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ClinLab > Clinical Chemistry General Questions > Flashcards

Clinical Chemistry General Questions Flashcards

1
Q

If you are collecting chemistry specimen which tubes should be used for serum? (2)

A
  • Tiger Top
  • Red Top

*All other tubes are plasma

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2
Q

This test is used to detect antigen in assay using antibodies.

A

Immunoassay

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3
Q

What are the 4 types of ELISA?

A
  • Direct
  • Indirect
  • Sandwich
  • Competitive
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4
Q

Any test result that may require rapid clinical attention is called what?

A

Critical value

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5
Q

Basic metabolic panel contains what 4 things?

A
  • Concentration of electrolytes
  • Volume status
  • Acid Base status
  • Baseline renal function
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6
Q

When looking at the BMP fish bone what 4 values are electrolytes?

A

Na, K, Cl, CO2

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7
Q

When looking at the BMP fish bone what 2 values measure renal function?

A

BUN, Creatinine

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8
Q

What is the major extracellular and intracellular electrolyte ?

A
  • Extracellular = sodium

- Intracellular = potassium

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9
Q

Serum sodium levels reflect changes in what?

A

Water balance

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10
Q

Which hormone is responsible for reabsorption of sodium?

A

Aldosterone

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11
Q

Which hormone is responsible for reabsorption of water?

A

ADH

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12
Q

What are the 3 primary functions of sodium?

A
  • Maintain osmotic pressure
  • Acid base balance
  • Transmit nerve impulses
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13
Q

What is the percentage of NaCl in the following saline solutions:

Normal
Half Normal
Hypertonic

A

Normal = 0.9%
Half normal = 0.45%
Hypertonic = 3%

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14
Q

Hyponatremia can be a result of what 3 things?

A
  • Hypervolemia
  • Hypovolemia
  • Euvolemia
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15
Q

Hyponatremia <116 mEg/L can result in what?

A

neurologic defects

seizures

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16
Q

How should sodium be replenished and why?

A

Must be replenished slowly to prevent central pontine myelinolysis

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17
Q

If the patient presents with symptomatic hyponatremia, what saline solution is recommended?

A

Hypertonic saline solution

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18
Q

What are the 2 functions of potassium?

A
  • Maintain intracellular neutrality

- Skeletal and cardiac contractions

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19
Q

How is potassium excreted and replenished?

A
  • excreted = urine

- replenished = diet

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20
Q

If potassium is significantly elevated what should you consider doing and why?

A

A redraw as test can be falsely elevated with hemolysis

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21
Q

Diabetic patients need to be supplemented with insulin and what electrolyte?

A

Potassium

*To prevent hypokalemia

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22
Q

What ECG changes are seen in hypokalemia? (2)

A
  • Flattened T waves

- Prominent U waves

23
Q

What ECG changes are seen in hyperkalemia? (3)

A
  • Peaked T waves
  • Widened QRS
  • Depressed ST segment
24
Q

Which electrolyte complements sodium to equal out the charge?

A

chloride

25
Q

This ratio measures the metabolic function of the liver and excretory function of the kidneys.

A

BUN: Creatinine ratioH

26
Q

What creatinine value should caution you against administering contrast dye?

A

1.5

27
Q

Creatinine is used to assess what 2 things?

A
  • renal function

- GFR

28
Q

Creatinine is a product of what?

A

muscle breakdown

29
Q

A BUN:Creatinine ratio of >20:1 suggests what? (2)

A

Prerenal causes:

  • volume depletion
  • dehydration
30
Q

A BUN:Creatinine ratio of <20:1 suggests what? (3)

A

Renal causes:

  • Acute tubular necrosis
  • Glomerulonephritis
  • CKD
31
Q

Hypoglycemia can be a result of what 4 things?

A
  • Insuline resistance
  • Starvation
  • Insulinoma
  • Hypothyroidism
32
Q

Hyperglycemia can be a result of what 2 things?

A
  • Diabetes

- Acute stress

33
Q

Calcium can be present in the body in what 3 ways? (%)

A
  • 15% bound to anions
  • 40% bound to albumin
  • 45% active free calcium
34
Q

What is the equation for corrected Ca level?

A

(Total Ca) + [ 0.8 * (4.0- (albumin))]

35
Q

What are 3 signs/symptoms of hypocalcemia?

A
  • nervousness
  • excitability
  • tetany
36
Q

What can cause refractory hypocalcemia?

A

-Hypomagnesemia

37
Q

What is the most common cause of hypercalcemia?

A

Hyperparathyroidism

38
Q

Vitamin D intoxication can result in what?

A

Hypercalcemia

39
Q

Anorexia, nausea, vomiting, somnolence and coma can be a result of what?

A

Hypercalcemia

40
Q

What is the equation to measure exact CreCl?

A

UV/P

U = 24hr urine creatinine excretion
V = volume urine/ml/min
P = serum creatinine
41
Q

What is the Cockroft-Gault formula for men? What do you have to add to calculate for women?

A

[(140-age)(weight in kg)] / (72*serum creatinine)

-For woman *.85 to numerator

42
Q

Creatinine clearance is a measure of what?

A

kidney function

43
Q

What is the simple formula for serum anion gap?

A

Na - (Cl + HCO3)

44
Q

When is a serum anion gap most commonly performed? (4)

A
  • altered mental status
  • unknown exposures
  • acute renal failure
  • acute illnesses
45
Q

What is the possible causes of anion gap acidosis (elevated anion gap)?

A
  • Methanol
  • Uremia
  • Diabetes ketoacidosis
  • Paraldehyde
  • Iron / INH
  • Lactic acidosis
  • Ethylene glycol /ETOH
  • Salicylates
46
Q

This means that there are more positively charged ions (acids) present in the blood than usual.

A

high anion gap

47
Q

A high anion gap suggests what?

A

anion gap metabolic acidosis

48
Q

T/F: You should NOT draw blood above an IV site.

A

True

49
Q

CO2 value is a measurement of what 3 things?

A

H2CO3
Dissolved CO2
HCO3

50
Q

Which of the volume are less specific and more sensitive to low volume states: BUN or creatinine?

A

BUN

51
Q

what study is used to estimate GFR?

A

Modification of Diet in Renal Disease (MDRD) study

52
Q

The formula used to calculate eGFR systematically ____________ the value in African Americans

A

underestimates

53
Q

The data used to develop the CKD-EPI formula showed that Black individuals in the dataset had, on average, GFR levels that were ____% higher than people of other races with the same age, sex, and serum creatinine level

A

16%

54
Q

eGFR algorithms result in _____ reported eGFR values (which suggest better kidney function) for anyone identified as black

A

higher

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