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Clinical Chemistry > Test 5 > Flashcards

Test 5 Flashcards

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1
Q

What fraction(s) of bilirubin is/are increased in a hemolytic disorder?

A

Unconjugated/Total

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2
Q

Which fraction might be expected to be increased in a hepatic disorder?

A

Conjugated

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3
Q

In severe hemolytic jaundice, what would be expected results for bilirubin and urobilinogen in the urine, feces, and blood?

A

Urine - greatly increased urobilinogen
Feces - increased urobilin
Blood - increased unconjugated bilirubin

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4
Q

Where and from what substance is urobilinogen formed?

A

bilirubin

Bacteria from intestines

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5
Q

Another name for prehepatic jaundice is _______.

A

Hemolytic

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6
Q

Another name for posthepatic jaundice is _______.

A

Obstructive

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7
Q

Another name for FREE (indirect) bilirubin is _______.

A

Unconjugated

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8
Q

Another name for direct bilirubin is _______.

A

Conjugated

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9
Q

What is the normal range for direct bilirubin?

What is the normal range for Total Bilirubin

A

Direct: 0.0-0.2mg%
Total: 0.2-1.0

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10
Q

Indirect bilirubin is converted to direct bilirubin by conjugation with _______ ____ by the _______.

A

Glucuronic acid

Liver

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11
Q

In what condition is conjugated bilirubin increased?

A

Biliary obstruction

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12
Q

In the Evelyn-Malloy method for bilirubin, quantitation of the bilirubin is made by measuring _______.

A

Azobilirubin

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13
Q

What reagents are used in the Watson-Schwartz test?

A 
Ehrlich's reagent
Chloroform
N-Butanol
Sodium acetate
(NOT Diethyl ether)
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14
Q

How are porphobilinogen and urobilinogen distinguished from each other since both form a colored compound with p-aminobenzaldehyde?

A

Porphobilinogen is extracted by chloroform

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15
Q

In the synthesis of heme, what is the direct precursor of porphobilinogen?

A

Delta-aminolevulinic acid (Delta ALA)

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16
Q

Why is the stool clay-colored in obstructive jaundice?

A

Urobilinogen is absent because of obstruction.

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17
Q

To what compound is free bilirubin in the plasma attached?

A

Albumin

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18
Q

What compound is the precursor of uroporphyrin, coproporphyrin, and protoporphyrin?

A

Porphobilinogen

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19
Q

If you know the total bilirubin and the conjugated bilirubin values, how can you determine the value for the unconjugated bilirubin?

A

TOTAL - CONJUGATED = UNCONJUGATED

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20
Q

Name the three enzymes involved in heme synthesis that are inhibited by lead.

A

Delta ALA synthase
Porphobilinogen deaminase
Ferrochelatase

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21
Q

What is the composition of Erhlich’s reagent?

A

Diazotized sulfanilic acid

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22
Q

Why is unconjugated bilirubin NOT found in the urine?

A

It is not water soluble

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23
Q

What color is urine which contains large amounts of porphyrins?

A

Port wine

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24
Q

Increased bile pigments in the body causes the condition of _______.

A

Jaundice

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25
Q

In bilirubin methods, total bilirubin develops a color only after the reagent _______ _______ is added.

A

Methyl alcohol

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26
Q

What is the biochemical defect associated with Gilbert’s disease?

A

Defective transport of bilirubin from plasma to liver cells due to reduced activity of the enzyme glucuronyl tranferase

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27
Q

What is the most common condition leading to porphyrinuria?

A

Lead poisoning

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28
Q

What normal substance results in the formation of bilirubin when it is broken down?

A

Hemoglobin

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29
Q

What substance is increased in the urine of patients with lead poisoning?

A

Delta ALA is present

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30
Q

Why is bilirubin unstable once the specimen has been centrifged?

A

Sensitivity to light

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31
Q

What observation is used to determine urinary porphyrins?

A

Red fluorescence in UV light

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32
Q

What is the basic unit of the structure of porphyrins?

A

Pyrrole ring

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33
Q

What specific pigment is possible for the color of normal adult feces?

