Final Exam for Clinical Chemistry (Quiz 6,7 and 8)

cholecystokinin function

Stimulates pancreatic enzyme secretion, gallbladder contraction, stomach & pylorus contraction, and intestinal motility

gastrin function

Stimulates stomach acid secretion, gastric mobility, and gastric mucosal growth

secretin function

Stimulates the secretion of gastric pepsin and pancreatic secretion of; water, proenzymes, anions, cations, & hormones

Bacterial Overgrowth

associated with structural or motility disorders of the small intestine and may lead to bile salt or vitamin B12 deficiencies

The following laboratory results most likely indicate which of the following conditions? Glucose: 47 LC

insulinoma

CNS Depressant example

Ethanol

Which of the following are mainly administered orally or a person is mainly exposed to the compound through oral ingestion? Ethanol Organophosphates Lead Cocaine Carbon monoxide Acetaminophen

Ethanol Organophosphates Lead Acetiminophen

Please provide the most lkely diagnosis for the following laboratory results.

Incorrect patient

Place the steps of a sandwich immunoassay, for Troponin-I, into the correct order with 1 being the first step and being the last step. Specimen troponin antigen (cTn-I Ag) binds to reagent capture antibody (anti-human cTn-I Ab) Conjugate antibody (anti-human cTn-I Ab) binds to specimen troponin antigen (cTn-I Ag) Fluorescent label produces light in the presence of horseradish peroxidase (HRP) Light production is directly proportional to the amount of cTn-I in the patient's serum

1. Specimen troponin antigen (cTn-I Ag) binds to reagent capture antibody (anti-human cTn-I Ab) 2. Conjugate antibody (anti-human cTn-I Ab) binds to specimen troponin antigen (cTn-I Ag) 3. Fluorescent label produces light in the presence of horseradish peroxidase (HRP) 4. Light production is directly proportional to the amount of cTn-I in the patient's serum

Place the following steps of cardiac muscle conrtraction in order with 1 being the first and 5 being the last step. Myosin head rotates towards the center of the muscle fiber's sarcomere (power stroke) Muscle contraction Troponin Complex moves to expose actin binding sites Myosin head splits ATP and binds to actin Troponin C binds Calcium

1. Troponin C binds Calcium 2. Troponin Complex moves to expose actin binding sites 3. Myosin head splits ATP and binds to actin 4. Myosin head rotates towards the center of the muscle fiber's sarcomere (power stroke) 5. Muscle contraction

Describe the process of digestion by placing the following events in order from the first step (1) to the last (4). Gastrin stimulates the stomach parietal cells to secrete HCL Gastrin, Pepsin, and Gastric acid secretion is inhibited and the pancreas is stimulated to release Insulin The presence of glucose and fat in the duodenum causes the secretion of Gastric Inhibitory Polypeptide (GIP) from the duodenal mucosa cells Food in the stomach causes the secretion of the hormone Gastrin from the gastrointestinal mucosa cells (as a response to physical stress or high pH)

1. food in the stomach causes the secretion of the hormone Gastrin from the gastrointestinal mucosa cells (as a response to physical stress or high pH) 2. Gastrin stimulates the stomach parietal cells to secrete HCL 3. the presence of glucose and fat in the duodenum causes the secretion of Gastric Inhibitory Polypeptide (GIP) from the duodenal mucosa cells 4. Gastrin, Pepsin, and Gastric acid secretion is inhibited and the pancreas is stimulated to release Insulin

A patient with the following results might also show abnormal levels of which of the following analytes? Please select all that apply.

CRP BNP AST LDL

Fecal fat is increased in which of the following conditions? Please select all that apply. Acute Pancreatitis Hepatitis Cystic Fibrosis Crohn's Disease Diabetes Mellitus

Acute pancreatitis Cystic fibrosis Crohn's disease

CNS Stimulant example

Amphetamines

What is the most likely diagnosis of a patient with the following results? The patient has/is experienced/experiencing:

An AMI couple of days ago prior to results

Which of the following does not influence the absorption of a drug? pH Tissue volume Availability of cytochrome P450 (CYP) Cardiac output

Availability of cytochrome P450 (CYP)

