AABchem1.18 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 homo-gentistic 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 homo-cysteine (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 TP…TP 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 reactionBeers law: concentration of analyte=Abs unknown/Abs std x con std

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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 is converted to and excreted into…

A

ammoniaurea

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31
Q

B2 microgobulin used as a marker for

A

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 noncovalently bound

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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 electro/endosmosisSeveral gels used routinely for protein electrophoresis attract positive ions from the buffer and form a positive ion cloud. This ion cloud moves in the opposite direction to the cathode. This phenomenon is called electroendosmosis or endosmosis.The tension created by these oppositely moving ion clouds can affect the movement of sample macromolecules. The migration of some proteins can be slowed, some proteins can become immobile, and other proteins are pushed toward the cathode.

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

Albumin65%

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56
Q

Method of detection for albumin and reagents used

A

dye binding, bromcresol purplemethyl orange

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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 these 4…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/plasminnephrotic/kindey diseasediabeteslupusincreased in prego

A

alpha 2 macroglobulinIncreased levels of alpha-2-macroglobulin are found in nephrotic syndrome when lower molecular weight proteins are lost, but alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.

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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 65-90% 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

Urine/CSF concentration firstBence Jones in urine migrate to..Prealbumin band seen in…

A

BJ to gamma regionPrealbumin in CSF

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83
Q

globulin increased globulin decreased in viral hepatitis

A

gamma increasedalbumin decreased

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84
Q

globulins increased…globulin decreased…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 ratioDecreased albumin seen in

A

nephrotic syndromeliver makes less albumin

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88
Q

Migration of globulins from anode to cathode and % of each…

A

albumin 65%, alpha1 2%, alpha2 8%, beta 10%, gamma 15%

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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 contractionsa group of lipids with hormone-like actions that your body makes primarily at sites of tissue damage or infection

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 of 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

Lieberman has cholesterolgoes to a.a. and s.a.

A

Lieberman Burchard reaction for cholesterolReagents are:Acetic AnhydrideandSulfuric Acid

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117
Q

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

A

Trig

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118
Q

Enzyme method for triglycerides…Hydrolyzes to…

A

Lipase hydrolyzes triglyceride to form glycerol

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119
Q

Fredewald calculation for LDL

A

TC- (TG/5+ HDL)

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120
Q

Friedwald calculation for VLDL

A

TG/5

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121
Q

Cannot used Friedwald calculation for LDL/VLDL if…

A

TG is >400mg/dL

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122
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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123
Q

Lipid goalsTCTrigLDLHDL

A

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

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124
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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125
Q

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

A

atheriosclerosis

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126
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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127
Q

4 non protein nitrogen

A

urea, ammoniauric acidcreatinine

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128
Q

non protein nitrogen increased in plasma in renal impairment called

A

azotemia

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129
Q

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

A

GFRcreatinine

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130
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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131
Q

Correction for clerance by body surface area

A

creat clearx1.73/area

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132
Q

Used with eGFR to stage/monitor CKD

A

urine albumin

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133
Q

Made from creatine in muscle

A

Creatinine

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134
Q

Method for creatininereacts withcolor formed

A

Jaffealkaline picrateyellow-red

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135
Q

Rises more rapidly than serum creatinine in acute renal failure

A

BUN

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136
Q

BUN increased in these two things

A

renal impairmenthigh protein

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137
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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138
Q

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

A

Colorimetric methodreacts with diacetyl monoxime

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139
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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140
Q

diacetyl monoxime-urease-

A

diacetyl monoxime-BUN/ureaurease-BUN/ammonia

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141
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 to 20:1BUN will be elevated

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142
Q

GFR marker made by nucleated cells

A

cystatin c

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143
Q

end product of purine metabolism from nuclei, allantoin

A

uric acid

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144
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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145
Q

phosphotungistic acid used in

A

uric acid

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146
Q

Uric acid NV mg/dL

A

2.6-7.2

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147
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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148
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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149
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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150
Q

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

A

ammonia

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151
Q

Analyte that is a prognostic indicator of liver failure

A

ammonianot eliminated by kidneys

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152
Q

Increased ammonia in these 3 main reasons

A

liver disease (cirrhosis, viral hep)impaired renal (increased urea,ammonia)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.

