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Hubble Notes > Clinical Chemistry > Flashcards

Clinical Chemistry Flashcards

1
Q

Error where there is continued difference between test and comparative method values

A

Constant error

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2
Q

Error where difference between test and comparative method values are proportional to analyte concentrate

A

Proportional error

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3
Q

Deterioration of reagents is a problem encountered in what phase of clinical analysis

A

Analytical phase

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4
Q

Ratio of WARNING to MANDATORY Westgard rules

A

3:3

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5
Q

QC Chart that demonstrates the Westgard Multirules

A

Levey-Jennings

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6
Q

Most widely used QC Chart in the clinical laboratory

A

Levey-Jennings

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7
Q

QC Chart used to compare results of different laboratories

A

Youden Twin Plot

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8
Q

Plot that gives the earliest indication of trend

A

CuSum graph

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9
Q

Closeness of measured value to the true value

A

Accuracy

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10
Q

An ability to give repeated results on the same sample that agree with one another

A

Precision

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11
Q

Measures of the diagnostic accuracy of the a test

A

Specificity & Sensitivity

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12
Q

Relates to the lowest concentration of a substance that can be detected in a test system

A

Analytical sensitivity

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13
Q

Ability to detect only the desired chemical with no interference from other chemicals

A

Analytical specificity

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14
Q

Ability to detect the presence of disease

A

Diagnostic sensitivity

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15
Q

Indicates the ability of the test to generate more true POSITIVE and few false negative results

A

Diagnostic sensitivity

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16
Q

Reflects the ability of the method to detect true NEGATIVE with very few false positive

A

Diagnostic Specificity

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17
Q

Indicates the number of patients with an abnormal test result who HAVE the disease

A

Positive Predictive Value (PPV)

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18
Q

PPV Formula

A

True Positive / (True Positive + False Positive)

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19
Q

Indicates the number of patients with a normal test result who DO NOT HAVE the disease

A

Negative Predictive Value (NPV)

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20
Q

NPV Formula

A

True Negative / (True Negative + False Negative)

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21
Q

Part (s) of descriptive statistics

A

Central tendency, dispersion

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22
Q

Measures of dispersion

A

Variance, SD, CV, Range

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23
Q

The lower the CV, the _________ the precision

A

Higher

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24
Q

The average of the given set of values

A

Mean

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25
Q

Middle or midpoint of a distribution

A

Median

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26
Q

Most frequent observation in a set of data

A

Mode

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27
Q

At least how many control values should be gathered before interpretation is done?

A

20

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28
Q

Normal Gaussian curve appearance

A

Bell-shaped

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29
Q

Normal Gaussian distribution curve occurs if mean __ median __ mode

A

Mean = median = mode

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30
Q

+/- 2SD is equivalent to what % in Gaussian curve?

A

95%

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31
Q

Statistically derived value representing values of “healthy” people

A

Reference value

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32
Q

How many subject specimens are needed to ESTABLISH a reference range interval?

A

At least 120

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33
Q

How many subject specimens are needed to VERIFY a reference range interval?

A

As few as 20

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34
Q

How should a laboratory verify the reference range it uses for a particular test?

A

Test samples from healthy people

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35
Q

Sample used for interlaboratory (external) quality testing

A

Blind sample

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36
Q

Evaluation of method performance by comparing results with other lab

A

Proficiency testing (EQA)

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37
Q

Comparison between patient’s most recent result & previous determined value

A

Delta check

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38
Q

Important criteria in evaluating instruments

A

Specificity & sensitivity

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39
Q

A good standard curve

A

Line is straight.
Line connect all points.
Line goes through the origin of X & Y axes.

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40
Q

There is a perfect correlation of values in linear regression if values falls on __

A

1

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41
Q

Test performed usually by nonlaboratorian personnel (nurses, RTs, etc.)

A

Point-of-care testing

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42
Q

Nonlaboratory personnel are reaponsible for __ % errors with regard to lab results

A

29%

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43
Q

Specimen used for point-of-care testing (POCT)

A

Capillary blood

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44
Q

QC of POCT instruments should be done every ___

A

Everyday (Once each day of use)

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45
Q

Usual cause of random error in clinical laboratory

A

Clerical error

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46
Q

Vapor & osmotic pressure, boiling & freezing points are example of ___

A

Colligative properties

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47
Q

Used to measure osmolality

A

Freezing point depression & boiling point depression

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48
Q

Specimen (s) for osmolality determination

A

Serum

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49
Q

The relative concentration of a solution

A

Dilution

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50
Q

How much diluent needs to be added to 0.2 ml of serum to make 1:20 dilution?

