Carbohydrates

Following overnight fasting, hypoglycemia in adults is defined as a glucose of:

Carbohydrates:

The following results are from a 21 year old patient with a back injury that appears otherwise healthy

whole blood glucose:   77 mg/dL

serum glucose:         88 mg/dL

CSF glucose:           56 mg/dL

Carbohydrates:

The preparation of a patient for standard glucose tolerance testing should include:

Carbohydrates:

If a fasting glucose was 90 mg/dL, what 2 hour post-prandial glucose would most closley represent normal glucose metabolism.

Carbohydrates:

A healthy person with a blood glucose of 80 mg/dL would have a simultaneously determined CSF glucose of:

Carbohydrates:

A 25 year old man became nauseated and vomited 90 mins after recieving a standard 75g carbohydrate dose for an oral glucose tolerance test. The best course of acton would be to:

Draw blood for glucose and discontinue test.

use of partial GGT results

Carbohydrates:

Cerebrospinal fluid for a glucose assay should be:

analyzed immediately.

effect of glycolysis on glucose

Carbohydrates:

What post-prandial glucose value demonstrates unequivocal hyperglycemia diagnostic for diabetes mellitus?

200 mg/dL

unequivocal diagnosis of diabetes

Carbohydrates:

Serum levels that define hypoglycemia in pre-term or low birth weight infants  are:

lower than adults.

age effect on glucose

Carbohydrates:

A 45 year old woman has a serum glucose concentration of 95 mg/dL and a 2 hour post prandial glucose concentration of 105 mg/dL. The statement which best describes her is:

Normal: reflecting glycogen breakdown by her liver.

Factors contributing to FBS

Carbohydrates:

Pregnant women with symptoms of thirst , frequent urination or unexplained weight loss should have which of the following test performed?

Glucose tolorence test.

gestational diabetes

Carbohydrates:

In a fasting state the arterial and capillary blood glucose concentration varies from the venous glucose concentration by approximately how many mg/dL?

5 mg/dL

arterial vs venous glucose values

Carbohydrates: 

The conversion of glucose or other hexoses into lactate or pyruvate is called?

glycolysis

definition of glycolysis

Carbohydrates:

Which value obtained during a glucose tolorance test are diagnostic of diabetes mellitus?

fasting glucose of 126.

diagonsis of diabetes

Carbohydrates:

The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding:

6-8 weeks

definition of glycated hemoglobin

Carbohydrates:

Monitoring long term glucose control in patients with adult onset diabetes can best be accomplished by measuring :

hemoglobin A1c

average glucose overtime is best

Carbohydrates:

The patient with type 1, insulin dependant diabetes mellitus has the following results:

fasting blood glucose      150 mg/dl

hemoglobin A1c                8.5%

fructosamine                   2.5 mg/dL

after recieving these test results, the technologist concluded that the patient is in a:

improving state of metabolic control.

the fructosamine is within range

Role of fructosimine

Carbohydrates:

Total glycosylated hemoglobin levels in a hemolysate reflect the:

average blood glucose levels of the past 2-3 months

Interpretation of glycated hemoglobin

Carbohydrates:

Which of the following hemoglobin levels has glucose-6-phosphate on the amino-terminal valine of the beta chain?

A1c

Hgb A1C structure

Carbohydrates:

A patient with hemolytic anemia will:

show a decrease in glycated hemoglobin value.

glycosolated hemoglobin is directly related to the life of the RBC

Carbohydrates:

In using ion-exchange chromatographic methods, falsely increased levels of Hgb A_1C might be demonstrated in the presence of

Hgb S

interference of HBG A_1C

Carbohydrates:

An increase in serum acetone is indicative of a defect in the metabolism of:

Carbohydrates

acetone in carbohydrate metabolism

Carbohydrates:

An infant with diarrhea is being evaluated for a Carbohydrate intolerance. His stool yealds a postive copper reduction test and a Ph of 5.0. It should be concluded that:

Further test are indicated.

Clinitest

Copper reduction detects many reducing substances.

Carbohydrates:

Samples are collected at the beginning of an exercise class and after 30 mins of aerobic activity. Which of the following would be most consistant with the post exercise sample?

elevated lactic acid, elevated pyruvate.

products of glycolysis

Carbohydrates:

What is the best method to diagnose lactase deficency?

H₂ breath test.

diagnosis of lactase deficiency

Acid base balance

The expected blood glucose result for a patient in chronic renal failure would match what pattern?

Metabolic acidosis

renal =metabolic

reduced excreation of acids

Acid base balance

Severe diarrhea causes:

Metabolic acidosis

excessive loss of bi-carb

Acid base balance

Thr following blood gas results were obtained:

Ph 7.18 (7.35-7.45)

PO₂= 86 mm Hg (25 - 29 mm Hg)

PCO₂= 60 mm Hg (35-45)

O₂ saturation =90%

HCO₃= 21 mmol/L(22-26)

TCO₂= 23 mmol/L

base excess -8 mmol/L

The patients results are compatible with what?

Emphysema

respiratory acidosis

the PO₂ and PCO₂ are elevated

Acid base balance

Factors that contribute to a PCO₂ electrode requiring 60-120 seconds to reach equilibrium include the:

diffuson characteristics of the membrane.

blood gas instrumentation

Acid base balance

An emphysema patient suffering from fluid accumulation in the alveolor space is likely to be in what metabolic state?

respiratory acidosis

diseases causing respiratory acidosis

Acid base balance

At blood Ph 7.40, what is the ratio of bicarbonate to carbonic acid:

20:1

Normal raito bicarbonate/carbonic acid

Acid base balance

The reference range for Ph of arterial blood measured at 37*C is:

7.35-7.45

Arterial Ph reference range

Acid base balance

A 68 year old man arrives in the emergency room with a glucose level of 722 mg/dL and serum acetone  of 4+ undiluted. An arterial blood gas from this patient is likely to be:

Low Ph

interpretation of metabolic acidosis.

Acid base balance

A patient is admitted to the emergency room in a state of metabolic alkalosis. What is consistant with this diagnosis:

High TC_O2 and HC_O3

Acid base balance

A person suspected of having metabolic alkalosis would have which of the following laboratory findings?

Acid base balance

Metabolic acidosis is described as :

A decrease in CO₂ content and PCO₂ with a decreased Ph

Component levels in metabolic acidosis

Acid base balance

Respiratory acidosis is described as an:

An increase in CO₂ content and PCO₂ with a decreased Ph

definition of respiratory acidosis

Acid base balance

A common cause of respiratory alkalosis is

Hyperventilation

respiratory alkalosis caused by

Acid base balance

Acidosis and alkalosis are best defined as fluctuations in blood Ph and CO₂ content due to:

Carbonic anhydrase.

