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mtap 2 (finals) road to manila hotel <333 > CLINICAL CHEMISTRY > Flashcards

CLINICAL CHEMISTRY Flashcards

1
Q

GIVE 4 FUNCTIONS OF LIPID

A

✓ Composed of mostly carbon-hydrogen (C-H) bonds
✓ Primary source of fuel
✓ Provides stability to cell membrane and allow for transmembrane transport
✓ Insoluble in blood or plasma, but soluble in organic solvents.

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2
Q

___ are commonly referred to as “fats” and are insoluble to blood

A

LIPIDS

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3
Q

The _____ carry lipids, allowing circulation of lipids to different
parts of the body

A

LIPOPROTEINS

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4
Q

Needed to transfer lipids to the ____, _____, ______

A

LIVER
CELLS
TISSUE

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5
Q

3 LIPOPROTEINS TRANSPORTERS:

A

✓ High Density Lipoproteins (HDL)
✓ Low Density Lipoproteins (LDL)
✓ Very Low Density Lipoproteins (VLDL)

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6
Q

5 MAJOR LIPIDS

A
  1. Fatty acids
  2. Triglycerides
  3. Phospholipids
  4. Cholesterol
  5. Fat-soluble Vitamins (A, D, E, K)
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7
Q

Mostly found as constituents of phospholipids or triglycerides

Mainly derived from the hydrolysis of triglycerides in the adipose tissue

A

FATTY ACIDS

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8
Q

FATTY ACIDS, Linear chains of ____ bonds that terminates with ____

A

C-H
-COOH

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9
Q

2 FUNCTIONS OF FATTY ACIDS

A

Important source of energy

Provides substance for the conversion of glucose (gluconeogenesis)

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10
Q

CLASSIFICATION OF FATTY ACIDS

ACCORDING TO THE PRESENCE OF ESTER BONDS:

A

UNESTERIFIED
ESTERIFIED

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11
Q

BOUND TO ALBUMIN

A

UNESTERIFIED

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12
Q

constituent of triglycerides or phospholipids

A

ESTERIFIED

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13
Q

ACCORDING TO THE NUMBER OF FATTY ACID STRUCTURE/ SIZE:

A

SHORT
MEDIUM
LONG CHAIN

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14
Q

8-12

A

MEDIUM

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15
Q

> -12

A

LONG CHAIN

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16
Q

SHORT

A

4-6

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17
Q

ACCORDING TO THE NUMBER OF DOUBLE BONDS:

A

SATURATED

UNSATURATED:MONOSATURATED

UNSATURATED:POLYSATURATED

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18
Q

NO DOUBLE BONDS
2 EXAMPLE

A

SATURATED
EX. BUTYRIC ACID, GLYCEROL

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19
Q

ONE DOUBLE BOND

A

UNSATURATED: MONOSATURATED

EX. OLEIC ACID

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20
Q

TWO OR MORE DOUBLE BONDS

A

UNSATURATED: POLYSATURATED

EX. LINOLEIC ACID

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21
Q

OTHER EXAMPLES OF FA:

A

PALMITIC ACID
STERIC ACID
ARACHIDONIC ACID

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22
Q

Contains saturated fatty acids or unsaturated fatty acids

Very hydrophobic/ water insoluble/ neutral lipid

Do not contain charged groups or hydrophilic groups

A

TRIGLYCERIDES

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23
Q

Main storage of lipid in man; chiefly found in ____

A

TRIGLYCERIDES
adipose tissue

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24
Q

_____ of the stored fat in the body is in this form

A

95%

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25
Q

The predominant form of triglyceride in the plasma is _____

A

GLYCERYL ESTER

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26
Q

When triglyceride is broken down/ catabolized, it will release______ , and used by the cells as a source of fuel or energy

A

fatty acids

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27
Q

It is able to provide insulation (excellent insulator)

A

TAG

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28
Q

Facilitated by enzymes and hormones for breakdown:

HORMONES:

A

Epinephrine and Cortisol

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29
Q

Facilitated by enzymes and hormones for breakdown:

o Enzyme:

A

Lipoprotein Lipase (LPL)

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30
Q

An average person ingests, absorbs, resynthesizes, and transports about _____ of TAG daily

