GoConqr has a new look! Let us know what you think.

Sign up free

Flashcards

ClinChem lab exam 2

Fritz Hull Clinical Chemistry II Lab Exam 2 English 46 cards

Cards in this deck (46)

  1. 1Alkaline phosphatase (ALP)Essential for bone mineralization,synthesized in osteoblasts.
    -Increased in bone destruction (bone dissolving back into it's compinents)
    -Decreased with the use of anti-reabsorbtive agents
  2. 2DigoxinCardioactive glycoside drug, can produce toxicity if not given at the right time during treatment.
    -treats congestive heart failure by increase the force of myocardial contraction.
  3. 3Alkaline phosphatase can be elevated in heart failure related to ventricular dysfunction. If digoxin is increased to toxic levels, what happens to the ventricles? Can these two analytes be related then?If digoxin is increased to a toxic level it can cause the impulse between the atria and the ventricles to stop -> which can cause ventricular heart failure -> which can cause an increase in ALP.
  4. 4What other phosphatase can be used to asses bone issues?Tartrate-resistant acid phosphatase - it is a marker of bone destruction, it is released by the osteoclasts.
  5. 5Most elevated bone marker in Paget's disease?Alkaline phosphatase (ALP)
  6. 6What role does digoxin play in cardiac therapy?It treats ventricular dysfunction by increasing the force of ventricular contraction.
  7. 73 minerals analyzed for bone disease?1) Calcium
    2) Phosphate
    3) Magnesium
  8. 8Digoxin is also known as?Lanoxin
  9. 9Digoxin is from?Digitalis (foxglove) plant
  10. 10Digoxin toxicity?Stops the impulse between the atria and the ventricles to stop and produces nausea, rapid heart rate and visual impairment.
    -has actually fallen out of favor because it does not decrease morbidity overall.
  11. 11Pharmodynamics"What a drug does to the body"
    - drug must be a specific concentration to bind receptors and this binding must elicit a specific effect.
  12. 12Pharmokinetics"What a body does to the drug"
    - the mathematical description of the physiological disposition of drugs over time; done to assure the proper dosing amounts of a drug.
  13. 13Therapeutic rangeRelationship between minimum effective concentration and minimum toxic concentration of a drug.
  14. 14Steady-state levelCondition of equilibrium reached during regular dosing when rate of drug input equals the rate of drug metabolism and elimination.
  15. 15Where should the steady state level be?Between the MEC and MTC.
  16. 16PeakWhen drug is at the highest concentration in blood just after dosing (just below MTC)
  17. 17TroughThe concentration just before next dose (just above MEC)
  18. 18How many half lives are required to reach the therapeutic range and steady state?approximately 5
  19. 19Why is timing of blood draw so important in the analysis of a therapeutic drug such as digoxin? When is the best time in the dosage/response cycle to draw a sample for TDM?Because digoxin is toxic in overdose, so if we are measuring it in order to determine dosage information we need to make sure that we are measuring it at the lowest possible value (ie the trough value, immediately before the next dose)
  20. 20MedTox Verdict system- a handheld, one-step, competitive membrane based immunochromatographic/lateral flow immunoassay.
    - It is QUALITATIVE; non-negative results must be confirmed with quantitative tests.
  21. 21MedTox Verdict system - control?Anti-Mouse ab immobilized at the control window. If the strip is working, the Anti-mouse ab will bind any of the mouse ab coated don the colloidal gold.
  22. 22MedTox Verdict system - Ab-collodial gold?Mouse monoclonal drug ab for each of the drugs tested is attached to colloidal gold in the sample well pad.
  23. 23MedTox Verdict system - Drug conjugates?Drug from each of the drug classes tested for is individually conjugated to bovine serum albumin of IgG and immobilized at a line labeled on the strip.
