final exam Flashcards by whitney webb

what fractions of bilirubin are increased in hemolytic disorder?

unconjugated bilirubin

total bilirubin

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which fraction might be expected to be inreased in a hepatic disorder?

conjugated bilirubin

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in severe hemolytic jaundice, what would be the expected results for bilirubin and urobilinogen in the blood, feces and urine?

urine: greatly increased urobilinogen
feces: increased urobilinogen
blood: increased unconjugated bilirubin

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where and fromw hat substance is urobilinogen formed?

bilirubin in intestines

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what is another name for prehepatic jaundice?

hemolytic

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what is another name for posthepatic jaundice?

obstructive

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another name for indirect bilirubin is?

unconjugated

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what is another name for direct bilirubin?

conjugated

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what is the normal range for total serum bilirubin?

0.2-1.0 mg/dl

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what is the normal range for direct bilirubin?

0.0-02 mg/dl

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indirect bilirubin is converted to direct bilirubin by conjugation with _____ by the _____

glucoronic acid

liver cells

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in what condition is conjugated bilirubin increased?

biliary obstruction

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in the jendrassik-Grof method for bilirubin determination, bilirubin reacts with what reagent to form the purple compound azobilirubin?

diazetised sulfunilic acid

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in the Jendrassik-Grof method what reagent is used to dissolve free bilirubin?

caffeine

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in the Evelyn-Malloy method for bilirubin, quantitation of the bilirubin is made by measuring _____

azobilirubin

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what reagents are used in the Watson-Schwartz test?

erlich’s reagent
chloroform
sodium acetate
N-Butanol

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how are porphobilinogen and urobilinogen distinguished from each other since both form a colored compound with p-aminobenzaldehyde?

prophobilinogen is extracted by the chloroform

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in the synthesis of heme, what is the direct precursor of porphobilinogen?

DELTA ALA

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why is the stool clay-colored in obstructive jaundice?

urobilinogen is absent because of blockage

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to what compound is free bilirubin in the plasma attached?

albumin

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what compound is the precursor of uroporphyrin, coproporphyrin, and protoporphyrin

porphobilinogen

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if you know the total bilirubin and the conjugated bilirubin values, how can you determine the value for the unconjugated bilirubin?

total minus conjugated

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name the three enzymes involved in heme synthesis that are inhibited by lead.

delta ALA synthase
porphobilinogen deaminase
ferrochelatase

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what is the composition of Erhlich’s reagent

diazotized fulfanilic acid

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why is unconjugated bilirubin NOT found in the urine

because it is not water soluble

what color is urine which contains large amounts of porphyrins?

port wine or magenta

increased bile pigments in the body causes the condition of_____

jaundice

in bilirubin methods, total bilirubin develops a color only after the reagent_____ is added

methyl alcohol

what is the biochemical defect associated with Gilbert's disease?

defective transportation of bilirubin from liver cells to plasma due to decreased activity of the enzyme gluconyl transferase

what is the most common condition leading to porphyrinuria?

lead poisoning

what normal substances result 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

why is bilirubin unstable once the specimen has been centrifuged?

light sensitivity

what observation is used to determine urinary porphyrins

pyrol ring

what specific pigment is possible for the of normal adult feces?

urobilinogen

what is indicated by the presence of lactic acid in duodenal contents?

acute/chronic gastritis | stomach carcinoma

a sweat chloride is done to check for disorders of what organ?

pancreas (but really cystic fribrosis)

what value for sweat chloride is indicative of cystic fibrosis?

60-200 meq/L

in what test is an ion-exchange resin used

diegnese blue

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 diseases of the ____

pancreas

what substance is used 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 and weigh it

what is measured by the Diagnex blue test?

gastric juices, | free HCL

what organ, besides the intestinal tract, for the Diagnex blue test must be properly functioning?

kidneys | to be filtered and interpreted

what is included in the determination of total gastric acidity?

free Hcl combined acidity

what is the composition of topfer's reagent

dimethylaminobenzene

toxic effects from the ingestion of rat poison can occur due to the presence of ____

chloride

ferric ions are used in the detection of which common drug

salicylates (aspirin)

what poisons are tested for by the Reinsch test?

arsinic and mercury

why should you avoid contact with mercury?

exceedingly toxic and can be absorped through the skin

what is the sample of choice for most cases of poisoning?

urine

what specimens are preferred 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?

to detect salicylates

acetaminophen (tylenol) is particularly toxic to the ____

liver

what enzyme is used to determine ethanol levels?

alcohol dehydroganase

what is an oncofetal antigen

a protein shown to exist in both fetal tissue and cancer cells

which tumor marker is used to detect prostatic cancer?

PSA

which tumor marker is used to detect testicular cancer?

AFP | beta-Hcg

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 one cardiac marker that is used int he triage cardiac panel the specimen for which can be collected in the ER by fingerstick

troponin

what does AFP stand for?

alphafetoprotein

what does CEA stand for?

carcinoembryonic antigen

name the metabolites of epinephrine, norepinephrine, and dopamine

metanephrine normetanephrine VMA homovanilic acid (HVA)

in the determination of 17-ketosteroids, 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/electrolyte balance?

aldosterone

explain laboratory findings, in regards to thyroid hormones and TSH, in hyperthyroidism and hypothyroidism

hyper- increased thyroid hormones and decreased TSH | hypo- decreased thyroid hormones and increased TSH

1-nitroso-2-napthol is use din the analysis of which amine metabolite? what amine is this a metabolite of?

5-HIAA | serotonin

where would you find a pheochromocytoma?

adrenal medulla

urinary 17-ketosteroids may be elevated in diseases of which endocrine gland?

adrenal gland

briefly explain the Pisano method. what is it used to measure?

acid hydrolysis and absorption on an ion-exchange resin is followed by elution with ammonium hydroxide. Resulting compound is converted to vanilin and reacted with periodate. colored product of the reaction is measure spectrophotometrically. with VMA, sodium metaperiodate is used but measruement performed the same as other catecholamines.

give a brief description of graves disease

is it an autoimmune disorder that occurs 6x more frequently in women than men. frequency in general population about 0.04% Ab's stimulate thyroid binding to TSH receptors causing diffuse hyperplasia of the thyroid lab results indicate: increased T3, T4, FT4I, T3U decreased or normal TSH may have exopthalmia and goiter

what is the first and best indicator of hyper- or hypothyroidism

TSH

what are the catacholamines?

epinephrine, norepinephrine dopamine

which hormones dos the thyroid gland produce?

calcitonin T3 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 pancreas

production of insulin and glucagon

which organ is the major site of steroid metabolism

liver

briefly explain addison's disease

underfunction of the adrenal cortex decreased output of aldosterone, epinephrine, and cortisol as well as some supplementary sex hormones it is primary adrenal insufficiency

cushing's syndrome is also known as

hyperadrenalcorticalism

HCG is produced by the ____ and begins to rise within ____ after conception

placenta | 1-2 days

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

briefly explain the function of oxytocin

site of action = smooth muscle main functions to stimulate contractions of the uterus during delivery and contractions of breast tissue cells to cause milk ejaculation

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

hydatidiform ole choriocarcinoma testicular tumors

what foods should be excluded from the diet for at least two days prior to collecting a urine speciemn for 5-HIAA

``` bananas avocados pineapple walnuts tomatoes kiwi eggplant ```

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 ____

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?

what hormones regulates the rate of thyroid hormones 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 the hypothalmus and pituitary to decrease production of CRH and ACTH decreased ACTH causes adrenal glands to decrease cortisol production