PART 1 Flashcards
1
Q
LIGHT IS CLASSIFIED ACCORDING TO ITS WAVELENGTH:
what light that has very short wavelengths?
what light that has very long wavelength?
A
Ultraviolet (UV) light
Infrared (IR) light
2
Q
LIGHT IS CLASSIFIED ACCORDING TO ITS WAVELENGTH:
When all visible wavelengths of light (400 to
700 nm) are combined, what light will be the resukt?
A
White light
3
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
NOT VISIBLE (ULTRAVIOLET LIGHT)
A
<380
4
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
Violet
A
380-440
5
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
Blue
A
440-500
6
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
Green
A
500-580
7
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
Yellow
A
580-600
8
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
Orange
A
600-620
9
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
Red
A
620-750
10
Q
APPROXIMATE WAVELENGTH (nm) COLOR OBSERVED
NOT VISIBLE (INFRARED LIGHT)
A
> 750
11
Q
Recommended form of heparin for use because it is least likely to interfere when performing tests for other lons?
A
LITHIUM HEPARIN
12
Q
EXAMPLES OF ANALYTES AFFECTED FOR
DIURNAL VARIATION
A
↑ in AM: ACTH, cortisol, Iron, aldosterone ACIA
↑in PM: ACP, growth hormone, PTH, TSH AGPT
13
Q
EXAMPLES OF ANALYTES AFFECTED FOR
POSTURE
A
↑ When standing: albumin, cholesterol, aldosterone, Ca2+
14
Q
EXAMPLES OF ANALYTES AFFECTED FOR
REQUIRE FASTING
A
Fasting blood sugar
glucose tolerance test
triglycerides
lipid panel
gastrin
insulin
aldosterone/renin
15
Q
EXAMPLES OF ANALYTES AFFECTED FOR
ANAEROBIC AND REQUIRE ICE, SLURRY (IMMEDIATE COOLING)
A
Lactic acid
Ammonia
Blood gas
ACTH
—ICa+2 (heparinized whole blood if not analyzed within 30 min)
—Blood gas (if not analyzed within 30 min pH, and po2),
16
Q
Early morning before the patient has eaten or become physically active; this is a good time to draw blood specimens because the body is at rest and food has not been ingested during the night.
A
BASAL STATE
17
Q
When a blood pressure cuff is used as a tourniquet, it is usually inflated to APPROXIMATELY_____
If Whole blood?
A
60 mm Hg
40 mm Hg
18
Q
the major NPN constituent in plasma and constitutes about 45% of the total
A
UREA
19
Q
Other major constituents in decreasing order of nitrogen contribution are?
A
UREA > AMINO ACIDS > URIC ACID > CREATININE > CREATINE > AMMΟΝΙΑ
20
Q
APPROACHES TO ASSAY OF UREA NITROGEN
COLORIMETRIC of Urea that is inexpensive, lacks specificity
A
DIACETYL
21
Q
APPROACHES TO ASSAY OF UREA NITROGEN
ENZYMATIC of Urea and that has Greater specificity, more expensive
A
NH3 FORMATION
22
Q
REFERENCE METHOD FOR UREA NITROGEN?
A
ISOTOPE DILUTION MASS SPECTROMETRY
23
Q
The condition of abnormally high urea nitrogen in the blood is called
A
uremia
24
Q
A significant increase in the plasma concentrations of urea and creatinine, in kidney insufficiency, is known as?
A
azotemia
25
BUN/CREA RATIO >20:1 w/ Normal CREA
Result of poor perfusion of the kidneys and therefore diminished glomerular filtration; kidneys are otherwise normal in their functioning capabilities
PRE-RENAL AZOTEMIA
26
conditions under PRE-RENAL AZOTEMIA?
↑ protein intake
Dehydration
Shock
Hemorrhage
CHF
27
BUN/CREA RATIO <10:1
Caused primarily by diminished glomerular filtration as a consequence of acute or chronic renal disease
RENAL AZOTEMIA
28
conditions under RENAL AZOTEMIA?
Acute Glomerulonephritis
Chronic GN
Acute Tubular Necrosis
29
BUN/CREA RATIO >20:1 w/ ↑ CREA
Result of poor perfusion of the kidneys and therefore diminished glomerular filtration; kidneys are otherwise normal in their functioning capabilities
POST RENAL AZOTEMIA
30
condition under POST RENAL AZOTEMIA?
