Bisc 344 - Clinical Chemistry And Toxicology - Test 3

Front 1

What are the upper chambers of the heart called?

Back 1

Atrium

Front 2

What are the lower chambers of the heart called?

Back 2

Ventricles

Front 3

What are blood vessels that carry blood away from the heart called?

Back 3

Arteries

Front 4

What are blood vessels that carry the flow of blood to the heart called?

Back 4

Veins

Front 5

What is the exception to the rule "veins carry deoxygenated blood"?

Back 5

Pulmonary artery and pulmonary vein; carry deoxygenated blood from the heart to the lungs and oxygenated blood from lungs to heart, respectively.

Front 6

Through which area does oxygenated blood leave the heart from the left ventricle?

Back 6

Aorta

Front 7

Which heart component returns deoxygenated blood from the body to the right atrium?

Back 7

Vena cava

Front 8

This mass of nervous tissue causes simultaneous contractions of the left and right atria at about 70-80 BMP.

Back 8

Sinoatrial Node (SA) node

Front 9

This mass of nervous tissue lies near the right atrium and it passes electrical impulses from the atria to the walls of the ventricles, causing simultaneous ventricular contractions.

Back 9

Atrioventricular node (AV) node

Front 10

This is the phase of the heartbeat where the heart contracts, pumping blood from the chambers to the vessels.

Back 10

Systole

Front 11

This is the phase of the heartbeat when the muscles relax and chambers fill with blood.

Back 11

Diastole

Front 12

Indicate each stage of a heartbeat wave as seen in an ECG with its corresponding letter.

Back 12

Atrial Excitation - P

Atrial Systole - Q

Artial Diastole - R

Ventricular Excitation - S

Ventricular Systole - T

Ventricular Diastole - U

Front 13

This is the most common type of heart disease, also called atherosclerosis. It occurs when plaque builds up in the inner walls of the coronary artery.

Back 13

Coronary Artery Disease (CAD)

Front 14

This is defined as deficient oxygenated blood flow to an organ.

Back 14

Ischemia

Front 15

This is the most common symptom of cardiac ischemia, causing chest pain and discomfort when the heart does not receive enough oxygenated blood

Back 15

Angina

Front 16

This describes the variety of progressive conditions resulting from acute cardiac ischemia, including unstable angina, myocardial infarction, and heart failure.

Back 16

Acute Coronary Syndrome (ACS)

Front 17

This is also referred to as a heart attack; defined as the death or necrosis of myocardial cells due to prolonged ischemia.

Back 17

Acute Myocardial Infarction (AMI)

Front 18

The cardiac biomarkers uses to diagnose and monitor acute coronary syndrome (ACS):

Back 18

Troponin, CK-MB mass, and Myoglobin

Front 19

What is the preferred cardiac biomarker for the diagnosis of MI?

Back 19

Troponin

Front 20

Oxygenated blood and nutrients are delivered to the cardiac tissue via what?

Back 20

Coronary arteries

Front 21

Waves of electrical signals show a different phase of the heartbeat. What is the display of electrical activity produced by the heart called?

Back 21

Electrocardiogram (ECG)

Front 22

Which of the following terms describes deficient blood flow to an organ due to lack of oxygenated blood?

Back 22

Ischemia

Front 23

What is used as criteria for the diagnosis of an acute myocardial infarction?

Back 23

ECG changes, elevation of cardiac biomarkers, ischemia symptoms

Front 24

Which of the following is sometimes used in the diagnosis of acute myocardial infarction?

Back 24

CK-MB

Front 25

Which of the following is the biomarker used to diagnose and evaluate heart failure and prognosis?

Back 25

B-type natriuretc peptide

Front 26

Which of the following biomarkers has the highest specificity for injury to cardiac tissue?

Back 26

Troponin I and T

Front 27

True or False: The Framingham score is the best validated model for predicting cardiac disease risk.

Back 27

True

Front 28

Upon onset of acute myocardial infarction symptoms, how many hours after injury to cardiac muscle will myoglobin blood levels rise?

Back 28

1-4 hours

Front 29

What is the reference range for blood plasma pH?

Back 29

7.4 (7.35-7.45)

Front 30

What is the equation to calculate pH if you only know hydrogen concentration?

Back 30

-log [H]

Front 31

This refers to an increase in H+ concentration that results in pH decrease

Back 31

AcidosisT

Front 32

This refers to a decrease in H+ concentration that results in pH increase

Back 32

Alkalosis

Front 33

What bodily system of the blood has a buffering effect?

