Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UA > ppt 8 > Flashcards

ppt 8 Flashcards

1
Q 
Bense Jones (BJ) protein test
(a.k.a. immunoglobulin light chain urine test)
A
  • abnormal globulin
  • BJ proteins are small light chains of immunoglobulin produced by the neoplastic plasma cells.
    • in tissue function to synthesize antibodies IgG, IgM, IgD, IgA
  • BJ proteins are not detected with routine urinalysis.
  • Only immunoelectrophoresis of urine can detect BJ proteins.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Special Urinalysis Bence Jones protein

A
  • Normally no BJ proteins are found in the urine.
  • BJ proteins finding in the urine always means
    the presence of abnormal growth of plasma cells in
    the body which could be a witness of serious disorders:
    • multiple myeloma (BJ proteins are found in
    • chronic lymphocytic leukemia (CLL)
    • lymphoma
    • metastatic lytic bone lesions
    • Waldenström’s macroglobulinemia
    • end-stage of renal failure
    • amyloidosis 50-80% of patients with this disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Multiple Myeloma

A

-is a cancer of plasma cells, a type
of white blood cell normally responsible for producing antibodies.
• In multiple myeloma, collections of abnormal plasma cells
accumulate in the bone marrow, where they interfere with the
production of normal blood cells
• Most cases of multiple myeloma also feature the production of
BJ protein which causes kidney problems
-anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

multiple myeloma presentation

A
  • decreased RBC
  • decreased WBC
  • decreased Platelets
  • increased bleeding
  • decreased erythropoetin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Multiple Myeloma mnemonic

A

CRAB:

  • C=Calcium (elevated)
  • R=Renal failure
  • A=Anemia
  • B=Bone lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

moth eaten lytic bone lesions are associated with what?

A

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

other Multiple myeloma signs and symptoms

A
  • lytic bone lesions
  • lung infection
  • fractures
  • renal failure
  • purpura
  • proteinuria
  • bence jones proteins
  • anemia (bone marrow infiltrates)
  • raynaud’s syndrome
  • serum-monoclonal gammopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

clinical manifestations of Multiple myeloma

A
  • constant bone pain
  • fractures of bones due to lytic processes
  • low counts of RBC, WBC, platelets
  • kidneys can be damaged by the tubulopathic effects of
    proteins or BJ light chains
  • nervous system symptoms and signs:
    = stroke-like manifestations
    = numbness, weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Human chorionic gonadotropin (HCG)

A

-is a hormone
produced by placenta or malignant tumors
- Normally HCG can be found in the urine only during the
pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

disorders associated with HCG in urine

A

-HCG is found in the urine of males or non-pregnant females in
a number of the disorders:
- testicullar (seminoma) and ovarian cancers
- choriocarcinoma in females
(malignant trophoblastic cancer, usually of the placenta)
- some types of cancers: stomach, pancreas, lungs,
liver
- teratoma
-Low values of HCG in the urine for pregnant women indicate:
- miscarriage
- death of baby or embryo
- ectopic pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

high HCG in blood

A

can be used for screening of Down’s
syndrome between 15-20 weeks of pregnancy
(it does not indicate 100% presence of this disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Edwards syndrome blood markers

A

trisomy 18

  • decreased MSAFP
  • decreased Unconjugated estriol
  • decreased hCG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

NTD (neural tube defect?) blood markers

A

-increased MSAFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

downs syndrome

A
  • trisomy 21
  • decreased MSAFP
  • decreased unconjugated estriol
  • increased hCG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Schilling’s test (urine)

A

is used to determine vitamin B12 deficiency :
- megaloblastic anemia (e.g. pernicious anemia)
- nervous system pathology due to vitamin B12 deficiency
- general malabsorption syndrome
whether the body adequately absorbs vitamin B12

• The test may be performed in four different stages to find the
cause of low absorption of vitamin B12.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Stages I Schilling’s test

A

(megaloblastic anemia)

low vitamin B12 level in food or diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Stages II Schilling’s test

A

low intrinsic factor (problems with the stomach) causing the low vitamin B12 level
(chronic atrophic gastritis, gastrectomy pernicious anemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Stages III Schilling’s test

A

vitamin B12 absorption in ileum
(Tropical sprue, Celiac disease (non tropical sprue), Crohn’s disease)
abnormal bacterial growth causing the low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Stages IV Schilling’s test

A

low vitamin B12 absorption caused by
problems with the pancreas
(malabsorption syndrome, pancreatitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A toxicology test checks:

A
  • blood
  • urine
  • saliva
  • breath air
  • sweat
  • hair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Urine toxicology test is usually used to

A

identify mood-altering
drugs that were taken several hours or days before the urine
sample was collected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

gold standard of drug testing?

