CC Flashcards
(142 cards)
1
Q
Aldosterone secreting ADRENAL ADENOMA
A
Cohns syndrome
2
Q
Hereditary - dec. bilirubin transport
A
Gilberts syndrome
3
Q
Hereditary - Deficiency w/ UDPT
A
Crigler najar (uridine diphosphate glucorynyl transferase)
4
Q
Acromegaly
Screening
Confirmatory
A
Screening: Somatomedin C/IGF-1 (insulin glucose factor)
Confirmatory: 2hr-OGTT
N: 350mg/dl
> - Type 1 (severe)
< - Type 2 (less)
5
Q
Treatment for Crigler najar 2
A
Phenobartital
Type 1
1. Transplant
2. Phototherapy
6
Q
Condition: IBIL - >20mg/dl
A
Kernicterus (brain dmge)
<20mg/dl - Ictericia = yellow skin, serum
Total bili - 2-3mg/dl (34.2-51.3 umol/l) = Jaundice
7
Q
Gel electrophoresis buffer
1. Negative
2. Positive
A
- Barbital buffer (alk)
- Citric accid (acd)
8
Q
GE:
1. Large DNA
2. Small DNA
A
- Agarose (gellidium red algae)
- Polyacryl amide
9
Q
- Protein malnutrition suffered mostly by displaced child
- Protein and carbohydrate deficiency
A
- Kwashiokor
- Marasmus
Treatment for Marasmus
* Refeeding syndrome - liquid to solid food (death if solid first)
10
Q
Driving force of HCO3 buffer sys
A
- CO2
- Carbonic anhydrase
11
Q
Only dec in DM
A
- HCO3
- Blood pH
12
Q
Important in electrolyte, volume, homeostasis regulates thur inc. NA2+ excretion
A
Atrial natriuretic factor (ANF)
3 neurohormones
* atrial natriuretic
* b type natriuretic peptide -brain
* c type natriuretic peptide -long bones
13
Q
Electrolyte for
1. Prod. and use of atp from glucose
2. Replication DNA and translate mRNA
3. ATPase ion pump
A
Mg2+
14
Q
Source of T4 and Caticholamines
A
Tyrosine
15
Q
Troponin
1. C
2. I
3. T
A
- Calcium binding
- Inhibitory protein
- Tropomyocin binding protein
16
Q
Long stress hormones that may lead to cushing syndrome
A
Cortisol
Inc. during stress and morning
17
Q
Circardian variation (24hrs cycle) it involves:
A
Liver enzymes: AST, ALT, GGT, AAP (Acetaminophen)
18
Q
Extra pts
PAMET HYMM
1. Music
2. Script
A
- Francis jerota pefanco
- Hector gentapanan gayares, jr.
19
Q
Type of glass used in PYREX, KIMAX
A
Borosilicate
20
Q
Type of glass used in COREX
A
Aluminosilicate
21
Q
- tolerates heat but clouds and scartch with alkali
A
borosilicate
22
Q
6x stronger with borosilicate thus, R with scatching in alkali
A
aluminosilicate
23
Q
a boron free glass - used with strong acids and alkali only
A
soft glass
24
Q
a soda lime glass - cheapest, for disposable and cause error due to alkali
A
flint glass
25
amber glass thus reduces light transmission
low actinic glass
## Footnote
BOALS type F
26
Excellent temperature and chemical resistance - glass
Teflon
Polytetrafluoroethylene
26
R to chemicals and used for tips and tubes
Polypropylene
26
R to chemicals but not to concentrated acids. for disposable transfer pipets
polyethylene
27
Stonger than polypropylene but not for chemical use and it has better temperature tolerance
polycarbonate
## Footnote
ppt = can autoclaved
27
rigid and clear for test tubes and graduated
polystyrene
28
soft and flexible but porous and is used for tubing
polyvinyl cl
29
* transfer pipets
* self drain
* single mark
* for nonviscous
volumetric (most accurate)
30
* transfer pipets
* blow out
* single mark
* for viscous
ostwald folin
31
