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Mercy CLS: Comprehensive Study > Chemistry > Flashcards

Chemistry Flashcards

1
Q

function of C-peptide

A

distinguish exogenous from endogenous insulin

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2
Q

↑↑ insulin and C-peptide

A

insulinoma

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3
Q

gestational DM fasting glucose

A

> 95

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4
Q

4 criteria for DM

A
  1. A1C >6.5%
  2. fasting glucose >126
  3. 2-hour post load glucose >200
  4. random glucose >200 + symptoms
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5
Q

glycolysis reduces glucose in a sample by 5-7% per hour

solution?

A

separate red cells from plasma within 2 hours
sodium fluoride tube

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6
Q

2 main glucose methodologies

A

glucose oxidase
hexokinase (reference method)

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7
Q

CSF glucose

A

60-70% plasma

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8
Q

facilitate absorption and transport of cholesterol

A

micelles

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9
Q

the more dense the lipoprotein, the (larger/smaller) it is

A

smaller

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10
Q

“address tags” to tell the lipoprotein where to go in the body

A

apolipoproteins

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11
Q

lowest density lipoprotein
transports triglycerides from intestines

A

chylomicrons

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12
Q

lipemic plasma which separates out to a creamy layer

A

chylomicrons

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13
Q

lipemia plasma which does not separate out

A

VLDL

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14
Q

Independent, causal risk factor for atherosclerosis
Highly heritable.

A

lipoprotein (a)

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15
Q

triacyl hydrolase (lipase) + glycerophosphate oxidase

A

triglycerides methodology

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16
Q

measure HDL in samples which have been…

A

ultracentrifuged to remove VLDL and LDL

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17
Q

Friedewald formula for calculating LDL

A

LDL = total cholesterol - (HDL + TG/5)

cannot be used if TG >400

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18
Q
  • ↑ waist circumference
  • ↑ triglycerides
  • ↓ HDL
  • ↑ BP
  • ↑ blood glucose
A

metabolic syndrome

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19
Q

UV, visible and infrared spectrum

A

UV < visible (380-750 nm) < infrared

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20
Q

changes the critical angle of light

A

solutes/particles in urine
refractometry
SG

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21
Q

Beer’s law

A

A = abc

A = absorbance
a = absorptivity
b = light path (1 cm)
c = concentration (g/L)

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22
Q

5 parts of a spectrophotometer

A
  • A stable source of radiant energy
  • A device that isolates a specific region of the electromagnetic spectrum
  • A sample holder
  • A photo detector
  • A read-out device
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23
Q

fulminate peptic ulcers
large amounts of gastric hypersecretion
non-β-islet-cell tumors of the pancreas

A

Zollinger-Ellison syndrome

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24
Q

2 causes of PUD

A
  • Helicobacter pylori
  • NSAIDs
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25
Q

oral lactose tolerance test for lactase deficiency positive

A

unchanged blood glucose
↑ stool glucose

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26
Q

large amounts of serum proteins pass into the bowel lumen and ultimately into the feces

A

protein-losing enteropathy

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27
Q

transmural inflammation of the G I tract
unknown etiology

A

Crohn’s disease

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28
Q

Celiac results from a(n) ………. response to the dietary ingestion of gluten-containing grains such as wheat

A

inappropriate T-cell-mediated immune

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29
Q

Arise from enterochromaffin cells of the GI tract
well-circumscribed, round, submucosal lesions

A

carcinoid tumors

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30
Q

Gliadin antibodies (IgA & IgG)
IgA-anti-tissue transglutaminase antibody (TTG)
IgA-endomysial antibody

A

celiac disease tests

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31
Q

test for PLE

A

Alpha-1-antitrypsin
protein electrophoresis (↓ albumin)

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32
Q

↑ fasting serum gastrin

A

Zollinger-Ellison

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33
Q

Whole-body scan after oral selenohomocholyltaurine (SeHCAT)
Measurement of 7α-hydroxy-4-cholesten-3-one

A

Bile salt malabsorption

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34
Q

parts of transferrin

A

apotransferrin-Fe+3 complex

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35
Q

Iron overload without associated tissue injury

A

hemosiderosis

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36
Q

bronzing
cirrhosis
DM

A

hereditary hemochromatosis

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37
Q

serum iron + ——- = TIBC

A

UIBC

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38
Q

heme → ———— → unconjugated bilirubin

A

biliverdin

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39
Q

uridine diphosphate-glucuronyl transferase (UDPGT)

