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Chem Theo Finals

Chem Theo

QuestionAnswer
Four things an accurate chemical analysis depend on Proper collection, Preservatives, Processing, Method of Analysis
What is the ideal time for lab measurements to be performed One hour- Quest centrifuge within one hour of collection- test within 2 hours: VARIES
Hemolyzed serum Serum or plama clear red; interfere with test
What sample is most often used for chemical analysis Serum- Fasting serum
The difference between plasma and serum Plasma liquid portion of circulating blood with fibrinogen and clotting factors- Serum only exist on top of blood
What methods are used to preserve specimens Part of specimen collection, Sodium flouride preservative: gray topped tube- refrigeration, must be RT before testing-Separate cells from plasma or serum- protect from light for bilirubin- freeze plasma or serum, must mix before testing
What is thixotropic gel used for To separate serum or plasma from cells, prevent shift of substance, prevent glycolysis T
What vacutainer is used to collect serum and why Gold and Red, no anticoagulants
How is a gold top tube processed Invert 5x, do not remove stopper, do not centrifuge immediately after drawing, clot upwright @ least 30 min no more than 60 @ RT so clot not connected to stopper, centrifuge @ least 15 min within one hour of collection
Precaution when handling blood Gloves, PPE, biohazard sharp container for blood and needle, immediately disinfect blood spill, open stopper carefully and away
What are fats called when they are combined with proteins lipoproteins- insoluble in water
VLDL very low density lipoprotein- carry lipid to tissue
HDL High density Lipoprotein- return stuck pieces back to liver; heart helping
LDL Low density lipoprotein- pieces stuck on blood vessel walls- artert clogging
VFR Very fast rising- Chylomicrons
What kind of cholesterol is desirable to have HDL
How does the body rid itself of cholesterol Through the bile
What does the precipitation of cholesterol in the gall bladder cause Gallstone; 60- 80% cholesterol by weight
Name 4 lipids Cholesterol, phospholipids, triglycrerides, fatty acids
Desirable cholesterol level Below 200 mg/dL
Borderline cholesterol level 200- 239 mg/dL
High risk cholesterol level for CAD Greater than 240
What ratio is used to predict the risk of a person getting clogged arteries Total/ HDL; less than or equal 4.5
What function do enzymes play in the body Catalyst; increase the rate of chemical reaction
Enzymes are which type od substance Proteins
What things can denature enzymes Heat, strong acid base, uv sunlight
What is substrate Material acted upon by enzyme
How are enzymes named First part, name of substrate. Ends in -ase and tell what type of reaction
Where are enzymes normally found intact cell; serum level usually very low
What does Amylase/ Hydrolase do Digestive enzyme that break down starch
What tissue is Amylase found Pancrease, salivary glands
What diseases are Amylase increased in acute, chronic pancreasitis
What does lipase do break down fats
What tissue is lipase found in Pancrease
What disease are lipase found in acute, chronic pancreitis
What pH is Alkaline phospahatase active in high pH, optimum ph 10
What disease is alkaline phosphatase increased in Bone, liver
What pH is acid phosphatase active in low pH, optimum pH 5 4.8- 5.1
Acid phosphatase is increased in what kind of cancer prostatic with metastasis
SGOT/ AST increased in what diseases Heart, muscle and liver- heart cell destruction and mono-
SGPT/ ALT increased in what disease liver
GGTP increased in what diseases liver, pancrease- sensitive to alcohol consumption
CPK found in what tissue heart, muscle, brain and lung- Fastest rising in an MI
3 iso enzymes and which tissue is from each CK1- BB chain- brain and lung, CK2- MB- heart, CK3- MM- muscle
Present in almost all tissues, remains elevated longest in MI LDH
How are isoenzymes separated Electroporiesis
Why are hemolyzed specimens not acceptable high concentration in RBC, 200x plasma limit
Which two enzymes are ordered together to evaluate pancreatic function emylase, lipase
Which test are in a cardiac profile CPK, Troponin I, Trooponin T
Which test are in a liver profile ALKP, GGTP, AST, ALT, LDH
Which is the most sensitive of the liver enzymes GGTP
What is a gold topped tube used for Serum, chemistry
Icteric hyperbilirubinemia/ jaundiced serum or plasma, brownish yellow from bilirubin- liver disease, hepatitis
Lipemic Serum or plasma milky white, may have been too soon after a meal
Accuracy True and actual value
Precision Repeat ability
Normal value Average result of healthy individual
Batch or run specimen analyzed @ same time
Calibrator Used to set machine values
Control Must fall within acceptable range before patient samples reported, check accuracy
What four things does control check for Meter, control/ reagent, technique, enviornmental, g
What steps should you follow if a control falls outside of the acceptable range Document, check expiration date, clean meter, retest same control vial
Define duplicate determination One specimen measured twice- check precision
What does a quality control program include Waived- QC as specified by kit manuf. Easy not lot of training. Moderate- complexity- Keep results two years.
