Exam I Flashcards
Match the type of CK isoenzyme with its specificity:
Cardiac
Muscle
Brain
CK-BB, CK-MM, CK-MB
Cardiac: CK-MB
Muscle: CK-MM
Brain: CK-BB
True or False: Amylase is more specific to pancreatitis than lipase
False.
Lipase is more specific to pancreatitis.
This test has greater specificity to liver damage:
Options: AST, ALP, Acid phosphatase, ALT
ALT
ALT stands for alanine transaminase. It is an enzyme found mostly in the liver.
True or False: In many reactions, we are looking at the reaction of the cofactor NADH to NAD to determine the value of the enzyme.
True
This enzyme has a short half-life and is found in the heart, liver, skeletal muscle, and kidney:
ALT, AST, GGT, CK
AST.
AST (aspartate aminotransferase) is an enzyme found in high levels in the liver, heart, muscles, and kidney.
True or False: The hook effect refers to high concentrations of analyze producing a lower signal than expected.
True
Example: hCG levels are so high, it can produce a fainter line on a pregnancy test, thus producing a lower signal than expected.
Match the type of inhibitor with the description.
- Non-competitive
- Competitive
- Uncompetitive
-These associate with enzymes at places other than the active site
-These bind only to the ES complex
-These share structural features found in the substrate.
Non-competitive: These associate with the enzyme at places other than the active site.
Competitive: These share structural features found in the substrate.
Uncompetitive: These bind only to the ES complex.
In this state, not all enyzme sites are saturated with substrate and substrate concentration is the rate-limiting step.
-First-order kinetics
-Zero-order kinetics
-Post-zone phenomenon
-Last-order kinetics
First-order kinetics
What is a zymogen?
-The protein portion of an enzyme
-An inactive, secreted form of the enzyme
-A cavity other than the active site
-the complete, active enzyme complex
An inactive, secreted form of the enzyme
The following statement could be used to describe zero-order kinetics: Substrate is present in excess, rate of reaction is constant with time and dependent only on the concentration of enzyme in the system.
True
When measuring enzyme activity, if the instrument is operating at 5C degreee lower than the temperature prescribed for the method, how would the results be affected?
-Lower than expected
-Higher than expected
-Varied, showing no patten in results
-all would be clinically abnormal
Lower than expected
What does an increase in serum enzyme levels indicate?
-Decreased enzyme catabolism
-Accelerated enzyme production
-Tissue damage and necrosis
-Increased glomerular filtration rate
Tissue damage and necrossis.
This is related to serum enzymes can show muscle tissue breakdown in the event of trauma or rhabdomylosis (myoglobin is liberated from injured or damaged skeletal muscle into the urine and blood.
Pathological condition in which the proximal tubules in the kidneys do not reabsorb glucose, amino acids, uric acids, and bicarbonates resulting in their loss to the urine concentrate.
-Lesch-Nyhan Syndrome
-Gout
-Congestive heart failure
-Fanconi Syndrome
Fanconi syndrome.
Falcon syndrome is a defect of proximal tubule leading to malabsorption of various electrolytes and substances that are usually absorbed by the proximal tubules.
Gout happens when irate, a substance in your body, builds up and arms needle-shaped crystals in your joints.
Lesch-Nyhan Syndrome is inherited as an X-linked recessive genetic disorder that, with rare female exceptions, most often affects males. It causes brain and behavior problems including severe arthritis, poor muscle control and mental disability.
This test can be used to monitor alcoholics with liver toxicity
AST, ALT, GGT, ALP
GGT
Which of the following serves as the glomerular filtration rate for clinicians?
Urea, Creatinine, Uric acid, Ammonia
Creatinine
Plasma creatinine levels are determined by all of the following except:
-Releative muscle mass
-Rate of creatine turnover
-Renal function
-Dietary intake of protein
Dietary intake of protein
A 56 year old male with gout is given allopurinol then returns to the ER a week later with a uric acid level of 8.6 mg/dL (2.4-7.0 mg/dL). what statement best describes the reason for the uric acid level?
-The patient overdosed on allopurinol
-Allopurinol returned uric acid levels to normal
-The patient did not take prescribed medication
The patient did not take prescribed medication.
Allopurinol is used to treat gout (a type of arthritis in which uric acid, a naturally occurring substance in the body, builds up in the joints and causes sudden attacks of redness, swelling, pain, and heat in one or more joints. ) Allopurinol is also used to treat high levels of uric acid that builds up in the blood as tumors break down in people with certain types of cancer who are being treated with chemotherapy medications.
What is an energy source utilized by muscles?
Creatinine, Creatine phosphate, myoglobin, nitrogen
Creatine phosphate
This non-protein nitrogen compound is found in the highest concentration in the blood
Ammonia, Uric acid, creatinine, urea nitrogen
Urea nitrogen
Which is not a clinical application of measurement of urea.
-Assess hydration status
-Evaluate liver function
-Verify adequacy of dialysis
-determine nitrogen balance
Evaluate liver function
Match BUN: Creatinine ration with the correct location of azotemia.
23, 11, 8, Intrarenal, Postrenal, Prerenal
23: Prerenal
11: Postrenal
8: Intrarenal
Which is not a likely cause of decreased BUN?
