Lab Med 1-15 Flashcards

1
Q

Do ALT or AST elevations persist longer?

A

ALT

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2
Q

How are proteins assessed in liver disease?

A

Total protein = normal

Direct assessment of albumin is the most useful

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3
Q

How can TSH differentiate between primary and secondary hypothyroidism?

A
Elevated = primary (thyroidal)  
Low = secondary (pitiutary)
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4
Q

How can you differentiate between primary and secondary hyperaldosteronism?

A

Primary (Conn’s) = low renin

Secondary = high renin

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5
Q

How can you differentiate the source of ALP?

A
Heat stability   
bone < intestine < liver < placenta, 
Regan isoenzyme  
"Bone burns and liver lives"  
High GGT
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6
Q

How does impaired gut absorption relate to liver disease?

A

Increases severity –> inability to absorb fat soluble substances –> no vitamin K –> no coag

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7
Q

How does leukemia affect white blood cells?

A
Total can increase, decrease, or not change 
Neutrophils increase (immature cells)
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8
Q

How does the thyroid secrete hormone?

A

Hypothalamus releases TRH –> pituitary releases TSH –> thyroid releases T4 (some T3) –> Tissues convert T4 to T3 –> negative feedback on hypothalamus

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9
Q

How is a clot localized?

A

Thrombomodulin makes II to activate protein C –> C + S = inactivation of V and VIII
Heparan activates antithrombin III = inhibition of II and X
XII activates plasmin = digest clot

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10
Q

How is a platelet plug form?

A

Tissue injury stimulates vWF binding to collagen and platelets
Displays factor Va

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11
Q

How is a TRH-TSH stimulating test interpreted - TSH inc in first 30 min then falls?

A

normal

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12
Q

How is acetaminophen toxicity treated?

A

Activated charcoal N-acetylcysteine

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13
Q

How is benzodiazepine toxicity treated?

A

Flumazenil –> do not use if patient has taken a TCA

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14
Q

How is bilirubin measured in amniotic fluid?

A

By direct spectrophotometry If mixed with blood use chloroform to clear sample

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15
Q

How is bilirubin transported?

A

In the unconjugated form bound to albumin from spleen to liver

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16
Q

How is a TRH-TSH stimulating test interpreted - flat response?

A

hypERthyroidism or pituitary TSH deficient

17
Q

How is a TRH-TSH stimulating test interpreted - large spike?

A

primary hypOthyroidism

18
Q

How is a TRH-TSH stimulating test interpreted - gradual prolonged increase?

A

hypothalamic hypOthyroidism (tertiary)

19
Q

What leads to Beta Gamma bridging?

A

Albumin tends to decrease, globulins increase (balance)