* graduated pipets
* to tip
* serial dilution
serologic
32
* graduated pipets
* between 2 marks
* serial dilution
mohr
## Footnote
BO - has etched rings
33
* air cushion between piston
* air displaced = vol of liquid
* for aqueous
air displacement pipettes
34
* direct contact w/ samples
* aspiration force constant
* for viscous/high density
positive displacement pipettes
35
* for body fluid cell ct/csf
* 200-2k rpm
cytocentrifuge
36
* std prep
* high degree of accuracy and precision
* 2/more purification: distiliiation, deionization, reverse osmosis, filtration
type 1 water
37
* rgt prep
* gen. lab test
type 2 water
38
# ```
* for quali tests
* washing glassware
type 3 water
## Footnote
final wash with type 1 or 2
38
1. decontamination of body fluids
2. contact time
3. inactivation of hbv
4. inactivation of hiv
1. 5.25% or 10%sodium hypochlorite
2. 20 mins
3. 10mins
4. 2mins
38
best indicator of precision - inverse rs
CV
39
nrl for cc
lung center of the ph
39
aka reproducibility
precision
40
2 controls every 24hrs for 20 days
internal/intralab qc
41
loss of precision due to deviating control values by random and systematic error
outliers
42
1. simplest approach in lab quality mgmt
2. to conitnually improve practices
3. to reduce test errors or defects
4. reduce waste to improve tat
1. pdca/deming cycle
2. cqi
3. six sigma
4. lean
42
inhibits urease and uricase - false dec in bun and uric lvls
sodium fluoride
42
length for lancet
1.75mm
43
tube/preservative that is affected by light also it prevent plt activation
dipyridamole in ctad
44
Measurement of the amount of light from a specific wavelength of the electromagnetic wavelength
spectrophotometry
45
1. 2 cuvets are struck by light at the same time; 2 photodetectors
2. 1 photodetector; light is alternately passed
through the sample and the reference cuvet by using a chopper
1. Double-beam-in-space
2. Double-beam-in-time
46
1. gamma counter; ligands labelled with iodine 125 or iodine 131
2. beta counter; ligands labelled with hydrogen 3 of carbon 14
1. crystal scintillation
2. liquid scintillation
47
used in therapeutic drug monitoring (specially for immunosuppressants)
1. Microparticle capture enzyme immunoassay (MEIA)
2. Fluorescence polarization immunoassay (FPIA)
47
measurement of immune
complexes (antigen-antibody
complexes)
turbidometry and nephelometry
47
1. Gold standard for drug analysis
2. IEM detection
3. non-protein nitrogenous compounds
4. biomolecules e.g. peptides and
protein signatures, also used for microbial or bacterial identification
1. gc-ms
2. tandem im
3. idms
4. maldo tof ms
48
Symptoms of hypoglycemia
Low plasma glucose level
Relief of symptoms following correction
Whipple’s triad
49
type 2 dm panic value for hyperglycemia
>500mg/dl
50
glycemic control over the past 2-3 weeks in cases when HbA1c is unreliable
fructosamine - glycosylated albumin
## Footnote
* unreliable - <3gdl
* ref. values - 205-285 umol/l
50
Pre-prandial: 70-130 mg/dL
Post-prandial: < 180 mg/dL
wb glucose
## Footnote
Capillary blood glucose is higher than venous blood glucose by 2-5mg/dL
50
Effect of dextrose contamination
10% contan, 5% dextrose, inc. pg by 500mg/dl
## Footnote
inc.