Chemical cause of alkalosis and acidosis

Acid base balance

A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood had been exposed to room air for at least 30 mins. The following change in blood gases will occur:

PO₂ increased/ HCO₃ decreased

blood gas sample conditions

Acid base balance

The following laboratory results were obtained:

Serum electrolytes

NA =                              136  (135 to 145 )

K=                                  4.4   (3.5 to 5 mEq/L)

Cl=                                  92   (98 - 108 mmol/L.)

Bicarb=                           40  (22-26 mmol/L)

arterial blood:

Ph=                                 7.32  (7.35-7.45)

PCO₂=                                79  (35-45mmHg)

These results are most compatible with

Acid base balance

Select the test which evaluates renal tubular function

osmolarity

best test for renal tubular function

Acid base balance

A patient had the following serum results:

NA=          140

K=              4.0

glucose=     95

BUN=          10

Which osmolality is consistant with these results.

270

NAx2 + glu/18 + BUN/2.8

you have to divide the glucose by 18 because 18 is the molecular weight of glocose, and 2.8 is the molecular weight of BUN this converts it to the correct units.

Acid base balance

The degree to which the kidney concentrates the glomerular filtrate can be determined by

urine to serum osmolality rate.

kidney concentration determination

Acid base balance

Osmolal gap is the difference between

Electrolytes

The most important buffer pair in plasma is the:

Bicarbonate/ carbonic acid pair.

Bicarbonate=HCO₃⁻.

carbonic acid= CO₂ + H₂O

Electrolytes

Quantitation of NA and K by ion selective electrode is the standard method because:

of advances in electro-chemistry

Electrolytes

What battery of test is most useful in evaluating an anion gap of 22 mEq/L

BUN, creatinine, salicylate and methanol

Drs look for salicylate poisioning  when they see this

Electrolytes

A patient with myeloproliferative disorder has the following values:

Hgb =            13

Hct=             38%

WBC=           30x10⁶

platelets =     100x10³

serum Na=     140

serum K=        7  what!!!

The serum K should be confirmed by

Testing heprinized plasma

effect on K by platelets on serumK

Electrolytes

Most of the carbon dioxide present in blood is in the form of :

Bicarbonate ion

major component of C_O2 in the blood

Electrolytes

Serum anion gap is increased in patients with:

[image]

Lactic acidosis

[image]

Electrolytes

The anion gap is useful for quality control of labratory results for:

sodium , potassium, cloride and total CO₂

is calculated by subtracting the serum concentrations of chloride and bicarbonate (anions) from the concentrations of sodium and potassium (cations):

= ([Na⁺] + [K⁺]) − ([Cl⁻] + [HCO₃⁻])

Electrolytes

The buffering capaciy of blood is maintained by a reversible exchange process between bi-carbonate and ??

Electrolytes

In respiratory acidosis a compensitory mechanism is the increase in:

Plasma bicarbonate concentration

(the C_O2 builds up in the blood)

Respiratory acidosis is a medical condition in which decreased ventilation (hypoventilation) causes increased blood carbon dioxide concentration and decreased pH (a condition generally called acidosis).

Carbon dioxide is produced constantly as the body's cells respire, and this CO₂ will accumulate rapidly if the lungs do not adequately expel it through alveolar ventilation.

Electrolytes

Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?

Electrolytes

A potassium level of 6.8 is obtained. Before reporting the results, the first step the technologist should take is to

Electrolytes

The solute that contributes the most to the total serum osmolality is:

Electrolytes

A sweat chloride of 55 mEq/L and a sweat sodium of 52 mEq/L were obtained on a patient who has a history of respriatory problems. The best interpretation of these results is:

Electrolytes

What is true about direct ion selective electrodes for electrolytes?

Electrolytes

Sodium determination by indirect ion selective electrode is falsely decreased by:

Elevated lipid levels

• Protein and lipids affects indirect ISE methods due to the volume displacement effect, with the most noticeable errors being in sodium estimation (pseudohyponatraemia in hyperproteinaemia and pseudohypernatraemia in hypoproteinaemia).In general, samples with high lipids and total protein concentration >100 or <40 g/L require sodium estimation to be performed on direct ISEs.

Electrolytes

A physician requested that electrolytes on a multiple myeloma patient be run by direct ISE and not indirect because:

Na is falsely decreased by indirect ISE.

• Protein affects indirect ISE methods due to the volume displacement effect, with the most noticeable errors being in sodium estimation (pseudohyponatraemia in hyperproteinaemia and pseudohypernatraemia in hypoproteinaemia). In general, samples with total protein concentration >100 or <40 g/L require sodium estimation to be performed on direct ISEs.

Electrolytes

What percentage of total serum calcium is non-diffusible protein bound?

Electrolytes

Calcium concentration in the serum is regulated by

Electrolytes

The regulation of calcium and phosphorus metabolism is accomplished by what gland?

Electrolytes

A patient has the following test results:

Increased serum calcium

decreased serum phosphate

increased levels of parathyroid hormone

The patient most likely has:

Electrolytes

A hospitalized patient is experiencing increased neuromuscular irritability (tetany). What test sholud be ordered immediatly?

Electrolytes

Which is most likely to be ordered in addition to serum calcium to determine the cause of tetany?

Electrolytes

A reciprocol relationship exist between:

Electrolytes

Fasting serum phosphate concentration is controlled primarily by the:

Electrolytes

A low concentration of serum phosphorus is commonly found in

Electrolytes

The following results were obtained:

Serum calcium increased

Serum alk phosphate decreased

Serum alk phosphatase norm or increased

urine calcium increased

urine alk phosphate increased

These results are compatible with:

Proteins and other nitrogen containing compounds

The primary function of serum albumin in the pheripheral blood is to:

 Proteins and other nitrogen containing compounds 

In a plural effusion caused by Streptococcus pneumoniae, the protein value of the pleural fluid as compaired to the serum value would probably be

 Proteins and other nitrogen containing compounds

 The first step in analyzing a 24 hour specimen for quantitive urine protein is:

 Proteins and other nitrogen containing compounds

 When performing a manual protein analysis on a xanthochromic spinal fluid , the technician should:

Make a patient blank

 spectural interference

 Proteins and other nitrogen containing compounds

 The direction in which albumin mirates (toward the anode or cathode) during electrophoretic sepraton of serum proteins, at a Ph of 8.6 is determined by:

 Proteins and other nitrogen containing compounds

 the protein that has the highest dye-binding capacity is

Proteins and other nitrogen containing compounds 

pick out a serum protein electrophoresis pattern of albumin

albumin big broad spike

[image]

Proteins and other nitrogen containing compounds

 The biuret reacton for the analysis of serum proteins depends on the number of

 Proteins and other nitrogen containing compounds

 In electrophoresis of proteins, when a sample is placed in an electric field connected to buffer of Ph 8.6 all of the proteins :

 Proteins and other nitrogen containing compounds 

The relative migration rate of proteins on cellulose acetate is based on:

Proteins and other nitrogen containing compounds

 The cellulose acetate electrophoresis at Ph 8.6 of serum proteins will show an order of migration beginning with the fastest migration as follows:

Albumin alpha 1 globulin alpha 2 globulin beta globulin gamma globulin

[image]

Proteins and other nitrogen containing compounds

 What amino acid is associated with sulfhydryl group

Cysteine

[image]

Proteins and other nitrogen containing compounds

 Maple syurp urine disease is characterized by an increase in which of the following urinary amino acids?

