Exam II Flashcards
A patient has a synovial fluid removed from their knee joint. The test results included a cell count with differential. The WBC count was 65,000 with 93% neutrophils. What is the most likely cause?
Septic, Inflammatory, crystal induced, hemorrhagic
septic
A patient has CSF chemistries and microbiology samples performed. Chemistries yield a very low glucose value but no growth is reported in micro cultures. What is a possible pathology to explain these results? It is to be noted that the CSF had a clear, colorless appearance.
Diabetic ketoacidosis, brain tumor, head trauma, blood/brain compromisation
Brain tumor
Which is not a common test to perform on a CSF sample?
Glucose, Uric acid, Protein, Lactate
Uric acid
True or False: Increased CSF glucose levels can indicate acute bacterial meningitis.
False
Which would typically not be a cause of an exudative pleural effusion?
Pulmonary abscess, Lymphoma, Bacterial pneumonia, Hepatic cirrhosis
Hepatic cirrhosis
True or False: The unique structure of hemoglobin allows it to act as both an acid-base buffer and O2 buffer.
True
Match the term with the definition
-Glycogenolysis
-Glycogenesis
-Gluconeogenesis
-Glycolysis
-Metabolism of glucose molecules to pyruvate or lactate for production of energy
-Conversion of glucose to glycogen for storage
-Formation of glucose of 6-phosphate from noncarbohydrate sources
-Breakdown of glycogen to glucose for use as energy
Glycogenolysis: Breakdown of glycogen to glucose for use as energy
Glycogenesis: Conversion of glucose to glycogen for storage
Gluconeogenesis: Formation of glucose of 6-phosphate from noncarbohydrate sources
Glycolysis: Metabolism of glucose molecule to pyruvate or lactate for production of energy
Which parameter on a blood gas analysis is calculated instead of being directly measured.
pH, HCO3, pO2, pCO2
HCO3
The best collection tube to use for glucose tolerance testing is:
Grey top/ NaF
What is the incremental fraction of oxygen at sea level?
21%
What is the best interpretation of the following results?
pH=7.53 (7.35-7.45)
CO2= 37 (35-45)
HCO3= 33 (22-29)
Metabolic alkalosis with no compensation
In external respiration, the partial pressure of oxygen in the alveolar membrane is __________, while the partial pressure of oxygen in the venous blood is _________.
100 mmHg, 40 mmHg
Image C shows three tubes that are xcanthocytic and image D shows three tubes with gradual amount of red color decreasing.
The following illustration of spinal fluid is representative of two distinct circumstances. Identify the proper circumstances leading to the appearance of both example C and example D.
C. Previous cerebrovascular hemorrhage
D. Traumatic tap
Differentiate bacterial infection, normal spinal fluid
A decrease in H+ ions, an increase in pH, and a decrease in pCO2 results in what acid-base disorder?
respiratory alkalosis
What is the best interpretation of the following results?
pH=7.28 (7.35-7.45)
CO2= 55 (35-45)
HCO3= 25 (22-29)
respiratory acidosis no compensation
A patient with an HA1C of 12% would be most likely to have an estimated average glucose of:
97, 140, 212, 298 mg/dL
298 mg/dL
A patient with a fasting glucose of 122 mg/dL would be considered to have a:
-Normal fasting glucose
-Impaired fasting glucose
-Preliminary diabetes diagnosis
Impaired fasting glucose
This type of diabetes is noted to have insulin resistance with an insulin secretory defect due to progressive loss of adequate beta cell insulin secretion.
-Type 1a
-Type 1b
-Type 2
-Gestational
Type 2
An increase in H+ ions, a decrease in pH, and an increase in pCO2 results in what acid-base disorder?
respiratory acidosis
As a CSF is collected, it is placed in a series of tubes for analysis. The correct order of testing should be:
Chemistry, Microbiology, Hematology
Which is not stimulated by epinephrine?
-Insulin
-Glucagon
-Glycogenolysis
-Gluconeogenesis
Insulin
Match the type of pancreatic cell with what it produces.
-alpha cell
-beta cells
-delta cells
-Insulin
-Glucagon
-Somatostatin
alpha cell: Glucagon
beta cells: Insulin
Delta cells: Somatostatin
Diabetic condition formed when a person’s own immune system destroys the islet cells of the pancreas, resulting in impaired production of insulin.
-Type I diabetes
-Type II diabets
-Gestational diabetes
Type I diabetes
It is recommended that all adults have a lipid profile performed every _____.
- 6 months
- 2 years
- 5 years
- 10 years
5 years
True or False: Women, on average, have higher HDL levels and lower total cholesterol and triglyceride levels than men.
