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clinical chemistry > exam II > Flashcards

exam II Flashcards

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1
Q

the major intracellular cation is ___ and the normal value is ___

A

potassium

3.5-5.0 mM/L

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2
Q

the major extracellular cation is ____ and the normal value is ___

A

sodium

136-145 mM/L

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3
Q

the major extracellular anion is ___ and the normal value is ___

A

chloride

90-109 mM/L

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4
Q

what is the end point of a mercurimetric chloride assay?

A

violet blue color -> complex of mercury and diphenylcarbozone

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5
Q

what two cations are most likely to be ordered to determine the cause of cardiac tetany?

A

calcium and magnesium

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6
Q

be able to calculate the anion gap if given values for sodium, potassium, chloride, and carbon dioxide. be able to correlate abnormal anion gaps with other test results (such as BUN) or with instrument/technologist error.

A

Na+ - (Cl- + HCO3)= 8-18 mmol/L

(Na+ + K+ ) - (Cl- + HCO3) = 12-20 mmol/L

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7
Q

to what does % saturation of transferrin refer? what is the normal value?

A

% saturation = serum Fe/ TIBC X 100

20-50%

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8
Q

what is hypokalemia?

A

low serum potassium

decreased dietary intake, vomiting, renal dysfunction, arrythmias

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9
Q

if tetany is due to calcium, what specific fraction of calcium is involved? will it be increased or decreased?

A

ionized Ca2+

decreased

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10
Q

what analyte in the blood is used to measure serum phosphorous? what is the normal value for serum phosphorus?

A

inorganic phosphate

2.7-4.5

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11
Q

why is it important to measure serum magnesium levels?

A

because cardiac tetany will cause heart to contract and not release causing death

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12
Q

in analyzing calcium by atomic absorption, why is lanthanum added?

A

to prevent interference of phosphate

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13
Q

calcium exists in serum as ____ and ____ which one is physiologically active?

A

ionized and protein bound calcium

Ionized (free) calcium

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14
Q

a patient with latic acid acidosis would have an ____ anion gap

A

increased

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15
Q

what is the purpose of adding magnesium carbonate to an iron binding capacity?

A

removal of excess unbound iron

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16
Q

what does TIBC measure?

A

estimates transferrin level in serum

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17
Q

what is the fiske-subbarow method for phosphorus ?

A

phosphate in the serum is combined with ammonium molybdate to form phosphomolybdate. which is then reduced to molybdenum blue (aminonapthasulfonic acid) which is measured with sphectrophotometry

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18
Q

there is an ____ relationship between serum calcium and phosphorus

A

reciprocal

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19
Q

what is the normal serum calcium level?

A

8.4-10.2

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20
Q

what would be the expected test results for calcium and phosphorus in hyperparathyroidism?

A

increased serum calcium

decreased phosphorus

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21
Q

what is the purpose of adding stannous chloride, ferrous sulfate, and ascorbic acid in the determination of inorganic phosphorus?

A

reducing agents

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22
Q

name several things that can affect level of circulating calcium

A

PTH
vitamin D
serum protein levels
bone cell activity

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23
Q

what two hormones control serum calcium levels

A

PTH

calcitonin

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24
Q

which electrolyte is the chief plasma protein base that helps in maintaining osmotic pressure?

A

sodium

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25
Q

hemolysis has the greatest effect on serum ____ levels

A

potassium and magnesium

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26
Q

what is the function of aldosterone?

A

promotes sodium reabsorption by the kidney which results in

increased water retention
increased blood volume
increased blood pressure

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27
Q

what hormone has the most control over serum phosphate levels?

A

PTH

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28
Q

what is the normal serum osmolarity?

A

275-295 mosm/kg of H2O

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29
Q

what are the four main buffer systems of the body

A

carbonic acid-bicarbonate system
other plasma proteins
hemoglobin
phosphate-phosphoric acid

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30
Q

the pKa of carbonic acid is _____

A

6.1

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31
Q

what is added to the reaction mixture in calcium determinations to prevent interference by magnesium?

A

8-hydroxyalquinoline

32
Q

what component of freezing point osmometer actually measures the sample temperature?

A

thermistor

33
Q

what two properties can be used to measure osmolarity?

A

vapor pressure

freezing point depression

34
Q

what analytes are the main contributors to serum and urine osmolarity?

A

electrolytes

35
Q

what is the principle of the freezing point osmometer?

