Test 1 Flashcards by Rowan Maclean

Controls

Specimen that is similar to patients sample. Has known value

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Standards

Highly purified substances of known composition to ensure accuracy. (Low, normal, high in chem)

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Quality control

Process that monitors accuracy and precision of a method

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What does Quality Assessment refer to?

Planned, step by step activities that ensure testing is being carried out correctly, providing accurate results

This process requires goals and measurement of performance

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What is the difference between quality assurance and quality control?

QA- planned and organized activities to ensure quality standards are met

QC- tasks put in place to find an correct problems that may occur in a single test. (Ie looking at control). Part of QA.

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What are trends in reference to the analytical elements of quality control?

QC values moving slowly up or down, indicating calibration error or failed reagent stability

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What are ‘shifts’ in relation to the analytical elements of QA?

Shifts of fur when there is a sudden spike or Change in QC values, indicating inaccurate calibration, temp changes, or dirty cuvettes

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What’s the difference between analytical and non analytical QA elements?

Non-analytical: ensuing workers are qualifies, establishing policies, preventative maintenance, and process control

Analytical: application of statistics/numbers to analyze measurements

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What are the two types of quality control? What are their differences?

Internal controls- controls built into testing device- In house samples or commercial samples with in house range

External controls- known reactive or non reactive controls available from manufacturer

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What are the two types of error?

Analytical:error occurring during analysis

Non-analytical:before or after analysis. (Patient labelling, preparations, transportation, etc)

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What is control range and how is it made?

Acceptable range for sample results to be

1- collect in house normal patient pool

2-run on equipment (20 or more times)

3- find mean and SD’s (SD 1, -1, 2, etc)

4- control range established +- 2SD

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What is a reference range and how is it determined?

Defence range is normal range for the patient pool in the area of the lab.

It is completely dependent upon what the normal ranges are for people in the area, what their sex is, age, etc

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What are the functions of carbohydrates?

Energy

Structure

Detoxification

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What are the two defining classifications of carbohydrates?

By whether they have a ketone or aldehyde reactive group (reducing)

By the number of carbons (ie glucose is a hexose- 6 carbons)

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What are the main monosaccharides?

Glucose

Fructose

Galactose

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What are the three main disaccharides?

Sucrose

Maltose

Lactose

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What are the three main polysaccharides?

Starch

Glycogen

Cellulose

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What is the order in which the body tries to metabolize glucose?

Energy production

Storage as glycogen or triglycerides

Conversion to keto acids, amino acids, or protein

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What is the process of carbohydrate digestion?

Mouth (amylase) > stomach (amylase is killed) > duodenum (breakdown into glucose) > absorption into liver through portal vein through diffusion and active transport

Glycolysis

Metabolism of glucose for production of energy

Glycogenolysis

Breakdown of glycogen into glucose

Gluconeogenesis

Formation of glucose from non-carb sources

Post cibum

After meal

Ante cebum

Before meal

Blood reducing substances

Measurement if any reducing substance in the blood (doesnt have to be glucose)

What are symptoms of hypoglycemia?

Dizziness, sweating, trembling, hunger, moodiness, confusion, blurred vision

What are some symptoms of hyperglycemia?

Thirst, frequent urination, fatigue

Mellituria

Presence of any sugar in the urine

Glucosuria

Presence of glucose in the urine

Glucose tolerance

How the body responds to a measured intake of glucose

Renal threshold

Level in blood at which substance will be excreted into urine

How do you convert between US and Can measurements for glucose?

US- mg/dL: divide by 18 Can- mmol/L: multiply by 18

What are the 4 main factors affecting glucose metabolism?

Absorption Hormones Liver disease Metabolic rate

What is another word for not absorbing glucose?

Malabsorption

What are the main hormones involved with glucose metabolism?

Insulin- beta cells of pancreas: stimulates uptake of glucose by increasing cell permeability Glucagon- alpha cells of pancreas: stimulate gylcogenolysis and gluconeogenesis to increase blood glucose Epinephrine- stimulates rapid glycogen breakdown Thyroxine GH Cortisol

What does liver disease do in relation to glucose?

Impresses body's ability to form glycogen, so when fasting, blood glucose drops drastically, as no long term energy stores exist

What are the symptoms and causes of diabetes insipidus?

Excessive water loss through kidneys due to lack of ADH Excessive urination (5-12L/day) and thirst

What are the ranges of glucose levels?

Low level-

What is average renal threshold?

>10mmol/L (12% less in whole blood b/c diluted)

What are some criteria for diagnosing diabetes mellitus?

FBS (8hrs) > 7mmol/L (normal 4.1-5.9) 2hrs after 75g load > 11.1mmol/L Plus polyuria, polydypsia, and unexplained weight loss

Why is lack of insulin an issue if we have stored fats?

Burning fats releases ketones, which increase blood pH and can be lethal- ketones can be measured in urine and serum (Ketones also present during pregnancy and malnutrition) Not fast enough

What are the three types of diabetes mellitus?

Type I- insulin dependent or early onset Type II- non insulin dependent or late onset Gestational diabetes- glucose intolerance from pregnancy

What is Type I diabetes? How is it treated?

Complete loss of insulin production Genetics, viral, autoantibody issue Requires insulin injections Polyuria, polydipsia, tiredness, weight loss, moodiness, ketones

What is type II diabetes? How is it treated?

Body has increased resistance to insulin, may eventually stop producing insulin altogether Oral medication can be taken Same symptoms as Type I, but usually overweight May display NO symptoms

What are some possible complications of Type I and Type II diabetes?

``` Heart disease Insulin shock Kidney disease Eye disease Impotence Nerve damage ```

What are some risks of gestational diabetes?

Macroscopic babies (possibly diabetic babies and risk of hypoglycemia, because used to high glucose level)

Calibration

Comparison of an instrument measurement to a physical constant