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Clinical Chemistry II - 4378 > Chemistry exam D > Flashcards

Chemistry exam D Flashcards

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1
Q

Vitamin B1 is

A

Thiamine

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1
Q

What type of vitamin causes vision impairment

A

Vitamin A( retinol)

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2
Q

If a Lab tech is brought to court, the court must first prove

A

Negligence according to new lab management first pp.

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3
Q

How should you test for precision?

A

Test three known elevated samples

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4
Q

Know how a elevated thyroid ( T4 and TSH) effects pregnancy

A

Estrogen and pregancy will cause a rise in both T4 and TSH
Normal pregnancy will cause a rise in T4 but a normal TSH

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5
Q

Preganancy will cause

A

elevated estrogen, which will cause an elevated in thyroid binding globulin, which will increase T4 but but a decrease in free T4 because they are bound to a carrier protein.

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6
Q

Pregnancy

A

will cause an elevated T4 but a normal TSH,

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7
Q

Most common cause of thyrotoxicosis is what

A

Graves disease which will cause an antibody against the thyroid cause an over excretion of thyroid hormones such as T4 and T3.

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8
Q

Hyperthyroidism will cause an elevated

A

T4 and a decrease in TSH.

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9
Q

Antibody screens will look for

A

Can look for autoimmune diseases like graves and look for pregnancy complications.

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10
Q

Beers lambert law=

Unknown / standard abs* std concentration

A

A* B* C where a is absorbance and B is path length in CM and C is concentration.

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11
Q

Unknown Abs=

A

Known standard absorbance * ( unknown concentration/ Standard concentration).

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12
Q

Absorbance= in terms of % T

A

2-log(T%)

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13
Q

Half-life equals simple equation

A

T^ X where X is the number of half-lives and T is the number your trying to figure out.

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14
Q

How much do you need if you have 5N of HCL when 2N HCL= 30ug/Dl?

A

N1V1=N2V2 5N of HCL* Unknown conc= 2N of HCL * 30ug/dl

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15
Q

Half live calculation= complex equation

A

NT= N0(1/2)^ ( t/t1/2)

where N0 is the concentration of the initial material
where t is the time elapsed
where t1/2 is the half-life of the substance

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16
Q

Normality equation is

A

number of equivalent units/ liter of solution
or
Mol* n= Normality

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17
Q

Molarity=

A

Mol of solute/ liter of solution

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18
Q

unbound TBH calculation

A

(T3 uptake* T4/100)= FTI or free thyroid index

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19
Q

T3 uptake measures the amount of unbound what

A

TBG

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20
Q

Since greater then 99% of thyroid hormones T3 and T4 are bound to proteins,

A

any change of TBG levels will cause an increase in serum T3 and T4.

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21
Q

Primary hypothyroidism

A

The thyroid secretes insufficient amounts of T3 and T4 and causes an increase in TSH.

so decrease T3 and T4 and an increase in TSH.

IF you have an autoantibody it is= hoshimotos

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22
Q

Secondary hypothyroidism

A

The pituitary gland secretes insufficient TSH leading to decrease levels of T3 and T4.

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23
Q

Addision disease has decreased what

A

Decreased cortisol
Decreased urinary steroids
Decrease Aldosterone
Decrease Na+
Decrease Cl-
Decrease Hb

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24
Q

Cushing’s disease had increased what

A

Increased Cortisol( no diurnal variation
Increased urinary steroids
“Buffalo Hump”
Increased Cl-
Increased Na+
Increase Aldosterone
Increased Hb

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25
Q

Catecholamines are a type of what

A

VMA metabolite

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26
Q

VMA is more sensitive than the other catecholamine metabolites which are

A

Metanephrine and Noremetanephine

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27
Q

Norepinephrine is a

A

Monoamine that contains a Catecol and an amine side chain.

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28
Q

Catecholamine produces _______ is derived from the adrenal medulla.

A

Tumors arising from the chromaffin cells

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29
Q

symptoms of chromaffin cell cancers are

A

Headaches, night sweating, and hypertension.

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30
Q

Which drug is used to correct heart irregularities

A

Quininones

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31
Q

Normal value of 100, with an SD of 1.3 and a confidence limit of 95%. What is the value in mg/dl?

