Chemistry I (Mlt Exam)

Front 1

Normality

Back 1

One gram equivalent weight of solute dissolved in 1 liter of solution. It is always equal to or larger than respective molarity. N=nM

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Beer-Lambert's Law

Back 2

Concentration of a substance is directly proportional to amt of light absorbed or inversely proportional to log of transmitted light. Only valid within linear proportion of the standard curve.
A = abc = log(100/%T)
A = 2-log%T

Front 3

Hypocalcemia

Back 3

Muscle spasms, tetany, cardiac arrhythmias, respiratory arrest.

Front 4

Hypercalcemia

Back 4

Anorexia, vomitting, constipation, depression. Commonly d/t hyperparathyroidism. Also vit D intoxication. Ionized calcium sensitive marker to dx asymptomatic hyperparathyroidism.

Front 5

Calcium regulation by PTH

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Decreased calcium stimulates PTH release, while increased calcium terminates PTH release. PTH activates osteoclasts to break down bone to increase serum Ca.

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Calcium regulation by Vitamin D

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Enhances calcium absorption in intestines and effect of PTH in tubular reabsorption of Ca

Front 7

Calcium regulation by Calcitonin

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-Increased Ca = release of calcitonin by parafollicular cells of thyroid gland
-Inhibits Vit D and PTH activity

Front 8

Bilirubin

Back 8

Produced by breakdown of hgb, myoglobin, and cytochromes

Front 9

Unconjucated bilirubin

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Biliverdin
-Insoluble in water (cannot be excreted)
-Porphyrin ring of heme oxidized to release iron and produce biliverdin.

Front 10

Conjugated bilirubin

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Bilirubin diglucoronide
-Conjugated in liver, stored in gallbladder, secreted into duodenum
-Excreted in stool as urobilinogen
-Water soluble
-Light photoisomerizes unconj -> conj. Bili

Front 11

Urobilinogen

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Anaerobic bacteria in gut convert bili to urobilinogens (ie. sterco, meso, and urobilinogen)

Front 12

Impaired bili excretion

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Decreased urobilinogen formation. Complete obstructive jaundice -> chalky white stool

Front 13

Biuret method

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Total protein. Colorimetric technique. Cupric ions complex in alkaline medium. Purple colored complex proportional to peptide bonds present

Front 14

Globulins

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TP – albumin

Front 15

Serum gel electrophoresis

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Proteins move according to net charge determined by pH of buffer. Serum applied to cathode end (buffer pH = 8.6), proteins migrate toward anode.  Albumin travels farthest, then α1 globulins, α2 globulins, β globulins, γ globulins

Front 16

Cholesterol

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Increased dietary cholesterol slows cholesterol synthesis
Decreased in various forms of liver disease; most notably alcoholic cirrhosis

Front 17

Triglyceride

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Broken down by lipoprotein lipases. Increased in storage diseases (Gaucher’s, Niemann-Pick)

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HDL

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Produced by liver and intestine

Front 19

Friedwald formula

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Indirect. 
LDL = TC – (HDL + TG/5)
Not valid for trig > 400mg/dL

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Apo A-1

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Major protein in HDL

Front 21

Apo B

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Major protein in all lipoproteins except HDL

Front 22

Increased glucose

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Hallmark of diabetes mellitus and can also indicate Cushing’s disease

Front 23

Glucose hexokinase

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Reference method. [Gluc] proportional to NADPH production. NADP+ from erythrocytes can influence results (hemolyzed samples problematic)

Front 24

Glucose oxidase

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Β-glucose. Peroxidase.

Front 25

Glucose dehydrogenase

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α-glucose. NADH -> dye + NAD

Front 26

Uric Acid

Back 26

Product of metabolic breakdown of purine nucleotides (adenosine/guanosine)

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First order kinetics

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Substrate binds free [E] at low substrate conc. Rxn directly prop. to substrate conc.

Front 28

Zero order kinetics

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When substrate conc. high enough to bind all available [E]s, rxn velocity is at its maximum (Vmax). Enzyme reactions performed in zero-order kinetics with enough substrate to ensure only 20% is converted to product.

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Km

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Concentration of substrate needed to drive reaction at half Vmax

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Competitive inhibitor

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Competes w/ substate for active site. Reversible.

