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AMT Chem Flashcards

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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 grp

lipo, 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

inherited metabolic disorder involving leucine, isoleucine, and valine (a group of branch chain amino acids).

A

maple syrup disease

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10
Q

Aminoacidpathy caused by defiency in the enzyme to metabolize phenylalanine

mousy 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 acid

deficiency of a single enzyme called homogentisate 1,2 dioxygenase

urine turns a dark brownish-black color when exposed to air

A

Alkaptonuria

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12
Q

Cystinuria

Tyrosinemia

A

inherited metabolic,
excessive amount of undissolved cysteine, doesn’t get reabsorbed by kidney, kidney stones

Tyrosine/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

Homocystinuria

build up of methionine and homo-cysteine (metabolite of methionine)

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14
Q

4 causes of hypoproteinemia

A

Not getting/making enough:
malnutrition
liver 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

dehydration
Multiple 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

Biuret
Dye binding
Kjeldahl
Refractometry

TP 6.4-8.3 g/dL

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18
Q

TP g/dL
albumin g/dL
microalbumin in urine mg/24hr

A

TP 6.4-8.3g/dL
Albumin 3.5-5 g/dL (about 60% of TP) rest is globulins

microalbumin 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

What does a biuret reaction for total protein analysis depend on?

A

Peptide bonds
Under strongly alkaline conditions, Cu2+ ions form multivalent complexes with peptide bonds in proteins. The absorbance attributable to proteins is measured spectrophotometrically at 540 nm, and the biuret reaction reacts equally with all proteins and peptides longer than two amino acids

