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Clinical Chemistry - JD > Review > Flashcards

Review Flashcards

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1
Q

Which analytes are affected by diurnal variation and are increased in the AM?

A

ACTH, cortisol, iron

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2
Q

Which analytes are affected by diurnal variation and are increased in the PM?

A

growth hormone, PTH, TSH

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3
Q

Fasting samples are required for which chemistry tests?

A

fasting glucose, triglycerides, and lipid panel

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4
Q

Alcohol will have what affect on glucose?

A

alcohol will decrease glucose levels

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5
Q

Alcohol will have what affect on GGT and triglycerides?

A

alcohol will increase these analytes

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6
Q

Stress can increase which three anallytes?

A

ACTH, cortisol, and catecholamines

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7
Q

Which analytes require being chilled after sample collection?

A

ammonia, lactic acid, and blood gas

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8
Q

Which analytes will be decreased when exposed to light?

A

bilirubin and carotene

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9
Q

When pumping the fist during sample collection, what analytes may increase, which then affects the pH by (increasing/lowering) it?

A

Increase in K, lactic acid, Ca, Phosphorous

Lowered pH

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10
Q

Which analytes may increase in a sample that was collected with prolonged use of a tourniquet?

A

K, total protein, lactic acid

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11
Q

If a sample was delayed in separating serum/plasma, which analytes will be increased?

A

ammonia, lactic acid, K, Mg, LD

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12
Q

If a sample was delayed in separating serum/plasma, which analyte will be decreased?

A

glucose (unless collected in fluoride)

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13
Q

Total protein, LD and Ca are higher in serum or plasma?

A

plasma

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14
Q

K, phosphate, glucose, CK, HCO3, ALP, ALB, AST, and trigs are higher in serum or plasma?

A

serum

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15
Q

Glucose is higher in plasma or whole blood?

A

plasma

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16
Q

Glucose (postprandial) and K are higher in capillary blood or venous blood?

A

capillary

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17
Q

Ca and total protein are higher in capillary blood or venous blood?

A

venous blood

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18
Q

K, phosphate, and Mg are higher in plasma or RBCs?

A

RBCs

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19
Q

Na and Cl are higher in plasma or RBCs?

A

plasma

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20
Q

A basic metabolic panel tests for which 8 analytes?

A

Na, K, Cl, CO2, GLU, Crea, BUN, and Ca

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21
Q

A comprehensive metabolic panel tests for which 13 analytes?

A

Na, K, Cl, CO2, GLU, Crea, BUN, ALB, Total Protein, ALP, AST, Bili, and Ca

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22
Q

An electrolyte panel tests for which analytes?

A

Na, K, Cl, CO2

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23
Q

A hepatic function panel tests for which 7 analytes?

A

ALB, ALT, AST, ALP, Bili (total), Bili (conjugated), total protein

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24
Q

A lipid panel tests for which analytes?

A

total cholesterol, HDL, LDL, and Trigs

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25
Q

A renal function panel tests for which 9 analytes?

A

Na, K, CO2, GLU, Crea, BUN, Ca, ALB, and phosphate

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26
Q

What substance is a major source of cellular energy and has decreased levels at room temp?

A

glucose

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27
Q

What additive is used to prevent glycolysis?

A

sodium fluoride

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28
Q

What are the most common methods for measuring glucose?

A

glucose oxidase and hexokinase

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29
Q

Diabetes mellitus, other endocrine disorders, acute stress, and pancreatitis may result due to hyperglycemia or hypoglycemia?

A

hyperglycemia

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30
Q

Possible causes of hypoglycemia:

A

insulinoma, insulin-induced hypoglycemia, hypopituitarism

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31
Q

Which methods are most commonly used to test total cholesterol?

A

enzymatic methods

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32
Q

Since total cholesterol is of little value in predicting CAD, it is typically tested along with which other analytes?

A

HDL and LDL

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33
Q

Which analyte is inversely related to CAD?

A

HDL

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34
Q

Which two lipids are risk factors for CAD?

A

LDL and Trigs

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35
Q

Which cholesterol is good?

A

HDL

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36
Q

What is the Friedewald formula and what does it calculate?

A

LDL = (total cholesterol) - (HDL) - (Trigs/5)
Trigs cannot exceed 400 mg/dL

Calculates LDL

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37
Q

How are LDL levels determined?

A

Calculated via the Firedewald equation or measured via direct homogenous assays

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38
Q

What is the main form of lipid storage?

A

Triglycerides

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39
Q

What methods are used to measure Trigs?

A

enzymatic methods using lipase

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40
Q

What type of specimen is required for testing trigs?

A

fasting specimen

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41
Q

How does dehydration, chronic inflammation, and multiple myeloma affect total protein levels?

A

increases TP levels

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42
Q

Nephrotic syndrome, malabsorption, overhydration, hepatic insufficiency, malnutrition, and agammaglobulinemia affect TP how?

A

decreases TP

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43
Q

Very low levels of TP are associated with

A

peripheral edema

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44
Q

Total protein is measured via which method?

A

Biuret method

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45
Q

What is the Biuret method?

A

Used to measure total protein by using an alkaline copper reagent that reacts with peptide bonds

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46
Q

Which analyte is the largest fraction of plasma proteins?

A

albumin

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47
Q

Albumin is increased or decreased with dehydration?

A

increased

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48
Q

Albumin regulates…

A

osmotic pressure

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49
Q

Malnutrition, liver disease, nephrotic syndrome, and chronic inflammation will increase or decrease albumin?

A

decrease

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50
Q

How is albumin measured?

A

Via dye-binding (BCG or BCP)

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51
Q

Which analyte is predictive of diabetic nephropathy?

A

microalbumin

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52
Q

What specimen is used to test microalbumin?

A

24 hour urine

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53
Q

How can microalbuminuria be determined on a random sample?

A

using the ALB:Crea ratio

30-300 mg albumin/g creatinine

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54
Q

Which hormone decreases glucose levels?

A

insulin

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55
Q

What is responsible for entry of glucose into cells?

A

insulin

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56
Q

In the regulation of glucose, insulin increases…

A

glycogenesis

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57
Q

Which 5 hormones increase glucose levels?

A

glucagon, cortisol, epinephrine, growth hormone, and thyroxine

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58
Q

In the regulation of glucose, Glucagon stimulates…

A

glycogenolysis and gluconeogenesis

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59
Q

In the regulation of glucose, Glucagon inhibits…

A

glycolysis

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60
Q

Which hormones are insulin antagonists?

