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Clinical Chemistry > Clinical Chemistry Part 1 > Flashcards

Clinical Chemistry Part 1 Flashcards

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1
Q

Enumerate the Basic Units and their respective symbol names

A

“LTM TALE”

Length - meter
Time - seconds
Mass - kilogram
Temperature - kelvin
Amount of substance - mole
Luminosity - candela
Electric current - ampere

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2
Q

Enumerate the analytes with 1 as their Conversion Factor

A

“Bi CLOPS 1”

Bicarbonate
Chloride
Lithium
Osmolality
Potassium
Sodium

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3
Q

Enumerate the analytes with 10 as their Conversion Factor

A

“HAT 10”

Hemoglobin
Albumin
Total Protein

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4
Q

What is the Conversion Factor of :
Thyroxine (T4):
Bilirubin:
Folic Acid
Creatinine

A

“The Big Fat Cock”

Thyroxine (T4) : 12.9
Bilirubin: 17.1
Folic Acid: 2.27
Creatinine: 88.4

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5
Q

What is the Conversion Factor of:
Glucose:
Uric Acid:
Ammonia:
Magnesium:

A

“GUAM .5”

Glucose: 0.0555
Uric Acid: 0.0595
Ammonia: 0.587
Magnesium: 0.5

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6
Q

What is the Conversion Factor of:
Cholesterol:
Triglycerides:
BUN:

A

“Ci-Ty of Baguio”

Cholesterol: 0.026
Triglycerides: 0.0113
BUN: .357

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7
Q

Enumerate the prefixes from factor 10^18 to 10^1

A

exa
peta
tera
giga
mega
kilo
hecta
deka

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8
Q

Enumerate the prefixes from factor 10^-1 to 10^-18

A

deci
centi
milli
micro
nano
pico
femto
atto

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9
Q

Temperature Conversion of Centigrade to Kelvin

A

Kelvin = C + 273.15

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10
Q

Temperature Conversion of Centigrade to Fahrenheit

A

F = (C x 9/5) +32

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11
Q

Temperature Conversion of Fahrenheit to Centigrade

A

C = (F - 32) x 5/9

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12
Q

It is objective and is based on the perception of the practitioner

A

Signs

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13
Q

It is subjective and is based on the perception of the patient

A

Symptoms

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14
Q

It connects all wards, surgical rooms, and departments of the hospital laboratory and pharmacy, and it greatly decreases transport time and TAT for test results

A

Pneumatic Tube Transport System

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15
Q

It is the measurement of an organization’s products or services against specific standards for comparison and improvement

A

Benchmarking

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16
Q

Trends an organization’s productivity over time, and is usually expressed as a ratio of the products or services to the various inputs used

A

Internal Benchmarking

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17
Q

Compares a laboratory’s productivity with that of the other laboratories

A

External Benchmarking

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18
Q

Time from ordering a test through analysis in the laboratory to the charting of the report

A

Turnaround Time (TAT)

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19
Q

Comparison of current analyte result with the result from the most recent previous analysis or the same patient

A

Delta Check

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20
Q

Failed delta check happens when the deviation is ______ %

A

> or = 20 %

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21
Q

Too low or too high values that represent life-threatening situations and should be reported immediately

A

Panic Value or Critical Value

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22
Q

It is a pair of medical decision points that extend the limits of the test results for a certain healthy population

A

Reference Interval or Reference Value

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23
Q

How many individuals are needed to VERIFY existing and established reference intervals

A

20 individuals

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24
Q

How many individuals are needed to ESTABLISH reliable estimates of reference intervals

A

120 individuals

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25
Q

CLSI Order of Draw

A

“BB Real Girl Love Gray” (SCSHEG)

Blood Culture (sterile tube)
Blue (coagulation)
Red (serum)
Green (heparin)
Lavender/Pink/Pearl (EDTA)
Gray (Glycolytic inhibitors)

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26
Q

Anticoagulant suitable for most drug analysis

A

Heparin

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27
Q

Needle gauge and bore size relationship

A

Needle gauge is INVERSELY PROPORTIONAL to the bore size.

“Life is Good in Star Bucks”

The LARGER the GAUGE , the SMALLER the BORE size

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28
Q

Commonly used gauge for adult patients

A

21G

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29
Q

Commonly used gauge pediatric patients

A

23G

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30
Q

What is the purpose of the 1 - 1.5 length of the needle?

A

For better control

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31
Q

It is a portable device to easily locate veins that are difficult to locate

A

AccuVein

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32
Q

AccuVein shines what type of light?

A

Infrared Light

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33
Q

AccuVein held how many inches above the site?

A

7 inches

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34
Q

Tourniquet application and tourniquet dimension

A

Tourniquet should be applied to the venipuncture site for about 3-4 inches above, and should not be more than 1 minute application.

Tourniquet dimension are 15 x 1 inch

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35
Q

Serum sample should be allowed to clot before being centrifuged, stand for how many minutes?

A

20 minutes

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36
Q

Centrifugation of whole blood and its components should be for approximately _____ minutes at an RCF or _________ x g.

A

10 minutes; 1000 - 2000 RCF x g

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37
Q

Pipettes should be calibrated by ________ and ___________.

A

Gravimetric and Photometric

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38
Q

Pipettes calibration should be done _________.