A

urine

But:
urine specific gravity constant urine temperature creatinine concentration
are performed on every specimen to ensure the urine has not been altered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Special Urinalysis uric acid

A

Uric acid is a product of the metabolic breakdown of
purine nucleotides. DNA/RNA
• 75% of this uric acid is excreted by the kidneys and 25%
is excreted in the intestinal tract.
• Uric acid concentrations in urine above and below
normal are correspondently known as:
hyperuricosuria and hypouricosuria
• Uric acid level can also be checked by using a blood
test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hyperuricosuria:

A
  • gout
  • metastatic cancer
  • multiple myeloma
  • cancer chemotherapy
  • high purine diet
  • leukemias
  • intake of uricosuric drugs:
    – ascorbic acid, calcitonin, estrogens, steroids, salicylates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Normal values of uric acid

A

range from 250 to 750 milligrams per 24 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hypouricosuria kidney diseases

A
  • chronic glomerulonephritis
  • eclampsia
  • chronic alcohol ingestion with kidney pathology
  • lead toxicity with kidney pathology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

creatinine clearance test

A

-Normal urine creatinine (24-hour sample) values can range
from 500 to 2000 mg/day.
-men <40= 107-139 mm/min
-women <40= 87-107
-values normally go down as you get older

• A creatinine clearance test measures how well creatinine is removed from blood by the kidneys, how well the
kidneys are working
• requires both urine and blood
-indicates glomerular filtration rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

High creatinine clearance:

A
  • strenuous exercise
  • pregnancy
  • muscle injury (especially crushing injuries)
  • burns
  • hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Low creatinine clearance:

A
  • serious kidney damage (infection, shock, low blood flow to the kidneys, cancer)
  • urinary tract blockage
  • heart failure,
  • dehydration
  • liver disease (cirrhosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Blood Urea Nitrogen (BUN)

A

-is a substance formed in the liver through an enzymatic protein breakdown process.
• Urea is the waste product of protein metabolism and
normally removed from the blood by the kidneys.
• BUN is a measurement of:
- kidney’s excretory function
- liver metabolic function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Abnormally high blood levels of BUN and creatinine is

collectively known as

A

azotemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q 
Prerenal azotemia (without primary involvement of the urinary
system):
A
  • hypovolemia due to GI bleeding, dehydration, shock
  • excessive protein ingestion (alimentary tube feeding)
  • starvation
  • excessive protein catabolism (burns, sepsis)
  • congestive heart failure
  • myocardial infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Renal azotemia (due to primary kidney diseases):

A
  • renal failure

- nephrotoxic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q 
Postrenal azotemia (due to primary lower urinary tract
involvement) :
A
  • lower urinary tract obstruction with abnormal

or inadequate excretion of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Decreased BUN level develops in the following pathologies:

A
  • liver failure (cirrhosis)
  • overhydration
  • negative nitrogen balance (a diet low in
    protein, malabsorption)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Acid Phosphatase

A

-is an enzyme found throughout the
body.
• organs :
prostate gland, spleen, pancreas, liver, heart, muscle, kidneys, bones, red blood cells, platelets
• Prostate gland has 100 times more Acid phosphatase than
any other body tissue (pAP)
• Acid phosphatase is normally found in low concentration in
the blood
• Blood test on Acid phosphatase can determine from which tissue the enzyme is coming, e.g. from the
prostate or RBC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Increased serum levels of Acid phosphatase is useful in the

diagnosis of a variety of medical conditions:

A
  • prostate cancer that has metastasized to the bone
  • systemic infection
  • anemia
  • multiple myeloma
  • thrombophlebitis
  • Paget’s disease
  • hepatitis
  • kidney diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Short-term increase of Acid phosphatase is possible

after:

A
  • digital rectal exam
  • catheterization
  • biopsy of prostate gland
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Prostate Specific Antigen

