood glucose
cortisol
171
peptide hormone made in alpha cells, increases blood sugar by making glucose from glycogen
glucagon
172
hormone made in delta cells, inhibits secretion of insulin making more glucose in blood
stomatostain
173
hormone that is adrenaline, neurotransmitter and regulates glucose
epinephrine
174
glycogen storage disease
increased or decreased glucose
von Gierkes
decreased
175
diabetes where glucose is normal
insipidus
176
condition with tumor that results in increased insulin
increased or decreased glucose
insulinoma
decreased glucose
177
two conditions that increase glucose
Thyroid, adrenal cortex
hashimotos
(Hypothyroidism, which is caused by Hashimoto's disease, decreases glucose absorption, leading to an accumulation of sugar. In turn, this accumulation of sugar causes more insulin to be produced to utilize excess glucose, eventually leading to insulin resistance.)
cushings(increased cortisol)
178
most employed automated method for glucose uses what two enzymes where there's oxidation that forms a chromagen
contamination can happen with
glucose oxidase, peroxidase
contamination with catalase
179
Gold standard for glucose testing/higher specificity...
Two enzymes used....
Amount of... is proportional to glucose
Is read at...nm
Hexokinase method
Hexokinase, G6PD
NADH formed is proportional to glucose
340nm
180
hexokinase method:
what is reduced and measured?
measured at what nm?
NAD coenzyme reduced to NADH
measured at 340nm
181
Normal fasting blood glucose
70-110mg/dL
182
Test to confirm prenatal borderline blood glucose
3 hr GTT
183
HmgA1C binds to hmg and monitors long term diabetes/largest fraction of HbA
how long of picture of glucose?
Normal?
Diabetic?
2-3mth
Normal 4.0-6.0%
Diabetic 6.5%
184
How is the formation of HbA1c related to plasma glucose concentration?
Directly proportional
The rate at which a glucose molecule attaches to hemoglobin to form a ketoamine is directly proportional to the glucose concentration in the plasma.
185
Juvenille onset, insulin dependent, autoimmune destruction of beta cells
ketoacidosis
Type 1
186
adult onset, non insulin, insulin resistance, no ketoacidosis, obsesity
Which of the following is a non-insulin dependent diabetes, is characterized by insulin resistance and progressive hyperglycemia, and is called “adult-onset diabetes”?
Type 2
187
What is a byproduct of insulin and can differentiate between medication/exo insulin and what the body makes/endogenous insulin?
C-peptide
not cystatin(kidney)
188
Diabetes caused by placental lactogen inhibiting insulin
GDM
gestational diabetes mellitus
189
Measurement of light intensity, chemical rxn forms color and is absorbed at specific wavelenth
visible light 400-700, frequency inverse to wavelength, uses quartz cuvette for UV range
tungsten or deuterium
spectrophotometry
190
Filter used for QC of spectrophotometer and what it tests
holmium oxide
glass filter
wavelength accuracy
*Glass filter for spectrometry
191
Meaasurement of emission of color when element is burned
flame photometry
192
Measurement of light abosorption of electromagnetic radiation
atomic absorption spectrophotometry
Atomic=radiation
Absorption
Spectrometry=light
193
Atomic absorption measures using what light source
also uses monochormator, flame sample cell, PM tube
hollow cathod lamp
194
term that decreases fluorescent intensity of a substance
is a disadvantage of...
quenching
fluorometry
195
Measurement using electrode, ref electrode, liquid, potential diff between the two equals concentration
ISE
196
Measurement of light scattered by particles in a solution and measured at an angle, seen in ag-ab rxn...
Measurement of reduction in light transmission by particles in suspension ie proteins
scattered: nephelometry
reduced transmisson: turbidimetry
197
In immunoelectrophoresis there must be excess...
and a constant.... ......
excess antibody
constant trough distance
198
Used to separate volatile or able to volatile and to confirm toxicology
Is a reference for alcohol...
This is used to enhance sensitivity and specificity...
gas chromatography
MS(mass spectro)
199
Technique w/sorbent coated and solvent screens for drugs/urine
Uses Rf value
Rf value is...
TLC Thin layer chromatography
Rf= drug distance/solvent distance
200
Osmometry based off
measures
m-Osmol/kg
freezing point depression
measure osmolality of urine/serum
(dissolved particle in sln)
Tubular fnc
201
Hmg-Verdo-hmg
Plasma/store: biliverdin-iron-globin
Liver: bilirubin-albumin
Conjugataed: Bili diglucuronide
...
202
Ehrlich, p-DMAB reagent measures
Urobilinogen
Increased in liver damage, hemolytic disease
Negative in bile duct obstruction
203
p-DMAB stands for, used in the
...method for...
p-Di-Methyl-Amino-
Benzaldehyde
Ehrlich method for urobilnogen
204
Color produced with Erlichs reagent w/porphobilinogen and urobilinogen
reagent used to distinguish the two
red/pink color
chloroform,
urobilinogen will be soluble
porphobilinogen will be insoluble and stay in aqueous phase
205
Protein that carries unconjugated bilirubin..
