FINALS Flashcards
1
Q
s measured by
peroxidase catalase reaction that will now form colored
dye which is known Quinoneimine dye that will be
detected by the device
A
Hydrogen Peroxide
2
Q
Another chemical method for cholesterol
○ Hydrolysis of CE using alcoholic KOH (potash)
to UE form
○ Extraction of UE form with petroleum ether
○ Measurement with Lieberm,ann-Burchard
reagent
A
Abell kendall
3
Q
Extraction of TAG by chloroform
○ Isolation of TAG by silicic acid chromatography
○ Release of glycerol by saponification
■ Saponification: alkaline hydrolysis of
triglycerides similar to van handful
and silversmith method
Positive: Formation of red colour indicated the
presence of steroids.
A
● Salkowski reaction
4
Q
Positive: Formation of green color indicates the
presence of steroids
A
Liebermanns Burchards Test
5
Q
■ Consuming hydrogen peroxide
leading to false decrease of the result
A
Bilirubin and ascorbic acid
6
Q
- reference method
A
CDC
7
Q
Glycerol and Sodium periodate will be reacted to form _____________
A
formaldehyde and formic acid
8
Q
___________ is measured by sulfuric acid
solution by chromotropic acid to produce the
end color
A
Formaldehyde
9
Q
heparin in combination with manganese to
precipitate apo B-containing LPP
A
Earliest
10
Q
– sodium phosphotungstate with magnesium
A
Alternative
11
Q
Dextran sulfate with magnesium
A
More specific
12
Q
elevated TAG levels
A
Interfering factor
13
Q
– assay for cholesterol content
A
Clear supernate
14
Q
Prolonged venous occlusion
A
hemoconcentration
(↑chole by 10-15%
15
Q
It inhibits certain kinds of oxidative and
enzymatic alterations occurring in the
lipoprotein during storage
A
Purple: EDTA
16
Q
__________ will cause a large osmotic effect
A
Citrate
17
Q
___________ reabsorbed by PCT
A
98-100%
18
Q
Metabolic waste product of _________
metabolism
A
URIC ACID - purine
19
Q
From the breakdown of ingested
nucleic acids (3)
A
Three (3) types of nucleic acids: DNA,
RNA, and artificial nucleic acids
20
Q
Filtered by the glomerulus
A
Uric acid
21
Q
_____________ are secreted by DCT
A
small amounts
22
Q
From amino acids, which are from our dietary intake
A
Purine
23
Q
Dietary intake which contains high amounts of purine
includes red meat (such as steaks), and beans
A
Purine
24
Q
Excess amount of purine will go to the ___________, in
which some of them will be _____________, and
some will be present in the intestine which will be then
converted by the gastrointestinal bacteria into its different
form, then it will be ____________
A
uric acid pool
excreted in the urine
defecated
25
Formed from the breakdown of nucleic acids
and is an end product of purine metabolism
Uric Acid
26
Transported by the plasma from the liver to the
kidney, where it is filtered and where about
________ is excreted (via urination)
Uric Acid - 70%
27
Uric acid Present as _______________ in the
plasma
MONOSODIUM URATES
28
_____________ is the appropriate term for the uric
acid IN THE BLOOD
Monosodium urate
29
if it is IN THE URINE
Uric acid crystal
30
what shape does uric acid crystal have?
