chem12.17 Flashcards

1
Q

Protein soluble in water

A

albumin

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2
Q

What diff proteins from carb/lipid

A

nitrogen

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3
Q

conjugated protein

A

protein plus prosthetic grplipo, glyco/muco, nucleo

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4
Q

5 plasma proteins

A

albumin, alpha 1, alpha 2, beta, gamma

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5
Q

Primary protein structure

A

amino acids

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6
Q

Secondary protein structure

A

alpha helix, beta pleated sheets

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7
Q

Tertiary protein structure

A

3D

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8
Q

Quaternary protein structure

A

2+ polypeptide chains

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9
Q

Enzyme deficiency with decreased enzymes leading to buildup of ketoacids decreased branched-chain ketoacid dehydrogenase enzyme activity(LIV)

A

maple syrup disease

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10
Q

Aminoacidpathy caused by defiency in the enzyme to metabolize phenylalaninemousy urine

A

Phenylketonuria, PKU

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11
Q

Aminoacidopathy due to enzyme deficiency due to lack of enzyme to break down tyrosine/phenylalanine leading to buildup of homogentistic aciddeficiency of a single enzyme called homogentisate 1,2 dioxygenaseblack urine

A

Alkaptonuria

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12
Q

CystinuriaTyrosinemia

A

inherited metabolic,excessive amount of undissolved cysteine, doesn’t get reabsorbed by kidney, kidney stonesTyrosine/metabolites excreted in urine

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13
Q

Deficiency in enzyme needed to metabolize methionine Increased levels of this amino causes stroke, CVD, alzheimers, osteoporesis, nutrional def

A

Homocystinuriabuild up of methionine and homocysteine (metabolite of methionine)

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14
Q

4 causes of hypoproteinemia

A

Not getting/making enough:malnutritionliver disease(doesn’t make protein)Protein loss: burns(protein loss thru wound)nephrotic syndrome(loss thru urine)

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15
Q

3 Causes of hyperproteinemia

A

dehydrationMultiple myeloma, Waldenstroms

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16
Q

5 immunoglobulin

A

G,A,M,E,D

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17
Q

4 measurements of TPTP g/dL

A

BiuretDye bindingKjeldahlRefractometryTP 6.4-8.3 g/dL

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18
Q

TP g/dLalbumin g/dLmicroalbumin in urine mg/24hr

A

TP 6.4-8.3g/dLAlbumin 3.5-5 g/dL (about 60% of TP) rest is globulinsmicroalbumin 50-200 mg/24hr

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19
Q

Calculation of A/G ratio

A

Albumin/TP-albumin

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20
Q

Total protein method that reacts with >= 2 peptide bonds in proteins

A

Biuret

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21
Q

Biuret reaction for TP uses…which forms what color complex

A

copper salts which forms a purple color

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22
Q

4 dyes in dye binding for TP

A

Bromophenol Blue Coomassie brilliant bluePonceau SAmido black

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23
Q

Reference method for TP, not used often

A

Kjeldahl

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24
Q

TP method that measures nitrogen

A

Kjeldahl

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25
Q

This reaction follows Beers law for a reasonable range of proteinDepends on presence of at least two peptide linkagesIs insensitive to low protein in urine

A

Biuret reaction

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26
Q

3 things that can interfere with Biuret method for TP

A

hemoglobin, hemolysis and lipids can interfere

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27
Q

Two dyes used in dye binding method for albumin

A

BCPBCGBromcresol

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28
Q

BCP/BCG is used in what method…are used to determine…

A

Dye-binding methodfor albumin

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29
Q

Principle of protein measurement calledpHcolor change from,tofalse pos seen in what pH

A

protein error of indicatorspH 3.0yellow to greenalkaline urine

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30
Q

Breakdown of protein in liver produces…and also produces…

A

ureaammonia

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31
Q

B2 microgobulin used as a marker for

A

marker for reduced GFR

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32
Q

CSF protein

A

15-45mg/dL

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33
Q

3 Methods for Urine/CSF protein, BAD acronym

A

BiuretAcid: SSA precipitationDye: Coomassie brillant blue

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34
Q

Increased CSF protein in these 3

A

meningitis, tramatic tap, MS

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35
Q

Protein in Spina bifida

A

AFPalpha fetoprotein

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36
Q

CEA stands for, is a

A

carcino-embryonic antigenoncofetal antigen

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37
Q

CEA nonspecific for

A

colorectal carcinoma/colon cancer

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38
Q

AFP

A

alpha fetoproteintumor associated; secreted by fetal liver

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39
Q

Increased AFP 4 conditions

A

liver/heptocellular cancerneural tube defects(spina bifida)ovariantesticular cancer

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40
Q

Decreased AFP in

A

Down syndrome

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41
Q

HCGMade by…Has…

A

human chorionic gonadotropinmade by placenta after implantation by trophoblastic cellsalpha+beta subunits

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42
Q

HCG seen in these two cancers

A

ovariantesticular

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43
Q

PSAMade by…Seen in..

A

prostate specific antigenmade by prostatic epi cellsprostatic cancer

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44
Q

CA-125

A

ovarian cancer

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45
Q

CA19-9

A

pancreaticGI, adenocarcinoma

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46
Q

CA15-3, 27.29

A

mestatic breast

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47
Q

Two markers in breast cancer

A

CA27-29, CA15-3

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48
Q

Thyroglobulin marker for

A

thyroid

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49
Q

All proteins carry a net…charge due to protein being a higher pH than its isoelectric pointand travel towards

A

net negative, anode

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50
Q

Fastest/smallest protein toward anode

A

albumin

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51
Q

Which globulin migrates to cathode due to electroendosmosis

A

gamma

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52
Q

pH of electrophoresis

A

8.6

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53
Q

Anode

A

positively charged electrode

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54
Q

Cathode

A

negatively charged electrode

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55
Q

Protein in highest concentration and made in liver% of plasma protein

A

Albumin60%

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56
Q

Method of detection for albumin and reagents used

A

dye binding, methyl orange, bromcresol purple

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57
Q

Albumin function

A

transport/binds proteinosmotic pressure

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58
Q

Albumin decreased in these 3 things

A

malnutritionliver diseasenephrotic syndrome/renal loss/kidney disease

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59
Q

Albumin increased in this

A

dehydration

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60
Q

Another name for prealbumin and used to assess…

A

trans-thy-retinnutrional status

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61
Q

Liver makes these 4 globulins and RE/plasma cells make this

A

liver: albumin, alpha 1/2, betaRE/plasma: gamma

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62
Q

two alpha 1 globulins

A

AAT: alpha1 antitrypsininhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.AFP: alpha fetoprotein

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63
Q

AAT increased, decreased in

A

increased in acute phase/prego(Action of Neutrophils cause AAT to try to keep it from damaging tissue)decreased in emphysema(Def means neutrophil byproducts are damaging tissue)

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64
Q

AFP increased, decreased in

A

increased in neural tube defects liver cancerovarian/testiculardecreased in Downs

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65
Q

Globulin increased in acute inflamation

A

alpha 2

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66
Q

Large globulin made in liver, inhibits trypsin/pepsin/plasminincreased in pregonephrotic/kindey disease diabetes, lupus

A

alpha 2 macroglobulin

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67
Q

three alpha 2 globulins

A

alpha 2 macroglobulinHaptoglobinceruplasmin

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68
Q

Alpha 2 globulin made in liveracute phase reactant that binds hmg

A

Haptoglobin

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69
Q

haptoglobin increased/decreased in these two

A

increased in acute phases, nephrotic syndrome(Increased α2-macroglobulin is seen in nephrotic syndrome due to increased synthesis and inability to pass through the glomerulus)decreased in transfusion, hemolysis

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70
Q

Alpha2 globulin transports copper, made in liver, acute phase reactant

A

Ceruloplasmin

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71
Q

Disease with decreased serum ceruloplasmin and increased serum/urine copper. Increased storage of copper in organs/cornea

A

wilsons

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72
Q

Disease with decreased ceruloplasmin due to decreased absorption, decreased serum copper

A

Menkes

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73
Q

Ceruplasmin is a …. that transports…increased in these two…decreased in these two conditions…

A

glycoprotein that transports copperincreased in acute phase/inflammation, pregodecreased in Wilsons disease and Menkes

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74
Q

Type of globulin that is carrier protein for iron and lipidselevated in

A

Beta globulinincreased LDLIDA

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75
Q

Beta globulins examples

A

Beta2 microglobulinbeta lipoprotein/LDLtransferrinhemoplexincomplementfibrinogenCRP

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76
Q

Beta globulin that is a heme scavenger

A

hemopexin

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77
Q

Beta globulin that transports iron

A

transferrin

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78
Q

examples of glycoproteins

A

transferrinceruloplasminmucinsAFPimmunoglobulins, antibodiesFSH, LH, HCG, TSHFibrinogen

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79
Q

A non-glycoprotein that are temp sensitive proteins that precipitate from serum/plasma at temps lower than 37C

A

Cryoglobulin

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80
Q

Striated muscle/cardiac; increased in heart attack, muscle dystrophy, crush

A

myoglobin

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81
Q

complex of 3 proteins in striated/cardiac; muscle contration, most sensitive for heart attach3 subunits

A

TroponinTnI, TnT, TnC

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82
Q

Bence Jones in urine migrate to..Prealbumin band seen in…

A

BJ to gamma regionPrealbumin in CSFUrine/CSF concentration first

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83
Q

globulin increased globulin decreased in viral hepatitis

A

gamma increasedalbumin decreased

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84
Q

globulins increasedglobulin decreased in maligment tumor

A

alpha 1/2 increasedalbumin decreased

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85
Q

beta-gamma bridge/broad gamma seen in

A

active cirrhosis/liver

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86
Q

M spike seen in

A

Monoclonal gammopathy

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87
Q

increased alpha 2/gamma ratio seen in

A

nephrotic syndromeliver makes less albumin

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88
Q

Migration of globulins from anode to cathode

A

albumin, alpha 1, alpha 2, beta, gamma

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89
Q

Polar hydrophillic and nonpoloar hydrophobic fatty acid chains; cell membranes are made of these

A

phospholipids

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90
Q

Examples of phospholipids

A

lecithinsphingomyelinPG(phosphatidyl glycerol)

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91
Q

Long chain polyunsaturated fatty acids that activates inflammation Stimultes clotting; also stimulates cervix to dialate and contractions

A

PGProstaglandins

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92
Q

Transports lipids, classified w/ultracentrifugationProtein part of lipoproteins/structural components

A

transports lipids: lipoproteinsProtein part: Apoprotein

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93
Q

Order of lipids from heaviest to lighest

A

HDL, LDL, VLDL, Chylo

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94
Q

Alpha lipoprotein is…Beta lipoprotein is…Prebeta lipoprotein is…Migration of liproteins from origin/cathode to anode

A

alpha: HDLBeta: LDLPreBeta: VLDLOrigin to Anode:Chylo, LDL, VLDL, HDL

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95
Q

Largest lipoprotein, carrier of exo TrigApoproteins associated with it

A

ChylomicronApoB-48

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96
Q

Exogenous/dietary lipids and it’s liproprotein/carrier

A

Triglycerideschylomicrons

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97
Q

most artherogenic lipid causing CHD, mostly composed of cholesterol and transported to the heart

A

LDL

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98
Q

Endogenous lipid made of mostly triglycerides

A

VLDL

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99
Q

Lipid transports lipid out to liver, heaviest and smallest

A

HDL

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100
Q

primary form of lipid storage…transported by these two…

A

triglyceridesexo/dietary: chylomicronsendo:VLDL

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101
Q

Lipid made monstly in liver, manufacture/repair cell membranes, makes biles salts/vitD, precurosr to steroids….two kinds:transports to cells…transports out of cells…

A

cholesterolto: LDLout of: HDL

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102
Q

% of Cholesterol made in liver…% of Trig made in liver versus diet…

A

Cholesterol 85%Trig 10% liver, 90 diet

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103
Q

Apoprotein B-100 are part of these two lipids

A

LDL, VLDL

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104
Q

Apoprotein A is part of this lipoprotein

A

HDL

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105
Q

Apoprotein B-48 is part of this lipoprotein

A

Chylo

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106
Q

LDL % carrries lipids

A

60-70

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107
Q

HDL % carries lipid

A

20-35

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108
Q

VLDL % carries lipid

A

5-12%

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109
Q

Major protein in HDL

A

Apolipoprotein A

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110
Q

Major protein in LDL/VLDL

A

Apolipoprotein B

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111
Q

Protein versus lipid density

A

protein more dense than lipid

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112
Q

Disease with very low HDL

A

Tangier

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113
Q

Method for cholesterolpurpose of saponification step

A

cholesterol oxidaseconvert cholesterol esters to free cholesterol

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114
Q

Liebermann Burchard reaction used to determine

A

cholesterol

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115
Q

2 reagents used for color developemnt in Liebermann Burchard reaction for cholesterol

A

acetic anhydridesulfuric acid

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116
Q

Lipid w/3 fatty acids/glycerolstorage form90% in diet, 10% liverlipemia from chylomicrons

A

Trig

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117
Q

Enzyme method for triglycerides…Hydrolyzes to…

A

Lipase hydrolyzes triglyceride to form glycerol

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118
Q

Fredewald calculation for LDL

A

TC- (TG/5+ HDL)

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119
Q

Friedwald calculation for VLDL

A

TG/5

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120
Q

Cannot used Friedwald calculation for LDL/VLDL if…

A

TG is >400mg/dL

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121
Q

Risk factors for CHDage by gendershistory ofbp, HDLtwo conditions

A

> 45men, >55 womenfamily history of CHDsmokingbp >120, HDL <40D.mellitus, metabolic syndrome

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122
Q

Lipid goalsTCTrigLDLHDL

A

TC <200Trig <150LDL<100HDL>35

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123
Q

Condition where blood cholesterol is increased

A

hypothyroidismThyroid hormones help your liver process blood. When your thyroid hormone levels are low, your liver processes blood more slowly, which can lead to higher levels of cholesterol in your bloodstream

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124
Q

Examples of ….lipid deposits in vascular/legs/armsCAD, AMI, arterieslipid in brain, stroke

A

atheriosclerosis

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125
Q

Disease with increased TC, LDL and decreased HDLCalculate coronary risk index using these two parametersElevated beta liproprotein is what lipid and leads to which kind of disease

A

CHDTC, HDLLDL, cardiovascular

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126
Q

4 non protein nitrogen

A

urea, ammoniauric acidcreatinine

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127
Q

non protein nitrogen increased in plasma in renal impairment called

A

azotemia

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128
Q

Best way to evaluate renal impairment and what is most common analyte to monitor it

A

GFRcreatinine

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129
Q

Creatinine clearance calcbased off the principle that creatinine passes into the ultrafiltrate

A

U creat/P creat x mL/1440vol in mL, min/24hr

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130
Q

Correction for clerance by body surface area

A

creat clearx1.73/area

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131
Q

Used with eGFR to stage/monitor CKD

A

urine albumin

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132
Q

Made from creatine in muscle

A

Creatinine

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133
Q

Method for creatininereacts withcolor formed

A

Jaffealkaline picrateyellow-red

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134
Q

Rises more rapidly than serum creatinine in acute renal failure

A

BUN

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135
Q

BUN increased in these two things

A

renal impairmenthigh protein

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136
Q

diacetyl monoxime used in determining…by measuring…can be used in untreated urine because…

A

BUNureamethod isn’t measuring ammonia

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137
Q

Type of method for BUN that measures urea…reagent that reacts with urea…

A

Colorimetric methodreacts with diacetyl monoxime

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138
Q

Enzymatic method for BUN uses….which hydrolyzes…to…

A

ureasewhich hydrolyzes urea into ammoniaUnlike the colorimetric method using diacetyl monoxime used for BUN/urea

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139
Q

diacetyl monoxime-urease-

A

diacetyl monoxime-BUN/ureaurease-BUN/ammonia

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140
Q

BUN mg/dLCreatinine mg/dLBUN/creatinine ratioelevated creatinine will result in elevated BUN of how much

A

BUN 6-20mg/dLCreatinine around 1mg/dL10:1-20:1BUN will be elevated

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141
Q

GFR marker made by nucleated cells

A

cystatin c

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142
Q

end product of purine metabolism from nuclei, allantoin

A

uric acid

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143
Q

The colorimetric method for uric acid is an alkaline oxidation where uric acid reduces…to…

A

phospho-tungistic acid to tungsten blue

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144
Q

phosphotungistic acid used in

A

uric acid

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145
Q

Uric acid NV mg/dL

A

2.6-7.2

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146
Q

Hyperuricemia causes

A

-gout-leukemia/lymphoma (overproduction of new cells, more breakdown)-Lesch-Nyhan(The HGPRT deficiency causes a build-up of uric acid in all body fluids. The combination of increased synthesis and decreased utilization of purines leads to high levels of uric acid production.)

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147
Q

Disease where there is over production of uric acid that arent recycled; mostly malesThe HGPRT deficiency causes a build-up of uric acid in all body fluids. The combination of increased synthesis and decreased utilization of purines leads to high levels of uric acid production.)

A

Lesch-Nyhan

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148
Q

Uric acid is measured by… at 290nm before/after treatment with…

A

UV absorption at 290 before/after treatment with uricaseAlso use isotope dilution/MS

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149
Q

This is from bacterial action on contents of colon and metabolized by liver

A

ammonia

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150
Q

Analyte that is a prognostic indicator of liver failure

A

ammonianot eliminated by kidneys

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151
Q

Increased ammonia in these 3 main reasons

A

liver disease (cirrhosis, viral hep)Reye’s SyndromeReye’s syndrome is a rare condition that happens in children after a viral infection or illness, especially if they took aspirin (salicylate) to treat their symptoms. Reye’s syndrome targets their brain, blood and liver.impaired renal (increased urea,ammonia)

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152
Q

Syndrome that leads to increased ammonia, mostly kids, previous virus, salicylate

A

Reyes

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153
Q

Bromphenol blue or GLDH used to measure

A

ammonia

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154
Q

Nessler used to detect

A

used to detect ammoninapotassium iodide plusmercury iodide/chloride plussodium hydroxide in waterdirty brown precipitate

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155
Q

Disaccharide with 2 glucose

A

maltose

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156
Q

Disaccharide with 1 glucose, 1 galactose

A

lactose

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157
Q

disaccharide with 1 glucose, 1 fructose

A

sucrose

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158
Q

monosaccharide with 6 carbons

A

hexose

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159
Q

process that uses glucose for energy, changed to lactic acid for energy

A

glycolysis

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160
Q

process of glucose to glycogen

A

glycogenesis

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161
Q

process of glycogen to glucose

A

glycogenolysis

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162
Q

process of glucose from noncarb sources

A

gluconeogenesis

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163
Q

renal threshold for glucoseCSF glucose % of plasmabest anticoagulant

A

160-180mg/dLCSF 60-65% of plasmasodium flouride

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164
Q

Diabetes melliutusplasma/OGTTA1C

A

> 200mg/dL>=6.5%

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165
Q

Hypoglycemia mg/dL

A

70mg/dl

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166
Q

Hormones that regulate glucosewhich one decreases?all the rest increase

A

insulin, glucagonepineph/cortisolGH, ACTHT3/T4(Thyroxine)Stomatostainonly one decreases is insulin

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167
Q

hormones made in pancreas:alpha cells/increase or decreasebeta cells/increase or decreasedelta cells/increase or decrease

A

alpha: glucagon, increasebeta: insulin, decreasedelta: stomatostain, increase

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168
Q

peptide hormone made in beta cells and decreases blood glucose/goes into cells

A

insulin

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169
Q

steroid hormone that is a glucocorticoid, made in adrenal cortex, and increases blood glucose

A

cortisol

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170
Q

peptide hormone made in alpha cells, increases blood sugar by making glucose from glycogen

A

glucagon

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171
Q

hormone made in delta cells, inhibits secretion of insulin making more glucose in blood

A

stomatostain

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172
Q

hormone that is adrenaline, neurotransmitter and regulates glucose

A

epinephrine

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173
Q

glycogen storage diseaseincreased or decreased glucose

A

von Gierkesdecreased

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174
Q

diabetes where glucose is normal

A

insipidus

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175
Q

condition with tumor that results in increased insulinincreased or decreased glucose

A

insulinomadecreased glucose

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176
Q

two conditions that increase glucose

A

hashimotos(Hypothyroidism, which is caused by Hashimoto’s disease, decreases glucose absorption, leading to an accumulation of sugar. In turn, this accumulation of sugar causes more insulin to be produced to utilize excess glucose, eventually leading to insulin resistance.)cushings(increased cortisol)

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177
Q

most employed automated method for glucose uses what two enzymes where there’s oxidation that forms a chromagencontamination can happen with

A

glucose oxidase, peroxidasecontamination with catalase

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178
Q

Gold standard for glucose testing/higher specificity…Two enzymes used….Amount of… is proportional to glucoseIs read at…nm

A

Hexokinase methodHexokinase, G6PDNADH formed is proportional to glucose340nm

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179
Q

hexokinase method:what is reduced and measured?measured at what nm?

A

NAD coenzyme reduced to NADHmeasured at 340nm

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180
Q

Normal fasting blood glucose

A

70-110mg/dL

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181
Q

Test to confirm prenatal borderline blood glucose

A

3 hr GTT

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182
Q

HmgA1C binds to hmg and monitors long term diabetes/largest fraction of HbAhow long of picture of glucose?Normal?Diabetic?

A

2-3mthNormal 4.0-6.0%Diabetic 6.5%

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183
Q

Juvenille onset, insulin dependent, autoimmune destruction of beta cellsketoacidosis

A

Type 1

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184
Q

adult onset, non insulin, insulin resistance, no ketoacidosis, obsesity

A

Type 2

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185
Q

What is a byproduct of insulin and can differentiate between medication/exo insulin and what the body makes/endogenous insulin?

A

C-peptide

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186
Q

Diabetes caused by placental lactogen inhibiting insulin

A

GDMgestational diabetes mellitus

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187
Q

Measurement of light intensity, chemical rxn forms color and is absorbed at specific wavelenthvisible light 400-700, frequency inverse to wavelength, uses quartz cuvette for UV rangetungsten or deuterium

A

spectrophotometry

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188
Q

Filter used for QC of spectrophotometer and what it tests

A

holmium oxide glass filterwavelength accuracy

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189
Q

Meaasurement of emission of color when element is burned

A

flame photometry

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190
Q

Measurement of light abosorption of electromagnetic radiation

A

atomic absorption spectrophotometry

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191
Q

Atomic absorption measures using what light sourcealso uses monochormator, flame sample cell, PM tube

A

hollow cathod lamp

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192
Q

term that decreases fluorescent intensity of a substanceis a disadvantage of…

A

quenchingfluorometry

193
Q

Measurement using electrode, ref electrode, liquid, potential diff between the two equals concentration

A

ISE

194
Q

Measurement of light scattered by particles in a solution and measured at an angle, seen in ag-ab rxn…Measurement of reduction in light transmission by particles in suspension ie proteins

A

scattered: nephelometryreduced transmisson: turbidimetry

195
Q

In immunoelectrophoresis there must be excess…and a constant…. ……

A

excess antibodyconstant trough distance

196
Q

Used to separate volatile or able to volatile and to confirm toxicologyIs a reference for alcoholThis is used to enhance sensitivity and specificity

A

gas chromatographyMS(mass spectro)

197
Q

Technique w/sorbent coated and solvent screens for drugs/urineUses Rf valueRf value is…

A

TLC Thin layer chromatographyRf= drug distance/solvent distance

198
Q

Osmometry based off measuresm-Osmol/kg

A

freezing point depressionmeasure osmolality of urine/serum(dissolved particle in sln)Tubular fnc

199
Q

Hmg-VerdohmgPlasma/store: biliverdin-iron-globinLiver: bilirubin-albuminConjugataed: Bili diglucuronide

A

200
Q

Ehrlich, p-DMAB reagent measures

A

Urobilinogen

201
Q

p-DMAB stands for, used in…for…

A

p-Di-Methyl-Amino-BenzaldehydeEhrlich method for urobilnogen

202
Q

Color produced with Erlichs reagent w/porphobilinogen and urobilinogenreagent used to distinguish the two

A

red/pink colorchloroform,urobilinogen will be soluble porphobilinogen will be insoluble and stay in aqueous phase

203
Q

Protein that carries unconjugated bilirubin..Where is bilirubin conjugated…Name of conjugated/direct bili…

A

albumin carries unconjugatedconjugated in liverconjugated is bilirubin diglucuronide

204
Q

Reaction for and alternate name bilirubin determination

A

diazo rxn/Jendrassik-Grofuses diazotized sulfanilicturns into purple azobilirubin

205
Q

Jendrassik-Grof measuresusesturns into

A

bilirubinuses diazo-tized sulfanilicturns into purple azobilirubin

206
Q

Bilirubin that is seen is not solube, thus not secreted in urine, cause of hemolytic trans rxn, prehaptic jaundice

A

indirect bili/unconjugated bili

207
Q

Bilirubin that is formed/converted in intestine

A

urobilinogen

208
Q

bilirubin that is oxidized/green in RE system

A

biliverdin

209
Q

oxidized form of urobilinogen excreted in urine…stool…

A

urobilin: urobilinogen goes to kidney; yellowstercobilin: urobilinogen oxidized, brown stool

210
Q

Evelyn Malloy method used for…Interference..

A

bilirubinhemolysis

211
Q

Jaundice with increasd unconjugated and increased urine urinobilinogen

A

Prehepatic jaundice

212
Q

Disease where all bili is increased, bili/uro in urine

A

hepatic

213
Q

condition where unconjugated is normal, decreased uro, but increased conjugated in urine

A

Posthepatic obstruction

214
Q

Have diff/mobility rates due to different aminos/structureElectrophoretic property is different for each isoenzymeBut have same rxn/react to same chemicals

A

Isoenzyme

215
Q

Metals ions in enzymatic reactions act as

A

activators

216
Q

This contant determines rate of conversion of substrate to product by differing substrate concentrations and rate of dissociation of complex

A

Michaelis-Menten

217
Q

Order rxn where large excess substrate allows for amt of enzyme activity to be limiting factor when all enzyme is bound to substratesubstrate: A reactant in a chemical reaction is called a substrate when acted upon by an enzyme.

A

zero order

218
Q

LD catalyzes lactate +NAD to… And…

A

pyruvate + NADH

219
Q

LD isoenzyme that migrates the fastest to anode and highest in heart/rbc

A

LD1 HHHH

220
Q

LD isoenzyme in healthy, HHHM

A

LD2

221
Q

LD isoezyme that migrates the slowest

A

LD5

222
Q

Increased in LD1,2,3

A

PApernicious anemia

223
Q

Enzyme greatly affected by hemolysis because its in all cells

A

LD

224
Q

CK increased in these 3: stress to muscles

A

heart attackmuscular dystrophyexercise

225
Q

3 CK isoenzymes are dimersFastest to slowestBrain faster than muscle

A

CKBB, CKMB, CKMM

226
Q

CK isoenzyme slowest, in skeletal muscle

A

CKMM

227
Q

CKMB sensitive for AMIrises w/in…down in…

A

2-4hrs2-4 days

228
Q

Most sensitive for AMI and two most usedrise/fall

A

TroponinTnT,TnI4-8hrs, 10 days

229
Q

LD rises, days last

A

rises 8-12hrs, 10-14 days

230
Q

Myoglobin rises, normal

A

30min, 24hrs

231
Q

condition can’t pump, fluids in lungs, cause CAD, BNP to diagnose

A

CHF

232
Q

Condition were lack of oxygen, ischemia, leads to CHF/angina/heart attackNarrowing of the small blood vessels that supply blood and oxygen to the heart.

A

CHDCoronary heart disease (CHD) is also called coronary artery disease

233
Q

3 conditions elevated AST1 not elevated

A

acute heartliver diseasemuscularnot elevated in acute pancreatitis

234
Q

Liver enzyme not affected by hemolysis

A

ALT

235
Q

Increased ALP in 3 things in liver

A

obstruction of biliary tract/jaundiceacute viral hepbiliary cirosis

236
Q

ALP increased in these 3 bone disordersincreased in 1 random

A

Pagets: overgrowthosteomalacia: soft bones, decreased D/CaRickets: Vit d defprego

237
Q

High ALP but no other liver increased

A

bone

238
Q

pH for ACPincreased in

A

5.0acidprostatic disease

239
Q

Enzyme in alcoholics, heptobiliary, obstructive jaundice, cirrhosis

A

GGT

240
Q

Enzyme in mumps and acute pancreatititsenzyme most specific for pancreatittis

A

mumps: amylasepancreatitis: lipase

241
Q

Cherry Crandall used to determine…substrate…

A

lipaseolive oil

242
Q

Disease with highest level of aldolase

A

muscular dystrophyAldolase is necessary for glycolysis in muscle as a “rapid response” pathway for production of adenosine triphosphate, independent of tissue oxygen.

243
Q

Zollinger-Ellison is a… increased…

A

gastrinomagastrin HCl

244
Q

diacetyl monoxime used to determine

A

BUN

245
Q

phospho-tungistic acid to tungsten blue used to determine

A

Uric acid

246
Q

most uric acid in plasma is what form…increased in…

A

monosodium urategout

247
Q

Kayser-Fleischer

A

Cooper deposits in cornea

248
Q

To evaluate ionized calcium you need to know these two things and why

A

pH and proteinionized calcium is pH dependent; ph will increase if CO2 is lostCa will increase with increased protein

249
Q

3 things that regulate calcium/increase/decrease

A

VitD/PTH: increase Ca-VitD increases GI absorption of Ca-low Ca will stimulate PTH productionCalcitonin: decrease Ca-inhibits bone reabsorption

250
Q

Hypocalcemia causes

A

Tetany (decreased Ca,Mg)VitD def, hypoPTHhypo mag, albuminNormally, the parathyroid glands release a hormone that increases blood calcium levels when they are low. Magnesium is required for the production and release of parathyroid hormone, so when magnesium is too low, insufficient parathyroid hormone is produced and blood calcium levels are also reduced (hypocalcemia).

251
Q

hypercalcemia

A

Vit excess, hyperPTHMalignancy

252
Q

In the complexometric titration for Ca, the pH is adjusted to prevent

A

interference from Mg8-hydroxy-quinoline removes Mg

253
Q

Method for Ca where its precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate

A

Clark-Collip

254
Q

Clark-Collip measures…it will be precipitated as…

A

Calciumoxalate

255
Q

In determining calcium, lanthanum is used to

A

bind phosphate

256
Q

Most phosphorus is in… at pH

A

bone 7.4

257
Q

Phosphorus is controlled by this and how does it affect it, opposite of Ca

A

PTH:decreases Phoincreases Ca

258
Q

Affect on PhosPTHCalcitonin, Vit D

A

PTH decreased PhoCalcitonin, Vit D increases phosphate

259
Q

Reagent used for phosphate

A

molybdatemolybdeum blue

260
Q

Hyperparathyroidism= increased PTH,Phosphorus is

A

decreased

261
Q

Hypoparathyroidism= decreased PTHPhosphorus…

A

increased

262
Q

Magnesium is controlled by kidney thru tubular reabsorption, what is renal threshold

A

1.5-2.1mg/dL

263
Q

Treatment for preeclampsia/contractions will result in what lab result to be increased

A

magnesiumhypermagnesemia

264
Q

Condition decreased iron/ferritin/% sat, increased transferrin/TIBC

A

IDA

265
Q

Reagent for magnesium

A

titan yellow

266
Q

2 Conditions with increased iron/ferritin/%sat and decreased transferrin/TIBC

A

sideroblastic and hemocromatosis

267
Q

trace metal involved in melanin, inorganic cofactor, bound to albumin, transported by ceruloplasmin

A

copper

268
Q

Fat soluble vitamins

A

A,D,E,K

269
Q

Water soluble vitamins

A

All B, C

270
Q

Fat soluble Retinol, cause of night blindness

A

A

271
Q

Fat soluble calciferol, hormone precursor, Rickets

A

D

272
Q

Fat soluble Tocopherol, antioxidant/immunityHemolytic anemia

A

E

273
Q

Fat soluble phylloquinine, for clotshemmorage

A

K

274
Q

Water soluble B1condition

A

thiaminBeriberi

275
Q

water soluble riboflavin

A

B2

276
Q

water soluble B3, condition

A

niacinpellegra

277
Q

water soluble pyridoxal

A

B6

278
Q

water soluble B7

A

Biotin

279
Q

water soluble B9, condition

A

folatemegaloblastic

280
Q

water soluble cobalamin, condition

A

B12PA/IF

281
Q

cause of Scurvy

A

C

282
Q

Major extracellular cation, NV

A

Sodium 135-145

283
Q

Hormone that increases Na reabsorption and acts on distal convoluted tubeReleased by adrenals

A

Aldosterone

284
Q

Hypoaldosterone NaHyperaldosterone Na

A

Hypo: decreased NaHyper: increased Na

285
Q

Normal valuesNa ClK

A

Na 135-145Major extracellular cationCl 98-106Major extracellular anion K 3.5-5.0Major intracellular cation

286
Q

BUNCreatinine

A

BUN 6-20Creatinine 0.7-1.5

287
Q

CO2/Bicarb

A

23-29

288
Q

Na 165Cl 125K 3.5

A

Saline contamination

289
Q

Diabetes mellitus FastingGlucose

A

126, 200

290
Q

Increased K causesPhleb issuesTubeCondition

A

Hemolysis, tourniquet, squeezingEDTADiabetic ketoacidosis(Insulin promotes potassium entry into cells. When circulating insulin is lacking, as in diabetic ketoacidosis, potassium moves out of cells, thus raising plasma potassium levels even in the presence of total body potassium deficiency )

291
Q

Used to enhance sensitivity of ISE electrode for K

A

Valinomycin

292
Q

Hypokalemia is less thanHyperkalcemia greater than

A

Potassium<3.5>5

293
Q

Chloride shift

A

Cl is inverse HCO3, when one leaves the other goes inHigh Cl, low HCO3=metabolic acidosis

294
Q

Causes of increased Cl

A

IVDehydrationMetabolic/diabetic acidosis(lose HCO3, chloride shift)

295
Q

Low Cl 4 things

A

Diarrhea, vomitingRenal failuremetabolic alkalosis

296
Q

Chloride measured with titration methods such asC.A. and S.S.C.A. is…S.S. is…

A

Coulometric amperometricSchales-Schales

297
Q

Coulometric amperometric method uses…What is measured…How is it measured…

A

TitrationChlorideTime needed to get to end pt

298
Q

Schales-Schales is what kind of method…For…Violet color formed from reaction with…

A

Mercurimetric titrationChlorideExcess Hg++

299
Q

C-A and S-S are both these kind of reactions…for…

A

TitrationChloride

300
Q

Most CO2 in blood is

A

Bicarb

301
Q

Specimen Least ordered, not used for CO2

A

Urine

302
Q

Anion Gap, NV

A

Na+K-(Cl+HCO3)10-20

303
Q

Increased anion Gap

A

Diabetic ketoacidosisLactic acidosisSalicylateMethanolEthanolPoly glycolUnmeasured

304
Q

Decreased anion Gap used as, due to

A

Analytical QCAnalyzer error

305
Q

Glass, Ag/AgCl, measures H for measurement of

A

pH

306
Q

pH electrode with membrane measures

A

pCO2PC, MD-NADH

307
Q

Platinum+Ag/AgCl, amperometric measures

A

pO2

308
Q

Henderson Hasselbalch

A

pH= pKa + log [salt]|[acid][A base]|[HA acid]pH=log HCO3/pCO2pH=log kidney/lungspH=log metabolic/respiratory

309
Q

Bicarb: carbonic acid ratio in plasma

A

20:1

310
Q

AcidosisNormalAlkalosis

A

<7.387.35-7.45, around 7.4>7.42

311
Q

Metabolic acidosis: pH, HCO3 levels compensation

A

Decreased pH, HCO3Lung: Hyperventilating releases CO2

312
Q

Metabolic alkalosis 2 parameters influenced, compensation

A

Increased pH, HCO3Lung: Hypoventilation increases CO2

313
Q

Respiratory acidosis 2 parameters, compensation

A

Decreased pH, Increased CO2Kidneys: increase bicarb

314
Q

Respiratory alkalosis 2 parameters, compensation

A

Increased pH, decreased pCO2Kidneys compensate

315
Q

Beer-Lambert law

A

The Beer-Lambert law relates the concentration of a sample to the amount of light the sample absorbs as it passes through the sample.

316
Q

Synovial: joints, hyaluronic acid makes viscous, obtain by arthrocentesis2 Synovial crystals/conditions

A

Uric acid: goutPyro-phosphate: pseudogout

317
Q

Amniotic fluid: access neural tube defects/AFP4 Fetal lung tests…

A

L/S: >2PGFLM 2Lamellar

318
Q

Sweat:AnalyteCondition, death cause

A

ClCystic fibrosis, pneumonia

319
Q

Sperm:mL, live%, motility %, #/mL

A

2-5mL>75% alive>50% motility# 20-250 million/mL

320
Q

Decreased CSF glucose seen inIncreased CSF glucose seen in

A

Decreased CSF glucose: Bacterial meningitis Increased CSF glucose:Diabetes

321
Q

CSF tube order/department

A

1 chem 2 micro3 heme

322
Q

CSF protein mg/dL

A

15-45

323
Q

CSF glucose

A

60-70% plasma

324
Q

CSF diff

A

70% lymph30% mono

325
Q

4 causes of increased CSF Protein

A

MeningitisIntracranial hemorrhageTraumatic tapMS

326
Q

Decreased CSF TP seen in

A

Leak, tear

327
Q

Increased CSF IgG index and oligoclonal banding seen in

A

MS Multiple scelerosis

328
Q

Urine ph normal…If left at rt becomes..

A

normal 6.0 (4.5-8)alkaline at RT

329
Q

Normal urine volume:poly> olig

A

1200-1500poly >2500olig<400noc: more at nightanuria: none

330
Q

left at RT, what decreases…increases

A

decreases:glucose/ketonesbili/urocells/castsincreases:nitrites/bacteriaturbiditypH

331
Q

3 things kidneys make2 hormones that influence kidney

A

renin, erythropoeitin, PGaldosterone, ADH

332
Q

Urine is made of 7 things

A

95% waterurea, uric acid, creatinineCl/Na/K

333
Q

Urine RBCs color

A

smoky, red/brown urine

334
Q

Urine bili/pyridum color

A

dark yellow/amber/orange

335
Q

Met/Hmg and homogentistic acid urine color

A

brown black upon standing

336
Q

Reabsorbs H2O onlyRebabsorbs solutes only

A

H2O only Descening Loopsolutes only ascending loop

337
Q

Specific gravity NV…increased in these 3decreased in this

A

1.003-1.030increased in: isotheniuria/renal damage 1.010diabetes mellitusxraydecreased in diabetes insipidus

338
Q

3 methods to determine sg

A

refractometerreagent stripharmonic oscillation: densitometry; current helps measure sg

339
Q

Urine strip protein method name…ph…what protein it binds to…color…confirm with…

A

protein error of indicators3.0albuminsulf.acid precipitation

340
Q

How many neprons per kidney….filtration ml/min

A

1 million20mL/min

341
Q

Protein of indicators on dipstick description…has nothing to do with…not affected by…What will cause false pos…

A

Most of the indicator is non-ionized and the protein will combine with the non-ionized form and will change the ratio of ionized and nonionizedHas nothing to do with pH and not affected by bence jonesFalse pos due to alkaline/buffered urine

342
Q

Renal threshold for glucosedipstick measures only glucosetwo enzymes in rxn

A

160-180mg/dLglucose oxidase, perioxidase

343
Q

Clinitest/Benedicts is a…is for…Can screen for…but reacts with…False neg with these two…

A

copper reduction method for glucosescreen for galctosemiareacts with all reducing substancesfalse neg with Vit C and pass thru

344
Q

Occult blood on urine dipstick depends on

A

perioxidase activity of rbc/hmg

345
Q

Nitrite:bacteria type…2 names for rxn:

A

GNR (E.coli)Diazo, Griess rxn

346
Q

RBC dipstick:false neg with one vitamin and mistaken with 3 things…false pos…

A

false neg: vitC, yeast, oil, calcium oxalate crystalsfalse pos: oxidizing like bleach

347
Q

UTI, renal calculi, acute glomerulonephritis you’ll see these cells

A

RBCs

348
Q

reagent for LE, color

A

diazo reagent, purple

349
Q

Cell related to glitter cell, UTI/pyelonephritistype seen in UTI

A

whiteneutrophils

350
Q

Seen in diabetes mellitus, breakdown of lipids…reagent…color…confirm with…

A

ketonessodium nitroprusside purpleAcetest (diacetic acid, acetone)

351
Q

Sodium nitroprusside used in determination of…on dipstick

A

ketones

352
Q

Acetest is used to confirm…detects these two..

A

confirm ketonesdiacetic acid, acetone

353
Q

Ictotest, Diazo rxn used for

A

Bilirubin

354
Q

Erlich, p-DMAB used in

A

Urobili

355
Q

Leukocyte in dilute hypotonic urine where granules appear to move/Brownian Mvt

A

glitter cell

356
Q

Large epithelial seen in catherterization, renal pelvis, ureter, bladder

A

transitional

357
Q

Cell seen in tubular necrosis, renal tubles, oval fat bodies are made from

A

renal tubular

358
Q

glycoprotein made from TRE that makes up casts (two names)

A

Tamm horsfall mucoproteinUromodulin

359
Q

Cast are formed in what part of tubules

A

distal convoluted tubule

360
Q

Casts seen in chronic renal disease, urinary stasis

A

waxy

361
Q

cast seen in stress/exercise, normal

A

hyaline

362
Q

cast seen in nephron/acute glomerulonephritis

A

RBC

363
Q

Cast from dialated collecting ducts

A

broad

364
Q

cast seen in acute glomerulonephritis and is decomposition of cellular

A

granular

365
Q

cast from break down of epi casts/oval fat bodies, nephrotic syndrome

A

fatty

366
Q

cell in pyleonephritis

A

wbc

367
Q

4 urine parasites

A

T.vagE.vermiculares (bread loaf ova)strongyS.haematobium

368
Q

5 abnormal crystals

A

Cysteine: 6 sidesLeucine: concentric circlesTyrosine: needlesBili: yellow/brown needlesCholesterol: notched plates

369
Q

3 normal crystals in acidic urine

A

Uric acid: rhomboid/pleomorphicamorphouse urates: pink sedimentCalcium oxalate: envelope/oval/dumbell, antifreeze

370
Q

4 normal crystals in alkaline urine

A

amorphous phosphatestriople phosphate: coffin lidcalcium carbonate: dumbellamm. biurate: thorny apple

371
Q

NV for… 50-200 mg/24hr

A

microalbumin

372
Q

AAT globulin

A

Alpha-1-antitrypsinAlpha1 globulininhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.

373
Q

Tangier low in

A

HDL

374
Q

Colorimetric method for BUN measures, uses Enzymatic method for BUN measures, uses Which one can be used for untreated urine, why

A

Colorimetric measures urea and uses diacetyl monoxime, can be used with untreated urine since it’s not measuring ammonia Enzymatic measures ammonia and uses urease

375
Q

The NAD coenzyme is reduced to NADH and measured at 340nm in this method…for which analyte?

A

HexokinaseGlucose

376
Q

diazo rxn/Jendrassik-Grof

A

Bilirubin

377
Q

Jendrassik-Grof andEvelyn Malloymeasure

A

Bilirubin

378
Q

Jendrassik-Grof=Bilirubin+Diazo (caffeine)=azobili

A

Jendrassik-Grof=Bilirubin+Diazo (caffeine)=azobili

379
Q

Evelyn Malloy method uses…as an accelerator Jendrassik-Grof uses…as an accelerator Measures…

A

Evelyn Malloy method uses methanol as an accelerator Jendrassik-Grof uses caffeine benzoate acetate as an accelerator bilirubin

380
Q

LD1 HHHH Fastest, marker for these two

A

heart/rbc

381
Q

sideroblastic and hemocromatosisIron,ferritin,%sat, transferrin/tibc high or low

A

increased iron/ferritin/%sat and decreased transferrin/TIBC

382
Q

Pyrophosphate seen in

A

pseudogout

383
Q

Porter-Silber reaction uses phenylhydrazine to detect…Zimmerman reaction detects…

A

PS=phenylhydrazine=corticosteroidsZimm=17-ketosteroids

384
Q

Phenlyhydrazine used to detect corticosteroids in what reaction

A

PS=Porter-Silber

385
Q

17-ketosteroids/17-KS is detected in what reaction…

A

ZimmermanZimmerman is a man that takes 17-KS/steroids

386
Q

Porter and Zimmermand take steroids

A

387
Q

Hypothalmus makes releasing/inhibiting hormones that act on the pituitaryPituitary then makes hormones that have their effects on organs that make the end product/action

A

388
Q

Primary caussed by…secondary caused by…tertiary caused by…

A

Primary…end organSecondary:pituitaryTertiary: Hypothalamus

389
Q

Increased GH causes these two thingskids versus adultsDecreased GH causes

A

kids: giantismadults: acromegalydwarfism

390
Q

Hormone that solely initiates and maintains lactation

A

prolactin

391
Q

Hypogonadism and prolactinoma (pituitary tumor) due to…

A

increased prolactin

392
Q

menstral disorder and inadequate lactation due to

A

decreased prolactin

393
Q

Vasopression is also called

A

antidiuretic hormone

394
Q

ADH acts on…to increase…decreased in…

A

acts on renal tubles to increase water reabsorptiondiabetes insipidus

395
Q

Hormone that stimulates urterine contraction/myoepithelial cells in breast thus ejecting milk

A

oxytocin

396
Q

Hormone that forms male sex characteristics, spermatogensis, facial hair, deep voice, sex drive

A

testosterone

397
Q

Testosterone is made from…

A

cholesterol (as is a lot of steriods)

398
Q

hormones that stimulate sex organ development, linear growth, epiphyseal fusion

A

androgens

399
Q

infertility men/women, adrenal hyperplasia, polycystic ovarian due to

A

hypertestosteronemia

400
Q

hypogonadism due to

A

hypotestosteronemia

401
Q

TRH, GRH, CRH GHRHPIF, GHIH released by

A

hypothalamus

402
Q

GH, PRL, TSH, LH, FSH, ACTH released by the

A

anterior pituitary

403
Q

ADH, oxytocin released by

A

posterior pituitary

404
Q

Hormone that induces ovulation, ovary secretes estrogens/progesterone for possible pregnancy and stimulates testes androgens in males

A

Luteinizing hormone

405
Q

GnRH stimulates this organ to produce… which affects these organs

A

GnRH stimulates pituitary to make LH and FSH to affect ovaries or testes

406
Q

GHIH/GHRH gets the pituitary to make… which acts on these two organs

A

soft tissue/bone

407
Q

FSH stimulates, secretesfemales:males:

A

females: egg development, estrogenmales: sperm, testosterone

408
Q

hypothalmus makes CRH that act on pituitary to make ACTH, this stimulates the adrenal cortex to make steroid hormones made from cholesterol3 steroids made adrenal cortex…

A

mineralcoritcoids(aldosterone)glucocorticoids(cortisol)sex hormones (androgens, estrogens)

409
Q

What converts angiotensinogen to angiotensin I which converts to II and stimulates cortex to make aldosterone

A

Renin

410
Q

hormone that induces secretion of glucorticoids(cortisol) of adrenal cortex

A

ACTHadreno-cortiotropic hormone

411
Q

CRH stimulates the…to make… which causes this organ to release cortisol, aldoseterone, estrogens and testosterone

A

CRH stimulates the pituitary to make ACTH causing the adrenal cortex to make cortisol, aldosterone, estrogens/testosterone

412
Q

Mineralocorticoids, glucorticoids, and androgens released by

A

adrenal cortex

413
Q

aldosterone is an example of a…maintains…excretes…retains…

A

mineralocorticoidmaintains H2O/electrolytesexcrete K/retain Na

414
Q

Cortisol is a type of

A

glucocorticoid

415
Q

Hyperadolsoterone, increased Na, decreased K, hypertension

A

Conns Disease

416
Q

Hypoaldosterone, decreased Na/Cl, decreased cortisoleverything down

A

Addisons Disease

417
Q

Increased cortisol, increased glucose, increased Nabuffalo hump

A

Cushingseverything up

418
Q

Testosterone is a type of

A

androgenmale sex hormone

419
Q

metabolite of androgen…reaction used to detect…

A

17-ketosteroid, 17-KSZimmerman reaction

420
Q

3 types of catecholaminespurpose

A

epinephnorepidopaminemobilize energy stores

421
Q

Two GI hormones

A

Gastrinserotonin

422
Q

Hormone increased in Zollinger Ellison syndrome

A

gastrin

423
Q

Hormone made in GI, vascoconstricter of PLTs/brain/tissue

A

serotonin

424
Q

5HIAA is a urinary metabolite of…increased in chromaffin cell tumors of GI, drugs, bananas, pineapples etc