Proteins and other nitrogen containing compounds

 Increased serum albumin concentrations are seen in which of the following conditions

Proteins and other nitrogen containing compounds

 The following data was obtained from a cellulose acetate protein electrophoresis scan:

albumin area =           75 units

gamma globulin area  30 units

total area                  180 units

total protein               6.5 g/dL

The gamma globulin content is?

1.1 g/dL

30/180 = X/6.5

 Proteins and other nitrogen containing compounds

A patient is admitted with billary cirosis. If a serum protein electrophoresis is performed, what globulin fraction will be most elevated?

Gamma

look for the beta gamma bridge

Proteins and other nitrogen containing compounds

 What serum protein fraction is most likely to be elevaed in patients patients with nephrotic syndrome?

alpha 2 globulin

due to loss of albumin increased alpha2 is compensitory

Proteins and other nitrogen containing compounds

Total protein  7.3

albumin          4.2

alpha-1           0.0 

beta               0.8

gamma            1.4

Proteins and other nitrogen containing compounds

Total protein 8.9 (high)

albumin  4.8

alpha1    0.8

alpha2    0.7

beta       0.8

gamma    2.3 (high)

Proteins and other nitrogen containing compounds

Total protein  6.1

albumin           2.3

alpha1              0.2

alpha2              0.5

beta                  1.2

gamma               1.9

big beta gamma bridge

Cirrosis

 Proteins and other nitrogen containing compounds

 A charisteristic of bence jones protein that is used to distinguish it from other urinary proteins is its solubility:

Proteins and other nitrogen containing compounds

 The electrophrotic pattern of plasma sample as compaired to a serum sample shows a:

Plasma= sharp fibrinogen peak

artifact band

Proteins and other nitrogen containing compounds

 At a Ph of 8.6 the gamma globulin move toward the cathode, dispite the fact that they are negatively charged. What is this phenomenon called?

Proteins and other nitrogen containing compounds

Total protein   7.8

albumin            3.0

alpha1              0.4

alpha2              1.8 (high)

beta                 0.5

gamma              1.1

Proteins and other nitrogen containing compounds

Total protein 8.5

albumin          4.3

alpha1            0.3

alpha2            0.7

beta               0.9

gamma            2.3

Polyclonal gammopathy

look for a broad band and slight elevation in the gamma region

Proteins and other nitrogen containing compounds

Analysis of CSF for oligoclonal bands is used to screen for what diease state:

                  ^{( its not diagnostic)}

 Proteins and other nitrogen containing compounds

The identificaton of bence jones protein is best accomplished by:

Immunofixation

monoclonal free kappa or lambda light chains

Proteins and other nitrogen containing compounds

 Total iron binding capacity measures the serum iron transporting capacity of:

Proteins and other nitrogen containing compounds

 The first step in the quantitation of serum iron is:

Proteins and other nitrogen containing compounds

A patients blood was drawn at 08:00 am for a serum iron determination. The result was 85 ug/dL. A repeat specimen was drawn at 08:00 pm; the serum was stored at 4*C and run the next morning. The result was 40um/dL. These results were likely due to

The time of day the specimen was drawn

diuranl variation of Iron metabolism

Proteins and other nitrogen containing compounds

  decreased  serum iron associated with increased TIBC is compatible with what disease state

Proteins and other nitrogen containing compounds

 A patient has the following results:

serum iron 250( high)

TIBC 350

The best conclusion is this patient has

 Proteins and other nitrogen containing compounds

To assure an accurate ammonia level result the specimen should be

Proteins and other nitrogen containing compounds

 Erroneous ammonia levels can be eleminated by:

assuring water and reagents are ammonia free.

separating plasma from cells and performing analysis as soon as possible.

drawing the specimen in a prechilled tube in ice.

Proteins and other nitrogen containing compounds

 A critically ill patient becomes comatose.The physician believes the coma is due to hepatic failure tha asssay most helpful would be:

Proteins and other nitrogen containing compounds

 A serum sample demonstrates an elevated result when tested with the jaffee reaction. This indicates

renal function impairment

creatinine measurement.

Proteins and other nitrogen containing compounds

 In order to prepare 100 ml of 15 mg/dL BUN working standards from a stock standard solution containing 500 mg/dL of urea nitrogen, the number of mL of stock solution that should be used

3.0 mLs

100x15/500

Proteins and other nitrogen containing compounds

 A patient with glomerulonenephritis is most likely to present with the following serum results:

Proteins and other nitrogen containing compounds

 An elevated serum iron with normal iron binding capacity is most likely associated with

pernicious anemia

ineffective erytheropoiesis

high turnover rate of iron

Proteins and other nitrogen containing compounds

The principle excreatory form of nitrogen is:

Proteins and other nitrogen containing compounds

In the jaffee reaction cratinine reacts with:

Proteins and other nitrogen containing compounds

Creatinine clearance is used to estimate the

Proteins and other nitrogen containing compounds

A blood creatinine value of 5.0 is most likely to be found with what blood value?

Proteins and other nitrogen containing compounds

Technical problems encountered during collection of an amniotic fluid specimen caused doubt as to weather the specimen was amniotic in origin. What test should be done to best establish that the fluid is amniotic in orgin?

creatinine measurement

maternal urine instead of amniotic fluid

Proteins and other nitrogen containing compounds

Which of the following repersents the end product of purine metabloism in humans?

Proteins and other nitrogen containing compounds

Which of the following substances is the biologically active precursor of a fat soluable vitamine?

retinol

Form of vitamine A

retinol is one of the three biologically active forms of fat soluable vitamine A

Proteins and other nitrogen containing compounds

The troponin complex consist of

Proteins and other nitrogen containing compounds

The presence of C-reactive protein in the blood is an indication of

an inflammatory  process

^{its an acute phase reactant}

Proteins and other nitrogen containing compounds

Oligoclonal bands are present on electrophoresis of concentrated CSF and also concurrently tested serum of the same patient. The interpretation is:

Non dianostic for multiple sclerosis

there are oligoclonal bands in other disorders as well.

