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PMLS Midterms > Clinical Chemistry > Flashcards

Clinical Chemistry Flashcards

1
Q
  • diagnosing & monitoring disease by measuring the concentration of
    chemicals
  • occasionally chemical analysis of feces, cerebrospinal, pleural fluid
A

clinical chemistry

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2
Q
  • the first to make the true connection between chemistry and medical practice
A

william prout

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3
Q

he was a vitalist but advocated the benefits to be derived from the application of chemistry to physiology in the treatment of disease

A

william prout

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4
Q

favored the study of physics and chemistry by medical students

A

william prout

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5
Q

stressed the practical diagnostic value of chemistry

A

henry bence jones

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6
Q

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

A

henry bence jones

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7
Q

“chemical studies are relevant to clinical medicine.”

A

Thomas Hodgkin

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8
Q

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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9
Q

the average medical student or average practitioner had barely a nodding acquaintance with chemistry and could not use a microscope.

A

19th century

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10
Q

When did the Massachusetts General Hospital recognize 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

1847

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11
Q

When did the Massachusetts General Hospital Established the position of “Chemist-Microscopist”

A

1851

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12
Q

To cope with the growing number of chemical tests, the physician would usually enlist the help of whom?

A

chemists or physicians skilled in chemistry

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13
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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14
Q

Determined reference intervals

A

Otto Knut Folin and Donald Dexter Van Slyke

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15
Q

Correlated variations with pathologic conditions

A

Otto Knut Folin and Donald Dexter Van Slyke

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16
Q

Elucidated metabolic pathways in health and disease

A

Otto Knut Folin and Donald Dexter Van Slyke

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17
Q

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

A

Donald Dexter Van Slyke

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18
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.

A

Otto Knut Folin

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19
Q

He also developed the Duboscq-type
colorimeter for the measurement of creatinine in urine

A

Otto Knut Folin

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20
Q

Developed the alkaline picrate method for the determination of creatinine concentration

A

Max Jaffe

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21
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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22
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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23
Q

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

A

AutoAnalyzer

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24
Q

Introduced by Norman Anderson

A

Centrifugal analyzer

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25
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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26
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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27
Q

Early Instrumentation in Clinical Chemistry

A

Colorimetry, Spectrophotometry, AutoAnalyzer, Centrifugal Analyzer, SMAC, Beckman Astra

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28
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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29
Q

Measures light absorbed by ground-state atoms

A

Atomic absorption spectrophotometry

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30
Q

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

A

Fluorometry

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31
Q

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

A

Chemiluminescence

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32
Q

Measures reduction in light transmission by particles in suspension

A

Turbidimetry

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33
Q

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

A

Nephelometry

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34
Q

The kinds of photometric methods

A

Spectrophotometry, Atomic absorption
spectrophotometry, Fluorometry, Chemiluminescence, Turbidimetry, Nephelometry

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35
Q

Kinds of chromatography methods

A

TLC, HPLC, GC

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36
Q

Screening test for drugs of abuse in urine

A

Thin-layer chromatography (TLC)

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37
Q

Separation of thermolabile compounds

A

High-performance liquid chromatography (HPLC)

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38
Q

Separation of volatile compounds or compounds that can be made volatile

A

Gas chromatography (GC)

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39
Q

Other analytic techniques

A

Ion-selective electrodes, Osmometry, Electrophoresis

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40
Q

↑ in diabetes mellitus, other endocrine disorders, acute stress, pancreatitis
↓ in insulinoma, insulin-induced hypoglycemia, hypopituitarism

A

Glucose, fasting

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41
Q
  • 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
A

Cholesterol, total

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42
Q

Appears to be inversely related to CAD

A

HDL cholesterol

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43
Q

Risk factor for CAD (Two answers)

A

LDL cholesterol and Triglycerides

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44
Q

↑ in dehydration, chronic inflammation, multiple myeloma
↓ nephrotic syndrome, malabsorption, overhydration, hepatic insufficiency, malnutrition, agammaglobulinemia

A

Total protein

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45
Q

↑ in dehydration
↓ in malnutrition, liver disease, nephrotic syndrome, chronic inflammation

A

Albumin

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46
Q

↑ in diabetics at risk of nephropathy

A

Microalbumin (on
urine)

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47
Q

Reference range for Glucose, fasting

A

70–99 mg/dL

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48
Q

Reference range for Cholesterol, total

A

Desirable:
<200 mg/dL

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49
Q

Reference range for HDL cholesterol

A

Desirable:
> 60 mg/dL

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50
Q

Reference range for LDL cholesterol

A

Optimal:
<100 mg/dL

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51
Q

Reference range for Triglycerides

A

Desirable:
<150 mg/dL

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52
Q

Reference range for Total protein

A

6.4–8.3 g/dL

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53
Q

Reference range for Albumin

A

3.5–5 g/dL

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54
Q

Reference range for Microalbumin (on
urine)

