Clinical Chemistry Flashcards
(248 cards)
1
Q
Albumin g/0.1L to g/L
A
10
2
Q
Bilirubin mg/dL to umol/L
A
17.1
3
Q
BUN mg/dL to mmol/L
A
0.357
4
Q
Chloride mEq/L to mmol/L
A
1
5
Q
Cholesterol mg/dL to mmol/L
A
0.026
6
Q
Creatinine mg/dL to umol/L
A
88.4
7
Q
Glucose mg/dL to mmol/L
A
0.0555
8
Q
Potassium mEq/L to mmol/L
A
1
9
Q
Sodium mEq/L to mmol/L
A
1
10
Q
Thyroxine ug/dL to mmol/L
A
12.9
11
Q
Total protein g/dL to mmol/L
A
10
12
Q
Triglyceride mg/dL to to mmol/L
A
0.0113
13
Q
Uric acid mg/dL to mmol/L
A
0.0595
14
Q
Shorter wavelength = ___ energy
A
high
15
Q
Visible light falls in between __nm to __nm wavelengths
A
400nm to 700nm
16
Q
Anticoagulant with the least interference with analyses
A
Heparin (green)
17
Q
Used for most chemical blood tests
A
Lithium heparin
18
Q
Assay of Urea Nitrogen
A
Colorimetric: Diacetyl (cheaper but lacks specificity)
Enzymatic: NH3 formation (better specificity but more expensive)
19
Q
Elevated urea in blood
A
Azotemia
20
Q
Elevated urea in blood accompanied by renal failure
A
Uremia or uremic syndrome
21
Q
Cause of pre-renal azotemia
A
Reduced renal blood flow or increased protein catabolism
22
Q
Cause of renal azotemia
A
Renal dysfunction
23
Q
Cause of post-renal azotemia
A
Obstruction of urine flow anywhere in the urinary tract
24
Q
Creatinine reacts with picric acid in alkaline solution to form red-orange chromogen
A
Jaffe Reaction
25
BUN:creatine ratio
10-20:1
26
BUN:creatine ratio in prerenal disease
BUN rises above 10-20:1
27
BUN:creatine ratio in true renal disease
BUN and creatine both rise; 10-20:1 ratio is maintained
28
Cigarette smoking causes
Ammonia contamination; false positive in liver tests
29
Bilirubin fractions
B1 (unconjugated)
B2 (conjugated)
Delta Bilirubin
30
B1 / Indirect Bilirubin
- noncovalently attached to Alb
| - does not react with color regent until dissociated from protein
31
B2 / Direct Bilirubin
- with 1/2 attached glucuronic acid molecules
| - reacts directly with color reagent
32
Delta Bilirubin
- covalently attached to protein
| - Reacts directly to color reagent; contributes to the direct bilirubin value
33
The following cause increase of what type of Bilirubin?
Hemolytic anemia
Newborn
Hereditary alteration of rate of conversion
Medications
B1
34
The following cause increase of what type of Bilirubin?
Bile obstruction
Some cases of hepatitis
Medications
B2
35
The following cause increase of what type of Bilirubin?
| Hepatitis
B1 and B2
36
EVELYN-MALLOY ASSAY
pH: ?
Dissociating agent: ?
Diazo product: ?
pH: acidic
Dissociating agent: methanol
Diazo product: reddish purple (560nm)
37
JENDRASSIK-GROF ASSAY
pH: ?
Dissociating agent: ?
Diazo product: ?