A

cortisol and growth hormone

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61
Q

In the regulation of glucose, cortisol increases…

A

gluconeogenesis

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62
Q

In the regulation of glucose, epinephrine promotes…

A

glycogenolysis and gluconeogenesis

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63
Q

In the regulation of glucose, thyroxine stimulates…

A

glycogenolysis

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64
Q

How does thyroxine act in the regulation of glucose?

A

increases glucose absorption for GI tract

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65
Q

What condition is prone to ketoacidosis and diabetic complications?

A

Type 1 Diabetes

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66
Q

Type 1 diabetes is an autoimmune disorder with the destruction of …… resulting in what deficiency?

A

destruction of beta cells resulting in absolute insulin deficiency

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67
Q

Which type of diabetes mellitus has a genetic predisposition?

A

Type 1

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68
Q

Insulin resistance in peripheral tissues can cause…

A

Type 2 diabetes

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69
Q

What are 2 possible causes for Type 2 diabetes?

A

insulin resistance in peripheral tissues and insulin secretory defect of beta cells

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70
Q

Which type of diabetes is associated with obesity?

A

Type 2

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71
Q

What cells secrete insulin?

A

beta cells

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72
Q

Which type of Diabetes typically has an onset later in life?

A

Type 2

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73
Q

Which type of diabetes is not dependent on exogenous insulin?

A

Type 2

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74
Q

What is the cause of gestational diabetes?

A

placental lactogen inhibits action of insulin

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75
Q

What test is performed only on a patient with symptoms of hyperglycemia and the sample can be collected at any time of the day without regard to time since their last meal?

A

Random plasma gluose

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76
Q

How long must a patient fast for a fasting plasma glucose?

A

at least 8 hours

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77
Q

What result for a random plasma glucose is indicative of diabetes mellitus?

A

> 200 mg/dL

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78
Q

What result for a fasting plasma glucose is indicative of diabetes mellitus?

A

> 126 mg/dL on 2 occasions

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79
Q

Which diabetes test is only used to test for gestational diabetes?

A

oral glucose tolerance test (OGTT)

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80
Q

When is an oral glucose tolerance test performed?

A

24-28 weeks gestation

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81
Q

What result for a Hgb A1C is indicative of diabetes?

A

> 6.5%

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82
Q

Which test gices an estimate of glucose control over the previous 2-3 months?

A

Hgb A1C

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83
Q

TRUE OR FALSE: Hgb A1C test can be used to diagnose diabetes in patients with hemoglobinopathies or abnormal RBC turnover.

A

FALSE

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84
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
Blood glucose

A

increased

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85
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
urine glucose

A

increased

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86
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
urine specific gravity

A

increased

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87
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
glycohemoglobin

A

increased

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88
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
ketones

A

increased

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89
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
anion gap

A

increased

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90
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
BUN

A

increased

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91
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
osmoality

A

increased

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92
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
cholesterol

A

increased

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93
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
triglycerides

A

increased

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94
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
bicarbonate

A

decreased

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95
Q

Is the following typically increased or decreased in laboratory findings for diabetes mellitus?
blood pH

A

decreased

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96
Q

What is defined as: A group of risk factors that seem to promote development of atherosclerotic cardiovascular disease and Type 2 Diabetes Mellitus?

A

Metabolic Syndrome

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97
Q

What are the 5 risk factors of metabolic syndrome?

A

decreased HCL, increased LDL, Trigs, Blood pressure, and blood glucose

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98
Q

Which aminoacidopathy is caused by a deficiency of an enzyme that converts phenylalanine to tyrosine leading to phenylpyruvic acid in the blood and urine?

A

phenylketonuria

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99
Q

Due to the build up of phenylpyruvic acid, patients with PKU tend to have urine with what odor?

A

mousy odor

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100
Q

Which aminoacidopathy can lead to mental retardation due to phenylalanine build-up?

A

phenylketonuria

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101
Q

The Guthrie bacterial inhibition assay can be performed to diagnose…

A

PKU

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102
Q

All newborns are screened for which aminoacidopathy?

A

Phenylketonuria

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103
Q

Which aminoacidopathy is caused by a disorder of tyrosine catabolism, resulting in tyrosine and its metabolites excreted in urine?

A

Tyrosinemia

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104
Q

What is the effects of tyrosinemia?

A

Liver and kidney disease, death

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105
Q

Which aminoacidopathy is caused by a deficiency or an enzyme needed in tyrosine and phenylalanine metabolism, resulting in the buildup of homogentisic acid?

A

Alkaptonuria

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106
Q

A patient with alkaptonuria will have diapers that stain black due to the build up of…

A

homogentisic acid in urine

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107
Q

A patient with which aminoacidopathy will, later in life, have darkening of tissues along with hip and back pain?

A

alkaptonuria

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108
Q

Maple syrup urine disease is caused by the build up of which amino acids?

A

leucine, isoleucine, and valine

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109
Q

A burnt-sugar odor to urine, breath, and skin is associated with which aminoacidopathy?

A

Maple syrup urine disease

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110
Q

Failure to thrive, mental retardation, acidosis, seizures, coma, and death are effects of which aminoacidopathy?

A

maple syrup urine disease

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111
Q

Which aminoacidopathy is caused by the deficiency of an enzyme needed for methionine metabolism?

A

homocystinuria

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112
Q

What builds up in the plasma and urine in homocystinuria?

A

methionine and homocystine

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113
Q

Osteoporosis, dislocated optic lenses, mental retardation, and thrombolytic events are effects of which aminoacidopathy?

A

homocystinuria

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114
Q

Which aminoacidopathy is caused by defective renal reabsorption of cysteine?

A

cystinuria

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115
Q

A positive (red-purple color) result on a urine cyanide nitroprusside test is diagnostic for…

A

cystinuria

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116
Q

Recurring kidney stones is an effect of which aminoacidopathy?

A

cystinuria

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117
Q

Proteins are (negatively or positively) charged and move toward the (anode or cathode).

A

negatively charged and move toward the anode

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118
Q

What is the order of migration from fastest to slowest in protein electrophoresis?

A

ALB, alpha-1, alpha-2, beta, gamma

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119
Q

Bence Jones proteins migrate to which region in protein electrophoresis?

A

gamma globulin region

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120
Q

Which specimen will have a prealbumin band in protein electrophoresis?

