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Clinical Chemistry > Test 2 > Flashcards

Test 2 Flashcards

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1
Q

______ _________ are the building blocks of proteins.

A

Amino Acids

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2
Q

_______ is the study of DNA.

A

Genomics

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3
Q

What are lipids?

A

Water insoluble fatty molecules

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4
Q

_______ _______ or ________ are laboratory techniques that allow for the detection of specific nucleotide sequences.

A

DNA Probes or NAT (Nucleic Acid Test)

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5
Q

There are ____ naturally occurring amino acids.

A

20

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6
Q

What is an aminoacidopathy?

A

Uncommon, inherited, genetic disorders of amino acid metabolism

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7
Q

What is the most common aminoacidopathy?

A

Phenylketonuria (PKU)

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8
Q

What type of inheritance causes PKU and how many defective genes do you have to inherit?

A

Autosomal recessive

2 defective genes from both parents

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9
Q

PKU has to do with the absence of what enzyme?

A

Phenylalanine Hydroxylase

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10
Q

In PKU, Phenylalanine cannot be converted into?

A

Tyrosine

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11
Q

In PKU, Phenylalanine accumulates and is converted into?

A

Phenylpyruvic Acid

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12
Q

Phenylpyruvic acid is toxic to newborns and young children and can result in what two problems?

A

Brain damage and mental retardation

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13
Q

What test uses Bacillus subtilis and B-2-thienylalanine on an agar and places the PKU blood filter on it?

A

Guthrie Test for PKU

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14
Q

How do you know a Guthrie test is positive?

A

The B-2-thienylalanine (the inhibitor for Bacillus subtilis) is inhibited by the phenylalanine and bacteria is able to grow.

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15
Q

What are some foods that PKU patients should avoid?

A

Milks, Eggs, Chocolate, Meat, Beer, Peas, Nuts, Beans

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16
Q

Amino acids are linked together via a special type of bond know as?

A

Peptide bond

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17
Q

What are the 4 most important NPNs (Non-Protein Nitrogen)?

A

BUN
Creatinine
Uric Acid
Ammonia

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18
Q

What is BUN?

A

A product of protein catabolism which produces ammonia

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19
Q

What does BUN stand for?

A

Blood Urea Nitrogen

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20
Q

What is azotemia?

A

Elevated plasma BUN

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21
Q

What can cause increased BUN that is not related to renal function?

A
  • Low Blood Pressure (CHF, Hemmorhage, Dehydration)
  • Decreased blood flow to kidneys
  • Increased dietary protein or protein catabolism
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22
Q

What causes decreased BUN that is not related to renal function?

A
  • Decreased dietary protein

- Increased protein synthesis (pregnancy, children)

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23
Q

What are the renal causes of increased BUN?

A
  • Glomerular nephritis

- Renal failure from Diabetes mellitus

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24
Q

What are the post renal causes of increased BUN (not related to kidney function)?