pH: alkaline
Dissociating agent: caffeine-sodium benzoate
Diazo product: Blue (600nm)
38
Diseases that contribute to elevations of unconjugated bilirubin
- Gilbert
- Crigler-Najjar
- Physiological jaundice of newborn
39
Diseases that contribute to elevations of conjugated bilirubin
- Dubin-Johnson
| - Rotor Syndrome
40
Treatment of kernicterus for children
Phototherapy
41
Prealbumin
- Indicator of malnutrition
| - Binds thyroid hormones and retinol-binding proteins
42
Albumin
- Binds bilirubin, steroids ad FA
| - MAJOR CONTRIBUTOR to oncotic pressure
43
a1-antitrypsin
- Acute phase reactant
| - Protease inhibitor
44
a1-fetoprotein
- Principal fetal protein
45
a1-lipoprotein
- HDL
| - Transports lipid
46
Haptoglobins
- Binds hemoglobin
47
Ceruloplasmin
- Peroxidase activity
48
a2-macroglobulin
- Inhibits thrombin, trypsin, pepsin
49
Pre-B-lipoproteins
- VLDL
| - Transports lipids primarlty triglyceride
50
Transferrin
- Transports iron
51
Hemopexin
- Binds heme
52
B-lipoprotein
- LDL
| - transports lipids primarily cholesterol
53
B2-macroglobulin
- Component of HLA molecules class I
54
Complement
- Immune response
55
Fibrinogen
- Precursor of fibrin clot
56
C-reactive protein
- Motivates phagocytosis
57
Arrange Igs according to %
G > A > M > D > E
58
Produces Abs in secretions
IgA
59
Produces Abs in early response
IgM
60
Produces Abs in allergic reactions
IgE
61
Increase in gamma area in protein electrophoresis
Mooclonocal disease
62
Decrease in alpha area in protein electrophoresis
Alpha-1 anti-typsin deficiency
63
Increase in alpha-2, beta areas in protein electrophoresis
Nephrotic syndrome
64
Increase alpha-1, alpha-2, beta areas in protein electrophoresis
Inflammation
65
Increase in beta-gamma bridge area in protein electrophoresis
Cirrhosis
66
Impaired biliary copper excretion --> increase in copper in lover and eyes (Kayser-Fleischer rings)
Wilson's Disease
67
Defect in copper absorption --> low copper --> white skin and hair
Menke's syndrome
68
Dye binding methods for serum albumin
Bromcresol Green and HABA
69
Wavelength for BCG and HABA for albumin
Around/below 500nm
| - BGG max at 630nm
70
Apolipoprotein for HDL
Apo A-1
71
Apolipoprotein for VLDL
Apo B-100
72
Apolipoprotein for LDL
Apo B-100
73
Apolipoprotein for Chylomicrons
Apo B-48
74
Major source for Apo A-1
Liver and intestines
75
Major source for Apo B-100, Apo B-48
Intestines
76
Major source of Apo (a)
Liver
77
Apolipoprotein for Lp (a)
Apo (a)
78
Floating B-lipoprotein
B-VLDL
79
Sinking pre-B-lipoprotein
Lp(a)
80
Abnormal lipoprotein found in pts with obstructive biliary disease and LCAT deficiency
LpX
81
Normal range for Total Cholesterol
< 200mg/dL
| CV: <3%
82
Normal range for HDL
> 60mg/dL
| CV: <4%
83
Normal range for LDL
< 100mg/dL
| CV: <4%
84
Normal range for triglycerides
< 150 mg/dL
| CV: <5%
85
Lipemia
Serum TG exceeds 400mg/dL (4.6mmol/L)
86
True of False:
| Cholesterol can be assayed from non-fasting blood samples
True; fasting has little effect on TC
87
Effect on glucose: insulin
Decrease
- increase cellular uptake
- glycolysis
88
Effect on glucose: Glucagon
Increase
| - increase glycogenolysis, gluconeogenesis
89
Effect on glucose: Cortisol
Increase
| - stimulates gluconeogenesis
90
Effect on glucose: Catecholamines
Increase
| - stimulates glycogenolysis
91
Effect on glucose: Thyroid hormones
Increase
| - stimulate glycogenolysis
92
Effect on glucose: Growth hormone
Increase
| - inhibits insulin action
93
Standard specimen for detection of diabetes
Venous plasma glucose
94
Metabolism of glucose at room temp
7mg/dL/hour
95
Metabolism of glucose at 4C
2mg/dL/hour
96
Oral glucose tolerance tes
Ingest 150g/day for 2 days then perform test after 8 to 14-hour fast
97
Anticoagulant for glucose
Fluoride (gray-top)
98
True or False:
| Whole blood tends to give approximately 10-15% lower glucose readings than plasma
True
99
Nelson-Somogyi
Glucose reduces copper in hot alkaline which in turn reduces arsenomolybdic acid --> greenish-blue complex
100
Folin-Wu
Glucose reduces copper in hot alkaline which in turn reduces phosphomolybdic acid --> blue complex (molybdenum oxide)
101
Neocuproine Method
Glucose reduces copper --> Cuprous ions complex with neocuproine --> yellow
102
Formula for LDL-C
(TG) - (VLDL-C) - (HDL-C)