Rhombus-shape
31
At concentrations greater than 6.8
mg/dL, the plasma is saturated
* RELATIVELY INSOLUBLE (blood pH)
32
medical term for kidney
stones; composed of minerals and salts
Renal calculi
33
has something to
do with the immune system, where it detects
foreign substances and deposits them on the
joints; it also causes inflammation (liquid not
crystals)
RHEUMATOID ARTHRITIS
34
is more on crystals /
stones
GOUTY ARTHRITIS
35
Prone to renal calculi (kidney stones)
* Tophi formation (tissues)
Gout
36
Give me the causes of Gout
Precipitation of sodium urates in the
joints
o Hyperuricemia (increased uric acid in the
blood)
37
Inhibits the action of the enzyme XANTHINE
OXIDASE
➢ With this, xanthine will not be converted into
uric acid, thus lowering uric acid concentration
in the blood
Allopurinol
38
catalyzes the oxidation of hypoxanthine to
xanthine, and of xanthine to uric acid
➢ responsible for the synthesis of uric acid
→ Xanthine oxidase
39
X-Linked genetic disorder
o Complete deficiency of hypoxanthine
guanine phosphoribosyltransferase
▪ Prevents reutilization of purine
bases resulting in increased
uric acid
* Lesch Nyhan syndrome
40
Caused by glucose-6-phosphate
dehydrogenase deficiency
* Glycogen storage disease
41
* Filtration and secretion are impaired
Chronic Renal Disease
42
Toxemia of pregnancy and lactic acidosis
* Ingestion of purine-rich diet
Starvation
Hyperuricemia
43
* Secondary to liver disease
Hypouricemia
44
Ingestion of purine-rich diet
Liver, kidney, shellfish, legumes
45
A disorder of reabsorption in
the PCT
o “Fanconi’s syndrome”
46
2 Chemotherapy drugs
6-mercaptopurine or azathioprine
o Overtreatment with allopurinol
47
→ Maximum days of treatment for increased uric acid: ________ days
60 days
48
Based on the oxidation of uric acid in PFF
(protein-free filtrate) with subsequent reduction
of phosphotungstic acid to tungsten blue
A. Caraway Method
49
Provides alkaline pH for color
development
o Sodium carbonate
50
Uricase catalyzes the oxidation of uric acids to
allantoin
B. Uricase Method
51
Measures the differential absorption of
uric acid and allantoin at ________
293 nm - B. Uricase Method
52
catalyzes the oxidation of uric acids to
allantoin
Uricase
53
* Lacks specificity
A. Caraway Method
54
* More specific
B. Uricase Method
55
* Negative interference/s: of uricasemethod
o Hemoglobin
o Xanthine
56
Measures the hydrogen peroxide produced as
uric acid is converted to allantoin
C. Couple Enzymatic Methods
57
Catalyze a chemical indicator
reaction
o Peroxidase or Catalase
58
* Interference/s: of Couple enzymatic method
o Bilirubin
o Ascorbic acid (destroy peroxide)
59
DHBS
3,5-dichloro-2-hydroxybenzenesulfonic acid
60
Produced in the catabolism or deamination of
amino acids and by bacterial metabolism in
the lumen of the intestine
Ammonia
61
Removed from the circulation and converted to
urea in the liver
Ammonia
62
o Causes swelling in the liver and brain
o Often affects children and teenagers
recovering from a viral infection, most
commonly the flu or chickenpox
* Reye’s syndrome
63
__________is complicated by its low concentration,
instability, and pervasive contamination
Ammonia
64
Diffusion of Ammonia (NH3) through
selective membrane into Ammonium
Chloride (NH4Cl) causing pH change,
which is measured potentiometrically
A. Ion-selective electrode+
65
o Ammonia (NH3) + bromophenol blue
→ blue dye
B. Spectrophotometric
66
Ammonium (NH4+) + 2-oxoglutarate +
NADPH + H+ → glutamate + NADP+
+ H2O
A. Glutamate Dehydrogenase (GLDH) Assay
67
Enzyme of glutamate dehydrogenase assay
▪ Enzyme: Glutamate
dehydrogenase (GLDH)
68
Most common on automated
instruments
o Accurate and precise
A. Glutamate Dehydrogenase (GLDH) Assay
69
Advantages of Ion selective electrode
o Good accuracy and precision
70
disadvantages of ion selective electrode
o Membrane stability may be a problem
71
___________ ammonia concentration
increases rapidly following specimen collection
because of in vitro amino acid deamination
* Venous blood should be obtained WITHOUT
TRAUMA and placed on ice immediately
Whole blood
72
Specimen requirement
* Heparin (Green tube top) or EDTA
73
More preferred tube top is ___________
green (HEPARIN)
74
Samples should be centrifuged at __________
within ________ minutes of collection and the plasma
or serum removed
* Hemolysis should be avoided
0C-4C
20 minutes
75
If the test tries to determine the synthetic ability of the
liver, it will fall _______
Hepatic Synthesis Ability.
76
When we talk about the liver, the majority of the
proteins are synthesized by the liver.