FASTING REQUIREMENT: _____ hours

A

60-130g
10-12HRS

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31
Q

evaluates suspected _____ and measures the body’s ability to metabolize fat

A

atherosclerosis

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32
Q

Fasting TAG ______ are at risk for ______
because of atherogenic VLDL remnants

A

≥ 200 mg/dL
Coronary Artery Disease

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33
Q

2 most important lipids in the management of CHD

A

TAG
CHOLESTEROL

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34
Q

One TAG has ___ fatty acids attached to ___ glycerol structure by ester bonds

A

THREE
ONE

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35
Q

TAG IS A.K.A

A

TRIACYLGLYCEROL or NEUTRAL FAT

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36
Q

PHOSPHOLIPIDS IS A.K.A

A

CONJUGATED LIPIDS

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37
Q

___ molecule of phospholipid has ___ fatty acids attached to ___ phosphorylated glycerol

A

ONE
TWO
ONE

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38
Q

___ position contain phospholipid head groups

A

THIRD

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39
Q

MOST ABUNDANT LIPID IN THE BODY

A

PHOSPHOLIPIDS

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40
Q

PHOSPHOLIPIDS IS DERIVED FROM

A

PHOSPHATIDIC ACID

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41
Q

contain hydrophilic and hydrophobic head groups

A

Amphipathic

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42
Q

makes phospholipids soluble in water

present on the outer part (directly exposed to
plasma and water); polar region

A

HYDROPHILIC

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43
Q

____ is present on the inner part; nonpolar region

A

HYDROPHOBIC

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44
Q

PHOSPHOLIPIDS ORIGINATES IN THE

A

LIVER AND INTESTINE

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45
Q

Not part of the lipid profile as it is not routinely measured

The measurement would only provide little information in the diagnosis on lipid abnormality on metabolism

A

PHOSPHOLIPIDS

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46
Q

PHOSPHOLIPIDS IS MEASURED IN?

A

FETAL LUNG MATURITY

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47
Q

Collection of ____ (especially in the ____ of pregnancy)
and the phospholipids are measured

A

amniotic fluid
third trimester

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48
Q

phospholipids also participates in ___ and ____

A

cell metabolism and blood coagulation

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49
Q

3 forms of phospholipids

A

LECITHIN
SPHINGOMYELIN
CEPHALIN

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50
Q

aka phosphatidylcholine

the major of phospholipid which is ___ of the phospholipid in the body

A

LECITHIN
70%

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51
Q

___ of the phospholipidin the body

The ONLY phospholipid in membranes that is NOT derived from
glycerol but from an amino alcohol called ____

A

20%
sphingosine

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52
Q

sphingomyelin Accumulates in the liver and spleen of patients suffering from _____

Serves as a reference material during ____ of pregnancy because
its concentration is constant as oppose to lecithin

A

Neimann-Pick Disease
3rd trimester

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53
Q

10% of the phospholipids in the body

A

cephalin

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54
Q

Unsaturated steroid alcohol contains four rings, component of steroids

Found on the surface of lipid bilayers of the cell membrane

Important constituent in the assembly of cell membrane and
bile acid

A

cholesterol

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55
Q

cholesterol is a.k.a

A

3-HYDROXY-5, 6 CHOLESTENE

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56
Q

contributes to the metabolism/ digestion of fats in the intestine

A

bile acid

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57
Q

Not catabolized by most cells

Does not serve as source of fuel or energy of the cells

The excess cholesterol in the cell is recycled and is either released in the blood or transported back to the liver

A

cholesterol

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58
Q

2 forms of cholesterol

A

unesterified
sterified

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59
Q

FREE CHOLESTEROL (amphipathic)

____ of the total cholesterol in the body (minor form)

A

UNESTERIFIED
30%

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60
Q

Present in the ____,___,____

Polar type

Produced via ____ and becomes available for
membrane, hormone, and bile acid synthesis

A

plasma or serum, and RBCs

lysosomal hydrolysis

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61
Q

CHOLESTEROL ESTER (neutral lipid)

_____ of the total cholesterol in the body (major form)

also present in ___,___

A

esterified
70%
serum and plasma

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62
Q

Important for the esterification of cholesterol

Catalyzes the esterification of cholesterol by promoting the
transfer of fatty acids from lecithin to cholesterol