A

3.8 mL

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51
Q

It is the amount of 1 substance relative to the amount of other substance in the solution

A

Concentration

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52
Q

Instrument that use diffraction gratings (commonly used monochromator)

A

Spectrophotometer

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53
Q

Beer’s law mathematically establishes relationship between concentration and ____

A

Absorbance

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54
Q

A solution that has a transmittance of 1.0% T would have an absorbance of ___
Formula:
Absorbance = 2-log (%T)

A

2.0

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55
Q

Formula for the concentration of the unknown sample (using spectrophotometer)

A

Unknown Concentration (Cu) = (Au/As) x Cs

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56
Q

Visible region

A

400 to 700 nm

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57
Q

<400 nm

A

UV region (VERY SHORT wavelength)

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58
Q

> 700 nm

A

Infrared region

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59
Q

Light source in the visible region

A

Tungsten lamp

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60
Q

Light sources in the UV region

A

Mercury arc, Deuterium, Hydrogen & Xenon Lamp

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61
Q

Light sources in the Infrared region

A

Merst glower & Glober

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62
Q

Zeroing the spectrophotometer before testing is done usually using ___

A

Reagent blank

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63
Q

Used to correct for absorbance caused by color of reagents

A

Reagent blank

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64
Q

Monochromator specification to measure true absorbance of compound with absorbance bandwidth of 30nm

A

5nm bandpass

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65
Q

Most commonly used photodetector, and the most sensitive to low levels of light

A

Photomultiplier tube

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66
Q

Detects light scattered towards a detector

A

Nephelometry

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67
Q

Detects amount of light blocked by a particulate matter (for measuring proteins)

A

Turbidimetry

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68
Q

Nephelometry is used for determination of

A

Ag-Ab complexes

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69
Q

Measurement of differences between 2 electrodes in terms of voltage at a constant current

A

Potentiometry

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70
Q

Gold standard for drug testing

A

GC-MS

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71
Q

Non destructive technique for detecting structure of organic compound (lipoprotein particle)

A

Nuclear magnetic resonance spectrophotometer (NMRS)

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72
Q

Effect on quenching on fluorescence

A

Decreased

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73
Q

Support media for zone electrophoresis

A

Agarose, cellulose acetate, polyacrylamide

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74
Q

Most commonly used stain for serum protein electrophoresis (SPE)

A

Ponceau S

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75
Q

A type of chemistry analyzer that uses reagents from different manufacturers / suppliers

A

Open system analyzer

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76
Q

Most basic or simplest pipette

A

Pasteur (glass/plastic) pipette

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77
Q

Parts of positive displacement pipet

A

Piston, piston seal, capillary

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78
Q

Glassware resistant to heat, corrosion & thermal shock

A

Borosilicate

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79
Q

Water that has passed through resin with charged particles is known as

A

Deionized water

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80
Q

Purpose of desiccators / desiccant?

A

Absorbs moisture

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81
Q

In general, oxidizers should never be placed with chemicals that are

A

Reducing agents

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82
Q

10% bleach inactivates hepatitis B virus within how many minutes?

A

10 minutes

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83
Q

10% bleach inactivates HIV within how many minutes?

A

2 minutes

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84
Q

Laboratory hazard prevention strategies include

A

Work practice controls, engineering controls, PPE, and emergency equipment

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85
Q

Equipment used to contain and expel noxious & hazardous fumes from chemical reagents

A

Fume hood

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86
Q

First step in pre-analytical phase

A

Test order

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87
Q

Instructing the patient to undergo fasting is part of ___

A

Patient preparation

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88
Q

Disinfectant for ethanol analysis blood collection

A

Benzalkonium chloride

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89
Q

Preferred site for venipuncture

A

Antecubital veins (Median cubital > Cephalic > Basilic)

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90
Q

Light source used by vein finders

A

Infrared

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91
Q

Most commonly used area for adult skin puncture

A

2nd, 3rd, 4th finger

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92
Q

Type of blood specimen for newborns

A

Blood spot

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93
Q

Ideal site of capillary blood collection in infants

A

Medial or lateral plantar surface of the heel

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94
Q

Shelf life (expiration date) of an evacuated tube is defined by

A

Vacuum retention & stability of the additive

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95
Q

The lower the temperature, the lower the gas pressure, the ________ the drawn volume in evacuated tube

A

Higher

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96
Q

The higher the temperature, the higher the gas pressure, the ________ the drawn volume in evacuated tube

A

Lower

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97
Q

Higher altitudes result to ______ blood volume

A

Lower

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98
Q

EDTA anticoagulant elevates ________ & ________ and lowers ________ & ________.

