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MLT130 Clinical chemistry > EXAM 2 > Flashcards

EXAM 2 Flashcards

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1
Q

The major intracellular cation is______ and its normal value is_______

A

Potassium

3.5-5.0 mm/L

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2
Q

The major extracellular cation is ________ and its normal value is ___________

A

Sodium

136-145 mm/L or mEq/L

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3
Q

The major extracellular anion is __________ and its normal value is __________

A

Chloride

90-109 mm/L

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4
Q

What is the endpoint of a mercurimetric chloride assay?

A

violet blue color- a complex of mercury and diphenylcarbozone

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5
Q

What 2 cations are most likely to be ordered to determine the cause of cardiac tetany?

A

calcium and magnesium

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6
Q

Be able to calculate the anion gap if given values for Na+, K+, Cl-, and CO2. Be able to correlate abnormal anion gaps with other test results (such as BUN) or with instrument/technologist error

A

Na+-(Cl-+HCO3-)
8-18 mmol/L
Na++K-(Cl-+HCO3-)
12-20 mmol/L

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7
Q

To what does % saturation of transferrin refer? What is the normal value?

A

ratio of serum iron to TIBC

20-50%

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8
Q

What is hypokalemia?

A

low serum potassium; can be caused by decreased dietary intake, vomiting, renal dysfunction

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9
Q

If tetany is due to calcium, what specific fraction of calcium is involved? Will it be increased or decreased?

A

decreased ionized Ca2+

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10
Q

What analyte in the blood is used to measure serum phosphorous? What is the normal value for serum phosphorous?

A

inorganic phosphate

2.7-4.5 mg%

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11
Q

Why is it important to measure serum magnesium levels?

A

tetany due to magnesium deficiency

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12
Q

In analyzing calcium by atomic absorption, why is lanthanum added?

A

to prevent interference of phosphate

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13
Q

Calcium exists in serum as ______ and _______. Which one is physiologically active?

A

ionized and protein bound

ionized is physiologically active

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14
Q

A patient with lactic acid acidosis would have an ________ anion gap

A

increased

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15
Q

What is the purpose of adding magnesium carbonate to an iron binding capacity? What does TIBC measure?

A

removes excess unbound iron

TIBC: estimates transferrin level in serum

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16
Q

What is the Fiske-Subbarow method for phosphorous?

A

molyvdate added to serum to form phosphomolyvdate

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17
Q

There is a _____________ relationship between serum calcium and phosphorous

A

reciprocal

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18
Q

What is the normal serum calcium level?

A

8.5-10.5 mg/dL

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19
Q

What would be the expected test results for calcium and phosphorous in hyperparathyroidism?

A

CA2+ is increased phosphorous is decreased

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20
Q

What is the purpose of adding stannous chloride, ferrous sulfate, and ascorbic acid in the determination of inorganic phosphorous?

A

reducing agents

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21
Q

Name several things that can affect the level of circulating calcium

A

serum protein levels, parathyroid hormone, bone-cell activity(osteoclastic activity) Vitamin D

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22
Q

What 2 hormones control serum calcium levels?

A

calcitonin-increased

parathyroid hormone-decreased

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23
Q

Which electrolyte is the chief plasma base that helps in maintaining osmotic pressure?

A

Na+

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24
Q

Hemolysis has the greatest affect on serum ________levels

A

potassium/magnesium

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25
Q

What is the function of aldosterone?

A

increased sodium reabsorption, increased H2O retention, increased BP and blood volume

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26
Q

What hormone has the most control over serum phosphate levels?

A

parathyroid hormone

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27
Q

What is the normal serum osmolality?

A

275-295 mosm/kg of H2O

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28
Q

What are the four main buffer systems of the body?

A

bicarbonate/carbonic acid
hemoglobin buffer
plasma proteins
phosphoric acid/phosphoric buffer

29
Q

The pKa of carbonic acid is ______________

A

6.1

30
Q

What is added to the reaction mixture in calcium determinations to prevent interference by magnesium?

A

8-hydroxyl quinoline

31
Q

What component of a freezing point osmometer actually measures the sample temperature?

A

thermistor

32
Q

What 2 properties can be used to measure osmolality?

A

vapor pressure

freezing point depression

33
Q

What analytes are the main contributors to serum and urine osmolality?

A

electrolytes

34
Q

What is the principle of the freezing point osmometer?