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Noncompetitive inhibitor

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Binds w/ enzyme at site other than active site. Reversible or irreversible

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Uncompetitive inhibitor

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Binds enzyme-substrate complex so that increasing substrate conc. leads to more enzyme-substrate complexes and more inhibition

Front 33

Aspartate aminotransferase (AST)

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• Highest concentrations in cardiac tissue, liver, and skeletal muscle
• Used to evaluate AMI, hepatocellular disorders, and skeletal muscle disorders
• In AMI, AST rises w/in 6-8 hours, peaks at 24hrs, then returns to normal w/in 5 days
• Usually elevated in pulmonary embolisms

Front 34

Alanine aminotransferase (ALT)

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• High concentrations in the liver
• Used to evaluate liver disorders and hepatocellular disorders

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Alkaline phosphatase (ALP)

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• Increased in hepatobiliary and bone disorders
• ALP levels also increased in children and elderly
• In biliary tract obstruction, ALP levels are 3-10x normal
• Highest elevations of ALP in Paget’s disease

Front 36

Acid phosphatase (ACP)

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• Found in high concentrations in the prostate, platelets, and RBCs
• Dx: prostate cancer

Front 37

Gamma-glutamyltransferase (GGT)

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• Increased levels in all hepatobiliary diseases
• Higher levels in biliary tract obstruction
• Sensitive indicator of alcoholism

Front 38

Amylase

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• Produced by pancreas and salivary glands
• Dx: acute pancreatitis
• Increased in mumps, peptic ulcer, intestinal obstruction, appendicitis

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Lipase

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• Produced primarily by pancreas
• Hydrolyses dietary trigs
• Confirms dx of acute pancreatitis

Front 40

Glucose-6-phosphate dehydrogenase (G6PD)

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• Very little G6PD in healthy serum
• Deficiency: RBC hemolysis
• Increased: megaloblastic anemia and AMI

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Lactate dehydrogenase (LD)

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• Zinc-containing enzyme part of glycolytic pathway
• Found in cytoplasm of all cells and tissues in body
• Elevated: cardiac, hepatic, or skeletal muscle disease
o Highest elevation: pernicious anemia

Front 42

Digoxin

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Cardiac glycoside used to treat congestive heart failure.
Inhibits membrane Na+/K+ ATPase that causes a decrease in intracellular K+ and increase in intracellular Ca (improves cardiac contraction)
Oral administration

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Lidocaine

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Correct ventricular arrhythmias and prevent ventricular fibrillation
Usually given by continuous IV

Front 44

Quinidine

Back 44

Correct cardiac arrhythmias
Oral administration

Front 45

Procainamide

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Treat cardiac arrhythmias, tachycardia
Oral administration

Front 46

Aminoglycosides

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Include gentamicin, tobramycin, kanamycin, and streptomycin
Kill gram negative rods
Usually administered IV and IM

Front 47

Vancomycin

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Eliminates gram positive cocci
Administered by IV

Front 48

Anticonvulsants

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Treat seizure disorders
Includes Phenobarbital, Phenytoin, Valproic acid, Carbamazepine, and Ethosuximide

Front 49

Lithium

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Treats bipolar disorders

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Tricyclic antidepressants

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Treat depression, insomnia, apathy, loss of libido

Front 51

Theophylline

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Treats asthma and other chronic obstructive pulmonary disorders (COPD)

Front 52

Cyclosporine

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Suppress graft-vs-host disease in allogenic transplants

Front 53

Tacrolimus

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Same as cyclosporine, but 100x more potent

Front 54

Ethanol

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Alcoholic hepatitis, cirrhosis
Test: enzymatic rxn of colored product NADH

Front 55

Methanol

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Severe acidosis, blindness, and death
Test: osmolal gap

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Isoproponaol

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Severe acute phase ethanol-like symptoms that persist for a long period
Test: gas chromatography

Front 57

Ethylene glycol

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Severe metabolic acidosis and renal tubular damage
Definitive dx made by HPLC

Front 58

Carbon monoxide

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Binds tightly to hgb and does not allow oxygen to attach
Produces hypoxia in brain and heart

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Cyanide

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Extremely toxic substance b/c exposure can occur by inhalation, ingestion, or transdermal absorption
Used in industry, insecticides, and rodenticides
Binds to heme iron and mitochondrial cytochromes

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Arsenic

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Binds to thiol groups in proteins
Symptoms include GI distress, CNS damage, hematopoietic effects

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Iron

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Large doses cause acute mucosal cell damage
Unbound iron in serum causes hepatic cell damage, shock, and production of lactic acidosis

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Lead

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Binds to proteins, changes structures/fxns, and inhibits enzymes
Leads to decreased Vit D, anemia, and basophilic stippling

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Pesticides

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Inhibit acetylcholinesterase (AChE), which is an important neurotransmitter
Include organophosphates and carbamates

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Salicylates

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Aspirin
Analgesic, antipyretic, and anti-inflammatory
Decreases thromboxane and prostaglandin formation through inhibition of cyclooxygenase

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Acetominophen

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Tylenol. 
Analgesic and antipyretic to treat fever, headache, and mild to moderate myalgia and arthralgia
Inhibits prostaglandin cyclooxygenase