Clinical Chemistry Flashcards
Albumin g/0.1L to g/L
10
Bilirubin mg/dL to umol/L
17.1
BUN mg/dL to mmol/L
0.357
Chloride mEq/L to mmol/L
1
Cholesterol mg/dL to mmol/L
0.026
Creatinine mg/dL to umol/L
88.4
Glucose mg/dL to mmol/L
0.0555
Potassium mEq/L to mmol/L
1
Sodium mEq/L to mmol/L
1
Thyroxine ug/dL to mmol/L
12.9
Total protein g/dL to mmol/L
10
Triglyceride mg/dL to to mmol/L
0.0113
Uric acid mg/dL to mmol/L
0.0595
Shorter wavelength = ___ energy
high
Visible light falls in between __nm to __nm wavelengths
400nm to 700nm
Anticoagulant with the least interference with analyses
Heparin (green)
Used for most chemical blood tests
Lithium heparin
Assay of Urea Nitrogen
Colorimetric: Diacetyl (cheaper but lacks specificity)
Enzymatic: NH3 formation (better specificity but more expensive)
Elevated urea in blood
Azotemia
Elevated urea in blood accompanied by renal failure
Uremia or uremic syndrome
Cause of pre-renal azotemia
Reduced renal blood flow or increased protein catabolism
Cause of renal azotemia
Renal dysfunction
Cause of post-renal azotemia
Obstruction of urine flow anywhere in the urinary tract
Creatinine reacts with picric acid in alkaline solution to form red-orange chromogen
Jaffe Reaction
BUN:creatine ratio
10-20:1
BUN:creatine ratio in prerenal disease
BUN rises above 10-20:1
BUN:creatine ratio in true renal disease
BUN and creatine both rise; 10-20:1 ratio is maintained
Cigarette smoking causes
Ammonia contamination; false positive in liver tests
Bilirubin fractions
B1 (unconjugated)
B2 (conjugated)
Delta Bilirubin
B1 / Indirect Bilirubin
- noncovalently attached to Alb
- does not react with color regent until dissociated from protein
B2 / Direct Bilirubin
- with 1/2 attached glucuronic acid molecules
- reacts directly with color reagent
Delta Bilirubin
- covalently attached to protein
- Reacts directly to color reagent; contributes to the direct bilirubin value
The following cause increase of what type of Bilirubin?
Hemolytic anemia
Newborn
Hereditary alteration of rate of conversion
Medications
B1
The following cause increase of what type of Bilirubin?
Bile obstruction
Some cases of hepatitis
Medications
B2
The following cause increase of what type of Bilirubin?
Hepatitis
B1 and B2
EVELYN-MALLOY ASSAY
pH: ?
Dissociating agent: ?
Diazo product: ?
pH: acidic
Dissociating agent: methanol
Diazo product: reddish purple (560nm)
JENDRASSIK-GROF ASSAY
pH: ?
Dissociating agent: ?
Diazo product: ?
pH: alkaline
Dissociating agent: caffeine-sodium benzoate
Diazo product: Blue (600nm)
Diseases that contribute to elevations of unconjugated bilirubin
- Gilbert
- Crigler-Najjar
- Physiological jaundice of newborn
Diseases that contribute to elevations of conjugated bilirubin
- Dubin-Johnson
- Rotor Syndrome
Treatment of kernicterus for children
Phototherapy
Prealbumin
- Indicator of malnutrition
- Binds thyroid hormones and retinol-binding proteins
Albumin
- Binds bilirubin, steroids ad FA
- MAJOR CONTRIBUTOR to oncotic pressure
a1-antitrypsin
- Acute phase reactant
- Protease inhibitor
a1-fetoprotein
- Principal fetal protein
a1-lipoprotein
- HDL
- Transports lipid
Haptoglobins
- Binds hemoglobin
Ceruloplasmin
- Peroxidase activity
a2-macroglobulin
- Inhibits thrombin, trypsin, pepsin
Pre-B-lipoproteins
- VLDL
- Transports lipids primarlty triglyceride
Transferrin
- Transports iron
Hemopexin
- Binds heme
B-lipoprotein
- LDL
- transports lipids primarily cholesterol
B2-macroglobulin
- Component of HLA molecules class I
Complement
- Immune response
Fibrinogen
- Precursor of fibrin clot
C-reactive protein
- Motivates phagocytosis
Arrange Igs according to %
G > A > M > D > E
Produces Abs in secretions
IgA
Produces Abs in early response
IgM
Produces Abs in allergic reactions
IgE
Increase in gamma area in protein electrophoresis
Mooclonocal disease
Decrease in alpha area in protein electrophoresis
Alpha-1 anti-typsin deficiency
Increase in alpha-2, beta areas in protein electrophoresis
Nephrotic syndrome
Increase alpha-1, alpha-2, beta areas in protein electrophoresis
Inflammation
Increase in beta-gamma bridge area in protein electrophoresis
Cirrhosis
Impaired biliary copper excretion –> increase in copper in lover and eyes (Kayser-Fleischer rings)
Wilson’s Disease
Defect in copper absorption –> low copper –> white skin and hair
Menke’s syndrome
Dye binding methods for serum albumin
Bromcresol Green and HABA
Wavelength for BCG and HABA for albumin
Around/below 500nm
- BGG max at 630nm
Apolipoprotein for HDL
Apo A-1
Apolipoprotein for VLDL
Apo B-100
Apolipoprotein for LDL
Apo B-100
Apolipoprotein for Chylomicrons
Apo B-48
Major source for Apo A-1
Liver and intestines
Major source for Apo B-100, Apo B-48
Intestines
Major source of Apo (a)
Liver
Apolipoprotein for Lp (a)
Apo (a)
Floating B-lipoprotein
B-VLDL
Sinking pre-B-lipoprotein
Lp(a)
Abnormal lipoprotein found in pts with obstructive biliary disease and LCAT deficiency
LpX
Normal range for Total Cholesterol
< 200mg/dL
CV: <3%
Normal range for HDL
> 60mg/dL
CV: <4%
Normal range for LDL
< 100mg/dL
CV: <4%
Normal range for triglycerides
< 150 mg/dL
CV: <5%
Lipemia
Serum TG exceeds 400mg/dL (4.6mmol/L)
True of False:
Cholesterol can be assayed from non-fasting blood samples
True; fasting has little effect on TC
Effect on glucose: insulin
Decrease
- increase cellular uptake
- glycolysis
Effect on glucose: Glucagon
Increase
- increase glycogenolysis, gluconeogenesis
Effect on glucose: Cortisol
Increase
- stimulates gluconeogenesis
Effect on glucose: Catecholamines
Increase
- stimulates glycogenolysis
Effect on glucose: Thyroid hormones
Increase
- stimulate glycogenolysis
Effect on glucose: Growth hormone
Increase
- inhibits insulin action
Standard specimen for detection of diabetes
Venous plasma glucose
Metabolism of glucose at room temp
7mg/dL/hour
Metabolism of glucose at 4C
2mg/dL/hour
Oral glucose tolerance tes
Ingest 150g/day for 2 days then perform test after 8 to 14-hour fast
Anticoagulant for glucose
Fluoride (gray-top)
True or False:
Whole blood tends to give approximately 10-15% lower glucose readings than plasma
True
Nelson-Somogyi
Glucose reduces copper in hot alkaline which in turn reduces arsenomolybdic acid –> greenish-blue complex