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Clinical Chemistry Flashcards

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1
Q

What could cause an elevated specific gravity but normal osmolality?

A

heavier molecules such as protein or glucose

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2
Q

What are the normal values for CSF glucose, protein appearance, and WBC’S?

A

Glucose: 50-80 mg/100 mL
Protein:15-45 mg/dL,
Appearance: clear and colorless,
WBC:0-5

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3
Q

Why is CO toxic?

A

prevents binding of Hgb to oxygen

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4
Q

Know the abnormal and normal metabolism of bilirubin, including what is increased and/or decreased in the serum, urine, and/or feces

A

-Total Bili 0.2-1.0 mg/dL
-Conj Bili 0.0-0.2 mg/dL;
-Unconj Bili 0.2-0.8 mg/dL
-Prehep: too much bili to liver, incr in urine/feces, (hemolytic anemias)
-Hepatic: problem with liver itself, incr in urine/feces (liver disease)
-Posthep: Bili obstruction, decr/absence urobili in urine/feces (stones,tumors)
e.g. obstructive jaundice=decr. fecal urobilinogen,
increased bile pigments=jaundice

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5
Q

Be able to interpret oral and intravenous GTT results

A

(2 hour plasma glucose) Normal: 200 mg/dL

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6
Q

Give precautions for bilirubin specimen handling

A
  • protect from light
  • run ASAP
  • no hemolysis
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7
Q

What enzyme tests cannot be preserved by freezing

A

LD

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8
Q

What is the cause of postprandial lipemia?

A

chylomicrons

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9
Q

How does the electrophoretic pattern of plasma differ from that of serum?

A

sharp fibrinogen peak in plasma

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10
Q

What is the order of migration of proteins on electrophoresis at pH 8.6?

A

fastest-albumin, A1, A2, Beta, Gamma(slowest)

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11
Q

What is the principle enzyme in saliva?

A

amylase

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12
Q

The immunoglobulins migrate with what protein on electrophoresis at pH 8.6?

A

gamma globulin

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13
Q

How do oral contraceptives affect total T4 and TBG in competitive binding
assays?

A

increased in both

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14
Q

Creatinine is the breakdown product of what substance?

A

Creatine

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15
Q

What tests are affected by hemolysis?

A

ACP, ALP, ALT, AST, BILI, CBC, CK, LD, aPTT, PT

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16
Q

What is the normal bicarbonate to dissolved CO2 ratio?

A

20:1

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17
Q

What is the anticoagulant of choice for blood gas analysis?

A

Heparin

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18
Q

How is serum globulin usually determined?

A

serum globulin=total protein-albumin

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19
Q

What is the predominant form of thyroid hormone in the circulation?

A

Thyroxine (T4)

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20
Q

How is a bloody CSF handled in the chemistry lab?

A

spin it down and analyze fluid; mention presence of blood

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21
Q

What is the unique value of enzymes as reagents?

A

specificity

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22
Q

What are the major intracellular and extracellular anions and cations?

A

intracellular anion: phosphate
intracellular cation: potassium
extracellular anion: chloride
extracellular cation: sodium

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23
Q

What is the normal pH of blood?

A

7.35-7.45

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24
Q

Differentiate a Transudate from and exudate.

A

transudate- clear, no clots, SG 1.015

exudate- cloudy,clots,SG>1.015

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25
Q

What protein is a contributing factor in edema formation?

A

albumin

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26
Q

How is the blood glucose level affected if the serum is left sitting on the clot for several hours?

A

decrease by 10% per hour

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27
Q

What is the most accurate pipette for measuring a 1 mL volume?

A

Oswald-Folin volumetric

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28
Q

What type of fast does the patient undergo for lipid studies?

A

12 hour

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29
Q

Be able to calculate problems on:

C1V1 = C2V2

A

can also be used for Normality

N1V1=N2V2

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30
Q

Be able to calculate problems on:

Creatinine Clearance

A

(Ucr)(Vu) / (Pcr)(T)

T=1440 minutes

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31
Q

Be able to calculate problems on:

Normality

A

N = grams divided by GEW divided by Liters

GEW=GMW divided by the total positive valence of ions in the compound

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32
Q

Be able to calculate problems on:

Percent Solutions

A

(w/w) {ex.} 5%=5/100=0.050
(w/v) {ex.} 10/100=x/1000 x=100
(v/v) {ex.} 2/100=x/50ml

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33
Q

Be able to calculate problems on:

Dilutions

A

Initial/preceding dilution X (x)= dilution needed

Ex. 1:10 X(x)=1:20 {solve for x}

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34
Q

Be able to calculate problems on:

Molarity

A

M = grams divided by GMW divided by Liters

GMW=add molar masses of each element in a compound; M is measured in moles per liter (mol/L)

35
Q

Be able to calculate problems on:

Beer’s Law

A 
concentration and absorbance in photometric determinations 
Cu=(Au)(Cs)/As
-Concentration standard (Cs)
-Concentration unknown (Cu)
-Absorbance standard (As)
-Absorbance unknown (Au)
36
Q

Be able to calculate problems on:

Anion Gap

A

(sodium + potassium)-(chloride+bicarbonate) OR

sodium-(chloride+bicarbonate)

37
Q

Know the principle behind the following:

Kjeldahl protein technique

A

conversion of nitrogen into ammonium; reference method for total protein determination

38
Q

Know the principle behind the following: Biuret method

A

directly proportional to the number of peptide bonds present; specifically reacts with least 2 peptide bonds or more (tripeptide or larger)

39
Q

Know the principle behind the following:

Osmolality

A

freezing point depression

40
Q

Know the principle behind the following:

