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Chemistry II Final

Terms in this set (87)

What are the symptoms of primary hyperthyroidism?
•Weight and muscle loss
•Fatigue
•Heart intolerance (tachycardia and tremor)
•Nervousness
•Exophthalmos (eye bulging)
•Hair loss
What values are increased and decreased in primary hyperthyroidism?
Increase T3, T4 and Decrease TSH
What is the common cause of primary hyperthyroidism?
Graves disease
What are the symptoms of primary hypothyroidism?
•Fatigue
•Weight gain, decreased mental & physical output
•Cold intolerance and enlarged thyroid gland
What values are increased and decreased in primary hypothyroidism?
Decreased T3, T4 and Increased TSH
List three disease states of hypothyroidism?
•Cretinism-congenital (dwarfism)
•Myxedema
•Hashimoto's Thyroiditis
Aldosterone
maintains blood pressure, promotes sodium reabsorption, and potassium secretion
Hyperaldosteronism
Conn disease- elevated aldosterone,
Hypoaldosteronism
Addison disease- lower aldosterone
Cushing syndrome
elevated cortisol
Addison disease
lower cortisol
What disease does a deficiency in vitamin D cause?
Rickets and osteoporosis
What disease does a deficiency in vitamin C cause?
Scurvy, necrosis of gums, emotional disturbance
What antibiotic treats infection caused by gram positive bacteria, is administered by IV, and cause red man syndrome?
Vancomycin
Define trough level. When is it collected?
Lowest Level and should be drawn right before the dose is given
Define peak level. When is it collected?
Highest Level and collection time is oral one hour after, IV 30 minutes after
Usually 5-7 doses are required to achieve steady state. Define steady state.
Refers to the situation where the overall intake of a drug is fairly in dynamic equilibrium with its elimination
CA15-3
breast cancer
CA 19-9
colorectal cancer
PSA
prostate cancer
Name the major apolipoprotein found in HDL.
Apo-A-1
Name the major apolipoprotein found in LDL
Apo-B-100
Which one is associated with an increased risk of heart disease?
LDL/Apo-B-100
List two lipoproteins that reflect light and give serum a turbid appearance.
VLDL (very low density lipoprotein) & Chylomicrons
What is a desirable cholesterol level?
Desirable ≤ 200 mg/dL
Which lipoprotein is the bad cholesterol? The good cholesterol?
LDL "Bad Cholesterol" and HDL "Good Cholesterol"
List three Creatinine Kinase isoenzymes and their tissue specificity.
CK-MM (Muscle), CK-MB (Heart), and CK-BB (Brain)
In an AMI, CK rises
rises within 4-6 hrs, peaks at 12-24 hrs, returns to normal within 2-3 days.
In an AMI, LDH rises
rises within 8-12 hrs, peaks at 12-48 hrs, returns to normal within
7-10 days
Lactate Dehydrogenase Highest levels are seen in which disease states
Pernicious anemia & megablastic anemia
AST
• SGOT/GOT
• Increased in viral hepatitis
ALT
•SGPT/GPT
•Specific indicator for liver disease
ALP (elevated levels normal in kids)
• Increased hepatobiliary (obstructive) diseases
• Bone disorders
• Refrigeration decrease activity
GGT
• Increased in all hepatobiliary disorders
• Alcoholism
Amylase
• Pancreas, salivary glands
• Increased in acute pancreatitis
Lipase
• Pancreas
• Increased in acute pancreatitis
• More specific than amylase
What hormone increases glucose?
•Glucagon-Primary hormone responsible for increasing glucose
What hormone decreases glucose?
Insulin- only hormone that decrease blood glucose
Type I Diabetes Mellitus
Deficiency of insulin (insulinopenia)
Abrupt onset; most often seen with childhood and adolescence
Type I DM Symptoms
o Polydipsia (thirst)
o Polyuria-frequent urination
o Polyphagia-hunger
o Rapid weight loss, mental confusion, nausea, hyperventilation
What does the HbA1C determine and what tube is it collected in ?
•Glycation, reflects blood glucose levels for the past 2-3 months
•Collected in EDTA
•Normal range 4-6%
Metabolic Acidosis
↓ HCO3 ↓pH ↓PCO2
Metabolic Alkalosis
↑ HCO3 ↑pH ↑PCO2
Respiratory Acidosis
↓ pH ↑ PCO2 ↑ HCO3
Respiratory Alkalosis
↑pH ↓PCO2 ↑ HCO3
What tests are included in an Electrolyte Profile and how is it measured?