| where in VLDL = TG / 2.175 (mmol/L) OR TG/5 (mg/L)
103
Michaelis-Menten hypothesis
Relation between reaction velocity and substrate concentration
First order: rate proportional to [S]; excess enzyme
Zero order: rate proportional to [E]; excess substrate; happens after reaction reaches maximum
104
2 General method to measure enzymatic reaction
(1) Fixed-Time
- reaction proceeds for a designated time and assumed to be linear over time
(2) Continuous-monitoring or kinetic assay
- multiple measurements, usually absorbances change
105
Enzyme classes (enumerate)
1. Oxidoreductase (GDP)
2. Transferase (Creatine kinase)
3. Hydrolase (Amylase)
- cleave substrate then add H2O
4. Lyases (Aldolase)
- cleaves C-C, C-O, C-N
5. Isomerase (Tripsephosphate isomerase)
- converts to another isomer
6. Ligase (Glutathione synthetase)
- bond formation
- ATP as energy source
106
Enzyme that regulates blood pressure
Angiotensin-converting enzyme
107
Clinical significance of creatine kinase
Myocardial infarction
| Skeletal muscle disorder
108
Clinical significance of alanine aminotransferase
Hepatic disorders
109
Clinical significance of alkaline phosphatase
Hepatic disorders
| Skeletal muscle disorder
110
Clinical significance of acid phosphatase
Prostatic carcinoma
111
Major factor producing false elevations in acid phosphatase
Hemolysis
112
Wavelength selection for ACP
410nm
113
Onset of elevation of CK in cardiac disorder
4-8 hrs
114
Time of peak activity of CK in cardiac disorder
12h-24 hrs
115
Onset of elevation of CK-MB in cardiac disorder
4-8 hrs
116
Time of peak activity of CK-MB in cardiac disorder
24-38 hrs
117
Onset of elevation of AST in cardiac disorder
8-12 hrs
118
Time of peak activity of AST in cardiac disorder
24 hrs
119
Onset of elevation of LD in cardiac disorder
12-24 hrs
120
Time of peak activity of LD in cardiac disorder
72 hrs
121
Creatine --> creatine phosphate
Tanzer-Gilvarg method
122
Creatine phosphate --> creatine
Olive-Rosalki
123
Lactate --> pyruvate
Wacker method
| - 340nm absorbance can be read directly
124
Pyruvate --> Lactate
Wroblewski-LaDue
| - decrease in 340nm absorbance
125
Routine measurement of electrolytes usually involves only
Na*, K*, LC-, HCO3-
126
Normal range of anion gap
AG = (Na+) - (Cl-) - (HCO3-)
Reference: 7-16 mmol/L
AG = (Na+) + (K+) - (Cl-) - (HCO3-)
Reference: 10-20 mmol/L
127
Causes of elevated anion gap
1. Renal failure
- phosphate and sulfate retention
2. Ketoacidosis
- starvation and diabetes
3. Alcohol
4. Lactic acidosis
5. Hypernatremia
128
Causes of low anion gap
Hypoalbuminemia and severe hypercalcemia
129
Normal sodium serum
140 mEq/L
130
Normal serum chloride
100 mEq/L
131
Normal serum bicarbonate
2 mEq/L
132
Substances working together to regulate blood pressure in renin-angiotensin system
Hormones, renin, angiotensin, aldosterone
low bp -- kidney release renin -- in circ., renin to angiotensin -- arteriolar constriction and stimulate suparenal glands to produce aldosterone -- sodium and water retention -- increase in blood pressure and blood volume
133
Molecules bounded to T4
70% Thyroxine-binding globulin
20% transthyretin
10% albumin
134
GROWTH HORMONE
| Endocrine grand and function
- Anterior pituitary gland
- Most abundant hormone of APG
- Growth of skeletal muscles and long bones
135
PROLACTIN
| Endocrine grand and function
- Anterior pituitary gland
| - Production of breast milk
136
ADRENOCORTICOTROPIC HORMONE
| Endocrine grand and function
- Anterior pituitary gland
| - Stimulates adrenal cortex to release hormones
137
THYROID-STIMULATING HORMONE
| Endocrine grand and function
- Anterior pituitary gland
| - Stimulates thyroid lol
138
FOLLICLE-STIMULATING HORMONE
| Endocrine grand and function
- Anterior pituitary gland
- Stimulates follicle development and estrogen production
- Sperm production
139
LUTEINIZING HORMONE
| Endocrine grand and function
- Anterior pituitary gland
- Stimulates ovulation; production of progesterone
- Stimulates testes to produce testosterone
140
OXYTOCIN
| Endocrine grand and function
- Posterior pituitary gland
| - Stimulates uterine contractions an milk ejection
141
ANTIDIURETIC HORMONE
| Endocrine grand and function
- Posterior pituitary gland
- Causes renal reabsorption of water
- Increase blood pressure