A

freezing point lowered by an amount that is directly proportional to the concentration of dissolved particles in a solution

36
Q

what does the PCO2 electrode actually measure

A

pH

37
Q

respiratory acidosis is an excess of ____

A

exchanged CO2

38
Q

during the chloride shift, the chloride moves from ___ to ___
what anion is exchanged for chloride?

A

plasma to RBC

bicarbonate

39
Q

what buffer system contributes most to the regulation of blood pH? what is the normal ratio of the two of the two portions of the buffer system?

A

bicarbonate - carbonic acid

20:1

40
Q

normal blood pH is _____

A

7.4

41
Q

most of the CO2 present in the blood is in the form of ____

A

bicarbonate

42
Q

what substance is necessary for the release of oxygen from hemoglobin?

A

2,3- DPG

43
Q

what happens in the body to compensate for a state of metabolic acidosis

A

lungs compensate by hyperventilating which gets rid of excess CO2

44
Q

what is the cause of metabolic alkalosis

A

excess HCO3

45
Q

what is p50?

A

a measure of the affinity of oxygen for hemoglobin & an indicator of the position of oxygen on the dissociation curve
hgb= 50% saturated
26-27mmHg

46
Q

list several precautions that must be used in handling a specimen for ABGs

A

must be anaerobic sample
transported within 15 minutes
complete mixing between palms of hands
heparin sample

47
Q

hyperventilation is a common cause of ____

A

respiratory alkalosis

48
Q

what reaction is catalyzed by the enzyme carbonic anhydrase?

A

formation of carbonic acid from CO2 & H2O

49
Q

what is the normal range for PCO2?

A

35-45 mmHg

50
Q

what is the normal range for pO2?

A

80-100 mmol/L

51
Q

in general respiratory acidosis results from____

A

decreased exchange of CO2

hypoventilation

52
Q

be able to recognize the henderson-hasselblach equation

A

pH= pka + log {base(HCO3)} / {acid(carbonic acid)}

53
Q

a fever of unknown origin would cause a ____ shift on the oxygen dissociation curve while an increased affinity for oxygen causes a ___ shift

A

right

left

54
Q

which anticoagulant is preferred for ABG analysis?

A

heparin

55
Q

the pO2 electrode is based on the principle of _____

A

amperometric measurement

56
Q

what would be the breathing pattern of a patient in respiratory alkalosis?

A

shallow/rapid (hyperventilation)

57
Q

what its he compensatory mechanism in respiratory acidosis?

A

reabsorption of HCO3 in kidneys causes an increased amount of HCO3 in blood

58
Q

what ABG parameter is most useful in assessing a fire victim?

A

pO2

59
Q

how would exposure to air bubbles affect an arterial blood sample?

A

increased pO2
increased pH
pCO2 decrease

60
Q

hyperventilation results in the loss of ___

A

CO2

61
Q

what events shift the oxygen dissociation curve to the left?

A

increased: affinity of Hgb for O2/ pH/ CO2

decreased p50, 2,3 -DPG, BT, pCO2

62
Q

a supercooled solution has a ____ temperature than its freezing points

A

colder

63
Q

every mole of solute decreases the freezing point of H20 by ____ degrees

A

1.86

64
Q

what is the name of the rapid stirrer mechanism in an osmometer?

A

vibrator

65
Q

what are the four forms of CO2 in the blood?

A

bicarbonate
carbonic acid
dissolved CO2
carbamino compounds

66
Q

when calcium levels decline, which hormone is secreted to restore normal calcium levels?

A

PTH

67
Q

what gases can be measured by a co-oximeter?

A

carboxyhemoglobin
sulfhemoglobin
methemoglobin

68
Q

how should the sample of an ABG measurement ben mixed?

A

roll between palms

69
Q

name several suitable sites for ABG draws

A

radial
brachial
femoral
temporal

70
Q

normal value of pH

A

7.35-7.45

71
Q

normal value of pO2

A

80-100

72
Q

normal value of pCO2

A

35-45

73
Q

normal O2 saturation

A

95-100

74
Q

normal HCO3

A

22-26

75
Q

if pH is decreased

A

acidosis

76
Q

if pH is increased

A

alkalosis

77
Q

example:
pH=7.5
pCO2=44
HCO3= 30

A

pH is increased and bicarbonate is increased

this suggests metabolic alkalosis

clinical chemistry (5 decks)

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