CHAPTERS 12,16,25, & 27 REVIEW

An electrolyte panel was performed on a patient in the emergency room. The following values were reported: Sodium: 150mEq/L Potassium: 5mEq/L Chloride: 110mEq/L Bicarbonate 30mEq/L The anion gap (without using K) for this patient is:

10

A patient brought into the emergency room has the following laboratory results: sodium = 140mmol/L Glucose= 80mg/dL BUN = 6.0mg/dL Osmolality = 316 mOsm/Kg H2O The calculated osmolality on this patient using the weisberg formula is:

286

Caffeine is used in bilirubin assays to

Accelerate indirect bilirubin reactions

Unconjugated bilirubin calculated in the bloodstream is bound to:

Albumin

What reagent is used in the bilirubin method to shift the color reaction to a wavelength with less interference

Alkaline tartarate

How can urea be measured?

Ammonia ions generated hu urease reaction, Mass spectrometry, pH indicator

Hypernatremia commonly occurs in:

Burns & Excess sweating w/o water intake

Given the following lab results, what is the most likely cause of the patients BUN? BUN: 45mg/dL Creatinine: 1.8 mg/dL Uric Acid: 7mg/dL PH: 7.22 pCO2: 74.4 mm Hg PO2 32.8 mm Hg O2 sat.: 51.3%

CHF

You just received a blood specimen from the emergency room. According to the requisition, the patient had overdosed on an antacid medicine containing bromide salts. You have been asked to run a STAT set of electrolytes on the serum. Which electrolyte would most likely be falsely elevated.?

CHLORIDE

In terms of drug therapies, what is most likely to interfere with jaffe chemistry for measuring creatinine

Cephalosporins

Anemia, hyperphosphatemia, hypocalcemia, and ongoing azotemia are most indicative of

Chronic renal failure

The method of choice for measurement of serum ionized calcium is

Cresolphthalein complexone

The sweat test for chloride is used as a screening test for:

Cystic Fibrosis

Fanconi syndrome is a disease of

Defective proximal tubules

A plasma specimen from a hospital patient is analyzed on an osmometer and reported as 400mOsm/Kg. What is the most likely effect on this patient's water distribution in the tissues?

Dehydration

Hyperkalemia occurs in

Dehydration, diabetes insipidus, diuretic therapy, primary adrenal insufficiency

A 21-year-old man with nausea, vomiting, and jaundice has the following laboratory findings: Total serum bilirubin: 8.5mg/dL Direct serum bilirubin: 6.1 mg/dL Urine urobilinogen: increased Urine bilirubin: Positive AST: 200 U/L ALP 160 U/L What disease state are these findings consistent with?

Early hepatitis

A patient brought into the emergency room has the following laboratory results: sodium = 140mmol/L Glucose= 80mg/dL BUN = 6.0mg/dL Osmolality = 316 mOsm/Kg H2O What does the "osmolal gap" suggest?

Ethanol intoxication

When blood is drawn into a vacutainer tube and allowed to clot, if serum is not separated from the cells, the serum potassium will send to decrease and the serum sodium will tend to increase

False

Monitoring of _ in patients on chemotherapy due to leukemia, lymphoma, or multiple myeloma is necessary to avoid nephrotoxicity

GFR

The only acceptable anticoagulant for a calcium determination is:

Heparin

Describe the best and correspondence collection and handling conditions for a blood ammonia measurement

Heparin, put on ice, refrigerated centrifuge, remove plasma, freeze if testing is delayed

One cause for a DECREASED anion gap is

Hypoalbuminemia

Azotemia refers to

Increase in blood urea

Why is serum bilirubin unstable

Light sensitivity

The major causes of decreased plasma urea concentration include:

Low protein intake Severe Liver disease

Are serum urea levels less affected by diet and metabolism than are serum creatinine levels?

No

Is the main functions of antidiuretic hormone to increase the reabsorption of sodium and increase the secretions of potassium

No

The combination of non-fasting and hemolyzed serum for a patient for phosphorus determination could possibly caused results to be

Normal

What conditions are associated with a low serum magnesium determination

Pancreatitis

Which electrolytes would be increased in the serum if a blood specimen was hemolyzed:

Potassium and phosphate

Interferences with coupled colorimetric methods for uric acid in serum can be minimized by the preparation of:

Potassiumferricyanide

When elevated amoints of bilirubin are presented to the liver with elevated serum unconjugated bilirubin, what type of jaundice occurs?

Prehepatic

What is the first feature of nephrotic syndrome that results in manifestation of the other four classic signs

Proteinuria

Production of bilirubin occurs in the _ and conjugation of bilirubin to glucuronide occurs in the _

RES; Liver

What is the purpose of the 8-hydroxyquinolone in the cresolphthalein determination for calcium

Reduce Mg interference

A low plasma osmolality and low sodium would be expected in a patient with

SIADH

What would you reply if a physician calls the laboratory and asks what lab tests should be requested to assess the acid-base balance function of a patients renal system

Serum bicarbonate, and blood pH

The most widely used method for bilirubin analysis uses two reagents _ and _ in the diazo reaction

Sulfanic acid; sodium nitrite

Describe everything about Urea:

Synthesized from CO2 and ammonia

In proximal renal tubule acidosis can tubular cells maintain a pH gradient and urine remains above pH 6.5

True

The enzyme that conjugates bilirubin in the hepatocyte is:

UDP-Gluconyl transferase

A toxic condition involving a very high serum level of urea and accompanied by failure of the three main functions of the renal System is referred to as

Uremia

Bilirubin is reduced to_ in the small intestine

Urobilinogen

The membrane substance used in the pot assign ion-selective electrode is

Valinomycin

The abbreviated modification of diet in renal disease(MDRD) equations considers

Variations in reporting of creatinine clearance and GFR

Does the enzymatic method for creatinine on the vitros analyzer use the reagent creatinine amidohydrolase

Yes

Doesn't enzymatic urea methods begin with hydrolysis of urease?

Yes

Is chloride the major extracellular anion in plasma?

Yes

May serum uric acid levels be elevated in patients undergoing cancer chemotherapy?

Yes