* 7 mg/dL/hour at room temperature
* 2 mg/dL/hour at 4oC (refrigerator temperature)
51
* hagedorn-jensen mtd
* reverse colorimetry
ferric reduction
51
* folin wu
* nelson somogyi
* neocuprione
copper reduction
52
what rxn in condensation is when intensity is proportional to glu conc
dubowski rxn
## Footnote
glucose with aromatic amines (ortho-toluidine)
53
* body's major cholesterol carrier
* transports a large amount of endogenous cholesterol
* "bad cholesterol,"
* increased risk for
atherosclerosis (atherogenic).
LDL
## Footnote
normal: brings cholesterol to peripheral cells for membrane synthesis and formation of adrenal and reproductive hormones
abnormal: deposited in tissues
53
* formed in the intestines
* apoproteins B-48, mainly
* Transports dietary or exogenous TGs
chylomicrons
53
# cholestero esters (70%)
attachment of fatty acid to non-esterified cholesterol - catalyzed by
Lecithin cholesterol acyltransferase (lcat)
## Footnote
transfer of excess cellular cholesterol from peripheral tissues to the liver for excretion
53
Highest conc in blood fromed in liver by co2 and ammonia. Major excretory product of metabolism of proteins and nitrogen containing chemicals
Urea
53
screening test for galactosemia
clinitest
## Footnote
Newborn screen - inborn error of carbs metabolism
53
* synthesized in the intestine and liver cells
* Reverse cholesterol transport
* antiatherogenic effect
* mainly apo a-1,2
hdl
54
* synthesized in the liver
* apolipoproteins B-100, mainly
* endogenous TGs
* secreted into the blood by the liver for metabolism in peripheral tissues
vldl
## Footnote
IDLs carry endogenous triglycerides and cholesterol esters
54
most common gsd; due to glucose6-phosphatase deficiency
von Gierke disease (GSD Type Ia)
## Footnote
under hepatic glycogenosis
54
2 major isomers in plasma
* b-d-glucose (65%)
* a-d-glucose (35%)
54
# under glucose peroxidase
* measures degree of O2 consumption using a pO2 (Clark) electrode
* oxygen detected is inversely proportional to glucose
polarographic -amperometric
## Footnote
prevent reformation of
**hydrogen** from hydrogen peroxide (cime)
* catalase
* iodide
* molybdate
* ethanol
54
An atherogenic because a significant part is transported to tissues and may be deposited there in excess amounts; bad cholesterol
LDL
## Footnote
remove by hdl
54
reference method for protein analysis
ultracentrifugation
54
* cardiovascular disorders such as stroke, MI, CHD
* Sinking pre-beta lipoprotein (apo a + b100)
* Competes with plasminogen or plasmin core binding sites
lp(a)
54
* obstructive biliary disease and LCAT deficiency
* Consists mostly of phospholipids and non-esterified cholesterol
lpx
54
* type 3 hyperlipoproteinemia
* Floating beta-lipoprotein
b-vldl
54
* Absolute absence of Apo B-
* mutated MTTP gene (chrom 4) with absolute nonexistent of apo B-48 and apo B-100
abetalipoproteinemia (bassen kornzweig syndrome)
54
* nonsense or missense mutation in the Apo-B gene
hypobetalipoproteinemia
55
# creatinine
1. ref. values
2. chemical mtd w/ rgt
2. enzymatic mtd w/ rgt
1. jaffe = 0.9-1.3mg/dl (m); 0.6-1.1mg/dl (f) ; enzymatic = 0.6-1.1mgdl (m); 0.5-0.8mg/dl (f)
2. jaffe mtd - alkaline picrate (red orange tautomer)
3. creatininase pod coupled (sarcosine oxidase), creatininase ck coupled (creatine phosphate)
55
* autosomal recessive
* mutated abca1 gene
* absence of hdl, apo a1,2
tangier dse
56
# urea
1. ref value
2. ref. mtd
2. chem mtd w/ rgt
3. enzyme mtd w/ rgt
1. 6-20mg/dl
2. idms
2. fearon - diazine (yellow)
3. Colorimetric = nesslerization - dimercuric ammonium iodide (yellow orange), berthelot - na nitropusside (blue)
* gldh enzyme
* conductimetric - inc. due to nh4+ and co32-
57
absorbent used for jaffe mtd.
