chem12.17 Flashcards
(479 cards)
1
Q
Protein soluble in water
A
albumin
2
Q
What diff proteins from carb/lipid
A
nitrogen
3
Q
conjugated protein
A
protein plus prosthetic grplipo, glyco/muco, nucleo
4
Q
5 plasma proteins
A
albumin, alpha 1, alpha 2, beta, gamma
5
Q
Primary protein structure
A
amino acids
6
Q
Secondary protein structure
A
alpha helix, beta pleated sheets
7
Q
Tertiary protein structure
A
3D
8
Q
Quaternary protein structure
A
2+ polypeptide chains
9
Q
Enzyme deficiency with decreased enzymes leading to buildup of ketoacids decreased branched-chain ketoacid dehydrogenase enzyme activity(LIV)
A
maple syrup disease
10
Q
Aminoacidpathy caused by defiency in the enzyme to metabolize phenylalaninemousy urine
A
Phenylketonuria, PKU
11
Q
Aminoacidopathy due to enzyme deficiency due to lack of enzyme to break down tyrosine/phenylalanine leading to buildup of homogentistic aciddeficiency of a single enzyme called homogentisate 1,2 dioxygenaseblack urine
A
Alkaptonuria
12
Q
CystinuriaTyrosinemia
A
inherited metabolic,excessive amount of undissolved cysteine, doesn’t get reabsorbed by kidney, kidney stonesTyrosine/metabolites excreted in urine
13
Q
Deficiency in enzyme needed to metabolize methionine Increased levels of this amino causes stroke, CVD, alzheimers, osteoporesis, nutrional def
A
Homocystinuriabuild up of methionine and homocysteine (metabolite of methionine)
14
Q
4 causes of hypoproteinemia
A
Not getting/making enough:malnutritionliver disease(doesn’t make protein)Protein loss: burns(protein loss thru wound)nephrotic syndrome(loss thru urine)
15
Q
3 Causes of hyperproteinemia
A
dehydrationMultiple myeloma, Waldenstroms
16
Q
5 immunoglobulin
A
G,A,M,E,D
17
Q
4 measurements of TPTP g/dL
A
BiuretDye bindingKjeldahlRefractometryTP 6.4-8.3 g/dL
18
Q
TP g/dLalbumin g/dLmicroalbumin in urine mg/24hr
A
TP 6.4-8.3g/dLAlbumin 3.5-5 g/dL (about 60% of TP) rest is globulinsmicroalbumin 50-200 mg/24hr
19
Q
Calculation of A/G ratio
A
Albumin/TP-albumin
20
Q
Total protein method that reacts with >= 2 peptide bonds in proteins
A
Biuret
21
Q
Biuret reaction for TP uses…which forms what color complex
A
copper salts which forms a purple color
22
Q
4 dyes in dye binding for TP
A
Bromophenol Blue Coomassie brilliant bluePonceau SAmido black
23
Q
Reference method for TP, not used often
A
Kjeldahl
24
Q
TP method that measures nitrogen
A
Kjeldahl
25
This reaction follows Beers law for a reasonable range of proteinDepends on presence of at least two peptide linkagesIs insensitive to low protein in urine
Biuret reaction
26
3 things that can interfere with Biuret method for TP
hemoglobin, hemolysis and lipids can interfere
27
Two dyes used in dye binding method for albumin
BCPBCGBromcresol
28
BCP/BCG is used in what method...are used to determine...
Dye-binding methodfor albumin
29
Principle of protein measurement calledpHcolor change from,tofalse pos seen in what pH
protein error of indicatorspH 3.0yellow to greenalkaline urine
30
Breakdown of protein in liver produces...and also produces...
ureaammonia
31
B2 microgobulin used as a marker for
marker for reduced GFR
32
CSF protein
15-45mg/dL
33
3 Methods for Urine/CSF protein, BAD acronym
BiuretAcid: SSA precipitationDye: Coomassie brillant blue
34
Increased CSF protein in these 3
meningitis, tramatic tap, MS
35
Protein in Spina bifida
AFPalpha fetoprotein
36
CEA stands for, is a
carcino-embryonic antigenoncofetal antigen
37
CEA nonspecific for
colorectal carcinoma/colon cancer
38
AFP
alpha fetoproteintumor associated; secreted by fetal liver
39
Increased AFP 4 conditions
liver/heptocellular cancerneural tube defects(spina bifida)ovariantesticular cancer
40
Decreased AFP in
Down syndrome
41
HCGMade by...Has...
human chorionic gonadotropinmade by placenta after implantation by trophoblastic cellsalpha+beta subunits
42
HCG seen in these two cancers
ovariantesticular
43
PSAMade by...Seen in..
prostate specific antigenmade by prostatic epi cellsprostatic cancer
44
CA-125
ovarian cancer
45
CA19-9
pancreaticGI, adenocarcinoma
46
CA15-3, 27.29
mestatic breast
47
Two markers in breast cancer
CA27-29, CA15-3
48
Thyroglobulin marker for
thyroid
49
All proteins carry a net...charge due to protein being a higher pH than its isoelectric pointand travel towards
net negative, anode
50
Fastest/smallest protein toward anode
albumin
51
Which globulin migrates to cathode due to electroendosmosis
gamma
52
pH of electrophoresis
8.6
53
Anode
positively charged electrode
54
Cathode
negatively charged electrode
55
Protein in highest concentration and made in liver% of plasma protein
Albumin60%
56
Method of detection for albumin and reagents used
dye binding, methyl orange, bromcresol purple
57
Albumin function
transport/binds proteinosmotic pressure
58
Albumin decreased in these 3 things
malnutritionliver diseasenephrotic syndrome/renal loss/kidney disease
59
Albumin increased in this
dehydration
60
Another name for prealbumin and used to assess...
