Final Exam Flashcards
which fractions of bilirubin are increased in a hemolytic disorder?
unconjugated/indirect
total bilirubin
which fraction might be expected to be increased in a hepatic disorder?
conjugated/direct
what would the expected results be for urobolinogen in the urine?
increased
what would the expected results be for urobolin in feces?
increased
what would the expected results be for unconjugated bilirubin in the blood?
increased
where and from what substance is urobilinogen formed?
bilirubin from bacteria in intestines
another name for prehepatic jaundice
hemolytic
another name for post hepatic bilirubin
obstructive
another name for indirect bilirubin
unconjugated
another name for direct bilirubin
conjugated
name the normal range for total serum bilirubin
0.2-1.0 mg/dl
normal range for direct bilirubin?
0.0-0.2 mg/dl
indirect bilirubin is converted to direct bilirubin by conjugation with _______ by the _______
glucuronic acid
liver
in what conditions is conjugated bilirubin increased?
biliary obstruction
in the Jendrassik-Grof method what reagent is used to dissolve free bilirubin?
caffine
in the Evelyn-Malloy method for bilirubin, quantitation of the bilirubin is my by measuring what?
azobilirubin
what reagents are used in the Watson-Schwartz test?
ehrlichs reagent
chloroform
n-butanol
sodium acetate
how are porphobilinogen and urobilinogen distinguished from each other since both form a colored compound with p-aminobenzaldehyde?
Extraction with chloroform
why is the stool clay-colored in obstructive jaundice?
urobilinogen***
to what compound is free bilirubin in the plasma attached?
albumin
what compound is the precursor of uroporphyrin, coproporphyrin, and protoporphyrin?
porphobilinogen
if you know the total bilirubin and conjugated bilirubin values, how can you determine the value for the unconjugated bilirubin?
total-conjugated = unconjugated
name the three enzymes involved in heme synthesis that are inhibited by lead
delta ALA synthesis
porphobilinogen deaminase
ferrochelatase
what is the composition of erhlichs reagent?
diazotized sulfanic acid
why is unconjugated bilirubin NOT found in the urine?
not water soluable
what color is urine which contains large amounts of porphyrins?
port wine
increased bile pigments in the body causes what condition?
jaundice
in bilirubin methods, total bilirubin develops a color only after the reagent ______ is added.
methyl alcohol
what is the biochemical defect associated with Gilberts disease?
defective transport of bilirubin from plasma to liver cells due to reduced activity of the enzyme glucouronyl transferase
what is the most common condition leading to porphyrinuria?
lead poisoning
what normal substance results in the formation of bilirubin when it is broken down?
hemoglobin
what substance is increased in the urine of patients with lead poisoning?
Delta ALA is present
why is bilirubin unstable on the specimen has been centrifuged?
sensitive to light
what observation is used to determine urinary porphyrins?
red fluourescence in uv light
what specific pigment is possible for the color of normal adult feces?
urobilin
what is indicated by the prescence of lactic acid in duodenal contents?
acute or chornic gastritis
stomach carcinoma
a sweat chloride is done to check for disorders of what organ?
pancreas
what value for sweat chloride is indicative of cystic fibrosis (CF)?
greater than 60-200 mEq/L
in what test is an ion-exchange resin used?
diagnex blue test
in what conditions is the gastric acidity low or absent?
gastric carcinoma
what is the normal pH of gastric juice after stimulation by a test meal?
1.5-4.0
duodenal fluid testing is used to diagnose disease of what organ?
pancreas
what substance is sued to induce sweating in sweat chloride analysis?
pilocarpine
in the sweat test, what should be the NEXT step once the electrodes are removed?
remove gauze from arm and weigh it
what is measured by the Diagnex Blue test?
tubeless test of free HCl in gastric secretions/juices
what organ besides the intestinal tract, must be properly functioning to do the Diagnex Blue test?
kidney
what is included in the determiniation of total gastric acidity?
free HCl and combined acidity
what is the composition of Topfers reagent?
dimethylaminobenzen
toxic effects from ingestion of rat poison can occur due to the presence of what?
fluoride
ferric ions are used in the detection of which common drug?
salicylates (asprin)
what poisons are tested for by the Reinsch test?
arsenic and mercury.
heavy metals but not lead (Pb)
why should you avoid contact with mercury?
it can be inhaled or obsorbed by the skin and is extremely toxic
what is the sample of choice for most cases of poisoning?
urine
what speicmens are rare in cases of arsenic poisoning?
hair
nails
what level of carboxyhemoglobin can be found in cigarette smokers?
