Exam 2 Study Questions – Flashcards
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| What is the primary dietary source of glucose for humans? |
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| Starch |
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| What is the primary storage form of glucose for humans? |
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| Glycogen |
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| What salivary and pancreatic enzyme is responsible for initial digestion of carbohydrates? |
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| AMS |
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| lipolysis |
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| Breakdown of fats with the production of ketones through the TCA cycle |
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| aerobic oxidation |
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| Acetyl CoA enters the TCA cycle and ATP, CO2 and water are made |
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| HMP shunt |
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| Endproduct is NADPH; important energy source in RBCs |
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| glycogenesis |
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| Conversion of glucose into the storage form |
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| glycolysis |
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| Production of pyruvate / lactate during oxygen depletion |
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| glycogenolysis |
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| Breakdown of glycogen back into glucose |
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| What is the only hormone that will lower blood glucose levels, and where is it produced? |
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| Insulin, made in the pancreas |
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| What primary hormone raises glucose levels, and where is it produced? |
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| Glucagon, made in the pancreas |
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| Which hormone is capable of raising glucose levels most rapidly, and where is it produced? |
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| Adrenaline (epinephrine), adrenal gland |
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| The ingestion of excess carbohydrate will lead to the production and storage of what type of compound? |
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| Fat |
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| List the reference range for fasting serum glucose. |
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| Approx 70-110 mg/dL |
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| How will ranges be affected if whole blood is tested? |
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| 10% lower |
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| What is the preferred anticoagulant for testing whole blood and color of collection tube? |
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| NaFl, gray top |
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| What is the preferred anticoagulant for plasma testing and color of collection tube? |
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| Heparin, green top |
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| What happens to glucose levels after one hour if unpreserved whole blood is left to sit? |
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| Levels may decrease 10-12% per hour |
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| Gestational |
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| May be transient Interference from lactogen |
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| Type 2 |
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| Obesity and sedentary lifestyle Adult onset Strongest genetic connection Includes most cases of diabetes |
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| Type 1 |
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| Autoimmune Insulin dependent Acute onset of polydipsia and polyuria |
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| What causes excess ketone production in diabetes? |
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| Increased fat metabolism |
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| List several metabolic complications seen in diabetes |
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| Renal and heart dz, vascular dz, blindness |
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| What constitutes "hypoglycemia"? |
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| glucose <50 mg/dL |
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| List the primary causes of hypoglycemia. |
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| Insulin shock due to overdose or insulin-producing tumor |
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| According to the ADA, what criteria is diagnostic for diabetes when testing: A fasting serum or plasma |
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| >126 |
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| According to the ADA, what criteria is diagnostic for diabetes when testing: A random serum or plasma |
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| >200 with symptoms |
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| According to the ADA, what criteria is diagnostic for diabetes when testing: A 2-hour postprandial sample |
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| >200 |
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| HbA1C is an indicator of glucose control for what preceding time period? |
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| 2-3 months |
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| What is the specimen requirement for HbA1C testing? |
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| EDTA |
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| What conditions can cause a falsely decreased HbA1C? |
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| hemolytic anemias, blood loss, alcohol, lead and some drugs |
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| What is microalbumin and what is the purpose of performing this test? |
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| Small levels of albumin not detected by urine dipstick; may indicate early renal dz |
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| List the two primary methodologies used to measure serum glucose. Include those substances known to cause interference. |
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| Glucose oxidase; BUN, uric acid and bilirubin interfere Hexokinase; bilirubin |
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| Exogenous fats are those derived from what source? |
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| Diet |
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| Endogenous fats are those derived from what source? |
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| Liver |
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| A fatty acid that contains NO double bonds is classified as saturated or unsaturated? |
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| Saturated |
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| Which type of fat is more easily excreted? |
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| Unsaturated |
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| What class of fats has a steroid alcohol base? |
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| Cholesterol |
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| What class of fats is composed of fatty acids plus glycerol? |
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| Triglyceride |
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| What type of fats are products of man-made manipulation of oils to solids? |
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| Trans fats |
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| Lung surfactants Principle component of most cell membranes |
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| phospholipids |
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| Cell membranes of brain and CNS |
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| glycolipids |
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| Steroid hormone and vitamin D precursor Component of bile acids |
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| cholesterol |
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| Regulates renin secretion |
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| prostaglandins |
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| Primary storage form of fat Broken down under the influence of lipase enzyme |
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| triglycerides |
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| No good function that we know of |
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| trans fatty acids |
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| Building blocks that contribute to production of acetyl CoA |
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| fatty acids |
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| What is the protein portion of the lipoprotein molecule called? |
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| apoprotein |
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| What abnormal lipoprotein is associated with CHD at an early age? |
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| Lp(a) |
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| Made in the intestines in response to food ingestion Causes a milky layer on serum after meals Carries exogenous Tg to tissues |
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| Chylomicrons |
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| Excess leads to plaques and clogged arteries "Bad" cholesterol |
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| LDL |
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| Contains the highest percentage of protein Transports cholesterol to liver for excretion |
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| HDL |
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| Transports Tg from liver to tissues |
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| VLDL |
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| Foam cells-->fatty streaks-->plaques Leading cause of death in U.S. |
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| Arteriosclerosis |
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| Major cause of pancreatitis Increase of glycerol-based lipids GGT and beta-gamma bridging |
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| Alcoholism |
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| Inc TG, chol, and LDL Microalbuminuria |
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| Diabetes |