A

CSF

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121
Q

An increase in alpha-1 and alpha-2 regions is a common serum protein electrophoresis pattern for…

A

acute inflammation

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122
Q

An increase in alpha-1, alpha-2, and gamma globulin regions is a common serum protein electrophoresis pattern for…

A

chronic infection

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123
Q

Beta-gamma bridging is a common serum protein electrophoresis pattern for…

A

Cirrhosis

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124
Q

A sharp increase in one immunoglobulin (M spike) and a decrease in all other fractions is a common serum protein electrophoresis pattern for…

A

monoclonal gammopathy

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125
Q

A diffuse increase in gamma globulins is a common serum protein electrophoresis pattern for…

A

polyclonal gammopathy

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126
Q

A decrease in the gamma globulin region is a common serum protein electrophoresis pattern for…

A

hypogammaglobulinemia

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127
Q

A decrease in albumin and an increase in alpha-2 is a common serum protein electrophoresis pattern for…

A

Nephrotic syndrome

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128
Q

A decrease in the alpha-1 region is a common serum protein electrophoresis pattern for…

A

Alph-1-antitrypsin deficiency

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129
Q

An increase in the beta region or an unusual band between alpha-2 and beta regions is a common serum protein electrophoresis pattern for…

A

hemolyzed sample

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130
Q

An extra band between the beta and gamma regions is a common serum protein electrophoresis pattern for…

A

plasma (fibrinogen)

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131
Q

What analyte is synthesized by the liver from ammonia?

A

BUN

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132
Q

An increase in BUN is clinically significant for

A

kidney disease

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133
Q

Which analyte is used as a urease reagent?

A

BUN

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134
Q 
Which of the following tubes cannot be used for BUN?
sodium fluoride
EDTA
citrate
lithium heparin
ammonium heparin
A

All except lithium heparin cannot be used for BUN

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135
Q

An increase in creatinine is clinically significant for…

A

kidney disease

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136
Q

What analyte is a waste product from dehydration of creatine?

A

creatinine

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137
Q

The Jaffe reaction uses which reagent to test for which analyte?

A

The Jaffe reaction uses picrate (alkaline) to test for creatinine.

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138
Q

What is the normal BUN:Crea ratio?

A

12-20

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139
Q

Increased uric acid can be clinically significant for…

A

gout, renal failure, ketoacidosis, lactate excess, high nucleoprotein diet, leukemia, lymphoma, polycythemia

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140
Q

A decrease in uric acid can be clinically significant for…

A

administration of ACTH, renal tubular defects

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141
Q

Increased levels of uric acid increase the risk for…

A

renal calculi and joint trophi

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142
Q

EDTA and fluoride interfere with the uricase method, which tests for…

A

uric acid

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143
Q

Why must urine pH be adjusted to 7.5-8 when determining uric acid levels?

A

to prevent precipitation

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144
Q

An increase in ammonia can be clinically significant for…

A

liver disease, hepatic coma, renal failure, Reye’s Syndrome

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145
Q

Which analyte is produced in the GI tract and high levels are neurotoxic?

A

ammonia

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146
Q

Ammonia should be collected in which tubes?

A

EDTA or heparin

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147
Q

Why will serum have increased levels of ammonia?

A

NH3 is generated during the clotting process

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148
Q

Causes of hypernatremia:

A

increased intake, IV administration, hyperaldosteronism, excessive sweating, burns, diabetes insipidus

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149
Q

Hypernatremia can cause:

A

tremors, irritability, confusion, coma

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150
Q

Causes of hyponatremia:

A

renal or extrarenal loss (vomiting, diarrhea, sweating, burns), increased extracellular fluid volume

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151
Q

Hyponatremia causes:

A

weakness, nausea, altered mental status

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152
Q

What is the major extracellular cation?

A

Sodium

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153
Q

Which analyte contributes to almost half of plasma osmolality?

A

sodium

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154
Q

Which analyte maintains normal distribution of water and osmotic pressure?

A

sodium

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155
Q

Sodium levels are regulated by…

A

aldosterone

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156
Q

What is the most common method for testing sodium?

A

ISE (ion-selective electrode)

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157
Q

Causes of hyperkalemia:

A

increased intake, decreased excretion, crush injuries, metabolic acidosis

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158
Q

Hyperkalemia can cause:

A

muscle weakness, confusion, cardiac arrhythmia, cardiac arrest

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159
Q

Causes of hypokalemia:

A

increased GI or urinary loss, diuretic use, metabolic alkalosis

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160
Q

Hypokalemia can cause:

A

muscle weakness, paralysis, breathing problems, cardiac arrhythmia, death

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161
Q

What is the major intracellular cation?

A

Potassium

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162
Q

Why are serum potassium levels higher than in plasma?

A

platelets release K during the clotting process

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163
Q

Squeezing the capillary site, prolonged tourniquet, pumping fist during venipuncture, IV fluid contamination, hemolysis, prolonged RBC contact, leukocytosis, and thrombocytosis can all increase which electrolyte values?

A

Potassium

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164
Q

What are the major electrolytes?

A

Na, K, Cl, and CO2 (total)

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165
Q

Causes of hyperchloremia:

A

Increased intake, IV administration, hyperaldosteronism, excessive sweating, burns, diabetes insipidus, excessive loss of HCO3

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166
Q

Sodium follows…

A

WATER

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167
Q

What is the major extracellular anion?

A

Chloride

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168
Q

Which electrolyte helps maintain osmolality, blood volume, and electric neutrality?

A

Chloride

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169
Q

Which electrolyte passively follows sodium?

A

Chloride

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170
Q

The sweat Cl test is diagnostic for…

A

cystic fibrosis

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171
Q

90% of total CO2 is in what form?

A

Bicarbonate (HCO3)

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172
Q

Increased total CO2 is clinically significant for…

A

metaboilic alkalosis and compensated repiratory acidosis

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173
Q

Total CO2 is composed of…

A

Mainly bicarb, but also carbonic acid and dissolved CO2

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174
Q

HCO3 is important in maintaining…

A

acid-base balance

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175
Q

Decreased total CO2 is clinically significant for…

A

metabolic acidosis and compensated respiratory alkalosis

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176
Q

If an electrolyte sample is uncapped, which electrolyte is affected and how?

A

Total CO2 will decrease

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177
Q

Causes of increased magnesium:

A

renal failure, increased intake (antacids), dehydration, bone cancer, endocrine disorders

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178
Q

Increased magnesium can cause:

A

cardiac abnormalities, paralysis, respiratory arrest, coma

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179
Q

Causes of decreased magnesium:

A

severe illness, GI disorders, endocrine disorders, renal loss

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180
Q

Decreased magnesium can lead to…

A

cardiac arrhythmias, tremors, tetany, paralysis, psychosis, coma

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181
Q

A decrease in which electrolyte is rare in non-hospitalized patients?