Where is bilirubin conjugated...
Name of conjugated/direct bili...
albumin carries unconjugated
conjugated in liver
conjugated is bilirubin diglucuronide
206
Jendrassik-Grof measures
uses
turns into
bilirubin
uses diazo-tized sulfanilic
turns into purple, measures green azobilirubin
Alkaline tartrate eliminates interference
207
Bilirubin that is seen is not solube, thus not secreted in urine, cause of hemolytic trans rxn, prehaptic jaundice
indirect bili/unconjugated bili
208
Bilirubin that is formed/converted in intestine
urobilinogen
209
bilirubin that is oxidized/green in RE system
biliverdin
210
oxidized form of urobilinogen excreted in
urine...
stool...
urobilin: urobilinogen goes to kidney; yellow
stercobilin: urobilinogen oxidized, brown stool
211
Evelyn Malloy method used for...
Interference..
bilirubin
hemolysis
212
Jaundice with increasd unconjugated and increased urine urinobilinogen
Prehepatic jaundice
213
Disease where all bili is increased, bili/uro in urine
hepatic
214
condition where unconjugated is normal, decreased uro, but increased conjugated bilirubin in urine
Posthepatic obstruction
215
Have diff/mobility rates due to different aminos/structure
Different Electrophoretic property
Different rxns
Same substrate
Isoenzyme
216
Metals ions in enzymatic reactions act as
activators
217
This contant determines rate of conversion of substrate to product by differing
substrate concentrations
and
rate of dissociation of complex
(Enzyme acting on substrate making product)
Michaelis-Menten
218
Order rxn where large excess substrate allows for amt of enzyme activity to be limiting factor when all enzyme is bound to substrate
substrate: A reactant in a chemical reaction is called a substrate when acted upon by an enzyme.
zero order
219
LD catalyzes lactate +NAD to... And...
pyruvate + NADH
220
LD isoenzyme that migrates the fastest to anode and highest in heart/rbc (Most negatively charged)
LD1 HHHH
221
LD isoenzyme in healthy, HHHM
LD2
222
LD isoezyme that migrates the slowest (most positively charged)
LD5
223
Increased in LD1,2,3
PA
pernicious anemia
224
Enzyme greatly affected by hemolysis because its in all cells
LD
225
CK increased in these 3: stress to muscles
heart attack
muscular dystrophy
exercise
226
3 CK isoenzymes are dimers
Fastest to slowest
Brain faster than muscle
CKBB, CKMB, CKMM
227
CK isoenzyme slowest, in skeletal muscle
CKMM
228
CKMB sensitive for AMI
rises w/in...down in...
2-4hrs
2-4 days
229
Most sensitive for AMI and two most used...
rise/fall...
Troponin
TnT,TnI
4-8hrs, 10 days
230
LD rises, days last
rises 8-12hrs, 10-14 days
231
Myoglobin rises, normal
30min, 24hrs
232
condition can't pump, fluids in lungs, cause CAD, BNP to diagnose
CHF
233
Condition were lack of oxygen, ischemia, leads to CHF/angina/heart attack
Narrowing of the small blood vessels that supply blood and oxygen to the heart.
CHD
Coronary heart disease (CHD) is also called coronary artery disease
234
3 conditions elevated AST
1 not elevated
acute heart
liver disease
muscular
not elevated in acute pancreatitis
235
2 Liver enzymes not affected by hemolysis
ALT, GGT
236
Increased ALP in 3 things in liver
obstruction of biliary tract/jaundice
acute viral hep
biliary cirosis
237
ALP increased in these 3 bone disorders
increased in 1 random
Pagets:
overgrowth
osteomalacia:
soft bones, decreased D/Ca
Rickets: Vit d def
prego (increased in mom and baby's bones)
238
High ALP but no other liver increased
bone
239
pH for ACP
increased in
5.0
acid
prostatic disease
240
Enzyme in alcoholics, heptobiliary, obstructive jaundice, cirrhosis
GGT
241
Enzyme in mumps and acute pancreatitits
enzyme most specific for pancreatittis
mumps: amylase
pancreatitis: lipase
242
Cherry Crandall used to determine...
substrate...
lipase
olive oil
243
Disease with highest level of aldolase
muscular dystrophy
Aldolase is necessary for glycolysis in muscle as a "rapid response" pathway for production of adenosine triphosphate, independent of tissue oxygen.
