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clinical chemistry > Exam 3 > Flashcards

Exam 3 Flashcards

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1
Q

what is the normal fasting glucose concentration of serum?

A

80-100 mg/dl

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2
Q

what are some of the requirements that must be adhered to during an oral GTT?

A

fast at least 10 hrs no more than 16
morning time
no eating drinking smoking
normal to high carbohydrate intake 3 days prior

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3
Q

list the order of mobility of serum proteins during an electrophoresis

A

most rapid: Albumin
slowest: gamma globulin
albumin-alpha1-alpha2-beta-gamma

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4
Q

why can the biuret method NOT be used for determining CSF or urine protein?

A

lacks sensitivity and can not detect low levels of protein

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5
Q

what does the biuret reagent specifically react with?

A

tripeptides or larger

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6
Q

what is the reference method for total protein determination?

A

Kjedahl

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7
Q

what method for measuring albumin is most commonly used in automated instruments?

A

dye binding method

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8
Q

what SPE abnormality is seen in multiple myeloma?

A

gamma globulin (increased)

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9
Q

what SPE abnormality is seen in nephrotic syndrome?

A

alpha 2 globulin and beta (increased)

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10
Q

glucose in CSF is approximately what amount of glucose in the blood?

A

2/3

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11
Q

in bacterial meningitis, what would be the expected results (increased or decreased) for CSF protein and CSF glucose?

A

increased protein

decreased glucose

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12
Q

what anticoagulant is used to prevent glycolysis?

A

sodium fluoride (gray top)

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13
Q

what is the action on ACTH on blood glucose levels?

A

increase

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14
Q

what is the action on Glucagon in blood glucose levels?

A

increase

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15
Q

what is the action of glucocorticoids in blood glucose levels?

A

increase

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16
Q

what is the action of insulin in blood glucose levels?

A

decrease

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17
Q

what is the actio of epinephrine in blood glucose levels?

A

increase (fight or flight)

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18
Q

what is the action of the enzyme glucose-6-phophate dehydrogenase?

A

removes hydrogen from glucose-6-phophate and gives it NADP

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19
Q

what technique is used to identify patients with familial hyperlipoproteinemia?

A

electrophoresis

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20
Q

what is the normal value for albumin?

A

3.5-5.0

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21
Q

what is the normal value for globulin?

A

2.5-3.5

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22
Q

what is the normal value for TP?

A

6.0-8.5

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23
Q

what phenomenon causs the gamma globulins to move toward the cathode in SPE, even though they are negatively charged?

A

electroendosmosis (EEO)

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24
Q

what specific form of hemoglobin is used to monitor patients with type 1 diabetes mellitus?

A

A1C

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25
Q

how is globulin in serum routinely determined?

A

TP-albumin

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26
Q

which fraction of lipoprotein contains the highest percentage of protein?

A

HDL

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27
Q

what is the order of migration, beginning at the origin, of lipoproteins?

A

chylomicrons
pre-beta
beta
alpha

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28
Q

what is the desirable level of total cholesterol in the serum?

A
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29
Q

what would be the most likely explanation if a patients laboratory results indicated elevated total cholesterol and triglyceride levels but a normal lipoprotein pattern?

A

patient is not fasting

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30
Q

which lipoprotein fraction is responsible for post-prandial lipemia?

A

chylomicrons

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31
Q

if plasma is used instead of serum for electrophoresis, what change will be observed?

A

fibrinogen spike in beta gamma region

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32
Q

what dyes can be used for the detection of albumin?

A

bromcresol green (BCG)
bromcresol purple
methyl orange
HABA

33
Q

what is considered to be the desirable level of HDL?

A

> or = to 40 mg/dl

34
Q

what is the value for noraml two hour post prandial glucose?

A
35
Q

in a normal glucose tolerance curve, the plasma glucose level returns to a normal fasting level in how many hours?

A

3 hours

36
Q

name 4 blood constituents that can produce a falsely decreased cholesterol level due interference with the enzymatic cholesterol assay

A

uric acid
ascorbic acid
bilirubin
glutathione

37
Q

what is the electrophoretic classification of HDL?

A

alpha

38
Q

what is the electrophoretic classification of LDL?

A

beta (bad cholesterol, 2/3 of plasma cholesterol)

39
Q

what is the electrophoretic classification of VLDL?

A

prebeta

40
Q

which lipoprotein has a protective effect against coronary artery disease?

A

HDL

41
Q

a protein isolated from a lipoprotein which is also affiliated with certain lipoproteins is what?

A

apoproteins

42
Q

what is the main function of lipoproteins in the body?

A

transport of body lipids throughout blood stream.

43
Q

GTT for diabetes mellitus

A

elevated after 3 hours
start high end high
takes longer to return to normal

44
Q

GTT for hypoglycemia

A

lower than normal after 3 hours

normal than falls to below fasting levels

45
Q

GTT for normal

A

return to normal fasting levels in 3 hours

46
Q

why is the performance of electrophoresis on CSF more difficult than SPE?

A

concentration level is too low

concentrate is 100x

47
Q

patients with borderline blood glucose levels are most often further tested by using what?

A

3 hr oral GTT

48
Q

what is acually measured in the hexokinase method for glucose?

A

NADPH

49
Q

what is the normal range for spinal fluid glucose?

A

40-70 mg/dl

50
Q

what period of fasting is required for patients for whom the doctor has ordered lipid panels?

A

12 hrs min

51
Q

what is the reaction that takes place during the biuret procedure?

A

cupric ions with peptide bonds (violet color)

a very dilute solution of ionized copper sulfate

52
Q

what precautions must be taken prior to collecting a specimen for lipid analysis?

A

12 hr fasting
2 week normal diet
no meds that affect lipids
defer 2 months after surgery,Mi or serious illness

53
Q

what is the most specific method for determining plasma cholesterol?

A

cholesterol oxidase enzymatic reaction

54
Q

what protein when found in increased amounts, lowers the risk of coronary heart disease?

A

apolipoprotein A1

55
Q

what is the only diagnostic purpose of performing a phospholipid measurement?

A

Neiman pick disease

56
Q

what unusual electrophoretic serum protein pattern is seen in cirrhosis of the liver?

A

beta gamma bridge

57
Q

what would be exected shape of a GTT curve if the patient has malabsorption syndrome?

A

no change in curve due to absorption (flat line)

to resolve do IV GTT

58
Q

what test may be used to assess the average plasma glucose level that a patient has maintained during a previous 2-3 month period?

A

glycosulated hemoglobin ( to which A1C belongs)

59
Q

the enzyme that causes the release of H2O2 when it reacts with glucose is?

A

glucose oxidase

60
Q

what would happen to the glucose in a blood specimen if it was drawn in a clot tube and was left uncentrifuged at room temperature?

A

decrease by 7 mg/dl per hr

61
Q

the amount of glucose which is used in an adult GTT test

A

75g

62
Q

what reagent is used for color development in the libermann-aburchard reaction?

A

combination of acetic anhydride sulfuric acid and acetic acid

63
Q

what adjustment is made to an OGTT if hypoglycemia is suspected?

A

additional testing at 4 and 5 hrs

64
Q

beta lipoproteins contain a high percentage of _______

A

cholesterol

65
Q

pre-beta lipoproteins contain a high percentage of ________

A

triglycerides

66
Q

how would a physician view the prognosis of a patient with an elevated HDL level?

A

good not at risk.

patient protected from athrosclerosis

67
Q

what is the most likely explanation of a mily serum?

A

increased chylomicrons

68
Q

what enzyme catalyzes the hydrolysis of triglycerides?

A

lipase (LPL)

69
Q

what is the normal range for spinal fluid protein?

A

15-45

70
Q

what compound is used to stimulate the pancreas to produce insulin?

A

tolbutamide for detection of insulinomas

71
Q

ultracentrigation seperates lipoproteins into various categories based on the physical property of ________

A

density

72
Q

what stains can be used to stain the protein bands obtains from SPE?

A 
ponceau S
amino black 10 B
bromphenol blue
lissamine green
coommassie blue
73
Q

at what pH is rountine SPE performed?

A

8.6

74
Q

what is gestational diabetes?

A

diabetes during pregnancy

75
Q

what is meant by the term renal threshold?

A

how much glucose the blood can hold before spilling over into the urine

76
Q

what is the renal threshold for glucose?

A

160-180 mg/dl

77
Q

what type of diabetes generally occurs in adults?

A

type 2

78
Q

name a test that can be used to determin the risk of RDS in newborns?

A

L/S ratio

clinical chemistry (4 decks)

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