A

Magnesium

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182
Q

Oxalate binds which electrolyte?

A

Mg

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183
Q

Causes of increased calcium:

A

primary hyperparathyroidism, cancer, multiple myeloma

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184
Q

Increased calcium can cause:

A

weakness, coma, GI symptoms, renal calculi

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185
Q

Causes of decreased calcium:

A

hypoparathyroidism, malabsorption, vitamin D deficiency, renal tubular acidosis

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186
Q

Decreased calcium can cause:

A

tetany (muscle spasms), seizures, cardiac arrhythmias

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187
Q

What is the most abundant mineral in the body?

A

calcium (99% in the bones)

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188
Q

Which electrolyte is controlled by the parathyroid, vitamin D, and calcitonin?

A

calcium

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189
Q

Why is heparin the only anticoagulant used to calcium samples?

A

all other anticoagulants bind calcium

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190
Q

What is the biologically active form of calcium?

A

ionized (free) Ca

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191
Q

TRUE OR FALSE: Calcium is not affected by pH or Temp

A

FALSE

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192
Q

Causes of increased phosphorous:

A

renal disease, hypoparathyroidism

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193
Q

Causes of decreased phosphorous:

A

hyperparathyroidism, Vitamin D deficiency, renal tubular acidosis

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194
Q

What is the major intracellular anion?

A

phosphorous

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195
Q

Phosphorous is a component of…

A

nucleic acids and many enzymes

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196
Q

Phosphorous is a major reservoir for…

A

energy (ATP)

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197
Q

Phosphorous is correlated with which other electrolyte?

A

Calcium

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198
Q

The presence of lactate is a sign of…

A

decreased oxygen to tissues

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199
Q

Which electrolyte is a byproduct of anaerobic metabolism?

A

lactate

200
Q

lactate samples should be collected in which tube?

A

heparin

201
Q

What are collection requirements for lactate?

A

Use a heparin tube and put on ice immediately or use fluoride to inhibit glycolysis

202
Q

What analyte is necessary for hemoglobin synthesis?

A

iron

203
Q

Iron is transported by…

A

transferrin

204
Q

What specimen is preferred for iron due to diurnal variation?

A

morning specimen

205
Q

Clinical significances of increased iron:

A

iron overdose, hemochromatosis, sideroblastic anemia, hemolytic anemia, liver disease

206
Q

Clinical significances of decreased iron:

A

iron deficiency anemia

207
Q

How is the total iron binding capacity determined?

A

Iron is added to saturate the transferrin in a sample, the excess is removed, and iron content is determined

208
Q

TIBC is (proportional/inversely) related to iron content.

A

inversely

209
Q

What is the clinical significance of an increased TIBC?

A

iron deficiency anemia

210
Q

What is the clinical significance of a decreased TIBC?

A

iron overdose, hemochromatosis

211
Q

100 X (serum iron/TIBC) = ?

A

% saturation (or transferrin saturation)

212
Q

What is the protein that transports iron?

A

apotranferrin

213
Q

The apotransferrin - iron complex is considered…

A

transferrin

214
Q

Increased transferrin is clinically significant for…

A

iron deficiency anemia

215
Q

Decreased transferrin is clinically significant for…

A

iron overdose, hemochromatosis, chronic infections, malignancies

216
Q

What is the storage form of iron?

A

ferritin

217
Q

What analyte is a rough estimate of body iron content?

A

ferritin

218
Q

Increased ferritin is clinically significant for…

A

iron overload, hemochromatosis, chronic infections, malignancies

219
Q

Name 6 factors that influence enzymatic reactions.

A

substrate concentration, enzyme concentration, temperature, pH, cofactors, and inhibitors

220
Q

Acid phosphatase (ACP) is found in which tissue(s)?

A

prostate

221
Q

Alkaline phosphatase (ALP) is found in which tissue(s)?

A

almost all tissues

222
Q

Aspartate aminotransferase (AST) is found in which tissue(s)?

A

highest in liver, heart, skeletal muscle

223
Q

Alanine aminotransferase (ALT) is found in which tissue(s)?

A

Liver, RBCs

224
Q

Gamma glutamyl transferase (GGT) is found in which tissue(s)?

A

liver, kidneys, pancreas

225
Q

Lactate dehydrogenase (LDH) is found in which tissue(s)?

A

All tissues

226
Q

Creatine kinase (CK) is found in which tissue(s)?

A

skeletal muscle, cardiac muscle, brain

227
Q

Amylase (AMS) is found in which tissue(s)?

A

salivary glands, pancreas

228
Q

Lipase (LPS) is found in which tissue(s)?

A

pancreas

229
Q

Glucose-6-phosphate dehydrogenase (G6PD) is found in which tissue(s)?

A

RBCs

230
Q

An increase in ACP in clinically significant for…

A

prostate cancer

231
Q

Which enzyme is not used to diagnose prostate cancer due to being more specific than ACP?

A

PSA

232
Q

Increased ALP is clinically significant for…

A

liver and bone disease

233
Q

Higher levels of ALP are seen in hepatocellular disorders or biliary tract obstruction?

A

biliary tract obstruction

234
Q

Which enzyme will be increased in children, pregnant women, adolescents, and patients with healing bone fractures?

A

Alkaline phosphatase (ALP)

235
Q

Increased AST can be clinically significant for…

A

liver disease, viral hepatitis, acute MI, muscular dytrophy

236
Q

Which enzyme will be markedly increased in viral hepatitis?

A

AST (and ALT)

237
Q

Which is more specific to the liver: AST or ALT?

A

ALT

238
Q

An increase in ALT is clinically significant for…

A

liver disease

239
Q

What is the most sensitive enzyme for all types of liver disease?

A

GGT

240
Q

Which enzyme can be used to monitor abstention from alcohol?

A

GGT

241
Q

Increased GGT is clinically significant for…

A

all heptobiliary disorders, chronic alcoholism

242
Q

Highest levels of GGT are seen with

A

obstructive disorders

243
Q

Which enzyme catalyzes the reaction: lactic acid to pyruvate?

A

LDH

244
Q

Highest levels of LDH are seen in…

A

pernicious anemia

245
Q

Increases in LDH are clinically significant for…

A

pernicious anemia, AMI, liver disease

246
Q

Which enzyme catalyzes the reaction: phosphocreatine + ADP to creatine + ATP?

A

CK

247
Q

CK is inhibited by all anticoagulants except…

A

heparin

248
Q

What is the most sensitive enzyme for skeletal muscle disease?

