Unit 4 Review Flashcards
Which of the following conditions will cause an increase anion gap?
Renal failure
The anion gap is determined from which of the following groups of electrolytes?
Sodium, chloride, potassium, and HCO3-
Which of the following conditions may be characterized by an increased anion gap?
*All of the above
- Salicylate intoxication
- diabetes mellitus
- lactate acidosis
A sweat chloride greater than 60 men/L is consistent with which of the following disorder?
Cystic fibrosis
Which of the following enzyme is used in several methods to measure serum total carbon dioxide?
Phosphoenolpyruvate carboxylase
Patients with hyponatremia may show signs of hypovolemia which is defined as:
Low blood volume
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?
Syndrome of inappropriate antidiuretic hormone (SIADH)
Chloride in sweat can be measured by which of the following techniques?
Coulometry and amperometry
In the blood, bicarbonate leaves the RBC and enters the plasma through an exchange mechanism with which of the following ions?
Chloride
Which of the following mechanisms aid in the transport of K+ into the cell against a concentration gradient?
Na+/K+ ATP pump
Symptoms including metal confusion, weakness, tingling sensations, respiratory muscle weakness are all associated with which of the following disorders?
- Hyperkalemia
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?
Atrial natriuretic peptide
Measurement of sodium, potassium, and chloride are commonly performed in laboratories using which of the following?
Ion selective electrodes
Calculate the anion gap given the following data:
Sodium = 145 mEq/L
Chloride = 102 mEq/L
HCO3 = 20 mEq/L
23 mEq/L
Which of the following conditions is associated with hypernatremia?
Diabetes insipidus
Which of the following electrolyte levels best correlate with plasma osmolarity?
Sodium
Plasma osmolality can be calculated using which of the following?
2(Na)+(glucose/18)+(BUN/2.8)
A patient with a toxic level of blood alcohol would cause which of the following?
An increased osmolarity gap
Serum lacks which of the following constituents?
Fibrinogen
Freezing point depression is one of the:
Colligative properties of a solution
A patient with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) would present with which of the following laboratory results?
Decreased serum sodium, osmalility, chloride, increased urine sodium
Which of the following sequences accurately reflects the renin-angiotensin-aldosterone system in response to hyponatremia?
Renin is released from the kidney; renin converts angiotensinogen to angiotensin I; angiotensin I is converted to angiotensin II
Electrolyte exclusion effect is characterized as which of the following?
A falsely low serum sodium result in a grossly lipemic specimen
A family of peptides called natriuretic peptides serves to regulate:
Sodium and water metabolism
Angiotensin II is a potent vasoconstrictor that:
Stimulates ADH secretion and thirst
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
Respiratory alkalosis
Which of the following compensatory mechanisms is correct for a patient in respiratory acidosis?
Decrease whole blood pCO2
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
Metabolic alkalosis
Which of the following represents the compensatory response of the kidney and lungs to a patient who is in metabolic acidosis?
- the kidneys will increase bicarbonate reabsorption and the patient will begin to breathe very deeply and often gasp of air
Respiratory alkalosis can be seen in patients with:
Hysterical hyperventilation
A patient’s blood gas results are shown below:
PH = 7.32
PCO2 = 58 mmHg
HCO3- = 28 mEq/L
The results indicate:
Respiratory acidosis
Which of the following mechanims is responsible for metabolic acidosis?
Bicarbonate deficiency
What is the calculated pH for a patient sample if the measured bicarbonate concentration is 22 mEq/L and he pCO2 is 57 mmHg?
7.2
Which of the following buffer has the greatest percentage buffering capacity?
Hb
Hypercapnia is defined as:
An elevated blood level of carbon dioxide
The specimen of choice for measuring blood pH, pO2, and pCO2 is:
Heparinized arterial blood
Name the equation shown below:
PH = pK’ + log[cHCO3-/(a x pCO2)]
Henderson-Hasselbalch equation
Convert pCO2 of 40 mmHg to the SI equivalent in kilopascals (kPa)
5.33
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:
Isohydric shift
Which of the following is a derived blood gas parameter?
Actual base excess
Which of the following materials represents the appropriate calibrator used to calibrate the pCO2 electrode?
A gas cylinder containing a known amount of carbon dioxide
Which of the following statements reflects the appropriate action to take after receiving an arterial blood gas specimen for analysis?
Gently push out the bubbles or clots that may collect at the end of the syringe
Which of the following contributes the most to the serum total CO2?
HCO3-
Which of the following effects result from exposure of a normal arterial blood sample to room air?
PO2 increased, PCO2 decreased, pH increased
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:
Respiratory acidosis
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?
Partially compensated metabolic alkalosis
Which of the following will shift the oxygen dissociation curve to the left?
Alkalosis
Which condition results in metabolic acidosis with severe hypokalemia and chronic alkaline urine?
Renal tubular acidosis
Which of the following mechanisms can cause metabolic acidosis?
Bicarbonate deficiency
Which of the following is the primary compensatory mechanism for metabolic acidosis?