Back 33

Hemoglobin system

Front 34

What two organs play a major role in regulating blood pH?

Back 34

Lungs and Kidneys

Front 35

What is the Henderson-Hasslebalch equation with regards to kindney/lung relationship?

Back 35

pH= pK1 + log (cHCO3-/0.031*PCO2)

Front 36

What substance in the Henderson-Hasslebalch equation denotes kidney function? Lung function?

Back 36

-HCO3- denotes kidney function

-pCO2/H2CO3 denotes lung function

Front 37

How do the lungs regulate pH?

Back 37

Retention and elimination of CO2 by changing the rate and volume of ventilation (eg. hyperventilation)

Front 38

How do the kidneys regulate pH?

Back 38

By excreting acid, primarily ammonium ions, and reclaiming HCO3 from glomerular filtrate

Front 39

Identify which organs are associated with the respiratory/metabolic portions of the acid/base balance.

Back 39

Lungs - respiratory

Kidneys - Metabolic

Front 40

What is the value of pK?

Back 40

6.1

Front 41

What is the ideal ratio in a healthy person when the lungs and kidneys are functioning properly and what is the resulting pH?

Back 41

20:1 bicarbonate to carbonic acid; 7.40

Front 42

What is the reference range for PCO2 and HCO3-

Back 42

PCO2 - 35-45

HCO3- - 22-26

Front 43

Describe the pH, HCO3-, and PCO2 for Primary Metabolic Acidosis.

Back 43

-pH: low

-HCO3-: low

-PCO2: normal

Front 44

Describe the pH, HCO3-, and PCO2 for Primary Respiratory Acidosis.

Back 44

-pH: low

-HCO3: normal

-PCO2: high

Front 45

How many oxygen molecules can bind to one hemoglobin molecule?

Back 45

4

Front 46

What are the four forms of hemoglobin?

Back 46

-Oxyhemoglobin

-Deoxyhemoglobin

-Carboxyhemoglobin

-Methemoglobin

Front 47

Describe the pH, HCO3-, and PCO2 for Acute Respiratory Acidosis.

Back 47

pH: low

pCO2: high

HCO3: normal

Front 48

Describe the pH, HCO3-, and PCO2 for Partially Compensated Respiratory Acidosis.

Back 48

pH: low

pCO2: high

HCO3: high

Front 49

Describe the pH, HCO3-, and PCO2 for Fully Compensated Respiratory Acidosis

Back 49

pH: Normal

pCO2: high

HCO3: high

Front 50

Describe the pH, HCO3-, and PCO2 for Acute Respiratory Alkalosis

Back 50

pH: high

pCO2: low

HCO3: normal

Front 51

Describe the pH, HCO3-, and PCO2 for Partially Compensated Respiratory Acidosis.

Back 51

pH: high

pCO2: low

HCO3: low

Front 52

Describe the pH, HCO3-, and PCO2 for Fully Compensated Respiratory Alkalosis

Back 52

pH: normal

pCO2: low

HCO3: low

Front 53

Describe the pH, HCO3-, and PCO2 for Partially Compensated Metabolic Acidosis.

Back 53

pH: low

pCO2: low

HCO3: low

Front 54

Describe the pH, HCO3-, and PCO2 for fully Compensated Metabolic Acidosis.

Back 54

pH: Normal

pCO2: low

HCO3: low

Front 55

Describe the pH, HCO3-, and PCO2 for Partially Compensated Metabolic Alkalosis

Back 55

pH: high

pCO2: high

HCO3: high

Front 56

Describe the pH, HCO3-, and PCO2 for Fully Compensated Metabolic Alkalosis

Back 56

pH: normal

pCO2: high

HCO3: high

Front 57

This organ is the largest. It is versatile and consists of two lobes.

Back 57

Liver

Front 58

These carry blood to and from the liver

Back 58

Hepatic artery and portal vein

Front 59

This is the structural unit of the liver, composed of cords of liver cells called hepatocytes that surround a central vein.

Back 59

Lobule

Front 60

Between the cords of hepatocytes, there are vascular spaces called _____ that are lined with endothelial cells and Kupffer cells (phagocytic macrophages)

Back 60

Sinusoids

Front 61

This is the major function of the liver

Back 61

Bile excretion

Front 62

This is the pigment that is the result of hemoglobin being broken down.

Back 62

Bilirubin

Front 63

What is the purpose of bile?

Back 63

Digestion, absorption of lipids in the duodenum

Front 64

What are the three types of jaundice?

