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MLT Clinical Chemistry > Unit 4 Review > Flashcards

Unit 4 Review Flashcards

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1
Q

Which of the following conditions will cause an increase anion gap?

A

Renal failure

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2
Q

The anion gap is determined from which of the following groups of electrolytes?

A

Sodium, chloride, potassium, and HCO3-

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3
Q

Which of the following conditions may be characterized by an increased anion gap?

A

*All of the above
- Salicylate intoxication
- diabetes mellitus
- lactate acidosis

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4
Q

A sweat chloride greater than 60 men/L is consistent with which of the following disorder?

A

Cystic fibrosis

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5
Q

Which of the following enzyme is used in several methods to measure serum total carbon dioxide?

A

Phosphoenolpyruvate carboxylase

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6
Q

Patients with hyponatremia may show signs of hypovolemia which is defined as:

A

Low blood volume

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7
Q

Which of the following disorders may develop due to increased secretion of antidiuretic hormone (ADH) by the hypothalamus in the absence of appropriate osmolar or volume stimuli?

A

Syndrome of inappropriate antidiuretic hormone (SIADH)

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8
Q

Chloride in sweat can be measured by which of the following techniques?

A

Coulometry and amperometry

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9
Q

In the blood, bicarbonate leaves the RBC and enters the plasma through an exchange mechanism with which of the following ions?

A

Chloride

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10
Q

Which of the following mechanisms aid in the transport of K+ into the cell against a concentration gradient?

A

Na+/K+ ATP pump

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11
Q

Symptoms including metal confusion, weakness, tingling sensations, respiratory muscle weakness are all associated with which of the following disorders?

A
  • Hyperkalemia
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12
Q

Which of the following compounds function to reduce the venous pressure that occurs with a given increase blood volume, increasing vascular permeability and promoting natriuretic and diuresis?

A

Atrial natriuretic peptide

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13
Q

Measurement of sodium, potassium, and chloride are commonly performed in laboratories using which of the following?

A

Ion selective electrodes

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14
Q

Calculate the anion gap given the following data:
Sodium = 145 mEq/L
Chloride = 102 mEq/L
HCO3 = 20 mEq/L

A

23 mEq/L

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15
Q

Which of the following conditions is associated with hypernatremia?

A

Diabetes insipidus

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16
Q

Which of the following electrolyte levels best correlate with plasma osmolarity?

A

Sodium

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17
Q

Plasma osmolality can be calculated using which of the following?

A

2(Na)+(glucose/18)+(BUN/2.8)

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18
Q

A patient with a toxic level of blood alcohol would cause which of the following?

A

An increased osmolarity gap

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19
Q

Serum lacks which of the following constituents?

A

Fibrinogen

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20
Q

Freezing point depression is one of the:

A

Colligative properties of a solution

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21
Q

A patient with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) would present with which of the following laboratory results?

A

Decreased serum sodium, osmalility, chloride, increased urine sodium

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22
Q

Which of the following sequences accurately reflects the renin-angiotensin-aldosterone system in response to hyponatremia?

A

Renin is released from the kidney; renin converts angiotensinogen to angiotensin I; angiotensin I is converted to angiotensin II

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23
Q

Electrolyte exclusion effect is characterized as which of the following?

A

A falsely low serum sodium result in a grossly lipemic specimen

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24
Q

A family of peptides called natriuretic peptides serves to regulate:

A

Sodium and water metabolism

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25
Q

Angiotensin II is a potent vasoconstrictor that:

A

Stimulates ADH secretion and thirst

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26
Q

What is the most probable acid/base imbalance in the patient described below? 26 year old male presents with the following signs and symptoms:
Extreme hysteria
Hyperventilating
Pulse 110 BPM
Lab data for ABGs:
PH = 7.550
PCO2 = 27 mmHg
HCO3 = 27 mEq/L
PO2 = 98 mmHg

A

Respiratory alkalosis

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27
Q

Which of the following compensatory mechanisms is correct for a patient in respiratory acidosis?

A

Decrease whole blood pCO2

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28
Q

A 43 year old female arrived at the emergency department with altered level of consciousness. She complained of chronic but moderate severity acid ingestion. This was partially relieved by taking antacids. Her blood gases results are as follows:
PH = 7.60
PCO2 = 38 mmHg
HCO3 = 40 mEq/L
The patient demonstrates

A

Metabolic alkalosis

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29
Q

Which of the following represents the compensatory response of the kidney and lungs to a patient who is in metabolic acidosis?

A
  • the kidneys will increase bicarbonate reabsorption and the patient will begin to breathe very deeply and often gasp of air
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30
Q

Respiratory alkalosis can be seen in patients with:

A

Hysterical hyperventilation

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31
Q

A patient’s blood gas results are shown below:
PH = 7.32
PCO2 = 58 mmHg
HCO3- = 28 mEq/L
The results indicate:

A

Respiratory acidosis

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32
Q

Which of the following mechanims is responsible for metabolic acidosis?

