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FINALY > Chemistry > Flashcards

Chemistry Flashcards

1
Q

What is the relationship between pH and HCO3?

A

They are proportional to one another.

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2
Q

What is the relationship between pH and PCO2?

A

They are inversely proportional to one another.

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3
Q

Your pH is increased, HCO3 decreased and PCO2 increased. What is this?

A

Analytical error, HCO3 and PCO2 should be decreasing pH but instead it has increased.

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4
Q

The pH is decreased, HCO3 is decreased what is this?

A

Metabolic acidosis

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5
Q

The pH is increased, PCO2 is decreased what is this?

A

Respiratory Alkalosis

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6
Q

How should a blood gas be collected?

A
  • Anaerobically, in a heparinized tube
  • Tested ASAP
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7
Q

Your PCO2 and HCO3 are abnormal but the pH is normal what happened?

A

Full compensation

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8
Q

Your PCO2 and HCO3 are abnormal and the pH is abnormal but getting closer to normal what happened?

A

Partial compensation

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9
Q

What is the #1 ketone present in DKA?

A

Beta Hydroxy buterate

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10
Q

Which ketones can be measured by the dip stick?

A
  • diacetic acid / acetoacetic acid
  • Some strips can pick up acetone 2%
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11
Q

What might cause false ketone reactions in a diabetic patient?

A

Creatinine

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12
Q

Patient presents to emerge and routine chemistry suggests to the doctor that the patient might be in DKA. The doctor orders an add on test for Ketones. Can you run the test with the sample in lab.

A

Yes - if the cap has remained on
otherwise recollect sample required

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13
Q

With which diabetic patient will you see Kousmal breathing?

A

Type 1 patient bc ketones present in their system drives metabolic acidosis - compensated by kousmal breathing (resp).

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14
Q

Which diabetic patient will have acid problems?

A

Type 1 - presence of ketones
Type 2 = no ketones present

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15
Q

For which diabetic patient is Hgb A1c the best monitoring test?

A

Type 2

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16
Q

How should a potassium level be collected?

A

Gold standard - PST

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17
Q

Your patient has an increased PLT count, the phlebotomist collects the sample in a SST. What do you expect to see with the potassium results?

A

Increased because K+ is released during clotting, SST has to clot before being spun and ran on the analyzer.

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18
Q

How much does gross hemolysis cause potassium levels to increase in the sample?

A

30%

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19
Q

You suspect your sample is hemolyzed which analytes are you looking at to determine the sample integrity.

A

LIPAFAM
- Lactic acid
- Inorganic Phosphates
- Potassium
- AST
- Folic acid
- ALT
- Magnesium

20
Q

Your potassium levels are 30 mmol/L, and your Calcium levels are 0.1 mmol/L. What do you do?

A
  • Recollect sample in a Heparinized tube, sample was collected in EDTA.
21
Q

Your sample flags with hemolysis on the analyzer, after investigating you can’t clear the hemolysis because the patient is undergoing in vivo hemolysis. What do you do with your results?

A

You can report them out with a degree of hemolysis, comment stating the results should be interpreted with caution for the following analytes (list the ones affected by hemolysis).

22
Q

A prolonged tied tourniquet will cause what and what do you expect to see if the sample was ran?

A
  • Stasis
  • Affect the protein results
23
Q

How should an ammonia level be collected?

A

EDTA on Ice, received within 20 mins of collection and spun cold

24
Q

What is the equation for sensitivity?

A

Sensitivity = TP / (TP + FN)

25
Q

What is the equation to determine specificity?

A

Specificity = TN / (TN + FP)

26
Q

In an un spun tube glycolysis continues at what rate?

A

Glucose decrease 5-7% per hour.

27
Q

What is the purpose of using a sodium fluoride tube?

A

Measuring glucose when delayed testing
- stops glycolysis after 1 hour

28
Q

How do you determine if Sensitivity/ Specificity is better for a test method?

A

Look at which one is closer to 100%, the more you increase FP/ FN the further away your getting.

29
Q

What analytes will you never dilute in chemistry?

A

Electrolytes

30
Q

What is beers law?

A

Absorbance is proportional to the concentration of the sample.

31
Q

What is the purpose of QC?

A

Check that the standard curve is accurate

32
Q

When is QC ran in chemistry?

A

2 levels every 24 hours

33
Q

The points at which QC measures is called?

A

Medical decision points

34
Q

How do you measure CV?

A

CV = SD/ X

35
Q

You make your calibrator too weak what will happen to your curve?

A

higher readings bc curve = less steep meaning absorbance is further from concentration.

36
Q

You make your calibrator too strong what will happen to your curve?

A

lower reading, curve is steeper = lower absorbance to concentration reading

37
Q

You do a dilution of 3/6, what must you do before you can determine your result from the dilution?

A

Dilute 3/3 and 6/3 to get a numerator of 1. 1/3 the dilution factor is 3 meaning you multiply the result by 3.

38
Q

Why would we run more than 2 levels of QC for an immunoassay?

A

because the relationship is not linear because we don’t truly know what the curve looks like.

39
Q

What is the hook effect?

A

Antigen excess / analyte excess - exceeds linearity

40
Q

You have high Gluc, Na, Cl, and low K, Co2. what happened?

A

Dextrose contamination

41
Q

Why do Patients in DKA have a high K+?

A

Because their in acidosis lots of H+ ions in the system and to compensate the body buffers the H+ in the red cells by Hgb. The cells are then too + charged so it kicks out K who mostly hangs out inside the RBC.

42
Q

What are the three variable the body is always trying to maintain?

A

1 - Volume
2 - pH
3 - Charge

43
Q

What is the best way to measure the persicion of a test method when given the SD and X?

A

Calculate the CV -> smallest CV = best precision

44
Q

What dilution does a wet chemistry analyzer do when testing samples?

A

1:33

45
Q
A

FINALY (4 decks)

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