A

Elevates = Sodium & Potassium
Lowers = Calcium & Iron

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99
Q

Anticoagulant that produces least interference with analyses

A

Heparin

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100
Q

Preferred anticoagulant for electrolyte testing

A

Heparin

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101
Q

CTAD coagulant is used for

A

Coagulation testing

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102
Q

Temperature for lyophilization

A

-40C or less

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103
Q

Normal color of serum

A

Straw / pale yellow

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104
Q

Conversion of glucose to lactate or pyruvate

A

Glycolysis

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105
Q

Conversion of non-carbohydrate compound into glucose

A

Gluconeogenesis

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106
Q

Ability to maintain steady glucose concentration in the blood

A

Glucoregulation

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107
Q

Glucose hormone produced by the ALPHA-cells of the Islets of Largerhans in the pancreas

A

Glucagon

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108
Q

Routine examination that assesses glucose homeostasis

A

FBS (Fasting Blood Sugar)

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109
Q

In OGTT, patient undergoes UNRESTRICTED diet of ___ CHO per day for ___ before testing

A

150 grams; 3 days

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110
Q

Standard glucose load for OGTT according to WHO

A

75 grams

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111
Q

Mode of administration of tolbutamide in the tolbutamide tolerance test

A

Intravenous

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112
Q

Part of “Glucose tolerance factor”

A

Chromium

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113
Q

Plasma glucose returns to normal level ____ hours after eating

A

1 1/2 to 2 hours

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114
Q

Long term glucose MONITORING (2-3 months)

A

Glycosylated hemoglobin (HBA1C)

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115
Q

Short term glucose monitoring

A

Fructosamine

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116
Q

Fasting blood glucose is _____ than in serum or plasma

A

10-15% lower

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117
Q

Venous blood glucose is _____ than capillary blood (due to tissue metabolism)

A

7 mg/dL lower

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118
Q

Capillary blood glucose is _____ with arterial blood glucose

A

Same

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119
Q

10% contamination with 5% dextrose will increase glucose by _____

A

500 mg/dL

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120
Q

Effect of hemolysis and bilirubin on plasma glucose using hexokinase method

A

False decrease

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121
Q

Glycolysis at ROOM temperature

A

7 mg/dL/hr

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122
Q

Glycolysis at REFRIGERATION temperature

A

2 mg/dL/hr

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123
Q

End product of glucose determination using Folin-Wu method

A

Phosphomolybdenum blue

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124
Q

End product of glucose determination using Nelson -Somogyi method

A

Arsenomolybdenum blue

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125
Q

The most specific enzyme reacting with only B-D-glucose

A

Glucose oxidase

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126
Q

The most specific glucose method

A

Hexokinase

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127
Q

Reference method for blood glucose determination

A

Hexokinase

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128
Q

Hallmark of Diabetes Mellitus

A

Hyperglycemia

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129
Q

Causes of hyperglycemia during pregnancy

A

Hormonal changes

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130
Q

A type of GLUCOSE INTOLERANCE with onset or first recognition during pregnancy

A

Gestational Diabetes Mellitus

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131
Q

Overzealous treatment of DM may lead to _____

A

Hypoglycemia

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132
Q

Symptoms of hypoglycemia appear at what glucose level?

A

50-55 mg/dL

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133
Q

Blood glucose level diagnostic for hypoglycemia

A

< 50 mg/dL

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134
Q

Biological substances that are insoluble in water & most biologic fluids

A

Triglyceride

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135
Q

Steroids are derived from _____

A

Non-glyceride lipids

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136
Q

Lipoprotein found in obstructive jaundice and LCAT deficiency

A

Lipoprotein X

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137
Q

Fasting period to produce reliable lipid profile result

A

12 hours

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138
Q

Lipid greatly affected by non-fasting specimens

A

Triglycerides

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139
Q

Fasting has a little effect on

A

Cholesterols

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140
Q

Triglycerides will increase how many hours after a meal?

A

2 hours

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141
Q

Serum is lipemic when triglyceride levels exceed

A

400 mg/dL

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142
Q

Triglyceride level if plasma is CLEAR

A

<200 mg/dL

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143
Q

Triglyceride level that causes HAZY/TURBID plasma

A

> 300 mg/dL

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144
Q

Triglyceride level that causes MILKY plasma

A

> 600 mg/dL

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145
Q

What is the purpose of acetic anhydride in Liebermann-Burchard assay?