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153
Q

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

A

Reyes

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154
Q

Bromphenol blue or GLDH used to measure

A

ammonia

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155
Q

Nessler used to detect

A

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

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156
Q

Disaccharide with 2 glucose

A

maltose

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157
Q

Disaccharide with 1 glucose, 1 galactose

A

lactose

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158
Q

disaccharide with 1 glucose, 1 fructose

A

sucrose

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159
Q

monosaccharide with 6 carbons

A

hexose

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160
Q

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

A

glycolysis

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161
Q

process of glucose to glycogen

A

glycogenesis

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162
Q

process of glycogen to glucose

A

glycogenolysis

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163
Q

process of glucose from noncarb sources

A

gluconeogenesis

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164
Q

renal threshold for glucoseCSF glucose % of plasmabest anticoagulant

A

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

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165
Q

Diabetes melliutusplasma/OGTTA1C

A

> 200mg/dL>=6.5%

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166
Q

Hypoglycemia mg/dL

A

70mg/dl

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167
Q

Hormones that regulate glucosewhich one decreases?all the rest increase

A

insulin, only one decreasesglucagonepineph/cortisolGH, ACTHT3/T4(Thyroxine)Stomatostain

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168
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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169
Q

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

A

insulin

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170
Q

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

A

cortisol

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171
Q

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

A

glucagon

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172
Q

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

A

stomatostain

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173
Q

hormone that is adrenaline, neurotransmitter and regulates glucose

A

epinephrine

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174
Q

glycogen storage diseaseincreased or decreased glucose

A

von Gierkesdecreased

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175
Q

diabetes where glucose is normal

A

insipidus

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176
Q

condition with tumor that results in increased insulinincreased or decreased glucose

A

insulinomadecreased glucose

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177
Q

two conditions that increase glucoseThyroid, adrenal cortex

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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178
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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179
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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180
Q

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

A

NAD coenzyme reduced to NADHmeasured at 340nm

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181
Q

Normal fasting blood glucose

A

70-110mg/dL

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182
Q

Test to confirm prenatal borderline blood glucose

A

3 hr GTT

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183
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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184
Q

Juvenille onset, insulin dependent, autoimmune destruction of beta cellsketoacidosis

A

Type 1

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185
Q

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

A

Type 2

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186
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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187
Q

Diabetes caused by placental lactogen inhibiting insulin

A

GDMgestational diabetes mellitus

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188
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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189
Q

Filter used for QC of spectrophotometer and what it tests

A

holmium oxide glass filterwavelength accuracy

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190
Q

Meaasurement of emission of color when element is burned

A

flame photometry

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191
Q

Measurement of light abosorption of electromagnetic radiation

A

atomic absorption spectrophotometry

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192
Q

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

A

hollow cathod lamp

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193
Q

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

A

quenchingfluorometry

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194
Q

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

A

ISE

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195
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

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196
Q

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

A

excess antibodyconstant trough distance

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197
Q

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

A

gas chromatographyMS(mass spectro)

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198
Q

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

A

TLC Thin layer chromatographyRf= drug distance/solvent distance

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199
Q

Osmometry based off measuresm-Osmol/kg

A

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

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200
Q

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

A

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201
Q

Ehrlich, p-DMAB reagent measures

A

Urobilinogen

202
Q

p-DMAB stands for, used in the…for…

A

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

203
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

204
Q

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

A

albumin carries unconjugatedconjugated in liverconjugated is bilirubin diglucuronide

205
Q

Reaction for and alternate name bilirubin determination…Uses…Turns into…

A

diazo rxn/Jendrassik-Grofuses diazotized sulfanilicturns into purple azobilirubin

206
Q

Jendrassik-Grof measuresusesturns into

A

bilirubinuses diazo-tized sulfanilicturns into purple azobilirubin

207
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

208
Q

Bilirubin that is formed/converted in intestine

A

urobilinogen

209
Q

bilirubin that is oxidized/green in RE system

A

biliverdin

210
Q

oxidized form of urobilinogen excreted in urine…stool…

A

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

211
Q

Evelyn Malloy method used for…Interference..

