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Chem Theo Finals
Chem Theo
| Question | Answer |
|---|---|
| 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
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