-High protein dietary intake
-Liver disease
-severe vomiting
-increased protein synthesis
High protein dietary intake
Causes of a low BUN include a diet very low in protein, by malnutrition, or by severe liver damage. Women and children may have a lower BUN level than men because of how their bodies break down protein.
The most frequently used analytic method for creatinine testing is the:
-Enzymatic method
-Kinetic Jaffe reaction
-Jaffe reaction
-Hexokinase
Jaffe reaction.
Creatinine reacts with picric acid in an alkaline solution to form a reddish colored complex. The reaction is commonly known as the Jaffe reaction.
Which test has the most strict collection requirements that include transporting the specimen on time and testing immediately?
-Ammonia
-BUN
-Uric acid
-Creatinine Clearance
Ammonia
This disease is commonly seen in children who have given aspirin during a viral infection.
Fanconi’s syndrome, Lesch-Nyhan syndrome, Reye’s syndrome, Gout
Reye’s syndrome
***Given the following information, calculate the creatinine clearance:
Urine creatinine: 120 mg/dL
Plasma creatinine: 1.5 mg/dL
Urine volume for 12hours: 600 mL
Patient BSA: 2.13
27.2, 53.8, 58.3, 81.7
53.8
Calculate the A/G ratio with a total protein of 7.7 g/dL and an albumin of 4.7 g/dL.
1.6
Match the description with the disease state.
Severe protein deficiency, Severe protein and calorie deficiency, Marasmus, Kwashiokor
Kwashiokor: Severe protein deficiency
Marasmus: Severe protein and calorie deficiency
Which is a negative acute phase reactant?
alpha-1 antitrypsin, transferrin, alpha-2 macroglobulin, haptoglobin
Transferrin
This protein is known for being a nephrotoxin.
Myoglobin, transferrin, haptoglobin, C-reactive protein
Myoglobin
Nephrotoxicity is defining as rapid deterioration in the kidney function due to toxic effect of medications and chemicals. Myoglobin is an endogenous protein that can become nephrotoxic under certain conditions such as crush injuries, drug overdose, and seizures where prolonged contraction of muscle leads to cell death and leakage of myoglobin
This test may be used to asses nutritional status
CRP, Alpha-1 antitrypsin, haptogloin, Prealbumin
Prealbumin
Proteins with 10-40% carbohydrates attached are
Glycoproteins, lipoproteins, mucoproteins, enzymes
Glycoproteins
Proteins consist of the elements:
Carbon, Oxygen, Nitrogen, all of theses, none of these
All of theses
In the stomach ______ breaks down proteins into peptides.
Papain, Pepsin, Sodium chloride, Pepsid
Pepsin
When a protein is disturbed and loses its functional and chemical characteristics, it is called:
Multimer, Depeptidation, Denaturation, Amphoteric
Denaturation
The most common secondary structure of a protein is:
Gamma helix, Alpha helix, Beta pleated sheet, Alpha pleated sheet
Alpha helix
Essential amino acids:
-Must be obtained through diet
-are synthesized by the body
Must be obtained through diet
In cerebral spinal fluid, ______% of protein comes from plasma, while ______% comes from the brain.
-80%, 20%
-90%, 10%
-5%, 95%
-95%, 5%
95%, 5%
Which protein has a function to maintain oncotic pressure?
Albumin, Prealbumin, Alpha-1 antitrypsin, alpha-2 macroglobulin
Albumin
True or False:When proteins have a more positive charge they are more easily dissolved.
True
Which is not true of amino acid analysis?
-Collect sample in a heparin tube
-Blood samples should be drawn after a 2-3 hour fast
-Analysis should be performed immediately or sample frozen
-Plasma should be removed carefully to avoid platelets and while blood cells
Blood samples should be drawn after a 2-3 hour fast
This type of analytical method measures the amount of light that can pass through a sample at a 180O angle from the incident light.
Fluorometry, Chemiluminescence, Turbidimetry, Nephelometry
Turbidimetry
True or False: Stray light refers to any wavelengths outside the band transmitted by the monochromator.
True
True or False: Dynodes are a series of anodes with successively higher voltages.
True
True or False: An advantage of a photocell over a phototube is that a photocell has an external power source and is more sensitive with lower amounts of light.
False
Calculate % transmittance through a tube containing 5 layers of solution with an absorbance of 20%.
33%
If you are stuck. Start with the absorbance. 100%-20% will give you your first layer. 80 % transmitted.
In order to get to the 2nd layer, you will need to multiply 80 by 0.80 and that will give you 64.
The next step is multiplying your layer by 0.80 again to get your 3rd layer. Keep doing this until you get to your 5th layer.
Beer’s Law is
The concentration of a substance is directly proportional to the amount of _______ absorbed or ________ proportional to the logarithm of the transmitted _______.
The concentration of a substance is directly proportional to the amount of light absorbed or inversely proportional to the logarithm of the transmitted light.
Place in the correct order. Light gets converted to:
Electrons, amps, volts, absorbance
This type of lamp is used in visible and infrared regions and is the most common type:
Mercury vapor, Hydrogen, Deuterium, Tungsten
Tungsten
Visible light falls between the color ______ at 400 nm and _____ at 700 nm.
violet, red
Which is the order that you would expect to see in LD isoenzymes in a patient who has had a heart attack.
LD1>LD2>LD3>LD4>LD5