● The liver is responsible for the synthesis of the
majority of proteins
1. HEPATIC SYNTHESIS ABILITY
77
is performed in the hematology
department
hematologic test
78
A test that allows us to differentiate intrahepatic
disorders from extrahepatic obstructive liver
diseases
PROTHROMBIN TIME
79
In ___________, the problem is the liver, it
cannot synthesize substances like the clotting factors.
intrahepatic diseases
80
___________ play a role in the coagulation of blood.
Seen in the plasma and there are some of the
substances needed by the liver like Vitamin K to
produce the clotting factors
Clotting factors
81
That is why if there is a problem or an abnormal result
of the prothrombin time, one of the treatments is the
administration of _________ and after the _______ is
administered, we will again test the patient for
prothrombin time.
vitamin K
82
The main reason why you are lacking clotting factors
is that there is a problem in the _________
also known as the __________
synthetic ability of the liver
Also known as the Vitamin K Response Test
83
If the normal reference range of prothrombin time is _________if there is a problem in the synthetic
ability of the liver, most probably the result will fall in
___________you can describe the result at
prolonged
9-12 - normal
if naay problem kay 20-25
84
Applicable when performing the procedures for
the determination of total protein and albumin
(package inserts).
● A/G ratio
ALBUMIN
85
○ Dye Extraction Test
○ A test for the function and the potency of the bile
ducts. Rarely used.
● Bromosulfophthalein Test (BSP)
86
○ Two methods used in BSP test:
1. Rosenthal White Method
2. MacDonald Method
87
A double collection method. You will collect
twice the sample from the patient.
▪ Inject a dye called ___________into
the body of the patient and the amount of dye
injected is ____ milligrams per kilogram of
bodyweight.
▪ You inject this dye then collect it after _____
minutes and after _______
1. Rosenthal White Method
bromosulfopthalein test
2 milligram
5 minutes and after 30 minutes
88
A single collection method.
▪ In terms of the amount of dye injected, it is ____
milligrams per kilogram of body weight.
▪ Collect after _______
2. MacDonald Method
5 milligrams
45 minutes
89
A metabolic product from bilirubin
▪ For the determination of urobilinogen, use
Ehrlich Method
● Urobilinogen
90
The detoxification function can be assessed by
determining the amount of enzymes in the blood of
the patient.
3. DETOXIFICATION FUNCTION
91
ENZYME TEST
(7)
● Enzyme test:
o ALP
o ALT
o AST
o 5’N
o GGT
o LAP
o LDH
92
Another test to assess the detoxification function of
the liver is to test the __________
the level of ammonia
93
__________ is a toxic form. It should be converted to
urea via the urea cycle – which occurs in the liver
Ammonia
94
● Test in ammonia determination:
● NESSLERIZATION REACTION
95
terminates reaction of the
diazo reagent with the bilirubin, destroying
excess diazo reagent
Ascorbic acid
96
shifts the
absorbance of azobilirubin to a more intense
blue color, resulting in less interference
alkaline tartrate solution
97
Developed to quantify bilirubin in your serum
samples, utilizing the classic diazo reaction
Maloy evelyn method
98
Conjugated bilirubin binded to albumin
* Longer half life compared to other bilirubin
* seen only in hepatic obstruction
DELTA BILIRUBIN
99
* Used only in neonatal population
* Measurement of reflected light from skin using two
wavelengths
* provides numerical index based on spectral
reflectance
BILIRUBINOMETRY
100
This is a test that involves diluting serum with saline.
You dilute serum with saline until it visually matches
the 0.01% potassium dichromate.
ICTERUS INDEX
101
Addition of alcohol may precipitate protein -
interference
o Serum is preferred for Malloy-Evelyn
102
The number of times that the serum will be diluted is
called _________
icterus index
103
__________ is an amino acid, with the chemical name, methyl
guanadine-acetic acid, that can be converted into
phosphocreatine. Phosphocreatine is a storage mechanism
in muscle cells used to regenerate the cells primary source
of energy: Adenosine Triphosphate (ATP)
Creatinine
104
____________ is the waste product formed in muscle from high
energy storage compound, creatine phosphate
(phosphocreatine
Creatinine
105
___________ made up of amino acid and
synthesized by the liver
creatine
106
Creatine
Synthesized primarily in the liver which is made up of amino
acids:
MAG
methionine, arginine, glycine
107
_________ is producing an anticoagulant, which is heparin, to
prevent the clotting of blood inside the body
liver
108
If there is renal failure, creatinine levels decrease in _______
and increase in _________
urine
blood
109
- Creatinine: below normal range = _____________
muscle dystrophy
110
alkaline hydrolysis of your
triglyceride. Similar to your van handel and
your silversmith method.