True
HDL has a major role in this type of lipid pathway
-Absorption pathway
-Exogenous pathway
-Endogenous pathway
-Reverse cholesterol pathways
Reverse cholesterol pathway
Which is the type of lipoprotein that contains the apolipoprotein Apo B48?
-HDL
-Chylomicrons
-LDL
-Lp(a)
Chylomicrons
True or False: Amphipathic lipid molecules contain both hydrophobic fatty acid chains and hydrophobic head groups.
False
Calculate the LDL from the following test results.
Total cholesterol: 223 mg/dL
HDL: 65 mg/dL
Triglycerides: 290 mg/dL
100
LDL = Total cholesterol - HDL - (Triglycerides /5)
The function of the major lipid components of the very-low density lipoproteins is to transport:
-Cholesterol form the peripheral cells
-Cholesterol and phospholipids to peripheral cells
-Exogenous triglycerides
-Endogeneous triglycerides
Endogenous triglycerides
Turbidity in serum suggests elevation of:
-Total proteins
-Albumin
-Cholesterol
-Chylomicrons
Chylomicrons
Match the electrolytes with what happens to it in the renal tubules
-Calcium
-Bicarbonate
-Chloride
-Magnesium
-Reabsorbed under influence of PTH
-Reabsorbed by passive transport in proximal tubule
-Recovered from glomerular filtrate
-Reabsorption occurs in Henle’s loop
Calcium: Reabsorbed under influence of PTH
Bicarbonate: Recovered form glomerular filtrate
Chloride: Reabsorbed by passive transport in proximal tubule
Magnesium: Reabsorption occurs in Henle’s loop
A rare disease of water and salt imbalance.
-Diabetes type 1
-Diabetes insipidus
-Diabetes type 2
-Diabetes - gestational
Diabetes insipidus
Of the total serum osmolality; sodium, chloride, and bicarb normally contribute what percent?
92
Match the ions to their charges
-Anions
-Cations
Negative
Positive
Anions: Negative
Cations: Positive
What is the type of lipoprotein that is known to contribute to plaque formation.
-LDL
-VLDL
-HDL
-Triglycerides
LDL
A patient presents to the ER with flushed skin, severe agitation, low-grade fever, and complaints of being extremely thirsty. Given these symptoms, what pathology would you consider?
-Hypernatremia
-Hyponatremia
-Hyperkalemia
-Hypokalemia
Hypernatremia
Which of the following is not associated with an increase in anion gap when it occurs in a single patient?
-Renal failure
-Ketoacidosis
-Glycol poisoning
-Instrument error
Instrument error
Causes of increased levels of protein in CSF include all but:
-Decreased dialysis of proteins from the plasma
-Lysis of contaminant blood from traumatic tap
-Increased permeability of the epithelial membrane
-Obstruction
Decreased dialysis of proteins form the plasma
In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what electrolyte?
-Sodium
-Potassium
-Chloride
-Phosphate
Chloride
Of total serum calcium, free ionized calcium normally represents approximately what percent?
- 10
- 45
- 60
- 90
45
The presence of only slightly visible hemolysis will significantly increase the serum level of which of the following analytes?
-Bibarbonate
-Chloride
-Potassium
-Sodium
Potassium
What is the major intracellular cation?
-Chlorider
-Potassium
-Sodium
-Bicarbonate
Potassium
What is the major extracellular cation?
-Potassium
-Chloride
-Sodium
-Bicarb
Sodium
Calculate the anion gap using the following lab data.
Na: 135
K: 4.0
Cl: 94
HCO3: 28
17
(NA+ + K+) - (Cl- + HCO3-) = anion gap
True or False: Unsaturated triglycerides are typically solid at room temperature.
False
The cation is the fourth most abundant cation in the body and second most abundant intracellularly. Hint: Consumption of processed foods can lead to inadequate intake and subsequent deficiency.
Calcium
Potassium
Magnesium
Sodium
Magnesium
Given the following results, calculate the plasma osmolality:
Sodium: 135
Glucose: 96
BUN: 22
282
Water makes up what percentage of body weight?
- 40-75%
- 5-10%
- 85-95%
- 20-40%
40-75%
Which phrase does not describe phospholipids.
-Hydrophobic head group
-Synthesized in all organs
-Amphipathic
-Unsaturated steriod alcohol
Unsaturated steroid alcohol
Electrolyte essential for myocardial contraction and important to maintain normal levels for critically ill patients.
-Chloride
-Calcium
-Sodium
-Zinc
Calcium
