final review

Question 1

which ALP enzyme travels closest to the anode following electrophoresis

Answer 1

liver, then bone/placenta,

Question 2

which marker is used to determine non specific inflammation

Answer 2

CRP C reactive protien

Question 3

what is the main isoenzyme of CK

Answer 3

CK3 ( CK- MM)

MM= Much more

Question 4

which enzyme can be measured in both serum & urine

Answer 4

amylase because of its small size

Question 5

what coagulation factor is increased in liver disease ( what test would be preformed ?

Answer 5

PT- INR

Question 6

if a patient has alcoholic cirrohiss

Answer 6

GGT

Question 7

what enzyme would be elevated if a patient had viral hepatitis

Answer 7

AST

Question 8

if a patient has something going on with their liver a protein will be decreased and fluid retention will be increased, what is that called and what is the protein

Answer 8

edema

low albumin protein

Question 9

what enzyme would be elevated in pancreatic carcinoma

Answer 9

post hepatic obstruction = ALP increased

• any carcinoma/ tumor = obstruction= post hepatic

Question 10

characteristics of an ideal cardiac marker

Answer 10

sensitive
elevated quickly
elevated long enough to be tested

Question 11

conditions that cause an incresed anion gap

Answer 11

MUDPILES 
methanol 
uremia 
d
p
lactic acid 
ethanol 
salicilates

Question 12

calculations to kno

Answer 12

anion gap
osmolality
osmolar gap
total bilirubin- conjugated = unconjugated
beers law
henderson hassel back formula ( pH, HCO3 or PCO2)
CSF (glucose is 60% of Blood glucose )
international units ( enzyme units) ( micromol/min/L )

Question 13

if a patient has hypoparathyroidism

Answer 13

Calcium will be low

phosphate will be increased

Question 14

what is the biologically active form of calcium

Answer 14

ionized calcium

Question 15

compleximetric dye method of calcium, why do we add 8 hydroxyquinoline

Answer 15

to prevent magnesium interference

Question 16

potassium of 7.1 mmol/L what should you do

Answer 16

check for hemolysis- hemolysis = recollect
no hemolysis rerun
still critical = call physician

Question 17

acid - base disturbance options *

Answer 17

uncompensated
partially
fully

metabolic or
respiratory

acidosis or alkilosis

Question 18

if a blood gas sample is exposed to air

Answer 18

pH increased
O2 increase
CO2 decreased

Question 19

how is metabolic acidosis compensated

Answer 19

hyperventilation

- expel CO2 and bring pH back to normal

Question 20

what electrolyte is affected most by hemolysis

Answer 20

potassium, then magnesium

Question 21

what is the anticoagulant for blood gas

Answer 21

heparin ( dry form )

Question 22

what hormone is involved in increase & decrease in calcium levels

Answer 22

PTH - increases

calcitonin - decreases

Question 23

where is calcitonin produced

Answer 23

parathyroid

Question 24

which 2 analytes is collected in grey top tube

Answer 24

1. Lactate ( has to go on ice )

2. alcohol levels for legal reasons ( we measure it on whole blood)

Question 25

what is the confirmatory method for drugs of abuse analysis

Answer 25

gas chromatography-mass spectrometry

Question 26

what does pilocarpine iontophoresis measure

Answer 26

sweat chloride for cystic fibrosis diagnosis > 60 mmol/L = cystic fibrosis

Question 27

what solution is used to calibrate a freezing point osmometer

Answer 27

sodium chloride

Question 28

what is the best method to measure sodium concentration on a sample thats highly lipemic

Answer 28

direct ISE - bc its undiluted if using indirect we dilute it and that causes a false decrease ( pseudohyponatreia )

Question 29

low blood volume causes synthesis of what hormone by kidneys

Answer 29

alosterone - increases Na+ retention & water along with it ( increases blood pressure

Question 30

a serous fluid has to be kept on ice and anareobic for which test

Answer 30

pH

Question 31

trinder reaction is used to measure

Answer 31

salicyilates

Question 32

if a patient has elevated levels of AFP in fetal serum what kind of condition might fetus have

Answer 32

neural tube defects

Question 33

when do we collect peak drug levels

Answer 33

shortly after dose | - except digoxin ( 8hrs to travel throughout tissues & reach equilibrium )

Question 34

what % of carboxyhemoglobin is in smokers

Answer 34

5-15%

Question 35

what do we use to collect a lead sample

Answer 35

royal blue with EDTA

Question 36

how do we treat patients who have overdosed on opiates

Answer 36

naloxone

Question 37

if a patient has monhydrate calcium oxalate crystals in urine and sheets of renal epithelial cells what might they have ingested

Answer 37

antifreeze ( ethylene glycol)

Question 38

what is the most common method to analyze ethanol in lab

Answer 38

enzymatic method ( ADH enzyme - alcohol dehydrogenase )

Question 39

when someone overdoses on acetaminophen what oxidant becomes depleted

Answer 39

glutathione

Question 40

how do we know the difference between a hemorrhage or traumatic tap in CSF

Answer 40

traumatic tap will fade hemorrhage will remain blood throughout all tubes

Question 41

if a male had an icreased hcG what does that indicate

Answer 41

testicular cancer

Question 42

what tumor marker is for colorectal cancer

Answer 42

CEA - carcino embryonic antigen

Question 43

estrogen & progesterone receptors are used for information on what

Answer 43

breast cancer

Question 44

CA- 125

Answer 44

ovarian cancer

Question 45

what is the reference method for calcium

Answer 45

ASS atomic absorption spec

Question 46

what is the specimen of choice for ionized calcium

Answer 46

heparinized calcium

Question 47

exposure to air for ionied calcium

Answer 47

measured on a blood gas analyzer decreases CO2 & Calcium - increase pH

Question 48

what is the most important factor in phosphate regulation

Answer 48

PTH

Question 49

when is lactate a by product

Answer 49

by product of the emergency mechanism that produces ATP when O2 delivery is severely decreased pyruvate is the normal end product of glucose metabolism when O2 is deficient - pyruvate is converted to lacttae & only 2 mol of ATP is produced opposed to 38 ATP regularly

Question 50

early indicator of hypoxia

Answer 50

lactatein blood accumulates

Question 51

pre hepatic vs post hepatic

Answer 51

pre- urine bilirubin neg | post- urobilinogen neg

Question 52

What is the main reason for respiratory acidosis

Answer 52

COPD ( chronic obstructive pulmonary disease)

Question 53

What kind of electrode does a blood gas analyzer use

Answer 53

Clarke electrode