A

-is a protein that is produced by
the prostate gland.
• The blood level of PsA is often elevated in men with prostate problems (benign pathologies or cancer).
• PsA test must be analyzed in conjunction with digital
rectal exam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

High level of PsA and enlargement of the prostate during

digital rectal exam may indicate:

A

-benign prostate hyperplasia, prostatitis (mostly due to venereal diseases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

High level of PsA and normal or small size of prostate on the
digital exam may indicate

A

-prostate cancer.
-But only prostate biopsy (!!!) can be used for diagnosis of
prostate cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Normal PsA range is different with age:

A
  • < 50 y/o – PsA is less than 2.5 ng/ml
  • 50-59 y/o – PsA is less than 3.5 ng/ml
  • 60-69 y/o – PsA is less than 4.5 ng/ml
  • > 70 y/o – PsA is less than 6.5 ng/ml
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Aspartate Aminotransferase - AST (a.k.a. serum
glutamic oxaloacetic transaminase – SGOT) is an
intracellular enzyme found in:

A
  • liver
  • cardiac muscle
  • skeletal muscles
  • kidney
  • pancreas
  • brain
  • RBC

-Low levels of AST are normally found in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Blood level of AST will increase in:

A
  • liver parenchymal cell damage
  • myocardial infarction
  • skeletal muscle trauma
  • acute renal diseases
  • acute pancreatitis
  • severe burns
  • hemolytic anemias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Alanin Aminotransferase - ALT (a.k.a. serum glutamic
pyruvic transaminase – SGPT) is an intracellular enzyme
found predominately in

A
  • the liver, less in the kidneys,
    pancreas and heart.
  • Low levels of ALT are normally found in the blood.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Most increases in ALT levels are caused by liver

damage:

A
  • hepatitis
  • cirrhosis
  • liver toxins
  • ALT can elevate in:
    • congestive heart failure
    • infectious mononucleosis
    • viral/systemic
  • exercise also causes elevated levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Gamma-Glutamyl Transpeptidase (GGTP)

A
  • enzyme
    found mostly in cell membranes
    of hepatobiliary system (liver, biliary system),
    pancreas, kidneys, heart.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

GGTP blood level is increased in:

A

-no change in ALT/AST
- liver diseases
- biliary system disorders (provided Alkaline phosphatase
blood level is increased)
- 1 to 2 weeks after an acute myocardial infarction
- pancreatitis (provided lipase and amylase blood levels
are increased)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q 
Alkaline Phosphatase (ALP) is an enzyme found
predominately in
A

-liver, bile ducts, bones, and less
present in kidneys, placenta, intestines.
• ALP helps break down proteins in the body
• Normally high ALP blood level is found in:
- rapidly growing children
- pregnant women
- bone healing after fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Abnormally high ALP blood level is found in:

A
  • biliary tract obstruction (along with increased blood level
  • osteoblastic bone tumors (e.g. Paget’s disease, where
  • osteomalacia (in rickets)
  • hepatitis (in conjunction with increased blood levels of
  • leukemia
  • lymphoma
  • sarcoidosis
    of GGTP) GGTP blood level is not increased)
    ALT, AST, GGTP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Abnormally low ALP blood level is found in:

A
  • protein malnutrition (e.g. Celiac disease)
  • deficiency in vitamins and minerals
    (e. g. osteoporosis , Vitamin D)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Lactic Acid Dehydrogenase, a.k.a. Lactate Dehydrogenase

LDH

A 
- an enzyme that helps produce energy. 
• It is present in almost all of the tissues in the body, such as:
- heart muscle 
- blood cells 
- skeletal muscles 
- liver 
- pancreas 
- brain 
- lungs

and becomes elevated in response to cell damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

LDH1 composition/location

A
  • HHHH

- myocardium & RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

LDH2 composition/location

A
  • HHHM

- reticuloendothelial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

LDH3 composition/location

A
  • HHMM

- Lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

LDH4 composition/location

A
  • HMMM

- Kidney, placenta, and pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

LDH5 composition/location

A
  • MMMM

- Liver and striated, muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Blood Analysis lactate dehydrogenase

A

• In the event of myocardial injury, the serum LDH levels will
rise within 24 – 48 hours after myocardial infarction onset,
peak in 2 to 3 days and return to normal in approximately 5
to 10 days.
-This makes the serum LDH level especially useful for delayed diagnosis of myocardial infarction.
• However, the use of LDH to diagnose infarction has been
largely superseded by the use of Troponin I or T measurement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Blood Analysis troponin

