Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
530 Cards in this Set
- Front
- Back
|
Convert 75mg/dL to mg/L |
750mg/L |
|
|
Glycogen is stored in the... |
Liver |
|
|
What does not release steroid hormones? |
Pituitary gland |
|
|
The alpha cells of the islets of Langerhans of the pancreas produce... |
Glucagon |
|
|
Laboratory evidence of which protein is diagnostic of cystic fibrosis? |
Cystic fibrosis transmembrane conductance regulator protein |
|
|
Glycolysis is... |
The conversion of glucose into lactate or pyruvate and then CO2 and H2O |
|
|
Scurvy is a disease caused by a deficiency in... |
Vitamin C |
|
|
Primary hypothyroidism may not be due to... |
Pituitary adenoma |
|
|
Diffusion of gasses in the body is defined as... |
The movement of charged, hydrophilic ions through a non polar lipid layer |
|
|
What practices is inappropriate when establishing quality control ranges? |
Exclusion of any quality control results greater than +/- 2 standard deviations from the mean |
|
|
The creatinine clearance test is routinely used to assess the glomerular filtration rate. Given the following for an average size adult, calculate a creatinine clearance
Urine creatinine: 120mg/dL Plasma creatinine: 1.2mg/dL 24 hour urine volume: 1520mL |
105.6mL/min |
|
|
Cushing's syndrome is characterized by what? |
High levels of corticosteroid |
|
|
Screening methods for drug abuse testing requires which assay characteristics? |
They must be analytically sensitive |
|
|
Gluconeogenesis is... |
The formation of glucose from non-carbohydrate sources, for example: amino acids, glycerol, and lactate |
|
|
Turbidimetry is the measurement of the reduction in light transmission caused by... |
Particle formation |
|
|
Which hormone is NOT produced by the placenta? |
Adrenocorticotropin (ACTH) |
|
|
Aspartate aminotransferase is elevated in diseases involving the... |
Heart muscle |
|
|
A pneumatic tube delivery system is designed to provide the laboratory with what functions? |
Point to point delivery of patient specimens |
|
|
Which is part of the coagulation cascade? |
Fibrinogen |
|
|
In fluorescence polarization immunoassay (FIPA), the electrons in the fluorescein molecules chemically attached to the hapten, react in what manner? |
They do not fluoresce |
|
|
A substance used in lipase reactions is... |
Olive oil emulsion |
|
|
The first serological marker for Hepatitis B is... |
HBsAg |
|
|
Which sets of laboratory results is associated with Wilson's disease? |
Decreased plasma copper and decreased plasma ceruloplasmin |
|
|
Mrs. Smith has the following chemistry results:
CK: Moderately increased LD: Moderately increased LD-1: Increased
The probable diagnosis is... |
Myocardial infarction |
|
|
A glucose result is falsely elevated and it was discovered that the previous sample on the sample carousel has abnormally high serum glucose. What can cause this error? |
Carryover |
|
|
Which detector label is used in fluorescent polarization immunoassay? |
Fluorescein |
|
|
A blood sample for a trough drug level should be drawn... |
Shortly before drug administration |
|
|
Although a total lactate dehydrogenase (LD) determination performed alone yields little information as to the area of tissue destruction, and electrophoretic separation of LD isoenzyme may be useful. What disorder is an increase in LD-5 and LD-4 associated? |
Acute hepatic disease |
|
|
Measurement of sodium, potassium, and chloride are commonly performed in laboratories using what? |
Ion selective electrodes |
|
|
What is false about PSA? |
It is not elevated in benign prostatic hyperplasia |
|
|
Viral hepatitis that results in the largest percentage of chronic hepatitis is... |
Hepatitis C |
|
|
What is NOT considered a reason for monitoring drug levels? |
Detect presence of potential interference |
|
|
Bile acids are synthesized in the liver from which lipid? |
Cholesterol |
|
|
In agarose gel electrophoresis of human serum at pH 8.6, the slowest moving fraction is... |
gamma-globulin |
|
|
A solution contains 45g/100mL glucose. It is diluted 1/10 and rediluted 1/10. What is the concentration of the final solution? |
4.5g/100mL |
|
|
The marker for colorectal and pancreatic carcinoma is... |
CA 19-9 |
|
|
A 2-2s quality control rule violation is defined as... |
Two consecutive control value that exceed +/- 2s |
|
|
In what disorder would the maternal serum level of alpha-1-fetoprotein be elevated? |
Neural tube defect |
|
|
The common ingredients of all biuret reagents are...
(3 answers) |
- Sodium potassium tartate
- Copper sulfate
- Sodium hydroxide |
|
|
A sneaky diabetic tried to lower her glucose by working out and watching her diet 1 or 2 days before her appointment. The rest of the time she spent the day in front of the TV and eating chocolate. what test could be used to detect this type of behavior? |
Glycosylated hemoglobin |
|
|
Serum lipase catalyzes... |
Hydrolysis of triglyceride to fatty acids and glycerol |
|
|
Uric acid values are usually elevated in patients with leukemia because of the breakdown of... |
Nucleic acids (adenine and guanine) |
|
|
What instruction for patients preparing for a glucose tolerance test is NOT included? |
Caffeine and nicotine intake are permitted before and during the test |
|
|
What is a type of characteristic of type 2 diabetes mellitus? |
Obesity and physical inactivity |
|
|
Protein is approximately ________ nitrogen |
16% |
|
|
The enzyme that catalyzes the reaction ATP + D-glucose --> ADP + D-glucose-6-phosphate is... |
Hexokinase |
|
|
Pituitary secretion of ACTH is inhibited by elevated levels of... |
Cortisol |
|
|
Renal azotemia is found in... |
Nephrotic syndrome |
|
|
Bile formed in the liver is stored in the... |
Gall bladder |
|
|
What test combination indicates the HIGHEST risk for coronary heart disease? |
Increased total cholesterol, decreased HDL cholesterol |
|
|
Mary's total protein is 7.5g/dL and her albumin is 4.2g/dL. What is her A/G ration? |
1.3 |
|
|
Determine the molarity of a solution if 125mL of a 3.5 molar solution is diluted to a final volume of 500mL |
0.875 M |
|
|
Creatinine reacts with strong alkaline picrate to form a yellow-red compound. This reaction is... |
Jaffe reaction |
|
|
Characteristics of the ideal cardiac marker does NOT include... |
Marker must return to normal in a relatively short period of time |
|
|
What condition is associated with an elevated total protein? |
Glomerular disease |
|
|
Complications of acute pancreatitis does NOT include... |
Hypotriglyceridemia |
|
|
Oxytocin and antidiuretic hormone (ADH) are hormones that are released by the... |
Posterior pituitary |
|
|
Which quality control rule would be violated 1 out of 20 time by chance alone? |
1-2s |
|
|
An elevated BUN usually indicates... |
Kidney disease |
|
|
Elevated blood levels of lead will result in a deficiency of what enzyme? |
Amino levulinic acid dehydrates |
|
|
Which type of hCG test would be most useful to assess a person suspected of having testicular cancer? |
Plasma immunoassay for intact hCG and B-hCG subunits |
|
|
Secondary causes of elevated LDL does NOT include... |
Hyperthyroidism |
|
|
Which carbohydrate is a polysaccharide? |
Starch |
|
|
What proteins do NOT transfer thyroid hormones? |
Gamma globulin |
|
|
Increased uric acid is NOT found in what condition? |
hypothyroidism |
|
|
In competitive inhibition of an enzyme reaction... |
The inhibitor binds to the enzyme at the same site as does the substrate |
|
|
What best describes a procedural difference between homogenous and heterogenous immunoassay? |
There is not physical separation of bound from free fractions in a homogenous immunoassay; whereas in a heterogeneous immunoassay, you must separate bound from free forms |
|
|
What must be determined to calculate diagnostic specificity? |
True-negatives and false-positives |
|
|
Zero order kinetics results: |
When there are equal amounts of enzyme and substrate present |
|
|
The principal protein for transport of iron from the investing to the liver, bone marrow, or spleen for storage is... |
transferrin |
|
|
Name the equation shown below:
pH= pK' + log [HCO3]/ a x pCO2 |
Henderson-Hasselbach equation |
|
|
TSH is secreted by what? |
Anterior pituitary |
|
|
What represents a disadvantage to acquiring and implementing total laboratory automation? |
The initial costs are very high |
|
|
What sequence accurately reflects the renin-angiotensin-aldosterone system in response to hyponatremia? |
Renin is released front eh kidney; renin converts angiotensin to angiotensin I; angiotensin I is converted to angiotensin II |
|
|
Urea/BUN is produced from... |
