Lecture MT 2 Review

Question 1

What ABG parameter measures the amount of hemoglobin that is bound with oxygen?

Answer 1

oxygen saturation

Question 2

The clinical significance of increased oxygen saturation is ____

Answer 2

hyperventilation

Question 3

The clinical significance of decreased oxygen saturation is ____

Answer 3

hypoxia
(anemia, abnormal Hgb)

Question 4

____ is caused by an absolute PCO2 deficit.

Answer 4

respiratory alkalosis

Question 5

What is the kidneys’ most significant effect on arterial blood pH?

Answer 5

• alter rate of HCO3- reabsorption
• exchange H+ ions
• alter ammonia production

Question 6

What ABG parameter increases to show respiratory compensation of metabolic alkalosis?

Answer 6

PCO2

Question 7

____ is an absolute HCO3- deficit resulting in decreased pH and HCO3- (base deficit)

Answer 7

metabolic acidosis

Question 8

What are 2 main causes of metabolic acidosis?

Answer 8

• ketoacidosis (^acid production)
• renal failure (less excretion of H+ ions)

Question 9

During internal respiration, hgb and HCO3- move out of RBCs in exchange for Cl- moving in, called ____

Answer 9

chloride shift

(Cl- moving out during external respiration = reverse chloride shift)

Question 10

What screening test for gestational diabetes is performed at 24-28 weeks of gestation?

Answer 10

1-hr PP (post prandial; 50g glucose orally)
(normal = <140mg/dL)

Question 11

What hormone is produced by pancreatic a-cells in response to decreased blood glucose (or insulin), and is the principle hormone to increase blood glucose?

Answer 11

glucagon

Question 12

Glucagon stimulates liver ____

Answer 12

glycogenolysis
(and gluconeogenesis)

Question 13

The process of glycogen formation from glucose is called ____

Answer 13

glycogenesis

Question 14

What test is an index of long-term plasma glucose control?

Answer 14

HgbA1C
(screen for, monitor, & Dx diabetes mellitus or pre-diabetes)

Question 15

What are 2 other names for HgbA1C?

Answer 15

• glycated hemoglobin
• glycosylated hemoglobin

Question 16

What is the fasting blood glucose (FBG) criteria for prediabetes?

Answer 16

100 - 125 mg/dL

Question 17

Insulin deficiency due to autoimmune destruction of pancreatic beta-cells is called ____

Answer 17

Type I / IDDM (insulin dependent diabetes mellitus)

Question 18

Patients with type I diabetes are dependent on ____ insulin to sustain life and prevent ____

Answer 18

• exogenous (analogue)
• DKA (diabetic ketoacidosis)

Question 19

Decreased insulin production and/or increased peripheral insulin resistance is called ____

Answer 19

Type II / NIDDM (non-insulin dependent diabetes mellitus)

Question 20

Hyperosmolar coma is mostly associated with ____

Answer 20

type II diabetes
(dehydration, slow onset, ^^osmolality)

Question 21

Diabetic ketoacidosis is mostly associated with ____

Answer 21

type I diabetes

Question 22

The mathematical calculation of the difference between the concentration of measured cations and measured anions in serum is called ____

Answer 22

anion gap

Question 23

Anion gap is particularly helpful in the diagnosis of ____

Answer 23

metabolic acidosis

Question 24

Renal failure, acidosis, dehydration, and diabetic ketoacidosis can all lead to ____

Answer 24

hyperkalemia

Question 25

Name 2 important causes of hyperosmolality.

Answer 25

- dehydration - hyperglycemia (diabetes mellitus)

Question 26

Potassium moves into cells in response to increased ____

Answer 26

insulin (insulin drives both K+ and glucose into cell, can cause *hypokalemia*)

Question 27

What is the major intracellular cation?

Answer 27

potassium (Cats like salty bananas)

Question 28

What is the major extracellular cation?

Answer 28

sodium (Cats like salty bananas)

Question 29

What are the 4 main contributors to plasma/serum (urine) osmolality?

Answer 29

- sodium - chloride - urea (BUN) - glucose

Question 30

Lipids must be transported to storage sites or for use within transport packets via ____

Answer 30

lipoproteins (chylomicrons)

Question 31

VLDLs contain Apo C, which release ____, which **hydrolyzes triglycerides**

Answer 31

LPL (lipoprotein lipase)

Question 32

What is the typical pattern of serum cardiac enzymes/proteins in the criteria for AMI diagnosis?

Answer 32

rise, peak, return to normal reference range

Question 33

The initial rise, peak and return to normal, characteristic to each cardiac marker is termed ____

Answer 33

diagnostic window

Question 34

What is now the "gold standard" for early diagnosis of AMI?

Answer 34

troponins (used to be CK isoenzymes)

Question 35

Increased ____ can precipitate pancreatitis.

Answer 35

triglycerides

Question 36

____ are key elements in cell membranes, myelin, and surfactant.

Answer 36

phospholipids

Question 37

What are the 2 most prominent lipids found in plasma?

Answer 37

cholesterol triglycerides

Question 38

What enzyme is elevated in the blood whenever osteoblastic activity increases?

Answer 38

alkaline phosphatase (ALP) (found in bone & liver)

Question 39

What is the most commonly measured vitamin D metabolite?

Answer 39

calcitriol

Question 40

What are the 2 most common causes of hypercalcemia?

Answer 40

- hyperparathyroidism - hypercalcemia of malignancy (plasma levels >10.5 mg/dL)

Question 41

What is the most common cause of hyperphosphatemia?

Answer 41

renal failure

Question 42

What is the only physiologically/biologically active form of calcium?

Answer 42

free or **ionized**

Question 43

____ correlates well with disease activity and is used to monitor therapy for Paget's disease?

Answer 43

alkaline phosphatase (ALP) (^ALP, normal Ca & PO4)

Question 44

1. What is the acid-base status? 2. Is this condition respiratory or metabolic? 3. Is this acid-base balance uncompensated, partially compensated, or fully compensated?

Answer 44

_pH = acidosis ^PCO2 = respiratory - ^HCO3 = partially compensated (metabolic, pH still not normal)

Question 45

What is the typical blood-gas profile in this acid-base imbalance?

Answer 45

_HCO3 = metabolic _pH = acidosis

Question 46

What additional test could be used to evaluate the patient’s average glucose level for the past 6 to 8 weeks to determine the patient’s compliance with diet and insulin recommendation?

Answer 46

Hgb A1C

Question 47

According to NCEP, at what level is LDL considered a risk factor for atherosclerosis and CAD?

Answer 47

>160 mg/dL

Question 48

What lab test can detect low levels of inflammation (chronic) and can be used as a predictor of risk for AMI and stroke?

Answer 48

High sensitivity CRP (hsCRP)

Question 49

What are the NCEP age related risk factors for males and females?

Answer 49

Male >45yrs Female >55yrs

Question 50

Cardiac muscle contains which CK isoenzymes? Which is the most cardiac specific?

Answer 50

- **CK-MB** - CK-BB - CK-MM

Question 51

Which cardiac marker did we learn about that because of its small size, is the first to be released from damaged myocardial cells and will show elevation in the serum/plasma the soonest?

Answer 51

Myoglobin (Troponin is still the gold standard)

Question 52

What Hgb A1C result is consistent with: 1. diabetes 2. Pre-diabetes 3. Normal

Answer 52

Diabetes >/= 6.5% Pre-diabetes 5.7 - 6.4% Normal 4.0 - 5.6%