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23
Q

4 dyes in dye binding for TP

A

Bromophenol Blue
Coomassie brilliant blue

Ponceau S
Amido black

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24
Q

Reference method for TP, not used often

A

Kjeldahl

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25
TP method that measures nitrogen
Kjeldahl
26
This reaction follows Beers law for a reasonable range of protein Depends on presence of at least two peptide linkages Is insensitive to low protein in urine...
Biuret reaction Beers law: concentration of analyte= Abs unknown/Abs std x con std
27
3 things that can interfere with Biuret method for TP
hemoglobin, hemolysis and lipemia
28
Two dyes used in dye binding method for albumin
BCP less interference BCG Bromcresol
29
BCP/BCG is used in what method... are used to determine...
Dye-binding method for albumin
30
Principle of protein strip measurement called pH color change from,to... Most sensitive to... false pos seen in what pH..
protein error of indicators: -indicatir is nonionized pH 3.0 yellow to green: due to ion/union changing Most sensitive to albumin False pos: alkaline urine *Not affected by bence Jones
31
Breakdown of protein turns to... liver converts it to
Gut bacteria make ammonia Liver turns to urea
32
B2 microgobulin used as a marker for
reduced GFR
33
CSF protein How many mg, What percent of plasma
15-45mg/dL, 1%
34
3 Methods for Urine/CSF protein, BAD acronym
Biuret Acid: SSA precipitation Dye: Coomassie brillant blue
35
Increased CSF protein in these 3
meningitis, tramatic tap, MS
36
Protein in Spina bifida
AFP alpha fetoprotein
37
CEA stands for, is a
carcino-embryonic antigen oncofetal antigen
38
CEA nonspecific for
colorectal carcinoma/colon cancer
39
AFP
alpha fetoprotein tumor associated; secreted by fetal liver
40
Increased AFP 4 conditions
liver/heptocellular cancer neural tube defects (spina bifida) ovarian testicular cancer
41
Decreased AFP in
Down syndrome
42
HCG Made by... Has...
human chorionic gonadotropin made by placenta after implantation by trophoblastic cells alpha+beta subunits NONcovalently bound NONidentical
43
HCG seen in these two cancers
ovarian testicular
44
PSA Made by... Seen in..
prostate specific antigen made by prostatic epi cells prostatic cancer
45
CA-125
ovarian cancer
46
CA19-9
pancreatic GI, adenocarcinoma
47
CA15-3, 27.29
mestatic breast
48
Two markers in breast cancer
CA27-29, CA15-3
49
Thyroglobulin marker for
thyroid
50
All proteins carry a net...charge due to protein being a higher pH than its isoelectric point and travel towards
net negative, anode
51
Fastest/smallest protein toward anode
albumin
52
Which globulin migrates to cathode due to electro/endosmosis Several 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.
gamma
53
pH of electrophoresis
8.6
54
Anode
positively charged electrode
55
Cathode
negatively charged electrode
56
Protein in highest concentration and made in liver % of plasma protein
Albumin 65%
57
Method of detection for albumin and reagents used
dye binding, bromcresol purple methyl orange
58
Albumin function
transport/binds protein osmotic pressure
59
Albumin decreased in these 3 things
malnutrition liver disease nephrotic syndrome/renal loss/kidney disease
60
Albumin increased in this
dehydration
61
Another name for prealbumin and used to assess...
trans-thy-retin nutrional status
62
Liver makes these 4 globulins and RE/plasma cells make this
liver: albumin, alpha 1/2, beta RE/plasma: gamma
63
two alpha 1 globulins
AAT: alpha1 antitrypsin inhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage. AFP: alpha fetoprotein
64
AAT increased in... and .... decreased causes this...
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)
65
AFP increased these 4... decreased in...
increased in: neural tube defects liver cancer ovarian/testicular decreased in Downs
66
Globulin increased in acute inflamation
alpha 2
67
Large globulin made in liver, inhibits trypsin/pepsin/plasmin nephrotic/kindey disease diabetes lupus increased in prego
alpha 2 macroglobulin Increased 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.
68
three alpha 2 globulins
alpha 2 macroglobulin Haptoglobin ceruplasmin
69
Alpha 2 globulin made in liver acute phase reactant that binds hmg
Haptoglobin
70
haptoglobin increased/decreased in these two
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
71
Alpha2 globulin transports 65-90% copper, made in liver, acute phase reactant
Ceruloplasmin
72
Disease with decreased serum ceruloplasmin and decreased serum, increased urine copper. Increased storage of copper in organs/cornea
wilsons
73
Disease with decreased ceruloplasmin due to decreased absorption, decreased serum copper
Menkes
74
Ceruplasmin is a .... that transports... increased in these two... decreased in these two conditions...
glycoprotein that transports copper increased in acute phase/inflammation, prego decreased in Wilsons disease and Menkes
75
Beta globulins examples
Beta2 microglobulin beta lipoprotein/LDL transferrin hemoplexin complement fibrinogen CRP
76
Beta globulin that is a heme scavenger
hemopexin
77
Beta globulin that transports iron
transferrin
78
examples of glycoproteins
transferrin ceruloplasmin mucins AFP immunoglobulins, antibodies FSH, LH, HCG, TSH Fibrinogen
79
A non-glycoprotein that are temp sensitive proteins that precipitate from serum/plasma at temps lower than 37C (4C)
Cryoglobulin
80
Striated muscle/cardiac; increased in heart attack, muscle dystrophy, crush
myoglobin
81
complex of 3 proteins in striated/cardiac; muscle contration, most sensitive for heart attach 3 subunits
Troponin TnI, TnT, TnC
82
Urine/CSF concentration first Bence Jones in urine migrate to.. Prealbumin band seen in...
BJ to gamma region Prealbumin in CSF
83
globulin increased globulin decreased in viral hepatitis
gamma increased albumin decreased
84
globulins increased... globulin decreased... maligment tumor
alpha 1/2 increased albumin decreased
85
beta-gamma bridge, broad gamma seen in
active cirrhosis/liver
86
M spike seen in
Monoclonal gammopathy
87
increased alpha 2/gamma ratio Decreased albumin seen in
nephrotic syndrome liver makes less albumin
88
Migration of globulins from anode to cathode and % of each...
albumin 65%, alpha1 2%, alpha2 8%, beta 10%, gamma 15%
89
Polar hydrophillic and nonpoloar hydrophobic fatty acid chains; cell membranes are made of these
phospholipids
90
Examples of phospholipids
lecithin sphingomyelin PG(phosphatidyl glycerol)
91
Long chain polyunsaturated fatty acids that activates inflammation Stimultes clotting; also stimulates cervix to dialate and contractions a group of lipids with hormone-like actions that your body makes primarily at sites of tissue damage or infection
PG Prostaglandins
92
Transports lipids, classified w/ultracentrifugation Protein part of lipoproteins/structural components...
transports lipids: lipoproteins Protein part: Apoprotein
93
Order of lipids from heaviest to lighest
HDL, LDL, VLDL, Chylo
94
Alpha lipoprotein is... Beta lipoprotein is... Prebeta lipoprotein is... Migration of liproteins from origin/cathode to anode Influenced by size and charge/amt protein
alpha: HDL most protein, fastest Beta: LDL PreBeta: VLDL, bigger than LDL Chylo: least protein, slowest Origin to Anode: Chylo, LDL, VLDL, HDL
95
Largest lipoprotein, carrier of exo Trig Apoproteins associated with it
Chylomicron ApoB-48
96
Exogenous/dietary lipids and it's liproprotein/carrier
Triglycerides chylomicrons
97
most artherogenic lipid causing CHD, mostly composed of cholesterol and transported to the heart Third fastest to anode
LDL
98
Endogenous lipid made of mostly triglycerides Second fastest to anode
VLDL
99
Lipid transports lipid out of liver, heaviest and smallest
HDL
100
primary form of lipid storage... transported by these two...
triglycerides exo/dietary: chylomicrons endo:VLDL
101
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...
cholesterol to: LDL out of: HDL
102
% of Cholesterol made in liver... % of Trig made in liver versus diet...
Cholesterol 85% Trig 10% liver, 90 diet
103
Apoprotein B-100 are part of these two lipids
LDL, VLDL
104
Apoprotein A is part of this lipoprotein
HDL
105
Apoprotein B-48 is part of this lipoprotein
Chylo
106
LDL % carrries lipids
LDL % carrries lipids 60-70
107
HDL % carries lipid
HDL % carries lipid 20-35
108
VLDL % carries lipid
VLDL % carries lipid 5-12%
109
Major protein in HDL
Apolipoprotein A
110
Major protein in LDL/VLDL
Apolipoprotein B
111
Protein versus lipid density
protein more dense than lipid
112
Disease with very low HDL
Tangier
113
Method for cholesterol purpose of saponification step
cholesterol oxidase convert cholesterol esters to free cholesterol
114
Liebermann Burchard reaction used to determine
cholesterol
115
2 reagents used for color developemnt in Liebermann Burchard reaction for cholesterol
acetic anhydride sulfuric acid
116
Lieberman has cholesterol goes to a.a. and s.a.
Lieberman Burchard reaction for cholesterol Reagents are: Acetic Anhydride and Sulfuric Acid
117
Lipid w/3 fatty acids/glycerol storage form 90% in diet, 10% liver lipemia from chylomicrons
Trig
118
Enzyme method for triglycerides... Hydrolyzes to...
Lipase hydrolyzes triglyceride to form glycerol
119
Fredewald calculation for LDL
TC- (TG/5+ HDL)
120
Friedwald calculation for VLDL
TG/5
121
Cannot used Friedwald calculation for LDL/VLDL if...
TG is >400mg/dL
122
Risk factors for CHD age by genders history of bp, HDL two conditions
>45men, >55 women family history of CHD smoking bp >120, HDL <40 D.mellitus, metabolic syndrome
123
Lipid goals TC Trig LDL HDL
TC <200 Trig <150 LDL<100 HDL>35
124
Condition where blood cholesterol is increased
hypothyroidism Thyroid 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
125
Examples of .... lipid deposits in vascular/legs/arms CAD, AMI, arteries lipid in brain, stroke
atheriosclerosis
126
Disease with increased TC, LDL and decreased HDL Calculate coronary risk index using these two parameters Elevated beta liproprotein is what lipid and leads to which kind of disease
CHD TC, HDL LDL, cardiovascular
127
4 non protein nitrogen
urea, ammonia uric acid creatinine
128
non protein nitrogen increased in plasma in renal impairment called
azotemia
129
Best way to evaluate renal impairment and what is most common analyte to monitor it
GFR creatinine
130
Creatinine clearance calc based off the principle that creatinine passes into the ultrafiltrate
U creat/P creat x mL/1440 vol in mL, min/24hr
131
Correction for clerance by body surface area
creat clearx1.73/area
132
Used with eGFR to stage/monitor CKD
urine albumin
133
Made from creatine in muscle
Creatinine
134
Method for creatinine reacts with color formed
Jaffe alkaline picrate yellow-red
135
Rises more rapidly than serum creatinine in acute renal failure
BUN
136
BUN increased in these two things
renal impairment high protein
137
diacetyl monoxime used in determining...by measuring... can be used in untreated urine because...
BUN urea method isn't measuring ammonia
138
Type of method for BUN that measures urea... reagent that reacts with urea...
Colorimetric method reacts with diacetyl monoxime
139
Enzymatic method for BUN uses.... which hydrolyzes...to...
urease which hydrolyzes urea into ammonia Unlike the colorimetric method using diacetyl monoxime used for BUN/urea