trans-thy-retinnutrional status
61
Liver makes these 4 globulins and RE/plasma cells make this
liver: albumin, alpha 1/2, betaRE/plasma: gamma
62
two alpha 1 globulins
AAT: alpha1 antitrypsininhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.AFP: alpha fetoprotein
63
AAT increased, decreased in
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)
64
AFP increased, decreased in
increased in neural tube defects liver cancerovarian/testiculardecreased in Downs
65
Globulin increased in acute inflamation
alpha 2
66
Large globulin made in liver, inhibits trypsin/pepsin/plasminincreased in pregonephrotic/kindey disease diabetes, lupus
alpha 2 macroglobulin
67
three alpha 2 globulins
alpha 2 macroglobulinHaptoglobinceruplasmin
68
Alpha 2 globulin made in liveracute phase reactant that binds hmg
Haptoglobin
69
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
70
Alpha2 globulin transports copper, made in liver, acute phase reactant
Ceruloplasmin
71
Disease with decreased serum ceruloplasmin and increased serum/urine copper. Increased storage of copper in organs/cornea
wilsons
72
Disease with decreased ceruloplasmin due to decreased absorption, decreased serum copper
Menkes
73
Ceruplasmin is a .... that transports...increased in these two...decreased in these two conditions...
glycoprotein that transports copperincreased in acute phase/inflammation, pregodecreased in Wilsons disease and Menkes
74
Type of globulin that is carrier protein for iron and lipidselevated in
Beta globulinincreased LDLIDA
75
Beta globulins examples
Beta2 microglobulinbeta lipoprotein/LDLtransferrinhemoplexincomplementfibrinogenCRP
76
Beta globulin that is a heme scavenger
hemopexin
77
Beta globulin that transports iron
transferrin
78
examples of glycoproteins
transferrinceruloplasminmucinsAFPimmunoglobulins, antibodiesFSH, LH, HCG, TSHFibrinogen
79
A non-glycoprotein that are temp sensitive proteins that precipitate from serum/plasma at temps lower than 37C
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 attach3 subunits
TroponinTnI, TnT, TnC
82
Bence Jones in urine migrate to..Prealbumin band seen in...
BJ to gamma regionPrealbumin in CSFUrine/CSF concentration first
83
globulin increased globulin decreased in viral hepatitis
gamma increasedalbumin decreased
84
globulins increasedglobulin decreased in maligment tumor
alpha 1/2 increasedalbumin 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 seen in
nephrotic syndromeliver makes less albumin
88
Migration of globulins from anode to cathode
albumin, alpha 1, alpha 2, beta, gamma
89
Polar hydrophillic and nonpoloar hydrophobic fatty acid chains; cell membranes are made of these
phospholipids
90
Examples of phospholipids
lecithinsphingomyelinPG(phosphatidyl glycerol)
91
Long chain polyunsaturated fatty acids that activates inflammation Stimultes clotting; also stimulates cervix to dialate and contractions
PGProstaglandins
92
Transports lipids, classified w/ultracentrifugationProtein part of lipoproteins/structural components
transports lipids: lipoproteinsProtein 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
alpha: HDLBeta: LDLPreBeta: VLDLOrigin to Anode:Chylo, LDL, VLDL, HDL
95
Largest lipoprotein, carrier of exo TrigApoproteins associated with it
ChylomicronApoB-48
96
Exogenous/dietary lipids and it's liproprotein/carrier
Triglycerideschylomicrons
97
most artherogenic lipid causing CHD, mostly composed of cholesterol and transported to the heart
LDL
98
Endogenous lipid made of mostly triglycerides
VLDL
99
Lipid transports lipid out to liver, heaviest and smallest
HDL
100
primary form of lipid storage...transported by these two...
triglyceridesexo/dietary: chylomicronsendo: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...
cholesterolto: LDLout 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
60-70
107
HDL % carries lipid
20-35
108
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 cholesterolpurpose of saponification step
cholesterol oxidaseconvert 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 anhydridesulfuric acid
116
Lipid w/3 fatty acids/glycerolstorage form90% in diet, 10% liverlipemia from chylomicrons
Trig
117
Enzyme method for triglycerides...Hydrolyzes to...
Lipase hydrolyzes triglyceride to form glycerol
118
Fredewald calculation for LDL
TC- (TG/5+ HDL)
119
Friedwald calculation for VLDL
TG/5
120
Cannot used Friedwald calculation for LDL/VLDL if...
TG is >400mg/dL
121
Risk factors for CHDage by gendershistory ofbp, HDLtwo conditions
>45men, >55 womenfamily history of CHDsmokingbp >120, HDL <40D.mellitus, metabolic syndrome
122
Lipid goalsTCTrigLDLHDL
TC <200Trig <150LDL<100HDL>35
123
Condition where blood cholesterol is increased
hypothyroidismThyroid hormones help your liver process blood. When your thyroid hormone levels are low, your liver processes blood more slowly, which can lead to higher levels of cholesterol in your bloodstream
124
Examples of ....lipid deposits in vascular/legs/armsCAD, AMI, arterieslipid in brain, stroke
atheriosclerosis
125
Disease with increased TC, LDL and decreased HDLCalculate coronary risk index using these two parametersElevated beta liproprotein is what lipid and leads to which kind of disease
CHDTC, HDLLDL, cardiovascular
126
4 non protein nitrogen
urea, ammoniauric acidcreatinine
127
non protein nitrogen increased in plasma in renal impairment called
azotemia
128
Best way to evaluate renal impairment and what is most common analyte to monitor it
GFRcreatinine
129
Creatinine clearance calcbased off the principle that creatinine passes into the ultrafiltrate
U creat/P creat x mL/1440vol in mL, min/24hr
130
Correction for clerance by body surface area
creat clearx1.73/area
131
Used with eGFR to stage/monitor CKD
urine albumin
132
Made from creatine in muscle
Creatinine
133
Method for creatininereacts withcolor formed
Jaffealkaline picrateyellow-red
134
Rises more rapidly than serum creatinine in acute renal failure
BUN
135
BUN increased in these two things
renal impairmenthigh protein
136
diacetyl monoxime used in determining...by measuring...can be used in untreated urine because...