A

Urobilin

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34
Q

What is the indicated by the presence of lactic acid in duodenal contents?

A

Acute or chronic gastritis

stomach carcinoma

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35
Q

A sweat chloride is done to check for disorders of what organ?

A

Pancreas

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36
Q

What value for sweat chloride is indicative of cystic fibrosis?

A

Greater than 60 to 200 mEq/L

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37
Q

In what test in an ion exchange resin used?

A

Diagnex Blue test

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38
Q

In what condition is the gastric acidity low or absent?

A

Gastric carcinoma

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39
Q

What is the normal pH of gastric juice after stimulation by a test meal?

A

1.5 - 4.0

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40
Q

Duodenal fluid testing is used to diagnose diseases of the _______.

A

Pancreas

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41
Q

What substance is used to induce sweating in sweat chloride analysis?

A

Pilocarpine

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42
Q

In the sweat test, what should be the NEXT step once the electrodes are removed?

A

Remove gaws from arm and weigh it.

43
Q

What is measured by the Diagnex Blue test?

A

Tubeless test of free HCl in gastric secretions/juices

44
Q

What organ, besides the intestinal tract, must be properly functioning to do the Diagnex Blue test?

A

Kidney

45
Q

What is included in the determination of total gastric acidity?

A

Free HCl and combined gastric acidity

46
Q

What is the composition of Topfer’s reagent?

A

Dimethylaminobenzene

47
Q

Toxic effects from the ingestion of rat poison can occur due to the presence of _______.

A

Fluoride

48
Q

Ferric ions are used in the detection of which common drug?

A

Salicylates (asprin)

49
Q

What poisons are tested for by the Reinsch test?

A

Arsenic and mercury

50
Q

Why should you avoid contact with mercury?

A

It can be inhaled or absorbed by the skin - is extremely toxic

51
Q

What is the sample of choice for most cases of poisoning?

A

Urine

52
Q

What specimens are preferred in cases of arsenic poisoning?

A

Hair

Nails

53
Q

What level of carboxyhemoglobin can be found in cigarette smokers?

A

5-15%

54
Q

What is the purpose of the Trindar reaction?

A

Detection of Salicylates

55
Q

Acetaminophen (Tylenol) is particularly toxic to the _______.

A

Liver

56
Q

What enzyme is used to determine ethanol levels?

A

Alcohol dehydrogenase

57
Q

What is oncofetal antigen?

A

A protein shown to exist in both embryo fetal tissue and cancer cells.

58
Q

Which tumor marker is used to detect prostatic cancer?

A

PSA

59
Q

Which tumor marker is used to detect testicular cancer?

A
  • Beta HCG

- AFP

60
Q

What color is in the blood in cases of carbon monoxide poisoning?

A

Bright (cherry) red

61
Q

What enzyme is decreased in insecticide poisoning?

A

Pseudocholinesterase

62
Q

Name the POCT that is useful in the diagnosis of congestive heart failure?

A

BNP

63
Q

Name one cardiac marker that is used in the triage cardiac panel the specimen for which can be collected in the ER by fingerstick.

A

Troponin I

64
Q

What does AFP stand for?

A

Alpha-fetoprotein

65
Q

What does CEA stand for?

A

Carcinoembryonic antigen

66
Q

Name the metabolites of epinephrine, norepinephrine and dopamine

A

Metanephrine, normetanephrine, VMA and homovanillic acid (HVA)

67
Q

in the determination of 17-ketosteroids, what is Zimmerman reagent composed of ?

A

Metadinitrobenzene

68
Q

The renal excretion of sodium, which in turn affects serum levels, is controlled by hormones produced where?

A

Adrenal Cortex

69
Q

What is the major hormone responsible for water and electrolyte balance?

A

Aldosterone

70
Q

Explain laboratory findings, in regards to thyroid hormones and TSH, in hyperthyroidism and hypothyroidism

A

Hyper Increases, thyroid hormones and decreases TSH

Hypo Decreases, thyroid hormones and Increases TSH

71
Q

1-Nitroso-2-naphthol is used in the analysis of which amine metabolite?

