Lab CE Chemistry

Ferritin

Gives the best overall picture of a patient's iron stores

molarity x molecular wi=eight x volume = grams

Gram per solution formula

LDL = total-HDL - VLDL (triglyceride/5)

LDL cholesterol formula

Albumin

Protein has the fastest electrophoretic mobility

Gamma-glutamyl transpeptidase (GGT)

enzyme is the most sensitive indicator of long term liver damage associated with alcohol ingestion:

a 70 year old type 2 diabetic patient

following patient is most at risk for hyperosmolar nonketonic coma

acetaminophen metabolisim

largely metabolized in the liver to glucuronide and sulfonate conjugates; a small amount is metabolized via cytochrome oxidase to a reactive benzoquinonemine intermidiate; the benzoquinoneimine intermidiate becomes toxic to the liver once tissue glutathione becomes depleted

0.04 to 0.08 pH units

pH alterations of normal blood in a closed vessel standing at 37 degrees Celsius for 1 hour is approximately:

glucagon insulin pancreatic polypeptide

produced primarily in the pancreatic islets

serum protein electrophoresis nephelometry colorimetric spectrophotometry

quantitative methods for the determination of albumin

glucuronic acid

substance is conjugated with the "indirect" bilirubin to form "direct" bilirubin

Troponin

the MOST specific biochemical marker of myocardial infarction

it rises much sooner after a myocardial infarction than CK-MB

the following statements is FALSE regarding troponin as a marker of myocardial infarction (MI)?

lithium

used primarily for the treatment of manic-depression

300 mg/dL

A serum sample is received in the clinical chemistry dept of the lab. The first time the sample is assayed, the result is 600 mg/dL. To verify this result (following the hospital's policy). the tech makes 2mL of a 1:2 dilution of the sample. I only 1 mL of this sample is analyzed, what would the result be? Assume that the original 600 mg/dL value was accurate and that the instrument did not automatically perform a dilution calculation

hemolysis of the RBC's

A specimen for potassium was drawn in a tube withouts anticoagulant at 6 AM during a tramatic patient stick. The results were 6.0 mmol/L. Why are the results elevated?

Thyroxine

Circulating organic iodine is found primarily in the form of:

antibody will react equally with labeled and unlabled antigen

Correct when describing the principles of competitive radioimmunoassay procedures

muscle mass

Creatinine excretion correlates best with which parameter

gestational diabetes

A 29 year old pregnant woman had an out patient glucose tolerance test. The patient was given a 100 gram dose of glucose and the following values were obtained: fasting = 110 mg/dL 1 hr = 188 mg/dL 2 hr = 175 mg/dL 3 hr = 143 mg/dL The MOST likely interpretation of this glucose tolerance would be:

it can be detected even if it is present in LOW concentration in the peripheral blood

A characteristic of a good cardiac biomarker is

A higher

A cytochrome P450 2D6 (CYP2D6) ultrarapid metabolizer (UM) would require _______________ dose of an active drug (non-prodrug) that is metabolized by CYP2D6 than a CYP2D6 extensive metabolizer (EM)

criteria for NHLBI and AHA

A large waistline. In women, ≥35 in. (88 cm); in men, ≥40 in. (102 cm) High triglyceride level, ≥150 mg/dL High fasting blood glucose, ≥100 mg/dL Low HDL cholesterol. In women, <50 mg/dL; in men, <40 mg/dL High blood pressure, that is, ≥130/85 mm Hg

potassium

A liquid ion-exchange membrane electrode using the antibiotic valinomycin is most selective for:

Fungal meningitis Amebic meningitis Trichinosis meningitis

A low CSF glucose level is associated with

Increased vasocontrition

A major action of angiotensin 2 is

281 mosmol/kg

A patient has the following serum results: Na = 130 mEq/L K = 4.9 mEq/L Cl = 107 mEq/L Glucose = 300 mg/dL BUN = 18 mg/dL Creatinine = 1.1 mg/dL Which osmolality result is consistent with these results?

