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33 Cards in this Set
- Front
- Back
What is a monoclonal spike?
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Monoclonal spike: represents antibodies arising from one population of cloned plasma cells, or one class of immunoglobulins from a disease process.
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What would a greatly elevated CKMB tell you? What is teh purpose of calculating an index?
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Injury to cardiac muscle. The index tells us the % of CK-MB in the total CK and can help elucidate the source of teh CKMB.
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What is the specimen of choice for lactic acid? Whan is an elevated lactic acid seen? What are the side effects of a greatly elevated lactic acid?
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Lactic acid.
Plasma (anticoagulated whole blood) in NaF or K oxalate tubes; cool immediately. Increased lactate is seen in conditions causing increased anaerobic glycolysis like shock, strenuous exercise, pulmonary edema, severe anemia & ethanol intoxication |
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Illustrate the principle of RIA & discuss the regulations to be met.
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RIA (radioimmunoassay).
Antibodies attached to a solid phase are exposed to both unlabeled patient antigens & purchased radioactively-labeled antigens. The 2 antigens compete for binding sites on the stationary antibody. Unbound antigens are removed & the bound labeled antigen is measured. The concentration of patient antigen is inversely proportional to the amount of labeled antigen. |
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List tests done with RIA technology.
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RIA tests:
Serum B2 & folate |
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Name several clinical uses of the quantitative beta-HCG.
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beta-HCG uses:
Pregnancy determination; ectopic pregnancies have consistently low HCG; Hydatidiform moles, choriocarcinoma, seminoma, & other cancerous conditions |
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What happens when a person is deficient in B12 or folic acid?
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Deficient B12 or folic acid.
Megaloblastic anemia; Imparied & alteration in protein synthesis; Neurologic problems occur with B12 deficiency. |
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What time of day are cortisol levels highest? Lowest? List several functions of cortisol.
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Cortisol:
Highest: 6--8 AM Lowest: 6 PM--12 AM Stiulates gluconeogenesis & glucogenesis in liver; Increases calcium absorption; Stimulates lipolysis in adipose tissue; Anti-inflammatory activity Immunosuppressive |
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Name 3 ways radioactivity is released.
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Radioactivity released:
Alpha particles Positive or negative charged electrons Gamma rays |
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What does it mean if a substance is radioactive?
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It emits electromagnetic radiation as a result of nuclear disintegration.
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Define half-life.
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Half-life: the time for sample (radioactive) activity to decrease to 1/2 of its initial value.
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Define scintillation.
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Scintillation: brief flash of light given off when gamma rays are absorbed by the sodium iodide crystal in a gamma counter.
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Define pharmacodynamics.
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Pharmacodynamics: the study of how a drug acts on a living organism, including the pharmacological response observed relative to the concentration of the drug at an active site in the organism.
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Define isotope.
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Isotope: different forms of the same element. Same # of protons & atomic #, but different # of neutrons & atomic weights.
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Define Curi (Ci).
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Curi (Ci): unit of radioactivity used before adoption of the Bq as the SI unit.
Ci = 3.70 x 10*10 dsp (disintegration per second) |
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What is the principle of competitive binding?
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Competitive binding principle:
Enzyme or radioactively labeled antigens compete with the patient's antigens for binding sites on stationary antibodies. Excess labeled antigen is then washed off & enzymatic or radioactivity is measured. |
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Name at least 4 disadvantages of RIA & 2 advantages.
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Disadvantages RIA:
Radioactive waste disposal is difficult/expensive; Radioisotope labels have short shelf life (1-2 mo); Expensive; Requires license; Dangerous (exposure to isotopes) Advantages RIA: Sensitive; Easy to automate procedures |
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Illustrate the difference in normal & MI migration of bands on CPK electrophoresis.
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CPK electrophoresis:
Normal: MB low; MM elevated (cathode) MI: MB elevated (3/4 of MM) |
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Illustrate normal & MI migration on LDH electrophoresis.
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Normal/MI--LDH electrophoresis:
LD "flip" betweeen 1 & 2 Normal: 1 low; 2 elevated (anode) MI: 1 elevated; 2 decreased (about 1/2 of 1) |
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Why is a TRH stimulation test done & what is measured?
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TRH: thyrotropin-releasing hormone;
Done to improve diagnostic accuracy in patients with symptoms that suggest hypothyroidism, but who have normal results of basal thyroid function tests. It measures pituitary TSH stores. |
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Why is an ACTH stimulation test done & what is measured?
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ACTH (Adrenocorticotropic hormone):
Done if acute or chronic adrenal insufficiency is suspected & to distinguish between primary & secondary diseases. It measures the ability of adrenal cortex to produce cortisol. |
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In both CK & LD isoenzyme procedure, what is the end product that is measured?
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CK & LD measurement:
NADH |
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Illustrate the basic protein electrophoresis.
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Basic protein electrophoresis.
Albumin - a-1 - a-2 - beta - gamma Anode Cathode |
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Describe teh "sandwich" enzyme immunoassay & the direct enzyme immunoassay.
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"Sandwich" enzyme/direct immunoassay.
Sandwich: Enzyme labeled antibody conjugated to the antigen-antibody complex is measured. Direct: Enzyme conjugated to a ligand (usually antigen OR antibody); added to sample; excess enzyme washed off & amount of reaction is measured. |
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Define immunoelectrephoresis.
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Immunoelectrophoresis: electrophoresis & immunodiffusion combination; used to separate & ID complex proteins.
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What is diffusing through the agar in immunoelectrophoresis?
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Immunoelectrophoresis agar diffusion.
Antiserum (in a trough parallel to migration path of the proteins) to 1 or more of the diffused proteins. |
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Discuss the functions of T3/T4 & the ratio of the two.
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T3/T4.
T4 (thyroxine) & T3 (triiodothymine) secreted by the thyroid gland. Thyroid hormones' primary function is controlling energy expenditure. Other functions include growth, development & sexual maturation. T3-free = 80-180 ng/dL T4 = 5-10 ug/dL There is 60 more t$ than T3 in circulation, but T3 is 4-5x more metabolically important. |
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Discuss fluorescence polarization competitive binding immunoassay. What happens if a patient has a low or high concentration of antigen?
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Fluorescence polarization competitive binding immunoassay.
Antibodies specific to the substance being measured are placed on a filter. Add patient antigen. Add enzyme-labeled antigens which fill up the remaining binding sites. Wash with a substrate containing the enzyme substrate to wash the excess antigen & remove excess enzyme. The reaction rate is then measured using fluorescence polarization. |
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When is a MB band seen on a CPK isoenzyme electrophoresis?
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MB band on CPK isoenzyme electrophoresis.
In myocardial damage |
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What is the purpose of a buffer? Can it be reused? Why or why not?
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Buffer.
Buffers maintain a steady pH. Large volumes of buffer (200 mL--1 L) may be reused if the polarity of the electrophoretic cell is switched after each run. Small volumes of buffer should be discarded after each use. |
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List 3 characteristics of a buffer which affects electrophoretic migration.
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3 characteristics of buffer.
Ionic strength Concentration pH |
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List 7 compounds that are commonly separated by electrophoresis.
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7 compounds separated by electrophoresis:
Serum proteins, lipoproteins, glycoproteins, urine proteins, nucleic acids, isoenzymes (CK, LD, ALP), hemoglobins, immunoglobulins. |
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Discuss thyroid hormone.
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Thyroid hormone.
Primary function is controlling energy expenditure. Other functions include growth, development & sexual maturation. |