A

Solvent & dehydrating agent

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146
Q

Enzymatic methods for cholesterol determination uses what enzyme (s)?

A

Cholesterol esterase & Cholesterol oxidase

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147
Q

LDL can be calculated from measurement of __________, __________, __________ by Friedewald approximation

A

Total cholesterol, HDL, and Triglycerides

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148
Q

LDL Formula

A

LDL = Total cholesterol - HDL - (Triglyceride/5)

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149
Q

What is the formula for VLDL using Friedewald method

A

VLDL = TAG/5 (mg/dL) or TAG/2.175 (mmol/L)

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150
Q

What is the formula for VLDL using De Long method

A

VLDL = TAG/6.5 (mg/dL) or TAG/2.825 (mmol/L)

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151
Q

Friedewald equation should not be used when plasma TAG exceeds

A

400 mg/dL

152
Q

Reference method for quantitation of lipoproteins

A

Ultracentrifugation

153
Q

24-hour plasma standing test is used to test

A

Chylomicrons

154
Q

Produces floating creamy layer

A

Chylomicrons

155
Q

Largest lipoprotein

A

Chylomicrons

156
Q

Minor lipoproteins

A

IDL, Lp (a)

157
Q

Lipoprotein that is the primary target of cholesterol lowering therapy; PRIMARY MARKER FOR CHD DISEASE

A

LDL

158
Q

Lipopathy associated with acanthocytosis, abetlipoproteinemia, & mutations in MTTP gene

A

Bassen-Kornzweig syndrome

159
Q

Familial HDL deficiency

A

Tangier’s disease

160
Q

Thyroid disorder with LOW cholesterol and triglycerides

A

Hyperthyroidism

161
Q

Thyroid disorder with HIGH cholesterol and triglycerides

A

Hypothyroidism

162
Q

Xanthelasma is most commonly caused by?

A

Hyoercholesterolemia

163
Q

In SPE, using a buffer solution at pH 8.6, proteins exhibit

A

Net negative charge

164
Q

The most negatively charged serum protein

A

Albumin

165
Q

Serum protein electrophoretic patter (anode to cathode)

A

Albumin > a1 > a2 > B > y

166
Q

Why are plasm samples not recommended for standard protein electrophoresis?

A

Pseudo-gamma bridging effect

167
Q

Cause of relative hyperproteinemia

A

Dehydration

168
Q

Cause of artifactual hyperalbuminemia

A

Prolonged tourniquet application

169
Q

Cause of dysproteinemia

A

Clonal proliferation of B plasma cells

170
Q

Common in multiple myeloma and Waldenstrom’s macroglobulinemia

A

Increased IgM

171
Q

Kayser-Fleischer rings are associated with what disease?

A

Wilson’s disease

172
Q

In Wilson’s disease, ceruloplasmin levels are ___

A

Decreased

173
Q

Myoglobin level of >300 ug/L, when will you report result?

A

Immediately

174
Q

Biomarker for thrombosis / pulmonary embolism

A

D-dimer

175
Q

Popular marker for congestive heart failure

A

Brain natriuretic peptide (BNP)

176
Q

According to Kjeldhal, 1 gram of nitrogen is equivalent to _____ grams of protein

A

6.54

177
Q

Disease (s) associated with low A/G ratio

A

Multiple myeloma, cirrhosis, kidney disease, autoimmune infection

178
Q

Made up of alkaline CuSO4, NaOH, KI, and NaK tartrate (Rochelle salt)

A

Biuret reagent

179
Q

Bromcrescol green (BCG) is more sensitive to _____ than hydroxybenzene benzoic acid (HABA)

A

Albumin

180
Q

Plays a vital role in controlling blood pressure and fluid balance

A

Renin

181
Q

Causes vasodilation of the afferent arterioles and constriction of the efferent arterioles *VACE

A

Angiotensin II

182
Q

A hormone that also acts as an enzyme

A

Renin

183
Q

Measures the ability of the kidneys to eliminate substance from the blood

A

Clearance test

184
Q

Measure of completeness of a 24-hour urine collection

A

Creatinine clearance

185
Q

Most commonly used clearance test to estimate GFR

A

Creatinine clearance

186
Q

What is 1440 in the creatinine clearance formula?