244
Zollinger-Ellison is a... increased...
gastrinoma
gastrin HCl
245
diacetyl monoxime used to determine
BUN
246
phospho-tungistic acid to tungsten blue used to determine
Uric acid
247
most uric acid in plasma is what form...
increased in...
monosodium urate
gout
248
Kayser-Fleischer
Cooper deposits in cornea
249
To evaluate ionized calcium you need to know these two things and why
pH and protein
ionized calcium is pH dependent;
ph will increase if CO2 is lost
Ca will increase with increased protein
250
things that regulate calcium
2 increase/1 decrease
VitD/PTH: increase Ca
-VitD increases GI absorption of Ca
-low Ca will stimulate PTH production
Calcitonin: decrease Ca
-inhibits bone reabsorption
251
Hypocalcemia causes
Tetany (decreased Ca,Mg)
VitD def, hypoPTH
hypo mag, albumin
Normally, the parathyroid glands release a hormone that increases blood calcium levels when they are low. Magnesium is required for the production and release of parathyroid hormone, so when magnesium is too low, insufficient parathyroid hormone is produced and blood calcium levels are also reduced (hypocalcemia).
252
hypercalcemia
Vit excess, hyperPTH
Malignancy
253
8-hydroxy-quinoline removes...
In determination of...
Mg
Ca
254
In the complexometric titration for Ca, the pH is adjusted to prevent...
Complexometric titrations are used mainly to determine metal ions by use of complex-forming reactions.
complexometric titration:
pH is adjusted to prevent
interference from Mg
with 8-hydroxy-quinoline removes Mg
255
Method for Ca where its precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate
Clark-Collip
precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate
256
Clark-Collip measures...
it will be precipitated as...
Calcium
oxalate
257
In determining calcium, lanthanum is used to
lanthanum binds phosphate
258
Most phosphorus is in... at pH
bone 7.4
259
Phosphorus is controlled by this and how does it affect it, opposite of Ca
PTH:
decreases Pho
increases Ca
260
Affect on Phos
PTH
Calcitonin, Vit D
PTH decreased Pho
Calcitonin, Vit D increases phosphate
261
Reagent used for phosphate
molybdate
molybdeum blue
262
Hyperparathyroidism= increased PTH,
Phosphorus is
decreased
263
Hypoparathyroidism= decreased PTH
Phosphorus...
increased
264
Magnesium is controlled by kidney thru tubular reabsorption, what is renal threshold
1.5-2.1mg/dL
265
Treatment for preeclampsia/contractions will result in what lab result to be increased
magnesium
hypermagnesemia
266
Condition decreased iron/ferritin/% sat, increased transferrin/TIBC
IDA
267
Reagent for magnesium
titan yellow
268
2 Conditions with increased iron/ferritin/%sat and decreased transferrin/TIBC
sideroblastic and hemocromatosis
269
trace metal involved in melanin, inorganic cofactor, bound to albumin, transported/bound mostly by ceruloplasmin
copper
270
Fat soluble vitamins
A,D,E,K
271
Water soluble vitamins
All B, C
272
Fat soluble Retinol, cause of night blindness
A
273
Fat soluble calciferol, hormone precursor, Rickets
D
274
Fat soluble Tocopherol, antioxidant/immunity
Hemolytic anemia
E
275
Fat soluble phylloquinine, for clots
hemmorage
K
276
Water soluble B1
condition
thiamin
Beriberi
277
water soluble riboflavin
B2
278
water soluble B3, condition
niacin
pellegra
279
water soluble pyridoxal
B6
280
water soluble B7
Biotin
281
water soluble B9, condition
folate
megaloblastic
282
water soluble cobalamin, condition
B12
PA/IF
283
cause of Scurvy
C
284
Major extracellular cation...
NV...
Sodium 135-145
285
Hormone that increases Na reabsorption and acts on distal convoluted tube
Released by adrenals
Aldosterone
286
Hypoaldosterone Na
Hyperaldosterone Na
Hypo: decreased Na
Hyper: increased Na
287
Normal values
Na
Cl
K
Na 135-145
Major extracellular cation
Cl 98-106
Major extracellular anion
K 3.5-5.0
Major intracellular cation
288
BUN
Creatinine
BUN 6-20
Creatinine 0.7-1.5
289
CO2/Bicarb
23-29
290
Na 165
Cl 125
K 3.5
Saline contamination
291
Diabetes mellitus
Fasting...
Nonfasting...
Glucose
126, 200
292
Increased K causes
Phleb issues...
Tube additive...
Condition...
Hemolysis, tourniquet, squeezing
EDTA
Diabetic ketoacidosis
(Insulin promotes potassium entry into cells. When circulating insulin is lacking, as in diabetic ketoacidosis, potassium moves out of cells, thus raising plasma potassium levels even in the presence of total body potassium deficiency )
293
Used to enhance sensitivity of ISE electrode for K
Valino-mycin
294
Hypokalemia is less than
Hyperkalcemia greater than
Potassium
<3.5
>5
295
Chloride shift
Cl is inverse HCO3, when one leaves the other goes in
High Cl, low HCO3=metabolic acidosis
296
Causes of increased Cl
IV
Dehydration
Metabolic/diabetic acidosis
(lose HCO3, chloride shift)
297
Low Cl
4 things
Diarrhea, vomiting
Renal failure: not reabsorbed
metabolic alkalosis: excess bicarb, less CO2
298
Chloride measured with titration methods such as
C.A. and S.S.