5-15%
what is the purpose of the Trindar reaction?
detection of salicylates (asprin)
acetaminophen is particularly toxic to what organ?
liver
what enzyme is used to determine ethanol levels?
alcohol dehydrogenase
what is an oncofetal antigen?
a protein shown to exist in both embyo fetal tissues and cancer cells
which tumor marker is used to detect prostatic cancer?
PSA
which tumor marker is used to detect testicular cancer?
Beta HCG
AF
what color is the blood in cases of carbon monoxide poisoning?
bright (cherry) red
what enzyme is decreased in insecticide poisoning?
pseudocholinesterase
name the point of care test that is useful in the diagnosis of congestive heart failure?
BNP
name on cardiac marker that is used in the triage cardiac panel and the specimen for which can be collected in the ER by fingerstick.
Troponin
what does AFP stand for?
alpha-feto protein
what does CEA stand for?
carcinoembryonic antigen
in the determiniation of 17-ketostroids, what is Zimmerman reagent composed of?
metadinitrobenzene
the renal excretion of sodium, which in turn affects serum levels is controlled by hormones produced where?
adrenal cortex
what is the major hormone responsible for water and electrolyte balance?
aldosterone
what are the laboratory findings in regards to thyroid hormones and TSH in hyperthyroidism?
increased thyroid hormones
decreased TSH
what are the laboratory findings in regards to thyroid hormones and TSH in hypothyroidism?
decreased thyroid hormones
increased TSH
1-nitroso-2naphthol is used in the analysis of which amine metabolite? what is it made of?
5-HIAA
serotonin
where would you find a pheochromochytoma?
adrenal medulla
urinary 17-ketosteroids may be elevated in diseases of which endocrine gland?
adrenal gland
pisano method
acid hydrolysis and absorption on an ion-exchange resin is follwed by elution with ammonium hydroxide.
what is the pisano method used to measure?
colored reaction is measure spectrophotometrically
graves disease
autoimmune disorder that occurs 6x more frequently in women that men. causes diffuse hyperplasia of the thyroid. increased T3, T4, FT41 and T3U..decreased TSH
what is the first and best indicator of hyper-or hypothyroidism?
TSH
what are cata cholamines?
epinephrine, norepinephrine and dopamine
which hormones does they thyroid gland produce?
Calcintonin, T3 and T4
what is another name for epinephrine?
adrenalin
to which amino acid does the thyroid gland bind inorganic iodide from the plasma?
tyrosine
what is the principle function of the pancrease?
production of insulin and glucagon
which organ is the major site of steroid metabolism?
liver
addisons disease
under function of adrenal cortex, decreased aldosterone, epinephrine and cortisol
primary adrenal insufficiency
cushings syndrome is also known as what?
hyperadrenalcorticalism
HCG is produced by the _____ and begins to rise within _____ days after conception
placenta
1-2
briefly explain the function of vasopressin
stimulates reabsorption of water by the kidney tubules
where is the hormone epinephrine produced?
adrenal medulla
argentaffinomas produced elevated levels of what?
serotonin
breifly explain the function of oxytocin
site of action is muscle
main function to stimulate contractions of uterus during delivery
what is the site of action for prolactin?
mammary glands
in men 2/3 of all 17-ketosteroids come from the ______ and 1/3 from the _____.
adrenals
testes
name some conditions other than pregnancy where you may find increased HCG levels
hydatidform mole
choriocarcinoma
testicular tumors
what foods should be exluded from the diet for at least two days prior to collecting a urine specimen for 5-HIAA?
bananas avocados pinapple plums walnuts
how is most plasma thyroxine found?
bound to globulin
what is the chief hormone excreted by the adrenal cortex?
cortisol
the most potent and biologically active estrogen is what?
17-beta-estradiol
what is the action of progesterone?
preparation of uterus for ovum implantation
what is the most potent of the biologically active androgens?
testosterone
what is the parent substance in the biosynthesis of all adrenal cortical steroids?
cholesterol
of the thyroid iodide hormones, which is the most biologically active?
T3
what hormone regulates the rate of thyroid hormone synthesis and secretion and where is it produced?
TSH
anterior pituitary
briefly explain the negative feedback mechanism in the relationship between cortisol and ACTH
increased cortisol levels cause they hypothalamus and pituitary to decrease production of CRH and ACTH
decreased ACTH causes adreanl glands to decrease cortisol production
