Clinical Chemistry
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62 terms
Terms | Definitions |
|---|---|
 Normal value for pKa | 6.1 |
| Normal value for pCO2 | 40 |
| Normal value for HCO3 | 25 |
| normal ratio of bicarb to PaCO2 | 20:1 |
| metabolic causes of methemoglobinemia | Children younger than 4 months exposed to various environmental agents Cytochrome b5 reductase deficiency G6PD deficiency Hemoglobin M disease Pyruvate kinase deficiency |
| drugs causing methemoglobinemia | Local anesthetic agents, especially prilocaine Oral pain relief gels, liquids and lozenges containing benzocaine Amyl nitrite, chloroquine, dapsone, nitrates, nitrites, nitroglycerin, nitroprusside, phenacetin, phenazopyridine, primaquine, quinones and sulfonamides |
| % of methemoglobin that results in death | 70% |
| hemoglobin bound to carbon monoxide | carboxyhemoglobin |
| co-oximeter measures | oxyhemoglobin deoxyhemoglobin methemoglobin carboxyhemoglobin |
| levels of 2,3-DPG are _______ in transfused cells, leading to misleading | low |
| HCO3 changes in acute resp acidosis | HCO3 increases 1-1.2 for every 10 mm increase PaCO2 in acute resp acidosis |
| HCO3 changes in chronic resp acidosis | HCO3 increases 3-4 for every 10 mm increase PaCO2 in chronic resp acidosis |
| HCO3 changes in acute resp alkalosis | HCO3 decreases 2.5 for every 10 mm decrease in PaCO2 in acute resp alkalosis |
| HCO3 changes in chronic resp alkalosis | HCO3 decreases 5 for every 10 mm decrease in PaCO2 in chronic resp alkalosis |
| HCO3 changes in metabolic acidosis | 10 HCO3 decrease produces 10 mm PaCO2 decrease |
| HCO3 changes in metabolic alkylosis | 14 HCO3 increase produces 10 mm PaCO2 increase |
| anion gap | Na - (Cl + HC03) |
| normal anion gap | <12 |
| causes of elevated anion gap | Methanol Uremia DKA Paraldehyde Lactic acidosis Ethylene Glycol Salicylate |
| Increased osmolal gap with met acidosis | methanol propylene glycol diethlylene glycol paraldehyde ethanol |
| Increased osmolal gap without met acidosis | isopropyl alcohol glycerol sorbitol mannitol acetone ethanol |
| respiratory acidosis | pCO2 > 44 (usually) |
| metabolic acidosis | HCO3 <25 (usually) |
| absorbance of bilirubin in amniotic fluid | 450 nm |
| hCG has an alpha chain identical to... | TSH, FSH, and LH |
| false positive hCT can be due to... | heterophile anitbody |
| detectable hCG time and level | 6-8 days, 10-50 mIU/mL |
| hCG doubles until... | 1200 U or 10 wks |
| hCG doubles every three days | 1200-6000 |
| hCG plateaus at... | end of 1st trimester or 100,000 |
| Are higher hCG levels higher in complete or incomplete moles? | Complete |
| Risk of malignancy for partial moles | < 5% |
| Risk of malignancy for complete moles | 20% |
| set up for ectopic pregnancy | fertility enhancing drugs. |
| arterial blood exposed to air does what | CO2 decreases 02 increases pH becomes alkaline |
| which anticoagulant does not alter the pH of the blood | Heparin |
| Left shift in hemoglobin dissociation curve | alkalosis hypothermia hemoglobinopathies (Hgb Chesapeake) |
| Right shift in hemoglobin dissociation curve | lowers affinity for 02 by hgb 2,3-DPG (increased) increased body temp acidosis (decreased pH) hypercapnia hemoglobinopathies (Hgb Kansas) |
| metabolic acidosis with severe hypokalemia and chronic alkaline urine | renal tubular acidosis - intrinsic defect prevents bicarb reabsorption - so alkaline urine instead of acidic. potassium goes with the bicarb. |
| excess aldosterone does what to bicarb? | net acid excretion |
| low parathyroid hormone does what to bicarb? | increased bicarb resorption |
| most common cause of hypernatremia | dehydration |
| too rapid correction of hyponatremia | central pontine myelinolysis |
| pseudohyponatremia (seru osmolarity > 280) may result from | hyperglycemia hyperlipidemia hyperproteinemia |
| drugs that cause hyponatremia | desmopressin, SSRI's and TCA's (also ecstasy) |
| correction of _______ results in a hypokalemia unless supplementation is given | DKA |
| all cases of acidosis are associated with hyperkalemia with the exception of... | renal tubular acidosis types I and II |
| action of parathyroid hormone | increased calcium decreased phosphate ****(increased excretion) increased chloride |
| primary hypoparathyroidism can be determined by low... | phosphate (secondary and tertiary have increased phosphate) |
| MEN I | parathyroid adenoma pituitary adenoma pancreatic islet cell tumor |
| MEN 2A | parathyroid adenoma pheochromocytoma medullary thyroid carcinoma |
| MEN I is involved with ____ of sporadic parathyroid adenomas | 25% |
| Secondary hyperparathyroidism is due to | peripheral resistance to PTH - hypocalcemia |
| Tertiary hyperparathyroidism is due to | post-renal transplants (the parathyroids become autonomous and are essentially primary hyperparathyroid |
| increased cAMP in presence of normal PTH | humoral hypercalcemia of malignancy |
| hypervitaminosis D increases renal reabsorption of ... | calcium and phosphate (potential calciphylaxis) |
| which forms of PTH have biologic activity | intact PTH N-terminal PTH |
| acidosis ________ the proportion of free calcium | increases (hence must be obtained from artery) |
| low protein calcium correction | 0.8 mg/dL Ca per 1 g/dL protein lost |
| persistent hypomagnesemia leads to ... | decreased PTH secretion |
| symptoms of hypocalcemia | muscle spasms, hyper-reflexia, paresthesias, lengthening of QT interval |
| symptoms of hypercalcemia | laryngeal spasm, tetany, and respiratory arrest |
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