A

freezing point lowered by an amount that is directly proportional to the concentration of dissolved particles in the solution

35
Q

What does PCO2 electrode actually measure?

A

pH

36
Q

Respiratory acidosis is an increase of ________due to respiratory alkalosis is a decrease of ___________

A

CO2;CO2

37
Q

During the chloride shift, the chloride moves from _______ to _________. What anion is exchanged for chloride?

A

plasma to cell

bicarbonate is exchanged for chloride

38
Q

What buffer system contributes most to the regulation of blood pH? What is the normal ratio of the two portions of the buffer system?

A

bicarbonate/carbonic acid

20:1

39
Q

Normal blood pH is ________

A

7.35-7.45 (slightly alkaline)

40
Q

Most of the CO2 present in the blood is in the form of __________

A

bicarbonate

41
Q

What substance is necessary for the release of oxygen from hemoglobin?

A

2,3-DPG(diphosphoglycerate)

42
Q

What happens in the body to compensate for a state of metabolic acidosis?

A

hyperventilation

43
Q

What is the cause of metabolic alkalosis?

A

excess bicarbonate and/or deficit of noncarbonic acid

44
Q

What is p50?

A

PO2 at which Hgb is 50% saturated with O2;

equal to 26-27 mmHg

45
Q

List several precautions that must be used in handling a specimen for ABG’s

A

anaerobic, 15 mins, place on ice, heparinized, drawn from the artery

46
Q

Hyperventilation is a common cause of ___________

A

respiratory alkalosis

47
Q

What reaction is catalyzed by the enzyme carbonic anhydrase?

A

carbonic anhydrase breaks down carbonic acid
CO2 + H2O–> H2CO3
formation of carbonic acid from CO2 and H2O

48
Q

What is the normal range for pCO2? for pO2?

A

pCO2: 35-45 mmHg

pO2: 80-100 mmHg

49
Q

In general, respiratory acidosis results from __________

A

decreased exchange of CO2 from lungs

increased CO2 hypoventillation

50
Q

Be able to recognize the Henderson-Hasselbalch equation

A

pH=pKa + Log

(bicarbonate/carbonic acid)

51
Q

A fever of unknown origin would cause a _________ shift of the oxygen dissociation curve while an increased affinity for oxygen causes a _________ shift

A

right

left

52
Q

Which anticoagulant is preferred for ABG analysis?

A

heparin

53
Q

The pO2 electrode is based on the principle of __________

A

amperometric

54
Q

What would be the breathing pattern of a patient in respiratory alkalosis?

A

shallow, rapid

55
Q

What is the compensatory mechanism in respiratory acidosis?

A

increase bicarbonate concentration and blood .reabsorption concentration

56
Q

What ABG parameter is most useful in assessing a fire victim?

A

pO2

57
Q

How would exposure to air bubbles affect an arterial blood sample?

A

pO2 would increase
pH would increase
pCO2 would decrease

58
Q

Hyperventilation is the loss of _________

A

CO2

59
Q

What events shift the oxygen dissociation curve to the left?

A

decreased- p50, 2,3 DPG, body temp, pCO2 increased-affinity of Hgb for O2, pH, CO2

60
Q

A supercooled solution has a _________temp than its freezing point

A

lower

61
Q

Every mole of solute decreases the freezing point of H2O by _______ degrees

A

1.86 degrees celsius

62
Q

What is the name of the rapid stirrer mechanism in an osmometer?

A

vibrator

63
Q

What are the 4 forms of CO2 in the blood?

A

bicarbonate (90-95%)
carbonic acid
dissolved CO2(dCO2)
carabamino compounds

64
Q

When calcium levels decline, which hormone is secreted to restore normal calcium levels?

A

PTH( parathyroid)

65
Q

What gases can be measured by a co-oximeter?

A

carboxyhemoglobin
sulfhemoglobin
methemoglobin

66
Q

How should the sample for an ABG measurement be mixed?

A

roll between palms

67
Q

Name several suitable sites for ABG draws

A

radial artery, brachial, femoral, temporal

68
Q

If given values for pH, pCO2, and HCO3-, be able to evaluate the acid-base status of the patient

A 
pH: 7.35-7.45
 pO2: 80-100
 pCO2: 35-45
 O2 sat: 95-100
 HCO3: 22-26

if pH is decreased it is acidosis, increased alkalosis.
if pH/pCO2 same=metabolic
if pH/pCO2 opposite=respiratory
look the PH first.

MLT130 Clinical chemistry (1 decks)

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