Test 5 Flashcards
Why can’t you use gel separator tubes when doing therapeutical drug monitoring?
Gel absorbs drugs
When do collect trough specimens for TDM?
Collect immediately before administration of drugs
When do you collect peak specimens?
30 minutes after completion of IV dose, 30-60 minutes after IM injection, or 60 minutes after oral dose
What is Digoxin (Lanoxin) used for?
Strengthens cardiac contractions, good for CHF
Overdose of Digoxin are treated with?
Digibind
What are NAPA and procanamind?
Anti-arrythmics (irregular heartbeats)
T3 is called?
Triiodothyrine
T4 is called?
Thyroxine
What is an essential component of T3 and T4?
Iodide
Name four binding proteins of T3 and T4?
Thyroxine Binding Protein, Transthyretin, Thyroxine Binding Prealbumin, Thyroxine Binding Albumin
____% of free T3
0.4%
___% of free T4
0.04%
TRH comes from what gland?
Hypothalamus
TRH stands for
Thyrotropin releasing hormone
TSH comes from what gland?
Anterior pituitary gland
Free T3 and T4 comes from what gland?
Thyroid
What is the single best test to determine primary hyperthyroidism and hypothyroidism?
TSH
What causes a primary thyroid disorder
Thyroid gland
What gland causes a secondary thyroid disorder
Anterior pituitary
What gland causes a tertiary thyroid disorder
Hypothalamus
The T3-uptake is an estimation of?
Thyroid binding proteins
Increased T3U could mean…
Primary hyperthyroid, steroids
Decreased T3U could mean…
Hypothyroid, pregnancy
The T3U is ________ __________ to the number of free thyroid binding hormone sites on various thyroid binding globulins.
Inversely proportional
Normal T3U is __-__%
25-35
How is T3U measured?
Pts plasma is incubated with tagged T3. Excess T3 is removed to binding agent. T3 measured in binding agent and plasma.
Increased T3 uptake by binding agent means…
Decrease in thyroid protein sites
Decreased T3 uptake by binding agent means…
Increased thyroid protein sites
What is FT4I?
Free T4 index
What does the FT4I measure?
Estimate of free T4
FT4I formula
FT4I = TT4 X THBR
THBR = ?
Patient T3U / Control T3U
What is the most common type of hypothyroid disease/
Hashimotos Disease
What is Myxedema?
Skin and tissue disorder due to severe prolonged hyptothyroidism
What is the most common hyperthyroid condition?
Graves disease
Graves disease has a increased _______ and decreased ___.
T3 and T4
TSH
HCG is synthesize by what?
The placenta after implantation
HCG is detectable how many days after conception?
1-2 days
HCG stimulates progesterone production by?
Corpus luteum
HCG plasma concentrations are higher in what trimester?
1st
All HCG tests utilize what technique?
Immunoassay
HCG is decreased in what circumstances?
Ectopic pregnancies and spontaneous abortion
HCG is increased in what circumstances?
Multiple fetus’ and gonadal tumors
What are the 3 different estrogens?
Estradiol, estrone, and estriol
Estrone is E_?
E1
Estradiol is E_?
E2
Estriol is E_?
E3
Normal estriol concentrations indicate what?
Fetal health and wellness
Decreased estriol indicates what?
Fetal under-development
What two hormones stimulate development of a follicle fluid filled sac housing the egg?
FSH and LH
A surge of what causes release of the egg from the follicle?
LH
What secretes progesterone to build the endometrium in preparation for implantation?
Corpus luteum
What stimulates the ovarian follicle?
FSH
What stimulates the development of endometrium?
Estradiol
What stimulates the testes to produce testosterone and estradiol?
LH
What produces LH and FSH?
Anterior pituitary
What is TDM?
Collection and measurement of prescribed medication
What are some reasons why TDM is done?
Non-compliant patients, monitor and make sure drugs aren’t toxic, chemical interactions with other drugs
What is Theophylline (Aminophylline)?
Pulmonary vasodilator for asthma treatment
What is lithium or tricyclics used for?
Anti-depressants
What is Dilantin, phenobarbital, and carbamazepine used for?
Anticonvulsants (anti-seizure)
What is half-life
Time for a drug to decrease by 1/2 its concentration
Why must you avoid the use of disinfectants that contain alcohol when doing alcohol blood test?
It can falsely increase blood ethanol
What is Salicylate?
Aspirin
Primary effects of aspirin overdose
Stimulation of respiration and respiratory alkalosis (decreased PCO2 and decreased plasma HCO3)
Secondary effects of aspirin overdose
Metabolic acidosis as salicylic acid accumulates (decreased HCO3 and normal PCO2)
What is acetaminophen?
Tylenol
What is speed?
Amphetamines
What are examples of opiates?
Heroin, morphine, codeine
What is PCP?
Phenclclidine
What is a tumor marker?
Biological substance produced by malignant cells or other non-malignant cells in response to a malignancy
Tumor markers can be found in?
Plasma, inside cells, and cell membranes
What is an ideal tumor marker?
Sensitive, specific, short half life
Do tumor marker diagnose?
No most are used to confirm or monitor already diagnosed cancer
What is CEA
Carcinoembryonic antigen
What type of antigen is CEA
Oncofetal antigen
What is the best tumor marker for colon cancer
CEA
CEA _______ after surgical removal of tumor.
Decreases
CEA ________ if malignancy re-occurs or spreads.
Increases