The catabolism of proteins and amino acids |
|
|
A family of peptides called natiuretic peptides serves to regulate... |
Sodium and water metabolism |
|
|
In uncontrolled diabetes mellitus, cholesterol and triglycerides are... |
Increased |
|
|
Risk factors for coronary heart disease does NOT include... |
High HDL cholesterol |
|
|
The cation with the highest intracellular concentration is... |
Potassium |
|
|
The role of cardiac biomarkers include... |
Diagnosis, monitoring, risk stratification, and therapeutic management |
|
|
Which assays is recommended in a screening test for colorectal cancer in persons over 50 years of age? |
Occult blood test |
|
|
Bromcresol Green (BCG) may be used in the dye-binding assay of... |
Albumin |
|
|
A 1 to 4 dilution must be prepared to make a total volume of 100uLl How much serum is used? |
25 uL |
|
|
What statement best describes discrete testing? |
Measures only the test requested on a sample |
|
|
What is NOT a metabolite of catecholamine? |
Monoiodothyronine |
|
|
What is a characteristic of unconjugated bilirubin? |
It is not water-soluble |
|
|
What is the concentration (g/dL) of a1/10 dilution of a 12% NaCl solution? |
1.20 |
|
|
Any specimen, by a command to the processing system, can be analyzed by any available process, in or out of sequence with other specimens, and without regard to their initial order describes which type of sample processing principle? |
Random access analysis |
|
|
The chemical bonds between amino acids in the primary structure of proteins are... |
Peptide bonds |
|
|
The reagent (accelerator) in the Jendrassik-Grof bilirubin procedure that makes indirect bilirubin water-soluble is... |
Caffeine |
|
|
What represents the compensatory response of the kidney and lungs to a patient who is in metabolic acidosis? |
The kidneys will increase bicarbonate reabsorption and the patient will begin to breath deeply and often gasp for air |
|
|
Enzymes that catalyze the transfer of groups other than hydrogen between compounds are classified as belonging to which enzyme class? |
Transferases |
|
|
What statement regarding bilirubin metabolism is true? |
It is produced from the destruction of RBCs |
|
|
What is a true statement about patients with Addison's disease? |
Serum levels of ACTH are high |
|
|
Myeloma (Bence Jones) protein is MOST often found electrophoretically in the area of... |
Gamma-globulin |
|
|
Elevated sweat chloride is associated with which disease? |
Cystic fibrosis |
|
|
The letters MSDS represent what? |
Material Safety Data Sheet |
|
|
Zinc plays a vital role in the synthesis of... |
Nucleic acid |
|
|
What compensatory mechanism is correct for patient in respiratory acidosis? |
Decrease whole blood pCO2 |
|
|
In the Hexokinase method for glucose determination, the actual end product measured is the... |
NADPH+ H+ produced from the reduction of NADP |
|
|
Which form of diabetes usually manifests itself early in life, and is associated with ketosis, low insulin levels, and autoantibodies to islet cells? |
Type 1 |
|
|
What is NOT a test of exocrine pancreatic function? |
Insulin |
|
|
What is NOT associated with gestational diabetes? |
Is diagnosed using the same glucose tolerance criteria as in non-pregnant women |
|
|
What represents the correct sequence for the rise and fall of myoglobulin, CK-MB, and cTn1 after an acute myocardial infarction? |
Myoglobulin, CK-MB, cTn1 |
|
|
What statistic is used to qualify the strength of the relationship between two variables? |
Correlation coefficient |
|
|
If a thermometer reads 39 degrees Farenheit, what is the equivalent degree Celsius? |
3.9 |
|
|
Trace elements in biological fluids can be measured using what instrumental techniques? |
Atomic absorption spectrometry |
|
|
What conditions will cause an increase in the anion gap? |
Renal failure |
|
|
A patient's blood gas results are shown:
pH 7.30 pCO2 60mmHg HCO3 25mmol/L
These results indicate... |
Respiratory acidosis |
|
|
The presence of only slightly visible hemolysis can significantly increase the serum level of what ions? |
potassium |
|
|
Increased serum peak and trough levels of amnioglycosides (e.g. gentamicin) are often associated with toxic effects to which organ? |
Kidney |
|
|
A 52 year old man went to his doctor for a physical examination. The patient was overweight and had missed his last 2 appointments. His blood pressure was elevated, cholesterol was 250mg/dL, and his triglyceride was 170mg/dL. An HDL test was performed with a result of 30mg/dL (20-60mg/dL normal range). What would be the patient's calculated LDL value? |
186mg/dL |
|
|
Linearity is useful for assessing... |
slope and intercept of an analytical method |
|
|
Which tumor marker is associated with cancer of the urinary bladder? |
Nuclear matrix protein |
|
|
What statement best defines the term accuracy? |
The closeness of the agreement between the measured value verses the true value of an analyte |
|
|
The anion gap is determined from which groups of electrolytes? |
Sodium, chloride, potassium, and TC02 |
|
|
As the concentration of analyte begins to exceed the amount of antibody present, the dose response curve will flatten (plateau) and with further increase may become negatively sloped, this describes... |
The Hook Effect |
|
|
What is FALSE concerning blood cholesterol concentrations? |
Increased cholesterol is associated with hyperthyroidism |
|
|
What analyte is NOT calibrated on a blood gas analyzer? |
TCO2 |
|
|
Serial sampling for cardiac biomarkers is defined as... |
Drawing blood samples periodically, usually at prescribed time intervals |
|
|
A breakdown product of bilirubin metabolism that is produced in the colon from the oxidation of urobilinogen by microorganisms is... |
Urobilin |
|
|
An exogenous substance used to assess the glomerular filtration rate that affords the most accurate measure of renal clearance is... |
Insulin |
|
|
A competitive immunoassay includes a patient analyte (antigen), antibody to the analyte (antigen), and... |
An antigen with a label attached to its structure |
|
|
What mechanism is responsible for metabolic acidosis? |
Bicarbonate deficiency |
|
|
Respiratory alkalosis can be seen in patients with... |
Hysterical hyperventilation |
|
|
What is the primary hypoglycemic hormone? |
Glucagon |
|
|
Myoglobin is a great cardiac biomarker because it... |
Diffuses into the blood more quickly than CK-MB |
|
|
A patient's creatinine is outside the linear range of the analyzer: 10uL of serum is added to 90uL of diluent and the diluted sample is reanalyzed. The creatinine value of the diluted sample is 1mg/dL. What is the correct creatinine value? |
10mg/dL |
|
|
Serum lacks what constituent? |
fibrinogen |
|
|
What hormone is useful in identifying women with ectopic pregnancies or abnormal intrauterine pregnancies? |
Human chorionic gonadotropin |
|
|
Free thyroxine assays measure what? |
Only the unbound thyroxine level |
|
|
Creatinine would be increased by... |
Muscular dystrophy |
|
|
Affinity is described by... |
The thermodynamic quantity defining the energy of interaction of a single antibody-binding site and its corresponding epitope on the antigen |
|
|
Hypokalemia may NOT be seen in... |
renal failure |
|
|
In obstructive liver disease, test results are... |
Feces: urobilinogen decreased, Urine: Positive bilirubin, Serum: conjugated bilirubin increased |
|
|
The lipoprotein fraction that has the highest ration of lipid to protein is... |
Chylomicrons |
|
|
What compound is a cardiac glycoside that is used in the treatment of congestive heart failure and arrhythmias by increasing the force and velocity of myocardial contraction? |
Digoxin |
|
|
What is the primary clinical usefulness of measuring carcinoembryonic antigen? |
Monitoring for recurrence of colon cancer |
|
|
A markedly elevated serum ATP is associated with... |
Hepatoma |
|
|
A 40 year old male patient with hemochromatosis presents to his clinician with what triad of symptoms? |
Bronzing of the skin, cirrhosis, and diabetes |
|
|
The highest levels of alkaline phosphatase are seen in... |
Obstructive liver disease |
|
|
Serum thyroid stimulation hormone (TSH) levels are decreased in what disease or condition? |
primary hyperthyroidism |
|
|
What is a cause of stray light failure in a spectrophotometer? |
Room light entering the spectrophotometer and impinging on the detector |
|
|
The principle method used to measure hormone levels in blood in most clinical laboratories is... |
Immunoassays |
|
|
The results of a precision study are shown. what is the percent coefficient of variation for the study?
