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CLIN CHEM > Finals Laboratory Exam > Flashcards

Finals Laboratory Exam Flashcards

Na and K, Blood Gas, PSA, Thyroid Endocrinology (99 cards)

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1
Q

A bilobed organ which are connected in the center by an isthmus.

A

Thyroid gland

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2
Q

T3 and T4 are derived from

A

tyrosine and iodine

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3
Q

The active thyroid hormones are made in the ____, the fundamental structural
unit of the thyroid gland, from tyrosine and iodine in the presence of peroxidase.

A

follicle

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4
Q

T4 is also known as

a. 3,5,3’5’ tetraiodothyronine
b. thyroxine
c. A and B
d.3,5,3’ tri-iodothyronine

A

T4 is also known as
​
a. 3,5,3’5’ tetraiodothyronine
b. thyroxine
c. A and B
d.3,5,3’ tri-iodothyronine

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5
Q

Around 80% of T3 is formed in

A

peripheral cells

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6
Q

inactive form of T3,
formed during chronic illness

A

rT3
(3, 3’, 5’)

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7
Q

the test is ordered when a clinician suspects subclinical hyperthyroidism when free T4 is normal. ____ is typically elevated in hyperthyroidism.

A

Triiodothyronine

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8
Q

The thyroid gland also contains ____ cells that produce calcitonin and other similar peptides.

A

parafollicular

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9
Q

This disorder is associated with increased levels of TSH and decreased free T4 levels.

A

Hypothyroidism

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10
Q

usually presents during the hypothyroid state following thyroid atrophy but may present as euthyroid with goiter due to the inflammatory state.

A

Hashimoto’s thyroiditis

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11
Q

the characteristic reaction to thyroid hormone deficiency, including puffiness in the face and surrounding the eyes due to accumulation of mucopolysaccharides and chondroitin sulfate. Other characteristics of hypothyroidism include cold intolerance, dry hair and skin, weight gain, etc.

A

Myxdema

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12
Q

Treatment involves thyroid hormone replacement

A

levothyroxine

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13
Q

is associated with both decreased TSH and free T4.
Symptoms are similar to those of primary hypothyroidism in the adult. It is gener-
ally of pituitary origin secondary to surgical removal of the pituitary or pituitary failure, such as following head trauma, cerebral vascular accident, or obstetric com-
plications.

A

Secondary hypothyroidism

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14
Q

A prohormone for T3 production

A

T4

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15
Q

Ref value for T3

Adults:
a. 60-150 ug/dL
b. 70-120 ug/dL
c. 60-160 ug/dL

Children:
a. 105-245 ug/dL
b. 120-145 ug/dL
c. 150-240 ug/dL

A

Ref value for T3

Adults:
a. 60 - 150 ug/dL
b. 70 - 120 ug/dL
c. 60 - 160 ug/dL

Children:
a. 105 - 245 ug/dL
b. 120 - 145 ug/dL
c. 150 - 240 ug/dL

Adults: 0.9 to 2.46 nmol/L
Children: 1.8 to 3.8 nmol/L

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16
Q

Ref value for T4
Adults:
a. 5.5 - 12.5 ug/dL
b. 5.0 - 10 ug/dL
c. 5.0 - 10.5 ug/dL

Neonate:
a. 11.8 - 22.6 ug/dL
b. 12 - 20 ug/dL
c. 11 - 22 ug/dL

A

Ref value for T4
Adults:
a. 5.5 - 12.5 ug/dL
b. 5.0 - 10 ug/dL
c. 5.0 - 10.5 ug/dL

Neonate:
a. 11.8 - 22.6 ug/dL
b. 12 - 20 ug/dL
c. 11 - 22 ug/dL

Adult: 71-161 nmol/L
Neonate 152-292 nmol/L

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17
Q

optic changes including exophthalmos, proximal muscle weakness, tachycardia, atrial fibrillation, hyperthermia, and weight loss or inability to gain
weight.