C.A. is...
S.S. is...
Coulometric amperometric
Schales-Schales
299
Coulometric amperometric method uses a... Method
It's is the...
Analyte measured...
Titration
Time needed to get to end pt
Chloride
300
Schales-Schales is what kind of method...
For...
Violet color formed from reaction with...
Mercurimetric titration
Chloride
Excess Hg++
301
C-A and S-S are both these kind of reactions...for...
Titration
Chloride
302
Most CO2 in blood is
Bicarb
303
Specimen Least ordered, not used for CO2
Urine
304
Anion Gap, NV
Na+K-(Cl+HCO3)
10-20
305
Increased anion Gap
Diabetic ketoacidosis
Lactic acidosis
Salicylate
Methanol
Ethanol
Poly glycol
Unmeasured
306
Decreased anion Gap used as, due to
Analytical QC
Analyzer error
307
Glass, Ag/AgCl, measures H for measurement of
pH
308
Platinum+Ag/AgCl, amperometric measures
pO2
309
Henderson Hasselbalch
pH= pKa + log [salt]|[acid]
[A base]|[HA acid]
pH=log HCO3/pCO2
pH=log kidney/lungs
pH=log metabolic/respiratory
310
Bicarb: carbonic acid ratio in plasma
20:1
311
Acidosis
Normal
Alkalosis
<7.38
7.35-7.45, around 7.4
>7.42
312
Metabolic acidosis: pH, HCO3 levels compensation
Decreased pH, HCO3
Lung: Hyperventilating releases CO2
313
Metabolic alkalosis 2 parameters influenced, compensation
Increased pH, HCO3
Lung: Hypoventilation increases CO2
314
Respiratory acidosis 2 parameters, compensation
Decreased pH,
Increased CO2
Kidneys: increase bicarb
315
Respiratory alkalosis 2 parameters, compensation
Increased pH,
decreased pCO2
Kidneys compensate
316
Beer-Lambert law
The Beer-Lambert law relates the concentration of a sample to the amount of light the sample absorbs as it passes through the sample.
317
Synovial: joints, hyaluronic acid makes viscous, obtain by arthrocentesis
2 Synovial crystals/conditions
Uric acid: gout
Pyro-phosphate: pseudogout
318
Amniotic fluid:
access neural tube defects/AFP
4 Fetal lung tests...
L/S: >2
PG
FLM 2
Lamellar
319
Sweat:
Analyte
Condition, death cause
Cl
Cystic fibrosis, pneumonia
320
Sperm:
mL, live%, motility %, #/mL
2-5mL
>75% alive
>50% motility
# 20-250 million/mL
321
Decreased CSF glucose seen in
Increased CSF glucose seen in
Decreased CSF glucose:
Bacterial meningitis
Increased CSF glucose:
Diabetes
322
CSF tube order/department
1 chem
2 micro
3 heme
323
CSF protein mg/dL
15-45
324
CSF glucose
60-70% plasma
325
CSF diff
70% lymph
30% mono
326
4 causes of increased CSF Protein
Meningitis
Intracranial hemorrhage
Traumatic tap
MS
327
Decreased CSF TP seen in
Leak, tear
328
Increased CSF IgG index and oligoclonal banding seen in...
MS
Multiple scelerosis
Oligoclonal bands are proteins called immunoglobulins. The presence of these proteins indicates inflammation of the central nervous system. The presence of oligoclonal bands may point to a diagnosis of multiple sclerosis.
329
Urine ph normal...
If left at rt becomes..
normal 6.0 (4.5-8)
alkaline at RT
330
Normal urine volume:
poly>
olig <
noc
anuria
1200-1500
poly >2500
olig<500
noc: more at night
anuria: none
331
left at RT, what
decreases...
increases...
False pos...
decreases:
glucose/ketones
bili/uro
cells/casts
increases:
nitrites/bacteria
turbidity(bacteria)
pH(amm)
False pos: protein
332
3 things kidneys make
2 hormones that influence kidney
renin, erythropoeitin, PG
aldosterone, ADH
333
Urine is made of 7 things
95% water
urea, uric acid, creatinine
Cl/Na/K
334
Urine RBCs color
smoky, red/brown urine
335
Urine bili/pyridum color
dark yellow/amber/orange
Phenazopyridine (Pyridium) is a dye that's a red-orange color
336
Met/Hmg and homogentistic acid urine color
brown black upon standing
337
Reabsorbs H2O only...
Rebabsorbs solutes only...
