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