140
diacetyl monoxime- urease-
diacetyl monoxime- BUN/urea urease- BUN/ammonia
141
BUN mg/dL Creatinine mg/dL BUN/creatinine ratio elevated creatinine will result in elevated BUN of how much
BUN 6-20mg/dL Creatinine around 1mg/dL 10:1 to 20:1 BUN will be elevated
142
GFR marker made by nucleated cells
cystatin c NOT c peptide
143
end product of purine metabolism from nuclei, allantoin
uric acid
144
The colorimetric method for uric acid is an alkaline oxidation where uric acid reduces...to...
phospho-tungistic acid to tungsten blue
145
phosphotungistic acid used in
uric acid *Acid=uric acid
146
Uric acid NV mg/dL
2.6-7.2
147
Hyperuricemia causes
-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.)
148
Disease where there is over production of uric acid that arent recycled; mostly males 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.)
Lesch-Nyhan
149
Uric acid is measured by... at 290nm before/after treatment with...
UV absorption at 290 before/after treatment with uricase Also use isotope dilution/MS
150
This is from bacterial action on contents of colon and metabolized by liver
ammonia
151
Analyte that is a prognostic indicator of liver failure
ammonia not eliminated by kidneys
152
Increased ammonia in these 3 main reasons
liver disease (cirrhosis, viral hep) impaired renal (increased urea,ammonia) Reye's Syndrome Reye’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.
153
Syndrome that leads to increased ammonia, mostly kids, previous virus, salicylate
Reyes
154
Bromphenol blue or GLDH used to measure
ammonia
155
Nessler used to detect
used to detect ammonina potassium iodide plus mercury iodide/chloride plus sodium hydroxide in water dirty brown precipitate
156
Disaccharide with 2 glucose
maltose
157
Disaccharide with 1 glucose, 1 galactose
lactose
158
disaccharide with 1 glucose, 1 fructose
sucrose
159
monosaccharide with 6 carbons
hexose
160
process that uses glucose for energy, changed to lactic acid for energy
glycolysis
161
process of glucose to glycogen
glycogenesis
162
process of glycogen to glucose
glycogenolysis
163
process of glucose from noncarb sources
gluconeogenesis
164
renal threshold for glucose CSF glucose % of plasma best anticoagulant
160-180mg/dL CSF 60-65% of plasma sodium flouride
165
Diabetes melliutus plasma/OGTT A1C
>200mg/dL >=6.5%
166
Hypoglycemia mg/dL
70mg/dl
167
Hormones that regulate glucose which one decreases? all the rest increase
insulin, only one decreases glucagon: alpha cells Stomatostain: delta cells epineph/cortisol GH, ACTH T3/T4(Thyroxine)
168
hormones made in pancreas: alpha cells/increase or decrease beta cells/increase or decrease delta cells/increase or decrease
alpha: glucagon, increase beta: insulin, decrease delta: stomatostain, increase
169
peptide hormone made in beta cells and decreases blood glucose/goes into cells
insulin
170
steroid hormone that is a glucocorticoid, made in adrenal cortex, and increases blood glucose
cortisol
171
peptide hormone made in alpha cells, increases blood sugar by making glucose from glycogen
glucagon
172
hormone made in delta cells, inhibits secretion of insulin making more glucose in blood
stomatostain
173
hormone that is adrenaline, neurotransmitter and regulates glucose
epinephrine
174
glycogen storage disease increased or decreased glucose
von Gierkes decreased
175
diabetes where glucose is normal
insipidus
176
condition with tumor that results in increased insulin increased or decreased glucose
insulinoma decreased glucose
177
two conditions that increase glucose Thyroid, adrenal cortex
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)
178
most employed automated method for glucose uses what two enzymes where there's oxidation that forms a chromagen contamination can happen with
glucose oxidase, peroxidase contamination with catalase
179
Gold standard for glucose testing/higher specificity... Two enzymes used.... Amount of... is proportional to glucose Is read at...nm
Hexokinase method Hexokinase, G6PD NADH formed is proportional to glucose 340nm
180
hexokinase method: what is reduced and measured? measured at what nm?
NAD coenzyme reduced to NADH measured at 340nm
181
Normal fasting blood glucose
70-110mg/dL
182
Test to confirm prenatal borderline blood glucose
3 hr GTT
183
HmgA1C binds to hmg and monitors long term diabetes/largest fraction of HbA how long of picture of glucose? Normal? Diabetic?
2-3mth Normal 4.0-6.0% Diabetic 6.5%
184
How is the formation of HbA1c related to plasma glucose concentration?
Directly proportional The rate at which a glucose molecule attaches to hemoglobin to form a ketoamine is directly proportional to the glucose concentration in the plasma.
185
Juvenille onset, insulin dependent, autoimmune destruction of beta cells ketoacidosis
Type 1
186
adult onset, non insulin, insulin resistance, no ketoacidosis, obsesity Which of the following is a non-insulin dependent diabetes, is characterized by insulin resistance and progressive hyperglycemia, and is called “adult-onset diabetes”?
Type 2
187
What is a byproduct of insulin and can differentiate between medication/exo insulin and what the body makes/endogenous insulin?
C-peptide not cystatin(kidney)
188
Diabetes caused by placental lactogen inhibiting insulin
GDM gestational diabetes mellitus
189
Measurement of light intensity, chemical rxn forms color and is absorbed at specific wavelenth visible light 400-700, frequency inverse to wavelength, uses quartz cuvette for UV range tungsten or deuterium
spectrophotometry
190
Filter used for QC of spectrophotometer and what it tests
holmium oxide glass filter wavelength accuracy *Glass filter for spectrometry
191
Meaasurement of emission of color when element is burned
flame photometry
192
Measurement of light abosorption of electromagnetic radiation
atomic absorption spectrophotometry Atomic=radiation Absorption Spectrometry=light
193
Atomic absorption measures using what light source also uses monochormator, flame sample cell, PM tube
hollow cathod lamp
194
term that decreases fluorescent intensity of a substance is a disadvantage of...
quenching fluorometry
195
Measurement using electrode, ref electrode, liquid, potential diff between the two equals concentration
ISE
196
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
scattered: nephelometry reduced transmisson: turbidimetry
197
In immunoelectrophoresis there must be excess... and a constant.... ......
excess antibody constant trough distance
198
Used to separate volatile or able to volatile and to confirm toxicology Is a reference for alcohol... This is used to enhance sensitivity and specificity...
gas chromatography MS(mass spectro)
199
Technique w/sorbent coated and solvent screens for drugs/urine Uses Rf value Rf value is...
TLC Thin layer chromatography Rf= drug distance/solvent distance
200
Osmometry based off measures m-Osmol/kg
freezing point depression measure osmolality of urine/serum (dissolved particle in sln) Tubular fnc
201
Hmg-Verdo-hmg Plasma/store: biliverdin-iron-globin Liver: bilirubin-albumin Conjugataed: Bili diglucuronide
...
202
Ehrlich, p-DMAB reagent measures
Urobilinogen Increased in liver damage, hemolytic disease Negative in bile duct obstruction
203
p-DMAB stands for, used in the ...method for...
p-Di-Methyl-Amino- Benzaldehyde Ehrlich method for urobilnogen
204
Color produced with Erlichs reagent w/porphobilinogen and urobilinogen reagent used to distinguish the two
red/pink color chloroform, urobilinogen will be soluble porphobilinogen will be insoluble and stay in aqueous phase
205
Protein that carries unconjugated bilirubin.. Where is bilirubin conjugated... Name of conjugated/direct bili...
albumin carries unconjugated conjugated in liver conjugated is bilirubin diglucuronide
206
Jendrassik-Grof measures uses turns into
bilirubin uses diazo-tized sulfanilic turns into purple, measures green azobilirubin Alkaline tartrate eliminates interference
207
Bilirubin that is seen is not solube, thus not secreted in urine, cause of hemolytic trans rxn, prehaptic jaundice
indirect bili/unconjugated bili
208
Bilirubin that is formed/converted in intestine
urobilinogen
209
bilirubin that is oxidized/green in RE system
biliverdin
210
oxidized form of urobilinogen excreted in urine... stool...
urobilin: urobilinogen goes to kidney; yellow stercobilin: urobilinogen oxidized, brown stool
211
Evelyn Malloy method used for... Interference..
bilirubin hemolysis
212
Jaundice with increasd unconjugated and increased urine urinobilinogen
Prehepatic jaundice
213
Disease where all bili is increased, bili/uro in urine
hepatic
214
condition where unconjugated is normal, decreased uro, but increased conjugated bilirubin in urine
Posthepatic obstruction
215
Have diff/mobility rates due to different aminos/structure Different Electrophoretic property Different rxns Same substrate
Isoenzyme
216
Metals ions in enzymatic reactions act as
activators
217
This contant determines rate of conversion of substrate to product by differing substrate concentrations and rate of dissociation of complex (Enzyme acting on substrate making product)
Michaelis-Menten
218
Order rxn where large excess substrate allows for amt of enzyme activity to be limiting factor when all enzyme is bound to substrate substrate: A reactant in a chemical reaction is called a substrate when acted upon by an enzyme.
zero order
219
LD catalyzes lactate +NAD to... And...
pyruvate + NADH
220
LD isoenzyme that migrates the fastest to anode and highest in heart/rbc (Most negatively charged)
LD1 HHHH
221
LD isoenzyme in healthy, HHHM
LD2
222
LD isoezyme that migrates the slowest (most positively charged)
LD5
223
Increased in LD1,2,3
PA pernicious anemia
224
Enzyme greatly affected by hemolysis because its in all cells
LD
225
CK increased in these 3: stress to muscles
heart attack muscular dystrophy exercise
226
3 CK isoenzymes are dimers Fastest to slowest Brain faster than muscle
CKBB, CKMB, CKMM
227
CK isoenzyme slowest, in skeletal muscle
CKMM
228
CKMB sensitive for AMI rises w/in...down in...
2-4hrs 2-4 days
229
Most sensitive for AMI and two most used... rise/fall...
Troponin TnT,TnI 4-8hrs, 10 days
230
LD rises, days last
rises 8-12hrs, 10-14 days
231
Myoglobin rises, normal
30min, 24hrs
232
condition can't pump, fluids in lungs, cause CAD, BNP to diagnose
CHF
233
Condition were lack of oxygen, ischemia, leads to CHF/angina/heart attack Narrowing of the small blood vessels that supply blood and oxygen to the heart.
CHD Coronary heart disease (CHD) is also called coronary artery disease
234
3 conditions elevated AST 1 not elevated
acute heart liver disease muscular not elevated in acute pancreatitis
235
2 Liver enzymes not affected by hemolysis
ALT, GGT
236
Increased ALP in 3 things in liver
obstruction of biliary tract/jaundice acute viral hep biliary cirosis
237
ALP increased in these 3 bone disorders increased in 1 random
Pagets: overgrowth osteomalacia: soft bones, decreased D/Ca Rickets: Vit d def prego (increased in mom and baby's bones)
238
High ALP but no other liver increased
bone
239
pH for ACP increased in
5.0 acid prostatic disease
240
Enzyme in alcoholics, heptobiliary, obstructive jaundice, cirrhosis
GGT
241
Enzyme in mumps and acute pancreatitits enzyme most specific for pancreatittis
mumps: amylase pancreatitis: lipase
242
Cherry Crandall used to determine... substrate...
