Chemistry Flashcards
An increased serum level of the following is most commonly associated with decreased glomerular filtration?
Creatinine
Jaffe reaction
Creatinine
What portion of bilirubin is increased in hemolytic anemia?
Increased unconjugated bilirubin
What type of bilirubin predominates in the serum of neonates?
Unconjugated bilirubin (Indirect)
When should peak drug levels be drawn?
1-2 hrs after dose
When should trough drug levels be drawn?
Immediately before next dose
Polyuria and low specific gravity and indicative of what disease process?
Diabetes Insipidus
What are the expected lab results of obstructive jaundice (posthepatic)?
Increased serum bilirubin
Increased urine bilirbin
Decreased urobilinogen
What are the expected lab values for prehepatic jaundice (hemolytic anemia)?
Increased serum unconjugated bilirubin
Increased urine urobilinogen
What are the expected lab values for hepatic disease (cirrhosis, viral hepatitis)?
Increased serum unconjugated + conjuaged bilirubin
Increased urine bilirubin + urobilinogen
Average glucose over 90 days
Diagnosis of diabetes
HbA1c
Detects small amounts of albumin in urine to assess early renal damage
Urinary albumin (microalbumin)
Fasting glucose > 126 mg/dL
>200 mg/dL random glucose
2 hr glucose >200 mg/dL
A1c >6.5%
Diabetes Mellitus
Impaired fasting glucose >100 but <126
Impaired glucose tolerance test >140 but <200
A1c 5.7-6.4%
Pre-diabetes
Insulin decreases what serum value?
Glucose
Metabolite of cocaine
benzoylecgonine
The primary form of secreted nitrogen is?
Urea
Increased in chemo patients, gout, renal failure and leukemia?
Uric acid
If this is increased it is toxic to the CNS?
ammonia level in the serum
Most common advanced liver disease with increased ammonia levels?
Reye’s syndrome
Which of the cardiac markers rises and returns to normal latesest (remains elevated the longest) in acute MI?
Troponin
This cardiac marker rises within 4-6 hrs and peaks at 24 hrs. Returns to normal 3-4 days
Total CK
This cardiac marker rises between 3-6 hrs and peaks at 12-24 hrs. Returns to normal in 2-3 days.
CK-MB
What chemistry will be elevated in young children who’s bones are rapidly developing and bone disorders?
ALP (alkaline phosphatase)
What causes Addison/s disease?
Destruction or failure of the adrenal cortex
Decreased aldosterone
Decreased cortisol
Decreased Hb, Na, Cl and urinary steroids
Addison’s Disease
“Anemic Addison has a problem with everything being decreased.”
Increased Cortisol + aldosterone
Increased Glucose, Na, urinary steroids
Cushing’s Disease
“Cushy Carl has a problem with everything being elevated.”
If elevated what analyte would support a diagnosis of congestive heart failure?
BNP
Decreased TSH
Increased T3 + T4
Hyperthyroidism
Most common cause of hyperthyroidism
Grave’s disease
Go getter Gertrude Graves….everything is racing except my TSH!
Increased TSH
Decreased T3 + T4
Hypothyroidism
Most common cause of hypothyroidism
Hashimoto’s disease
What are the male sex hormones?
androgens
What are the female sex hormones?
estrogens
This hormone regulates reabsorption of water in distal renal tubules?
ADH
This regulates production of adrenocortical hormones by adrenal cortex?
ACTH
This hormone regulates sperm and egg produciton?
FSH
This hormone regulates maturations of follicles, ovulation, production of estrogen, progesterone, testosterone?
LH
Which analyte is measured by the diazo reaction?
bilirubin
What casts have a smokey appearance along with positive blood and protein, RBCs?
Hemoglobin casts
An electrophoresis pattern with a spike in the gamma region is indicative of what?
monoclonal gammopathy
An electrophoresis pattern with a beta gamma bridges is indicative of what?
Cirrhosis
An absence of gamma bridging in protein electrophoresis is indicative of what?
hypogammaglobulinemia
A spike in the Alpha 2 and decrease in albumin in protein electrophoresis is indicative of what?
nephrotic syndrome
What is the clinical utility of testing serum for prealbumin?
Serial low levels indicated compromised nutritional status
What differs in structure, but catalyzes the same reaction?
Isoenzymes
Calculate the LDL
TC-HDL-TG/5
Calculate the anion gap
(Na + K) - (HCO3 + Cl) 10-20 mM/L
Na - (HCO3 + Cl) 7-10 mM/L
Calculate osmolality
2NA + Glucose/18 + BUN/2.8
Ionized calcium is effected by what?
Loss of CO2 and increased pH
If a specimen is done by venipuncture what would be decreased?
PO2
Calculate bicarbonate
Total CO2- H2CO3
Calculate H2CO3
pCO2 x 0.03
Bubbles in syringe would affect blood gas analysis how?
Increased pH + pO2
Decreased pCO2
Sample sitting more then 30 mins would affect blood gas analysis how?
Decreased pH + pO2
Increased pCO2
The secretion of androgens by the testes is stimulated by what?
LH
Which assay is most appropriate to screen for thyroid disease?
TSH
This electrolyte primarily maintains osmotic pressure in the plasma?
Sodium
What cells can not be detected in a urine sample because they lack esterase?
lymphocytes
Measurement of acid phosphatase is used to detect neoplastic disease of the:
prostate
How is LD measured?
By the increase in absorbance at 40 nm as NADH is produced.
If some anti-coagulated blood is added to a red top serum separator what analyte measurement will be markedly increased?
Potassium
Lactate + NAD—–>pyruvate + NADH is the reaction for what analyte?
LD (lactate dehydrogenase)
Increased T4 and increased TSH is indicative of what?
hyperpituitarism
What test should be performed to positively identify crystals in urine?
prussian blue stain
Which crystals in joints cause gout?
monosodium urate
An elevated GGT can be seen in what disease process?
Liver disease
What urinalysis reagent strip test uses the pseudoperoxidase reaction?
Blood
What can effect the level of ionized calcium?
pH
When should levels for trough drug levels be collected?
immediately before next dose
What conditions will increases the total T4 by increasing Thyroxine-binding globulin (TBG)?
pregnancy and estrogen therapy
The volume of plasma from which a substance is removed per unit of time is what?
renal clearance
What analyte is elevated in rhabdomyolosis?
myoglobin
What cell is present in CSF in greater numbers in newborns than in older children or adults?
monocytes
What is the most sensitive analyte of alcoholic liver diasease?
GGT
CSF tube #1
CSF tube #2
CSF tube #3
#1 #2 #3-hematology
Of the total serum calcium, free ionized calcium normally represents approximately what percent?
45%
To compensate for a decreased blood pH the kidneys will:
excrete H ions
To compensate for an increased blood pH the kidneys will:
retain H ions
What is the normal ration of bicarbonate to carbonic acid in arterial blood?
20:1
The plasma protein mostly involved with the binding and transport of free hemoglobin dimers?
haptoglobin
A reaction between soluble antigen and soluble antibody to form aggregates?
Precipitation