Saponification
111
a method that ionizes the
chemical species and sorts the ions based on its
mass ratio
Mass spectrometry
112
should be refrigerated if cannot be analyzed within an
hour
Urine
113
Polymer of fructose
● Extremely stable substance that is not reabsorbed or
secreted by the tubules
● Not a normal body constituent
● Not routinely done because necessary for continuous IV
infusion
● Ideally reference method but not usually done due to its
laborious procedure
Inulin
114
● Has a MW of approx. 11,800 Daltons
Dissociates from human leukocyte antigens at a constant
rate
● Rapidly removed from the plasma by glomerular filtration
then reabsorbed completely by the PCT
● Not reliable in patients with immunologic conditions >
multiple myeloma & lymphoma (increased production of
WBC which has nucleus)
● found in nucleated cells
Beta 2 microglobulin
115
Has a MW of approx. 13,000 Da
● Inhibitor of cysteine proteinase
● Produced by all nucleated cells at constant rate
● Freely filtered and completely reabsorbed in the PCT
(normally not seen in urine)
● Plasma concentration appear to be unaffected by gender,
race, age, and muscle mass
● Measurements are difficult and expensive - NOT routinely
used
CYSTATIN C
116
● Also known as prostaglandin D2 synthase
BETA TRACE PROTEIN
117
● 2-(alpha-mannopyranosyl)-L-tryptophan (MPT)
TRYPTOPHAN GLYCOCONJUGATE
118
● ex. technetium diethylenetriaminepentaacetic
USE OF RADIOISOTOPES
119
Usually associated with an enzyme (metalloenzyme)
or another protein (metalloprotein) as an essential
component or cofactor.
TRACE ELEMENTS
120
________ is the most commonly used for determinations
Atomic absorption spectrophotometry
121
_________ affect analyses of these trace
elements.
Reagents and water
122
methods and instrumentation
AAS - Atomic Absorption Spectrophotometry
FAAS - Flame Atomic Absorption Spectroscopy
AES - Atomic Emission Spectroscopy
123
___________ is made up of amino acids and broken
down for reuse for protein synthesis
Globin
124
___________ part is broken down into biliverdin and iron
Heme
125
___________ transferred to the liver, wherein it
will be transported further into the small
intestine.
Biliverdin
126
___________ serve as pigments
that give color to the waste products or
excretions.
Stercobilin and urobilin
127
About ________ of our iron is found in our red blood
cells and it is called _________, responsible for
giving red color.
70% - hemoglobin
128
__________where our red blood cells
are produced, part of hematopoietic
process
bone marrow
129
where our red blood cells
are disrupted after their lifespan.
spleen and liver
130
In adult male, the average loss of _______ per
day must be replaced by dietary sources.
o Pregnant or premenopausal women and children
have greater iron requirements.
1 mg of iron
131
In adult male, the average loss of _______ per
day must be replaced by dietary sources.
o Pregnant or premenopausal women and children
have greater iron requirements.
1 mg of iron
132
Pregnant: ________ requires a great amount of
iron for development.
fetus
133
* ________________
have greater iron requirements.
Pregnant or premenopausal women and children
134
- heme will be broken down into iron,
wherein it will be carried by transferrin into the
liver. It will be further transported from the
liver to the bone marrow (ferritin) for storage
until its time for new cell production or
hematopoietic processes
iron
135
__________ bound to enzymes
8 mg
136
_________ iron transport protein in the
serum. Transports iron from the liver to bone
marrow in the form of Ferritin. Stored until it
is time to make new cells or hematopoietic
processes.
Transferrin
137
___________ is the major iron storage protein in
our body. It will be recycled for new RBCs,
wherein this new RBC will again circulate for
120 days in the circulatory system as a
mature RBC. It is capable of functioning as a
vehicle transport for oxygen, carbon dioxide,
gas exchange, and nutrient exchange. It
reaches its maximum life. It will go back to the
spleen for natural death and degradation,
repeating the cycle.
Ferritin
138
* Essential component of hemoglobin
BIOCHEMICAL FUNCTIONS
139
* Iron must remain in __________
ferrous state
140
facilitates the diffusion of oxygen into
tissue because it binds oxygen with greater affinity
than hemoglobin.
Myoglobin
141
are essential for electron transport in
the respiratory chain, with reversible cycling of ferric
iron to ferrous iron, resulting in the production of ATP
Cytochromes
142
are iron-containing
enzymes that convert H2O2 to water
Peroxidase and catalase
143
inversely proportional with the TIBC
Iron
144
MCHC
Mean Corpuscular Hemoglobin
Concentration.
145
A laboratory test being
measured, especially if the doctor wants to
focus on the iron state of the patient.