Which of the following classes of compounds may be included in drugs-of-abuse (DAU) screening? Barbiturates Sterols Alcohols Prostaglandins

Barbiturates

Immunosuppressant example

Cyclosporine

Which of the following are considered accurate regarding biotransformation of a drug? Please select all that apply. the kidney performs most of the drug metabolism in the body Cytochrome P450 (CYP) functions as the terminal oxidase protein in the liver Methyl, Hydroxyl, or Amino groups may be added to a drug metabolite to make it more polar some drugs get excreted in their original (parent) form

Cytochrome P450 (CYP) functions as the terminal oxidase protein in the liver Methyl, Hydroxyl, or Amino groups may be added to a drug metabolite to make it more polar some drugs get excreted in their original (parent) form

Which of the following biomarkers is thought to contribute to the pathogenesis of the inflammatory response and atherosclerosis? BNP PAPP-A Cytokines, especially IL-6 and IL-8 cTnT

Cytokines, especially IL-6 and IL-8

Which of the following is an example of a definitive or reference method that is suitable for confirming positive DAU? Immunoassays HPLC Electrophoresis GCMS

GCMS

Antibiotic example

Gentamicin

gastric inhibitory polypeptide (GIP) function

Inhibits the secretion of gastric acid, pepsin, and gastrin Reduces gastric & intestinal motility

BNP is elevated in the blood of patients with which of the following? Please select all that apply. Left-sided heart failure Brain tumors Congestive Heart Failure (CHF) Liver disease

Left-sided heart failure Congestive Heart Failure (CHF)

Antidepressant example

Lithium

Which of the following is considered a common mode of exposure to lead? plants glass thermometers paint

Paint

Hallucinogen example

Phenycyclidine (PCP)

Anti-epileptic example

Phenytoin (Dilantin)

Most drugs are excreted in which form? Polar Nonhydrated Nonpolar As the parent compound

Polar

If there is a blockage in the aortic arch (blood vessel where blood leaves the heart to circulate through the rest of the body), due to plaque build-up, what portion of the electrocardiogram will be the most abnormal? Please select all that apply. U wave ST wave QRS wave P wave

ST wave and QRS wave

Analgesic example

Salicylate

Which of the following is considered true about drug metabolism? a steady state of a therapeutic drug is demonstrated by zero order kinetics on the Michaelis-Menten plot half life of a drug is the length of time a drug is completely eliminated from the blood toxicity of a drug describes the level of all forms of the drug in the blood therapeutic drug levels are directly measured using urine

a steady state of a therapeutic drug is demonstrated by zero order kinetics on the Michaelis-Menten plot

Please interpret the provided laboratory results and give a possible diagnosis.

acute pancreatitis triggered by alcohol

Which is considered an ideal cardiac biomarker? LD cTn-I Myoglobin CK-MB

cTn-I

Which of the following is considered a Primary cause of Acute Coronary Syndrome (ACS)? Please select all that apply. coronary spasm plaque formation hypertension anemia

coronary spasm plaque formation

Peptic Ulcer

duodenal and gastric ulceration due to increased acid production and an infection with Helicobacter pylori

The main pancreatic duct joins the common bile duct from the liver and drains into the: duodenum colon gallbladder stomach

duodenum.

Zollinger-Ellison's syndrome (ZES) is associated with which of the following conditions? hyposecretion of IgA and IgM gastric hypersecretion overactive large bowel excessive loss of protein

gastric hypersecretion

Celiac Disease

gut derived T-cells and proinflammatory cytokines damage the epithelial cells in the presence of gluten proteins

Protein Losing Enteropathy

loss of significant amounts of serum proteins into the bowel lumen and into the feces

Which of the following are considered results which would aid a MLT in identifying an invalid drug screen specimen? Please select all that apply. taste pH creatinine level smell

pH creatinine level smell

Which of the following are true about the endocrine products of the pancreas?

they are hormones which help control a person's glucose levels they enter the portal vein and go to the liver

The pancreas performs both Endocrine and Exocrine functions. Please select all of the following which indicates the Exocrine function. somatostatin glucagon proinsulin trypsin cholesterol esterase lipase

trypsin cholesterol esterase lipase