Term
|
Definition
| functions as coenzyme in metabolic reactions involving transfer of single-carbon units from donor to reciepiant compound |
|
|
Term
| What is essential for DNA synthesis and normal rbc maturations? |
|
Definition
|
|
Term
| what are the dietary sources of Folate? |
|
Definition
| fruits, green leafy vegetables, yeasts, and organ meats |
|
|
Term
|
Definition
|
|
Term
| what are some causes of folate deficiency? |
|
Definition
low folate intake, malabsorption as a result of gastrointestinal disease, pregnancy and drugs such as phenytoin.
also associated with chronic alcoholism |
|
|
Term
| which type of anemia does folate deficiency cause |
|
Definition
|
|
Term
| which principle does the cobas 6000 use to test folate |
|
Definition
|
|
Term
|
Definition
| a complex corrinoid compound that contains 4 pyrrole rings surrounded by a single carbon atom |
|
|
Term
| what are the dietary sources of Vitamin B12? |
|
Definition
|
|
Term
|
Definition
| stored mostly in the liver but found in the bone marrow and other tissues |
|
|
Term
| what roles does B12 play in dna synthesis? |
|
Definition
| vitamin B12 along with Folate are critical to DNA synthesis which in turn effects RBC maturation |
|
|
Term
| what is myelin sheath and how does B12 effect it? |
|
Definition
B12 is essential to myelin sheath.
Myelin sheath is: the insulating enevelope that surrounds the core of nerve fibers or the axon and facilitates the transmission of nerve impulses |
|
|
Term
| what does B12 deficiency cause? |
|
Definition
| neurological abnormalities, decreased serum B12 levels, and increased excretion of methylmalonic acid |
|
|
Term
| what causes pernicious anemia? |
|
Definition
| B12 deficiency due to lack of intrinsic factor |
|
|
Term
| what causes B12 deficiency? |
|
Definition
| low vitamin B intake, gastroectomy and disesases of the small intestine, malabsorption and trans-cobalamin deficiency |
|
|
Term
| which principle does the COBAS 6000 use to test Vitamin B12 |
|
Definition
|
|
Term
| what is Creatine Kinase (CK)? |
|
Definition
| an enzyme that is involved in the transfer of energy in muscle metabolism |
|
|
Term
| what are the 2 subunits of CK? |
|
Definition
B- brain form
M-muscle form |
|
|
Term
| What are the 3 CK isoenzymes? |
|
Definition
CK-BB: CK1
CK-MM: CK3
CK-MB: CK2 |
|
|
Term
|
Definition
| isoenzyme of the brain that is only found in the blood when the blood brain barrier has been breached |
|
|
Term
|
Definition
| isoenzyme that accounts for almost all the CK activity in the skeletal muscle |
|
|
Term
|
Definition
| has the most specificity for the heart |
|
|
Term
| what are elevated CK-MB levels associated with? |
|
Definition
| myocardial cell death and damage due to acute myocardial infarction (AMI) |
|
|
Term
| Describe the rise and fall pattern of CKMB levels |
|
Definition
| levels can be detected 4-6 hrs after onset of chest pain; levels peak at 12-24 hrs; levels return to normal after 24-48hrs |
|
|
Term
| what are other causes of elevated CKMB? What is the difference between them and an AMI? |
|
Definition
cardiac surgery after coronary bypass, and valve replacement or repair of congenital defects.
