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Essentials for Disease Process > Chemical Pathology > Flashcards

Chemical Pathology Flashcards

1
Q

What are the 4 roles of biochemical testing in the diagnosis of disease?

A
  1. Screen patients to detect disease
  2. Confirms presence of a suspected disease
  3. Monitors the progression or response to treatment for the disease
  4. Provides information on the prognosis and likely outcomes of the disease.
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2
Q

What are the 6 different specimen types used in the lab?

A
  1. Serum
  2. Plasma
  3. Urine
  4. Blood Gas
  5. Cerebrospinal fluid
  6. Whole Blood
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3
Q

What preanalytical variables affect results obtained in the lab?

A
  1. Incorrect labeling
  2. Wrong sample
  3. Haemolysis
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4
Q

What is the difference between plasma and serum?

A

Plasma has anticoagulants and blood cells are removed. The serum is clotted.

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5
Q

What happens during haemolysis and why should it be avoided?

A

Haemolysis is the breakdown of red blood cells and it disrupts the integrity of blood.

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6
Q

What are the benefits of point-of-care tests?

A

It is quick and results are available immediately.

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7
Q

What are the 2 different ways of sample collection?

A
  1. Urine Containers

2. Blood Tubes

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8
Q

What is bilirubin?

A

Bilirubin is the compound that is formed from haem proteins.

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9
Q

How is unconjugated bilirubin taken to the liver?

A

Unconjugated bilirubin travels in the blood to the liver via a carrier protein called albumin

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10
Q

What is added to unconjugated bilirubin to make it water-soluble?

A

Glucuronic acid

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11
Q

How is bilirubin excreted from the body?

A

Stercobilin in stool or urobilinogen in urine

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12
Q

What is the cause of Jaundice?

A

Increase in bilirubin

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13
Q

Name 3 causes of prehepatic jaundice

A
  1. Incompatible blood group
  2. Abnormal Haemoglobins
  3. RBC defects
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14
Q

Name 3 causes of intrahepatic jaundice

A
  1. Alcohol
  2. Infective Agents
  3. Hypoxia
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15
Q

Name the cause of posthepatic jaundice

A

Cholestasis - Obstruction of Bile Ducts

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16
Q

How does neonatal jaundice occur?

A

Neonate has high levels of RBC with shorter life span. Therefore, high levels of bilirubin because liver is immature.

17
Q

What enzyme is liver specific?

A

ALT (Alanine aminotransferase)

18
Q

What 2 liver enzymes are indicators of liver cellular damage?

A

ALT + AST

Alanine aminotranferase + aspartate aminotransferase

19
Q

What liver enzymes increase with obstructive liver disease?

A

ALP + GGT

Alkaline Phosphatase + Gamma-glutamyltransferase

20
Q

Where is insulin secreted?

A

Beta-cells in pancreatic Islets of Langerhans

21
Q

Discuss the metabolic actions of insulin

A
  1. Glucose levels rise
  2. Glucose binds to GLUT-2 receptor on beta-cells of Islets of Langerhans
  3. Glucose is metabolized inside the cell and ATP is released
  4. ATP closes the K-channel, K remains inside cell. Therefore, depolarizes the cell
  5. Calcium enters the cell and insulin is released
22
Q

What are the 3 counter-regulatory hormones to insulin?

A
  1. Glucagon
  2. Cortisol
  3. Growth Hormone
23
Q

What is the difference between Type 1 and Type 2 diabetes?

A

Type 1 - Autoimmune disease in which the pancreas does not secrete enough insulin
Type 2 - insufficient insulin is secreted to prevent hyperglycaemia

24
Q

What is the difference between primary and secondary diabetes?

A

Primary - decrease in insulin secretion or insulin action

Secondary - due to other diseases that increase the counter-regulatory hormones to insulin

25
Q

What should normal glucose levels be?

A

3.0 mmol/L - 6.0 mmol/L

26
Q

How is diabetes diagnosed (3)?

A
  1. Plasma glucose is more than 11.1 mmol/L
  2. Fasting plasma glucose more than 7.0 mmol/L
  3. 2 hour Oral Glucose Tolerant Test more than 11.1 mmol/L
  4. Glycated Haemoglobin (HbA1C) greater than 6.5%
27
Q

What is HbA1C?

A

Glycated Haemoglobin - glucose and haemoglobin are bound to each other without an enzyme

28
Q

What are the 2 acute complications of diabetes?

A
  1. Ketoacidosis

2. Non-ketonic hyperglycaemia

29
Q

What are the 6 abnormalities observed in patients with diabetic ketoacidosis?

A
  1. High glucose
  2. High Potassium
  3. High urea
  4. High creatinine
  5. Low Sodium
  6. Lactic acidosis

Essentials for Disease Process (4 decks)

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