142
THYROXINE and TRIIODOTHYROXINE
| Endocrine grand and function
- Thyroid Gland
- Body's metabolic hormone
- Increase rate of glucose oxidation of cells
- For normal growth and development
143
CALCITONIN
| Endocrine grand and function
- Thyroid gland
| - Calcium deposition in long bones
144
PARATHYROID HORMONE
| Endocrine grand and function
- Adrenal cortex (outermost)
| - Regulate Na+ and K+ reabsorption
145
GLUCOCORTICOIDS
| Endocrine grand and function
- Adrenal cortex (middle)
| - Resist long term stress -- increase blood glucose and decrease inflammation response
146
SEX HORMONES
| Endocrine grand and function
- Adrenal cortex (innermost)
| - androgen and estrogen -- secondary sex characteristics
147
CATECHOLAMINES
| Endocrine grand and function
- Adrenal medulla
| - Epinephrine and norepinephrine
148
INSULIN
| Endocrine grand and function
- Islets of Langerhans of the Pancreas (beta cells)
| - Increase rate of glucose uptake
149
GLUCAGON
| Endocrine grand and function
- Islets of Langerhans of the Pancreas (alpha cells)
| - Stimulates liver to release glucose to the blood
150
ESTROGEN
| Endocrine grand and function
- Ovaries
- Stimulates maturation of reproductive organs
- Development of secondary sex characteristics
- With progesterone, cause mentrual cycle
151
PROGESTERONE
| Endocrine grand and function
- Ovaries
| - Works with estrogen to establish mentrual cycle
152
TESTOSTERONE
| Endocrine grand and function
- Testes
- Maturation of male sex organs
- Secondary sex organs
- Production of sperm
153
MELATONIN
| Endocrine grand and function
- Pineal gland
| - Biological rhythms and reproductive behavior
154
THYMOSIN
| Endocrine grand and function
- Thymus
| - Maturation of T cells
155
Screening test for acromegaly
Somatomedin C or Insulin-like Growth Factor 1
156
Confirmatory test for acromegaly
Glucose suppression test (OGTT 75g glucose)
157
Cushing's syndrome
Increase in cortisol production
158
Screening test for Cushing's syndrome
- 24hr urninary free cortisol test
- Overnight dexamethasone suppression test (most widely used)
- Salivary cortisol test
159
Confirmatory test for Cushing's syndrome
- Low-dose dexamethasone suppression test
- Midnight plasma cortisol
- CRH stimulation test
160
Equation that mathematically describes the dissociation of weak acids/bases
Henderson-Hasselbalch Equation
161
Measurement of electrical potential due to activity of free ions
Potentiometry
162
Measurement of current flow produced by an oxidation reaction
Amperometry
163
For pO2, glucose, chloride, and peroxidase determinations
Amperometry
164
Increase/decrease of pO2 and pCO2 during fever
For every degree of fever:
pO2 will fall 7%
pCO2 will rise 3%
165
Derived from leaves of coca plant (Erythroxylon)
Cocaone
166
Flowers of hemp plant
Marijuana
167
Resin of hemp plant
Hashish
168
Most commonly abused substance
Ethyl alcohol
169
Blood alcohol %w/v : no obvious impairment
0.01-0.05
170
Blood alcohol %w/v : mild euphoria
0.03-0.12
171
Blood alcohol %w/v : decreased inhibition, loss of critical judgment, memory impairment, diminished reaction time
0.09-0.25
172
Blood alcohol %w/v : Mental confusion, strongly impared motor skills
0.18-0.30
173
Blood alcohol %w/v : Unable to stand or walk, vomiting
0.27-0.40
174
Blood alcohol %w/v : Coma and possible death
0.35-0.50
175
Blood alcohol %w/v : legally intoxicated
Greater than 100mg/dL of blood concentration
176
From incomplete combustion
Carbon monoxide
177
Odor of bitter almonds
Cyanide poisoning
178
Methods of determination for heavy metal poisoning
- Atomic absorption spectrophotometry
- Anodic strippling voltametry
- Reinsch test
179
Heavy metal with high affinity for keratin
Arsenic
180
Toxicity has been noted in patients who received long-term hemodialysis
Aluminum
181
Once used as an analgesic
Bromide
182
Primary product of hepatic metabolism of cocaine
Benzolecgonine
183
How many days is cocaine detectable in urine
Up to 3 days; 20 days for chronic users
184
Primary screening for cocaine use
Immunoassay
185
Confirmatory test for cocaine use (and other drugs)
GC/MS
186
Most potent and most abundant cannabinoid found in marijuana
THC (Tetrahydrocannabinol)
187
Most commonly used to treat congestive heart failure and cardiac arrythmias