H2O only Descening Loop
solutes only ascending loop
338
Specific gravity NV...
increased in these 3
decreased in this
1.003-1.030
increased in:
-renal damage(isotheniuria 1.010)
-diabetes mellitus
-xray
decreased in diabetes insipidus
339
3 methods to determine sg
refractometer
reagent strip
harmonic oscillation:
densitometry; current helps measure sg
340
Urine strip protein method name...
ph...and can leach to the pH strip and ...the pH
what protein it binds to...
color...
confirm with...
protein error of indicators
3.0 and can leach to the pH strip and lower the pH
albumin
sulf. acid precipitation
341
How many neprons per kidney....
filtration ml/min
1 million
90-120mL/min
342
Protein of indicators on dipstick description...
has nothing to do with...
not affected by...
What will cause false pos...
Most of the indicator is non-ionized.
The protein will combine with the non-ionized form and will change the ratio of ionized and nonionized
Has nothing to do with pH and not affected by bence jones
False pos due to alkaline/buffered urine
343
Renal threshold for glucose
dipstick measures only glucose
two enzymes in rxn
160-180mg/dL
glucose oxidase, perioxidase
344
Clinitest/Benedicts is a... ...method for...
Can screen for...
but reacts with...
False neg with these two...
copper reduction method for glucose
screen for galctosemia
reacts with all reducing substances
false neg with Vit C and pass thru
345
Occult blood on urine dipstick depends on
perioxidase activity of rbc/hmg
346
Nitrite:
bacteria type...
2 names for rxn:
GNR (E.coli)
Diazo, Griess rxn
347
RBC dipstick:
false neg with one vitamin and mistaken with 3 things...
false pos...
false neg: vitC
yeast, oil,
calcium oxalate crystals
false pos: oxidizing like bleach
348
UTI, renal calculi, acute glomerulonephritis you'll see these cells
RBCs
349
reagent for LE, color
diazo reagent, purple
350
Cell related to glitter cell, UTI/pyelonephritis...
type seen in UTI...
white
neutrophils
351
Seen in diabetes mellitus, breakdown of lipids...
reagent...
color...
confirm with...
ketones
sodium nitroprusside
purple
Acetest (Acetoacetic/diacetic acid, acetone)
352
Sodium nitroprusside used in determination of...on dipstick
ketones
353
Acetest is used to confirm...
detects these two..
confirm ketones
diacetic acid, acetone
False pos: highly pigmented, levadopa
354
Ictotest, Diazo rxn used for
Bilirubin
VitC false neg
Bike duct obstructions, liver, ciirhosis
355
Reagent used in Erlich
p-DMAB
356
Erlich, p-DMAB used in
Urobili
357
Leukocyte in DILUTE HYPOTONIC urine where granules appear to move/Brownian Mvt
glitter cell
358
Large epithelial seen in catherterization, renal pelvis, ureter, bladder
transitional
359
Cell seen in tubular necrosis, renal tubles, oval fat bodies are made from
renal tubular
360
glycoprotein made from TRE that makes up casts (two names)
Tamm horsfall mucoprotein
Uromodulin
361
Cast are formed in what part of tubules
distal convoluted tubule
362
Casts seen in chronic renal disease, urinary stasis
waxy
363
cast seen in stress/exercise, normal
hyaline
364
cast seen in nephron/acute glomerulonephritis
RBC
365
Cast from dialated collecting ducts
broad
366
cast seen in acute glomerulonephritis and is decomposition of cellular
granular
367
cast from break down of epi casts/oval fat bodies, nephrotic syndrome
fatty
368
cell in pyleonephritis
wbc
369
4 urine parasites
T.vag
E.vermiculares (bread loaf ova)
strongy
S.haematobium
370
5 abnormal crystals
Cysteine: 6 sides
Leucine: concentric circles
Tyrosine: needles
Bili: yellow/brown needles
Cholesterol: notched plates
371
3 normal crystals in acidic urine
Uric acid: rhomboid/pleomorphic
amorphouse urates: pink sediment
Calcium oxalate: envelope/oval/dumbell,
*monohydrate form in antifreeze
372
4 normal crystals in alkaline urine
amorphous phosphates
triople phosphate: coffin lid
calcium carbonate: dumbell
amm. biurate: thorny apple
373
NV for... 50-200 mg/24hr
microalbumin
374
AAT globulin
Alpha-1-antitrypsin
Alpha1 globulin
inhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.
375
Tangier low in
HDL
376
Colorimetric method for BUN measures...uses...
Enzymatic method for BUN measures...uses...
Which one can be used for untreated urine, why
Colorimetric measures urea and uses diacetyl monoxime, can be used with untreated urine since it's not measuring ammonia
Enzymatic measures ammonia and uses urease
377
Hexokinase
Glucose method reduces this coenzyme...
To...
