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Exam 2 Flashcards

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
What is the Fiske-Subbarow method for phosphorus?
molybdate added to serum to form phosphomolybdate which is reduced to aminonaphthosulfonic acid
26
What type of relationship exists between serum calcium and phosphorus?
reciprocal
27
What is the normal serum calcium level?
8.4-10.2 mg/dL
28
What would be the expected test results for calcium and phosphorus in hyperparathyroidism?
calcium is increased, phosphorus is decreased
29
What is the purpose of adding stannous chloride, ferrous sulfate, and ascorbic acid in the determination of inorganic phosphorus?
they are reducing agents
30
What are some things that can affect the level of circulating calcium? (4)
serum protein levels, PTH, bone-cell activity, vitamin D
31
What two hormones control serum calcium levels?
calcitonin and PTH
32
Which electrolyte is the chief plasma base that helps in maintaining osmotic pressure?
sodium
33
What ions does hemolysis have the greatest affect?
potassium and magnesium
34
What is the function of aldosterone? (4)
increased sodium reabsorption, increased water retention, increased blood pressure, and blood volume
35
What hormone has the most control over serum phosphate levels?
PTH
36
What is the normal serum osmolality?
275-295 mosm/kg of water
37
What are the four main buffer systems of the body?
bicarbonate-carbonic acid, hemoglobin buffer, plasma proteins, phosphoric acid-phosphate buffer
38
What is the pKa of carbonic acid?
6.1
39
What is added to reaction mixture in calcium determinations to prevent interference by magnesium?
8-hydroxylquinolone
40
What component of a freezing point osmometer actually measures the sample temperature
thermistor
41
What two properties can be used to measure osmolality?
vapor pressure and freezing point depression
42
What analyses are the main contributors to serum and urine osmolality?
electrolytes
43
What is the principle of the freezing point osmometer?
freezing point lowered by an amount that is directly proportional to the concentration of dissolved particles in the soluteion
44
What does the PCO2 electrode actually measure?
pH
45
Respiratory acidosis is an excess of?
carbon dioxide
46
What is respiratory acidosis due to
decreased exchange of carbon dioxide
47
During the chloride shift, the chloride moves from where to where?
plasma to cell
48
What anion is exchanged for chloride?
bicarbonate
49
What buffer system contributes most to the regulation of blood pH?
bicarbonate-carbonic acid
50
What is the normal ratio of the two portions of the buffer system?
20:1 if lungs and kidneys are functioning properly
51
What is pH of normal blood?
7.35-7.45 (slightly alkaline)
52
Most of the carbon dioxide in the blood is in the form of?
bicarbonate
53
What substance is necessary for the release of oxygen from hemoglobin?
2,3-DPG
54
What does DPG stand for?
diphosphoglycerate
55
What happens in the body to compensate for a state of metabolic acidosis?
hyperventilation
56
What is the cause of metabolic alkalosis?
excess bicarbonate
57
What is p50?
PO2 at which hemoglobin is 50% saturated with oxygen
58
What is the normal range for p50?
26-27 mmHg
59
What are some precautions that must be used in handling a specimen for ABGs?
anaerobic, transported within 15 minutes, place on ice, heparinized, drawn from the artery, mixed well
60
Hyperventilation is a common cause of?
respiratory alkalosis
61
What reaction is catalyzed by the enzyme carbonic anhydrase?
forms carbonic acid from carbon dioxide and water
62
What is the normal range for pCO2?
25-45 mmHg
63
What is the normal range for pO2?
80-100 mmHg
64
In general, respiratory acidosis results from?
decreased exchange of carbon dioxide from lungs resulting in increased carbon dioxide hypoventilation
65
A fever of unknown origin would cause why type of shift in the oxygen dissociation curve?
shift to the right
66
What type of shift is caused by an increased affinity for oxygen?
shift to the left
67
Which anticoagulant is preferred for ABG analysis?
heparin
68
The pO2 electrode is based on what principle?
amperometric
69
What would be the breathing pattern of a patient in respiratory alkalosis?
shallow, rapid
70
What is the compensatory mechanism in respiratory acidosis?
increasing bicarbonate concentration by increasing reabsorption in the kidneys
71
What ABG parameter is most useful in assessing a fire victim?
pO2
72
How would exposure to air bubbles affect an arterial blood sample?
pO2 would increase, pH would increase, pCO2 would decrease
73
Hyperventilation results in the loss of?
CO2
74
Every mole of solute decreases the freezing point of H2O by how many degrees?
1.86 C
75
What is the name of the rapid stirrer mechanism in an osmometer?
vibrator
76
What are the 4 forms of carbon dioxide in the blood?
bicarbonate, carbonic acid, dissolved CO2, carabamino compounds
77
What percentage of the blood is made up of bicarbonate?
90-95%
78
When calcium levels decline, which hormone is secreted to restore normal calcium levels?
parathyroid hormone
79
What gases can be measured by a co-oximeter?
carboxyhemoglobin, sulfhemoglobin, and methemoglobin
80
How should the sample for an ABG measurement be mixed?
Roll between palms
81
Name four suitable sites for ABG draws
radial, brachial, femoral, and temporal arteries
82
What is ceruloplasmin?
transport protein for copper
83
What disease is ceruloplasmin decreased?
Wilson's disease
84
What is oligoclonal banding?
increased CSF IgG and multiple distinct bands in the globulin zone
85
Where is oligoclonal banding typically seen?
90% of MS patients
86
What is the normal range of blood pH?
7.35-7.45
87
What is the normal range for bicarbonate?
22-26
88
What is the acid-base status of a patient with a decreased pH?
acidosis
89
What is the acid-base status of a patient with an increased pH?
alkalosis
90
What does it mean if the pH and pCO2 is the same?
metabolic
91
What does it mean if the pH and pCO2 is the opposite?
respiratory
92
What is the Henderson-Hasselbach equation?
pH = pKa + log (base/acid)
93
What kind of relationship to calcitonin and PTH have?
antagonistic
94
What events shift the oxygen dissociation curve to the left?
decreased p50 causes an increased affinity of hemoglobin for O2

Clinical Chemistry (5 decks)

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