A

Constant (24 hours = 1440 minutes)

187
Q

It is freely filtered by glomerulus, not reabsorbed, BUT MINIMALLY SECRETED by the renal tubules

A

Creatinine

188
Q

UV method uses _____ enzyme to convert uric acid (⬆️ absorbance) into allantoin (⬇️ absorbance)

A

Uricase

189
Q

Uric acid absorbs light strongly in the region around _____ nm

A

285 (UV region)

190
Q

Reference method for NPNs (urea)

A

IDMS

191
Q

Reagent in the urea determination that uses colorimetry forming a yellow end-product

A

Diacetyl monoxime (DAM)

192
Q

Jaffe reaction is the most frequently used method to measure CREATININE that uses _____ reagent

A

Alkaline picrate

193
Q

Accurate results are obtained when Fuller’s earth or Lloyd’s reagent is used for _____ measurements

A

Creatinine

194
Q

Creatinine levels in the blood are affected by _____

A

Muscle mass

195
Q

Normal BUN:CREATININE ratio

A

(10-20) : 1

196
Q

Product of purine metabolism

A

Uric acid

197
Q

Use of chemotherapeutic agents increases what NPN?

A

Uric acid

198
Q

What condition is associated when metabolism of uric acid, and not of other NPNs is impaired

A

Gout

199
Q

An elevated condition of urea (& creatinine) in the blood is called

A

Azotemia

200
Q

Very high plasma concentration accompanied by renal failure is called

A

Uremia / Uremic syndrome

201
Q

Three main categories of azotemia

A

Prerenal azotemia
Renal azotemia
Postrenal azotemia

202
Q

BUN and creatinine will be significantly elevated if the GFR is decreased by at least ___ %

A

50%

203
Q

Major waste product of protein catabolism

A

Urea

204
Q

Product of amino acid deamination

A

Urea/Ammonia

205
Q

Marker for hepatic coma (hepatic encephalopathy)

A

Ammonia

206
Q

Appropriate sample for ammonia determination

A

Freshly drawn blood

207
Q

Effect of cigarette smoking on plasma ammonia determination

A

Increased

208
Q

Liver function tests are usually based on which principle?

A

Photometry

209
Q

Formula for total bilirubin

A

TB = CB + UB

210
Q

Normal value for total bilirubin in adults

A

0.2 - 1.0 mg/dL
(3 - 17 umol/L)

211
Q

Jaundice is clinically evident when bilirubin level exceeds

A

2 mg/dL

212
Q

In the liver, bilirubin is conjugated by addition of

A

Glucuronyl groups (glucuronic acid)

213
Q

Bilirubin fraction increased in PRE-HEPATIC (hemolytic) jaundice

A

Unconjugated

214
Q

Bilirubin fraction increased in HEPATIC jaundice

A

Conjugated & Unconjugated

215
Q

Bilirubin fraction increased in POST-HEPATIC (obstructive) jaundice

A

Conjugated

216
Q

Bilirubin fraction that DOES NOT require an accelerator to react

A

Conjugated (direct) bilirubin

217
Q

Form of bilirubin that is soluble in water

A

Conjugated (direct) bilirubin

218
Q

Form of bilirubin that is insoluble in water

A

Unconjugated (indirect) bilirubin

219
Q

Form of bilirubin that has LONGER HALF-LIFE than other forms of bilirubin

A

Delta bilirubin

220
Q

Elevation of bilirubin in newborns (due to immature liver)

A

Physiologic jaundice

221
Q

Kernicterus is an abnormal accumulation of UNCONJUGATED BILIRUBIN in the

A

Brain tissues

222
Q

Neonate bilirubin level is 28 mg/dL. When will you report the result?

A

Immediately

223
Q

The danger of kernicterus is a certainty at bilirubin levels exceeding _____

A

20 mg/dL

224
Q

True or false: Enzymes are proteins

A

True

225
Q

Reaction rate is directly proportional to SUBSTRATE concentration

A

First order kinetics

226
Q

Reaction rate only depends on ENZYME concentration

A

Zero order kinetics

227
Q

Phase in which enzyme activity is usually measured

A

Linear phase

228
Q

Two general methods that are used to measure the extent of an enzymatic reaction

A

Fixed-time
Kinetic assays

229
Q

In this assay, multiple measurements of change in absorbance are made during the reaction

A

Kinetic / continuous monitoring assay

230
Q

In this assay, reactants are mixed; reaction proceeds for designated time; and reaction is stopped & measurement is made

A

Fixed-time assay

231
Q

What is this called? “E + S = ES = E + P”

A

Enzyme catalytic reaction

232
Q

What is this called? “Vmax (S) / Km + S”

A

Michaelis-Menten equation

233
Q

This is needed to achieve full enzyme activity

A

Coenzyme

234
Q

Non-protein molecule necessary for enzyme activity

A

Cofactor

235
Q

ACP, ALP, ALT, AMY, AST, CK, GGT, LD, and LPS are?

