Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CLS 701 > Day 1 > Flashcards

Day 1 Flashcards

1
Q

Accuracy and precision relate to QA or QC?

A

QC - looks at the accuracy and precision of analyzers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

State regulations are overseen by… National regulations are overseen by…

A

LFS (Dept of Health)

CLIA, enforced by CMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What hospital standards are nurses and hospital staff more familiar with? Clinical labs?

A

JCAHO

CAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Plasma is collected in the tube with this colored cap… Serum is collected in the tube with this colored cap…

A

Purple

Red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A blood tube that is yellow in color is due to…

A

Icterus (bilirubin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A blood tube that is red in color is due to…

A

Hemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A blood tube that is turbid is due to…

A

Lipemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What will happen if a calcium test is collected in an EDTA (purple top) tube?

A

Absorbs calcium, value very low

  • erroneous results
  • anti-coagulants become involved in testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3 types of spectrophotometry measurements

A

Colorimetric

Endpoint

Initial Rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Colorimetric - measuring absorbance of an ___

A

Analyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Endpoint - measuring absorbance of some ___ with the analyte, then calculating the concentration of the analyte using reaction formula

A

Product of a reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Initial rate - measuring the ___ over time, then using that rate to calculate analyte concentration

A

Change in absorbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Proteins absorb UV at this wavelength

A

280 nm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The BUN measurement is this type of spectrophotometric measurement

A

Initial rate

-rate can be positive or negative, depending on measurement of product or reactant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Turbidity vs nephelometry - what does each measure?

A

Turbidity = light absorbed/blocked

Nephelometry = light scattered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are reference intervals determined?

A

Mean +/- 2 SD

  • accepts 95% of population, excludes 5%
  • values from 120 patient population
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a delta check? Delta checks are useful for determining pre-analytical, analytical, or post-analytical errors?

A

Review of previous results, looking for a relative change of an analyte
-tells us if analyzer has changed significantly

Pre-analytical and analytical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 6 types of reagent grade water as classified by CLSI?

A 
Clinical laboratory reagent water (CLRW)
Special reagent water (SRW)
Instrument feed water
Manufacturer supplied
Autoclave/wash
Commercially purified/bottled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thirst is stimulated by this part of the brain… Which is in response to this physiological condition…

A

Hypothalamus

Increased osmolality of blood

  • due to elevated sodium level
  • drinking water increase water content of extracellular fluid, diluting sodium and decreasing osmolality of the plasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

This hormone, ___, acts on the cells of the collecting ducts of the kidneys to increase water reabsorption to decrease osmolality. The hormone is secreted by…

A

Vasopressin (ADH = antidiuretic hormone)

Posterior pituitary gland
-hormone made in hypothalamus first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where is aldosterone made? What does aldosterone do? How is it different than vasopressin?

A

Adrenal gland

Causes nephron distal tubules to reabsorb sodium and water

  • absorb salt first, which causes water to follow via osmosis
  • increases blood volume

Vasopressin reabsorbs water
Aldosterone reabsorbs Na and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cushing’s disease and Addison’s disease both involve this organ…

A

Adrenal gland

-disorders are opposite of each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is seen in Cushing’s disease and Addison’s disease in terms of the amount of hormones being released?

A

Cushing’s disease = excessive cortisol release
-mnemonic: Cushing’s = cortisol

Addison’s disease = low cortisol AND low aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are natriuretic peptides?

A

Compounds that cause sodium excretion in urine. Compounds have an opposite effect to the Renin-angiotensin-aldosterone system

  • pee out more water
  • similar to diuretic, except pee is salty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Diabetes insipidus is due to deficiency in which hormone? What is a common symptom of the disease?

A

ADH (vasopressin)

  • disruption in production, release, breakdown, or cells responding to
  • 4 main categories

Always thirsty, even after drinking

  • pee a lot
  • very dilute urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the name for the force that tends to move water from dilute solutions to concentrated solutions?

A

Osmotic pressure (osmosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How many mOsm (milliosmoles) per kg are present for the following compounds, each at 15 mmole solute per kg water: glucose, NaCl, CaC12

A

Glucose: 15 mOsm/kg
-1 ion only

NaCl: 30 mOsm/kg
-dissociates into 2 ions

CaCl2: 45 mOsm/kg
-dissociates into 3 ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Osmolality can be measured in two ways

A

Freezing point depression
-1 osmol of solute/kg lowers freezing point of water by 1.86C

Vapor pressure depression

  • solute added to solvent
  • vapor press of solvent in equilibrium with liquid phase decreased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the osmolal gap? What is the normal osmolal gap?