A

50–200 mg/24 hour
predictive of diabetic
nephropathy

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55
Q

↑ in kidney disease
↓ in overhydration or liver disease

A

Blood Urea
Nitrogen (BUN)

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56
Q

↑ in kidney disease

A

Creatinine

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57
Q

↑ in gout, renal failure, ketoacidosis, lactate excess, high nucleoprotein diet, leukemia, lymphoma, polycythemia
↓ in the administration of ACTH, renal tubular defects

A

Uric acid

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58
Q

↑ in liver disease, hepatic coma, renal failure, Reye’s syndrome

A

Ammonia

59
Q

Reference range for Blood Urea
Nitrogen (BUN)

A

8–26 mg/dL

60
Q

Reference range for Creatinine

A

0.7–1.5 mg/dL

61
Q

Reference range for Uric acid

A

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

62
Q

↑ due to ↑ intake or IV administration,
hyperaldosteronism, excessive sweating, burns, diabetes insipidus
↓ due to renal or extrarenal loss (vomiting, diarrhea, sweating, burns) or ↑ extracellular fluid volume

A

Sodium

63
Q

↑ due to ↑ intake, ↓ excretion, crush injuries, metabolic acidosis
↓ due to ↑ GI or urinary loss, use of diuretics, metabolic alkalosis

A

Potassium

64
Q

↑ due to same conditions as ↑ Na+ and excess loss of HCO3–
↓ from prolonged vomiting, diabetic ketoacidosis, aldosterone deficiency, salt-losing renal diseases, metabolic alkalosis, compensated respiratory acidosis

A

Chloride

65
Q

↑ in metabolic alkalosis, compensated respiratory acidosis
↓ in metabolic acidosis, compensated respiratory alkalosis

A

CO2, total

66
Q

Reference range for Sodium

A

136–145 mmol/L

67
Q

Reference range for Potassium

A

3.5–5.1 mmol/L

68
Q

Reference range for Chloride

A

98–107 mmol/L

69
Q

Reference range for CO2, total

A

23–29 mmol/L

70
Q

Reference range for Magnesium

A

1.6–2.6 mg/dL

71
Q

Reference range for calcium

A

Total: 8.6–10 mg/dL
Ionized: 4.60–5.08 mg/dL

72
Q

Reference range for Phosphorus,
inorganic (phosphate)

A

2.5–4.5 mg/dL

73
Q

Reference range for Lactate (lactic acid)

A

4.5–19.8 mg/dL

74
Q

↑ due to renal failure, ↑ intake (e.g., antacids),
dehydration, bone cancer, endocrine disorders
↓ due to severe illness, GI disorders, endocrine
disorders, renal loss

A

Magnesium

75
Q

↑ with primary hyperparathyroidism, cancer, multiple myeloma.
↓ with hypoparathyroidism, malabsorption, vitamin D deficiency, renal tubular acidosis

A

Calcium

76
Q

↑ with renal disease, and hypoparathyroidism.
↓ with hyperparathyroidism, vitamin D deficiency, renal tubular acidosis

A

Phosphorus, inorganic (phosphate)

77
Q

Sign of ↓ O2 to tissues

A

Lactate (lactic acid)

78
Q

Reference range for Iron

A

Male: 65–175
Female: 50–170 μg/dL

79
Q

Reference range for Transferrin

A

200–360 mg/dL

80
Q

Reference range for Ferritin

A

Male: 20–250
Female: 10–120 μg/L

81
Q

↑ with iron overdose, hemochromatosis, sideroblastic anemia, hemolytic anemia, liver disease
↓ with iron deficiency anemia

A

Iron

82
Q

↑ with iron deficiency anemia
↓ iron overdose, hemochromatosis, chronic infections, malignancies

A

Transferrin

83
Q

↑ iron overload, hemochromatosis, chronic infections, malignancies
↓ iron deficiency anemia

A

Ferritin

84
Q

Tissue of Acid phosphatase (ACP)

A

Prostate

85
Q

Tissue of Alkaline phosphatase (ALP)

A

Almost all

86
Q

Tissue for Aspartate aminotransferase
(AST)

A
  • Many
  • Highest in liver, heart, and
    skeletal muscle
87
Q

Tissue for Alanine aminotransferase (ALT)

A

Liver, RBCs

88
Q

Tissue for Gamma-glutamyl transferase
(GGT)

A

Liver, kidneys, pancreas

89
Q

Tissue for Lactate
dehydrogenase (LD)

A
  • All
  • Highest in liver, heart,
    skeletal muscle, RBCs
90
Q

Tissue for Creatine kinase (CK)

A

Cardiac muscle, skeletal
muscle, brain

91
Q

Tissue for Amylase (AMS)

A

Salivary glands, pancreas

92
Q

Tissue for Lipase (LPS)

A

Pancreas

93
Q

Tissue for Glucose-6-phosphate
dehydrogenase (G6PD)

A

RBCs

94
Q

↑ in prostate cancer

A

Acid phosphatase (ACP)

95
Q

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

A

Alkaline phosphatase (ALP)

96
Q

↑ with liver disease (marked ↑ with viral
hepatitis), acute myocardial infarction (AMI), muscular dystrophy

A

Aspartate aminotransferase (AST)

97
Q

↑ with liver disease

A

Alanine aminotransferase (ALT)

98
Q

↑ in all hepatobiliary disorders, chronic
alcoholism

A

Gamma-glutamyl transferase (GGT)

99
Q

↑ with AMI, liver disease, pernicious
anemia

A

Lactate dehydrogenase (LD)

99
Q

↑ with AMI, liver disease, pernicious
anemia

A

Lactate dehydrogenase (LD)

100
Q

↑ with AMI, muscular dystrophy

A

Creatine kinase (CK)

101
Q

↑ in acute pancreatitis, other abdominal
diseases, mumps

A

Amylase (AMS)

102
Q

↑ in acute pancreatitis

A

Lipase (LPS)

102
Q

↑ in acute pancreatitis

A

Lipase (LPS)

103
Q

Inherited deficiency can lead to drug induced hemolytic anemia

A

Glucose-6-phosphate
dehydrogenase (G6PD)

104
Q

Cardiac Markers for Diagnosis of Acute Myocardial Infarction

A

Creatinine kinase (CK-MB), Myoglobin, Cardiac troponins (cTn)

105
Q

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

A

B-type natriuretic peptide
(BNP)

106
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)

107
Q
  • Limited value for predicting the risk of CAD by itself
  • Used in conjunction with HDL and LDL cholesterol
A

Total cholesterol

108
Q

Reference range for Total bilirubin

A

0.2–1 mg/dL

109
Q

Reference range for Conjugated (direct) bilirubin

A

<0.2 mg/dL

110
Q

Reference range for Unconjugated (indirect)
bilirubin

A

<0.8 mg/dL

111
Q

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

A

Total bilirubin

112
Q

↑ liver disease, obstructive jaundice

A

Conjugated (direct) bilirubin

113
Q

↑ prehepatic, posthepatic, and some types of
hepatic jaundice

A

Unconjugated (indirect)
bilirubin

114
Q

Tissue of origin of Insulin

A

Pancreatic β cells

115
Q

Tissue of origin of Somatostatin

A

Pancreatic δ cells

116
Q

Tissue of origin of Glucagon

A

Pancreatic α cells

117
Q

Tissue of origin of Epinephrine

A

Adrenal medulla

118
Q

Tissue of origin of Cortisol

A

Adrenal cortex

119
Q

Tissue of origin of Adrenocorticotropic
hormone (ACTH)

A

Anterior pituitary gland

120
Q

Tissue of origin of Growth hormone

A

Anterior pituitary gland

121
Q

Tissue of origin of Thyroxine

A

Thyroid

122
Q
  • Enhances release of glucose from glycogen
  • Enhances release of fatty acids from adipose
    tissues
A

Epinephrine

123
Q
  • Enhances synthesis of glucose from amino
    acids or fatty acids
A

Cortisol

124
Q
  • Enhances release of cortisol
  • Enhances release of fatty acids from adipose
    tissue
A

Adrenocorticotropic hormone (ACTH)

125
Q
  • Antagonizes insulin
A

Growth hormone

126
Q
  • Enhances release of glucose from glycogen
  • Enhances absorption of sugars from intestine
A

Thyroxine

127
Q

Na+, K+, chloride, CO2, glucose, creatinine, BUN, Ca2+

A

Basic metabolic panel

128
Q

Na+, K+, chloride, CO2, glucose, creatinine, BUN, albumin, total protein, ALP, AST, bilirubin, Ca2+

A

Comprehensive metabolic panel

129
Q

Na+, K+, Cl–, CO2

A

Electrolyte panel

130
Q

Albumin, ALT, AST, ALP, bilirubin (total and direct), total protein

A

Hepatic function panel

131
Q

Total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides

A

Lipid panel

132
Q

Na+, K+, CO2, glucose, creatinine, BUN, Ca2+, albumin, phosphate

A

Renal function panel

133
Q

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

A

Minimum effective concentration (MEC)

134
Q

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

A

Minimum toxic concentration (MTC)

135
Q

Salicylates, acetaminophen

A

Analgesics

136
Q

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

A

Antiepileptics

137
Q

Methotrexate

A

Antineoplastics

138
Q

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

A

Antibiotics

139
Q

Digoxin, disopyramide, procainamide, quinidine

A

Cardioactives

140
Q

Tricyclic antidepressants, lithium

A

Psychoactives

141
Q

Cyclosporine, tacrolimus (FK-506)

A

Immunosuppressants

142
Q

Drugs routinely tested

A

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

PMLS Midterms (5 decks)

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