final review Flashcards
which ALP enzyme travels closest to the anode following electrophoresis
liver, then bone/placenta,
which marker is used to determine non specific inflammation
CRP C reactive protien
what is the main isoenzyme of CK
CK3 ( CK- MM)
MM= Much more
which enzyme can be measured in both serum & urine
amylase because of its small size
what coagulation factor is increased in liver disease ( what test would be preformed ?
PT- INR
if a patient has alcoholic cirrohiss
GGT
what enzyme would be elevated if a patient had viral hepatitis
AST
if a patient has something going on with their liver a protein will be decreased and fluid retention will be increased, what is that called and what is the protein
edema
low albumin protein
what enzyme would be elevated in pancreatic carcinoma
post hepatic obstruction = ALP increased
- any carcinoma/ tumor = obstruction= post hepatic
characteristics of an ideal cardiac marker
sensitive
elevated quickly
elevated long enough to be tested
conditions that cause an incresed anion gap
MUDPILES methanol uremia d p lactic acid ethanol salicilates
calculations to kno
anion gap
osmolality
osmolar gap
total bilirubin- conjugated = unconjugated
beers law
henderson hassel back formula ( pH, HCO3 or PCO2)
CSF (glucose is 60% of Blood glucose )
international units ( enzyme units) ( micromol/min/L )
if a patient has hypoparathyroidism
Calcium will be low
phosphate will be increased
what is the biologically active form of calcium
ionized calcium
compleximetric dye method of calcium, why do we add 8 hydroxyquinoline
to prevent magnesium interference
potassium of 7.1 mmol/L what should you do
check for hemolysis- hemolysis = recollect
no hemolysis rerun
still critical = call physician
acid - base disturbance options *
uncompensated
partially
fully
metabolic or
respiratory
acidosis or alkilosis
if a blood gas sample is exposed to air
pH increased
O2 increase
CO2 decreased
how is metabolic acidosis compensated
hyperventilation
- expel CO2 and bring pH back to normal
what electrolyte is affected most by hemolysis
potassium, then magnesium
what is the anticoagulant for blood gas
heparin ( dry form )
what hormone is involved in increase & decrease in calcium levels
PTH - increases
calcitonin - decreases
where is calcitonin produced
parathyroid
which 2 analytes is collected in grey top tube
- Lactate ( has to go on ice )
2. alcohol levels for legal reasons ( we measure it on whole blood)
what is the confirmatory method for drugs of abuse analysis
gas chromatography-mass spectrometry
what does pilocarpine iontophoresis measure
sweat chloride for cystic fibrosis diagnosis
> 60 mmol/L = cystic fibrosis
what solution is used to calibrate a freezing point osmometer
sodium chloride
what is the best method to measure sodium concentration on a sample thats highly lipemic
direct ISE - bc its undiluted
if using indirect we dilute it and that causes a false decrease ( pseudohyponatreia )
low blood volume causes synthesis of what hormone by kidneys
alosterone - increases Na+ retention & water along with it ( increases blood pressure
a serous fluid has to be kept on ice and anareobic for which test
pH
trinder reaction is used to measure
salicyilates
if a patient has elevated levels of AFP in fetal serum what kind of condition might fetus have
neural tube defects
when do we collect peak drug levels
shortly after dose
- except digoxin ( 8hrs to travel throughout tissues & reach equilibrium )
what % of carboxyhemoglobin is in smokers
5-15%
what do we use to collect a lead sample
royal blue with EDTA
how do we treat patients who have overdosed on opiates
naloxone
if a patient has monhydrate calcium oxalate crystals in urine and sheets of renal epithelial cells what might they have ingested
antifreeze ( ethylene glycol)
what is the most common method to analyze ethanol in lab
enzymatic method ( ADH enzyme - alcohol dehydrogenase )
when someone overdoses on acetaminophen what oxidant becomes depleted
glutathione
how do we know the difference between a hemorrhage or traumatic tap in CSF
traumatic tap will fade
hemorrhage will remain blood throughout all tubes
if a male had an icreased hcG what does that indicate
testicular cancer
what tumor marker is for colorectal cancer
CEA - carcino embryonic antigen
estrogen & progesterone receptors are used for information on what
breast cancer
CA- 125
ovarian cancer
what is the reference method for calcium
ASS atomic absorption spec
what is the specimen of choice for ionized calcium
heparinized calcium
exposure to air for ionied calcium
measured on a blood gas analyzer
decreases CO2 & Calcium - increase pH
what is the most important factor in phosphate regulation
PTH
when is lactate a by product
by product of the emergency mechanism that produces ATP when O2 delivery is severely decreased
pyruvate is the normal end product of glucose metabolism
when O2 is deficient
- pyruvate is converted to lacttae & only 2 mol of ATP is produced opposed to 38 ATP regularly
early indicator of hypoxia
lactatein blood accumulates
pre hepatic vs post hepatic
pre- urine bilirubin neg
post- urobilinogen neg
What is the main reason for respiratory acidosis
COPD ( chronic obstructive pulmonary disease)
What kind of electrode does a blood gas analyzer use
Clarke electrode