A

Bicarbonate deficiency

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33
Q

What is the calculated pH for a patient sample if the measured bicarbonate concentration is 22 mEq/L and he pCO2 is 57 mmHg?

A

7.2

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34
Q

Which of the following buffer has the greatest percentage buffering capacity?

A

Hb

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35
Q

Hypercapnia is defined as:

A

An elevated blood level of carbon dioxide

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36
Q

The specimen of choice for measuring blood pH, pO2, and pCO2 is:

A

Heparinized arterial blood

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37
Q

Name the equation shown below:
PH = pK’ + log[cHCO3-/(a x pCO2)]

A

Henderson-Hasselbalch equation

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38
Q

Convert pCO2 of 40 mmHg to the SI equivalent in kilopascals (kPa)

A

5.33

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39
Q

The reaction that allow CO2 to move from peripheral tissues cells to plasma, then to erythrocytes and O2 from erythrocytes to plasma, and then into peripheral tissue cells in termed:

A

Isohydric shift

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40
Q

Which of the following is a derived blood gas parameter?

A

Actual base excess

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41
Q

Which of the following materials represents the appropriate calibrator used to calibrate the pCO2 electrode?

A

A gas cylinder containing a known amount of carbon dioxide

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42
Q

Which of the following statements reflects the appropriate action to take after receiving an arterial blood gas specimen for analysis?

A

Gently push out the bubbles or clots that may collect at the end of the syringe

43
Q

Which of the following contributes the most to the serum total CO2?

A

HCO3-

44
Q

Which of the following effects result from exposure of a normal arterial blood sample to room air?

A

PO2 increased, PCO2 decreased, pH increased

45
Q

A patients blood gas results are as follows:
PH = 7.25
Dissolved CO2 = 1.8 mEq/L
HCO3- = 27 mEq/L
These results would be classified as:

A

Respiratory acidosis

46
Q

A patients blood gas results are:
PH - 7.48
PCO2 = 52 mmHg
HCO3- = 40 mEq/L
PO2 = 98 mmHg
These results are consistent with which of the following?

A

Partially compensated metabolic alkalosis

47
Q

Which of the following will shift the oxygen dissociation curve to the left?

A

Alkalosis

48
Q

Which condition results in metabolic acidosis with severe hypokalemia and chronic alkaline urine?

A

Renal tubular acidosis

49
Q

Which of the following mechanisms can cause metabolic acidosis?

A

Bicarbonate deficiency

50
Q

Which of the following is the primary compensatory mechanism for metabolic acidosis?

A

Hyperventilation

51
Q

A patient has the following arterial blood gas results:
PH = 6.55
PCO2 = 26 mmHg
PO2 = 99 mmHg
HCO3- = 22 mEq/L
Which of the following is most likely to account for these results?

A

Hyperventilation

52
Q

What is the blood pH when the PCO2 is 60 mmHg and HCO3- is 18 mEq/L?

A

7.10

53
Q

What is the normal ratio of bicarbonate to dissolved CO2 in arterial blood?

A

20.1

54
Q

Diffusion of gases in the body is defined as:

A

The movement of charged hydrophilic ions through a nonpolar lipid bilayer

55
Q

An increase in temperature will result in a change to Hb-oxygen dissociation curve. This change reflects which of the following?

A

A shift in the curve to the right

56
Q

Which of the following compounds initially condenses to form aminolevulinin acid?

A

Succinylcholine coenzyme A and glycine

57
Q

What is the required oxidation state (valence) of iron that enables it to bind to a chromogen in most spectrophotometric assays?

A

+2

58
Q

Which of the following compounds chelates iron and is the immediate precursor of heme formation
?

A

Protophorhyrin IX

59
Q

What is the primary storage form of iron?

A

Ferritin

60
Q

Which of the following chromogens will produce a colored complex with iron?

A

Ferrozine

61
Q

Which of the following specimens is appropriate to determine the concentration of lead in body fluids?

A

Whole blood

62
Q

Free erythrocyte protoporphyrin levels are useful for assessing exposure to which of the following metals?

A

Lead

63
Q

What is the complex makes up transferrin?

A

Apotransferrin Fe3+

64
Q

A 30 year old male with ALA- dehydratase deficient porphyria (ADP) may present with which of the following clinical features?

A

Abdominal pain and neurological dysfunction

65
Q

Total-iron binding capacity (TIBC) is equal to:

A

The sum of the serum iron and unsaturated iron binding capacity (UBIC)

66
Q

Hemochromatosis is best described as which of the following following?

A

A genetically related disorder in which the body accumulates excess amounts of iron

67
Q

Which of the following statements is correct when precuring specimens for measuring porphyria compounds?

A

Protect the specimen from light

68
Q

A 40 year old male patient with hemochromatosis often presents to this clinician with which of the following triad of symptoms?

