ASCP MLS Chemistry practice
Secondary Hyperparathyroidism (vit D or renal)
Ca low, phos low, PTH increase, Vit D low
primary hyperparathyroidsim
Ca+ high, phos high in urine low in serum, PTH high, vit D high, Calcitonin high
Primary hypoparathyroidism
Ca+ low, phos low in urine high in serum, PTH low, Vit D low, Calcitonin Low
Parathyroid hormone
PTH increases calcium
Glycogenesis
Conversion of glucose to glycogen for storage
Proinflammatory state
Elevations of C-reactive protein (CRP). often associated with atherosclerosis, high levels of homocysteine.
hCG tumor marker
Embryonal, placenta, testicular, choriocarcinoma
Indirect LDL-c by Calculaation
Friedewald equation: LDL-c = [total cholesterol] - [HDL cholesterol -[triglyceride/5]] *not valid when TG > 400 mg/dl *TG/2.22 used when LDL-c expressed in mmol/L
anti-RNP antibody
Mixed connective tissue disease
Thyroid
T3, T4, calcitonin
Thyroid gland hormones
T3, T4, calcitonin
Anterior pituitary hormones
TSH
Hashimoto's Thyroiditis
TSH low, T4 N-low, Ab studies: Thyroid peroxidase Ab
Graves Disease
TSH low, T4 high, AB studies: Thyroid receptor Ab
CA-125 tumor marker
ovarian cancer
Lipase
pancreas, pancreatitis
deficiency in vitamin D
rickets
deficiency in vitamin C
scurvy
leptin
A hormone produced by adipose (fat) cells that acts as a satiety factor in regulating appetite.
Vanillylmandelic acid (VMA)
A metabolite of catecholamines epinephrine and norepinephrine. Found in urine and useful in tumor marker testing.
AST <3x URL, ALP >2x URL
Cholestatic Disease: obstruction jaundice
Alcoholic liver disease tests
GGT- recent alcohol intake. Elevation of AST making a D ratio greater than 1
AFP tumor marker
Hepatocellular carcinoma, testicular seminoma (germ cell tumor)
AST >3 URL, ALP <2x URL
Hepatocellular disease
GGT
Heptobiliary: liver; alcohol use
Prothrombotic state
High fibrinogen or plasminogen activator inhibitor-1 in the blood
hepatic jaundice causes
Jaundice resulting from conditions that affect the liver cells directly, such as viral or toxic hepatitis. Gilbert's, Crigler-Najjar
Post-hepatic cholestasis
Jaundiced patient, marked increase in ALP, conjugated bilirubin, and slight increase in alanin aminotransferase ALT
optimal cholesterol
LDL <100 mg/dl HDL <40 mg/dl
DNA complementary base pairs
Adenine (A) pairs with Thymine (T) Cytosine (C) pairs with Guanine (G)
speckeled pattern
occurs in teh presence of antibody to any extractable nuclear antigen devoid of DNA or histone. THe antibody is detected against the saline extractable nuclear antiges, anti-RNP and anti-Sm. A grainy pattern with numerous round dots of nuclear fluorescence, without staining of the nucleoli.
fully compensated metabolic acidosis
pH normal, with decrease in pCO2
Amylase
pancreas, salivary; pancreatitis
Cortisol
part of the negative feedback mechanism for ACTH, elevated levels stimulate the pituitary gland to inhibit the secretion of ACTH
Follicle stimulate hormone (FSH) is produced by
pituitary gland
WHO guidelines for AMI, patient must have 2 of the following:
positive cardiac marker, signs and systems, abnormal ECG, history
What analytes would be increased due to delay in centrifugation?
potassium, AST, ALT, creatinine etc because they are released over time from cells into serum or plasma
Epinephrine
promote glycogenolys, conversion to glucose increases plasma glucose
Glucagon
promote glycogenolys, conversion to glucose increases plasma glucose
apoprotein
protein component that is free from lipid
semi-automated and automated urine chemical reagent strip readers:
remove subjectivity allowing for better reproducibility
IL-6
responds to tissue injury
Semen analysis
sample should be delivered within 1 hour to ensure accurate testing results.