Sodium, Potassium, Chloride, Bicarbonate and measured by ISE
What is the formula for the anion gap?
(Na+ + K+) - (Cl- + HCO3-) = anion gap
If specimen is lipemic, utilize
ultracentrifugation
What is the correct order of draw for the following tubes?
blue, red,green,purple
What tube is used for lactic acid? Explain how it should be collected?
Sodium fluoride (gray top),release turniquet, collected on ice
What tube is used for ammonia? Explain how it should be collected?
Purple,collected on ice
Drug of Abuse Panel - medical use, random urine, centrifuged
•Amphetamines
•Barbiturates
•Benzodiazepines
•Cocaine
•Methadone
•Opiates
•PCP
•THC
How many amino acids is each protein made of? What is significant about the R group?
20 amino acids
R group (radical or side chain) -this chain is what distinguishes the AA from each other
Humans need 8 essential amino acids. Define essential.
Must be ingested rather than be made by the body
Porphryins if water soluble
excretion occurs in kidneys
Porphryins if non-water soluble
excretion occurs in feces
Acute porphyria
affect the nervous system
Cutaneous porphyria
affect the skin
Define renal threshold.
The max amount of substance that the kidneys can reabsorb. Once the limit is reached, the extra "spills over" into the urine (ex: glucose in DM)
Blood urea nitrogen/BUN
Azotemia
CHF, dehydration,
Creatinine
good indicator of renal function and glomerular filtration
BNP
increased in CHF
Protein electrophoresis-performed when abnormality is detected in total protein:
List Normal order of migration, at pH 8.6
•1 Albumin
•2 Alpha-1 globulins
•3 Alpha-2 globulins
•4 Beta-globulins
•5 Gamma-globulins
Troponin
specific for AMI
Myoglobin-increased in muscle damaging disorders
rhabdomylosis
CRP
elevated in inflammatory response- bacterial infection, MI
CSF protein levels
increased in meningitis
Iron -essential element needed for the functioning of living cells
•Used in hemoglobin, myoglobin, enzymes
•Stored as ferritin and hemosiderin
•Transferred by transferrin
•Usually related to diet, blood loss
•Termed anemia
UIBC
unsaturated iron binding capacity -how much ferritin is not storing iron
TIBC
total iron binding capacity/TIBC=UIBC + serum iron
Define bilirubin
Breakdown product of hemoglobin
Define icterus.
Jaundice-occurs when bilirubin concentration is elevated; causes deposit of excess bilirubin in skin and sclera
Unconjugated bilirubin=
(indirect bilirubin)- circulating bilirubin before received in liver
Conjugated bilirubin=
(direct bilirubin)- circulating bilirubin after liver has received it and has conjugated it to albumin
Hgb S
decreased oxygen carrying capacity
•SS- sickle cell disease
•SA- sickle cell trait
Hgb f- fetal
Increased affinity for oxygen
•Persists 6 months after birth
Hgb A2
•Normal variant of Hgb A
•Found at low levels in normal blood
•2 alpha and 2 delta chains
Creatinine clearance
(U x V)/P X (1.73)/A
Friedwald calculation
LDL=cholesterol-HDL-(triglyceride/5)
Cannot use if triglyceride > 400
Estimated Osmolality
2 Na+glucose/2+BUN/(2.8)
Comprehensive Metabolic Panel - CMP, CHEM 12, SMA 12
Glucose calcium albumin total protein sodium potassium CO2 chloride BUN creatinine
ALP ALT AST bilirubin
Basic Metabolic Panel - BMP, SMA7 (8), CHEM 7 (8)
Glucose calcium sodium potassium CO2 chloride BUN creatinine
Renal Function Panel - RFP, Renal, Kidney panel
Sodium potassium chloride CO2 phosphorous calcium albumin BUN creatinine glucose GFR
Hepatic Panel- Liver panel, LFT
ALT ALP AST bilirubin albumin total protein GGT
Lipid Panel
Cholesterol triglycerides HDL LDL
Cardiac Panel
CPK (CK)
CPK-MB (CKMB)
Troponin I (Troponin T)
Electrolyte Panel
Sodium, Potassium, Chloride, CO2
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