Creatinine clearance/GFR

A

Creatinine clearance tests GFR based on assumption that all creatinine passes into the urine. (GFR = volume of plasma filtered by the glomerulus per unit of time; GFR=V/t)

41
Q

Know the principle behind the following:

Nephelometer

A

measurement of light is directly proportional to the number of particles in solution

42
Q

Know the principle behind the following:

Fluorometer

A

measurement of light excited by a UV light source

43
Q

Know the principle behind the following:

Sweat Chloride

A

uses pilocarpine through an electric current into the skin

44
Q

Know the principle behind the following:

Oral GTT

A

detects abnormal glucose metabolism

45
Q

Know the significance of the following terms to clinical chemistry:
Glycosylated Hb

A

HgA1C give a picture of PT blood glucose concentration over the past 3 months

46
Q

Know the significance of the following terms to clinical chemistry:
Intrinsic Factor

A

required for B12 absorption

47
Q

Know the significance of the following terms to clinical chemistry:
Jaffe reaction

A

determines creatinine levels

48
Q

Know the significance of the following terms to clinical chemistry:
3 hour GTT

A

borderline fasting blood sugar pts

49
Q

Know the significance of the following terms to clinical chemistry:
Kernicterus

A

Kernicterus is a bilirubin-induced brain dysfunction.

50
Q

Know the significance of the following terms to clinical chemistry:
+/- 2SD

A

includes 95.5% of values

51
Q

Know the significance of the following terms to clinical chemistry:
Hollow Cathode Lamp

A

used in atomic absorption

52
Q

Know the significance of the following terms to clinical chemistry:
Pheochromocytoma

A

abnormal adrenal medulla which causes increased VMA, norepinephrine, and epinephrine

53
Q

Know the significance of the following terms to clinical chemistry:
VMA

A

vanillylmandelic acid - a test for catecholamine-secreting tumors performed on a 24-hour urine specimen; it is based on the finding that vanillylmandelic acid is the major urinary metabolite of norepinephrine and epinephrine

54
Q

Know the significance of the following terms to clinical chemistry:
5-HIAA

A

increased in cancers involving entero chromofins of GI tract

55
Q

Know the significance of the following terms to clinical chemistry:
Berthelot Reaction

A

hydrolysis of urea

56
Q

Know the reagents used in the following test:

Prostatic Acid Phosphatase

A

L tartrate

57
Q

Know the reagents used in the following test:

Urobilinogen

A

p aminobenzaldehyde

58
Q

Know the reagents used in the following test:

BUN

A

diacetyl monoxime

59
Q

Know the clinical significance of the following test:

Urinary 17-ketosteroids

A

increased in adrenal cortex

60
Q

Know the clinical significance of the following test:

Duodenal Fluid Testing

A

diagnose pancreas disease

61
Q

Know the clinical significance of the following test:

HDL Cholesterol

A

High Density Lipoprotein Cholesterol- it is not readily catabolized by most cells and dose not serve as a source of fuel

62
Q

Know the clinical significance of the following test:

AFP (Tumor marker)

A

alpha feta protein;hepatoma

63
Q

Know the clinical significance of the following test:

LD

A

increased in MI

64
Q

Know the clinical significance of the following test:

CK

A

increased 1st in MI

65
Q 
Know the clinical significance of the following test:
Acid Phosphatase (vaginal fluid)
A

rape

66
Q

Know the clinical significance of the following test:

CK isoenzymes

A

CKMB(heart)increased in MI
CKMM muscle
CKBB brain

67
Q

Know the clinical significance of the following test:

Uric Acid

A

increased in gout

68
Q

Know the clinical significance of the following test:

Sweat Chloride

A

CF

69
Q

Know the clinical significance of the following test:

GGT

A

GGT levels are elevated in conditions such as Acute Pancreatitis, Diabetes Mellitusm and MI

70
Q

Know the clinical significance of the following test:

SGOT/AST

A

increased in MI, viral hepatitus, skeletal muscle disease

71
Q

Know the clinical significance of the following test:

5-HIAA

A

5-Hydroxyindoleacetic acid is the main metabolite of serotonin

72
Q

Know the clinical significance of the following test:

Ionic Calcium

A

low in tetany

73
Q

Know the clinical significance of the following test:

Amylase

A

increased in pancreatic diagnosis

74
Q

Know the clinical significance of the following test:

Creatinine

A

is the indicator of a good kidney function. High creatinine means that the kidney is not filtering well or not in good function

75
Q

Know the clinical significance of the following test:

ALT (Alanine Aminotransferase)

A

confined mainly to evaluation of hepatic disorders: have a longer half-life

76
Q

Know the clinical significance of the following test:

Anion Gap

A

indicating an increase in one or more of the unmeasured anions in the serum and also as a form of QC for the analyzer used to measure these electrolytes

77
Q

Patients with an increased catabolism of purines most likely have an increased serum
concentration of what substance?

A

uric acid

78
Q

How would the urine volume of a patient with diabetes insipidus be affected upon
administrations of ADH?

A

decrease

79
Q

Recognize erroneous results caused by drawing blood from an IV site.

A

transferring blood from a syringe to a tube

80
Q

The serum protein electrophoresis pattern in multiple myeloma shows what abnormality?

A

spike in the gamma globulin

81
Q

Know the normal values for LDL, HDL, cholesterol and triglycerides.

A

HDL: 40-75 mg/dl
LDL: 50-130 mg/dl
Tri: 60-150 mg/dl
Cholesterol: 140-200 mg/dl

82
Q

What substance in the intestines is required for the absorption of vitamin B12?

A

intrinsic factor

83
Q

List three enzymes whose clinical significance is related to the detection of a MI.

A

AST
CK
LD

Clinical Chemistry (4 decks)

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