exam 2 qs Flashcards
A patient has a synovial fluid removed from their knee joint. The test results included a cell count with differential. The WBC count was 65,000 with 93% neutrophils. What is the most likely cause?
- septic
- inflammatory
- crystal induced
- hemorrhagic
septic
A patient has CSF chemistries and microbiology samples performed. Chemistries yield a very low glucose value but no growth is reported in micro cultures. What is a possible pathology to explain these results? It is to be noted that the CSF had a clear, colorless appearance.
- diabetic ketoacidosis
- brain tumor
- head trauma
- BBB compromisation
brain tumor
Which is not a common test to perform on a CSF sample?
- glucose
- uric acid
- protein
- lactate
uric acid
-glucose is measured to determine cellular activity
- uric acid is measured in synovial and pleural fluid
- protein levels can indicate BBB
- lactate is produced from glucose consumptioni
True or False
Increased CSF glucose levels can indicate acute bacterial meningitis.
False
Which would typically not be a cause of an exudative pleural effusion?
- pulmonary abscess
- lymphoma
- hepatic cirrhosis
- bacterial pneumonia
hepatic cirrhosis
True or False
The unique structure of hemoglobin allows it to act as both an acid-base buffer and O2 buffer.
true
define glycogenolysis
breakdown of glycogen to glycose for use as energy
define glycogenesis
conversion of glucose to glycogen for storage
define gluconeogenesis
formation of glucose-6-phosphate from noncarbohydrate sourcesd
define glycolysis
metabolism of glucose molecule to pyruvate or lactate for production of energy
Which parameter on a blood gas analysis is calculated instead of being directly measured.
- pH
- HCO3
- pO2
- pCO2
HCO3
The best collection tube to use for glucose tolerance testing is:
- gold top/serum
- green top/ lithium heparin
- lavender top/EDTA
- grey top/NaF
grey top / NaF
What is the incremental fraction of oxygen at sea level?
- 21
- 10
- 79
- 100
21
What is the best interpretation of the following results?
pH=7.53 (7.35-7.45)
CO2= 37 (35-45)
HCO3= 33 (22-29)
- metabolic acidosis w/ partial compensation
- metabolic alkalosis w/ no compensation
- respiratory alkalosis w/ partial compensation
- metabolic alkalosis w/ full compensation
metabolic alkalosis w/ no compensation
n external respiration, the partial pressure of oxygen in the alveolar membrane is __________, while the partial pressure of oxygen in the venous blood is _________.
- 40 mmHg, 100 mmHg
- 100 mmHg, 40 mmHg
- 45 mmHg, 40 mmHg
- 159 mmHg, 45 mmHg
100 mmHg, 40 mmHg
A decrease in H+ ions, an increase in pH, and a decrease in pCO2 results in what acid-base disorder?
- metabolic acidosis
- metabolic alkalosis
- respiratory acidosis
- respiratory acidosis
respiratory alkalosis
What is the best interpretation of the following results?
pH=7.28 (7.35-7.45)
CO2= 55 (35-45)
HCO3= 25 (22-29)
- respiratory acidosis w/ no compensation
- respiratory acidosis w/ full compensation
- metabolic acidosis w/ no compensation
- metabolic acidosis w/ full compensation
respiratory acidosis w/ no compensation
A patient with an HA1C of 12% would be most likely to have an estimated average glucose of:
- 97 mg/dL
- 140
- 212
- 298
298
A patient with a fasting glucose of 122 mg/dL would be considered to have a:
- normal fasting glucose
- impaired fasting glucose
- preliminary diabetes diagnosis
impaired fasting glucose
This type of diabetes is noted to have insulin resistance with an insulin secretory defect due to progressive loss of adequate beta cell insulin secretion.
- type 1a
- type 1b
- type 2
- gestational
type 2
An increase in H+ ions, a decrease in pH, and an increase in pCO2 results in what acid-base disorder?
- metabolic acidosis
- metabolic alkalosis
- respiratory acidosis
- respiratory alkalosis
respiratory acidosis
As a CSF is collected, it is placed in a series of tubes for analysis. The correct order of testing should be:
- chem, heme, micro
- cytology, heme, micro
- chem, micro, heme
- heme, micro, cytology
chem, micro, heme
Which is not stimulated by epinephrine?
- insulin
- glucagon
- glycogenolysis
- gluconeogenesis
insulin
what do alpha pancreatic cells produce
glucagon
what do beta pancreatic cells produce
insulin
what do delta pancreatic cells produce
somatostatin
Diabetic condition formed when a person’s own immune system destroys the islet cells of the pancreas, resulting in impaired production of insulin.
- type 1
- type 2
- gestational
type 1
It is recommended that all adults have a lipid profile performed every _____.
- 6 months
- 2 yrs
- 5 yrs
- 10 yrs
5 yrs
True or False
Women, on average, have higher HDL levels and lower total cholesterol and triglyceride levels than men.
true
HDL has a major role in this type of lipid pathway
- absorption pathway
- exogenous pathway
- endogenous pathway
- reverse cholesterol pathway
reverse cholesterol pathway
Which is the type of lipoprotein that contains the apolipoprotein Apo B48?
- HDL
- chylomicrons
- LDL
- Lp(a)
chylomicrons
True or False
Amphipathic lipid molecules contain both hydrophobic fatty acid chains and hydrophobic head groups.
false
Calculate the LDL from the following test results.
Total cholesterol: 223 mg/dL
HDL: 65 mg/dL
Triglycerides: 290 mg/dL
100
The function of the major lipid components of the very-low density lipoproteins is to transport:
- Cholesterol from the peripheral cells
- Cholesterol and phospholipids to peripheral cells
- Exogenous triglycerides
- Endogenous triglycerides
endogenous triglycerides
Turbidity in serum suggests elevation of:
- total protein
- albumin
- cholesterol
- chylomicrons
chylomicrons
Match the electrolytes with what happens to it in the renal tubules: Calcium
- reabsorbed under influence of PTH
- recovered from glomerular filtrate
- reabsorbed by passive transport in proximal tubule
- reabsorption in henele’s loop
reabsorbed under influence of PTH
Match the electrolytes with what happens to it in the renal tubules: bicarbonate
- reabsorbed under influence of PTH
- recovered from glomerular filtrate
- reabsorbed by passive transport in proximal tubule
- reabsorption in henele’s loop
recovered from glomerular filtrate
Match the electrolytes with what happens to it in the renal tubules: chloride
- reabsorbed under influence of PTH
- recovered from glomerular filtrate
- reabsorbed by passive transport in proximal tubule
- reabsorption in henele’s loop
Reabsorbed by passive transport in proximal tubule
Match the electrolytes with what happens to it in the renal tubules: Magnesium
- reabsorbed under influence of PTH
- recovered from glomerular filtrate
- reabsorbed by passive transport in proximal tubule
- reabsorption in henele’s loop
reabsorption in Henle’s loops
A rare disease of water and salt imbalance.
- type 1 diabetes
- diabetes insipidous
- type 2 diabetes
- gestational diebtes
diabetes insipidous
Of the total serum osmolality; sodium, chloride, and bicarb normally contribute what percent?
- 92
- 8
- 45
- 72
92
Match the ions to their charges: Anions and cations
anions - negative
cations - positive
What is the type of lipoprotein that is known to contribute to plaque formation.
- LDL
- VLDL
- HDL
- triglycerides
LDL
A patient presents to the ER with flushed skin, severe agitation, low-grade fever, and complaints of being extremely thirsty. Given these symptoms, what pathology would you consider?
- hypernatremia
- hyponatremia
- Hyperkalemia
- Hypokalemia
hypernatremia
Which of the following is not associated with an increase in anion gap when it occurs in a single patient?
- Renal failure
- Ketoacidosis
- Glycol poisoning
- instrument error
instrument error
Causes of increased levels of protein in CSF include all but:
- Decreased dialysis of proteins from the plasma
- Lysis of contaminant blood from traumatic tap
- Increased permeability of the epithelial membrane
- obstruction
Decreased dialysis of proteins from the plasma
In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what electrolyte?
- sodium
- potassium
- chloride
- phosphate
chloride
Of total serum calcium, free ionized calcium normally represents approximately what percent?
- 10
- 45
- 60
- 90
45
The presence of only slightly visible hemolysis will significantly increase the serum level of which of the following analytes?
- bicarb
- chloride
- potassium
- sodium
potassium
What is the major intracellular cation?
- chloride
- potassium
- sodium
- bicarb
potassium
What is the major extracellular cation?
- potassium
- chloride
- sodium
- bicarb
sodium
Calculate the anion gap using the following lab data.
Na: 135
K: 4.0
Cl: 94
HCO3: 28
17
True or False
Unsaturated triglycerides are typically solid at room temperature.
false
The cation is the fourth most abundant cation in the body and second most abundant intracellularly. Hint: Consumption of processed foods can lead to inadequate intake and subsequent deficiency.
- calcium
- magnesium
- potassium
- sodium
magnesium
- potassium is the most abundant cation intracellularly
- magnesium second, used as an enzyme cofactor
- sodium is the most abundant extracellular
- calcium is necessary for myocardial contractions, present in low concentrations
Given the following results, calculate the plasma osmolality:
Sodium: 135
Glucose: 96
BUN: 22
282
(2*Na)+(glucose/20)+(BUN/3)
Water makes up what percentage of body weight?
40-75%
Which phrase does not describe phospholipids.
- Hydrophobic head group
- Synthesized in all organs
- Amphipathic
- Unsaturated steroid alcohol
unsaturated steroid alcohol
Electrolyte essential for myocardial contraction and important to maintain normal levels for critically ill patients.
- chloride
- calcium
- sodium
- zinc
calcium
Calculate the osmol gap given the following information:
Sodium: 140
Glucose: 62
BUN: 35
Measured osmo: 300
5
what is the osmol determination calculation
(2*Na)+(glucose/20)+(BUN/3)
how do you calculate anion gap
[Na + K] - [Cl + HCO3]
how do you calculate LDL
LDL = total cholesterol - HDL - (trig/5)
equation for creatinine clearence
(urine creatinine/plasma creatinine) * (urine vol mL/ minutes) * (1.73/BSA)
What type of triglycerides are typically solid at room temperature
saturated
Glycated hemoglobin reflects the average glucose for what time period?
4-8 wks
- gives time for glycated RBC lvls to average out