A

hyperthyroidism

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18
Q

this disease is characterized as a toxic diffuse goiter (an enlarged, hyperactive thyroid gland) with an immunologic origin. Patients with this disease have circulating thyroid-stimulating antibodies (TSAb). This is most likely due to a defect in suppressor T lymphocytes, which allows for antigenic stimulation by thyroid antigens and production of immunoglobulins.

A

Graves’ disease

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19
Q

is a more common cause of hyperthyroidism in older adults. The cause of hyperactive nodes in the
thyroid is unknown, but it is generally thought that it is not immunologic.

A

Toxic multinodular goiter, also known as Plummer’s disease

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20
Q

increased levels of TSH and in-
creased levels of free T4.

A

Secondary hyperthyroidism

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21
Q

decreased TSH
increased Free T4

A

Graves’ disease

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22
Q

amount of iodine expressed in micrograms per 100 milliliters of blood serum that is precipitated with serum proteins

normal value ranges from 4 to 8 μg/100mL

A

Protein-bound iodine (PBI)

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23
Q

iodine that can be separated from plasma
proteins by butanol

Reference range : 2 – 6.5 μg/100mL

A

Butanol-extractable iodine(BEI)

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24
Q

Normal reference range (RIA) :

TT4 (72-163 nmol/L)
a. 5.5 - 12.5 ug/dL
b. 5.0 - 12 ug/dL
c. 5.5 - 15 ug/dL

TT3 (1.23-3 nmol/L)
a. 80 - 200 ng/dL
b. 90 - 200 ng/dL
c. 70 - 220 ng/dL

A

Normal reference range (RIA) :