A
  • Kidney stones
  • Bladder or prostate tumors
  • UTIs
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25
What is the normal BUN/Creatinine ratio?
10 - 20 to 1
26
How is creatinine formed?
At a constant rate by the muscles as a function of muscle mass
27
How is creatinine removed?
It is removed from the plasma by glomerular filtration
28
What is increased plasma creatinine associated with?
Decreased glomerular filtration (renal function)
29
Is plasma creatinine affected by diet?
No
30
Why must a delta check be investigated on a patient who's had a change in creatinine result?
Plasma creatinine is very stable from day to day and should not dramatically change.
31
What is the Jaffee method used for?
Measures creatinine | Creatinine + Picrate Acid = Colored Chromagen
32
What is uric acid?
Breakdown product of purines (nucleic acid/DNA)
33
Purines from cellular breakdown are converted to ______ _____ by the liver.
Uric acid
34
Where is uric acid filtered?
Glomerulus
35
What are some causes for increased uric acid?
- Gout - Leukemia and Lymphoma - Megaloblastic Anemia - Renal Disease
36
What happens when you have gout?
Painful uric acid crystals in joints
37
What age of males and what type of people get gout?
Alcoholic and older males > 40
38
What is ammonia produced from?
Deamination (removal) of amino acids
39
______ converts ammonia into urea.
Liver
40
What happens to plasma ammonia levels in severe hepatic disease?
Liver fails to convert ammonia to urea and increases ammonia levels
41
What are some causes of increased ammonia levels?
Liver disease, Reye's syndrome, severe renal disease
42
When drawing blood for ammonia levels, how should it be stored during transport?
On ice in an EDTA tube and be tested immediately
43
How is the creatinine clearance calculated?
(UV/P) x (1.73/A) ``` U = Creatinine concentration of 24 hr. urine V = 24 hr. urine volume (mLs/min) P = Plasma creatinine concentration ```
44
What must you divide the V by in a creatinine clearance formula?
Divide by 1440 to convert mLs/24 hours to minutes.
45
What is the creatinine clearance?
A calculated measurement of the rate at which creatinine is removed from the plasma by the kidneys.
46
Decreased creatinine clearance is associated with?
Decreased glomerular filtration
47
Enzymes are _______ ________.
Protein catalysts
48
Enzymes are measured by their _________.
Activity
49
What is the substrate?
Product you start out with in a chemical reaction
50
Does the enzyme get used up during a reaction?
No
51
What is the active site?
Physical location on the enzyme molecule which interacts with a substrate molecule
52
What is the allosteric site?
Non-active site, which may interact with other substances to change the overall enzyme 3-D shape
53
What are isoenzymes?
Structurally different enzymes but which catalyzes the same chemical reaction
54
What is a cofactor?
A non-protein substance required for normal enzyme activity
55
What are the 2 types of cofactors?
Activators (inorganic) and Coenzymes (organic)
56
What is a holoenzyme?
Enzyme + Coenzymes = Active Enzyme
57
What is a proenzyme?
Enzyme - Coenzyme = Inactive Enzyme
58
Enzymes _______ the activation energy for chemical reactions.
lower
59
The enzyme is not _____ or ______ by the chemical reaction.
Consumed or depleted
60
Do we want to be at zero order or first order when measuring enzyme activity?
Zero order
61
What is a competitive inhibitor?
Substance that binds at enzymes active site and competes with substrate
62
What is a non-competitive inhibitor?
Substances that bind at an enzymes non-active site and alters enzymes 3D shape and decreasing enzyme activity.
63
__________ substrate concentration if there is a competitive inhibitor.
Increase
64
What is substrate depletion?
When you have extreme elevations of enzyme activity and there is a depletion of substrate
65
What is the common unit for enzyme activity?
International units
66
What does 1 IU equal?
That amount of enzyme that will convert 1 micromole of substrate into product per minute under defined conditions
67
What three tissues can you find the enzyme creatinine kinase (CPK, CK)?
Brain, muscle, and cardiac
68
Increased plasma CPK is associated with what?
Damage to the cardiac, brain, or muscle tissue
69
Increased CPK is useful to diagnose what two diseases?
AMIs and skeletal muscle diseases
70
How many isoenzymes does CPK have?
Three
71
What three isoenzymes does CPK have?
CPK-BB (brain) CPK-MB (cardiac) CPK-MM (skeletal muscle)
72
Cardiac muscle is ____% CK-MM and ___% CK-MB.
80 and 20
73
Increased CPK-MB is a strong indication of?
AMI
74
RBCs lack CPK, but hemolyzed RBCs release adenylate kinase into the plasma, this can cause what type of result?
Falsely increased
75
Where can you find the enzyme LDH (lactate dehydrogenase)?
Skeletal muscle, cardiac muscle, renal tissue, and RBCs
76
Plasma LDH is elevated in what four conditions?
Liver disease, cancers, AMI, and hemolytic disease
77
How many isoenzymes does LDH have?
5
78
Where can you find the enzyme AST (aspartate aminotransferase)?
Skeletal muscle, cardiac muscle, liver tissue, and lung tissue
79
Where can you find the highest concentrations of ALT (Alanine amino transferase)?
In the liver
80
Increased plasma ALT is closely associated with?
Liver disease
81
What enzyme requires Mg as an activator?
Alkaline phosphate (ALK PHOS)
82
What's the optimal pH for the enzyme alkaline phosphate?
9.0-10.0 alkaline
83
Where can you find high concentrations of ALK PHOS?
Bone and liver
84
What enzyme catalyzes the breakdown of starch and glycogen to glucose?
Amylase
85
Where can you find high concentrations of Amylase?
Pancreas and saliva
86
Increased plasma or urine amylase is very suggestive of?
Pancreatitis or pancreatic malignancy
87
What enzyme has the same function as ALK PHOS but has a different pH at 5.0 (acidic)?
Acid phosphatase
88
Increased plasma GGT (gamma-glutamyltransferase) is associated with?
Hepatobiliary disease and alcoholic cirrhosis
89
Insurance companies utilize what enzyme to detect alcoholism?
GGT Gamma-glutamyltransferase
90
What does the enzyme lipase do?
Hydrolyze (breakdown) fat
91
Where can you find high concentrations of lipase?
Pancreas
92
What is the most specific enzyme for detection of pancreatitis?
Lipase

Clinical Chemistry (7 decks)

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