in these cases CKMB doesnt exhibit the rise/fall pattern indicative of an AMI |
|
|
Term
| what most the CKMB to total CK ratio be to indicate heart damage? |
|
Definition
|
|
Term
| what is the relative index |
|
Definition
|
|
Term
| what are some other causes of CKMB elevation? |
|
Definition
| skeletal muscle trauma, dermatomyositis, duschenne's muscular dystrophy, Reye's syndrome, rhabdomyolysis, drug overdose, delirium tremens, or chronic alcohol poisoning |
|
|
Term
| which principle does the COBAS 6000 use to test CKMB? |
|
Definition
|
|
Term
| what are the 2 types of cardiac troponin? |
|
Definition
| troponin I (TnI) and troponin T (TnT) |
|
|
Term
| what is the difference between TnI and TnT? |
|
Definition
| TnI measures only cardiac troponin, TnT may be increased in the absence of heart damage |
|
|
Term
| what is TnT's correlation with acute coronary syndrome (ACS) |
|
Definition
| TnT is an independant prognosis- marker that can predict the near, mid, and even long term outcome of patients with ACS |
|
|
Term
| what causes elevated TnT levels? |
|
Definition
| congestive heart failure (CHF), cardiomyopathy, myocarditis, heart contusion, renal failure, lung embolism, stroke or after cardiac surgery |
|
|
Term
| are elevated TnT levels synonomous with the cause of myocardial injury? |
|
Definition
| No, elevated levels are indicative of myocardial injury but not synonomous with the cause |
|
|
Term
| which principle does the COBAS 6000 use to test TnT? |
|
Definition
|
|
Term
|
Definition
| a cytoplasmic protein in striated cardiac and skeletal muscleculature |
|
|
Term
| what is the importance of the determination of myoglobin in the serum |
|
Definition
| determination of myoglobin in the serum is an important factor in the diagnosis of AMI and successful reperfusion following lysis therapy |
|
|
Term
| Describe the rise/fall pattern of myoglobin |
|
Definition
| in an AMI levels are elevated 1-3hrs after onset of chest pain; levels peak btwn 5-12hrs; levels return to normal after 18-30hrs |
|
|
Term
| what is important about the degree of elevation of myoglobin levels? |
|
Definition
| the degree of elevation indicates the size of the infarction |
|
|
Term
| which principle does the COBAS 6000 use to test myoglobin |
|
Definition
|
|
Term
| what is proBNP and what is it used for |
|
Definition
-prohormone brain natrieutic peptide
-is used as an aid in the diagnosis of individuals suspected of having CHF |
|
|
Term
| what is proBNP further indicated for |
|
Definition
-it is further indicated for the risk of straitifications of patients with AMI and CHF
- it is also suitable for assessing vascular remodeling and contributes to the establishment of individualized rehabilitation
|
|
|
Term
| what does the concentration of proBNP in the serum/plasma indicate |
|
Definition
| the prognosis of left ventricular dysfunction |
|
|
Term
| which principle does the COBAS 6000 use to test proBNP |
|
Definition
|
|
Term
|
Definition
| chemical signals produced by specialized cells, secreted into the blood stream, and carried to targeted tissues |
|
|
Term
| how is cellular function regulated |
|
Definition
|
|
Term
| are homones capable of responding to emergency situations |
|
Definition
| yes hormones can be secreted through specialized nerve cells and are capable of responding to emergency situations as well as maintaining internal chemal environments |
|
|
Term
| what are the 3 types of chemical hormones |
|
Definition
-steroids
-polypeptides or proteins
- substances derived from amino acids (amines) |
|
|
Term
|
Definition
| lipid molecules that have cholestorl as a precursor |
|
|
Term
| where are steroids produced |
|
Definition
| adrenal glands, ovaries, testes, and placenta |
|
|
Term
| what controls the steroid rate of secretion |
|
Definition
| the rate of synthesis and the amount of cholesterol stored control the steroid rate of secretion |
|
|
Term
| what are the 2 forms of proteins |
|
Definition
| proteins may be peptides or glycoproteins |
|
|
Term
|
Definition
| insulin, glucagon, parathyroid hormone (PTH), GH,and prolactin (PRL) |
|
|
Term
| what are proteins stored and synthesized as |
|
Definition
| secretory granules that are released as needed |
|
|
Term
| what are the glycoproteins |
|
Definition
follicle stimulating hormone (FSH), leutenizing hormone (LH) and HGC
- they are all comprised of alpha/beta subunits |
|
|
Term
|
Definition
| epinephrine, norepinephrine, thyroxine, and triiodothyroxine |
|
|
Term
| which amines behave like protein hormones |
|
Definition
| epinephrine and norepinephrine |
|
|
Term
| which amines behave like steroids |
|
Definition
| thyroxine and triiodothyroxine |
|
|
Term
| how is the endocrine system regulated |
|
Definition
primarily by means of control of hormone synthesis rather than by rate hormone degradation