TT4 (72-163 nmol/L)
a. 5.5 - 12.5 ug/dL
b. 5.0 - 12 ug/dL
c. 5.5 - 15 ug/dL

TT3 (1.23-3 nmol/L)
a. 80 - 200 ng/dL
b. 90 - 200 ng/dL
c. 70 - 220 ng/dL

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25
the **gold standard** – by employing this technique, TBG’s variable effect on total T4 concentration is eliminated a. Equilibrium dialysis b. Kinetic rate reaction c. Coated Ab Tubes d. Microencapsulated antibodies
which is the gold standard – by employing this technique, TBG’s variable effect on total T4 concentration is eliminated **a. Equilibrium dialysis** b. Kinetic rate reaction c. Coated Ab Tubes d. Microencapsulated antibodies
26
Mixed directly with patients serum a. Equilibrium dialysis b. Kinetic rate reaction c. Coated Ab Tubes d. Microencapsulated antibodies
Mixed directly with patients serum a. Equilibrium dialysis b. Kinetic rate reaction c. Coated Ab Tubes **d. Microencapsulated antibodies**
27
an in vitro indirect measure of the unsaturated binding sites on the thyroid hormone-binding proteins
RT3U Test | Normal value 25-35%; ratio: 0.85-1.15
28
use to differentiate primary hypo from secondary hypo
TSH Test
29
the sensitivity of the third generation TSH assays has led to the ability to detect what is termed ____ (or mild degree of thyroid dysfunction- due to the large reciprocal change in TSH levels seen for even small changes in free T4)
SUBCLINICAL DISEASE
30
- Measures pituitary stores - Differentiate secondary (pituitary) from tertiary (hypothalamic) hypothyroidism
Thyroid Releasing Hormone Stimulation Test
31
Main carrier of T4 and T3 ◦ Helpful in patients who have serum T3 & T4 levels that don’t agree with other
Thyroid Binding Proteins (TBP)
32
- “Hibernate hormone” - Produced by 5-deiodination of T4
Reverse T3 (rT3)
33
Used as a tumor marker to evaluate the effectiveness of treatment for thyroid cancer and to monitor its reoccurrence. a. Colloid Ab b. Thyroglobulin Ab c. Microsomal Ab
Thyroglobulin Antibodies
34
Antibodies directed against antigen in the cytoplasm. a. Colloid Ab b. Thyroglobulin Ab c. Microsomal Ab
Microsomal Antibodies
35
Uses 123I or 99TC to define areas of increased or decreased uptake within the gland. a. T3 Suppression test b. Radioactive Iodine Uptake (RAIU) test c. Thyroid scan
Uses 123I or 99TC to define areas of increased or decreased uptake within the gland. a. T3 Suppression test b. Radioactive Iodine Uptake (RAIU) test **c. Thyroid scan**
36
a substance that can donate hydrogen A. Acid H+ ions B. Base OH- ions
a substance that can donate hydrogen **A. Acid H+ ions** B. Base OH- ions
37
Strong acids have pKa values of less than ___ a. 3.0 b. 4.0 c. 9.0 whereas strong bases have pKa values greater than ___ a. 3.0 b. 4.0 c. 9.0
a. less than 3.0 c. 9.0
38
Through metabolism, the body produces approximately ____ of H+ each day.
150 g
39
____ is also known as the ionization constant.
The dissociation constant
40
is a weak acid because it does not completely dissociate into H+ and HCO3– a. H2CO3 b. HCl
is a weak acid because it does not completely dissociate into H+ and HCO3– **a. H2CO3** b. HCl
41
whereas a strong acid, such as ____, completely dissociates into H+ and Cl– in solution. a. H2CO3 b. HCl
whereas a strong acid, such as ____, completely dissociates into H+ and Cl– in solution. ​ a. H2CO3 **b. HCl**
42
The ____ (HPO42– H2PO4–) is the primary buffer in urine and is involved in the exchange of sodium ion in the urine filtrate.
phosphate buffer system
43
Blood gas analyzers use ____ as sensing devices
electrodes
44
is measured using Potentiometry a. PO2 b. PCO2 and pH
is measured using Amperometry (Clarke electrode) a. PO2 **b. PCO2 and pH**
45
To maintain electroneutrality (the same number of positively and negatively charged ions on each side of the red cell membrane), chloride diffuses into the cell. This is known as the ____
chloride shift (also known as the Hamburger shift).
46
