ASCP Random

Lidocaine

Antiarrhythmic MEGX (Toxic -- must monitor both MEGX and Lidocain concentration)

Quinidine

Antiarrhythmic Peak Quinodine Sulfate -- 2 Hours Peak Quinodine Gluconate -- 4-5 hours

Procainamide

Antiarrhythmic Peak at 1 hour Monitor both NAPA and parent drug concentration Metabolized into NAPA -- has same therapeutic effect is original drug

A patient's BUN value is 15 mg/dl and his creatinine is 5 mg/dl. If this patient is not undergoing dialysis, what conclusion would you draw from these results?

BUN is normal, Crea is significantly elevated. One of the values is incorrect.

Primary metabolite of cocaine

Benzoylcognine

Vitamin B1 deficiency

Beriberi

An aerobic gram negative coccobacillus was isolated from a nasopharyngeal swab 48 hours after culture from a 6 month old with the following culture characteristics on Bordet-Gengou agar: Small zones of beta-hemolysis Urease: positive Oxidase: negative Motility: negative The MOST probable identification of this isolate is: Pasteurella multocida Bordetella pertussis Bordetella parapertussis Bordetella bronchiseptica

Bordetella parapertussis The clinical and laboratory findings most closely match that of a Bordetella species; particularly a Bordatella parapertussis infection. Bordetella pertussis is oxidase positive but urease negative B. parapertussis is oxidase negative and urease positive. B. bronchosepticus is positive for both enzymes.

Zollinger Ellison

Gastric, duodenal, pancreatic tumors Production of extreme high levels of gastrin

Vitamin C deficiency

scurvy , necrosis of gums, emotional disturbances

Steady state concentration of drug attained after ____ doses.

seven doses

Pantothenic Acid deficiency

weakness, malaise

All of the statements below regarding amylase and lipase in pancreatitis are TRUE EXCEPT: Amylase and lipase are as predictive in chronic as in acute pancreatitis. Diagnosis sensitivity is increased by assaying both amylase and lipase. Urinary amylase: creatinine ratio is the most sensitive test for acute pancreatitis. Serum lipase peaks at 24 hours after an episode of acute pancreatitis and remains high for 7-8 days.

Amylase and lipase are as predictive in chronic as in acute pancreatitis`

Type I Hypersensitivity

Anaphylactic IgE/Mast cell mediated Rhinitis, hay fever, asthma, food allergies

A test that can be used as a confirmatory test for urobilinogen is:

Watson-schwartz

Crigler Najjar 1. defect 2. Bilirubin Findings

Crigler Najjar has defect/deficiency of UDP glycoronyl transferase. Life threatening Build up of unconjugated bilirubin decreased conjugated bilirubin decreased urobilinogen decreased urobilin clay colored stools.

TDM Peak Draw from IV

30 minutes after completion of administration

Platelets that are not collected by an apheresis method must be prepared within ________ of the collection of Whole Blood.

8 hours

Fat soluble vitamins

A D E K stored in liver and adipose tissue Can build up to toxic levels

Acidic drugs bind to

Albumin

Basic drugs bind to

A1-acid glycoprotein (orosomucoid)

Complement Recognition Complex Complement Activation Complex Complement Membrane Attack Complex

C1 C4 C2 C3 C5,6,7,8,99999999

Vitamin B2 and B6 deficiency

Cheilosis, glossitis, ocular disturbances

Bioavailability of a drug refers to

Concentration of drug in serum/plasma at any time in its metabolic curve.

Methotrexate

Destroys neoplastic cells Inhiibts DNA synthesis Leucovorin can be administered to offset methotrexate

Dubin-Johnson 1. Defect 2. Bilirubin Findings

Dubin Johnson results from difficulty transporting conjugated bilirubin out of hepatocytes.. Non-life threatening Mild build up of conjugated bilirubin Mild build up of unconjugated bilirubin (found in urine) Normal Urobilinogen Normal urobilin

The seeds of the Dolichos biflorus plant will agglutinate A2 cells but not A1 cells. The correct answer is highlighted below True False

False Dolichos bifloris agglutinates A1 not A2

Gilbert's Syndrome 1. defect 2. Bilirubin Findings

Gilbert's disease results from hepatocyte defect with transporting unconjugated bilirubin into cell. Non-life threatening Mild build-up of unconjugated bilirubin Mild decrease in conjugated bilirubin Normal/decreased Urobilinogen Normal/decreased Urobilin

Aminoglycosides

Gram negative antibiotics (genta, tobra, kana, amikacin) Associated with renal and hearing damage.

Microaerophilic Strep

Group F Small beta hemolytic colonies PYR positive Capnophilic Smell like caramel/butterscotch S. anginosus, S. constellatus, S. intermedius

Thyroid antibody types 1. Hashimotos 2. Grave's Disease

Hashimotos TMA - Thyroid antimicrosomal antibodies (anti-TPO) Anti-Tg Graves TSI - Thyroid Stimulating Immunoglobulin (Anti-TRab)

Which hemoglobin, when elevated, acts as a protection against sickling in patients with HbS? Hemoglobin A2 Hemoglobin C Hemoglobin F Hemoglobin G

Hemoglobin F

Vitamin E deficiency

Hemolytic disease of premature neonates

Vitamin k deficiency

Hemorrhage (Lac of factors 2,7,9,10)

It is common practice to perform a spot indole test on all swarming Proteus species recovered from wound infections. The rationale for this practice is:

Indole positive = Proteus vulgaris = increased penicillin resistance.