(mechanisms of control) |
|
|
Term
| how is the production of hormones regulated |
|
Definition
by a set of feedback relationships
- if concentrations of hormones rise within a desired level the system will take steps to cause the level to fall and vice/versa if the concentration is decreased |
|
|
Term
| what does the fertility assay test for |
|
Definition
| FSH, LH, progesterone, PRL, and quantitative HCG |
|
|
Term
| how much destruction of a functioning mass of a gland is necessary before clinical evidence of deficiency occurs |
|
Definition
- as much as 90%
-serial dilutions are made to catch a disruption early |
|
|
Term
|
Definition
| formed in the parathyroid gland and secreted into the blood stream |
|
|
Term
| how is the secretory activity of the parathyroid gland ascertained? |
|
Definition
| selective measurement of intake pth |
|
|
Term
| what does pth with vitamin D and calcatonin do |
|
Definition
| bring about the mobilization of calcium and phosphate from the skeletal system and increase uptake of calcium in the intestine and the excretion of phosphate via the kidneys |
|
|
Term
| how is the secretion of pth inhibited and promoted |
|
Definition
| pth is inhibited by high calcium concentrations and promoted by low calcium concentrations |
|
|
Term
| what does parathyroid gland disorders lead to |
|
Definition
| elevated/ depressed blood calcium levels (hypocalcemia/hypercalcemia) brought about by a change in the secretion of PTH |
|
|
Term
| what is hypoparathyroidism |
|
Definition
| subfunctioning of the parathyroid glands |
|
|
Term
| what is hyperparathyroidism |
|
Definition
| hyperfunctioning of the parathyroid gland resulting in increased secretion of pth |
|
|
Term
| what are the primary and secondary causes of hyperparathyroidism |
|
Definition
-primary: adenomas of the parathyroid gland
-secondary: the blood calcium levels are low as a result of other pathological states |
|
|
Term
|
Definition
| a glycoprotein with 2 subunits |
|
|
Term
|
Definition
| secreted by the anterior pituitary gland in response to gonadotropin-releasing hormone secreted by the hypothalamus |
|
|
Term
| what does fsh play a critical role in |
|
Definition
FSH and LH play a critical role in maintianing normal function of the male/female reproductive system
|
|
|
Term
| describe fsh reaction in the female |
|
Definition
| the targeted tissue is the ovarian follicle; fsh stimulates follicle development and production of estradiol and other estrogens during the follicular phase of the menstrual cycle |
|
|
Term
| describe fsh action in males |
|
Definition
| the targeted tissue is the steroli cells in the seminiferous tubules of the testes; fsh stimulates spermatogenesis |
|
|
Term
| what increased fsh levels associated with |
|
Definition
| menopause and primary ovarian hypofunction in females and primary hypogonadism in males |
|
|
Term
| what are decreased fsh levels associated with |
|
Definition
| primary ovarian hyperfunction in females and hypergonadism i males |
|
|
Term
| what fsh levels are associated with polycystic ovary disease in females |
|
Definition
| normal or decreased fsh levels |
|
|
Term
| which principle does the COBAS 6000 use to test FSH |
|
Definition
|
|
Term
| how does LH secretion come about |
|
Definition
| the hypothalamus secretes gonadotropin-releasing hormone (GnRH), a single peptide releasing hormone that controls the secretion of gonadotropins, LH, and FSH from the anterior pituitary gland |
|
|
Term
| what are the targeted tissues of LH in females |
|
Definition
| the targeted tissues are ca cells of the ovarian follicles, grafian follicle, and corpus luteum |
|
|
Term
| what does LH do in the female |
|
Definition
| stimulates production of androgens that FSH converts to estradiol during the follicular phase; LH acts synergistically with FSH to cause ovulation during the mid cycle peak; LH stimulates progesterone during the luteul phase of the menstraul cycle. |
|
|
Term
|
Definition
in males the targeted tissue is the Leydig cells in the interstitial tissues of the testes
-LH stimulates testosterone secretion |
|
|
Term
| what are increased LH levels associated with |
|
Definition
menopause, primary ovarian hypofunction, and polycystic ovarian disease in females
primary hypogonadism in males |
|
|
Term
| what are decreased levels of LH associated with |
|
Definition
| primary ovarian hyperfunction in females and primary hypergonadism in males |
|
|
Term
| which principle does the COBAS 6000 use to test LH |
|
Definition
|
|
Term
| what secretes progesterone in women |
|
Definition
| in menstruating women progesterone is secreted mainly by the corpus luteum of the ovary |
|
|
Term
| what does progesterone do |
|
Definition
| it is partially responsible for cyclic changes in the endometrium that are necessary for attachment and growth of an embryo |