Proteins and other nitrogen containing compounds

draw a peptide bond

O

||

  C-N

      |

      H

Proteins and other nitrogen containing compounds

90% of the copper present in the blood is bound to:

Proteins and other nitrogen containing compounds

Which of the following determinations is useful in prenatal diagnosis of open neural tube defects?

amniotic fluid alpha-fetoprotein

alpha-fetoprotein is the embryonic form of albumun

Proteins and other nitrogen containing compounds

If you see a pre-albumin peak of about 4.5% on an electrophoresis you are looking at what kind of specimen

 Proteins and other nitrogen containing compounds

Serum concentrations of vitamin B12 are elevated in:

chronic granulocytic leukemia

^{thats interesting!}

Proteins and other nitrogen containing compounds

Absorption of vitamine B12 requires the presence of:

Proteins and other nitrogen containing compounds

The procedure used to determine the presence of neural tube defect is:

Heme derivatives

The principle of the occult test depends upon the:

Heme derivatives

A breakdown product of hemoglobin is

Heme derivatives

Hemoglobin S can be separated from hemoglobin D by

Electrophoresis on a different medium and acidic Ph.

^4.5

Heme derivatives

On electrophoresis at alkaline Ph, which of the following is the slowest migrating hemoglobin

Hemoglobin C

C=crawl

Heme derivatives

The hemoglobin that is resistant to alkali (KOH) denaturation is:

Hemoglobin F

^{fetal hemoglobin}

Heme derivatives

The

following bilirubin results are obtained on a patient

day 1     4.3

day2    4.6

day3     4.5

day4     2.2

day5     4.4

day6     4.5

Given that the controls were within range each day, what is a probable explanation for the result on day 4:

Heme derivatives

Urobilinogen is formed in the :

Heme derivatives

In bilirubin determinations, the purpose of adding concentrated caffene solution or methyl alcohol is to

Heme derivatives

A total bilirubin is 3.1 and the conugated biliruben is 2.0 the unconjugated bilirubin is

1.1

^{do the subtraction}

Heme derivatives

The principle of the tablet test for bilirubin in urine or feces is:

Heme derivatives

Serial bilirubin determinations are charted:

day1 collected at 7 am tested at 8am    14.0

day2 collected 7am tested 6pm              9.0

day3 collected 6am tested 8 am             15.0

the best explaination for the result is

Heme derivatives 

In the liver, bilirubin is converted to:

Heme derivatives

In what disease state is conjugated bilirubin a major serum component?

Heme derivatives

Kernicterus is an abnormal accumulation of bilirubin in:

Heme derivatives

In what conditon does decreased activity of glucronyl transferase result in increased unconjugated bilirubin and kernicterus in neonates

Crigler-Najjar syndrome

A deficiency in the bilirubin specific form of glucuronosyltransferase is thought to be the cause of Gilbert's syndrome, which is characterized by unconjugated hyperbilirubinemia.

It is also associated with Crigler-Najjar syndrome, a more serious disorder where the enzyme's activity is either completely absent (Crigler-Najjar syndrome type I) or less than 10% of normal (type II).

Heme derivatives

A 21 year old man with nausea, vomiting and jaundice has the following laboratory finding

total serum bilirubin             8.5

conjugated serum bilirubin   6.1

urine urobilinogen                 increased

fecal urobilinogen                 decreased

urine bilirubin                       positive

AST     300 (high)

alkaline phosphaase    170

conjugated hyperbilirubinemia, probably due to hepatocelular damage

^{hepatocellular damage = AST of 300}

Heme derivatives

biochemical profile

TP 7.3

alb 4.1

cal 9.6

pho 3.3

glu  95

BUN 16 (high)

uric acid 6.0

creat    1.2

total bili 3.7 (high)

alk phos  275 (very high)

LD    185

AST  75 (high)

the results are most consistant with

common bile duct stone

^{post hepatic billiary obstruction}

^{(high alk phos, high bili, high AST)}

Heme derivatives

A stool specimen that appears black and tarry should be tested for the presence of:

Heme derivatives

What substance gives feces its normal color?

Heme derivatives

A condition with erythrocyte protophrin is increased is:

Iron deficemcy anemia.

 high RBC zinc protoporphrin

Zinc protoporphyrin (ZPP) is a compound found in red blood cells when heme production is inhibited by lead and/or by lack of iron.  Instead of incorporating a ferrous ion, to form heme, protoporphyrin IX, the immediate precursor of heme, incorporates a zinc ion, forming ZPP. The reaction to insert a ferrous ion into protoporphyrin IX is catalyzed by the enzyme ferrochelatase

Heme derivatives

 A serum sample was assayed for bilirubin at 10 am and the result was 12. The same sample retested at 3 pm. The result is now 8. The most likely explanation for this descrepancy is:

the sample was exposed to light.

^{if you get this wrong........ , you are just stupid}

Heme derivatives

Which of the following elevates carboxy- hemoglobin

exposure to carbon monoxide

Carboxyhemoglobin \ (COHb) is a stable complex of carbon monoxide and hemoglobin that forms in red blood cells when carbon monoxide is inhaled or produced in normal metabolism. Large quantities of it hinder delivery of oxygen to the body. Tobacco smoking (through carbon monoxide inhalation) raises the blood levels of COHb by a factor of several times from its normal concentrations. It is bright, cherry red.

Heme derivatives

The reason carbon monoxide is so toxic is because :

It has 200 ^yikes times the affinity of oxygen for hemoglobin binding sites.

Hemoglobin binds to carbon monoxide preferentially compared to oxygen (approx 240:1),^[so effectively, COHb will not release the carbon monoxide, and therefore hemoglobin will not be available to transport oxygen from the lungs to the rest of the body.

Heme derivatives

Detection of carriers of hereditory coproporphyria should include analysis of:

fresh morning specimen for

delta-aminolevulinic acid.

The "committed step" for porphyrin biosynthesis is the formation of δ-aminolevulinic acid  by the reaction of the amino acid glycine with succinyl-CoA from the citric acid cycle. Two molecules of dALA combine to give porphobilinogen (PBG), which contains a pyrrole ring. Four PBGs are then combined through deamination into hydroxymethyl bilane (HMB), which is hydrolysed to form the circular tetrapyrrole uroporphyrinogen III. This molecule undergoes a number of further modifications. Intermediates are used in different species to form particular substances, but, in humans, the main end-product protoporphyrin IX is combined with iron to form heme. Bile pigments are the breakdown products of heme.

Heme derivatives

A fresh urine sample is recieved for analysis for "porphyrins or porphyria" without further information or specifications. Initial analysis should include:

Heme derivatives

Which of the following enzymes of heme synthesis is inhibited by lead?

porphobilinogen synthase.

