Clin Chem 2 Exam 3

Front 1

AA metab disorder

Back 1

PKU
MSUD
HCY
TYR I

Front 2

mc and preventable cause or mental retardation
inability to prod thyroid homr > cretinism
life long thyroid replacement

Back 2

Congenital hypothyroidism

Front 3

steroid biosynthesis > decr cortisol prod and aldosterone
21-hydroxylase def
> salt wasting

Back 3

Adrenal hyperplasia/ adenogenital synd

Front 4

def. in active transport molecule responsible for reabs a.a. from PCT > incr in urine
Cystinuria and Hartnup

Back 4

Renal aminoaciduria

Front 5

lack of transport molecule for COL(lysine)A
> colorless hexagonal cysteine crystals in acidic urine

Back 5

Cystinuria

Front 6

def in active transp molecule for reabs of a.a. from PCT
> incr aa in urine

Back 6

Hartnup synd

Front 7

incr blood conc due to def in metabolic pathway of aa
incr conc in urine and plasma
PKU
Tyrosinemia
Alaptonuria
Albinism (phe)
MSUD
Homocystinuria

Back 7

Overflow aciduria

Front 8

phenylalinine-hydorx def (req to convert phe > tyrosine)
incr conc in plasma and urine
> abn metabs in urine= phenylketones
musty odor
elim phe from diet
Guthrie test

Back 8

PKU

Front 9

bact growth = incr phe in serum
> 6mg/dL , diet restriction

Back 9

Guthrie
PKU

Front 10

incr tyrosine in blood
disorer of phe pathway

Back 10

Tyrosinemia

Front 11

homogentisic acid oxidase > build up pf HA > black depositis in cartlige
phe pathway

Back 11

Alkaptonuria

Front 12

absence of tyrosinase (tyrosine> melanin)
phe pathway

Back 12

Albinism

Front 13

branched chain aminaciduria
ketoacid decarboxylase def (for metab of leu, isoleu, val)
dietary restricts dont work

Back 13

MSUD

Front 14

cystathione synthase def (homocystine> cystathione)
effects methionine regen
give folic acid and B12

Back 14

Homocystinuria

Front 15

Carb abns

Back 15

Galactosemia
GSD

Front 16

def of enzyme requ to convert galactose>glc
> accuml of galactitol= neurotoxic
Clinitest

Back 16

Galactosemia

Front 17

enzyme def and accuml of glycogen in liver and skel muscle

Back 17

GSD

Front 18

G6P def
glycogenolysis, hypohlc, growth retardation, ketosis, Lactic acidosis, hepatomegaly

Back 18

GSD 1

Front 19

other def
milder sympts
incr glycogen in skel muscle

Back 19

GSD II, V, VII

Front 20

liver form

Back 20

GSD III, VI

Front 21

severe liver form
cardiac and skel muscle

Back 21

GSD IV

Front 22

def in enzymes resp for metab of f.a.

Back 22

lipid abn

Front 23

abn lipid storage \body cant utilize stored fat

Back 23

glycolipid def

Front 24

def transmembrane protein
> viscous secr, lung disease, pancreatic insuff
incr in Cl sweat test

Back 24

CF

Front 25

for CF
uses pilocarpine
> 60 = CF
N= >35

Back 25

Sweat Cl test

Front 26

chemical is drug if

Back 26

it is selective for site of action
reversible
prod theraputic/toxic effect

Front 27

minimum
lowest conc that will prod response

Back 27

MEC

Front 28

lowest conc that will prod an adverse resp

Back 28

MTC

Front 29

TI=

Back 29

MTC/MEC

Front 30

plasma level =

Back 30

tissue conc

Front 31

peak dosent equal conc in tissue, only after 8 hours

Back 31

Digoxin

Front 32

peak conc of drug is <MTC and trough is > MEC

Back 32

Steady state

Front 33

constant dose given every 1/2 L after 5-7 doses

Back 33

steady state

Front 34

thet route the drug follows from into to prod of resp

Back 34

drug disposition

Front 35

removes xenbiotics

Back 35

liver

Front 36

most drugs

Back 36

passive distribution

Front 37

distrbution effects

Back 37

pH
binding to plasma proteins

Front 38

only __ drugs are lipid sol

Back 38

nonionized

Front 39

equ for weak basic drugs

Back 39

pH=pK + log (nonion/ion)

