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IPAP > Clin Lab Exam 2 > Flashcards

Clin Lab Exam 2 Flashcards

1
Q

Inflammatory Cardiac Markers

A

CRP — hs-CRP (Marker of inflammation)

PTX-3 — Prognostic biomarkers of Adverse Outcome in pts w/ Unstable Angina Pectoris, MI, and HF

Homecysteine — INC risk for CHD, Stroke, Vascular Disease

IL-6 — Development of Atherosclerosis

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2
Q

Plaque Destabilization Markers

A

Myeloperoxidase — Marker of Plaque Instability, Predictive marker for future CV adverse events

Soluble Cluster of Differentiation 40 Ligand (sCD40L) — Plaque Rupture and Subsequent MI

TNF-a — ROle in Atherosclerosis (Indicative of recurrent NON-fetal MI or a Fetal CV event)

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3
Q

Myocardial Necrosis Markers

A

H-FABP — Predictive biomarker of Mortality following Acute Coronary Syndrome

BNP — Secreted in response to Excessive Stretching of Heart Muscle Cells; Predictive marker for pts w/ CHF (INC w/ Severity)

Ischemia-Modified Albumin (IMA) — Early ID of Ischemia

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4
Q

Urea Synthesis

LOW cont for Urea in blood + INC cont of NH3 & Amnio Acids (Precursor) =

A

End-Stage Liver Disease

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5
Q

Possible Disease

(Ammonia Metabolism)

HYPERammonemia —> __________

Ex?

A

Toxic Effects on the CNS (Neuro)

Reye Syndrome

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6
Q

Liver testing

INC UNconjugated Bilirubin —> _______

Elevations in UNconjugated bilirubin —> Development of _________, especially in ____________

A

Jaundice

Kernicterus, Infants

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7
Q

Prehepatic Jaundice

Reason?

Ex?

Lab?

A

Increased RBC Destruction

Hemolytic Anemia

Urine Urobilinogen — INC
Urine Bilirubin — NEG

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8
Q

Hepatic Jaundice

Reason?

Ex?

A

Direct damage to the liver cell

LIVER DISEASE

Critter-Najjar Syndrome

Dublin-Johnson Syndrome — Ineffective removal of conjugated bilirubin

hepatitis

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9
Q

Post-Hepatic Jaundice

Reason?

Ex?

Lab?

A

Blockage of the flow of BILE from the liver

Gallbladder stone, bile duct stones, Cancer

Urine Urobilinogen — DEC or NONE
Urine Bilirubin — POS

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10
Q

Liver Enzymes & Diseases

AST + ALT =

ALP + GGT =

GGT ONLY =

ALP ONLY =

5’-Nucleotidase =

Glutathione S-Transferases =

A

AST + ALT = Liver Disease (Hepatitis)

ALP + GGT = Biliary Disease (Cholestasis)

GGT ONLY = Alcoholic Liver Disease

ALP ONLY = Bone Disorders

5’-Nucleotidase = Hepatobiliary Disease (GGT + ALP)

Glutathione S-Transferases = Liver Disease (AST + ALT)

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11
Q

Pancreatic Enzymes

Characteristics?

A

Amylase

Lipase (LPS)

Trypsin (TRY)

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12
Q

Most Specific Enzyme Test for Acute Pancreatitis

A

Lipase (LPS)

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13
Q

Pancreatic Enzyme that help Determine Severity

A

Trypsin (TRY)

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14
Q

INC TRY-1 + AMY + LPS =

A

Chronic Renal Failure

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15
Q

Plasma Proteins

A 
Albumin
Globulin
Alpha-1
Alpha-2
Beta
Gamma
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16
Q

Plasma Proteins

Albumin

_____________ in plasma

_____________ of the Intravascular Fluid (maintain appropriate _______ in tissues)

DEC (Cause)

INC (Cause)

A

Highest Concentration in plasma

Colloid Osmotic Pressure (Maintains appropriate fluid balance in tissues)