How does ion concentration in the urine relate to specific gravity?
specific gravity increases as ionic concentration increases
Adipocyte-secreted TNF-a
stimulates adipocytes to increase their release on non-esterified fatty acids and decrease apidonectin synthesis. Inhibits insulin activity, leading to insulin resistance. is increased in obesity causing an increased insulin resistance
Leptin
synthesized and released from adipose cells in response to adipose tissue changes. it reduces intracellular lipid levels in may types of body cells and thus improves insulin sensitivity, usually increased in obesity. is an appetite suppressant and inhibitor of fatty liver formation.
Transcriptase
used to synthesize RNA from DNA viral template
icterus
yellow serum containing bilirubin, aka jaundice
cholesterol test performed on EDTA is
4.7 % lower than serum samples
normal glucose
74-99 mg/dl
anion gap
= Na - (Cl + HCO3) Normal is between 8 and 12 = (Na + K) -(CL+ CO2)
deficiency in thiamine (vitamin B1)
Beriberi
Osmolality calculation
1.86 Na + (gluc/18) + (Bun/2.8) +9 or 2Na + (gluc/20)+ (BUN/3)
Impaired fasting glucose
100-125 mg/dL
Adult reference range for cholesterol?
140-200 mg/dL
Impaired glucose tolerance: pre diabetes
2 hour: 140-199 mg/dL
diabetes mellitus
2 or more: FPG >= 126 mg/dL, 2 hPP >= 200 mg/dl
Gestational Diabetes Mellitus (GDM)
2 or more: FPG>95 mg/dl, 1 hr >180 mg/dl, 2hr >155 mg/dl, 3hr >140 mg/dl
Osmolality
2 x Na + [Glucose (mg/dL0/20] + [BUN (mg/dL)/3]
Nucleolar pattern
(a)staining in the nucleoli of the interphase cell and (b) staining of the chromosomal area of the metaphase mitotic cell
Transthyretin
(prealbumin- migrates ahead of albumin in electrophoresis) major transport protein for thyroxine
Creatinine clearance calculation
(volume of plasma that is cleared of creatinine by the kidney per 1 unit of time) (urine creatinine conc x urine volume)/ Plasma creatinine conc. = mL/min or when given surface area use: U crea x Vol/P crea x 1.73/SA = mL/min/m2
CKMB
AMI
liver enzymes
AST, ALT, ALP, GGT, LDH
Caffeine-Benzoate
Substance Used in Jendrassik-Grof Method to Accelerate the Reaction of Unconjugated Bilirubin with the Diazo Reagent
A patient presents with an elevation of unconjugated bilirubin, normal serum alkaline phosphatase, normal liver enzymes, and no bilirubin in the urine
Increase rate of hemolysis
prehepatic jaundice causes
Result of excessive destruction of red blood cells Characteristic of hemolytic anemias or transfusion reactions
Sm antigen
SLE
Iron deficiency
Serum iron low, transferrin high, TIBC high, Ferritin low, % Sat of iron low
Anemia of chronic disease
Serum iron low, transferrin low, TIBC low, Ferritin high, % Sat of iron low
CRP
measured by sensitive methods correlates with AMI
CKMM
muscular disease
deficiency in vitamin A
night blindness
posthepatic jaundice causes
obstruction of bile flow - structural disorders of bile duct, cholelithiasis (gall stones), tumors, sterile gut,
Respiratory Acidosis
low pH, high HCo3, N pCO2
Adiponectin
a protective cytokine synthesized and secreted almost exclusively by the adipocytes. Is anti-inflammatory and increases insulin sensitivity. decreased in weight gain, obesity, and in those who are insulin resistant
Resistin
a protein produced by adipose cells that promotes inflammation and causes insulin resistance
Metabolic Acidosis
low pH, low HCO3, N pCO2
Adrenal cortex hormones
aldosterone, cortisol, androgens
Creatinine clearance tests
are utilized to estimate the glomerular function of the kidney. (volume of plasma that is cleared of creatinine by the kidney per 1 unit of time). 24 hour urine specimen
Type I hyperlipoproteinemia
associated with deficiencies of lipoprotein lipase. high chylomicrons
prehepatic jaundice results
bilirubin indirect- increased, direct normal, urine negative urobilinogen: stool increased, urine increased
post hepatic jaundice results
bilirubin: serum: indirect-increased, direct- increased, Urine-positive Urobilinogen: stool- decreased to negative, urine- decreased to negative
hepatic jaundice results
bilirubin: serum: indirect-increased, direct-increased, urine-postive (conjugated) urobilinogen: stool-variable, urine-increased