A

bilirubinhemolysis

212
Q

Jaundice with increasd unconjugated and increased urine urinobilinogen

A

Prehepatic jaundice

213
Q

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

A

hepatic

214
Q

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

A

Posthepatic obstruction

215
Q

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

A

Isoenzyme

216
Q

Metals ions in enzymatic reactions act as

A

activators

217
Q

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

A

Michaelis-Menten

218
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

219
Q

LD catalyzes lactate +NAD to… And…

A

pyruvate + NADH

220
Q

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

A

LD1 HHHH

221
Q

LD isoenzyme in healthy, HHHM

A

LD2

222
Q

LD isoezyme that migrates the slowest

A

LD5

223
Q

Increased in LD1,2,3

A

PApernicious anemia

224
Q

Enzyme greatly affected by hemolysis because its in all cells

A

LD

225
Q

CK increased in these 3: stress to muscles

A

heart attackmuscular dystrophyexercise

226
Q

3 CK isoenzymes are dimersFastest to slowestBrain faster than muscle

A

CKBB, CKMB, CKMM

227
Q

CK isoenzyme slowest, in skeletal muscle

A

CKMM

228
Q

CKMB sensitive for AMIrises w/in…down in…

A

2-4hrs2-4 days

229
Q

Most sensitive for AMI and two most used…rise/fall…

A

TroponinTnT,TnI4-8hrs, 10 days

230
Q

LD rises, days last

A

rises 8-12hrs, 10-14 days

231
Q

Myoglobin rises, normal

A

30min, 24hrs

232
Q

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

A

CHF

233
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

234
Q

3 conditions elevated AST1 not elevated

A

acute heartliver diseasemuscularnot elevated in acute pancreatitis

235
Q

2 Liver enzymes not affected by hemolysis

A

ALT, GGT

236
Q

Increased ALP in 3 things in liver

A

obstruction of biliary tract/jaundiceacute viral hepbiliary cirosis

237
Q

ALP increased in these 3 bone disordersincreased in 1 random

A

Pagets: overgrowthosteomalacia: soft bones, decreased D/CaRickets: Vit d defprego (increased in mom and baby’s bones)

238
Q

High ALP but no other liver increased

A

bone

239
Q

pH for ACPincreased in

A

5.0acidprostatic disease

240
Q

Enzyme in alcoholics, heptobiliary, obstructive jaundice, cirrhosis

A

GGT

241
Q

Enzyme in mumps and acute pancreatititsenzyme most specific for pancreatittis

A

mumps: amylasepancreatitis: lipase

242
Q

Cherry Crandall used to determine…substrate…

A

lipaseolive oil

243
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.

244
Q

Zollinger-Ellison is a… increased…

A

gastrinomagastrin HCl

245
Q

diacetyl monoxime used to determine

A

BUN

246
Q

phospho-tungistic acid to tungsten blue used to determine

A

Uric acid

247
Q

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

A

monosodium urategout

248
Q

Kayser-Fleischer

A

Cooper deposits in cornea

249
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

250
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

251
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).

252
Q

hypercalcemia

A

Vit excess, hyperPTHMalignancy

253
Q

8-hydroxy-quinoline removes…In determination of…

A

MgCa

254
Q

In the complexometric titration for Ca, the pH is adjusted to prevent…Complexometric titrations are used mainly to determine metal ions by use of complex-forming reactions.

