Final Flashcards
Trace elements are drawn in a ___ tube:
royal blue top
Testing for trace elements is often performed in ___:
clean rooms
List the two categories of trace elements:
Essential
Non-essential
Why are non-essential trace elements still of medical interest:
Because of their toxic properties
What is the preferred sample for arsenic testing:
urine
(blood has short half life)
(hair and nails used for chronic/long term exposure)
In 2000, ___ was approved to treat Acute promyelocytic leukemia:
Arsenic trioxide
Cadmium is absorbed primarily via __:
food
Newborns are virtually free of ____ :
cadmium
__ and ___ have higher rates of cadmium toxicity:
smokers
females
Why can blood samples be used to measure cadmium:
Cd binds to the RBC
Yellow containers may contain ___ in the pigments:
Cadmium
What is mercury’s known function in humans:
none
Mercury exposure occurs via ___, __, and ___:
inhalation
ingestion
injection
Inorganic mercury is ____, organic mercury is ____:
inorganic: non-toxic
organic: toxic
Organic mercury is highly selective for lipid rich ___:
neurons
Lead exposure is primarily via __ and ___:
GI
Resp tract
All children under 2 are screened for ___:
lead
_____ most commonly used sample for lead testing, but __ and __ can also be used:
Venous whole blood
hair and nails
___ is widely used in mascara production and found in some tattoo pigments:
Mercury
Genetic condition causing copper toxicity:
Wilson’s Disease
___ is the best known, least understood Copper protein:
Ceroloplasmin
Ceruloplasmin is an ___, contains 95% of copper in the body, allows Fe to enter transferrin w/o forming toxic Fe products:
alpha-2 globulin
Significantly elevated levels of ____ can cause plasma to appear greenish:
Ceruloplasmin
Extreme cases of Cu deficiency is called:
Menkes Disease
___ is associated with peculiar hair, growth retardation, appears at 3 months with death at 5 years:
Menkes Disease (Cu deficiency)
This disease is seen at 6-40 years old, results in neuro and liver dysfunction, and is associated with Kayser-Fleischer rings:
Wilson’s Disease
Cu toxicity
Kayser-Fleischer rings are:
green/brown discoloration of cornea associated with Wilson’s Disease (Cu tox)
Zinc deficiency is confirmed via ___ and ___:
low urine zinc
decreased serum zinc
The body contains about __grams of iron, more than __ is in RBC’s:
4-5
half
75% of __ is physiologically active, the rest is stored:
iron
List the two storage forms of iron:
ferritin (Fe3 + apoferritin)
Hemosiderin
T/F
Hemosiderin is harmless in reticuloendothelial cells:
True
What is the equation for iron saturation %:
(Serum Fe/TIBC) x 100 = % sat
Is transferrin a positive acute phase protein?
No. It is a negative acute phase protein.
___ deficiency results in diabetes-likk hyperglycemia:
Chromium
Keshan Diases and Kashin-Beck are associated with __ deficiency:
Selenium
Once a drug is absorbed, it enters the hepatic portal system, this is called __:
First pass metabolism
The ___ fraction of the drug best correlates with concentration and therapeutic or toxic effects:
free fraction
Drugs can be cleared from the body in these 2 ways:
- hepatic metabolism
* renal filtration
Serum concentration will increase when rate of absorbance of drugs is ___ than excretion:
greater
Serum concentration will decrease when elimination and distribution of drug ___ absorbance:
exceeds
___ half-lives to reach steady state, and __ half-lives for drug to clear:
- 5
5. 5
Goal of peak/trough testing is to achieve a __ in therapeutic range and keep __ below toxic range:
trough
peak
Trough is typically drawn _____, while peak is typically drawn___:
trough: right before dose is given
peak: 1 hour after dose
Which drug is an exception to timing of peak drawing:
digoxin
has slow absorption, draw 6-8 hrs after dose
Do IM drug doses need TDM:
No, usually just a single dose
Gel tubes shouldn’t be used for ___:
anti-epileptics
As a rule, use ___tube for drug draws:
red top
As a rule, do NOT use ___ or ___ when drawing for anticoagulant monitoring, only use ___ generally:
- EDTA or Citrate
* heparin
Norpace, Quinidine, and Procanamide are all ___:
anti-arrhythmic drugs
Red man syndrome is associated with ___ toxicity:
vancomycin