A

serotonin

425
Q

Catecholamines produced in…by…

A

adrenal medullaby chromaffin cells

426
Q

Metabolites of epineph

A

metanephrine, VMA

427
Q

Metabolites of norepineph

A

normetaneph,VMA

428
Q

Metabolites of dopamine

A

HVA

429
Q

Pheochromocytoma is a tumor with increased

A

VMA

430
Q

Neuroblastoma is a tumor with increased

A

HVA

431
Q

Most of the releasing and inhibiting hormones (except for ACTH) are producted by the…

A

hypothalamus

432
Q

Thyroid hormones: stimulate metabolic processesIn tissues…is coverted to….99.97% of…is bound to mosntly TBG, some TB-PA, albumin99.5% of….is also bound

A

In tissues T4 is converted to T399.97% of T4 is bound to TBG99.5% of T3 is bound

433
Q

TSH stimulates the … to make these two

A

thyroid, T3/T4

434
Q

3 things hormones made by thyroid

A

thyroxine/T4, triiodothyronine/T3calcitonin

435
Q

Thyroxine/T4 increases…Triiodothyronine/T3 increases…Calcitonin increases…

A

Thyroxine, Triiodothyronine: metabolismCalcitonin: Ca reabsorbtion

436
Q

3 calcitropic hormones

A

PTH, VitD, calcitonin

437
Q

Parathyroid mades these two…PTH stimulates renal production of this…

A

Calcium, PhosphorusVitD

438
Q

Low PTH lowers/increases serum…

A

Lowers serum Ca, DIncreases Phos

439
Q

Hypothalamus releases…which acts on anteroir pituitary

A

TRH

440
Q

TRH stimulates pituitary to release… which acts on…

A

TSH, acts on thyroid

441
Q

TSH stimulates thyroid to make…

A

T3,T4

442
Q

Free… stimulate negative feedback loop and inhibit secretion of…

A

Free T3/4 inhibit TSH

443
Q

primary Hyperparathyroidism also called…symptoms

A

Gravesweight loss, heat, hair loss, anxious

444
Q

Graves is hyper or hypo…T3/T4 levels…TSH levels…

A

hyper: T3/T4decreased TSH to stop production of T3/T4Primary means thyroid overproduces T3/T4 due to TSH antibodies

445
Q

Primary Hypothyroidism is called…symptoms

A

Hashimotosweight gain, tired, cold

446
Q

Hashimotos is hyper or hypo…T3/T4 levels…TSH levels…

A

hypo: T3/T4increased TSH to increased T3/T4 levelsThyroid autoab

447
Q

Major binding protein for thyroxineHow is it measured

A

TBGthyroid binding globulinBy measuring T3 uptake (amount of TBG bound to thyroid hormones)

448
Q

3 good indicators for hypothyroidism1 not good indicator

A

FT4, TT4, s-TSH (singles best)not good T3 uptake (indirect, not used)

449
Q

Ovaries productes these two hormones

A

estrogen, estadiol

450
Q

hormone female sex charac, hyper=amenorrhea, hypo=menopause

A

Estrogen

451
Q

hormone that’s active form of estrogen, evaluates fetoplacental function

A

estadiol

452
Q

Progesterone made by the

A

corpus luteum

453
Q

prepares uterus for pregoj, maintains endometrium lining, inhibits uterine contractions, prepares breasts for lactation

A

progesterone

454
Q

progesterone levelsperimenopausepostmenopause

A

peri: increased progesteronepost:decreased progesterone

455
Q

What hormone maintains progesterone in early pregnancy

A

HCG

456
Q

HCG increased/decreased…

A

increased: prego, mutiple pregos, tumorsdecreased: spontaneous abortion

457
Q

HCG subunits are…

A

alpah, beta subunitsnoncovalently bound subunits

458
Q

subunit that cross reacts with LH,FSH,TSh

A

alpha

459
Q

subunit that has analytical specificity

A

beta

460
Q

Trimester with highest level of HCG…When does it show up, how long does it last…

A

firstseen in days, peaks 2-3mths

461
Q

Toxicology, best specimen for screening/qualitative, best for quantitative

A

Urine-QLBlood-QNT

462
Q

Creatitinine, pH, or oxidizing activity, dilute/substituted/adultered as a measure of

A

validity

463
Q

Major disadvantage of immunoassay drug detection…best 2 ways to confirm for drugs that have positive screens…

A

Immunoassays can’t simultaneously assay multiple drugs in one specimengas chromatography/MS

464
Q

Aminoglycosides and Glycoprotein are two kinds of

A

antibiotics

465
Q

Kind of Glycoprotein/antibiotic

A

Vancomycininhibit cell wall synthesis, treat gp

466
Q

gentami/tobramy/amika/kana-cin are allinhibit protein synthesis, treat gn

A

aminoglycosides

467
Q

Monitor toxic range of antibiotics to prevent damage to…and…

A

hearing/ototoxickidneys/nephrotoxic

468
Q

Phenobarbital, phenytoin/dilantinValproic acid, Carbamazepineethosuximide are all

A

anti-epileptic/anti-convulsants

469
Q

Bronchodialatorasthma, IV/oral, 10-20ug/mL, toxic >20ug

A

Theophyllineactive metabolite in neotates is caffeine, also caffeine given as a brochodilator

470
Q

Cyclosporine, Tacrolimus, Sirolimus,MPA all are

A

immunosuppressives

471
Q

Methotrexate are all

A

antineoplastics/antitumor

472
Q

Cyanide, arsenic, mercury all are

A

heavy metals

473
Q

Substances/acute poisoning

A

acetaminophen-liver damagesalicylatesalcohols-ethanol,isopro,glycolcyanidecarbon monoxidecarboxyhmg (200x infinity)organophosphates/pesticide:-CNS, decrease cholinesterase

474
Q

Must wait until…to TDMhow many half lives to reach…how many half lives to clear…metabolized by liver, excreted in urine

A

steady state5.5

475
Q

Specimen drawn imme before next dose is called…Peaks drawn…hrs

A

Trough1-2hrs after oral dose

476
Q

Amtriphtyline, Imipramine, DoxepinLithium are all

A

pyschotropics

477
Q

Amtriphtyline, Imipramine, Doxepin are all

A

tricyclics

478
Q

Digoxin, Quinidine, Procainamide,Disopyramide, Lidocaine all are

A

Antiarrythmics/cardiactive

479
Q

What body does to drug…What drug does to body…

A

Body does to drug: pharmacokineticsDrug does to body: pharmacodynamics