A deficiency of porphobilinogen synthase is usually acquired (rather than hereditary) and and can be caused by heavy metal poisoning, especially lead poisoning, as the enzyme is very susceptible to inhibition by heavy metals

Porphobilinogen synthase,synthesizes porphobilinogen through the asymmetric condensation of two molecules of aminolevulinic acid. All natural tetrapyrroles, including hemes, chlorophylls and vitamin B₁₂, share porphobilinogen as a common precursor.It is involved in the second step of the metabolism of porphyrin

Heme derivatives

serum haptoglobin...

can be separated into distinct phenotypes by starch-gel electrophoresis.

 starch gel electrophoresis provides a much finer separation

^{Haptoglobin phenotyping for rare dificiency states}

Enzymes

The most specific enzyme test for acute pancreatitis is:

lipase

• Elevated serum AMYLASE and LIPASE levels, in combination with severe abdominal pain, often trigger the initial diagnosis of acute pancreatitis. However, they have no role in assessing disease severity.
• Serum lipase rises 4 to 8 hours from the onset of symptoms and normalizes within 7 to 14 days after treatment.

Enzymes

What enzyme is used in the diagnosis of acute pancretitis?

Amylase and lipase

• Elevated serum AMYLASE and LIPASE levels, in combination with severe abdominal pain, often trigger the initial diagnosis of acute pancreatitis. However, they have no role in assessing disease severity.
• Serum lipase rises 4 to 8 hours from the onset of symptoms and normalizes within 7 to 14 days after treatment.

Enzymes

What enzyme catalyzes the conversion starch to glucose and maltose

Amylase (AMS)

Amylase is an enzyme that catalyses the breakdown of starch into sugars. Amylase is present in human saliva, where it begins the chemical process of digestion. Food that contains much starch but little sugar, such as rice and potato, taste slightly sweet as they are chewed because amylase turns some of their starch into sugar in the mouth. The pancreas also makes amylase (alpha amylase) to hydrolyse dietary starch into disaccharides and trisaccharides which are converted by other enzymes to glucose to supply the body with energy.

Enzymes

What set of results would be consistant with macroamylasemia

Increased serum amylase, normal urine amylase.

Macroamylasemia is an asymptomatic condition which results when the amylase molecule and immunoglobulins combind to for a complex. The complex is too large to be filtered across the glomerulus. Lack of renal clearence leads to an increased serum amylase and a decreased urine amylase.

Enzymes

A physician suspects his patient has pancreatitis. What test would be most indicative of this disease...

Enzymes

 aspartate amino transferase (AST) is characteristically elevated in diseases of the.. 

liver

Low levels of AST are normally found in the blood. When body tissue or an organ such as the heart or liver is diseased or damaged, additional AST is released into the bloodstream. The amount of AST in the blood is directly related to the extent of the tissue damage. After severe damage, AST levels rise in 6 to 10 hours and remain high for about 4 days.

Enzymes

Amino transferase enzymes catalyse the:

exchange of amino and keto groups between alpha-amino and alpha-keto acids

In biochemistry, a transaminase or an aminotransferase is an enzyme that catalyzes a type of reaction between an amino acid and an α-keto acid. To be specific, this reaction (transamination) involves removing the amino group from the amino acid, leaving behind an α-keto acid, and transferring it to the reactant α-keto acid and converting it into an amino acid.

Enzymes

 Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are both elevated in what disease?

Enzymes

The greatest activities of serum AST and ALT are seen in what:

Enzymes

 Malate dehydrogenase is added to the aspartate aminotransferase (AST) reaction to catalyze the conversion of :

Oxalacetate to malate

in the coupled reaction of AST measurement, malate dehydrogeate catalyzes the oxidation of oxaloacetate to malate in the indicator reaction.

Enzymes 

Given the following results :

ALP slight increase

AST marked increase

ALT marked increase

GGT slight increase.

this is most consistant with

acute hepatitis

in acute hepatocellular disorders the serum levels of AST and ALT can be 100 times the upper reference of normal. Slight increases of the enzyme activities are seen in chronic hepatitis, hemangioma, and obstructive jaundice.

Enzymes 

What clinical disorder is associated with the greatest elevation of lactate dehydrogenase isoenzyme:

pernicious anemia

the main use for LDH is as a general indicator of the existence and severity of acute or chronic tissue damage

Useful in the differential diagnosis of acute myocardial infarction, megaloblastic anemia (folate deficiency, pernicious anemia), hemolytic anemia, and very occasionally renal infarct. These entities are characterized by LD₁ increases, often with LD₁:LD₂ inversion.

Enzymes

 The enzyme, which exists in skeletal muscle, heart and brain, is grossley elevated in active muscular dystrophy and rises early in myocardial infarction is:

Enzymes

The enzyme present in almost all tissues that may be separated by electrophoresis into 5 components is

LD

lactate dehydrogenase.

Enzymes

 A common cause of falsely increased LD₁ fraction of lactic dehydrogenase is:

Hemolysis

so LD₁ is in the Red blood cells

Useful in the differential diagnosis of acute myocardial infarction, megaloblastic anemia (folate deficiency, pernicious anemia), hemolytic anemia, and very occasionally renal infarct. These entities are characterized by LD₁ increases, often with LD₁:LD₂ inversion.

Enzymes

 The presence of which of the following isoenzymes indicates acute myocardial damage?

Enzymes

In what of the following conditions would a normal level of creatine kinase be found:

acute myocardial infarct

 hepatitis

progressive muscular dystrophy

intramuscular injection

 Enzymes

Of the following diseases, the one most often associated with elevations of lactate dehydrogenase isoenzymes 4 and 5 on electrophoresis is.

liver disease (4 and 5)

^{Hemolytic anemia (1-2)}

^{myocardial infarct (1-2)}

^{pulmonary edema (3)}

Enzymes

When myocardial infarction occurs, the first enzyme to become elevated is:

Enzymes 

A scanning of a CK isoenzyme fractionation revealed 2 peaks: a slow cathode peak (CKMM) and an intermediate peak (CKMB). A possible interpretation for this pattern is:

myocardial infarction

^{CKMM= myocardial muscle}

^{CKMB= heart}

Enzymes 

An electrophoretic separation of Lactate dehydrogenous isoenzymes that demonstrats an elevation in LD-1 and LD-2 in a flipped pattern is consistant with ...

Enzymes

An increased total serum lactate dehydrogenase (LD) activity, confined to fractions 4 and 5 is most likely to be associated with:

Acute viral hepatitis

^{4 and 5= liver}

Enzymes

 A 10 year old child was admitted to pediatricts with an initial diagnosis of skeletal muscle disesase. The best confirmatory tests would be:

Aldolase and creatine kinase

Aldolase A is an enzyme that catalyses a reverse aldol reaction: The substrate, fructose 1,6-bisphosphate is broken down into glyceraldehyde 3-phosphate and dihydroxyacetone phosphate This reaction is a part of glycolysis.

