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Clinical Chemistry > Test 4 > Flashcards

Test 4 Flashcards

1
Q

What is the substrate for the enzyme aspartate amino transferase (AST)?

A

Aspartate and alpha ketoglutamic acid

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2
Q

Creatinine is formed from the breakdown of what?

A

creatine

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3
Q

PSP is removed from the body by what organ?

A

kidney

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4
Q

What is the principle of the Berthelot reaction and what substances can falsely elevate values in the reaction?

A

hydrolysis of urea to ammonium carbonate by enzyme urease ammonia, lipemia, and icteric specimens
Color of the compound form is Blue indophenol

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5
Q

Increased ALT values are associated with diseases of what organ?

A

liver

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6
Q

What is the normal value for serum AST at 37 degrees C?

A

5-35 IU/L

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7
Q

Which anticoagulant should NOT be used for urease testing?

A

sodium fluoride

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8
Q

What is the normal percentage for the CK-MB isoenzyme?

A

less than 6 %

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9
Q

What reagent is used in the measurement of uric acid?

A

phosphotunstic acid

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10
Q

Creatinine clearance is used to assess the rate of what?

A

glomerular filtration

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11
Q

Calculation for creatinine clearance if given urine volume and values for urine plasma.

A

CrCl=Ucr * Vu/ Pcr * T

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12
Q

What additional information must be known for the calculation if the pt is an infant, young child, or adolescent?

A

body surface area

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13
Q

What is the most common endogenous substance used to assess the glomerular filtration rate?

A

creatinine

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14
Q

What is the most common exogenous substance used to assess the glomerular filtration rate?

A

inulin

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15
Q

Serum creatine kinase is most often elevated in diseases of what tissue?

A

muscle

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16
Q

Serum lipase levels are elevated to diseases of what organ?

A

pancreas

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17
Q

Diacetyl monoxime reacts with what to produce a yellow product?

A

urea

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18
Q

What is uremia?

A

abnormal substances in the blood (urea in the blood)

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19
Q

What is the normal value for CK in males at 37 degrees C?

A

15-160 IU/L

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20
Q

Name 3 ways that can be used in the lab to measure the rate of an enzymatic reaction?

A

multiple point, kinectic, continuous monitoring point

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21
Q

Define IU(international unit)

A

the quantity of enzyme that will catalyze the reaction of one micromole (mmol) of substrate per minute

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22
Q

What is the peak absorbency of reduced NAD (NADH)?

A

340 nm

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23
Q

The Jaffe reaction is used to measure what?

A

creatinine

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24
Q

Which non-protein nitrogen component comprises the largest fraction of NPN in the blood?

A

urea/BUN

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25
Q

Which enzyme is useful in the detection of insecticide poisoning?

A

pseudocholinesterase

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26
Q

Low levels of which enzyme can cause a pt to be susceptible to prolonged apnea when exposed to certain types of anesthesia?

A

pseudocholinesterase

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27
Q

Increased levels of LD-4 and LD-5 are associated with what?

A

acute hepatic disease

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28
Q

Gout is caused by the deposition of _______in joints and other tissues?

A

uric acid

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29
Q

What is the clinical significance of a mildly elevated ALP in a teenager?

A

no significance

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30
Q

What is the normal ratio of BUN to creatine? Be able to suggest the value of one if you are given the value for the other

A

10:1 and 15:1

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31
Q

What enzyme is normally elevated during pregnancy?

A

alkaline phosphatase

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32
Q

L-tartrate is used in the specific assay of which enzyme?

A

prostatic acid phosphatase

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33
Q

Which isoenzyme is detectable within 4-6 hours after an MI?

A

CK-2 or CK-MB (muscle and brain)

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34
Q

Retention of BSP can be used to measure what organ’s function?

A

liver

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35
Q

What substrate and coenzyme are required to measure ammonia?

A

alpha-ketoglutarate

Co-enzyme NADH

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36
Q

What is the main way that ammonia levels are kept within normal limits?

