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Clinical Chemistry > Week 6: Bood Chemistry > Flashcards

Week 6: Bood Chemistry Flashcards

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0
Q

what are some pre analytical factors that can affect quality of test results

A 
Collection procedure
 - correct needle size
 - fill tubes in correct order
 - store correctly 
 - visually inspect
Labeling, handling, shipping
Patient variables (ex. fasting)
Equipment difficulties
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1
Q

What are some reasons why we would run a clinical chemistry profile

A

screen for disease
assess pre surgical risk
distinguish between differential diagnosis
assess severity of existing disease
monitor progression/response to therapy
identify patterns that suggest dysfunction

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2
Q

What are some things we can do as techs to ensure quality control and accurate results from a chemistry analyzer?

A 
Proper calibration
Routine maintenance (ex. software update)
Running daily controls
Blanking methods
Monitor for deterioration of reagents
Monitor condition of analyzer
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3
Q

With chemistry, what type of sample do we usually look at?

A

Serum

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4
Q

What are plasma proteins produced and what are some of their function?

A

Primarily in the liver

structural component of all cells, organs, and tissues
osmotic pressure
enzymes
buffers
hormones 
clotting
defense 
transport molecules
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5
Q

what is total plasma protein

A

all proteins including fibrinogen

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6
Q

what is total serum protein

A

all proteins excluding clotting factors

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7
Q

Protein concentrations are affected by:

A

hepatic synthesis
altered protein breakdown or excretion
dehydration or over hydration

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8
Q

what are some methods we can use to test protein concentration

A

refractometric method

biuret method

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9
Q

You run a test and the Albumin levels are below normal range.

What is the medical name for this condition?
What would our concern be?

A

Hypoproteinemia

liver disease, renal disease, diet, intestinal function

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10
Q

What are Globulins?

How do you calculate Globulins

A

Complex group of proteins

  • Alpha globulins (come from liver)
  • Gamma globulins (antibodies)

concentration= TP - Albumin

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11
Q

What is A:G ratio

A

Albumin to Globulin ratio

its the first indication of protein abnormalties

A/G= A:G value

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12
Q

What is a hepatobiliary assay

A

tests for liver and gallbladder function

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13
Q

What is ALT and where would we find it?

A

Alanine Aminotransferase (enzyme in the cytoplasm of hepatocytes)

liver cells, renal cells, cardiac muscle, skeletal muscle, and the pancreas

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14
Q

When would we see an increase of ALT

A

within 12hrs of hepatocyte damage

peaks within 12 - 48 hrs

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15
Q

What is AST and where would we find it

and when could we see an increase in this

A

Aspartate Aminotransferase (Enzyme in hepatocytes)

liver cells, erythrocytes, cardiac muscle, skeletal muscle, kidneys, and the pancreas

levels may rise after exercise or IM injection (not just liver damage)

16
Q

What is AP?

Where is it found?

A

Alkaline Phosphatase

present in bone, cartilage, intestine, placenta, and hepatobiliary system cells

17
Q

What is Bilirubin

what do assays help determine:

A

derived from breakdown of hemoglobin in the spleen

Cause of jaundice
Hepatocellular damage
Bile duct injury/obstruction
Erythrocyte destruction

18
Q

Where would we find Bile acids?

When would we see elevated bile acids?

A

Liver - gallbladder - duodenum

when any process impairs hepatocellular, biliary, or enterohepatic circulation

19
Q

What factors would affect testing of bile levels

A

inadequate fasting
spontaneous gallbladder contraction
prolonged fasting (over 12hrs)
Diarrhea

20
Q

Where would we find cholesterol?

what condition do we test cholesterol for?

A

produced primarily in the liver

Hypothyroidism
Hyperadrenocorticism
Diabetes mellitus
Nephrotic syndrome

21
Q

What is BUN?

What factors can show an increase in BUN levels?

A

Blood Urea Nitrogen (Urea comes from protein breakdown)

Contamination (ex. staph)
Dehydration
Diet (high protein)

22
Q

What turns creatine into serum creatinine?

A

Muscle metabolism

23
Q

What are the divisions of pancreas function

A

Exocrine (digestive enzymes)

Endocrine (insulin)

24
Q

What is function of amylase?

where is it produced?

what caused an increase?

A

breakdown of starch

primarily in the pancreas

pancreatic disease, enteritis, intestinal obstruction, intestinal perforation

25
Q

What is the function of Lipase?

Where is it produced?

Lipase and amylase are typically measured together and if amylase is increased then lipase should be increased. I amylase is increased but lipase is not where is this probably coming from?

A

break down fat

pancreas-specific

intestines

26
Q

What is the function of Trypsin

A

break down protein

27
Q

What is Serum TLI?

Decreases with…

Increases with…

A

Serum trypsin-like immunoreactivity

decreases with functional pancreas mass

increases with lower glomerular filtration rate

28
Q

What is Serum PLI?

We use this to test for what condition?

A

Serum pancreatic lipase immunoreactivity

pancreatitis

29
Q

What are the major function of electrolytes?

What is a testing method?

What can cause an error in testing?

A

Maintain water balance
Osmotic pressure
Muscular and nervous function
Acid-base regulation

Electrochemical (ion specific)

lipemia

30
Q

What are the cations of electrolytes

What are the anions of electorlytes

A

Sodium, potassium, magnesium

Chloride, Bicarbonate

31
Q

What is CK?

Where is it primarily found?

What can cause an increase?

A

Creatine Kinase

primarily from striated muscle (skeletal and cardiac)
also found in brain

damage to muscle causes an increase in CK

32
Q

What can cause an increase in Lactate (Lactic acid)

A

Hypoxia, hypoperfusion and peritonitis

33
Q

What is Fructosamine

what can cause an increase

A

reaction of glucose bound to protein

persistent hyperglycemia

34
Q

What is the glucose tolerance testing rule out?

A

diabetes mellitus

35
Q

what is the insulin tolerance test for?

A

differentiates the cause of diabetes mellitus

36
Q

Why do we do a ACTH stimulation

A

test for suspected hypo - or hyperandrenocorticism

37
Q

What does a high dose dexamethasone suppression test for?

What does a low dose dexamethasone suppression test for?

A

high dose - differentiates pituitary from adrenal causes (helps determine treatment)

low dose - hyperadrenocorticism

38
Q

what is T4?

Cholesterol is often elevated with a ____functional thyroid gland.

A

Thyroxin- tests thyroid function

Hypo

Clinical Chemistry (2 decks)

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