BUNureamethod isn't measuring ammonia
137
Type of method for BUN that measures urea...reagent that reacts with urea...
Colorimetric methodreacts with diacetyl monoxime
138
Enzymatic method for BUN uses....which hydrolyzes...to...
ureasewhich hydrolyzes urea into ammoniaUnlike the colorimetric method using diacetyl monoxime used for BUN/urea
139
diacetyl monoxime-urease-
diacetyl monoxime-BUN/ureaurease-BUN/ammonia
140
BUN mg/dLCreatinine mg/dLBUN/creatinine ratioelevated creatinine will result in elevated BUN of how much
BUN 6-20mg/dLCreatinine around 1mg/dL10:1-20:1BUN will be elevated
141
GFR marker made by nucleated cells
cystatin c
142
end product of purine metabolism from nuclei, allantoin
uric acid
143
The colorimetric method for uric acid is an alkaline oxidation where uric acid reduces...to...
phospho-tungistic acid to tungsten blue
144
phosphotungistic acid used in
uric acid
145
Uric acid NV mg/dL
2.6-7.2
146
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.)
147
Disease where there is over production of uric acid that arent recycled; mostly malesThe HGPRT deficiency causes a build-up of uric acid in all body fluids. The combination of increased synthesis and decreased utilization of purines leads to high levels of uric acid production.)
Lesch-Nyhan
148
Uric acid is measured by... at 290nm before/after treatment with...
UV absorption at 290 before/after treatment with uricaseAlso use isotope dilution/MS
149
This is from bacterial action on contents of colon and metabolized by liver
ammonia
150
Analyte that is a prognostic indicator of liver failure
ammonianot eliminated by kidneys
151
Increased ammonia in these 3 main reasons
liver disease (cirrhosis, viral hep)Reye's SyndromeReye’s syndrome is a rare condition that happens in children after a viral infection or illness, especially if they took aspirin (salicylate) to treat their symptoms. Reye’s syndrome targets their brain, blood and liver.impaired renal (increased urea,ammonia)
152
Syndrome that leads to increased ammonia, mostly kids, previous virus, salicylate
Reyes
153
Bromphenol blue or GLDH used to measure
ammonia
154
Nessler used to detect
used to detect ammoninapotassium iodide plusmercury iodide/chloride plussodium hydroxide in waterdirty brown precipitate
155
Disaccharide with 2 glucose
maltose
156
Disaccharide with 1 glucose, 1 galactose
lactose
157
disaccharide with 1 glucose, 1 fructose
sucrose
158
monosaccharide with 6 carbons
hexose
159
process that uses glucose for energy, changed to lactic acid for energy
glycolysis
160
process of glucose to glycogen
glycogenesis
161
process of glycogen to glucose
glycogenolysis
162
process of glucose from noncarb sources
gluconeogenesis
163
renal threshold for glucoseCSF glucose % of plasmabest anticoagulant
160-180mg/dLCSF 60-65% of plasmasodium flouride
164
Diabetes melliutusplasma/OGTTA1C
>200mg/dL>=6.5%
165
Hypoglycemia mg/dL
70mg/dl
166
Hormones that regulate glucosewhich one decreases?all the rest increase
insulin, glucagonepineph/cortisolGH, ACTHT3/T4(Thyroxine)Stomatostainonly one decreases is insulin
167
hormones made in pancreas:alpha cells/increase or decreasebeta cells/increase or decreasedelta cells/increase or decrease
alpha: glucagon, increasebeta: insulin, decreasedelta: stomatostain, increase
168
peptide hormone made in beta cells and decreases blood glucose/goes into cells
insulin
169
steroid hormone that is a glucocorticoid, made in adrenal cortex, and increases blood glucose
cortisol
170
peptide hormone made in alpha cells, increases blood sugar by making glucose from glycogen
glucagon
171
hormone made in delta cells, inhibits secretion of insulin making more glucose in blood
stomatostain
172
hormone that is adrenaline, neurotransmitter and regulates glucose
epinephrine
173
glycogen storage diseaseincreased or decreased glucose
von Gierkesdecreased
174
diabetes where glucose is normal
insipidus
175
condition with tumor that results in increased insulinincreased or decreased glucose
insulinomadecreased glucose
176
two conditions that increase glucose
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)
177
most employed automated method for glucose uses what two enzymes where there's oxidation that forms a chromagencontamination can happen with
glucose oxidase, peroxidasecontamination with catalase
178
Gold standard for glucose testing/higher specificity...Two enzymes used....Amount of... is proportional to glucoseIs read at...nm
Hexokinase methodHexokinase, G6PDNADH formed is proportional to glucose340nm
179
hexokinase method:what is reduced and measured?measured at what nm?
NAD coenzyme reduced to NADHmeasured at 340nm
180
Normal fasting blood glucose
70-110mg/dL
181
Test to confirm prenatal borderline blood glucose
3 hr GTT
182
HmgA1C binds to hmg and monitors long term diabetes/largest fraction of HbAhow long of picture of glucose?Normal?Diabetic?
2-3mthNormal 4.0-6.0%Diabetic 6.5%
183
Juvenille onset, insulin dependent, autoimmune destruction of beta cellsketoacidosis
Type 1
184
adult onset, non insulin, insulin resistance, no ketoacidosis, obsesity
Type 2
185
What is a byproduct of insulin and can differentiate between medication/exo insulin and what the body makes/endogenous insulin?