lipase olive oil
243
Disease with highest level of aldolase
muscular dystrophy Aldolase is necessary for glycolysis in muscle as a "rapid response" pathway for production of adenosine triphosphate, independent of tissue oxygen.
244
Zollinger-Ellison is a... increased...
gastrinoma gastrin HCl
245
diacetyl monoxime used to determine
BUN
246
phospho-tungistic acid to tungsten blue used to determine
Uric acid
247
most uric acid in plasma is what form... increased in...
monosodium urate gout
248
Kayser-Fleischer
Cooper deposits in cornea
249
To evaluate ionized calcium you need to know these two things and why
pH and protein ionized calcium is pH dependent; ph will increase if CO2 is lost Ca will increase with increased protein
250
things that regulate calcium 2 increase/1 decrease
VitD/PTH: increase Ca -VitD increases GI absorption of Ca -low Ca will stimulate PTH production Calcitonin: decrease Ca -inhibits bone reabsorption
251
Hypocalcemia causes
Tetany (decreased Ca,Mg) VitD def, hypoPTH hypo mag, albumin Normally, 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
hypercalcemia
Vit excess, hyperPTH Malignancy
253
8-hydroxy-quinoline removes... In determination of...
Mg Ca
254
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.
complexometric titration: pH is adjusted to prevent interference from Mg with 8-hydroxy-quinoline removes Mg
255
Method for Ca where its precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate
Clark-Collip precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate
256
Clark-Collip measures... it will be precipitated as...
Calcium oxalate
257
In determining calcium, lanthanum is used to
lanthanum binds phosphate
258
Most phosphorus is in... at pH
bone 7.4
259
Phosphorus is controlled by this and how does it affect it, opposite of Ca
PTH: decreases Pho increases Ca
260
Affect on Phos PTH Calcitonin, Vit D
PTH decreased Pho Calcitonin, Vit D increases phosphate
261
Reagent used for phosphate
molybdate molybdeum blue
262
Hyperparathyroidism= increased PTH, Phosphorus is
decreased
263
Hypoparathyroidism= decreased PTH Phosphorus...
increased
264
Magnesium is controlled by kidney thru tubular reabsorption, what is renal threshold
1.5-2.1mg/dL
265
Treatment for preeclampsia/contractions will result in what lab result to be increased
magnesium hypermagnesemia
266
Condition decreased iron/ferritin/% sat, increased transferrin/TIBC
IDA
267
Reagent for magnesium
titan yellow
268
2 Conditions with increased iron/ferritin/%sat and decreased transferrin/TIBC
sideroblastic and hemocromatosis
269
trace metal involved in melanin, inorganic cofactor, bound to albumin, transported/bound mostly by ceruloplasmin
copper
270
Fat soluble vitamins
A,D,E,K
271
Water soluble vitamins
All B, C
272
Fat soluble Retinol, cause of night blindness
A
273
Fat soluble calciferol, hormone precursor, Rickets
D
274
Fat soluble Tocopherol, antioxidant/immunity Hemolytic anemia
E
275
Fat soluble phylloquinine, for clots hemmorage
K
276
Water soluble B1 condition
thiamin Beriberi
277
water soluble riboflavin
B2
278
water soluble B3, condition
niacin pellegra
279
water soluble pyridoxal
B6
280
water soluble B7
Biotin
281
water soluble B9, condition
folate megaloblastic
282
water soluble cobalamin, condition
B12 PA/IF
283
cause of Scurvy
C
284
Major extracellular cation... NV...
Sodium 135-145
285
Hormone that increases Na reabsorption and acts on distal convoluted tube Released by adrenals
Aldosterone
286
Hypoaldosterone Na Hyperaldosterone Na
Hypo: decreased Na Hyper: increased Na
287
Normal values Na Cl K
Na 135-145 Major extracellular cation Cl 98-106 Major extracellular anion K 3.5-5.0 Major intracellular cation
288
BUN Creatinine
BUN 6-20 Creatinine 0.7-1.5
289
CO2/Bicarb
23-29
290
Na 165 Cl 125 K 3.5
Saline contamination
291
Diabetes mellitus Fasting... Nonfasting... Glucose
126, 200
292
Increased K causes Phleb issues... Tube additive... Condition...
Hemolysis, tourniquet, squeezing EDTA Diabetic 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
Used to enhance sensitivity of ISE electrode for K
Valino-mycin
294
Hypokalemia is less than Hyperkalcemia greater than
Potassium <3.5 >5
295
Chloride shift
Cl is inverse HCO3, when one leaves the other goes in High Cl, low HCO3=metabolic acidosis
296
Causes of increased Cl
IV Dehydration Metabolic/diabetic acidosis (lose HCO3, chloride shift)
297
Low Cl 4 things
Diarrhea, vomiting Renal failure: not reabsorbed metabolic alkalosis: excess bicarb, less CO2
298
Chloride measured with titration methods such as C.A. and S.S. C.A. is... S.S. is...
Coulometric amperometric Schales-Schales
299
Coulometric amperometric method uses a... Method It's is the... Analyte measured...
Titration Time needed to get to end pt Chloride
300
Schales-Schales is what kind of method... For... Violet color formed from reaction with...
Mercurimetric titration Chloride Excess Hg++
301
C-A and S-S are both these kind of reactions...for...
Titration Chloride
302
Most CO2 in blood is
Bicarb
303
Specimen Least ordered, not used for CO2
Urine
304
Anion Gap, NV
Na+K-(Cl+HCO3) 10-20
305
Increased anion Gap
Diabetic ketoacidosis Lactic acidosis Salicylate Methanol Ethanol Poly glycol Unmeasured
306
Decreased anion Gap used as, due to
Analytical QC Analyzer error
307
Glass, Ag/AgCl, measures H for measurement of
pH
308
Platinum+Ag/AgCl, amperometric measures
pO2
309
Henderson Hasselbalch
pH= pKa + log [salt]|[acid] [A base]|[HA acid] pH=log HCO3/pCO2 pH=log kidney/lungs pH=log metabolic/respiratory
310
Bicarb: carbonic acid ratio in plasma
20:1
311
Acidosis Normal Alkalosis
<7.38 7.35-7.45, around 7.4 >7.42
312
Metabolic acidosis: pH, HCO3 levels compensation
Decreased pH, HCO3 Lung: Hyperventilating releases CO2
313
Metabolic alkalosis 2 parameters influenced, compensation
Increased pH, HCO3 Lung: Hypoventilation increases CO2
314
Respiratory acidosis 2 parameters, compensation
Decreased pH, Increased CO2 Kidneys: increase bicarb
315
Respiratory alkalosis 2 parameters, compensation
Increased pH, decreased pCO2 Kidneys compensate
316
Beer-Lambert law
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
Synovial: joints, hyaluronic acid makes viscous, obtain by arthrocentesis 2 Synovial crystals/conditions
Uric acid: gout Pyro-phosphate: pseudogout
318
Amniotic fluid: access neural tube defects/AFP 4 Fetal lung tests...
L/S: >2 PG FLM 2 Lamellar
319
Sweat: Analyte Condition, death cause
Cl Cystic fibrosis, pneumonia
320
Sperm: mL, live%, motility %, #/mL
2-5mL >75% alive >50% motility # 20-250 million/mL
321
Decreased CSF glucose seen in Increased CSF glucose seen in
Decreased CSF glucose: Bacterial meningitis Increased CSF glucose: Diabetes
322
CSF tube order/department
1 chem 2 micro 3 heme
323
CSF protein mg/dL
15-45
324
CSF glucose
60-70% plasma
325
CSF diff
70% lymph 30% mono
326
4 causes of increased CSF Protein
Meningitis Intracranial hemorrhage Traumatic tap MS
327
Decreased CSF TP seen in
Leak, tear
328
Increased CSF IgG index and oligoclonal banding seen in...
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
Urine ph normal... If left at rt becomes..
normal 6.0 (4.5-8) alkaline at RT
330
Normal urine volume: poly> olig < noc anuria
1200-1500 poly >2500 olig<500 noc: more at night anuria: none
331
left at RT, what decreases... increases... False pos...
decreases: glucose/ketones bili/uro cells/casts increases: nitrites/bacteria turbidity(bacteria) pH(amm) False pos: protein
332
3 things kidneys make 2 hormones that influence kidney
renin, erythropoeitin, PG aldosterone, ADH
333
Urine is made of 7 things
95% water urea, uric acid, creatinine Cl/Na/K
334
Urine RBCs color
smoky, red/brown urine
335
Urine bili/pyridum color
dark yellow/amber/orange Phenazopyridine (Pyridium) is a dye that's a red-orange color
336
Met/Hmg and homogentistic acid urine color
brown black upon standing
337
Reabsorbs H2O only... Rebabsorbs solutes only...
H2O only Descening Loop solutes only ascending loop
338
Specific gravity NV... increased in these 3 decreased in this
1.003-1.030 increased in: -renal damage(isotheniuria 1.010) -diabetes mellitus -xray decreased in diabetes insipidus
339
3 methods to determine sg
refractometer reagent strip harmonic oscillation: densitometry; current helps measure sg
340
Urine strip protein method name... ph...and can leach to the pH strip and ...the pH what protein it binds to... color... confirm with...
protein error of indicators 3.0 and can leach to the pH strip and lower the pH albumin sulf. acid precipitation
341
How many neprons per kidney.... filtration ml/min
1 million 90-120mL/min
342
Protein of indicators on dipstick description... has nothing to do with... not affected by... What will cause false pos...
Most of the indicator is non-ionized. The protein will combine with the non-ionized form and will change the ratio of ionized and nonionized Has nothing to do with pH and not affected by bence jones False pos due to alkaline/buffered urine
343
Renal threshold for glucose dipstick measures only glucose two enzymes in rxn
160-180mg/dL glucose oxidase, perioxidase
344
Clinitest/Benedicts is a... ...method for... Can screen for... but reacts with... False neg with these two...
copper reduction method for glucose screen for galctosemia reacts with all reducing substances false neg with Vit C and pass thru
345
Occult blood on urine dipstick depends on
perioxidase activity of rbc/hmg
346
Nitrite: bacteria type... 2 names for rxn:
GNR (E.coli) Diazo, Griess rxn
347
RBC dipstick: false neg with one vitamin and mistaken with 3 things... false pos...
false neg: vitC yeast, oil, calcium oxalate crystals false pos: oxidizing like bleach
348
UTI, renal calculi, acute glomerulonephritis you'll see these cells
RBCs
349
reagent for LE, color
diazo reagent, purple
350
Cell related to glitter cell, UTI/pyelonephritis... type seen in UTI...
white neutrophils
351
Seen in diabetes mellitus, breakdown of lipids... reagent... color... confirm with...
ketones sodium nitroprusside purple Acetest (Acetoacetic/diacetic acid, acetone)
352
Sodium nitroprusside used in determination of...on dipstick
ketones
353
Acetest is used to confirm... detects these two..
confirm ketones diacetic acid, acetone False pos: highly pigmented, levadopa
354
Ictotest, Diazo rxn used for
Bilirubin VitC false neg Bike duct obstructions, liver, ciirhosis
355
Reagent used in Erlich
p-DMAB
356
Erlich, p-DMAB used in
Urobili
357
Leukocyte in DILUTE HYPOTONIC urine where granules appear to move/Brownian Mvt
glitter cell
358
Large epithelial seen in catherterization, renal pelvis, ureter, bladder
transitional
359
Cell seen in tubular necrosis, renal tubles, oval fat bodies are made from
renal tubular
360
glycoprotein made from TRE that makes up casts (two names)
Tamm horsfall mucoprotein Uromodulin
361
Cast are formed in what part of tubules
distal convoluted tubule
362
Casts seen in chronic renal disease, urinary stasis
waxy
363
cast seen in stress/exercise, normal
hyaline
364
cast seen in nephron/acute glomerulonephritis
RBC
365
Cast from dialated collecting ducts
broad
366
cast seen in acute glomerulonephritis and is decomposition of cellular
granular
367
cast from break down of epi casts/oval fat bodies, nephrotic syndrome
fatty
368
cell in pyleonephritis
wbc
369
4 urine parasites
T.vag E.vermiculares (bread loaf ova) strongy S.haematobium
370