pCO2 ref value a. 35 to 45 mmHg b. 22 to 29 mmol/L c. 23 to 27 mmol/L d. 85 to 105 mmol/L
pCO2 ref value **a. 35 to 45 mmHg** b. 22 to 29 mmol/L c. 23 to 27 mmol/L d. 85 to 105 mmol/L
47
HCO3 ref value a. 35 to 45 mmHg b. 22 to 29 mmol/L c. 23 to 27 mmol/L d. 85 to 105 mmol/L
HCO3 ref value a. 35 to 45 mmHg **b. 22 to 29 mmol/L** c. 23 to 27 mmol/L d. 85 to 105 mmol/L
48
Total CO2 ref value a. 35 to 45 mmHg b. 22 to 29 mmol/L c. 23 to 27 mmol/L d. 85 to 105 mmol/L
Total CO2 ref value a. 35 to 45 mmHg b. 22 to 29 mmol/L **c. 23 to 27 mmol/L** d. 85 to 105 mmol/L
49
results from a decrease in blood pH - Decreased bicarbonate ions - Increased presence of hydrogen ions
Acidosis
50
* Increased presence of bicarbonate ions * Decreased hydrogen ions
Alkalosis
51
- increase in presence of organic acid levels - The body is losing bicarbonate ions
METABOLIC ACIDOSIS
52
Carbon monoxide poisoning, excess alcohol intake, excess in strenuous exercise / activity
METABOLIC ACIDOSIS
53
METABOLIC ACIDOSIS. Lungs compensate by
hyperventilation
54
- presence of hypoventilation - Airflow obstruction in lungs - Decreased elimination of CO2
RESPIRATORY ACIDOSIS
55
Asthma, chronic obstructive pulmonary disease (COPD)
RESPIRATORY ACIDOSIS
56
compensation of kidneys in respiratory acidosis a. excretion of hydrogen reabsorption of bicarbonate b. excretion of bicarbonate reabsorption of hydrogen
Excretion of hydrogen Reabsorption of bicarbonate
57
- Body is losing acid compounds - Decrease excretion of bicarbonate by kidneys
METABOLIC ALKALOSIS
58
Excessive vomiting (loss of stomach acid)
METABOLIC ALKALOSIS
59
METABOLIC ALKALOSIS compensation
Hypoventilation
60
- Excessive elimination of carbon dioxide - Increase in levels of bicarbonate
RESPIRATORY ALKALOSIS
61
Plasma should be used in PSA tests. T or F?
False
62
serves as the solid phase as well as the pipetting device for the assay.
solid phase receptacle (SPR)
63
The assay principle combines a two-step enzyme immunoassay sandwich method with a final fluorescent detection
(ELFA)
64
Conditions decreased in PSA
- Surgical / Medical - Castration - Finasteride - Micronutrients
65
Most detectable PSA in serum (65-90%) is bound to
𝛼 - antichymotrypsin (ACT)
66
During the final detection step, the substrate____, the fluorescence of which is measured at 450 nm.
4-Methyl-umbelliferone
67
**Slightly to moderately elevated** PSA a. 0 to 2.5ng/mL b. 2.6 to 10 ng/mL c. 10 to 19.9 ng/mL d. 20 ng/mL or more
**Slightly to moderately elevated** PSA ​ a. 0 to 2.5ng/mL **b. 2.6 to 10 ng/mL** c. 10 to 19.9 ng/mL d. 20 ng/mL or more
68
** moderately elevated **PSA a. 0 to 2.5ng/mL b. 2.6 to 10 ng/mL c. 10 to 19.9 ng/mL d. 20 ng/mL or more
** moderately elevated **PSA ​ a. 0 to 2.5ng/mL b. 2.6 to 10 ng/mL **c. 10 to 19.9 ng/mL** d. 20 ng/mL or more
69
**4.1 **ng/mL PSA reference a. 60 years and above b. 70-79 years c. 60-69 years d. 50-59 years
**4.1 **ng/mL PSA reference ​ **a. 60 years and above** b. 70-79 years c. 60-69 years d. 50-59 years
70
**6.5** ng/mL PSA reference a. 60 years and above b. 70-79 years c. 60-69 years d. 50-59 years
**6.5** ng/mL PSA reference a. 60 years and above **b. 70-79 years** c. 60-69 years d. 50-59 years
71
< 4.5 ng/mL PSA reference a. 60 years and above b. 70-79 years c. 60-69 years d. 50-59 years
< 4.5 ng/mL PSA reference a. 60 years and above b. 70-79 years **c. 60-69 years** d. 50-59 years
72
is the primary extracellular cation in the human body and is excreted principally through the kidneys.
sodium
73
has the melting point is 97.79 °C and the boiling point is 882.8 °C
sodium
74
The melting point of potassium is 63.5 °C and the boiling point is 759 °C.
K
75
Boiling point of potassium a. 759 °C b. 882.8 °C
Boiling point of potassium **a. 759 °C** b. 882.8 °C
76
Melting point of Sodium a. 63.5 °C b. 97.79 °C
Melting point of Sodium a. 63.5 °C **b. 97.79 °C **
77
is in the period 4 of the periodic table a. Na b. K
is in the period 4 of the periodic table a. Na **b. K**
78
