Chem Theory
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| What are fats called when they are combined with proteins? | Lipoproteins
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| What is VLDL? | Very low density lipoprotein- Carries lipids to tissues
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| What is HDL? | High density lipoprotein- returns stuck pieces back to liver
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| What is LDL? | low density lipoprotein- pieces become stuck along artery walls
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| What kind of cholesterol is desirable to have? | HDL
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| How does the body rid itself of cholesterol? | through bile
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| What does the precipitation of cholesterol in the gall bladder cause? | gall stones
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| What does a cholesterol value of Below 200 mg/dL mean? | desirable
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| What does a cholesterol value of 200-239 mg/dL mean? | borderline
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| What does a cholesterol value of 240 mg/dL and above mean? | high risk- correlated to Coronary artery disease (CAD)
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| What ratio is used to predict the risk of a person getting clogged arteries? | Total/ HDL less than or = 4.5
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| What function do enzymes play in the body? | catalysts- increase rate of chemical reaction
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| Enzymes are which type of substance? | protein
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| What things can denature(damage) enzymes | heat, strong acid, strong base, vigorous shaking, UV radiation
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| How are enzymes named? | 1st part is name of substrate. 2nd part ends with ase and tells what kind of reaction
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| Where are enzymes normally found? | in intact cells.- Serum levels normally very low
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| What does Amylase do? | digestive enzyme- breaks down starch
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| What disease is Amylase increased? | acute/chronic pancreatitis
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| What does Lipase do? | digestive- breaks down fats
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| What disease is Lipase increased? | acute/chronic pancreatitis
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| Alkaline phosphatase is active in what pH? | High pH. optimum pH 10
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| What disease is Alkaline phosphatase increased in? | bone and liver
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| Acid phosphatase is active in what pH? | Low pH optimum pH 5
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| What cancer is acid phosphatase increased in? | prostatic
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| What diseases is SGOT/AST increased in? | heart, muscle, liver, RBC
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| What disease is SGPT/ALT increased in? | Liver
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| What disese is GGTP increased in? | liver and pancreas
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| What is GT/GGT sensitive to? | Alcohol- parallels ALKP
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| CPK is found in which tissues? | heart, muscle, brain and lung
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| What is CPK the fastest rising in? | Myocardial Infarction
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| What is CK1 isoenzyme and which tissue is it from? | BB chain- brain and lung
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| What is CK2 isoenzyme and which tissue is it from? | MB chain- heart- MI
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| What is CK3 isoenzyme and which tissue is it from? | MM chain- muscle
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| LDH remains elevated longest in what? | MI
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| How are isoenzymes separated? | electrophoresis
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| Which 2 enzymes are ordered together to evaluate pancreatic function? | amaylase and lipase
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| Which test are in a cardiac profile? | CPK, Troponin I and Troponin T
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| Which tests are in a liver profile? | ALKP, GGTP, AST, ALT and LDH
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| Which is the most sensitive of the liver enzymes? | GGTP
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| What 4 things does an accurate chemical analysis depend on? | 1.Proper collection
2. Preservation
3. Processing
4. Method of analysis
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| What is the ideal time for lab measurements to be performed? | One hour
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| What sample is most often used for chemical analysis? | Serum- fasting
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| What is the difference between plasma and serum? | Plasma- liquid portion contains fibrinogen/ clotting factors. Serum- liquid portion W fibrinogen/clotting factors removed
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| What is the thixotropic gel used for? | prevents shifts of substances and prevents glycolosis
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| What Vacutainer is used to collect serum and why? | gold/red- no anticoagulant
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| How is a gold top tube processed? | clot upright at least 30 minutes no more than 60. centrifuge at least 15 minutes within 1 hour of collection
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| What is a hemolyzed serum? | serum or plasma that is clear red
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| What is Icteric | hyperbilirubinemia- jaundice- serum/plasmais brownish yellow
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| What is lipemic? | serum or plasma is milky white- may be drawn to soon after a meal
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| What is accuracy? | true or actual value
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| What is precision? | repeatability- ability to get the same answer again
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| What is batch or run? | specimens analyzed at the same time
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| What is calibrator? | used to set machine values
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| What is control? | Must fall within an acceptable range before pt samples are run
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| What four things does the control check for? | Everything- instrument working, strips/ control reagent, technique and environment
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| What is duplicate determination? | 1 of specimen is measured twice. Checks persicion
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| What are the NPN compounds? | Urea
creatinine
uric acid
amonina
creatine
amino acid
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| What is urea the breakdown product of? | Protein
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| What does BUN stand for? | Blood urea nitrogen
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| What 2 things affect serum BUN? | protein in diet and urine volume
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| What causes increased BUN in pre renal? | Dehydration
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| What causes increased BUN in renal? | glomerulonephritis- cant filter
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| What causes increased BUN in post renal? | Kindey stones and enlarged prostate
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| What is azotemia? | increase in NPN's in the blood, acidosis, water electrolyte imbalance and death
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| What does creatine and phosphocreatine break down into? | creatinine- waste product
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| Where does creatine and phosphocreatine break down? | muscle
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| What are two tests to assess kidney function? | B1 and creatine
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| What is uric acid the break down product of? | nucleic acids
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| Which foods are high in purines? | meat
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| When is uric acid increased in the serum? | gout
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| Where is ammonia made? | bacteria in intestine
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| What are amino acids? | building blocks of protein
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| What is the function of ALbumin protein fraction? | maintains normal blood volume
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| What is the function of Fibrinogen protein fraction? | necessary for clotting
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| What is the function of Gamma globulins protein fraction? | Antibodies
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| What does TSP stand for? | Total serum protein
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| What is a normal A/G ratio result? | 1.0-2.5
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| What is electrophoresis? | Used to separate protein into specific fractions by movement of charged particles in an electric field
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| What is glycoogen? | Storage form of glucose
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| What is glycogenesis? | Formation of glycogen from glucose
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| What is glycogenolysis? | breakdown of glycogen to glucose
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| What is glycolysis? | glucose changed to give energy
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| What is gluconeogenesis? | new glucose formation
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| Where is glycogen made and stored? | made in liver- stored in liver/muscle
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| Where is insulin made? | made in beta cells of the islets of langerhans. in pancreas
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| What does insulin do? | stimulates the transport of glucose through cell membrane
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| Where are ketone bodies made? | in the liver
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| What are ketone bodies made from? | made from excess fatty acids
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| What is ketoacidosis? | blood pH less that 7.35 due to ketone bodies
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| Which type of diabetes has a tendency to get ketoacidosis? | type 1
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| Which type of diabetes may be controlled by diet alone? | Type 2
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| What do diabetes metabolize instead of glucose? | lipids, fats, triglycerides
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| What is retinopathy? | sclerosis- hardening of blood vessels in eye
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| What are some complications of diabetes? | aterosclerosis
CAD
peripherial vascular disease
poor wound healing
neuropathy
susceptiable to infection
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| What samples are taken for the OGTT? | fasting, 1,2,3 hours after glucose
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| How is the 2 hours postprandial glucose test done? | after meal
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| What does the Hb-A1c test measure? | hemoglobin A1 combined with glucose
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| What is the advantage of the Hb-A1c/glycosylated hemoglobin test? | reflects the blood glucose over a 3 month period. Normal is 4-6%
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