Chemistry exam D Flashcards
Vitamin B1 is
Thiamine
What type of vitamin causes vision impairment
Vitamin A( retinol)
If a Lab tech is brought to court, the court must first prove
Negligence according to new lab management first pp.
How should you test for precision?
Test three known elevated samples
Know how a elevated thyroid ( T4 and TSH) effects pregnancy
Estrogen and pregancy will cause a rise in both T4 and TSH
Normal pregnancy will cause a rise in T4 but a normal TSH
Preganancy will cause
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.
Pregnancy
will cause an elevated T4 but a normal TSH,
Most common cause of thyrotoxicosis is what
Graves disease which will cause an antibody against the thyroid cause an over excretion of thyroid hormones such as T4 and T3.
Hyperthyroidism will cause an elevated
T4 and a decrease in TSH.
Antibody screens will look for
Can look for autoimmune diseases like graves and look for pregnancy complications.
Beers lambert law=
Unknown / standard abs* std concentration
A* B* C where a is absorbance and B is path length in CM and C is concentration.
Unknown Abs=
Known standard absorbance * ( unknown concentration/ Standard concentration).
Absorbance= in terms of % T
2-log(T%)
Half-life equals simple equation
T^ X where X is the number of half-lives and T is the number your trying to figure out.
How much do you need if you have 5N of HCL when 2N HCL= 30ug/Dl?
N1V1=N2V2 5N of HCL* Unknown conc= 2N of HCL * 30ug/dl
Half live calculation= complex equation
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
Normality equation is
number of equivalent units/ liter of solution
or
Mol* n= Normality
Molarity=
Mol of solute/ liter of solution
unbound TBH calculation
(T3 uptake* T4/100)= FTI or free thyroid index
T3 uptake measures the amount of unbound what
TBG
Since greater then 99% of thyroid hormones T3 and T4 are bound to proteins,
any change of TBG levels will cause an increase in serum T3 and T4.
Primary hypothyroidism
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
Secondary hypothyroidism
The pituitary gland secretes insufficient TSH leading to decrease levels of T3 and T4.
Addision disease has decreased what
Decreased cortisol
Decreased urinary steroids
Decrease Aldosterone
Decrease Na+
Decrease Cl-
Decrease Hb
Cushing’s disease had increased what
Increased Cortisol( no diurnal variation
Increased urinary steroids
“Buffalo Hump”
Increased Cl-
Increased Na+
Increase Aldosterone
Increased Hb
Catecholamines are a type of what
VMA metabolite
VMA is more sensitive than the other catecholamine metabolites which are
Metanephrine and Noremetanephine
Norepinephrine is a
Monoamine that contains a Catecol and an amine side chain.
Catecholamine produces _______ is derived from the adrenal medulla.
Tumors arising from the chromaffin cells
symptoms of chromaffin cell cancers are
Headaches, night sweating, and hypertension.
Which drug is used to correct heart irregularities
Quininones
Normal value of 100, with an SD of 1.3 and a confidence limit of 95%. What is the value in mg/dl?
+/- 2 SD
A drug that you need to send out for confirmation gives you an equation like NAD–> NADH at 340nm. Which method would you do?
HPLC with MS.
Schillings test
Pernicious anemia if IF fixes the problem.
How many milliliters of HCL ( SG of 1.9, 38% assay purity would you need to make a 1000ML solution of .5N HCL
(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
Proiodine is the prodrug of
Phenobarbital
Who manages wavied testing
CLIA
If a patient had low cortisol and ACTH was still low, what could it be caused by
Addisons
Which method separates analytes based on media and their solubility
Chromatography
What is the purpose of nephelometry measuring at 90-degree angles?
light scatter that is appropriate for the particle size, Rayleigh= 90 degrees where Size is greater then the wavelength.