A

Macroenzymes

236
Q

ALP isoenzyme electrophoretic pattern (anode to cathode)

A

Liver > Bone > Placental > Intestinal

237
Q

ALP isoenzyme heat stability (most heat stable to most heat labile)

A

Placental > Intestine > Liver > Bone

238
Q

Levamisole inhibits what ALP isoenzyme (s)?

A

Bone and Liver ALP

239
Q

Phenylalanine inhibits what ALP isoenzyme (s) ?

A

Placental and Intestinal ALP

240
Q

3M Urea inhibits what ALP isoenzyme (s) ?

A

Bone ALP

241
Q

Buffer used in ALP analysis

A

AMP (amino methyl propanol)

242
Q

Physiologic increase in serum ACP has been reported in specimens obtained from patients after _____ exam

A

Rectal

243
Q

Enzyme that is also useful in forensic clinical chemistry, in the investigation of rape cases

A

ACP

244
Q

Effect of high concentration of bilirubin & hemoglobin to ACP determination

A

Increased (specimen is hemolyzed)

245
Q

Enzyme that catalyzes the conversion of starch to glucose and maltose

A

Amylase

246
Q

Assay for amylase that involves formation of maltose

A

Coupled-enzyme

247
Q

Assay for amylase that measures the disappearance of starch SUBSTRATE

A

Amyloclastic

248
Q

Assay for amylase that measures the appearance of PRODUCT

A

Saccharogenic

249
Q

Assay for amylase that measures increasing COLOR from production of PRODUCT

A

Chromogenic

250
Q

Enzyme that is best indicator of PANCREATIC function

A

Lipase

251
Q

Least specific enzyme (found in many tissues)

A

Lactate dehydrogenase

252
Q

Cause (s) of flipped LD pattern

A

Acute Myocardial Infarction (AMI), renal infarction, hemolysis

253
Q

Major tissue sources of AST

A

Cardiac tissue
Liver
Skeletal muscle

254
Q

LIVER specific enzyme

A

ALT

255
Q

Old name for AST

A

SGOT

256
Q

Old name for ALT

A

SGPT

257
Q

Enzyme indicator used in measuring ALT activity

A

Lactate dehdrogenase

258
Q

Enzyme indicator used in measuring AST activity

A

Malate dehydrogenase

259
Q

More sensitive and specific screening test for post-transfusion hepatitis

A

ALT

260
Q

Enzyme increased in alcoholism

A

GGT

261
Q

Enzyme whose significance is DECREASED ACTIVITY

A

Pseudocholinesterase

262
Q

Positive result in the turbidimetric method for lipase

A

Decreased turbidity

263
Q

Chloride shift is maintained by a reversible exchange process between _____ & _____

A

Bicarbonate & chloride

264
Q

Formula for Anion Gap; Normal value: 10-20 mmol/L

A

AG = (Na + K) - (Cl + HCO3)

265
Q

Formula for Anion Gap; Normal value: 7-16 mmol/L

A

AG = Na - (Cl + HCO3)

266
Q

The difference between the unmeasured cations and unmeasured anions is called

A

Anion gap

267
Q

It is a form of quality control for the analyzer used to measure electrolytes

A

Anion gap

268
Q

Hypernatremia occurs when serum sodium is

A

> 145 mmol/L (increased)

269
Q

Hyponatremia occurs when serum sodium is

A

<135 mmol/L (decreased)

270
Q

Hormone that regulate sodium reabsorption

A

Aldosterone

271
Q

Relationship of ADH and sodium levels

A

Inverse

272
Q

Effect of low ADH on serum sodium

A

Increased sodium

273
Q

Effect of high glucose on serum sodium concentration

A

Decreased sodium

274
Q

Promotes natriuresis, blocks aldosterone secretion, inhibits vasopressin

A

Atrial natriuretic factor

275
Q

Hyperlipidemia causes artifactual _____

A

Hyponatremia

276
Q

Low sodium caused by pseudohyponatremia, what to do?

A

Test for osmolality

277
Q

Electrolytes, BUN, crea, osmolality are done on patient who ingested ethanol. What to do?