A

synthesizes of urea from ammonia

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37
Q

Amylase is an enzyme that breaks down what?

A

starch

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38
Q

Why should hemolyzed specimens NOT be used for acid phosphatase?

A

RBC contain acid phosphatase, levels increase

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39
Q

Acid phosphatase is primarily associated with diseases of what?

A

prostate

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40
Q

What is the proper treatment of serum to be assayed for ACP?

A

acidified to a pH below 6

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41
Q

What is the substrate for alkaline phosphatase methods of analysis?

A

para-nitrophenolphosphase

42
Q

In the urease method, urea is converted to what?

A

ammonium carbonate

43
Q

Increased levels of serum alkaline phosphatase can indicate diseases of what?

A

bone or liver

44
Q

The enzyme responsible for the reversible oxidation of lactic acid to pyruvic acid is what?

A

LD (lactate dehydrogonase)

45
Q

In the creatine kinase reaction _______ is converted to _______

46
Q

What is the endpoint of purine metabolism in man

47
Q

Serum amylase might be expected to be increased in the diseases of what?

48
Q

Which enzyme can be used to establish the presence of semen?

A

acid phosphatase

49
Q

Phenylketonuria (PKU) results from a deficiency in which enzyme?

A

phenylalanine hydroxylase

50
Q

What is the substrate for the enzyme alanine aminotransferase (ALT)?

A

alanine and alpha-ketoglutamic acid

51
Q

What is the source of urease used in enzymatic methods for the determination of BUN?

A

Jack Bean meal

52
Q

What precaution must be taken with specimens to be used for blood ammonia determinations?

A

avoid ammonia forming in vitro (outside the body), placed on ice, correct tube, plasma, tested within 15 mins, kept closed because of atmospheric ammonia

53
Q

What is the correct order of migration of the creatine kinase (CK) isoenzymes starting with the slowest?

54
Q

What are the substrates for amylase in the dye-labeled substrate method?

A

starch and dye

55
Q

In the creatine method, a color develops when creatinine combines with what?

A

alkaline picrate

56
Q

The major isoenzymes of lactate dehydrogenase come from the _____ and ______?

A

heart

liver

57
Q

What is the principle of the enzymatic method for measurement of ammonia?

A

change in absorbance at 340 nm

-uses enzyme glutamate dehydrogonase and the substrate alpha ketoglutorate reaction is followed by a drecease in absorbance at 340 nm as NADPH is converted to NADP

58
Q

Strenuous exercise can cause elevated what?

59
Q

What causes the BSP dye to form colorless to colored?

A

alkali medium

60
Q

What would hemolysis do to the results of a lactate dehydrogenase(LD) measurement? How are the results affected if the specimen is frozen?

A

elevate results

cannot freeze falsely decreased

61
Q

What test can differentiate between liver and bone origin of an elevated alkaline phosphatase?

62
Q

What is the best anticoagulant to use for plasma specimens to be tested for lactate dehydrogenase?

63
Q

What is the order of migration for the isoenzymes of alkaline phosphatase (ALP)?

A

liver is the fastest, bone, placenta, intestinal

64
Q

What is the characteristic change in the isoenzymes of lactate dehydrogenase (LD) that is seen in a myocardial infarction (ALP)?

A

LD1 is greater than LD2

LD flip

65
Q

Creatinine excretion correlates best with the what?

A

muscle mass

66
Q

Which enzyme is the first to become elevated following an MI?

67
Q

Aspartate aminotransferase (AST) is elevated in diseases of what?

68
Q

In the performance of a creatinine clearance, when should the specimen for serum creatinine be collected in relation to the collection of the urine?

A

midway thru urine collection and not longer than 24 hrs before or after collection

69
Q

For how long and at what temp should specimens for lactate dehydrogenase (LD) be stored?

A

2-3 days at room temp

70
Q

What enzyme can be used in the detection of alcoholism and in the monitoring of pts in alcohol treatment centers?

