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MLT 100 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

pH reference range

A

normal: 7.35
acidosis: <7.35
Alkalosis: >7.35

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2
Q

pCO2 reference range

A

normal: 35-45 mmHg

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3
Q

pO2 reference range

A

80-100 mmHg

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4
Q

HCO3 reference range

A

22-26 mmol/L

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5
Q

HCO3 : H2O2

A

20:1

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6
Q

pH/HCO3/H2CO3 equation (HH)

A

ph=pka + log (HCO3/pCO2*0.0301)

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7
Q

pH measurement

A

Glass membrane

H+ exchange causing potential to develop

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8
Q

pCO2 measurement

A

Serveringhaus electrode

pH buffer lowered in presence of CO2 (proportional)

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9
Q

pO2 measurement

A

Clark electrode

change in electrical current occurs as O2 diffuses from blood

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10
Q

HCO3/H2CO3 buffer

A

CO2 + H2O are converted into H2CO3 by carbonic anhydrase which is broken down into H+ and HCO3-

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11
Q

HCO3 decrease (pH)

A

pH decreases

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12
Q

HCO3 increase (pH)

A

pH increase

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13
Q

Hyperventilation

A

CO2 removed, pH increase

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14
Q

Hypoventilation

A

CO2 retained, pH decrease

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15
Q

Metabolic acidosis

A

Decreased pH
Decreased pCO2
Decreased HCO3
Diabetes

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16
Q

Metabolic alkalosis

A

pH increased
pCO2 increased
HCO3 increased
Vomiting

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17
Q

Respiratory acidosis

A

Decreased pH
Increased pCO2
Increased HCO3
Emphysema

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18
Q

Respiratory alkalosis

A

Increased pH
Decreased pCO2
Decreased HCO3
Hyperventilation

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19
Q

Metabolic Acidosis (increased AG)

A

Ketoacidosis
Lactic acid
Toxic ingestion of aspirin
ethylene glycol

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20
Q

Metabolic Acidosis (normal AG)

A

renal diseases

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21
Q

Metabolic Acidosis (MUDPILES)

A 
Methanol
Uremia
Diabetes
Paraldehyde 
Isoniazid
Lactic acidosis 
Ethylene glycol
Salicylate toxicity
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22
Q

metabolic alkalosis causes

A

base excess
cushing’s disease
vomitting

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23
Q

full compensation

A

20:1 balance bicarb/carbo

pH normal

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24
Q

partial compensation

A

balance off

pH normal or approaching

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25
Q

uncompensated

A

pH off

compensatory mechanism is still normal

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26
Q

specimen collection (ABG)

A

arterial blood
radial
STAT
heparin syringe

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27
Q

bubbles in syringe (ABG)

A

increased pH
decreased pCO2
increased pO2

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28
Q

Syringe at room temp (ABG)

A

decreased pH
increased pCO2
decreased pO2

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29
Q

glycolysis (ABG)

A

decreased pH, pO2

increased pCO2

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30
Q

pH and temperature

A

per 1 degree rise pH decreased 0.015

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31
Q

Amount of O2 bound to Hemoglobin

A

availability of O2
fever
type of hemoglobin
pH

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32
Q

Alkalosis (Hemoglobin)

A

O2 readily bound to hemoglobin

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33
Q

Acidosis (hemoglobin)

A

O2 will not bind to hemoglobin

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34
Q

Function of Lipids

A

energy
hormone precursors
cell membranes
insulators

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35
Q

fatty acids

A

linear chain of C-H bonds

part of triglycerides/phospholipids

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36
Q

Saturated fatty acids

A

contain CH3 without double bonded C-C atoms

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37
Q

Monounsaturated fatty acids

A

one double bond

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38
Q

polyunsaturated fatty acids

A

more than one double bond

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39
Q

triglycerides

A

3 fatty acids and glycerol
synthesized by body
hydrophobic

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40
Q

phospholipids

A

2 fatty acids
hydrophillic/hydrophobic
cell membranes
synthesized in liver

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41
Q

cholesterol

A

produced in liver from acetyl-CoA (500-1000mg)

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42
Q

dietary cholesterol recommendation

A

<300 mg / day

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43
Q

cholesterol functions

A

cell membranes
precursor to steroids
conversion of bile acids
not a fuel source

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44
Q

cholesteryl esters

A

hydrophobic

center of lipid drops/lipoproteins

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45
Q

lipoproteins

A

lipids+proteins

Transportation of insoluble fats through blood

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46
Q

apolipoprotein

A

outer layer of proteins around lipid drop

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47
Q

large lipoprotein

A

increased lipid

decreased density

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48
Q

small lipoprotein

A

increased protein

increased density

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49
Q

chylomicron

A

largest/least dense lipoprotein
high % triglycerides
produced in intestines
VLDL, LDL, HDL

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50
Q

chylomicron function

A

transport dietary fat to adipose/muscle cells

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51
Q

chylomicron specimen

A

creamy layer upon plasma
reflect light
cause turbidity

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52
Q

VLDL

A

-Very Low Density Lipoproteins

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53
Q

LDL

A

-Low Density Lipoprotein

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54
Q

VLDL function

A

endogenous triglycerides to adipose tissue

made by liver

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55
Q

LDL function

A

transport cholesterol from liver to cells

bad cholesterol

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56
Q

few LDL receptors

A

blood cholesterol rises, excess deposited into arteries

57
Q

HDL

A

High Density Lipoprotein

58
Q

HDL function

A

transport cholesterol from peripheral tissue TO the liver, to be incorporated into bile salts
“scavenger of excess cholesterol”

59
Q

Friedwald

A

LDL=Tot - HDL - (tri/5)

60
Q

HDL reference range

A

good: >60 mg/dl
okay: 40-59 mg/dl
bad: <40 mg/dl

61
Q

Cholesterol range

A

140-200 mg/dl

62
Q

LDL range

A

50-130 mg/dl

63
Q

triglyceride range

A

60-150 mg/dl

64
Q

Non-HDL calculation

A

130 mg/dl
good predictor of heart disease
no fasting
counts LDL and VLDL

65
Q

Apo A-I

A

Major protein on HDL

66
Q

Apo B

A

protein on LDL, VLDL, chylomicrons

100: LDL, associated with CVD
48: chylomicrons

67
Q

Apo C

A

Breakdown triglycerides

68
Q

Lipid absorption

A

Micelles contact membranes of intestinal cells, enter circulation, picked up by albumin and taken to liver

69
Q

micelles

A

lipid aggregates with bile acids

70
Q

pancreatic lipase

A

cuts off fatty acids and converts to more polar compounds (amphipathic)
form micells

71
Q

exogenous pathway

A

transport of dietary lipids

Chylomicron remnants taken up by liver, broken down by lysosomal enzymes

72
Q

released from exogenous pathways

A

fatty acids, free cholesterol, amino acids

73
Q

endogenous pathway

A

transport of hepatic derived lipids

74
Q

VLDL endogenous pathway

A

loses core lipids, converts to remnants, half are converted to LDL, half are taken in by liver

75
Q

Reverse cholesterol transport

A

HDL
excess cholesterol transported to liver. Cholesteryl esters to chylomicrons. VLDL to liver.
Conversion of cholesterol into bile acids

76
Q

Thyroxine/Cholesterol

A

Hypothyroid: hyper cholesterol
Hyperthyroid: hypocholesterol

77
Q

Estrogen/Cholesterol

A

Post-menopausal: increased LDL

78
Q

Pregnancy/cholesterol

A

Increased cholesterol

79
Q

Arteriosclerosis

A

Deposition of lipids in artery walls

80
Q

Hyperlipoproteinemia

A

Elevated lipoproteins

81
Q

Hypercholesterolemia

A

Linked to heart disease

Lacking/deficient LDL receptors (LDL build up)

82
Q

Hypercholesterolemia symptoms

A

heart attacks
xanthomas
300-1000mg/dl

83
Q

Hypertriglyceridemia

A

imbalance between synthesis and clearance of VLDL.
deficience of apo-C and LPL
can cause pancreatitis

84
Q

Hypertriglyceridemia/hormones

A

hormones trigger lipase

insulin, glucagon, GH, ACTH, thyrotropin, epinephrine, norepinephrine

85
Q

Hypolipoproteinemia

A

Low lipoproteins,

decrease in HDL

86
Q

Disease/Hypolipoproteinemia

A

Tangier disease

87
Q

Metabolic syndrome

A 
increased trig. 
obesity. 
high blood pressure. 
low HDL. 
Glucose intolerance.
88
Q

Elevated lipid treatment

A

Treat secondary cause first (i.e diabetes)
treat by exercise/diet
drug treatment (statins)

89
Q

Lipid analysis specimen collection

A

Serum

Fasting

90
Q

Cholesterol testing

A

Cholesterol oxidase coupled reaction

91
Q

NCEP ranges

A

Tot. Cho: <200 mg/dl
Trig: <150 mg/dl
LDL: <100 mg/dl
HDL: >40 mg/dl

92
Q

3 major renal functions

A

Glomerular filtration
Tubular reabsorption
Tubular secretion

93
Q

Nonprotein Nitrogen Compounds

A

Products of catabolism of proteins and nucleic acids

94
Q

Major Non-protein Nitrogen Analytes

A

Urea
Uric Acid
Creatinine
Ammonia

95
Q

BUN origin

A

Formed in liver when ammonia is removed and combined with CO2

96
Q

BUN reference range

A

Plasma/Serum: 6-20 mg/dl

24h Urine: 12-20 g/d

97
Q

BUN Clinical sig

A

Evaluation of renal function
Hydration
Nitrogen balance
Dialysis

98
Q

BUN/Glomerular function

A

Increased BUN = decreased glom. function

99
Q

Azotemia

A

elevated urea concentration

100
Q

Uremia

A

increased urea accompanied by renal failure

101
Q

BUN/Creatinine Ratio

102
Q

Prerenal azotemia

A 
Congestive heart failure
Shock
Burns 
Increased protein 
Dehydration
103
Q

Renal azotemia

A

Disease of nephron

ex. glomerulonephritis, nephrotic syndrome

104
Q

Post renal azotemia

A

Obstruction to urine outflow

ex. kidney stones

105
Q

Prerenal Azotemia ratio

A

Elevated BUN
Elevated ratio
Normal creatinine

106
Q

Renal Azotemia ratio

A

Normal ratio
Elevated BUN
Elevated creatinine

107
Q

Post renal azotemia ratio

A

Elevated BUN
Elevated ratio
Elevated creatinine

108
Q

Decreased BUN/ low ratio

A

Decreased protein
Liver disease
Tubular necrosis
Dialysis

109
Q

Specimen collection BUN

A

Plasma, Serum, Urine

110
Q

BUN methodology

A

Urease catalyzes urea and produced ammonia

111
Q

Uris Acid formation

A

Product of catabolism of nucleic acids

majority reabsorbed by glomerulus

112
Q

Uric Acid clinical significance

A 
Gout
Purine metabolism 
Renal calculi 
Chemotherapy 
kidney dysfunction
113
Q

Uric acid reference range

A

Men: 3.5-7.2 mg/dl
Women: 2.6-5.5 mg/dl
Child: 2.0-5.5 mg/dl

114
Q

Gout

A

Uric acid crystals
older males
Monosodium urate: >6.0 mg/dl

115
Q

Hyperuricemia

A

Gout
Purine-rich diet
Chronic renal disease

116
Q

Hyperuricemia disease

A

Lesch-Nyhan syndrome

117
Q

Hypouricemia

A

Hepatocellular disease
Fanconi syndrome
<2.0 mg/dl

118
Q

Uric Acid specimen collection

A
  • Plasma
  • Serum removed ASAP
  • Urine
119
Q

Uric Acid Methedology

A

Uricase method

Caraway method

120
Q

Uric acid interferences

A

hemolysis
bilirubin
Vitamin C
Decrease results

121
Q

Creatinine formation

A

Creatine in muscle loses phosphoric acid and water

122
Q

Creatinine (Plasma)

A

Inversely related to glomerular filtration rate

123
Q

Creatinine advantages

A

Formed at constant rate
Identify fluid as urine

kidney function before cat scan

124
Q

Creatinine clinical significance

A

renal function/kidney damage

–> increased creatinine = decreased GFR

125
Q

Creatine clinical significance

A

increased associated with muscle disease

126
Q

Creatinine specimen collection

A

plasma/serum

24 h urine

127
Q

Specimen requirements Creatinine

A

Avoid hemolysis/icterus

128
Q

Creatinine methedology

A

Jaffe: creatinine reacts with picric acid (red-orange)
Kinetic Jaffe: picrate
enzymatic: creatinase

129
Q

Creatinine clearance reference ranges

A

Males: 97-137 ml/min
Females: 88-128 ml/min

130
Q

Creatinine disadvantages

A
  • 24 h collection
  • correction
  • drugs inhibit secretion
  • elevated blood levels increase creatinine
  • bacterial breakdown
131
Q

GFR/Creatinine

A

Decerased GFR = Increased serum creatinine

132
Q

Ammonia formation

A

Breakdown of amino acids

Bacterial metabolism

133
Q

Ammonia disease

A

Reye’s syndrome
Renal failure
Liver disease

134
Q

Ammonia reference range

A

Adult: 19-60 ug/dl
Child: 68-136 ug/dl

135
Q

Ammonia specimen collection

A 
Whole blood
-EDTA, Heparin 
STAT
no tourniquet 
on ice
136
Q

Ammonia error

A

No smoking prior to collection

137
Q

Ammonia methodology

A

Glutamate dehydrogenase

138
Q

eGFR advantages

A

indicate impaired renal function

139
Q

eGFR disadvantages

A

GFR can remain normal until extensive kidney damage has occured

MLT 100 (2 decks)

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