A

LCAT: lecithin-cholesterol acyl tranferase

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63
Q

LCAT RESULTING PRODUCT:
SYNTHESIZED IN:
ACTIVATOR:

A

lysolecithin and cholesterol esters

LIVER

APO A-1

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64
Q

Excess cholesterol is re-esterified by the microsomal enzyme ____ and is stored until it is needed

A

acyl – cholesterol acyl transferase (ACAT)

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65
Q

CHOLESTEROL IS THE PRECURSOR FOR THE FORMATION OF: 4 ANSWER

A

BILE SALTS
STEROID HORMONES
VITAMIN D (CHOLECALCIFEROL)
CELL MEMBRANE

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66
Q

Directly measured with reagent

All components of analytes are measured
(esterified and unesterified)

A

TAG

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67
Q

____ (good chole) measured directly with reagent & machine ____ and ___ are not directly measured with reagent, these are calculated/computed, but separated in costs

A

HDL
VLDL AND LDL

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68
Q

_____ : routinely measured

_______ is essential in the diagnosis of lipoprotein diseases and management of lipoprotein disorders and lipid abnormalities

A

CHOLESTEROL
TOTAL CHOLESTEROL

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69
Q

2 LIPID POSSESES AMPHIPATIC STRUCTURE

A

PHOSPHOLIPIDS
CHOLESTEROL

70
Q

ONLY LIPID do not possess amphipathic structure, hence it is insoluble

A

TAG

71
Q

Macromolecular complexes of lipids with specialized proteins
knows as ____

A

apolipoproteins (APO)

72
Q

main purpose of APO

A

transport TAG and CH to sites of energy storage and utilization

73
Q

TAG and Ch travel in plasma NOT as free-floating molecules but as a part of water-soluble complexes called _____

A

lipoproteins (Lp)

74
Q

Free cholesterol phospholipids are found on the _____

A

surface (hydrophilic)

75
Q

TAG and cholesterol esters are found in the _____

A

core regions (hydrophobic)

76
Q

TRUE OR FALSE
APO determines the density of lipoprotein; the lesser the protein the more dense the lipoprotein

A

false (greater)

77
Q

4 functions of apolipoprotein

A

1.Stabilizes and maintains structural integrity
2. Ligands (LI) for cell receptor Ligand is a molecule that binds or forms complex with other molecules
3. Activators and inhibitors of enzymes
4. Amphipathic

78
Q

APO Contains structural motif called ____ making it available to bind to lipids

A

“amphipatic helix”

79
Q

major types of APO

A

CHYLOMICRONS
VLDL
LDL
HDL

80
Q

SMALLEST: MOST DENSE

A

HDL

81
Q

biggest; least dense (lightest)

A

CHYLOMICRONS

82
Q

MINOR TYPES

A

LPA
IDL

83
Q

ABNORMAL TYPES

A

LppX
β-VLDL

84
Q

the transporter of dietary TAG

A

CHYLOMICRONS

85
Q

most cholesterol rich lipoprotein

A

LDL

86
Q

molecule that binds or forms complex with other molecules

A

ligands

87
Q

promotes fat absorption in the intestine

A

bile salts

88
Q

3 steroid hormones

A

glucocorticoids, mineralcorticoid, estrogen

89
Q

promotes Ca absorption in the intestine

A

vitamin D (cholecalciferol)

90
Q

Largest and least dense lipoprotein

A

chylomicrons

91
Q

Major transporter of exogenous triglycerides (from diet)

Responsible for the transport of dietary TAG (exogenous TAG)

A

chylomicrons

92
Q

chylomicrons composition & produced in?

A

90%
intestine

93
Q

chylomicrons

Completely cleared out of the circulation in ____

Strict ____ fasting is required for lipid profile testing

False ↑ lipid profile if chylos are present in the blood

Lipid and Glucose Testing: ____ fasting is acceptable

A

6-9 hours
12-H
10-H

94
Q

a.k.a PRE-BETA LIPOPROTEIN

A

VLDL

95
Q

VLDL is produced in?