A

• The troponin test measures the levels of certain proteins
called troponin T and troponin I in the blood
-These proteins are released when the heart muscle has been damaged, such as a heart attack
-The more damage of the heart, the greater the amount of troponin T and I in the blood
• Cardiac troponin levels are normally so low they cannot be
detected with most blood tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Troponin levels will be increased after an MI

A
  • within 6 hours
    -may remain high for 1 to 2 weeks after a
    heart attack onset.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Creatine Phosphokinase (CPK)

A
  • is an enzyme found
    mainly in the brain, lungs, heart, and skeletal muscles
    • CPK is made of three slightly different substances:
  • CPK-1 (also called CPK-BB) is found mostly
    in the brain and lungs
  • CPK-2 (also called CPK-MB) is found
    mostly in the heart
  • CPK-3 (also called CPK-MM) is found
    mostly in skeletal muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Increased CPK-1 (BB) levels may be due to:

A
  • brain cancer
  • brain injury (due to injury, stroke, or bleeding
    in the brain)
  • electroconvulsive therapy
  • pulmonary infarction
  • seizure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

CPK-2 (MB) levels rise

A
  • 3-6 hours after a heart attack onset.
    • If there is no further heart muscle damage, the level peaks
    at 12-24 hours and returns to normal 12-48 hours after
    tissue death.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

CPK-2 levels do NOT usually rise with:

A
  • chest pain caused by angina
  • pulmonary embolism (blood clot in the lung)
  • congestive heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Increased CPK-3 (MM) levels are usually a sign of muscle

injury or muscle stress and may be due to:

A
  • crush injuries
  • muscle damage due to drugs or being
    immobile for a long time (rhabdomyolysis)
  • muscular dystrophy
  • myositis (skeletal muscle inflammation)
  • recent seizures
  • recent surgery
  • strenuous exercise
  • appendectomy**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Blood (serum) myoglobin

A
  • When muscle is damaged, myoglobin is released into
    the bloodstream.
  • The kidneys help remove myoglobin from the body into
    the urine.
  • In large amounts, myoglobin can damage the kidneys.
  • Serum myoglobin levels may be obtained to confirm suspected muscle damage, including heart and skeletal muscle damage.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

A normal (negative) myoglobin result is

A

0 - 85 ng/mL.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Greater-than-normal myoglobin levels

A
  • heart attack (level will rise within 3 hours of myocardial injury)
  • muscular dystrophy
  • rhabdomyolysis
  • skeletal muscle inflammation (myositis)
  • skeletal muscle ischemia (oxygen deficiency)
  • skeletal muscle trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

normal albumin %

A

55%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

normal globulin %

A

38%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

normal fibrinogen %

A

7%

72
Q

All blood proteins are synthesized in the

A

liver

73
Q

All blood proteins are synthesized in the liver except:

A
  • gamma-globulins (immunoglobulins) which

are synthesized in the lymph nodes

74
Q

Normal range of albumins in the blood

A

3.5-5.0 g/dl

75
Q

Normal range of globulins in the blood

A
  1. 0-2.5 g/dl

- participate in immune reactions

76
Q

Normal albumin-to-globulin ratio is

A

> than 1 (~1.4)

77
Q

Normal range of fibrinogen in the blood

A
  1. 2-0.45 g/dl

- needed for coagulation

78
Q

Increased serum albumin levels can be found in:

A
  • dehydration
79
Q

Decreased serum albumin levels can be found in:

A
  • advanced malignancy
  • liver disease – the liver synthesizes albumin
  • Crohn’s disease
  • starvation – inadequate protein intake
  • nephrotic syndrome
  • kwashiorkor
  • hypertensive disorders of pregnancy(pre-eclampsia & eclampsia) pregnancy amplifies the loss of protein in the 3th trimester of
80
Q

Increased globulin levels can be found in:

A
  • liver diseases (e.g. acute or chronic hepatitis B, C, D)
  • amyloidosis
  • multiple myeloma
    – usually produces a monoclonal spike of gamma globulins
  • leukemias
  • lymphomas
81
Q

Decreased fibrinogen can be found in:

A
  • liver cirrhosis
82
Q

total protein test measures

A
  • the total amount of two classes of proteins: albumin and globulin.
  • The normal range is 6.0 to 8.3 gm/dL.
  • diagnoses: nutritional problems, kidney disease, liver diseases etc.
  • increased during
    pregnancy.
83
Q

Higher-than-normal levels of total blood proteins may be due to:

A
  • chronic inflammation or infection (hepatitis B, C, D, AIDS)
  • multiple myeloma
  • Waldenström macroglobulinemia
84
Q

Lower-than-normal levels of total blood proteins may be due to:

A
  • agammaglobulinemia
  • bleeding (hemorrhage)
  • burns (extensive)
  • glomerulohephritis (nephrotic syndrome)
  • liver diseases (cirrhosis)
  • protein malnutrition
  • malabsorption syndrome
85
Q

normal fasting blood glucose levels

A
  • 70 - 100 mg/dL
86
Q

normal random blood glucose levels

A

below 125 mg/dL.

87
Q

Hypoglycemia means blood glucose level

A

< 70 mg/dl

88
Q

Hyperglycemia means blood glucose level

A

> 125 mg/dl

89
Q

fasting blood glucose

level of 100-125mg/dL means

A
  • impaired fasting glucose, a type of prediabetes.

- This increases risk for type 2 diabetes.

90
Q

fasting blood glucose level of 126 mg/dL and higher most often
means

A
  • diabetes mellitus
91
Q

Persistent hyperglycemia:

A
  • diabetes mellitus
  • pancreatitis
  • pancreatic tumor
  • pheochromocytoma
  • Cushing’s syndrome
  • insuloma
  • Addison’s disease
  • ectopic insulin production (e.g. ovarian carcinoid mesotheliomas, liver, kidney, lung
    cancer)
92
Q

Transient hyperglycemia

Stress hyperglycemia

A
  • stroke
  • heart attack
  • after surgery
  • shock
  • severe liver damage
  • acute alcohol
    intoxication
  • severe glycogen
    storage disease
  • strenuous exercises
  • overdosage of insulin
    or other diabetic medicines
93
Q

The glucose screening tolerance test measures

A

body’s ability to
break down glucose, that is the body’s main source of
energy.

94
Q

glucose tolerance test

A

• A patient is not supposed to eat or drink anything for at
least 8 hours before the test, and not eat during the test.
• Before the test begins, fasting blood will be taken.
• Then patient drinks a liquid containing glucose (usually
75 grams).
• The patient’s blood will be taken again every 60 minutes
after drinking the solution.
• The test takes up to 4 hours.

95
Q

normal blood values of glucose tolerance test

A
  • fasting: 70 to 100 mg/dL ***
  • 1 hour: less than 200 mg/dL
  • 2 hours: less than 140 mg/dL
  • 3 hours: less than 125 mg/dl
  • 4 hours: less than 115 mg/dl
96
Q

A glucose tolerance test level that is higher than normal could mean:

A
  • prediabetes
  • diabetes type 2
  • gestational diabetes
97
Q

2 hours after beginning of the glucose tolerance test:

- if glucose level is 140-199 mg/dL, it is called

A

impaired glucose tolerance, could also be called prediabetes

98
Q

if glucose tolerance test level is 200 mg/dL or higher, it is a sign of

A

diabetes (type 2 or gestational)

99
Q

A high glucose level may also be related to another

medical problem

A

e.g. Cushing syndrome

100
Q

A test result is positive if ketones are found in the blood.

This may indicate:

A
  • alcoholic ketoacidosis MC
  • diabetic ketoacidosis (melitis never insipidous)
  • starvation
  • uncontrolled blood glucose in diabetics
101
Q

Transient ketoacidosis could be present in

A
  • children at age before 16 years old after they ate a lot of meat, chocolate, fast food, after drinking soft beverages.
  • acetone breath
  • part of liver panel
102
Q

Amylase

A
  • an enzyme
  • produced by pancreas
    and salivary glands
  • test blood and urine
103
Q

Decreased amylase levels may occur due to:

A
  • cancer of the pancreas

- damage to the pancreas (pancreonecrosis)

104
Q

Increased blood and urine amylase levels may occur due to:

A
  • acute pancreatitis (e.g. due to bile duct blockage, peptic ulcer penetration to pancreas)
  • chronic pancreatitis
  • cancer of the pancreas, (metastasis to ovaries, or lungs)
  • infection or blockage of the salivary glands(such as mumps)
105
Q

cancer of the pancreas, metastasizes to

A

ovaries, or lungs

106
Q

Lipase test

A
  • protein (enzyme) released by the pancreas into the small intestine.
  • digests fat
  • check for pancreas disease
  • appears in blood when pancreas is damaged
107
Q

Higher-than-normal lipase levels may be due to:

A
  • acute or chronic pancreatitis
  • bowel obstruction
  • celiac disease
  • penetration of peptic ulcer to pancreas
  • cancer of the pancreas
  • infection or swelling of the pancreas

condition that blocks the flow of lipase from the pancreas to small intestine

108
Q

Cholesterol

A
  • liver produces about 80% of the body’s cholesterol (the rest from food)
  • required for the production of steroids, sex hormones, bile acids, cellular membranes, and vitamin D.
109
Q

avocado, flax seeds and nuts contain cholesterol-like chemicals called:

A

phytosterols

110
Q

Cholesterol is attached to a protein and the two together are
called a

A
  • lipoprotein
  • three types of lipoproteins:
    • LDL
    • HDL
    • VLDL
111
Q

low-density lipoproteins (LDL)

A

contain a higher ratio of cholesterol to protein and are thought of as the “bad” cholesterol.

112
Q

high-density lipoproteins (HDL)

A

are made up of a higher level of protein and a lower level of cholesterol - “good” cholesterol.

113
Q
  • very low-density lipoproteins (VLDL) contain even
A

less protein than LDL

114
Q

Lipid profile or lipid panel

A 
- is a panel of blood tests that serves as an initial broad medical screening tool for abnormalities in lipids, such as cholesterol and
triglycerides
- The lipid profile typically includes:
   - (LDL) 
   - (HDL) 
   - triglycerides 
   - total cholesterol
115
Q

A high HDL level is related to

A

lower risk of heart and blood vessel diseases.

116
Q

what transports endogenous triglycerides, phospholipids

and cholesterol to adipose tissue?

A

VLDL

117
Q

normal values LDL

A

lower than 130 mg/dL

118
Q

normal values HDL

A

greater than 40 - 60 mg/dL

119
Q

normal values total cholesterol

A

160 - 200 mg/dL

120
Q

normal values triglycerides

A

10 - 150 mg/dL

121
Q

normal values VLDL

A

2 - 30 mg/dL

122
Q

Optimal LDL/HDL ratio is

A

less than 3.5 : 1

123
Q

According to the American Heart Association, it is best to

keep the ratio of total cholesterol/HDL =

A

below 5:1

124
Q

Total cholesterol of < 160 mg/dl can be a sign of

A
  • hemorrhagic stroke
  • depression
  • reduced synthesis of hormones
  • could indicate liver cancer
125
Q

total cholesterol of > 200 mg/dl is a predisposing factor for:

A
  • atherosclerosis
  • cardiovascular diseases
  • ischemic stroke
  • obesity
126
Q

abnormal levels of lipid panel: LDL

A

> 130 mg/dl results from:

- inactivity
- obesity 
- diabetes mellitus - High levels of LDL are linked to an increased risk of heart and blood vessel disease, including coronary artery disease, heart attack and death.
127
Q

abnormal levels of lipid panel: HDL

A
  • Low levels of HDL significantly increase the risk of heart disease. Inactivity, obesity and cigarette smoking also reduce HDL levels.
  • High levels linked to a reduced risk of heart and blood vessel disease. The higher HDL level, the better.
128
Q

abnormal levels of lipid panel: Triglycerides

A
  • Elevated in obese or diabetic patients. Level increases from eating simple sugars or drinking alcohol.
  • Associated with heart and blood vessel diseases.
129
Q

Alpha fetoprotein (AFP)

A
  • normally produced by the liver and yolk sac

- normal values 0-40 micrograms/liter.

130
Q

normal value for pregnant women of Alpha fetoprotein

A
  • 10–130 micrograms/liter.
  • with 14-22 weeks of
    pregnancy
131
Q

If the fetus has an open neural tube defect, AFP is thought
to leak directly into the amniotic fluid causing unexpectedly
_____ concentrations of AFP.