glycogen storage form of glucose
glycogenesis formation of glycogen from glucose
glycolysis glucose changed to give energy
glycogenolysis breakdown of glycogen to glucose
gluconeogenesis glucose from fat or protein
Where is glycogen made and stored made in liver; stored in liver and muscle
Where is insulin made Beta cell of Ishlets of Langerhans in pancrease
What does insulin do Stimulates the transport of glucose thru cell membrane, must be present for glucose to enter cell
Where are ketone bodies made In the liver
What are ketone bodies made from Excess fatty acids; partially metabolized into ketone bodies by the liver
ketonuria ketone bodies in the urine
ketonemia ketone bodies in the blood
ketoacidosis Ketone blood pH (acid)> 7.35 due to ketone bodies in the blood
hyperglycemia high glucose in the blood
hypoglycemia low glucose in the blood
glucosouria/ glycosuria glucose in the urine
renal threshold blood level above which glucose spill in the urine; 160- 180 mg/dL- over maximum reabsorptive level
IDDM aka as Insulin Dependent DM- Type 1 juvenile
IDDM age of onset any age youth > than 20
IDDM type of onset abrupt
IDDM sypmtoms weight loss
Do IDDM have endogenous insulin None
Is oral agents used for IDDM No
NIDDM aka Non- insulin dependent DM- Type 2 adult
NIDDM age of onset any age common in adults over 30
NIDDM Type of onset Gradual
NIDDM Symptoms wounds heal slowly, drowsy after meal, vision
DO NIDDM have endogenous insulin some
Is oral agents used for NIDDM yes, 1/3 oral agent, 1/3 diet, 1/3 insulin
What is the cause of IDDM Genetic susceptible, auto-immune destruction of beta cells
What is the cause of NIDDM Beta cell exhaustion, target cell resistant
Which type of diabetes has a tendency to get ketoacidosis Ty 1 juvenile no insulin of own
IDDM type of onset abrupt
IDDM sypmtoms weight loss
Do IDDM have endogenous insulin None
Is oral agents used for IDDM No
NIDDM aka Non- insulin dependent DM- Type 2 adult
NIDDM age of onset any age common in adults over 30
NIDDM Type of onset Gradual
NIDDM Symptoms wounds heal slowly, drowsy after meal, vision
DO NIDDM have endogenous insulin some
Is oral agents used for NIDDM yes, 1/3 oral agent, 1/3 diet, 1/3 insulin
What is the cause of IDDM Genetic susceptible, auto-immune destruction of beta cells
What is the cause of NIDDM Beta cell exhaustion, target cell resistant
Which type of diabetes has a tendency to get ketoacidosis Type 1 juvenile, no insulin of own
Which diabetes may be controlled by diet alone Type 2
What do diabetics metabolize instead of glucose lipids, fats, triglycerides, fatty acids
Complications of diabetes of diabetes Atherosclerosis, CAD, peripheeral vascular disease, poor wound healing, susceptible frequent infection, nephropathy, neuropathy
Diabetic coma insulin level none/low
Diabetic coma blood glucose level high
Do diabetic coma have urine glucose yes/present
Diabetic coma onset hours/ days
Symptoms of diabetic coma deep breathing, dry tongue/skin, fruity breath, drowsy, lethargic, coma
How do you treat patient with diabetic coma insulin
Insulin shock insulin level none
Insulin shock blood glucose level too low
Insulin shock urine glucose negative
Insulin shock onset sudden/ matter of minutes
Insulin shock symptoms shallow breathing, perspiration, shaky, light headed, faint, drunk acting
How do you treat patient with insulin shock 15 grams of readily available carbs, small box of rasins, tbs of honey, 7-8 lifesavers
What samples are taken for OGTT fasting 1, 2, 3, hours after glucose
What does Hb-A1c test measure glysolated hemoglobin
What is the advantage of the Hb-A1c/ glycosylated hemoglobin test reflect the blood glucose over a 3 month period
What are NPN Compounds urea, creatinine, uric acid, ammonia, creatine, amino acid
What is urea the breakdown product of Protein
What does BUN stand for Blood urea nitrogen
What two things affect serum BUN Protein in diet, urine volume
What causes increased BUN Pre-renal dehydration, DM, - Renal cause- glomerulonephritis, polycystic kidney disease- Post renal- kidney stones enlarged prostate
What is azotemia increase in NPN in the blood
What does creatine and phosphocreatine break down into creatinine- waste
What are two test to assess kidney function BUN, Creatinine
What is uric acid the break down product of purines- protiens
Where is uric acid formed in the liver
Which foods are high in purines meat, fish, poultry, organ meat, anchoves, beef broth,
When is uric acid increaded in the serum gout, cell turnover- leukemia, polycythemia
Where is ammonia made bacteria in intestines, breakdown of protein, kidney tubules
What are amino acids building blocks of proteins
What are the different plasma proteins and where are each made albumin, fribrinogen, alpha globulin, beta- made in the liver- gamma globulin, made in reticuloendothelial system including lymph nodes- B lymphocytes
Important function of protein transport of metals, iron, hormones and lipids
What does TSP stand for Total serum protein
What is the normal A/G ratio 1.0/ 2.5
Created by: bossy777