1. lloyd's rgt (na aluminum silicate)
2. fuller's earthy
## Footnote
Note: needs kinetic and the use of absorbent to inc. measurements of absroption. Absorbents will only bind to crea
58
1. bun crea ratio
2. pre renal azotemia ratio
3. renal/post renal azotemia ratio
4. ratio for repeated dialysis, liver dse, low protein diet
1. 10-20:1
2. >20:1 w/ normal creatinine
3. <20:1 w/ elevated crea
4. <10:1
59
1. catabolism of purines in nucleic acid or nucleoprotiens
2. deposited in joints at what concentrations
1. uric acid
2. >6.8 mg/dl
60
# uric acid
1. chemical mtd
2. enzymatic mtd
3. ref. values
1. phosphotungstic acid mtd - caraway, archibald, henry (blue)
2. uricase mtd - (293nm)
3. 3.5-7.2mg/dl(m); 2.6-6.0mg/dl (f)
61
1. catabolism of amino acids
2. toxic compound metabolized in liver via
1. ammonia
2. krebs kenseleit or urea cycle
62
# ammonia
1. chemical mtd
2. enzymatic mtd
3. ref. values
1. potentiometric - ph measurements; colorimetric - nezzlerization, berthelot - bromphenol blue
2. gldh mtd -glutamate
3. 19-60ug/dl
63
hyperammonia can be found in:
1. reye syndrome
2. hepato encephalopathy
64
# protein electrophoresis
1. support media - pace
2. stains used - c pal
3. colorimeted designed to scan, quantitate the pattern
1. polyacrylamide gel, agarose, cellulose acetate
2. coomasie b. blue, ponceau s, amido black, lissamine green
3. densitometer
65
1. pre albumin aka as
2.better indicator of what condition
3.binds and transprt what hormone and vit
4.knowns as the 2nd most abundant protein in
1. transthyretin/thyroxine binding pre albumin (tbpa)
2. malnutrition
3. t4, vit.a w/ retinol binding protien
4. csf
66
1. major contributor to osmotic pressure also a general transport protein. Also most abundant plasma protein
2. dec albumin - dec. osmotic pressure leads to
3. Inc is only ass w/ what condition
1. albumin
2. edema and transudative effusion
3. dehydration
67
1. from yolk sac and liver of fetus inc at 13 wks and declines at 34 wks
2. measured at and reported as
1. a-fetoprotein
2. 15-20 wks ; multiples of median (mom)
## Footnote
Note:
* only inc in pregnant and in adult due to hepatocellular carcinoma and gonadal tumors
68
1. most abundant protein in alpha 1 band
2. serves as inhibitor
3. inhibited enzymes
1. a1-antitrypsin
2. proteolytic inhibitor
3. plasmin, elastase, thrombin, collagenase, chymotrypsin (pet c2)
## Footnote
Note
* seen in repiratory tract, closed spaces (ph maintained) thus, deficieny in a1-antitrypsin is dec in pulmo dse, juvenile hepatic dsorders (cirrhosis)
* not effective in stomach and intestines
* deciency of a1-antitrypsin is asstd w/ serpina 1
69
1. it binds to progesterone and some drugs
2. it has high carbohydrate content
3. only dec in what condition
4. what its unique characteristic
1. a1-acid glycoprotein
2. orosmucoid
3. nephrotic syndrome
4. neg charge even in acid pH
## Footnote
Notes
* inc in rheumatoid arthritis, pneumonia w/ cell proliferation conditions
70
1. also a protease inhibitor but a mild apr
2. bind with what antigen
1. a1-antichymotrypsin
2. prostate specific antigen
71
* vit. d binding protein and has a role in calcium homeostasis
gc-globulin (dbp)
72
1. also a protease inhibitor but it is a largest non immunoglobulin protein
2. in ten fold in what condition
3. dec markedly in what condition
1. a2-macroglobulin
2. nephrotic syndrome and protein lose conditions
3. acute pancreatitis