Mean= 100mg/dL Standard deviation= 2.5mg/dL Variance= 6.25mg/dL |
2.5% |
|
|
The specimen of choice for measuring pH, pO2, and pCO2 is... |
Heparinized arterial blood |
|
|
The most common cause of chronic pancreatitis is... |
Chronic alcohol abuse |
|
|
A serum lipase was diluted 1:20, the value from the analyzer is 39U/L. What is the patient's actual lipase result? |
780 U/L |
|
|
A patient's glucose result is 78mg/dL. Convert this result to mmol/L |
3.9 |
|
|
What is the value in SI units for blood glucose of 100mg/dL? |
5.5mmol/L |
|
|
How many grams of solid NaOH are required to prepare 100mL of a 10% solution in water? |
10g |
|
|
How many grams of NaOH are required to prepare a 2.00 molar solution? GMW of NaOH= 40g |
80 |
|
|
The creatinine clearance (mL/min) is equal to... |
Urinary creatinine x volume / plasma (serum) creatinine
UV/P(S) |
|
|
The following results were obtained:
Urine creatinine: 90mg/dL (7956 umol/L) Serum creatinine: 0.90mg/dL (79.6 umol/L) Patient's total body surface: 1.73 m^2 24 hour urine volume: 1500mL
What is the patient's creatinine clearance? |
104 |
|
|
One international unit of enzyme activity is the amount of enzyme that will, under specified reaction conditions of substrate concentration, pH and temperature, cause utilization of substrate at the rate of... |
1 umol/min |
|
|
An adult diabetic with renal complications has the following results:
Sodium: 133 mEq/dL (133mmol/L) Glucose: 487 mg/dL (26.8mmol/L) BUN: 84mg/dL (30.0mmol/L) Creatinine: 5mg/dL (442.0 umol/L)
Calculate serum osmolality using this formula:
(osmolality (mOsm/kg))= 2(Na+meq/L) + glucose(mg/dL) /18 + Urea N (mg/dL) /2.8 |
323 mOsm/kg |
|
|
0.450 moles of NaCl are dissolved in 95.0mL of water. Calculate the molarity of the NaCl solution. Mass of NaCl is 58.4430 |
4.7 M |
|
|
15g of NaCl occupy a volume of 75mL. What is the molarity of the solution? Mass of NaCl is 58.4430 |
3.4 M |
|
|
45.0g of Ca(NO3)2 was used to create a 1.3 M solution. What is the volume of the solution? Mass of Ca(NO3)2 164.0884g/mol |
210mL |
|
|
There are how many meters in 2000mm? |
2m |
|
|
30mg is the same mass as... |
0.03g |
|
|
How many centimeters in 0.101mm? |
0.0101cm |
|
|
What is an example of an inferential statistic? |
t-test |
|
|
Proportional error is characterized by... |
The magnitude of the error increases as the concentration of the analyte increases |
|
|
What type of error is present when the magnitude of error increases with increasing sample concentration? |
Proportional error |
|
|
Percent coefficient of variation is calculated using what formula? |
SD/mean x 100 |
|
|
A correlation CV of less than 1.0 is due to... |
Random error |
|
|
What is the appropriate course of action for a 1-3s QC failure? |
Reject all patient results and troubleshoot the problem |
|
|
The best laboratory test for detecting cystic fibrosis is... |
Sweat Chloride |
|
|
Pseudo-Hyperkalemia can result from... |
Hemolysis |
|
|
What is required to perform polymerase chain reaction PCR?
(3 answers) |
-a thermal cycler, an instrument that automatically controls and alternates the temperature for programmed periods of time
- primers to make the ends of the target sequence of DNA to be replicated in the annealing process - Taq polymerase , an enzyme used to replicate DNA strands |
|
|
What are the steps in the PCR process?
(3 answers) |
- denaturation of DNA at a high temperature to separate the double strands
- annealing of the DNA by primers - extension of the DNA by Taq polymerase |
|
|
What is true about the Western Blot assay?
(3 answers) |
- used to detect RNA
- the RNA is denatured, separated by electrophoresis, and the transferred to a nitrocellulose membrane - a test used to confirm HIV infection to a patient with a positive HIV antibody screen |
|
|
A technique that is an example of an amplification technique…
(3 answers) |
- PCR
- RT-PCR - bDNA, or branched DNA assay |
|
|
Current diagnostic applications of Molecular Diagnostics include…
(3 answers) |
- infectious disease
- genetic testing - forensic testing |
|
|
In RNA, which nucleotide base replaces thymine of DNA?
|
- Uracil
|
|
|
The central dogma is that DNA is used to make RNA, which is then used to make protein. In this scheme the 2 processes that are involved are termed…
|
Replication and transcription
|
|
|
RT-PCR is used for...
|
Viral load testing for HIV and HCV
|
|
|
An advantage of amplification technologies for clinical laboratories is...
|
they lend themselves to automated methods
|
|
|
A patient has consistently high blood glucose results. Which hormone is most likely defective or present in insufficient amounts?
|
glucagon
|
|
|
What defines glycolysis?
|
conversion of glucose into lactate or pyruvate
|
|
|
Prior to 2011, there were 3 criteria by the American Diabetes Association for the classification and diagnosis of diabetes, with only 1 needing to be present to establish the diagnosis. What are these criteria?
(3 answers) |
- classic diabetes symptoms and a random serum glucose >200mg/dL
- a fasting serum glucose >126mg/dL - a 2 hour post prandial glucose of >200mg/dL |
|
|
What plasma glucose result would most likely reflect glucosuria in a patient?
|
180mg/dL
|
|
|
At 5 months gestation, a pregnant woman has an elevated glucose value of 150mg/dL on her 1hr. glucose screen. The positive screen requires her to take the 3hr glucose tolerance test (3HR GGT). The following results are obtained. What is the diagnosis?
Fasting= 120mg/dL 1HR= 160mg/dL 2HR= 227mg/dL 3HR= 180mg/dL |
gestational diabetes
|
|
|
Hormones that promote an increase in the blood glucose level is…
(3 answers) |
- cortisol
- glucagon - insulin |
|
|
What is the expected glucose value of a normal 2 hour postprandial serum specimen as compared to the reference interval for a fasting serum glucose?
|
approximately the same, 120mg/dL or less
|
|
|
Laboratory tests are performed on a 57 year old postmenopausal female. Her non-fasting serum glucose is 220mg/dL, and her Hb A1c is 11%. How should this patient be classified/
|
Type 2 diabetes mellitus
|
|
|
The hormone that facilitates the entry of glucose into the cell is...
|
insulin
|
|
|
Which glucose methods is considered to be the reference method?
|
hexokinase
|
|
|
In cases of hypoglycemia, the body responds by releasing which 2 hormones, one is primarily responsible for the symptoms of anxiety, dizziness, and sweating.
|
glucagon and epinephrine
|
|
|
One of the acute complications of diabetes mellitus is...
|
ketoacidosis
|
|
|
Which test method is the most specific for measuring plasma glucose?
|
Hexokinase
|
|
|
In a type 1 diabetic, insulin concentration is...
|
low
|
|
|
A 45 year old female with a history of diabetes in her family is most likely to develop which type of diabetes?
|
Type 2
|
|
|
Current diagnostic criteria for diabetes, as defined by the ADA, is based on which test?
|
Hemoglobin A1c (glycated hemoglobid)
|
|
|
What is a product in the reaction of glucose and ATP catalyzed by hexokinase?
|
glucose-6-phosphate
|
|
|
A patient's serum glucose was 1045mg/dL using a glucose oxidase procedure. What is the MOST likely explanation for this value?
|
sample was drawn from the site of an indwelling catheter
|
|
|
A chromogenic glucose oxidase method is being used for glucose determinations. The presence of ascorbic acid is detected in a sample for testing. How would the presence of ascorbic acid affect this assay?
|
lowers results by competing with chromogen for H202
|
|
|
Which test provides the best index of a patient's average blood glucose level over a 2 month periods?
|
hemoglobin A1c
|
|
|
What statement about glucose values in whole blood vs. plasma is true?
|
whole blood glucose values are lower than serum or plasma values
|
|
|
Which blood collection additive inhibits continued glycolysis (but can not be used for any other testing but glucose), and has a gray colored stopper?
|
sodium fluoride
|
|
|
In regard to carbohydrate analysis, enzymatic methods measure...
|
mono- and disaccharides
|
|
|
The retrospective time period that glycated hemoglobin concentration represents is dependent on the...
|
life span of the RBC
|
|
|
What is true about acute hyperglycemia in type 1 diabetics?
(3 answers) |
- is a life threatening condition that requires hospitalization
- insulin is low, glucagon is secreted, and fats are utilized for energy - leads to metabolic acidosis |
|
|
What condition is associated with hypoglycemia?