A

CK

249
Q

Highest levels of CK are seen in…

A

muscular dystrophy

250
Q

Increased CK can be clinically significant for…

A

AMI, muscular dystrophy

251
Q

Which enzyme creaks down starch to simple sugars?

A

amylase

252
Q

In acute pancreatitis, what is the rise, peak and fall of amylase?

A

rise: 2-12 hours
peak: 24 hours
fall: 3-5 days

253
Q

Increased amylase is clinically significant for…

A

acute pancreatitis, other abdominal diseases, mumps

254
Q

Increased lipase is clinically significant for…

A

acute pancreatitis

255
Q

Which enzyme breaks down triglycerides into fatty acids and glycerol?

A

lipase

256
Q

Which is more specific for pancreatic disease: lipase or amylase?

A

lipase

257
Q

An inherited deficiency of this enzyme can lead to drug induced hemolytic anemia.

A

G6PD

258
Q

CK-MB will be increased in which type of disorder?

A

cardiac disorder

259
Q

AST, ALT, LDH will be increased in which type of disorder?

A

hepatocellular disorders

260
Q

ALP and GGT will be increased in which type of disorder?

A

biliary tract obstruction

261
Q

CK, AST, LDH, and aldolase will be increased in which type of disorder?

A

skeletal muscle disorders

262
Q

ALP will be increased in which type of disorder?

A

bone disorders

263
Q

amylase and lipase will be increased in which type of disorder?

A

acute pancreatitis

264
Q

Name 3 cardiac markers for AMI.

A

CK-MB, myoglobin, troponin

265
Q

Which cardiac marker is the first to rise after an AMI?

A

myoglobin

266
Q

Which cardiac marker has the highest sensitivity and specificity for an AMI?

A

Troponin

267
Q

What is considered a definitive marker for AMI?

A

Troponin

268
Q

What substance is released from heart muscle of the left ventricle in CHF?

A

B-type natriuretic peptide (BNP)

269
Q

What test tests for heart failure?

A

BNP

270
Q

What is the clinical significance of using BNP as a test for heart failure?

A

B-type natriuretic peptide (BNP) is released from the heart muscle of the left ventricle when fluid builds from heart failure. The BNP then acts on the kidneys to increase excretion of fluid.

271
Q

What is the best single marker for predicting cardiovascular events?

A

hs-CRP

272
Q

What test can be used to identify individuals at risk of cardiovascular disease?

A

hs-CRP

273
Q

Name 5 tests that can be used to test for Coronary Artery disease (CAD)

A

Cardiac C-reactive protein, total cholesterol, HDL, LDL, Trigs

274
Q

What is the major cause of CAD and is a primary target for therapy?

A

LDL

275
Q

Which enzyme is needed to conjugate bilirubin?

A

glucuronyl transferase

276
Q

What is formed in the intestines from bacterial action on bilirubin?

A

urobilinogen

277
Q

Increases in total bilirubin can be clinically significant for..

A

liver disease, hemolysis, HDFN, kernicterus (brain damage) in infants

278
Q

What is a special requirement in the collection of bilirubin samples?

A

the sample must be protected from light

279
Q

Jendrassik-Grof method is used to measure…

A

bilirubin

280
Q

What is added to the Jendrassik-Grof method so unconjugated bilirubin reacts?

A

accelerator

281
Q

What reagent is used in the Jendrassik-Grof method to measure bilirubin?

A

Diazo reagent

282
Q

Another term for conjugated bilirubin is…

A

direct bilirubin

283
Q

Increases in conjugated bilirubin can be clinically significant for…

A

liver disease, obstructive jaundice

284
Q

Delta bilirubin is bilirubin that is bound to…

A

albumin

285
Q

When is delta bilirubin only typically seen?

A

significant hepatic obstruction

286
Q

Which form of bilirubin isn’t measured, but calculated?

A

unconjugated bilirubin

287
Q

Increases in unconjugated bilirubin can be clinically significant for…

A

prehepatic, posthepatic, and some types of hepatic jaundice

288
Q

Which types of bilirubin are bound to albumin?

A

unconjugated and delta bilirubin

289
Q

Which bilirubin is soluble in water?

A

conjugated bilirubin

290
Q

Which bilirubin is not present in urine?

A

unconjugated bilirubin

291
Q

What type of reaction does unconjugated bilirubin have with diazotized sulfanilic acid?

A

indirect (reacts only in the presence of an accelerator)

292
Q

What type of reaction does conjugated bilirubin have with diazotized sulfanilic acid?

A

direct (reacts without accelerator)

293
Q

Which form of bilirubin has high affinity for brain tissue?

A

unconjugated bilirubin

294
Q

Which form of bilirubin is nonpolar?

A

unconjugated bilirubin

295
Q

Which form of bilirubin is polar?

A

conjugated bilirubin

296
Q 
What would the results of the following tests typically look like for prehepatic jaundice?
Total bilirubin:
Direct Bilirubin:
Urine bilirubin:
Urine urobilinogen:
A

Total bilirubin: increased
Direct Bilirubin: normal
Urine bilirubin: neg
Urine urobilinogen: increased

297
Q 
What would the results of the following tests typically look like for hepatic jaundice?
Total bilirubin:
Direct Bilirubin:
Urine bilirubin:
Urine urobilinogen:
A

Total bilirubin: increased
Direct Bilirubin: variable
Urine bilirubin: variable
Urine urobilinogen: decreased

298
Q 
What would the results of the following tests typically look like for posthepatic jaundice?
Total bilirubin:
Direct Bilirubin:
Urine bilirubin:
Urine urobilinogen:
A

Total bilirubin: increased
Direct Bilirubin: increased
Urine bilirubin: positive
Urine urobilinogen: decreased

299
Q

Name 6 Anterior pituitary hormones.

A

ACTH, FSH, GH, LH, Prolactin, TSH

300
Q

Which hormone regulates the production of adrenocortical hormones by the adrenal cortex?

A

ACTH

301
Q

ACTH is regulated by which hormone secreted from the hypothalamus?

A

corticotropin-releasing hormone (CRH)

302
Q

Which pituitary hormone is increased in Cushing’s disease?

A

ACTH

303
Q

TRUE OR FALSE: ACTH expresses diurnal variation.

A

True - highest levels are in the morning

304
Q

Which pituitary hormone needs to be collected on ice and stored frozen?

A

ACTH

305
Q

Which pituitary hormone regulates sperm and egg production?

A

FSH

306
Q

FSH is regulated by which hormone secreted from the hypothalamus?

A

gonado-tropin releasing hormone (GnRH)

307
Q

Which pituitary hormones sharply increase just before ovulation?

A

FSH and LH

308
Q

Which pituitary hormone regulates protein synthesis, cell growth and division?

A

growth hormone (GH)

309
Q

Which hormones secreted from the hypothalamus regulate GH?

A

growth-hormone releasing hormone (GHRH) and somatostatin

310
Q

Increased levels of GH can be clinically significant for…

A

gigantism and acromegaly

311
Q

Decreased levels of GH can be clinically significant for…

A

dwarfism

312
Q

Which pituitary hormone regulates follicle maturation, ovulation, production of estrogen, progesterone, testosterone?

A

LH

313
Q

Which hormone secreted by the hypothalamus regulates the secretion of LH?

A

GnRH

314
Q

Which pituitary hormone regulates lactation?

A

Prolactin

315
Q

Which hypothalamus hormones regulate prolactin?

A

prolactin-releasing factor (PRF) and prolactin-inhibiting factor (PIF)

316
Q

Which pituitary hormone regulates the production of T3 and T4 by the thyroid?

A

TSH

317
Q

Which hypothalamus hormone regulates the secretion of TSH?

A

thyrotropin-releasing hormone (TRH)

318
Q

Increased levels of TSH are seen in…

A

hypothyroidism

319
Q

Decreased levels of TSH are seen in…

A

hyperthyroidism

320
Q

Name 2 posterior pituitary hormones.

A

ADH and oxytocin

321
Q

Which pituitary hormone regulates the reabsorption of water in the distal renal tubules?

A

ADH

322
Q

Which pituitary hormones are actually produced in the hypothalamus, but then stored in the posterior pituitary?

A

ADH and oxytocin

323
Q

The release of ADH is stimulated by…

A

increased osmolality, decreased blood volume or blood pressure

324
Q

ADH is (increased or decreased) in diabetes insipidus.

A

decreased

325
Q

Which pituitary hormone regulates uterine contractions during childbirth and lactation?

A

oxytocin

326
Q

What is another name for thyroxine?

A

T4

327
Q

What is another name for triidothyronine?

A

T3

328
Q

T4 is short for which thyroid hormone?

A

thyroxine

329
Q

T3 is short for which thyroid hormone?

A

triidothyronine

330
Q

Which thyroid hormone(s) regulate metabolism, growth, and development?

A

T3 and T4

331
Q

Calcitonin is a thyroid hormone that regulates…

A

inhibits calcium reabsorption

332
Q

Name 3 thyroid hormones.

A

thyroxine (T4), triidothyronine (T3), and calcitonin.

333
Q

T3 and T4 are regulated by which hormone?

A

TSH

334
Q

Most T4 is bound to…

A

thyroxine-binding globulin (TBG)

335
Q

What is the principle thyroid hormone that is the most concentrated?

A

T4

336
Q

T3 and T4 are increased in…

A

hyperthyroidism

337
Q

T3 and T4 are decreased in…

A

hypothyroidism

338
Q

Most T3 is formed from…

A

deiodinized T4

339
Q

How many atoms of iodine does T3 contain?

A

3

340
Q

How many atoms of iodine does T4 contain?

A

4

341
Q

Which thyroid hormone is the most potent?

A

T3

342
Q

Which thyroid hormone has the highest concentration?

A

T4

343
Q

Which thyroid hormone is important in diagnosing thyroid cancer?

A

calcitonin

344
Q

Parathyroid hormone (PTH) regulates…

A

Calcium and phosphate

345
Q

What would be the expected test results for the following in hyperparathyroidism?
PTH
Calcium
Phosphate

A

PTH: increased
Calcium: increased
Phosphate: decreased

346
Q

What would be the expected test results for the following in hypoparathyroidism?
PTH
Calcium
Phosphate

A

PTH: decreased
Calcium: decreased
Phosphate: increased

347
Q

A thyroid insufficiency is called…

A

primary hypothyroidism

348
Q

A pituitary insufficiency in regards to hypothyroidism is termed…

A

secondary hypothyroidism

349
Q

What is the most common cause of hyperthyroidism?

A

Graves Disease

350
Q

What types of tests are used for thyroid testing?

A

immunoassays

351
Q

In primary hypothyroidism, what results would be expected for the following?
TSH:
FT4:
FT3:

A

TSH: increased
FT4: decreased
FT3: decreased

352
Q

In secondary hypothyroidism, what results would be expected for the following?
TSH:
FT4:
FT3:

A

TSH: decreased
FT4: decreased
FT3: decreased

353
Q

In hyperthyroidism, what results would be expected for the following?
TSH:
FT4:
FT3:

A

TSH:decreased
FT4: increased
FT3: increased

354
Q

In T3 thyrotoxicosis, what results would be expected for the following?
TSH:
FT4:
FT3:

A

TSH: decreased
FT4: normal
FT3: increased

355
Q

TRUE OR FALSE: If the TSH test comes back normal, T3 and T4 should be tested next.

A

False. no further testing is needed

356
Q

What is the biologically active form of T3 and T4?

A

Free T3 and Free T4

357
Q

What is the first test used to screen for thyroid problems?

A

TSH

358
Q

Due to free T3 not being helpful in diagnosing hypothyroidism, it is usually only tested when…

A

TSH is decreased and FT4 is not increased (possible thyrotoxicosis)

359
Q

What is the next test ordered when TSH is abnormal?

A

FT4

360
Q

Name the adrenal cortex hormones.

A

aldosterone and cortisol

361
Q

Aldosterone regulates…

A

reabsorption of sodium in the renal tubules

362
Q

Increases in aldosterone can cause…

A

hypertension (due to water and sodium retention)

363
Q

Decreases in aldosterone can lead to…

A

severe water and electrolyte abnormalities

364
Q

Cortisol regulates…

A

carbohydrate, fat, and protein metabolism, water and electrolyte balance, suppresses inflammatory and allergic reactions

365
Q

Cortisol is regulated by…

A

ACTH

366
Q

Which adrenal cortex hormone expresses diurnal variation?

A

cortisol

367
Q

Cushing’s syndrome is…

A

when there is an increase in cortisol with loss of diurnal variation

368
Q

Decreased levels of cortisol are seen in…

A

Addison’s disease

369
Q

Which hormones are responsible for the “fight or flight syndrome”?

A

epinephrine and norepinephrine

370
Q

What is the primary hormone of the adrenal medulla?

A

epinephrine

371
Q

Epinephrine and norepinephrine regulate…

A

stimulation of the sympathetic nervous system

372
Q

Epinephrine and norepinephrine are categorized as

A

catecholamines

373
Q

What are the metabolites of epinephrine and norepinephrine?

A

metanephrines and VMA

374
Q

What is the term used to describe a rare chatecolamine producing tumor?

A

pheochromocytoma

375
Q

Increased levels of chatecholamines are seen with…

A

pheochromocytoma

376
Q

Which hormones are responsible for the development of female reproductive organs and secondary sex charateristics that also regulate the menstrual cycle and maintain pregrgnancy?

A

estrogens

377
Q

What is the major estrogen produced by the ovaries?

A

Estradiol

378
Q

What is the most potent estrogen?

A

Estradiol

379
Q

Other than the ovaries, where else can estrogen be produced?

A

adrenal cortex

380
Q

Which hormone prepares the uterus for ovum implantation and helps maintain pregnancy?

A

progesterone

381
Q

What reproductive hormone can be used to monitor fetal growth and development?

A

Estriol (estrogen)

382
Q

Which hormone is useful in infertility studies and assess placental functions?

A

progesterone

383
Q

Pregnanediol is a metabolite of…

A

progesterone

384
Q

Which hormone is considered progesterone production by corpus luteum during early pregnancy and regulated the development of fetal gonads?

A

HCG

385
Q

Which hormone is used to detect pregnancy?

A

HCG

386
Q

Other that detecting pregnancy, HCG can be useful in detecting…

A

gestational trophoblastic disease, testicular tumor, and other HCG-producing tumors

387
Q

Human placental lactogen (HPL) regulates..

A

estrogen and progesterone production by the corpus luteum.

development of mammary glands

388
Q

Which hormone regulates development of male reproductive organs and secondary sex characteristics?

A

testosterone

389
Q

Insulin regulates…

A

carbohydrate metabolism

390
Q

Glucagon regulates…

A

glycogenolysis, gluconeogenesis, lipolysis

391
Q

Insulin is produced in which cells of the islets of Langerhans?

A

bet cells

392
Q

Glucagon is produced by which cells of the islets of Langerhans?

A

alpha cells

393
Q

What hormone causes increased movement of glucose into cells for metabolism?

A

insulin

394
Q

Which hormone increases plasma glucose levels?

A

glucagon

395
Q

Which hormone decreases plasma glucose levels?

A

insulin

396
Q

Insulin is decreased in which disease?

A

diabetes mellitus

397
Q

Insulin is increased in which events?

A

insulinoma, hypoglycemia

398
Q

What term is used to describe the lowest concentration of a drug in blood that will produce desired effect?

A

minimum effective concentration (MEC)

399
Q

What term is used to describe the lowest concentration of drug in blood that will produce adverse response?

A

minimum toxic concentration (MTC)

400
Q

What is therapeutic index?

A

ratio of MTC to MEC

401
Q

What term is used to describe the lowest concentration of drug measured in blood that should be reached just before the next scheduled dose and should fall below the MEC?

A

Trough

402
Q

What is the term to describe the highest concentration of drug measured in blood that is drawn immediately on achievement of steady state and should not exceed MTC?

A

Peak

403
Q

What term is used to describe the amount of drug absorbed and distributed equals the amount of drug metabolized and excreted?

A

steady state.

404
Q

How many half lives does it usually take to reach a steady state?

A

5-7 half-lives

405
Q

What is a half-life?

A

Time required for concentration of a drug to be decreased by half

406
Q

salicylates and acetaminophen are of which therapeutic drug group?

A

analgesics

407
Q

Which therapeutic drug group does the following drug belong to? Phenobarbital

A

antiepileptics

408
Q

Which therapeutic drug group does the following drug belong to? phenytoin

A

antiepileptics

409
Q

Which therapeutic drug group does the following drug belong to? valproic acid

A

antiepileptics

410
Q

Which therapeutic drug group does the following drug belong to? carbamazepine

A

antiepileptic

411
Q

Which therapeutic drug group does the following drug belong to? ethosuximide

A

antiepileptic

412
Q

Which therapeutic drug group does the following drug belong to? felbamate

A

antiepileptic

413
Q

Which therapeutic drug group does the following drug belong to? gabapentin

A

antiepileptic

414
Q

Which therapeutic drug group does the following drug belong to? lamotrigine

A

antiepileptic

415
Q

Which therapeutic drug group does the following drug belong to? methotrexate

A

antineoplastics

416
Q

Which therapeutic drug group does the following drug belong to? aminoglycosides (amikacin, gentamicin, kanamycin, tobramycin)

A

antibiotics

417
Q

Which therapeutic drug group does the following drug belong to? vancomycin

A

antibiotics

418
Q

Which therapeutic drug group does the following drug belong to? digoxin

A

cardioactives

419
Q

Which therapeutic drug group does the following drug belong to? disopyramide

A

cardioactives

420
Q

Which therapeutic drug group does the following drug belong to? procainamide

A

cardioactives

421
Q

Which therapeutic drug group does the following drug belong to? quinidine

A

cardioactives

422
Q

Which therapeutic drug group does the following drug belong to? tricylic antidepressants

A

psychoactives

423
Q

Which therapeutic drug group does the following drug belong to? lithium

A

psychoactives

424
Q

Which therapeutic drug group does the following drug belong to? cyclosporine

A

immunosuppressant

425
Q

Which therapeutic drug group does the following drug belong to? tacrolimus

A

immunosuppressant

426
Q

gas chromatography and enzymatic methods are used to detect which toxic substance?

A

ethanol

427
Q

Differential spectrophotometry (co-oximeter) and gas chromatography are used to detect which toxic substance?

A

carbon monoxide

428
Q

Atomic absorptions is used to detect which toxic substances?

A

arsenic and lead

429
Q

Which toxic substance is detected by measuring serum pseudocholinesterase?

A

pesticides

430
Q

(AFP) a-fetoprotein is a tumor marker for which type of cancer?

A

liver

431
Q

Cancer antigen (CA) 15-3 is a tumor marker for which type of cancer?

A

breast

432
Q

Cancer antigen (CA) 19-9 is a tumor marker for which type of cancer?

A

pancreatic

433
Q

Cancer antigen (CA) 125 is a tumor marker for which type of cancer?

A

ovarian

434
Q

Carcinoembryonic antigen (CEA) is a tumor marker for which type of cancer?

A

colorectal

435
Q

Human chorionic gonadotropin (hCG) is a tumor marker for which type of cancer?