## Footnote
Note
* inc in pills
73
1. binds free hgb to preserve iron
2. dec in wat condition due to formation of complex for removal by the liver
1. haptoglobin
2. intravascular hemolysis
74
1. copper binding protein
2. dec in what condition due to copper accumulation in tissues such as cornea
1. ceruloplasmin
2. wilson's dse
## Footnote
Note
* inc in pills
* alpha 2 - CHAM
75
transports ferric form of iron. Also seen as inc. in presudoparaprotein, ida, and pregnancy
transferrin
76
* most abundant complement component
* for immune response - classical and alternative pathways
c3 complement
77
binds heme and conserve iron although hgb is broken down
hemopexin
78
* component of mhc/hla found on nucleated cells (lymphocytes)
* measure gfr but unreliable if there's inflammation/autoimmune dsrs
b2-microglobulin
## Footnote
notes
* inc. in sle
79
1. most sensitive positive acute phase reactant and most nonspecific marker of inflammation (inc. 1000x). it also enhances pahogocytosis and a gamma migrating beta globulin
2. Refers to sensitivity of assay to determine low levels in serum
3. Predictor for what condition including values
1. c reactive protein
2. high sensitivity crp (hs-crp)
3. CV risk (low <1.0mg/l ; >3mg/l)
## Footnote
notes
* 0.3-8.6mg/l (m)
* 0.2-9.1mg/l (f)
* serum amyloid a - inc in inflam but later na, transport cholesterol
80
1. plasma proteins produced
2. immoglobulins produced
1. liver
2. b cells (plasma cells)
81
1. extra band in beta and gamma region is due to
2. extra band in beta/alpha 2 and beta region
1. fibrinogen (plasma only)
2. hemoglobin (due to hemolyzed serum)
82
# increase in what conditions
1. igG
2. igA
3. igM
4. igE
5. igD
1. collagen dse
2. autoimune dse
3. waldenstrom macroglobulinemia (bacterial, viral, fungal)
4. allergies (asthma, hay, parasitic)
5. connective tissue dsrdr
## Footnote
notes
* igG,igA,igD - inc in liver dsrdr, inxn
83
conditions under hyperproteinemia
1. monoclonal gammopathy - inc in total protein conc. inappropriate production of gamma globulins (igG.igM)
2. MM - inc. igG
3. waldenstrom macroglobulinemia - inc. igM (tall gamma, low albumin)
4. dehydration
84
# urinary proteins
1. Glomerular dysfunction can be detected in its early stages by measuring
2. test mtd (Cbb BTS)
3. ref val for urine total protein
4. ref val for urine albumin
1. microalbumin
2. coomasie brilliant blue, nezethonium chloride, trichloroacetic acid, sulfosalicylic acid
3. 1-14mg/dl ; <100mg/dl
4. <30mg/day
85
1. ultrafiltrate of plasma formed in ventricles of brain
2. ref value
1. csf
2. 15-45mg/dl
## Footnote
same test performed w/ urinary proteins
86
* found in skeletal and cardiac muscles
* primary oxygen carrying protein - it contains heme
* nonspecific marker for MI -next to trop (rule out mi)
* a negative predictor for first 2-4 hrs after chest pain
## Footnote
MISCELLANEOUS PROTEINS:
MC and NC are BF ACla NAH
myoglobin
87
myoglobin is released in AMI
1. rising
2. peaking
3. normal
1. 1-3hrs
2. 5-12hrs
3. 18-30hrs
## Footnote
ref value
* 30-90mg/dl (m)
* <50mg/dl (f)
88
1. gold std for acute coronary syndrome/mi
2. used as an ami indicator
3. what complex binds to filaments of skeletal and cardiac muscles to regulate muscle contraction
1. cardiac troponins
2. trop I, trop T
3. trop I,T,C
## Footnote
* T inc first and has an early peak but I returns to normal first and also it has greater cardiac specificity