BDO
31
NPN
ENZYMATIC MTD that Measure ammonia colorimetrically or with ISE
CREATININE
32
APPROACHES TO ASSAY OF CREATININE
colorimetric of CREA that is simple and NONSPECIFIC
ENDPOINT
33
APPROACHES TO ASSAY OF CREATININE
colorimetric of CREA that is Rapid, increased specificity
KINETIC
34
NPN
CHEMICAL; JAFFE
CREATININE
35
APPROACHES TO ASSAY OF URIC ACID
CHEMICAL that uses Phosphotungstic acid
Caraway Mtd
36
NPN
COLORIMETRIC: Problems with turbidity, several common drugs interfere
URIC ACID
37
NPN
ENZYMATIC: UV -- Need special instrumentation and optical cells
URIC ACID
38
NPN
ENZYMATIC: H₂O₂ -Hydrogen peroxide
Interference by reducing substances
URIC ACID
39
APPROACHES TO ASSAY OF AMMONIA
CHEMICAL MTD?
SPECTRO MTD?
ENZYMATIC MTD?
CHEM = ISE - potentiometry
SPECTRO = Bromophenol Blue
ENZYMATIC = Glutamate Dehydrogenase
40
what sample are preferred for blood ammonia determination since rapid sepration from cells introduces less error?
--Analysis must be peroformed ASAP to eliminate endogenous formation of ammonia while sample is standing
PLASMA sample
41
CAUSES OF ELEVATED PLASMA ΑΜΜΟΝΙΑ?
Smoking
Reye's syndrome (aspirin)
Hepatic encephalopathy
Hereditary disorders in urea cycle enzymes
Pulmonary problems
42
Dye-binding methods for serum albumin?
Bromcresol green (BCG)
2-(4-hydroxyazobenzene)-benzoic acid (HABA)
43
ALBUMIN
wavelength used for Bromcresol green (BCG) ?
wavelength used for 2-(4-hydroxyazobenzene)-benzoic acid (HABA) ?
630 nm --absorbance at 630 nm is less likely to be affected by absorbance due to bilirubin or hemoglobin in the sample
HABA 500 nm
44
conditions of DECREASED A/G?
hypoalbuminaemia
hypercalcemia
hypermagnesemia
liver cirrhosis
nephrotic syndrome
lithium intoxication
45
conditions of INCREASED A/G?
hyperglobulinaemia
multiple myeloma
hypernatremia
uremia/renal failure
ketoacidosis
ingestion of toxins -- ethanol, methanol etc
lactic acidosis
instrument error
46
COLOR REACTION FOR QUANTI OF BILI
BILI + diazotized sulfanilic acid =?
what is the color?
azobilirubin -- pink purple
47
COLOR REACTION FOR QUANTI OF BILIRUBIN
Evelyn Malloy
ph:
dissocaiting agent:
Evelyn Malloy
ph: ACID
dissocaiting agent: 50% METHANOL
48
COLOR REACTION FOR QUANTI OF BILIRUBIN
JENDRASSIK GOF
ph:
dissocaiting agent:
JENDRASSIK GOF
ph: ALKALINE
dissocaiting agent: CAFFEINE SODIUM BENZOATE
49
COLOR REACTION FOR QUANTI OF BILIRUBIN
Diazo product of JENDRASSIK GOF:
Diazo product of EVELYN MALLOY:
COLOR REACTION FOR QUANTI OF BILIRUBIN
Diazo product of JENDRASSIK GOF: Red/reddish-purple (560 nm max abs.)
Diazo product of EVELYN MALLOY: Blue (600 nm max abs)
50
Noncovalently attached to albumin
Does not react with the color reagent until the bilirubin is first dissociated from the protein
UNCONJUGATED BILIRUBIN/B1
51
Contains one or two attached glucuronic acid molecules
Reacts directly with the color reagent
CONJUGATED BILIRUBIN/B2
52
Bilrubin fraction that is covalently attached to protein
Reacts directly with the color reagent and contributes to the direct, or conjugated, bilirubin value
DELTA BILIRUBIN
53
B1?
"HUWIN-PS"
- aka HEMOBILIRUBIN
- Unconjugated bilirubin/ B1
- Water INsoluble
- Indirect-reacting / Indirect Bilirubin
- Non-polar bilirubin
- Pre-hepatic bilirubin
- Slow-reacting
54
B2?
- aka CHOLEBILIRUBIN
- Conjugated bilirubin/ B2
- Water soluble
- Direct-reacting/ Direct Bilirubin
- Polar bilirubin
- Post-hepatic/hepatic bilirubin
- One-minute/prompt bilirubin
- Obstructive, regurgitative
55
MNEMONIC: Friderickson Classification of disorders in SPE
"CCLDT"
CM
Chole
Lipids - -Combined
Dysbeta-LP
TAG
56
conditions under PRE-HEPATIC BILIRUBIN
Extravascular
Hemolytic Anemia
Newborns
57
conditions under HEPATIC BILIRUBIN- Liver Diseases
if B1 affected?
if B2 affected?