(3 answers) |
- an insulinoma
- G6PD deficiency, or von Gierke disease - galactosemia |
|
|
In regards to diabetics, the presence of microalbuminuria is indicative of...
|
developing nephropathy
|
|
|
The analytical process can be divided into 3 phases...
|
-preanalytic
- analytic -postanalytic |
|
|
What represents the analytical phase?
|
chemical analysis
|
|
|
Characteristic of automated chemistry analyzers in use today…
(3 answers) |
- ion selective electrodes
- fiberoptics - sophisticated computer hardware and software for data handling |
|
|
What is a driving force for more automation?
(3 answers) |
- high-volume testing
- fast turnaround time - expectation of high quality, accurate results |
|
|
Advantages to automation are…
(3 answers) |
- increased number of tests performed
- minimized labor component - use of small amounts of samples and reagents in comparison to manual procedures |
|
|
What is an example of a CURRENT discrete analyzer with random access capability?
(3 answers) |
- Abbott Architect C8000
- Beckman Coulter SXC 600I - Roche Cobas 6000 |
|
|
Automated analyzers are designed with either an extensive wash system to clean out the sample probe after each patient aspiration or with a disposable tip to deliver sample in order to...
|
minimize carry over from one sample to the next
|
|
|
Which chemistry analyzers uses slides to contain the entire reagent system?
|
Vitros analyzers
|
|
|
Incubation of the reaction mixture is part of which process of automated chemistry analyzers?
|
the chemical reaction phase
|
|
|
What is the most important goal in selecting a chemistry analyzer?
|
to find the right instrument for the unique needs of each individual laboratory
|
|
|
What is of interest in improving productivity of laboratory testing as driven by the pressures of health care reform?
(3 answers) |
- front-end automation systems to sort, centrifuge, decap, and deliver specimens to laboratory analyzers - back-end automation systems to transport specimens from laboratory instruments int storage and retrieval from storage for retesting - data management systems to enhance and improve communications between the instruments and the host LIS(laboratory information system) |
|
|
What is the symbol for microgram?
|
ug
|
|
|
A nanogram is...
|
10^-9 grams
|
|
|
What is the symbol for milliliter?
|
mL
|
|
|
what is the symbol for millimole?
|
mmol
|
|
|
Convert the following ml to L
500mL= ________L |
0.5L
|
|
|
Convert mmol to mol
100mmol= ________mol |
0.1mol
|
|
|
Convert gm to mg
5gm= _________mg |
5000mg
|
|
|
Convert mg to gm
80mg= ________gm |
0.08gm
|
|
|
Convert dL to mLs
1 dL= _______mL |
100mL
|
|
|
Convert dL to L
1dL= ________L |
0.1L
|
|
|
Convert uL to mL
300uL=________mL |
0.3mL
|
|
|
A calcium standard solution contains 10mg/dL of calcium. What is the concentration in millimoles per Liter? mw of Ca= 40g/mol
|
2.5mmol/L
|
|
|
What is the molarity of a solution that contains 18.7g of KCl in 500mls? mw of KCl is 74.5g
|
0.5
|
|
|
To prepare 3 L of 5 M solution of sodium hydroxide, NaOH, how many grams of NaOH will you need? Atomic weights: Na= 23, O= 16, H= 1
|
600g
|
|
|
To prepare 2 L of 5M solution of HCl, how many liters of a stock 10M solution will you need?
|
1L
|
|
|
How many grams of H2SO4 (mw=98g) are required to prepare 1L of a 3%w/v solution?
|
30g
|
|
|
A standard solution of urea contains 100mg/dL. How many millimeters are needed to prepare 200mL of working standard containing 20mg/dL of urea?
|
40
|
|
|
A clean 1.0 volumetric flask is filled to the calibration line with Type 1 water. To the water in the flask, 9.0g of NaCl is added and mixed by inversion. This method of preparation will result in a solution whose concentration is...
|
slightly less than 0.9g/dL
|
|
|
Using 100ul of a patient's serum, how would you make a 1:5 dilution with saline?
|
100ul serum + 400ul of saline
|
|
|
What term identifies the chemical reagent with the highest purity? |
analytical grade |
|
|
What is the most appropriate term to describe water that is used as a solvent in the clinical laboratory? |
reagent grade water |
|
|
The type of water desired for use in test methods requiring maximum accuracy and precision is... |
Type 1 |
|
|
A control has a mean of 2.8 with a standard deviation of 0.3. Of the values obtained, 68% should fall within a range of... |
2.5-3.1 |
|
|
The lab is considering a new method for BUN. A within run precision study was performed by running the abnormal control 10 times. The mean obtained was 50mg/dL and the SD was 4.6. The manufacture claims the CV for this method is 5.0%. What is the calculated CV and is this precision acceptable? |
calculated CV at 9.2% is greater than the manufacture's claim, precision is unacceptable |
|
|
What is an example of a post analytical function of a laboratory information system? |
laboratory report production |
|
|
What is used to measure the rpm of a centrifuge? |
tachometer |
|
|
The QC chart of an instrument runs stat chemistry panels shows 10 consecutive data points on one side of the mean. The first thing a CLT should do is... |
follow the trouble shooting procedures for the test method |
|
|
A patient's glucose was 1045mg/dl. Normal is around 100mg/dl. What is the MOST likely explanation for this value? |
the sample was drawn form the site of an indwelling catheter (IV) that had glucose running it |
|
|
A laboratory is changing methodologies for a certain analyte. What statistical measurements is best used to compare results from specimens performed by both methods? |
correlation coefficient (or r value) |
|
|
Which analyte can deteriorate if a blood specimen is exposed to light? |
bilirubin |
|
|
A Total Protein control as a mean of 5.5mg/dl, with an SD of 0.5. At the 95% confidence interval, the control values must fall between... |
4.5-6.5 |
|
|
The coefficient of variation is the standard deviation expressed as a percentage of the mean. CV is a measure of the |
precision of an assay |
|
|
What statement describes a reference range (normal values)? |
Analysis from 95% of a healthy population for the liver enzyme ALT will show results from 6-37 U/L |
|
|
In addition to utilizing Levey-Jennings charts, what other criteria should be applied to interpret internal quality control data? |
Westgard multirule |
|
|
What term refers to the measure of scatter around the mean o f a Gaussian (normal) distribution curve? |
standard deviation |
|
|
What term refers to deviation form the true value caused by in terminate errors inherent in every laboratory measurement? |
random error |
|
|
What term refers to the closeness with which the measured value agrees with the mean? |
accuracy |
|
|
What percentage of values will fall between +/- 1SD in a Gaussian (normal) distribution? |
68% |
|
|
To provide independent validation of internal quality control programs, external surveys have been developed. What is a representative survey program? |
CAP (College of American Pathologists) |
|
|
Proficiency testing should be performed by... |
all personnel who routinely perform the procedure |
|
|
Which Westgard rule is the warning to check for failure of the remaining rules to determine if a run should be rejected? |
12s |
|
|
On a Levey-Jennings chart, what situation requires corrective action to be taken? |
one value is greater than 3 SD above the mean |
|
|
What assistance does an external quality control assurance program provide for a laboratory? |
Evaluation of its performance by comparisons with other laboratories using the same method |
|
|
3 true statements about test specificity... |
- Specificity is diseased focused - A highly specific method will identify patients who do not have the disease with a high level of probability - The higher a test's specificity, the fewer false positives |
|
|
What is this formula used to calculate? square root of [Sum(xi-mean)squared/ number-1] |
standard deviation |
|
|
What is the name for the term that represents the central value a control should be distributed around if the method remains stable? |
mean |
|
|
What term refers to the closeness with which a measured value agrees with the true value? |
accuracy |
|
|
3 characteristics and use of control material |
- has physical and chemical properties resembling test specimens - contains preanalyzed concentrations of analyses being measured - concentration of analytes should be within the normal and abnormal ranges |
|
|
What describes the Westgard 22s multirule? |
2 consecutive data points fall outside +2SD or -2SD on the same side of the mean |
|
|
When comparing a potential new test with a comparative method, one observes error that is consistently affecting results in one direction. What is this type of error known as? |
systematic error |
|
|
Which analyte is not affected by hemolysis? |
glucose |
|
|
The method verification study used to verify the reportable range is... |
linearity |
|
|
If the mean of a cholesterol control is 100mg/dl, and the SD is 2.0, what is the coefficient of variation? |
2% |
|
|
In method evaluation, the SD and the CV are calculated to verify what manufacturer's claim? |
precision |
|
|
If 2 methods agree completely, what will the correlation coefficient ("r" value), slope of the line (m), and the y-intercept equal? |
r=1, m= 1, y=0 |
|
|
Preanalytical variables, which account for 75% of laboratory errors, does not include which function... |
analytical testing |
|
|
The quality assurance program of a laboratory, of which quality control is one component, should detect errors in... |
all systematic actions necessary to provide adequate confidence that laboratory services will satisfy given medical needs for patient care |