A

5-HIAA

72
Q

Want amine is this a metabolite of?

A

serotonin

73
Q

Where would you find a pheochromocytoma

A

Adrenal medulla

74
Q

Urinary 17- ketosteroids may be elevated in diseases of which endocrine gland

A

Adrenal gland

75
Q

Briefly explain the Pisano method. What is it used to measure

A

Acid Hydrolysis and absorption on an ion-exchange resin is followed by elution with ammonium hydroxide. Resulting compound is converted to a vinillin and reacted with periotdate. Colored product of the reaction is measure spectrophotometrically. With VMA, sodium metaperiodate is used but measurement performed the same as other catecholamines.

76
Q

Give a brief description of Graves disease

A

It is an autoimmune disorder that occurs 6x more frequently in women than men, Frequency in general population about 0.04%. Ab’s stimulate thyroid by binding the TSH receptors causing diffuse hyperplasia of the thyroid Lab results indicate Increased T3,T4,FT4I,T3U and Decrease or normal TSH. May have exopthalimia and goiter.

77
Q

What is the first and best indicator of hyper- or hypothyroidism

A

TSH

78
Q

What are the catacholamines

A

Epinephrine, nonrepinephrine , and dopamine

79
Q

Which hormones does the thyroid gland produce

A

Calcitonin,T3 and T4

80
Q

What is another name for epinephrine

A

Adrenalin

81
Q

To which amino acid dose the thyroid gland bind inorganic iodide from the plasma

A

tyrosine

82
Q

What is the principle function of the pancreas

A

production of insulin and glucagon

83
Q

Which organ is the major site of steroid metabolism

A

Liver

84
Q

Briefly explain Addison’s disease

A

under function of adrenal cortex; decreased output of aldosterone, epinephrine, and cortisol as well as some supplementary sex hormones; it is a primary adrenal insufficiency

85
Q

Cushing’s Syndrome is also known as

A

hyperadrenalcorticalsim

86
Q

HCG is produced by the _____ and begins to rise within ______ after conception

A
  • placenta

- 1-2 days

87
Q

Briefly explain the function of vasopressin

A

stimulates re-absorption of water by the kidney tubules

88
Q

Where is the hormone epinephrine produced

A

Adrenal medulla

89
Q

Argentaffinomas was produced elevated levels of what

A

serotonin

90
Q

Briefly explain the function of oxytocin

A

site of action =smooth muscle; main functions to stimulate contractions of uterus during delivery and contractions of breast tissue cells to cause milk ejection

91
Q

What is the site of action for prolactin

A

Mammary glands

92
Q

In men,2/3 of all 17-ketosteroids come fro the _____ and 1/3 from the _____

A

adrenals

testes

93
Q

Name some conditions, other than pregnancy, where you may find increased HCG levels

A

Hydatidiform mole,choriocarcinoma, testicular tumors

94
Q

What foods should be excluded from the diet for at least two days prior to collecting a urine specimen for 5-HIAA

A

Bananas, Avocados,pineapples, plums, walnuts, tomatoes, kiwi, and eggplant

95
Q

How is most plasma thyroxine found

A

bound to globulin

96
Q

what is the chief hormone excreted by the adrenal cortex

A

cortisol

97
Q

the most potent and biologically active estrogen

A

is 17-Beta-estradiol

98
Q

what is the action of progesterone

A

preparation of uterus for ovum implantation

99
Q

what is the most potent of the biologically active androgens

A

testosterone

100
Q

What is the parent substance in the biosynthesis of all adrenal cortical steroids

A

cholesterol

101
Q

Of the thyroid iodide hormones, which is the most biologically active

A

T3

102
Q

What Hormone regulates the rate of thyroid hormone synthesis and secretion and where is it produced

A

TSH/Anterior pituitary

103
Q

Briefly explain the negative feedback mechanism in the relationship between cortisol and ACTH

A

Increased cortisol levels cause the hypothalamus and pituitary to decrease prodction of CRH and ACTH; Decrease ACTH causes adrenal glands to decrease cortisol production

Clinical Chemistry (2 decks)

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