Front 40

equ for weak acid drugs

Back 40

pH=pK + log (ion/nonion)

Front 41

if pH>pH = ion
if pH< pK = nonion

Back 41

for acidic drugs

Front 42

if ph>pK = nonion
if pH,Pk = ion

Back 42

for basic drug

Front 43

abs easier

Back 43

acid than base drug

Front 44

are transported easily incirc with no carrier protein

Back 44

water sol drug

Front 45

trans protein for acid drug

Back 45

albumin

Front 46

carrier protein for basic drug

Back 46

alpha 1 gylcoprotein

Front 47

major site is liverminor site = kidney, brain, lungs, skin, GI

Back 47

biotranformation

Front 48

rxns metabolize lipophilic drugs to more polar forms to facilitate renal excr
by redox rxn
cytochrome P450 in smooth ER undergo redox that inactivates drugs
metab product are biologically active

Back 48

Phase I

Front 49

for polar drugs
rxn= conjugation
conjugates are water sol and can be excr by kidneys
drugs are metab according to 1st order

Back 49

Phase II

Front 50

if conc is within capacity of detox/conj rxn

Back 50

1st order
dep on conc

Front 51

excr through kidneys

Back 51

water sol drugs

Front 52

secr through bile

Back 52

lipid sol, polar drugs

Front 53

clearance=

Back 53

Vd x kelim

Front 54

Vd=

Back 54

dose/imm plasma conc

Front 55

Kelim=

Back 55

0.693/t(1/2)

Front 56

75% free
from digitalis plant
improv contract by effecting Na/K/ATPase pump
for CHF

Back 56

Digoxin

Front 57

antiarrythmic
for AMI
compl metab in liver> 2 metabs

Back 57

Lidocane

Front 58

antiarrythmic
metab in liver> NAPA

Back 58

Procainamide

Front 59

antiarrythmic, myocardial depressant that lowers hearts ability to conduct current
metab in liver > 3 hydroxyquinidine

Back 59

Quinidine

Front 60

treats for gram neg bact

Back 60

Aminoglycosides

Front 61

for gram pos bact

Back 61

Vancomycin

Front 62

antiepileptic drugs

Back 62

Phenobarbital
Pheytoin
Valproic acid
Carbamazepine
Ethosoximide

Front 63

Psychoactive drugs

Back 63

Lithium
TCA

Front 64

Bronchodilator

Back 64

Theophylline

Front 65

Immunosupp

Back 65

Cyclospoine
Tacrolimus

Front 66

tox of 6

Back 66

<5 mg/kg

Front 67

tox of 5

Back 67

5-50 mg/kg

Front 68

tox of 4

Back 68

50-500 mg/kg

Front 69

tox of 3

Back 69

0.5-5 g/kg

Front 70

tox of 2

Back 70

5-15 g/kg

Front 71

tox of 1

Back 71

>15 g/kg

Front 72

low TI
assume subs is present
need quant result
invasive (blood)
slow TAT
metab may interfere
expensive

Back 72

TDM

Front 73

screen
qualitative
noninvasive(urine)
fast TAT
can detect metabs
cheap

Back 73

Toxicology

Front 74

is toxic to 50% of population

Back 74

TD50

Front 75

ASA
analgesic
interfers with plt aggr and gi
overdose> resp alkalosis
-incr lactate
->ketoacids>metab acidosis
mixed acid/base disorder
>500 = lethal

Back 75

Salicylate, Aspirin

Front 76

Measure Salicylate

Back 76

Trinder rxn, purple color

Front 77

anagesic
overdose> hepatotoxicity (necrosis)
metab and conj by liver
damage is 3-5 p.i.
>150 @ 4 hrs is toxic
liver can conjugate acetamidoquinone (intermediate) by glutathione

Back 77

Acetaminophine
Tylenol

Front 78

Acetominophine overdose>

Back 78

incr N-acetylbenzoquinoneimine (conj by glutathione)
hepatic necrosis
Antidote = NAC ( to incr cystine)

Front 79

200-250 more affinity for Hgb
N= 0-5% COHgb
smoker <15%
70-80%= lethal

Back 79

CO

Front 80

CO measurement

Back 80

Spot CO check, bright red blood

Front 81

most common
metab by liver
nonpolar
metab by alcohol dehydrog (redox) > acetaldehyde and acetate (2nd)
200-400= unconcious
.1g/dL= toxic