A

liver

96
Q

synthesized in the liver
derived from diet

A

endogenous TAG
exogenous TAG

97
Q

COMPOSITION OF VLDL

A

65%

98
Q

a.k.a BETA LIPOPROTEIN/ BAD CHOLESTEROL

A

LDL

99
Q

Most cholesterol rich
Most atherogenic

A

LDL

100
Q

can contribute to the formation of insoluble fatty plaque of blood
flow (obstruction in blood vessel)

A

LDL

101
Q

Product of lipolysis of VLDL

IDL FURTHER CATABOLIZE TO?

A

LDL

102
Q

COMPOSITION OF LDL

A

50%

103
Q

a.k.a ALPHA LIPOPROTEIN/ GOOD CHOLESTEROL

A

HDL

104
Q

COMPOSITION OF HDL

PRODUCED IN?

A

30%
LIVER AND INTESTINE

105
Q

reverse cholesterol transport mechanism

if HDL is ___, the risk for coronary heart disease/ CVD is high

o if LDL is ___ , the risk for CHD is high

A

low
high

106
Q

Nascent disc-shaped, discoidal shape

Considered as the CARDIOPROTECTIVE LIPOPROTEIN

A

HDL

107
Q

Delivery of exogenous lipids to hepatic and peripheral cells

A

CHYLOMICRONS

108
Q

Transfer endogenous triglycerides from the liver to peripheral tissues

A

VLDL

109
Q

Transfer dietary cholesterol to peripheral

A

LDL

110
Q

Transfer cholesterol from peripheral cells back to liver

A

HDL

111
Q

Only minor type of lipoprotein

A

LPA

112
Q

Also known as the SINKING PRE-β LIPOPROTEIN

A

LPA

113
Q

↑ confers increased risk for: premature coronary heart disease and
stroke

A

LPA

114
Q

Competes with plasminogen for fibrin

A

LPA

115
Q

Product of VLDL metabolism “VDL remnant” and soon converted to
LDL” subclass of LDL”

A

IDL

116
Q

It is an abnormal lipoprotein found in obstructive jaundice and
LCAT deficiency

A

LPPX

117
Q

Specific and sensitive indicator of cholestasis

A

LPPX

118
Q

Found in type 3 hyperlipoproteinemia/ dysbetalipoproteinemia

A

β-VLDL

119
Q

It is known as “abnormally migrating β-VLDL”

A

β-VLDL “Floating β Lipoprotein”

120
Q

TOTAL CHOLESTEROL REFERENCE RANGE

A

140-220 mg/dL

121
Q

HDL CHOLESTEROL RF

A

40-75 mg/dL

122
Q

LDL CHOLESTEROL REF. RANGE

A

50-130 mg/dL

123
Q

TAG REF RANGE

A

60-150 mg/dL

124
Q

Conversion of dietary lipids into more polar (amphipathic) compounds by the enzyme pancreatic lipase (major lipase fraction in the blood)

A

LIPID ABSORPTION

125
Q

LIPID ABSORPTION HAPPENS IN?

A

SMALL INTESTINE

126
Q

______ can also be linked to infection, no absorption, problem in
lipid absorption (too much fat globules in feces)

A

STEATORRHEA

127
Q

3 LIPOPROTEIN PHYSIOLOGY / DISORDERS

A

1.Arteriosclerosis
2.Hyperlipoproteinemia
3.Hypolipoproteinemia

128
Q

Deposition of esterified cholesterol (hydrophobic) in artery wall

A

ARTERIOSCLEROSIS

129
Q

heart (angina and MI)

A

Coronary Artery disease (CAD)

130
Q

arteries in the arms or legs

A

Peripheral vascular disease (PVD)

131
Q

vessels of the brain (stroke)

A

Cerebrovascular disease (CVD)

132
Q

Increased cholesterol

Increased LDL, decreased receptors

Amphipathic, Clear appearance but with high level

A

HYPERCHOLESTEROLEMIA

133
Q

Increased triglycerides

Decreased LPL or Apo C-II

VLDL -/→ VLDL remnants

Chylos -/→ Chylos remnants

Highly hydrophobic

A

HYPERTRIGLYCERIDEMIA

134
Q

✓ Increased triglycerides, cholesterol
✓ Increased VLDL and chylos remnants
✓ Presence of Apo E2/2

