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Clinical Chemistry II - 4378 > EXAM C > Flashcards

EXAM C Flashcards

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1
Q

What is the formula for osmolality?

A

2Na + (glucose/18) + (BUN/2.8)

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2
Q

How to calculate molarity

A

moles of solute / volume of solution

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3
Q

What is used to bind to inorganic phosphate?

A

Molybdenum Blue

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4
Q

What could cause hyponatremia?

A

-vomiting/diarrhea with adequate water intake
-sweating, burns
-renal reabsorption disease
-hypoaldosteronism (Addison’s’s disease)
-polyuria and osmotic diuresis (diabetes mellitus)

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5
Q

Normal range for sodium?

A

135-145 mmol/L

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6
Q

How is calcium and magnesium related?

A

directly

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7
Q

How is chloride and sodium related?

A

directly

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8
Q

How is phosphate and calcium related?

A

inversely

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9
Q

normal range for potassium?

A

3.5-5.2 eEq/L

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10
Q

normal range for calcium?

A

9.2-11 eEq/L

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11
Q

Normal range for magnesium?

A

1.3-2.1 eEq/L

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12
Q

Normal range for bicarbonate?

A

22-26 eEq/L

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13
Q

Normal range for chloride?

A

98-106 eEq/L

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14
Q

is phosphorous intra or extracellular?

A

intracellular

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15
Q

Normal range for phosphorus?

A

2.3-4.7

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16
Q

Hyperchloremia: Metabolic __________

A

acidosis

-Due to the ⬆ of Cl- that replaces [HCO3-] which ⬇ to compensate for the H+ production.

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17
Q

Hypochloremia: Metabolic ___________

A

alkalosis

-⬇ Cl- causes alkalosis from prolonged vomiting or an ⬆ in renal reabsorption of [HCO3-].

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18
Q

Insulin excess → will ____________ potassium

A

decrease

-Insulin will increase uptake of glucose by cells → more cellular respiration → ATP production will increase → activity of the sodium-potassium ATPase will be increased leading to decreased serum potassium levels.

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19
Q

What will happen if a blood gas sample is exposed to air?

A

Increase pH?

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20
Q

anemia of chronic infection lab values?

A

Iron Levels: ⬇ decreased
Transferrin % Saturation: decreased
TIBC: ⬇
Ferritin levels: Normal to high

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21
Q

PTH regulates _____level being reabsorbed in the intestine.

A

Mg+2

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22
Q

validation is used to….

A

check if the QC is good by what the manufacturer says

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23
Q

Verification is….

A

what an MLS must do before sending out results

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24
Q

Definition of calibration

A

the functional relationship between measured values and analytical quantities.

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25
Q

What is the transport time for arterial blood samples?

A

two hours in glass and 15 min in plastic ontainer

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26
Q

Increased Cl and Na could mean…

A

cystic fibrosis

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27
Q

What do the labs look like with bone disease?

A

osteoporosis the levels of Ca2+, phosphorus, and PTH are within normal limits. The levels of Ca2+and phosphorus are decreased while PTH increases in osteomalacia conditions. Levels of Ca2+ are increased, phosphorus is decreased, and PTH is increased.

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28
Q

What do labs look like with malabsorption?

A

Ca2+ & phosphorus ⬇ while PTH ⬆

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29
Q

What do labs look like with renal failure?

A

Ca2+ and PTH ⬆ and phosphate⬇ levels.

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30
Q

What do labs look like with liver disease?

A

all levels of Ca2+, phosphorus, and PTH ⬇

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31
Q

What are the labs with primary hyperparathyroidism?

A

PTH: increased
Calcium: increased
Phosphate: decreased

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32
Q

What are the labs with secondary hyperparathyroidism?

A

PTH: increased
Calcium: low to normal
Phosphate: low to high

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33
Q

What are the labs with primary hypoparathyroidism?

A

PTH: decreased
Calcium: decreased
Phosphate: Increased

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34
Q

What are the labs with Pseudohypoparathyroidism?

A

PTH: Increased
Calcium: decreased
Phosphate: Increased (opposite of primary HP)

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35
Q

What are the labs with secondary hypoparathyroidism?

A

PTH: decreased
Calcium: decreased
Phosphate: increased or decreased (depends on the severity of hypomagnesemia)

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36
Q

An increase in PTH would likely cause an increase of

A

Ca

37
Q

you can determine whether a patient’s osmolality is being affected by factors other than sodium, potassium, chloride and bicarbonate; this is called the….

A

osmolal gap

38
Q

Causes of an increased osmolal gap include …

A

presence of volatile substances such as alcohols

39
Q

Causes of a decreased osmolal gap include

A

ADH oversecretion (SIDAH)
lung cancer

40
Q

Osmolal gap =

A

measured osmolality – calculated osmolality,

41
Q

abnormal gap indicates abnormal concentrations of…

A

unmeasured LMW substances in blood, such as ketone bodies or toxins (eg. ethanol, methanol, ethylene glycol)

42
Q

What anticoagulant is used for blood gasses?

A

heparin

43
Q

Copper physiologic function serves as a ___________ for many enzymatic activities.

A

cofactor

44
Q

Ceruloplasmin is a __________enzyme that stores and transports copper to wherever the body needs it.

A

metallo

45
Q

Copper Excess
is an inherited autosomal recessive disorder that causes a defect in Cu2+ metabolism. This causes a build up of copper in tissues such as liver, brain, kidney and cornea (cooper-kayser-fleisher rings) to a toxic toxic level.