Back 81

Ethanol

Front 82

treat other alcohols with

Back 82

Ethanol

Front 83

alcohol testng

Back 83

ADH method
measure abs
pos for Ethanol, neg/low for methanol and isopropanol

Front 84

OG
incr ____ for every 60mg/dl of Ethanol

Back 84

10 mOsm/kg

Front 85

OG for other than ethanol

Back 85

1.86(Na) + glc/18 + Bun/2.8 + ETOH/5

Front 86

toxic at 300 mg/dL

Back 86

Ethanol

Front 87

toxic at 200 mg/dL

Back 87

Isoprpanol

Front 88

toxic at 50 mg/dL

Back 88

Methanol and EG

Front 89

incr osmol
normal pH
no acetone

Back 89

Ethanol

Front 90

incr osmol
normal pH
acetone pos

Back 90

Isopropanol

Front 91

incr osmol
decr pH

Back 91

Methanol

Front 92

incr og
metab acidosis
incr AG
oxalate crystals
renal impairment

Back 92

EG

Front 93

with carrier gas

Back 93

mobile phase

Front 94

collects cooked particle

Back 94

pre column

Front 95

oven column
high temp

Back 95

liquid stationary phase

Front 96

detector

Back 96

FID

Front 97

time form injection of dample to peak vol in FID

Back 97

Rt

Front 98

quantitate peak by

Back 98

comapring calibrator peak with sample peak

Front 99

errors in GLC

Back 99

change in flow rate (mobile), oven temp (liquid), volt of FID

Front 100

alcohol effects from Ethanol

Back 100

hypoglycemia if fasting
>ketoacidosis
hepatomegaly due to trig accuml from metab of ethanol instead of fa

Front 101

diag of chronic alcohol abuse

Back 101

incr plasma uric acid, ggt, and trigs

Front 102

methanol>

Back 102

formaldehyde>formic acid
severe metab acidosis, pancreatic necrosis and visual

Front 103

isopropanol>

Back 103

acetone

Front 104

EG>

Back 104

formic acid, glycolic acid, oxalic acid
renal failure

Front 105

poor nutrition in alcoholics >

Back 105

decr folate
decr Mg and Ca
decr phosphate

Front 106

1 unit of alcohol =

Back 106

10 ml ETOH = 8g ETOH

Front 107

sedative, depressant
Phenobarbital-epilepsy
Treatment, aid respiration and cardiac
replaced by benzodiazepine (metab is oxazepam)

Back 107

Barbituates

Front 108

opium, morphine, codeine
sleep and pain relief
supress CNS, decr resp, coma
heroin is metab by liver> morphine and excr by kidneys as glucuronide
Treat with Naloxone

Back 108

Narcotics

Front 109

organophosphates
inhibs acetylcholinesterase>effects heart and lungs, cramps, CNS
measure isoenzyme. pseudocholine

Back 109

Pesticides

Front 110

CNS stim, blocks dopamine receptors
treats narcolepsy and ADD
metab in liver> benzoic acid
heart probs if overdose

Back 110

Amphetamines

Front 111

local anesthetic and CNS stim
short 1/2 L
metab by cholinesterase > benzoylecognine (inact)
excr by kidneys
Tox= hyperten and MI
confirm with GCMS

Back 111

Cocaine

Front 112

THC
urinary metab = THC-COOH

Back 112

Cannabinoids

Front 113

anesthetic and hallucinogen
violence, seizures, resp, death

Back 113

PCP

Front 114

neonate renal dev

Back 114

glomerular and tubular dev over 1st 2 years
GFR is decr in neonates and incr over time
poor reabs of water and electrolytes > hemoconc

Front 115

neonate hepatic dev

Back 115

> neonatal jaundice
incr total and unconj bili

Front 116

no UDP-G prod > jaundice

Back 116

Crigler-Najjar

Front 117

neonate Endocrine dev

Back 117

by Hypothal, pituitary, thyroid/adrenal
primary and secondary probs

Front 118

congenital hypothyroidism

Back 118

default in thyroid (primary)