A

ovarian and testicular

436
Q

Prostate-specific antigen (PSA) is a tumor marker for which type of cancer?

A

prostate

437
Q

thyroglobulin is a tumor marker for which type of cancer?

A

thyroid

438
Q

Name 4 clinical uses of tumor markers.

A

Aid in diagnosis, stage disease, monitor therapy, and detect recurrence

439
Q

TRUE OR FALSE: Tumor markers alone can be used to diagnose cancer.

A

FALSE. Most are not useful in screening

440
Q

Which tumor marker is produced by the fetal liver, re-expressed in certain tumors, and also increased in hepatitis and pregnancy?

A

a-fetoprotein (AFP)

441
Q

Which tumor marker can be increased in smokers?

A

carcinoembryonic antigen (CEA)

442
Q

What can be defined as a weak acid and it’s salt or conjugate base that minimizes changes in pH?

A

buffer

443
Q

What is the most important buffer in the human body?

A

bicarbonate/carbonic acid (buffers blood pH)

444
Q

What is the formula for the blood pH buffer?

A

H+ + HCO3- H2CO3 H2O + CO2

445
Q

total CO2 - 1 = ?

A

bicarbonate

446
Q

Bicarbonate is regulated by the…

A

kidneys

447
Q

What is the Henderson-Hasselbalch equation?

A

pH = 6.1 + log(HCO3/H2CO3)

448
Q

When blood pH decreases, this is an…

A

acidosis

449
Q

When blood pH increases, this is an…

A

alkalosis

450
Q

What compensates for a respiratory acid-base problem?

A

kidneys

451
Q

What compensates for a metabolic acid-base problem?

A

lungs

452
Q

What condition has:
decreased pH
increased PCO2
normal HCO3-

A

respiratory acidosis

453
Q

What is the ideal ratio for PCO2:HCO3-?

A

20:1

454
Q

What condition has:
decreased pH
normal PCO2
decreased HCO3-

A

metabolic acidosis

455
Q

What condition has
increased pH
decreased PCO2
normal HCO3-

A

respiratory alkalosis

456
Q

What condition has:
increased pH
normal PCO2
increased HCO3-

A

metabolic alkalosis

457
Q

How is respiratory acidosis compensated?

A

Kidneys retain HCO3- and excrete H+

458
Q

How is metabolic acidosis compensated?

A

hyperventilation (excrete CO2)

459
Q

How is respiratory alkalosis compensated?

A

kidneys excrete HCO3- and retain H+

460
Q

How is metabolic alkalosis compensated?

A

hypoventilation (retain CO2)

461
Q

What is the term to describe low O2 content in arterial blood?

A

hypoxemia

462
Q

What is the term to describe lack of O2 at the cellular level?

A

hypoxia

463
Q

What is the term to describe baromertric pressure times % gas concentration?

A

partial pressure

464
Q

What is the term to describe the amount of dissolved CO2 in blood?

A

PCO2

465
Q

What is a measurement of respiratory component that is inversely proportional to respiration?

A

PCO2

466
Q

What assesses pulmonary function?

A

PO2

467
Q

What is the term to describe a graph showing the relationship between oxygen saturation and PO2?

A

oxygen dissociation curve

468
Q

The oxygen dissociation curve provides information about…

A

hemoglobin’s affinity for O2

469
Q

What is the phosphate compound in RBCs that at low levels, inhibits the release of O2 to tissues?

A

2,3-Diphosphoglycerate (2,3-DPG)

470
Q

What is the term to describe the amount of O2 that is combined with hemoglobin and is expressed as % O2 that can be combined with hemoglobin?

A

oxygen saturation

471
Q

1 g of Hgb can combine with how many mL of O2?

A

1.34 mL

472
Q

What is the term to describe the partial pressure of O2 at which hemoglobin oxygen saturation is 50%.

A

P50

473
Q

What does it mean if the value for P50 is low?

A

there is increased oxygen affinity (shift to the left in the O2 dissociation curve)

474
Q

What does it mean if the value for P50 is high?

A

there is decreased oxygen affinity (shift to the right in the O2 dissociation curve)

475
Q

What is the reference range for blood pH?

A

7.35-7.45

476
Q

What is the reference range for PCO2?

A

35-45 mm Hg

477
Q

What is the reference range for PO2?

A

80-100 mm/Hg

478
Q

What is the reference range for arterial blood HCO3-?

A

22-26 mmol/L

479
Q

What is the reference range for total CO2 in arterial blood?

A

23-27 mmol/L

480
Q

A pH electrode measures..

A

[H+]

481
Q

The Severinghaus electrode measures…

A

Dissolved CO2

482
Q

The Clark electrode measures…

A

Dissolved O2

483
Q

The co-oximeter measures…

A

oxygen saturation

484
Q

If an arterial blood gas sample was at room temperature for more than 30 minutes, what would the effects be?

A

decreased PO2
decreased pH
Increased PCO2

485
Q

If an arterial blood gas sample was exposed to air, what would the effects be?

A

decreased PCO2, increased pH, increased PO2

486
Q

Albumin/(total protein-albumin) = ?

A

A/G ratio (1-2.5)

487
Q

(Na+ + K+) - (Cl- + HCO3-) = ?

A

Anion gap (10-20

488
Q

An increased BUN:Crea ration with increased BUN and normal Crea indicates…

A

prerenal condition

489
Q

An increased BUN:Crea ratio with increased Crea indicates…

A

postrerenal condition

490
Q

A reversed A/G ratio can be clinically significant for…

A

multiple myeloma and liver disease

491
Q

Reasons for an increased anion gap.

A 
Salicylate poisoning
Lactic acidosis
Unmeasured anions
Methanol
Polyethylene glycol
Ethanol
Diabetic ketoacidosis
492
Q

(Urine Crea x Urine Volume mL) / (plasma crea x time in minutes) =?

A

creatinine clearance

493
Q

A decreased creatinine clearance is an early indicator for…

A

renal disease

494
Q

2(Na+) + (glu/20) + (BUN/3) = ?

A

calculated osmolality (275-295 Osm/kg)

495
Q

Measured osmolality - calculated osmolality = ?

A

osmolal gap (0-10 mOsm/kg)

496
Q

What are reasons for an osmolal gap to be >10?

A 
Methanol
Ethanol
Diuretics
Isopropyl alcohol
Ethylene glycol
497
Q

Decreased urine:serum osmolality can be clinically significant for…

A

renal tubular deficiency, diabetes insipidus

Clinical Chemistry - JD (1 decks)

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