A

enzyme used to conjugate bilirubin

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40
Q

reduces conjugated bilirubin to urobilinogen and stercobilinogen

A

bacterial action

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41
Q

chalky white stool

A

post-hepatic jaundice

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42
Q

Least serious of the inherited unconjugated hyperbilirubinemia and the most common

A

Gilbert’s syndrome

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43
Q

Children are born with a decreased or absolute lack of UDP-glucuronyl transferase.

A

Crigler-Najjar Syndrome

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44
Q

most common cause of unconjugated bilirubinemia

A

neonatal jaundice

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45
Q

fatal complication of neonatal jaundice

A

kernicterus (neurologic damage)

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46
Q

Caused by 6 months to a year of moderate alcohol consumption and results in very few lab abnormalities.

A

alcoholic steatohepatitis

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47
Q

The Child-Turcotte-Pugh system is the most common.

A

cirrhosis staging system

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48
Q

Autosomal recessive disorder of copper metabolism
Kayser-Fleischer rings

A

Wilson disease

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49
Q

Jendrassik-Grof
diazo reagent
blue-green

A

bilirubin methodology

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50
Q

Berthelot reaction
Glutamate dehydrogenase

A

ammonia methodology

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51
Q

The velocity is directly proportional to the substrate concentration.

A

first-order kinetics

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52
Q

The reaction rate is independent of substrate concentration because all enzyme is saturated

A

zero-order kinetics

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53
Q

Inhibitor is structurally different than the substrate and binds to an allosteric site on the enzyme molecule.

A

noncompetitive inhibition

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54
Q

When an inhibitor binds to the E S complex to form an enzyme-substrate inhibiting complex that does not yield product.

A

uncompetitive inhibition

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55
Q

relative CK index and interpretation

A

RI = 100(CK-MB)/total CK

<5% —crushing injury
>5% —myocardial injury

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56
Q

2 > 1 > 3 > 4 > 5

A

LD ratios in healthy person

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57
Q

LD1 and LD2

A

heart

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58
Q

LD3

A

lungs

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59
Q

LD4 and LD5

A

liver and muscle

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60
Q

LD1 > LD2

A

MI

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61
Q

measure the interconversion of NAD+ to NADH at 340 nm

A

LD methodology

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62
Q

Wacker
Wroblewski
LaDue

A

LD methodologies

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63
Q

function of BNP/NTproBNP

A

detecting congestive heart failure

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64
Q

Measuring blood levels of ———- provides better risk assessment for heart disease than measuring any other biomarker.

A

hs-CRP

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65
Q

Marked elevations of —— and —— are associated with hepatocellular disease or damage to hepatocytes.

A

AST
ALT

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66
Q

Marked elevation of —— and ——- is associated with hepatobiliary disease or obstructive liver disease.

A

ALP
GGT

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67
Q

liver enzyme of little value due to lack of tissue specificity.

A

AST

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67
Q

De Ritis Ratio & interpretation

A

AST/ALT

> 1 —alcoholic liver disease
<1 —viral hepatitis

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68
Q
A
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69
Q

ALT elevation

A
  • hepatobiliary disease
  • Paget’s disease/bone disease

Distinguish using GGT; elevated in hepatobiliary disease.

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70
Q

Most sensitive indicator of alcoholic liver disease

A

GGT

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71
Q

Useful with ALP and GGT results in determining whether ALP elevation is from bone or liver disease.