Front 119

secondary hypothyroidism

Back 119

pituitary wont sercrete TSH

Front 120

neonate adrenal probs

Back 120

21-hydroxy def> decr aldosterone and cortisol prod
>hypernatremia and decr glc

Front 121

if TDM is < 2

Back 121

the liver metabs slower

Front 122

if TDM is >2

Back 122

liver metabs 2x faster

Front 123

geriatric changes

Back 123

decr water, muscle, bone density, organs fnx
incr lipids (chol and trigs)

Front 124

incr in Geriatric pts

Back 124

K
LD
CK
GGT
AST
ALP(women)
BUN
pCO2
Glc
TSH
uric acid

Front 125

decr in geriatric pts

Back 125

albumin
pO2
bili
T3
growth hormone
CrCl

Front 126

stays the same in geriatric pts

Back 126

Cl-
free T4
Na
insulin
pH

Front 127

TDM and the elderly
elimination probs

Back 127

decr renal mass and blood flow
decr GFR
> overdose

Front 128

CSF

Back 128

150 ml in adults
prod and reabs at 500 ml/day
formation bu ultrafiltrae of plasma and active secr by epithelial membs

Front 129

CSF fnxs

Back 129

cushion for brain
maintains constant chem environ
removes metab products

Front 130

CSF is

Back 130

mostly water
40-70 mg/dl glc
.02-.04 protein
280 Na

Front 131

decr glc in CSF with incr lactate

Back 131

bact inf

Front 132

protein in CSF

Back 132

incr in inf = blood brian barrier inf
done by electrophoresis
incr in prealbumin

Front 133

serous fluids

Back 133

pleural
peritoneal
pericardial

Front 134

parietal memb

Back 134

lines cavity wall

Front 135

visceralmemb

Back 135

cover organs

Front 136

disruption of seros fluid > increase in vol> effusion
caused by

Back 136

effusion

Front 137

caused by incr in hydrostatic pressure in pericardial fluid

Back 137

CHF

Front 138

caused by decr oncotic pressure

Back 138

hypoprotein

Front 139

caused by incr capillary perm

Back 139

inflamation and inf

Front 140

systemic disorder that disrupts balance in reg of fluid filtration and reabs btwn serous membs

Back 140

transudate

Front 141

cond that directly involves teh memb of the cavity
infs and malignancies

Back 141

exudate

Front 142

clear
<1.015 spg
<.5 protein
<.6 LD

Back 142

transudate

Front 143

cloudy
>1.015 spg
>.5 protein
>.6 LD

Back 143

exudate

Front 144

> 60 chol
fluid:serum chol >.3
fluid:serum bili >.6

Back 144

pleural exudate

Front 145

caused by cirrhosis/hepatic>transudate
bact inf> exudate
serum:ascites albumin >1.1 = transudate

Back 145

peritoneal

Front 146

change in perm of membs due to inf, etc
cardiac compression

Back 146

pericardial fluid

Front 147

clear pericardial exudate

Back 147

metab disorder

Front 148

turbid pericardial exudate

Back 148

inf or mailg

Front 149

milky pericardial exudate

Back 149

lymph damage

Front 150

bloody pericardial exudate

Back 150

memb damage

Front 151

incr bloody pericardial exudate

Back 151

cardiac punct

Front 152

TP

Back 152

TP(fluid)/TP(serum)

Front 153

LD

Back 153

LD(fluid)/LD(serum)

Front 154

TP <.5 and LD <.6

Back 154

transudate

Front 155

TP >.5 and LD > .6

Back 155

exudate

Front 156

incr aldosterone
decr renin
incr bp
decr K > incr pH
adrenal tumor
incr Na (incr water) > incr bp

Back 156

Conn's
primary hyperaldost

Front 157

decr TSH, testosterone, T4, FSH, LH
incr prolactin
a.p. tumor

Back 157

Prolactinoma
hypothal tumor (tertiary)

Front 158

decr K, caused by incr aldosterone due to 11beta def
incr glc, pH, HCO3, cortisol
incr ACTH
tumor on pit or in lungs

Back 158

Cushings
secondary (a.p.)

Front 159

chronic pheumonia
incr sweat cl
P. aeruginosa in sputum
confirm with RFLP

Back 159

CF

Front 160

incr trips
incr temp
decr bp
incr neuts
incr chol, trigs
decr HDL
incr Amylase, lipase, CRP
incr Na, Ca
decr K

Back 160

Pancreatitis

Front 161

decr Cl, HcO3, pCO2, pH
incr BUN,Osmol
pos for ketones
OG and AG incr

Back 161

Salicylate

Front 162

incr bp, pulse, resp rate
incr CO2, glc, VMA (due to incr catecholamines)
decr Na, Cl, CK
headache, diaphoresis, palpitations

Back 162

Pheochromocytoma

Front 163

AF

Back 163

ultrafiltrate of moms plasma
has plasma values for electrolytes, urea, cr

Front 164

mature AF

Back 164

incr urea, uric acid, and CR
incr pulmonary lipids
incr protein and hormones
300-1500 ml

Front 165

low AF level

Back 165

oligohydraminos

Front 166

incr AF

Back 166

polyhydraminos

Front 167

HDN

Back 167

monitored by AF A450
incr bili in af
> fetal anemia> erythropoiesis> incr unconj bili due to incr conj by liver

Front 168

meconium spectro

Back 168

peak at 400-405 nm

Front 169

hgb spectro

Back 169

peak btwn 400-450

Front 170

liley chart

Back 170

compares A450 to determine intrauterine hemolysis
zone III is worst

Front 171

can be given to delay birth

Back 171

cortisol

Front 172

PG

Back 172

>2 mg/l = low risk for RDS

Front 173

amniotic surfactant to albumin ratio

Back 173

>50 = mature

Front 174

storage form of surfactant
count= surfactant present
>30000 = mature <10000 = RDS

Back 174

LBC

Front 175

ONTD

Back 175

spina bifida
encephalocele
anencepha

Front 176

neural tube doesnt close
spinal fluid seeps into AF and gets absorbed into moms plasma

Back 176

spina bifida

Front 177

protrusionof brain through abn opening in neural tube

Back 177

Encephalocele

Front 178

fetus doesnt devl a cerebrum

Back 178

anenecepha

Front 179

ONTD detected by

Back 179

incr AFP by babies liver
in moms plasma

Front 180

in second trimester
transport protein sim to albumin
transports subs that arent water sol (steroid hormones, vitamins, libids, bili)
large mol weight

Back 180

AFP

Front 181

result reported in MOM = how many times normal
<2 MOM is normal
incr in 90% of ONTD
folic acid def

Back 181

amniotic fluid AFP

Front 182

trisomy 21
congen heart probs
retardation
facial profile
decr MSAFP, unconj estriol
incr chorionic gonadotropin
def test is fetal karyotyping

Back 182

Down synd

Front 183

> ONTD and death
same results of DS
def test is karyotyping

Back 183

Trisomy 18

Front 184

formed btwn amniotic sac and uterine wall
detect in moms cervix
negative = delivery is unlikely
pos = delivery soon

Back 184

fetal fibronetin

Front 185

aa def
in liver

Back 185

tyrosinemia

Front 186

test for alkaptonuria

Back 186

urine will be dark upon standing or with an added base (alkaline urine)

Front 187

GALT def
def of G-1-P-U

Back 187

Galactosemia

Front 188

Screening for DOA

Back 188

is 1st step
qualitative
immunoassay

Front 189

confirmation for DOA

Back 189

use a different method
specific and sensitive

Front 190

CO is measured

Back 190

spectro at 4-7 lambdas

Front 191

IS

Back 191

corrects for probls in GLC
pure liquid
not in sample

Front 192

in pesticides
binds protiens
cleared through renal
gi sympts

Back 192

Arsenic

Front 193

organic
inhalation or ingestion
kidney, gi, neuro
treat with chelators and peninilamine

Back 193

Mercury

Front 194

Paint and soil
Inhibits enzymes
Effects vit D metab
Causes change in bone and Ca metab
Decr conc of 25-hydroxy and 1-25 dyhydroxy Vit D
Decr Heme synthesis
Incr urinary ALA
Basophilic stippling
Treat with chelators and penicillamine

Back 194

Lead

Front 195

How Lead effects heme synth

Back 195

inhibs PBG synthase and ferrochelatase
> incr ALA and protoporphyrin
>incr Zinc in RBCs

Front 196

Ability of surfactants to prod foam with addition of ethanol

Back 196

FSI shake test

Front 197

At puberty

Back 197

GnRH decr and no longer inhibs FSH and LH
Males prod incr androgens and females prod incr progesterone and estrogen