DEC
Liver Disease — Low intake, Synthesis
Nephrotic Syndrome — Increase loss

INC
Dehydration

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17
Q

Plasma Proteins

Pre-Albumin

Present in _______ Concentrations

Carrier protein for _____________

Transports _________

Sensitive marker of _____________

DEC (Cause)

INC (Cause)

A

Low concentration

Carrier protein for Thyroxine (T4) & Triiodothyronine (T3)

Transports Vitamin A

Sensitive marker of Inadequate Dietary Protein Intake

DEC
Liver Disease, Acute Inflammatory Responses, Poor Nutrition

INC
Steroid Therapy, Alcoholism, Chronic Renal Failure

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18
Q

Alpha-1-globulin

A

Antitrypsin (AAT) — Major component

Fetoprotein (AFP)

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19
Q

Alpha-1 Antitrypsin (AAT)

__________ — Regulate Inflammatory Response

Proteases inhibitor that ______________________

A deficiency of AAT — _________________

_______ in inflammatory disorders

A

Acute-Phase Reactant

Proteases inhibitorthat neutralizes trypsin-like enzymes(elastase) — Damage structural proteins in surrounding tissue

Pulmonary Deficiency (Asthma, COPD)

Increased in inflammatory disorders

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20
Q

Plasma Protein

Alpha-1 Fetoprotein (AFP)

Protect _____ from _____________

_______ screening (this protein freely crosses the __________)

INC AFP during ___________ = ________

LOW AFP during ________ = _________

HIGH AFP during _______ = _____________

A

Protect the FETUS from “attack” by the mother’s immune system

Pre-natal screening (this protein freely crosses the PLACENTA)

INC —> Open Neural Tube Defect in the fetus

LOW —> Down Syndrome and Trisomy 18

HIGH —> Liver Cancer

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21
Q

Alpha-2-globulin

A

Haptoglobin
Ceruloplasmin
Alpha-2- Macroglobulin (Similar function to AAT)

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22
Q

Plasma Protein
Alpha-2

Haptoglobin

___________________ (Like AAT)

Binds \_\_\_\_\_\_\_\_\_ (\_\_\_\_\_\_ —> Toxic)
Function?

INC —

DEC —

A

Acute-Phase Reactant

Binds Free Hgb (Free Hgb —> Toxic)
Prevents the loss of Hgb and Iron from the Kidneys

INC — Trauma, Inflammation

DEC — Liver Disease, Nephrotic Syndrome

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23
Q

Alpha-2

Ceruloplasmin

____ of the total serum______ is found in ceruloplasmin

____________(Like AAT)

LOW —-

INC —-

A

> 90% of the total serum copper

Acute-Phase Reactant

LOW — Wilson’s Disease

INC — Pregnancy, Inflammatory Disorders

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24
Q

Alpha-2 Macroglobulin

________ a variety of protease enzymes (Trpysin, Pepsin, Plasmin)

INC —

DEC —

A

Inhibits

INC — Renal Disease, Pregnancy, Contraceptive Use, Estrogen Therapy

DEC — Acute Inflammatory Disorders, Acute Pancreatitis

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25
Q

Beta-globulin

A 
Transferrin
Hemopexin
Complement
Fibrinogen
C-Reactive Protein (CRP)
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26
Q

Beta

Major component of Beta-globulin

Transport of Iron and Prevents loss of iron through the kidneys

DEC — Liver Disease (DEC synthesis)

INC - Iron Deficiency Anemia and Pregnancy

A

Transferrin

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27
Q

Beta

Removes Circulating Heme and Porphyrins

INC — Malignant Melanoma

A

Hemopexin

28
Q

Beta

Involved in immune and inflammatory response

Acute-Phase reactant

INC — Inflammatory states

DEC — Systemic Lupus Erythematosis

A

Complement

29
Q

Beta

Fibrinogen

Acute-Phase Reactant

Formation of Fibrin clot when activated by __________ (Removed during the clotting process —> NOT seen in serum)

DEC — __________

A

Thrombin

Disseminated Intravascular Coagulation (DIC)

30
Q

Beta

CRP

Migrates w/ ____________

An Acute-Phase Reactant (CV)

Facilitates ____________ (____________)

Slightly Elevated —

INC —

A

MIgrate w/ the Gamma Globulins

Facilitates Complement Coating (Opsonization)

Slightly Elevated — Inflammatory Disease

INC — Chronic Inflammatory Process within the vascular system (Enhances the formation of atherosclerotic plaques in the coronary arteries)

31
Q

Gamma-globulins

Most abundant — ?