A

5’-Nucleotidase (5’-NT, NTP)

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72
Q

increased in acute pancreatitis, obstructive liver disease, acute alcoholism, and other conditions that affect the pancreas

A

amylase

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73
Q

Maltotetraose reaction

A

amylase methodology

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74
Q

Important in screening for cystic fibrosis and chronic pancreatitis

A

trypsin

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75
Q

↑ ACP (acid phosphatase)

A

benign prostate hypertrophy (BPH) and prostate surgery

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76
Q

phosphatase used in investigating rape

A

ACP

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77
Q

Ochronosis

A

Darkening of the tissues of the body because of the excess homogentisic acid (alkaptonuria)

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78
Q

sensitive marker of poor nutritional status such as protein-energy malnutrition (PEM)

A

Prealbumin/Transthyretin

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79
Q

60% of serum protein

A

albumin

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80
Q

A/G ratio & normal

A

albumin/globulins

normal —1.1-2.5

81
Q

In nephrotic syndrome, increased up to 10 times normal because it is retained while smaller proteins are excreted in the urine

A

alpha 2 macroglobulin

82
Q

biuret method

A

total protein

83
Q

Bromocresol green
Bromocresol purple

A

albumin methodologies

84
Q

protein electrophoresis sample

A

serum —avoid fibrinogen peak

85
Q

MM antibody classes

A

IgG or IgA

86
Q

MM CRAB

A
  • hypercalcemia
  • renal insufficiency
  • anemia
  • bone lesions
87
Q

Malignant proliferation of plasmacytoid cells producing IgM

A

Waldenstrom’s macroglobulinemia

88
Q

mainly albumin in urine

A

glomerular proteinuria

89
Q

all proteins in urine

A

tubular proteinuria

90
Q

normal BUN:creatinine ratio

A

12:0 to 20:1

91
Q

Berthelot’s reaction

A

BUN methodology

92
Q

urease + Na nitroprusside

A

Berthelot’s reaction
BUN methodology

93
Q

Nessler’s reaction

A

BUN methodology

94
Q

Diacetyl or Fearon Reaction

A

BUN methodology

95
Q

proportional to the muscle mass of the individual and it is released into the body fluids at a constant rate

A

creatinine

96
Q

Jaffe reaction
alkaline picrate

A

creatinine methodology

97
Q

major product of purine (adenine and guanine) catabolism

A

uric acid

98
Q

Phosphotungstic acid
allantoin

A

uric acid methodology

99
Q

creatinine clearance

A

CrCl = (urine conc)(urine volume in ml/min)/(plasma conc)

100
Q

creatinine clearance corrected for body mass

A

CrCl = (UV/P)(1.73/BSA)

101
Q

inability to make ammonia produces an ——— urine

A

alkaline

(blood is acidic)

102
Q

Hamburger shift

A

Cl- and HCO3- “trade places” in the RBC to keep the pH correct

103
Q

Henderson-Hasselbalch Equation for blood pH

A

pH = 6.1 + log[HCO3/(pCO2)(0.03)]

104
Q

normal blood pH

A

7.35-7.45

105
Q

normal blood HCO3

A

22-26 mmol/L

106
Q

normal blood pCO2

A

35-45 mmHg

107
Q

accounts for about 80% of buffering capacity

A

hemoglobin

108
Q

acidemia (increases/reduces) Hgb affinity for O2

A

reduces

muscle environment

109
Q

normal pO2

A

85-108 mmHg

110
Q

↓ pH
↓ bicarb
N pCO2

A

uncompensated metabolic acidosis

111
Q

fully compensated

A

pH is normal, but bicarb and CO2 are both out

112
Q

blood gas sample requirements

A

Arterial specimen tightly stoppered
Heparinized syringe
On ice
No air bubbles
Perform ASAP

113
Q

methodology using the Nernst equation

A

potentiometry

114
Q

anion gap & normal

A

anion gap = (Na + K) - (Cl + HCO3)
normal —10 - 20 mEq/L

anion gap = (Na) - (Cl + HCO3)
normal —7 - 16 mEq/L

115
Q

effects on boiling and freezing points as osmolality increases

A

Boiling point is elevated
Freezing point is depressed

116
Q

calculated osmolality

A

mOsm/kg = 1.86(Na) + (glucose/18) + (urea/2.8) + 9

117
Q

normal serum osmo

A

275-300 mOsm/kg

118
Q

osmo gap

A

osmo gap = measured osmo - calculated osmo
normal — approx. 0

119
Q

effects of angiogensin, aldosterone, ADH on NaCl & water

A

angiotensin, aldosterone: ↑ NaCl and water reabsorption

ADH: ↑ water reabsorption

120
Q

effects of BNP, urodilatin on NaCl & water

A

inhibits reabsorption

121
Q

RAAS works to ——– BP

A

increase

122
Q

↑ ADH
↓ water output
↑ water retention

A

SIADH

123
Q

reduces excretion of urine by reabsorbing the water back into the body

A

ADH

124
Q

ADH deficiency

A

diabetes insipidus

125
Q

2 types of DI

A
  • nephrogenic —does not respond to ADH
  • central —does not produce ADH
126
Q