A

+/- 2 SD

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32
Q

A drug that you need to send out for confirmation gives you an equation like NAD–> NADH at 340nm. Which method would you do?

A

HPLC with MS.

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33
Q

Schillings test

A

Pernicious anemia if IF fixes the problem.

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34
Q

How many milliliters of HCL ( SG of 1.9, 38% assay purity would you need to make a 1000ML solution of .5N HCL

A

(38(100/1.19)) = .4522g/ml of HCL

then take 1N=1M HCl so .5N=.5M of HCL

then you take 1000ml and divide that by 1000 to get 1 L and .5M of HCL=.5mol of HCL

then you take .5 and multiply it by the molecular weight which is 36.47 .5*.36.47= 18.235g

Then you take 18.22/.4522= 40.4ml

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35
Q

Proiodine is the prodrug of

A

Phenobarbital

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36
Q

Who manages wavied testing

A

CLIA

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37
Q

If a patient had low cortisol and ACTH was still low, what could it be caused by

A

Addisons

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38
Q

Which method separates analytes based on media and their solubility

A

Chromatography

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39
Q

What is the purpose of nephelometry measuring at 90-degree angles?

A

light scatter that is appropriate for the particle size, Rayleigh= 90 degrees where Size is greater then the wavelength.

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40
Q

Cardiac glycoside is

A

Digoxin, digitoxin

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41
Q

antiarrhythmics

A

Lidocaine, proponolol, quinidine procainaimide, disopyrimide, aminodarone

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42
Q

Antiasthmatic is what drug

A

theophylline

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43
Q

antiepileptics are

A

Carbamazepine,Etosuximide, phenobarbitual, phenytoin, primidone Valoproic acid and Benzodiazepines

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44
Q

Antidepressants are

A

Nortryptyline, protryptyline, lithium

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45
Q

antineoplastics

A

Methotrexate

46
Q

Immunosuppressents

A

cyclosporine and tacrolimus

47
Q

Anticoagulants

A

Warfarin

48
Q

Antibiotics

A

Gentamycin, Amikacin, tobramycin, and Vancomycin

49
Q

Produces what by hydroxylation of tyrosin

A

Catecholamines such as norepinephrine and epinephrine

50
Q

The functions of catecholamine are

A

Increase blood pressure, Heart rate, and Blood sugar

51
Q

Catecholamines are released in response to

and transported and regulated by ___________

A

Pain and emotional stress and transported free in blood and regulated by feedback

52
Q

Metabolites of catecholamine target

A

metanephrine and normetanephrine

53
Q

Vallniylvandelic acid enzyme is what

A

The enzyme is monoamine oxidase, MAO)

54
Q

Metabolite of cocaine is

A

Cholinesterases
and Benzoylegonine and ecgonine methyl ester

55
Q

Steroids are derived from what

A

Cholesterol

56
Q

Theophylline is a broncho what

A

Dilator

57
Q

Something about the best way for 100% bioavailability

A

Intravenous

58
Q

CV=

A

(SD/mean)* 100

59
Q

Theophylline is 5 at peak level and 4.2 at trough level, what is the most likely explanation for this

A

Blood for peak level was drawn to soon

60
Q

The patient has a history of miscarriage; what is the best hormone the dr can look at in the first trimester to see for injury to a baby

A

B-HCG

61
Q

The patient has a history of hypertension and increased catecholamine; what could be this disorder.

A

pheochromocytoma

62
Q

TH regulations what form of metabolism

A

Glucose metabolism–> glucose going into the cell, Glucose –> fat and muscle and regulates lipolysis. Also regulates body metabolism and regulates oxidative phosphorylation. gluconeogenesis–> low TH and glycogenolysis–> high TH.

regulates basal energy metabolism

63
Q

Cretinism

A

where there is no thyroid gland and if not treated can lead to developmental disorders and leads to death.

64
Q

Juvenile myxedema

A

is a genetic defect where the thyroid gland is not functioning after birth

65
Q

Adult myxedema

A

Where the thyroid gland stops functioning at the age of thirty. where there is hair loss and baldness, mental dullness might occur and leads to a failure to thrive. vocal cords will swell, and there are anemia, obesity, and paranoia.

66
Q

goiter

A

enlargement of the thyroid gland due to deficiency of iodine.

