exam 3 Flashcards by whitney webb

what is the normal glucose concentration of serum?

80-100 mg/dl

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

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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list the order of mobility of serum proteins during an electrophoresis

albumin most rapid
A1
A2
beta fractions
gamma

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what does the biuret reagent specifically react with?

tripetides or larger chains

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

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

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what is the reference method for total protein determination?

kjelhdal’s method

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

dye-binding

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what SPE abnormality is seen in multiple myeloma?

monoclonal gammopathy (increase in gamma region)

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what SPE abnormality is seen in nephrotic syndrome?

decreased albumin

increased A2 and beta region

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

2/3

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in bacterial meningitis, what would be the expected results for CSF protein and CSF glucose

increased protein

decreased glucose

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what anticoagulant is used to prevent glycolysis

sodium fluoride

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ACTH

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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glucagon

alpha cells of the islets of langerhans

increases blood glucose levels by stimulating glycogenolysis and gluconeogenesis

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glucocorticoids

cortex of adrenal glands

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

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insulin

beta cells of the islets of langerhans

only one that decreases blood glucose levels

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epinephrine

adrenal medulla

acts to increase the blood glucose level by stimulating glycogenolysis

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

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

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what technique is used to identify patients with familial hyperlioproteinemia?

electrophoresis

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what are the normal values for albumin?

3.5-5.0 g/dl

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what are the normal values for globulin?

2.5-3.5 g/dl

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what are the normal values for total protein?

6.0-8.5 g/dl

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

electroendosmosis (EEO)

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what specific form of hemoglobin is used to monitor patient’s with Type 1 diabetes mellitus?

Hgb A1C

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how is globulin in serum routinely determined?

total protein minus albumin (calculated)

which fraction of lipoprotein contains the highest percentage of protein?

HDL

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

chylomicrons prebeta beta alpha

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

less than 200 mg/dl

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?

patient was not fasting

which lipoprotein fraction is responsible for post-prandial lipemia?

chylomicrons

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

fibrinogen spike in beta/gamma region

what is considered a desirable level of HDL?

greater than or equal to 40 mg/dl

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

less than 140 mg/dl

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

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

ascorbic acid bilirubin uric acid glutothione

what is the electrophoresis classification of HDL

high density lipoproteins (good lipids) | ALPHA

what is the electrophoresis classification of LDL

low density lipoproteins (bad lipids) | BETA

what is the electrophoresis classification VLDL

very low density lipoproteins | PREBETA

which lipoprotein has a protective effect against coronary artery disease?

HDL

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

apoprotein

what is the main function of lipoproteins in the body?

transport lipids through the blood stream

how would you interpret the GTT for diabetes mellitus?

glucose values start higher, rise higher, remain higher longer

how would you interpret the GTT for hypoglycemia?

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

how would you interpret the GTT for a normal patient?

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

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

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

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

3 hour oral GT

what is actually measured in the hexokinase method for glucose?

NADPH

what is the normal range for spinal fluid glucose?

40-70 mg/dl

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

12 hour fast

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

cupric ions react with peptide bonds to form a violet color | protein solutions treated with alkalinized copper sulfate

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

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

what is the most specific method for determining plasma cholesterol ?

cholesterol oxidase enzymatic reaction

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

apolipoprotein A1- associated with HDL

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

neimann-pick disease

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

tolbutamide

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

density

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

``` ponceau S amido black 10 B brophenol blue lissamine green coommassle blue ```

at what pH is routine SPE performed

8.6

what is gestational diabetes?

diabetic state due to metabolic and hormonal changes during pregnancy

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

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

what type of diabetes generally occurs in adults?

type 2

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

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

what dyes can be used for the detection of albumin?

methyl orange HABA BCG BCD

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

beta-gamma bridge (no separation)

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

flat line | IV GTT

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

glycosylated hemoglobin

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

glucose oxidase

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

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

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

75g

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

acetic anhydrase and sulfuric acid

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

specimens are taken at 4 and 5 hours

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

cholesterol | triglycerides

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

great

what is the most likely explanation of a milky serum?

called lipemic | increased chylomicrons

what enzyme catalyzes the hydrolysis of triglycerides?

lipase

what is the normal range for spinal fluid protein

15-45 mg/dl