clinical biochemistry

Question 1

What is the main indicator of ECF oncotic pressure?

Answer 1

Sodium

Question 2

When are low sodium values seen?

Answer 2

water retention

Question 3

When are high sodium values seen?

Answer 3

dehydration

Question 4

What do low calcium values indicate?

Answer 4

hormonal disturbances

Question 5

What do high calcium values indicate?

Answer 5

bone disease or bone cancer

Question 6

What does hyperphosphatemia indicate?

Answer 6

degenerative bone disease

Question 7

What condition often accompanies hypophosphatemia?

Answer 7

DKA

Question 8

What causes hypokalemia?

Answer 8

GI and renal disturbances

Question 9

What causes hyperkalemia?

Answer 9

“renal insufficiency”

Question 10

What is indirect bilirubin?

Answer 10

bilirubin that is not conjugated to glucoronic acid and is tightly bound to albumin

Question 11

What is direct bilirubin?

Answer 11

bilirubin conjugated to glucoronic acids

Question 12

What is the normal serum protein concentration?

Answer 12

7%

Question 13

How much of the total serum protein is made up for by albumin?

Answer 13

50%

Question 14

Name three important molecules carried by albumin

Answer 14

unconjugated bilirubin, Free fatty acids, steroid hormones

Question 15

What ion can albumin bind?

Answer 15

calcium

Question 16

What does hypoalbunemia manifest as?

Answer 16

edema

Question 17

What are globulins an indicator for?

Answer 17

immune cell function

Question 18

What is CRP secreted by?

Answer 18

Liver

Question 19

What is CRP an indicator for?

Answer 19

acute metabolic response to injury

Question 20

When do CRP levels rise?

Answer 20

6 hours after injury

Question 21

How quickly does myoglobin release occur after MI?

Answer 21

very quickly

Question 22

Creatine kinase? (CK-MB)

Answer 22

appears and disappears very quickly after MI

Question 23

At what time point can troponin levels indicate an MI has not happened? How quickly is troponin released?

Answer 23

12 hours

very early after MI

Question 24

When is the cardiac isoform of LDH released?

Answer 24

several days

Question 25

What are increased levels of alkaline phosphatase indicative of?

Answer 25

bone or liver disease

Question 26

Specifically, alkaline phosphatase?

Answer 26

obstruction of bile duct of bone remodeling disease

Question 27

How does one differentiate between liver of bone disease regarding alkaline phosphatase levels?

Answer 27

liver disease brings about in increase in serum bilirubin levels

Question 28

What tissue has highest levels of AST?

Answer 28

heart (10:1 compared to ALT)

Question 29

What combination of ALT and AST indicate liver damage?

Answer 29

high AST and high ALT

Question 30

With high AST and ALT, how does one know specifically about liver damage?

Answer 30

concomitant bilirubin levels

Question 31

What four components is urine tested for?

Answer 31

glucose, protein, ketones, bilirubin

Question 32

Why does bilirubin appear in the urine? Is this normal?

Answer 32

biliary obstruction.

No. pathological.

Question 33

What happens to serum BUN during kidney failure?

Answer 33

elevated

Question 34

What product in the urine is a good indicator for endogenous production of insulin?

Answer 34

C-peptide

Question 35

What is indirect bilirubin tightly bound to?

Answer 35

albumin

Question 36

What is the most common cause for hypoalbuminemia?

Answer 36

liver disease

Question 37

When do myoglobin levels rise after an MI?

Answer 37

immediately

Question 38

In muscles, what are the comparative ratios of ALT to AST?

Answer 38

10:1 AST:ALT

these are equal in the liver

Question 39

What is BUN a ratio of?

Answer 39

amino acid degradation / urea production and excretion

Question 40

What may elevated BUN levels indicate?

Answer 40

impaired renal function

Question 41

What is the most common cause of hypoalbuminemia?

Answer 41

liver disease