A

Every 3 months or quarterly

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39
Q

A pipette that contain and hold particular volume but does not dispense exact volume or exact amount

A

TC Pipette

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40
Q

A pipette that dispenses the volume indicated in the pipette

A

TD Pipette

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41
Q

Has continuous etched ring at the top of the pipette

A

Blowout Pipette

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42
Q

Blow-out pipette with graduations up to the tip

A

Serologic Pipette

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43
Q

Pipette with no or do not have etched rings

A

Self-draining pipette

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44
Q

Self-draining pipette and does not have graduations up to the tip

A

Mohr Pipette

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45
Q

An analytic testing of patient specimens performed outside the laboratory

A

POCT (Point Of Care Testing)

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46
Q

Most common sample for POCT

A

Capillary Blood

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47
Q

Most common test for POCT

A

Blood Glucose

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48
Q

Quality Control for POCT

A

Each day of use

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49
Q

Expel noxious and hazardous fumes from chemical reagents; and its face velocity

A

Fume Hoods; 100 - 120 feet per minute

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50
Q

Remove particles that may be harmful to the employee who is working with infective biologic specimen

A

Biosafety Cabinet

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51
Q

Total system or process that encompasses pre-analytic, analytic, post-analytic factors and ensuring quality results

A

Quality Assurance

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52
Q

It is a system for recognizing and minimizing analytical errors and ensuring accuracy and precision

A

Quality Control

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53
Q

Nearness of the assayed value to the true value

A

Accuracy

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54
Q

Nearness of the assayed value to each other

A

Precision or Reproducibility

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55
Q

The most widely used QC chart

A

Levey-Jennings Chart

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56
Q

This will give the earliest identification of a shift or a trend

A

CuSum

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57
Q

A gradual change; six consecutive values in either increasing or decreasing pattern; and its main cause is _______.

A

Trend; Reagent deterioration

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58
Q

Abrupt or sudden change; six consecutive values on the same side of the mean, and its main cause is ______.

A

Shift; instrument or improper calibration

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59
Q

Enumerate the random errors and systematic errors in the Westgard Rules

A

Random errors:
12s, 13s, R4s

Systematic errors:
22s, 41s, 10x

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60
Q

It occurs when a data set can be described by the standard deviation and mean

A

Gaussian or Normal Distribution

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61
Q

For a Normal Distribution, Mean ___ Median ___ Mode

A

Mean = Median = Mode

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62
Q

Shape of the Gaussian Curve, exactly ____ or ____ under the gaussian curve

A

Symmetric and Bell shaped, exactly 1.0 or 100% nuder the Gaussian curve

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63
Q

The most commonly used interval

A

+/- 2 SD

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64
Q

+/- 1 SD = ___
+/- 2 SD = ___
+/- 3 SD= ___

A

+/- 1 SD = 68.3 %
+/- 2 SD = 95.5%
+/- 3 SD = 99.7 %

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65
Q

Too high or too low values that are typically removed; control results outside the established limits

A

Outlier

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66
Q

Reduces or eliminates WASTES (non-valued activities)

A

Lean

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67
Q

2 strategies used in Lean

A

5S and PDCA

5S “SoseShStSu”
Sort
Set in order
Shine
Standardize
Sustain

PDCA
Plan
Do
Check
Act

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68
Q

Eliminates DEFECTS (process variations)

A

Six Sigma

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69
Q

Steps in Six Sigma

A

DMAIC
Define
Measure
Analyze
Improve
Control

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70
Q

Unit used in Six Sigma

A

DPMO (defects per million opportunities)

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71
Q

Calibration of the speed of centrifuge is done ______, and uses ______ or _______.

A

Every 3 months or quarterly, uses tachometer or strobe light

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72
Q

Calibration of the timer of centrifuge is done ______ ; and uses ______.

A

Monthly; stopwatch

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73
Q

Disinfection of Centrifuge is done ______.

A

Weekly

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74
Q

Beer’s law states that concentration is _________ proportional to absorbance and ________ proportional to transmittance

A

Concentration is DIRECTLY PROPORTIONAL to Absorbance
Concentration s INDIRECTLY PROPORTIONAL to Transmittance

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75
Q

Determine analyte concentration substance in solution by measuring amount of light absorbed

A

Spectrophotometry

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76
Q

Measures light absorbed by atoms in ground state

A

Atomic Absorption Spectrophotometry (AAS)

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77
Q

Measures light emitted by a single atom excited by a flame

A

Flame emission photometry

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78
Q

It uses two monochromators, and it measures light emitted by a molecule excited by electromagnetic radiation; used for drug and hormone analysis

A

Fluorometry

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79
Q

Unknown sample react with known substance with the presence of indicator dye

A

Volumetric or Titrimetric

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80
Q

Measures light blocked

A

Turbidimetry

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81
Q

Measures light scattered

A

Nephelometry

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82
Q

Migration of charged particles in an electrical field

A

Electrophoresis

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83
Q

Separation of components according to their physical and chemical characteristics

A

Chromatography

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84
Q

Separation based on fragmentation and ionization

A

Mass Spectroscopy

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85
Q

Measures electrical current

A

Amperometry

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86
Q

It is used to quantitate pH, pO2, pCO2 in a patient

A

Ion Selective Electrode

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87
Q

All samples, in one test

A

Batch Testing

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88
Q

One clinical specimen, multiple tests

A

Parallel Testing

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89
Q

Multiple tests analyzed one after the other

A

Sequential Testing

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90
Q

It produces roaring blue flame

A

Bunsen Burner

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91
Q

Colors in bunsen burner:
____ - high temperature flame
____ - incomplete combustion
____ - insufficient oxygen
____ - not produce

A

Blue - high temperature flame
Orange - incomplete combustion
Yellow - insufficient oxygen
Red - not produce

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92
Q

Used to zero instrument BEFORE measuring a test sample

A

Reagent Blank

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93
Q

Used to zero instrument DURING a test procedure

A

Sample Blank

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94
Q

Glucose metabolism will yield:

A

Lactate, pyruvate, and Acetyl Coenzyme A (Acetyl CoA)

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95
Q

Complete oxidation will yield:

A

Carbon dioxide and water

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96
Q

Causes increase in blood glucose

A

Gluconeogenesis
Glycogenolysis
Lipolysis

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97
Q

Causes decrease in blood glucose

A

Glycolysis
Glycogenesis
Lipogenesis

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98
Q

Metabolism or breakdown of glucose to pyruvate and lactate to produce energy

A

Glycolysis

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99
Q

Conversion of glucose to glycogen for storage in liver and/or in muscles

A

Glycogenesis

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100
Q

Formation of glucose-6-phosphate from non-carbohydrate sources

A

Gluconeogenesis

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101
Q

Conversion carbohydrates to fatty acids

A

Lipogenesis

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102
Q

Breakdown of glycogen to produce glucose for energy

A

Glycogenolysis

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103
Q

Breakdown of fats

A

Lipolysis

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104
Q

FBS
Normal:
Pre-diabetic/Impaired:
Diabetes mellitus:

A

FBS
Normal: <100 mg/dL
Pre-diabetic/Impaired: 101-125 mg/dL
Diabetes mellitus: > or = 126 mg/dL

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105
Q

2h PPG
Normal:
Pre-diabetic/Impaired:
Diabetes mellitus:

A

2h PPG
Normal: <140 mg/dL
Pre-diabetic/Impaired: 140-200 mg/dL
Diabetes mellitus: > or = 200 mg /dL

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106
Q

HBa1c
Normal:
Diabetes mellitus:

A

HBa1c
Normal: 5.7 - 6.4 %
Diabetes mellitus: > or = 6.5 %

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107
Q

Hypoglycemia blood glucose:

A

<70 mg/dL

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108
Q

_____ mg/dL hypoglycemia observable symptoms appear, other hyperglycemic agents are released

A

<or = 50-55 mg/dL

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109
Q

Condition associated with hypoglycemia; diagnostic tests are: ____ and ____

A

Whipple’s triad; 5h Glucose Tolerance Test and 72 hr fasting

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110
Q

Hyperglycemia blood glucose ____ mg/dL ; renal threshold for glucose is ____.

A

> 126 mg/dL ; 160 - 180 mg/dL

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111
Q

Characteristics of Type I DM
Other name:
Onset:
Pathogenesis:
Frequency:
Ketoacidosis:
C peptide level:
Medication:

A

Characteristics of Type I DM
Insulin Dependent
Juvenile onset
Autoimmune
5-10 %
Ketoacidosis prone
C peptide level is low / undetectable
Insulin injection

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112
Q

Characteristics of Type II DM
Other name:
Onset:
Pathogenesis:
Frequency:
Ketoacidosis:
C peptide level:
Medication:

A

Characteristics of Type II DM
Insulin Independent
Adult onset
Lifestyle
90-95 %
Ketoacidosis not prone
C peptide level is normal / detectable
Oral hypoglycemic agents

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113
Q

Type of diabetes that is acquired, and develops due to pancreatic disease such as pancreatic cancer or pancreatitis

A

Type 3C Diabetes Mellitus

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114
Q

Standard sample for glucose

A

Fasting venous plasma

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115
Q

Fasting hours for glucose

A

8 - 10 hrs fasting

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116
Q

Fasting for lipid profile

A

12 hrs of fasting

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117
Q

Whole blood blood glucose level is ______ % lower than plasma glucose

A

10-15%

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118
Q

Glucose is metabolized at a rate of _____at room temperature and ____ at refrigerator temperature (4 C)

A

7 mg/dL/hr - Room Temperature
2 mg/dL/hr - Ref Temp (4 C)

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119
Q

Glucose CSF is ____ % of plasma glucose

A

60-70 %

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120
Q

Normally, glucose should return near or within normal range after ____ after carbohydrate load.Blood glucose of healthy individuals should return in?

A

2 hours

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121
Q

Standard screening test for glucose test

A

Fasting Plasma Glucose

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122
Q

Used for long term monitoring glucose control (2-3 months or 2-4 months or 8-16 weeks (reflecting the lifespan of RBCs) )

A

HBa1c or Glycosylated hemoglobin or Ketoamine

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123
Q

For every 1 % increase in HBa1c, there is a _____ change in plasma glucose

A

35 mg/dL

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124
Q

Ideal value or HBa1c is ____.

A

< 7 %

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125
Q

Used for short term monitoring of glucose control (3-6 weeks or 19 days (reflecting the lifespan of albumin) )

A

Fructosamine or Glycated albumin

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126
Q

Reduction methods are ______ higher than enzymatic techniques

A

5-15 mg/dL

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127
Q

Most specific for beta-D glucose

A

Glucose oxidase

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128
Q

Most specific, reference method

A

Hexokinase

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129
Q

Used to measure the amount of glucose present in the sample; glucose is converted into ____ and ____, followed by subsequent reaction wherein H202 is used to oxidized dye creating a ____ tautomer measured at ____ nm

A

Peroxidase Test (Trinder Method); gluconic acid and H2O2, RED; 540 nm

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130
Q

Color produced in GOD-POD method?

A

Red

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131
Q

Most common glycogen storage disease, described by the deficiency of Glucose-6-phosphate

A

Von Gierke’s Disease

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132
Q

Lacks glycogen synthase

A

Type 0 GSD

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133
Q

It used to establish fasting hypoglycemia and insulin hypersecretion syndrome; administered as ______ over two minutes

A

Tolbutamide Tolerance test; IV bolus

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134
Q

Are important for body function and serve as precursors of steroid hormones, cell membrane structure, fuel and energy storage

A

Lipids

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135
Q

Steroid hormones are derived from

A

Non-glyceride

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136
Q

Building blocks of lipids

A

Fatty acids

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137
Q

Serves as the main storage form of lipid in man

A

Triglycerides

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138
Q

Unsaturated steroid hormone alcohol containing 4 rings with single side chain tail, and not catabolized by most cells

A

Cholesterol

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139
Q

Total Cholesterol
Desirable:
Borderline:
High:

A

Cholesterol
Desirable: <200 mg/dL
Borderline: 200-240 mg/dL
High: >240 mg/dL

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140
Q

Recommended cut-off for Serum Cholesterol
Ages 2-19 y/o
Moderate:
High:

A

Ages 2-19 y/o
Moderate: >170 mg/dL
High: >185 mg/dL

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141
Q

Recommended cut-off for Serum Cholesterol
Ages 20-29 y/o
Moderate:
High:

A

Ages 20-29 y/o
Moderate: > 200 mg/dL
High: > 220 mg/dL

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142
Q

Recommended cut-off for Serum Cholesterol
Ages 30-39 y/o
Moderate:
High:

A

Ages 30-39 y/o
Moderate: > 220 mg/dL
High: > 240 g/dL

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143
Q

Recommended cut-off for Serum Cholesterol
Ages 40 and above
Moderate:
High:

A

Ages 40 and above
Moderate: > 240 mg/dL
High: > 260 mg/dL

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144
Q

Composed of 3 molecules of fatty acids and one mole of glycerol connected by ______ bond

A

Triglyceride; ester bond

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145
Q

Triglycerides
Normal:
Borderline high:
High:
Very high:

A

Triglycerides
Normal: < 150 mg/dL
Borderline high: 150 - 199 mg/dL
High: 200 - 499 mg/dL
Very high: > 500 mg/dL

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146
Q

Old reference method for measurement of Triglycerides

A

Van Handel & Zilversmith

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147
Q

New reference method for Triglycrides

A

GC-MS

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148
Q

A patient sample is assayed for fasting triglycerides and a triglyceride value of 1036 mg/dL. This value is of immediate concern because of its association with which of the following conditions?

A

Pancreatitis

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149
Q

They are large macromolecules that transport triglyceride and cholesterol to the sites of energy storage and utilization

A

Lipoproteins

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150
Q

Largest, lightest, and least dense; causes nonfasting turbidity; apolipoprotein B48

A

Chylomicrons

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151
Q

Also known as pre-beta lipoprotein, causes sting turbidity; apolipoprotein B100

A

VLDL

152
Q

Also known as beta lipoprotein / bad cholesterol; is directly proportional to the risk of atherosclerosis and CHD; apolipoprotein B100

A

LDL

153
Q

Deficiency or lack of LDL causes ___.

A

Abetalipoproteinemia or Bassen-Kornzweig syndrome

154
Q

Also known as alpha lipoprotein / good cholesterol; most anodal lipoprotein; apolipoprotein A1

A

HDL

155
Q

Deficiency of HDL causes ____.

A

Tangier’s disease

156
Q

Reference method for lipoprotein tests; based on he density of lipoproteins

A

Ultracentrifugation

157
Q

For standing plasma test, sample is stored at ____ for _____.

A

Stored at 4 C for 24 hours

158
Q

Chylomicron is seen as _______ ,while VLDL causes the sample to be _____.

A

Chylomicron is seen as floating creamy layer ,while VLDL causes the sample to be turbid

159
Q

Friedwald formula if mmol/L and if mg/dL

A

LDL = TC - HDL - (TAG / 2.175) if mmol/L

LDL = TC - DL - (TAG / 5) if mg/dL

160
Q

Lipid profile fasting hours ; and lipid profile / panel

A

10-12 hours; HDL, TC, LDL, TAG

161
Q

Require fasting samples among the lipid profile or panel

A

LDL and TAG

162
Q

Require non-fasting samples among the lipid profile or panel

A

HDL and TC

163
Q

Lipoprotein assay required or preferred sample

A

EDTA plasma

164
Q

LDL values
Optimal:
Near or above optimal:
Borderline:
High:
Very high:

A

LDL values
Optimal: < 100 mg/dL
Near or above optimal: 100 - 129 mg/dL
Borderline: 130 - 159 mg/dL
High: 160 - 189 mg/dL
Very high: > 190 mg/dL

165
Q

HDL values
Cut-off level:
High risk:
Low risk:

A

HDL values
Cut-off level: 40 mg/dL
High risk: < 35 mg/dL
Low risk: > 60 mg/dL

166
Q

Fredrickson Classification of Lipid Disorders
Type 1 Hyperchylomicronemia; Familial LPL

A

High TAG ; High CM

167
Q

Fredrickson Classification of Lipid Disorders
Type IIa Familial Hypercholesterolemia

A

High Cholesterol ; High LDL

168
Q

Fredrickson Classification of Lipid Disorders
Type IIb Familial Combined Hyperlipidemia

A

Only CM is Normal; the rest is High

169
Q

Fredrickson Classification of Lipid Disorders
Type III Familial Dysbetalipoproteinemia

A

High TAG, High Chole, High VLDL

170
Q

Fredrickson Classification of Lipid Disorders
Type IV Familial Hypertriglyceridemia

A

High TAG; High VLDL

171
Q

Fredrickson Classification of Lipid Disorders
Type V

A

Only LDL is Normal; the rest is High

172
Q

These are macromolecules composed of various amino acids and are connected by ______ bonds

A

Proteins; Peptide bonds

173
Q

Most proteins are produces by the ______, with the exception of immunoglobulins which are produced by _____.

A

Liver; Plasma cells

174
Q

Negative acute phase reactant, also known as transthyretin, marker for poor nutritional status or malnutrition, and transport T4 and retinol; migrates ahead of albumin

A

Prealbumin

175
Q

Negative acute phase reactant, maintains oncotic pressure, highest protein concentration; lowest level seen in nephrotic syndrome

A

Albumin

176
Q

Neutralizes trypsin-like enzymes(neutrophil elastase) deficiency will lead to emphysema

A

Alpha 1-antitrypsin

177
Q

Produced by fetal liver; increased in hepatoma ,testicular cancer, neural tube defects (spina bifida), presence of twins; decreased in trisomy 21 or down syndrome

A

Alpha 1-Fetoprotein

178
Q

Also known as orosomucoid; useful for neonatal immune system

A

Alpha 1 Acid Glycoprotein

179
Q

Associated with Alzheimer’s disease

A

Alpha 1-antichymotrypsin

180
Q

Increase affinity with vitamin D and actin

A

Group specific globulin

181
Q

Inhibits proteases such as trypsin, pepsin, plasmin; largest major non-immunoglobulin protein in plasma

A

Alpha 2-macroglobulin

182
Q

Binds hemoglobin, and prevents loss of hemoglobin and iron in urine during intravascular hemolysis

A

Haptoglobin

183
Q

Binds and transports copper in the body, has peroxidase activity; deficiency would lead to ______ disease.

A

Ceruloplasmin; Wilson’s disease

184
Q

Binds heme and indicator of intravascular hemolysis

A

Hemopexin

185
Q

Negative acute phase reactant, also known as siderophilin; transport iron to its storage sites

A

Transferrin

186
Q

Found on the surface of all nucleic cells; needed for antigen presentation

A

Beta 2-microglobulin

187
Q

Reacts to C-polysaccharide of Pnemococcus; serves as a marker of coronary artery disease and acute inflammation

A

CRP

188
Q

Produced in plasma cells and acts in humoral immunity

A

Immunoglobulin

189
Q

Transports and stores oxygen from hemoglobin to contractile cells; the first protein to increase in Myocardial Infarction and a nephrotoxic protein

A

Myoglobin

190
Q

Three proteins that bind the thin filaments of cardiac muscle; most important marker and gold standard for diagnosis of Acute Myocardial Infarction (AMI)

A

Troponin

191
Q

Most specific for AMI

A

Troponin I

192
Q

Cardiac marker and is diagnostic to CHD

A

B type natriuretic peptide

193
Q

Biochemical marker of bone resorption

A

Cross linked C-telopeptide

194
Q

Used to predict short term risk of premature delivery

A

Fetal fibronectin

195
Q

Used as a marker for bacterial infection

A

Procalcitonin

196
Q

Marker for CSF leakage

A

B trace protein

197
Q

Electrophoretic Pattern

A

Albumin
Alpha 1
Alpha 2
Beta
Gamma

198
Q

Sample of choice for electrophoretic pattern

A

Serum

199
Q

Alpha 2 band spike; Increase Alpha 2; decrease Alpha 1, beta , gamma, and albumin

A

Nephrotic Syndrome

200
Q

Increase IgA; beta-gamma bridging effect, decrease alpha 1 ,alpha 2 and albumin

A

Liver Cirrhosis

201
Q

Alpha 1 flat curve; decrease or deficiency of alpha 1-antitrypsin

A

Emphysema

202
Q

Gamma spike; monoclonal spike; bence jones protein

A

Multiple myeloma

203
Q

Polyclonal gammopathy; All increased, increase A1, A2, gamma; Diffused increase

A

Chronic Inflammation

204
Q

Decreased albumin, All increased; increase A1, A2

A

Acute Inflammation

205
Q

Small spikes in beta region

A

IDA

206
Q

Narrow / extra band in beta region

A

Use of plasma instead of serum

207
Q

Unusual band between A2 and beta region

A

Hemolyzed Sample

208
Q

Reference method for protein determination, based on the measurement of the ______ content of proteins; utilized ____ as reagent, and measures _______ (end product)

A

Kjedahl Method; nitrogen content; H2O2; ammonia

209
Q

Most widely used method for protein determination ,based on _____ ions forming a complex with substances connected by peptide bonds forming ______ color.

A

Biuret; cupric ions; violet

210
Q

Protein determination method with highest analytical sensitivity ,based on the oxidation of ________ to give ____ color

A

Folin-ciocalteu/Lowry Method; phenolic compounds; deep blue

211
Q

Major end product of protein catabolism

A

Blood Urea Nitrogen

212
Q

Urea = BUN x ______

A

2.14

213
Q

A condition with elevated concentration of nitrogenous substances like BUN and Creatinine in blood

A

Azotemia

214
Q

A syndrome with marked elevation of urea, acidemia, electrolyte imbalance, and renal failure

A

Uremia or Uremic Syndrome

215
Q

End product of muscle metabolism derived from Creatine; not affected by diet but directly proportional with mass or skeletal muscle

A

Creatinine

216
Q

Synthesized primarily in the liver from amino acid; glycine, arginine and methionine

A

Creatine

217
Q

Provides an estimate of the amount of plasma that must flow through kidney glomerular per minute; it is a test for _______________. ______is used to convert 24 hrs to minutes and serves as constant. _____ represents the average body surface.

A

Creatinine clearance; glomerular filtration rate; 1440; 1.73

218
Q

The final breakdown of purine catabolism

A

Uric Acid

219
Q

Product of amino acid deamination; increase in cirrhosis, Reye’s syndrome, acetaminophen poisoning and chronic renal disease

A

Ammonia

220
Q

BUN
Normal Value and Reference method

A

6-20 mg/dL ; IDMS (Isotope Dilution Mass Spectrometry)

221
Q

Creatinine
Normal Value and Reference method

A

Male - 0.9 - 1.3 mg/dL
Female- 0.6 - 1.1 mg/dL ; IDMS

222
Q

Uric Acid
Normal Value and Reference Method

A

Male - 3.5 - 7. 2 mg/dL
Female - 2.6 - 6.0 mg/dL ; IDMS

223
Q

Liver function test: Synthetic function

A

Total protein, prothrombin time, albumin level and A/G ratio

224
Q

Conjugation and Excretion Test

A

Bilirubin, bromsulphthalein dye excretion test

225
Q

Detoxification function

A

Ammonia and Liver enzyme test

226
Q

This assay is based on Van den Berg reaction where there is diazotization of bilirubin forming _____.

A

Bilirubin; azobilirubin

227
Q

Used as accelerator in Evelyn -Malloy method; color of the end product

A

Methanol; pink to purple

228
Q

Most commonly used method for bilirubin assay; _____ accelerator used ; ____ color end product

A

Jendrassik-Grof Method; caffeine sodium benzoate; blue to violet

229
Q

Also known as Bilirubin 1, B1, Pre-hepatic bilirubin, unconjugated bilirubin, hemobilirubin
Water insoluble, indirect reacting, slow reacting

A

Indirect Bilirubin

230
Q

Also known as Bilirubin 2, B2,Post-hepatic/Hepatic/Obstructive/Regurgitive Bilirubin
Water soluble, direct reacting, prompt/one minute

A

Direct Bilirubin

231
Q

Enzyme-Organ Associations
Heart

A

“CASL”

CK-MB
AST
LD1>LD2

232
Q

Enzyme-Organ Associations
Liver
Hepatocellular disorder:
Biliary tract obstruction:

A

Hepatocellular disorder: “ASAL”
AST
ALT
LD5

Biliary tract obstruction: “ALaGAT”
ALP
GGT

233
Q

Enzyme-Organ Associations
Skeletal Muscle

A

“CALA”

CK-MM
AST
LD
Aldolase

234
Q

Enzyme-Organ Associations
Bone

A

ALP

235
Q

Enzyme-Organ Associations
Pancreas

A

Amylase
Lipase

236
Q

Enzyme-Organ Associations
Brain

A

CK-BB

237
Q

Enzyme-Organ Associations
Prostate

A

ACP

238
Q

Enzymes are expressed as _______ .

A

SI unit or KU (mols)

239
Q

Enzymes with high specificity

A

ACP
ALT
GGT
Amylase
Lipase

240
Q

Enzymes with moderate specificity

A

AST
ALP
CK

241
Q

Enzyme with low specificity

A

LDH

242
Q

These are normally resent in plasma at higher concentrations than in most tissues and typically produced by liver and constantly liberated into the plasma to maintain a steady-state concentration

A

Plasma Enzymes

243
Q

Disease associated with high levels of enzyme LD

A

Megaloblastic or Pernicious anemia

244
Q

Disease associated with high levels of enzyme CK

A

Duchennne Muscular Dystrophy

245
Q

Disease associated with high levels of enzyme ALP

A

Paget’s Disease or Osteitis Deformans

246
Q

It is an enzyme that catalyzes the interconversion of lactic acid and pyruvic acid using the coenzyme NAD+. The reaction can proceed in either a _________ (lactate to pyruvate) or ________ (pyruvate to lactate) direction

A

Lactate dehydrogenase; forward ; reverse

247
Q

This reaction preferred if LD1 is being measured, more specific but slower; optimal pH is ______

A

Forward Reaction; 8.3 - 8.9

248
Q

This reaction is three times faster, requires smaller sample and shorter reaction times but susceptible to substrate exhaustion and loss of linearity; optimal pH is ______.

A

Reverse Reaction; 7.1 - 7.4

249
Q

Isoenzyme most abundant in cardiac muscle and RBCs

A

LD 1 ( HHHH )

250
Q

Isoenzyme most abundant in serum of healthy individual

A

LD 2 ( HHHM )

251
Q

Isoenzyme seen in organs lungs, kidney, pancreas, spleen, adrenal, platelets

A

LD 3 ( HHMM )

252
Q

Isoenzyme seen in skeletal muscle and liver

A

LD 4 ( HMMM )

253
Q

Isoenzyme most abundant in skeletal muscle and liver

A

LD 5 ( MMMM )

254
Q

Isoenzyme also known as alcohol dehydrogenase

A

LD 6

255
Q

Isoenzyme seen in spermatozoa

A

LD-c ( CCCC )

256
Q

It is a hydrolase that catalyzes the hydrolysis of phosphomonoesters at an alkaline pH

A

ALP ( Alkaline phosphatase )

257
Q

Elevations of ALP are of most diagnostic significance in the evaluation of ________ and ________ disorders.

A

Hepatobiliary and bone disorders

258
Q

Buffer utilized by Bessy-Lowry-Brock method

A

Glycine

259
Q

Buffer utilized by Bowers-McComb method

A

2-amino-2-methyl-1-propanol or diethanolamine

260
Q

Substrate utilized by Bessy-Lowry-Brock method and Bowers McComb method

A

p-nitro-phenylphostate

261
Q

Also known as SGOT

A

Aspartate aminotransferase

262
Q

Also known as SGPT

A

Alanine aminotransfearse

263
Q

An enzyme that catalyze the transfer of amino group between aspartate and a-keto acid with the subsequent formation of oxaloacetate and glutamate

A

AST / SGOT

264
Q

A method utilized to measure the activity of AST; which incorporates a coupled enzymatic reaction sing ___________ as the indicator reaction and monitors the change in absorbance at 340 nm continuously as NADH is oxidized to NAD

A

Karmen Method; MD ( malate dehydrogenase )

265
Q

A hydrolase that catalyzes the breakdown of starch and glycogen ; it is the smallest enzyme d readily filtered by the renal glomerulus ; _______ and _______ acts as enzyme cofactors

A

Amylase; Calcium and Chloride

266
Q

Also known as butyrylcholinesterase / acetylcholine thyldrolase, it is used as a marker of pesticide / organophospahte poisoning when decreased

A

Pseudocholinesterase

267
Q

An enzyme marker for skeletal muscle injury

A

Aldolase

268
Q

Gastric proteolytic enzyme which cleaved ingested proteins, it is produced by the pancreas and is more specific marker for acute pancreatitis than amylase

A

Trypsin

269
Q

In AMI, what is the first marker to elavate

A

Myoglobin

270
Q

In AMI, what is the first enzyme to elavate

A

CK-MB

271
Q

Electrolytes that functions in volume and osmotic regulation

A

Sodium, potassium, chloride

272
Q

Electrolytes that functions in myocardial rhythm and contractility, euromuscular excitability

A

Potassium, calcium, magnesium

273
Q

Electrolytes that functions in production and use of ATP from glucose

A

Magnesium, phosphate

274
Q

Electrolytes that functions in blood coagulation

A

calcium, magnesium

275
Q

Electrolytes that functions in acid-base balance

A

Bicarbonate, potassium, chloride

276
Q

Electrolyte that functions in he regulation of ATPase ion pumps

A

Magnesium

277
Q

Electrolytes that serves as cofactors in enzyme activation

A

Magnesium, zinc, calcium

278
Q

_______ is a threshold substance, meaning that no sodium will be excreted in the urine until the renal threshold (120 mmol/L) is exceeded. ____ is not a threshold substance and will be secreted by the tubules even when plasma potassium levels are low.

