Chapter 33 Blood Chemistry and Immunology

19. Describe the procedure for an oral glucose tolerance test.

blood specimen is drawn for an FBG. if it indicates hyperglycemia the physician is notified. after the FBG the patient is instructed to drink a solution containing 75g of glucose within a 5 minute time frame. at regular intervals a blood specimen is taken to determine the patients ability to handle increased amount of glucose

41. What conditions result in elevated blood triglycerides?

obesity, type 2 diabetes, physical inactivity, excessive alcohol consumption, smoking, hypothyroidism, kidney disease, and liver disease

2. What is the purpose of quality control?

to ensure the test results are reliable and valid

12. List two reasons for performing a fasting blood glucose test.

to evaluate patients diagnosed with diabetes on their progress and regulate treatment, and on other patients as a routine screening test to detect prediabetes and diabetes

1. Serum is required for most blood chemistry tests.

true

10. Symptoms of infectious mononucleosis include severe fatigue, fever, and sore throat.

true

2. Insulin is required for normal use of glucose in the body.

true

3. An abnormally low level of glucose in the body is known as hypoglycemia.

true

3. The oral glucose tolerance test is used to assist in the diagnosis of diabetes mellitus.

true

4. The hemoglobin A1c test measures the average amount of blood glucose over a 3-month period.

true

6. The primary use of the cholesterol test is to screen for the presence of coronary artery disease.

true

7. LDL picks up cholesterol from ingested fats and the liver and carries it to the cells.

true

8. An antibody is a substance that is capable of combining with an antigen.

true

8. The triglyceride test requires that the patient not eat or drink for 12 hours before the test.

true

9. The RPR test is a screening test for syphilis.

true

17. What is the purpose of an oral glucose tolerance test?

used to screen for diabetes and to monitor the effects of insulin dosage in patients with diabetes

26. What information is provided by a hemoglobin A1C test?

valuable information for determining whether a diabetic patient's blood glucose level is under control. supplies the physician with an assesment of the average amount of glucose in the blood over a 3 month period

4. At a minimum, when should a calibration check be performed on a blood chemistry analyzer?

when a new lot number of testing reagents is put into use

31. What is cholesterol?

white, waxy, fatlike substance that is essential for nomal functioning of the body

b. Prediabetes:

100-125mg/dL

c. At bedtime:

100-140

b. One to 2 hours after meals:

100-180

c. Diabetes:

126 mg/dL or above

b. Borderline high:

150-199mg/dL

b. Two-hour postprandial blood glucose:

2-hour PPBG

c. High:

200-499mg/dL

c. High cholesterol level:

240mg/dL and greater

22. What is the ideal insulin testing schedule for SMBG?

4 times a day-in the morning, before lunch, before dinner, and at bedtime

27. What is the normal A1C range for an individual without diabetes?

4-6%

d. Very high:

500mg/dL or higher

28. What is the recommended A1C percentage for an individual with diabetes?

7%

a. Normal:

70-99mg/dL

a. Before meals:

80-120

c. Oral glucose tolerance test:

OGTT

a. Fasting blood glucose:

FBG

37. At what level is HDL cholesterol considered a risk factor for coronary artery disease?

Female-less than 50mg/dL, Male-less than 40mg/dL

1. What type of specimen is required for most blood chemistry tests?

Serum

16. Describe the procedure for performing a 2-hour postprandial blood glucose test.

a blood specimen is collected from the patient exactly 2 hours after consumption of the meal or glucose solution

32. List the two main sources of cholesterol in the blood.

liver, an individuals diet

LDL

an excess amount of it in the blood can cause plaque to build up on the arterial walls resulting in atherosclerosis

c. C-reactive protein:

assist in diagnosing or charting the progress of rheumatoid arthritis, acute rheumatic fever, widespread malignancy, and bacterial infections

b. Borderline cholesterol level:

between 200-239mg/dL

8. What is the function of glucose in the body?

chief source of energy for the body

35. What does a total cholesterol test measure?

combined measurement of LDL cholesterol and HDL cholesterol in the blood

20. Define hypoglycemia, and list three conditions that may cause it to occur.

condition in which the glucose in the blood is abnormally low (FBG below 70mg/dL) overdose of insulin, addison disease, bacterial sepsis, carcinoma of pancreas, hepatic necrosis, or hpothyroidism

13. What is prediabetes?

conditon in which glucose levels are the higher than normal but not high enough to be classified as diabetes

18. What type of patient preparation is required for an oral glucose tolerance test?

consume a high carbohydrate diet, consisting of 150g of carbohydrates per day, for 3 days before the OGTT. the patient must be in a fasting state when the test begins.