Hyperventilation
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?
Hyperventilation
What is the blood pH when the PCO2 is 60 mmHg and HCO3- is 18 mEq/L?
7.10
What is the normal ratio of bicarbonate to dissolved CO2 in arterial blood?
20.1
Diffusion of gases in the body is defined as:
The movement of charged hydrophilic ions through a nonpolar lipid bilayer
An increase in temperature will result in a change to Hb-oxygen dissociation curve. This change reflects which of the following?
A shift in the curve to the right
Which of the following compounds initially condenses to form aminolevulinin acid?
Succinylcholine coenzyme A and glycine
What is the required oxidation state (valence) of iron that enables it to bind to a chromogen in most spectrophotometric assays?
+2
Which of the following compounds chelates iron and is the immediate precursor of heme formation
?
Protophorhyrin IX
What is the primary storage form of iron?
Ferritin
Which of the following chromogens will produce a colored complex with iron?
Ferrozine
Which of the following specimens is appropriate to determine the concentration of lead in body fluids?
Whole blood
Free erythrocyte protoporphyrin levels are useful for assessing exposure to which of the following metals?
Lead
What is the complex makes up transferrin?
Apotransferrin Fe3+
A 30 year old male with ALA- dehydratase deficient porphyria (ADP) may present with which of the following clinical features?
Abdominal pain and neurological dysfunction
Total-iron binding capacity (TIBC) is equal to:
The sum of the serum iron and unsaturated iron binding capacity (UBIC)
Hemochromatosis is best described as which of the following following?
A genetically related disorder in which the body accumulates excess amounts of iron
Which of the following statements is correct when precuring specimens for measuring porphyria compounds?
Protect the specimen from light
A 40 year old male patient with hemochromatosis often presents to this clinician with which of the following triad of symptoms?
Bronzing of the skin, cirrhosis, and diabetes
Protoporphyrin that chelates iron called:
Heme
The biosynthesis of heme commences with which two compounds?
Glycine and succinyl CoA
A patient with acute intermittent porphyria is deficient in which enzyme?
Hydroxymethylbilane synthase
What is the unique quality that many porphyria compounds possess that allows for their detection within body tissues and in a test tube?
The fluoresce and are detected by exposing them to EMR at a specific wavelength
Heme is defined as:
Protoporphyrins that chelate iron
Which of the following enzymes is the first one used in the biosynthesis of heme?
Delta-aminolevulinate-synthase
Which of the following laboratory test groups and results best reflects a patient with iron deficiency anemia?
Serum iron, decreased; serum TIBC, increased; transferring saturation, decreased
How many pyrrole rings are there in a porphyria structure?
4
The addition of sifficient Fe 3+ to saturate iron binding site of transferrin is referred to as which of the following?
Unsaturated iron binding capacity
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
Variegate porphyria
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
Iron deficiency anemia
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
Acute intermittent porphyria
The fractional extent to which a dose of drug reaches its site of action is referred to as:
Bioavailability
Which of the following Best reflect the four correct pharmacological parameters that determine serum drug concentration?
Absorption, distribution, metabolism, excretion
Which of the following is the correct definition of first-pass effect of a drug?
When a drug is metabolized in the gut wall and liver before it reaches the systemic circulation
The goal of therapeutic drug monitoring (TDM) is to:
Provide the patient with the optimum dosage of drug to effect the best outcome
The pharmacological response of a drug is initiated when the drug is in which form?
Free
FK506 (tacrolimus) is classified as a (an):
Immunosuppressant
Plasma clearance of a drug is defined as:
The volume of plasma from which all drug appears to be removed in a given times (mL/min)
Steady state of a drug is typically achieved after:
Approximately seven half-lives
Which of the following drugs is used as an immunosuppressant in liver transplants?
Tacrolimus
A drug this is administered into the subarachnoid space or ventricles (intrathecal) is referred to as:
Parenteral
Which of the following compounds in an anticonvulsant used to control tonic-clinic (grand mal) seizures?
Phenytoin
Which of the following compounds relaxes the smooth muscles of the bronchial passages?
Theophylline
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?
Digoxin
Carbamazepine, pyrimidine, and valproic acid are all examples of:
Antiepileptic drugs
Depakene or Depakote are proprietary names for which of the following compounds?
Valproic acid
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?
Distribution
Phase I biotransformation includes
Attachment of a hydroxyl group
Which of the following compounds is the major metabolite of primidone?
Phenobarbital
A blood sample for a trough drug level should be drawn:
Shortly before drug administration
Which of the following are the toxic effects of phenobarbital?
Severe tiredness/dizziness, in ability to wake up, and very slow breathing rates
Clearance (CL) of a drug is defined as which of the following?
The rate of elimination by all routes normalized t the concentration of drug, in some biological fluids
Which of the following is bactericidal for Streptococci, Corynebacterium, Clostridia, Listeria, and Bacillus species?
Vancomycin
Phenobarbital is classified as a (an):
Sedative and hypnotic