Sodium atom is smaller than potassium atom. T/F?
True
79
Ref. value of sodium a. 135 -155 mEq/L b. 3.6 - 5.2 mmol/L c. 13.7 - 19.9 mg/dL d. B and C
Ref. value of sodium **a. 135 -155 mEq/L** b. 3.6 - 5.2 mmol/L c. 13.7 - 19.9 mg/dL d. B and C
80
Ref. value of sodium a. 135 -155 mEq/L b. 3.6 - 5.2 mmol/L c. 13.7 - 19.9 mg/dL d. B and C
Ref. value of sodium **a. 135 -155 mEq/L** b. 3.6 - 5.2 mmol/L c. 13.7 - 19.9 mg/dL d. B and C
81
Ref. value of potassium a. 135 -155 mEq/L b. 3.6 - 5.2 mmol/L c. 13.7 - 19.9 mg/dL d. B and C
Ref. value of potassium ​ a. 135 -155 mEq/L b. 3.6 - 5.2 mmol/L c. 13.7 - 19.9 mg/dL **d. B and C**
82
cases of dehydration, which can have many causes, including not drinking enough fluids, diarrhea, kidney dysfunction, and diuretics. a. hypernatremia b. hyponatremia
cases of dehydration, which can have many causes, including not drinking enough fluids, diarrhea, kidney dysfunction, and diuretics. ​ **a. hypernatremia** b. hyponatremia
83
common in older adults, especially those who are hospitalized or living in long- term care facilities. Signs and symptoms altered personality, lethargy and confusion. Severe cases causes seizures, coma and even death. a. hypernatremia b. hyponatremia
common in older adults, especially those who are hospitalized or living in long- term care facilities. Signs and symptoms altered personality, lethargy and confusion. Severe cases causes seizures, coma and even death. ​ ​ a. hypernatremia **b. hyponatremia**
84
can cause heart attack or death a. hyperkalemia b. hypokalemia
can cause heart attack or death **a. hyperkalemia** b. hypokalemia
85
furosemide and steroids, dialysis, diabetes insipidus, hyperaldosteronism, hypomagnesemia
a. hyperkalemia **b. hypokalemia**
86
is based on the measurement of the emitted light intensity when a metal is introduced into the flame.
FLAME PHOTOMETER
87
Advanatges - **Simple** quantitative analytical test based on the flame analysis. - Inexpensive. - The determination of elements such as alkali and alkaline earth metals is **performed easily with most reliable and convenient methods.** Disadvantage - **Difficult to obtain the accurate results** of ions with higher concentration - Information about the molecular structure **cannot be determined.** a. ION-SELECTIVE ELECTRODES (ISE) DETERMINATION b. FLAME PHOTOMETER c. SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION
Advanatges - **Simple** quantitative analytical test based on the flame analysis. - Inexpensive. - The determination of elements such as alkali and alkaline earth metals is **performed easily with most reliable and convenient methods.** Disadvantage - **Difficult to obtain the accurate results** of ions with higher concentration - Information about the molecular structure **cannot be determined.** a. ION-SELECTIVE ELECTRODES (ISE) DETERMINATION **b. FLAME PHOTOMETER** c. SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION
88
The present method is based on modifications of those first described by Maruna3 and Trinder4 in which sodium is precipitated as the triple salt, sodium magnesium uranyl acetate, with the excess uranium then being reacted with ferrocyanide, producing a chromophore whose absorbance varies inversely as the concentration of sodium in the test specimen. a. ION-SELECTIVE ELECTRODES (ISE) DETERMINATION b. FLAME PHOTOMETER c. SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION
The present method is based on modifications of those first described by Maruna3 and Trinder4 in which sodium is precipitated as the triple salt, sodium magnesium uranyl acetate, with the excess uranium then being reacted with ferrocyanide, producing a chromophore whose absorbance varies inversely as the concentration of sodium in the test specimen. ​ a. ION-SELECTIVE ELECTRODES (ISE) DETERMINATION b. FLAME PHOTOMETER **c. SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION**
89
SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION linearity a. 300 mEq/L b. 200 mEq/L c. 500 mEq/L
SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION linearity ​ a. 300 mEq/L **b. 200 mEq/L** c. 500 mEq/L
90
SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION linearity Reagent: I. Uranyl Acetate II. Acetic acid III. Potassium Ferro cyanide IV. Magnesium Acetate a. I and II b. III and IV c. IV only d. I and IV
SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION linearity Reagent: I. Uranyl Acetate II. Acetic acid III. Potassium Ferro cyanide IV. Magnesium Acetate a. I and II b. III and IV c. IV only **d. I and IV**
91
SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION linearity Sodium color reagent: I. Uranyl Acetate II. Acetic acid III. Potassium Ferro cyanide IV. Magnesium Acetate a. I and II b. III only c. IV only d. I and IV
SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION linearity Sodium color reagent: I. Uranyl Acetate II. Acetic acid III. Potassium Ferro cyanide IV. Magnesium Acetate a. I and II **b. III only** c. IV only d. I and IV
92
Sodium Standard: Sodium Chloride solution: ____ mEq/L of sodium a. 150 b. 200 c. 135
Sodium Standard: Sodium Chloride solution: ____ mEq/L of sodium **a. 150** b. 200 c. 135
93
are the most common method used in the analysis for many electrolytes. is an analytical technique used to determine the activity of ions in aqueous solution by measuring the electrical potential.
B. ION-SELECTIVE ELECTRODES (ISE) DETERMINATION
94
Only ____ is measuredby ISE because it consist of or are covered by a unique material that is more selective for one ion. a. free unbound ion b. bound ion
Only ____ is measuredby ISE because it consist of or are covered by a unique material that is more selective for one ion. ​ **a. free unbound ion** b. bound ion
95
ISE ALTERNATE VOLUMES: ____ mL SAMPLE TO 2.5 mL FILTRATE REAGENT a. 50 b. 60 c 0.05
ISE ALTERNATE VOLUMES: ____ mL SAMPLE TO 2.5 mL FILTRATE REAGENT **a. 50** b. 60 c 0.05
96
ISE COLOR DEVELOPMENT ____ mL ACID REAGENT & 0.1 ml SUPERNATANT & 0.1 ml COLOUR REAGENT. a. 2.0 b. 2.8 c. 2.5
ISE COLOR DEVELOPMENT ____ mL ACID REAGENT & 0.1 ml SUPERNATANT & 0.1 ml COLOUR REAGENT. ​ a. 2.0 b. 2.8 **c. 2.5**
97
Potassium is determined spectrophotometrically through a **kinetic coupling assay system** using potassium dependent pyruvate kinase. Pyruvate generated is converted to lactate accompanying conversion of NADH to NAD. The corresponding decrease of optical density at 380 nm is proportional to the potassium concentration in the serum. a. ION-SELECTIVE ELECTRODES (ISE) DETERMINATION b. FLAME PHOTOMETER c. SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION d. POTASSIUM ENZYMATIC METHOD (FIXED TIME) for POTASSIUM DETERMINATION
Potassium is determined spectrophotometrically through a **kinetic coupling assay system** using potassium dependent pyruvate kinase. Pyruvate generated is converted to lactate accompanying conversion of NADH to NAD. The corresponding decrease of optical density at 380 nm is proportional to the potassium concentration in the serum. a. ION-SELECTIVE ELECTRODES (ISE) DETERMINATION b. FLAME PHOTOMETER c. SODIUM REAGENT SET (COLORIMETRIC METHOD) for SODIUM DETERMINATION **d. POTASSIUM ENZYMATIC METHOD (FIXED TIME) for POTASSIUM DETERMINATION**
98
POTASSIUM ENZYMATIC METHOD (FIXED TIME) for POTASSIUM DETERMINATION linearity a. Up to 8 mmol/L b. Up to 10 mmol/L c. Up to 20 mmol/L
POTASSIUM ENZYMATIC METHOD (FIXED TIME) for POTASSIUM DETERMINATION linearity ​ **a. Up to 8 mmol/L** b. Up to 10 mmol/L c. Up to 20 mmol/L
99
POTASSIUM ENZYMATIC METHOD (FIXED TIME) for POTASSIUM DETERMINATION Ref. value a. 3.2 to 5.2 mmol/L b. 3.5 to 5.1 mmol/L c. 3.0 to 5.5 mmol/L
POTASSIUM ENZYMATIC METHOD (FIXED TIME) for POTASSIUM DETERMINATION Ref. value ​ a. 3.2 to 5.2 mmol/L **b. 3.5 to 5.1 mmol/L** c. 3.0 to 5.5 mmol/L | (13.7-19.9 mg/dL)

CLIN CHEM (7 decks)

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