Enzymes

In the immunoinhibition phase of the CKMB procedure the:

M subunit is inactivated.

In the immunoinhibition technique for CKMB determination, antibodies are directed aginst the M and B units of the enzymes. Anti-M inhibits all M activity but not B activity. CK activity is measured before and after inhibition. The activity remaining  after inhibition is a result of the  subunit for BB and MB actvity

Enzymes

 The presence of increased CKMB activity on a CK electrophoresis pattern is most likely found in a patient suffering from:

Enzymes

You notice an elevated peak in the LD5 region of electrophoresis what is most likely condition

viral hepatitis

elevated levels of LD-5 are seen in viral hepatitis

LD4 and 5 =liver

Enzymes 

Increased serum lactate dehydrogenas activity due to elevation of fast fraction (1 and 2) on electrophoretic separation is caused by:

Enzymes

A serum sample drawn in the emergency room from a 42 year old man yealded these values:

CK 185 (slightly high)

AST 123 high

CKMB 6 normal

what might account for these values

crush injury to thigh

AST is 4 times normal if it was hepatitis it would be 100 times normal

Enzymes 

Given the following results:

ALP marked increase

AST slight increase

AL slight increase

GGT marked increase.

This is most consistant with

obstructive jaundice

 The ALP is the Key here

remember ALP for obstructive jaundice or bone

Enzymes 

Given the following results:

ALP slight increase

AST slight incrase

ALT slight increase

GGT slight increase

Chronic hepatitis

slight sustained increases mean chronic

Enzymes

 What specimen preparation is commonly used to preform the alkaline phosphatase isoenzyme determination

Serum is divided into 2 aliquats, one is heated at 56*C and the other is unheated.

the heat activation method of ALP isoenzyme separation involves heating an aliquot of the serum sample at 56*C for 10 mins , An untreated aliquot of the sample along with the heated one are assayed for ALP activity

Heat stability  distinguishes bone and liver isoenzymes ("bone burns, liver lasts") Placental alkaline phosphatase is elevated in seminomas.

Enzymes

Reagan isoenzyme has the same properties as ALP that originates in the:

Enzymes

 The most labile fraction of alkaline phosphatase is obtained from:

bone

the major serum ALP isoenzymes are located in the liver, bone , intestine and placenta. Placenta ALP is the most heat stable followed by intestinal, liver and bone fractions in decreasing order.

Placenta is stable as babys table

Enzymes

The most sensitive enzymatic indicator for liver damage from ethanol intake is:

GGT

gama -glutamyl transferase

Enzymes

Isoenzyme assays are preformed to improve:

Enzymes

The protein portion of an enzyme is called:

Enzymes

Which of the following chemical determinations may be of help in establishing the presence of seminal fluid:

Enzymes 

What enzyme substrate for prostatic acid phosphatase is best for the "continuous monitoring method"

Enzymes

 Lactate dehydrogenase, malate dehydroenase, isocitrate dehydrogenase and hydroxybuterate dehydrogenase all:

Lipids and lipoproteins

  High levels of what lipoprotein class are associated with decreased risk of accelerated atherosclerosis

Lipids and lipoproteins

 The most consistant analytical error involved in the routein determination of HDL-cholesterol is caused by:

Lipids and lipoproteins

 If LDL-cholesterol is calculated by the friedwald formula, what are the 2 measurements that need to be carried out by the same chemical procedure?

Lipids and lipoproteins

 The chemical composition of HDL cholesterol cooresponds to:

5% trig

15% Cholesterol

50% protein

HDL is most dense. Protein is the most dense.

Lipids and lipoproteins

 In familial hypercholesterolemia the hallmark finding is an elevation of:

Lipids and lipoproteins

 Premature atherosclerosis can occcur when which of the following becomes elevated:

Lipids and lipoproteins

 Transportation of 60-75% of the plasma cholesterol is preformed by:

Lipids and lipoproteins

 What disease results from a familial absence of high density lipoproteins?

 Lipids and lipoproteins

 A 1 year old girl with a hyperlipoproteinemia and lipase deficency has the following lipid profile:

cholesterol 300

LDL: increased

HDL: decreased

Trig: 200

chylomicrons present

a serum specimen from this patient that was refrigerated overnight would most likely be

creamy layer over clear serum

lipid analysis using overnight refrigeration involves incubating the serum at 4* overnight. The chylomicrons, present as a thick homoenous cream layer, maybe observed floating at the plasma surface.

Lipids and lipoproteins

 Which of the following lipid results would be expected to be falsley elevated on a serum specimen from a nonfasting patient?

Lipids and lipoproteins

A nine month old boy from Isreal has gradually lost his ability to sit up, and develops seziures. He has an increased amount of phospholipid called GM2-ganglioside in his neurons, and he lacks the enzyme hexosaminidase A in his leukocytes. These findings suggest:

Lipids and lipoproteins

 In amniotic fluid, the procedure used to determine fetal lung maturity is:

Lipids and lipoproteins

The class of phopolipids surfactants the take a sharp rise at week 30 gestation on amniotic fluid analysis is thought to originate in what fetal organ system.

Lipids and lipoproteins

A fasting serum sample from an asymptomatic 43 year old woman is examined visually and chemically with the following results:

initial appearance of serum= milky

serum after overnight incubation=cream layer over turbid serum

trig 2,000

cholesterol 550

this sample contains predominatly

Lipids and lipoproteins

 Chylomicrons are present in which of the following dyslipidemias?

Lipids and lipoproteins

 The function of the major lipid components of the very-low density lipoproteins (VLDL) is to transport:

Lipids and lipoproteins

Turbitity is serum suggets an elevation of:

Endocrinology and Tumor markers

TSH is produced by the:

Endocrinology and Tumor markers

A patient has the following thyroid profile:

total t₄ decreased

free t₄ decreased

thyroid peroxidase antiboby positive

TSH decreased

Endocrinology and Tumor markers

A 45 year old woman complains of fatique, heat intolerance and hair loss. Total and free T4 are abnormally low. If the TSH showed marked elevation, this would be consistant with:

Endocrinology and Tumor markers

 The majoriy of thyroxine T₄ is converted into the more biologically active hormone:

Endocrinology and Tumor markers

 A 12 year old child with a decreased serum T4 is described as being somewhat dwarfed, stocky, overweight, and having corse features. Of the folllowing , the most informative additional laboratory test would be the serum:

Endocrinology and Tumor markers

 The screening test for congenital hypothyroidism is based upon:

 Endocrinology and Tumor markers

Which one of the following set of results is consistant with primary hypothyroidism (hasimoto Thyroiditis)

result A TSH decT4 dec antimicro Ab pos

result B TSH inc T4 inc  Anti microAb pos    

result C TSH nor T4 dec  Ab neg            

result D TSH inc T4 dec Ab  positive

Result D

TSH increased  T4 decreased and antimcrosomal Ab positive.

