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Clinical Chemistry > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

What is the major intracellular cation?

A

potassium

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2
Q

What is the normal value for potassium?

A

3.5-5.0 mM/L

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3
Q

What is the major extracellular cation?

A

sodium

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4
Q

What is the normal value for sodium?

A

136-145 mM/L or mEq/L

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5
Q

What is the major extracellular anion?

A

chloride

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6
Q

What is the normal value for chloride?

A

90-109 mM/L

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7
Q

What is the endpoint of a mercurimetric chloride assay?

A

violet blue color

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8
Q

What is the violet blue color of a mercurimetric chloride assay a result of?

A

complex of mercury and diphenylcarbozone

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9
Q

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

A

calcium and magnesium

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10
Q

To what does %saturation of transferrin refer?

A

ratio of serum iron to TIBC

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11
Q

What is the normal value of % saturation?

A

20-50%

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12
Q

What is hypokalemia?

A

low serum potassium

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13
Q

What are some causes of hypokalemia? (3)

A

decreased dietary intake, vomiting, renal dysfunction

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14
Q

If tetany is due to calcium, what specific fraction of calcium is involved?

A

ionized calcium

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15
Q

If tetany is due to calcium, will it be increased or decreased?

A

decreased

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16
Q

What analyte in the blood is used to measure serum phosphorus?

A

inorganic phosphate

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17
Q

What is the normal value for serum phosphorus?

A

2.7-4.5 mg/dL

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18
Q

Why is it important to measure serum magnesium levels?

A

tetany due to magnesium deficiency

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19
Q

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

A

to prevent interference of phosphate

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20
Q

Calcium exists in serum as…? (2)

A

ionized and protein bound

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21
Q

Which of the two types of calcium is physiologically active?

A

ionized

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22
Q

A patient with lactic acid acidosis would have an increased or decreased anion gap?

A

increased

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23
Q

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

A

removes excess unbound iron

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24
Q

What does TIBC measure?

A

estimates transferrin level in serum

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25
Q

What is the Fiske-Subbarow method for phosphorus?

A

molybdate added to serum to form phosphomolybdate which is reduced to aminonaphthosulfonic acid

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26
Q

What type of relationship exists between serum calcium and phosphorus?

A

reciprocal

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27
Q

What is the normal serum calcium level?

A

8.4-10.2 mg/dL

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28
Q

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

A

calcium is increased, phosphorus is decreased

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29
Q

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

A

they are reducing agents

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30
Q

What are some things that can affect the level of circulating calcium? (4)

A

serum protein levels, PTH, bone-cell activity, vitamin D

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31
Q

What two hormones control serum calcium levels?

A

calcitonin and PTH

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32
Q

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

A

sodium

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33
Q

What ions does hemolysis have the greatest affect?

A

potassium and magnesium

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34
Q

What is the function of aldosterone? (4)

A

increased sodium reabsorption, increased water retention, increased blood pressure, and blood volume

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35
Q

What hormone has the most control over serum phosphate levels?

A

PTH

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36
Q

What is the normal serum osmolality?

A

275-295 mosm/kg of water

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37
Q

What are the four main buffer systems of the body?

A

bicarbonate-carbonic acid, hemoglobin buffer, plasma proteins, phosphoric acid-phosphate buffer

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38
Q

What is the pKa of carbonic acid?

A

6.1

39
Q

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

A

8-hydroxylquinolone

40
Q

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

A

thermistor

41
Q

What two properties can be used to measure osmolality?

A

vapor pressure and freezing point depression

42
Q

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

A

electrolytes

43
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 soluteion

44
Q

What does the PCO2 electrode actually measure?

A

pH

45
Q

Respiratory acidosis is an excess of?

A

carbon dioxide

46
Q

What is respiratory acidosis due to

A

decreased exchange of carbon dioxide

47
Q

During the chloride shift, the chloride moves from where to where?

A

plasma to cell

48
Q

What anion is exchanged for chloride?

A

bicarbonate

49
Q

What buffer system contributes most to the regulation of blood pH?