A

high

132
Q

What causes neural tube defect NTDs

A
  • folic acid deficiency,
  • anti-seizure medications (e.g., valproic acid),
  • uncontrolled diabetes,
  • alcohol,
  • obesity,
  • increased body temperature
133
Q

High-than-normal levels ( > 40) of AFP in men and non-pregnant women may be due to:

A
  • cancer of:
    • testes, ovaries
    • biliary tract
    • liver
    • stomach
    • pancreas
  • liver cirrhosis
  • malignant teratoma
  • recovery from hepatitis
134
Q

High level of AFP ( > 130) in the mother’s blood between 14th and 22nd weeks of pregnancy may be due to:

A
  • birth defects, including:
    • anencephaly
    • spina bifida
    • abdominal wall defect
    • tetralogy of Fallot
  • genetic disorders (e.g. Turner syndrome, a.k.a. 45 XO)
  • intrauterine death (usually results in a miscarriage)
  • multiple pregnancy (twins, triplets, etc.)
135
Q

Low level of AFP in pregnant woman could indicate

A

Down’s syndrome, or Edward’s syndrome (Trisomy 18) in a baby

136
Q

Antinuclear Antibodies

A
  • produced by immune system
  • attack the body’s own tissues
    • Usually, there is no detectable ANA in the blood (negative test).
    • Sometimes, however, people who do not have any specific disease may have low levels of ANA for no
    obvious reason.
    • ANA is reported as a “titer.”
    -Low titers are in the range of 1:40 to 1:60.
137
Q

-Low titers are in the range of

A

1:40 to 1:60.

138
Q

A positive ANA can also be a sign of autoimmune diseases:

A
  • chronic liver disease
  • vasculitis
  • dermatomyositis
  • rheumatoid arthritis
  • Sjögren syndrome
  • scleroderma
139
Q 
ANA does not confirm a diagnosis of systemic
lupus erythematosus (SLE) without the \_\_\_\_\_\_\_\_\_\_\_\_\_?
A

double-

stranded form of DNA (anti-dsDNA)

140
Q

what is the target antigen for Anti-dsDNA antibodies?

A

double stranded DNA (ds, duh)

141
Q

Anti-dsDNA antibodies

A
  • highly diagnostic of systemic lupus
    erythematosus (SLE) and are implicated in the
    pathogenesis of lupus nephritis.
  • Less than 1% of healthy individuals have this antibody.
142
Q

ELISA

A

enzyme-linked immunosorbent assay

-is associated with anti-dsDNA

143
Q

Anti-dsDNA antibodies can also be found in what diseases

A
  • rheumatoid arthritis
  • viral infection (e.g. HIV, Epstein-Barr virus)
  • autoimmune hepatitis
144
Q 
Antistreptolysin O (ASO) titer is a blood test
to measure
A

antibodies against streptolysin O, a

substance produced by group A Streptococcus

145
Q

Acceptable values of ASO, where there is no clinical suspicion of
Streptococcus infection are as follows:

A
  • adults: less than 200 units
  • children: less than 400 units
  • The presence of these antibodies indicates an exposure to these bacteria
146
Q

Acceptable values of ASO, where there is no clinical suspicion of
Streptococcus infection are as follows:

A
  • adults: less than 200 units
  • children: less than 400 units
    -The presence of these antibodies indicates an exposure to these bacteria
  • This titer has a significance only if it is greatly elevated
    >200
    -antibody level begin to rise 1-3 weeks after initial infection peaks 3-5 weeks
147
Q

If Antistreptolysin O (ASO) titer test is positive and is associated with symptoms of
a previous infection by group A Streptococcus, it could
indicate:

A
  • rheumatic fever
  • scarlet fever
  • bacterial endocarditis
  • acute glomerulonephritis
  • strep. throat
148
Q

C-reactive protein (CRP) is produced by

A
  • liver

- checks for inflammation and destruction in the tissue

149
Q

A positive CRP test means presence of inflammation in the
body. This may be due to a variety of different conditions,
including:

A
  • cancer
  • connective tissue diseases (rheumatoid arthritis,
    rheumatic fever, SLE etc.)
  • heart attack (positive CRP test after 18-72 hours of MI)
  • infection (e.g. pneumonia, tuberculosis)
  • inflammatory bowel disease (IBD)
150
Q

high-sensitivity C reactive protein or hs-CRP

A
  • used to determine a person’s risk for heart disease
151
Q

low risk of developing cardiovascular disease if

hs-CRP level is lower than

A

1.0mg/L

152
Q

average risk of developing cardiovascular disease if

hs-CRP levels are

A

1.0 - 3.0 mg/L

153
Q

high risk for cardiovascular disease if

hs-CRP level is higher than

A

3.0 mg/L

154
Q

HIV tests may detect

A

antibodies, antigens or viral RNA.

