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clinical chemistry > exam 4 > Flashcards

exam 4 Flashcards

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1
Q

what is the substance for the enzyme aspartate amino transferase (AST)

A

aspartate

alpha ketoglutamic acid

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2
Q

creatinine is formed from the breakdown of what

A

creatine

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3
Q

PSP is removed from the blood by what

A

kidneys

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4
Q

what is the principle of the Berthelot reaction and what substances can cause falsely elevated values in the reaction?

A

hydrolysis of urea to ammonium carbonate by enzyme urease ammonia. ammonium reacts with phenol and sodium hypochlorite to form a BLUE colored indophenol. Sodium nitroprusside serves as the catalyst

ammonium, lipemia, icteric specimens

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5
Q

increased ALT values are associated with dieases of the what

A

liver

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6
Q

what is the normal values for serum AST at 37 C

A

5-35 IU/L

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7
Q

which anticoagulant should NOT be used for urease testing?

A

sodium fluoride

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8
Q

what is the normal percentage for the CK-MB isoenzyme?

A

less than 6%

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9
Q

what reagent is used in the measurement of uric acid?

A

phosphotungstic acid

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10
Q

creatinine clearance is used to assess the rate of what

A

glomerular filtration

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11
Q

creatinine clearance formula

A

CrCl= (UaVu) / (PaT)

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12
Q

what additional information must be known for the CrCl formula if the patient is a infant, young child, or adolescent

A

body surface area

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13
Q

what is the most common endogenous substance used to assess the glomerular filtration rate

A

creatinine

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14
Q

what is the most common exogenous substance used to assess the glomerular filtration rate

A

inulin

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15
Q

serum creatine kinase is most often elevated in diseases of what?

A

muscle tissue

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16
Q

serum lipase levels are elevated in diseases of what?

A

pancreas

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17
Q

Diacetyl Monoxime reacts with ____ to produce a yellow product.

A

urea

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18
Q

what is uremia?

A

retention of urea and abnormal substances in the blood

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19
Q

what is the normal value for CK in males at 37 C

A

15-160 IU/L

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20
Q

name three ways that can be used in the laboratory to measure the rate of an enzymatic reaction and give the general term that can be applied to two of the three methods

A

multiple point assay
continuous monitoring method

both called kinetic

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21
Q

define international unit (IU)

A

catalyzes one micromole (umol)/ minute of substrate

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22
Q

what is the peak absorbance of reduced NAD (NADH)?

A

340 nm

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23
Q

the jaffe reaction is used to measure what?

A

creatinine

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24
Q

which non-protein nitrogen component compromises the largest fraction of NPN in the blood?

A

urea

BUN

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25
Q

which enzyme is useful in the detection of insecticide poisoning?

A

pseudocholinesterase

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26
Q

low levels of which enzyme can cause a patient to be susceptible to prolonged apnea when exposed to certain types of anesthesia?

A

pseudocholinesterase

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27
Q

increased levels of LD-4 and LD-5 are associated with what?

A

liver/ acute hepatic disease

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28
Q

Gout is caused by the deposition of what in joints and other tissues

A

uric acid

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29
Q

what is the clinical significance of a mildly elevated ALP in a teenager?

A

no clinical significance

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30
Q

what is the normal ratio of BUN to creatinine?

A

10:1 - 15:1

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31
Q

what enzyme is normally elevated during pregnancy?

A

alkaline phosphatase

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32
Q

L-tartrate is used in the specific assay of which enzyme?

A

prostatic acid phosphatase

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33
Q

which isoenzyme is detectable within 4-6 hours after a MI?

A

CK-2 or CK-MB

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34
Q

retention of BSP can be used to measure what function?

A

liver

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35
Q

what substrate and coenzyme are required to measure ammonia?

A

alpha ketoglutarate

NADH

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36
Q

what is the main way that ammonia levels are kept within normal limits?

A

synthesis of urea in the liver

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37
Q

Amylase is an enzyme that breaks down what?

A

starch

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38
Q

why should hemolyzed specimens NOT be used for acid phosphatase?

A

RBC contain acid phosphatase levels increase

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39
Q

acid phosphatase is primarily associated with diseases of what

A

prostate

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40
Q

what is the proper treatment of serum to be assayed for ACP?

A

acidified to a pH below 6

41
Q

what is the substrate for alkaline phosphatase methods of analysis?

A

para-nitrophenolphosphase

42
Q

in the urease method, urea is converted to what?

A

ammonium carbonate

43
Q

increased levels of serum alkaline phosphatase can indicate diseases of what?

A

bone or the liver

44
Q

the enzyme responsible for the reversible oxidation of lactic acid to pyruvic acid is what?

A

LD

lactase dehydrogonase

45
Q

in the creatine kinase reaction what is converted?

A

ATP to ADP

46
Q

what is the end product or purine metabolism in man?

A

uric acid

47
Q

serum amylase might be expected to be increased in diseases of the what?

A

pancreas and salivary glands

48
Q

which enzyme can be used to establish the presence of semen?

A

acid phosphatase

49
Q

phenylketonuria (PKU) results from a deficiency in which enzyme?

A

phenylalanine hydroxylase

50
Q

what is the substrate for the enzyme alanine aminotransferase (ALT)

A

alanine

alpha-ketoglutamic acid

51
Q

what is the source of urease used in enzymatic methods for the determination of BUN

A

jack bean meal

52
Q

what precaution must be taken with specimens to be used for blood ammonia determinations?

A

avoid ammonia forming in vitro
placed on ice
correct tube
plasma tested within 15 minutes

53
Q

what is the correct order of migration of the creatine kinase (CK) isoenzymes starting with the slowest?

A

CK-MM
CK-MB
CK-BB

54
Q

what is(are) the substrate(s) for amylase in the dye-labeled substrate method?

A

starch & dye

55
Q

in the creatinine method, a color develops when creatinine combines with what

A

alkaline picrate

56
Q

the major isoenzymes of lactate dehydrogenase come from the what?

A

heart and liver

57
Q

what is the principle of the enzymatic method for measurement of ammonia?

A

change in absorbance at 340 nm uses enzyme glutamate dehydrogenase and the substrate alpha-ketoglutarate & the reaction is followed by decreased absorbance @ 340 nm as NADPH is converted to NADP

58
Q

strenuous exercise can cause an elevated what

A

CK

59
Q

what causes the BSP dye to turn from colorless to colored?

A

alkali medium

60
Q

what would hemolysis do to the results of a lactate dehydrogenase (LD) measurement?

A

elevates results

61
Q

how are the results of LD measurement affected if the specimen is frozen?

A

falsely decreased

62
Q

what test can differentiate between liver and bone origin of an elevated alkaline phosphatase?

A

GGT

63
Q

what is the best anticoagulant to use for plasma specimens to be tested for LD

A

heparin

64
Q

what is the order of migration for the isoenzymes of alkaline phosphatase

A

liver fastest
bone
placenta
intestinal

65
Q

what is the characteristic change in the isoenzyme of LD that is seen in MI?

A

LD 1 is greater than LD 2

66
Q

creatinine excretion correlates best with what

A

muscle mass

67
Q

which enzyme is the first to become elevated following a MI?

A

CK-MB

68
Q

aspartate amino transferase is elevated in diseases of what

A

heart

69
Q

for how long and at what temperature should specimens for LD be stored

A

2-3 days at room temperature

70
Q

in the performance of a creatinine clearance, when should the specimen for serum creatinine be collected in relation to the collection of the urine?

A

midway through urine collection NOT longer than 24 hours before or after collection

71
Q

what enzyme can be used in the detection of alcoholism and in the monitoring of patients in alcohol treatment centers

A

GGT

72
Q

what is the normal value for prostatic acid phosphatase

A

less than 2.1 ng/ml

73
Q

why are creatinine levels in the serum not a good indicator of early renal damage?

A

values are not above the upper limit of normal until 1/2 to 2/3 of renal function is abnormal

74
Q

what is the composition of Nessler’s reagent and for what test is it used?

A

double iodide of potassium/mercury

BUN

75
Q

which has more liver specificity, alanine aminotrasnferase (ALT) or aspirate amintoranferase (AST)

A

ALT is more specific

AST is for the heart

76
Q

in which organs is the activity of creatine kinase (CK) the greatest

A

brain
heart
skeletal muscle

77
Q

what is the main factor that determines how much the level of an enzyme in serum increases?

A

extent

severity of damage to its tissues or cells of origin

78
Q

how does progressive muscular dystrophy affect AST and ALT levels

A

increases AST and ALT levels

79
Q

what is the normal value for serum amylase at 37C

A

95-290 IU/L

80
Q

what is the major creatinine kinase isoenzyme of normal serum?

A

CK-MM

81
Q

at what temperature should serum CK specimens be stored?

A

4C refrigerated

82
Q

what is the purpose of the PSP test and the p-aminohippurate test

A

measure excretory capacity of the kidneys

83
Q

to what class of enzyme do amylase and lipase belong

A

hydrolase

84
Q

what is the normal value for serum BUN

A

8-26 mg/dl

85
Q

what is the old name for AST

A

SGOT

serum glutamic oxaloacetic transaminase

86
Q

what is the old name for CK

A

CPK

creatine phosphokinase

87
Q

what two isoforms of CK are used for the early detection of an MI

A

CK-MM

CK-MB

88
Q

what is the main use of ammonia measurements

A

diagnose Reye’s syndrome

hepatic coma

89
Q

what happens to the creatinine clearance value in renal disease

A

decreases

90
Q

What is the normal range for total serum bilirubin?

A

0.2-1.0 mg%

91
Q

In the Jendrassik-Grof method, what is the caffeine benzoate solubilizer used for?

A

Solubilizes the water-insoluble fraction of bilirubin and will yield a total bilirubin value. Without it, the rxn will yield conjugated bilirubin only

92
Q

A list of risk factors for coronary heart disease

A 
Smoking
Hypertension
Increased total cholesterol & LDL
Decreased HDL
Diabetes mellitus
Age
Obesity
Physical Inactivity
Family history of premature CHD
Left ventricular hypertrophy
93
Q

List of biochemical markers for coronary heart disease

A

Triglycerides
Lp(a)
Homocysteine
hs-CRP

94
Q

List of the ideal characteristics of a cardiac marker

A 
Cardiac specific
Rises soon after infarction occurs
Elevated over a sustained period of time
Easy to measure analytically
Broad dynamic range for measurements
Quick turnaround of tests
Diagnostic utility verified by clinical studies
95
Q

Which marker has been recognized for the earliest biochemical marker for AMI?

A

Myoglobin

96
Q

What is the biggest disadvantage of troponin as a cardiac marker?

A

Remains in blood 7-10 days (can’t detect new infarction within that time frame)

97
Q

What is the most likely cause of prehepatic bilirubin?

A

Increased amount of bilirubin being presented to the liver, such as in acute or chronic hemolytic anemias

98
Q

Why are high levels of bilirubin seen in infants?

A

infant deficiency of enzyme glucuronyl transferase (last to develop because most bili processing done by mother)

99
Q

What precautions need to be taken when processing bilirubin?

A

Serum or plasma (except in Malloy-Evelyn, use serum)
Fasting specimen preferred
Hemolysis not acceptable
Keep away from light
Stable 2 days at RT, 1 week at 4C, indefinitely at -20C

clinical chemistry (5 decks)

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