A

bicarbonate-carbonic acid

50
Q

What is the normal ratio of the two portions of the buffer system?

A

20:1 if lungs and kidneys are functioning properly

51
Q

What is pH of normal blood?

A

7.35-7.45 (slightly alkaline)

52
Q

Most of the carbon dioxide in the blood is in the form of?

A

bicarbonate

53
Q

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

A

2,3-DPG

54
Q

What does DPG stand for?

A

diphosphoglycerate

55
Q

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

A

hyperventilation

56
Q

What is the cause of metabolic alkalosis?

A

excess bicarbonate

57
Q

What is p50?

A

PO2 at which hemoglobin is 50% saturated with oxygen

58
Q

What is the normal range for p50?

A

26-27 mmHg

59
Q

What are some precautions that must be used in handling a specimen for ABGs?

A

anaerobic, transported within 15 minutes, place on ice, heparinized, drawn from the artery, mixed well

60
Q

Hyperventilation is a common cause of?

A

respiratory alkalosis

61
Q

What reaction is catalyzed by the enzyme carbonic anhydrase?

A

forms carbonic acid from carbon dioxide and water

62
Q

What is the normal range for pCO2?

A

25-45 mmHg

63
Q

What is the normal range for pO2?

A

80-100 mmHg

64
Q

In general, respiratory acidosis results from?

A

decreased exchange of carbon dioxide from lungs resulting in increased carbon dioxide hypoventilation

65
Q

A fever of unknown origin would cause why type of shift in the oxygen dissociation curve?

A

shift to the right

66
Q

What type of shift is caused by an increased affinity for oxygen?

A

shift to the left

67
Q

Which anticoagulant is preferred for ABG analysis?

A

heparin

68
Q

The pO2 electrode is based on what principle?

A

amperometric

69
Q

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

A

shallow, rapid

70
Q

What is the compensatory mechanism in respiratory acidosis?

A

increasing bicarbonate concentration by increasing reabsorption in the kidneys

71
Q

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

A

pO2

72
Q

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

A

pO2 would increase, pH would increase, pCO2 would decrease

73
Q

Hyperventilation results in the loss of?

A

CO2

74
Q

Every mole of solute decreases the freezing point of H2O by how many degrees?

A

1.86 C

75
Q

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

A

vibrator

76
Q

What are the 4 forms of carbon dioxide in the blood?

A

bicarbonate, carbonic acid, dissolved CO2, carabamino compounds

77
Q

What percentage of the blood is made up of bicarbonate?

A

90-95%

78
Q

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

A

parathyroid hormone

79
Q

What gases can be measured by a co-oximeter?

A

carboxyhemoglobin, sulfhemoglobin, and methemoglobin

80
Q

How should the sample for an ABG measurement be mixed?

A

Roll between palms

81
Q

Name four suitable sites for ABG draws

A

radial, brachial, femoral, and temporal arteries

82
Q

What is ceruloplasmin?

A

transport protein for copper

83
Q

What disease is ceruloplasmin decreased?

A

Wilson’s disease

84
Q

What is oligoclonal banding?

A

increased CSF IgG and multiple distinct bands in the globulin zone

85
Q

Where is oligoclonal banding typically seen?

A

90% of MS patients

86
Q

What is the normal range of blood pH?

A

7.35-7.45

87
Q

What is the normal range for bicarbonate?

A

22-26

88
Q

What is the acid-base status of a patient with a decreased pH?

A

acidosis

89
Q

What is the acid-base status of a patient with an increased pH?

A

alkalosis

90
Q

What does it mean if the pH and pCO2 is the same?

A

metabolic

91
Q

What does it mean if the pH and pCO2 is the opposite?

A

respiratory

92
Q

What is the Henderson-Hasselbach equation?

A

pH = pKa + log (base/acid)

93
Q

What kind of relationship to calcitonin and PTH have?

A

antagonistic

94
Q

What events shift the oxygen dissociation curve to the left?

A

decreased p50 causes an increased affinity of hemoglobin for O2

Clinical Chemistry (5 decks)

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