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Clinical Chemistry > Test 2 > Flashcards

Test 2 Flashcards

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1
Q

______ _________ are the building blocks of proteins.

A

Amino Acids

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2
Q

_______ is the study of DNA.

A

Genomics

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3
Q

What are lipids?

A

Water insoluble fatty molecules

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4
Q

_______ _______ or ________ are laboratory techniques that allow for the detection of specific nucleotide sequences.

A

DNA Probes or NAT (Nucleic Acid Test)

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5
Q

There are ____ naturally occurring amino acids.

A

20

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6
Q

What is an aminoacidopathy?

A

Uncommon, inherited, genetic disorders of amino acid metabolism

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7
Q

What is the most common aminoacidopathy?

A

Phenylketonuria (PKU)

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8
Q

What type of inheritance causes PKU and how many defective genes do you have to inherit?

A

Autosomal recessive

2 defective genes from both parents

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9
Q

PKU has to do with the absence of what enzyme?

A

Phenylalanine Hydroxylase

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10
Q

In PKU, Phenylalanine cannot be converted into?

A

Tyrosine

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11
Q

In PKU, Phenylalanine accumulates and is converted into?

A

Phenylpyruvic Acid

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12
Q

Phenylpyruvic acid is toxic to newborns and young children and can result in what two problems?

A

Brain damage and mental retardation

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13
Q

What test uses Bacillus subtilis and B-2-thienylalanine on an agar and places the PKU blood filter on it?

A

Guthrie Test for PKU

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14
Q

How do you know a Guthrie test is positive?

A

The B-2-thienylalanine (the inhibitor for Bacillus subtilis) is inhibited by the phenylalanine and bacteria is able to grow.

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15
Q

What are some foods that PKU patients should avoid?

A

Milks, Eggs, Chocolate, Meat, Beer, Peas, Nuts, Beans

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16
Q

Amino acids are linked together via a special type of bond know as?

A

Peptide bond

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17
Q

What are the 4 most important NPNs (Non-Protein Nitrogen)?

A

BUN
Creatinine
Uric Acid
Ammonia

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18
Q

What is BUN?

A

A product of protein catabolism which produces ammonia

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19
Q

What does BUN stand for?

A

Blood Urea Nitrogen

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20
Q

What is azotemia?

A

Elevated plasma BUN

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21
Q

What can cause increased BUN that is not related to renal function?

A
  • Low Blood Pressure (CHF, Hemmorhage, Dehydration)
  • Decreased blood flow to kidneys
  • Increased dietary protein or protein catabolism
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22
Q

What causes decreased BUN that is not related to renal function?

A
  • Decreased dietary protein

- Increased protein synthesis (pregnancy, children)

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23
Q

What are the renal causes of increased BUN?

A
  • Glomerular nephritis

- Renal failure from Diabetes mellitus

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24
Q

What are the post renal causes of increased BUN (not related to kidney function)?

A
  • Kidney stones
  • Bladder or prostate tumors
  • UTIs
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25
Q

What is the normal BUN/Creatinine ratio?

A

10 - 20 to 1

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26
Q

How is creatinine formed?

A

At a constant rate by the muscles as a function of muscle mass

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27
Q

How is creatinine removed?

A

It is removed from the plasma by glomerular filtration

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28
Q

What is increased plasma creatinine associated with?

A

Decreased glomerular filtration (renal function)

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29
Q

Is plasma creatinine affected by diet?

A

No

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30
Q

Why must a delta check be investigated on a patient who’s had a change in creatinine result?

A

Plasma creatinine is very stable from day to day and should not dramatically change.

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31
Q

What is the Jaffee method used for?

A

Measures creatinine

Creatinine + Picrate Acid = Colored Chromagen

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32
Q

What is uric acid?

A

Breakdown product of purines (nucleic acid/DNA)

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33
Q

Purines from cellular breakdown are converted to ______ _____ by the liver.

A

Uric acid

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34
Q

Where is uric acid filtered?

A

Glomerulus

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35
Q

What are some causes for increased uric acid?

A
  • Gout
  • Leukemia and Lymphoma
  • Megaloblastic Anemia
  • Renal Disease
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36
Q

What happens when you have gout?

A

Painful uric acid crystals in joints

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37
Q

What age of males and what type of people get gout?

A

Alcoholic and older males > 40

38
Q

What is ammonia produced from?

A

Deamination (removal) of amino acids

39
Q

______ converts ammonia into urea.

A

Liver

40
Q

What happens to plasma ammonia levels in severe hepatic disease?

A

Liver fails to convert ammonia to urea and increases ammonia levels

41
Q

What are some causes of increased ammonia levels?

A

Liver disease, Reye’s syndrome, severe renal disease

42
Q

When drawing blood for ammonia levels, how should it be stored during transport?

A

On ice in an EDTA tube and be tested immediately

43
Q

How is the creatinine clearance calculated?

A

(UV/P) x (1.73/A)

U = Creatinine concentration of 24 hr. urine
V = 24 hr. urine volume (mLs/min)
P = Plasma creatinine concentration
44
Q

What must you divide the V by in a creatinine clearance formula?

