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PMLS MIDTERMS > Clinical Chemistry > Flashcards

Clinical Chemistry Flashcards

1
Q

concerned with diagnosing and monitoring disease by measuring the concentration of
chemicals, principally in blood plasma and urine.

A

Clinical chemistry

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2
Q

chemical analysis of feces and other body fluids

A

Clinical chemistry

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3
Q

-first to make the true connection between chemistry and medical practice
-He was a vitalist
- application of chemistry to physiology in the treatment of disease
-Favored the study of physics and chemistry by medical students

A

William Prout

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4
Q

-Urged the medical school curriculum to include first-rate instruction in English
- “Medical men would be much better served if they spent some time in acquiring knowledge about chemistry and physics instead of learning sore Latin and Greek.”

A

Henry Bence Jones

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5
Q

-“Chemical studies are relevant to clinical medicine.”
-Continuous exchange between the solid parts and blood. “It is in the blood that we must look for many important modifications in connection with disease.”

A

Thomas Hodgkin

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6
Q

Recognizing the powerful aid that the science of medicine “has received from the study of
organic chemistry and the knowledge and use of the microscope,” authorized the purchase of a microscope at a cost

A

Massachusetts General Hospital
1847

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7
Q

Established the position of “Chemist-Microscopist” To cope with the growing number of chemical tests, the physician would usually enlist the help of chemists or physicians skilled in chemistry

A

Massachusetts General Hospital
1851

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8
Q

Proposed that American hospitals employ clinical chemists to advance their ability to differentiate
between the physiologic and the pathologic

A

Otto Knut Folin

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9
Q

Chemistry In Medical Education

A

William Prout
Henry Bence Jones
Thomas Hodgkin
Massachusetts General Hospital
Otto Knut Folin

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10
Q

-Determined reference intervals
-Correlated variations with pathologic conditions
-Elucidated metabolic pathways in health and disease

A

Otto Knut Folin and Donald Dexter Van Slyke

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11
Q

Invented a volumetric gas-measuring apparatus for the determination of CO2 concentration

A

Donald Dexter Van Slyke

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12
Q

-Together with Hsien Wu, they made a method for the production of a protein-
free filtrate that can be used for determining blood sugar.
-He also developed the Duboscq-type colorimeter for the measurement of creatinine in urine

A

Otto Knut Folin

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13
Q

Developed the alkaline pirate method for the determination of creatinine concentration

A

Max Jaffe

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14
Q

Clinical Chemistry in Laboratory Diagnosis

A

Otto Knut Folin and Donald Dexter Van Slyke
Max Jaffe

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15
Q

-Observation of the intensity of colored product after chemical reactions
-Pioneered by Folin after the development of the Duboscq-type visual colorimeter

A

Colorimetry

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16
Q

-Measurement of light intensity at selected wavelengths
-Initiated by the development of the Beckman DU Spectrophotometer by Cary and Beckman

A

Spectrophotometry

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17
Q

Continuous-flow instrument that reacted specimens and reagents to produce a
measurable color density

A

AutoAnalyzer

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18
Q

-Introduced by Norman Anderson
-Second attempt towards automation; First clinical analyzer to incorporate a computer

A

Centrifugal analyzer

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19
Q

Capable of performing multiple tests analyzed
one after another on a given clinical specimen

A

Sequential Multiple Analyzer with Computer (SMAC)

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20
Q

Introduced the perfected technology of automated pipetting, which is the approach of
choice for automation in clinical chemistry laboratories even up to these days.

A

Beckman Astra

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21
Q

Early Instrumentation in Clinical Chemistry

A

Colorimetry
Spectrophotometry
AutoAnalyzer
Centrifugal analyzer
Sequential Multiple Analyzer with Computer (SMAC)
Beckman Astra

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22
Q

Laboratory Methods

A

Photometric methods
Chromatography
Other analytic techniques

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23
Q

Photometric methods

A

Spectrophotometry
Atomic absorption spectrophotometry
Fluorometry
Chemiluminescence
Turbidimetry
Nephelometry

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24
Q

Chromatography

A

Thin-layer chromatography (TLC)
High-performance liquid chromatography (HPLC)
Gas chromatography (GC)

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25
Q

Other analytic techniques

A

lon-selective electrodes
Osmoretry
Electrophoresis

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26
Q

-A chemical reaction produces a colored substance that absorbs light of a specific wavelength
-The amount of light absorbed is directly proportional to the concentration of the
analyte

A

Spectrophotometry

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27
Q

Measures light absorbed by ground-state atoms

A

Atomic absorption spectrophotometry

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28
Q

Atoms absorb light of a specific wavelength and emit light of a longer wavelength