A

Determine osmolal gap

278
Q

Electrolytes that transmits nerve impulses

A

Potassium

279
Q

Marked hyperkalemia may lead to

A

Cardiac arrest

280
Q

Potassium is falsely _____ in hemolyzed blood samples

A

Increased

281
Q

Factors affecting serum calcium levels include

A

⬆️ Vitamin D
⬆️ Parathyroid hormone
⬇️ CALCITONIN

282
Q

Milk-alkali syndrome may lead to

A

Hypercalcemia

283
Q

A pro-oxidant contributing to DNA damage; lipid peroxidation; carcinogenesis, etc

A

Iron

284
Q

It REGULATES intracellular iron TRANPORT from intestinal surface to inside the cell

A

DMT-1

285
Q

For _____ testing, blood should be collected in a tube containing 10 mg NaF & 2 mg K2C2O4 per mL pf blood

A

Lactate

286
Q

It refers to the dissociable substance that can yield hydroxyl ions

A

Base

287
Q

A substance that can yield hydrogen (H+) or hydronium (H3O) ion when dissolved

A

Acid

288
Q

Most important buffer pair in plasma

A

HCO3 : H2CO3 pair

289
Q

Weak acid or weak base and their related salts; resists any change in pH & H+ ion concentration

A

Buffer

290
Q

__________ include bicarbonate, carbonic acid, plasma proteins, hemoglobin and inorganic phosphate

A

Blood buffers

291
Q

It is the primary substance in the carbonic acid-bicarbonate buffer system

A

Bicarbonate

292
Q

Normal ratio of BICARBONATE TO CARBONIC ACID

A

20:1

293
Q

During onset of fever, pCO2 increases by _____ and pO2 decreases by _____

A

3% 7%

294
Q

Electrode used for pH

A

Gas electrode

295
Q

Electrode used for pCO2

A

Severinghaus electrode

296
Q

Electrode used for pO2

A

Clark electrode

297
Q

Electrode used for K+

A

Valinomycin-based electrode

298
Q

Used to calibrate pH meter

A

Buffer

299
Q

Most common preanalytic error in blood pH measurement

A

Excess heparin

300
Q

When a blood sample is exposed to air, pH and pO2 levels _____ while pCO2 _____

A

Increases; decreases

301
Q

When a capped blood is allowed to stand at RT, pH and pO2 levels _____ & pCO2 _____

A

Decreases; increases

302
Q

Hormone secreted in endocrine cell and released into interstitial space

A

Paracrine

303
Q

Known as the “master gland”

A

Pituitary gland

304
Q

The anterior pituitary gland is positioned in what part of the skull?

A

Sphenoid bone

305
Q

Hormones produced by the anterior pituitary gland

A

TSH, Prolactin, FSH, LH, ACTH, GH

306
Q

Most abundant hormone of the anterior pituitary gland

A

Growth hormone (GH)

307
Q

Hormone markedly increased during deep sleep

A

Somatotropin (GH)

308
Q

ADH is secreted by what gland

A

Posterior pituitary gland

309
Q

ADH is produced by what gland

A

Hypothalamus

310
Q

Excess growth hormone in adults

A

Acromegaly

311
Q

Increased growth hormone in adults (acromegaly) can cause

A

Hyperglycemia

312
Q

Mineral compound found in teeth

A

Hydroxyapatite (Ca phosphate)

313
Q

Part of the thyroid gland that produces hormones

A

Follicles

314
Q

Thyroid follicles are spheres of thyroid cells surrounding a core of viscous substances called

A

Colloid

315
Q

Trace element important in thyroid hormone synthesis

A

Iodine

316
Q

Most abundant thyroid hormone

A

Thyroxine

317
Q

Thyroid hormones are derived from what amino acid

A

Tyrosine

318
Q

Thyroxine is present in the body in the largest amount as _____

A

Thyroxine-bound to globulin (TBG)

319
Q

Comparably, T3 in the circulation is _____ than T4

A

Lower

320
Q

Indirectly assesses the concentration of circulating free T4

A

Free thyroxine index (FT4I)

321
Q

Used to confirm results of FT3 & FT4, or abnormalities in the relationship of total T4 and THBR test

A

Thyroxine-bound globulin (TBG)

322
Q

Single screening test for thyroid disease

A

TSH Assay

323
Q

If a screening test is high, which test is likely to be ordered next?