Since Vancomycin has long distribution phase, usually only ___ levels are drawn::
trough
___ is the preferred draw sample for Anti-epileptics:
Trough
Phenobarbitol, phenytoin, Valproic acid, carbamazepine, Gabapentin, Lamotrigine, etc are examples of ___:
anti-epileptics
Imipramine, Amitryptilin, Doxepin, Clozapine, and Olanzapine are examples of ____:
Tricyclic antidepressants
Clozapine and Olanzapine can both be used to treat ___:
Schizophrenia
Cyclosporine, Tacrolimus, Sirolimus, are examples of ____:
Immunosuppressive drugs
What is the main anti-neoplastic drug listed in our notes, also used for RA, and is NOT aided by TDM:
Methotrexate
With ___, dose given is more important than the concentration; it works by inhibiting DNA synthesis in all cells:
methotrexate
___ are used for screening, dx, prognosis, monitor therapy and detect reoccurrence:
Tumor markers
Tumor marker concentration will generally __ with tumor progression/metastases:
increase
It is important to use the ___ assay methodology when comparing results on single person:
same
____ is when analyte exceed analytical range extensively; must dilute these samples:
Hook effect
____ is an antibody that competes for binding sites:
Heterophile antibody
You can only report and exact value when it is within the ___range, otherwise must report as < or >:
linear
Is there standardization among tumor marker assays:
no. important to use the same methodology when comparing results on single patient.
___ is used to for dx and prognosis of hepatocellular carcinoma, also seen in germ cell tumors, and combined with BHCG to classify and stage testicular cancer:
AFP
Is AFP specific:
no. it is also increased in pregnancy and liver disease
T/F
The higher the AFP, the worse the prognosis in hepatocellular carcinoma:
True
__is used to detect RELAPSE of colorectal cancer:
CEA
CEA stands for:
Carcinoembryonic antigen
T/F
CEA is entirely specific for colon cancer:
false.
is also increased in liver damage, heavy smokers, chemo etc1
Is CEA useful in screening for colorectal cancer?
no. is only useful in detecting relapse.
____ is a prognostic indicator of ovarian cancer, dx marker to classify testicular disease and useful marker to classify gestational trophoblastic disease:
HCG
HCG is normal secreted by the ___ to prepare and maintain ___:
placenta
pregancy
___ will be increased with germ cell tumor of ovary and testes:
HCG
Do healthy men have low levels of circulating PSA?
yes
___ is best used to monitor the progression of prostat cancer after therapy:
PSA
Patients with malignancy have lower __PSA:
free
___PSA is used to screen for and monitor prostate cancer:
Total
Are AFP and CEA an oncofetal antigens:
Yes
Can some enzymes, proteins, hormones, and oncofetal antigens be used as tumor markers?
yes
List a hormone that can be used as a tumor marker:
catecholamines
List a protein that can be used as a tumor marker:
beta 2 microglobulin
monitor renal transplant pts for rejection
CA-125 is used to detect ___ at an early stage; not used to screen asymptomatic patients:
ovarian
___ is the only clinically accepted marker for ovarian cancer:
CA-125
CA 19-9 is used to differentiate between ___ and other cancers:
pancreatic cancer
CA 15-3 is used to monitor ____ treatment and disease recurrence:
breast cancer
Is CA 19-9 a good screening tool for pancreatic cancer:
no
T/F
Levels of CA 19-9 and 15-3 can be increased in otherwise healthy individuals, as well as in other benign conditions:
True
T/F
Levels of CA-125 correlate with cancer stage:
true
___ is chronic protein deficiency with adequate non-protein calorie intake:
Kwashiorkor
___ is deficiency of calories with adequate protein intake:
Marasmus
Which would have marked hypoalbuminemia, Marasmus or Kwashiorkor:
Kwashiorkor
albumin would be normal in Marsmus
___ is the most abundant plasma protein and is used to assess hospitalized patients nutritional status:
albumin
____ is a glycoprotein and an early indicator of iron deficiency:
Transferrin
T/F
Transferrin will indicate protein depletion before albumin:
True.
___is the major transport protein for Thyroxin and Vitamin A:
Pre-albumin
Pre-albumin is a major transport protein for ___ and ___:
Thyroxin and Vitamin A