C-peptide
186
Diabetes caused by placental lactogen inhibiting insulin
GDMgestational diabetes mellitus
187
Measurement of light intensity, chemical rxn forms color and is absorbed at specific wavelenthvisible light 400-700, frequency inverse to wavelength, uses quartz cuvette for UV rangetungsten or deuterium
spectrophotometry
188
Filter used for QC of spectrophotometer and what it tests
holmium oxide glass filterwavelength accuracy
189
Meaasurement of emission of color when element is burned
flame photometry
190
Measurement of light abosorption of electromagnetic radiation
atomic absorption spectrophotometry
191
Atomic absorption measures using what light sourcealso uses monochormator, flame sample cell, PM tube
hollow cathod lamp
192
term that decreases fluorescent intensity of a substanceis a disadvantage of...
quenchingfluorometry
193
Measurement using electrode, ref electrode, liquid, potential diff between the two equals concentration
ISE
194
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: nephelometryreduced transmisson: turbidimetry
195
In immunoelectrophoresis there must be excess...and a constant.... ......
excess antibodyconstant trough distance
196
Used to separate volatile or able to volatile and to confirm toxicologyIs a reference for alcoholThis is used to enhance sensitivity and specificity
gas chromatographyMS(mass spectro)
197
Technique w/sorbent coated and solvent screens for drugs/urineUses Rf valueRf value is...
TLC Thin layer chromatographyRf= drug distance/solvent distance
198
Osmometry based off measuresm-Osmol/kg
freezing point depressionmeasure osmolality of urine/serum(dissolved particle in sln)Tubular fnc
199
Hmg-VerdohmgPlasma/store: biliverdin-iron-globinLiver: bilirubin-albuminConjugataed: Bili diglucuronide
...
200
Ehrlich, p-DMAB reagent measures
Urobilinogen
201
p-DMAB stands for, used in...for...
p-Di-Methyl-Amino-BenzaldehydeEhrlich method for urobilnogen
202
Color produced with Erlichs reagent w/porphobilinogen and urobilinogenreagent used to distinguish the two
red/pink colorchloroform,urobilinogen will be soluble porphobilinogen will be insoluble and stay in aqueous phase
203
Protein that carries unconjugated bilirubin..Where is bilirubin conjugated...Name of conjugated/direct bili...
albumin carries unconjugatedconjugated in liverconjugated is bilirubin diglucuronide
204
Reaction for and alternate name bilirubin determination
diazo rxn/Jendrassik-Grofuses diazotized sulfanilicturns into purple azobilirubin
205
Jendrassik-Grof measuresusesturns into
bilirubinuses diazo-tized sulfanilicturns into purple azobilirubin
206
Bilirubin that is seen is not solube, thus not secreted in urine, cause of hemolytic trans rxn, prehaptic jaundice
indirect bili/unconjugated bili
207
Bilirubin that is formed/converted in intestine
urobilinogen
208
bilirubin that is oxidized/green in RE system
biliverdin
209
oxidized form of urobilinogen excreted in urine...stool...
urobilin: urobilinogen goes to kidney; yellowstercobilin: urobilinogen oxidized, brown stool
210
Evelyn Malloy method used for...Interference..
bilirubinhemolysis
211
Jaundice with increasd unconjugated and increased urine urinobilinogen
Prehepatic jaundice
212
Disease where all bili is increased, bili/uro in urine
hepatic
213
condition where unconjugated is normal, decreased uro, but increased conjugated in urine
Posthepatic obstruction
214
Have diff/mobility rates due to different aminos/structureElectrophoretic property is different for each isoenzymeBut have same rxn/react to same chemicals
Isoenzyme
215
Metals ions in enzymatic reactions act as
activators
216
This contant determines rate of conversion of substrate to product by differing substrate concentrations and rate of dissociation of complex
Michaelis-Menten
217
Order rxn where large excess substrate allows for amt of enzyme activity to be limiting factor when all enzyme is bound to substratesubstrate: A reactant in a chemical reaction is called a substrate when acted upon by an enzyme.
zero order
218
LD catalyzes lactate +NAD to... And...
pyruvate + NADH
219
LD isoenzyme that migrates the fastest to anode and highest in heart/rbc
LD1 HHHH
220
LD isoenzyme in healthy, HHHM
LD2
221
LD isoezyme that migrates the slowest
LD5
222
Increased in LD1,2,3
PApernicious anemia
223
Enzyme greatly affected by hemolysis because its in all cells
LD
224
CK increased in these 3: stress to muscles
heart attackmuscular dystrophyexercise
225
3 CK isoenzymes are dimersFastest to slowestBrain faster than muscle
CKBB, CKMB, CKMM
226
CK isoenzyme slowest, in skeletal muscle
CKMM
227
CKMB sensitive for AMIrises w/in...down in...
2-4hrs2-4 days
228
Most sensitive for AMI and two most usedrise/fall
TroponinTnT,TnI4-8hrs, 10 days
229
LD rises, days last
rises 8-12hrs, 10-14 days
230
Myoglobin rises, normal
30min, 24hrs
231
condition can't pump, fluids in lungs, cause CAD, BNP to diagnose
CHF
232
Condition were lack of oxygen, ischemia, leads to CHF/angina/heart attackNarrowing of the small blood vessels that supply blood and oxygen to the heart.
CHDCoronary heart disease (CHD) is also called coronary artery disease
233
3 conditions elevated AST1 not elevated
acute heartliver diseasemuscularnot elevated in acute pancreatitis
234
Liver enzyme not affected by hemolysis
ALT
235
Increased ALP in 3 things in liver
obstruction of biliary tract/jaundiceacute viral hepbiliary cirosis
236
ALP increased in these 3 bone disordersincreased in 1 random
Pagets: overgrowthosteomalacia: soft bones, decreased D/CaRickets: Vit d defprego
237
High ALP but no other liver increased
bone
238
pH for ACPincreased in
5.0acidprostatic disease
239
Enzyme in alcoholics, heptobiliary, obstructive jaundice, cirrhosis
GGT
240
Enzyme in mumps and acute pancreatititsenzyme most specific for pancreatittis
mumps: amylasepancreatitis: lipase
241
Cherry Crandall used to determine...substrate...
lipaseolive oil
242
Disease with highest level of aldolase
muscular dystrophyAldolase is necessary for glycolysis in muscle as a "rapid response" pathway for production of adenosine triphosphate, independent of tissue oxygen.
243
Zollinger-Ellison is a... increased...
gastrinomagastrin HCl
244
diacetyl monoxime used to determine
BUN
245
phospho-tungistic acid to tungsten blue used to determine
Uric acid
246
most uric acid in plasma is what form...increased in...
monosodium urategout
247
Kayser-Fleischer
Cooper deposits in cornea
248
To evaluate ionized calcium you need to know these two things and why
pH and proteinionized calcium is pH dependent; ph will increase if CO2 is lostCa will increase with increased protein
249
3 things that regulate calcium/increase/decrease
VitD/PTH: increase Ca-VitD increases GI absorption of Ca-low Ca will stimulate PTH productionCalcitonin: decrease Ca-inhibits bone reabsorption
250
Hypocalcemia causes
Tetany (decreased Ca,Mg)VitD def, hypoPTHhypo mag, albuminNormally, the parathyroid glands release a hormone that increases blood calcium levels when they are low. Magnesium is required for the production and release of parathyroid hormone, so when magnesium is too low, insufficient parathyroid hormone is produced and blood calcium levels are also reduced (hypocalcemia).
251
hypercalcemia
Vit excess, hyperPTHMalignancy
252
In the complexometric titration for Ca, the pH is adjusted to prevent
interference from Mg8-hydroxy-quinoline removes Mg
253
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
254
Clark-Collip measures...it will be precipitated as...
Calciumoxalate
255
In determining calcium, lanthanum is used to
bind phosphate
256
Most phosphorus is in... at pH
bone 7.4
257
Phosphorus is controlled by this and how does it affect it, opposite of Ca
PTH:decreases Phoincreases Ca
258
Affect on PhosPTHCalcitonin, Vit D
PTH decreased PhoCalcitonin, Vit D increases phosphate
259
Reagent used for phosphate
molybdatemolybdeum blue
260
Hyperparathyroidism= increased PTH,Phosphorus is
decreased
261
Hypoparathyroidism= decreased PTHPhosphorus...
increased
262
Magnesium is controlled by kidney thru tubular reabsorption, what is renal threshold
1.5-2.1mg/dL
263
Treatment for preeclampsia/contractions will result in what lab result to be increased
magnesiumhypermagnesemia
264
Condition decreased iron/ferritin/% sat, increased transferrin/TIBC
IDA
265
Reagent for magnesium
titan yellow
266
2 Conditions with increased iron/ferritin/%sat and decreased transferrin/TIBC
sideroblastic and hemocromatosis
267
trace metal involved in melanin, inorganic cofactor, bound to albumin, transported by ceruloplasmin
copper
268
Fat soluble vitamins
A,D,E,K
269
Water soluble vitamins
All B, C
270
Fat soluble Retinol, cause of night blindness
A
271
Fat soluble calciferol, hormone precursor, Rickets
D
272
Fat soluble Tocopherol, antioxidant/immunityHemolytic anemia
E
273
Fat soluble phylloquinine, for clotshemmorage
K
274
Water soluble B1condition
thiaminBeriberi
275
water soluble riboflavin
B2
276
water soluble B3, condition
niacinpellegra
277
water soluble pyridoxal
B6
278
water soluble B7
Biotin
279
water soluble B9, condition
folatemegaloblastic
280
water soluble cobalamin, condition
B12PA/IF
281
cause of Scurvy
C
282
Major extracellular cation, NV
Sodium 135-145
283
Hormone that increases Na reabsorption and acts on distal convoluted tubeReleased by adrenals
Aldosterone
284
Hypoaldosterone NaHyperaldosterone Na
Hypo: decreased NaHyper: increased Na
285
Normal valuesNa ClK
Na 135-145Major extracellular cationCl 98-106Major extracellular anion K 3.5-5.0Major intracellular cation
286
BUNCreatinine
BUN 6-20Creatinine 0.7-1.5
287
CO2/Bicarb
23-29
288
Na 165Cl 125K 3.5
Saline contamination
289
Diabetes mellitus FastingGlucose
126, 200
290
Increased K causesPhleb issuesTubeCondition
Hemolysis, tourniquet, squeezingEDTADiabetic ketoacidosis(Insulin promotes potassium entry into cells. When circulating insulin is lacking, as in diabetic ketoacidosis, potassium moves out of cells, thus raising plasma potassium levels even in the presence of total body potassium deficiency )
291
Used to enhance sensitivity of ISE electrode for K
Valinomycin
292
Hypokalemia is less thanHyperkalcemia greater than
Potassium<3.5>5
293
Chloride shift
Cl is inverse HCO3, when one leaves the other goes inHigh Cl, low HCO3=metabolic acidosis
294
Causes of increased Cl
IVDehydrationMetabolic/diabetic acidosis(lose HCO3, chloride shift)
295
Low Cl 4 things
Diarrhea, vomitingRenal failuremetabolic alkalosis
296
Chloride measured with titration methods such asC.A. and S.S.C.A. is...S.S. is...
Coulometric amperometricSchales-Schales
297
Coulometric amperometric method uses...What is measured...How is it measured...
TitrationChlorideTime needed to get to end pt
298
Schales-Schales is what kind of method...For...Violet color formed from reaction with...
Mercurimetric titrationChlorideExcess Hg++
299
C-A and S-S are both these kind of reactions...for...