  24. 24MedTox Verdict system - Negative result?If non of the drug that is being tested for is present in the sample, a easily visible reddish-purple line appears at the labeled location in the result window.
    - negative results can reported as soon as the line is visible
  25. 25MedTox Verdict system - non-negative result?When drug(s) are present in the sample, the ab-colloidal gold binds to the drug(s) before it can migrate up the strip, so it therefore cannot bind to the drug immobilized on the membrane and no line is generated.
    - Report negative results at 5 minutes
    - Control line must be present for results to be valid
  26. 26MedTox Verdict system - how much urine?100 microliters
  27. 27Possible reasons for obtaining a negative screening test result when all indication point to a non-negative drug status?1) Adulteration (lots of bendryl, etc.)
    2) Dilution (lots of water)
    3) Certain tea's
  28. 28What is a test that is used to retest and quantify drugs of abuse in a sample?Gas chromatography/mass spectrophotometry
  29. 29Comprehensive Metabolic Panel includes?1) Albumin
    2) BUN
    3) Cholesterol
    4) Creatinine
    5) Glucose
    6) Total protein
  30. 30Why is it difficult to determine normal reference intervals for a group of older individuals?It's difficult to find "healthy" elderly subject to establish a baseline value from and everyone ages very differently.
  31. 31Elderly sensory changesDecreased sense of smell
    Decreased sense of taste
    Reduced visual acuity (cant see as well)
    Impaired hearing
  32. 32Elderly endocrine system changes1) Thyroid deterioration - hypo and hyper-thyroidism increases (TSH most affected)
    2) Menopause - cessation of ovarian estrogen production, testosterone production decreases
    3) Parathyroid hormone decrease - from bone loss?
  33. 33Elderly enzyme changes1) Increased ALP (2x ULN) attributed to liver/renal changes affecting vitamin D, as well as the demineralization of bone causing more ALP in circulation
    2) increased creatine kinase between ages 60-70, then it decreases
  34. 34Elderly hematology changes1) ESR higher
    2) RBC lower, HCT lower
    3) Lymphocytes lower
  35. 35Delta OD450 analysisBilirubin in amniotic fluid is assessed and the degree of hemolysis is indicated.
  36. 36Peak absorbance of bilirubin450 nm
  37. 37Delta OD450 analysis - graphsBOTH SEMI LOG
    1) amniotic fluid absorbance readings (y-axis) vs. wavelength (x-axis) (for the components of the amniotic fluid)
    2) Difference in the OD (optical density) readings (y-axis) (bilirubin only) VS. gestation in weeks (x-axis)
  38. 38Bilirubin absent or in small amounts?Reading at 450 nm should fall directly on the best fit line.
  39. 39Bilirubin present?Will be off of the best fit line, in which case you will need to calculate the difference between your actual reading at 450nm and the expected reading (where the line crosses the 450 vertical)
  40. 40Why would a turbid sample cause problems for this procedure?It could potentially mess up the absorbance readings.
  41. 41Difference between conjugated and unconjugated bilirubin?Conjugated bilirubin is bound to albumin and is on its way to be excreted, whereas unconjugated bilirubin is not (dangerous)
  42. 42What type of bilirubin are we measuring?unconjugated bilirubin
  43. 43Role of amniotic fluid?Cushions fetus and maintains constant moist environment and temperature.
  44. 44What does amniotic fluid consist of?1) Water
    2) Electrolytes
    3) Non protein nitrogens
    4) Proteins
    5) Hormones
    6) Phospholipid surfactant
  45. 45Main physiologic factor in determining whether or not labor can be induced?Gestation weeks (looked at mainly for lung development)
  46. 46What may happen if the newborn is born too prematurely?Death due to the lungs not being able to support it.

Information

Description
Lab Exam 2 Clinical Chemistry II Flashcards on ClinChem lab exam 2, created by Fritz Hull on 06/04/2016.
Created by
Fritz Hull
Views
3
Rating

More on Diagnostic Enzymes and Biomarkers

Feedback

What is it about?

What do you think of the new look?

How do you like it?