* ref values varies
89
1. synthesized in and secreted from
myocardial ventricles in response to ventricular volume expansion and
pressure overload
2. specimen needed
3. ref value
4. assay that measures N terminal proBNP (NT-proBNP)
1. b type natriuretic peptide
2. heparinized plasma
3. <100pg/ml
4. proBNP - electrochemiluminescence principle (no interference from nesiritide (human recombinant bnp) - treat congestive heart failure (cnf))
90
* endogenous marker of gfr
* for px not amendable to urinate for 24hr collection
cystatin c
91
* potentional gfr marker
* correlates w/ cystatin c and urine microproteins (b2 microglobulin)
b trace protein
92
1. marker for nutritional status
2. predict the risk of premature delivery because it is a normal constituent in placenta and amniotic fluid
1. fibronectin (fn)
2. fetal fn
93
* biochemical marker of bone resorption in serum and urine
* proteolytic fragments of collagen I
cross linked c telopeptides
94
biomarker for alzheimer's dse
neural thread protein
95
1. insoluble protein aggregates due to altered b-pleated sheets. Deposited in tissue
2. tests that aids in differential diagnosis of alzhaimer's dse from other dementia
1. amyloid
2. amyloid b42, tau protein
96
* inc cause damage to arterial walls that precedes formation of plaques
* indicator of arterial inflammation
homocyteine
97
1. ref mtd for nitrogen
2. ave nitrogen content of protein
3. rgt for digestion process that coverted nitrogen to ammonium ion
1. kjeldhal mtd
2. 16%
3. sulfuric acid
97
# ```
measurement based on velocity of light - bended light direct proportional to solute (protein) in water (serum)
refractometry
97
* for csf protein analysis
buffed used
1. csf
2. urine
3. automated mtd
turbidimetry
1. trichlotoacetic acid
2. sulfosalicylic acid
3. benzalkonium chloride
97
Wat condition is pre hepatic. Hemolytic dsrds is seen and inc in urobilinogen due to failure of transport
unconju hyperbilirunemia (inc unconju, n conju)
98
1. combine copper sulfate, potassium iodide in sodium hydroxide, and potassium sodium tartrate
2. detect peptide bonds form violet - direct prop
1. biuret rgt
2. biuret mtd
99
more sensitive than biuret; oxidizes phenolic compounds in proteins via phosphotungstomolybdic acid form blue
FOLIN-CIOCALTEAU (LOWRY) METHOD
100
mtd that forms violet when amino and peptides are present
ninhydrin mtd
100
1. dye for total protein (CAP)
2. dye for albumin - routinely performed (BB 2M)
1. coomassie b. blue (sensitive), amido black, ponceau s
2. bromocresol purple (sensitive), bromocresol green (common), 2,4haba (less), methyl orange (non)
100
Notes
* a/g ratio = alb / tp - alb
* low a/g = either dec. alb or inc. glob
* monoclonal gammopathy - dec. a/g, inc. glob, inc tp
* ns, ple, liver dse - dec a/g, dec alb, dec tp
* mm - inc ap, low a/g
101
Note
* B1 is related to kernicerus because it is a unconjugated bili which means toxic and if inc it may cross to BBB. Produced from senescent of erythrocytes
* B2 is post hepatic, conjugated, soluble, direct (indirect need solubilizer to react w/ diazo) and is excreted in urine
101
1. conjugated bilirubin aka
2. enzyme converts unconjugated bilirubin in smooth endoplasmic reticulum of the liver
1. bilirubin diglucoronide
2. udpgt - urine diphosphate glucuronyl transferase
102
isoenzyme under amylase
* pancreatic amylase
* salivary amylase - wheat germ lectin (inhibited)
102
102
102
102
102
