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Flashcards in Final Deck (99):
1

Trace elements are drawn in a ___ tube:

royal blue top

2

Testing for trace elements is often performed in ___:

clean rooms

3

List the two categories of trace elements:

Essential
Non-essential

4

Why are non-essential trace elements still of medical interest:

Because of their toxic properties

5

What is the preferred sample for arsenic testing:

urine
(blood has short half life)
(hair and nails used for chronic/long term exposure)

6

In 2000, ___ was approved to treat Acute promyelocytic leukemia:

Arsenic trioxide

7

Cadmium is absorbed primarily via __:

food

8

Newborns are virtually free of ____ :

cadmium

9

__ and ___ have higher rates of cadmium toxicity:

smokers
females

10

Why can blood samples be used to measure cadmium:

Cd binds to the RBC

11

Yellow containers may contain ___ in the pigments:

Cadmium

12

What is mercury's known function in humans:

none

13

Mercury exposure occurs via ___, __, and ___:

inhalation
ingestion
injection

14

Inorganic mercury is ____, organic mercury is ____:

inorganic: non-toxic
organic: toxic

15

Organic mercury is highly selective for lipid rich ___:

neurons

16

Lead exposure is primarily via __ and ___:

GI
Resp tract

17

All children under 2 are screened for ___:

lead

18

_____ most commonly used sample for lead testing, but __ and __ can also be used:

Venous whole blood
hair and nails

19

___ is widely used in mascara production and found in some tattoo pigments:

Mercury

20

Genetic condition causing copper toxicity:

Wilson's Disease

21

___ is the best known, least understood Copper protein:

Ceroloplasmin

22

Ceruloplasmin is an ___, contains 95% of copper in the body, allows Fe to enter transferrin w/o forming toxic Fe products:

alpha-2 globulin

23

Significantly elevated levels of ____ can cause plasma to appear greenish:

Ceruloplasmin

24

Extreme cases of Cu deficiency is called:

Menkes Disease

25

___ is associated with peculiar hair, growth retardation, appears at 3 months with death at 5 years:

Menkes Disease
(Cu deficiency)

26

This disease is seen at 6-40 years old, results in neuro and liver dysfunction, and is associated with Kayser-Fleischer rings:

Wilson's Disease
(Cu toxicity)

27

Kayser-Fleischer rings are:

green/brown discoloration of cornea associated with Wilson's Disease (Cu tox)

28

Zinc deficiency is confirmed via ___ and ___:

low urine zinc
decreased serum zinc

29

The body contains about __grams of iron, more than __ is in RBC's:

4-5
half

30

75% of __ is physiologically active, the rest is stored:

iron

31

List the two storage forms of iron:

ferritin (Fe3 + apoferritin)
Hemosiderin

32

T/F
Hemosiderin is harmless in reticuloendothelial cells:

True

33

What is the equation for iron saturation %:

(Serum Fe/TIBC) x 100 = % sat

34

Is transferrin a positive acute phase protein?

No. It is a negative acute phase protein.

35

___ deficiency results in diabetes-likk hyperglycemia:

Chromium

36

Keshan Diases and Kashin-Beck are associated with __ deficiency:

Selenium

37

Once a drug is absorbed, it enters the hepatic portal system, this is called __:

First pass metabolism

38

The ___ fraction of the drug best correlates with concentration and therapeutic or toxic effects:

free fraction

39

Drugs can be cleared from the body in these 2 ways:

*hepatic metabolism
*renal filtration

40

Serum concentration will increase when rate of absorbance of drugs is ___ than excretion:

greater

41

Serum concentration will decrease when elimination and distribution of drug ___ absorbance:

exceeds

42

___ half-lives to reach steady state, and __ half-lives for drug to clear:

5.5
5.5

43

Goal of peak/trough testing is to achieve a __ in therapeutic range and keep __ below toxic range:

trough
peak

44

Trough is typically drawn _____, while peak is typically drawn___:

trough: right before dose is given
peak: 1 hour after dose

45

Which drug is an exception to timing of peak drawing:

digoxin
(has slow absorption, draw 6-8 hrs after dose)

46

Do IM drug doses need TDM:

No, usually just a single dose

47

Gel tubes shouldn't be used for ___:

anti-epileptics

48

As a rule, use ___tube for drug draws:

red top

49

As a rule, do NOT use ___ or ___ when drawing for anticoagulant monitoring, only use ___ generally:

*EDTA or Citrate
*heparin

50

Norpace, Quinidine, and Procanamide are all ___:

anti-arrhythmic drugs

51

Red man syndrome is associated with ___ toxicity:

vancomycin

52

Since Vancomycin has long distribution phase, usually only ___ levels are drawn::

trough

53

___ is the preferred draw sample for Anti-epileptics:

Trough

54

Phenobarbitol, phenytoin, Valproic acid, carbamazepine, Gabapentin, Lamotrigine, etc are examples of ___:

anti-epileptics

55

Imipramine, Amitryptilin, Doxepin, Clozapine, and Olanzapine are examples of ____:

Tricyclic antidepressants

56

Clozapine and Olanzapine can both be used to treat ___:

Schizophrenia

57

Cyclosporine, Tacrolimus, Sirolimus, are examples of ____:

Immunosuppressive drugs

58

What is the main anti-neoplastic drug listed in our notes, also used for RA, and is NOT aided by TDM:

Methotrexate

59

With ___, dose given is more important than the concentration; it works by inhibiting DNA synthesis in all cells:

methotrexate

60

___ are used for screening, dx, prognosis, monitor therapy and detect reoccurrence:

Tumor markers

61

Tumor marker concentration will generally __ with tumor progression/metastases:

increase

62

It is important to use the ___ assay methodology when comparing results on single person:

same

63

____ is when analyte exceed analytical range extensively; must dilute these samples:

Hook effect

64

____ is an antibody that competes for binding sites:

Heterophile antibody

65

You can only report and exact value when it is within the ___range, otherwise must report as < or >:

linear

66

Is there standardization among tumor marker assays:

no. important to use the same methodology when comparing results on single patient.

67

___ is used to for dx and prognosis of hepatocellular carcinoma, also seen in germ cell tumors, and combined with BHCG to classify and stage testicular cancer:

AFP

68

Is AFP specific:

no. it is also increased in pregnancy and liver disease

69

T/F
The higher the AFP, the worse the prognosis in hepatocellular carcinoma:

True

70

__is used to detect RELAPSE of colorectal cancer:

CEA

71

CEA stands for:

Carcinoembryonic antigen

72

T/F
CEA is entirely specific for colon cancer:

false.
is also increased in liver damage, heavy smokers, chemo etc1

73

Is CEA useful in screening for colorectal cancer?

no. is only useful in detecting relapse.

74

____ is a prognostic indicator of ovarian cancer, dx marker to classify testicular disease and useful marker to classify gestational trophoblastic disease:

HCG

75

HCG is normal secreted by the ___ to prepare and maintain ___:

placenta
pregancy

76

___ will be increased with germ cell tumor of ovary and testes:

HCG

77

Do healthy men have low levels of circulating PSA?

yes

78

___ is best used to monitor the progression of prostat cancer after therapy:

PSA

79

Patients with malignancy have lower __PSA:

free

80

___PSA is used to screen for and monitor prostate cancer:

Total

81

Are AFP and CEA an oncofetal antigens:

Yes

82

Can some enzymes, proteins, hormones, and oncofetal antigens be used as tumor markers?

yes

83

List a hormone that can be used as a tumor marker:

catecholamines

84

List a protein that can be used as a tumor marker:

beta 2 microglobulin
(monitor renal transplant pts for rejection)

85

CA-125 is used to detect ___ at an early stage; not used to screen asymptomatic patients:

ovarian

86

___ is the only clinically accepted marker for ovarian cancer:

CA-125

87

CA 19-9 is used to differentiate between ___ and other cancers:

pancreatic cancer

88

CA 15-3 is used to monitor ____ treatment and disease recurrence:

breast cancer

89

Is CA 19-9 a good screening tool for pancreatic cancer:

no

90

T/F
Levels of CA 19-9 and 15-3 can be increased in otherwise healthy individuals, as well as in other benign conditions:

True

91

T/F
Levels of CA-125 correlate with cancer stage:

true

92

___ is chronic protein deficiency with adequate non-protein calorie intake:

Kwashiorkor

93

___ is deficiency of calories with adequate protein intake:

Marasmus

94

Which would have marked hypoalbuminemia, Marasmus or Kwashiorkor:

Kwashiorkor
(albumin would be normal in Marsmus)

95

___ is the most abundant plasma protein and is used to assess hospitalized patients nutritional status:

albumin

96

____ is a glycoprotein and an early indicator of iron deficiency:

Transferrin

97

T/F
Transferrin will indicate protein depletion before albumin:

True.

98

___is the major transport protein for Thyroxin and Vitamin A:

Pre-albumin

99

Pre-albumin is a major transport protein for ___ and ___:

Thyroxin and Vitamin A