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clinical chemistry > exam 3 > Flashcards

exam 3 Flashcards

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1
Q

what is the normal 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 
refrain from smoking
no exercising
no eating
normal-high carb intake 3 days prior
done in the morning
fasting for 10 hours but no more than 16 hours
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3
Q

list the order of mobility of serum proteins during an electrophoresis

A 
albumin most rapid
A1
A2
beta fractions
gamma
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4
Q

what does the biuret reagent specifically react with?

A

tripetides or larger chains

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5
Q

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

A

it lacks the sensitivity to detect the low levels of protein in these specimens

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6
Q

what is the reference method for total protein determination?

A

kjelhdal’s method

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7
Q

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

A

dye-binding

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8
Q

what SPE abnormality is seen in multiple myeloma?

A

monoclonal gammopathy (increase in gamma region)

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9
Q

what SPE abnormality is seen in nephrotic syndrome?

A

decreased albumin

increased A2 and beta region

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10
Q

glucose in CSF is approximately ____ of the amount of glucose in the blood

A

2/3

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11
Q

in bacterial meningitis, what would be the expected results 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

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13
Q

ACTH

A

anterior pituitary

increase blood glucose levels by inhibiting glucose uptake by the tissues and increased output of glucose by the liver

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14
Q

glucagon

A

alpha cells of the islets of langerhans

increases blood glucose levels by stimulating glycogenolysis and gluconeogenesis

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15
Q

glucocorticoids

A

cortex of adrenal glands

increase blood glucose level by increasing gluconeogensis and inhibits glucose metabolism in peripheral tissues

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16
Q

insulin

A

beta cells of the islets of langerhans

only one that decreases blood glucose levels

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17
Q

epinephrine

A

adrenal medulla

acts to increase the blood glucose level by stimulating glycogenolysis

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18
Q

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

A

remove hydrogen from G-6-P and gives to NADP

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19
Q

what technique is used to identify patients with familial hyperlioproteinemia?

A

electrophoresis

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20
Q

what are the normal values for albumin?

A

3.5-5.0 g/dl

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21
Q

what are the normal values for globulin?

A

2.5-3.5 g/dl

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22
Q

what are the normal values for total protein?

A

6.0-8.5 g/dl

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23
Q

what phenomenon causes 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 patient’s with Type 1 diabetes mellitus?

A

Hgb A1C

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25
Q

how is globulin in serum routinely determined?

A

total protein minus albumin (calculated)

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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
prebeta
beta
alpha

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28
Q

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

A

less than 200 mg/dl

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29
Q

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

A

patient was 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

32
Q

what is considered a desirable level of HDL?

A

greater than or equal to 40 mg/dl

33
Q

what is the value for a normal two-hour post-prandial glucose?

A

less than 140 mg/dl

34
Q

in a normal glucose tolerance curve, the plasma glucose level returns to a normal fasting level in ____ hours

A

3

35
Q

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

A

ascorbic acid
bilirubin
uric acid
glutothione

36
Q

what is the electrophoresis classification of HDL

A

high density lipoproteins (good lipids)

ALPHA

37
Q

what is the electrophoresis classification of LDL

A

low density lipoproteins (bad lipids)

BETA

38
Q

what is the electrophoresis classification VLDL

A

very low density lipoproteins

PREBETA

39
Q

which lipoprotein has a protective effect against coronary artery disease?

A

HDL

40
Q

a protein isolated from a lipoprotein which is also affiliated with certain lipoproteins is referred to as _____

A

apoprotein

41
Q

what is the main function of lipoproteins in the body?

A

transport lipids through the blood stream

42
Q

how would you interpret the GTT for diabetes mellitus?

A

glucose values start higher, rise higher, remain higher longer

43
Q

how would you interpret the GTT for hypoglycemia?

A

glucose values appear normal at 3 hours and falls low at 4-5 hours and they start lower

44
Q

how would you interpret the GTT for a normal patient?

A

fasting they have a normal value

1 hour they become slightly elevated and starts coming back down at 2 hours and is normal by 3 hours

45
Q

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

A

because protein concentrations are so low they need to be 100 % concentrated

46
Q

patients with borderline blood glucose levels are most often further tested by performing a ____

A

3 hour oral GT

47
Q

what is actually measured in the hexokinase method for glucose?

A

NADPH

48
Q

what is the normal range for spinal fluid glucose?

A

40-70 mg/dl

49
Q

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

A

12 hour fast

50
Q

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

A

cupric ions react with peptide bonds to form a violet color

protein solutions treated with alkalinized copper sulfate

51
Q

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

A

normal diet for 2 weeks prior to testing
no medication use that affects lipids
fasting
testing deferred for 2 months following AMI , major surgery , serious illness

52
Q

what is the most specific method for determining plasma cholesterol ?

A

cholesterol oxidase enzymatic reaction

53
Q

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

A

apolipoprotein A1- associated with HDL

54
Q

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

A

neimann-pick disease

55
Q

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

A

tolbutamide

56
Q

ultracentrifugation separates lipoproteins into various categories based on the physical property of _____

A

density

57
Q

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

A 
ponceau S
amido black 10 B
brophenol blue
lissamine green
coommassle blue
58
Q

at what pH is routine SPE performed

A

8.6

59
Q

what is gestational diabetes?

A

diabetic state due to metabolic and hormonal changes during pregnancy

60
Q

what is meant by the term renal threshold? what is the renal threshold for glucose?

A

level of glucose in the blood above which glucose will “spill over” into the urine
160-180 mg/dl

61
Q

what type of diabetes generally occurs in adults?

A

type 2

62
Q

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

A

l/s ratio needs to be 2 to signify lung maturity
PG
phospholipid levels

63
Q

what dyes can be used for the detection of albumin?

A

methyl orange
HABA
BCG
BCD

64
Q

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

A

beta-gamma bridge (no separation)

65
Q

what would be the expected shape of a GTT curve if the patient has malabsorption syndrome? what test should be done instead?

A

flat line

IV GTT

66
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

glycosylated hemoglobin

67
Q

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

A

glucose oxidase

68
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

the RBC will reduce serum glucose levels by 7% each hour

69
Q

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

A

75g

70
Q

what reagent is used for color development in the livermann-burchard reaction

A

acetic anhydrase and sulfuric acid

71
Q

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

A

specimens are taken at 4 and 5 hours

72
Q

b-lipoproteins contain a high percentage of ____ while pre-b-lipoproteins contain a high percentage of ____

A

cholesterol

triglycerides

73
Q

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

A

great

74
Q

what is the most likely explanation of a milky serum?

A

called lipemic

increased chylomicrons

75
Q

what enzyme catalyzes the hydrolysis of triglycerides?

A

lipase

76
Q

what is the normal range for spinal fluid protein

A

15-45 mg/dl

clinical chemistry (5 decks)

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