A

The difference between the osmolality of blood that is measure vs what is calculated
-something else in the blood not taken into account in calculation

< 10 mOsm/kg = normal
> 10 mOsm/kg = abnormal (abnormal concentration of unmeasured substances)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which are extracellular and which are intracellular: chloride, phosphates/proteins, potassium, sodium, bicarbonate (HCO3-), magnesium

A

Extracellular: chloride, sodium, bicarbonate

Intracellular: phosphates/proteins, potassium, magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Name an extracellular buffer. Name an intracellular buffer

A

Bicarbonate (HCO3-)

Phosphates/proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What would falsely increase in a hemolyzed specimen?

A

Intracellular ions

-potassium, phosphates/proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Difference between osmosis and diffusion? What is active transport?

A

Diffusion = passive movement of solutes

Osmosis = passive movement of fluids

Active transport = uses ATP (active) to move solutes against concentration gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In any compartment, the total charges of positive and negative electrolytes must be ___

A

Equal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

The electrolyte balance in blood, serum or plasma is determine by the ___ measurement

A

Anion Gap

  • sum of “routinely measured” cations minus the sum of the “routinely measured” anions in the blood
  • value must always be positive; negative values may indicate lab error interference
36
Q

Why is it okay to normally leave potassium out of the anion gap calculation?

A

Potassium values low and intracellular

-increased during hemolysis or tissue damage

37
Q

When sodium is above the renal threshold, is blood sodium is high or low? Will sodium show up in the urine?

A

High

Yes
-excreted

38
Q

When sodium is below the renal threshold, is blood sodium is high or low? Will sodium show up in the urine?

A

Low

No

  • kidneys reabsorb sodium
  • should see some sodium in urine in healthy people
39
Q

Is a mildly hemolyzed specimen acceptable for a sodium measurement? Is a severely hemolyzed specimen acceptable for a sodium measurement?

A

Yes
-most sodium is extracellular

No

  • will dilute sodium in serum
  • lowers measured value
40
Q

What is the term for high sodium? 3 main causes for high sodium levels…

A

Hypernatremia

Excess water loss
Decreased water intake
Increase intake/retention of sodium

41
Q

What is the term for low sodium? 3 main causes for high sodium levels…

A

Hyponatremia

Excess sodium loss
Increased water retention
Water imbalance

42
Q

Excess of interstitial fluid, locally, due to inflammation, hypersensitivity or venous blockage is called…

A

Edema

43
Q

In diabetes insipidus, sodium levels are __ in the blood and osmolality is ___ in the urine

A

High

Low

44
Q

Why would a person with diabetes (hyperglycemia) have hyponatremia?

A

High glucose in blood increases blood osmolality, which causes water to flow into blood due to osmosis, diluting serum sodium concentration

45
Q

What do hypervolemia and hypovolemia mean?

A

Hypervolemia = too much fluids in blood

Hypovolemia = too little fluids in blood

46
Q

Is transport of potassium into cells in exchange for sodium an active or passive transport?

A

Active

-sodium-potassium pump

47
Q

What is the renal threshold for potassium?

A

None

48
Q

Is a hemolyzed specimen acceptable for a potassium measurement? Why or why not?

A

No

Potassium is intracellular
-falsely high potassium results

49
Q

Do kidneys reabsorb potassium? Why or why not?

A

No

Very little potassium in blood, most intracellular
-easily replenish blood potassium with daily intake

50
Q

What is the term for high potassium? 2 main causes for high potassium levels…

A

Hyperkalemia

Decreased renal excretion
Cellular shift
-false elevation: hemolysis, thrombocytosis, fist clenching

51
Q

What is the term for low potassium? 3 main causes for low potassium levels…

A

Hypokalemia

GI loss
Renal loss
Cellular shift

52
Q

In cystic fibrosis patients, if we measure their sweat, we can see this electrolyte has increased

A

Chloride

53
Q

Increased chloride is called… Decreased chloride is called…

A

Hyperchloremia
-compensate loss of HCO3-

Hypochloremia
-vomit, diabetic ketoacidosis, aldosterone deficiency, pyelonephritis

54
Q

Chloride closely follows the patterns of this other electrolyte…

A

Sodium

55
Q

When this molecule, ___, is used up trying to balance blood sodium, chloride can be used to compensate

A

Bicarbonate (HCO3-)

  • consumed by reaction with H+ produced in metabolic acidosis
  • increased Cl- reabsorption (Na+ with Cl-)
56
Q

Where is magnesium mostly found?

A

Bone, tissue

  • very little in blood
  • extracellular magnesium used to maintain intracellular levels
57
Q

Increased magnesium is called… Decreased magnesium is called…

A

Hypermagnesemia

Hypomagnesemia

58
Q

ISE is a method used to measure bound or free electrolytes?

A

Free (ionized)

  • one electrode is selective for ion
  • other electrode is reference
59
Q

Increased calcium IN BLOOD is called ___. Increased calcium IN URINE is called ___.

A

Hypercalcemia

Hypercalcuria

60
Q

Are phosphates/phosphorus mostly extracellular or intracellular?