24. List three advantages of blood glucose monitoring at home.

convenience of testing, greater involvement in self-management decisions, reliable decision making regarding insulin dosage, and delay in or prevention of long-term complications

47. What are the symptoms of infectious mononucleosis?

mental and physical fatigue, fever, sore throat, severe weakness, headache,and swollen lymph nodes

b. Antistreptolysin test:

detect ASO antibodies in the serum

a. Rheumatoid factor:

detects the presence of RF antibodies and assists in the diagnosis of rheumatoid arthritis

6. List three reasons why a control may not produce expected results.

deterioration of testing components as a result of expiration or improper storage; improper environmental testing conditions; errors in the technique used to perform the procedure

d. ABO and Rh blood typing:

determine an individual's ABO and Rh blood type

30. When should the calibration (coding) procedure be performed on a glucose meter?

each time a new container of test strips is opened

9. Explain the function of insulin in the body.

enables glucose to enter the body's cells and be converted to energy, also needed for the proper storage of glycogen in liver and muscle cells

1. The function of glucose in the body is to build and repair tissue.

false

2. The normal range for a fasting blood glucose level is 120 to 160 mg/dL.

false

4. Before meals, it is recommended that the blood glucose level for a diabetic patient be 60 to 80 mg/dL.

false

5. Most of the cholesterol found in the blood comes from the intake of dietary cholesterol.

false

5. The recommended hemoglobin A1c level for a patient with diabetes is 4% to 6%.

false

7. An HDL cholesterol level greater than 50 mg/dL is a risk factor for coronary artery disease.

false

9. Mononucleosis is transmitted through coughing and sneezing.

false

10. The varicella virus causes infectious mononucleosis.

false Epstein-bar

6. The buildup of plaque (due to high cholesterol) on the walls of arteries is known as thrombophlebitis.

false atherosclerosis

39. What type of patient preparation is required for a triglyceride test?

fast for at least 12 hours before collection of the blood specimen

15. What type of patient preparation is required for a 2-hour postprandial blood glucose test?

fast, beginning at midnight preceding the test and continuing until breakfast, for breakfast the patient must consume a prescribed meal that contains 100g of carbohydrate, which consists of orange juice, cereal with sugar, toast, and milk. alternative is a test-load glucose solution

33. What is atherosclerosis, and why is it a health risk?

fate deposits, or plaque, to build up on the walls of the arteries. the arteries becomes more occluded which eventually could lead to a heart attack

29. What are the storage requirements for blood glucose reagent test strips?

in a cool dry area at room temperature with the cap tightly closed

42. What is the purpose of performing a BUN?

kidney function test, see the level of urea in the blood

a. Normal:

less than 150mg/dL

a. Desirable cholesterol level:

less than 200mg/dL

7. When running controls on a blood chemistry analyzer, what should be done if the controls do not perform as expected?

patient testing should not be conducted until the problem has been identified and resolved

23. What type of damage can occur to the body from prolonged high glucose levels in blood?

progressive damage to the body organs, resulting in blindness, kidney disease, nerve damage, and circulation problems

44. List three examples of antigens.

protein, glycoprotein, complex, polysaccharides, or nucleic acid

21. Why is it important for an insulin-dependent diabetic to perform self monitoring of blood glucose (SMBG)?

provides diabetic patients with feedback for maintaining normal blood glucose levels, also assists them in anticipating and treating day-to-day or hour-to-hour fluctuations in glucose levels brought on by food, exercise, stress, and infection

HDL

removes excess cholesterol from the cells and carries it to the liver to be excreted

46. How is infectious mononucleosis transmitted?

saliva by direct oral contact

43. What is the definition of immunology?

scientific study of antigen and antibody reactions

38. What is the primary use of the cholesterol test?

screen for the presence of high blood cholesterol related to coronary artery disease

11. What type of patient preparation is required for a fasting blood glucose test?

should not have anything to eat or drink except water for 12 hours preceding the test

3. What is the purpose of calibrating a blood chemistry analyzer?

to check the precision of the blood chemistry analyzer

5. What is the purpose of running a control on a blood chemistry analyzer?

to determine if the testing reagents are performing properly and to detect any errors in technique by the individual performing the test