|
|
3 true statements of Wesgard R4s rule |
- is only applied within run - detects random error - the range (or difference) between 2 controls within a run exceeds 4SDs. |
|
|
When performing a study for reference ranges on a new method... |
validate the manufacturer's reference range with 20 "normal" specimens, and if no more than 2 fall outside the state reference range, accept it. |
|
|
Lipids are... |
hydrophobic |
|
|
Phospholipids are... |
structural and functional components of the cell mebranes |
|
|
The turbid appearance of lipemic serum is due to an elevated level of... |
triglycerides |
|
|
3 components of the outer shell of lipoproteins |
- protein - phospholipids - free cholesterol |
|
|
LDL cholesterol can be estimated using the Friedewald formula: LDL= Total Cholesterol - (HDL + triglycerides/5) The calculation should not be used when the... |
triglyceride level is greater than 400mg/dl
|
|
|
If LDL receptors are nonfunctional due to disease, the plasma levels of which lipid increase the most? |
cholesterol |
|
|
What sample is likely to be lipemic? |
triglycerides 400mg/dl (normal <150mg/dl) |
|
|
To produce reliable results, when should blood specimens for lipid studies be drawn? |
in the fasting state, approximately 10-12 hours after eating |
|
|
A patient's total cholesterol is 300mg/dl, his HDL is 50mg/dl, his triglyceride is 200mg/dl. What is the patient's calculated LDL? |
210 |
|
|
Ketone bodies are formed because of a excessive breakdown of fatty acids. Of the metabolites, which may be classified as a ketone? |
beta-hydroxybutyric acid |
|
|
The quantification of high-density lipoprotein cholesterol (HDL) is significant in the risk assessment of what disease? |
coronary artery disease |
|
|
3 true statements about cholesterol |
- standing for long periods of time can falsely elevate cholesterol due to hemoconcentration - a precursor to all steroid hormones - the lipoprotein fraction with the greatest proportion of cholesterol is LDL |
|
|
What class of lipoprotein is also known as alpha-lipoprotein and Apo A lipoprotein? |
HDL |
|
|
What result would be the most consistent with high risk coronary heart disease? |
20mg/dl HDL and 250mg/dl total cholesterol |
|
|
Exogenous triglycerides (triglycerides from a diet) are transported in the plasma from what form? |
chylomicrons |
|
|
What may be described as a variant form of LDL, associated with increased risk of atherosclerotic cardiovascular disease? |
Lp(a) |
|
|
A healthy active 10y.o. boy with no prior history of illness had a sports physical that included lab work. After centrifugation of the SST tube drawn for chemistry the serum looks cloudy and milky. The following results were obtained, glucose= 105mg/dl, cholesterol= 285mg/dl, triglyceride= 420mg/dl. What would be the most probable explanation of these findings? |
the boy has an inherited genetic disease causing a lipid imbalance |
|
|
Proteins, carbohydrates, and lipids are the 3 major biological compounds of human metabolism. What is the element that distinguishes carbohydrates and lipid compounds? |
nitrogen |
|
|
In serum protein electrophoresis, when performed with a buffer solution at pH 8.6, what characterizes the proteins? |
exhibit net negative charge |
|
|
3 true statements about albumin |
- migrates the fastest towards the anode because it is the most highly charged - dehydration is the only condition that causes an increase in serum albumin - is the only protein fraction, when separated in serum by electrophoresis on agarose gel, that contains a single protein. |
|
|
In a healthy individual, which protein fraction has the greatest concentration in serum? |
albumin |
|
|
3 true statements about protein electrophoresis |
- performed using a buffer of pH 8.6 - performed on agarose gel, which has a pore size large enough for the proteins to move freely through and separate into 5 fractions - a heavy distinct band in the gamma region indicated the presence of monoclonal gammopathy |
|
|
When quantitating serum protein using the biuret reaction, the biuret reagent is reacting with... |
peptide bonds in protein |
|
|
3 plasma proteins manufactured in the liver... |
- albumin - haptoglobin - fibrinogen |
|
|
What glycoprotein binds with hemoglobin to facilitate the removal of hemoglobin by the reticuloendothelial system and those will be decreased in hemolytic disorders? |
haptoglobin |
|
|
Multiple myeloma, a plasma cell dyscrasia that usually affects persons over the age of 40 years, may have what 3 characterizations? |
- monoclonal band in the gamma region - hyperglobulinemia - increase serum protein values |
|
|
3 true statements about alcoholism |
- produces beta-gamma bridging in serum protein electrophoresis - is a secondary cause of hyperlipoproteinemia - causes an increase in the enzyme GGT |
|
|
What list of serum components (from anode to cathode) is the order of protein migration in serum protein electrophoresis? |
- albumin - alpha 1 - alpha 2 - beta - gamma |
|
|
What analytical technique is used to identify the immunoglobulin class that is elevated in monoclonal gammopathies? |
immunofixation electrophoresis |
|
|
In the nephrotic syndrome... |
albumin is decrease, a2 and b fractions are increased, hyperlipidemia and edema are also present |
|
|
A test used to evaluate nitrogen balance in burn, trauma, and non-ambulatory patients is... |
Prealbumin |
|
|
What does an increase in serum enzyme levels indicate? |
tissue damage and necrosis |
|
|
The activity of enzymes in serum is determined rather than concentration because... |
the amount of enzyme is too low to measure |
|
|
The properties of enzymes are correctly described by what statement? |
enzymes are protein catalysts of biological origin |
|
|
3 true statements concerning serum enzymes |
- both AST (aspartate transaminase) and LDH (lactate dehydrogenase) are elevated in acute myocardial infarction - increased serum alkaline phosphatase (ALP) may be found in bone disease - strenuous exercise prior to biochemical serum testing may result in an increased CPK value |
|
|
Clinical assays that measure enzyme activity are designed to follow... |
zero-order kinetics |
|
|
3 true statements about creatine kinase (CK)... |
- rises early after acute myocardial infarction - catalyzes the phosphorylation of creatine by ATP - found mainly in skeletal and cardiac muscles and in brain tissue |
|
|
3 true statements concerning gamma glutamyl transferase (GGT)... |
- present in almost all cells of the body - elevated in liver and some pancreatic diseases - elevated in chronic alcoholism |
|
|
To aid in the diagnosis of skeletal muscle disease, such as muscular dystrophy, which serum enzyme measurement would be of most use? |
creatine kinase (CPK) |
|
|
An example of using enzymes as reagents in the clinical laboratory is... |
EMIT and ELISA methods |
|
|
3 true statements about clinically important enzymes... |
- amylase and lipase elevation are commonly seen in pancreatitis - the isoenzyme of CPK elevated in muscle disease is CK-MM - the isoenzyme elevated in acute myocardial infarction is CK-MB |
|
|
A physician ordered the following tests for a liver profile on a patient: Asparate amiontransferase (AST) Alanine amiontransferase (ALT) Gamma glutamyl transferase (GGT) Creatine kinase (CK) Which does NOT give significant information regarding liver function? |
Creatine kinase (CK) |
|
|
What compound is often measured at 340nm in a secondary or indicator reaction for enzyme analysis? |
NADH |
|
|
3 true statements about substrate depletion in enzyme analysis |
- to obtain the correct enzyme value, less patient sample is used - so much enzyme is present, it uses up all available substrate and zero order kinetics are not followed - continuous monitoring enzyme reactions are most commonly used in enzyme assay design to allow detection of substrate depletion |
|
|
An enzyme that is elevated in BOTH serum and urine because of acute pancreatitis is... |
amaylase |
|
|
Activation energy is... |
decreased by enzymes |
|
|
Situation: It is 8:00am and you are working in the Specimen Receiving/ Processing area of the laboratory. The following specimens are received. What requires intervention before proceeding with processing and testing? Answer order: Test requested/ Specimen Received/ Time collected |
Glucose/ sodium fluoride/ 6:10am |
|
|
The normal range for the pH of arterial blood measured at 37 degrees Celsius is... |
7.35-7.45 |
|
|
What set of results is consistent with a diagnosis of respiratory acidosis? Answer order: Arterial pH/ Arterial pCO2 |
decreased/ increased |
|
|
In the plasma, an excess in the concentration of bicarbonate without a change in PCO2 from normal will result in what metabolic state? |
metabolic alkalosis |
|
|
What collection scenario will produce accurate blood gas results? |
immediately upon removing the needle, eject any bubbles front eh syringe and seal the tip |
|
|
A 68 year old man arrives in the ED with a glucose of 450mg/dL and a 4+ serum acetone. An arterial blood gas from this patient is likely to indicate |
high pH |
|
|
3 true statements about acid-base levels in the body |
- The lungs can act within minutes to restore acid-base balance - A disorder of acid-base status caused in the CO2 level is called respiratory - A disorder of acid-base status caused by a change in the bicarbonate level is called metabolic |
|
|
What is the most predominant buffer in the body? |
bicarbonate/ carbonic acid |
|
|
To maintain a pH of 7.4 in plasma, it is necessary to maintain a... |
20:1 ratio of bicarbonate to carbonic acid |