A

Intracellular

61
Q

When glucose levels in the blood goes above the renal threshold, it will appear in the ___, and the condition is called…

A

Urine

Glucosuria

62
Q

High blood sugar stimulates the release of this hormone, ___, which triggers the production of… Low blood sugar stimulates the release of this hormone, ___, which triggers the release of…

A

Insulin = glycogen

Glucagon = release stored glycogen
-glycogen converted into glucose

63
Q

Diabetes mellitus - what is the classic triad of symptoms? Are these symptoms seen in Type I or Type II?

A 
Excessive urination (polyuria)
Excessive thirst (polydypsia)
Excessive hunger (polyphagia)

Type I diabetes

64
Q

Do ketones go up or down with Type I diabetes mellitus? Why?

A

Up

Body thinks it’s starving due to lack of insulin, breaks down lipids for energy
-lipid breakdown = pH decrease (ketoacidosis)

65
Q

Is the anion gap increased or decreased with diabetes mellitus?

A

Large increase

  • ketone bodies increase
  • potassium goes out of cells to compensate for low pH due to ketoacidosis
  • bicarbonate decreased to reduce negative charges
66
Q

In renal diabetes, the blood glucose level is ___, and the urine glucose level is ___. Why?

A

Normal
High

Glucosuria due to low sugar threshold in kidneys

  • kidneys fail to reabsorb normal amount of glucose back into blood
  • glucose above threshold excreted into urine
67
Q

Is glucagon increased or decreased in diabetes mellitus?

A

Increased

  • body thinks it’s starving due to insulin deficiency
  • in both Type I and II diabetes
68
Q

Difference between Type I and Type II diabetes

A

Type I = insulin deficiency

  • from autoimmune disease
  • usually before age 20
  • ketones and glucagon present

Type II = insulin resistance

  • acquired diabetes
  • insulin and glucagon present
69
Q

In both Type I and Type II diabetes mellitus, the blood glucose is… The urine glucose is…

A

Hyperglycemic

Glucosuria

70
Q

The gold standard test for diabetes mellitus is…

A

A1C

  • higher glucose conc = higher A1C level
  • < 7% of total hemoglobin in healthy people
  • may falsely increase in certain conditions, pregnancy
71
Q

What is hemoglobin A1C?

A

Glycosylated hemoglobin

  • glucose molecules stick to hemoglobin
  • reflects average glucose over 6-8 week period
  • cutoff at 6.5% = good sensitivity/specificity
72
Q

How does the oral glucose tolerance test (OGTT) work?

A

Give patient 100g glucose orally

  • draw blood at specific interval
  • establishes when glucose reaches highest concentration and how rapidly it returns to normal levels
73
Q

What are the OGTT test results for a normal person vs a diabetic?

A

Normal - venous blood sugar does not exceed 200 mg/ 100 ml blood. Returns below 120 mg in 2 hours

Diabetic - glucose level peaks above 200 mg. Does not return below 120 mg after 2 hours

74
Q

What is the precursor form of insulin called? What does it break down into (2)?

A

Proinsulin

Insulin
C-peptide

75
Q

How can we tell if insulin is made endogenously vs exogenous insulin from an insulin shot?

A

Endogenous insulin - proinsulin breaks down into insulin and c-peptide. C-peptide can be measured

Exogenous insulin - no c-peptide

76
Q

What is gestational diabetes and when does it resolve?

A

Insulin resistance due to hormones blocking insulin’s effect (similar to Type II diabetes)
-begins around 20-24 weeks

Resolves after delivery
-hormone levels return to normal

77
Q

What is the term for ketones in the urine? Is this condition present in Type I or Type II diabetics?

A

Acetouria

Type I only

78
Q

Vomiting causes the loss of this electrolyte and can cause this condition

A

Chloride = hypochloremia

79
Q

Plasma vs serum tubes - which one has anti-coagulants added? Which one is devoid of fibrinogen and other clotting factors?

A

Plasma

Serum

80
Q

In addition to stimulating glycogen release, glucagon also promotes the enhancement of this process to make more glucose…

A

Gluconeogenesis

81
Q

What does the potassium-hydrogen ion exchange do? Under what condition is it used?

A

K pumped out of cell and H+ go into cells to increase blood pH

Acidosis

82
Q

What test should we use to distinguish bacterial from viral meningitis?

A

CSF glucose testing

  • bacteria = low (< 40% of serum glucose)
  • viral = normal
83
Q

Besides Type I diabetes, ketones appearing in the urine can also be as indicator for…

A

Congestive heart failure

-also ketogenic diet

84
Q

What is the best anticoagulant for potassium?

A

Heparin

-EDTA causes huge potassium spike

85
Q

Which electrolyte is the major extracellular anion?

A

Chloride

CLS 701 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions