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Clinical Chemistry > Chemistry Exam 3 > Flashcards

Chemistry Exam 3 Flashcards

1
Q

Primary concern with medical, legal consequences of exposure.
Major focus: generate evidence

A

Forensic toxicology

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2
Q

Main focus: relationship between xenobiotics and disease states
Diagnostic testing and therapeutic intervention
Consider specialty

A

Clinical toxicology

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3
Q

The evaluation of environmental chemical pollutants and their impacts on human health

A

Environmental toxicology

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4
Q

Describe environmental exposure to chemicals or drugs

A

biotics

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5
Q

Describe substances from an animal, plant, mineral, or gas (venom,…)

A

poisons

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6
Q

Endogenous substances biologically synthesized either in living cells or in microorganisms

A

toxins

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7
Q

Highest mortality rate, poisoning cases

A

suicide

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8
Q

Most frequently in kids. Also common in teens and adults with both therapeutic or illicit drugs

A

Accidental

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9
Q

Correlates a single, acute oral dose range with the probability of a lethal outcome in

A

An average 70kg (154lb) male

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10
Q

The predicted dose that would produce a toxic response in 50% of population

A

Toxic dose TD50

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11
Q

Predicted dose that would result in death for 50% of population

A

Lethal dose LD50

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12
Q

Predicted to have a therapeutic benefit or be effective in 50% population

A

Effective dose ED50

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13
Q

Fewer toxic/adverse effects when dose is in the T.R.

A

larger therapeutic index

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14
Q

Therapeutic index

A

Ratio of TD50 or LD50 to the ED50

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15
Q

Toxicity that single, short-term exposure to a substance in which the dose is sufficient to cause immediate toxic effects

A

Acute

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16
Q

Toxicity that associated with repeated and frequent exposure for extended time periods (months to years) at doses that are insufficient to cause an immediate acute response

A

Chronic

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17
Q

Chronic may affect different systems than acute

A

True

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18
Q

Toxic agents exhibit unique absorption, distribution, metabolism and elimination

A

Toxicokinetic

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19
Q

“Trace element free” blood collection tubes

A

royal blue top

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20
Q

tube for specifically for lead testing

A

tan blue top tube

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21
Q

Most significant metabolism pathway for alcohols

A

Alcohol→(ADH)→Aldehyde→(ALDH)→Acid

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22
Q

Exposure common for alcohol
Excessive consumption—leading cause of economic, social, and medical problems in the world

A

ethanol

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23
Q

Legal limit for alcohols
Associated with decreased judgement and motor function

A

80 mg/dL

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24
Q

What causes severe metabolic acidosis—can lead to tissue injury and possible death
Common lab solvent
Responsible for optic neuropathy that can lead to blindness

A

Methanol Formic acid

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25
Q

Alcohol responsible for optic neuropathy that can lead to blindness

A

methanol

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26
Q

Rubbing alcohol
Metabolized by hepatic ADH to acetone (end product)

A

isopropanol

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27
Q

Common component of hydraulic fluid and antifreeze
Sweet taste
Results in severe metabolic acidosis
Rapid formation and deposition of calcium oxalate crystals in the renal tubules
May result in renal tubular damage

A

ethylene glycol

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28
Q

How many time does affinity of Hgb to CO higher than O2

A

200-225 times

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29
Q

Half life of CO

A

60-90 min

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30
Q

Any exposure to strong acids or bases associated with injury
Aspiration and ingestion—greatest hazards
Aspiration associated with pulmonary edema and shock

A

caustic agents

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31
Q

Used in electroplating and galvanizing
Pigments in paint and plastics
Itai-itai disease
Toxics to kidneys
Half life 30 years

A

cadmium

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32
Q

Half life of lead in bones and soft tissue

A

20 years and 120 days

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33
Q

TUMOR MARKERS
If cancer move to other parts of the body it is called

A

metastasis

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34
Q

Biomarker found in the blood or tissue and when elevated is linked to cancer

A

tumor marker

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35
Q

protein produced during fetal development and elevated in individuals with cancer

A

oncofetal antigens

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36
Q

Found on the surface of all nucleated cells
Used as a non-specific marker of the high cell turnover common in tumors

A

beta macroglobulin

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37
Q

Valuable in diagnosing neuroblastomas, pituitary and adrenal adenomas

A

endocrine tumor marker

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38
Q

Monoclonal defined antigens identified from human tumor extracts and cell lines

A

Carbohydrate and Cancer Antigen Tumor Markers

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39
Q

“non-serological” markers
Helps to choose between endocrine and cytotoxic therapies

A

receptor tumor markers

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40
Q

Tumor specific
Absent in healthy individuals
Readily detectable in body fluids

A

Ideal tumor marker

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41
Q

Study of the movement of drugs
in the body

A

pharmacokinetic

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42
Q

the major transporter of drug

A

albumin

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43
Q

the phenomenon in which a drug is metabolized an results in a reduced concentration of the drug before reaching the circulatory system

A

1st pass effect

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44
Q

The study of the biochemical and physiological effects of drugs and their mechanisms of actions:

A

pharmacodynamics

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45
Q

This tumor marker often is measured in both the total and free form:

A

PSA

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46
Q

The concentration range of a drug within which the drug produces the desired effect:

A

therapeutic range

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47
Q

This tumor marker is primarily used as a marker for ovarian cancer:
May be elevated in patients with endometriosis, 1st tri of pregnancy, or during menstruation

A

ca 125

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48
Q

This is found as a contaminant of homemade liquors and can cause optic neuropathy

A

methanol

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49
Q

This is a significant environmental pollutant and is easily taken up by crops – especially tobacco

A

cadmium

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50
Q

This is a cardioactive drug that is used to treat arrythmias and CHF. Biotin is known to interfere with this test:

A

digoxin

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51
Q

The most direct and effective route of administration of a drug

A

IV

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52
Q

This is a common malignant tumor in kids associated with high levels of plasma, epinephrine, norepinephrine and dopamine

A

neuroblastoma

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53
Q

This test is used along with hCG to classify nonseminomatous tumor
Often elevated in patients with hepatocellular carcinoma (HCC) and germ cell tumors

A

AFP

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54
Q

13) This is a kind of testing method that can be performed on solid tissue tumor markers

A

Immunohistochemistry

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55
Q

The predicted dose that would produce a toxic response in 50% of the population

A

TD50

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56
Q

This may occur when analyte concentrations exceed the analytical range excessively

A

hook effect

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57
Q

This drug is the hepatic metabolite of procainamide

A

NAPA`

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58
Q

This drug commonly is tested for both the total and free forms

A

phenytoin (dilantin)

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59
Q

Endogenous substances biologically synthesized either in living cells or in microorganisms

A

toxins

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60
Q

This method of analysis of toxic agent has good sensitivity but lacks specificity:

A

screening

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61
Q

These types of tumor markers are valuable in diagnosing neuroblastomas, pituitary and adrenal adenomas

A

endocrine tumor markers

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62
Q

This tumor marker is the prototypical oncofetal antigen and is used for monitoring colorectal cancer:
Increased in heavy smokers and some patients following radiation treatments

A

CEA

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63
Q

Uses the results from animal experiments to predict what level of exposure will cause harm to humans:

A

Descriptive Toxicology

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64
Q

This is a metal with 3 forms, one of which is liquid at room temp

A

MERCURY

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65
Q

This is a useful system to compare relative toxicities of substances as the predicted endpoint is death:

A

Dose-Response Relationship

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66
Q

B-macroglobulin and immunoglobulins are part of this group of tumor markers:

A

Serum Protein Tumor Markers

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67
Q

Chemicals and drugs that are not normally found in or produced by the body:

A

Xenobiotics

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68
Q

This is an example of something that can have significant interference in immunoassays by cross-linking with the capture/label antibody:

A

HAMAs

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69
Q

This drug is ototoxic enough that it is recommended that baseline audiology testing is performed:

A

Tobramycin

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70
Q

Largely a result of the high metabolic demand of these proliferative cells
Tend to correlate to tumor burden

A

enzyme tumor marker

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71
Q

Unique characteristics and concentrations of T.M.–2 major consideration

A

lack of standardization and wide range

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72
Q

Used to help diagnose carcinoid tumors, pheochromocytoma, & neuroblastoma

A

Catecholamines & metabolites

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73
Q

Rare tumor associated with hypertension
Elevated plasma metanephrines, urine vanillylmandelic acid, free catecholamines

A

Pheochromocytoma

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74
Q

Elevated levels correlate with cancer stage of CA125

A

50% stage 1
90% stage 2
>90% stage 3 or 4

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75
Q

Dimeric hormone secreted by trophoblasts
Elevated in trophoblastic tumors, mainly choriocarcinoma and germ cell tumors of ovary and testes
Prognostic for ovarian cancer
Diagnostic for classification of testicular cancer

A

HCG

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76
Q

produced in the epithelial cells of the acini and ducts of the prostate gland

A

glycoprotein

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77
Q

Mucin 1 (MUC1), Normally expressed in glandular or luminal epithelial cells
Best application is serial testing for breast cancer patients

A

CA 15-3

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78
Q

Best validated biomarker for pancreatic cancer
Modified Lewis (Le a ) blood group antigen

A

CA 19-9

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79
Q

Primarily used for ovarian cancer
Improved specificity over CA-125—which can be elevated in non-malignant conditions like endometriosis

A

HE4

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80
Q

Auxiliary test for neuroendocrine tumors

A

NSE

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81
Q

drug absorption of weak acids

A

in stomach

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82
Q

drug absorption of weak bases

A

in intestine

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83
Q

the movement of a drug between blood circulation and tissues and organs and the relative proportion of the drug in the tissues

A

drug distribution

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84
Q

interact with site of action & result in biological response

A

free/unbound drugs

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85
Q

The biochemical pathway responsible for a large portion of drug metabolism

A

MFO - Hepatic mixed-function oxidase

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86
Q

number doses typically needed before steady-state oscillation is achieved

A

5-7

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87
Q

The science of studying variations and developing drug therapies to compensate for the genetic differences impacting therapy regimens

A

pharmacogenomic

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88
Q

Prominent gene affecting drug metabolism

A

CYP450

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89
Q

Natural product extracted from bark to treat arrythmias

A

quinidine

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90
Q

Treat gram neg and some gram pos infections
Inhibit bacterial protein synthesis

A

aminoglycosides

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91
Q

Treats GNR—life threatening

A

gentamicin

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92
Q

Treat severe blood infections
Can be administered orally to reduce intestinal flora

A

amikacin

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93
Q

“redman syndrome”—extremity flushing
Against GPC and GPR
Poor GI absorption

A

vancomycin

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94
Q

Used to treat and suppress seizures
Only effective while drug metabolites are in the body
goal: get therapeutic benefit with little to no adverse effects

A

Antiepileptic Drugs (AEDs)

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95
Q

Grand mal seizures—when resistance to other AEDs

A

primidone

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96
Q

Severe adverse events—only use if no response to other AEDs

A

carbamazepine

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97
Q

Mood altering used to treat:
Bipolar disorder, recurrent depression, aggressive or self-mutilating behavior
Also preventative for cluster headaches or migraines

A

lithium

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98
Q

Used to treat depression, insomnia, extreme apathy, loss of libido
Ex: imipramine, amitriptyline, doxepin

A

TCA

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99
Q

Used to treat refractory schizophrenia
Absorption rapid and complete

A

clozapine

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100
Q

Treats schizophrenia, acute manic episodes, recurrence of bipolar disorders
Can be IM but usually oral

A

olanzapine

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101
Q

Cyclic polypeptide–suppress graft vs host rejection of heterotopic transplanted organs

A

cyclosporine

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102
Q

Antifungal agent used to prevent graft rejection in kidney transplants

A

sirolimus

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103
Q

Derived form sirolimus
Short half life—more rapid achievement of steady state pharmacokinetics

A

everolimus

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104
Q

prodrug that is rapidly converted in the liver to its active form, MPA (Mycophenolic Acid)

A

Mycophenolate mofetil

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105
Q

Assessment of therapeutic benefit not aided by TDM because pharmacodynamics are hard to establish
EX drug: methotrexate

A

Antineoplastics

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106
Q

Used to treat respiratory disorders
For patients who can’t use an inhaler or have nocturnal symptoms

A

theophylline

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107
Q

Describes the changes in health effects of a defined population based on the exposure to the xenobiotic

A

quantal dose-relationship

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108
Q

Toxic agents exhibit unique absorption, distribution, metabolism and elimination

A

toxicokinetics

109
Q

Methods used for analysis of toxic agents

A

Immunoassays-common for most drug screens
Gas chromatography (GC) with mass spectrometry (MS)
Reference method for most organic compounds
Liquid chromatograph with tandem mass spectrometer (LC-MS)
Emerged as an important analytical technique
Inorganic compounds
Use inductively coupled plasma mass spec (ICP-MS) or atomic absorption (AA) methods
Nuclear magnetic resonance (NMR) spectroscopy has potential applications

110
Q

Most significant metabolism pathway of alcohol

A

Alcohol→(ADH)→Aldehyde→(ALDH)→Acid

111
Q

reactive intermediate, most converted to acetate but some is released in the free state

A

Acetaldehyde

112
Q

osmolality ratio of osmo to serum ethanol

A

Serum osmo increases 10 mOsm/kg per 60 mg/dL increase in serum ethanol

113
Q

Super-toxic substance
Used in industrial processes, insecticides, rodenticides
Binds to heme iron
High lactic levels commonly found

A

cyanide

114
Q

Less harmful organic forms with foods
Clams, oysters, scallops, mussels, crustaceans, bottom feeding fish

A

arsenic

115
Q

Potent inhibitor of many enzymes
Noteworthy effects on Vit D metabolism and heme synthesis

A

lead

116
Q

Intentionally added to environment to harm or kill something
Insecticides, herbicides, fungicides, rodenticides
Found in occupational and home settings

A

pesticides

117
Q

Reye’s syndrome with viral infections in kids

A

salicylates
common drug: Acetylsalicylic acid—aspirin

118
Q

Overdose associated with severe hepatotoxicity
Alcoholics more susceptible

A

Tylenol

119
Q

Confirmation testing for drug abuse

A

immunoassays -more common

120
Q

Typical screening panel

A

Amphetamines, barbiturates, benzodiazepenes, cocaine, opioids, THC, tricyclic antidepressants

121
Q

Originally sleep inducers
Most commonly abused
Used as “downer” after cocaine or amphetamine “high”

A

barbiturate

122
Q

Depressants of CNS
Among drugs most commonly prescribed because of:
Efficacy, safety, low addiction potential, minimal side effects, high public demand for sedative and anti-anxiety

A

Benzodiazepines
Diazepam (Valium), chlordiazepovide (Librium), lorazepam (Ativan) alprazolam (Xanax)

123
Q

Psychoactive compounds found in marijuana

A

Cannabinoids: Tetrahydrocannabinol (THC)

124
Q

Effective local anesthetic, few adverse effects at therapeutic concentrations
Alkaloid salt

A

cocaine

125
Q

Used to treat depression and mood disorders
Imipramine metabolizes to desipramine
Amitriptyline metabolizes to nortriptyline
Doxepin metabolizes to nordoxepin

A

Tricyclic Antidepressants (TCAs)

126
Q

Amphetamine derivative “ecstasy”

A

Methylenedioxymethamphetamine (MDMA)

127
Q

“angel dust”
Illicit drug with stimulant, depressant, anesthetic, and hallucinogenic properties

A

Phencyclidine (PCP)

128
Q

Used to increase muscle mass to improve athletic performance
Can cause enlargement of the heart

A

Anabolic Steroids

129
Q

A drug’s most direct and effective method of delivery to its site of action is:

A

Intravenous administration

130
Q

Which of the following is not true regarding the absorption of drugs?
Drug absorption rates may change with age
Morphine may slow the gastrointestinal motility of a drug
Liquid medications are often absorbed slower than capsule medications
Crohn’s disease may alter the absorption of some drugs

A

Liquid medications are often absorbed slower than capsule medications

130
Q

T/F Drugs are susceptible to hepatic metabolism, and this increases the concentration of the drug before it reaches the circulatory system.

A

false

131
Q

Which of the following statements is true regarding drug elimination?
One drug half-life is the time needed for the drug concentration to increase by half
Five to seven drug doses are required to reach a steady state of drug concentration
Most medications are administered as a single dose versus a scheduled basis
Aminoglycoside antibiotics are reabsorbed by the renal tubules

A

Five to seven drug doses are required to reach a steady state of drug concentration

132
Q

The relationship between a drug’s concentration at its target sites and its physiological responses is known as:

A

Pharmacodynamics

133
Q

Which of the following is not true concerning therapeutic drug monitoring?
It ensures correct drug doses for the expected therapeutic range
It helps to identify non-compliance of the patient
It identifies drug-drug interactions if multiple drugs are taken simultaneously
It establishes a one-fit dosing model for all patients

A

It establishes a one-fit dosing model for all patients

134
Q

A blood draw to determine a peak level of a drug should be drawn:

A

One hour after an orally administered dose

135
Q

CYP450 is a gene that influences the effectiveness of a drug in an individual.

T/F

A

True

136
Q

Which of the following is not true concerning aminoglycosides?

A

Ototoxic effects of the drug are reversible

137
Q

Pharmacokinetics and drug concentration are influenced by which of the following factors?

A

Absorption, distribution, metabolism, excretion

138
Q

Only bound fractions of drugs can interact with the site of action and result in a biological response.

A

False

139
Q

Tolerance to drugs could be explained as:

A

Constant exposure of receptors to drugs that leads to a reduced response

140
Q

This drug is used to treat arrhythmias and CHF.

A

Digoxin

141
Q

This drug may have the adverse effect of “redman syndrome”

A

Vancomycin

142
Q

This antiepileptic drug requires hepatic markers to be check frequently due to risk of hepatic dysfunction.

A

Valproic acid

143
Q

Immunosuppressive drugs typically are collected as serum samples.

true/false

A

false

144
Q

Common routes of exposure to toxins are through the gastrointestinal tract, lungs, and skin.

t/f

A

true

145
Q

Which specimen type is preferred for analytes demonstrating variation in urinary elimination patterns?

A

24-hour collection

146
Q

Which of the following is not true concerning analysis of toxic agents?

A

Screening tests have good specificity but lack sensitivity

147
Q

All of the following statements are true regarding blood alcohol measurements except:
During venipuncture, the skin must be disinfected with iodine or chlorohexidine gluconate

Plasma and serum are acceptable specimen types for analysis
When testing will be delayed, sodium chloride can be used as a preservative to maintain specimen integrity
Specimens should remain capped to avoid evaporation

A

When testing will be delayed, sodium chloride can be used as a preservative to maintain specimen integrity

148
Q

The affinity of carbon monoxide for hemoglobin is 20-25 times greater than oxygen
t/f

A

false

149
Q

Toxic levels of acetaminophen are associated with

A

Hepatotoxicity

150
Q

Which of the following statements is not true concerning testing for drugs of abuse?

A

Confirmatory testing must use methods with high specificity and low sensitivity

151
Q

Which type of toxicology uses the results from animal experiments to predict what level of exposure will cause harm to humans?

A

Descriptive

152
Q

Which is not a common route of exposure to toxic substances.
Ingestion
Intravenous
Inhalation
Transdermal absorption

A

IV

153
Q

What phrase best describes what ED50 stands for?

A

A drug is predicted to have a therapeutic benefit for 50% of the population.

154
Q

Chronic exposure to a toxin always has the same effect as acute exposures.
t/f

A

false

155
Q

Which is not a common specimen type for analysis of toxic agents?

urine
blood
oral fluid

A

all are common

156
Q

An alternative test that may be performed in order to estimate ethanol in serum is the osmolality.
t/f

A

true

157
Q

This toxic substance can be found in its organic form in clams and oysters.

A

arsenic

158
Q

This environmental pollutant has been linked to Itai-itai disease.

A

cadmium

159
Q

Which of the following enzymes is increased in patients with cancer involving bone?

A

Alkaline phosphatase

160
Q

Which tumor marker is associated with neuroblastoma?

A

HVA

161
Q

The utilization of tumor markers is most important for:

A

Monitoring the effectiveness of treatment

162
Q

Abnormally low tumor marker concentrations are associated with antigen deficiency and can cause false negative results
t/f

A

false

163
Q

To accurately monitor tumor marker levels of the patient, it is important to use the same methodology each time of testing.

t/f

A

true

164
Q

If tumor cells are found in both the original tumor and also in the regional lymph nodes, this would be classified as stage:

A

3

165
Q

All tumor markers can be used to screen asymptomatic populations.
t/f

A

false

166
Q

Which is not something that is a consideration when considering using immunoassay method for tumor markers.
Hook effect
Requires more specialized skill and experience
Assay linearity
HAMAs

A

Requires more specialized skill and experience

167
Q

Serotonin secreting tumors from small intestine

A

carcinoid

168
Q

Which is not an example of an enzyme tumor marker.
ALP
AST
PSA
LDH

A

AST

169
Q

Which tumor marker is used primarily with hepatocelluar carcinoma and testicular cancer.
AFP
CA-125
CEA
hCG

A

AFP

170
Q

Elevations in this tumor marker in CSF may indicate Creutzfeldt-Jakob disease.

A

NSE

171
Q

A patient has a synovial fluid removed from their knee joint. The test results included a cell count with differential. The WBC count was 65,000 with 93% neutrophils. What is the most likely cause?

A

septic

172
Q

A patient has CSF chemistries and microbiology samples performed. Chemistries yield a very low glucose value but no growth is reported in micro cultures. What is a possible pathology to explain these results? It is to be noted that the CSF had a clear, colorless appearance.

A

brain tumor

173
Q

Which is not a common test to perform on a CSF sample?
glucose
uric acid
protein
lactate

A

uric acid

174
Q

Increased CSF glucose levels can indicate acute bacterial meningitis.

T/F

A

false

175
Q

Which would typically not be a cause of an exudative pleural effusion?
Pulmonary abscess
Lymphoma
Bacterial pneumonia
Hepatic cirrhosis

A

Hepatic cirrhosis

176
Q

The unique structure of hemoglobin allows it to act as both an acid-base buffer and O2 buffer.
T/F

A

true

177
Q

Breakdown of glycogen to glucose for use as energy

A

Glycogenolysis

178
Q

Conversion of glucose to glycogen for storage

A

Glycogenesis

179
Q

Formation of glucose of-6-phosphate from noncarbohydrate sources

A

Gluconeogenesis

180
Q

Metabolism of glucose molecule to pyruvate or lactate for production of energy

A

Glycolysis

181
Q

Which parameter on a blood gas analysis is calculated instead of being directly measured.

A

HCO3

182
Q

The best collection tube to use for glucose tolerance testing is:
Gold top/serum
Grey top/NaF
Green top/lithium heparin
Lavender top/EDTA
Grey top/NaF

A

Grey top/NaF

183
Q

What is the incremental fraction of oxygen at sea level?

A

21%

184
Q

In external respiration, the partial pressure of oxygen in the alveolar membrane is __________, while the partial pressure of oxygen in the venous blood is _________.

A

100 mmHg, 40 mmHg

185
Q

A decrease in H+ ions, an increase in pH, and a decrease in pCO2 results in what acid-base disorder?

A

Respiratory alkalosis

186
Q

A patient with an HA1C of 12% would be most likely to have an estimated average glucose of:

A

298 mg/dL

187
Q

A patient with a fasting glucose of 122 mg/dL would be considered to have a:

A

Impaired fasting glucose

188
Q

This type of diabetes is noted to have insulin resistance with an insulin secretory defect due to progressive loss of adequate beta cell insulin secretion.

A

Type 2

189
Q

As a CSF is collected, it is placed in a series of tubes for analysis. The correct order of testing should be:

A

Chemistry, Microbiology, Hematology

189
Q

An increase in H+ ions, a decrease in pH, and an increase in pCO2 results in what acid-base disorder?

A

Respiratory acidosis

190
Q

Which is not stimulated by epinephrine?
Insulin
Glucagon
Glycogenolysis
Gluconeogenesis

A

insulin

191
Q

Match the type of pancreatic cell with what it produces.
Cell: Alpha cell, beta cell, delta cell
Product: glucagon, insulin, somatostatin

A

alpha - glucagon
beta - insulin
delta - somatostatin

192
Q

Diabetic condition formed when a person’s own immune system destroys the islet cells of the pancreas, resulting in impaired production of insulin.

A

type 1

193
Q

It is recommended that all adults have a lipid profile performed every _____.

A

5 years

194
Q

Women, on average, have higher HDL levels and lower total cholesterol and triglyceride levels than men.
T/F

A

True

195
Q

HDL has a major role in this type of lipid pathway

A

Reverse cholesterol pathway

196
Q

Which is the type of lipoprotein that contains the apolipoprotein Apo B48?

A

Chylomicrons

197
Q

Amphipathic lipid molecules contain both hydrophobic fatty acid chains and hydrophobic head groups.
T/F

A

False

198
Q

Calculate the LDL from the following test results.