A

Wilson’s disease

46
Q

what lab result with Wilsions disease?

A

There will be NO copper found in the serum due to low levels of ceruloplasmin

47
Q

Copper deficiency syndrome?

A

Menkes kinky hair syndrome

48
Q

glucose producing lactic acid: what could it affect?

A

decrease pH? The osmo gap

49
Q

Deficiency of what is associated with poor wound healing:

A

Zinc

50
Q

The conditions associated with hypokalemia are…

A

Vomiting & diarrhea,
hyperaldosteronism/cushing’s syndrome
renal reabsorption disease
metabolic alkalosis
insulin excess
diuretic therapy.

51
Q

The conditions associated with hyperkalemia:

A

hypoaldosteronism/Addison’s disease,
renal failure,
acidosis,
insulin deficiency,
cellular breakdown
Anoxia (lack of oxygen)

52
Q

Which disease is associated with decreased Mg intestinal absorption and increased urinary Mg excretion

A

Alcohol

53
Q

What is the purpose of EDTA?

A

Chelate calcium; decrease interferences

54
Q

Increased ammonia is due to what pathology?

A

Hepatic encephalitis

55
Q

When preparing 10% sulfuric acid. To make 100 mL what do you add first?

A

Add water first! (add acid)

56
Q

What is the primary benefit of westgard multirules
a. Reduce errors
b. Predict trends
c. Correlate todays results to previous days results
d. Evaluate controles from multiple runs

A

D

57
Q

The purpose of running controls each day is to check the?

A

accuracy

58
Q

What is the confidence limit of a sample falling within 2SD of the mean?

A

95%

59
Q

When comparing two methods of analysis your scatter plot should ….
a. Constant error
b. No error
c. Random error
d. Proportional error

A

?

60
Q

In QC, in term range refers to:

A

Mean +/- 2 SD

61
Q

HOW TO CALCULATE W/V %

A

mass of solute / volume of solution x100

62
Q

How to calculate CV

A

SD/mean x100

63
Q

iron is released from transferrin in an ________ environment.

A

acidic

-It also reduces 3+ to 2+ in this environment.

64
Q

any other reasons for the high osmolality or it was only bc of glucose?

A

-Sodium
-Osmolarity = 2Na + glu/18 + BUN/2.8
-Sodium accounts for way more in the calculation

65
Q

b-HCG allows for more,,,

A

sensitive/specificity

66
Q

The function of hydroxyquinoline in calcium measurements?

A

Chelate Mg2+; decrease interference

67
Q

Which has an effect on calcium levels?
a. Calcitonin (c-cells from the thyroid id)
d. PTH
c. Vit D
d. All of the above

A

all the above

68
Q

What is the principle of “active” calcium measurements?

A

a. OCPC (o-cresolphthalein complexone) red complex
b. If it asks for ionized calcium → ISE

69
Q

PTH case study with pt mention of bone lesions (osteitis fibrosa). Data had high PTH and Ca^2+ and low phosphate.

A

Primary hyperparathyroidism

70
Q

Know the changes that would occur to calcium (?) and phosphate in metabolic ___

A

Metabolic acidosis: ⬆ionized calcium and Phosphorus → stone (hydroxyapatite)

71
Q

6 linear points out of the mean would be….

A

Trend

72
Q

What occurs with a right shift for oxygen binding?

A

everything increased (⬆H+, temp, 2,3-Bpg) but affinity and pH ⬇

73
Q

Uriniary blockage can cause hypo_______

A

hyponatremia

74
Q

hyperaldosteronism is ___________ syndrome

A

cushing’s

75
Q

Potassium is ________ with hypoaldosteronism

A

increased

76
Q

____ will enter the cell in acidosis while ___ leaves the cells.

A

H+, K+

causes hyperkalemia and vise versa

77
Q

Insulin causes potassium to ___________ and vise versa.

A

decrease

78
Q

Hypochloremic metabolic __________.

A

alkalosis

79
Q

How is anion gap calculated?

A

(Na + K) - (Cl + HCO3) = 15 mmol/L (10-20)

Na - (Cl + HCO3) = 12 mmol/L (7-16)

80
Q

What parameters constitute total CO2?

A

Total CO2 exists as dissolved CO2 (3%), carbamino derivatives of plasma protein (33%),
and as bicarbonate (64%).

81
Q

What is the major from of CO2 that is transported in the blood?

A

bicarbonate

82
Q

Acidosis can result in elevated levels of plasma _____________.

A

potassium

83
Q

What is the result of alkalosis on potassium?

A

total body potassium will be increased. Potassium will move from the extracellular to intracellular space, shifting with H+; The increase in intracellular potassium stimulates the cells of the distal nephron of the kidney to secrete potassium in the urine.

84
Q

Describe the relationship between parathyroid hormone and magnesium levels.

A

There is a lack of parathyroid hormone production with the decrease in magnesium levels. Magnesium is required for enzymes involved with parathyroid hormone secretion and target organs responses.

85
Q

Why is measured serum osmolality compared with calculated osmolality?

A

to detect presence of unmeasured osmotically active substances, mainly volatile substances, that only contribute to the measured osmolality

86
Q

Formula for calculated osmolality:

A

2 (Na+) + Glucose + Urea

87
Q

What tube is used for lactic acid?

A

grey top: sodium fluoride

88
Q
A

Clinical Chemistry II - 4378 (28 decks)

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