B1
- Gilbert
- Crigler Najar
B2
- Dubin
- Rotor
58
conditions under POST HEPATIC BILIRUBIN?
BDO
59
PLASMA PROTEINS
INDICATOR OF MALNUTRITION; binds thyroid hormones and retinol-binding protein
pre-albumin / transthyretin
60
PLASMA PROTEINS
Binds bilirubin, steroids, fatty acids; major contributor to oncotic pressure
albumin
61
PLASMA PROTEINS
a1-GLOBULIN; Acute-phase reactant; protease inhibitor
1-antitrypsin
62
PLASMA PROTEINS
a1-GLOBULIN; Principal fetal proteina1-fetoprotein
a1-fetoprotein
63
PLASMA PROTEINS
a1-GLOBULIN; Acute-phase reactant
a1-acid glycoprotein / orosomucoid
64
PLASMA PROTEINS
a1-GLOBULIN; Transports lipid
a1-lipoprotein (HDL)
65
PLASMA PROTEINS
a1-GLOBULIN; Inhibits serine proteinases (ie, chymotrypsin)
a1-antichymotrypsin
66
PLASMA PROTEINS
a1-GLOBULIN; Inhibits proteinases (ie, trypsin)
Inter-a-trypsin inhibitor
67
PLASMA PROTEINS
a1-GLOBULIN; Binds vitamin D and actin
Gc-globulin
68
PLASMA PROTEINS
a1-GLOBULINS?
al-GLOBULINS
1-antitrypsin
a1-fetoprotein
a1-acid glycoprotein / orosomucoid
a1-lipoprotein (HDL)
a1-antichymotrypsin
Inter-a-trypsin inhibitor
Gc-globulin
69
PLASMA PROTEINS
a-2-GLOBULINS?
"CHA"
Ceruloplasmin
Haptoglobins
a2-Macroglobulin
70
PLASMA PROTEINS
a2-GLOBULINS; Acute-phase reactant; binds hemoglobin
Ceruloplasmin
71
PLASMA PROTEINS
a2-GLOBULINS ;Peroxidase activity; contains copper
Haptoglobins
72
PLASMA PROTEINS
a2-GLOBULINS ; Inhibits thrombin, trypsin, pepsin (nephrotic syndrome)
a2-Macroglobulin
73
PLASMA PROTEINS
B-GLOBULINS?
Pre-B-Lipoproteins (VLDL)
Transferrin (Siderophilin)
Hemopexin
B-Lipoproteins (LDL)
B2-Micorglobulin (B2M)
Complement
Fibrinogen
C-reactive protein (CRP)
74
PLASMA PROTEINS
B-GLOBULINS; Transports lipids (primarily triglyceride)
Pre-B-Lipoproteins (VLDL)
75
PLASMA PROTEINS
B-GLOBULINS; Transports iron
Transferrin (Siderophilin)
76
PLASMA PROTEINS
B-GLOBULINS; Transports iron
Hemopexin
77
PLASMA PROTEINS
B-GLOBULINS; Transports lipids (primarily cholesterol)
B-Lipoproteins (LDL)
78
PLASMA PROTEINS
B-GLOBULINS; Component of human leukocyte antigen (HLA) molecules class I
B2-Micorglobulin (B2M)
79
PLASMA PROTEINS
B-GLOBULINS; Immune response
Complement
80
PLASMA PROTEINS
B-GLOBULINS; Precursor of fibrin clot
Fibrinogen
81
PLASMA PROTEINS
B-GLOBULINS; Acute-phase reactant; motivates phagocytosis in inflammatory disease (Bishop) (Henry-y)
CRP
82
PLASMA PROTEINS
Y-GLOBULINS?
antibodies -- GAMDE
83
STANDARD DYES USED FOR STAINING PROTEIN ELECTROPHORESIS?
"LCAP"
Lissamine green
Coomassie brilliant blue
Amido black
Ponceau S
84
STANDARD DYES USED FOR STAINING
LIPOPROTEINS?
"OFS"
Oil Red O
Fat Red 7B
Sudan black
85
STANDARD DYES USED FOR STAINING
GLYCOPROTEINS?