Transferrin
binds to and transports ferric iron
Haptoglobin
binds to free hemoglobin
Glycogenolysis
breakdown of glycogen to glucose for use as energy
CA15-3 tumor marker
breast cancer
homogeneous or diffused pattern
characterizes anti-DNA nucleoprotein antibodies (antibodies to nDNA, dsDNA, ssDNA, DNP or histones). smooth staining in the nuclei of the interphase cells and smooth staining in the chromosomal areas of the metaphase mitotic cells
CEA tumor marker
colon cancer
BNP
congestive heart failure
Diseases associated with increased ALP (alkaline phosphatase)
damaged liver cells, rapid bone growth, bone diseases, or a disease that affects how much calcium is in the blood (hyperparathyroidism) and vitamin D deficiency
Type II Hyperlipoproteinemia
decreased synthesis of LDL-R causing elevated serum LDL
urobilinogen in feces and urine tests
detected by dipstick method using Ehrlich's reagent *HPLC reference method
increased urine albumin excretion rate indicates
diabetic renal disease, diabetic nephropathy
Jendrassik-Grof method
diazotized sulfanilic acid + caffeine accelerator forms azobilirubin
Atherogenic dyslipidemia
elevated levels of triglycerides and small-dense lipoprotein and low levels of high-density lipoprotein cholesterol.
Taq polymerase
enzyme used for primer extension during the annealing of primers to target sequences in PCR
Reverse transcriptase
enzyme used to synthesize DNA from RNA viral template
adrenal medulla hormones
epinephrine and norepinephrine
Normal blood values for 100g OgTT for gestational diabetes are:
fasting: < 95mg/dL 1 hour: <180 mg/dL 2 hour: < 155mg/dL 3hour: < 140 mg/dL at least 2 of the patient's values must exceed the result limits for GDM
Glycolysis
first step in releasing the energy of glucose, in which a molecule of glucose is broken into two molecules of pyruvic acid
Gluconeogenesis
formation of glucose from noncarbohydrate sources
hormones of pancreatic islets
glucagon, insulin, pancreatic polypeptide, somatostatin
Storage pool iron
hemosiderin and ferritin
Type III hyperlipoproteinemia
high chylomicrons adn LDL
Respiratory Alkalosis
high pH, N HCO3, low pCO2
Metabolic Alkalosis
high pH, high HCO3, N pCO2 vomiting
Type IV hyperlipoproteinemia
high triglycerides and increased VLDL
Type V Hyperlipoproteinemia
increase in chylomicrons and VLDL
PSA, PAP tumor marker
Prostatic cancer
Thermocycler
instrument that alters the temperature and allows the denaturing and annealing steps of PCR
pernicious anemia refers to cobalamin deficiency that results from the lack of
intrinsic factor
Spectrophotometeric absorbance is reltaed to % transmittance in what way?
inversely and logarithmically A=log (1/T) or A=-log(T)
The migration rate of cellulose acetate
is the result of ionic charge on the proteins
Isoenzymes of alkaline phosphatase occur in
kidney, bone, intestines, liver and placenta
Insulin
mainly responsible for the entry of glucose into the cell for energy production. produced by the B-cells of islets of Langerhans in the pancreas
retinol-binding protein (RBP)
major transport protein for Vitamin A, useful in assessing changes in nutritional status
What analytes would be decreased due to delay in centrifugation?
glucose, ionized calcium, bicarbonate, folate, etc. due to cellular consumption
AST
hepatobiliary, bone: bone disorders
Increased Alpha-getoprotein in adults
hepatocellular carcinoma
ALT
hepatocellular, hepatitis, liver
Anti-Ro (SS-A) antibody
included in the non-histone protein (NhPs) and NhP-RNA complexes in systemic rheumatic diseases. The incidence of the antibody is 50% in cases of SLE.
hyperglycemia
increased blood glucose levels often associated with diabetes mellitus
Type I Diabetes Mellitus
increased serum ketones and urine ketones
Cortisol
increases gluconeogenesis, formation of glucose from noncarbohydrates, which raises plasma glucose concentration
Resistin
inflammatory cytokine that is increased in obesity. it increases resistance and enhances adhesion molecules present on endothelial cells. It is synthesized and secreted by macrophages and adipocytes