DEC _____________ — __________ (Caused by immunodeficiency disorder)

INC —

________ — INC (A, D, E, or G)

A

IgG

DEC Immunoglobulins — Faulty Plasma Cells Function

INC — Monoclonal Gammopathies

Multiple Myeloma — INC (A, D, E, or G)

32
Q

Common Electrophoresis Patterns

INC Gamma Globulin-M (Bridge) —> _____________

INC a1 + a2+ Globulin —> _____________

DEC Albumin, a1, b, gamma BUT INC a2 —> _______________

A

Multiple Myeloma

Acute Phase Reactants (Infectious Disease)

Nephrotic Syndrome

33
Q

Acute Phase Reactants

A 
CRP
AAT
Fibrinogen
haptoglobin
Complement
Ceruloplasmin
34
Q

Lipid Panel

A

Total Cholesterol — Sum of Blood’s Cholesterol (Normal = 200)

HDL — Carry away LDL Cholesterol (Transport to Liver)

LDL

  • Buildup of fatty deposits (plaques) in the arteries (Atherosclerosis)
  • If rupture —> Heart Attack or Stroke
  • MORE IMPORTANT for therapeutic decision making

Triglycerides
— Store energy and give it to muscles
-High = Eat more calories than you burn
-Most ADVERSELY affected by a Non-Fasting Sample

35
Q

Most important carrier of T4

A

TBG

36
Q

Thyroid Hormone secretion is controlled by _____________ (Hypothalamus, Pituitary, and Thyroid Follicular cells)

A

Negative Feedback System

37
Q

Major site of Negative Feedback System

A

Pituitary

38
Q

Thyroid Function Tests

Best way to initially test thyroid function (Most appropriate single screening test)

A

TSH

39
Q

Most important to determine how the thyroid is functioning

A

Free T4

40
Q

T3

(Often) Diagnosis ___________ or Determine the ________ of the ________________

A

HYPERthyroidism, Severity of HYPERthyroidism

41
Q

Main cause of Thyroid Disorder

A

Iodine Deficiency (Malnutrition)

42
Q

Thyroid Disorder

Primary HYPOthyroidism

Endo —

Exo —

A

Endo — Hashimoto Thyroditis

Exo — Iodine Deficiency

43
Q

Thyroid Disorders

Secondary HYPOthyroidism

A

Hormone Deficiency

TRH (Hypothalamus)
TSH (Pituitary Gland)

44
Q

Thyroid Disorders

HYPERthyroidism

Primary —

Serum TSH is almost ________

Secondary —

A

Primary — Grave’s DIsease (Most common)

Serum TSH is almost ABSENT

Secondary — TSH-producing Pituitary Adenoma

45
Q

HYPERthyroidism

A

Sleeplessness
Weight loss
HEAT intolerance
Excessive sweating

46
Q

HYPOthyroidism

A

Increased sleeping
Weight & Hair gain
COLD intolerance

47
Q

Special Collection

First morning —

Fasting (second morning) —

24 H —

Midstream Clean-Catch —

Suprapubic aspiration —

A

First morning —. Pregnancy

Fasting (second morning) — Diabetic screening/monitoring

24 H — Kidney Function

Midstream Clean-Catch —. Bacterial culture(Infection)

Suprapubic aspiration — UTI

48
Q

Abnormal Urine Color

Dark amber/Orange —

Red —

Brown/Black —

Dark Orange —

Green —

A

Dark amber/Orange —. Conjugated bilirubin

Red — RBCs

Brown/Black — Methemoglobin, Melanin (Malignant melanoma)