5 abnormal crystals
Cysteine: 6 sides Leucine: concentric circles Tyrosine: needles Bili: yellow/brown needles Cholesterol: notched plates
371
3 normal crystals in acidic urine
Uric acid: rhomboid/pleomorphic amorphouse urates: pink sediment Calcium oxalate: envelope/oval/dumbell, *monohydrate form in antifreeze
372
4 normal crystals in alkaline urine
amorphous phosphates triople phosphate: coffin lid calcium carbonate: dumbell amm. biurate: thorny apple
373
NV for... 50-200 mg/24hr
microalbumin
374
AAT globulin
Alpha-1-antitrypsin Alpha1 globulin inhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.
375
Tangier low in
HDL
376
Colorimetric method for BUN measures...uses... Enzymatic method for BUN measures...uses... Which one can be used for untreated urine, why
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
Hexokinase Glucose method reduces this coenzyme... To... At...nm
NAD coenzyme is reduced to NADH and measured at 340nm
378
diazo rxn/Jendrassik-Grof
Bilirubin
379
Jendrassik-Grof and Evelyn Malloy measure
Bilirubin
380
Jendrassik-Grof= Bilirubin+Diazo (caffeine)=azobili
Jendrassik-Grof= Bilirubin+Diazo (caffeine)=azobili
381
Evelyn Malloy method uses...as an accelerator Jendrassik-Grof uses...as an accelerator Measures...
Evelyn Malloy method uses methanol as an accelerator Jendrassik-Grof uses caffeine benzoate acetate as an accelerator bilirubin
382
LD1 HHHH Fastest, marker for these two
heart/rbc
383
sideroblastic and hemocromatosis Iron,ferritin,%sat, transferrin/tibc high or low
increased iron/ferritin/%sat decreased transferrin/TIBC Sideroblastic 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
Pyrophosphate seen in
pseudogout
385
Porter-Silber reaction uses phenylhydrazine to detect... Zimmerman reaction detects...
PS=phenylhydrazine= corticosteroids Zimm= 17-KS/17-ketosteroids
386
Phenlyhydrazine used to detect corticosteroids in what reaction
PS=Porter-Silber
387
17-ketosteroids/17-KS is detected in what reaction... Is a metabolite of...
Zimmerman Zimmerman is a man that takes 17-KS/steroids metabolite of androgens
388
Porter and Zimmerman take steroids
...
389
Hypothalmus makes releasing/inhibiting hormones that act on the pituitary Pituitary then makes hormones that have their effects on organs that make the end product/action
...
390
Primary caussed by... secondary caused by... tertiary caused by...
Primary...end organ Secondary:pituitary Tertiary: Hypothalamus
391
Increased GH causes these two things kids versus adults Decreased GH causes
kids: giantism adults: acromegaly dwarfism
392
Hormone that solely initiates and maintains lactation
prolactin
393
increased prolactin cause of these two
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
menstral disorder and inadequate lactation due to
decreased prolactin
395
Vasopression is also called
antidiuretic hormone
396
ADH acts on...to increase... decreased in...
acts on renal tubles to increase water reabsorption diabetes insipidus
397
Hormone that stimulates urterine contraction/myoepithelial cells in breast thus ejecting milk
oxytocin
398
Hormone that forms male sex characteristics, spermatogensis, facial hair, deep voice, sex drive
testosterone
399
Testosterone is made from...
cholesterol (as is a lot of steriods)
400
hormones that stimulate sex organ development, linear growth, epiphyseal fusion
androgens
401
infertility men/women polycystic ovarian due to adrenal hyperplasia: A group of genetic conditions limiting hormone production in the adrenal glands.
hypertestosteronemia
402
hypogonadism due to
hypotestosteronemia
403
TRH, GRH, CRH GHRH PIF, GHIH released by
hypothalamus
404
GH, PRL, TSH, LH, FSH, ACTH released by the ... ...
anterior pituitary
405
ADH, oxytocin released by
posterior pituitary
406
Hormone that induces ovulation, prmotes ovary secretion of estrogens/progesterone for possible pregnancy and stimulates testes to produce testosterone
Luteinizing hormone
407
GnRH, gonadotropin-releasing hormone stimulates this organ to produceb these 2 hormones... which affects these two organs
GnRH stimulates pituitary to make LH and FSH to affect ovaries or testes
408
GHIH is also called
Somatostatin
409
GHIH/Somatostatin GHRH: growth hormone-releasing hormone
Somatostatin from the hypothalamus inhibits the pituitary gland's secretion of growth hormone and thyroid stimulating hormone. GHRH: growth hormone-releasing hormone
410
Somatostatin inhibits the pituitary gland’s secretion of...and...
Somatostatin from the hypothalamus inhibits the pituitary gland’s secretion of GH and TSH
411
FSH stimulates, secretion of females: males:
females: egg development, estrogen males: sperm, testosterone
412
hypothalmus makes CRH, Corticotrophin-releasing hormone that act on pituitary to make ACTH, Adrenocorticotropic hormone this stimulates the adrenal cortex to make steroid hormones made from cholesterol 3 steroids made in adrenal cortex...
mineralcoritcoids(aldosterone) glucocorticoids(cortisol) sex hormones (androgens, estrogens)
413
What converts angiotensinogen to angiotensin I which converts to II and stimulates cortex to make aldosterone
Renin
414
hormone that induces secretion of glucorticoids(cortisol) of adrenal cortex
ACTH adreno-cortiotropic hormone
415
CRH stimulates the...to make... which causes... to release cortisol, aldoseterone, estrogens and testosterone
CRH stimulates the pituitary to make ACTH causing the adrenal cortex to make cortisol, aldosterone, estrogens/testosterone
416
Mineralocorticoids, glucorticoids, and androgens released by
adrenal cortex
417
aldosterone is an example of a... maintains...and... by retaining...and... and excreting...
mineralocorticoid maintains H2O and electrolytes by retaining water and Na and excreting K
418
Cortisol is a type of
glucocorticoid
419
Hyperadolsoterone, increased Na, decreased K, hypertension
Conns Disease
420
Conns Disease has increased...and thus increased... decreased... leading to....due to increased...
has increased aldosterone and thus increased Na Decreased K leading to hypertenstion due to increased fluid retention
421
Hypoaldosterone, decreased Na/Cl, decreased cortisol everything down
Addisons Disease
422
Increased cortisol, increased glucose, increased Na buffalo hump
Cushings everything up
423
Testosterone is a type of
androgen male sex hormone
424
metabolite of androgen... reaction used to detect...
17-ketosteroid, 17-KS Zimmerman reaction
425
3 types of catecholamines purpose
epineph norepi dopamine These hormones are released into the body in response to physical or emotional stress. 
426
Two GI hormones
Gastrin serotonin
427
Hormone increased in Zollinger Ellison syndrome
gastrin
428
Hormone made in GI, vascoconstricter of PLTs/brain/tissue
serotonin
429
5HIAA is a urinary metabolite of... increased in chromaffin cell tumors of GI, drugs, bananas, pineapples etc
serotonin
430
Catecholamines produced in...by...
adrenal medulla by chromaffin cells
431
Metabolites of epineph
metanephrine, VMA
432
Metabolites of norepineph
normetaneph,VMA
433
Metabolites of dopamine
HVA
434
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 headache with increased...
VMA
435
Pheochromocytoma is a small vascular tumor of the adrenal medulla, causing irregular secretion of...and... metabolite is...
epinephrine and norepinephrine VMA
436
Neuroblastoma is a childhood cancer that starts in immature nerve cells (neuroblasts) with increased...
HVA
437
Most of the releasing and inhibiting hormones (except for ACTH) are producted by the...
hypothalamus
438
Thyroid hormones: stimulate metabolic processes In tissues...is coverted to.... 99.97% of...is bound to mosntly TBG, some TB-PA, albumin 99.5% of....is also bound
In tissues T4 is converted to T3 99.97% of T4 is bound to TBG 99.5% of T3 is bound
439
TSH stimulates the ... to make these two
thyroid, T3/T4
440
3 things hormones made by thyroid
thyroxine/T4, triiodothyronine/T3 calcitonin
441
Thyroxine/T4 and Triiodothyronine/T3 increases... Calcitonin increases...
Thyroxine, Triiodothyronine: metabolism Calcitonin: Ca reabsorbtion
442
3 calcitropic hormones
PTH, VitD, calcitonin
443
Low PTH lowers these two... increases this...
Lowers serum Ca, D Increases Phos
444
TRH stimulates pituitary to release... which acts on...
TSH, acts on thyroid
445
TSH stimulates thyroid to make...
T3,T4
446
Free... stimulate negative feedback loop and inhibit secretion of...
Free T3/4 inhibit TSH
447
primary Hyperparathyroidism also called... symptoms
Graves weight loss, heat, hair loss, anxious
448
Graves is hyper or hypo... T3/T4 levels... TSH levels... thyroid overproduces... due to... ...
hyper: T3/T4 decreased TSH to stop production of T3/T4 Primary means thyroid overproduces T3/T4 due to TSH antibodies
449
Primary Hypothyroidism is called... symptoms
Hashimotos weight gain, tired, cold
450
Hashimotos is hyper or hypo... T3/T4 levels... TSH levels... due to... ...
hypo: T3/T4 increased TSH to decreased T3/T4 levels Thyroid autoab
451
Major binding protein for thyroxine/T4 How is it measured
TBG thyroid binding globulin By measuring T3 uptake (amount of TBG bound to thyroid hormones)
452
3 good indicators for hypothyroidism 1 not good indicator
FT4, TT4, s-TSH (singles best) Most is T4 not T3 not good T3 uptake (indirect, not used)
453
Ovaries productes these two hormones
estrogen, estadiol
454
hormone female sex charac, hyper=amenorrhea, hypo=menopause
Estrogen
455
hormone that's active form of estrogen, evaluates fetoplacental function
estadiol
456
Progesterone made by the... ... ... and then by the...in pregnancy
ovarian corpus luteum and then placenta in pregnancy Progesterone 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
prepares uterus for prego, maintains endometrium lining, inhibits uterine contractions, prepares breasts for lactation
progesterone
458
progesterone levels perimenopause postmenopause
peri: increased progesterone post:decreased progesterone
459
What hormone maintains progesterone in early pregnancy
HCG
460
HCG increased/decreased...
increased: prego, mutiple pregos, tumors decreased: spontaneous abortion
461
HCG subunits are...
alpha, beta subunits NON-covalently bound subunits NONidentical
462
subunit that cross reacts with LH,FSH,TSh
alpha
463
subunit that has analytical specificity
beta
464
Trimester with highest level of HCG... When does it show up, how long does it last...
first seen in days, peaks 2-3mths
465
Toxicology, best specimen for screening/qualitative, best for quantitative
Urine-QL Blood-QNT
466
Creatitinine, pH, or oxidizing activity, dilute/substituted/adultered as a measure of
validity
467
Major disadvantage of immunoassay drug detection... best 2 ways to confirm for drugs that have positive screens...
Immunoassays can't simultaneously assay multiple drugs in one specimen gas chromatography/MS
468
Aminoglycosides and Glycoprotein are two kinds of
antibiotics
469
Kind of Glycoprotein/antibiotic that inhibits.. ..synthesis of gram...
Vancomycin inhibit cell wall synthesis, treat gp
470
gentami/tobramy/amika/kana-cin are all... they inhibit... ... of gram...
aminoglycosides inhibit protein synthesis, treat gn
471
Monitor toxic range of antibiotics to prevent damage to...and...
hearing/ototoxic kidneys/nephrotoxic
472
Phenobarbital, phenytoin/dilantin Valproic acid, Carbamazepine ethosuximide are all
anti-epileptic/anti-convulsants
473