|
|
Term
| what are the major sources of progesterone in females |
|
Definition
| corpus luteum and the placenta |
|
|
Term
| what are minor sources of progesterone |
|
Definition
| adrenal cortex in men and women and the testes in men |
|
|
Term
| when do progesterone levels reach there peak |
|
Definition
| in the middle of the luteal phase |
|
|
Term
| why do we perform clinical evaluations of progesterone |
|
Definition
| clinical evaluation of progesterone confirms ovulation and normal luteul phase in non-pregnant woman |
|
|
Term
| what does inadequate production of progesterone indicate |
|
Definition
| inadequate production of progesterone by the corpus luteum may indicate luteul phase deficiency which is associated with infertility and early miscarriage |
|
|
Term
| what effects do oral contraceptives have on progesterone levels |
|
Definition
| women using oral contraceptives have suppressed progesterone levels |
|
|
Term
|
Definition
| a single chain polypeptide hormone secreted by the anterior pituitary gland under the control of prolactin-inhibiting and prolactin-releasing factors |
|
|
Term
| what secretes the inhibiting/releasing factors |
|
Definition
|
|
Term
| where else is PRL synthesized |
|
Definition
| prolactin is also synthesized in the placenta and present in the amniotic fluid |
|
|
Term
|
Definition
| intiates and maintains lactation in females |
|
|
Term
| what are elevated levels of PRL in the absence of pregnancy or post-pardum lactation indicative of |
|
Definition
|
|
Term
| what is the most common hypothalmic-pituitary dysfunction encountered in clinical endocrinology |
|
Definition
|
|
Term
| what does hyperprolactinemia result in |
|
Definition
galactorrhea, amenorrhea, and infertility in females and impotence and hypogonadism in men
- it may also result in renal failure, hypothyroidism, and prolactin-secreting-pituitary adenomas |
|
|
Term
| which principle does the COBAS 6000 use to test PRL |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| responsible for the development of the secondary female sex characteristics |
|
|
Term
| what are the 3 primary hormones in the estrogen class |
|
Definition
-estrone (E1)
-estradiol ( E2)
-estriol (E3) |
|
|
Term
| of the 3 hormones in the estrogen class which is the most potent |
|
Definition
|
|
Term
| where are estrogens secreted from |
|
Definition
| corpus luteum and the placenta |
|
|
Term
| what is responsible for the majority of estrogen production during pregnancy |
|
Definition
|
|
Term
| where is estrogen produced |
|
Definition
| estrogen is produces primarily in the ovaries but small quantities are also produced in the adrenal cortex and the testes |
|
|
Term
| how is the determination of estradiol used clinically |
|
Definition
| used for manifestations in the elucidation of fertility disorders in the hypothalamus-pituitary-gonad-axis, gynecomastasia, estrogen- producing ovarian and testicular cancers, and in hyperplasia of the adrenal cortex |
|
|
Term
| what effect does menopause and premature ovarion failure have on E2 |
|
Definition
|
|
Term
| how does estrogen replacement therapy effect E2 |
|
Definition
| it may suppress or elevate E2 |
|
|
Term
| how does monitoring of follicular development/hormone induction therapy with exogenous gonadotropins effect E2 |
|
Definition
| e2 levels may be normal or elevated |
|
|
Term
|
Definition
-gynecomastasia will result in elevated or normal e2 levels
-testicular, adrenal, or pituitary tumors will result in normal or elevated e2 levels
-testicular dysfunction will result in normal or elevated e2 levels |
|
|
Term
|
Definition
-prococious puberty in girls will elevate e2
- delayed puberty in girls will suppress e2 |
|
|
Term
| where is testosterone synthesized almost exclusively |
|
Definition
| leydig cells of the testes |
|
|
Term
| what regulates testosterone |
|
Definition
| testosterone is regulated by LH and subject to negative feedback via the pituitary or hypothalamus |
|
|
Term
| what does testosterone do |
|
Definition
-promotes the development of the secondary sex characteristics in men
-serves to maintain the function of the prostate and seminal vesicles |
|
|
Term
| where is testosterone found in women |
|
Definition
| small amounts found in the ovaries |
|
|
Term
| what can increased production of testosterone in women cause |
|
Definition
| virilization, depending on the increase |
|
|
Term
| when is determination of testosterone levels in female helpful |
|
Definition
-diagnosis of androgenic syndrome (AGS)
-polycystic ovaries
-when an ovarian tumor, adrenal tumor, adrenal hyperplasia or ovarian insufficiency is suspected |
|
|
Term
| when is testosterone levels determined in men |
|
Definition
-when reduced testosterone is suspected.