Endocrinology and Tumor markers 

A 68 year old female patient tells her physician of being cold all the time and recent weight gain with no change in diet. The doctor orders a TSH level, and the laboratory reports a value of 8.7 (high) This patient most likely has:

Endocrinology and Tumor markers

 What hormone is secreted by the placenta and used for the early detection of pregnancy?

Endocrinology and Tumor markers

 During pregnancy the form of estrogen measured in urine is mostly:

Endocrinology and Tumor markers

Refer to the graph

sharp rise 1st month then down 1/4 and then level off:

The HCG levels in the graph most probably represent:

Endocrinology and Tumor markers

In the amniotic fluid, the procedure used to detect hemolytic disease of the newborn is:

Endocrinology and Tumor markers

 During the normal pregnancy, quantitative human chorionic gonadotropin (HCG) levels peak how many weeks after the last menstral period?

Endocrinology and Tumor markers

 Laboratory measures maternal serum alpha-fetoprotein (MSAFP) at 16-18 weeks gestation as a screen for fetal disorders. The 16-week MSAFP median for lab is 32ug/L . A 37 year old woman has an MSAFP level of 34 at her 16th week. This result is consistant with:

 normal MSAFP level for 16 week gestation

32/34 =1.06

 it is under 2.0 so it is normal if it was over 2.0 it would be abnormal

 Endocrinology and Tumor markers

 Which of the following steroids is an adrenal cortical hormone

[image]

aldosterone

aldosterone is a hormone produced by the adrenal cortex

Endocrinology and Tumor markers

 What common substrate is used in the biosynthesis of adrenal steroids, including androgens and estrogens.

cholesterol

all adrenal steroids are derived from cholesterol

Endocrinology and Tumor markers

 Biologically the most active , naturally occuring androgen is:

Endocrinology and Tumor markers

Plasma for cortisol determinations were collected at 7 am , after waking the patient and at 10 pm that evening . The cortisol level of the morning sample was higher than the evening sample. This is consistant with

Endocrinology and Tumor markers

 Night blindness is associated with deficiency of which vitamines

Endocrinology and Tumor markers

 Beriberi is associated with deficicency of vitamine :

Endocrinology and Tumor markers

 Scurvy is associated with deficicency of which of the following vitamines:

Endocrinology and Tumor markers

 Rickets is associated with what deficiency of what vitamine

Endocrinology and Tumor markers

 Pellagra is associated with deficency of what vitamine?

Endocrinology and Tumor markers

 The major action of angiotension II is

Endocrinology and Tumor markers

 The urinary excreation product measured as an indicator of epinephrine production is:

vanillylmandelic acid (VMA)

Endocrinology and Tumor markers

 What hormone regulates normal blood calcium levels?

Endocrinology and Tumor markers

The most common form (95%) of congenital adrenal hyperplasia is 21-hydroxylase deficiency, what is elevated in plasma?

Endocrinology and Tumor markers

 A diagnosis of primary adrenal insufficiency requires demonstration of:

Endocrinology and Tumor markers

The screen for adrenal cortical hyperfunction with the greatest sensitivity and specificity is :

Endocrinology and Tumor markers

A patient has signs and symptoms of acromegaly. The diagnosis would be confirmed if the patient had which of the following:

Endocrinology and Tumor markers 

Estrogen and progesterone receptor assays are useful in identifying patients who are likely to benifit from endocrine therapy to treat  which of the following

Endocrinology and Tumor markers 

Which of the following sample collections would give an acurate assesment of potental excess cortisol production (hypercortisolism)

Collect a 24 hour urine free cortisol

Because of circadian ryythm

Endocrinology and Tumor markers 

How is primary hypocortisolism (addisons disease) differentiated from secondary hypocortisolism (of pituitary origin)

Endocrinology and Tumor markers

Aldosterone is released by the adrenal cortex upon stimulation by:

Endocrinology and Tumor markers 

In developing the reference for a new EIA for CEA, the range for the normal population was broader that that publised by the vender. Controls are acceptible with narrow coefficient of variation, this may be explained by:

Incluson of nonsmokers and smokers in the study population.

CEA is increased in smokers

Endocrinology and Tumor markers

 Clinical assays for tumor markers are most important for

Endocrinology and Tumor markers

 Detection of which of the following substances is most useful to monitor the course of a patient with testicular cancer

alpha-fetoprotein

^{most testicular cancers are Germ cell in origin}

Endocrinology and Tumor markers

 Increased concentrations of alpha-fetoprotein (AFP) in adults are most characteristically associated with

Endocrinology and Tumor markers 

Carcinoembryonic antien (CEA) is most likely to be produced in a malignancy involving the

Endocrinology and Tumor markers

 Which of the following is useful in the detection and managemant of carcinoma of the prostate

total prostate specific antigen

(^tPSA)

Endocrinology and Tumor markers

Which of the following statements most correctly describes the utility of clinical labaratory assays for tumor markers?

Endocrinology and Tumor markers

Cancer antigens 125 (CA 125) is a tumor marker associated  with:

Endocrinology and Tumor markers 

In addition to carcinoma of the prostate, elevated prostate specific antigen (PSA) can occur due to:

TDM and Toxicology

Blood specimens for digoxin assays should be obtained between 8 hours or more after drug administraton bcause:

TDM and Toxicology

 A drug has a half life of six hours. If a dose is given every six hours, a steady state drug level would usually be achieved in

24-42 hours

5-7 doses

TDM and Toxicology 

Free theraputic drug levels are usually higher when serum protein concentrations are below normal . In what condition would this most likely occur:

Nephrotic syndrome

massive protein loss, drugs bind to proteins

TDM and Toxicology

 Which of the following factors is/is not relevant to theraputic drug monitoring?

of the amino glycosides, antibiotics, and vancoumycin?

NOT= intestinal absorption (not administered orally)

IS =nephrotoxicity, otottoxicity, renal function

TDM and Toxicology

 The drug procainamide is prescribed to treat cardiac arrhythmia. What biologically active liver metabolite of procainomide is measured simultaneously?

