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Clinical Chemistry > Test 2 > Flashcards

Test 2 Flashcards

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1
Q

What is the normal glucose concentration of serum?

A

80-100 mg%

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2
Q

What are some of the requirements that must be adhered to during an oral GTT?

A

Patient cannot smoke
Fasting at least 10 hours, not more than 16 hours
Done in the morning
Refrain from eating, drinking, smoking, exercise

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3
Q

List the order of mobility of serum proteins during an electrophoresis.

A
  • Most rapid: Albumin
  • Slowest: Gamma globulin

Order:
Albumin - Alpha 1 - Alpha 2- Beta fractions - Gamma

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4
Q

Why can the biuret method NOT be used for determining CSF or urine protein?

A

Lacks sensitivity. Cannot detect low concentrations of protein.

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5
Q

What does the biuret reagent specifically react with?

A

Tripeptides or larger.

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6
Q

What is the reference method for total protein determination?

A

Kjeldahl

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7
Q

Which method for measuring albumin is most commonly used in automated instruments?

A

Dye binding method

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8
Q

What SPE abnormality is seen in multiple myeloma?

A

Gamma globulin (increased)

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9
Q

What SPE abnormality is seen in nephrotic syndrome?

A

Alpha 2 globulin (increased)

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10
Q

Glucose in CSF is approximately ______ of the amount of glucose in the blood.

A

2/3

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11
Q

In bacterial meningitis, what would be the expected results for CSF protein and CSF glucose?

A

Protein - Increased

Glucose - Decreased

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12
Q

What anticoagulant is used to prevent glycolysis?

A

Sodium fluoride (gray top tube)

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13
Q

ACTH

A

Increases blood glucose levels.

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14
Q

Glucagon:

A

Increases blood glucose levels.

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15
Q

Glucocorticoids:

A

Increases blood glucose levels.

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16
Q

Insulin:

A

Decreases blood glucose levels.

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17
Q

Epinepherine:

A

Increases blood glucose levels.

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18
Q

What is the action of the enzyme glucose-6-phosphate dehydrogenase?

A

Removes hydrogen from glucose-6-phosphate, gives it to NAPD.

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19
Q

What technique is used to identify patients with familial hyperlipoproteinemia?

A

Electrophoresis

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20
Q

What are the normal values for albumin, globulin, and total protein?

A

Albumin: 3.8 - 4.7
Globulin: 2.3 - 3.5
Total Protein: 6 - 8

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21
Q

What phenomenon causes the gamma globulins to move towards the cathode in SPE, even though they are negatively charged?

A

Electroendosmosis (EEO)

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22
Q

What specific form of hemoglobin is used to monitor patients with Type I diabetes mellitus?

A

A1C

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23
Q

How is globulin in serum routinely determined?

A

total protein (minus) albumin

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24
Q

Which fraction of lipoprotein contains the highest percent of protein?

A

HDL

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25
Q

What is the order of migration, beginning at the origin, of lipoproteins?

A

Chylomicrons - prebeta - beta - alpha

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26
Q

What is the desirable level of total cholesterol in the serum?

A

less than 200 mg

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27
Q

What would be the most likely explanation if a patient’s laboratory results indicated elevated total cholesterol and triglyceride levels but a normal lipoprotein pattern?

A

Patient is not fasting.

Also, possible 2x draw - fasting for lipoproteins, not fasting for other Chemistry results.

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28
Q

Which lipoprotein fraction is responsible for post-prandial lipemia?

A

Chylomicrons

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29
Q

If plasma is used instead of serum for electrophoresis, what change will be observed?

A

Fibrinogen creates an extra fraction in beta gamma region. (Aka: M-Spike)

30
Q

What dyes can be sued for the detection of albumin?

A

Bromcresol green (BCG), bromcresol purple, bromcresol orange, PABA.

31
Q

What is considered to be the desirable level of HDL?

A

> /= 40

32
Q

What is the value for a normal two-hour post-prandial glucose?

A

less than 140

33
Q

In a normal glucose tolerance curve, the plasma glucose level returns to a normal fasting level in ____ hours.

A

3 hours (180 mins)

34
Q

Name four blood constituents that can produce a falsely decreased cholesterol level due to interference with the enzymatic cholesterol assay.

A

Uric acid
Ascorbic acid
Bilirubin
Gludathion

35
Q

What is the electrophoresis classification of the following lipoproteins:

A

HDL - alpha
LDL - beta (bad cholesterol, 2/3 of plasma cholesterol)
VLDL - prebeta

36
Q

Which lipoprotein has a protective effect against coronary artery disease?