71
Q

What is the normal value for prostatic acid phosphatase (ACP)?

A

less than or equal to 2.1 ng/ml

72
Q

Why are the creatinine levels in the serum not a good indicator of early renal damage?

A

values are not above upper limit of normal until 1/2 to 2/3 of renal function is abnormal

73
Q

What is the composition of Nessler’s reagent and for what test is it used?

A

double iodide of potassium/mercury

BUN

74
Q

Which has more liver specificity, alanine aminotransferase (ALT) or aspartate aminotransferase (AST)?

A

ALT is more specific

AST is for heart

75
Q

In which organs is the activity of creatine kinase (CK) the greatest?

A

brain, heart, and skeletal muscle

76
Q

What is the main factor that determines how much the level of an enzyme in serum increases?

A

extent and severity of damage to its tissues or cells of origin

77
Q

How does progressive muscular dystrophy affect AST and ALT levels?

A

increases AST and ALT levels

78
Q

What is the normal value for serum amylase at 37 degrees C?

A

95-290 IU/l

79
Q

What is the major creatine kinase (CK) isoenzyme of normal serum?

80
Q

At what temp should serum CK specimens be stored?

A

4 degrees C refrigerated

81
Q

What is the purpose of the PSP test and the p-aminohippurate test?

A

measure excretory capacity of the kidneys

82
Q

To what class of enzymes do amylase and lipase belong?

83
Q

What is the normal value for serum BUN?

A

8-26 mg/dl

84
Q

What is the old name for AST?

A

SGOT(serum glutamic oxaloacetic transaminase)

85
Q

What is the old name for CK?

A

CPK (creatine phosphokinase)

86
Q

What two isoforms of CK are used for the early detection on an MI?

87
Q

What are the main uses of ammonia measurements?

A

diagnose Reyes syndrome and hepatic coma

88
Q

What happens to the creatinine clearance value in renal disease?

89
Q

What is the normal range for total serum bilirubin?

A

0.2-1.0 mg%

90
Q

In the Jendrassik-Grof method, what is the caffeine benzoate solubilizer used for?

A

…Solubilizes the water-insoluble fraction of bilirubin and will yield a total bilirubin value. Without it, the rxn will yield conjugated bilirubin only

91
Q

A list of risk factors for coronary heart disease

A 
...Smoking
Hypertension
Increased total cholesterol & LDL
Decreased HDL
Diabetes mellitus
Age
Obesity
Physical Inactivity
Family history of premature CHD
Left ventricular hypertrophy
92
Q

List of biochemical markers for coronary heart disease

A

…Triglycerides
Lp(a)
Homocysteine
hs-CRP

93
Q

List of the ideal characteristics of a cardiac marker

A 
..Cardiac specific
Rises soon after infarction occurs
Elevated over a sustained period of time
Easy to measure analytically
Broad dynamic range for measurements
Quick turnaround of tests
Diagnostic utility verified by clinical studies
94
Q

Which marker has been recognized for the earliest biochemical marker for AMI?

95
Q

What is the biggest disadvantage of troponin as a cardiac marker?

A

Remains in blood 7-10 days (can’t detect new infarction within that time frame)

96
Q

What is the most likely cause of prehepatic bilirubin?

A

Increased amount of bilirubin being presented to the liver, such as in acute or chronic hemolytic anemias

97
Q

Why are high levels of bilirubin seen in infants?

A

infant deficiency of enzyme glucuronyl transferase (last to develop because most bili processing done by mother)

98
Q

What precautions need to be taken when processing bilirubin?

A

Fasting specimen preferred
Hemolysis not acceptable
Keep away from light

99
Q

ranges for total, conjugated, and un-conjugated biliruben

A

Total:
Conjugated:
Un-Conjugated:

100
Q

prehepatic, hepatic, and posthepatic specific conditions of each

A

Prehepatic:
Hepatic:
Posthepatic:

Clinical Chemistry (2 decks)

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