A

Fluorometry

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29
Q

A chemical reaction that produces light
Usually involves the oxidation of luminol, acridinium esters, or dioxetanes

A

Chemiluminescence

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30
Q

Measures reduction in light transmission by particles in suspension

A

Turbidimetry

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31
Q

Similar to turbidity, but the light is measured at an angle from a light source

A

Nephelometry

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32
Q

Screening test for drugs of abuse in urine

A

Thin-layer chromatography (TLC)

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33
Q

Separation of thermolabile compounds

A

High-performance liquid chromatography (HPLC)

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34
Q

Separation of volatile compounds or compounds that can be made volatile

A

Gas chromatography (GC)

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35
Q

The potential difference between two electrodes directly related to concentration of analyte

A

lon-selective electrodes

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36
Q

Determines osmolality (i.e., measurement of number of dissolved particles in solution, irrespective of molecular weight, size, density, or type) based on freezing-point depression

A

Osmoretry

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37
Q

Electrophoresis

A

-Separation of charged particles in an electrical field
-Anions move to positively charged pole; cations to negatively charged pole
-The greater the charge, the faster the migration

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38
Q

Glucose, fasting NV

A

70-99 mg/dL

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39
Q

Cholesterol, total NV

A

<200 mg/dL

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40
Q

HDL cholesterol NV

A

60 mg/dL

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41
Q

LDL cholesterol NV

A

Optimal:
<100 mg/dL

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42
Q

Triglycerides NV

A

Desirable:
<150 mg/dL

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43
Q

Total protein NV

A

6.4-8.3 g/dL

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44
Q

Albumin NV

A

3.5-5 g/dL

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45
Q

Microalbumin (ON URINE) NV

A

50-200 mg/24 hour
+ in diabetics at risk of nephropathy

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46
Q

Carbohydrates, Lipids and Proteins
Analytes

A

Glucose, fasting
Cholesterol, total
HDL cholesterol
LDL cholesterol
Triglycerides
Total protein
Albumin
Microalbumin

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47
Q

high glucose, fasting

A

diabetes mellitus, other endocrine disorders, acute stress, pancreatitis

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48
Q

low glucose, fasting

A

insulinoma, insulin-induced hypoglycemia,
hypopituitarism

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49
Q

clinical significance in cholesterol

A

-Limited value for predicting risk of coronary artery disease (CAD) by itself
-Used in conjunction with high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol

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50
Q

clinical significance in HDL cholesterol

A

Appears to be inversely related to CAD

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51
Q

clinical significance in LDL cholesterol

A

Risk factor for CAD

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52
Q

clinical significance in triglycerides

A

Risk factor for CAD

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53
Q

high protein

A

dehydration, chronic inflammation, multiple myeloma

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54
Q

low protein

A

nephrotic syndrome, malabsorption, overhydration, hepatic insufficiency, malnutrition, agammaglobulinemia

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55
Q

high albumin

A

dehydration

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56
Q

low albumin

A

malnutrition, liver disease, nephrotic syndrome, chronic inflammation

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57
Q

high microalbumin or urine

A

diabetics at risk of nephropathy

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58
Q

Blood Urea Nitrogen (BUN) NV

A

8-26 mg/dL

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59
Q

Creatinine NV

A

0.7-1.5 mg/dL

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60
Q

Uric acid NV

A

Male 3.5-7.2 mg/dL
Female: 2.6-6 mg/dL

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61
Q

Ammonia NV

A

19-60 ug/dL

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62
Q

Nonprotein Nitrogen compounds

A

Blood Urea Nitrogen (BUN)
Creatinine
Uric acid
Ammonia

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63
Q

high BUN

A

kidney disease

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64
Q

low BUN

A

overhydration or liver disease

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65
Q

high creatinine

A

kidney disease

66
Q

high uric acid

A

gout, renal failure, ketoacidosis, lactate excess, high nucleoprotein diet, leukemia, lymphoma,
polycythemia

67
Q

low uric acid

A

administration of ACTH, renal tubular defects

68
Q

high ammonia

A

liver disease, hepatic cora, renal failure, Reye’s syndrome

69
Q

Sodium NV

A

136-145 mmolL

70
Q

Potassium NV

A

3.5-5.1 mmol/L

71
Q

Chloride NV

A

98-107 mmol/L

72
Q

CO2, total NV

A

23-29 mmol/L

73
Q

Major electrolytes
analytes

A

Sodium
Potassium
Chloride
CO2, total

74
Q

sodium is high due to

A

high intake or IV administration,
hyperaldosteronism, excessive sweating, burns, diabetes insipidus

75
Q

sodium is low due to

A

renal or extrarenal loss (vomiting, diarrhea,
sweating, burns) or high extracellular fluid volume