A

COMBINED HYPERLIPIDEMIA

135
Q

dehydration and oxidation of cholesterol to form a colored
compound

A

CHOLESTEROL MEASUREMENT

136
Q

HOW MANY WEEK PREP FOR CHOLESTEROL MEASUREMENT

A

2 WEEKS

137
Q

4 PRECAUTIONS FOR CHOLESTEROL MEASUREMENT

A
  1. Avoid hemolyzed specimen (false elevated)
  2. Avoid icteric specimen (false elevated)
  3. Avoid water contamination
  4. There must be precise and accurate timing for color development
138
Q

COLOR DEVELOPERS IN CHOLESTEROL MEASUREMENT

A

➢ Glacial acetic acid
➢ Acetic anhydride
➢ Concentrated sulfuric acid

139
Q

non enzymatic method in cholesterol management

A

ABELL KENDALL

140
Q

4 general methods of ABELL KENDALL

A

1-STEP METHOD Involves colorimetry
Mix, incubate, and measure
2-STEP METHOD Involves colorimetry and extraction
3-STEP METHOD Involves colorimetry, extraction and saponification
4-STEP METHOD Involves colorimetry, extraction, saponification, and
precipitation

141
Q

Liebermann–Burchard reaction

A

GREEN SOLUTION

142
Q

Salkowski reaction

A

RED SOLUTION

143
Q

The absorbance of the green/ red solution is directly proportional with the concentration of _____

A

cholesterol

144
Q

The absorbance of the quinoneimine dye is directly proportional with the
concentration of cholesterol

A

ENZYMATIC METHOD: CHOLESTEROL OXIDASE

145
Q

CDC reference method:

A

ABELL, LEVY, and BRODIE methods

146
Q

_____ is used for the extraction of cholesterol following hydrolysis
using ____

A

HEXANE
alcoholic potassium hydroxide

147
Q

quinoneimine dye

A

pinkish violet

148
Q

FASTING FOR TRIGLYCERIDE MEASUREMENT

A

12HRS

149
Q

COLORIMETRIC METHOD IN TRIGLYCERIDE MEASUREMENT

A

Van Handel and Zilversmith

BLUE SOLUTION

150
Q

FLUOROMETRIC

A

Hantzsch Condensation
YELLOW SOLUTION

151
Q

ENZYMATIC METHOD FOR TRIGLYCERIDE MEASUREMENT

A

GLYCEROL KINASE

152
Q

CDC REFERENCE METHOD FOR GLYCEROL KINASE

A

: MODIFIED VAN HANDEL and ZILVERSMITH

153
Q

PREFERRED SAMPLE FOR LIPOPROTEIN MEASUREMENT

A

SERUM FROM SST

154
Q

The density of the lipoprotein is compared with the density of the
potassium bromide

A

Ultracentrifugation

155
Q

REAGENT FOR Ultracentrifugation

DONE FOR HOW MANY HOURS?

A

Potassium bromide (SG: 1.063)

24HRS

156
Q

Based on the lipoprotein migration in an electric field

A

Electrophoresis

157
Q

LIPID STAINS FOR ELECTROPHORESIS

A

Oil red O, Fat red 7B, and Sudan black

158
Q

most sensitive supporting medium for lipoprotein
electrophoresis

A

AGAROSE GEL

159
Q

products scatter light at a specific angle

A

IMMUNOEPHELOMETRIC METHOD

160
Q

insoluble product blocking the
light

A

IMMUNOTURBIDIMETRIC METHOD

161
Q

antibody is involved in the reagent There is involved antibody in the reagent

A

IMMUNOCHEMICAL METHOD

162
Q

for determination of LDL and VLDL concentration

A

APO B

163
Q

for determination of HDL concentration

A

APO A-1

164
Q

LCAT activator,
ABCA1 lipid
acceptor Critical for
esterification of
cholesterol because
of LCAT

A

APO A-1

165
Q

inactivates
LCAT

A

APO A-II

166
Q

LDL receptor
ligand

A

APO B-100

167
Q

Remnant
receptor ligand

A

APO B-48

168
Q

LPL cofactor

A

APO C-II

169
Q

LDL inhibitor

A

APO C-III

170
Q

LDL receptor
ligand

A

APO E OR APO B-100

171
Q

plasminogen
inhibitor

A

APO(a)

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