Back 64

Prehepatic (increase in unconjugated bilirubin but no bilirubin in urine), hepatic (uptake, conjugation, secretion of bilirubin that impairs liver cells), post hepatic (mechanical obstruction of bile flow to intestines)

Front 65

This is a syndrome that is the result of impairment in the cellular uptake of bilirubin.

Back 65

Gilbert's Syndrome

Front 66

This syndrome results from the enzyme deficiency in conjugating bilirubin

Back 66

Crigler-Najjar Syndrome

Front 67

These syndromes affect the excretion of conjugated bilirubin by the liver cells.

Back 67

Dubin Johnson and Rotor's Syndromes

Front 68

What does the liver synthesize?

Back 68

Proteins, carbs, lipids

Front 69

Which proteins does the liver synthesize?

Back 69

Albumin, alpha and beta globulins, clotting factors except VIII

Front 70

This is the irreversible scarring of liver tissue caused by alcohol abuse, hemochromatosis, and an autoimmune disorder

Back 70

Cirrhosis

Front 71

This syndrome occurs in children. It has an unknown cause and follows a viral infection that causes neurological abnormalities. It seems to be related to aspirin therapies.

Back 71

Reye's Syndrome

Front 72

What is the enzyme used to diagnose bone and liver disease?

Back 72

ALP (alkaline phosphatase)

Front 73

What enzymes are used to assess hepatocellular damage?

Back 73

AST (found in all tissues) and ALT (found primarily in the liver)

Front 74

This is the inflammation of the liver and it has many causes.

Back 74

Hepatitis

Front 75

This type of Hepatitis is caused by contaminated food or water. Many people have antibodies without infection. Usually not life threatening.

Back 75

Hepatitis A

Front 76

This is contracted from parental, perinatal, or sexual contact and it is a blood borne infection. 2/3 are asymptomatic or have mild flu-like illness. 1/3 develop hepatitis syndrome (malaise, irregular fevers, right upper quadrant tenderness, jaundice, dark urine). 90% of patients recover within 6 months.

Back 76

Hepatitis B

Front 77

This type of hepatitis is an RNA virus that is blood borne. It has a high rate of progression to chronic hepatitis, cirrhosis, and carcinoma.

Back 77

Hepatitis C

Front 78

This type of hepatitis is only found in patients with Hepatitis B. It's an RNA virus that uses hepatitis B for replication.

Back 78

Hepatitis D

Front 79

This type of hepatitis is contracted through the fecal/oral route. It's found in underdeveloped countries and is generally a mild disease.

Back 79

Hepatitis E

Front 80

This organ is involved in the digestive process and is located outside of the GI tract. It's composed of endocrine and exocrine portions.

Back 80

Pancreas

Front 81

What are the endocrine functions of the pancreas?

Back 81

Production of insulin and glucagon

Front 82

What are the exocrine functions of the pancreas?

Back 82

Production of digestion enzymes

Front 83

What is the endocrine component of the pancreas and what is its function?

Back 83

Islets of Lagerhans- secrets insulin, glucagon, gastrin and somatostatin

Front 84

What is the exocrine component of the pancreas and what is its function?

Back 84

Acinar Cells - line pancreas connected by ducts that produce digestive enzymes

Front 85

This pancreatic disease is an inherited autosomal recessive disease characterized by the dysfunction of mucous and exocrine glands. Mucous plugs block lumen of the bowel, leading to obstruction.

Back 85

T

Cystic Fibrosis

Front 86

This pancreatic disease is very painful and very common. If the bile duct is obstructed, the signs are prevalent and digestive problems occur.

Back 86

Pancreatic carcinoma

Front 87

This pancreatic carcinoma complication can affect the endocrine capacity of the pancreas.

Back 87

Islet Cell Tumors

Front 88

This pancreatic carcinoma complication can affect gastrin production. It's also called Zollinger Ellison Syndrome

Back 88

Alpha Cell Tumors

Front 89

This refers to the inflammation of the pancreas caused by autodigestion. It's often associated with alcohol abuse or billary tract disease.

Back 89

Pancreatitis

Front 90

This serum enzyme is most often used to detect pancreatic disease. It reaches its peak at 24 hours and returns to normal in 3-5 days.

Back 90

Amylase

Front 91

This pancreatic enzyme is more difficult to measure, but it stays increased at the same time as amylase, but is elevated longer than amylase.

Back 91

Lipase

Front 92

This cardioactive drug is toxic to many organs in excess, causing nausea, vomiting, visual disturbances, and adverse cardiac effects. It's used to treat Congestive Heart Failure.