|
|
The bicarbonate and carbonic acid ratio is calculated from an equation by |
Henderson-Hasselbalch |
|
|
3 parts of the acid-base system in the body |
- lungs - bicarbonate to carbonic acid buffer system - kidneys |
|
|
What is the specimen of choice for analysis of acid-base disturbances in adults? |
arterial blood |
|
|
A patient's arterial blood gas results are: pH 7.25 (7.35-7.45) PCO2 70mmHg (34-45) HCO3- 25mmol/L (22-26) These results are consistent with... |
respiratory acidosis |
|
|
A common cause of respiratory alkalosis is... |
hyperventilation |
|
|
A breakdown product of hemoglobin is... |
bilirubin |
|
|
What condition is characterized by yellow pigmentation of the skin? |
jaundice |
|
|
Testing for bilirubin was performed on a specimen that was hemolyzed and had been sitting in a test tube rack for several hours before analysis. The results may be... |
increased by the hemolysis, but decreased by the exposure of light |
|
|
In the liver, bilirubin is converted to... |
bilirubin diglucuronide |
|
|
Urobilinogen is formed in the... |
intestine |
|
|
Total iron-binding capacity measures the serum iron transporting capacity of... |
transferrin |
|
|
Kernicterus is an abnormal accumulation of bilirubin in... |
brain tissue |
|
|
Decreased serum iron with increased TIBC is compatible with what disease state? |
iron deficiency anemia |
|
|
What is the primary storage form of iron? |
ferritin |
|
|
A patient with biliary obstruction has a serum bilirubin assay performed. The bilirubin results were determined using the Jendrassik-Grof method as follows: Total bilirubin= 0.8mg/dL conjugated bilirubin= 1.0 mg/dL These results are most consistent with... |
technical error occurring during analysis |
|
|
A patient suffering from an acute hemolytic episode has a total bilirubin of 2.2mg/dL. Based on this information, what conjugated and unconjugated bilirubin results would you expect? Normal ranges: Conjugated (0-0.2mg/dL) Unconjugated (0-1.1mg/dL) |
0.1/2.1 |
|
|
What serum test results are most consistent with obstructive liver disease? Answer order: Total bilirubin, Direct bilirubin, Alkaline Phosphatase |
increased, increased, increased |
|
|
What disorder can be classified as a form of pre hepatic jaundice? |
acute hemolytic anemia |
|
|
What functions as a transport protein for bilirubin in the blood? |
albumin |
|
|
What is a form of post hepatic jaundice? |
neoplasm of the common bile duct |
|
|
As red blood cells disintegrate, hemoglobin is released and converted to the pigment bilirubin. What organ is primarily responsible for this function? |
spleen |
|
|
What condition is characterized by an elevation of total bilirubin primarily due to an increase in the conjugated bilirubin fraction? |
obstructive jaundice |
|
|
3 statements true about pernicious anemia |
- an inherited disease that causes megaloblastic anemia - the patient can not absorb Vitamin B12 due to an antibody that blocks intrinsic factor - intrinsic factor in the intestine is necessary for the body to absorb Vitamin B12 |
|
|
What is the routine cause of neonatal physiological jaundice that is common after birth in premature infants? |
deficiency in the bilirubin conjugation enzyme system in the immature liver of the newborn |
|
|
If the total bilirubin is 4.3 mg/dL and the conjugated bilirubin is 2.1mg/dL, the unconjugated bilirubin is... |
2.2mg/dL |
|
|
3 products of the pituitary |
- TSH - FSH - prolactin |
|
|
What condition corresponds to these laboratory findings? Increased- ACTH and potassium Decreased - Cortisol, aldosterone, sodium |
Addison's disease |
|
|
What hormone exhibits diurnal variation in regard to its release into the peripheral circulation? |
Cortisol |
|
|
A physician suspects a patient has Cushing's syndrome. Based on this information, what test would assist in this diagnosis?
|
cortisol level |
|
|
The recommended screening test for thyroid disease is... |
TSH |
|
|
Both TSH and ACTH are... |
tropic hormones produced by the anterior pituitary gland |
|
|
What laboratory test would be ordered to rule out a phenochromocytoma in a patient with unexplained hypertension? |
24-hour urine for catecholamines |
|
|
Decreased T4 levels and increased TSH are associated with what condition? |
hypothyroid |
|
|
Changes in protein concentration affect what thyroid hormone the most? |
Total T4 (Thyroxine) |
|
|
What laboratory results is consistent with the presence of Grave's disease? |
increased Free T4 |
|
|
The autoimmune disorder that results in hypothyroidism is... |
Hashimoto's thyroiditis |
|
|
A positive result for a drug performed by immunoassay testing is called... |
an unconfirmed positive |
|
|
Chain of custody for a specimen for drug analysis can be described as... |
Procedures established to ensure the proper identification of who the specimen belongs to and that it has not been tampered with or misidentified in any way during the testing process |
|
|
Heroin s synthesized from what drug? |
Morphine |
|
|
After absorption, codeine is rapidly metabolized to what compound? |
morphine |
|
|
THC (9-tetrahydrocannabinol) is the principle active component of what drug? |
marijuana |
|
|
Drug detection cut-off limits are set to... |
minimize both false positive and false negative results |
|
|
Nortriptyline, Imipramine, Amitriptyline, and Doxepin belong to what class of drug? |
tricyclic antidepressants |
|
|
What class of drugs has a sedative effect and is used to treat anxiety? |
benzodiazepines |
|
|
Drugs of abuse testing can... |
only detect recent drug use |
|
|
Drug abuse is... |
occurs in all age groups and genders, including the elderly and pregnant women |
|
|
What does cocaine metabolize to that is found in urine? |
benzoylecgonine |
|
|
Measurement of urine temperature, pH, specific gravity, and creatine are performed to... |
asses validity of a specimen |
|
|
Over the counter antihistamines can cross react with what class of drugs and give a positive result? |
amphetamines |
|
|
What drugs belong to the class benzodiazepine? |
librium, valium, and ativan |
|
|
Confirmation of a positive drug result by immunoassay is most commonly performed by what reference method? |
Gas Chromatography/ Mass Spechtometry (GC/MS) |
|
|
The drug of abuse that is stored in fat cells and has a long detection time in chronic users is... |
marijuana |
|
|
What drug of abuse can cause a myocardial infarction in overdose situations? |
cocaine |
|
|
Ecstasy belongs to what class of drugs and may or may not be picked up in a screen for this class of drug? |
amphetamines |
|
|
What drugs are derived from the opium poppy and are detached in the screen for opiates |
opium, cocaine, and morphine |
|
|
If a patient arrives in the emergency department and has been given the following drugs in the ambulance, what drug he test positive for on a urine drug screen? Drugs given: valium, morphine, phenobarbital (3 answers) |
- benzodiazepine - opiates - barbiturates |
|
|
Complete this sentence: Drugs of Abuse screens performed in the clinical laboratory... |
are immunoassay tests that detect the presence of both illegal and prescription drugs that can cause medical problems |
|
|
The antidepressants known as Selective Seretonin Reuptake Inhibitors (SSRIs) are Prozac (fluoxetine), Luvox (fluvoxamine), Zoloft (sertraline), and Paxil (paroxetine). Are these detected in drugs of abuse screening tests? |
No |
|
|
The first 2 types of viral hepatitis distinguished during WWII were |
-hepatitis A, known as HAV -hepatitis B, known as HBV |
|
|
Individuals affected with a hepatitis virus tend to have what 3 generalized symptoms? |
- fatigue - loss of appetite - nausea |
|
|
Symptoms of hepatitis... |
vary considerably from one individual to another |
|
|
A definitive diagnosis of viral hepatitis can be made by... |
only the use of viral specific hepatitis tests |
|
|
Viral hepatitis tests are used to… (3 answers) |
- Diagnose - Monitor - Screen |
|
|
Transmission of hepatitis A usually occurs through… (2 answers) |
- close person to person contact - ingestion of contaminated food or water |
|
|
Almost 1/3 of reported cases of HAV are... |
children younger than 5 years |
|
|
3 true statements of hepatitis A |
- onset of symptoms in hepatitis A is abrupt and last approximately 1-8 weeks - peak infectivity occurs during the 2 weeks period before the onset of jaundice of the elevation of liver enzymes - a person positive for anti-HAV IgM has acute hepatitis A |
|
|
Prevention/ Prophylaxis for hepatitis A include… (3 answers) |
- Good sanitary habits - Immune globulin given to those exposed to HAV and travelers who will be visiting developing countries where sanitation is poor - Hepatitis A vaccination given to children over 2, persons at risk for exposure, and those seeking immunity |
|
|
3 routes of transmission for hepatitis B |
- needle stick - sexual contact - hemodialysis |
|
|
What individuals would not be at risk for hepatitis B? |
travelers to endemic countries |
|
|
Approximately how many individuals in the US die each year due to chronic liver disease associated with HBV? |
5,000 |
|
|
The average incubation period for hepatitis B is... |
60-90 days |
|
|
What percentage of children less than 5 years old infected with HBV progress to chronic HBV infection? |
30-90% |
|
|
What 2 markers in the Acute Viral Hepatitis Panel will be positive in a person who has acute hepatitis B? |
-HBsAg - Anti-HBc IgM |
|
|
What hepatitis marker indicates a person has immunity to hepatitis B either indicating the person has had the disease and has developed natural immunity or has had the vaccination for hepatitis B?