A

Sodium; Potassium

279
Q

Major extracellular cation

A

Sodium

280
Q

Determines the osmolality of the plasma, and maintaining osmotic pressure

A

Sodium

281
Q

When serum/plasma sodium is <135 mmol/L

A

Hyponatremia

282
Q

When serum/plasma sodium is >145 mmol/L

A

Hypernatremia

283
Q

Major intracellular cation

A

Potassium

284
Q

It is the plasma electrolyte that has the narrowest reference range and is most strictly regulated by the body

A

Potassium

285
Q

When serum/plasma potassium > 5 mmoml/L

A

Hyperkalemia

286
Q

How many percent of calcium are found in the bone and how many percent are found in the ECF and soft tissues?

A

99 % in the bone and 1 % in ECF and soft tissues

287
Q

Associated with hypercalcemia

A

“CHIMPSA”

Cancer
Hyperthyroidism
Iatrogenic
Multiple myeloma
Hyperparathyroidism
Sarcoidosis
Acidosis

288
Q

Associated with hypocalcemia

A

“CHARD”

Calcitonin
Hypoparathyroidism
Alkalosis
Renal Failure
Vit D deficiency

289
Q

Specimen for electrolyte analysis

A

Heparinized

290
Q

It is the difference between unmeasured anions and cations, also serve as form of quantity control for the analyzer used to measure these electrolytes

A

Anion Gap

291
Q

AG = Na - (Cl + HCO3) : _____
AG = (Na + K) - (Cl + HCO3) : _______

A

7 - 16 mmol/L
10 - 20 mmol/L

292
Q

Decrease anion gap can be seen in cases of

A

Hypoalbuminemia
Hypercalcemia
Multiple Myeloma
Instrument error

293
Q

Increase anion gap can be seen in :

A

“MUDPHILES”

Methanol poisoning
Uremia
Diabetic acidosis
Paraldehyde ingestion
Hypernatremia
Isoniazid / Iron poisoning
Lactic acidosis
Ethylene glycol / ethanol poisoning
Salicylate poisoning

294
Q

A physical property f a solution that is based on the concentration of solutes (expressed as millimoles) per kilogram of solvent

A

Osmolality

295
Q

Sample of choice for measuring osmolality

A

Serum and urine

296
Q

Concentration of osmotically active particles in solution reported in millimoles per liter; not routinely used

A

Osmolarity

297
Q

Expressed as moles of solute per liter of solution

A

Molarity

298
Q

Hormones produced by the hypothalamus

A

“TGCGSPP”

Thyrotropin-Releasing Hormone
Gonadotropin-Releasing Hormone
Corticotropin-Releasing Hormone
Growth Hormone, RH
Somatostatin
Prolactin Releasing Hormone
Prolactin Inhibiting Hormone

299
Q

Hormones produced by the Anterior Pituitary / Adenohypophysis

A

TSH / Thyroid Stimulating Hormone
FSH / Follicle Stimulating Hormone
Luteinizing Hormone
Prolactin
Growth Hormone / Somatotropin
ACTH

300
Q

Hormones in the Posterior Pituitary

A

Oxytocin
ADH (Antidiuretic Hormone) / Vasopressin

301
Q

Hormone in Pineal Gland

A

Melatonin

302
Q

Hormones in the Thyroid Gland

A

Thyroxine and Triiodothyronine (T3 T4)
Calcitonin

303
Q

Hormone in the Parathyroid Gland

A

Parathyroid Hormone

304
Q

Hormones in the Adrenal

A

“ACDNE”

Aldosterone
Cortisol
DHEA (dehydroepiandrosterone)
Norepnephrine
Epinephrine

305
Q

Hormone in the Kidney

A

Renin

306
Q

Hormone that stimulate TSH and Prolactin release

A

Thyrotropin Releasing Hormone

307
Q

Hormone that inhibit release of GH ,TSH , insulin, and glucagon

A

Somatostatin

308
Q

Hormone that stimulates growth of follicles with LH, and stimulates spermatogenesis

A

Follicle Stimulating Hormone

309
Q

Stimulates follicle maturation, ovulation and production of testosterone, estrogen and progesterone

A

Luteinizing Hormone

310
Q

Hormone for initiation and maintenance of lactation, inhibited by dopamine

A

Prolactin

311
Q

Hormone for water and salt balance

A

Aldosterone

312
Q

Hormone for metabolism of carbohydrates

A

Cortisol

313
Q

Convert angiotensinogen o angiotensin I, and acts both n enzyme and hormone

A

Renin

314
Q

It is found in the lower anterior neck and shaped like a butterfly

A

Thyroid Gland

315
Q

Thyroid cells are organized into ____ which are spheres of thyroid cells surrounding a core f a viscous substance termed _____, also it is the center of thyroid hormone production

A

Follicles; Colloid

316
Q

It is critical in regulating body metabolism, production of proteins, neurologic development, brain maturation of fetus and numerous other body functions

A

Thyroid Hormone

317
Q

Is most abundant, approximately 80% of thyroid hormone

A

Thyroxine (T4)

318
Q

Mostly derived from deiodination of T4 but 3–8 times more active than T4

A

Triiodothyronine (T3)

319
Q

Secreted by parafollicular C cells and is involved in calcium homeostasis

A

Calcitonin

320
Q

Transport majority of T3 and 70-75 % of T4

A

Thyroxine Binding Globulin (TBG)

321
Q

Transport T3 and 10% T4

A

Albumin

322
Q

Transport 15-20 % of T4 but no affinity to T3, also transports retinol / vitamin A

A

Pre-albumin / Transthyretin

323
Q

0.04 % T4 and 0.4 % T3 are _____

A

Unbound

324
Q

Thyroid panel is composed of:

A

TSH (main test), FT4, FT3, or Total T3

325
Q

It is primarily dependent on the specificity of the antibody used and the absence of antithyroglobulin autoantibodies

A

Thyroglobulin assay

326
Q

Helps regulate water, electrolyte balance, and blood pressure, and also important in reabsorption of sodium (Na)

A

Mineralocorticoids (Aldosterone)

327
Q

This leads to increased sodium (hypernatremia), and water reabsorption > increase of blood volume > hypertension. Also stimulates tassium secretion (in exchange of Na in PCT) > hypokalemia. Lastly it results in secretion f H (in exchange of Na in DCT) leading to alkalosis

A

Hyperaldosteronism

328
Q

Disease associated with hyperaldosteronism

A

Conn’s disease

329
Q

It is due to bilateral ; adrenal hyperplasia or adreanl adenoma

A

Primary Hyperaldosteronism

330
Q

Activation of RAAS

A

Secondary hyperaldosteronism

331
Q

It stimulates gluconeogenesis in the liver resulting in increased blood glucose level

A

Glucocorticoids (Cortisol)

332
Q

Syndrome associated with hypercortisolism

A

Cushing’s syndrome

333
Q

Syndrome associated with hypercortisolism

A

Addison’s Syndrome

334
Q

Naturally synthesized estrogen are carbon-18 compounds

A

Estrogen

335
Q

Metabolite of estradiol, most abundant in post-menopausal women

A

Estrone

336
Q

Most potent and most abundant in pre-menopausal women, also produced by males

A

Estrogen

337
Q

Metabolite of estradiol, seen in pregnant women

A

Estriol

338
Q

A tumor in adrenal medulla

A

Pheochromocytoma

339
Q

Best test r diagnosing pheochromocytoma is measurement of ________ and______ in a 24 hr collection

A

Fractionated metanephrines and catecholamines

340
Q

The most sensitive screening profile for pheochromocytoma

A

Measuring both total plasma catecholamines and urine metanephrines

341
Q

The most specific and sensitive diagnostic test for pheochromocytoma

A

Plasma metanephrines measured by HPLC

342
Q

Has the highest false negative e (up to 41% ) of the urine catecholamine tests

A

Urine VMA by HPLC or Fluorometric assay

343
Q

Screening test for Cushing’s syndrome

A

24 hr urinary free cortisol test, overnight dexamethasone suppression test (most widely used), midnight salivary cortisol test

344
Q

Confirmatory test for Cushing’s syndrome

A

Low dose dexamethasone suppression test, midnight plasma cortisol, corticotropin releasing hormone stimulation test

345
Q

Test for Cushing’s disease

A

High dose dexamethasone (suppress if CD)

346
Q

Normal value for pH

A

7.35 - 7.45

347
Q

Normal value of pCO2

A

35 - 45

348
Q

Normal value of pO2

A

80 - 100

349
Q

Normal value of HCO3

A

22 - 26 mmol/L

350
Q

Normal value of H2CO3

A

1.05 - 1.035 mmol/L

351
Q

Normal value f Total CO2

A

23 - 27 mmol/L

352
Q

Normal value of O2 sat

A

> = 95 %

353
Q

It is an important buffer system of the body

A

Bicarbonate-Carbonic Acid System

354
Q

The ratio of bicarbonate-carbonic acid is ____

A

20:1

355
Q

It is the driving force of the bicarbonate-carbonic id system

A

Carbon dioxide

356
Q

Increase in CO2 concentration, from cellular metabolism , will shift the equilibrium to the _______ forming more bicarbonate and hydrogen ions

A

Right

357
Q

Causes of Metabolic alkalosis

A

Vomiting

358
Q

Compensation f Metabolic alkalosis

A

Hypoventilation

359
Q

Causes of Metabolic acidosis

A

Diabetic ketoacidosis
Lactic acidosis
Renal failure
Diarrhea
Inorganic acids

360
Q

Compensation of Metabolic acidosis

A

Hyperventilation

361
Q

Causes of Respiratory alkalosis

A

Anxiety
Severe pain
Aspirin / Salicylate overdose

362
Q

Compensation of Respiratory alkalosis

A

HCO3 is excreted

363
Q

Causes of Respiratory acidosis

A

COPD
MG
Drug overdose
Botulism
Stroke
Myxedema
Pneumonia

364
Q

Compensation of Respiratory acidosis

A

Kidney retain HCO3

365
Q

The most important factor affecting blood gasses and pH measurement

A

Temperature

366
Q

pH decreases by _______, pO2 will fall by ______ and pCO2 will rise by _____ each Celsius above 37 C

A

Ph decreases by 0.015, pO2 will fall by 7 % and pCO2 will ise by 3 % each Celcius above 37 C

367
Q

Specimen of choice for blood gas analysis

A

Arterial Blood collected on syringe with 0.05 mL/mL dried heparin as anticoagulant

368
Q

Confirmatory testing for drug testing

A

GC - MS

369
Q

Gas chromatography is for ________ while mass spectrometry is for _______.,

A

Quantitation ; Identification

370
Q

Standard screening test for drug analysis

A

TLC

371
Q

In screening or the presence of cocaine, _______ is measured.

A

Benzoylecgonine

372
Q

Most common drug of abuse

A

Alcohol

373
Q

It is acquired by ingestion which occurs mainly in children less than 6 years old, inhalation, and occasionally skin contact

A

Lead poisoning / Plumbism

374
Q

CDC cut off level for children is

A

< 10 ug / L

375
Q

Toxic blood level

A

> 70 ug / dL

376
Q

An environmental pollutant which can be highly toxic to humans affecting several organ system. It is an industrial by product especially by manufacturing, smelting, chlorine bleaching and incineration

A

Dioxins or also known as 2,3,7,8 - tetrachlorodibenzo-p-dioxin

Clinical Chemistry (2 decks)

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