A

interference from Mg8-hydroxy-quinoline removes Mg

255
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

256
Q

Clark-Collip measures…it will be precipitated as…

A

Calciumoxalate

257
Q

In determining calcium, lanthanum is used to

A

bind phosphate

258
Q

Most phosphorus is in… at pH

A

bone 7.4

259
Q

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

A

PTH:decreases Phoincreases Ca

260
Q

Affect on PhosPTHCalcitonin, Vit D

A

PTH decreased PhoCalcitonin, Vit D increases phosphate

261
Q

Reagent used for phosphate

A

molybdatemolybdeum blue

262
Q

Hyperparathyroidism= increased PTH,Phosphorus is

A

decreased

263
Q

Hypoparathyroidism= decreased PTHPhosphorus…

A

increased

264
Q

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

A

1.5-2.1mg/dL

265
Q

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

A

magnesiumhypermagnesemia

266
Q

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

A

IDA

267
Q

Reagent for magnesium

A

titan yellow

268
Q

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

A

sideroblastic and hemocromatosis

269
Q

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

A

copper

270
Q

Fat soluble vitamins

A

A,D,E,K

271
Q

Water soluble vitamins

A

All B, C

272
Q

Fat soluble Retinol, cause of night blindness

A

A

273
Q

Fat soluble calciferol, hormone precursor, Rickets

A

D

274
Q

Fat soluble Tocopherol, antioxidant/immunityHemolytic anemia

A

E

275
Q

Fat soluble phylloquinine, for clotshemmorage

A

K

276
Q

Water soluble B1condition

A

thiaminBeriberi

277
Q

water soluble riboflavin

A

B2

278
Q

water soluble B3, condition

A

niacinpellegra

279
Q

water soluble pyridoxal

A

B6

280
Q

water soluble B7

A

Biotin

281
Q

water soluble B9, condition

A

folatemegaloblastic

282
Q

water soluble cobalamin, condition

A

B12PA/IF

283
Q

cause of Scurvy

A

C

284
Q

Major extracellular cation, NV

A

Sodium 135-145

285
Q

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

A

Aldosterone

286
Q

Hypoaldosterone NaHyperaldosterone Na

A

Hypo: decreased NaHyper: increased Na

287
Q

Normal valuesNa ClK

A

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

288
Q

BUNCreatinine

A

BUN 6-20Creatinine 0.7-1.5

289
Q

CO2/Bicarb

A

23-29

290
Q

Na 165Cl 125K 3.5

A

Saline contamination

291
Q

Diabetes mellitus FastingGlucose

A

126, 200

292
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 )

293
Q

Used to enhance sensitivity of ISE electrode for K

A

Valino-mycin

294
Q

Hypokalemia is less thanHyperkalcemia greater than

A

Potassium<3.5>5

295
Q

Chloride shift

A

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

296
Q

Causes of increased Cl

A

IVDehydrationMetabolic/diabetic acidosis(lose HCO3, chloride shift)

297
Q

Low Cl 4 things

A

Diarrhea, vomitingRenal failuremetabolic alkalosis

298
Q

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

A

Coulometric amperometricSchales-Schales

299
Q

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

A

TitrationChlorideTime needed to get to end pt

300
Q

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

A

Mercurimetric titrationChlorideExcess Hg++

301
Q

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

A

TitrationChloride

302
Q

Most CO2 in blood is

A

Bicarb

303
Q

Specimen Least ordered, not used for CO2

A

Urine

304
Q

Anion Gap, NV

A

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

305
Q

Increased anion Gap

A

Diabetic ketoacidosisLactic acidosisSalicylateMethanolEthanolPoly glycolUnmeasured

306
Q

Decreased anion Gap used as, due to

A

Analytical QCAnalyzer error

307
Q

Glass, Ag/AgCl, measures H for measurement of

A

pH

308
Q

Platinum+Ag/AgCl, amperometric measures

A

pO2

309
Q

Henderson Hasselbalch

A

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

310
Q

Bicarb: carbonic acid ratio in plasma

A

20:1

311
Q

AcidosisNormalAlkalosis

A

<7.387.35-7.45, around 7.4>7.42

312
Q

Metabolic acidosis: pH, HCO3 levels compensation

A

Decreased pH, HCO3Lung: Hyperventilating releases CO2

313
Q

Metabolic alkalosis 2 parameters influenced, compensation

A

Increased pH, HCO3Lung: Hypoventilation increases CO2

314
Q

Respiratory acidosis 2 parameters, compensation

A

Decreased pH, Increased CO2Kidneys: increase bicarb

315
Q

Respiratory alkalosis 2 parameters, compensation

A

Increased pH, decreased pCO2Kidneys compensate

316
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.