Increased urine output >2.5L/day
Urine is diluted, low specific gravity, low urine osmolality
Crave water/ice

A

DI

127
Q

Low serum osmolality
Fluid overload (weight gain)
Hyponatremia, with continued sodium excretion
Low urine output with high specific gravity

A

SIADH

128
Q

> 25 osmo gap

A

suspect ingestion of toxic substances

129
Q

stimulate and promote cellular growth, differentiation, and survival

A

trophic hormones

130
Q

used by the hypothalamus to stimulate the pituitary

A

releasing factor (hormone)

131
Q

hormone overproduction is not suppressed by feedback inhibition

A

gland autonomy

132
Q

used to document hyposecretion of hormones

A

stimulation tests

133
Q

used to document hypersecretion of hormones

A

suppression tests

134
Q

Hormonal disorder of middle-aged persons marked by elongation and enlargement of bones of the extremities and certain head bones

A

acromegaly

135
Q

Elevated levels of GH occurring before long-bone growth is complete

A

pituitary gigantism

136
Q

2 catecholamine-producing tumors of the adrenal gland

A

pheochromocytoma and neuroblastomas

137
Q

↑ VMA
↑ Urinary Catecholamines
Normal Dopamine
Normal HVA

A

pheochromocytoma

138
Q

↑ VMA
↑ Urinary Catecholamines
↑ Dopamine
↑ HVA

A

neuroblastoma

139
Q

collection for catecholamine measurement

A

24 hour urine properly collected and preserved with hydrochloric acid to maintain acid pH, stored at -80°C

blood in heparin or EDTA tubes on ice, centrifuged at 4°C, plasma stored at -80°C

140
Q

primary hypersecretion of hormone

A

main hormone ↑
tropic hormone ↓

141
Q

secondary hypersecretion of hormone

A

main hormone ↑
tropic hormone ↑

142
Q

primary adrenal hyposecretion

A

Addison’s disease

143
Q

profound fatigue, weakness, weight loss, hypoglycemia, hyperpigmentation, hypotension, and hyperkalemia

A

Addison’s disease

144
Q

Destructive events in the hypothalamus or pituitary gland that result in a decreased ability to secrete ACTH or CRH

A

secondary or tertiary adrenal hyposecretion

145
Q

Cosyntropin Synacthen

A

used in ACTH stimulation tests

146
Q

Assesses the pituitary reserve and is useful for differential diagnosis of adrenal insufficiency

A

Metyrapone Stimulation

147
Q

secondary adrenal hypersecretion
Pituitary is stimulated to release increased amounts of ACTH

A

Cushing’s disease

148
Q

primary adrenal hypersecretion
Elevated levels of cortisol due to either medications or the presence of an adrenal tumor (adrenal adenoma)

A

Cushing’s syndrome

149
Q

17-OHCS test (urine)

A

Cushing’s

150
Q

Dexamethasone Suppression Test

A

Cushing’s

151
Q

adrenal hyperplasia with deficient synthesis of cortisol

A

Congenital Adrenal Hyperplasia (CAH)

152
Q

Two main causes of autonomous hypersecretion of aldosterone

A

Conn’s syndrome
Idiopathic hyperaldosteronism

153
Q

most reliable way to diagnose primary hyperaldosteronism

A

Adrenal bilateral vein catheterization and measuring serum aldosterone

154
Q

Moonface
Buffalo Hump
Facial acne
Hirsutism
Purple Abdominal Striae
Bruises and petechiae
Osteoporosis
Edema
Thin skin

A

Cushing’s

155
Q

deficiency of GnRH during embryonic development in both males and females. Characterized by hypogonadism and lost sense of smell (anosmia).