Back 92

Digoxin

Front 93

This cardioactive drug is used to treat arhythmia and is given through an IV. It's used also to prevent ventricular fibrillation. Toxicity can cause central nervous system issues, seizures, severe blood pressure, etc.

Back 93

Lidocaine

Front 94

This cardioactive drug is used to treat cardiac arrhythmias and is given orally. Toxicity can include nausea, vomiting, abdominal discomfort.

Back 94

Quinidine

Front 95

This group of antibiotics are used to treat gram negative bacteria that are resistant to other antibiotics.

Back 95

Aminoglycosides

Front 96

This antibiotic is effective against gram positive cocci and bacilli and is administered by IV.

Back 96

Vancomycin

Front 97

This antiepileptic drug is a slow acting barbituate used to control seuzires.

Back 97

Phenobartital

Front 98

This antiepileptic drug is used to treat seizures but high or low levels can cause seizures.

Back 98

Phenytoin

Front 99

This antiepileptic drug is used to treat petit mal seizures. Toxicity causes nausea, weight gain, pancreatitis, etc.

Back 99

Valproic acid

Front 100

This psychoactive drug is used to treat manic depression. Toxicity can result in muscle rigidity, seizures, and coma.

Back 100

Lithium

Front 101

This bronchodilator is used to treat asthma.

Back 101

Theophylline

Front 102

These substances are intentionally added to the environment to harm an undesirable life form. These substances can harm through food contamination. Can cause death and man diseases.

Back 102

Pesticides

Front 103

Aspirin is a common type of analgesic and this; used to decrease prostaglandin and can cause lots of toxic effects such as the inhibition of the krebs cycle, metabolic acidosis, hyperventilation

Back 103

Salicylates

Front 104

This is a common analgesic drug and overdose is associated with severe hepatotoxicity.

Back 104

Acetaminophin

Front 105

These are therapeutic drugs used for narcolepsy and ADD. Stimulants with high abuse potential.

Back 105

Amphetamines

Front 106

These are a group of compounds related chemically to male sex hormone testosterone. Can increase muscle mass and improve athletic performance.

Back 106

Anabolic steroids

Front 107

This is a group of psychoactive compounds found in marijuana. THC is the most potent and abundant.

Back 107

Cannabinoids

Front 108

This is an effective local anesthetic with few adverse effects at therapeutic concentrations. At high concentrations, can cause excitement and euphoria with high abuse potential.

Back 108

Cocaine

Front 109

This is a class of substances capable of analgesia, sedation, and anesthesia; high abuse potential. Includes heroin.

Back 109

Opiates

Front 110

Illicit drug with stimulant, depressant, anesthetic and hallucinogenic properties; high abuse potential

Back 110

Phencyclidine

Front 111

These are tranquilizers and CNS depressants. Wide range of therapeutic roles and are commonly used. Barbituates and benzodiazepines are most common.

Back 111

Sedative/hypnotics

Front 112

This is a metabolite of procainamide.

Back 112

NAPA

Front 113

This drug is used to treat asthma

Back 113

Theophylline

Front 114

This is the distance a drug moves in TLC divided by the distance of the solvent front.

Back 114

Retention Factor

Front 115

This drug is particularly toxic to the liver.

Back 115

Acetaminophen

Front 116

This analyte can deteriorate if exposed to light

Back 116

Bilirubin

Front 117

Bilirubin is a breakdown product of this component

Back 117

Hemoglobin

Front 118

The protein that is responsible for the transportation of bilirubin

Back 118

Albumin

Front 119

A disease in which only the unconjugated portion of bilirubin is increased

Back 119

Hemolytic or prehaptic jaundice

Front 120

This organ is responsible for the conjugation of bilirubin

Back 120

Liver

Front 121

This is when a trough level should be drawn

Back 121

Shortly before the next drug administration

Front 122

This is the number of half-lives required to reach steady state.

Back 122

Five

Front 123

This is the most commonly used confirmatory method for identification of drugs of abuse.

Back 123

GC with mass spectrometry

Front 124

This is the primary product of methanol metabolism by ADH and ALDH

Back 124

Formic Acid

Front 125

This drug of abuse has the highest prevalence

Back 125

Alcohol

Front 126

This disease state is associated with increased pH and decreased CO2

Back 126

Respiratory alkalosis

Front 127

This disease state is associated with decreased pH and a decreased HCO3

Back 127

Metabolic acidosis

Front 128

This is the reference range for arterial pH

Back 128

7.35-7.45

Front 129

This is the normal ratio of bicarbonate to dissolved carbon dioxide in arterial blood

Back 129

20:1