Cardiac glycoside is
Digoxin, digitoxin
antiarrhythmics
Lidocaine, proponolol, quinidine procainaimide, disopyrimide, aminodarone
Antiasthmatic is what drug
theophylline
antiepileptics are
Carbamazepine,Etosuximide, phenobarbitual, phenytoin, primidone Valoproic acid and Benzodiazepines
Antidepressants are
Nortryptyline, protryptyline, lithium
antineoplastics
Methotrexate
Immunosuppressents
cyclosporine and tacrolimus
Anticoagulants
Warfarin
Antibiotics
Gentamycin, Amikacin, tobramycin, and Vancomycin
Produces what by hydroxylation of tyrosin
Catecholamines such as norepinephrine and epinephrine
The functions of catecholamine are
Increase blood pressure, Heart rate, and Blood sugar
Catecholamines are released in response to
and transported and regulated by ___________
Pain and emotional stress and transported free in blood and regulated by feedback
Metabolites of catecholamine target
metanephrine and normetanephrine
Vallniylvandelic acid enzyme is what
The enzyme is monoamine oxidase, MAO)
Metabolite of cocaine is
Cholinesterases
and Benzoylegonine and ecgonine methyl ester
Steroids are derived from what
Cholesterol
Theophylline is a broncho what
Dilator
Something about the best way for 100% bioavailability
Intravenous
CV=
(SD/mean)* 100
Theophylline is 5 at peak level and 4.2 at trough level, what is the most likely explanation for this
Blood for peak level was drawn to soon
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
B-HCG
The patient has a history of hypertension and increased catecholamine; what could be this disorder.
pheochromocytoma
TH regulations what form of metabolism
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
Cretinism
where there is no thyroid gland and if not treated can lead to developmental disorders and leads to death.
Juvenile myxedema
is a genetic defect where the thyroid gland is not functioning after birth
Adult myxedema
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.
goiter
enlargement of the thyroid gland due to deficiency of iodine.
Hashimotos disease
where you have an autoantibody that targets thyroxine and thyroglobulin leads to hypothyroidism.
Graves disease
Is where you have an autoantibody that resembles TSH and leads to hyperthyroidism and is more common in women.
Thyroid tumors ( goiters)
Caused by an abnormal enlargement of the gland due to lo little or too much hormone being produced.
Thyroid hormones regulation
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.
thyroid hormones T3 and T4 are produced by
Idinozation of tyrosine
Where is thyroglobulin stored?
In the colloid within follicles and T4 is formed by adding Iodine ions to thyroglobulin.
thyroid binding globulin
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
Glucocoritcoids
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.
mineralocorticoids
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
androgens
Is secreted from the zona reticularis and stimulates Dihydroepisterone, testosterone, and DHEA- Sulfate release. Responsible for males’ secondary sex characteristics.
estrogen
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.
Cortisol feedback mechanism
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.
functions of cortisol
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.
angiotension aldosteron system
angiotensinogen–> angiotension 1 by renin
angiotension one–> angiotension 2 by ACE ( vasoconstrictor= angiotension 2)
Angiotension 2–> ADH arginine vasopressin( vasocontrictor) and aldosterone.
Angiotensinogen 1 is weaker than what
Angiotensinogen 2 but it can regulate BP to some degree.
17 hydroxysteroids regulate
glucocorticoids Cortisol
17 ketosteroids regulate
androgen testosterone
both hydro ketones and hydroxysteroids can be used to measure what
Cortisol and measure addisions and cushings
Catecholamines are produced in the ________ and are precursors to ___________ and have a ________ side chain, with a _______ molecule.
Addernal medulla
tyrosine
Amino
catechol
Norepinephrine
Stimulates insulin increasing, glycogenolysis increases vasoconstriction, piloerection stimulates sweating
epinephrine
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
Dopamine
Functions as a neurotransmitter and stored within granules inside of neurons .
what is high before the follicular phase
FSH
What is high at Ovulation
LH
LH stimulates the secretion of what
FSH
Why are FH and LSH measured?
For childhood development issues. and for gonad communication problems, and finally, for Pregnancy complications,
What is gastrin
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.
what is estrogen
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.
Progesterone
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.
how do you test for estrogens
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.
Estradiol
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.
Estrone synthesis
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.
what type of assay is used for T4 measurements
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.
T3 rasin immunoassay
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.
TSH assay
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.
T-3 uptake assay
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.
Free thyroid index is what type of assay.
An assay that measures free T4
It is an assay that is used for cases of hyper or hypothyroidism.
T3 uptake calculate
Total serum T4 * uptake of serum / % of T uptake pooled reference serum
Cortisol is a example of _____
It is measured with what type of analyte
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.
Cushing’s disease
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.
Dexamethasone
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.
metyrapone
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.
ACTH stimmulation
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.
Salt loading
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.
Zimmerman reaction
Glucuronic and acid cleavage will remove cortisol after extraction and then a reaction of cortisol and nitrobenzene will produce a colored compound( purple)