Bronchodialator asthma, IV/oral, 10-20ug/mL, toxic >20ug
Theophylline active metabolite in neotates is caffeine, also caffeine given as a brochodilator
474
Cyclosporine, Tacrolimus, Sirolimus,MPA all are
immunosuppressive
475
Methotrexate are all
antineoplastics/antitumor
476
Cyanide, arsenic, mercury all are
heavy metals
477
Substances/acute poisoning
acetaminophen-liver damage salicylates alcohols-ethanol,isopro,glycol cyanide carbon monoxide(carboxyhmg 200x infinity) organophosphates/pesticide: -CNS, decrease cholinesterase
478
Must wait until...to TDM how many half lives to reach... how many half lives to clear... metabolized by liver, excreted in urine
steady state 5.5
479
Specimen drawn imme before next dose is called... Peaks drawn...hrs
Trough 1-2hrs after oral dose
480
AID: Amtriphtyline, Imipramine, Doxepin Lithium are all
pyschotropics
481
Amtriphtyline, Imipramine, Doxepin are all
tricyclics
482
Digoxin, Quinidine, Procainamide, Disopyramide, Lidocaine all are
Antiarrythmics/cardiactive
483
Increased alpha 2 in these two
Acute inflammation nephrotic syndrome
484
Tetany decreased in these two
Ca,Mg
485
LD 4,5 related to
Liver disease
486
Elevation in LD1/LD2 in a flipped pattern is related to
Myocardial infarction
487
Increased total serum LD 4,5 related to
Acute viral hepatitis
488
Increased LD 1,2 related to
Hemolytic anemia
489
Gilbert, Crigler-Najjar and Dubin-Johnson syndromes all are issues with what analyte
Billirubin
490
Syndrome that's genetic liver disease, reduced glucuronyl transferase, thus increased bili
Gilbert syndrome
491
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
Crigler-Najjar Syndrome Complete:Type 1 Decreased: Type 2
492
Syndrome that's genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion
Dubin-Johnson syndrome
493
Dubin-Johnson syndrome
Syndrome that’s genetic with defect in bilirubin transport across membrane, leads to dark pigment, porphyrin excretion
494
2 Hepatitis fecal, oral
A, E
495
3 Recent Hep B infection markers
HBsAg,HBeAg Anti-HBc IgM
496
DNA hep, with a core and envelope BF, sex, IV drug
Hep B B=body fluids
497
RNA, blood-to-blood contact: blood transfusion, needles, no vaccine Development of cirrhosis
Hep c C=cirrosis
498
Hep that needs HBV, coinfection
Hep D
499
Tetany caused by these two
(decreased Ca,Mg)
500
2 Sex hormones... Type of... Made in...
Androgen: testestosterone Estrogen: estradiol Steroid Made in adrenal cortex
501
Electrode w/silver chloride anode, platinum wire cathode suspended in KCl w/a permeable membrane measures
PO2
502
H+ concentration (pH) has what kind of electrode
glass
503
An electrochemical tecnique used to measure the amount of electricity passing between 2 electrodes in and electrochemical cell. Quantity of amount of electricity directly proportional to the chemical reaction at the electrode.
Coulometry
504
Coulometry is an automated method that generates silver ions and often is used to measure..in...
chloride in sweat C=chloride, Coulometry
505
Application of coulometry is titration of...with silver ions generated by electrolysis from a silver wire at the anode
titration of chloride
506
glass electrode reference electrode specimen put in a capillary tube surrounded by buffer solution the tube is made of ... sensitive glass across which a potential difference is generated, which is proportional to the...
pH
507
PO2 electrode is uses this principle where theres measurement of a electrical current at a constant voltage or potential
amperometry
508
Clark electrode or polargraphic electrode ....molecules diffuse across a plastic membrane to small platinum or gold 2nm diameter wire cathode in a glass rod immersed in a phosphate buffer with KCl ...is reduced and this creates current flow between the cathode and silver/silver chloride anode. increasing the voltage increases the current up to a plateau determined by the rate of supply of ...molecules & proportional to the concentration.
PO2 measurement
509
A self contained potentiometric electrode measures.... ...gas from the sample diffuses thru the selective membrane and dissolves in the internal electrolyte layer. Carbonic acid is formed and dissociates, shifting ph
PCO2 CO2 gas
510
modified glass electrode comprises of a glass pH electrode that is permeable to... ...diffuses from the specimen into the ...solution where it dissociates with a change in pH which is measured by the electrode potential difference is proportional to concentration
PCO2 HCO3
511
Glucose method that is glucoses specific colorimetric method
glucose oxidase
512
In the hexokinase method for glucose, what is the end product measured
NADH from the reduction of NAD
513
Procedure for calcium that uses lanthanum chloride to eliminate interfering substance... what substance does it bind to...
...atomic absorption spectrophometry ...Binds to phosphate AAS measures calcium by detecting its atomic absorption by electromagnetic radiation. Atomic absorption spectrometry (AAS) detects elements in either liquid or solid samples through the application of characteristic wavelengths of electromagnetic radiation from a light source. Individual elements will absorb wavelengths differently, and these absorbances are measured against standards. ... Phosphates present can complex with calcium. Addition of lanthanum chloride competes for the phosphate and prevents interference with calcium
514
Both Malloy Evelyn and Jendrassik-Grof measure... which determines...
measures azobilirubin determines bilirubin
515
Coenzyme and reduced used in LD reaction
NAD/NADH
516
Increased LD4,5 in these two
liver and skeletal musdscle
517
increased LD3 in
pulmonary edema
518
Steady state theurapeutic drug achieved between... and...doses
4-7
519
Benzoylecgonine is a metabolite of what drug
cocaine
520
Pheytoin is also called... is what kind of drug...
Dilantin anticonvulsant
521
IU is amt of enzyme that would convert...of substrate per min 1 IU=
1micro mol 1IU=micro mol/min
522
Fraction increased in biliary cirrhosis
gamma elevated gamma w/beta gamma bridging due to increased IgA
523
Fraction increased due to nephrotic syndrome
Alpha2 globulin loss of albumin, increased alpha 2 is compensatory
524
Lack of alpha1 globulin due to these two
alpha1 AT def servere emphysema Emphysema is caused by the protease-antiprotease imbalance when smoking-induced release of neutrophil elastase in the lung is inadequately inhibited by the deficient levels of AAT, the major inhibitor of neutrophil elastase.
525
Electrophoretic pattern of plasma will show a
sharp fibrinogen peak
526
Slight increase in alpha 2 and decrease albumin due to
acute inflammation, acute phase reactants
527
Broad increase in gamma electrophoresis due to...
polyclonal gammopathy/chronic inflammation
528
Condition with decreased activity of glucuronyl transferase leading to increased unconjugated bili/kernicterus in neonates
Crigler Najjar Syndrome
529
Immunosuppressants T, C, S, M
Tacro, Cyclo, Siro, Myco
530
Tricyclics AID
Amt, Imi,Dox
531
Antiarrhythmic Digoxin -dine, -amide, -caine
...
532
High alpha 2 only
Acute inflammation
533
High alpha 2/gamma ratio
Nephrotic syndrome
534
High alpha 1&2 with low albumin
Malignant tumor
535
High gamma with low albumin
Viral hepatitis
536
Beta game bridge, broad gamma
Active cirrosis/liver
537
From anode, migration of serum proteins... Percentages...
Albumin, alpha1, alpha2, beta, gamma 65, 2, 8, 10, 15
538
Alpha1 globulins
Alpha1 antitrypsin, AAT Alpha1 glycoprotein Alpha liprotein AFP
539
Alpha 2 globulins
Alpha2 macroglobulin Haptoglobin Ceruplasmin
540
Beta globulins
Beta2 microglobulin Beta lipoprotein Transferrin Hemoplexin Complement Fibrinogen CRP
541
Acute phase reactant, binds hmg... Increased in... Decreased in these 3...
Haptoglobin Increased in inflammation Decreased in HA hemolytic transfusion reaction Hemolytic disease of newborn (Lots of loose hmg needs to be picked up)
542
2 alpha2 globulins that are acute phase reactants, increase with inflammation
Haptoglobin Ceruplasmin
543
Ceruplasmin will be... When there's excess storage of copper Seen in...
Decreased Wilson's
544
Ceruplasmin will be... When there's decreased absorption of copper... Seen in...
Decreased... Menkes
545
GLDH, coupled enzyme rxn for...
Urea, BUN
546
In GLDH for urea, what is formed at end
NAD
547
Conductimetric uses gold electrode to measure...
Urea
548
What is measured in conductimetric method for urea...
NH4 conductivity
549
Ref method for creatinine and uric acid
Isotope dilution M/S
550
-ISE, pH -Spectro/blue dye -enzyme: GLDH Used for
Ammonia
551
Most common ammonia method used
GLDH Enzymatic
552
Fluorescein isothiocyanate and Phycoeryrhrin are...
Two fluorochromes in fluorescent immunoassay
553
Method where there's absorption of one wavelength and emission of a longer, lower one
Fluorometry
554
Luminol and acridinium esters are used in this method
Chemiluminescent
555
Method where light is made from chemical reaction; Rapid increase in intensity of emitted light followed by gradual decayb to ground state with emission of photons
Chemiluminescent
556
Labeled antigen is called a...in radio immunoassays
Tracer The basic principle of radioimmunoassay is competitive binding, where a radioactive antigen ("tracer") competes with a non-radioactive antigen for a fixed number of antibody or receptor binding sites.
557
Cintillation counter and gamma counter are used in
Radio immunoassays
558
Isotopes used in radio immunoassays
3^H, 125^I
559
Enzymes used in immunoassays increase...
Analytical specificity
560
The pCO2 electrode is a...electrode but... doesn't affect sample. Electrode measures... ...
pH electrode measures dissolved CO2
561
Method that measures light adsorption of electromagnetic radiation by atoms
Atomic adsorption spectrometry
562
Hollow cathode lamp is light source for
AAS Atomic adsorption spectrometry
563
Measures coulombs needed for a reaction Analytical technique that measures the amount of electricity (in coulombs) required to fully react with a sample.
Coulometry
564
Measures current at a single potential Detection of ions in a solution based on electric current or changes in electric current.
Amperometry A=alone
565
Measures current flow of solution as a function of an applied voltage an electromechanical technique of analyzing solutions that measures the current flowing between two electrodes in the solution as well as the gradually increasing applied voltage to determine respectively the concentration of a solute and its nature
Polarography
566
Chromatography that uses Rf value to id drugs of abuse
Thin layer chromatography, TLC
567
Rf in TLC is the ... Of the... Over the ...of the...
Distance of drug over Distance of solvent
568
Chromatography that consists of a stationary phase in LC (liquid) of small diameter particles
High performance liquid chromatography
569
Chromatography that's a ref method for alcohol, drugs of abuse
Gas chromatography
570
What enzyme increased at RT
ALP
571
3 enzymes not affected by hemolysis
ALT, GGT Amylase
572
Peptide used to diagnose CHF... Common causes of CHF...
BNP, Btype natriuretic peptide CAD
573
Hyperparathyroidism, antacids, dextrose sln all... phosphorus
Decrease
574
Hypoparathyroidism and renal failure can... phosphorus
Increase
575
Final site urine concentration
Collecting duct
576
Sg seen in severe renal damage
1.010 Isothenuria
577