317
Q

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

A

Uric acid: goutPyro-phosphate: pseudogout

318
Q

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

A

L/S: >2PGFLM 2Lamellar

319
Q

Sweat:AnalyteCondition, death cause

A

ClCystic fibrosis, pneumonia

320
Q

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

A

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

321
Q

Decreased CSF glucose seen inIncreased CSF glucose seen in

A

Decreased CSF glucose: Bacterial meningitis Increased CSF glucose:Diabetes

322
Q

CSF tube order/department

A

1 chem 2 micro3 heme

323
Q

CSF protein mg/dL

A

15-45

324
Q

CSF glucose

A

60-70% plasma

325
Q

CSF diff

A

70% lymph30% mono

326
Q

4 causes of increased CSF Protein

A

MeningitisIntracranial hemorrhageTraumatic tapMS

327
Q

Decreased CSF TP seen in

A

Leak, tear

328
Q

Increased CSF IgG index and oligoclonal banding seen in…

A

MS Multiple scelerosis Oligoclonal bands are proteins called immunoglobulins. The presence of these proteins indicates inflammation of the central nervous system. The presence of oligoclonal bands may point to a diagnosis of multiple sclerosis.

329
Q

Urine ph normal…If left at rt becomes..

A

normal 6.0 (4.5-8)alkaline at RT

330
Q

Normal urine volume:poly> olig

A

1200-1500poly >2500olig<500noc: more at nightanuria: none

331
Q

left at RT, what decreases…increases

A

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

332
Q

3 things kidneys make2 hormones that influence kidney

A

renin, erythropoeitin, PGaldosterone, ADH

333
Q

Urine is made of 7 things

A

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

334
Q

Urine RBCs color

A

smoky, red/brown urine

335
Q

Urine bili/pyridum color

A

dark yellow/amber/orangePhenazopyridine (Pyridium) is a dye that’s a red-orange color

336
Q

Met/Hmg and homogentistic acid urine color

A

brown black upon standing

337
Q

Reabsorbs H2O onlyRebabsorbs solutes only

A

H2O only Descening Loopsolutes only ascending loop

338
Q

Specific gravity NV…increased in these 3decreased in this

A

1.003-1.030increased in: -renal damage(isotheniuria 1.010)-diabetes mellitus-xraydecreased in diabetes insipidus

339
Q

3 methods to determine sg

A

refractometerreagent stripharmonic oscillation: densitometry; current helps measure sg

340
Q

Urine strip protein method name…ph…and can leach to the pH strip and …the pHwhat protein it binds to…color…confirm with…

A

protein error of indicators3.0 and can leach to the pH strip and lower the pHalbuminsulf. acid precipitation

341
Q

How many neprons per kidney….filtration ml/min

A

1 million90-120mL/min

342
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.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

343
Q

Renal threshold for glucosedipstick measures only glucosetwo enzymes in rxn

A

160-180mg/dLglucose oxidase, perioxidase

344
Q

Clinitest/Benedicts is a… …method 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

345
Q

Occult blood on urine dipstick depends on

A

perioxidase activity of rbc/hmg

346
Q

Nitrite:bacteria type…2 names for rxn:

A

GNR (E.coli)Diazo, Griess rxn

347
Q

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

A

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

348
Q

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

A

RBCs

349
Q

reagent for LE, color

A

diazo reagent, purple

350
Q

Cell related to glitter cell, UTI/pyelonephritis…type seen in UTI…

A

whiteneutrophils

351
Q

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

A

ketonessodium nitroprusside purpleAcetest (Acetoacetic/diacetic acid, acetone)

352
Q

Sodium nitroprusside used in determination of…on dipstick

A

ketones

353
Q

Acetest is used to confirm…detects these two..

A

confirm ketonesdiacetic acid, acetone

354
Q

Ictotest, Diazo rxn used for

A

Bilirubin

355
Q

Reagent used in Erlich

A

p-DMAB

356
Q

Erlich, p-DMAB used in

A

Urobili

357
Q

Leukocyte in DILUTE HYPOTONIC urine where granules appear to move/Brownian Mvt

A

glitter cell

358
Q

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

A

transitional

359
Q

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

A

renal tubular

360
Q

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

A

Tamm horsfall mucoproteinUromodulin

361
Q

Cast are formed in what part of tubules

A

distal convoluted tubule

362
Q

Casts seen in chronic renal disease, urinary stasis

A

waxy

363
Q

cast seen in stress/exercise, normal

A

hyaline

364
Q

cast seen in nephron/acute glomerulonephritis

A

RBC

365
Q

Cast from dialated collecting ducts

A

broad

366
Q

cast seen in acute glomerulonephritis and is decomposition of cellular

A

granular

367
Q

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

A

fatty

368
Q

cell in pyleonephritis

A

wbc

369
Q

4 urine parasites

A

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

370
Q

5 abnormal crystals

A

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

371
Q

3 normal crystals in acidic urine

A

Uric acid: rhomboid/pleomorphicamorphouse urates: pink sedimentCalcium oxalate: envelope/oval/dumbell, *monohydrate form in antifreeze

372
Q

4 normal crystals in alkaline urine

A

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

373
Q

NV for… 50-200 mg/24hr

A

microalbumin

374
Q

AAT globulin

A

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

375
Q

Tangier low in

A

HDL

376
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

377
Q

HexokinaseGlucose method reduces this coenzyme…To…At…nm

A

NAD coenzyme is reduced to NADH and measured at 340nm

378
Q

diazo rxn/Jendrassik-Grof

A

Bilirubin

379
Q

Jendrassik-Grof andEvelyn Malloymeasure

A

Bilirubin

380
Q

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

A

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

381
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

382
Q

LD1 HHHH Fastest, marker for these two

A

heart/rbc

383
Q

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

A

increased iron/ferritin/%sat decreased transferrin/TIBCSideroblastic anemia is a type of anemia that results from abnormal utilization of iron during erythropoiesis. Hemochromatosis, or iron overload, is a condition in which your body stores too much iron. It’s often genetic.

384
Q

Pyrophosphate seen in

A

pseudogout

385
Q

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

A

PS=phenylhydrazine=corticosteroidsZimm=17-KS/17-ketosteroids

386
Q

Phenlyhydrazine used to detect corticosteroids in what reaction

A

PS=Porter-Silber

387
Q

17-ketosteroids/17-KS is detected in what reaction…Is a metabolite of…

A

ZimmermanZimmerman is a man that takes 17-KS/steroidsmetabolite of androgens

388
Q

Porter and Zimmerman take steroids

A

389
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

390
Q

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

A

Primary…end organSecondary:pituitaryTertiary: Hypothalamus

391
Q

Increased GH causes these two thingskids versus adultsDecreased GH causes

A

kids: giantismadults: acromegalydwarfism

392
Q

Hormone that solely initiates and maintains lactation

A

prolactin

393
Q

increased prolactin cause of these two

A

Hypogonadism: In hyperprolactinemia, which induces hypogonadism, the excess prolactin interferes with secretion of gonadotropin-releasing hormone, resulting in decreased testosterone and erectile dysfunction.and prolactinoma (pituitary tumor)

394
Q

menstral disorder and inadequate lactation due to

A

decreased prolactin

395
Q

Vasopression is also called

A

antidiuretic hormone

396
Q

ADH acts on…to increase…decreased in…

A

acts on renal tubles to increase water reabsorptiondiabetes insipidus

397
Q

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

A

oxytocin

398
Q

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

A

testosterone

399
Q

Testosterone is made from…

A

cholesterol (as is a lot of steriods)

400
Q

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

A

androgens

401
Q

infertility men/womenpolycystic ovarian due toadrenal hyperplasia: A group of genetic conditions limiting hormone production in the adrenal glands.

A

hypertestosteronemia

402
Q

hypogonadism due to

A

hypotestosteronemia

403
Q

TRH, GRH, CRH GHRHPIF, GHIH released by

A

hypothalamus

404
Q

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

A

anterior pituitary

405
Q

ADH, oxytocin released by

A

posterior pituitary

406
Q

Hormone that induces ovulation, prmotes ovary secretion of estrogens/progesterone for possible pregnancy and stimulates testes to produce testosterone

A

Luteinizing hormone

407
Q

GnRH, gonadotropin-releasing hormonestimulates this organ to produceb these 2 hormones… which affects these two organs

A

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

408
Q

GHIH is also called

A

Somatostatin

409
Q

GHIH/SomatostatinGHRH: growth hormone-releasing hormone

A

Somatostatin from the hypothalamus inhibits the pituitary gland’s secretion of growth hormone and thyroid stimulating hormone.GHRH: growth hormone-releasing hormone

410
Q

Somatostatin inhibits the pituitary gland’s secretion of…and…

A

Somatostatin from the hypothalamus inhibits the pituitary gland’s secretion of GH and TSH

411
Q

FSH stimulates, secretion offemales:males:

A

females: egg development, estrogenmales: sperm, testosterone

412
Q

hypothalmus makes CRH, Corticotrophin-releasing hormonethat act on pituitary to make ACTH, Adrenocorticotropic hormonethis stimulates the adrenal cortex to make steroid hormones made from cholesterol3 steroids made in adrenal cortex…

A

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

413
Q

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

A

Renin

414
Q

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

A

ACTHadreno-cortiotropic hormone

415
Q

CRH stimulates the…to make… which causes… 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

416
Q

Mineralocorticoids, glucorticoids, and androgens released by

A

adrenal cortex

417
Q

aldosterone is an example of a…maintains…and…by retaining…and…and excreting…

A

mineralocorticoidmaintains H2O and electrolytes by retaining water and Na and excreting K

418
Q

Cortisol is a type of

A

glucocorticoid

419
Q

Hyperadolsoterone, increased Na, decreased K, hypertension

A

Conns Disease

420
Q

Conns Disease has increased…and thus increased…decreased…leading to….due to increased…

A

has increased aldosterone and thus increased NaDecreased K leading to hypertenstion due to increased fluid retention

421
Q

Hypoaldosterone, decreased Na/Cl, decreased cortisoleverything down

A

Addisons Disease

422
Q

Increased cortisol, increased glucose, increased Nabuffalo hump

A

Cushingseverything up

423
Q

Testosterone is a type of

A

androgenmale sex hormone

424
Q

metabolite of androgen…reaction used to detect…

A

17-ketosteroid, 17-KSZimmerman reaction

425
Q

3 types of catecholaminespurpose

A

epinephnorepidopamine These hormones are released into the body in response to physical or emotionalstress.

426
Q

Two GI hormones

A

Gastrinserotonin

427
Q

Hormone increased in Zollinger Ellison syndrome

A

gastrin

428
Q

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

A

serotonin

429
Q

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

A

serotonin

430
Q

Catecholamines produced in…by…

A

adrenal medullaby chromaffin cells

431
Q

Metabolites of epineph

A

metanephrine, VMA

432
Q

Metabolites of norepineph

A

normetaneph,VMA

433
Q

Metabolites of dopamine

A

HVA

434
Q

Pheochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headachewith increased…

A

VMA

435
Q

Pheochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of…and…metabolite is…

A

epinephrine and norepinephrineVMA

436
Q

Neuroblastoma is a childhood cancer that starts in immature nerve cells (neuroblasts) with increased…

A

HVA

437
Q

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

A

hypothalamus

438
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

439
Q

TSH stimulates the … to make these two

A

thyroid, T3/T4

440
Q

3 things hormones made by thyroid

A

thyroxine/T4, triiodothyronine/T3calcitonin

441
Q

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

A

Thyroxine, Triiodothyronine: metabolismCalcitonin: Ca reabsorbtion

442
Q

3 calcitropic hormones

A

PTH, VitD, calcitonin

443
Q

Low PTH lowers these two…increases this…

A

Lowers serum Ca, DIncreases Phos

444
Q

TRH stimulates pituitary to release… which acts on…

A

TSH, acts on thyroid

445
Q

TSH stimulates thyroid to make…

A

T3,T4

446
Q

Free… stimulate negative feedback loop and inhibit secretion of…

A

Free T3/4 inhibit TSH

447
Q

primary Hyperparathyroidism also called…symptoms

A

Gravesweight loss, heat, hair loss, anxious

448
Q

Graves is hyper or hypo…T3/T4 levels…TSH levels…thyroid overproduces… due to… …

A

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

449
Q

Primary Hypothyroidism is called…symptoms

A

Hashimotosweight gain, tired, cold

450
Q

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

A

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

451
Q

Major binding protein for thyroxine/T4How is it measured

A

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

452
Q

3 good indicators for hypothyroidism1 not good indicator

A

FT4, TT4, s-TSH (singles best)Most is T4 not T3not good T3 uptake (indirect, not used)

453
Q

Ovaries productes these two hormones

A

estrogen, estadiol

454
Q

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

A

Estrogen

455
Q

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

A

estadiol

456
Q

Progesterone made by the… … … and then by the…in pregnancy

A

ovarian corpus luteum and then placenta in pregnancyProgesterone is also secreted by the ovarian corpus luteum during the first ten weeks of pregnancy, followed by the placenta in the later phase of pregnancy.corpus luteum: yellowish mass of progesterone-secreting endocrine tissue that forms immediately after ovulation

457
Q

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

A

progesterone

458
Q

progesterone levelsperimenopausepostmenopause

A

peri: increased progesteronepost:decreased progesterone

459
Q

What hormone maintains progesterone in early pregnancy

A

HCG

460
Q

HCG increased/decreased…

A

increased: prego, mutiple pregos, tumorsdecreased: spontaneous abortion

461
Q

HCG subunits are…

A

alpha, beta subunitsNON-covalently bound subunits

462
Q

subunit that cross reacts with LH,FSH,TSh

A

alpha

463
Q

subunit that has analytical specificity

A

beta

464
Q

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

A

firstseen in days, peaks 2-3mths

465
Q

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

A

Urine-QLBlood-QNT

466
Q

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

A

validity

467
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

468
Q

Aminoglycosides and Glycoprotein are two kinds of

A

antibiotics

469
Q

Kind of Glycoprotein/antibioticthat inhibits.. ..synthesis of gram…

A

Vancomycininhibit cell wall synthesis, treat gp

470
Q

gentami/tobramy/amika/kana-cin are all…they inhibit… … of gram…

A

aminoglycosidesinhibit protein synthesis, treat gn

471
Q

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

A

hearing/ototoxickidneys/nephrotoxic

472
Q

Phenobarbital, phenytoin/dilantinValproic acid, Carbamazepineethosuximide are all

A

anti-epileptic/anti-convulsants

473
Q

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

A

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

474
Q

Cyclosporine, Tacrolimus, Sirolimus,MPA all are

A

immunosuppressive

475
Q

Methotrexate are all

A

antineoplastics/antitumor

476
Q

Cyanide, arsenic, mercury all are

A

heavy metals

477
Q

Substances/acute poisoning

A

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

478
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

479
Q

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

A

Trough1-2hrs after oral dose

480
Q

AID: Amtriphtyline, Imipramine, DoxepinLithium are all

A

pyschotropics

481
Q

Amtriphtyline, Imipramine, Doxepin are all

A

tricyclics

482
Q

Digoxin, Quinidine, Procainamide,Disopyramide, Lidocaine all are

A

Antiarrythmics/cardiactive

483
Q

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

A

Body does to drug: pharmacokineticsDrug does to body: pharmacodynamics

484
Q

Increased alpha 2 in these two

A

Acute inflammationnephrotic syndrome

485
Q

Tetany decreased in these two

A

Ca,Mg

486
Q

LD 4,5 related to

A

Liver disease

487
Q

Elevation in LD1/LD2 in a flipped pattern is related to

A

Myocardial infarction

488
Q

Increased total serum LD 4,5 related to

A

Acute viral hepatitis

489
Q

Increased LD 1,2 related to

A

Hemolytic anemia

490
Q

Gilbert, Crigler-Najjar and Dubin-Johnson syndromes all are issues with what analyte

A

Billirubin

491
Q

Syndrome that’s genetic liver disease, reduced glucuronyl transferase, thus increased bili

A

Gilbert syndrome

492
Q

Name of syndrome where there’s two types,the type and name where there’s compete absence of glucuronyl transferase, severe unconjugated bili and kernicterus…Type work decreased glucuronyl transferase, chronic increased bili

A

Crigler-Najjar Syndrome Complete:Type 1 Decreased: Type 2

493
Q

Syndrome that’s genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion

A

Dubin-Johnson syndrome

494
Q

Dubin-Johnson syndrome

A

Syndrome that’s genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion

495
Q

2 Hepatitis fecal, oral

A

A, E

496
Q

3 Recent Hep B infection markers

A

HBsAg,HBeAgAnti-HBc IgM

497
Q

DNA hep, with a core and envelopeBF, sex, IV drug

A

Hep B

498
Q

RNA, blood-to-blood contact:blood transfusion, needles, no vaccineDevelopment of cirrhosis

A

Hep c

499
Q

Hep that needs HBV, coinfection

A

Hep D

500
Q

Tetany caused by these two

A

(decreased Ca,Mg)