TitrationChloride
300
Most CO2 in blood is
Bicarb
301
Specimen Least ordered, not used for CO2
Urine
302
Anion Gap, NV
Na+K-(Cl+HCO3)10-20
303
Increased anion Gap
Diabetic ketoacidosisLactic acidosisSalicylateMethanolEthanolPoly glycolUnmeasured
304
Decreased anion Gap used as, due to
Analytical QCAnalyzer error
305
Glass, Ag/AgCl, measures H for measurement of
pH
306
pH electrode with membrane measures
pCO2PC, MD-NADH
307
Platinum+Ag/AgCl, amperometric measures
pO2
308
Henderson Hasselbalch
pH= pKa + log [salt]|[acid][A base]|[HA acid]pH=log HCO3/pCO2pH=log kidney/lungspH=log metabolic/respiratory
309
Bicarb: carbonic acid ratio in plasma
20:1
310
AcidosisNormalAlkalosis
<7.387.35-7.45, around 7.4>7.42
311
Metabolic acidosis: pH, HCO3 levels compensation
Decreased pH, HCO3Lung: Hyperventilating releases CO2
312
Metabolic alkalosis 2 parameters influenced, compensation
Increased pH, HCO3Lung: Hypoventilation increases CO2
313
Respiratory acidosis 2 parameters, compensation
Decreased pH, Increased CO2Kidneys: increase bicarb
314
Respiratory alkalosis 2 parameters, compensation
Increased pH, decreased pCO2Kidneys compensate
315
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.
316
Synovial: joints, hyaluronic acid makes viscous, obtain by arthrocentesis2 Synovial crystals/conditions
Uric acid: goutPyro-phosphate: pseudogout
317
Amniotic fluid: access neural tube defects/AFP4 Fetal lung tests...
L/S: >2PGFLM 2Lamellar
318
Sweat:AnalyteCondition, death cause
ClCystic fibrosis, pneumonia
319
Sperm:mL, live%, motility %, #/mL
2-5mL>75% alive>50% motility# 20-250 million/mL
320
Decreased CSF glucose seen inIncreased CSF glucose seen in
Decreased CSF glucose: Bacterial meningitis Increased CSF glucose:Diabetes
321
CSF tube order/department
1 chem 2 micro3 heme
322
CSF protein mg/dL
15-45
323
CSF glucose
60-70% plasma
324
CSF diff
70% lymph30% mono
325
4 causes of increased CSF Protein
MeningitisIntracranial hemorrhageTraumatic tapMS
326
Decreased CSF TP seen in
Leak, tear
327
Increased CSF IgG index and oligoclonal banding seen in
MS Multiple scelerosis
328
Urine ph normal...If left at rt becomes..
normal 6.0 (4.5-8)alkaline at RT
329
Normal urine volume:poly> olig
1200-1500poly >2500olig<400noc: more at nightanuria: none
330
left at RT, what decreases...increases
decreases:glucose/ketonesbili/urocells/castsincreases:nitrites/bacteriaturbiditypH
331
3 things kidneys make2 hormones that influence kidney
renin, erythropoeitin, PGaldosterone, ADH
332
Urine is made of 7 things
95% waterurea, uric acid, creatinineCl/Na/K
333
Urine RBCs color
smoky, red/brown urine
334
Urine bili/pyridum color
dark yellow/amber/orange
335
Met/Hmg and homogentistic acid urine color
brown black upon standing
336
Reabsorbs H2O onlyRebabsorbs solutes only
H2O only Descening Loopsolutes only ascending loop
337
Specific gravity NV...increased in these 3decreased in this
1.003-1.030increased in: isotheniuria/renal damage 1.010diabetes mellitusxraydecreased in diabetes insipidus
338
3 methods to determine sg
refractometerreagent stripharmonic oscillation: densitometry; current helps measure sg
339
Urine strip protein method name...ph...what protein it binds to...color...confirm with...
protein error of indicators3.0albuminsulf.acid precipitation
340
How many neprons per kidney....filtration ml/min
1 million20mL/min
341
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 and the protein will combine with the non-ionized form and will change the ratio of ionized and nonionizedHas nothing to do with pH and not affected by bence jonesFalse pos due to alkaline/buffered urine
342
Renal threshold for glucosedipstick measures only glucosetwo enzymes in rxn
160-180mg/dLglucose oxidase, perioxidase
343
Clinitest/Benedicts is a...is for...Can screen for...but reacts with...False neg with these two...
copper reduction method for glucosescreen for galctosemiareacts with all reducing substancesfalse neg with Vit C and pass thru
344
Occult blood on urine dipstick depends on
perioxidase activity of rbc/hmg
345
Nitrite:bacteria type...2 names for rxn:
GNR (E.coli)Diazo, Griess rxn
346
RBC dipstick:false neg with one vitamin and mistaken with 3 things...false pos...
false neg: vitC, yeast, oil, calcium oxalate crystalsfalse pos: oxidizing like bleach
347
UTI, renal calculi, acute glomerulonephritis you'll see these cells
RBCs
348
reagent for LE, color
diazo reagent, purple
349
Cell related to glitter cell, UTI/pyelonephritistype seen in UTI
whiteneutrophils
350
Seen in diabetes mellitus, breakdown of lipids...reagent...color...confirm with...
ketonessodium nitroprusside purpleAcetest (diacetic acid, acetone)
351
Sodium nitroprusside used in determination of...on dipstick
ketones
352
Acetest is used to confirm...detects these two..
confirm ketonesdiacetic acid, acetone
353
Ictotest, Diazo rxn used for
Bilirubin
354
Erlich, p-DMAB used in
Urobili
355
Leukocyte in dilute hypotonic urine where granules appear to move/Brownian Mvt
glitter cell
356
Large epithelial seen in catherterization, renal pelvis, ureter, bladder
transitional
357
Cell seen in tubular necrosis, renal tubles, oval fat bodies are made from
renal tubular
358
glycoprotein made from TRE that makes up casts (two names)
Tamm horsfall mucoproteinUromodulin
359
Cast are formed in what part of tubules
distal convoluted tubule
360
Casts seen in chronic renal disease, urinary stasis
waxy
361
cast seen in stress/exercise, normal
hyaline
362
cast seen in nephron/acute glomerulonephritis
RBC
363
Cast from dialated collecting ducts
broad
364
cast seen in acute glomerulonephritis and is decomposition of cellular
granular
365
cast from break down of epi casts/oval fat bodies, nephrotic syndrome
fatty
366
cell in pyleonephritis
wbc
367
4 urine parasites
T.vagE.vermiculares (bread loaf ova)strongyS.haematobium
368
5 abnormal crystals
Cysteine: 6 sidesLeucine: concentric circlesTyrosine: needlesBili: yellow/brown needlesCholesterol: notched plates
369
3 normal crystals in acidic urine
Uric acid: rhomboid/pleomorphicamorphouse urates: pink sedimentCalcium oxalate: envelope/oval/dumbell, antifreeze
370
4 normal crystals in alkaline urine
amorphous phosphatestriople phosphate: coffin lidcalcium carbonate: dumbellamm. biurate: thorny apple
371
NV for... 50-200 mg/24hr
microalbumin
372
AAT globulin
Alpha-1-antitrypsinAlpha1 globulininhibits the neutrophil elastase activity in the lung and hence can protect it from proteolytic damage.