Obstructive jaundice

A patient presents with the following test results: Total bilirubin: 3.0 mg/dL Conjugated Bilirubin: 1.2 mg/dL Urine urobilinogen: decreased Stool color: clay colored The MOST [robable cause is:

glucose

Following serum constituents is unstable if a blood specimen is left standing at room temp for eight hours before centrifugation and processing

free ionized calcium

Form of calcium is biologically active

elevated serum calcium and decreased serum phosphorus

Found in a primary hyperparathyroidism case

Bicarbonate ions

carbondioxide is predominately found in the form of:

Immunoelectrophoresis

Method may be employed to definitively identify Bence-Jones proteins

Immunoassay

Most common technique that is used by clinical labs for therapeutic drug monitoring

It is not a chronologically used drug so toxicity is less likely; the half life is short, and the drug is cleared quickly; it has a wide therapeutic window

Albuterol is a fast-acting broncodilator used actively during asthma attacks. Explains why TDM for albuterol is not available or common

Potassium Sodium chloride Carbon dioxide (in form of bicarbonate)

An electrolyte panel (chem-4) consists of:

Magnesium

An important metallicc activator of alkaline phosphatase and creatinine kinase is:

Heparin

Anticoagulant will produce a significant effect on calcium levels in plasma

Yes, he meets the NHLBI and AHA criteria for metabolic syndrome

Below are the laboratory results on a 20-year-old overweight male. His waist circumference is 41 inches and blood pressure is 105/70. Fasting Blood Glucose: 130 mg/dL Triglycerides: 190 mg/dL HDL: 50 mg/dL The National Heart, Lung, and Blood Institute (NHLBI) and American Heart Association (AHA) have created a set of parameters to define the presence of metabolic syndrome. Does this patient meet the criteria for metabolic syndrome diagnosis?

specificity

C-reactive protein (CRP) is often used as a marker of inflammation. However, it has a low

220 mg/dL

Calculate LDL cholesterol concentration if total choleterol is 280 mg/dL, triglyceride is 100 mg/dL, and the HDL cholesterol is 40.0 mg/dL

gastrin

Cells primarily produced in the gastrointestional tract and it stimulates the secretion os gastric acid and gastric mucosal growth

Stray light

Deviations from Beer's Law are caused by:

Thyroxine (T4) Cortisol Glucagon

Hormones that stimulate gluconeogenesis, the formation of glucose from noncarbohydrate sources such as amino acids, glycerol, and fatty acids

pregnancy

Human chorionic gonadatropin (hCG) is used in the determination of:

leave it at room temp

If CSF tubes numbered #1, #2 and #3 CANNOT be analyzed within one hour, the correct procedure for the microbiology sample tube is to:

Decreased T4 Increased TSH Increased TRH stimulation

In patients with suspected primary hypothyroidism associated with Hashimoto's thyroiditis, one would expect the folowing lab results:

increased

Patients who develop severe sepsis or septic shock commonly have __________ plasma lactate values

increased pCO2

Respiratory acidosis is associated with:

creatinine

Serum constitutes is increased following strenuous exercise

5 fractions

Serum proteins can be seperated by cellulose acetate electrophoresis into how many basic fractions

X linked agammaglobinemia

Slump in the entire gamma region. Suggests an immunodeficiency such as:

caffeine-benzoate

Substance used in the Jendrassik-Grof method to accelerate the reaction of unconjugated bilirubin with the diazo reagent

169 mg/dL

The formula for conversion of hemoglobin A1C (HbA1c) to glucose is mg/dL = 28.7 x A1C) - 46.7. The HbA1C measured on a patient is reported as 7.5%. What would be reported as the estimated average glucose (eAG) for this % A1C (rounded to the nearest whole number)

hemolysis

The most likely cause of an elevated serum potassium level in an apparently normal individual is:

all non-diabetic pregnant women should be screened at 24 to 28 weeks gestation

True about diagnosing diabetes

the person has an increased probability of developing cardiovascular disease

What conclusion can be made if a person has cardiovascular risk marker that is abnormal

Urea

What is the largest constituent of plasma nonprotein nitrogen

78.4 g

What wieght of H2SO4 is contained in 200 mL of a 4 molar H2SO4 solution? (Atomic weight H=1; S=32; O=16)

A 2 hr glucose level is less than 140 mg/dL

When evaluaating a 2 hr glucose tolerance test report performed on a pregnant woman, what result is considered NORMAL?

a drug that has a narrow therapeutic window

Which of the following drug examples would be a good candidate for therapeutic drug monitoring (TDM)?

Magnesium

Which of the following would NOT be considered a normal part of a routine electrolyte panel (profile)

A glycated protein that is an index of carbohydrate management over 2 - 3 months

Which one of the following statements best describes hemoglobin A1c (HbA1c)?

Gastrin

Zollinger-Ellison syndrome is characterized by a large (usually 20-fold) elevation of:

Heparin

additive should be used for the collection of a sample for blood gas analysis

Leptin

adipocyte product is an important messenger in metabolism, signaling the hypothalamus that there are changes in fat stores?

B-type natriuretic peptide (BNP)

assay is performed to diagnose congestive heart failure (CHF)

Hepatocellular Carcinoma Viral Hepatitis Testicular tumors

associated with an increased level of alpha-fetoprotein