Cardiotropics
188
Treatment for seizure disorders
Anticonvulsants (valproic acid)
189
Anti-inflammatory drugs
- Acetaminophen (Tylenol)
| - Acetylsalicylic acid
190
Antiasthmatics
Theophylline
| - most commonly prescribed, both for prevention and treatment of symptomatic exacerbations
191
Chemotherapeutic agents
Mrthothrexate
- anti-neoplastic agent
- treatment for psoriasis, RA, collagen vascular diseses
192
Treatment and prophylaxis of manic-depression/bipolar disorder
Lithium
193
Analgesic, antipyretic, anti-inflammatory
Aspirin
194
A blood level medication below the therapeutic range is considered
Subtherapeutic -- no clinical benefit
195
AFP tumor marker
Hepatic and testicular markers
196
ALP tumor marke
Lung cancer
197
Amylase tumor marker
Pancreatic cancer
198
BRCA-1
Breast or ovarian cancer
199
CA-125
Ovarian cancer (T&R)
200
CA-15.3
Breast cancer (T&R)
201
CA-19.1
Gastric, pancreatic, colorectal cancer
202
CA-50
Gastric, pancreatic cancer (T&R)
203
CA-27.29
Breast cancer (T&R)
204
Calcitonin tumor marker
Medulla thyroid cancer
205
Cathepsin-D
Breast cancer
206
CEA
Colorectal, stomach, breast, lung cancer (T&R)
207
CK-1 tumor marker
Small cell lung cancer, prostate cancer
208
Estrogen receptor tumor marker
Breast cancer
209
GGT tumor marker
Hepatoma
210
HER-2/neu tumor marker
Breast cancer (Tx)
211
Nuclear matrix protein tumor marker
Urinary bladder cancer
212
Algorithm whereby the most recent result is compared with the previously determined value
Delta check
213
Developed by Westgard and Groth to further judge whether control results indicate out-of-control situations
Multi-rule procedures
214
Warning rule
1 2s
215
Allows high sensitivity to random error
1 3s
216
Allows high sensitivity to systematic error
2 2s
217
Allows detection of random error
R4s
218
Allows detection of systematic error
4 1s; 10x
219
Type of error with no trend or means of predicting it
Random error
220
Control values different from previously established limits
Systematic error
221
Control values that continue to increase/decrease for 6 consecutive days
Trend
222
Control values distribute themselves one one side of the mean for 6 consecutive days
Shift
223
Due to transient instrumental differences or improper calibration of instrument
Shirt
224
Main cause is deterioration of reagents
Trend
225
Control values far from main set of value
Outliers
226
Smaller %CV = ____ precision
Greater
227
Ability of a test to detect Disease
Sensitivity
228
Ability of a test to detect the absence of disease
Specificity
229
Test that compares accuracy of two methods; difference between the mean values of each procedure
T test
230
Test that compares precision of two methods; difference between the standard deviations of two groups
F test
231
BMI of overweight
25-29.9 kg/m2
232
BMI of obese
>/ 30.0 kg/m2
233
Time/state before the pt has eaten or become physically active
Basal state
234
If blood pressure cuff is used as tourniquet
60mmHg
235
BSC : airflow in at front, rear and top through HEPA filter
BSC Class I
236
BSC: 70% recirculated through HEPA; exhaust via HEPA
BCS Class II A
237
BSC: 30% recirculated through HEPA; exhaust via HEPA and hard-ducted
BSC Class II B1
238
BSC: No recirculation; total exhaust via HEPA and hard-ducted
BSC Class II B2
239
BSC: Same as IIA but under negative pressure; exhausted air is ducted
BSC Class II B3
240
BSC: Supply air inlets through two HEPA filtes
BSC Class III
241
Most common POC coagulation test
APT
242
Fire: RACE
Rescue
Alarm
Contain
Extinguish
243
[Type of reagent water]
- Maximum purity
- For standard solutions, ultramicrochemical analyses, tissue/cell culture
Type I
244
[Type of reagent water]
| - most lab determinations
Type II
245
[Type of reagent water]
| - most qualitative measurements/exams
Type III
246
[Type of centrifuge]
- Attain horizontal position when spinning, vertical position when the head is not moving
- 3000 rpm
Horizontal or swinging bucket centrifuge
247
[Type of centrifuge]
- Angled compartments and allow small particles to sediment more rapidly
- 52 degree angle
Fixed-angle or angle-head centrifuge
248
[Type of centrifuge]
- high speed to separate layers of different specific gravities
- commonly used to separate lipoproteins
Ultracentrifuges