373
Tangier low in
HDL
374
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
375
The NAD coenzyme is reduced to NADH and measured at 340nm in this method...for which analyte?
HexokinaseGlucose
376
diazo rxn/Jendrassik-Grof
Bilirubin
377
Jendrassik-Grof andEvelyn Malloymeasure
Bilirubin
378
Jendrassik-Grof=Bilirubin+Diazo (caffeine)=azobili
Jendrassik-Grof=Bilirubin+Diazo (caffeine)=azobili
379
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
380
LD1 HHHH Fastest, marker for these two
heart/rbc
381
sideroblastic and hemocromatosisIron,ferritin,%sat, transferrin/tibc high or low
increased iron/ferritin/%sat and decreased transferrin/TIBC
382
Pyrophosphate seen in
pseudogout
383
Porter-Silber reaction uses phenylhydrazine to detect...Zimmerman reaction detects...
PS=phenylhydrazine=corticosteroidsZimm=17-ketosteroids
384
Phenlyhydrazine used to detect corticosteroids in what reaction
PS=Porter-Silber
385
17-ketosteroids/17-KS is detected in what reaction...
ZimmermanZimmerman is a man that takes 17-KS/steroids
386
Porter and Zimmermand take steroids
...
387
Hypothalmus makes releasing/inhibiting hormones that act on the pituitaryPituitary then makes hormones that have their effects on organs that make the end product/action
...
388
Primary caussed by...secondary caused by...tertiary caused by...
Primary...end organSecondary:pituitaryTertiary: Hypothalamus
389
Increased GH causes these two thingskids versus adultsDecreased GH causes
kids: giantismadults: acromegalydwarfism
390
Hormone that solely initiates and maintains lactation
prolactin
391
Hypogonadism and prolactinoma (pituitary tumor) due to...
increased prolactin
392
menstral disorder and inadequate lactation due to
decreased prolactin
393
Vasopression is also called
antidiuretic hormone
394
ADH acts on...to increase...decreased in...
acts on renal tubles to increase water reabsorptiondiabetes insipidus
395
Hormone that stimulates urterine contraction/myoepithelial cells in breast thus ejecting milk
oxytocin
396
Hormone that forms male sex characteristics, spermatogensis, facial hair, deep voice, sex drive
testosterone
397
Testosterone is made from...
cholesterol (as is a lot of steriods)
398
hormones that stimulate sex organ development, linear growth, epiphyseal fusion
androgens
399
infertility men/women, adrenal hyperplasia, polycystic ovarian due to
hypertestosteronemia
400
hypogonadism due to
hypotestosteronemia
401
TRH, GRH, CRH GHRHPIF, GHIH released by
hypothalamus
402
GH, PRL, TSH, LH, FSH, ACTH released by the
anterior pituitary
403
ADH, oxytocin released by
posterior pituitary
404
Hormone that induces ovulation, ovary secretes estrogens/progesterone for possible pregnancy and stimulates testes androgens in males
Luteinizing hormone
405
GnRH stimulates this organ to produce... which affects these organs
GnRH stimulates pituitary to make LH and FSH to affect ovaries or testes
406
GHIH/GHRH gets the pituitary to make... which acts on these two organs
soft tissue/bone
407
FSH stimulates, secretesfemales:males:
females: egg development, estrogenmales: sperm, testosterone
408
hypothalmus makes CRH that act on pituitary to make ACTH, this stimulates the adrenal cortex to make steroid hormones made from cholesterol3 steroids made adrenal cortex...
mineralcoritcoids(aldosterone)glucocorticoids(cortisol)sex hormones (androgens, estrogens)
409
What converts angiotensinogen to angiotensin I which converts to II and stimulates cortex to make aldosterone
Renin
410
hormone that induces secretion of glucorticoids(cortisol) of adrenal cortex
ACTHadreno-cortiotropic hormone
411
CRH stimulates the...to make... which causes this organ to release cortisol, aldoseterone, estrogens and testosterone
CRH stimulates the pituitary to make ACTH causing the adrenal cortex to make cortisol, aldosterone, estrogens/testosterone
412
Mineralocorticoids, glucorticoids, and androgens released by
adrenal cortex
413
aldosterone is an example of a...maintains...excretes...retains...
mineralocorticoidmaintains H2O/electrolytesexcrete K/retain Na
414
Cortisol is a type of
glucocorticoid
415
Hyperadolsoterone, increased Na, decreased K, hypertension
Conns Disease
416
Hypoaldosterone, decreased Na/Cl, decreased cortisoleverything down
Addisons Disease
417
Increased cortisol, increased glucose, increased Nabuffalo hump
Cushingseverything up
418
Testosterone is a type of
androgenmale sex hormone
419
metabolite of androgen...reaction used to detect...
