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Clinical Chemistry > Test 1 > Flashcards

Test 1 Flashcards

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1
Q

The major intracellular cation is

A

Potassium

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2
Q

The major intracellular cations normal value is

A

3.5-5.0 mm/L

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3
Q

The major extracellular cation is

A

Sodium

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4
Q

The major extracellular cation normal value is

A

136-145 mm/L or mEq/L

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5
Q

The major extracellular anion is

A

Chloride

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6
Q

The major extracellular anion normal value is

A

90-109 mm/L

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7
Q

What is the endpoint of a mercurimetric chloride assay?

A

violet blue color- a complex of mercury and diphenylcarbozone

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8
Q

What 2 cations are most likely to be ordered to determine the cause of cardiac tetany?

A

calcium and magnesium

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9
Q

Be able to calculate the anion gap if given values for Na+, K+, Cl-, and CO2. Be able to correlate abnormal anion gaps with other test results (such as BUN) or with instrument/technologist error

A

-Na+-(Cl-+HCO3-)
8-18 mmol/L
-Na++K-(Cl-+HCO3-)
12-20 mmol/L

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10
Q

To what does % saturation of transferrin refer? What is the normal value?

A

ratio of serum iron to TIBC

20-50%

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11
Q

What is hypokalemia?

A

low serum potassium; can be caused by decreased dietary intake, vomiting, renal dysfunction

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12
Q

If tetany is due to calcium, what specific fraction of calcium is involved? Will it be increased or decreased?

A

decreased ionized Ca2+

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13
Q

What analyte in the blood is used to measure serum phosphorous? What is the normal value for serum phosphorous?

A

inorganic phosphate

2.7-4.5 mg%

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14
Q

Why is it important to measure serum magnesium levels?

A

tetany due to magnesium deficiency

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15
Q

In analyzing calcium by atomic absorption, why is lanthanum added?

A

to prevent interference of phosphate

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16
Q

Calcium exists in serum as ______ and _______. Which one is physiologically active?

A
  • ionized and protein bound

- ionized is physiologically active

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17
Q

A patient with lactic acid acidosis would have an ________ anion gap

A

increased

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18
Q

What is the purpose of adding magnesium carbonate to an iron binding capacity?

A

removes excess unbound iron

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19
Q

What does TIBC measure?

A

estimates transferrin level in serum

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20
Q

What is the Fiske-Subbarow method for phosphorous?

A

molybdate added to serum to form phosphomolybdate reduces to aminonapthosulfonic acid

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21
Q

There is a _____________ relationship between serum calcium and phosphorous

A

reciprocal

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22
Q

What is the normal serum calcium level?

A

8.4-10.2 mg/dL

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23
Q

What would be the expected test results for calcium and phosphorous in hyperparathyroidism?

A

CA2+ is increased phosphorous is decreased

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24
Q

What is the purpose of adding stannous chloride, ferrous sulfate, and ascorbic acid in the determination of inorganic phosphorous?

A

reducing agents

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25
Q

Name several things that can affect the level of circulating calcium

A

serum protein levels, parathyroid hormone, bone-cell activity(osteoclastic activity) Vitamin D

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26
Q

What 2 hormones control serum calcium levels?

A

calcitonin-increased

parathyroid hormone-decreased (PTH)

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27
Q

Which electrolyte is the chief plasma base that helps in maintaining osmotic pressure?

A

Na+

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28
Q

Hemolysis has the greatest affect on serum ________levels

A

potassium/magnesium

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29
Q

What is the function of aldosterone?

A

increased sodium reabsorption, increased H2O retention, increased BP and blood volume

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30
Q

What hormone has the most control over serum phosphate levels?

A

parathyroid hormone (PTH)

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31
Q

What is the normal serum osmolality?

A

275-295 mosm/kg of H2O

32
Q

What are the four main buffer systems of the body?

A

bicarbonate/carbonic acid
hemoglobin buffer
plasma proteins
phosphate phosphoric acid/phosphate phosphoric buffer

33
Q

The pKa of carbonic acid is

A

6.1

34
Q

What is added to the reaction mixture in calcium determinations to prevent interference by magnesium?

A

8-hydroxyl quinoline

35
Q

What component of a freezing point osmometer actually measures the sample temperature?

A

thermistor

36
Q

What 2 properties can be used to measure osmolality?

A

vapor pressure

freezing point depression

37
Q

What analytes are the main contributors to serum and urine osmolality?

A

electrolytes

38
Q

What is the principle of the freezing point osmometer?

A

freezing point lowered by an amount, that is directly proportional to the concentration of dissolved particles in the solution

39
Q

What does PCO2 electrode actually measure?

A

pH

40
Q

Respiratory acidosis is an increase of ________while due to respiratory alkalosis decreased exchange of ___________

A

CO2

41
Q

During the chloride shift, the chloride moves from _______ to _________. What anion is exchanged for chloride?

A

plasma to cell

bicarbonate is exchanged for chloride

42
Q

What buffer system contributes most to the regulation of blood pH?

A

bicarbonate/carbonic acid

43
Q

What is the normal ratio of the two portions of the buffer system?

A

20:1

44
Q

Normal blood pH is

A

7.34-7.44 (slightly alkaline)

45
Q

Most of the CO2 present in the blood is in the form of

A

bicarbonate

46
Q

What substance is necessary for the release of oxygen from hemoglobin?

A

2,3-DPG(diphosphoglycerate)

47
Q

What happens in the body to compensate for a state of metabolic acidosis?

A

hyperventilation

48
Q

What is the cause of metabolic alkalosis?

A

excess bicarbonate and/or deficit of noncarbonic acid

49
Q

What is p50?

A

PO2 at which Hgb is 50% saturated with O2;

equal to 26-27 mmHg

50
Q

List several precautions that must be used in handling a specimen for ABG’s

A

anaerobic, 15 mins, place on ice, heparinized, drawn from the artery

51
Q

Hyperventilation is a common cause of

A

respiratory alkalosis

52
Q

What reaction is catalyzed by the enzyme carbonic anhydrase?

A

carbonic anhydrase breaks down carbonic acid
CO2 + H2O–> H2CO3
formation of carbonic acid from CO2 and H2O

53
Q

What is the normal range for pCO2? for pO2?

A

pCO2: 35-45 mmHg
pO2: 80-100 mmHg

54
Q

In general, respiratory acidosis results from

A

decreased exchange of CO2 from lungs

increased CO2 hypoventillation

55
Q

Be able to recognize the Henderson-Hasselbalch equation

A

pH=pKa + Log

bicarbonate/carbonic acid

56
Q

A fever of unknown origin would cause a _________ shift of the oxygen dissociation curve while an increased affinity for oxygen causes a _________ shift

A

right

left

57
Q

Which anticoagulant is preferred for ABG analysis?

A

heparin

58
Q

The pO2 electrode is based on the principle of

A

amperometric measurement

59
Q

What would be the breathing pattern of a patient in respiratory alkalosis?

A

shallow, rapid

60
Q

What is the compensatory mechanism in respiratory acidosis?

A

increase bicarbonate concentration in the blood by absorption in the kidneys

61
Q

What ABG parameter is most useful in assessing a fire victim?

A

pO2

62
Q

How would exposure to air bubbles affect an arterial blood sample?

A

pO2 would increase
pH would increase
pCO2 would decrease

63
Q

Hyperventilation is the loss of

A

CO2

64
Q

What events shift the oxygen dissociation curve to the left?

A

decreased- p50, 2,3 DPG, body temp, pCO2

increased-affinity of Hgb for O2, pH, CO2

65
Q

A supercooled solution has a _________temp than its freezing point

A

lower

66
Q

Every mole of solute decreases the freezing point of H2O by _______ degrees

A

1.86 degrees celsius

67
Q

What is the name of the rapid stirrer mechanism in an osmometer?

A

vibrator

68
Q

What are the 4 forms of CO2 in the blood?

A

bicarbonate (90-95%)
carbonic acid
dissolved CO2(dCO2)
carabamino compounds

69
Q

When calcium levels decline, which hormone is secreted to restore normal calcium levels

A

parathyroid

70
Q

What gases can be measured by a co-oximeter?

A

carboxyhemoglobin
sulfhemoglobin
methemoglobin

71
Q

How should the sample for an ABG measurement be mixed?

A

roll between palms

72
Q

Name several suitable sites for ABG draws

A

radial artery, brachial, femoral, temporal

73
Q

If given value for pH be able to evaluate the acid-base status of the patient

A

pH:7.35-7.45

74
Q

If given value for pCO2 be able to evaluate the acid-base status of the patient

A

pCO2: 35-45

75
Q

If given value for HCO3-be able to evaluate the acid-base status of the patient

A

HCO3: 22-26

76
Q

What is ceruloplasmin?

A

transport protein for copper

decreased in Wilson’s disease

77
Q

What is oligoclonal banding and where is it typically seen?

A

increased CSF IgG and multiple distinct bands in the globulin zone.
seen in 90% of MS patients

Clinical Chemistry (4 decks)

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