67
Q

Hashimotos disease

A

where you have an autoantibody that targets thyroxine and thyroglobulin leads to hypothyroidism.

68
Q

Graves disease

A

Is where you have an autoantibody that resembles TSH and leads to hyperthyroidism and is more common in women.

69
Q

Thyroid tumors ( goiters)

A

Caused by an abnormal enlargement of the gland due to lo little or too much hormone being produced.

70
Q

Thyroid hormones regulation

A

Thyroid releasing hormone stimulates TSH release from the anterior pituitary gland and causes an increase in T4 and T3. Which then causes a feedback mechanism to ensure that makes it that when T4 and T3 are low then TSH production is stimulated and vise versa.

71
Q

thyroid hormones T3 and T4 are produced by

A

Idinozation of tyrosine

72
Q

Where is thyroglobulin stored?

A

In the colloid within follicles and T4 is formed by adding Iodine ions to thyroglobulin.

73
Q

thyroid binding globulin

A

is a glycoprotein that binds T3 and T4 and prevents them from being excreted in the urine. 99.9% of T4 and 70% T3 is bound to this protein

74
Q

Glucocoritcoids

A

Are produced by the adrenal cortex and make in the zona fascicuclata and function to make cortisol, deoxycoritisol, cortisone, and involved in the stress response to stimulate other gluconeogenesis, mobilizes fats and proteins and is involved in immunosuppression.

75
Q

mineralocorticoids

A

are aldosterone that is secreted in the zona glomerulosa. It is involved in regulating sodium reabsorption. Furthermore, it regulates fluid volume and increased blood volume through the renin angiotensin aldosterone system

76
Q

androgens

A

Is secreted from the zona reticularis and stimulates Dihydroepisterone, testosterone, and DHEA- Sulfate release. Responsible for males’ secondary sex characteristics.

77
Q

estrogen

A

is produced in the zona reticularis and is involved in the development of secondary sex characteristics in females. Which includes estradiol which is the bioactive form, estriol, and estrogen.

78
Q

Cortisol feedback mechanism

A

Low blood glucose stimulates the Corticotropin-releasing hormone CRP which then stimulates the release of ACTH and then of Deoxycorticol, which then secretes cortisol from the adrenal cortex. Cortisol then binds to transcortin or is in its free active form.

79
Q

functions of cortisol

A

Responses to stress and stimulates gluconeogenesis and then stimulates an antiinflammatory response but to much can reduce the immune systems function. Also stimulates the enzymes involved in gluconeogenesis. and stimulates fat metabolism and erythropoiesis.

80
Q

angiotension aldosteron system

A

angiotensinogen–> angiotension 1 by renin
angiotension one–> angiotension 2 by ACE ( vasoconstrictor= angiotension 2)
Angiotension 2–> ADH arginine vasopressin( vasocontrictor) and aldosterone.

81
Q

Angiotensinogen 1 is weaker than what

A

Angiotensinogen 2 but it can regulate BP to some degree.

82
Q

17 hydroxysteroids regulate

A

glucocorticoids Cortisol

83
Q

17 ketosteroids regulate

A

androgen testosterone

84
Q

both hydro ketones and hydroxysteroids can be used to measure what

A

Cortisol and measure addisions and cushings

85
Q

Catecholamines are produced in the ________ and are precursors to ___________ and have a ________ side chain, with a _______ molecule.

A

Addernal medulla

tyrosine

Amino

catechol

86
Q

Norepinephrine

A

Stimulates insulin increasing, glycogenolysis increases vasoconstriction, piloerection stimulates sweating

87
Q

epinephrine

A

Depends on which receptor insulin is working on and is opposite of NE sometimes–> stimulates vasodilation, a bronchodilator, smooth muscle relaxation, and stimulates vasoconstriction and effects carb metabolism

88
Q

Dopamine

A

Functions as a neurotransmitter and stored within granules inside of neurons .

89
Q

what is high before the follicular phase

A

FSH

90
Q

What is high at Ovulation

A

LH

91
Q

LH stimulates the secretion of what

A

FSH

92
Q

Why are FH and LSH measured?

A

For childhood development issues. and for gonad communication problems, and finally, for Pregnancy complications,

93
Q

What is gastrin

A

Is a hormone that is responsible for the secretion of HCL and is located in the stomach. Its function is to help the body produce acid and is also involved in controlling bile flow, also in controlling the pancreas enzymes. In Zollinger-Nelson syndrome, it is 4 * the upper reference range, and there are no renal issues.

94
Q

what is estrogen

A

It is a hormone that is produced in women and men. It is responsible for the development of women’s secondary sex characteristics such as Breast development, and is higher in women of child bearing age. Also it gives men protection of there sperm.

95
Q

Progesterone

A

Is a hormone that is high in women regulates the sexual desire of women and is important in pregnancy. Also, it stimulates the menstrual cycle in women.

96
Q

how do you test for estrogens

A

You do a urine immunoassay where you conjugate estriol is raised against 16,17___dihemisuccinate _____ to serum bovine albumin, and it is a homogeneous immunoassay, an Illumnescence assay.

97
Q

Estradiol

A

Is the most important form of estrogen in the body and is responsible for conversion to estrogen in fat tissues. Also, it is produced in the placenta during pregnancy, and the adrenal cortex + the ovaries mainly.

98
Q

Estrone synthesis

A

Is primarily responsible for measuring in menopausal women, and it is the least common type of estrogen. It is common in pre-puberty girls . Furthermore, in pre-puperty girls it is converted in the tissues as androstenedione. Also, it may be measured in women and men who have cancers of the ovarian or adrenal gland and testes.

99
Q

what type of assay is used for T4 measurements

A

Double antibody binding immunoassay, where a anti T4 antibinds binds to T4 and then 1251 antibody that is attached to a conjugate is used as a substrate. It is used to measure free T4 in serum.

100
Q

T3 rasin immunoassay

A

Is used to measure T3 which will indirectly give the concentration of T4, and uses a resin to bind T3 then in cases of hypothyroidism T3 rasin is low and in cases of hyperthyroidism T3 rasin is High.

101
Q

TSH assay

A

Uses a multiplex assay that will use streptavidin as a substrate and biotinylated antibodies to TSH. then the wells are washed and you use Flow cytometry as a interpret device.

102
Q

T-3 uptake assay

A

Is an assay that measures the amount of unsaturated TBG, and it does so that T4 values can be indirectly measured because in cases where you have an increase in T4. you will most likely have an increase in TBG. Unsaturated TBG is the amount of unbound by T4 or T3 TBGs in the blood.

103
Q

Free thyroid index is what type of assay.

A

An assay that measures free T4

It is an assay that is used for cases of hyper or hypothyroidism.

104
Q

T3 uptake calculate

A

Total serum T4 * uptake of serum / % of T uptake pooled reference serum

105
Q

Cortisol is a example of _____

It is measured with what type of analyte

A

Diurnal variation

It is measure with a creatinine clearance to make sure that it is a 24 hour sample

Low blood glucoce–> pituitary—> CRH–> the release of ACTH—-> the release of Cortisol and since glucose is low at night then it means cortisol is high in the morning 15-25g at Am vs 5-15g at 4pm.

106
Q

Cushing’s disease

A

There is a high amount of cortisol and aldosterone and this leads to increased sodium and decrease potassium. Which then leads to increased Blood pressure and a increase in blood glucose. Furthermore, there is a low of diurnal variation since cortisol is high all day.

107
Q

Dexamethasone

A

Is a drug that reduces cortisol levels and does this by ACTH reduction. If it reduces then the patient has no cushings disease. If it does not reduce then the patient has crushing disease.

108
Q

metyrapone

A

is a drug that is used to suppress help distinguish the difference from Cushings disease( pituitary disease) from Cushings syndrome ( which is a adrenal response). It does this by stimulating ACTH release and in Cushings syndrome will be decreased in response vs in Cushings disease it will be increased in response.

109
Q

ACTH stimmulation

A

Is a test where you give your patient some ACTH and is where cortisol is increased by a factor of 2. Furthermore, It is used to diagnosis Addisons disease as compared to cushings disease.

110
Q

Salt loading

A

Is where you give a patient a large amount of salt and in cushings there is a increase in salt in the urine as compared to addisons a decrease salt in the urine.

111
Q

Zimmerman reaction

A

Glucuronic and acid cleavage will remove cortisol after extraction and then a reaction of cortisol and nitrobenzene will produce a colored compound( purple)

112
Q
A

Clinical Chemistry II - 4378 (28 decks)

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