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| Inc. TG and chol, Dec. albumin Massive proteinuria and oval fat bodies |
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| Nephrotic syndrome |
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| Supersaturated bile |
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| Gallstones |
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| LDL receptor problem Cause of early onset heart disease |
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| Familial hypercholesterolemia |
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| Name the enzyme needed to break cholesterol esters into free cholesterol particles. |
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| cholesteryl esterase |
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| List the most common interfering factors in the cholesterol test. |
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| Bilirubin, ascorbic acid |
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| List specimen requirements for TG and chol. |
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| Fasting preferred |
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| Name the enzyme needed to break TG into fatty acids and glycerol. |
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| Lipase |
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| Describe the homogeneous method of HDL quantitation. |
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| Selective enzymes block non-HDL lipids; reagent reacts with free HDL |
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| Which of the NPNs is the best indicator of liver dysfunction? |
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| Ammonia |
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| What test is commonly used as an indicator of GFR? |
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| Creatinine clearance |
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| List the 3 most common causes of an elevated uric acid. |
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| Gout, chemo/irradiation, renal dz |
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| Which NPN is elevated in Reye's syndrome? |
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| Ammonia |
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| Define azotemia. |
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| Increased BUN |
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| Define uremia. |
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| Increased BUN with renal failure |
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| For each of the following, identify it as a prerenal, renal, or postrenal cause of an elevated BUN: Kidney stone |
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| post |
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| For each of the following, identify it as a prerenal, renal, or postrenal cause of an elevated BUN: Glomerular disease |
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| renal |
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| For each of the following, identify it as a prerenal, renal, or postrenal cause of an elevated BUN: Congestive heart failure |
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| pre |
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| For each of the following, identify it as a prerenal, renal, or postrenal cause of an elevated BUN: Bladder tumor |
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| post |
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| For each of the following, identify it as a prerenal, renal, or postrenal cause of an elevated BUN: High protein diet |
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| pre |
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| Match the NPN with the source: Muscle metabolism |
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| Creatinine |
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| Match the NPN with the source: Purine metabolism |
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| Uric acid |
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| Match the NPN with the source: Protein metabolism |
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| BUN |
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| Which NPN is adversely affected by fluoride and citrate in the sample? |
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| BUN |
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| Picric acid in an alkaline environment. Name the reaction and the analyte being measured. |
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| Jaffe reaction for creatinine |
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| List special handling requirements for ammonia analysis. |
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| Put tube on ice immediately after collecting; spin @ 4 C, test ASAP or keep on ice. |
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| Match the function with its primary site or action: Initial filtration of blood Blood retention of proteins and cells |
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| Glomerulus |
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| Match the function with its primary site or action: Reabsorption of most water, glucose and amino acids Secretion of non-filterable wastes |
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| Proximal tubule |
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| Match the function with its primary site or action: Na reabsorbed under the influence of aldosterone Water reabsorption under the influence of ADH |
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| Distal tubule |
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| Na reabsorbed under the influence of? |
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| aldosterone |
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| Water reabsorption under the influence of? |
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| ADH |
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| In order to maintain electrical neutrality, what 2 analytes will be excreted when Na is reabsorbed? |
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| K and H |
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| What two analytes are excreted or reabsorbed to help maintain blood pH? |
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| H & HCO3 |
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| In response to a decrease in blood pressure or volume, the kidneys secrete the hormone ____, which stimulates the production of angiotensin. |
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| Renin |
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| Angiotensin stimulates the adrenal gland to secrete the hormone |
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| aldosterone. |
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| Aldosterone then causes the renal tubules to reabsorb the analyte |
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| sodium |
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| An increase in sodium causes the plasma osmolality to: |
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| Rise |
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| In response to an increased osmolality, the pituitary gland secretes |
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| ADH (vasopressin). |
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| ADH in turn causes the tubules to reabsorb |
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| water. |
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| After ADH causes reabsorption of water, the blood volume/pressure will then |
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| Fall |
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| U Cr = 105mg/dL U vol = 950 mL S Cr = 1.5mg/dL Time = 24 hours BSA = 1.95 m2 What is the Creatinine Clearance? |
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| 46 mL/min |
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| U Cr = 105mg/dL U vol = 950 mL S Cr = 1.5mg/dL Time = 24 hours BSA = 1.95 m2 What is the Corrected Creatinine Clearance? |
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| 41 mL/min |
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| What is a normal average GFR for adults? |
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| 120 ml/min |
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| What are advantages of the eGFR and cystatin C as compared to a traditional creatinine clearance? |
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| No urine needed |
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| What urine dipstick result is considered the best indicator of renal disease? |
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| Protein |
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| What cell and cast type is consistent with: Renal failure |
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| waxy/broad casts |
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| What cell and cast type is consistent with: Acute glomerulonephritis |
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| red cells and RBC casts |
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| What cell and cast type is consistent with: Pyelonephritis |
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| WBC and WBC casts |
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| What cell and cast type is consistent with: Nephrotic syndrome |
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| RTE, oval fat bodies, fatty casts and cholesterol crystals |
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| What substance in plasma contributes the most to osmolality? |
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| sodium |
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| Would the urine of someone with diabetes mellitus have a dipstick SG that is increased, decreased or normal? |
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| Normal |
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| Would the urine of someone with diabetes mellitus have a refractometer SG that is increased, decreased or normal? |
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| Increased |
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| What test is used as an early indicator of renal disease in diabetics? |
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| microalbumin |
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| In someone who is deficient in ADH (diabetes insipidus), would the SG of the urine be increased, decreased or normal? |
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| Decreased |
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| In someone who is deficient in ADH (diabetes insipidus), would the Urine Volume be increased, decreased or normal? |
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| Increased |