A

Bronzing of the skin, cirrhosis, and diabetes

69
Q

Protoporphyrin that chelates iron called:

A

Heme

70
Q

The biosynthesis of heme commences with which two compounds?

A

Glycine and succinyl CoA

71
Q

A patient with acute intermittent porphyria is deficient in which enzyme?

A

Hydroxymethylbilane synthase

72
Q

What is the unique quality that many porphyria compounds possess that allows for their detection within body tissues and in a test tube?

A

The fluoresce and are detected by exposing them to EMR at a specific wavelength

73
Q

Heme is defined as:

A

Protoporphyrins that chelate iron

74
Q

Which of the following enzymes is the first one used in the biosynthesis of heme?

A

Delta-aminolevulinate-synthase

75
Q

Which of the following laboratory test groups and results best reflects a patient with iron deficiency anemia?

A

Serum iron, decreased; serum TIBC, increased; transferring saturation, decreased

76
Q

How many pyrrole rings are there in a porphyria structure?

A

4

77
Q

The addition of sifficient Fe 3+ to saturate iron binding site of transferrin is referred to as which of the following?

A

Unsaturated iron binding capacity

78
Q

Which of the following porphyria’s best reflect this patients symptoms and laboratory results?
A 42-year old white South African male presents to his clinical experiencing acute neurological attacks and sensitivity of his skin to sunlight. The patients urine showed PBG> ALA. Urine porphyrins analysis revealed elevation of urinary coproporphyrinogen III

A

Variegate porphyria

79
Q

A 25 year old female visits her physician complaining of lethargy and wants to to take a nap all the time. Her physician order laboratory tests and the results are shown below. Which of the following conditions best represents this patients status?

Serum iron = decreased
TIBC = increased
Transferrin saturation % = decreased
Serum ferritin = decrease

A

Iron deficiency anemia

80
Q

The following laboratory results are consistent with which of the following conditions?
Urine PBG/ALA = PBG>ALA
Urine porphyrins = increased
Fecal porphyrins = normal
Erythrocyte porphyrins = Normal

A

Acute intermittent porphyria

81
Q

The fractional extent to which a dose of drug reaches its site of action is referred to as:

A

Bioavailability

82
Q

Which of the following Best reflect the four correct pharmacological parameters that determine serum drug concentration?

A

Absorption, distribution, metabolism, excretion

83
Q

Which of the following is the correct definition of first-pass effect of a drug?

A

When a drug is metabolized in the gut wall and liver before it reaches the systemic circulation

84
Q

The goal of therapeutic drug monitoring (TDM) is to:

A

Provide the patient with the optimum dosage of drug to effect the best outcome

85
Q

The pharmacological response of a drug is initiated when the drug is in which form?

A

Free

86
Q

FK506 (tacrolimus) is classified as a (an):

A

Immunosuppressant

87
Q

Plasma clearance of a drug is defined as:

A

The volume of plasma from which all drug appears to be removed in a given times (mL/min)

88
Q

Steady state of a drug is typically achieved after:

A

Approximately seven half-lives

89
Q

Which of the following drugs is used as an immunosuppressant in liver transplants?

A

Tacrolimus

90
Q

A drug this is administered into the subarachnoid space or ventricles (intrathecal) is referred to as:

A

Parenteral

91
Q

Which of the following compounds in an anticonvulsant used to control tonic-clinic (grand mal) seizures?

A

Phenytoin

92
Q

Which of the following compounds relaxes the smooth muscles of the bronchial passages?

A

Theophylline

93
Q

Which of the following compounds is a cardiac glycoside that is used in the treatment of congenital heart failure and arrhythmias by increasing the force and velocity of myocardial contraction?

A

Digoxin

94
Q

Carbamazepine, pyrimidine, and valproic acid are all examples of:

A

Antiepileptic drugs

95
Q

Depakene or Depakote are proprietary names for which of the following compounds?

A

Valproic acid

96
Q

Following the entrance of a drug into the vascular compartment, it will be carried to all organs and fluid compartments. This statements describes which of the of following?

A

Distribution

97
Q

Phase I biotransformation includes

A

Attachment of a hydroxyl group

98
Q

Which of the following compounds is the major metabolite of primidone?

A

Phenobarbital

99
Q

A blood sample for a trough drug level should be drawn:

A

Shortly before drug administration

100
Q

Which of the following are the toxic effects of phenobarbital?

A

Severe tiredness/dizziness, in ability to wake up, and very slow breathing rates

101
Q

Clearance (CL) of a drug is defined as which of the following?

A

The rate of elimination by all routes normalized t the concentration of drug, in some biological fluids

102
Q

Which of the following is bactericidal for Streptococci, Corynebacterium, Clostridia, Listeria, and Bacillus species?

A

Vancomycin

103
Q

Phenobarbital is classified as a (an):

A

Sedative and hypnotic

MLT Clinical Chemistry (7 decks)

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