|
Anti-HBs |
|
|
The sexual partners and household contacts of those diagnosed with hepatitis B should be... |
counseled or tested for HBV |
|
|
What are 2 indicators of recovery from hepatitis B? |
-presence of anti-HBs - normal liver enzymes |
|
|
The hepatitis B vaccine is... |
80-95% effective |
|
|
Hepatitis B Immune Globulin (HBIG) is given to... |
provide temporary passive immunity to hepatitis B |
|
|
Which test is used in the prenatal screening of pregnant women? |
HBsAg |
|
|
Routes of transmission with HCV include… (3 answers) |
- contaminated needle sticks - sexual intercourse - perinatal- infant born to infected mother |
|
|
What percentage of hepatitis C infections are from unknown sources? |
10% |
|
|
3 true statements of HCV |
- the majority of persons infected with hepatitis C may be asymptomatic - Hepatocellular carcinoma develops in 1-5 percent of individuals with chronic HCV infection - HCV is now the leading cause of liver transplantation in the US |
|
|
3 measures to prevent HCV infection include |
- screening the blood and blood products - destruction of disposable needles, and adequate sterilization of reusable materials such as surgical or dental instruments - the use of universal precautions in the lab that includes the wearing of gloves, fluid resistant lab coats, and eye/face protection |
|
|
What directions should be given to a patient for the collection of a 24-hour urine specimen for Creatinine Clearance Test? |
Start collection at 6am, void the first specimen and save all remaining urine specimens through 6am the following day |
|
|
Given the values below and assuming the patient has an average body surface area, what is the creatinine clearance? Urine creatinine= 120mg/dL Serum creatinine= 1.2mg/dL Urine volume= 1520mLs in 25 hours |
106min/mL |
|
|
What is the most common cause of azotemia (increased BUN levels in the blood)? |
congestive heart failure |
|
|
What is a problem the may occur in measuring ammonia levels? |
false increase due to sample sitting at room temperature for 2 hours before running test |
|
|
A creatinine clearance result below the normal reference range most likely indicates a disease in... |
renal glomerular filtration |
|
|
Review serum test results creatinine-2.5mg/dL (0.7-1.5mg/dL) cholesterol-180mg/dL (<200mg/dL) glucose-110mg/dL (70-110mg/dL) urea-40mg/dL (8-26mg/dL) uric acid-6.9mg/dL (2.5-7.0mg/dL) calcium-8.9mg/dL (8.5-10.3mg/dL) These results are most consistent with... |
compromised renal function |
|
|
Increased serum uric acid is found in each of the following conditions… (3 answers) |
- gout - renal failure - rapid cell turnover associated with chemotherapy regimens |
|
|
What is the compound that comprises the majority of nonprotein-nitrogen fractions in serum? |
urea |
|
|
The formation of urea and its excretion in the urine provides the principal means by which the body is able to free itself of excess… |
ammonia |
|
|
3 truths about handling specimens for ammonia |
- exposure to air must be avoided, the evacuation tube must be filled completely - the specimen must be placed on ice immediately and centrifuged as soon as possible to inhibit metabolic process the lead to ammonia formation in vitro - testing for ammonia should begin within 20 minutes of drawing the specimen |
|
|
Elevated levels of ammonia occur in what 3 disorders? |
- Reye's syndrome - Renal failure - Chronic liver failure |
|
|
An increased serum level of what analyte is most commonly associated with a decreased glomerular filtration rate? |
creatinine |
|
|
A serum creatinine level was found to be 6.0mg/dL (normal range= 0.6-1.2mg/dL) What BUN results would support the same pathological condition? (normal range of BUN= 8-24mg/dL) |
70mg/dL |
|
|
3 truths about creatinine |
- the analyte measured in the Jaffe reaction - the precursor of creatinine is creatine - a compound found in urine that can be used to asses the completeness of a 24-hour urine collection |
|
|
What is the end product of purine catabolism in men? |
uric acid |
|
|
what disorder is best characterized by laboratory findings that include increased serum levels of phosphorus, magnesium, potassium, uric acid, urea (BUN), and creatinine? |
chronic renal failure |
|
|
Recurrent arthritis caused by urate (uric acid) deposition in joint fluid and synovial fluid is called... |
gout |
|
|
3 truths about the anion gap |
- the most commonly used formula is Na-(Cl+CO2) - an elevated value indicates a metabolic acidosis - a decreased CO2 (bicarbonate) value will cause an increased anion gap |
|
|
Increased CO2 value can be caused by
|
emphysema |
|
|
Osmolality measurements determine the... |
moles of dissolved solutes per kilogram of solvent |
|
|
The following results obtained on a patient's serum: Sodium-136mEq/L (135-145) Osmolality-320mOsm/L (275-295) Potassium-4.3mEq/L (4.6-5.1) Glucose-99mg/dL (70-110) Chloride-95mEq/L (100-110) Urea nitrogen (BUN)-25mg/dL (8-24) Bicarbonate (CO2)-22mEq/L (22-32) In considering this data, what is a true statement? |
The electrolytes are NOT in balance, and the value obtained for osmolality does NOT correlate with the other data |
|
|
A hospitalized patient is experiencing increased neuromuscular irritability. Which test should be ordered immediately? |
calcium |
|
|
What situation indicates that n instrument problem may be present and requires further investigation? |
a series of low anion gaps |
|
|
Sodium is... |
regulated in the body by response to both blood volume and osmolality |
|
|
3 true statements about a calculated serum osmolality |
- (1.86 x Na+) + (1/18 x glucose) + (1/2.8 x BUN) + 9 is the formula used for the calculation - useful in detecting and monitoring the course of treatment of the toxic ingestion of methanol and ethylene glycol - If the difference between the measured value and the calculated value osmolality value is >0, there is an indication of an abnormal concentration of unmeasured substances in the blood. |
|
|
Are these results in electrolyte balance? Na+= 145, K+= 4.0, Cl-= 90, C02= 15 |
No |
|
|
Which electrolyte is the chief plasma cation whose main function is maintaing osmotic pressure? |
sodium |
|
|
A plasma sample was analyzed using ION selective electrodes (ISEs) with these results Na+= 140 K+= 14.0 Cl-= 112 CO2= 18 Cl-= 3.9 These results are consistent with a specimen... |
collected in an EDTA tube |
|
|
The presence of visible hemolysis will significantly increase the serum level of which electrolyte? |
potassium |
|
|
Plasma calcium levels may be influenced by… (3 answers) |
- Parathyroid hormone (PTH) - Vitamin D - Calcitonin |
|
|
What is true about lactic acid? |
-an explained anion gap of >20 may be caused by increased lactic acid in the plasma |
|
|
What is the major intracellular cation? |
potassium |
|
|
What is the major extracellular cation? |
sodium |
|
|
Hyponatremia can be caused by… (3 answers) |
- renal failure - aldosterone deficiency - hypomagnesemia |
|
|
Hyperkalemia can be caused by… (3 answers) |
- renal failure - sample hemolysis - blood transfusion |
|
|
Decreased renal function or renal failure will cause… (3 answers) |
- hypermagnesemia - hyperphosphatemia - hyperkalemia |
|
|
Hyperparathyroidism is the main cause of increased levels of what ion? |
calcium |
|
|
What 3 analytes are falsely decreased by hemolysis? |
- potassium - phosphorus - magnesium |
|
|
What analyte is NOT falsely decreased by hemolysis? |
sodium |
|
|
In the collection of plasma specimens for lactate, what anticoagulant would be most appropriate? |
fluoride plus oxalate |
|
|
Which 2 ions are essential for normal cardiac function? |
K+ and Ca+ |
|
|
A trough sample for routine therapeutic drug monitoring is usually obtained... |
just before the next scheduled dose |
|
|
In what form must a drug be in to elicit a pharmacological response? |
free |
|
|
Steady state is reached by a drug in how many half lives?