Dark Orange — Pyridium (Bladder infection)

Green — Bacterial Infections (UTI) & Intestinal tract infection

49
Q

Polyuria

Excess glucose in blood —>

Decrease in the production of ADH —>

A

DM

Diabetes Insipidus

50
Q

Dipstick Test

Glucosuria w/o HYPERglycemia (Renal Glucosuria) =

W/ HYPERglycemia =

A

Impaired Tubular Reabsorption (Pregnancy)

DM, Cushing Syndrome, Pancreatitis

51
Q

Dipstick

Ketones

Ketonuria —> __________

Positive Result (2)

A

Inability to utilize Carb (DM)

Starvation or Acute Dieting
DM

52
Q

Dipstick

Urobilinogen

Positive

Elevated Urobilinogen + Negative Bilirubin =

INC

Pre =

Hepatocellular =

DEC to Absent

Intra- or Extra- Hepatic Obstruction

A

Intravascular Hemolysis

Pre = Hemolysis

Hepatocellular = Hepatitis

DEC to Absent

Intra- or Extra- Hepatic Obstruction = Carcinoma

53
Q

Specific Gravity

Normal —

High —

Low —

Excretion w/ a consistent SG of 1.010 =

A

Normal - 1.005 - 1030 w/ normal urine output

High — Dehydration w/ Oliguria

Low — Diabetes Insipidus (Polyuria and Very Low Concentration in Urine)

Isosthenuria (Consistent SG of 1.010)

54
Q

Proteinuria + HTN & EDEMA =

A

Pre-Eclampsia/Eclampsia & Very serious conditions w/ Pregnancy

55
Q

Nitrite

Type of Urine Sample used

Positive?

A

First morning urine specimen

UTI

56
Q

Leukocyte Esterase (LE)

INC number of _____ in the urine (_____)

____ — W/ positive Nitrite result

____ — W/O positive Nitrite result

A

WBCs (Pyuria)

UTI — w/ Nitrite

Vaginal or Urethral Infections — W/O Nitrite

57
Q

Osmolality

Evaluate ___________________

Establish the differential diagnosis of _________ and ___________

Evaluate the secretion of and Renal Response to __________(___________) — Response to High Blood Plasma Osmolality

Clinical Application
Neurogenic — _____________
Nephrogenic — ____________

A

Renal Concentrating ability

HYPERnatremia & HYPOnatremia

ADH (Diabetes Insipidus)

Neurogenic — Diabetes Insipidus
Nephrogenic — Inability of the Renal Tubules to respond to ADH

58
Q

RBC

Associated w/ ___________

Hematuria + Pyuria (WBCs) =

Proteinuria + RBC casts =

A

Glomerular Damage

UTI

Nephronal Hematuria

59
Q

WBCs

Moderate/Heavy Proteinuria + Hematuria + WBC Casts =

Small amount of Protein + Hematuria + NO Casts =

A

Kidney infection

Bladder infections (Cystitis)

60
Q

Urine Test

Squamous Epithelial Cells

____cells/hpf — Contaminated Sample

A

> 10

61
Q

Casts

_______ — INC lv of protein in urine is necessary for cast formation

_____ — Major constituent of casts, mucoprotein excreted by renal tubular epithelial (RTE) cells

_____ — Oliguria allows time for proteins to precipitate within the tubules

A

Proteinuria

Tamm-Horsfall Protein

Stasis

62
Q

Casts

Indicative of Serious Renal Disease

A

Cellular

63
Q

Casts

Mostly Tamm-Horsfall Protein

Non-pathological increased — Dehydration

Pathologic increased — Acute Glomerulonephritis & Pyelonephritis (Kidney Infections)

A

Hyaline

64
Q

Casts

Renal Failure or End-Stage Renal Failure Casts

A

Broad

65
Q

Casts

DM, Nephrotic Syndrome

A

Fatty

IPAP (27 decks)

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