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MTAP 1 > Chemistry week 3 > Flashcards

Chemistry week 3 Flashcards

Elec, blood gases, Toxicology, Endocrinology

1
Q

Ions capable of carrying an electric charge

A

Electrolyes

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1
Q

Positively charge electrolyte

A

Cation

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2
Q

negatively charge electrode

A

Cathode

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3
Q

Negatively charge electrolyte

A

Anion

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4
Q

Positively charge electrode

A

Anode

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5
Q

Electrolyte that functions in volume and osmotic regulations

A

Sodium, Chloride, Potassium

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6
Q

Electrolyte that functions in myocardial rhythm and contractility

A

Potassium, Calcium, Magnesium

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7
Q

Electrolyte that functions in Regulations of APTase ion pump

A

Magnesium

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8
Q

Electrolyte that functions in neuromuscular exciteability

A

Potassium, Calcium, Magnesium

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9
Q

Electrolyte that functions in Production and Use of ATP

A

Magnesium, phosphate

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10
Q

Electrolyte that functions as an Acid base balance

A

Potassium, Chloride, Bicarbonate

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11
Q

Electrolyte that functions in Blood coagulation

A

Calcium, Magnesium

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12
Q

Electrolyte that function as Cofactors in enzyme activation

A

Calcium, Magnesium, Zinc, Chloride, Potassium

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13
Q

Most abundant cation in the extracellular fluid
Major extracellular cation

A

Sodium

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14
Q

Promotes sodium retention and potassium secretion

A

Aldosterone

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15
Q

Promotes sodium excretion

A

Atrial natriuretic factor

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16
Q

Sodium renal threshold

A

110 - 130 mmol/L (average of 120mmol/L)

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17
Q

Sodium normal value

A

135 - 145 mmol/L

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18
Q

Can be caused by loss of water, decreased water
intake, and increased sodium intake or retention

A

Hypernatremia

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19
Q

Major defense mechanism against hypernatremia

A

Thirst

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20
Q

▪ Most common electrolyte disorder.
▪ Can be caused by increased sodium loss,
increased water retention, and water imbalance.

A

Hyponatremia <135 mmol/L

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21
Q

1/3 in the body

A

ECF

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22
Q

2/3 in the body

A

ICF

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23
Q

FORMULA FOR OSMOLALITY

A
  • 2 Na + (Glucose mg/dL / 20) + (BUN mg/dL / 3)
    OR
  • 1.86 Na + (Glucose / 18) + (BUN /2.8) + 9
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24
Q

____ of osmolality also increases ADH 4 times more

A

1-2% increase

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25
Q

____ of osmolality can shut off ADH production

A

1-2% decrease

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26
Q

Increased sodium level which induce the release of more ADH to direct the reabsorption of water in the kidney

A

Hypernatremia

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27
Q

Decrease in blood volume

A

Hypovolemia

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28
Q

Increase in blood volume

A

Hypervolemia

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29
Q

Mechanism that requires energy to move ions across cellular membranes

A

Active transport

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30
Q

Passive movement of ions across a membrane depending on the charge of concentrations

A

Diffusion

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31
Q

Refers to the difference between the sums of the concentration of the principal cations and of the principal anions

A

Anion gap

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32
Q

Anion gap formula

A

NA - (Cl + HCO3)
OR
(NA + K) - (Cl + HCO3)

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33
Q

Uremia, Ketoacidosis, Methanol, Aspirin, or ethylene glycol poisoning, Severe dehydration, Lactic acidosis

A

Increased anion gap

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34
Q

A rare condition wherein sodium chloride gradients cannot form in the loop of Henle causing the retention of chloride ion that is not available for the countercurrent mechanism and sodium loss

A

Bartter’s syndrome

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35
Q

Below ___ mmol/L for 48 hours or less is considered a medical emergency which can lead to coma or death when not treated immediately

A

120 mmol/L Na

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36
Q

Panic value for hypernatrimia

A

160 mmol/L

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37
Q

Method of determination of hypernatremia

A

ISE - potentiometry where measurement is based on the changes in voltage or potential at a constant current. Measure with GLASS

AAS - uses fire to consume the analyte which is measured at its GROUND STATE

FES/FEP - Uses fire to consume the analyte into atomic particles which is measure at its EXCITED STATE

Colorimetric (Albanese Lein) - Combining sodium with zinc uranyl acetate → sodium uranyl acetate precipitate → addition of water produces YELLOW solution

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38
Q

Direct ISE - uses an ____ sample

A

Undiluted

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39
Q

Indirect ISE - Uses an ___ sample

A

Diluted

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40
Q

Major intracellular cation of the ICF

A

Potassium

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41
Q

Low or High potassium level can cause

A

Arrhytmia

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42
Q

Catecholamines such as epinephrine promotes entry of Potassium into the cell

A

Beta-2 stimulator

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43
Q

Impairs the entry of potassium into the cell

A

Beta-blocker

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44
Q

Overdose of ___ promotes acute entry of Potassium into the skeletal muscles and liver

A

Insulin

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45
Q

Dehydration, Diabetes Insipidus, Hypoadrenalism, Acidosis, Hemolysis

A

Hyperkalemia

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46
Q

Muscle weakness, tingling, numbness, or mental confusion

A

Hyperkalemia

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47
Q

may alter the ECG (K)

A

6-7 mmol/L

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48
Q

May cause fatal cardiac arrest (K)

A

> 10 mmol/L

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49
Q

Infusion of insulin, Alkalosis, Vomiting, overhydration, Use of loop diuretics, SIADH, Bartter’s syndrome

A

Hypokalemia

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50
Q

Reference method for determination of Sodium

A

AAS

Routinely used - ISE

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51
Q

Potassium method of determination

A

FES - Violet end color
ISE - uses Valinomycin gel
AAS - Reference method
Colorimetry - Lockhead and Purcell

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52
Q

Chief counterion of sodium

A

Chloride

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53
Q

Chloride functions

A

Maintaining osmolality
Blood volume
Electrical neutrality

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54
Q

Chloride shift

A

Maintains electroneutrality
Bicarbonate diffuses out into the plasma and Chloride diffuses into red cells to maintain electrical balance (BoCi)

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55
Q

Functions in blood coag, enzyme activation, and cardiac and skeletal muscle excitability

A

Calcium

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56
Q

Ical
Protein bound
complexed with anions
What %?

A

50% Ical
40% protein bound (albumin)
10% complexed with anions

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57
Q

Hormones that control calcium level

A

Parathyroid hormone - Parathyroid gland
Vitamin D - Skin, Kidney
Calcitonin - Thyroid Gland

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58
Q

Hypercalcemic hormone

A

Parathyroid hormone and Vit D

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59
Q

Hypocalcemic hormone

A

Calcitonin

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60
Q

Cancer, Hyperthyroidism, Iatrogenic causes, Multiple myeloma, hyperParathyroidism, Sarcoidosis

A

Hypercalcemia (CHIMPS)

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61
Q

Calcitonin, Hypoparathyroidism, Alkalosis, Renal failure (Ca Bi So), Vitamin D deficiency

A

Hypocalcemia (CHARD)

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62
Q

Flame test
Lithium
Potassium
Rubidium
Magnesium
Calcium
Sodium

A

Lithium - red
Potassium - violet
Rubidium - Red
Magnesium - blue
Calcium - orange
Sodium - yellow

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63
Q

4 electrolytes for anion gap

A

Sodium, Potassium, Chloride, and Bicarbonate

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64
Q

Methanol poisoning, Uremia, Diabetic ketoacidosis, Paraldehyde ingestion, Hypernatremia, Instrument error, Iron, Inhalants, Isoniazid, Ibuprofen, Lactic acidosis, Ethylene glycol/Ethanol acidosis, Salicylates, Starvation

A

Increased anion gap (MUDPHILES)

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65
Q

Decreased Anion gap

A

Increased in unmeasured cation
Decrease in unmeasured anion
(ADIC)
eg. Hypoalbuminemia
Hypercalcemia

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66
Q

Major electrolyte concentration that provides the largest contribution to the osmolality value of serum (92%)

A

Sodium, Chloride, Bicarbonate

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67
Q

Osmolality method of determination

A

Direct method - Osmometer (colligative property)
Indirect method - computation
* 2 Na + (Glucose mg/dL / 20) + (BUN mg/dL / 3)
OR
* 1.86 Na + (Glucose / 18) + (BUN /2.8) + 9

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68
Q

____ particle concentration = _____ freezing point, vapor pressure and ____ boiling point, osmotic pressure

A

Increase, decrease, increase

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69
Q

Essential for the function of cellular enzymes and energy metabolism

A

Magnesium

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70
Q

Important role in membrane stabilization, nerve conduction, and ion transport and calcium channel activity

A

Magnesium

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71
Q

Distribution of magnesium

A

46% in tissues
53% in bones
1% in serum
1/3 are bound to albumin
2/3 are free or ionized form or bound to citrate

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72
Q

Regulation of magnesium

A

Henle’s loop is the major renal regulatory site (50-60% is reabsorbed in the ascending limb)

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73
Q

Hypermagnesemia in the ff (rare)

A

Iatrogenic
Elderly and patients with bowel disorder and renal insufficiency

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74
Q

Important in constituent in nucleic acid, phospholipid, and phospoproteins

A

Phosphorus

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75
Q

Regulation of phosphorus

A

Vitamin D - Increases phosphate levels by absorption in the intestine and reabsorption in the tubules
Growth hormone - increases phosphate level by decreasing renal excretion of phosphate
Parathyroid hormone - facilitates excretion of phosphate for reabsorption of calcium

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76
Q

Acidosis, over medication with vitamin D, infant’s drinking cow’s milk or adult drinking laxatives, lymphoblastic leukemia, Dec. PTH

A

Hyperphosphatemia

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77
Q

Alcohol abuse, vitamin D deficiency, steatorrhea, Ketoacidosis, COPD, Asthma, and malignancy

A

Hypophosphatemia

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78
Q

Specimen of choice for phophate

A

Serum sample

Plasma - lithium heparin as anticoagulant

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79
Q

By product of an emergency mechanism that produces a small amount of ATP when oxygen is severely diminished

A

Lactate

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80
Q

Can be an early indicator of hypoxia

A

Lactate

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81
Q

Specimen of choice for lactate

A

Anticoagulant iodacetate and fluoride or heparin can be used. Must be placed in ice and quickly separated

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82
Q

Specimen handling for lactate

A

Avoid using tourniquet, if used blood should be collected immediately w/ no hand clenching

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83
Q

Normal value of pH

A

7.35 - 7.45

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84
Q

Normal value of pCO2

A

35-45 mmHg

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85
Q

Normal value of HCO3

A

22-29 mEq/L

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86
Q

pCO2 <35 mmHg

A

Respiratory alkalosis

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87
Q

pCO2 >45 mmHG

A

Respiratory acidosis

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88
Q

HCO3 <22 mEq/L

A

Metabolic acidosis

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89
Q

HCO3 >29 mEq/L

A

Metabolic alkalosis

90
Q

Electrode for pH and it’s principle

A

Glass electrode

91
Q

Electrode for pCO2 and it’s principle

A

Clarke electrode Amperometry/polagraphy

92
Q

Electrode for HCO3 and it’s principle

A

Severinghaus electrode / Potentiometry

93
Q

Hormones produced:
Thyrotrophin-releasing hormone
Corticotrophin-releasing factor
Other releasing or inhibiting horomens

A

Hypothalamus

94
Q

Hormones produced:
TSH
ACTH
LH
Prolactin
GH

A

Anterior pituitary gland

95
Q

Hormones produced: (store and secrete)
Vasopressin
Oxytocin

A

Posterior pituitary gland

96
Q

Hormones produced:
Epinephrine (Adrenaline)
Norepinephrine (Noradrenaline)
(Catecholamines)

A

Adrenal Medulla

97
Q

Hormones produced:
Cortisol
Aldosterone
11-deoxycortisol

A

Adrenal cortex

98
Q

Hormones produced:
T3
T4
Calcitonin

A

Thyroid gland

99
Q

Hormones produced:
PTH

A

Parathyroid gland

100
Q

Hormones produced:
Insulin
Glucagon

A

Pancreas

101
Q

Hormones produced:
Gastrin

A

Gastrointestinal tract

102
Q

Hormones produced:
Estrogen
Progesterone

A

Ovaries

103
Q

Hormones produced:
Progesterone
hCG
Human placental lactogen

A

Placenta

104
Q

Hormones produced:
Testosterones
Other androgens

A

Testes

105
Q

Hormones produced:
EPO
1,25-dihydroxy Vitamin D
Prostaglandin

A

Kidneys

106
Q

What type of hormones?
Cortisol
Aldosterone
Progesterone
Estrogens
Testoterones

A

Steroid hormones

107
Q

What type of hormones?
Insulin
PTH
LH
FSH
TSH
Thyrotropin-releasing hormone
ACTH
Prolactin
GH
Calcitonin
Glucagon

A

Peptide or protein hormones

108
Q

What type of hormones?
Epinephrine
Norepinephrine
T4
T3

A

Amines or amino acid derivatives

109
Q

What type of hormones?
Prostaglandins

A

Fatty acids

110
Q

Stimulates the release of TSH and PROLACTIN

A

TRH

111
Q

Stimulates the release of LH and FSH

A

Gonadotropin-releasing hormone (GnRH)

112
Q

Stimulates ACTH release

A

Corticotrophin-releasing hormone (CRH)

113
Q

Stimulates GH release

A

Growth hormone releasing hormone (GHRH)

114
Q

Inhibits GH and TSH

A

Somatostatin

115
Q

Inhibits prolactin release

A

Dopamine

116
Q

Also known as the master gland

A

Anterior Pituitary gland

117
Q

Most abundant of all pituitary hormone

A

GH

118
Q

Decreased GH or GHD

A

Dwarfism

119
Q

Confirmatory test for dwarfism

A

Insulin tolerance test

120
Q

Due to overproduction of GH in adulthood

A

Acromegaly

121
Q

Screening and confirmatory test for adulthood

A

Screening = IGH-1 / Serum somatomedin C
Confirmatory - OGTT

122
Q

Hypersecretion of GH during childhood

A

Gigantism

123
Q

Turns off secretion of ACTH and CRH

A

Increased cortisol

124
Q

Stimulates secretion of ACTH

A

Decreased cortisol

125
Q

ACTH is highest at what time of the day

A

Morning

126
Q

ACTH function

A

Stimulates the synthesis of cortisol (adrenal cortex)

127
Q

Gondaotropins

A

FSH and LH

128
Q

what does FSH do in male

A

Aids in spermatogenesis

129
Q

What does FSH do in female

A

aids in ovulation and final follicular growth

130
Q

What does LH do in male

A

Helps leydig cells produce testosterone

131
Q

What does LH do in female

A

Helps corpus luteum produce estrogen

132
Q

Also known as thyrotropin

A

TSH

133
Q

Also known as pituitary lactogen hormone

A

Prolactin

134
Q

Does not have the capacity to produce hormones, only releases hormones.

A

Posterior pituitary gland

135
Q

Vasopressin and Oxytocin are produced in?

A

Hypothalamus

136
Q

Main stimulus for the creation of thyroid hormone

A

Iodine

137
Q

Lobes of thyroid glands are connected by

A

Isthmus

138
Q

Produced by follicular cells

A

T3 and T4

139
Q

Produced by parafollicular cells

A

Calcitonin

140
Q

Two major cells of thyroid gland

A

Follicular cells and Parafollicular cells

141
Q

Most active thyroid hormonal activity

A

T3

142
Q

Better indicator of recovery from hyperthyroidism as the recognition of recurrence of hyperthyroidism

A

T3

143
Q

Most abundant thyroid hormone

A

T4

144
Q

T3 - INC
T4 - INC
TSH - DEC

A

Primary hyperthyroidism

145
Q

T3 - INC
T4 - INC
TSH - INC

A

Secondary Hyperthyroidism

146
Q

T3 - N
T4 - N
TSH - DEC

A

Subclinical Hyperthyroidism

147
Q

T3 - Dec
T4 - Dec
TSH - INC

A

Primary hypothyroidism

148
Q

T3 - Dec
T4 - Dec
TSH - Dec

A

Secondary hypothyroidism

149
Q

T3 - N
T4 - N
TSH - INC

A

Subclinical Hypothyroidism

150
Q

Primary hormone that responds to stress

A

Catecholamines

151
Q

Outer region of adrenal gland

A

Adrenal cortex

152
Q

Major site of steroid hormone

A

Adrenal cortex

153
Q

Principal source of meralocorticoid (aldosterone)

A

Zona glomerulosa

154
Q

Site of glucocorticoid synthesis (cortisol)

A

Zona Fasciculata

155
Q

Produces androstenedione and dehydroepiandrosterone

A

Zona reticularis

156
Q

Principal glucocorticoid

A

Cortisol

157
Q

Cushing’s syndrome

A

Excessive production of cortisol

158
Q

Screening test for cushing’s syndrome

A

24 hour urinary free cortisol
Overnight dexamethasone
Midnight salivary cortisol

159
Q

Confirmatory test for cushing’s syndrome

A

Low-dose dexamethasone suppression
Midnight plasma control
Corticotrophin-releasing hormone stimulation test

160
Q

Cortisol: INC
ACTH: INC

A

Cushing’s disease (Primary)

161
Q

Cortisol: INC
ACTH: DEC

A

Cushing’s syndrome (secondary)

162
Q

Addison’s disease

A

Decrease cortisol production

163
Q

Screening test and confirmatory test for addison’s disease

A

Screening: ACTH stimulation test
Confirmatory test: Insulin tolerance test

164
Q

Most potent mineralocorticoid

A

Aldosterone

165
Q

Conn’s disease

A

Primary Hyperaldosteronism

166
Q

Function is for sodium retention

A

Aldosterone

167
Q

Screening and confirmatory test for conn’s disease

A

Screening - Plasma aldo concentration/ Plasma renin activity ration

Confirmatory test - Saline suppression test
Oral sodium loading test
Fludrocortisone suppresion
Captopril challenge

168
Q

Testosterone - DEC
LH and FSH - DEC

A

Pre-testicular (secondary hypogonadism)

169
Q

Testosterone - DEC
LH and FSH - INC

A

Testicular (Primary hypogonadism)

170
Q

Testosterone - N
LH and FSH - N

A

Post-testicular

171
Q

Rise in FSH stimulates estrogen production

A

Follicular phase

172
Q

After the LH surge, subsequent luteinization of the graafian follicle to form the corpus luteum

A

Luteal phase

173
Q

Most abundant estrogen in post-menopausal women

A

Estrone (E1)

174
Q

Most potent estrogen secreted by the ovary and the most abundant estrogen in premenopausal women

A

Estradiol (E2)

175
Q

Estrogen found in maternal urine
Major estrogen secreted by the placenta during pregnancy

A

Estriol (E3)

176
Q

Used to assess fetoplacental viability and as a marker for Down syndrome

A

Estriol (E3)

177
Q

Natural steroid produced by the human fetal liver
May be used as an oral contraceptive

A

Estetrol (E4)

178
Q

FSH and LH - HIGH
E2 - LOW

A

Menopause (primary hypogonadism)

179
Q

FSH and LH - LOW
E2 - LOW

A

Sheehan’s syndrome (Secondary hypogonadism)

180
Q

Diagnostic marker for Zollinger Ellison syndrome

A

Gastrin

181
Q

Produced by trophoblast cells of the placenta

A

hCG

182
Q

A dimeric molecule consisting of one alpha and one beta subunit that confers antigenic individuality

A

hCG

183
Q

Diagnostic marker for carcinoid tumor

A

5-HIAA

184
Q

Secreted in one location and release into blood circulation, binds to specific receptor to elicit physiological response

A

Endocrine

185
Q

Secreted in endocrine cells and released into interstitial space; binds to specific receptor in adjacent cells and affects its function

A

Paracrine

186
Q

Secreted in endocrine cells and sometimes released into interstitial space; binds to specific receptor on cell of ORIGIN resulting SELF-regulation of its function

A

Autocrine

187
Q

Secreted in endocrine cells and remains in relation to plasma membrane; acts on immediately adjacent cell by direct cell-cell contact

A

Juxtacrine

188
Q

Secreted in endocrine cells and released into lumen of gut

A

Exocrine

188
Q

Secreted in neurons and release into extracellular space; binds to receptor nearby cells and affects its function

A

Neurocrine

189
Q

Secreted in neurons and released from nerve endings; interacts with receptors of cells at distant site

A

Neuroendocrine

190
Q

Secreted in the cells and REMAINED as well as function inside the synthesis of origin

A

Intracrine

191
Q

The hypothalamus is above the pituitary gland and is connected to the ____

A

Infundibulum

192
Q

Responsible for secreting compounds towards the pituitary gland in order for the hypothalamus to be able to regulate the compounds released by the pituitary gland

A

Neurons

193
Q

Carry the trophic hormones directly to the anterior pituitary

A

Portal vessel

194
Q

Release their hormones into the second set of capillaries for distribution to the rest of the body

A

Endocrine cells of the pituitary gland

195
Q

Inhibitory neutrotansmitter

A

Gamma-aminobutyric acid (GABA)

196
Q

Affected by serotonin, endorphins, acetylcholine

A

ACTH release

197
Q

Stress, inflammation, hypoglycemia

A

Physiologic stimulus

198
Q

Looks like a pinecone

A

Conarium/Epiphysis cerebri (pineal gland)

199
Q

Inappropriate production of breast milk

A

Galactorrhea - Hypersecretion of PRL

200
Q

Inhibits the release of ADH

A

Ethanol

201
Q

Cortisol is bound to a glycoprotein which is known as

A

Transcortin

202
Q

Most potet meralcorticoid

A

Aldosterone

203
Q

Resembles primary aldosteronism clinically, but aldosterone level is
low and absence of hypertension

A

Liddle’s syndrome

204
Q

Aldosterone: Inc
Renin : dec
BP: High
K: Low

A

Primary hyperaldosteronism

205
Q

Aldosterone: Inc
Renin: Inc
BP: high except in edematous disorder
K: Low / normal

A

Secondary hyperaldosteronism

206
Q

Aldosterone: Dec
Renin: Inc
BP: Low
K: High

A

Primary hypoaldosteronism

207
Q

Hyperthyroidism with peculiar edema behind the eyes called exolphthalmos

A

Grave’s disease

208
Q

The thyroid turns into a woody or stone-hard mass

A

Riedel’s

209
Q

Most common cause of primary hypothyroidism

A

Hashimoto’s disease

210
Q

Aluminum is measured using

A

ICP-MS or GFAAS

211
Q

Blackfoot disease

A

Arsenic exposure

212
Q

Normal amount of copper in the body

A

50-120mg

213
Q

Menke’s disease

A

extreme copper deficiency

214
Q

Interferes with absorption of iron and zinc

A

Copper

215
Q

Wilson’s disease

A

Copper toxicity

216
Q
  • Iron deficiency
  • Late pregnancy
  • Oral contraceptives
  • Viral Hepatitis
A

Increase in TIBC

217
Q
  • Chronic infections
  • Malignancy
  • Iron poisoning
  • Nephrosis
  • Kwashiorkor
  • Thalassemia
A

Decrease in TIBC

218
Q

Typical threshold for acute lead toxicity

A

45ug/dL

219
Q

Upper threshold for lead toxicity, shows signs and symptoms

A

60ug/dL

220
Q

Acute manganese aerosol intoxication

A

Locura manganica (manganese madness)

221
Q

Keshan’s disease and Kashin-beck disease

A

Selenium deficiency

MTAP 1 (22 decks)

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