TDM and Toxicology

 Cocaine is metabolized to

TDM and Toxicology

 The metabolite 11-nor-tetrahydrocannabinol-9-COOH can be detected by immunoassay 3-5 days after a single use of

TDM and Toxicology

 A three year old child was evaluated for abdominal pain and anorexia by a physician . A CBC revealed a hemoglobin of 9.8 and basophillic stippling of the RBCs . The doctor should order further test to check for poisioning from:

TDM and Toxicology

Zinc protoporphyrin or free protoporphrin measirements are useful to assess blood concentrations of:

TDM and Toxicology

A carbonate salt used to control manic depressive disorders is

lithium

lithium

lithium

lithium

lithium

lithium

TDM and Toxicology

An anti-epileptic (or anticonvulsant) used to control sezure disorders is

TDM and Toxicology

 A drug that relaxes smooth muscles of the bronchial passages is

TDM and Toxicology

A cardiac glycoside that is used in the treatment of congenital failure and arrhythmias by increasing the force and velocity of myocardial contraction is:

TDM and Toxicology

 A salicylate level is performed to detect toxicity caused by ingestion of excess:

TDM and Toxicology

 lithium therapy is widely used in the treatment of

TDM and Toxicology

Serum and urine copper levels are assayed on a hospital patient with the following results:

serum Cu 20ug/dL(low)

urine Cu 83 ug/dL(high)

this is most consistant with :

wilsons disease

^{urine copper is high in wilsons disease}

TDM and Toxicology

an active metabolite of amytriptyline is

TDM and Toxicology

 Phenobarbatol is a metabolite of

TDM and Toxicology

 Testing for the diagnosis of lead poisioning  should include

Quality Assesment

 Blood recieved in the labrotory for blood gas analysis must meet which of the following requirements?

Quality Assesment

 After a difficult veinapuncture requireing prolonged application of the tourniquiet, the serum K+ was found to be 6.8 mEq/L The best course of acton is to:

Repeat the test using freshly drawn serum

^{hemoconcentration stupid}

Quality Assesment

 Serum from a patient with metastatic carcinoma of the prostate was separated from the clot and stored at room temperture. The following results were obtained:

Ca 10.8

LD 420

ALP 0.1

The technician should repeat the :

ALP with freshly drawn serum

(no room temp, must use sodium citrate then freeze to stabilize)

Quality Assesment

 A lipemic serum is separated and frozen at -20*C for assay at a later date. One week later, prior to preforming an assay for triglycerides, the specimens should be:

Quality Assesment 

The different water content of erythocytes and plasma makes true glucose concentration in whole blood a function of the

Quality Assesment

In a specimen collected for plasma glucose analysis, sodium flouride:

Quality Assesment 

As part of a hyperlipidemia screening program, the following results were obtained on a 25 year old woman 6 hours after eating:

trig 260

cholesterol 120

which of the following is the best interpretation of these results?

Quality Assesment 

Blood was collected in a serum tube on a patient who has been fasting since midnight. The time of collection was 7am . The labratory test which should be recollected is:

triglycerides.

must be fasting 10-14 hours.

Quality Assesment

Arterial blood that is collected in a heparinized syringe but exposed to room air would be most consistant in which of the following specimens:

PO₂ elevated, PCO₂ decreased

 Ph elevated

O₂ in CO₂ out

Quality Assesment

Specimens for blood gas determination should be drawn into a syringe containing:

Quality Assesment

Unless blood gas measurements are made immediatly after sampling , in vitro glycolysis of the blood causes a

Quality Assesment

Which of the following serum constituents is unstable if a blood specimen is left standing at room temperature for 8 hours before processing?

Quality Assesment 

An arterial blood specimen submitted for blood gas analysis was obtained at 08:30 am but was not receved in the laboratory until 11:am. the technologist should:

Quality Assesment

In monotoring glomerular function, which of the following test has the higest sensitivity?

Laboratory Mathematics

 If the PKa is 6.1, the CO₂ is 25, the salt equals the total CO₂ content minus the carbonic acid; the carbonic acid equals: 0.03X PCO₂ and PCO₂ = 40 it may be concluded that

pH = 6.1 + log [(25-1.2)/(1.2)]

pH = 6.1 + log(saltacid)

Salt= total carbon dioxide content (CO₂)- carbonic acid (0.03x40)

Laboratory Mathematics

A 24 hour urine (total volume=1.136mls) is sbmited to the laboratoy for quantitive urine protein. Calculate the amount of protein excreted per day , if the total protein is 52 mg/dL

Laboratory Mathematics

The following results were obtained:

urine creatinine 90 mg/dL

serm creainine 0.90 mg/dL

patients total body surface: 1.3 M²

total volume urine 24 hours 1500 ml

90 X 1500/0.90x1.73

104

Laboratory Mathematics

One international unit of enzyme activity is the amount of enzyme that will, under specified reacton conditions of substrate concentration, pH and temperature, cause utilization of substrate at the rate of

Laboratory Mathematics

 The bicarbonate and carbonic acid ratio is calculated from an equation by:

Laboratory Mathematics 

¹²⁵ I  has a physical half life of 60.0 days. A sample tested today had activity of 10,000 CPM/mL how many days from today will the count be 1250 CPM/mL

10,000

60 days 5,000

120days 2500

180 days 1250

180 days

Laboratory Mathematics

In spectrophotometric determination, which of the following is the formula for calculating the absorbance of a soluton?

Laboratory Mathematics

Which of the following is the henderson Hasselbach equaton?

Laboratory Mathematics 

An adult diabetic with renal complications has the following results:

Na 133

glu 487

BUN 84

creat 5

In the basis of these results the calculated serum osmolality is:

304

2X na + glu/18 + BUN/2.8

Laboratory Mathematics

look at the figure on page 120

it is a right angle with a positive straight slope that starts 1/5 of the was up the Y axis

The above figure shows the reciprocal of the measured velocity of an enzyme reaction plotted aginst the reciprocol of the substrate concentration.

True statements about this figure include:

Laboratory Mathematics 

The following results were obtained in a creatinine clearance evaluation

urine concentration 84

urine volume 1440

serum concentration 1.4

body surface area 1.66

84X1440 / 1.4 X 1.66

65

Laboratory Mathematics

 In the international system of units , serum urea is expressed in millimoles per liter:

urea NH₂CONH₂

atomic weight N=14, C=12, O= 16, H+1

a serum containing 28 mg/dL would be equivalent to what concentration of urea.

28 / 2.14 =13

10

The urea nitroen factor is 2.14

Laboratory Mathematics

 The uria nitrogen concentration of a serum sample was measured to be 15 mg/dL

urea   NH₂CONH₂

atomic weight N=14, c=12. O=10, H=1

he urea concentration of the sample in mg/dL is

32

The urea nitrogen factor is 2.14

15x2.14=32

Laboratory Mathematics

The osmol gap is defined as measured Osm/kg minus the calculated Osm/kg. Normally , the osmol gap is less than

0

 the difference between between the actual osmolality commonly measured by freezing point depression and the calculated osmolality is reffered to as the calculated osmolality is referred to as the osmol gap. normally the osmol gap is <10

Laboratory Mathematics

 Normally the bicarbonate concentration is abut 24 mEq/L and the carbonic acid concentration is about 1.2; pK =6.1,log 20=1.3. using the equation pH =pK + log [salt/acid] calculate the pH