76
Q

potassium is high due

A

high intake, low excretion, crush injuries, metabolic acidosis

77
Q

potassium is low due to

A

high Gl or urinary loss, use of diuretics, metabolic alkalosis

78
Q

chloride is high due to

A

same conditions as high NA
excess loss of HCO3

79
Q

chloride is low from

A

prolonged vomiting, diabetic ketoacidosis,
aldosterone deficiency, salt-losing renal diseases, metabolic alkalosis, compensated respiratory acidosis

80
Q

high CO2

A

metabolic alkalosis, compensated respiratory
acidosis

81
Q

low CO2

A

metabolic acidosis, compensated respiratory
alkalosis

82
Q

Magnesium NV

A

1.6-2.6 mg/dL

83
Q

Calcium NV

A

Total: 8.6-10 mg/dL
lonized: 4.60-5.08 mg/dL

84
Q

Phosphorus, inorganic (phosphate) NV

A

2.5-4.5 mg/dL

85
Q

Lactate (lactic acid)

A

4.5-19.8 mg/dL

86
Q

Other electrolytes

A

Magnesium
Calcium
Phosphorus, inorganic (phosphate
Lactate (lactic acid)

87
Q

high magnesium is due to

A

due to renal failure, high intake (e.g., antacids),
dehydration, bone cancer, endocrine disorders

88
Q

low magnesium is due to

A

severe illness, Gl disorders, endocrine
disorders, renal loss

89
Q

calcium is high with

A

primary hyperparathyroidism, cancer, multiple
myeloma.

90
Q

calcium is low with

A

hypoparathyroidism, malabsorption, vitamin D
deficiency, renal tubular acidosis

91
Q

phosphate is high with

A

with renal disease, and hypoparathyroidism.

92
Q

phosphate is low with

A

with hyperparathyroidism, vitamin D deficiency, renal tubular acidosis

93
Q

clinical significance lactate

A

sign of lowered O2 to tissues

94
Q

iron NV

A

Male: 65-175
Female: 50-170 ug/dL

95
Q

Transferrin

A

200-360 mg/dL

96
Q

Ferritin

A

Male: 20-250
Female: 10-120 ug/L

97
Q

iron analytes

A

Iron
Transferrin
Ferritin

98
Q

iron is high with

A

with iron overdose, hemochromatosis, sideroblastic anemia, hemolytic anemia, liver disease

99
Q

iron is low with

A

iron deficiency anemia

100
Q

transferrin is high with

A

iron deficiency anemia

101
Q

transferrin is low with

A

iron overdose, hemochromatosis, chronic infections, malignancies

102
Q

high ferritin

A

iron overload, hemochromatosis, chronic infections, malignancies

103
Q

low ferritin

A

low deficiency anemia

104
Q

Acid phosphatase (ACP)
tissue

A

Prostate

105
Q

Alkaline phosphatase (ALP)
tissue

A

Almost all

106
Q

Aspartate aminotransferase (AST)
tissue

A

Many
Highest in liver, heart, and skeletal muscle

107
Q

Alanine aminotransferase (ALT)
tissue

A

Liver, RBCs

108
Q

Gamma-glutamyl transferase (GGT)
tissue

A

Liver, kidneys, pancreas

109
Q

Lactate dehydrogenase (LD)
tissue

A

All, Highest in liver, heart,
anemia
skeletal muscle, RBCs

110
Q

Creatine kinase (CK)
tissue

A

Cardiac muscle, skeletal muscle, brain

111
Q

Amylase (AMS)
tissue

A

Salivary glands, pancreas

112
Q

Lipase (LPS)

A

Pancreas

113
Q

Glucose-6-phosphate dehydrogenase (G6PD)

A

RBCS

114
Q

Enzymes of clinical significance

A

Acid phosphate (ACP)
Alkaline phosphate (ALP)
Alanine aminotransferase (AST)
Alanine aminotransferase (ALT)
Gamma-glutamyl transferase (GGT)
Lactate dehydrogenase (LD)
Creatine kinase (CK)
Amylase (AMS)
Lipase (LPS)
Glucose-6-phosphate-dehydrogenase (G6PD)

115
Q

high prostate cancer

A

Acid phosphate (ACP)

116
Q

liver and bone disease; levels higher
in biliary tract obstruction than in hepatocellular disorders

A

Alkaline aminotransferase (AST)

117
Q

high with liver disease (marked high with viral hepatitis), acute myocardial
skeletal muscle infarction (AM), muscular dystrophy

A

Aspartate aminotransferase (AST)

118
Q

high with liver disease

A

Alanine aminotransferase (ALT)

119
Q

high in all hepatobiliary disorders, chronic
alcoholism

A

Gamma-glutamyl transferase (GGT)