Total cholesterol: 223 mg/dL

HDL: 65 mg/dL

Triglycerides: 290 mg/dL

A

100

199
Q

The function of the major lipid components of the very-low density lipoproteins is to transport:

A

Endogenous triglycerides

200
Q

Turbidity in serum suggests elevation of:

A

Chylomicrons

201
Q

Electrolytes that reabsorbed under influence of PTH

A

calcium

202
Q

electrolytes that recovered from glomerular filtrate

A

bicarbonate

203
Q

electrolytes that reabsorbed by passive transport in proximal tubule

A

chloride

204
Q

Reabsorption occurs in Henle’s loop

A

Magnesium

205
Q

A rare disease of water and salt imbalance.

A

Diabetes insipidus

206
Q

Of the total serum osmolality; sodium, chloride, and bicarb normally contribute what percent?

A

92

207
Q

What is the type of lipoprotein that is known to contribute to plaque formation.

A

LDL

208
Q

A patient presents to the ER with flushed skin, severe agitation, low-grade fever, and complaints of being extremely thirsty. Given these symptoms, what pathology would you consider?

A

Hypernatremia

209
Q

Which of the following is not associated with an increase in anion gap when it occurs in a single patient?
Renal failure
Ketoacidosis
Glycol poisoning
Instrument error

A

Instrument error

210
Q

Causes of increased levels of protein in CSF include all but:
Decreased dialysis of proteins from the plasma
Lysis of contaminant blood from traumatic tap
Increased permeability of the epithelial membrane
Obstruction

A

Decreased dialysis of proteins from the plasma

211
Q

In order to maintain electrical neutrality in the red blood cell, bicarbonate leaves the red blood cell and enters the plasma through an exchange mechanism with what electrolyte?

A

Chloride

212
Q

Of total serum calcium, free ionized calcium normally represents approximately what percent?

A

45

213
Q

The presence of only slightly visible hemolysis will significantly increase the serum level of which of the following analytes?

A

Potassium

214
Q

What is the major intracellular cation?

A

potassium

215
Q

What is the major extracellular cation?

A

Sodium

216
Q

Unsaturated triglycerides are typically solid at room temperature.
T/F

A

false

217
Q

The cation is the fourth most abundant cation in the body and second most abundant intracellularly. Hint: Consumption of processed foods can lead to inadequate intake and subsequent deficiency.

A

Magnesium

218
Q

Water makes up what percentage of body weight?

A

40-75%

219
Q

Which phrase does not describe phospholipids.
Hydrophobic head group
Synthesized in all organs
Amphipathic
Unsaturated steroid alcohol

A

Unsaturated steroid alcohol

220
Q

Electrolyte essential for myocardial contraction and important to maintain normal levels for critically ill patients.

A

calcium

221
Q

Type of CK isoenzyme with its specificity
CK: cardiac, muscle, brain
Specificity: CK-MB, CK-BB, CK-MM

A

Cardiac=CK-MB
Muscle=CK-MM
Brain=CK-BB

222
Q

Amylase is more specific to pancreatitis than lipase.
T/F

A

false

223
Q

This test has greater specificity to liver damage.

A

ALT

224
Q

In many reactions, we are looking at the reaction of the cofactor NADH to NAD to determine the value of the enzyme.
T/F

A

true

225
Q

This enzyme has a short half-life and is found in the heart, liver, skeletal muscle, and kidney.

A

AST

226
Q

The hook effect refers to high concentrations of analyte producing a lower signal than expected.
T/F

A

true

227
Q

These type of inhibitor associate with enzymes at places other than the active site.

A

non-competitive

228
Q

These type of inhibitor share structural features found in the substrate.

A

competitive

229
Q

These type of inhibitor bind only to the ES complex.

A

uncompetitive

230
Q

In this state, not all enzyme sites are saturated with substrate and substrate concentration is the rate-limiting step.

A

1st order

231
Q

An inactive, secreted form of the enzyme

A

zymogen

232
Q

The following statement could be used to describe zero-order kinetics: T/F

Substrate is present in excess, rate of reaction is constant with time and dependent only on the concentration of enzyme in the system.

A

true

233
Q

When measuring enzyme activity, if the instrument is operating at 50 C lower than the temperature prescribed for the method, how would the results be affected?

A

Lower than expected

234
Q

What does an increase in serum enzyme levels indicate?