MCHC
146
whether or not tissue
damage is present
HEMOCHROMATOSIS
147
– increased serum iron and TIBC
or transferrin, but without demonstrable tissue
damage.
hemosiderosis
148
released from binding proteins, can
enhance the production of free radicals to cause
oxidative damage
ferric iron
149
the
most common; we can also find out the patient’s
hydration status with hematocrit
Packed Cell Volume (PCV) or Hematocrit –
150
you can conclude safely that if it is
within normal range, the patient is not anemic. If lower
– the patient is anemic.
o The basis for blood donation
Hemoglobin
151
Red blood cell count and indices
* Total iron and TIBC
* Percent saturation
* Transferrin
* Ferritin
152
– increases in iron
deficiency and decreases in iron overload
Serum Transferrin Receptors
153
– not to the iron
circulating as free hemoglobin.
Ferric iron bound to transferrin –
154
is preferred because of the diurnal
variation
Early morning
155
Amount of iron that could be bound by saturating
transferrin and other minor iron-binding proteins
present in the serum or plasma sample
TOTAL IRON-BINDING CAPACITY (TIBC)
156
* Also called the transferrin saturation
* the ratio of serum iron to TIBC
Percent saturation
157
* Also the transport system of the iron
* Measured by immunochemical methods (e.g.
nephelometry)
Transferrin
158
Measured in serum by immunochemical methods
Ferritin
159
_______ is the stored form. If they decrease, it
results in iron deficiency
Ferritin
160
Shellfish, liver, nuts, and legumes
* Dietary Requirements
- copper
161
regulation of copper
intestine
162
________ is the major copper-carrying protein
in the blood and plays a vital role in iron metabolism
* Acute phase protein
ceruloplasmin
163
* Less than ________ is lost in urine and sweat
CERULOPLASMIN - 3%
164
Component of enzymes involved in __________
redox
reactions
165
_________ competes with copper for absorption from the
intestine
Zinc
166
Malnutrition (no intake) and malabsorption (has
sufficient intake but does not absorb)
Deficiency
167
– recessive X-linked genetic
defect in copper transport and storage
Menkes’ syndrome
168
Mostly by accidental ingestion of copper solutions
* Use of intrauterine devices containing copper
EXCESS
169
hepatolenticular degeneration
o Associated with copper accumulation in the liver,
brain, kidney, and cornea
Wilson's disease
170
________ is normally transferred from intestine to the
liver but cannot be transported out from the liver
copper
171
_________= transported in the circulation by albumin
65%
172
_______ = alpha2-macroglobulin
35%
173
Major route of excretion is by the feces and ______
is by pancreatic secretion
25%
174
Metal cofactor for enzyme activity
o Usually an integral component of the active site
of the enzyme
* Biochemical Functions
175
Constituent of Vitamin B12, which is involved in folate
metabolism and erythropoiesis (or hematopoiesis—
formation of our red blood cells or erythrocyted)
COBALT
176
Use in metal alloys, metal plating, dyes, and leather
tanning
* Natural or industrial waste
* +6 ion is far more toxic than the +3 ion
* Richest source is diet
* Transported to the tissue by transferrin
* Important in glucose metabolism as an essential
activator of insulin
* Flameless AAS
CHROMIUM
177
* Preventing dental caries (or cavities)
* Excess is associated with mottling of teeth and
calcification in soft tissue
* May also minimize bone loss or even stimulate bone
formation
* Readily absorbed by the gut and distributed totally to
the bone and teeth
* Excreted in the kidney
FLUORIDE
178
* Largely protein-bound
* Activator of several enzymes
* Transported in plasma by albumin, alpha2-
macroglobulin, and transferrin
* Excreted in bile and pancreatic secretions
* Flameless AAS
MANGANESE
179
* Cofactors for several oxidase enzymes
* Mostly absorbed in the stomach and small intestine
* Released and excreted either in the urine or in the bile
* Excess exposure may cause inhibition of copperdependent enzymes (ceruloplasmin and cytochrome
oxidase)
MOLYBDENUM
180
* Cofactors for several oxidase enzymes
* Mostly absorbed in the stomach and small intestine
* Released and excreted either in the urine or in the bile
* Excess exposure may cause inhibition of copperdependent enzymes (ceruloplasmin and cytochrome
oxidase)
MOLYBDENUM
181
* Cofactor in glutathione peroxidase and iodothyronine
diodinase
* Antioxidant properties and is involved in metabolism
of thyroid hormones
* Deficiency found in: cardiomyopathy and skeletal
weakness, osteoarthritis, and increased incidence of
cancer
* AAS
SELENIUM