120
Q

high with AMI, liver disease, pernicious
anemia

A

Lactate dehydrogenase (LD)

121
Q

high with AMI, muscular dystrophy

A

Creatine kinase (CK)

122
Q

high in acute pancreatitis, other abdominal
diseases, mumps

A

Amylase (AMS)

123
Q

high in acute pancreatitis

A

Lipase (LPS)

124
Q

Glucose-6-phosphate
dehydrogenase (G6PD)

A

Inherited deficiency can lead to drug-
induced hemolytic anemia

125
Q

Cardiac Markers for Diagnosis of Acute Myocardial Infarction

A

Creatine kinase (CK-MB)
Myoglobin
Cardiac troponins (cTn)

126
Q

Tests for Heart Failure

A

B-type natriuretic peptide (BNP)

127
Q

Tests to Assess Risk of Coronary Artery Disease (CAD)

A

Cardiac C-reactive protein CRP (CRP)
Total cholesterol

128
Q

Released from the heart muscle of the left ventricle when fluid builds from heart failure

A

B-type natriuretic peptide

129
Q

high with AMI, muscular dystrophy

A

Creatine kinase (CK

130
Q

High-sensitivity CRP (hs-CRP) to ID individuals at risk of cardiovascular disease
Best single biomarker for predicting cardiovascular events; test on two
occasions because of individual variability

A

Cardiac C-reactive protein (cCRP)

131
Q

Limited value for predicting the risk of CAD by itself
Used in conjunction with HDL and LDL cholesterol

A

Total cholesterol

132
Q

types of bilirubin

A

Total bilirubin
conjugated (direct) bilirubin
unconjugated (indirect) bilirubin

133
Q

total bilirubin NV

A

0.2-1 mg/dL

134
Q

conjugated bilirubin

A

<0.2 mg/dL

135
Q

unconjugated bilirubin NV

A

<0.8 mg/dL

136
Q

high in liver disease, hemolysis, and hemolytic
disease of newborn
In infants, >20 mg/dL is associated with brain
damage

A

total bilirubin

137
Q

liver disease, obstructive jaundice

A

conjugated bilirubin

138
Q

prehepatic, posthepatic, and some types of
bilirubin hepatic jaundice

A

unconjugated bilirubin

139
Q

Enhances entry of glucose into cells
Enhances storage of glucose as glycogen or
conversion to fatty acids
Suppresses breakdown of protein into amino
acids, of adipose tissue into free fatty
acids

A

insulin

140
Q

Suppresses glucagon release from a cells
Suppresses release of insulin, pituitary tropic
hormones, gastrin and secretin

A

Somatostatin

141
Q

Enhances release of glucose from glycogen
Enhances synthesis of glucose from amino
acids or fatty acids

A

Glucagon

142
Q

Epinephrine

A

Adrenal medulla

143
Q

Cortisol

A

Adrenal cortex

144
Q

Adrenocorticotropic hormone (ACTH)

A

Anterior pituitary gland

145
Q

Growth hormone

A

Anterior pituitary gland

146
Q

Thyroxine

A

Thyroid

147
Q

Enhances release of glucose from glycogen
Enhances release of fatty acids from adipose
tissues

A

epinephrine

148
Q

Enhances synthesis of glucose from amino
acids or fatty acids

A

cortisol

149
Q

Enhances release of cortisol
Enhances release of fatty acids from adipose
tissue

A

Adrenocorticotropic
hormone (ACTH)

150
Q

Antagonizes insulin

A

growth hormone

151
Q

Enhances release of glucose from glycogen
Enhances absorption of sugars from intestine

A

thyroxine

152
Q

The lowest concentration of drug in blood that will produce
desired effect

A

Minimum effective concentration (MEC)

153
Q

The lowest concentration of drug in blood that will produce an
adverse response

A

Minimum toxic concentration (MC):

154
Q

Salicylates, acetaminophen

A

Analgesics

155
Q

Phenobarbital, phenytoin, valproic acid, carbamazepine, ethosuximide
felbamate, gabapentin, lamotrigine

A

Antiepileptics

156
Q

Methotrexate

A

Antineoplastics

157
Q

Aminoglycosides (amikacin, gentamicin, kanamycin, tobramycin),
vancomycin

A

Antibiotics

158
Q

Digoxin, disopyramide, procainamide, quinidine

A

Cardioactives

159
Q

Tricyclic antidepressants, lithium

A

Psychoactives

160
Q

Cyclosporine, tacrolimus (FK-506)

A

Immunosuppressants

161
Q

Amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine,
methadone, opiates, phencyclidine, tricyclic antidepressants

A

Drugs routinely tested for Drugs of Abuse

PMLS MIDTERMS (4 decks)

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