A

Kallman’s syndrome

156
Q

XXY chromosomes (47 karyotype), infertile, small testicles, sparse facial and body hair, reduced muscle mass, and enlarged breasts

A

Klinefelter’s syndrome

157
Q

55 X karyotype

A

Turner’s syndrome

158
Q

46 XX or XY karyotype

A

pure gonadal dysgenesis

159
Q

infertility, hirsutism, obesity, irregular vaginal bleeding, and acanthosis nigricans

A

PCOS

160
Q

Molar tissue is a developmental anomaly of the placenta that has the potential for malignant growth

A

hydatidiform mole

161
Q

LH:FSH ratio >2:1
no menstural cycle

A

PCOS

162
Q

no estrogen
increased LSH and FSH

A

menopause

163
Q

most common cause of hypothyroidism

A

Hashimoto’s

164
Q

most common cause of hyperthyroidism

A

Grave’s disease

165
Q

Exophthalmic eye (Eye bulging)
Tremors
Weight Loss

A

Graves’ disease

166
Q

thyroid peroxidase +

A

Hashimoto’s

167
Q

thyroid receptor antibody +

A

Grave’s disease

168
Q

goiter

A

Hashimoto’s

169
Q

phylloquinone

A

vitamin K assay

170
Q

Beriberi, Wernicke-Korsakoff syndrome

A

B1 (thiamine) deficiency

171
Q

Pellagra

A

B3 (niacin) deficiency

172
Q

Rickets

A

vitamin D deficiency

173
Q

PTH and vitamin D3 —– serum iCa and —— Phos

A

↑
↓

174
Q

should be measured with iCa

A

pH; inverse relationship

175
Q

sample for intraoperative PTH

A

K3-EDTA

176
Q

CEA

A

GI, pancreatic, lung, breast malignancies

177
Q

CA 15-3

A

breast, ovarian malignancy

178
Q

CA 549

A

breast malignancy

179
Q

CA 27.29

A

breast malignancy

180
Q

CA 125

A

ovarian malignancy

181
Q

CA 19-9

A

GI, pancreatic, hepatic malignancies

182
Q

CA 242

A

GI, pancreatic malignancies

183
Q

protooncogene p53

A

breast, colorectal, lung, liver malignancies

184
Q

therapeutic drugs run on WB

A

Cyclosporine & Tacrolimus

185
Q

Structural analog of phenobarbital

A

primidone

186
Q

major metabolite is NAPA

A

procainamide

187
Q

Alkaloid obtained from the bark of the cinchona tree

A

quinidine

188
Q

signs of adulterated urine

A
  • pH <3 or ≥11
  • Nitrite concentration ≥ 500 ug/mL
  • Presence of chromium (VI)
  • The presence of halogens (bleach, iodine, fluoride)
  • The presence of glutaraldehyde
  • The presence of pyridine (pyridinium chlorochromate)
  • The presence of a surfactant
  • The presence of any other adulterant not specified in 3-7 is verified using an initial test on the first aliquot and a different confirmatory test on the second aliquot
189
Q

Not useful if the time of ingestion is unknown or unreliable

A

acetaminophen levels

190
Q

Can cause…

Respiratory alkalosis
Uncompensated respiratory acidosis
Metabolic acidosis

A

salicylate poisoning

191
Q

Represent the most widely prescribed drugs due to their principal pharmacological effects

A

benzos

192
Q

Qualitative screening test in urine is designed to detect the metabolite benzoylecgonine

A

cocaine

193
Q

Causes miosis or constriction of the pupils in most patients

A

methadone

194
Q

Current biomarker for assessment is venous whole blood with or without measured fluorinated ethylene propylene (FEP).

A

lead

195
Q

Competes with ethanol for alcohol dehydrogenase (ADH)

A

methanol

196
Q

Calcium oxalate crystals in the urine
Increase in osmol gap
Increase in anion gap

A

ethylene glycol

197
Q

measure serum butyrylcholinesterase (pseudocholinesterase) activity to diagnose acute ingestion or monitoring chronic exposure

A

Organophosphate and Carbamate Compounds

198
Q

% CV =

A

100(SD)/mean

199
Q

RCF =

A

(1.118 x 10^-5)(r)(rpm)^2

200
Q

two etched rings at the top

A

blowout step on pipette

201
Q

1 gallon = ——— liters

A

3.79

Mercy CLS: Comprehensive Study (9 decks)

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