155
Q

tests for HIV

A
  • ELISA is done first

- Western blot is done second and is needed to confirm ELISA

156
Q

PCR (polymerase chain reaction)

A
  • test for detection of the genetic material of HIV itself.
  • This test can identify HIV in the blood within 2-3 weeks
    of infection.
  • PCR test is also used for babies born to HIV-positive mothers, because their blood contains their mother’s HIV antibodies for several months.
157
Q

HLA-B27

human leukocyte antigen B27 (HLA-B27)

A
  • ## is a blood test to look for a protein that is found on the surface of white blood cells
158
Q

HLAs are proteins that help the body’s immune

system

A

tell the difference between its own cells and foreign, harmful substances

159
Q

A positive test means HLA-B27 is

A

**present
- Psoriatic arthritis (especially associated with development of spondylitis)
- Ankylosing spondylitis
- Inflammatory bowel diseases (IBD)
- Reiter’s syndrome
- uveitis (iritis)
- mnemonic PAIR
- does not always mean presence of a
disease.

-therefore negative means its absent

160
Q

Rheumatoid factor (RF)

A
  • found in rheumatoid arthritis in 80% of cases

- Normally RF is less than 1:40 titer.

161
Q

Positive RF can also be found in:

A
  • Sjögren’s syndrome (in 70% of patients)
  • SLE
  • dermatomyositis
  • sarcoidosis
  • scleroderma
  • chronic hepatitis
162
Q

Prothrombin Time (PT)

A
  • measures clotting time

- normal values : 11-13.5 seconds

163
Q

Ammonia Test

A
  • ammonia in blood
  • forms when protein is broken down by bacteria in intestines
  • liver normally converts ammonia to urea
  • normal levels: 15-60 micrograms/dl
164
Q

High levels of ammonia in the blood may be caused by:

A
  • liver diseases (cirrhosis, hepatitis)
  • kidney failure
  • heart failure
  • Reye’s syndrome
165
Q

AFP(Alpha-fetoprotein) tumor marker-

A

cancers of ovaries &testes**

some primary liver cancers (hepatocellular)

166
Q

Bence-Jones Proteins -tumor marker

A
  • multiple myeloma**
  • Waldenstrom’s
  • macroglobulinemia,
  • chronic lymphocytic leukemia
167
Q

CA 15-3 (Cancer Antigen) - breast**

tumor marker

A

(often not elevated in early stages of breast cancer), lung, ovarian, endometrial, bladder, gastrointestinal

168
Q

CA 19-9 (Cancer Antigen) tumor marker

A
  • pancreas** ,
    colorectal, liver, biliary tree
    stomach
169
Q

CA 125 (Cancer Antigen) tumor marker

A
  • ovarian cancer**

breast, colorectal, uterine, cervical, pancreatic, liver, lung

170
Q

CA 27.29 tumor marker

A

breast** (best used to detect recurrence or metast.)

colorectal, stomach, liver, lung, pancreatic, ovarian, prostate cancers

171
Q

CEA (Carcinoembryonic Antigen) tumor marker

A

-colorectal cancers **
breast, thyroid, liver, lung, head & neck, bladder, cervical, stomach, kidney, ovarian, pancreatic, lymphoma, melanoma

172
Q

HCG (Human Chorionic Gonadotrophin) tumor marker

A

ovarian ,testicular cancers**, gestational trophoblastic neoplasia

173
Q

LDH (Lactic Dehydrogenase) tumor marker

A
  • lymphoma,

- melanoma, - acute leukemia

174
Q

PAP (Prostatic Acid Phosphatase) tumor marker

A

metastatic prostate
cancer**
myeloma, lung cancer,
osteogenic sarcoma

175
Q

PSA (Prostate Specific Antigen) tumor marker

A

–prostate carcinoma**

UA (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions