Week 7 Clin Chem Exam

Front 1

Name the three layers of the heart

Back 1

epicardium
myocardium
endocardium

Front 2

of the three layers of the heart, which is most susceptable to ischemia?

Back 2

endocardium

Front 3

Cardiac cycle
systole=

Back 3

ventricles contract

Front 4

Cardiac cycle
Diastole=

Back 4

oxyginated blood returns into the left atrium

Front 5

EKG has three parts
P wave
QRS complex
T wave
what do they measure?

Back 5

P wave= atrial contraction
QRS complex= ventricle contraction
T wave= elec. recovery of ventricles

Front 6

most acute coronary syndromes start with?

Back 6

atherosclerosis

Front 7

what is angina?

Back 7

chest pain associated with a decrease in oxygen to the heart muscle

Front 8

Hypertension starts at what pressure?

Back 8

160/95

Front 9

This is a group A strep and affects all three layers of the heart?

Back 9

Rheumatic fever

Front 10

This is strep and staff, and affects the inner lining of the heart chambers and valves?

Back 10

endocarditis

Front 11

This can be a bacteria, fungus, or virus, and has fluid in the pericardial sac?

Back 11

pericarditis

Front 12

Name the five cardiac enzimes.

Back 12

LD, CK, CK-MB, myoglobin, tropinin

Front 13

this enzyme is released from cells when heart cells die?

Back 13

tropinins

Front 14

Myoglobin can be a marker for these two organs?

Back 14

heart
liver

Front 15

C-reactive protien is a marker for?

Back 15

atherosclerosis

Front 16

increases, peaks, duration, ref. range

tropinin I

Back 16

4-6hrs, 12-18hrs, up to 6 days, 0-.1ug/l

Front 17

increases, peaks, duration, ref. range

Tropnin T

Back 17

2-6hrs, day 2, 7-14 days, 0-.1ug/l

Front 18

increases, peaks, duration, ref. range

CKMB

Back 18

4-6hrs, 24hrs, 48-72hrs, 0-5ng/l

Front 19

increases, peaks, duration, ref. range

Myoglobin

Back 19

1hr, 2-12hrs, 12hrs, <70ug/l

Front 20

BNP is a hormone that does what?

Back 20

functions in volume reduction and vasodilation

Front 21

Ref Range of BNP

Back 21

<100ng/L

Front 22

What is the Cardiac marker methodology

Back 22

monoclonal antibody immunoessay

Front 23

Vasodilators do what?

Back 23

increase blood to the heart by dilating peripheral arteries and veins

Front 24

Diuretics do what?

Back 24

eliminate excess fluid and reduce blood volume

Front 25

Beta Blockers do what?

Back 25

decrease heart rate or force of contractions

Front 26

Calcium channel antagonists do what?

Back 26

decrease smooth muscle contraction

Front 27

these liver cells are capable of protien synthesis, energy metabolism, transport, excretion, and storage?

Back 27

hepatocytes

Front 28

These phagocytic macrophages are found on the sinusoid lining?

Back 28

Kupfer cells

Front 29

These are small tubules between hypatocytes tht carry bile to the gall bladder?

Back 29

Canaliculi

Front 30

Almost all __________ are made in the liver.

Back 30

proteins

Front 31

Liver needs to be quite damaged befor ________ levels decrease.

Back 31

albumin

Front 32

3 functions of the liver?

Back 32

storage
detoxification
excretion

Front 33

Bilirubin comes from the breakdown of?

Back 33

RBCs

Front 34

Total bilirubin =

Back 34

direct + indirect

Front 35

Bilirubin can break down in________ and is increased in (3)

Back 35

light
jaundice, hepatitis, cirrosis

Front 36

Bilirubin Ref Range

Back 36

Direct = 0-.2
indirect = .2-.8
total = .2-1

Front 37

______ is more increased and lasts longer than _____ usually and is seen elevated in (4)

Back 37

ALT, AST
hepatitis, liver neoplasia, cirrosis, liver damage

Front 38

LD-1, 2, 4, and 5 are elevated in ________ _________.

Back 38

liver disease

Front 39

LD-3 is increased in ______ ________.

Back 39

viral hepatitis

Front 40

What is cholestasis

Back 40

flow of bile from liver is blocked

Front 41

What is ischemic hepatitis

Back 41

when cells are not getting enough oxygen

Front 42

Kidneys maintain normal _________, ___________, and _________ ______
status, eliminates _______ and produces several __________.

Back 42

fluid, electrolyte, acid base, waste, hormones

Front 43

Kidney is made of 1 million functional units called?

Back 43

nephrons

Front 44

The __________ is made of interconnected bundle of capillary loops enclosed within a sac, ________ blood allowing ________ and small _________ to pass through.

Back 44

Glomerules, filters. water, solutes

Front 45

What do the proximal tubules do?

Back 45

reabsorbs 70% of sodium and cloride, reabsorbs most of the bicarbinate, glucose, phosphate, potassium and sulfate and secretes uric acid, ammonium ions, and 90% of hydrogen into the urin

Front 46

Loop of Henle in the decending portion is only permiable by _________.

Back 46

Water

Front 47

Loop of henle in the ascending portion is only permiable by __________.

Back 47

electrolytes

Front 48

loop of Henle, by end _____% of water and 95% of ________ has been reabsorbed.

Back 48

90%
sodium

Front 49

The distal tubule adjusts what, to do what?

Back 49

sodium absorption to maintain normal fluid levels

Front 50

The hormone _______ is produced by _________ in response to changes in volume and stimulates production of ___________.

Back 50

Renin
nepgrons
aldosterone

Front 51

Aldosterone acts on the distal tubules to allow ___________ of _________ in exchange for excretion of __________ or __________.

Back 51

reabsorption, sodium, potassium, hydrogen

Front 52

The ________ hormone acts on the _________ duct to reabsorb _______.

Back 52

antidiretic, colecting, water

Front 53

Excretion, homeostatic regulation, and endocrine, are all __________ functions.

Back 53

Kidney

Front 54

Urinary excretion =

Back 54

glomerule filtration + tubilar secretion - tubular reabsorption

Front 55

The kidneys control the homeostatic regulation of?

Back 55

electrolytes and water

Front 56

Prostaglandins are?

Back 56

fatty acids that increase renal blood flow.

Front 57

What does Erythropoietin do.

Back 57

acts on bone marrow cells to stimulate erythropoiesis

Front 58

Reni9n is produced in the __________ cells in response to ________ _______ _______

Back 58

Juxtaglomular, low blood pressure

Front 59

Increased renin results in formation of __________ __ in the liver which is a vasoconstrictor and key stimulus of __________ release.

Back 59

Angiotension II, aldosterone

Front 60

Aldosterone controls _________ and ________ balance in the kidneys.

Back 60

salt, water

Front 61

Decreased _ _ _ precedes kidney failure.

Back 61

GFR

Front 62

Creatine Clearance Ref Range
male/female

Back 62

male = 97 - 137
female = 88 - 128
decreases with age

Front 63

hematuria, proteinurea, decreased GFR, increased BUN, Anemia, Oligurea, edema, and hypertension are all signs of

Back 63

Acute Glomerulonephritis

Front 64

What is Nephrotic syndrome

Back 64

injury and increased permiability of glomerule basement membrane

Front 65

Decreased phospherus, glycosuria, and slight proteinuria are all signs of?

Back 65

renal tubular acidosis

Front 66

UTI of kidneys is called ________ and bladder is called___________

Back 66

pyelonephritis, cystitis

Front 67

Renal Calculi is?

Back 67

kidney stones

Front 68

GFR <10ml/m is a result of?

Back 68

acute renal failure

Front 69

The GI tract begins with the ______ and ends with the _________.

Back 69

mouth, anus

Front 70

GI hormones influence ______, ________, _________, and _________ in the gut.

Back 70

motility, secretion, digestion, absorption

Front 71

Gastrin stimulates the secretion of _______ ______, stimulates the release of __________ and increases _______ and ________ motility.

Back 71

gastric acid, secretin, gastric, intestinal

Front 72

Zollinger-Ellison syndrome is

Back 72

presence of gastrinomas that produce and secrete large quantities of gastrin

fasting gastrin levels (2-2000 times)
concentrations >1000 ng.l with gastric acid hypersecretion.

Front 73

(CCK) Cholecystokinin is?

Back 73

intestinal hormone that activates the gall bladder contraction and stimulates secretion of pancreatic enzymes

Front 74

Secretin is secreted by the _________ and does what?

Back 74

duodunum and small intestine
neutralizer of acid
inhibitor of somatostatin

Front 75

What is (VIP) Vasoactive intestinal polypeptide

Back 75

hormone that increases water and electrolyte secretion from the pancreas and gut
Note: Verner-Morrison syndrome, Crohns disease

Front 76

Gastric Inhibitory Polypeptide (GIP)

Back 76

Stimulates insulin secretion
stimulates intestinal fluid and electrolyte secretion
elevated in states of starvation, prolonged fasting

Front 77

Somatostatin

Back 77

hormone that inhibits endocrine secretion

Front 78

Motilin

Back 78

hormone that is a strong stimulant of smooth muscle contraction

Front 79

Pepsinogen is

Back 79

the precurser of pepsin

Front 80

pepsin

Back 80

released in stomache and degrades food proteins into amino acids

Front 81

H pylori AKA Helicobactor pylori is what?

Back 81

bacteria found in the mucus layer of the stomache

Front 82

What is Maldigestion?

Back 82

dysfunction of the digestive function

Front 83

What is Malabsorbtion?

Back 83

Dysfunction of the absorbtive process occuring in the small intestine.

Front 84

What is Steatorrhea? what is it sa diagnosis of?

Back 84

Excess amounts of fat in fecal matter.
malabsorption

Front 85

Pancreas is composed of two types of tissue, what are they and what do they do?

Back 85

endocrine tissue, hormone releasing
exocrine tissue, enzyme secreting

Front 86

Trypsin, Chymotrypsin, elastase, collagenase, lipase, lecithinase, amylase, and ribonucleases are all enzymes of the

Back 86

pancreas

Front 87

Pancreatic action is controlled by?

Back 87

(CCK) cholecystokinin and secretin

Front 88

Secretin is responsible for

Back 88

alkaline pancreatic fluid which protects the intestines from damage

Front 89

CCK is responsible for

Back 89

the release of enzymes from acinar cells into pancreatic fluid.

Front 90

These ($) are measured for pancreatitis and obstruction.

Back 90

amylase
lipase
trypsin
elastase