A

Divide by 1440 to convert mLs/24 hours to minutes.

45
Q

What is the creatinine clearance?

A

A calculated measurement of the rate at which creatinine is removed from the plasma by the kidneys.

46
Q

Decreased creatinine clearance is associated with?

A

Decreased glomerular filtration

47
Q

Enzymes are _______ ________.

A

Protein catalysts

48
Q

Enzymes are measured by their _________.

A

Activity

49
Q

What is the substrate?

A

Product you start out with in a chemical reaction

50
Q

Does the enzyme get used up during a reaction?

A

No

51
Q

What is the active site?

A

Physical location on the enzyme molecule which interacts with a substrate molecule

52
Q

What is the allosteric site?

A

Non-active site, which may interact with other substances to change the overall enzyme 3-D shape

53
Q

What are isoenzymes?

A

Structurally different enzymes but which catalyzes the same chemical reaction

54
Q

What is a cofactor?

A

A non-protein substance required for normal enzyme activity

55
Q

What are the 2 types of cofactors?

A

Activators (inorganic) and Coenzymes (organic)

56
Q

What is a holoenzyme?

A

Enzyme + Coenzymes = Active Enzyme

57
Q

What is a proenzyme?

A

Enzyme - Coenzyme = Inactive Enzyme

58
Q

Enzymes _______ the activation energy for chemical reactions.

A

lower

59
Q

The enzyme is not _____ or ______ by the chemical reaction.

A

Consumed or depleted

60
Q

Do we want to be at zero order or first order when measuring enzyme activity?

A

Zero order

61
Q

What is a competitive inhibitor?

A

Substance that binds at enzymes active site and competes with substrate

62
Q

What is a non-competitive inhibitor?

A

Substances that bind at an enzymes non-active site and alters enzymes 3D shape and decreasing enzyme activity.

63
Q

__________ substrate concentration if there is a competitive inhibitor.

A

Increase

64
Q

What is substrate depletion?

A

When you have extreme elevations of enzyme activity and there is a depletion of substrate

65
Q

What is the common unit for enzyme activity?

A

International units

66
Q

What does 1 IU equal?

A

That amount of enzyme that will convert 1 micromole of substrate into product per minute under defined conditions

67
Q

What three tissues can you find the enzyme creatinine kinase (CPK, CK)?

A

Brain, muscle, and cardiac

68
Q

Increased plasma CPK is associated with what?

A

Damage to the cardiac, brain, or muscle tissue

69
Q

Increased CPK is useful to diagnose what two diseases?

A

AMIs and skeletal muscle diseases

70
Q

How many isoenzymes does CPK have?

A

Three

71
Q

What three isoenzymes does CPK have?

A

CPK-BB (brain)
CPK-MB (cardiac)
CPK-MM (skeletal muscle)

72
Q

Cardiac muscle is ____% CK-MM and ___% CK-MB.

A

80 and 20

73
Q

Increased CPK-MB is a strong indication of?

A

AMI

74
Q

RBCs lack CPK, but hemolyzed RBCs release adenylate kinase into the plasma, this can cause what type of result?

A

Falsely increased

75
Q

Where can you find the enzyme LDH (lactate dehydrogenase)?

A

Skeletal muscle, cardiac muscle, renal tissue, and RBCs

76
Q

Plasma LDH is elevated in what four conditions?

A

Liver disease, cancers, AMI, and hemolytic disease

77
Q

How many isoenzymes does LDH have?

A

5

78
Q

Where can you find the enzyme AST (aspartate aminotransferase)?

A

Skeletal muscle, cardiac muscle, liver tissue, and lung tissue

79
Q

Where can you find the highest concentrations of ALT (Alanine amino transferase)?

A

In the liver

80
Q

Increased plasma ALT is closely associated with?

A

Liver disease

81
Q

What enzyme requires Mg as an activator?

A

Alkaline phosphate (ALK PHOS)

82
Q

What’s the optimal pH for the enzyme alkaline phosphate?

A

9.0-10.0 alkaline

83
Q

Where can you find high concentrations of ALK PHOS?

A

Bone and liver

84
Q

What enzyme catalyzes the breakdown of starch and glycogen to glucose?

A

Amylase

85
Q

Where can you find high concentrations of Amylase?

A

Pancreas and saliva

86
Q

Increased plasma or urine amylase is very suggestive of?

A

Pancreatitis or pancreatic malignancy

87
Q

What enzyme has the same function as ALK PHOS but has a different pH at 5.0 (acidic)?

A

Acid phosphatase

88
Q

Increased plasma GGT (gamma-glutamyltransferase) is associated with?

A

Hepatobiliary disease and alcoholic cirrhosis

89
Q

Insurance companies utilize what enzyme to detect alcoholism?

A

GGT Gamma-glutamyltransferase

90
Q

What does the enzyme lipase do?

A

Hydrolyze (breakdown) fat

91
Q

Where can you find high concentrations of lipase?

A

Pancreas

92
Q

What is the most specific enzyme for detection of pancreatitis?

A

Lipase

Clinical Chemistry (7 decks)

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