At...nm
NAD coenzyme is reduced to NADH and measured at 340nm
378
diazo rxn/Jendrassik-Grof
Bilirubin
379
Jendrassik-Grof and
Evelyn Malloy
measure
Bilirubin
380
Jendrassik-Grof=
Bilirubin+Diazo (caffeine)=azobili
Jendrassik-Grof=
Bilirubin+Diazo (caffeine)=azobili
381
Evelyn Malloy method uses...as an accelerator
Jendrassik-Grof uses...as an accelerator
Measures...
Evelyn Malloy method uses methanol as an accelerator
Jendrassik-Grof uses caffeine benzoate acetate as an accelerator
bilirubin
382
LD1 HHHH
Fastest, marker for these two
heart/rbc
383
sideroblastic and hemocromatosis
Iron,ferritin,%sat, transferrin/tibc high or low
increased iron/ferritin/%sat
decreased transferrin/TIBC
Sideroblastic anemia is a type of anemia that results from abnormal utilization of iron during erythropoiesis.
Hemochromatosis, or iron overload, is a condition in which your body stores too much iron. It’s often genetic.
384
Pyrophosphate seen in
pseudogout
385
Porter-Silber reaction uses phenylhydrazine to detect...
Zimmerman reaction detects...
PS=phenylhydrazine=
corticosteroids
Zimm=
17-KS/17-ketosteroids
386
Phenlyhydrazine used to detect corticosteroids in what reaction
PS=Porter-Silber
387
17-ketosteroids/17-KS is detected in what reaction...
Is a metabolite of...
Zimmerman
Zimmerman is a man that takes 17-KS/steroids
metabolite of androgens
388
Porter and Zimmerman take steroids
...
389
Hypothalmus makes releasing/inhibiting hormones that act on the pituitary
Pituitary then makes hormones that have their effects on organs that make the end product/action
...
390
Primary caussed by...
secondary caused by...
tertiary caused by...
Primary...end organ
Secondary:pituitary
Tertiary: Hypothalamus
391
Increased GH causes these two things
kids versus adults
Decreased GH causes
kids: giantism
adults: acromegaly
dwarfism
392
Hormone that solely initiates and maintains lactation
prolactin
393
increased prolactin cause of these two
Hypogonadism:
In hyperprolactinemia, which induces hypogonadism, the excess prolactin interferes with secretion of gonadotropin-releasing hormone, resulting in decreased testosterone and erectile dysfunction.
and
prolactinoma
(pituitary tumor)
394
menstral disorder and inadequate lactation due to
decreased prolactin
395
Vasopression is also called
antidiuretic hormone
396
ADH acts on...to increase...
decreased in...
acts on renal tubles to increase water reabsorption
diabetes insipidus
397
Hormone that stimulates urterine contraction/myoepithelial cells in breast thus ejecting milk
oxytocin
398
Hormone that forms male sex characteristics, spermatogensis, facial hair, deep voice, sex drive
testosterone
399
Testosterone is made from...
cholesterol (as is a lot of steriods)
400
hormones that stimulate sex organ development, linear growth, epiphyseal fusion
androgens
401
infertility men/women
polycystic ovarian due to
adrenal hyperplasia:
A group of genetic conditions limiting hormone production in the adrenal glands.
hypertestosteronemia
402
hypogonadism due to
hypotestosteronemia
403
TRH, GRH, CRH GHRH
PIF, GHIH released by
hypothalamus
404
GH, PRL, TSH, LH, FSH, ACTH released by the ... ...
anterior pituitary
405
ADH, oxytocin released by
posterior pituitary
406
Hormone that induces ovulation, prmotes ovary secretion of estrogens/progesterone for possible pregnancy and stimulates testes to produce testosterone
Luteinizing hormone
407
GnRH,
gonadotropin-releasing hormone
stimulates this organ to produceb these 2 hormones... which affects these two organs
GnRH stimulates pituitary to make LH and FSH to affect ovaries or testes
408
GHIH is also called
Somatostatin
409
GHIH/Somatostatin
GHRH: growth hormone-releasing hormone
Somatostatin from the hypothalamus inhibits the pituitary gland's secretion of growth hormone and thyroid stimulating hormone.
GHRH: growth hormone-releasing hormone
410
Somatostatin inhibits the pituitary gland’s secretion of...and...
Somatostatin from the hypothalamus inhibits the pituitary gland’s secretion of GH and TSH
411
FSH stimulates, secretion of
females:
males:
females: egg development, estrogen
males: sperm, testosterone
412
hypothalmus makes CRH, Corticotrophin-releasing hormone
that act on pituitary to make ACTH,
Adrenocorticotropic hormone
this stimulates the adrenal cortex to make steroid hormones made from cholesterol
3 steroids made in adrenal cortex...
mineralcoritcoids(aldosterone)
glucocorticoids(cortisol)
sex hormones (androgens, estrogens)
413
What converts angiotensinogen to angiotensin I which converts to II and stimulates cortex to make aldosterone
Renin
414
hormone that induces secretion of glucorticoids(cortisol) of adrenal cortex
ACTH
adreno-cortiotropic hormone
415
CRH stimulates the...to make... which causes... to release cortisol, aldoseterone, estrogens and testosterone
CRH stimulates the pituitary to make ACTH
causing the adrenal cortex to make cortisol, aldosterone, estrogens/testosterone
416
Mineralocorticoids, glucorticoids, and androgens released by
adrenal cortex
417
aldosterone is an example of a...
maintains...and...
by retaining...and...
and excreting...
mineralocorticoid
maintains H2O and electrolytes by retaining water and Na and excreting K
418
Cortisol is a type of
glucocorticoid
419
Hyperadolsoterone, increased Na, decreased K, hypertension
Conns Disease
420
Conns Disease has increased...and thus increased...
decreased...
leading to....due to increased...
has increased aldosterone and thus increased Na
Decreased K
leading to hypertenstion due to increased fluid retention
421
Hypoaldosterone, decreased Na/Cl, decreased cortisol
everything down
Addisons Disease
422
Increased cortisol, increased glucose, increased Na
buffalo hump
Cushings
everything up
423
Testosterone is a type of
androgen
male sex hormone
424
metabolite of androgen...
reaction used to detect...
17-ketosteroid, 17-KS
Zimmerman reaction
425
3 types of catecholamines
purpose
epineph
norepi
dopamine
These hormones are released into the body in response to physical or emotional stress.
426
Two GI hormones
Gastrin
serotonin
427
Hormone increased in Zollinger Ellison syndrome
gastrin
428
Hormone made in GI, vascoconstricter of PLTs/brain/tissue
serotonin
429
5HIAA is a urinary metabolite of...
increased in chromaffin cell tumors of GI, drugs, bananas, pineapples etc
serotonin
430
Catecholamines produced in...by...
adrenal medulla
by chromaffin cells
431
Metabolites of epineph
metanephrine, VMA
432
Metabolites of norepineph
normetaneph,VMA
433
Metabolites of dopamine
HVA
434
Pheochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headache
with increased...
VMA
435
Pheochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of...and...
metabolite is...
epinephrine and norepinephrine
VMA
436
Neuroblastoma is a childhood cancer that starts in immature nerve cells (neuroblasts)
with increased...
HVA
437
Most of the releasing and inhibiting hormones (except for ACTH) are producted by the...
hypothalamus
438
Thyroid hormones: stimulate metabolic processes
In tissues...is coverted to....
99.97% of...is bound to mosntly TBG, some TB-PA, albumin
99.5% of....is also bound
In tissues T4 is converted to T3
99.97% of T4 is bound to TBG
99.5% of T3 is bound
439
TSH stimulates the ... to make these two
thyroid, T3/T4
440
3 things hormones made by thyroid
thyroxine/T4, triiodothyronine/T3
calcitonin
441
Thyroxine/T4 and Triiodothyronine/T3 increases...
Calcitonin increases...
Thyroxine, Triiodothyronine: metabolism
Calcitonin: Ca reabsorbtion
442
3 calcitropic hormones
PTH, VitD, calcitonin
443
Low PTH lowers these two...
increases this...
Lowers serum Ca, D
Increases Phos
444
TRH stimulates pituitary to release... which acts on...
TSH, acts on thyroid
445
TSH stimulates thyroid to make...
T3,T4
446
Free... stimulate negative feedback loop and inhibit secretion of...
Free T3/4 inhibit TSH
447
primary Hyperparathyroidism also called...
symptoms
Graves
weight loss, heat, hair loss, anxious
448
Graves is hyper or hypo...
T3/T4 levels...
TSH levels...
thyroid overproduces... due to... ...
hyper: T3/T4
decreased TSH to stop production of T3/T4
Primary means thyroid overproduces T3/T4 due to TSH antibodies
449
Primary Hypothyroidism is called...
symptoms
Hashimotos
weight gain, tired, cold
450
Hashimotos is hyper or hypo...
T3/T4 levels...
TSH levels...
due to... ...
hypo: T3/T4
increased TSH to decreased T3/T4 levels
Thyroid autoab
451
Major binding protein for thyroxine/T4
How is it measured
TBG
thyroid binding globulin
By measuring T3 uptake (amount of TBG bound to thyroid hormones)
452
3 good indicators for hypothyroidism
1 not good indicator
FT4, TT4, s-TSH (singles best)
Most is T4 not T3
not good T3 uptake (indirect, not used)
453
Ovaries productes these two hormones
estrogen, estadiol
454
hormone female sex charac, hyper=amenorrhea, hypo=menopause
Estrogen
455
hormone that's active form of estrogen, evaluates fetoplacental function
estadiol
456
Progesterone made by the... ... ... and then by the...in pregnancy
ovarian corpus luteum and then placenta in pregnancy
Progesterone is also secreted by the ovarian corpus luteum during the first ten weeks of pregnancy, followed by the placenta in the later phase of pregnancy.
corpus luteum: yellowish mass of progesterone-secreting endocrine tissue that forms immediately after ovulation
457
prepares uterus for prego, maintains endometrium lining, inhibits uterine contractions, prepares breasts for lactation
progesterone
458
progesterone levels
perimenopause
postmenopause
peri: increased progesterone
post:decreased progesterone
459
What hormone maintains progesterone in early pregnancy
HCG
460
HCG increased/decreased...
increased: prego, mutiple pregos, tumors
decreased: spontaneous abortion
461
HCG subunits are...
alpha, beta subunits
NON-covalently bound subunits
NONidentical
462
subunit that cross reacts with LH,FSH,TSh
alpha
463
subunit that has analytical specificity
beta
464
Trimester with highest level of HCG...
When does it show up, how long does it last...
first
seen in days, peaks 2-3mths
465
Toxicology, best specimen for screening/qualitative, best for quantitative
Urine-QL
Blood-QNT
466
Creatitinine, pH, or oxidizing activity, dilute/substituted/adultered as a measure of
validity
467
Major disadvantage of immunoassay drug detection...
best 2 ways to confirm for drugs that have positive screens...
Immunoassays can't simultaneously assay multiple drugs in one specimen
gas chromatography/MS
468
Aminoglycosides and Glycoprotein are two kinds of
antibiotics
469
Kind of Glycoprotein/antibiotic
that inhibits.. ..synthesis of gram...
Vancomycin
inhibit cell wall synthesis, treat gp
470
gentami/tobramy/amika/kana-cin are all...
they inhibit... ... of gram...
aminoglycosides
inhibit protein synthesis, treat gn
471
Monitor toxic range of antibiotics to prevent damage to...and...
hearing/ototoxic
kidneys/nephrotoxic
472
Phenobarbital, phenytoin/dilantin
Valproic acid, Carbamazepine
ethosuximide are all
anti-epileptic/anti-convulsants
473
Bronchodialator
asthma, IV/oral, 10-20ug/mL, toxic >20ug
Theophylline
active metabolite in neotates is caffeine, also caffeine given as a brochodilator
474
Cyclosporine, Tacrolimus, Sirolimus,MPA
all are
immunosuppressive
475
Methotrexate are all
antineoplastics/antitumor
476
Cyanide, arsenic, mercury all are
heavy metals
477
Substances/acute poisoning
acetaminophen-liver damage
salicylates
alcohols-ethanol,isopro,glycol
cyanide
carbon monoxide(carboxyhmg 200x infinity)
organophosphates/pesticide:
-CNS, decrease cholinesterase
478
Must wait until...to TDM
how many half lives to reach...
how many half lives to clear...
metabolized by liver, excreted in urine
steady state
5.5
479
Specimen drawn imme before next dose is called...
Peaks drawn...hrs
Trough
1-2hrs after oral dose
480
AID:
Amtriphtyline, Imipramine, Doxepin
Lithium are all
pyschotropics
481
Amtriphtyline, Imipramine, Doxepin are all
tricyclics
482
Digoxin, Quinidine, Procainamide,
Disopyramide, Lidocaine all are
Antiarrythmics/cardiactive
483
What body does to drug...
What drug does to body...
Body does to drug: pharmacokinetics
Drug does to body: pharmacodynamics
484
Increased alpha 2 in these two
Acute inflammation
nephrotic syndrome
485
Tetany decreased in these two
Ca,Mg
486
LD 4,5 related to
Liver disease
487
Elevation in LD1/LD2 in a flipped pattern is related to
Myocardial infarction
488
Increased total serum LD 4,5 related to
Acute viral hepatitis
489
Increased LD 1,2 related to
Hemolytic anemia
490
Gilbert, Crigler-Najjar and Dubin-Johnson syndromes all are issues with what analyte
Billirubin
491
Syndrome that's genetic liver disease, reduced glucuronyl transferase, thus increased bili
Gilbert syndrome
492
Name of syndrome where there's two types,
the type and name where there's compete absence of glucuronyl transferase, severe unconjugated bili and kernicterus...
Type work decreased glucuronyl transferase, chronic increased bili
Crigler-Najjar Syndrome
Complete:Type 1
Decreased: Type 2
493
Syndrome that's genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion
Dubin-Johnson syndrome
494
Dubin-Johnson syndrome
Syndrome that’s genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion
495
2 Hepatitis fecal, oral
A, E
496
3 Recent Hep B infection markers
HBsAg,HBeAg
Anti-HBc IgM
497
DNA hep, with a core and envelope
BF, sex, IV drug
Hep B
B=body fluids
498
RNA, blood-to-blood contact:
blood transfusion, needles, no vaccine
Development of cirrhosis
Hep c
C=cirrosis
499
Hep that needs HBV, coinfection
Hep D
500
Tetany caused by these two
(decreased Ca,Mg)