|
5 to 6 |
|
|
Drug also known as Dilantin |
phenytoin |
|
|
Drug also known as Tegretol |
carbamazepine |
|
|
Carbamazepine is often given in combination with phenobarbital because... |
it decreases the metabolism of phenobarb and thus increases the blood level |
|
|
Most widely prescribed antiepileptic |
Dilantin |
|
|
Antiepileptic drug that causes leukopenia at therapeutic levels, and aplastic anemia at very high levels |
carbamazepine |
|
|
Monitored by the use of peak and trough levels… |
the antibiotics- gentamicin, tobramycin, and vancomycin |
|
|
Can cause damage to the kidneys and hearing (nephrotoxic and ototoxic)…. |
gentamicin |
|
|
A bronchodilator used to treat asthma and under developed lungs in premature infants that metabolizes to caffeine |
theophylline |
|
|
Levels of this drug must only be measured 8 hours after the dose is given |
digoxin |
|
|
An antineoplastic agent used to treat leukemia, lymphoma, and cancer that must be monitored to prevent low levels of white blood cells |
methotrexate |
|
|
What drug is used as an immunosuppressant in organ transplantation, especially in liver transplants? |
Tacrolimus (FK-506) |
|
|
If the laboratory reports a serum alcohol level at 120mg/dL, what would be the value of a legal blood alcohol |
.12% |
|
|
What other alcohols metabolizes to formaldehyde causing blindness and death? |
methanol |
|
|
What is used in the treatment of manic depression? |
lithium |
|
|
What, when taken in overdose levels, leads to severe metabolic acidosis and in rare instances can cause Reye's syndrome? |
salicylate |
|
|
Acetaminophen (Tylenol), is particularly toxic to what organ? |
the liver |
|
|
The first cardiac markers for acute myocardial infarction (AMI) performed in the laboratory were... |
CK-MB and LD-1 isoenzyme electrophoresis |
|
|
CK-MB is... |
found mostly in heart muscle, but also found in small amounts in skeletal muscle |
|
|
Troponin is… (2 answers) |
-a protein only found in heart muscle, and a value above 0.5ng/mL is diagnostic for AMI
- used for both AMI diagnosis and as a marker of coronary heart disease (CAD) or risk stratification |
|
|
Myoglobin |
if not increased over 1-3 hours, can be used to rule out a heart attack |
|
|
Cardiac markers... |
must be measured serially over time to rule in or rule out an AMI |
|
|
Both CK-MB and troponin |
peak at 12-24 hours following an AMI |
|
|
The test for CK-MB consists of... |
a measurement of Total CK, CK-MB, and a calculation of the CK-MB index |
|
|
BNP
|
is a marker for congestive heart failure |
|
|
2 independent risk factors for coronary artery disease are... |
homocysteine and high sensitive CRP |
|
|
Tumor markers are...
|
used as a noninvasive indicator of prognosis, early recurrence, presence of residual disease, and remission of certain cancers |
|
|
PSA, or prostate specific antigen levels are elevated |
in 2 conditions, BPH and prostate cancer |
|
|
A tumor marker used for both liver cancer and testicular cancer is... |
AFP, or alpha-fetoprotein |
|
|
What is true about alpha-fetoprotein (AFP)? |
may be present in pancreatic and gastric cancer as well as liver and testicular cancer |
|
|
Two oncofetal antigens that are present at high concentration in fetal development and re-expressed in adult neoplastic tissue are... |
AFP and CEA |
|
|
Which marker for colon cancer is higher in smokers than non-smokers? |
CEA |
|
|
CEA (carbinoembryonic antigen) is an oncofetal antigen used most often to monitor which 2 types of cancer? |
colon and lung |
|
|
HCG is found elevated in pregnancy and what 2 abnormal conditions? |
testicular cancer and hydatiform mole |
|
|
CA15-3 is elevated in what type of cancer? |
breast |
|
|
A tumor marker elevated in pancreatic and colorectal cancer is... |
CA19-9 |
|
|
HCG is secreted by... |
placental tissue after embryo implantation |
|
|
The earliest pregnancy can be detected is... |
a the time of embryo implantation, or one week before menses is due |
|
|
HCG |
doubles every 2 days in a viable pregnancy, and peaks at the 3rd month |
|
|
Ectopic pregnancy |
is characterized by lower than expected HCG levels |
|
|
The HCG molecule has which subunit that is the same as LH, FSH, and TSH? |
alpha-subunit |
|
|
The triple screen performed in the 3rd to 5th month of pregnancy is a screen for... |
neural tube defects such as spina bifid a and Down Syndrome |
|
|
Which hormone controls the menstrual cycle in a negative feedback loop with estuarial, and high levels signal menopause?
|
FSH (follicle stimulating hormone) |
|
|
Which 2 hormones, one in females and one in males, are the primary sex hormones responsible for puberty and secondary sex characteristics? |
estradiol and testosterone |
|
|
Elevated levels of this hormone are found in pituitary tumors and can cause enlarged breasts and milk production in males, and produces lactation in nursing mothers |
prolactin |
|
|
Testosterone is bound in serum to which 2 proteins? |
albumin and SHBG (Sex hormone binding globulin) |
|
|
What is the end product of the metabolism of cells? |
hydrogen ion (H+) |
|
|
Which system can react within minutes to restore acid-base balance? |
the lungs |
|
|
Which compound is an indicator of the respiratory acid-base status? |
CO2 |
|
|
Carbonic acid (H2CO3) disassociates into what 2 compounds? |
CO2 and H2O |
|
|
Which component does the lung control to maintain the correct ratio? |
CO2 |
|
|
A disorder of acid-base status caused by a change in the CO2 level is called... |
respiratory |
|
|
A disorder of acid-base caused by a change in the bicarbonate level is called... |
metabolic |
|
|
If a persons pH level is above 7.45 that person is in... |
alkalosis |
|
|
If a persons pH level is below 7.35 that person is in...
|
acidosis |
|
|
Hyperventilation due to anxiety is called a respiratory alkalosis because... |
the patient is exhaling too much CO2 and losing acid |
|
|
A person with a fever will exhibit rapid breathing (hyperventilation) to correct a… |
metabolic acidosis |
|
|
Hypoventilation due to emphysema, pneumonia, or a pulmonary embolism will cause what substance to build up in the blood, and cause what type of disorder? |
carbon dioxide, respiratory acidosis |
|
|
A metabolic acidosis can be caused by... |
renal failure |
|
|
Why would a person with a lung disease that causes a build up of CO2 not be acidotic? |
because the kidney will compensate by retaining more bicarbonate to maintain the 20:1 ratio of bicarbonate to carbonic acid |
|
|
Diarrhea, renal failure, and ketoacidosis can all cause... |
metabolic acidosis |
|
|
A patient has been vomiting for 2 days and has a blood pH of 7.50. What is the most likely acid-base disorder? |
metabolic alkalosis |
|
|
Hypoventilation can compensate for... |
metabolic alkalosis |
|
|
A patient's arterial blood gas results are…
pH 7.37 PCO2 75mmHg HCO3- 37mmol/L These values are consistent with... |
compensated respiratory acidosis |
|
|
The measurement of the pressure of dissolved CO2 (PCO2) in the blood is most closely associated with what substance?
|
carbonic acid |
|
|
What is the term that describes the sum of carbonic acid and bicarbonate in plasma? |
Total CO2 |
|
|
What characterizes respiratory acidosis? |
increased PCO2 |
|
|
Which blood gas parameters are measured as opposed to being calculated? |
pH, PCO2, PO2 |
|
|
The Henderson-Hasselbalch equation is used to... |
calculate the amount of bicarbonate and treat acid-base disorders |
|
|
Capillary specimens for ABG testing are...
|
only used in neonates |
|
|
The anticoagulant of choice for a blood glass measurement is... |
lithium heparin, dry |
|
|
When arterial good from a normal patient is exposed to room air…. |
PCO2 decreases, PO2 increases, pH increases |
|
|
The red and white blood cells will continue to metabolism in arterial blood gas specimens left at room temperature for over an hour an will cause the following changes |
PO2 decreases, PCO2 increases, pH decreases |