A

Tissue damage and necrosis

235
Q

Pathological condition in which the proximal tubules in the kidneys do not reabsorb glucose, amino acids, uric acids, and bicarbonates resulting in their loss to the urine concentrate.

A

Fanconi Syndrome

236
Q

This test can be used to monitor alcoholics with liver toxicity

A

GGT

237
Q

Which of the following serves as the glomerular filtration rate for clinicians?

A

creatinine

238
Q

Plasma creatinine levels are determined by all of the following except:
Relative muscle mass
Rate of creatine turnover
Renal function
Dietary intake of protein

A

Dietary intake of protein

239
Q

A 56 year old male with gout is given allopurinol then returns to the ER a week later with a uric acid level of 8.6 mg/dL (2.4-7.0 mg/dL). What statement best describes the reason for the uric acid level?
The patient did not take prescribed medication
The patient overdosed on allopurinol
Allopurinol returned uric acid levels to normal

A

The patient did not take prescribed medication

240
Q

What is an energy source utilized by muscles?

A

Creatine phosphate

241
Q

This non-protein nitrogen compound is found in the highest concentration in the blood.

A

Urea nitrogen

242
Q

Which is not a clinical application of measurement of urea.
Assess hydration status
Evaluate liver function
Verify adequacy of dialysis
Determine nitrogen balance

A

Evaluate liver function

243
Q

Match the BUN:Creatinine ratio with the correct location of azotemia.
23 11 8
postrenal intrarenal prerenal

A

23 - pre
11 - post
8 - intrarenal

244
Q

Which is not a likely cause of decreased BUN.
High protein dietary intake
Liver disease
Severe vomiting
Increased protein synthesis

A

high protein dietary intake

245
Q

The most frequently used analytic method for creatinine testing is the:

A

Jaffe reaction

246
Q

Which test has the most strict collection requirements that include transporting the specimen on ice and testing immediately.

A

Ammonia

247
Q

disease associate with severe protein deficiency

A

Kwashiokor

248
Q

disease associate with severe protein and calorie deficiency

A

Marasmus

249
Q

Which is a negative acute phase reactant?

A

Transferrin

250
Q

This protein is known for being a nephrotoxin.

A

Myoglobin

251
Q

This test may be used to assess nutritional status.

A

Prealbumin

252
Q

Proteins with 10-40% carbohydrates attached are

A

Glycoproteins

253
Q

Proteins consist of the elements:
Carbon
Oxygen
Nitrogen
All of these
None of these

A

all

254
Q

In the stomach ______ breaks down proteins into peptides.

A

pepsin

255
Q

When a protein is disturbed and loses its functional and chemical characteristics, it is called:

A

Denaturation

256
Q

Essential amino acids:
Must be obtained through diet
Are synthesized by the body

A

Must be obtained through diet

257
Q

In cerebral spinal fluid, ______% of protein comes from plasma, while ______% comes from the brain.

A

95%, 5%

258
Q

When proteins have a more positive charge they are more easily dissolved.
T/F

A

True

259
Q

Which is not true of amino acid analysis?
Collect sample in a heparin tube
Blood samples should be drawn after a 2-3 hour fast
Analysis should be performed immediately or sample frozen
Plasma should be removed carefully to avoid platelets and white blood cells

A

Blood samples should be drawn after a 2-3 hour fast

260
Q

This type of analytical method measures the amount of light that can pass through a sample at a 180O angle from the incident light.

A

Turbidimetry

261
Q

Stray light refers to any wavelengths outside the band transmitted by the monochromator.
T/F

A

true

262
Q

Dynodes are a series of anodes with successively higher voltages.
T/F

A

true

263
Q

An advantage of a photocell over a phototube is that a photocell has an external power source and is more sensitive with lower amounts of light.
T/F

A

false

264
Q

Calculate % transmittance through a tube containing 5 layers of solution with an absorbance of 20%.

A

33%

265
Q

This type of lamp is used in visible and infrared regions and is the most common type:

A

tungsten

266
Q

Visible light falls between the color ______ at 400 nm and _____ at 700 nm.

A

violet, red

267
Q

Which is the order that you would expect to see in LD isoenzymes in a patient who has had a heart attack.

A

LD1>LD2>LD3>LD4>LD5

Clinical Chemistry (5 decks)

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