A

FT4

324
Q

Test to differentiate drug induced TSH elevation and hypothyroidism

A

FT4 Test

325
Q

Test that quantitates the concentration of TBG

A

T3 uptake

326
Q

T3 uptake is _____ proportional to T3 and T4 concentrates

A

Directly

327
Q

Screening test for congenital hypothyroidism

A

T4 (decreased)

328
Q

Confirmatory test for congenital hypothyroidism

A

TSH (increased)

329
Q

Most likely interferes with quantitation of thyroglobulin

A

Anti-thyroglobulin autoantibodies

330
Q

Testing for this HORMONE requires EARLY MORNING specimen collection

A

Cortisol

331
Q

Specimen for ACTH determination

A

Pre-chilled EDTA blood

332
Q

ACTH is highest between _____ to _____ and lowest between _____ to _____

A

Highest = 6:00 - 8:00 am
Lowest = 6:00 - 11:00 pm

333
Q

Excess growth hormone in children

A

Gigantism

334
Q

Cortisol is highest between _____ to _____ and lowest between _____ to _____

A

Highest = 8:00 to 10:00 am
Lowest = 10:00 pm to 12:00 mn

335
Q

Increased cortisol, decreased ACTH

A

Cushing’s syndrome

336
Q

Increased cortisol, increased ACTH

A

Cushing’s disease

337
Q

Oral salt loading test is a confirmatory test for

A

Conn’s disease

338
Q

Increased catecholamines is seen in

A

Pheochromocytoma

339
Q

Major metabolite of catecholamines

A

Vanillylmandelic acid (VMA)

340
Q

Metabolite of dopamine

A

Homovanillic acid

341
Q

Specimen (s) for catecholamine measurements

A

Plasma, 24 hour urine

342
Q

_____ will result in male and female inferitility

A

Hypogonadism

343
Q

Hormone that prepares the endometrium for embryo implantation and maintains it throughout pregnancy

A

Progesterone

344
Q

Most potent estrogen

A

Estradiol

345
Q

Most potent androgen

A

Testosterone / Dihydrotestosterone

346
Q

Estrogen found in both men and women

A

Estradiol

347
Q

Estradiol is produced by what gland

A

Ovaries

348
Q

Method used for measuring URINARY ESTROGENS

A

Kober reaction

349
Q

Method used for measuring 17-hydroxycorticosteriods (17-OHCS)

A

Porter-Silber method

350
Q

Method for measuring 17-ketogenic steroids

A

Zimmerman reaction

351
Q

Method for measuring METANEPHRINES and NORMETANEPHRINES

A

Pisano method

352
Q

Hormone that inhibits gastric emptying, stimulates pancreatic secretions and gallbladder contractions

A

Cholecystokinin (CCK)

353
Q

Absorption, circulation, distribution, metabolism, clearance, age, medium, gastric pH, liver and kidney functions are all factors for

A

Drug metabolism

354
Q

Trough concentrations for most drugs are drawn _____ before the next dose

A

Right before

355
Q

Peak concentrations are drawn _____ after an orally administered dose

A

1 hour

356
Q

Anticoagulant suitable for therapeutic drug monitoring

A

Heparin

357
Q

Anti-tussive opiate

A

Codeine

358
Q

Most prominent benzodiazepine

A

Valium

359
Q

Most commonly used assay for aspirin determination

A

Trinder reaction

360
Q

Used to treat bipolar disorder; may cause hypercalcemia

A

Lithium

361
Q

Drug of choice for controlling petit mal seizures

A

Ethosuximide

362
Q

Most sensitive organ to alcohol ingestion

A

Liver

363
Q

Form of alcohol not suitable for comsumption

A

METHANOL, isopropyl alcohol

364
Q

Drug of abuse with direct toxicity on myocardium

A

Cocaine

365
Q

Metabolite of cocaine

A

Benzoylecgonine

366
Q

Derived from the flowers of the hemp plant Cannabis sativa

A

Marijuana

367
Q

Psychoactive substance of marijuana

A

Tetrahydrocannabinol (THC)

368
Q

A marijuana user may still test positive for THC even after ___ days of last use

A

45

369
Q

Methylenedioxymethampethamine is commonly known as

A

Ecstasy

370
Q

Reporting of absence of analyte for drug abuse

A

Negative

371
Q

Plumbism is associated with an increased in amounts of

A

Lead

372
Q

“GARLIC ODOR” breath and metallic taste

A

Arsenic toxicity

373
Q

“BITTER ALMONDS ODOR” breath and altered mental status

A

Cyanide toxicity

374
Q

Metal with high affinity to keratin

A

Arsenic

375
Q

Interferes with sulfhydryl groups, reduce oxidative phosphorylation & ATP production

A

Arsenic

376
Q

Form of mercury that is considered an environmental pollutant

A

Organic mercury

Hubble Notes (13 decks)

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