-hypogonadism, estrogen therapy, chromosome abberations (such as Klinefelters syndrome) and liver cirrhois |
|
|
Term
| which principle does the COBAS 6000 use to test testosterone |
|
Definition
| competitive principle, using a monoclonal antibody specifically directed against testosterone |
|
|
Term
| what gives HCG its unique biochemical and immunological properties |
|
Definition
|
|
Term
| where is hcg synthesized and what does it do |
|
Definition
| hcg is synthesized by the placenta and it is involved in maintaining the corpus luteum during pregnancy |
|
|
Term
| what happens to hcg levels in pregnancy |
|
Definition
| in pregnancy hcg levels increase exponentially for about 8-10 weeks after last menstrual period |
|
|
Term
| what are sources of elevated hcg other than pregnancy |
|
Definition
| eptopic pregnancy, threatened abortion, microabortion, recent termination of pregnancy, and more rarely hcg secreting tumors |
|
|
Term
| which principle does the COBAS 6000 use to test HCG |
|
Definition
|
|
Term
|
Definition
-the most prominent glucocorticosteriod
-it is essential for the maintenence of several body functions |
|
|
Term
| where is cortisol synthesized |
|
Definition
| it is synthesized from the common precursor cholesterol in the zona fasciculate of the cortex of the adrenal gland |
|
|
Term
| what are the most important physiological effects of cortisol |
|
Definition
-the increase of blood glucose ( enhancement of glucogenesis and catabolic action)
- anti-inflammatory and immunosuppresive actions |
|
|
Term
| how are synthesis and secretion of cortisol controlled |
|
Definition
| a negative feedback mechanism within the hypothalamus-pituitary-adrenal cortex axis |
|
|
Term
| what is cortisol a negative feedback mechanism of |
|
Definition
| cortisol itself acts as a negative feedback mechanism on the pituiary gland and the hypothalamus |
|
|
Term
| serum cortisol normal shows diurnal variation. what does that mean |
|
Definition
| maximum concentrations are usually reached early in the morning |
|
|
Term
| cortisol status is helpful in diagnosising what |
|
Definition
| the function or malfunction of the adrenal gland, the pituitary, and the hypothalamus |
|
|
Term
| what is the specimen of choice for diagnosis of Cushing's syndrome and why |
|
Definition
| -the determination of cortisol in the 24hr urine is the specimen of choice for the detection of Cushing's syndrome since cortisol secretion in the urine is not subject to the diurnal rhythm of cortisol serum secretions |
|
|
Term
| What is Prostate Specific Antigen (PSA) |
|
Definition
| a single chain glycoprotein normally found in the cytoplasm of epithelial cells lining the acini and ducts of the prostate gland and in the seminal fluid |
|
|
Term
| when is psa detected in a males serum |
|
Definition
| psa is detected in the serum of males with normal, benign hypotrophic, and malignant prostate tissue |
|
|
Term
| what causes serum levels of PSA to be elevated |
|
Definition
| in diseases of the prostate including benign prostatic hypertrophy and prostatic carcinoma |
|
|
Term
| what are elevated psa levels indicative of |
|
Definition
| elevated psa levels are generally indicative of a pathological codition of the prostate |
|
|
Term
| is the % free psa lower or higher in patients who have prostate cancer |
|
Definition
| % free psa is significantly lower in patients having prostate cancer than those with benign disease or normal control |
|
|
Term
| what is Carcinoembryonic Antigen (CEA) |
|
Definition
| monomeric glycoprotein with a variable carbohydrate component |
|
|
Term
|
Definition
| cea is mainly found in the fetal gastrointestinal tract and in fetal serum |
|
|
Term
| where are high concentrations of cea frequently found |
|
Definition
| high concentrations of cea are frequently found in cases of colorectal adencarcinoma |
|
|
Term
| what causes slight to moderate elevations in cea |
|
Definition
| slight to moderate cea elevations occur in 20-50% of benign diseases of the liver, pancreas, intestine, and lungs |
|
|
Term
| does smoking effect cea levels |
|
Definition
| yes, smokers have elevated cea levels |
|
|
Term
| what is the main indication of cea determination |
|
Definition
| the main indication of cea determination is the follow-up and therapy management of colorectal carcinoma |
|
|
Term
|
Definition
| thyroxine is a hormone synthesized and secreted by the thyroid gland and it plays an important role in regulating metabolism |
|
|
Term
| how is thyroxine controlled |
|
Definition
- secretion of thyroxine in the circulation is in response to TSH
-thyroxine is regulated by a negative feedback mechanism involving the thyroid gland, pituitary gland, and the hypothalamus |
|
|
Term
| what free thyroxine (FT4) |
|
Definition
| the physiologically active thyroxine component |
|
|
Term
| in what conditions does FT4 levels parallel changes in total T4 levels |
|
Definition
| hypothyroidism/ hyperthyroidism |
|
|
Term
| when is measuring ft4 useful |
|
Definition
| measuring ft4 is useful when altered levels of total t4 occur due to changes in t4 binding proteins, especially TBG |
|
|
Term
| what is measured when thyroid disorders are suspected |
|
Definition
|
|
Term
| how is thyrosuppressive therapy monitored |
|
Definition
| determination of ft4 levels |
|
|
Term
| how is Thyroid Stimulating Hormone (TSH) controlled |
|
Definition
| tsh is synthesized and secreted in the anterior pituitary in response to negative feedback mechanisms involving concentrations of FT3 and Ft4 |
|
|
Term
| what are the 2 main actions of TSH |
|
Definition
- stimulate cell production and hypertrophy
-stimulate the thyroid gland to synthesize and secrete t3 and t4 |
|
|
Term
| what directly stimulates tsh production |
|
Definition
| the hypothalamic tripeptide, thrytropin-releasing-hormone (TRH) |
|
|
Term
| why is quantitating tsh important |
|
Definition
- quantitating tsh is important in evaluating thyroid function
-it is useful in differential diagnosis of primary(thyroid) secondary( pituitary) and tertiary (hypothalamus) hypothyroidism |
|
|
Term
| how are tsh levels affected in primary hypothyroidism |
|
Definition
| -tsh levels are significantly elevated |
|
|
Term
| how are tsh levels affected in secondary and tertiary hypothyroidism |
|
Definition
|
|
Term
| how does tsh respond to trh stimulation in secodary hypothyroidism |
|
Definition
| in secondary hypothyroidism tsh response to trh stimulation is absent |
|
|
Term
| how does tsh respond to trh stimulation in tertiary hypothyroidism |
|
Definition
| in tertiary hypothyroidism tsh response to trh stimulation is normal to exaggerated |
|
|
Term
|
Definition
| primary hypothyroidism is located om the thyroid, TSh levels are low and trh stimulations show elevated t3 and t4 levels with low to undetectable tsh levels |
|
|
Term
|
Definition
| located in the pituitary, tsh levels are low, and tsh response to trh stimulation is absent |
|
|
Term
|
Definition
| located in the hypothalamus, tsh levels are low, and tsh response to trh is normal to exaggerated |
|
|