A

HDL

37
Q

A protein isolated from a lipoprotein which is also affiliated with certain lipoproteins is referred to as an

A

Apoproteins

38
Q

Interpret the GTT results for the following:

A
  • Diabetes mellitus: elevated after 3 hours. Start high, stay high, take longer to return to normal.
  • Hypoglycemia: lower than normal after 3 hours. Normal, then falls to below fasting levels.
  • Normal: elevates at 1hr starts to decrease by 2 then return to normal fasting levels in 3 hours
39
Q

Why is the performance of electrophoresis on CSF more difficult than SPE?

A

Protein concentration is low. Concentrate it 100x.

40
Q

Patients with borderline blood glucose levels are most often further tested by preforming a

A

3 hour Oral GTT

41
Q

What is actually measured in the hexokinase method for glucose?

A

NADPH

42
Q

What is the normal range for spinal fluid glucose?

A

2/3 plasma or 40-70 mg/dL

43
Q

What period of fasting is required for patients for whom the doctor has ordered lipid panels?

A

12 hours minimum

44
Q

What is the reaction that takes place during the biuret procedure?

A

Copper reduction (purple color)

45
Q

What precautions must be taken prior to collecting a specimen for lipid analysis?

A

12 hrs fasting - 2 week normal diet - no medications that affect lipids - defer 2 months after surgery, AMI, or serious illness

46
Q

What is the main function of lipoproteins in the body?

A

Transport of body lipids throughout bloodstream.

47
Q

What is most specific method for determining plasma cholesterol?

A

Cholesterol oxidase enzymatic reaction.

48
Q

What protein, when found in increased amounts, lowers the risk of coronary heart disease?

A

Apoprotein A1

49
Q

What is the only diagnostic purpose for performing a phospholipid measurement?

A

Nieman Pick Disease

50
Q

What unusual electrophoretic serum protein pattern is seen in cirrhosis of the liver?

A

Beta gamma bridge

51
Q

What would be the expected shape of a GTT curve if the patient has malabsorption syndrome?

A

No change in curve (nothing absorbed) - resulting in a flatline.
To resolve: IV GTT test instead.

52
Q

What test may be used to asses the average plasma glucose level that a patient has maintained during a previous 2-3 month period?

A

Glycosulated Hemoglobin (to which A1C belongs)

53
Q

The enzyme that causes the release of H2O2 when it reacts with glucose is

A

Glucose oxidase

54
Q

What would happen to the glucose in a blood specimen if it was drawn in a clot tube and was left uncentrifuged at room temperature?

A

Decrease by 7 mg/dL per hour

55
Q

The amount of glucose which is used in an adult GTT is

A

75g

56
Q

What reagent is used for color development in the Libermann-Buchard reaction?

A

Combination of acetic anhydride and sulfuric acid

57
Q

What adjustment is made to an OGTT if hypoglycemia is suspected?

A

Additional 4-5 hours of testing

58
Q

B-lipoproteins contain high % of ________ while pre-B-lipoproteins contain a high % of ________

A
  • Cholesterol

- Triglycerides

59
Q

How would a physician view the prognosis of a patient with an elevated HDL level?

A

Good, not at a high risk. Patient protected from arthrosclerosis.

60
Q

What is the most likely explanation of a milky serum?

A

Increased chylomicrons

61
Q

What enzyme catalyzes the hydrolysis of triglycerides?

A

Lipase

62
Q

What is the normal range for spinal fluid protein?

A

15 - 45

63
Q

What compound is used to stimulate the pancreas to produce insulin?

A

Tolbudamide.

Why? Detection of insulinomas.

64
Q

Ultracentrifugation separates lipoproteins into various categories based on the physical property if

A

Density

65
Q

What stains can be used to stain the protein bands obtained from SPE?

A

Ponceau S
Amino Black 10 B
Bromphenol blue
Lissamine green

66
Q

At what pH is routine SPE performed?

A

8.6

67
Q

What is gestational diabetes?

A

Diabetes during pregnancy

68
Q

What is meant by the term renal threshold? What is the renal threshold for glucose?

A

glucose levels in the blood above which glucose spills over into the urine
160-180 mg/dL

69
Q

What type of diabetes occurs in adults?

A

Type 2

70
Q

Name a test that can be used to determine the risk of RDS in newborns?

A

Phospholipid test

-L/S ratio

Clinical Chemistry (4 decks)

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