Oval fat bodies: highly refractile RTE w/fat Form... Seen in...
Maltese cross Nephrotic syndrome
578
Crystal seen in renal calculi and ethylene glycol poisoning
Calcium oxalate
579
... Protein is a form of transferrin present in csf
Tau protein
580
Lipoprotein Origin/cathode to anode:
Chylo, beta, pre beta, alpha
581
5'NT Nucleotidase is in.. But not...
In liver but not bone
582
Decreased cholinesterase seen in
Organophosphate/pestiside poisoning
583
Major anion of extra cellular
Cl
584
HCO3 NV versus pCO2 NV
HCO3 22-26 pCO2 35-45
585
pO2 NV
85-105
586
Alkaline urine gives... ... With protein
Falsely positive
587
Water soluble... Fat soluble...
Water: B, C -pee out Fat: ADEK -risk of toxicity
588
Homocystinuria maple syrup disease Phenylketonuria, PKU Alkaptonuria All are amino acid... Two that aren't are...
Deficiencies Two that aren't are are Cystinuria, Tyrosinemia
589
LDL % carrries most of the lipids 60-70 HDL % carries lipid 20-35 VLDL % carries the least lipid 5-12%
...
590
Glu-glu: mal Glu-galac: lac Glu-fruc: sucr
...
591
Holmium oxide glass filter... Hollow cathod lamp....
Holmium oxide glass filter... Spectrometer wavelength accuracy Hollow cathod lamp.... Atomic adsorption
592
Both measure... Jendrassik-Grof uses, turns into... Evelyn Malloy method affected by...
Bilirubin Jendrassik-Grof measures: uses diazo-tized sulfanilic turns into purple azobilirubin Evelyn Malloy method affected by hemolysis
593
Calcium: titration complexometric: titration interference from Mg, 8-hydroxy-quinoline removes Mg Clark-Collip: precipitated as CALCIUM OXALATE and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate lanthanum: binds PHOSPHATE so it doesn't interfere with calcium
594
Cl NV... CO2/bicarb...
Cl 98-106 Major extracellular anion CO2/bicarb 23-29
595
Lose Cl thru Diarrhea, vomiting and loss thru Renal failure, not reabsorbed Increased in metabolic acidosis
...
596
Lipid carried: LDL carries %... HDL carries %... VLDL carries %...
LDL carries %... 60-70 -carries the most lipids HDL carries %... 20-35 VLDL carries %... 5-12
597
Method for cholesterol: cholesterol oxidase -purpose of saponification step is to convert cholesterol esters to free cholesterol Liebermann Burchard reaction: -2 reagents used for color developemnt: acetic anhydride sulfuric acid Lieberman has cholesterol and goes to a.a. and s.a.
...
598
Uric acid: 2.6-7.2 mg/dL The colorimetric method: -is an alkaline oxidation where uric acid reduces phospho-tungistic acid to tungsten blue Uricase/enzymatic: -UV absorption at 290 before/after treatment with uricase
599
Ammonia: Bromphenol blue or GLDH used to measure Nessler
...
600
Bilirubin: Jendrassik-Grof: uses diazo-tized sulfanilic, turns into purple azobilirubin Evelyn Malloy: Watch for hemolysis
601
Calcium: Titrant is added until the reaction is complete. To be suitable for determination, the end of the titration reaction must be easily observable complexometric titration: *pH is adjusted to prevent interference from *Mg with 8-hydroxy-quinoline removes Mg Clark-Collip: -precipitated as Ca oxalate and converted to oxalic acid w/sulfuric acid and measured by titration against K permanganate *lanthanum binds *phosphate
calcium: pH, Mg CC, oxalate Lanthanum, phosphate
602
Chloride measured with titration methods such as C.A. and S.S. Titrant is added until the reaction is complete. To be suitable for determination, the end of the titration reaction must be easily observable Coulometric amperometric: time -Titration -Time needed to get to end pt Schales-Schales: excess Hg -Mercurimetric titration -Violet color formed from reaction with excess Hg++
...
603
Migration of lipoproteins from cathode(-) to anode (+)...
Chylo, beta, pre beta, alpha Named in order from anode to cathode... +Alpha, pre beta, beta, chylo -Chylo slowest, HDL fastest -Pre beta before beta
604
Bicarb NV
HCO3 22-26
605
Which of the following determinations is used to assess the total body lead poisoning burden?
Whole blood lead Whole blood lead levels are the most commonly used biomarker of human lead exposure. In lead poisoning, impaired iron delivery or utilization within the mitochondrion has the similar effect of increasing erythrocyte zinc protoporphyrin.
606
Which analyte rises first in response to inflammation? Associated with this disease...
C-reactive protein, or CRP, is one of the first acute-phase proteins to increase as a result of inflammation. Increase in serum of CRP concentrations is associated with a risk of future CHD events.
607
Which of the following instruments ionizes the target molecule then separates and measures the mass-to-charge ratio?
Mass spectrometer Mass spectrometer instruments measure mass-to-charge ratios rather than molecular mass but are referred to as mass spectroscopy.
608
In a developing embryo, which type of deficiency can lead to death or severe neurological birth defects?
Folate A folate deficiency in a developing embryo can lead to death or severe neurological birth defects. Folate and single-carbon metabolism are imperative to both cell growth and division.
609
What are the two most common aminotransferases measured in the clinical laboratory?
AST,ALT
610
SSA stands for... used for...
Sulfosalicylic acid Proteins are precipitated by 5-sulphosalicylic acid. Any resulting turbidity will give an estimation of the amount of protein present in the urine which can be subjectively quantitated visually or more precisely quantitated using photometry. Cells and casts in the urine must be removed by centrifuging before carrying out the test. The test can detect albumin, hemoglobin, myoglobin, and Bence Jones proteins.
611
A refractometer is an instrument that measures how light bends as it passes through a sample. The degree to which a sample bends light is correlated to the number and size of solute particles. When a refractometer tests a urine sample, it measures the specific gravity of the urine. The urine's specific gravity indicates the kidneys’ ability to balance water content and excrete waste. Typical values range between 1.005 to 1.030. A low specific gravity suggests an inability to concentrate urine, excessive hydration, or diabetes insipidus. A high specific gravity could indicate dehydration or diabetes mellitus.
pass thru refractometer
612
A screening test for diagnosing intermittent porphyria, although it might also become positive in porphyria cutanea tarda (a skin form of porphyria). In this method, porphobilinogen is detected by a color reaction with Ehrlich reagent and confirming that the color is not removed by chloroform. As the test is just a screening test, it usually is confirmed by a more specific test such as a Hoesch test.
Watson-Schwartz differentiation test
613
Test that is a colorimetric screening for porphobiloinogen in urine. More sensitive and specific. Color directly relates to amount. Inverse Erlich reaction: volume of urine to reagent reversed, acidity prevents urobilinogen from reacting. Positive is pink at interface
Hoesch test
614
PH urine
4.5-8.0
615
Amount of urine.. normal: anuria: oliguria: polyuria:
normal: 1200-1500ml anuria: none oliguria: <400 polyuria: >2500
616
3 urine substances false positive with bleach
Glucose, blood, WBC
617
Alkaline urine: False pos in, false neg in
False pos protein False neg SG
618
Highly pigmented/Medication color false pos is urine 4 substances
Ketones, nitrite urobilinogen, Bilirubin
619
4 urine substances false neg with vitC
Glucose, blood bilirubin, nitrite
620
What tubule reabsorbs 80% of the fluid, electrolytes...
Proximal Water, NaCl,K, aminos etc
621
Loop of Henley: Which one reabsorbs water only Which one reabsorbs solutes only
Descending: water only Ascending: solutes only
622
Casts formed in... Final concentration in...
Casts formed in... Distal Final concentration in... Collecting
623
Most frequently used supravital stain in microscopic exam trying Urine
Sternheimer Malbin The Sternheimer-Malbin (SM) stain is a commonly used supravital stain containing crystal-violet and safranin. WBC's, epithelial cells, and casts stain well with SM stain. Sedi-Strain (Clay Adams, Sparks, MD) and Kova stain (ICL Scientific) are among those commercially available. Nuclei and cytoplasm of various cells can be stained with a 0.5% solution of toluidine blue.
624
Name of and 3 colors of CSF supernatant due to hemoglobin, hemorrhage
Xanthochromia Pink, orange, yellow
625
abnormally high urea nitrogen in the blood is called... A significant increase in the plasma concentrations of urea and creatinine, in kidney insufficiency, is known as... Once instance urea levels are lower...
high urea nitrogen: uremia increase in plasma concentration of urea and creatinine is azotemia. During pregnancy, lower-than normal urea levels are often seen. Azotemia can result from prerenal, renal, or postrenal causes: * Prerenal azotemia is the result of poor perfusion of the kidneys and therefore diminished glomerular filtration. The kidneys are otherwise normal in their functioning capabilities. Poor perfusion can result from dehydration, shock, diminished blood volume, or congestive heart failure. Another cause of prerenal azotemia is increased protein breakdown, as in fever, stress, or severe burns. * Renal azotemia is caused primarily by diminished glomerular filtration as a consequence of acute or chronic renal disease. Such diseases include acute glomerulonephritis, chronic glomerulonephritis, polycystic kidney disease, and nephrosclerosis. * Postrenal azotemia is usually the result of any type of obstruction in which urea is reabsorbed into the circulation. Obstruction can be caused by stones, an enlarged prostate gland, or tumors
626
HER2/neu a marker for Breast, Ovarian, and Cervical Cancer Markers
oncogene HER2/neu as a prognostic indicator and a marker related to the choice of therapy. This is particularly useful since the introduction of Herceptin as a chemotherapeutic agent that targets the HER2/ neu receptor. Breast cancer patients who express HER2/neu in their cancers have a poor prognosis
627
example of aminoglycoside antibiotic... example of glycopeptide antibiotic...
Aminoglycoside antibiotics such as gentamicin Glycopeptide antibiotics such as vancomycin
628
carbamazepine, phenytoin, ethosuximide, phenobarbitone, valproic acid are all examples of
Anticonvulsant (antiepileptic) drugs
629
digoxin is a
cardioactive
630
amitriptyline, clomipramine, desipramine, dothiepin, imipramine, nortriptyline (AID)
Tricyclic antidepressants
631
HOW LONG CAN URINE SIT OUT AT RT
A fresh urine specimen is particularly important for reliable results. If the urine cannot be examined within 2 hours, it should be refrigerated as soon as possible after collection. Specimens left at room temperature for more than 2 hours are not acceptable.
632
AChE Acetylcholinesterase
enzyme in cns,rbc, fetal serum confirm pos afp open neural tube defect
633
% of CSF made by chroidal cells in choroid plexus % of CSF made by ependymal cells
70% of CSF made by chroidal cells 30% of CSF made by ependymal cells
634
CSF found in... obtained between these two or these two
subarachnoid space 3/4th or 4/5th
635
CSF storage chemical... micro... cell...
CSF storage chemical...frozen micro...RT cell...fridge
636
Albumin not normal in CNS CSF/serum albumin index of... is normal
<9
637
4 bands in CSF protein electrophoresis