Periodic acid-Schiff
86
PROTEINS
AS A CARDIAC BIOMARKER; IT HAS BEEN USED IN CONJUNCTION WITH TROPONIN TO HELP DIAGNOSE OR RULE OUT A HEART ATTACK
MTOGLOBIN
87
PROTEINS
GOLD STANDARD" in the DIAGNOSIS OF ACUTE CORONARY SYNDROME (ACS)
CARDIAC TROPONIN =
Troponin I (cTnl)
Troponin T (cTnT)
88
PROTEINS
- PROMOTE EXCRETION OF SODIUM AND WATER
- OPULAR MARKER FOR CONGESTIVE HEART FAILURE
- NATRIURETIC PEPTIDES
- BRAIN NATRIURETIC PEPRIDE (BNP)
89
PROTEINS
- for wound healing; used as a NUTRITIONAL MARKER (next to prealbumin, albumin)
- a glycoprotein used to help predict the short-term risk of premature delivery
- Fibronectin
- Fetal Fibronectin
90
PROTEINS
Lower levels of this protein correlate with an increased risk of heart disease, type 2 diabetes, metabolic syndrome, and obesity
ADIPONECTIN
91
PROTEINS
-Synonym prostaglandin D synthase
- An ACCURATE MARKER OF CSF LEAKAGE
B-TRACE PROTEIN
92
PROTEINS
-Proteolytic fragments of collagen I formed during bone resorption (turnover)
-a BIOCHEMICAL MARKER OF BONE RESORPTION that can be detected in serum and urine
CROSS-LINKED C-TELOPEPTIDES/CTX
93
PROTEIN
Proposed as a new sensitive endogenous serum marker for the glomerular filtration rate
CYSTATIN C
94
PROTEIN
- stains with Congo red
- supplemental test to help differentiate a diagnosis of ALZHEIMER DISEASE from other forms of dementia
Amyloid
95
LIPOPROTEIN ELECTROPHORESIS
ORDER From the origin:
chylomicrons → LDL (beta) → VLDL (pre-beta) → HDL (alpha)
96
LIPOPROTEIN ELECTROPHORESIS
Most commonly used support medium?
AGAROSE GEL
97
APOLIPOPROTEINS
Major structural protein in HDL and VLDL
apo E
98
APOLIPOPROTEINS
Major structural protein Lp (a)
Apo (a)
99
APOLIPOPROTEINS
-Major structural protein in HDL
-Activates LCAT
-Ligand for HDL binding
Apo A1
100
APOLIPOPROTEINS
Structural protein in HOL
Activates LCAT
Enhances hepatic triglyceride lipase activity
Apo A2
101
APOLIPOPROTEINS
Major structural protein in VLDL and LDL
Apo B-100
102
APOLIPOPROTEINS
Primarily structural protein in chylomicrons
Apo B-48
103
-MINOR LIPOPROTEINS?
-MINOR APOLIPOPROTEINS?
- Intermediate Density Lipoprotein (IDL)
L(a)
- apo D
apo J
apo H
apo F
apo G
104
ABNORMAL LIPOPROTEINS
- Floating ẞ' lipoprotein
- VLDL density, electrophoretic ally near LDL
- increased in Dysbeta-LP / Type 3 hyperlipoproteinemia
B-VLDL
105
ABNORMAL LIPOPROTEINS
- Sinking pre- ẞ' lipoprotein
- LDL density, but migrates similarly to VLDL
- increased in cardiovascular disease (premature Coronary Heart Disease)
Lp (a)
106
ABNORMAL LIPOPROTEINS
- Abnormal lipoprotein found in patients with obstructive biliary disease
- patients with familial lecithin:cholesterol acyltransferase (LCAT) deficiency
LpX
107
NCEP ANALYTICAL PERFORMANCE GOALS PRECISION
HDL-C (>42mg/dl) :
LDL-C :
TAG :
T-CHOLE :
HDL-C (>42mg/dl) : 4%CV
LDL-C : 4%CV
TAG : 5%CV
T-CHOLE : 3%CV
108
LIPID PROFILE NORMAL VALUES
HDL-C :
LDL-C :
TAG :
T-CHOLE :
"Heavy, Light, Tama, Tama"
HDL-C : >60 - HIGH ; <40- LOW
LDL-C : <100
TAG : <150
T-CHOLE : <200
109
Desirable VLDL CHOLESTEROL Calculated
< or equal to 30mg/dl
110
Friedewald calculation FORMULA?
IF mg/dl :
IF mmol/L :
IF mg/dl : TC - HDL - TAG/5
IF mmol/L : TC - HDL - TAG/2.175
111
De Long Mtd FORMULA?
IF mg/dl :
IF mmol/L :
IF mg/dl : TC - HDL - TAG/ 6.5
IF mmol/L : TC - HDL - TAG/2.825
112
what formula gives a more accurate estimate of VLDL - C?
De Long MTD