17-ketosteroid, 17-KSZimmerman reaction
420
3 types of catecholaminespurpose
epinephnorepidopaminemobilize energy stores
421
Two GI hormones
Gastrinserotonin
422
Hormone increased in Zollinger Ellison syndrome
gastrin
423
Hormone made in GI, vascoconstricter of PLTs/brain/tissue
serotonin
424
5HIAA is a urinary metabolite of...increased in chromaffin cell tumors of GI, drugs, bananas, pineapples etc
serotonin
425
Catecholamines produced in...by...
adrenal medullaby chromaffin cells
426
Metabolites of epineph
metanephrine, VMA
427
Metabolites of norepineph
normetaneph,VMA
428
Metabolites of dopamine
HVA
429
Pheochromocytoma is a tumor with increased
VMA
430
Neuroblastoma is a tumor with increased
HVA
431
Most of the releasing and inhibiting hormones (except for ACTH) are producted by the...
hypothalamus
432
Thyroid hormones: stimulate metabolic processesIn tissues...is coverted to....99.97% of...is bound to mosntly TBG, some TB-PA, albumin99.5% of....is also bound
In tissues T4 is converted to T399.97% of T4 is bound to TBG99.5% of T3 is bound
433
TSH stimulates the ... to make these two
thyroid, T3/T4
434
3 things hormones made by thyroid
thyroxine/T4, triiodothyronine/T3calcitonin
435
Thyroxine/T4 increases...Triiodothyronine/T3 increases...Calcitonin increases...
Thyroxine, Triiodothyronine: metabolismCalcitonin: Ca reabsorbtion
436
3 calcitropic hormones
PTH, VitD, calcitonin
437
Parathyroid mades these two...PTH stimulates renal production of this...
Calcium, PhosphorusVitD
438
Low PTH lowers/increases serum...
Lowers serum Ca, DIncreases Phos
439
Hypothalamus releases...which acts on anteroir pituitary
TRH
440
TRH stimulates pituitary to release... which acts on...
TSH, acts on thyroid
441
TSH stimulates thyroid to make...
T3,T4
442
Free... stimulate negative feedback loop and inhibit secretion of...
Free T3/4 inhibit TSH
443
primary Hyperparathyroidism also called...symptoms
Gravesweight loss, heat, hair loss, anxious
444
Graves is hyper or hypo...T3/T4 levels...TSH levels...
hyper: T3/T4decreased TSH to stop production of T3/T4Primary means thyroid overproduces T3/T4 due to TSH antibodies
445
Primary Hypothyroidism is called...symptoms
Hashimotosweight gain, tired, cold
446
Hashimotos is hyper or hypo...T3/T4 levels...TSH levels...
hypo: T3/T4increased TSH to increased T3/T4 levelsThyroid autoab
447
Major binding protein for thyroxineHow is it measured
TBGthyroid binding globulinBy measuring T3 uptake (amount of TBG bound to thyroid hormones)
448
3 good indicators for hypothyroidism1 not good indicator
FT4, TT4, s-TSH (singles best)not good T3 uptake (indirect, not used)
449
Ovaries productes these two hormones
estrogen, estadiol
450
hormone female sex charac, hyper=amenorrhea, hypo=menopause
Estrogen
451
hormone that's active form of estrogen, evaluates fetoplacental function
estadiol
452
Progesterone made by the
corpus luteum
453
prepares uterus for pregoj, maintains endometrium lining, inhibits uterine contractions, prepares breasts for lactation
progesterone
454
progesterone levelsperimenopausepostmenopause
peri: increased progesteronepost:decreased progesterone
455
What hormone maintains progesterone in early pregnancy
HCG
456
HCG increased/decreased...
increased: prego, mutiple pregos, tumorsdecreased: spontaneous abortion
457
HCG subunits are...
alpah, beta subunitsnoncovalently bound subunits
458
subunit that cross reacts with LH,FSH,TSh
alpha
459
subunit that has analytical specificity
beta
460
Trimester with highest level of HCG...When does it show up, how long does it last...
firstseen in days, peaks 2-3mths
461
Toxicology, best specimen for screening/qualitative, best for quantitative
Urine-QLBlood-QNT
462
Creatitinine, pH, or oxidizing activity, dilute/substituted/adultered as a measure of
validity
463
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 specimengas chromatography/MS
464
Aminoglycosides and Glycoprotein are two kinds of
antibiotics
465
Kind of Glycoprotein/antibiotic
Vancomycininhibit cell wall synthesis, treat gp
466
gentami/tobramy/amika/kana-cin are allinhibit protein synthesis, treat gn
aminoglycosides
467
Monitor toxic range of antibiotics to prevent damage to...and...
hearing/ototoxickidneys/nephrotoxic
468
Phenobarbital, phenytoin/dilantinValproic acid, Carbamazepineethosuximide are all
anti-epileptic/anti-convulsants
469
Bronchodialatorasthma, IV/oral, 10-20ug/mL, toxic >20ug
Theophyllineactive metabolite in neotates is caffeine, also caffeine given as a brochodilator
470
Cyclosporine, Tacrolimus, Sirolimus,MPA all are
immunosuppressives
471
Methotrexate are all
antineoplastics/antitumor
472
Cyanide, arsenic, mercury all are
heavy metals
473
Substances/acute poisoning
acetaminophen-liver damagesalicylatesalcohols-ethanol,isopro,glycolcyanidecarbon monoxidecarboxyhmg (200x infinity)organophosphates/pesticide:-CNS, decrease cholinesterase
474
Must wait until...to TDMhow many half lives to reach...how many half lives to clear...metabolized by liver, excreted in urine
steady state5.5
475
Specimen drawn imme before next dose is called...Peaks drawn...hrs
Trough1-2hrs after oral dose
476
Amtriphtyline, Imipramine, DoxepinLithium are all
pyschotropics
477
Amtriphtyline, Imipramine, Doxepin are all
tricyclics
478
Digoxin, Quinidine, Procainamide,Disopyramide, Lidocaine all are
Antiarrythmics/cardiactive
479
What body does to drug...What drug does to body...
Body does to drug: pharmacokineticsDrug does to body: pharmacodynamics