Prealbumin/transthyretin albumin Tranferrin (Beta1) T Transferrin(Beta 2)
638
What CSF protein confirms presence of CSF
T tranferrin(beta 2)
639
3 most common bacteria in bacterial meningitis in CSF
N.meningiitis H.influenzae S.pneumo
640
transudates wbcs exudates wbcs
transudates <1000 wbc exudates >1000 wbc
641
Caused by increase purine metabolism, uric acid, Monosodium urate crystals
gout
642
knee, Ca pyrophosphate dihydate crystalsj
pseudogout
643
Sperm get to lab within... liquefy within... ml... ct.... pH...
witin1 hr to lab 30min to liquify, by 60 min 2-5mL 20-250million ph 7.2-7.8
644
Reagent strip protein sensitive to... SSA sensitive to...
reagent to albumin SSA to all protein
645
Micro-Bumintest (Bayer) tests for
microalbuminuria
646
Rous test for
Hemosiderin
647
Test that diff urobilinogen from porphobilinogen
Watson-Schwart
648
EM Quant (Merkoquant)
Vit C when interference
649
Test for porphobilinogoen and inverse Erlich
Hoesch
650
Which of the following determinations is used to assess the total body lead poisoning burden?
most commonly used biomarker of human lead exposureWhole blood lead In lead poisoning, impaired iron delivery or utilization within the mitochondrion has the similar effect of increasing erythrocyte zinc protoporphyrin.
651
triglycerides Normal, borderline, high, very high
Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L) Borderline high — 150 to 199 mg/dL High — 200 to 499 mg/dL Very high — 500 mg/dL or above
652
Which drug is used in treatment of congestive heart failure, requires TDM, and is part of the cardiac glycosides class of medications?
Digoxin, with the proprietary name Lanoxin, is one of a group of cardiac glycosides obtained from digitalis plants. Digoxin also acts to restore the force of cardiac contraction in congestive heart failure.
653
The degree of wavelength isolation is a function of the monochromator type and
width of entrance and exit slits. The degree of wavelength isolation is dependent on both the type of monochromator used and the width of the entrance and exit slits.
654
What additional information is typically required to measure enzymatic activity in a 24-hour urine test?
Weight, height, and total volume of 24-hour collection The volume of urine excreted indicates the balance between fluid ingestion and water lost from the lungs, sweat, and intestine.
655
The measurement of the decrease in intensity of an incident light beam as it passes through a solution of particles defines which of the following methods?
Turbidimetry While both turbidimetry and nephelometry measure scattered light. Turbidimetry is a method to measure the decrease in intensity of an incident light beam as it passes through a solution of particles.
656
The kidneys are the site of the active form of which vitamin?
Vitamin D The kidneys convert vitamin D from supplements/ the sun to the active form of vitamin D. With chronic kidney disease, low vitamin D levels can be found.
657
In a urine reagent strip, methyl red is used to indicate what pH change?
Methyl red is used to indicate a pH change from 4.4 to 6.2 with a color change from red to yellow.
658
The speed at which light travels through air divided by the speed at which it travels through a substance is the
refractive index. The speed at which light travels through air divided by the speed at which it travels through a substance is the refractive index. This value varies directly with the number of dissolved particles in the solution. Although not identical to specific gravity, refractive index varies and corresponds with specific gravity.
659
Which two chemicals are used during a pH reagent strip test with a double indicator system?
Bromothymol blue and methyl red The reagent strip test for pH uses methyl red and bromothymol blue double indicator system that measures the urine pH from 5 to 9.
660
What can cause turbidity in a room temperature, fresh random specimen?
Crystalized chemicals Normal but concentrated urine typically crystalizes certain chemicals out of solution at room or refrigerator temperature.
661
What is the identification of oval fat bodies confirmed with?
Sudan III Sudan III and Oil Red O are stains used to identify fat in substances. With these stains, lobules of triglyceride or neutral fat appear orange or red.
662
Which of the following crystals should be accompanied by a positive test for urine bilirubin?
Tyrosine crystals are also seen with leucine crystals. Both are associated with severe liver disease.
663
Modern HPLC systems can work at pressures up to _________ psi.
5000 to 6000 Modern HPLC systems can work at pressures up to 5000 to 6000 psi.
664
Which of the following are the two methods used to characterize monoclonal proteins?
Immunoelectrophoresis and Immunofixation Electrophoresis Immunoelectrophoresis (IEP) and immunofixation electrophoresis (IFE) are used to characterize monoclonal urine and serum proteins. In clinical labs, IFE, however, has essentially replaced IEP.
665
What is a simple sugar, or monosaccharide, derived from the breakdown of dietary carbohydrates?
Glucose Intestinal absorption of carbohydrates occurs in the small intestine, where monosaccharides, the single- sugar units of carbohydrates, are absorbed.
666
Whole blood % versus plasma glucose
WB 10-15% less
667
Prep for GTT
High carb 3 days
668
In fasting, arterial/capillary glucose is... Higher than venous
2-5mg
669
Diagnostic for diabetes... fasting plasma (8hrs)... random plasma... 2hr plasma... OGTT... A1C....
fasting plasma (8hrs)...126 random plasma...200 2hr plasma... OGTT...fasting 92 A1C....6.5
670
Electrolyte panel 4 items
Na, K, Cl, CO2
671
BMP 8 things 4 electrolytes, 3 renal related, 1 mineral
Na, Cl, K, CO2 glucose, creatinine, BUN Ca
672
CMP 4 electrolytes, 3 renal related, 1 mineral plus 5 liver
Na, Cl, K, CO2 glucose, creatinine, BUN Ca albumin, TP, ALP, AST, bilirubin
673
Liver function panel 6 things
albumin, TP, ALT, AST, ALP, bili
674
renal panel 9 things... Electrolytes, renal, mineral
Na, K, CO2 glucose, creatinine, BUN, albumin, phoshate Ca
675
5 analytes that increase glucose, 1 that doesnt
Keeps glucose in blood: glucagon: break down glycogen, keep glucose up cortisol, epinephrine: energy from other sources GH Thyroxine: glucose in GI absorbed Takes glucoses out of blood: insulin
676
onset 1-3hrs peak 6-10hrs normal 1-2days
Myoglobin: onset, peak, returns normal fastest
677
H2 breath test where bacteria acts on unabsorbed disaccharides used to diagnose
Lactase deficiency
678
Biliary obstruction has this increased in serum
Conjugated bilirubin
679
Which method for bilirubin uses alcohol that causes issues with turbidity from precipitated proteins
Evelyn Malloy
680
Which method for bilirubin uses a serum blank, thus not being affected by turbidity from precipitated proteins
Jendrassik Grof
681
In acute pancreatitis, amylase and lipase rise within Amylase returns to normal in
In acute pancreatitis, amylase and lipase rise within a few hours Amylase returns to normal in 3 days
682
LD 1 and 2 seen in these two
Heart, HA
683
Pulmonary LD Liver LD
Pulmonary LD 3 Liver LD 4,5
684
Best in carcinoma of prostate marker
Total prostatic specific antigen
685
Hyperlipidemia 1: Exogenous triglyceride; young; cant remove chylo/VLDL 2: increaed LDL 3: dysbetalipo 4: endogenous 5: mixed exo/endo
686
Oral GGT test Prego grams: Standard grams: if 1hr >140, give... and compare fasting, 1,2,3hrs
Oral GGT test Prego grams: 50 Standard grams: 75 if 1hr >140, give...100 and compare fasting, 1,2,3hrs
687
Hypoglycemia... Clinical sig hypo...
hypo <70 mg/dl clinical <54 mg/dl
688
A1C glucose attaches to....of Hmg A
N-terminus valine
689
Test for diabetes where glucose attaches to proteins, average over 2-3 weeks, intermediate control
Fructosamine, total glycated protein
690
5NT 5-nucleotidase see in...but not...
seen in liver but not bone
691
Destroys acetylcholine, decreased levels indicate organophosphate poisoning
cholineesterase
692
CRP and homocsysteine can be markers to access for risk of
cardiac risk
693
Procalcitonin/PCT is made in the thyroid and helps rule out...
sepsis
694
Equation of logarithmic expression of ionization constant equation of a weak acid
Henderson-Hasselbalch
695
Henderson equation
pH-pKa + log (HCO3/H2CO3) salt/acid kidney/lungs metabolic/respiratory
696
In acidbase disorder, it will be respiratory issue if CO2 is going ..... to pH it will be metabolic disorder if HCO3 is going...as ph
it will be respiratory issue if CO2 is going opposite to pH it will be metabolic disorder if HCO3 is going same direction as ph
697
pH 7.35-7.45 HCO3 22-26 CO2 35-55 O2 85-105
698
pH... HCO3... CO2...
pH 7.35-7.45 HCO3 22-26 CO2 35-55
699
Cocaine compound tested
benzoylecgonine
700
2 opiates
codeine, morphine
701
2 general classes of antibiotics
aminoglycosides: cin -gentamicin, tobramycin, amikacin glycoprotein: -vancomycin
702
Quinidine Procainamide Disopyradmide Lidocaine all
antiarrhymmic/cardioactive
703
Phenytoin/Dilantin Phenobartitol Valproic acid all
anticonvulsant
704
Amitriptyline Imipramine Doxepin all lithium
psychotrpoics
705
Cyclosporine Tacroliumus Sirolimus Mycophenolic acid all
immunsuppressants
706
Hyper/Hypo Primary is... Secondary is... Tertiary is...
Hyper/Hypo Primary is...end organ Secondary is...pituitary Tertiary is...hypothalamus
707
Tissue T4, bound to TBG T3 is tissue T4 converted, active
708
Graves T4/3 are.... with antibodies to
increased, antibodies to TSH receptors
709
Hashimotoes T4/T3 are..with antibodies to
decreased T4/T3, antibodies to TRab, TPO thryoid autoab
710
Metabolic acidosis or alkalosis can compensate quicker, may have compensated CO2.
Metabolic alkalosis high pH, HCO3 high TCO2 Metabolic acidosis low ph, HCO3 low CO2
711
Additive for blood gas... glycolsis affect on ph and CO2... parameters measured directly in automated... calculated...
Additive for blood gas...heparin glycolsis affect on ph and CO2...rise in CO2, fall ph parameters measured directly in automated...ph, CO2,O2 -HCO3 and oxg sat are calculatedbn
712
which best for renal tubular function...
osmolality over creatinine clearance best in diabetes
713
if Na, K, glucose, BUN are normal osmal gap is
275-295
714
degree kidney concentrates filtrate determined by...
urine to serum osmolality ratio serum >300, urine <300 is diabetes insipidis not concentrating urine
715
Coulometry is an automated method to measure....using silver ions
chloride
716
Lanthanun Chloride eliminates interence in atomic absorption spectrophotometry to measure...
calcium
717
Assays for....measure hormone not bound to TBG/TBPA, or albumin
free T4
718
Congential hypothyroidism screen with
Free T4 blood spot
719
Predominating estrogen useful for prenatal screen
estriol
720
Hormone triggers ovulation
LH LH-ovulation-follicle-corpus leteum
721
Normal pregnancy, hcG peaks at... and after....weeks of last period...
peaks 2-3months peaks 2-2.5mths after period 8-10weeks
722
this increases vasoconstriction and thus stimulationg formation of aldosterone
angiogensin II
723
half life is how many doses... If half life is 6hrs, given every 6 hrs, when is stead state...
5-7 24-42 hrs (6x5-6x7)=24-42
724
Salicylate is called
aspirin
725
Best sample for forensic toxicity of drugs of abuse
random urine

AMT Chemistry (1 decks)

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