Which of the following statements is true regarding cardiovascular disease and adipose tissue? (more than 1 answer is correct) Inflammatory cytokines, synthesized and released by adipose tissue, contribute to the development of cardiovascular disease A state of abnormal lipids and lipid levels found in metabolic syndrome contribute to the development of cardiovascular disease Obesity in metabolic syndrome contributes to the development of cardiovascular disease by increased synthesis and secretion of adiponectin Increased synthesis and secretion of PAI-1 in metabolic syndrome contributes to cardiovascular disease by increasing blood pressure

Inflammatory cytokines are synthesized by adipose tissue that increase cardiovascular disease State of abnormal lipids and lipid levels found in metabolic syndrome contribute tot he development of cardiovascular disease.

Pesticide toxicity

Inibit acetyl-cholinesterase (true cholinesterase)

Rotor's Syndrome

Intrahepatic cholestasis due to bile duct injury. Non-life threatening Build up of conjugated bilirubin (found in urine) Normal unconjugated bilirubin Normal/decreased urobilinogen Normal/decreased urobilin

Vitamin B12 deficiency

Megaloblastic anemia, neurological abnormaltiies

NASBA definition (Molecular diagnosticS)

Nucleic acid sequence based amplification (NASBA) used to amplify RNA sequences. A primer-dependent technology that can be used for the continuous amplification of nucleic acids in a single mixture at one temperature.

TCA

Old antidepressants Peak at 2-12 hours

TDM Peak Draw from Oral

One hour after completion of administration (Generally)

Niacin Deficiency

Pellagra

Sirolimus

Prevents GVHD and rejection after transplant

Tacrolimus

Prevents GVHD and rejection after transplant

Cyclosporine

Prevents transplant GVHD and rejection Peaks in 4-6 hours

Which of the following conditions would NOT be associated with an increased level of alpha-fetoprotein? Prostate Cancer Hepatocellular Carcinoma Viral Hepatitis Testicular Tumors Pancreatic Cancer

Prostate cancer

Vitamin D deficiency

Rickets, bone disease

Serotonin

Synthesized from typtophan by enterochromaffin cells lier metabolizes into 5-HIAA Metastatic carcinoid tumors produce high levels of serotonin. High levels of 5-HIAA found in urine

Type IV Hypersensitivity

T-cell Dependent / Delayed Release of cytokines by T-cells PPD, contact dermatitis, tuberculin skin test

M:E Ratio calculation

The M:E ratio is calculated from the total granulocyte precursors and the total erythroid precursors. It does not include non-myeloid nucleated cells such as lymphocytes, monocytes etc. It should always be interpreted in context with the overall bone marrow cellularity. Although laboratories may have slightly different reference ranges, the typical reference range for the M:E ratio is 2:1 - 4:1

Protein C Activation and Function

Thrombin cleaves N-terminus of zymogen Protein C. Protein C binds cofactor Protein S. Enhanced activity by thrombomodulin, Endothelial protein C receptor (EPCR) Serine protease. Destroys VIII and V

TMA definition (molecular diagnostics)

Transcription Mediated Amplification

Digoxin

Treats CHF Inhibits NAK pump. Decreases K+, Increases Ca2+. Increased Ca2+ causes increased contracility. Peak in 2-3 hours Peak Concentration of drug in heart tissue best indicated by serum levels at 8 hours

Vancomycin

Treats gram positive infection Associated with nephrotoxicity, hearing damage, red man syndrome

Lithium

Treats manic depression Peak in 2-4 hours

Water soluble vitamins

Vitamins OTHER THAN A D E IK Excreted in urine do not build up

Theophylline

Antiasthmatic

Type II Hypersensitivity

Antibody Mediated/Cytotoxic Antibody binds to foreign antigen HDN, TfRXN, Autoimmune hemolytic anemia

Carbamazepine

Antiepilleptic

Valproic Acid

Antiepilleptic

Phenobarbital

Antiepilleptic Peak at 10 hours Monitor both primidone and phenobarbital Phenobarbital (primidone is administered and converted to phenobarbital)

Phenytoin

Antiepilleptic Prevents brain swelling after accidents Peak at 4-5 hours Highly protein bound

Today, amniocentesis is preferred to Doppler sonography for monitoring the severity of hemolytic disease of the fetus and newborn (HDFN). True False

Because Doppler sonography is noninvasive, it is a safer alternative to amniocentesis for fetal monitoring and has largely replaced serial amniocentesis for predicting severity of HDFN

Side effects of lead poisoning

Blocks heme synthesis Basophilic stippling Urinary excretion of ALA and coproporphyrins

Heparin Function

Heparin binds to the enzyme inhibitor antithrombin III (AT), causing a conformational change that results in its activation. The activated AT then inactivates thrombin and other proteases involved in blood clotting, most notably factor Xa.

Hippurate Hydrolysis

Hippurate ---> Benzoate + Glycine (purple)

Gastrin

Hormone that stimulates gastric HCl and pancreatic enzymes

TDM Trough Draw

Immediately before next dose

Type III Hypersensitivity

Immune Complex Formation of antibody-antigen matrices in tissues. Serum sickness, arthus rxn, SLE, RA

Vitamin A deficiency

dry skin, eye infections, night blindness

If a pregnant female who was injected with RhIg antenatally has anti-D at delivery, routine antibody titration to determine the titer of the anti-D is considered a good practice.

false

galactosemia 1. enzyme defect 2. findings (glucose test strip, clinitest)

galactose-1-phosphate uridyl transferase

mothball

howell jolly

Folate deficiency

megaloblastic anemia, hyperpigmentation of the skin, hepatosplenomegally

Biotin deficiency

neurologic symptoms, skin symptoms, visual symptoms