Week 6: Bood Chemistry Flashcards

(39 cards)

0
Q

what are some pre analytical factors that can affect quality of test results

A
Collection procedure
 - correct needle size
 - fill tubes in correct order
 - store correctly 
 - visually inspect
Labeling, handling, shipping
Patient variables (ex. fasting)
Equipment difficulties
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1
Q

What are some reasons why we would run a clinical chemistry profile

A

screen for disease
assess pre surgical risk
distinguish between differential diagnosis
assess severity of existing disease
monitor progression/response to therapy
identify patterns that suggest dysfunction

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2
Q

What are some things we can do as techs to ensure quality control and accurate results from a chemistry analyzer?

A
Proper calibration
Routine maintenance (ex. software update)
Running daily controls
Blanking methods
Monitor for deterioration of reagents
Monitor condition of analyzer
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3
Q

With chemistry, what type of sample do we usually look at?

A

Serum

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4
Q

What are plasma proteins produced and what are some of their function?

A

Primarily in the liver

structural component of all cells, organs, and tissues
osmotic pressure
enzymes
buffers
hormones 
clotting
defense 
transport molecules
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5
Q

what is total plasma protein

A

all proteins including fibrinogen

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6
Q

what is total serum protein

A

all proteins excluding clotting factors

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7
Q

Protein concentrations are affected by:

A

hepatic synthesis
altered protein breakdown or excretion
dehydration or over hydration

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8
Q

what are some methods we can use to test protein concentration

A

refractometric method

biuret method

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9
Q

You run a test and the Albumin levels are below normal range.

What is the medical name for this condition?
What would our concern be?

A

Hypoproteinemia

liver disease, renal disease, diet, intestinal function

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10
Q

What are Globulins?

How do you calculate Globulins

A

Complex group of proteins

  • Alpha globulins (come from liver)
  • Gamma globulins (antibodies)

concentration= TP - Albumin

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11
Q

What is A:G ratio

A

Albumin to Globulin ratio

its the first indication of protein abnormalties

A/G= A:G value

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12
Q

What is a hepatobiliary assay

A

tests for liver and gallbladder function

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13
Q

What is ALT and where would we find it?

A

Alanine Aminotransferase (enzyme in the cytoplasm of hepatocytes)

liver cells, renal cells, cardiac muscle, skeletal muscle, and the pancreas

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14
Q

When would we see an increase of ALT

A

within 12hrs of hepatocyte damage

peaks within 12 - 48 hrs

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15
Q

What is AST and where would we find it

and when could we see an increase in this

A

Aspartate Aminotransferase (Enzyme in hepatocytes)

liver cells, erythrocytes, cardiac muscle, skeletal muscle, kidneys, and the pancreas

levels may rise after exercise or IM injection (not just liver damage)

16
Q

What is AP?

Where is it found?

A

Alkaline Phosphatase

present in bone, cartilage, intestine, placenta, and hepatobiliary system cells

17
Q

What is Bilirubin

what do assays help determine:

A

derived from breakdown of hemoglobin in the spleen

Cause of jaundice
Hepatocellular damage
Bile duct injury/obstruction
Erythrocyte destruction

18
Q

Where would we find Bile acids?

When would we see elevated bile acids?

A

Liver - gallbladder - duodenum

when any process impairs hepatocellular, biliary, or enterohepatic circulation

19
Q

What factors would affect testing of bile levels

A

inadequate fasting
spontaneous gallbladder contraction
prolonged fasting (over 12hrs)
Diarrhea

20
Q

Where would we find cholesterol?

what condition do we test cholesterol for?

A

produced primarily in the liver

Hypothyroidism
Hyperadrenocorticism
Diabetes mellitus
Nephrotic syndrome

21
Q

What is BUN?

What factors can show an increase in BUN levels?

A

Blood Urea Nitrogen (Urea comes from protein breakdown)

Contamination (ex. staph)
Dehydration
Diet (high protein)

22
Q

What turns creatine into serum creatinine?

A

Muscle metabolism

23
Q

What are the divisions of pancreas function

A

Exocrine (digestive enzymes)

Endocrine (insulin)

24
What is function of amylase? where is it produced? what caused an increase?
breakdown of starch primarily in the pancreas pancreatic disease, enteritis, intestinal obstruction, intestinal perforation
25
What is the function of Lipase? Where is it produced? Lipase and amylase are typically measured together and if amylase is increased then lipase should be increased. I amylase is increased but lipase is not where is this probably coming from?
break down fat pancreas-specific intestines
26
What is the function of Trypsin
break down protein
27
What is Serum TLI? Decreases with... Increases with...
Serum trypsin-like immunoreactivity decreases with functional pancreas mass increases with lower glomerular filtration rate
28
What is Serum PLI? We use this to test for what condition?
Serum pancreatic lipase immunoreactivity pancreatitis
29
What are the major function of electrolytes? What is a testing method? What can cause an error in testing?
Maintain water balance Osmotic pressure Muscular and nervous function Acid-base regulation Electrochemical (ion specific) lipemia
30
What are the cations of electrolytes What are the anions of electorlytes
Sodium, potassium, magnesium Chloride, Bicarbonate
31
What is CK? Where is it primarily found? What can cause an increase?
Creatine Kinase primarily from striated muscle (skeletal and cardiac) also found in brain damage to muscle causes an increase in CK
32
What can cause an increase in Lactate (Lactic acid)
Hypoxia, hypoperfusion and peritonitis
33
What is Fructosamine what can cause an increase
reaction of glucose bound to protein persistent hyperglycemia
34
What is the glucose tolerance testing rule out?
diabetes mellitus
35
what is the insulin tolerance test for?
differentiates the cause of diabetes mellitus
36
Why do we do a ACTH stimulation
test for suspected hypo - or hyperandrenocorticism
37
What does a high dose dexamethasone suppression test for? What does a low dose dexamethasone suppression test for?
high dose - differentiates pituitary from adrenal causes (helps determine treatment) low dose - hyperadrenocorticism
38
what is T4? Cholesterol is often elevated with a ____functional thyroid gland.
Thyroxin- tests thyroid function Hypo