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clinical chemistry > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

major intracellular cation and its normal value

A

potassium

3.5-5.0

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2
Q

major extracellular cation and its normal value

A

Sodium

136-145

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3
Q

major extracellular anion and its normal value

A

chloride

90-109

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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

magnesium and calcium

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6
Q

to what does % saturation of transferrin refer and what is the normal value?

A

variation of iron and TBIC

20-50%

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7
Q

what is hypokalemia?

A

low serum potassium

decreased dietary intake, vomiting, renal dysfunction

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8
Q

if tetany is due to calcium, what specific fraction of calcium is involved? Increased or decreased?

A

decreased ionized calcium

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9
Q

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

A

inorganic phosphate

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10
Q

what is the normal value for serum phosphorus?

A

2.8-4.0 mg/dl

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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 absortion, why is lanthanum added?

A

to prevent phosphate from interferring

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13
Q

calcium exists in serum as what?

A

ionized and protein bound

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14
Q

is ionized or bound protein physiologically active?

A

ionized calcium

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15
Q

a patient with lactic acid acidoisis would have a increased or decreased anion gap?

A

increased

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16
Q

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

A

removes excess unbound iron TIBC

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17
Q

what does TIBC measure?

A

estimates transferrin levels in serum

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18
Q

what is the fiske-subbarow method for phosphorus?

A

molybdate added to serum to form phosphomolybdate

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19
Q

what kindof relationship is between serum calcium and phosphorus?

A

recipricol

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20
Q

what is the normal serum calcium level?

A

8.5-10.5 mg/dl

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21
Q

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

A

increased calcium

decreased phosphorus

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22
Q

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

A

reducing agents

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23
Q

name several things that can affect the level of circulating calcium.

A

serum protein levels
parathyroid hormone
vitamin d
bone cell activity

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24
Q

what 2 hormones control serum calcium levels?

A

parathyroid hormone PTH- decreased

calcitonin- increased

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25
Q

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

A

sodium Na

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26
Q

hemolysis has the greatest effect on what serum levels?

A

potassium/magnesium

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27
Q

what is the function of aldosterone?

A

increased sodium absorption
increased H2O retention
increased BP
increased blood volume

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28
Q

what hormone has the most control over serum phosphate levels?

A

PTH

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29
Q

what is the normal serum osmolality?

A

215-295 mOsm/kg of H2O

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30
Q

what are the 4 main buffer systems of the body?

A 
bicarbonate
carbonic acid
hemoglobin buffer
plasma proteins
phosphoric acid
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31
Q

the pKa of carbonic acid is what?

A

6.1

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32
Q

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

A

8-hydroxylquinoline

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33
Q

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

A

thermistor

34
Q

what 2 properties can be used to measure osmolality?

A

vapor pressure and freezing point

35
Q

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

A

electrolytes

36
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.

37
Q

what does the PCO2 electrode actually measure?

A

pH

38
Q

respiratory acidosis is an excess of?

A

CO2

39
Q

respiratory alkalosis is and excess of?

A

O2

40
Q

during the shift, the chloride moves from _____ to _____. what anion is exchanged for chloride?

A

plasma to cell

bicarbonate is exchanged for chloride

41
Q

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

A

bicarbonate/carbonic acid

42
Q

what is the normal ratio of the 2 portions of the buffer system?

A

20:1

43
Q

normal blood pH?

A

7.34-7.45 slightly alkaline

44
Q

most of the CO2 present is in the form of what?

A

bicarbonate

45
Q

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

A

2,3 DPG

46
Q

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

A

hyperventilation

47
Q

what is the cause of metabolic alkalosis?

A

excess of HCO3 or deficient of non carbonic acid

48
Q

what is p50?

A

PO2 at which Hgb is 50% saturated with O2 equal to 26-27 mm Hg

49
Q

lis several precautions that must be used in handliing a specimen for ABGs.

A

anaerobic
15 mins on ice
drawn from artery
heparinized

50
Q

hyperventilation is the the common cause of what?

A

respiratory acidosis

51
Q

what reaction is catalyzed by the enzyme carbonic anhydrase?

A

carbonic anhydrase breaks down to carbonic acid

CO2+H2O—> H2CO3 formation of carbonic acid from CO2+H2O

52
Q

what is the normal range for pCO2?

A

35-45 mm hg

53
Q

what is the normal range for O2?

A

80-100 mm hg

54
Q

in general respiratory alkolosis results from what?

A

hypoventilation

55
Q

pH=pKa + log (bicarbonate/carbonic acid)

A

Henderson-Hasselbalch equation

56
Q

what would a shift to the right be from?

A

fever

57
Q

what would a shift to the left be from?

A

increased affinity for oxygen

58
Q

which anticoagulant is preferred for ABG analysis

A

heparin

59
Q

the pO2 electrode is based on what method?

A

amperometric measured

60
Q

what would be the breathing pattern of a patient is respiratory alkalosis?

A

shallow/rapid breathing

61
Q

what is the compensatory mechanism in repiratory acidosis?

A

increasing the reabsorption of HCO3

bicarbonate in the blood due to increasing reabsorption in the kidneys

62
Q

how would exposure to air bubble affect an arterial blood sample?

A

pO2 increase
pH increase
pCO2 decrease

63
Q

hyperventilation results in the loss of what?

A

CO2

64
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

65
Q

supercooled solution has a lower/higher temp than its freezing point?

A

lower

66
Q

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

A

1.86 C

67
Q

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

A

vibrator

68
Q

what are the 4 forms of CO2 in the blood?

A

bicarbonate
carbonic acid
dissolved CO2
carabambino compoundds/acids

69
Q

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

A

parathyroid PTH

70
Q

what gases can be measured by a co-oximeter?

A

carboxyhemoglobin
methemoglobin
sulfhemoglobin

71
Q

how should the sample for an ABG measurement be mixed?

A

roll between palms

72
Q

what are some suitable sites for ABG draws?

A

radial
brachial
femoral
temporal

73
Q

value for pH

A

7.35-7.45

74
Q

value for PO2

A

80-100

75
Q

value for pCO2

A

35-45

76
Q

value for O2 saturated

A

95-100

77
Q

value for HCO3

A

22-26

78
Q

transport of protein for copper decreased in Wilsons disease

A

ceuroplasma

79
Q

what is oligoclonal banding?

A

increased CSF IgG and multiple distinct bands in globulin zone

80
Q

where can oligoclonal banding be seen?

A

90% of MS patients

clinical chemistry (4 decks)

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